Acute care for illness
Preventive and well child care
Physicians on-call 24/7
Lab and radiology services
Interpretation in Spanish during patient visits
Referrals to pediatric specialists
Chronic disease management
Mental health counseling
Assistance with Medicaid/FAMIS enrollment
APC provides comprehensive outpatient medical care to children, ages 0 to 19, whose family income is at or below 200% of the Federal Poverty Level, currently $44,100 for a family of four. Care is provided regardless of the family’s ability to pay for services.
Each year nearly 75% of APC visits are related to illness, injury or the management of chronic disease. APC pediatricians treat children with all the common childhood injuries and illnesses: from sprains and strains to lacerations and fractures; from diaper rash and ear pain, to strep throat and conjunctivitis. By treating these highly communicable diseases, APC is not only keeping its patients well, but it is protecting the health of other children throughout our community in day care centers and schools.
APC also treats children with complicated chronic diseases such as diabetes and congenital heart defects, and rare diseases necessitating coordinated efforts amongst specialists and therapists. (See chronic disease management.)
Physicians On Call 24/7
One service that distinguishes APC from many clinics serving disadvantaged children is our 24/7 on-call access to pediatricians. Every parent knows the terrifying experience of caring for a very sick child in the middle of the night. Concerned parents can reach APC pediatricians by phone at any time of day or night.
APC avoids duplication of services by working closely with many public and private health and human service agencies. These include Arlington Public Health Nurses, School Nurses, Parent Infant Education, Chest Clinic, STD Clinic, WIC, Child Health Clinic, Child Protective Services and After Hours Mental Health Services. Other agencies such as AMEN, AFAC, Victoria Transcultural Center, Northern Virginia Family Services, and various homeless shelters may all be contacted on behalf of APC families.
Former Arlington County Health Director Dr. Susan Allan wrote: “Before opening of APC, our public health staff who worked with children struggled to find medical care for young children and those in schools. APC has been an exceptional community partner for our public health programs such as the School Health Bureau, our immunization program, the tuberculosis program, Child Protective Services, and other programs struggling to serve our needy and vulnerable children.”
Lab and Radiology Services
APC ensures that children receive the lab tests needed for proper diagnosis and treatment by obtaining necessary specimens on site. There is no need to take the child to a separate location for testing. In 2009, APC performed more than 1,000 blood draws and performed 2,550 lab tests on site, a 25% increase over the previous year. These include rapid strep tests, urinalyses, and other simple tests. An additional 1,526 specimens were handled and sent to outside labs (38% increase compared to the prior year). Virginia Hospital Center performs laboratory tests for all uninsured children, at no cost to the family.
Most radiology exams are referred to Virginia Hospital Center, only 3 miles away from APC. Virginia Hospital Center provides radiology services at no cost to uninsured children referred by APC. Each year Virginia Hospital Center provides about $100,000 in free lab and radiology services for APC’s uninsured children.
APC maintains a limited pharmacy on site thanks to in-kind contributions from pharmaceutical companies. These medications are given to uninsured children who might otherwise be unable to afford them. In addition, thanks to generous donations from individuals and organizations such as the Marjorie Hughes Fund and AMEN, APC provides financial assistance to help purchase medications at discounted rates at CVS Pharmacy, and through NovaScripts Central. APC also links with Bridges to Access and other pharmacy assistance programs making it possible to fill hundreds of free prescriptions each year.
Language Assistance for Limited English Proficiency (LEP)
Many APC parents are recent immigrants. English is their second language and their command of English may be quite limited. Nearly all APC staff are fluent in Spanish and English. Some staff members also speak Arabic and French. For other languages (ranging from Mongolian to Urdu), APC accesses interpreters by telephone ensuring that critical information is communicated and understood by pediatrician, parents and patients.
Preventive and Well Child Care
The timely assessments of physical and mental development, immunizations, lab tests, hearing and vision testing, oral health assessments, and anticipatory guidance are the foundation for optimal pediatric care. Yet, too often, well child exams are neglected by immigrant families and those living in poverty. Each year approximately 25% of APC visits are for well child care including school physicals and sports exams.
APC follows the American Academy of Pediatrics guidelines for well child care. APC recognizes that specific preventive and health-promoting interventions lead to increased parental effectiveness, injury prevention, good health habits, prevention of secondary disability and dysfunction, reduced high-risk behavior, increased self-esteem for children.
Nothing has been shown to be more effective in protecting the health of children than proper immunization. APC administers more than 8,000 vaccines each year to protect children — and the community — against life-threatening, preventable diseases. APC achieved 100% compliance with the Virginia Vaccines for Children program regulations in 2009.
Referrals to Pediatric Specialists
Many children required evaluation and treatment by pediatric specialists including cardiology, dermatology, gastro-enterology, neurology, ophthalmology, orthopedics, etc. APC must coordinate the referrals and follow up to ensure that specialist reports are received and treatment plans are completed. When the child is uninsured, it is challenging to find pediatric specialists willing to provide care free or at discounted rates. APC has worked to develop a network of pediatric specialists willing to treat our uninsured patients. APC also works closely with CareConnection to obtain medical specialty services for eligible children.
Chronic Disease Management
APC is a valued community resource for hundreds of Children with Special Health Care Needs (CSHCN). Many of the CSHCN APC cares for are profoundly affected by conditions such as cerebral palsy, developmental delay, extreme prematurity, and severe asthma. They require higher levels of care, significant parent education, and care coordination with multiple pediatric specialists. Because their care is complicated by language and cultural barriers, misconceptions, poverty, and poor mental health, few other providers are willing to provide the level of care needed — especially when the child is uninsured.
APC has two LPN Care Coordinators for CSHCN. With a caseload of some 250 CSHCN, the Care Coordinators work to 1) assure patients receive the full range of services needed, including medications, equipment, transportation, specialty care and specialized therapies; 2) optimize utilization of community services; 3) ensure compliance with treatment plans; 4) provide education to build parental competence and confidence; 5) advocate for patients and families; and 6) identify and report unmet needs to the Medical Director.
Mental Health Specialists
APC is a leader in the integration of mental health services in the primary care setting. The American Academy of Pediatrics Bright Futures in Practice: Mental Health notes: “Approximately 12% of all children and adolescents in primary care pediatric setting have substantial psychological difficulties. Risk factors such as poverty and chronic illness may increase the prevalence rate to more than 20 percent (Wolraich, 1996).”
APC conservatively estimates 15% of its patients would benefit from mental health counseling.
APC has a full time Licensed Clinical Social Worker (LCSW) on staff. He counsels children who are referred for developmental conditions and psychosocial problems, such as chronic health conditions, ADHD, behavioral problems, eating disorders, anxiety and depression. Parents may need assistance with basic parenting skills, or may themselves suffer from PTSD, or depression associated with acculturation. Children and parents learn life skills and coping skills that help them make better choices for a lifetime.
The LSCW also responds to families in crisis and assists in cases involving Child Protective Services or police when necessary. He provides an important link with schools and other social service agencies.
Assistance with Medicaid/FAMIS Enrollment
APC is committed to serving the health care needs of Arlington County’s most vulnerable children — regardless of the family’s ability to pay for services and without regard to their legal status in this country.
Half of APC patients are uninsured when they enroll. APC assists all eligible children with applications for Medicaid, FAMIS+, and FAMIS. Each year the APC Case Manager helps some 400 children obtain or renew Medicaid/FAMIS benefits, ensuring them of greater access to pediatric specialists and ancillary care, prescription medications, and hospitalizations. Many children, however, remain uninsured because their immigration status makes them ineligible for assistance.