It Should Matter to You Too!
When a baby or young child suffers chronic illness with potential long term disabilities, the family is under tremendous pressure. In addition to frequent medical appointments, the family also faces struggles to understand their child’s diagnosis and what the future may hold for their special child.
Because Special Children
have Special Needs
Although medical doctors and specialists are essential to help these children achieve medical stability, they typically require intensive, specialized therapies in order to reach milestones and develop functional skills. This is when good developmental therapies come into play. It is the therapists that work closely with the family and have an impact on the long term outcome of these children; whether they would eat, sit, walk or talk.
Although many children are entitled to the NJ State funded Early Intervention Program, the quality and experience of the therapists varies greatly. Many therapists have largely educational experience or may be treating the geriatric population most of the time, but want to have different clinical experiences. Early Intervention service is either their side job or a stepping stone. These therapists, although legitimate for the services they provide, they are, however, not the best for the medically complex and fragile children.
Parents who seek more and better therapies for their children often run into trouble with their medical insurance coverage. While some medical insurance companies deny anything “developmental” all together, the rest of them provide limited developmental therapy coverage. They typically offer between 30-90 visits combined therapies per year.
Unfortunately, these provisions often are not sufficient to cover intensive therapies that these children may need. As the reimbursement rates vary greatly between medical insurance companies, most outpatient rehabilitation facilities or services that accept medical insurances require their developmental therapists to see as many patients as possible a day to maintain their profit. Such time and cost pressure restricts a therapist’s ability to offer optimal therapy. Increasingly true, particularly in NJ, many experienced and specialized developmental therapists go out on their own to become private practitioners. In private practice, they are able to offer these children appropriate and adequate therapies. However, medical insurance companies make it difficult for them to become in-network providers. Hence, many do not accept medical insurance although most do provide medical billings for parents to seek reimbursement directly from their own medical insurance companies.
Sammy’s Friends Foundation aims to educate parents on how to recognize good therapy. We also offer monetary assistance for parents who have sought the best possible and most appropriate therapies for their special child. Because we, like the parents of these precious children, want them to live to their full potential and have the best quality of life.