Day Care Centers For The Most Fragile Kids Struggle To Stay Open

Beth Kemplin and 5-year-old son Bear rest at home in Grass Valley, Calif. Bear has been diagnosed with cerebral palsy, autism and pica, a compulsion to eat objects such as rocks and toys. (Pauline Bartolone/California Healthline)

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Beth Kemplin said that for the first several months after the birth of her son, Bear, she had no idea he would be severely disabled. She started to notice something was wrong when, at 10 months old, he couldn’t sit up. He didn’t babble or meet her eye. He cried 20 hours a day.

Now, at 5½ years old, Bear’s list of medical diagnoses is long: cerebral palsy, autism, a seizure disorder and pica, a compulsion to eat objects like rocks and toys.

Kemplin had to quit a job to look after Bear when he was about 1, because she couldn’t find a day care center that would take him. That forced the family to rely on cash aid and food stamps.

Then, Kemplin found Ridgeline Pediatric in Grass Valley, Calif., one of 18 day health centers around the state designed to care for kids with severe disabilities. The private facilities are staffed by nurses and funded primarily by Medi-Cal, California’s version of the Medicaid program for low-income people.

The Ridgeline program allowed Kemplin to return to work and pull her family out of poverty. But now, it and other centers around the state are struggling financially themselves.

Medi-Cal hasn’t raised the rates it pays them in 18 years, according to the Department of Health Care Services, which runs Medi-Cal. Owners of the centers say they aren’t getting enough money to offer their staff competitive wages, so employees are quitting for higher-paying jobs.

Some owners have banded together to ask Medi-Cal for an extra $8 million a year so they can pay their nurses more.

Ridgeline and other facilities close their doors on days when they have insufficient staff, or they limit the number of kids they take in. Potential new clients are on waiting lists.

Given the pay scale, it’s hard for the centers to replace departing employees.

“We’ve had postings for skilled nursing that have gone six months without a single applicant,” said Mike Lyman, owner of Ridgeline Pediatric day centers in Grass Valley and Yuba City.

Ridgeline hired a few registered nurses recently who soon left after working for just three to six months, Lyman said. “These children that have developmental delays, they don’t understand why this person had to leave. ‘Where is this person that I know and trust?’” he said.

The needs of the 544 kids with severe disabilities cared for by these centers compete with other budget priorities. Democratic Gov. Jerry Brown is famously averse to new spending. He and lawmakers will have to agree on a new budget by June 15 — and these children’s parents will be watching.

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