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A therapy provider for kids with disabilities has quit leasing the Easter Seals building on Valley View Boulevard as a venue for those services, so that it can save money, disappointing the parents of some of its child patients.
Procare had been losing significant money on the arrangement, due to low reimbursements from Medicaid, but had been off-setting some of those losses through a contract under which it provided daytime therapy for students of an area school, according to Procare Partner/ Director Jim Foreman.
That unnamed school, however, recently cut ties with Procare, so that it could provide its students therapy services in-house, eliminating the source of funding that had made Procare's losses at the Easter Seals building sustainable, prompting Procare to switch its venue for the disabled children to its own facilities in Altoona and in Roaring Spring, leading to issues with parents, due to space limitations at the new sites, according to Foreman and Alisa Resko-Lewis, who may switch her 8-year-old son to a Murrysville provider, despite inconvenience and higher costs.
Resko-Lewis' son had two speech therapy sessions at the Procare site within Gorilla House Gym in Altoona, and the boy had a hard time focusing, because an adult physical therapy patient was in the same room riding an exercise bike, Resko-Lewis said.
"This new option is not acceptable," Resko-Lewis said.
Medicaid pays only about one-third of what is normally reimbursed for outpatient therapy, Foreman said.
The reimbursement level is "horrible," he said.
In many cases, it amounts to less than labor costs alone, he said.
Procare had been willing to put up with such shortfalls because the near market-rate compensation from the school had helped subsidize the service that Procare wanted to provide to the disabled children at the Easter Seals location, Foreman said.
The decision by the school to handle its own therapy needs, however, deprived Procare of a third of its revenue, forcing it to move away from the Easter Seals building in a scramble to survive, even though the We Care Foundation that leases the building from the county was only charging a modest rent, according to Foreman.
The move to Procare's own busy clinics was sudden, occurring over a weekend, Foreman said.
"I'm not sure anyone was thrilled" by the move away from the dedicated Easter Seals therapy space, he said.
He doesn't begrudge any family that decides to find an alternative to Procare, he said.
"I get it: people were used to what they were used to," he said.
He's not sure how many families found an alternative provider.
He's hopeful that the company can make the new situation more palatable, Foreman said.
Since Resko-Lewis' departure, Procare has outfitted a room that will be dedicated to pediatric patients, Foreman said.
Despite the dissatisfaction of some, "no care was inappropriate or illegal or substandard," he said.
There were never more than two patients in a room in which the disabled kids were receiving care, he said.
The switch has led to the loss of some therapists because under the new arrangement some had to work both at the Altoona and Roaring Spring locations, according to Foreman.
Among problems with the kind of therapy needed for the about 90 kids who had been treated at the Easter Seals building is the limits that Medicaid puts on the number of therapy sessions it will pay for, according to Foreman.
For most of the disabled patients, the need for therapy is ongoing -- unlike the needs of a patient with an acute injury that will get better, thus ending the need for rehabilitation, Foreman said.
"Treatments to be effective need to be year-round, preferably twice a week," he said.
Medicaid is either the primary or secondary insurance for most of the disabled patients, he said.
"We're doing the best we can with the cards we were dealt," Foreman said.
Meanwhile, the We Care Foundation has been in discussions with care providers that it hopes will sublease the Easter Seals building, according to foundation President Bob Bilger.
The foundation's goal for rent is just to cover costs, Bilger said.
Those potential sub-tenants include providers of speech and occupational therapy, a behavioral therapy group and a group that provides chiropractic care for kids, as well as an "adult neuro" group, Bilger said.
Families who are still getting therapy from Procare would have the option of coming back to the Easter Seals building to get care from those other providers, he said.
One potentially helpful quality for an Easter Seals building tenant is an enthusiasm for fundraising, Bilger said.
The two-story building with clinical space throughout and various kinds of equipment, plus a sensory room downstairs, may soon be more fully occupied than it's ever been, Bilger said.
Procare was a good partner for a long time, Bilger said, adding there is no bad blood between the foundation and the company.
Mirror Staff Writer William Kibler is at 814-949-7038.