Kendrea Beckett was born at 31 weeks weighing 3 pounds, and she suffers from reactive airway disease. Her mother had a prenatal brain tumor and died Christmas Day 2004. Her grandmother, Valerie Stanton, became her primary caregiver.
The problems Stanton faced extended far beyond her granddaughter's medical condition: She works, and local day care centers couldn't accommodate her granddaughter's needs.
At the time, the baby was receiving outpatient services at Kennedy Krieger Institute.
On a daily visit Stanton learned of an affiliate of the hospital, the World of Care child care center, sponsored by the PACT: Helping Children With Special Needs program.
The center is a specialized day care for kids with disabilities or medical or developmental problems. It is staffed by social workers, specialized teachers and registered nurses.
For many area families, World of Care is the difference between working and welfare. It's a one-stop shop to meet medical and developmental needs.
According to Audrey Leviton, the executive director for PACT, the day care is the only medically based child care in the Baltimore region. The program is available to children from infancy to 5 years old with severe medical or developmental needs.
"The center is an affordable alternative to home nursing for sick kids," said Leviton. "Some of our parents would have no choice but to quit working if we didn't exist. The actual cost of the program is $140 a day. We get $70 from medical assistance and the average parent pays $25 to $35 a day, which is much cheaper than a home nurse."
Families from Baltimore City and Baltimore, Howard, Carroll and Anne Arundel counties are using the facility. Some of the treatments and services offered at the center, in addition to nursing care, are occupational, physical and speech and language therapies, as well as social work counseling.
Usually, children would have to go to different sites for these services. Parents would have to take time off from work to take the child to appointments, an inconvenience the staff at the center eliminates.
Leviton said the inclusive program makes such an impact on the children that sometimes it's enough to allow them to function in a regular school environment.
After a short time at the center, developmentally, Kendrea is almost on target.
"Kendrea gets her nebulizer treatments and daily physical assessments," said Leviton. "She receives occupational, physical and speech therapy on site. We do a lot of coordinating with doctors and specialists. We get to know the kids and their conditions very well. This helps us to meet all the needs of the kids and catch problems from the start."
Another child at the center, Kaleem Mitchell, was born at 24 weeks. He has chronic kidney disease and chronic lung disease, and is dependent upon an oxygen system. His mother said a home nurse from Baltimore County told her about the program after learning she had to quit her job as a computer analyst to care for her son.
"When I visited the child care I was very impressed," said Sharein Mitchell. "They had nurses and small classrooms and a lot of caregivers with the kids. I knew Kaleem could not go to a regular day care environment - the classes were too big and it would be too easy to have something slip through the cracks.
"I feel that Kaleem is safe and being taken care of by people who know how to deal with his problems. I'm back at work now, and I know I don't have to worry about him."
Mitchell said the facility has had a miraculous impact on his health and growth.
"When he first started going to the center, he wasn't walking, he had no verbal communication skills, and he wasn't eating," she said. "Now he eats, his talking has improved and he only needs his feeding tube at night. He's thriving. It's been just wonderful. I'm working on getting him in a less-restricted school."
Leviton said the World of Care center is an alternative to school placement for children who need more care.
"What normally happens with our kids is that they stay with us until they're stabilized, and as long as they can verbalize their needs they can transfer from here to school," said Leviton. "They are usually fine as long as the school has a full-time nurse on duty. And, in some instances, the kids' medical issues are resolved when they leave."
To ensure the best-quality care, Leviton said, the institute puts a lot of time and resources into training its staff members. In that regard, PACT is extending its outreach to other day cares that work with children with special needs.
"We want to help educate the nonmedical-based facilities on caring for special needs," said Leviton. "We are hosting a series of workshops to address the issue. We have about 40 or so local day cares already signed up.
"We think it's important to make all caregivers aware of things they can do to make life better for these special kids."