Sharing her love of books with kids is good medicine

Karen Damon is helping remedy that — and delivering some education, to boot.

Each Friday at 1 p.m., the retired schoolteacher lugs a tub of books into the Rocky Mountain Youth Clinic in Aurora. And for the next two hours, she reads books to the waiting young people. She uses plush toys to engage toddlers, helps 5-year-olds sound out words and has older kids read to her.

"The key here is to give children a head start on literacy," said Damon, who today will be honored as Rocky Mountain Youth's first volunteer of the year award. "It's so much fun to come here and read to everyone from babies to elementary-school students."

By Damon's reckoning, a child of two parents with a middle income is read to for 1,000 hours before entering first grade. Low-income kids average closer to 25 hours.

"The kids come in, and I read to them in the waiting room before they're called in for their appointments," said Damon, who reads to a rotating group totaling 20 kids on any given Friday. "Maybe I only have 10 minutes with them, but I still feel I've contributed to those thousand hours."

Damon arrived in Colorado in 2007 to be an "in-town grandmom" to her grandchildren. She had lived in Beaverton, Ore., where she taught kindergarten and first grade. She was also involved with the SMART (Start Making a Reader Today) program, an effort at jump-starting literacy among children.

She wanted to continue working with kids, so she contacted Reach Out and Read Colorado, which connected her with the clinic.

"When you read to babies, it helps forge structures in their brain to learn languages," Damon said.

Because many clinic patients are Hispanic, Damon is learning Spanish. "I want to be able to say 'cow' and 'kitty' and 'dog' in Spanish," she said.

On a recent Friday afternoon, Damon pulled a copy of "The Very Hungry Caterpillar" from her book tub.

Erik Casillas, 8, and his sister, 5-year-old Elizabeth, sat rapt as Damon recounted the multilegged critter's adventures. Erik helped Damon with the reading, slowly going over the sentences. Their mom, Luz, watched.

"My son is in third grade, but his teachers say he reads at a first-grade level," said Casillas, who arrived from Mexico 11 years ago. "So this is good."

Alfie Meister, a pediatrician at the clinic, agrees.

"I tell the parents of my patients that beyond getting their children vaccinations, the most important thing they'll do for them is read to them for 10 minutes every night," Meister said.

Damon recently bought 100 used books from the Aurora Public Library, donating them to the clinic. Children ages 6 months to 5 years who come for a checkup get a book.

"A lot of our families struggle to put food on the table, let alone put a book in the hands of their children," said Jill Friedentag Fishman, the clinic's community and volunteer-relations manager.

Which is where Damon comes in. "It's very rewarding for me to do that," she said.

William Porter: 303-954-1877 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Aurora expanding school-based clinic program

By Yesenia Robles
The Denver Post

Posted: 09/19/2010 01:00:00 AM MDT

After two years of serving students' medical needs through a school-based clinic, Aurora Public Schools has decided the need is great enough to open a second clinic in October.

Rocky Mountain Youth Clinics operates the clinic at Crawford Elementary in Aurora, and has seen the number of patients who use it double from 1,000 in 2008 to 2,000 in 2009. The new clinic will be at Laredo Elementary.

Larry Wolk, executive director of Rocky Mountain Youth Clinics, expects the second clinic will see at least 1,000 students a year.

"We know there are children who miss a lot of school because they have some conditions that are not taken care of," said Mary Beth Rensberger, director of health services at Aurora Public Schools.

"When we can get kids down the hall to a same-day appointment rather than waiting weeks sometimes," she said, "it helps get them back to school sooner."

Denver Health operates 12 similar school-based clinics at Denver Public Schools.

Marisol Vizcaya, an Aurora mom of two, said she's glad the clinic program is expanding.

"They were very professional, and I really like the way they talk to kids," she said.

Her daughter is enrolled at another Aurora school, and her son, Gael Fierro, 3, has had stomach problems since birth.

Gael has now begun seeing a specialist for the first time this year after getting an immediate referral from the staff at the Crawford Elementary clinic.

Vizcaya said that before finding the clinic at the school, she had struggled to find a doctor who would see Gael because he'd lost his eligibility for Medicaid and had not yet received approval from CHP Plus.

At the Rocky Mountain Youth Clinics, children from the community are not turned away for inability to pay or lack of insurance, Wolk said, adding that the majority do have Medicaid or CHP Plus.

Wolk said the need for the clinic doesn't stem solely from lack of health care, however.

"It serves a social need too. It's more convenient than making them come all the way to a hospital," Wolk said.

Wolk founded the nonprofit with the vision of helping children who need health care, but don't have it readily accessible.

Rocky Mountain Youth Clinics has operated school-based clinics across Colorado since 1996 in areas such as Montrose, Fort Collins and Fountain. It has turned over many of those clinics to local organizations or doctors. No such plans exist for the Aurora clinics.

The clinic model is more sustainable if the people who run it also live in the community, Wolk said. The company operates three traditional clinics in Thorton, Aurora and Denver offices. "We have our three clinics here, so we feel we can provide a lot more services here," he said.

Rocky Mountain Youth Clinics also operates two mobile clinics — one dental and one medical — donated by the Ronald McDonald Foundation.

The mobile clinics rotate among Aurora and Denver public schools. Later this year, a third mobile clinic will be opened, offering dental and medical services; it will serve Aurora and Denver, as well as rural districts.

In January, Rocky Mountain Youth Clinics will also open Colorado's first "Grow Clinic" at its Thornton office.

The "Grow Clinic," copied from a Boston model, will address the needs of children who are malnourished, over- weight or underweight. Parents will receive "pantry prescriptions" for healthy food, which they can then fill at the clinic's food bank, also at the Thornton facility.

Wolk said Rocky Mountain Youth Clinic staff have become "experts at serving pediatric populations in need," and part of knowing how to serve those populations is going beyond clinic visits. The "Grow Clinic" and events such as bicycle-helmet giveaways are a few examples.

Aurora district health-services director Rensberger said community members have noticed and support the clinics.

"It has been a very positive phenomenon," she said.

Yesenia Robles: 303-954-1372 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Colorado delays Medicaid payments

By Jennifer Brown
The Denver Post

Posted: 06/17/2010 01:00:00 AM MDT
Temporarily short on money, Colorado has declared a fiscal emergency and delayed payments to doctors and clinics taking care of the state's neediest patients.

Under state law, the Medicaid department can delay reimbursements to doctors, hospitals and clinics during a fiscal emergency. Physicians treating patients with the health-insurance plan for the poor will not receive normally scheduled payments on June 25 or July 2, a hardship for safety-net clinics in particular that rely on public funds.

State officials said they would begin catching up on payments July 9 after a new fiscal year begins.

Some clinics found out about the freeze only last week. Others had earlier warnings and were able to stash away a reserve to cover payroll, rent and utility bills — which helped a little, said Dr. Larry Wolk, executive director of Rocky Mountain Youth Clinics, where 75 percent of the 55,000 patients have Medicaid.

"That's like saying, 'Prepare for me to punch you,' " Wolk said. "It still doesn't hurt any less."

When a similar payment delay occurred several years ago, Rocky Mountain Youth Clinics had to withhold paychecks and borrow from a bank to pay staff who would have suffered without their salaries. This time, the clinics are relying on grants and donations as they go without about $150,000 in cash flow for the next few weeks.

"We're trying to be a safety- net provider," Wolk said. "We're dependent on Medicaid keeping us afloat with timely payments."

The state is far from insolvent, but it has reached the lower limit for the amount of cash reserves required by law. One reason is that more people and businesses than expected asked for extensions on their income taxes and haven't made additional payments to the state, said Sen. Moe Keller, a Wheat Ridge Democrat and vice chairwoman of the legislative budget committee.

"We don't have the revenue in hand that we had budgeted to," she said.

Size of reserve reduced

The state is delaying $38 million in Medicaid payments this month in an attempt to end the year with 2 percent, about $132 million, of the total budget in reserve, said state budget director Todd Saliman.

The legislature already lowered the amount of the required reserve from 4 percent of the state budget to 2 percent. The reserve is required in case the number of prison inmates rises unexpectedly or an influx of people sign up for the state children's insurance plan, among other contingencies.

"We do understand this is a hardship, and that's probably not even strong enough, but it's a hardship for providers," said Joanne Lindsay, spokeswoman for the state Department of Health Care Policy and Financing. "That's why the governor's office waited as late as possible to decide to do this."

Gov. Bill Ritter's spokesman, Evan Dreyer, called it a "cash- flow issue" and pointed out that a payment delay is better than a "reduced payment or a payment denied."

"The very difficult reality is our economy continues to struggle, and it's impacting everyone," Dreyer said.

Senate weighs bailout

In Washington, the Senate is debating whether the federal government should send an additional $24 billion — which would mean about $200 million for Colorado next year — to bail out struggling state Medicaid programs. Colorado's budget for next year was balanced with the expectation that the money would arrive. If it doesn't, a 2011 emergency, along with additional cuts to other state programs, is possible.

The payment delays in Colorado have inspired some safety-net clinics to seek help from private organizations that could float them interest-free cash if this happens again.

"It's a question of who is best suited to carry the burden," said Wolk, of Rocky Mountain Youth Clinics.

For Beacon Center, a Denver-area nonprofit that provides mental-health care for children, the payment delays mean missing out on up to $15,000 this month.

"That puts a pretty serious hit on our month," executive director Mike Guthrie said.

But that's not Guthrie's biggest concern. He wonders what this means for the future of care for society's neediest patients.

The message he got this time was: "Go ahead and provide the services, and we'll cover it later," he said. "Next time, is it: 'Don't provide services to Medicaid kids'?"