Centers For Children Accelerates Growth

Every Wednesday morning in Little Rock, a group of nine doctors and support staff from the Arkansas Children’s Hospital hop on a plane bound for Highfill.

By 8:30 a.m. they are seeing patients at the new Centers for Children in Lowell. They stay on site for a box lunch and by 4 p.m. they’re headed back to the airport, in time to be home for dinner.

Doctors from ACH have seen more than 1,000 patients this way since July, when the Centers began offering 12 specialized regional clinics versus the four previously available.

By the end of the year, services in 15 specialties will be offered.

In addition to the miles and hours doctors are saving by no longer driving to Northwest Arkansas, parents who would have traveled to Little Rock in the past have been spared around 400,000 miles on the road and saved hundreds of thousands of dollars in fuel costs and wages by staying close to home.

“Seeing the mothers’ faces at how excited they are to have it all right here and not have to go to Little Rock just means the world to them,” said Centers for Children medical administrator Angie Hardcastle. “To me, that’s what it’s all about.”

As the Northwest Arkansas’ population has boomed in the past 15 years, so has the demand for pediatric care in disciplines from immunology to cardiology.

More than 14,000 patients from Northwest Arkansas were treated at ACH in 2006 and a collaborative agreement reached Jan. 25 between the boards of ACH and University of Arkansas-Medical Sciences has allowed plans to accelerate in Lowell.

UAMS and ACH are sharing the costs of the Centers’ $4 million operating budget equally, said UAMS pediatric department administrator Tom East.

“It’s a very good partnership,” East said. “It’s our first joint venture of this kind and we’re proud of that to get this clinic going.”

The final 5,000 SF is being built out of the 40,000-SF, two-story building constructed by The Pinnacle Group just north of J.B. Hunt’s headquarters.

The Center is adding a pulmonary lab, an X-ray lab, exam rooms and doctors offices to provide the ancillary services that make it a “one-stop shop” for pediatric care.

Demand is so high most of the clinics are booked until April or May and administrators are already making plans to expand from the once-a-week offerings.

Support Network

Before the Centers opened, the only regional care available in Northwest Arkansas was in cardiology, asthma, neurology and developmental rehabilitation.

The clinics were housed in Fayetteville and East said the service was “hit or miss” with doctors driving up from Little Rock depending on demand.

Flying has taken around four hours of travel time out of the equation.

“The doctors really like it,” East said. “They want to go up there now. It makes it easier on their schedule. It’s like another day of work. Now they can see more patients at both places.”

The Centers added its first full-time specialist in June when Dr. Astryd Menendez rejoined UAMS after five years in private practice in Northwest Arkansas.

Menendez is a pediatric pulmonologist specializing in diseases both within the lung and in ventilatory (breathing) controls.

After completing her fellowship at Tulane University in New Orleans, Menendez worked for UAMS from 1995-2000 before taking time off following the birth of her son.

“In private practice, I was seeing the same type of patients, but the difference is the support I have being part of UAMS-Arkansas Children’s Hospital,” Menendez said.

From both her time at UAMS and in private practice, she’s heard about the difficulties for many families to travel to and from Little Rock, and some sophisticated tests like sleep studies to diagnose neurological illnesses still require a trip.

But one advantage to the doctors coming to Northwest Arkansas each Wednesday is the consulting that takes place between specialties and the ability for patients to see more than one physician on a single visit.

The pulmonary lab under construction and the presence of a full-time specialist in the discipline is the model the Centers will follow as resources catch up to need.

“The goal in the next few years is to have all the specialties here Monday through Friday seeing patients,” Hardcastle said.

Hardcastle said the next specialist the Centers plan to add is a neurologist and recruitment efforts are under way. The challenge to adding specialists is having all the diagnostic equipment paid for and in place before landing a top specialist.

East said a big advantage the Centers has in recruiting is Northwest Arkansas itself.

“It’s such a neat place to live,” East said. “Younger physicians really like that environment and we’re trying to encourage younger physicians to relocate up there.”

Minding Costs

UAMS and ACH are sharing the costs in Lowell, and for now, that means sharing the bottom line.

East expects the Centers will operate in the red for 2007 and most likely will again in 2008 with a similar $4 million projected budget.

“Right now cost far outweighs revenue of what we’re doing,” East said.

The Centers have a nutritionist and a social worker who provide services that often aren’t billable to insurance, and overhead like maintaining expensive equipment makes fundraising vital.

“One-time gifts are great,” Menendez said. “But we love ongoing donations.”

Between the Schmieding Developmental Center and Schmieding Kids First on the first floor and the Centers for Children on the second, there are currently about 50 staff members.

Hardcastle said she’d like to add 20 to 25 more in the coming year between physicians, nurses and support staff. Two specialties she wants to add in 2008 are in orthopedics and urology.

The Arkansas Children’s Hospital is one of the most popular charities in the state and Hardcastle said the focus is keeping donations in Northwest Arkansas.

The Arkansas Children’s Foundation, the fundraising arm of the ACH, has a total endowment of about $130 million and raises around $15 million per year, according to its 2006 annual report.

“[The Foundation is] constantly meeting with donors, bringing them here for visits to see the building, having lunches or meetings every day,” Hardcastle said. “What we’re hoping to communicate to the community is that their money can stay right here. They can come and see what their dollars are providing.”

While some large donors in Northwest Arkansas are exploring ways to redirect their ACH giving to the Centers for Children, the largest gift to date came from central Arkansas.

A $1 million gift from John and Karen Flake of Little Rock helped purchase the X-ray, EEG and echocardiogram machines. A high-capacity data line from Lowell to Little Rock allows for immediate test results of the echocardiogram, which has been available since September.

Though the Flakes are from Little Rock, their ties to the area have strengthened lately as Flake & Kelley Commercial Real Estate is a growing presence in the market. John Flake is also one of the new owners of the Northwest Arkansas Mall along with Sam Mathias and Doyle Rogers.

The Flakes’ daughter and Midwest Mall Properties COO Jessica Dearnley also has three children, giving them a real stake in helping provide the most high-quality pediatric care possible.

East said the demand for services and the costs to providing them means plans for faster growth. Large gifts like the Flakes’ are crucial to offset the huge start-up costs of each specialty.

“We’re trying to figure how we can ramp it up quicker, get more physicians and hopefully more revenue,” he said.