Local Commentary

Senator Whipple’s Richmond Report


Monday’s meeting in Norfolk was enlightening and inspirational.

The subcommittee on Health and Human Resources of the Senate Finance Committee met at Children’s Hospital of the King’s Daughters to learn about current Medicaid issues and to tour the facility.

Children’s Hospital of the King’s Daughters (CHKD) is one of 43 free-standing children’s hospitals in the United States. The most comparable facility in this area is the Children’s National Medical Center in D.C.

CHKD is THE pediatric facility in Hampton Roads and serves other parts of Virginia as well.

The hospital serves everyone who walks in the door, so not only does it provide care that is completely uncompensated, more than half the patient population is on Medicaid. Because Medicaid reimburses hospitals at a rate that is far below cost (about two-thirds of the actual cost), the hospital loses money on every Medicaid patient. Although all hospitals suffer from this lack of full compensation, most have fewer Medicaid patients and can make up the losses more easily. For CHKD, it is a very serious problem.

Some help comes from the “disproportionate share” program that provides more funding for hospitals that serve a lot of Medicaid patients, but it tops out at 21%. So CHKD, with more than 50% Medicaid patients, gets no more than a number of hospitals with lower percentages of Medicaid patients.

Clearly one of our jobs in the coming year is to find a way to address this problem. The best solution would be for Medicaid to reimburse the full, reasonable cost of care, but I’m afraid it will be a long time before we can get to that point. In the short term, we may need to change the distribution of the disproportionate share program or provide extra funding to children’s hospitals.

Our tour of the hospital convinced us of the value of its work. We saw children receiving cancer treatments in colorful and cheerful surroundings with toys and videos and art work to distract them from their difficult situations. Families receive great support from staff and volunteers.

The Neonatal Intensive Care Unit (NICU) had teeny, tiny premature babies who were receiving the best available care from skilled nurses and other staff who monitor their every breath. A wall of pictures showed successful “graduates” of the NICU who are now strapping teenagers. The hospital next door handles high risk deliveries in the region and the infants are immediately transported to CHKD.

Another special place in the hospital is the Transitional Care Unit for children who still require specialized treatment and nursing care and are not yet ready to go home. Some of them need to be weaned from ventilators; others have special feeding needs. If it were not for the TCU, they might have to be in nursing homes instead of this more suitable, child-centered environment.

Field trips like the one to Norfolk help us understand the real people, in this case babies and children, who are affected by policy decisions in the General Assembly.


Senator Whipple represents the 31st District in the Virginia State Senate. She may be e-mailed at district31@sov.state.va.us