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The HSC Foundation’s first operating subsidiary opened in 1883 as the Children’s Country Home. When the home opened its doors, it admitted boys from age four to ten and girls from age four to twelve. Service was limited since the house could only accommodate six children at a time for a 10-14 day stay. All the children were referred by Washington churches.
The building of a small addition to the house in 1884 increased the capacity to fifteen children, but even with the extra space, not all referred children could be admitted. In 1885, the Board of Managers decided to initiate a building fund which they hoped would enable them to buy a larger house. Charles Glover of the Riggs Bank agreed to serve as treasurer of the fund, and the public was invited to send contributions. Mr. Glover became so involved in the project that he purchased several acres of land west of Rock Creek Park. He gave the property to the Board in memory of his daughter, who had died at the age of four.
As the years passed, the children who were referred to the home were increasingly those convalescing from disease or surgery. The age range of the children admitted now stretched from infancy to age fourteen. In the 1920s, the Home increasingly responded to the need for the treatment of asthmatics and rheumatic fever cases. These changes led to more variations in the length of stay and the net result was that the number of children served by the home each summer nearly doubled.
By 1928, the Board of Managers expanded the summer program to year-round service because of the growing number of patients and increased emphasis on convalescent care. But the wooden house had not been constructed for use in wintertime so in 1929, the Board decided to sell the old Home. They wanted to build a new, more permanent institution. A beautiful six acre parcel of land at the corner of 18th Street and Bunker Hill Road in northeast was chosen (the site of The HSC Pediatric Center today).
The building was designed and constructed along the lines of French architecture to have a homelike appearance. The cornerstone was laid by the President’s wife, Mrs. Herbert Hoover. The new Home, capable of accommodating fifty children, was completed and first occupied on July 16, 1930. It was awarded a certificate by the District of Columbia Board of Trade as the outstanding building in the city. The building is now on both the District of Columbia and federal historic registries of historic buildings.
In the ‘40s and ‘50s, the Home evolved into a chronic medical facility, caring for children suffering the effects of polio, rheumatic fever, cerebral palsy and congenital malformations. Two additional wings were added to the Home in 1950. Convalescent care continued to be the major service, and to reflect more accurately the services provided, in 1951, the name was changed to The Children’s Convalescent Home.
The range of services grew even further, and the Home took on the character and services of a hospital. In 1953, the Convalescent Home became a full member of the American Hospital Association. In 1956, a new wing was dedicated by Senator Lester Hill, and the ribbon was cut by Mr. Herbert Hoover, Jr. The facility received its license as a “chronic and convalescent care hospital” and in 1956, the name was changed to The Children’s Convalescent Hospital.
From its beginning as a country home, the institution had maintained a good working relationship with Children’s National Medical Center and this, along with its later affiliation with Georgetown University School of Medicine gave it excellent supportive medical resources. Having developed its services far beyond convalescent care, in 1968, the hospital changed its name to The Hospital for Sick Children, and a modern, fully-equipped, 80-bed addition to the hospital was officially dedicated and opened.
In the early 1980s, the enormous progress in saving marginally viable infants and children led to a growing need for subacute or transitional care. Patients included premature and low-birth weight infants, babies suffering from various birth traumas, kids of all ages needing orthopedic rehabilitation, accident victims, children with feeding and/or absorption disorders, and some with chronic or terminal conditions.
In the 1970s and ‘80s, the Hospital leadership had reflected on the short and long-term needs of local children and the importance of changing to meet these needs. As a result, in 1984, The HSC Foundation was created to ensure sound fiscal management and to grow philanthropic revenues over time.
In 1994, the Foundation’s and Hospital’s boards of directors approved a recommendation to establish a managed care organization for children with disabilities. To meet the continuum of care requirements of these children, this would be the means to transition them out of hospitals and into outpatient and home care environments. The health system’s corporate structure was expanded, and Health Services for Children with Special Needs, Inc. (HSCSN) was incorporated to develop a national model of managed care services for children and youth.
In February of 1996, HSCSN enrolled its first member. To be eligible for enrollment, children and youth must be under 21 years of age, live in the District and receive Supplemental Security Income (SSI) benefits. Once enrolled, HSCSN members are assigned to a Care Manager or a Care Manager Associate, depending on the needs and complexity of their condition or illness. Care Managers have expertise in the fields of medicine, social services or behavioral health. Working as a team, the Care Manager, the primary caregiver or parent(s), the member (depending on age), the primary care physician, and other necessary providers and specialists decide on an individualized Plan of Care for the member. These plans spell out the different types of services the child is expected to require, provide advice on the child’s health situation and serve as a basis for the arrangement of appropriate care. The Care Manager works with the families and healthcare providers to make medical appointments, coordinate services and arrange for transportation to appointments for the members.
HSCSN’s provider network is based on an “open panel” design. It allows any provider who meets HSCSN’s credentialing and practice requirements to execute a contract with the agency. Emphasis is placed on obtaining contracts with providers who have experience in caring for children with disabilities and complex medical needs. By allowing all eligible providers to contract with the network, members have greater choice when selecting their healthcare professionals. It also allows them to maintain existing relationships with physicians and other healthcare providers.
At the same time, the Foundation’s Board of Directors began to assess the organization’s capacity and preparedness to continue to successfully serve its patient population and carry out its mission in a turbulent and competitive health care environment. After careful review of the overall organization, consensus was reached to simplify and consolidate governance and management of The HSC Health Care System. The consolidation of management and clinical services has been successfully undertaken and has increased the HSC system’s capacity to carry out its mission of improving access to care for children with disabilities. In addition to these efforts, the Foundation strengthened its commitment to work with local and national foundations and other organizations serving similar populations.
At the end of 2004, The Hospital for Sick Children became The HSC Pediatric Center. The new name maintained the tradition built over the years by keeping the HSC initials. Although the name changed, its mission remained the same.
However, in April of 2006, the Foundation’s Board of Directors approved a new vision and revised mission statement for the overall organization that broadened its service audience to individuals of all ages with disabilities – not exclusively children. Additionally, it established a Community Benefit Program that would involve the organization in activities beyond its subsidiaries and the Washington metropolitan region.