The HSC Foundation’s first operating subsidiary, The HSC Pediatric Center, opened in 1883 as the Children’s Country Home. When the Home opened its doors, it admitted boys from age four to 10 and girls from age four to 12. Service was limited, since the house could only accommodate six children at a time for a 10 to 14 day stay. All children were referred by churches in Washington, DC.
A small addition to the Children’s County Home built in 1884 increased its capacity to 15 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 that they hoped would enable them to purchase a larger building. 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 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 14. In the 1920s, the Home increasingly responded to the need for the treatment of asthma and rheumatic fever. These changes led to more variations in the length of stay and the net result was that the number of children served 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 the winter, 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 Washington, DC was chosen (the current 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 50 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 registries of historic buildings.
In the 1940s and 1950s, the Home evolved into a chronic medical facility, caring for children with 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 more accurately reflect 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.
Having developed its services far beyond convalescent care and maintaining good relationships with local acute care hospitals, in 1968, the hospital changed its name to The Hospital for Sick Children, and a fully-equipped, 80-bed addition to the hospital was officially dedicated and opened.
In the early 1980s, the enormous progress in medical advances led to a growing need for subacute or transitional care for infants and children. Patients included premature and low-birth weight infants, babies suffering from various birth traumas, children of all ages needing orthopedic rehabilitation, accident victims, children with feeding and/or absorption disorders, and some with chronic or terminal conditions.
Hospital leadership reflected on the short and long-term needs of these children and the importance of evolving to best meet their health care 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 a second subsidiary, Health Services for Children with Special Needs, Inc. (HSCSN), was incorporated to develop a national model of managed care services for children and youth.
HSCSN enrolled its first member in 1996. To be eligible for enrollment, children and young adults must be under 26 years of age, live in the District, and receive Supplemental Security Income (SSI) benefits. Once enrolled, HSCSN members are assigned to a care manager who has 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. These plans spell out the different types of services the member is expected to require, provide advice on the member’s health situation and serve as a basis for the arrangement of appropriate care. The care manager works with the families and health care providers to make medical appointments, coordinate services, and arrange for transportation to medical appointments.
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 health care providers, and this “open panel” design allows families to maintain existing relationships with physicians and other health care 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 consolidate governance and management of The HSC Health Care System. This consolidation of management and clinical services has increased the 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.
In 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, and although the name has changed, the mission remained the same. Additionally, in 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. It also established a community benefit program that involves the organization in activities beyond its subsidiaries and the Washington metropolitan region.
In 2009, HSC Home Care, LLC, a licensed home care agency in the District of Columbia that specializes in caring for infants, children and young adults through the age of 21 with disabilities was formed. As the System’s third subsidiary, HSC Home Care provides home care services and one-on-one caregiver training to clients in a familiar environment. In 2013, HSC Home Care received its license to operate in the state of Maryland as a residential service agency. HSC Health & Residential Services provides focused care services in the home and in residential settings, such as skilled nursing care inclusive of well mom and baby visits and auxiliary services from certified nursing assistants and home health and personal care aides.
In 2011, The HSC Foundation developed a new initiative to assist youth and young adults with disabilities in creating and living a self-directed path to adulthood and employment, and established the National Youth Transitions Center as a collaborative learning community to benefit young people with disabilities as they transition from adolescence to adulthood and from school to work.