The environment in which children grow up can shape their behaviors and influence their health, studies show. The social and economic features of a community can have major implications on mortality, general health status, disabilities, birth outcomes, mental health, injuries, violence, and other important health signs, according to a brief published by the Robert Wood Johnson Foundation Commission to Build a Healthier America.
Camden City in Camden County, New Jersey, is directly across the Delaware River from Philadelphia, Pennsylvania. Although it is surrounded by some of the wealthiest communities in New Jersey, it’s ranked the poorest and most crime-ridden city in New Jersey. Neighborhood Scout—an online research group—ranked Camden City as the fourth most dangerous city in 2017.
This is because with a population of 70,309 people, Camden City had 1,895 violent crimes in 2014—meaning the city averaged 25.66 violent crimes per 1,000 residents. That rate is six times higher than the national average of 3.8.
Additionally, Camden City is among the poorest cities in the nation. The unemployment rate is 30 to 40 percent, with a median household income of $26,000. In 2011, a Rolling Stone report found that a quarter of a billion dollars was being made in revenue from about 175 open-air drug markets, but the annual tax income was only $24 million.
Virtua is a large healthcare system serving southern New Jersey that provides care through three hospitals (Virtua Marlton, Virtua Memorial, and Virtua Voorhees), three health and wellness centers, two long term care and rehab centers, three medically-based fitness centers, 16 mobile intensive care units, and a variety of outpatient health services. Virtua also has two satellite emergency departments.
The healthcare system’s mission supports health, wellness, and accessibility to all. Beginning in late 2013, Virtua began making strides to promote the health and well-being of the children in Camden City when the Early Intervention Program (EIP) became a comprehensive agency in Camden County.
EIP provides a variety of therapeutic and support services to help infants and toddlers with developmental issues. As part of the program, practitioners—including physical therapists, occupational therapists, speech-language pathologists, social workers, special education teachers, behaviorists, and teachers—help children from birth to age three overcome delays.
During 2011, 2012, and most of 2013, most of those in Camden City who were eligible for EIP had difficulty receiving timely services. Services are considered timely when they start within 30 days of a plan being written. Camden City’s national reputation as a high crime area made it difficult for healthcare providers to ensure their own safety, limiting their ability to respond to requests for services through EIP.
In 2013, more than 200 children in Camden County waited more than 30 days for their services to start—waiting an average of 48.39 days with a longest wait of 121 days. This not only affected families in Camden County, but also held up other children on the list for services because if the first child on the waitlist was from Camden City, he or she had to receive services before other children further down the list could receive services. With no practitioners available, the number of children served decreased over time while the wait time for services increased.
The security department of 19 full-time employees and several part-time employees assigned to the Virtua Camden campus provides routine and emergency services to the entire campus, as well other services: producing ID badges, managing beepers, managing the lost and found, receiving package delivers, handling patient belongings and valuables, and providing nuclear medicine escorts and vehicle assistance.
When the notion of providing security escorts to EIP staff was proposed, the security department rose to the challenge. Each officer volunteered to be available for patient visits, realizing how important it was for young children in Camden to receive the EIP services.
To set up a security escort, EIP staff would call the security department—at least two days before the service was needed but no more than five days in advance—and provide the date the service was needed, the pick-up time, and the drop-off time. EIP staff also shared their cellphone number so they could be reached.
The security department then logged the information into an Early Intervention & Home Care Security Escort Form that included the practitioner’s name, cell phone number, and estimated start and end times. Then, from a list of available officers, the department would contact officers to fill the security escort—preference was given to non-overtime per diem, part time, and pool officers. If a security officer was not available, the department would contact the EIP manager.
When practitioners arrived on campus, the assigned security officer would travel with the practitioner—in his or her personal vehicle—to the appointment location. The officer then stationed themselves outside the location, unless specifically invited to enter, to respond to any signs of distress and protect the practitioner’s vehicle.
The value and success of the security escort program continued the EIP’s growth. Within a few months, the security escort service expanded as the department became critical in supporting the EIP. In December 2013, the department provided 20.75 hours of security escorts per month and the average wait time for children waiting for services dropped from 48 days to 12.
By October 2014, the service had expanded to provide 83.50 hours per month, and continued to grow. A mother and her child were also invited to share their experience with the EIP at a holiday staff meeting and the difference the service made to her family.
The mother explained that children only have a small window of time to receive early intervention services because when they reach 36 months of age, they are no longer eligible to receive services. By reducing the wait time for services, the security department was able to ensure more children were reached, and their needs were identified and addressed.
In 2015, the security department saw a decrease in the number of calls it was receiving for escort services. Department leadership contacted the EIP leadership to discuss the decrease, and found that EIP staff had become more comfortable providing services within Camden City without a security presence. The EIP staff said they felt welcomed by the residents and that the residents knew they were providing valuable services to the children of Camden.
Meanwhile, the number of services that the EIP provides has continued to grow in Camden County—increasing from 284 in 2012, to 294 in 2013, 4,123 in 2014, 6,302 in 2015, and 7,978 in 2016.
Maria P. Emerson, MA, CCC-SLP, is the director of the Virtua Early Intervention Program. Maria Franchio, PT, is AVP of Virtua Rehabilitation Services. Dana Gussey is a public health major at Stockton University and an intern in the Virtua Safety Department. Paul Sarnese is the AVP of safety, security, and emergency management for the Virtua Safety Department.