Judges’ comments:
This is a topic that is almost never discussed. Kudos for tackling this heart-breaking topic in the first place. The story came to life with the children. It was sad and the little boy who was dying sounded so mature for his age. The story tugged at your heart without being sappy. Despite being such a sad topic – it’s a reality some families have to face and I was not changing the channel until it was over.
Ground-breaking, insightful story. Excellent sound bites. Well-organized narrative, easy to follow and grasp. Fact-filled and well-researched, but emotionally moving as well. Poignant punch line (boy interviewed at length died before story aired).
1. Provide the title of your story or series and the names of the journalists involved.
Pediatric Hospice, by April Dembosky
2. List date(s) this work was published or aired.
August 19, 2010, 6:50 a.m., The California Report, KQED Radio, 88.5 FM, San Francisco
August 19, 2010, 8 p.m., Health Dialogues, KQED Radio, 88.5 FM, San Francisco
3. Provide a brief synopsis of the story or stories, including any significant findings.
Current national debate around end-of-life care is focused on elderly Medicare patients. Arguments are rife around what the government will pay for at the end of life and how policies affect patients’ medical decisions. But what about when children die? Federal reimbursement rules are no different for 5 year-olds than they are for 85 year-olds. Children cannot receive in-home palliative and hospice care unless they forego any life-prolonging treatment and agree to a doctor’s prognosis that they have less than six months to live. In California, Medi-Cal, the state’s public insurance, began testing a new reimbursement model in a pilot project that allows children in select counties to receive both hospice and curative treatments concurrently. The belief is that in-home palliative care will prevent Emergency Room visits and air-lifts to specialty Children’s Hospitals, thereby saving Medi-Cal money, rather than costing more. Preliminary studies show that not only is money saved, but children live longer and better when they can get both kinds of care. This story looks at the current pilot project and the state of pediatric palliative care in California. Fulfilling the goals of the project have been very difficult because many hospice agencies that would be qualified to provide care for children have either closed down in the recession, or are otherwise unwilling to participate because of costs and fear of medical complications.
4. Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
I reviewed numerous studies on adult and pediatric palliative care and statistics in the Dartmouth Atlas. No FOI requests were made.
5. Explain types of human sources used.
Over the course of 10 months, I interviewed numerous doctors and medical researchers, state Children’s Services administrators, and many bereaved parents and children living with (or dying from) serious, terminal illnesses.
6. Results (if any).
The story raised awareness to a medical and policy issue that most families and doctors choose to ignore. After the story aired, some counties that had difficulty securing hospice agencies to partner with were able to secure them. Doctors also told me that they had used the story to begin difficult conversations with families who were hesitant to participate in the pilot program because of fears and stereotypes associated with the term hospice.
7. Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
No.
8. Advice to other journalists planning a similar story or project.
California is one of few states exploring this issue. Florida, Colorado, and New York have also passed laws allowing concurrent palliative and curative care. Several other states are drafting legislation and would be good places to look at the unfolding of end-of-life care policies affecting children. Leave yourself plenty of time to connect with families and spend time with them. Building trust with sources confronting an impending death can take much more time. Also, reporting on death can be something of an art – you must strike a balance between being sensitive but also matter of fact.