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We had the pleasure of talking with Linda Brown. Linda is an Occupational Therapist who has worked with medically fragile children for over fifteen years. She is the owner of BrightStart Pediatrics and creator of the BrightStart program that meets the medical, developmental and social needs of the children they serve.

1. Please describe the program and services you provide at BrightStart Pediatrics. “BrightStart Pediatrics is called a PPEC center, Prescribed Pediatric Extended Care. That is the name given to us by the state of Florida to describe the kind of center we are. As a PPEC center we provide nursing services and therapy services to children that meet the medical criteria to come to the center. Parents think of us as a school or daycare but we are actually a medical facility. And we have to comply with all the same regulations that other medical centers have to. We employ nurses, so we have nurses and therapists that care for our children. The children come in in the morning and the nurses do an assessment to see if there are any changes in their medical condition or their status since the last time we saw them. Then they enter into the program into a specific room that has already been decided according to their developmental level and needs. Throughout the day we provide the nursing care and we provide developmental activities in the rooms. If they are in need of occupational or physical therapy then those services can be provided throughout their day. We provide whatever is necessary for them during the day and then they go home at night.”

2. Please describe the traits of the children you serve. “It is not based on a diagnosis because children with any diagnosis can present very differently. So really what we look at is the child’s need for some kind of skilled prevention. Because we do have pediatric nurses that are caring for them the payer source, which is typically Florida Medicaid or private insurance, is looking for a reason why they need nursing. And that differs for each payer source as they usually define the criteria. We often work with Florida Medicaid which is a common payer of ours, so examples of a child that would qualify under Florida Medicaid could be an infant with an apnea monitor, an infant with oxygen, children with gastrostomy tubes, children with tracheostomy, children on ventilators or a child needing frequent medications. If a child needs medication every six hours for instance then that child cannot go to a typical daycare while the mom goes to work because they won’t administer that medication. Really there isn’t anything that is too complex. We look at whether the child is stable enough to be transported to and from the center and what kind of care they need.”

3. What ages of children do you serve? “Technically we can see children from birth to eighteen years of age. Most of our children are between the ages of birth to five. Often it is between the ages of three and five that children are able to be integrated into the school system. And we encourage that if it is a possibility for that child. At five, all children should be enrolled into some kind of a school system. So the older children that we serve, over the age of five, are typically children that are either under homebound status for some reason as directed by their physician or they could come to us after school or when school is out for holidays or summer break. On a typical day most of the children in our center are between new born and five years of age.”

4. What do the daily activities look like? “BrightStart is set up with different rooms based on the children’s developmental needs and not necessarily based on their chronological age. So the activities are different in different rooms. For example, in our newborn room for infants and babies that are not mobile, you don’t have to worry about the them crawling into each other’s space and infection is always a concern. So babies are in their own crib and in their own space. We have mats on the floor and bouncy seats, we play classical music and have things that would be appropriate for an infant environment. As you move into other rooms, we have an older infant room for kids that are crawling, pulling to stand and beginner walkers. And in this kind of room we do tummy time, crawling gyms, blocks and big foam things and lots of different activities. At this age we encourage nap time in the afternoon and we get into a structure of some time to be on the floor and some time to be outside and some time for napping. We have a toddler room. Our toddlers and preschoolers have a teacher employed in that room. We work on preschool readiness, colors, letters and finger painting. We have a structured time when we do preschool types of tasks and time to play on an outside playground. On certain days like Fridays we have pool day when we pull out sprinklers and pull out little pools in the back play area. And they eat lunch together. Some kids eat orally and some kids may not. We have a standard lunch time so they can learn some of those skills from each other. We have a nap time and then they go back into some structured activities. Of course, any child needing therapy would be pulled out for certain therapy activities. Our fourth room is what we call our big kid room. These kids are more developmentally delayed and need to be protected from some of our kids that are more active. These children usually need to be positioned in wheel chairs or on the floor but they need to be able to do that without worrying about a toddler climbing on them. In that room we also read stories, have music playing, have different kinds of sensory activities going on for the children to be able to participate in whatever level they are able.”

4. Do you offer therapies for other children that do not go to your center for school or childcare? “Yes we do but it depends on the therapists availability. Obviously, our therapists primary focus is to the children enrolled in our center. And it is handled on a case by case basis to determine the availability of the therapist to see an out patient that is not enrolled in the center.

5. How would a parent get started? “We love to show our center to people and it is the best way to get a feeling for us and for what we can do for your child and to see if it is a good fit. Every parent has to make the best decision for their child. We get information from the parent on the phone or when they show up for a visit. We are happy to schedule an appointment or they may show up unannounced. In the later case whoever is available at the moment would be happy to show them around, give them a tour and answer some of their questions.

6. Do you offer transportation? “Yes, for children who are enrolled in the day program. If they are funded by Medicaid and Medicaid does cover transportation to and from the center if the family isn’t able to transport them, then we will provide transportation. We have a number of children that access that service. The van from Medicaid comes to our center in the morning at 6am and picks up our medical escort, an EMT that supervises our children during transport, and then we go to the houses of the children grouped geographically by different areas and pick them up and bring them to the center.

7. Do you help parents obtain the doctors order to attend your center? “Of course we help them with that process. Some parents come in with it already because they already know what they need but if a family hears about us from another family and they come in without having the paperwork part of it together then it is very simple. We work with many of the physicians in town. We talk to the families and see what they would like us to do. We’ve done this many times and come across most issues that can come up and have an idea of how to solve them.”

BrighStart has two centers, one in South Orlando which serves children in South Orlando, Kissimmee, St. Cloud. And a second center in Sanford, which serves Seminole County, Altamonte Springs, Sanford, Oviedo and Volusia County. For more information please visit their website at www.BrightStartPeds.com

It is our mission, at Bright Feats, to connect families with centers like BrightStart and other medical, educational and special needs resources. If we can help you please contact us.

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