[Editor’s Note: Last year, 80 asylum-seeking children with specialty care needs were enrolled in Migrant Clinicians Network’s Specialty Care Access Network (SCAN). Every single one of them has a story like Lola’s, who is profiled in this article. SCAN gives children a medical lifeline, by connecting them to two incredible MCN resources: 1) Health Network, our virtual case management program, to enroll the child in primary care, make sure they are up to date on vaccines and preventative care, and get connected with social support like sliding-scale fees and nutrition programs in their family’s receiving community; and 2) the SCAN Champions, MCN’s network of pediatricians and pediatric specialists across the country who help to connect these children to the specialists that they need. Our health systems are very difficult to navigate and specialty care in particular is often scarce even when desperately needed. SCAN helps remove some of many barriers to specialty care that these newly arrived family encounter so that children can thrive in their new communities. Read this article from MCN’s in-print clinical publication, Streamline, to see how one child’s care was secured. Want to read more Health Network stories? Check out our #HealthNetworkHelpsPeople page. Be sure not to miss our clinical articles on migrant health --  subscribe to Streamline! And please help us do this critical work: support MCN.]

Children of immigrants, even those with US citizenship, can face significant barriers to accessing health care. Lola* was born in Texas with both atrial and ventricular septal defects that created increased pressure on her lungs. Her parents, newly arrived asylum seekers, were still migrating to their final destination in the mid-Atlantic when they sought care for newborn Lola. Health care obstacles for such families are plentiful, and teams of case workers, advocates, and doctors often need to work together to create a plan of action.

For a newborn, these heart defects can be detected early by tracking growth, labored breathing, and exhaustion the baby experiences when doing activities like feeding. Lola was on track when it came to growth, but the signs of exhaustion prompted doctors in Texas to perform an echocardiogram, which uncovered the defects. Surgery to repair the holes would be needed to ensure Lola could live a happy and healthy life. Because the family intended to move, the infant was quickly enrolled into Health Network, Migrant Clinicians Network’s virtual case management system for migrants with ongoing health needs. While Lola’s doctors did not believe Lola needed emergency surgery in Texas before moving, the severity of her condition warranted approval of travel plans by her medical team before she could leave the state.

After enrollment, Lola’s case came to Camila Valasquez, Health Network Associate and the case manager for MCN’s Specialty Care Access Network, or SCAN, MCN’s network of pediatricians and pediatric specialists around the country dedicated to rapidly connecting the most vulnerable patients we serve to the specialty care they need. Our SCAN champions focus on their local region, using their connections in the health care system to help Health Network Associates find the right specialty clinician for their patients’ needs. Velasquez reached out to the SCAN champion in the mid-Atlantic region where Lola and her family intended to move, in search of a pediatric cardiologist. First, her family had to migrate.

“The truth is that when you're dealing with little kids, even little amounts of pressure differences can be a lot for a tiny heart,” said MCN’s Laszlo Madaras, MD, MPH, Chief Medical Officer, who oversees SCAN patients. Soon, her doctors approved a flight plan for Lola and her family. Her medication would keep her stable until the surgery could be performed.

The Texas immigration shelter where Lola’s family was staying while she was in the hospital had to use their resources to ensure that a flight would be available to the family as soon as possible. Velasquez and our SCAN champions on the East Coast activated their networks to guarantee that once the family was on a plane, transportation would be waiting for them at the airport to take them to a hospital. Velasquez transferred medical records so that the hospital had the needed case information and was ready to proceed with the lifesaving surgery. Such interstate case management and inter-organizational planning are by nature complex and delicate, and every part of this system needed to be working in sync and to be in constant communication.

This coordination between doctors, hospitals, and our team was completed in just over a week from Lola’s enrollment in Health Network to her arrival at the hospital on the East Coast. From there, the hospital was able to bring social workers onto the case who enrolled Lola and her parents into a financial aid program to ensure that Lola’s surgery would be affordable for her family. “I was in contact with the family five times, and I reached out to SCAN champions and health centers a total of 12 times,” Velasquez reported, demonstrating a highly efficient process in which an active SCAN champion assisted readily with finding and enrolling local care. The case was closed on Health Network’s side by the next week after some final conversations with the parents where they confirmed Lola was stable and that the hospital was taking over the case, moving forward with the plans for surgery.

“It was really satisfying to be able to feel at ease knowing that she got into care quickly and that she received the best possible care,” said Valasquez. “It felt like it lined up as perfectly as a case can. It was one of those cases where you were at ease the whole time because the child was in good hands.”

Learn more about Health Network, including how to enroll patients:
https://www.migrantclinician.org/our-work/health-network.html

Learn more about SCAN and how to become a SCAN Champion:
https://www.migrantclinician.org/our-work-virtual-case-management/specialty-care-access-network.html 

*Name and some identifying details have been altered to protect the patient’s identity.