Outreach and Enrollment for Children & Youth

The young girl waited outside the health clinic wearing a pink hat to hide her bald head and hugging her legs as the pain of cramps intensified.

Leslie Rangel, 9, had been to doctors before, back when her dad had health insurance through his construction jobs. But now, like so many families struggling in hard times, the Rangels had lost their insurance, and Leslie was living with the pain.

When Leslie first started losing her hair at age 4, doctors thought it was the stress of a new baby sister. Another doctor thought her pain and hair loss symptoms indicated a hormone imbalance. She would need injections, but could not get them until she turned 10.

Then one day, at Clínica Tepeyac, a Denver clinic that serves poor and uninsured patients, Leslie joined her little sister who was getting a school physical.

Dr. Mary Zavadil had spotted Leslie on her way in to volunteer at the clinic that morning. After taking care of her little sister, Zavadil asked Leslie’s mom if her older daughter needed help, too.

The story of their years-long ordeal gushed out. Maria de los Angeles Rangel explained Leslie’s history of suffering and the lack of answers. Leslie was tiny – barely bigger than her younger sister – yet when the pain in her legs got bad and her mother took her to the emergency room, doctors blamed growing pains.

Clinic managers immediately added Leslie as a patient. On the spot, strong spasms spread over her stomach and legs, nearly bringing Leslie to tears. Zavadil knew something far more serious was wrong. She consulted with a fellow doctor, Jim Williams, who had never seen such strong, widespread cramps. Both doctors worked together to get Leslie on medication and admitted to The Children’s Hospital while clinic managers immediately filled out paperwork to get Leslie on Medicaid.

The intervention was critical. It turns out that Leslie is one of only about 40 people in the world with an extremely rare disease called Satoyoshi Syndrome. Now – thanks to Clínica Tepeyac – she is getting regular medical care, and Zavadil is following her in her private practice.

Clínica Tepeyac has received a three-year grant from The Colorado Trust to increase children’s access to health care services, and to expand outreach and enrollment for children and youth. The clinic is now better able to identify and enroll eligible, but uninsured children – like Leslie – in Medicaid and CHP+ (Child Health Plan Plus, Colorado’s version of the State Children’s Health Insurance Program, or SCHIP).

Clinic mangers say that the economic downturn is causing increased demand for services. And many children are falling through the cracks. “This child probably never would have seen a doctor because she didn’t have Medicaid, and they’re uninsured and have very little income,” said Williams. “A visit would have cost at least $250 and they would have had a difficult time accessing any health care.”

Instead, the clinic performed a miracle for the family. “She went from not a chance of being seen to being at a top research center at Children’s,’’ Williams said. He also noted that people in lower socioeconomic groups tend to suffer more serious health concerns because they don’t have access to regular care.

Doctors cannot give Leslie a quick cure. The fourth-grader’s hair will never grow back, and she’ll always be small. But now, at least, the family has answers, insurance for Leslie and trusted doctors to accompany them on their journey. “It’s a relief,’’ Leslie’s mother said. “It’s a lot better to know because you can prepare yourself for what’s going to happen. And Leslie is a lot happier because the medication has taken a lot of the pain away.”