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Arizonas health care delivery system has changed dramatically in the 17 years since Phoenix Childrens was established and further transformations appear likely. Among the ongoing challenges: the rising percentage of children who are uninsured or underinsured (a 42% increase since 1989), and the new risks to childrens health from poverty, environmental cases, increased violence, and child abuse. Arizona ranks near the bottom of the United States (41st out of 50 states) in overall health of children, based on an average of such comparisons as the number of children in the state without health insurance (50th), child poverty rates (39th), school dropout rates (49th), teenage pregnancy (46th), and teen death rate by accident, homicide, and suicide (39th). (Kids Count Databook 2000, the Annie E. Casey Foundation) All of these factors reinforce the necessity of addressing childrens health care from a specialized and focused perspective. They also underscore the need for a hospital that treats ill and injured children without regard for the familys ability to pay. Over the last decade, Phoenix Childrens has provided over $63 million in charity care to needy youngsters. In addition, implementing sliding-fee-scales for general pediatrics, nearly half of the children cared for by PCH are enrolled in AHCCCS, Arizonas Medicaid plan.

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