The Children's Advocacy Project, which serves sexually, physically and emotionally abused children, has searched for a physician to join its team as a medical director the past eight months with little success.

Without a medical director, the organization is unable to bill Medicaid, according to Amanda Moeller, director of the advocacy center. As a result, it would lose about half of its mental health patients and no longer be able to provide well-child checkups for the Natrona County Department of Family Services.

Currently, Dr. Beth Robitaille, a physician at Community Health Center of Central Wyoming, serves as the medical director at CAP, but she gave up the post earlier this year. Robitaille said she would stay until CAP found a new director.

"Medical has been a weak link for us and it is for centers nationwide," Moeller said. "Some communities are lucky and have providers who want to do this."

Moeller said they have had trouble finding a director despite the fact that the position requires only about four to 10 hours a month and is compensated.

She suspects physicians do not want to add another time commitment to their already swamped schedules, but she is hoping someone in the community will "step up" to take the position.

When DFS takes a child into custody, the department is required by law to have the child seen by a medical provider within 30 days, said Paul Fritzler, district manager for Natrona County DFS.

CAP performs most of the well-child checkups, which are covered by Medicaid. The project wanted to expand its services to become more sustainable and began offering these checkups in 2006.

Fritzler said it is great CAP provides this service, because the organization can see a child quickly and medical professionals at CAP are trained to recognize the signs of abuse.

"Most of these children's circumstances for coming into DFS have to do with abuse or neglect," Fritzler said.

The lack of a medical director at CAP results in a delay "in assessment of needs and a delay of services," to CAP families, Fritzler said.

At least six child abuse cases have been discovered from these well-child checkups at CAP that would have not been caught otherwise, Moeller said.

Plus, the money CAP receives from Medicaid for the exams provides some revenue for the organization that is about 80 percent government funded, she said.

Several nurse practitioners and a mental health professional provide services at CAP, but they are unable to bill Medicaid themselves. They need a physician.

"If Medicaid would just change their rules, we would be fine," Moeller said.

CAP needs a medical director for other reasons besides billing, Moeller said. CAP helps law enforcement, legal services and DFS investigate child abuse cases and a physician can lend expertise to the team.

A doctor might be able to tell if something is a symptom of a disease rather than a sign of child abuse, Moeller said.

The doctor would also be able to educate other providers in the community about child abuse.

"We can't just be here to do forensic interviews for Natrona County," Moeller said. "It's not fiscally possible."

Contact health reporter Allison Rupp at (307) 266-0534 or allison.rupp@trib.com.