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Nurse Overcomes Sexism to Build Business Helping Frail Children

Forty years ago, a guidance counselor told a mother that her 18-year-old child could be anything he wanted to be. Terry’s potential was endless, said the counselor.

Then the counselor met Terry , a girl , and the meeting took a traumatic twist.

“It seems funny now, it wasn’t funny then,” said San Diego entrepreneur Terry Racciato, explaining how the counselor mistook her gender because of her name’s masculine spelling.

Racciato, 54, remembers, “He said, ‘I’m sorry but it’s just not going to happen for you. What a waste of all that potential.’ ”

He then told her to be realistic, because within five years she’d be married with children and incapable of holding a job. Her only options in the meantime were to be a nurse, teacher or telephone operator, he said.

Racciato chose nursing, but she never settled down.

Instead, a tenacious Racciato became a registered nurse with a minor in business to spite those who said she should aim low.

It proved to be an important first step in her starting a string of successful health care businesses, including Together We Grow.

Founded in 1990, Together We Grow is a $4 million-a-year company that provides pediatric health day care with centers in Kearny Mesa and Oceanside.

Pediatric health day care involves watching healthy children along with children with medical issues. The idea is to make regular children more accepting of others while helping special needs children feel more confident around their peers.

“People ask me why parents of typical children would want to have their children here and it’s because they gain so much about how to be accepting of other people instead of just the alphabet,” said Racciato, who serves as the company’s chief executive officer.

Racciato pioneered pediatric health day care in the late 1980s when she lobbied for the state of California to get a $24.5 million a year federal grant to help families of disabled children pay for such care.

Parents of typical children, who don’t qualify for low-income assistance, pay the median cost for traditional day care in the area, which ranges from $160 to $240 a week, depending on age.

The number of typical vs. medically frail children enrolled is a fairly even 50/50 split, with about 100 children enrolled at any given time, Racciato said.

She said she makes a 5 percent profit off her $4 million-a-year revenues but insists she’s not in it for the money.

“A lot of people do their jobs and expect when they retire, they’re going to do what they really want to do, they’re going to pursue that passion they never had time for, but I’m really lucky,” Racciato said. “I’m already doing it. This is my passion.”

Pat Hyndman, Racciato’s mentor with the CEO group, Vistage International, finds her spunk remarkable, especially given how difficult it can be to run a business dependent on state funds.

“She makes life so delightful for so many kids who have nothing else to be delighted about except to come here,” Hyndman said. “The kind of business she’s in is not easy.”

Case in point: It’s been seven years since the state has raised the amount it gives to help care for qualifying children.

In that time, Racciato’s operational costs have gone up, including utilities and insurance, and she has born the brunt of it all. She has also scraped by when the state has failed to pass a budget on time.


A Force To Be Reckoned With

There are seven pediatric health day care facilities in the state, two of which belong to Racciato and her husband, Joe, who handles the business’ computing needs.

The other five are much smaller. In fact, of the 175 licensed bed spots, Together We Grow has 125 of them.

Although most care occurs during the day, both centers offer overnight stays twice a month to give parents a night off. The overnight stays also present the opportunity for older, disabled children already in the school system to enjoy the center.

“Pediatric health day care was written so families could have a normal life,” said Racciato, who had to badger city officials and agency heads to get the necessary zoning and licensing regulations to open a dual-use center.

The solution: Different rooms within the centers are regulated by different agencies , one that regulates traditional day care centers, another that monitors the care of medically frail children.

Because half of the children fall under one jurisdiction and half fall under the other, permission slips are kept on file at all times to allow the children to cross the hallway freely regardless of whether they’re technically in traditional day care or one for the medically frail.

Also, in medical emergencies, staff must make sure a child is cared for in a room licensed by the agency in charge of medically frail children.

“It’s messy, but sometimes you just have to get creative,” Racciato said.

Each center is built to acute-care hospital standards. Cleanliness is everything, Racciato said.

The 70 employees who staff the two centers are trained in special education or early education, or both. A small percentage are certified nursing assistants.

Nursing students from trade school Maric College nearby do their required pediatric rotation there. Instructor Judith Werkey supervises the program.

“I think it’s a better experience from my perspective because we can talk about growth and development and issues with that, but for the students to actually see and interact with these children is far more educational than anything I can tell them,” Werkey said.

Racciato believes the program is a good way to grow future staff.

“It’s part of why we spend a good amount of time with them,” Racciato said. “Because if you don’t have a good experience, you won’t come back to it.”


Taking A ‘Special’ Interest

Racciato was inspired to start Together We Grow after years of running a staffing company that provided in-home care for medically frail children. She said it became painfully obvious why the children failed when they entered school.

They were so isolated at home that they didn’t know how to interact with other children or how to follow simple school rules, such as how to stand in line or sit in a circle, she said.

Racciato ran that business, called SpecialCare, for most of the 80s. It was her first official business venture and was started in her garage with $500. She initially sold hospital staffing, then moved onto home-care staffing.

She said she started it after she voiced her opinions to her boss at the time and he sarcastically replied, “Why don’t you just go and start your own staffing service then?”

It wasn’t easy. She was frequently told to “go away.”

One person even told her he “would not do business with a nurse, and sure as hell not with a woman.” But comments like those, and the others that suggested she go home and serve her husband, only made her more persistent.

“You challenge me by telling me I can’t do something,” Racciato said.

At its peak, SpecialCare managed 500 employees in Orange, Riverside, San Bernardino and San Diego counties.

Racciato added a medical equipment unit and home pharmacy service before selling the staffing agency to Maryland-based Maxim Healthcare Services in the late 1980s for an undisclosed sum.

She retained the medical equipment side of the business and still operates

SpecialCare today out of Kearny Mesa with 10 employees and annual revenues of $2 million.

It took $5 million to start Together We Grow, money taken from the sale of the staffing service along with a small-business loan and leveraging her home.


Just Getting Started

Today, three generations of Racciatos can be found at the centers. In addition to Racciato and her husband, one of their two sons works as an assisted technology specialist, while his wife runs the Oceanside center. Some of their nine grandchildren receive day care. Her other son met his wife at one of the centers where she worked.

One particularly precocious granddaughter has already offered to be the boss in her grandma’s place, but Racciato, still determined to make the world a better place than she found it, isn’t quite ready to accept that offer.

“I can’t see myself retiring before 70,” she said.

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