Makayla Brooker looks up when her great-grandfather, Douglas E. Hill of Keene, enters the playroom at Cedarcrest. She knows that guy – he comes to visit her three or four times every day.

"Hey McB," Hill says, and the one-year-old breaks into a wide grin.

Makayla spent the first six months of her life in five different hospitals in the Boston area, laying in cribs and staring at the ceiling. Today, she sits up, stands when helped and, silent all her young life, is starting to laugh and make sounds. Though Makayla still has a tracheostomy to help her breath and must feed through a stomach tube, she is "progressively doing more and more," Hill says. "It's phenomenal to see the strides she's made since arriving at Cedarcrest. Her coordination is improving, her awareness continues to improve and she has begun eating food by mouth – taste tests only so far."

Though it's certainly not an easy road for Makayla and her family, the future looks much better since she moved to Cedarcrest six months ago. Diagnosed in Boston with a rare disorder called Smith-Magenis Syndrome, it looked for a time as if she might be living in a hospital or a medical needs foster home for the rest of her life. Thanks to help from the staff at Cedarcrest, Makayla's family was able to persuade Boston physicians that Cedarcrest was a better home for her. Now, she lives only a few minutes from the Keene home where Hill, his wife and Makayla's mother, Candace Brooker, live.

"The daily trips to Boston have now been replaced by daily trips to Cedarcrest," Hill says. "All that time spent traveling can and is now being spent with her (Makayla)."

Like all the children at Cedarcrest, Makayla has multiple medical problems. She was born with a cleft palate, was unable to eat and had severe breathing problems. She was only home for a few days before she began her stay in various hospitals as physicians tried to find out what was wrong.

Hill has been with Makayla every step of the way. A retired millwright and former state legislator, he spends hours every day at Cedarcrest. He and Makayla's great-aunt, Marie Mason of Keene, have taken a number of classes to learn how to deal with Makayla's medical needs.

"We've become part of the family out here," Hill says. "I can't think of a better way to spend my time."

Hill feels very lucky that he is able to spend so much time with Makayla. Since families of the 26 children at Cedarcrest come from all over the state and even Vermont, they are usually not able to visit their children as often.

Cedarcrest is one of only two facilities in New Hampshire that provides long-term comprehensive medical care for children with complex medical needs and the only one that serves children under three.

"The staff really works on including all children, from the youngest to the oldest, in all the programs and activities," Hill says. "And anytime Makayla goes out on the grounds, much less to a clinic in Keene or Lebanon, all this equipment has to go with her – tanks of oxygen, feeding units, a suction kit. It almost takes a separate car for the equipment," he says with a laugh. "She is turning out to be quite a traveling trouper."

Virtually all of Makayla's care at Cedarcrest is Medicaid-funded, as is true for all the children there. Patricia Farmer, director of development and community relations, explains that Medicaid covers about 95 percent of the daily care of the children. This includes medical care as well as on-site physical, occupational and communications therapy.

Cedarcrest also offers special education to both residents and two students from the community; funds for this come from the students' local school districts.

Any building or facility renovation needs, however, must be raised through donations. In 2001, Cedarcrest did a major expansion of its educational facilities. It is currently trying to raise $5,000 to buy another lift to help in the transition of children from their beds to a wheelchair. Cedarcrest has one lift now and at least 19 children who must use wheelchairs.

In addition to the children, like Makayla, who live at Cedarcrest, there are others who come for short stays because they need temporary round-the-clock care, perhaps as a transition between hospital and home. One of the 26 beds is kept open for such needs, Farmer says.

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