Caring for maine's children presentation

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Caring for maine's children presentation

  1. 1. Caring for Maine’s Children: A Grant to Improve Access to Pediatric Primary Healthcare in Western Maine Nichole C. Martin RN, BSN, CEN Husson University
  2. 2. Medical Home Model Primary care that is accessible, continuous, comprehensive, family- centered, coordinated, compassionate, and culturally effective -American Academy of Pediatrics, March 2007 64% of Maine parents report healthcare for their child as being received from a provider that meets this definition 2010 Maine Children’s Growth Council Report: School Readiness
  3. 3. Research shows having a regular source of preventive and primary care is associated with: – lower per person costs – lower emergency room utilization – fewer hospital admissions – fewer unnecessary tests and procedures – less illness and injury – higher patient satisfaction American Academy of Family Physicians
  4. 4. Let’s look at Maine
  5. 5. Facts on Health Based on a 2009 study by the Muskie School of Public Service: • Maine emergency department (ED) usage was 31% higher than the national average • The Maine population age 0 – 1 years of age has the highest rate of ED use AND the highest proportion of frequent ED use (4 or more visits in a year) • The Maine population age 1 – 4 years of age has the third highest rate of ED use • Maine children age 1 – 4 years showed a 25% increase in ED use than the the national average for that age bracket Analysis of 2006 Emergency Department
  6. 6. Facts on Health • 28.2% of Maine children ages 10 – 17 are overweight or obese • 26.4% of Maine children ages 19 – 35 months are not current on their childhood immunizations • 18% of Maine high school students reported smoking cigarettes in 2009 – increased from 14% in 2007 (a 29% increase… yikes!) – first reported increase since 1997 Maine Kids Count 2010 Data Book
  7. 7. Facts on Health • 78.5% of Maine children did not receive developmental screenings during well-child visits • Parents of 32.2% of Maine children age 0 – 5 have at least one concern about their child’s development, learning, or behavior • In 2008, 17% of Maine children had special needs Maine Kids Count 2010 Data Book
  8. 8. Facts on Insurance • 6% of Maine children are without health insurance • 9% of low-income Maine children are without health insurance • 53% of uninsured children in Maine are low- income children who are eligible for MaineCare coverage Maine Kids Count 2010 Data Book
  9. 9. Rural Maine • Less health care providers per capita – 20% of the nation’s population live in an area designated as rural – 9% of the nation’s physicians practice in rural areas • Increased transportation barriers – Little or no public transportation – Longer distances to travel for Healthy Maine 2010: Opportunities for • Rural residents visit a physician less often and later in the course of an illness
  10. 10. Rural Maine • 60% of Mainers live in a rural area • Rural counties in Maine tend to have a lower median income and higher rate of poverty “Family economic distress is associated with negative social… and health outcomes for children” - Mather & Adams USDA Economic Research Service via www.ers.usda.gov Healthy Maine 2010: Opportunities for All The Risk of Negative Child Outcomes in Low-Income Families
  11. 11. Facts on Poverty The child poverty rate has become one of the most widely used indicators of child well- being • Maine’s estimated household income is $37,400, the lowest in New England and below the national average of $41,343 • 21.8% of Maine children under age 5 are living in poverty, this is higher than the national average! • 16.5% of children under age 18 are living in poverty • Maine children living in small communities make up 72% of the population of impoverished children Maine Kids Count 2010 Data Book Healthy Maine 2010: Opportunities for All
  12. 12. Facts on Poverty • Average income for rural Maine is $32,500 • Franklin county is among the most impoverished counties • In 2008 – 17.5% of Franklin county lives in poverty – 22.5% of Franklin county children 0 – 17 years old live in poverty USDA Economic Research Service via www.ers.usda.gov
  13. 13. So what’s this grant all about?
  14. 14. Broad Objective Improve access to pediatric primary care in western Maine
  15. 15. Focused Objective Obtain funding to staff a Family and Community Nurse Practitioner (FCNP) with strong experience in pediatrics at the Rangeley Family Medicine practice in Rangeley, Maine Photo courtesy of Rangeley Family Medicine
  16. 16. Why Rangeley, Maine? • Sits among a rural and medically underserved region in Maine • Home to an existing FQHC • Serves a large catchment area including: – Rangeley − Madrid – Oquossoc − Magalloway – Dallas, Lincoln, and Sandy − Multiple unorganized townships River Plantations • Borders extend: – west to the New Hampshire border – north to the Canadian border – east to the Carrabassett Valley region – south to the Townships C, D, and E
  17. 17. Rangeley Family Medicine • FQHC established in 1994 • Offers routine physicals, chronic and acute medical visits, laboratory services and minor surgery • Provided care to almost 1,700 local and seasonal residents in 2009 • Currently staffed with 3 physicians board certified in family medicine www.healthreachchc.org
  18. 18. Let’s look at the region
  19. 19. Southern Maine Regional Resource Center for Public Health Emergency Preparedness via smrrc.org Maine is divided into eight DHHS districts, based on population, geography, county borders, and hospital service areas
  20. 20. Office of Rural Health and Primary Care via maine.gov
  21. 21. DHHS District 3 – Western Maine Southern Maine Regional Resource Center for Public Health Emergency Preparedness
  22. 22. OfficeofRuralHealthandPrimaryCare viamaine.gov
  23. 23. DHHS District 3 – Western Maine • Consists of Franklin, Oxford, and Androscoggin counties • 71 municipalities (incorporated local governments): cities, towns, plantations (unincorporated townships are a recognized part of the District. A TWP is officially served by the Maine CDC and may be served by the local health officer of an adjacent town.) Office of Local Public Health via maine.gov
  24. 24. DHHS District 3 – Western Maine Franklin Oxford Androscoggi n Total population (2006 estimate) 29,850 56,461 107,011 Children under age 5 years old 1,401 2,864 6,746 Children 5 – 17 years old 4,688 9,097 17,663 Number of pediatricians, family /general practitioners 22 24 67 Children participating in MaineCare 3,452 (52.5%) 7,357 (58.6%) 13,735 (53.2%) Maine Kids Count 2010 Data Book 2010 Maine Children’s Growth Council Report: School Readiness
  25. 25. Area Resources • Hospitals – Franklin Memorial Hospital, Farmington – Redington-Fairview General Hospital, Skowhegan – Rumford Hospital, Rumford • Pediatric Practices – Pine Tree Pediatrics, Farmington – RMA Pediatrics, Skowhegan
  26. 26. Going the distance • Rangeley to Farmington 1 hour • Rangeley to Rumford 1.25 hour • Rangeley to Skowhegan 1.5 hour courtesy Google maps
  27. 27. What will this grant do? • Provide greater access to pediatric primary care • Improve completion of developmental and behavioral screening in children • Allow early identification of developmental delays and behavioral problems
  28. 28. What will this grant do? • Assist with early intervention for health and wellness needs • Increase childhood immunization rate in Maine • Improve referral rate to other needed healthcare and community services
  29. 29. This overview is presented with special thanks to the Maine Children’s Alliance Photo courtesy of Maine Kids Count 2009 Data Book
  30. 30. Much of the data used in this grant proposal was obtained from the 2010 Maine Kids Count Data Book Funded by The Annie E. Casey Foundation
  31. 31. References • American Academy of Family Physicians. Retrieved from www.aafp.org • American Academy of Pediatrics. Retrieved from www.aap.org • HealthReach Community Health Centers. Retrieved from www.healthreachchc.org • Maine CDC - Office of Local Public Health. Retrieved from www.maine.gov/dhhs/boh/olph • Maine Children’s Alliance. (2009). Maine kids count 2009. Augusta, ME: Author. • Maine Children’s Alliance. (2010). 2010 Maine children’s growth council report: School readiness. Augusta, ME: Author. • Maine Children’s Alliance. (2010). Maine kids count 2010. Augusta, ME: Author. • Maine Office of Rural Health and Primary Care. Retrieved from www.maine.gov/dhhs/boh/orhpc • Mather, M., & Adams, D. (2006). The risk of negative child outcomes in low-income families. Retrieved from http:// www.aecf.org/KnowledgeCenter/Publications.aspx?pubguid={87AC5496-D08E-4EA2-8749-C1075F0EBBB0} • Mills, D. A., & Leahy-Lind, S. (2002). Healthy Maine 2010: Opportunities for all. Augusta, ME: Author. • Muskie School of Public Service. (2009). Analysis of 2006 emergency department use: A study conducted on behalf of the emergency department use work group of the Maine advisory council on health system development. Retrieved from http://www.maine.gov/tools/ whatsnew/attach.php?id=68564&an=1 • Southern Maine Regional Resource Center for Public Health Emergency Preparedness. Retrieved from www.smrrc.org • USDA Economic Research Service. Retrieved from www.ers.usda.gov All photos taken by N. Martin unless otherwise credited
  32. 32. Thank you!

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