Communications, Awareness and Healthcare Affordability

Goal: A healthy community that knows about and accesses available healthcare resources

Statement of Need

1. Healthcare services are difficult to access in Lycoming County.
2. Pregnant women in Lycoming county are not accessing prenatal care during their first trimester, which can result in increased potential for health problems for mother and/or child.
3. Breast cancer is the most common form of cancer found among women.
4. Uninsured and underinsured residents of Lycoming County have limited access to dental care resulting in the potential for increased health problems stemming from poor oral health.
5. Individuals who require specially trained dental professionals and/or sedation must travel considerable distances to receive dental care.
6. Some Lycoming county children are behind in their scheduled immunizations.
7. Lycoming County residents are dying from asthma at a rate higher than all other 11 counties within Northcentral District) PA.
8. Many Lycoming County residents report that they or their family members are un- or under-insured and therefore find health, dental and prescriptions unaffordable.

Documentation of Need

1. More than 90% of Lycoming County residents (1995 LCHIC) who receive Medical Assistance benefits report difficulty in accessing health care services (affordable) for themselves and their families.
2. Health status indicators on the PA DOH website state that for the 1998-2000 period, 251 (20.2%) of pregnant women in Williamsport (city) received no PNC in the first trimester; for the 1997-99 period, 213 (16.6%) of pregnant women in Lycoming County received no prenatal in the first trimester, 1.8% higher than the 14.9% rate for all of PA.
3. According to American Cancer Society statistics for Lycoming County, 63.7% of women >40 years of age had mammograms within the last year; 56.2 had mammograms and clinical breast exams within the last year; the ACS goal is 90% by 2015.
4. The 1995 LCHIC Health Survey showed that >90% of medical assistance recipients identified difficulty in accessing health and dental care.
5. Dental care is the number 1 need named by families of Hope Enterprise, Inc. participants.
6. The PA DOH statistics show that 17% of children are not fully immunized compared to 14% in the Commonwealth.
7. PA DOH statistics indicate that Lycoming County has the highest number of asthma-related deaths (38) within the Northcentral District, reflecting a mortality rate of 0.32/1000 deaths compared to 0.16/1000 in the Commonwealth for the period 1990-98; (10.66% of Lycoming County students are listed as having asthma compared to 7.84% of all PA students for 1999-2000).
8. The 1995 LCHIC Health Survey showed that of those respondents with children <18 years of age living at home, 11.8% stated that their children were not insured; which is higher than the 8% reported by the State.

Measurable Outcomes

1. Decrease the number of Medical Assistance recipients who report difficulty accessing health care services.
2. Increase the number of pregnant women who receive 1st trimester prenatal care.
3. Increase the number of women who schedule mammograms.
4. Increase the number of patients who receive dental care at the SHS Dental Clinic.
5. Establish local provider site for special needs dental care.
6. Increase the number of Lycoming County children who are up-to-date on scheduled immunizations.
7. Decrease the number of Lycoming County deaths in children related to asthma to zero (0) and by 10% (4) in adults.
8. Decrease the number of uninsured Lycoming County families (adults and children).

Evaluation

1. By 02/05 LCHIC survey will show a 10% improvement in MA recipients’ reported access to healthcare services.
2. By 02/05 the DOH Health Status Indicators will show a 10% increase in the percentage of patients who receive 1st trimester prenatal care.
3. By 02/05 the local ACS Office will report a 6% increase in the number of 40+ women scheduling mammograms.
4. By 02/03 the SHS Dental Clinic will report a 20% increase in the number of unduplicated patients receiving dental care.
5. By 06/03 identify 2 practitioners available for local special needs dental care.
6. By 02/03 the DOH Health Status Indicators will show a 7% increase in the percentage of children receiving scheduled immunizations.
7. By 02/04 the PA DOH statistics will reflect an absence (0%) of Lycoming County deaths in children related to asthma and a decrease in adult death related to asthma by 10%.
8. By 2/04 statistics will reflect a 10% decrease in the number of uninsured individuals in Lycoming County.

Existing Programs

1. DPW, County Assistance Office, DOH offer assistance and referral.
2. Community Health Center, Family Reproductive Services, Pregnancy Care Center, Providence House, Family Medicine, private practices.
3. Health Woman 50, SHS, Evangelical Hospital, Mammogram free clinics.
4. St. Anthony’s, Penn College, SHS Dental Clinic.
5. None in Lycoming County.
6. Department of Health, pediatric and family practice offices.
7. Asthma Coalition, DOH.
8. DPW, CHIP

Work Plan

• 1A. Facilitate access to services through educational outreach programs, website development with public access and collaboration with public assistance and public health organizations and agencies.
• 1B. Review utilization of Community Health Center services through SHS; identifying mechanisms to facilitate service acquisition of services.
• 2A. Investigate alternative venues for prenatal services.
• 2B. Distribute published materials promoting early & consistent prenatal care.
• 3A. Implement “Tele-friend” campaign.
• 3B. Distribute published materials promoting mammograms.
• 4A. Dental Coordinator to provide outreach/education throughout Lycoming County.
• 4B. Distribute published materials promoting preventive dental care.
• 4C. Convene Dental Clinic work group to address operational issues to improve community access to dental care.
• 5A. Convene special dental needs committee for needs assessment and planning.
• 6A. Distribute published materials promoting timely immunizations.
• 6B. Work with DOH, medical and pharmaceutical personnel to identify potential solutions/action plans.
• 7A. Work with Asthma Coalition, DOH and other concerned community groups to increase awareness of the seriousness of untreated or under-treated asthma.
• 7B. Work with the Asthma Coalition, DOH, school nurses, third-party payers and medical providers to ensure compliance with the accepted “standard of care” for treating asthma in children and adults.
• 8A. Collaborate with DPW and other social service agencies to educate families about the available health insurance programs such as CHIP.
• 8B. Work with social service agencies to facilitate enrollments in appropriate health insurance programs.

Rev 9/16/02