Family First Health

State officials recognized the work of Family First Health Center in coordinating school-based health services as an outreach for students who may not otherwise be able to access dental, medical and vision care.

“Family First Health’s school-based health center is working to reduce barriers for families by providing critically needed services directly in school so that all young people, no matter their zip code, have equal opportunity to learn and grow,” said Val Arkoosh, secretary of the state Department of Human Services, in a news release after a visit to York City’s Hannah Penn K-8 School last week.

Hannah Penn K-8 is the location of a satellite office that provides students with a variety of services. Health officials pointed to the partnership that helped create the center as a potential model for increasing health care access.

“As a pediatrician, I’ve seen first-hand how school-based health clinics help children who otherwise may have gaps in their healthcare get the medical, behavioral, dental and vision services they need,” said Debra Bogen, the state’s acting health secretary, in the news release.

The Family First Health Center is open Monday through Friday with varying hours and offers health services to students. Adult and pediatric care are available as well as health exams, immunizations, preventative care and more, according to the center’s website.

This health center has Spanish interpreters on staff and trained staff members that assess eligibility for insurance assistance programs, in addition to various on-call staff to deal with emergencies 24/7.

In 2020, the health center received $2 million in grant funding from the United Health Foundation that allowed Family First Health to “significantly expand” its offerings, according to the state officials. The health center first opened in 1997 with help from the city, the school district and WellSpan Health.

The 2020 grant also funds health navigators who get families connected to more social services and home visits.

YORK, Pa. (WHTM) – Representatives from Hannah Penn School, Family First Health, and the United Health Foundation were joined by Pennsylvania Department of Human Services (DHS) Secretary Dr. Val Arkoosh and Pennsylvania Department of Health (DOH) Acting Secretary Dr. Debra Bogen Wednesday to discuss improving health care access for underserved communities through school-based health centers.

Services provided by school-based health centers include:

• Medical
• Behavioral
• Dental
• Vision

Such healthcare centers are places where Medicaid has higher rates in the community.

The health centers that are embedded in schools are used to ease barriers to care and achieve health equity among children.

“As a physician, I worked with families whose health was negatively impacted by the lack of access to health care and other essential services. This is a complex issue, and I am thrilled to be here with partners in health care, government, and education to be a part of the solution,” Secretary Arkoosh said. “Family First Health’s school-based health center is working to reduce barriers for families by providing critically needed services directly in school so that all young people, no matter their zip code, have equal opportunity to learn and grow.”

“As a pediatrician, I’ve seen first-hand how school-based health clinics help children who otherwise may have gaps in their healthcare get the medical, behavioral, dental, and vision services they need,” Acting Secretary of Health Dr. Debra Bogen said. “During National Health Center week, it is important to showcase how clinics such as Family First Health work to bridge the health equity divide and create a healthier Pennsylvania for all.”

In 2020, Family First Health’s school-based health center received $2 million in grant funding from the United Health Foundation.

This grant helped expand primary care that includes behavioral health care and wellness services.

The school-based center can be used by students, their families, and the York community.

Health navigators who connect families to social services and provide home visits where needed were funded by the grant as well.

“The United Health Foundation and Family First Health partnership has created incredible community impact across York,” said Blair Boroch, CEO, of UnitedHealthcare Community Plan of Pennsylvania. “Nearly 2,000 families have been engaged in wellness programs at Hannah Penn’s school-based health center, and students now have expanded access to primary care and behavioral health screenings. Community health workers are also providing in-home support to families, helping individuals manage chronic conditions, and screening and providing referrals to social supports.”

“The team at FFH is so pleased to welcome Secretaries Arkoosh and Bogen to our health center location at Hannah Penn K – 8 School. In a school-based location, we are uniquely able to deliver on our mission of improving lives by addressing the root causes of health disparities.  With partners like UnitedHealth Foundation, we have been able to expand our programs and services at the school to provide much-needed care for our community. National Health Center Week is the ideal time to highlight the impact of this model.  We believe there is no more important time to work closely with schools and families to improve health and are grateful for the opportunity to share our work.”

Watch the video here.

York, PA — Meeting the medical needs of the community in a comfortable, familiar setting. Family First Health, partnering with the York City School District, to provide a school-based health center for all.

“It is crucial,” said Secretary Dr. Val Arkoosh, Pennsylvania Department of Human Services.

In honor of National Health Center Week, Dr. Arkoosh toured the center at Hannah Penn Middle School. For 26 years, the school-based health center has offered exams, shots, lab capabilities and overall access to healthcare.

Serving 1,100 patients a year, from students to family members, the center makes healthcare more accessible.

“To have a place like this, that is convenient right at the family school, that has a sliding scale for payments, depending on the income status … those are services that not every doctor’s office can provide,” said Dr. Arkoosh.

Funding for the center comes from Medicaid reimbursement, individual payments and grants from private donors.

Leaders in York County are trying to make the local healthcare and human services coordination systems better and easier to navigate, but they need help from residents of York County.

The project, funded by the County of York, aims to find new ways to work together to improve community health and well-being, said Kevin Jackson, a consultant working with Family First Health.

“We have all navigated health and human service systems, and during COVID we saw that organizations both large and small were more innovative to get to needs quickly, but coming out of COVID people are settling back into old inefficient and siloed ways,” he said. “We want to make sure we don’t lose this innovative spirit with how we serve community members.”

Jackson said that a person’s overall health and well-being requires a connected and coordinated network of systems and services.  Where we live, what we have access to, what we can afford and how we socially connect all matter.  Many community members continue to find it challenging, frustrating and inequitable to access essential resources such as food, housing, transportation and healthcare.

“Everyone wants to be healthy and have access to what they need to be healthy,” he said. “So that’s why everyone needs to work together to make sure referrals, hand-offs, resources and funding go where they need to go in York County.  We can and must do better.”

Jackson said the goal for this project is to bring together health and human services from various healthcare systems and community organizations to create a better experience for community members as they move through these systems.

To do this, Healthy York Coalition brought together over 130 health organizations, government officials, and community-based organization leaders to discuss ways that everyone could work together for better health in the county.

“There are no shortages of people who care, so we brought them together and out of this meeting we created three teams to help us understand the community member experience, their journey as they go through our systems, where communication and process breakdowns happen, and how we can make a positive impact in their experience,” Jackson said. “But you can’t do that without asking for the experience of the community member, so that’s where we need help. We want to know their candid experiences, what they would suggest, what their ideas may be.  We want to engage them in the process, not have directors and executives solely make decisions for them.”

Those who would like to send feedback or ideas can email yourvoicematters@familyfirsthealth.org. They can also call and leave a message at 717-356-2226. Additionally, they can use the attached QR code to complete a quick survey.

To view the code, please visit here.

When nurses provide pain-free shots, they can have a meaningful impact on a patient’s future health decisions. These five tips can help you achieve that goal.

No one likes getting injections. Some patients tolerate it and others avoid injections at all costs because they fear the needle or possible pain from the shot. Pain is a subjective response that is heightened by fear.

Using proven strategies to administer pain-free injections, nurses can improve a patient’s experience and compliance with medical recommendations. Our two nurse contributors share their tips for administering pain-free injections, which have helped them and their colleagues improve patient outcomes.

Importance of Pain-Free Immunization Experiences

As most people can attest, the pain of an injection is short-lived and relatively minor compared to other medical procedures, chronic diseases, or injuries. Yet, the fear of injections can negatively impact patient compliance and outcomes.

A 2019 systematic review in the Journal of Advanced Nursing revealed needle fear was as high as 50% in adolescents and 30% in young adults. According to the data, needle fear was the reason for avoiding the flu vaccine in 27% of hospital employees, 16% of all adults, and 8% of healthcare workers.

Nurses meaningfully impact a patient’s future experiences and willingness to comply with immunization recommendations when they can reduce or eliminate the perception of pain during an injection.

Vickie Ensor Bands, MSA, MSN, RN, has been a nurse for over 40 years and is the director of community outreach and health improvement for the University of Maryland Upper Chesapeake Health.

“Patients are scared and anxious and are depending on the person giving them the injection to have the skill needed not to hurt them,” she said.

Common Causes of Pain During Immunization

Although pain is a subjective experience, nurses must recognize the common triggers. One common factor is muscle tightness at the site of the injection since it can cause more inflammation and discomfort.

Lori Garman BSN, RN, has been a clinical nurse since 2004. She also notes that restraining a patient during an injection can raise muscle tightness and result in a far more painful injection.

Another factor is the medication being administered. Bands notes that the solution’s pH, viscosity, and chemical makeup can cause pain during the injection. Other factors that nurses must consider are the size and length of the needle, the temperature of the medication, and the accurate placement of the injection. Bands notes that placement is particularly important in the elderly.

“Many older adults can have muscle wasting and the person giving the injection needs to use great skill when injecting in making sure they do not hit the bone. This can cause pain at the time of the injection as well as days of lasting discomfort,” she said.

Tips for Pain-Free Vaccine Administration

Pain-free injection administration is possible and will likely impact the patient’s willingness to follow their physician’s immunization recommendations in the future. Consider these five tips the next time you’re giving an injection.

1 | Location, Location, Location

Each time an injection is given, the area must be landmarked. The needle must enter the right location to avoid nerve damage or accidentally inject directly into the bloodstream. You can’t identify the deltoid muscle in the arm or accurately inject the quadricep in the leg without first measuring landmarks.

2 | Size and Length of the Needle

Choose a needle length that reaches into the muscle without hitting the bone. The length of the needle will differ for a bodybuilder vs. an 85-year-old housebound woman with little muscle development. The size of the needle also has an impact on the patient’s pain response.

Select the smallest needle bore that is large enough to comfortably deliver the medication. When in doubt, the institution’s pharmacist is a good resource.

3 | Room Temperature and Given Slowly

Bands recommends that medications known to irritate the tissue should be given at room temperature and injected slowly. This helps decrease the patient’s pain response. Most biologic medications are stored near 40 degrees Fahrenheit. Injecting cold medication increases nerve stimulation and pain. Injecting medication slowly helps the tissue to absorb it and not create a fluid pocket.

4 | In and Out Quickly

When the medication is not irritating it is the needle that causes the most discomfort. Sharp, small bore needles cause the least pain. The objective is to insert the needle quickly, inject the medication slowly, and remove it quickly to reduce the impact on the sensory nerves. Bands described the technique like using a dart.

5 | Distraction Is Key

Patients who are focused on the needle and watching the shot go in tend to experience more pain. Nurses can use mechanical and auditory distraction techniques when administering injections. Sometimes applying them simultaneously is the best technique.

“Distraction helps to lessen the pain as the patient is not focused on the vaccine being administered. My advice is to talk to patients about the weather, something popular on TV, or the news,” Garman said.

Experts have also shown that mechanical distraction, such as skin tapping or deep muscle pressure, can help distract the body from the pain response.

Giving Shots to Children

Giving injections to children has its own unique challenges. Children may not only have needle fear, but likely don’t decide to get an injection. This puts them in a position of being out of control. Parents can help by preparing their children before an office visit where they may get a shot.

Nurses can coach parents to explain the procedure with neutral terms, such as “poke”, “pinch”, or “pressure” instead of “pain” and “shot.” Children should be allowed to express their fear and feel heard. At the time of the injection, nurses can show parents how to hold their child so there is minimal movement during the injection.

“The child should never be restrained, but we want to ensure they are safely receiving the vaccine, and the healthcare professional is safe while administering the vaccine,” Garman notes.

“Giving an injection to a child can be as anxiety producing to the person giving it as it is to the child receiving the injection,” says Band. Children are also a moving target and nurses often have a small window of opportunity to give the injection appropriately.

She recommends preparing the medication before entering the room and keeping it out of sight while a parent distracts the child. “Right needle, right location, and being quick, in and out, are key things to consider when giving a child a vaccine or injection,” she said.

By Jenny Englerth

It is not an exaggeration to say that as a society, we are failing to keep our children healthy. Parents and caregivers do their best but the systems that support children’s health are poorly designed and under-resourced. School health education programs are being slashed, mental health needs are growing, the obesity epidemic is not improving, and pediatric vaccination levels are at a 30-year low.

What is happening in policy decisions on the national level is glaringly evident in our own communities.

As the president and CEO of Family First Health, I’m acutely aware of these needs. In York, where Family First Health is based, about 18 percent of children in grades K-12 are considered obese. The CDC says that number jumps to 26.2 percent for Hispanic and 24.8 percent for Black children, so it is a social justice and equity issue as well as a public health issue.

Obesity in children increases the risk for physical health issues like high blood pressure, high cholesterol, Type 2 diabetes, and asthma, while mentally it is associated with anxiety and depression. We can address these health risks and support our children if we, as a community, work in new and different ways with children and their families.

By providing early, hands-on education for students to make decisions that will positively impact their health, today and in the future, we can change the course at an individual and community level. Now is the time to act.

The last week in April marked Every Kid Health Week, which spotlighted the actions schools and families are taking to improve the health and wellness of their kids. Family First Health works with many school districts and specifically with the students and families of the School District of the City of York to improve the health of our children through our school-based health center at Hannah Penn K-8.

Our school-based health center team provides healthcare and health resources via our health center on the school campus, allowing students to receive medical attention from medical staff during the school day. We also have a health coach located in the school who educates students about smart eating habits, exercise, hygiene, and other health-related topics such as mental health, puberty, and sexual health and is responsive to the unique needs of the students in the school we serve.

Recently, the School District of the City of York identified an increase in vaping. Family First Health was there to step in and coordinate presentations on the risks of vaping along with alternatives for managing stress. When the school identifies a need, we are there to support them and offer our services and resources.

“The partnerships with FFH and other health agencies have provided key resources that allow trained professionals to speak to our students about health-related issues. It is an opportunity that many times parents and families miss due to a variety of barriers. The partnerships help to stop the cycle of misinformation as they are hearing information from trusted adults who are professionals in the building,” said Dr. George Fitch, Assistant Superintendent of Student Services for the School District of the City of York.

Our Hannah Penn Center is York County’s only school-based health center. The medical services include medical, dental, behavioral health, and community health programs. These are also open to the public – so a mom, making an appointment for her child, can be cared for at the same location.

While it’s great to discuss the benefits of these in-school health centers on student well-being, the numbers speak for themselves. In one study, just low to moderate use of school-based health centers by students related to approximately a 33 percent lower likelihood of them dropping out of school.

At a time when parents and policymakers are looking to make schools safer spaces for students, providing them with accessible resources for healthy living is one of the easiest ways to help them.

Jenny Englerth is the president and CEO of Family First Health.