In the News

No kid likes to get shots.

That’s something Dr. Hetal Petal has seen firsthand; from her patients and her own daughter.

“She always says ‘mommy, we can go to the doctor, but no shots,” Patel said.

That’s why Family First Health came up with a new way to teach kids about vaccines and why those shots are necessary. It’s a book called Little Heroes: Attack of the Galactic Grime. It’s an out-of-this-world story with an important earthly message.

“It’s a journey that we start – and it’s a long journey – and the book does that with all the stations,” Patel said. “We start in infancy and go all the way to 12.”

“They see these characters get these shots and realize ‘oh, they’re protected, so maybe it’s not so bad for me to get my shots and I’ll be protected, too,” said Lori Garman, manager of clinical services.

Garman and her daughter, Greta, were the creative forces behind the story.

Family First says routine vaccine visits waned during the pandemic and many are still not caught up yet. The book addresses the different types of shots, boosters and even the concept of herd immunity.

“It’s sort of like, ‘yes, we should do this so I am healthy, but I should also do this to protect everyone around me,” Patel said. “The book does a really good job of pointing that out.”

The book is available in English, Spanish and Haitian Creole.

“We felt it was pertinent to have it in all three languages,” Garman said.

You can pick up a free copy of the book at any Family First Health location. They also have an online version, which is interactive.

You can find the online version of the book here.

You can find more vaccine resources by clicking here.

Watch the video here.

Bright and early Thursday morning, as students filed into Hannah Penn K-8 for another day of learning, a small team transformed the school’s library into a mobile dentist clinic.

The initiative is part of Family First Health’s school dentist program, offering in-school dental care for all ages and grade levels. LaJuan Mountain, the vice president of dental services for Family First Health, said the clinic helps provide better accessibility to both students and parents who would otherwise be unable to visit the dentist.

“There was a barrier with parents not being able to get off work to get their kids into the office,” Mountain said. “So seeing them in a school setting prevents the parent from losing a day at work, and it prevents the child from missing a day at school.”

In addition to closing the divide for access, Family First Health is working to change the overall dental culture in the York community.

Oftentimes, Mountain said, individuals might only see a dentist when something is wrong. The same goes for kids, too, when it’s often too late.

These routine screenings provide essential care to ensuring a child’s teeth are healthy and strong, she added.

Family First Health’s dental unit partners with a number of schools in York, Adams and Lancaster counties. On Thursday at Hannah Penn, the team had 176 scheduled services with students.

Nicole Tome, the school-based health center manager at Family First Health’s Hannah Penn Center, said the program is a wonderful way to provide essential care while missing little class time.

“Attendance is a nationwide issue for schools — and it’s no different here in York,” Tome said. “But when we have students here, we want them to be in class and learning. So mobile school dentistry events really cut down significantly on the time that students are away from their seats.”

The entire process takes roughly 20 to 30 minutes and includes dental screenings, cleanings, X-rays and a fluoride rinse. Health professionals will then use the data collected during exams to determine how often they should return to school.

If a student requires additional care — filling cavities for instance — Family First Health will schedule those appointments, too.

The cost of care is covered by the parent’s insurance. In instances where a family might not have insurance, though, Family First Health will work to get them insured.

This could mean being covered by state-funded insurance, for example, Mountain said.

Though being called down to get dental care at school might be an embarrassing situation for children, Tome said the kids often come out of appointments feeling confident and empowered.

“I think they’re more proud of the moment and they feel good about themselves,” Tome said. “I think it’s helping to boost their self-esteem and they leave with smiles on their faces because they know that they now know a little bit more about how to take care of their bodies.”

You can learn more about Family First Health and its programs at www.familyfirsthealth.org.

Watch the video here.

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.

By C. Lisa Lathrop RN, BSN, IBCLC, Program Manager/Nurse Supervisor Nurse-Family Partnership at Family First Health

August is National Breastfeeding Month, 2023

The breastfeeding journey should begin during pregnancy.

Expectant moms can and should prepare for breastfeeding before giving birth. There is much to learn and understand about the first few days and months postpartum. At Family First Health, we have the Nurse-Family Partnership (NFP) Program which supports moms to have a healthy pregnancy and healthy baby by partnering the mom with a personal registered nurse. This nurse offers support advice, and information in many areas and is available to the mom until the baby turns two years old.

Most nurses in the NFP program have undergone a certified lactation counselor training certificate which means they can support moms prenatally with education and then postpartum through feeding assessments and skilled hands-on assessments. We also have two International Board-Certified Lactation Consultants (IBCLCs) on staff who can help with complicated cases. There can be many barriers to a mom’s success with breastfeeding and we’ve found that educating the mom on those topics before they deliver increases the number of moms who choose to breastfeed and the length of how long they continue that breastfeeding journey.

Supply and demand

The first hours and days of a baby’s life are crucial to a mom’s milk supply. Early, frequent skin-to-skin can impact breastfeeding and how often the baby eats can also influence it. The frequency of feedings in those first few weeks determines milk supply months down the road. Some will misinterpret the baby’s cluster feedings and assume the baby isn’t getting enough milk during feeding sessions. Sometimes, this results in parents offering a bottle of formula instead of continuing with frequent feedings. If mothers are educated and know what is normal, they are prepared when the time comes.

Milk myths

Did you know milk supply can be influenced by the mother’s calorie intake or stress level? That moms burn up to 500 calories per day as their body creates milk? Or that a baby’s latch is not supposed to be painful?

Lactation consultants and IBCLCs can help moms navigate these topics. Many moms are seen by a lactation consultant while in the hospital, but ongoing education and support are invaluable. While breastfeeding has a longstanding place in history – it isn’t always easy and that is why support exists.

Community resources for all parents

Even if you’re not part of the NFP program, which requires a woman to be less than 28 weeks pregnant with her first child and meet income requirements, resources like WIC (Women, Infants, and Children) and private or public lactation consultants are available. Breastfeeding education classes, both online and in person, also offer valuable insights for expectant mothers. I encourage every parent to bring up the topic of breastfeeding early and often to their doctor during prenatal visits. Ask for educational materials, support or online classes the physician may recommend.

Education Is empowerment

If a parent chooses to breastfeed, they should have every resource available to support that experience. It is critical that they understand the changes in their body and how to help meet the needs of the baby. We are working at Family First Health’s Nurse-Family Partnership to bridge the knowledge gap and make breastfeeding a rewarding journey for every parent and every baby, but if someone is not in our program or in our service area, we want them to know they, too, can find resources to support them.

So, if you’re newly pregnant and seeking a nurturing community, consider these incredible avenues for guidance and care and know that Family First Health’s NFP community stands ready to uplift and empower you every step of the way.

Family First Health Gettysburg Center is located in the Marshall’s Plaza (formerly Peebles Plaza) in Gettysburg. The health center was launched in 2009 following a community needs study and initiation by Healthy Adams County.  Phone (717) 337-9400

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.