In the News

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.

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.

ADAMS COUNTY, Pa. (WHP) – One community health program is looking to address higher mortality concerns among low-income women who feel unseen and unheard by the healthcare system. Organizers say a lot of falls back on accessibility.

“As a first time parent, you have no idea what you’re doing and you’re scared,” Hailey McKee told CBS 21 News’ Samantha York.

McKee gave birth to her daughter, Penelope, 15 months ago. She was immediately hit with the harsh reality so many other parents are facing: inflated expenses.

“$27 for a big pack of diapers that might last you a month,” McKee explained. “And that’s generic brand.”

Rising costs are straining young families. Baby formula spiked 30% in the last three years, according to the U.S. Bureau of Labor Statistics. Wipes are up over 10% in price.

“How am I going to be able to do this?” McKee questioned when she learned she was pregnant.

McKee turned to Family First Health’s Nurse-Family Partnership program, which promotes health equity.

“We’re meeting these women in the places where they need it the most,” Nurse-Family Partnership Program Manager and Nurse Supervisor Lisa Lathrop explained. “When they can sometimes feel the most vulnerable.”

In Pennsylvania, over 24% of counties don’t have full access to maternity care, according to the Pennsylvania Department of Health. It leaves nearly 200,000 residents in need of support.

“Even though I was working, I mean, we still didn’t have much,” McKee recalled.

“Young women, in particular, I think often times women who are living with lower income, they feel very unheard and unseen in their health appointments,” Lathrop continued.

“I think a lot of times with the healthcare system that you’re just left to figure it out on your own,” McKee said.

Nurse-Family Partnership recognizes a lack of health coverage keeps low-income parents from the care they need. Instead, they’re meeting them where they are: at home.

“They’re always there,” McKee said.

“Being that we only serve first-time pregnant mothers who meet income guidelines, we’re serving people who we can make the biggest difference in their lives,” Lathrop added.

The program connects expectant mothers to a registered nurse, free of charge, who becomes their personal healthcare provider and guides them through pregnancy and the first two years of the child’s life.

“I feel like it gave me confidence, even when I was in one of my darkest times,” McKee explained. “Because you’re in survival mode.”

“They’re more motivated to provide a better life for their own child than what they might have had when they were a child,” Lathrop said.

The community health program also refers parents to other support groups to help the family become economically self-sufficient.

“Having them get a car seat for me and, you know, stuff my car full of clothes was like a huge weight off my shoulders,” McKee recalled. “Because I felt like a bad mom.”

Those behind the program say it enables those stuck in a healthcare gap to feel seen and heard.

“They have felt empowers to ask more questions of their healthcare providers,” Lathrop explained.

“You have to be your own advocate,” McKee said. “And just keep going at them until somebody hears you.”

Those interested can contact the program’s team at 717-843-6330 or 717-916-4099. They can also email dcaraballo@familyfirsthealth.org or clathrop@familyfirsthealth.org.

More information about the program can be found here.

Watch the video here

YORK COUNTY, Pa. (WHP) – According to the World Health Organization, the U.S. has the highest mortality rate for mothers among high income countries. Black mothers are nearly three times more likely to die from pregnancy-related complications.

Family First Health is meeting expectant mothers in the places they need it most. Its Nurse-Family Partnership program connects mothers to a registered nurse for support through their pregnancy at no charge.

Those behind the program say a lack of health coverage is often a barrier for low-income parents to get the care they need and they often feel unseen and unheard by the healthcare system.

“Being that we only serve first-time pregnant mothers who meet income guidelines, we’re serving people who we can make the biggest difference in their lives,” said Nurse-Family Partnership Program Manager and Nurse Supervisor for Adam and York City Lisa Lathrop.

Nurse-Family Partnership services include:

• The support to have a healthy pregnancy and healthy baby
• Board Certified Lactation Consultants and Certified Lactation Counselors on Staff to help with breastfeeding
• Certified Car Seat technician to assist with safe car seat installation
• Spanish speaking in-home interpreter
• The ability to learn and practice things that make you more confident as a mom, like breastfeeding, nutrition, child development, safe-sleep techniques, and much more
• Referrals for healthcare, childcare, job training, and other support services available in your community
• Support to continue your education, develop job skills, or follow your dreams for the future

Women who are pregnant with their first child, pregnant 28 weeks or less and meet income requirements are eligible.

In the Nurse-Family Partnership program, nurses are available until the child is two years old.

Those interested can contact the program’s team at 717-843-6330 or 717-916-4099. They can also email dcaraballo@familyfirsthealth.org or clathrop@familyfirsthealth.org.

More information about the program can be found here.

Watch the video here