The Governor of Illinois, Pat Quinn, has officially declared January Cervical Cancer Awareness Month. It is predicted that 590 women in Illinois will be diagnosed with cervical cancer this year while 180 women will lose their life to the disease. All women are at risk for cervical cancer but it occurs most often in women over 30 years of age. The Human Papillomavirus (HPV) is the main cause of cervical cancer.

With routine screening and follow up, cervical cancer is highly preventable. Early detection through routine screenings will help to increase the chances of survival. The Illinois Breast and Cervical Cancer Program (IBCCP), which is offered at Erie Family Health Center, provides free mammograms, breast exams, pelvic exams, and Pap Tests to uninsured women. IBCCP has provided 17,908 cervical cancer screenings to uninsured women in the past fiscal year. Throughout January, public and private organizations and state and local governments throughout the country will promote education about cervical cancer causes, screenings, and treatments.

Erie Teen Center’s Comprehensive Approach and New Walk-In Services

Not many will argue that teenage years can be a very confusing time in a person’s life. No longer a child, but not quite an adult, teens consistently performing a balancing act between these two worlds. Peer pressures from the media and social groups also can become an obstacle in a teen’s life. For teens in need of somewhere turn, Erie Teen Center becomes a haven of support and information for adolescents trying to mull their way through this challenging time.

Erie Teen Health Center has been in operation for over 25 years. It is the only freestanding, comprehensive teen health center in the Chicagoland area. While most adolescent sites only offer family planning services or care for young women, Erie Teen Center offers a multitude of services for young adults ages 12 to 24, including reproductive care, well child care, school and sport physicals, behavioral health services, health education and case management. The response from the teen patients has been overwhelmingly positive and most patients hear about Erie Teen Center through word-of-mouth. Last year alone, Erie Teen Center provided over 6,000 patient visits.

While adolescents and teens tend to be a healthy population in general, they also are a group who is more likely to participate in high risk behaviors—yet teens have the lowest rates of accessing preventive health care. “This is a critical point in their development, and many adolescents are not seeking care,” says Amy Valukas, site director of Erie Teen Center. “Studies have found that preventive, primary, reproductive and behavioral health services that are matched to teens, with a focus on reducing high-risk behaviors, have the potential of improving the health of young people.” From the moment teens enter Erie Teen Center, everyone from the front desk staff, to the nurses, medical assistants and providers are educating these teens about reducing risk behaviors and promoting good self care.

Amy says the overwhelming support teens receive from the staff encourages teens to come to Erie Teen Center and most importantly, what keeps them coming back. “Studies have found adolescents are more likely to access health care when their confidentiality is assured, they are shown respect, providers are non-judgmental, health care is provided in a teen-only setting and they are given time discuss their concerns” says Amy. Amy also highlights the Erie Teen Center staff as another source of comfort and compassion for the teen patients. “Erie Teen Center staff is committed to providing just that – comprehensive, confidential, low or no-cost teen friendly care.” Other services, such as case management, Centering Pregnancy and Parenting programs for teen parents and even text message appointment reminders all consistently ensure teen patients they are supported in their health care.

Erie Teen Center is excited to offer a new service to its patients: walk in services. Walk in services are now available for patients between the ages of 12 and 19.  These services include pregnancy testing, rapid HIV testing and STD testing, are offered every Wednesday from 2 pm to 6 pm and do not require an appointment. Considering many of these young adults are navigating the health care system for the first time, walk-in services offers them the flexibility they need and reduces barriers to accessing quality health care. Besides pregnancy, HIV and STD testing, services will also include comprehensive education on reducing high-risk behaviors in the future. Teens also will be educated on how to access future care through scheduling an appointment.

There are a lot of complexities that encompass a young teenager’s life, but because of places like Erie Teen Center, accessing quality health care isn’t one of them. Erie Teen Center is more than just another health center. It is a place of support and compassion, made up of people working tirelessly to meet the needs of every aspect of a patient’s health.

This month Erie was presented with a check for a grant we received from the Aetna Foundation for the Henson Wellness Program at Erie Henson School-Based Health Center. The support from Aetna will allow Erie to provide the Henson Wellness Program to directly help reduce childhood obesity through three types of innovative programs: 1. BodyWorks afterschool program, 2. Building Active Lives Around Nutrition Centered Education (BALANCE) classroom-based curriculum and 3. Henson Garden Initiative.

The BodyWorks program will provide obese or overweight girls with the tools/strategies to improve eating and exercise habits. The BALANCE program will help children incorporate good nutrition and physical activity into their daily lives. The launch the Henson Garden Initiative will increase knowledge of nutrition while engaging children in physical activity by planting and maintaining a garden at Henson Elementary. All three of the programs are important to help children live healthier, happier lives. Thank you Aetna!

Beats this week:

1) Over the summer, many children who normally received free or reduced lunch from their school now find themselves with less to eat. Check out this great story about some local food pantries that are attempting to meet the need to feed Chicagoland children during the summer. And the bonus is that they are super healthy lunches!

2) Today, Health and Human Services Secretary, Kathleen Sebelius announced a new $250 million investment that will aim to develop new medical providers. This program, which was created using Affordable Care Act funds, will help ease the shortage of primary care providers by training and developing nearly 16,000 new medical providers over the next five years.

3) More sad news for the state of Illinois: for the second time in a little more than a week, the credit rating for Illinois has been downgraded due to the state’s inability to balance the budget. Currently, the only state with a worse rating than Illinois is California.

4)  In April, Health Beats reported on an announcement of a plan from the FDA that would reduce the amount of salt consumed by Americans. Well, nearly two months later over one dozen major US food companies have announced they will voluntarily reduce the level of salt in the foods they produce. That’s right, in the next few years you can expect to see the sodium levels decrease in Heinz ketchup!

5) Key delegations in the American Medical Association called for revisions to the AMA’s endorsement of health care reform this week. Specifically, these delegations would like the AMA to revise its stance on Medicare payment cuts, raise the doctor payment for Medicaid and enact sweeping liability reform.

The idea of just handing out health insurance to those in need of it seems wonderful.  Unfortunately, it isn’t that simple.  In a way, it’s like giving everyone in Chicago a free CTA pass for one day.   You may have the means to ride the El, but if the train is full, you’re not going anywhere.   The same idea goes for health care.  In April, Dr. Francis blogged on Beats Per Minute about the shortage of primary care doctors available to care for this surge of now-insured patients and how community health centers could be the new training ground for upcoming generations of primary care doctors.  Also back in April, Health Beats blogged about the upcoming physician shortage, as well as the possibility of reducing some of the restrictions on nurse practitioners to help lessen the blow of incoming health care demand surge.

Nursing Our Way Out

 Twenty-eight states are taking the same route in addressing the shortage of primary care physicians.  These states, which include Illinois, are considering loosening the regulations and restrictions of nurse practitioners (NPs) and expanding the types of services that NPs can provide.   The Patient Protection and Affordable Care Act, which was recently signed into law by President Obama, will bring nursing midwives to the same Medicare pay rate as OB-GYNs.  This new health care law will also give $50 million to nurse-managed health clinics that offer primary care to low-income patients, $50 million for hospitals to train advanced degree nurses to care for Medicare patients as well as 10% bonuses for medical providers, including NPs, who work in areas where physicians are limited.

 Recently, the National Nurse Act of 2010 has been introduced into the House.  This Act would create a “National Nurse” who would be nominated by the Secretary of Health and Human Services and would be equal in standing with the Deputy Surgeon General.  Regardless of whether or not this Act makes it all the way through Congress, it is still another piece of evidence that nurses are continuing to make head way in health care. 

The Other Side

Currently, laws vary widely across all states on what NPs can and cannot do.  Many states place doctors in charge of NPs, while Montana doesn’t require doctor collaboration with NPs in any way.  Also, some states bar the use of the ‘Dr.’ abbreviation for nurses who hold Doctorates of Nursing while a majority of other states allow it. 

The Macy Foundation, a New York-based non-partisan charity that focuses on the education of health professionals, recently called for NPs to be amongst the leaders in primary health care and urged the removal of state and federal barriers that keep NPs from being able to provide primary care. While acknowledging the need for additional health care providers, the American Medical Association (AMA), however, but does not see increasing the roles of NPs as a solution to the physician shortage. “A shortage of one type of professional is not a reason to change the standards of medical care,” said Dr. Cecil Wilson, the AMA president. “We need to train more physicians.”

Whatever the solution, the health care world does recognize the need for exponential growth of primary care providers over the coming years. Getting everyone a ticket to health care is only half the battle – getting them through the exam room doors is what’s going to be the tricky part.

Beats this week:

1) School vending machines could see a drastic change to their contents in the near future. A provision of the Children Nutrition Act passed by the U.S. Senate would allow for regulation of the food served in the school, as well as the vending machines. Crispy edamame, bananas and flavored organic water could be some of the items available in school vending machines.

2) Over ten days has passed since the Illinois Legislature adjourned without passing a budget for the state. So the question remains, what is left to be debated? Progress Illinois breaks it down for us here.

3) Researchers at Harvard released a study this week that claims exposure to pesticides may increase the occurrence of Attention Deficit Hyperactivity Disorder (ADHD) in children. Specifically, the researchers found that relatively low-level exposure to common pesticides –probably from residues on foods – doubles the risk of developing ADHD.

4) The Health section of the New York Times featured a story this week about a physicians group in Philadelphia that provides primary care using a patient and prevention centered model, called patient-centered medical homes. The overall theme of the article: changing the way primary care is provided is difficult and expensive but it is absolutely necessary.

5) The debate on whether cell phones cause cancer still continues this week with the release of a study funded by the United Nations, which had inconclusive results according to most experts. While the study did find a minimal link between cell phone use and a rare form of brain cancer, the researchers concluded that because cancer can take years and decades to develop – sometimes longer than cell phones have been around– it is difficult to completely ascertain all of the risks. And the debate continues…

Millions more to seek primary care by 2014

With the ink of President Obama’s signature barely dry on the Patient Protection and Affordable Care Act, a transformation is about to happen over the next decade.  For the first time in our country’s history, there will be a major effort to make health insurance available to almost all Americans – nearly 32 million will be added to the health insurance rolls. 

Most community health centers like Erie care for high volumes of patients without insurance (34% at Erie) or covered by Medicaid (62% at Erie). Medicaid is the federal-state partnership to provide health care coverage for those living at the federal poverty level or below.  Starting in 2014, some 16 million more people  will become eligible for Medicaid as the income limits to qualify are raised from 100% of the federal poverty level (about $22,000 per year for a family of 4) to 133% of the federal poverty level (about $30,000 per year for a family of 4). 

Where will 16 million more Americans seek health care?  Community health centers already serve almost 20 million Americans; over a million in Illinois and over 600,000 in the Cook County area.  Located in neighborhoods and towns which are some of the most medically underserved and economically challenged in the country, community health centers are perfectly positioned to expand services. 

Placing a brand new Medicaid card in the hands of millions will not solve the daily challenges people living in poverty face every day:  challenges in literacy, joblessness and lack of transportation.  Although the health care reform bill makes efforts to pay private doctors better for seeing Medicaid-covered patients, many private physicians, private physician groups and university-based practices do not accept or severely limit access for Medicaid patients.  A massive increase will be needed in primary care capacity at the community level. 

Overall, this is good news for community health centers.  Many health center patients who have no health insurance will now be eligible, either for Medicaid or for more affordable insurance through their employer or purchased on their own.  Let’s not forget, that another 16 million Americans will get on the health insurance bus through insurance exchanges, employer-based insurance and other means. 

More bricks and mortar are needed

The health care bill provides $11 billion in new funding for the health center programs over the next five years.  Health centers successfully competing for these funds will be able to expand.  Expect 20 million more people to access high quality, culturally competent behavioral, medical and oral health care at community health centers over the next 10 years – a doubling of the current capacity.

There’s not enough primary care work force

Currently, there simply is not enough primary care doctors and advanced practice nurses to meet the coming demand.  The health care reform bill provides funding for health centers to become teaching centers for the next generation of primary care doctors. Erie is already launching a training program sponsored by Northwestern McGaw Medical Center and Norwegian American Hospital.  Within 3 years, twenty-four family physicians-to-be will be in training at Erie.

Once physicians are trained, they need an incentive to work in medically underserved communities.  Many graduating medical students carry the burden of well over $100,000 in school loans.  The health care bill includes $1.5 billion over the next 5 years to expand the National Health Service Corps, a loan repayment program for doctors who choose to practice in medically underserved areas.  This initiative will place an additional 15,000 primary care doctors, nurse practitioners, dentists, and behavioral health specialists in communities of need.

Will community health centers vanish?

With the demand for primary care services increasing by 32 million over the next decade and low acceptance of Medicaid amongst healthcare providers, the need for community health centers has never been greater.

Push the throttle forward, fasten seat belts and get ready for take-off!

Beats this week:

1) Months ago, Beats Per Minute wrote about how health care reform would strain the already existing primary care shortage in the United States. This week, the Associated Press also discussed the issue.

2) Modern Healthcare featured the Thomson Reuters 100 Top Hospitals, which included Erie’s long-standing partner, Northwestern Memorial Hospital. Other Chicago hospitals recognized include Advocate Illinois Masonic Medical Center and Rush University Medical Center.

3) While Republicans vowed that they would repeal health care reform, it seems that most have backed off from that sentiment over concerns that it might negatively impact the GOP in the November elections.

4) What’s better than eating chocolate for fun? Eating chocolate because it might reduce your risk of having a heart attack or stroke! German researchers concluded this week that individuals who consumed around six grams of chocolate a day had a 39 percent lower risk of either a heart attack or stroke. The researchers stated, though, that it was too early to start making recommendations for individuals to consume daily amounts of chocolate.

5) H1N1 is still going strong in some parts of the country. This week, the CDC and Surgeon General reported that the Southeast, mainly Georgia, Alabama and South Carolina, are experiencing an uptick in cases of H1N1.

Beats this week:

1)  Today, the Chicago Tribune covered health care reform and its potential impact on low-income individuals in Chicago. Erie Family Health Center and other community health agencies were featured in the story by Judith Graham.

2) Four community health centers in Milwaukee received $1 million from GE to increase primary care services to uninsured and underinsured individuals. This is the second city to receive GE Developing Health funding – a three-year program providing funding to health centers.

3) According to a new report, one in four Californians under the age of 65 are without health insurance.  In the last two years, the state’s number of uninsured individuals has increased by nearly 2 million. Despite these alarming statistics, California does not actually have the highest rate of uninsured but follows closely behind Texas.

4) The story of health care reform continues to unfold. Currently, the Obama administration is putting the pressure on for House Democrats to give the green light on health care. Rep. Dennis Kucinich is the most recent Democrat to ‘flip’ their vote from ‘no’ to ‘yes.’

5) Public Health Officials in Lake County (northern Illinois) have partnered with local churches to make a final push for H1N1 vaccination. Read Beats Per Minute’s coverage on why it is still important to get vaccinated this late in the flu season.

Beats this week:

1) Over the weekend, patients began lining up before dawn at a dentist office in the Logan Square community of Chicago to receive free dental care. The annual event, which is hosted by Dentists With Heart, drew a line of several hundred people.

2) This week, the New York Times reported that after an extended quiet period, the U.S. is finally seeing a surge in medical schools. Could this be a response to the need for primary care providers? Beats Per Minute discussed this very issue last month.

3) Wondering why no one is talking about H1N1 anymore? The Centers for Disease Control is! The CDC says that H1N1 cases are down but reported that from April 2009 through January 2010, the U.S. saw 57 million possible cases, 257,000 hospitalizations and 11,690 deaths.

4) A study released this week found that over the last three decades chronic conditions have significantly increased in children. In fact, from 1994 to 2006 the percentage of children with chronic conditions, such as asthma, obesity and behavioral health issues, nearly doubled. The highest rates of chronic conditions were found in Latino and African American children.

5) It was announced this week that two Illinois universities will receive federal stimulus money to invest in electronic medical records technology. Last month, Erie Family Health Center completed the implementation of electronic health records at all of our nine sites. Read about it here!