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Community Peds Information for Med Students

COM PEDS - Info for 3rd Yr Med Students

Community Pediatrics
Information for 3rd Year Medical Students


With faculty pediatricians you will work directly with underserved children and their families, other agencies, and away from the Hospital.

THE AMERICAN ACADEMY OF PEDIATRICS STATEMENT ON COMMUNITY PEDIATRICS

  1. Pediatricians should use community data (epidemiologic, demographic, and economic) to increase their understanding of the health and social risks on child outcomes and of the opportunities for successful collaboration with other child advocates.
  2. Pediatricians should work collaboratively with public health departments and colleagues in related professions to identify and decrease barriers to the health and well-being of children in the communities they serve.20,21
  3. Pediatricians should become comfortable with an interdisciplinary collaborative approach and advocacy effort to child health. Pediatricians can play an important role in coordinating and focusing new and existing services to realize maximum benefit for all children.22,23
  4. Pediatricians and other members of the community should interact and advocate to improve all settings and organizations in which children spend time (eg, child care facilities, schools, youth programs). School and community resources should be considered as assets in developing strategies for the problems that children will face now and throughout their lives.
  5. Pediatricians should nurture and advocate for neighborhood structures that support healthy families capable of promoting optimal health, safety, and development in their children.
  6. Pediatricians should advocate improving the effectiveness and efficiency of health care for all children, striving to ensure that every child in the community has a medical home.
  7. Pediatricians should educate themselves concerning the availability of community resources that affect the health and well-being of the children they serve.
  8. Pediatricians are encouraged to become involved in the education of residents and medical students in community settings. Pediatricians have the unique opportunity to model roles outside the traditional clinical roles that students and residents encounter. Pediatric academicians should use resources from the AAP and the Ambulatory Pediatric Association to engage the community pediatrician as an educator, both in the care of individual patients in community-based practice and in roles related to promotion of the well-being of all children in the community. Community-based resources outside the bounds of the traditional hospital and outpatient office setting should be used to instruct residents in the effect of the community on child health status and the positive effect of interdependent collaboration of community agencies with health professionals on child health.

Medical student, resident, and continuing medical education programs should consider and periodically review basic community pediatric competencies to be included in training and maintenance of certification efforts for pediatricians.

PEDIATRICS Vol. 115 No. 4 April 2005, pp. 1092-1094 (doi:10.1542/peds.2004-2680

UNDERSERVED AMERICANS
From The Health Resources and Services Administration
Shortage Designation: HPSAs, MUAs & MUPs

The Health Resources and Services Administration Shortage Designation Branch develops shortage designation criteria and uses them to decide whether or not a geographic area, population group or facility is a Health Professional Shortage Area or a Medically Underserved Area or Population.
Health Professional Shortage Areas

HPSAs may be designated as having a shortage of primary medical care, dental or mental health providers. They may be urban or rural areas, population groups or medical or other public facilities.

As of March 31, 2009, there are:

  • 6,080 Primary Care HPSAs with 65 million people living in them. It would take 16,585 practitioners to meet their need for primary care providers (a population to practitioner ratio of 2,000:1.
  • 4,091 Dental HPSAs with 49 million people living in them. It would take 9,579 practitioners to meet their need for dental providers (a population to practitioner ratio of 3,000:1).
  • 3,132 Mental Health HPSAs with 80 million people living in them. It would take 5,352 practitioners to meet their need for mental health providers (a population to practitioner ratio of 10,000:1).

Medically Underserved Areas/Populations

Medically Underserved Areas (MUA) may be a whole county or a group of contiguous counties, a group of county or civil divisions or a group of urban census tracts in which residents have a shortage of personal health services. 
Medically Underserved Populations (MUPs) may include groups of persons who face economic, cultural or linguistic barriers to health care.

The Centers for Youth and Families

PROGRAMS & SERVICES

Centers for Youth and Families provides an extensive continuum of mental health care for children ages 3-20 along with prevention services and a wide variety of resources for parents.

Outpatient clinics in Little Rock and Jacksonville provide treatment services for children and youth who are experiencing emotional or behavioral problems. Clients can receive individual, family and group therapies as well as psychiatric consultation, evaluation and medication management.
School-Based mental health services are provided in many area schools providing better access to needed treatment for children experiencing emotional or behavioral problems.  The professional staff are able to help in linking interventions across home and school.

Therapeutic Family Homes Program recruits, trains and approves families to serve as therapeutic foster parents for emotionally and behaviorally disturbed children and youth.  Children are placed with specially trained families who can provide intensive support and supervision for children in a home/community based setting.  Additional services provided include individual, family and/or group therapy, crisis intervention, case management, psychiatric evaluation/consultation, medication management, and advocacy services.

The Emergency Shelter provides immediate temporary shelter to youth in crisis age 8 - 18.  The shelter provides a stable environment as well as safety and compassionate support for youth who are in state custody or are considered homeless or runaways.

The Transitional Therapeutic Living Center provides comprehensive mental health services, 24 hour a day staff access and transportation to adolescents between ages 15-21 with the goal of helping them become self-sufficient.  Staff supervises youth in a home-like setting with program rules and guidelines, incentive programs and behavioral programming.

Day Treatment allows children and youth with social, emotional or behavioral problems, who can no longer function in a regular academic setting, continue their education and learn to succeed in an academic environment.  Referrals are made by the school district in which the child is enrolled.
Residential Care is available for children and youth who have serious emotional or behavioral problems and have not responded to outpatient services.  These children continue their education and are given intensive help through our residential programs. The Elizabeth Mitchell Children’s Center treats children ages 5-11 and also has a specialized track for children with sexually reactive behavior.  The Elizabeth Mitchell Adolescents Center treats youth ages 11-17.

Community Support Services are designed to coordinate and plan for community-based services for children and adolescents with severe emotional disturbance and their families.  The consumer/family case manager relationship is primary and essential and community integration/reintegration is fostered by assertive outreach.

FOSTER CARE

PRESS RELEASE
Dec. 18, 2008

Contact:
Tara Manthey
Communications Director
501-786-7378 mobile
This email address is being protected from spambots. You need JavaScript enabled to view it.

Child Welfare System Shows Little Improvement

DCFS lagging in starting cases in timely manner, AACF analysis shows

LITTLE ROCK - Arkansas children at risk of abuse or neglect are waiting longer for help from the state Division of Child and Family Services, according to an analysis of performance indicators by Arkansas Advocates for Children and Families.

The annual report found that after a few years of improvement, the division fell further behind in quickly starting investigations after receiving reports of abuse or neglect. "Waiting for Helping Hands: An Analysis of the Arkansas Child Welfare Crisis" is AACF's fourth annual report on the child welfare system.

"We found that the system charged with protecting abused or neglected children has shown little improvement in the past year," said Jennifer Ferguson, AACF Deputy Director. "This is especially worrisome given the deaths this year of children in protective custody. We worry that many children aren't safe."

Among the findings:

  • Between March 2008 and June 2008, the number of investigations initiated within 72 hours of a report dropped from 81 percent to 65 percent. The division's goal is 95 percent.
  • In cases where a child remained in the home, child welfare workers visited those children at least monthly only 53 percent of the time. This rate is up from 46 percent in 2007, but is still far below the division's goal is 80 percent.
  • Child welfare workers performed an assessment of a child's safety and home situation in a timely manner only 43 percent of the time. This is an improvement from 35 percent in 2007, but still falls short of the division's goal of 80 percent.

The indicators examined are from the 2008 state fiscal year, which ended in June. Since that time, Gov. Mike Beebe and the Department of Human Services have begun to address some problems through key leadership changes, an increased emphasis on accountability and moving more resources to local offices, Ferguson said.

"The governor has said the child welfare system is a top priority," Ferguson said. "We hope he maintains that commitment as the economy worsens, because it's expected that more children will enter the system as families are destabilized and stretched to the limit."

Among the AACF recommendations for immediate consideration:

  • DCFS must initiate action on cases sooner and provide more intensive services to families within the first 30 days of a case opening, so families can get the services they need to care for children and keep their children at home.
  • DCFS workers must be able to devote sufficient time to each case. Caseloads per worker should be reduced from the current average of 28 per worker. The ideal average is 15 per worker.
  • DCFS should strive to ensure that county supervisors use data reports to promote greater accountability among staff, reward achievements and better monitor deficiencies.

Arkansas Advocates for Children and Families is a statewide, non-profit child advocacy organization established in 1977. Our mission is to ensure that all children and their families have the resources and opportunities to lead healthy and productive lives and to realize their full potential. On the web at www.aradvocates.org.

Finding a Family for a Lifetime: Aging Out of the Foster Care System

At the website:
http://www.aradvocates.org/research/publications_category.asp?id=1

COMMUNITY HEALTH CENTERS

Mid-Delta Health Systems, Inc.
Established: 1977
Counties in Service Area:
Monroe, Prairie, Arkansas, Phillips (portion)

Mission:

The Mission of Mid-Delta Health Systems is: 1. to improve the quality of life for the population within our scope of operation; 2. to provide accessible, high quality, comprehensive primary health care; 3. to promote health and safety through education; 4. to protect the dignity and rights of each patient; and, 5. to maintain a safe and professional environment for staff and patients.

Services:

Provide comprehensive primary healthcare services to the entire family. Services include primary medical, dental, mental health and preventive health services. Services may vary at health center locations. A representative from each health center location can provide additional information regarding local services.

Insurance:

Mid-Delta Health Systems, Inc. accepts patients on Medicare, Medicaid, private insurances, and uninsured based on a sliding fee scale.

Locations:

Mid-Delta Health System, Inc.
401 Midland
Clarendon, AR 72029
Phone: (870) 747-3381

WRITTEN ASSIGNMENT

Based on the week’s experience, write the following, with sufficient length and synthesis-

YOUR definition of ‘community’

Three things you learned about children, community, and health (NOT “I learned to look at TMs”)

Using this Federal Health Resources Services Administration website determine the status of your hometown or local zip code and Clarendon Arkansas

Determine the population and income of your hometown and Clarendon using www.Census.gov

Using this Federal Health Resources Services Administration website determine the status of your hometown or local zip code and Clarendon, Arkansas

 http://datawarehouse.hrsa.gov/geoHPSAAdvisor/

 http://hpsafind.hrsa.gov/

Services and Information