MCH COMMUNITY BENEFITS

Monadnock Community Hospital Assessment of FY 2006 Community Benefits Plan

Monadnock Community Hospital will address identified health needs through the following seven initiatives during FY 2006:

Targeted population:

Uninsured and Underinsured patients of all ages.

Goal: 

To help eligible, uninsured and underinsured patients of all ages to receive needed prescription medications.

Community Benefits Action:

The Medication Bridge program will help eligible uninsured and underinsured patients access free or discounted prescription medications available through most major pharmaceutical companies.  A full time MCH employee and a part time assistant will be designated to help people work with their healthcare provider in applying for these medications.

MCH will provide office space, furniture and equipment at Monadnock Community Hospital for the Medication Bridge Program, as well as all support needed by the program coordinator.

MCH projections indicate that close to $1,000,000 of free or discounted medication benefits will be provided to our community through this program in FY 2006.

In addition to providing assistance with medication, the program coordinator is able to refer patients to the social services department when she determines there are outstanding needs for financial assistance or access to other community resources.

Assessment:

Prescription assistance program served 324 patients. 2,355 prescriptions were filled and $619,214 in medication was dispensed.   Cost to administer the program through Monadnock Community Hospital was $92,300 for FY 2006.

We attribute the decrease in program numbers from the prior year can to Medicare Part D.  Seniors are a large part of the population served by the medication bridge program, and the Medicare Part D program resulted in many seniors no longer being eligible for our program.  We are committed to the medication bridge program and are looking forward to focusing our efforts on younger populations that would be eligible for prescription assistance.

II.

Targeted population:

School-Aged Children, K-3 at Public Elementary Schools in Primary Service Area.

Goal: 

Monadnock Healthy Teeth will provide oral health care; education, preventive care, and restoration when needed.

Community Benefits Action: 

MCH’s comprehensive school-based dental program, Monadnock Healthy Teeth, serves the public elementary schools in the hospital’s primary service area.  The program includes classroom education, dental screening, optional fluoride rinse, and referral for cleaning and restorative care as needed.

By adding a part-time hygienist in FY 2006, we will increase our capacity to serve more children.  This school year we will be able to reach every grade school in the ConVal, Jaffrey-Rindge, and Mascenic school districts.  We have also brought the MHT program to a number of area preschools and head start programs.  In looking at expansion planning with this type of program, it makes sense for us to look at younger children, rather than expanding the program to older grades.  One of the first steps was to begin to include area preschools, which we started last year.  We have begun to form alliances with the local pediatricians office, the childbirth educators here at Monadnock Hospital, and have also had conversations with obstetric offices.  The earlier that we can reach children and their parents, in terms of education and helping with them with proper oral hygiene, the less decay we will see in the long term.

An Advisory Board that meets quarterly guides the program. The Advisory Board is made up of 12 community representatives including dentists and school nurses.

Assessment:

The Healthy Teeth accomplishments in FY 2006 include:

  • 1,703 students received in-school oral health education.
  • 661 students received in-school oral health screenings.
  • 298 students received in-school dental cleanings.
  • 65 students received sealants placed on their teeth.
  • 67 students were identified for referral to a dentist for restorative care.
  • 66 students were placed in a dental home.

Other program accomplishments:

  • Visited every school elementary school in the hospital’s primary service area, made possible with the addition of a part-time hygienist.
  • Worked with other school based dental program to help develop educational curriculums and best practices.
  • Visited many area preschools to present educational programming.
  • Participated in local Head Start programs, with complete programming from education to restorative care and placing the Head Start children in a dental home.
  • Continued to work with the Jaffrey-Rindge and Mascenic School Districts on a successful fluoride rinse program; actively working with the school board to implement the program in the ConVal district.
  • Enlisted the support of 3 additional local dentists in the program, bringing total to 18 dentists participating in the program.
  • Hosted 4 New Hampshire Technical Institute Dental Hygiene Students as part of their public health clinical rotation.
  • Presented education programming to both parents and children at the local family center, as well as other venues that we were invited to; mother’s groups, etc…
  • Participated in a number of local health fairs and community outreach programs.

III.

Targeted population: 

At-risk populations in the Community.

Goal: 

To pilot a teen health clinic.

Community Benefits Action: 

Monadnock Area Teen Health (M.A.T.H.) was programmatically developed in FY 05.  The program will open its doors in FY 06.

M.A.T.H. is housed in The River Center on Concord Street in Peterborough and is open to all teens in MCH’s primary service area.  Teens access the walk-in clinic for confidential appointments from 3:30 – 6:30 p.m. every Monday.  The Clinic will be staffed by a pediatrician (employed by Monadnock Pediatrics, an MCH owned practice) and a registered nurse.

M.A.T.H. provides health education, treatment and referral for teen health issues including; nutrition & diet, depression, exercise, stress, alcohol & drug use, and reproduction.  Walk-ins from teens who do not have a primary care provider are anticipated.  Our physician in the clinic will promote the importance of having a PCP and will provide teens with referral to a physician’s office.

A $5 donation is suggested for each walk-in visit to the clinic.  A pediatrician at MCH who is passionate about adolescent health volunteered to staff the program at no cost to MCH for the first 6 months of the programs operation.

Assessment:

The MATH program was up and running for 6 months in FY 2006.  In those six months of operation we saw 12 teens come through the doors.  We were disappointed in how little traffic that we saw, so a decision was made to close the doors at the current location on Concord Street.

In reviewing what we could have done differently to make this program a success; we’ve come up with a number of ideas.  We feel that the location was inappropriate and not accessible for students.  Another obstacle was that we were only open one night per week, and we need to be open more.  We are committed to this program, and there are clinicians willing to volunteer their time for the program.  We are actively looking at alternative venues to operate, such as the local high school.  There are more challenges associated with operating in the school environment, but we feel it will be more successful the closer we are to the teens.

IV.

Targeted population:

Low income, working poor and elderly citizens.

Goal: 

To promote access to needed health services through Monadnock Community Hospital’s financial grant program and Social Service Department.

Community Benefits Action:

MCH’s financial grant program will help ensure that all individuals are treated with respect, that patient information remains confidential, and paperwork will be kept to a minimum for patients applying for financial grants.  Any person applying for a financial grant will do so through MCH’s Department of Social Services.

A patient is eligible for a 100% discount at 200% of the Federal Poverty Guidelines and a sliding fee up to 400% of the Federal Poverty Guidelines.           

The social workers at MCH will also assess if families applying for a financial grant may also benefit from additional services available in the community such as fuel assistance, food banks, etc.  The Department of Social Service at MCH will help these families’ access services from other community resources.

MCH projects that in conjunction with the Medication Bridge program; financial assistance in FY 2006 will increase to over $1,000,000.

Assessment:

In FY 2006, the MCH financial grant program processed 656 cases for financial grant assistance.  A total of  $1,438,680 in charity care was awarded to low-income individuals.

We have also created a liaison between the Financial Grant Coordinator and the Medication Bridge Coordinator so that the two are working more closely together.  This allows for greater efficiencies and well as an additional tool for identifying those in our community that may be in need of assistance.

V.

Targeted population:

All Women

Goal:   

To increase access to basic preventive screening exams for women

Community Benefits Action: 

MCH will create a central access point for women to receive annual breast exams as well as PAP/pelvic exams for breast and cervical cancer.

We will continue and expand the “No Woman Left Behind” program.

Assessment:

In FY 2006, 69 Women participated in the “No Woman Left Behind” program.  The maximum number of women that can be cared for through this program is 70.  Women who fell outside of the financial criteria are referred to the Financial Grant program.

VI.

Targeted population:

All Citizens

Goal: 

Enhance access to primary care providers. 

Community Benefits Action: 

MCH will continue its effort to recruit hospitalists, internal medicine and family practice physicians.  Recruitment will continue for general surgeons.

Assessment:

During FY 2006 a number of specialty physicians were added to the MCH medical staff; the following providers will enhance our primary care offerings; Stephan Coffman, M.D. (Monadnock Surgical Associates) and Joseph DeVera, M.D., (Hospitalist). Recruitment efforts continue for 2 more internal medicine doctors, behavioral health practitioners, as well as a general surgeon.  We have a very talented general surgeon, Edward Checkan, M.D., working temporarily at MCH – it is our hope that he will chose to stay and practice here. 

VII.

Targeted population:

All Citizens

Goal: 

Strengthen the local EMS system 

Community Benefits Action: 
MCH plans to strengthen the local EMS system in FY 2006 in the following ways:

  • Recruit and retain EMS volunteers and help stabilize volunteers groups in primary service area. Enhance public recognition of volunteers through annual party, other events.  Create space in or near MCH’s Emergency Department for EMS staff to do paperwork.
  • Ensure adequate continuing education for EMS volunteers. Establish schedule of classes, support instructors.  Work with area chiefs to determine class type and need.  Allocate some Emergency Department’s Medical Director’s time for instruction.  Consider bringing EMS trainees into the Emergency Department for hands-on instruction.
  • Explore cost of full paramedic intercept program and the cost of an incremental approach. Meet with town officials in primary service area re: budget allocations to help support establishment of intercept program.

Assessment:

  • In May 2006, MCH hosted its second annual EMS appreciation and recognition dinner.  This event was held at the Monadnock Country Club and attended by nearly 100 EMS volunteers serving the towns in our primary service area.  Two awards were presented; the EMS Provider of the Year, and EMS Unit of the Year.  Brass plaques with the recipients’ names are displayed in MCH’s emergency room.  Each year, the awardees will be added to these plaques.  This was the second year we have done this event, and we have found it to be a very successful tool in thanking our EMS providers and providing them with some recognition.
  • In 2006 Monadnock Community Hospital held 27 EMS Continuing Education Courses totaling 94 Hours of actual classroom time (prep time not included).  Of those 94 Hours, the Emergency Department/EMS Medical Director actually taught (not including prep time) was 6 Hours.  The option of the EMS providers coming into the Emergency Department to practice is available to them.  This year, only 1 practicing provider has taken advantage of this.  However we did have approximately 55 EMS students come into our Emergency Department to do a total of 625 hours.  In 2007, at the request of local EMS and Fire services, we will be hold monthly continuing education for AND quarterly 8 hour Saturday Continuing Education courses.   Our EMS Coordinator has extended his services to area agencies.  Presently on a monthly basis, he does the continuing education for the Temple Fire/Rescue.
  • Improvements have been made to streamline the processed in the Emergency Department.  These improvements were designed to facilitate the paperwork process for EMT’s when they are at the hospital.