Access to Care Project

Lane Community College

William Bennett
Scott Dawson
Shana Perkins

Assigned scenario:
Summer is a 15 year old sophomore at South Eugene High School. She is 5 months pregnant. She lives at home with her parents in a home near the corner of Potter Street and 21st Avenue. Summer and her boyfriend would like to keep the baby. Summer’s boyfriend Jake is talking about moving into Summer’s parents’ house but Summer’s parents are not so sure that they want Jake living with them. a. What prenatal resources are available to Summer? b. How much will prenatal care cost? c. Is it likely that Summer’s prenatal care and the baby’s medical care be covered by her parents’ standard medical insurance policy? What criteria, if any need to be met? d. What post-partum resources are available to facilitate Jake’ & Summer’s parenting skills? e. Summer would like to transfer to Churchill High School to participate in their child care program. What bus route will Summer need to take to get from her parents’ home to Churchill High School?

NOTE* Our group identified local medical coverage networks including Peacehealth, Oregon Medical Group (OMG) and Private Payer. We chose to gather data from OMG and assumed the insurance coverage of the parents covers services on an approved provider list limiting her to the OMG network.

Questions:

Community resources available to teen parents are numerous and qualification is based on availability of resources and the social conditions in the home. Summer lives with her parents, is enrolled in school and has insurance coverage that will pay for the birth of her child. If Summer did not have insurance, was homeless, was in an abusive relationship, or used drugs or alcohol that put her and her child at risk, she would be eligible for assistance through Lane County Public Health. Prenatal services are provided through Charnelton Community Clinic and it provides comprehensive care for women of all ages and cultures. Women receive prenatal care and maternity case management during their pregnancy, which includes education on the physical changes of pregnancy, nutrition, exercise, childbirth, infant health and parenting. Breastfeeding support and education and postpartum care are provided after delivery of the baby. (http://www.lanecounty.org) Another excellent resource for at risk children, including pregnant teens is Relief Nursery Inc. (http://www.reliefnursery.org) with two locations located at 1725 West 25th Ave. and at 125 East 8th street. Relief Nursery has operated in Eugene for over thirty years and is focused on working with families to promote child welfare while keeping the families together. The organization serves over 1000 families in the community each year. In addition, after the loss of the Birth to Three Program locally, Relief Nursery has partnered with Healthy Start of Lane County. This program provides weekly home visits, parenting education, and support to first-birth parents. The program is called Parenting Now and can be found at 86 Centennial Loop in Eugene or on the web at http://info.parentingnow.org. In my research I also learned that Summer would not qualify for services at Volunteers in Medicine and that our local Planned Parenthood does not offer prenatal care.

Summer is in her Sophomore year at South Eugene High School. She will Give Birth in January. I contacted the health clinic at SHS and was referred to the school counselor for information about the Teen Parent Program in Eugene School District 4J. I learned that the program, formerly located at Churchill High School in west Eugene, had moved much closer to her SE area home and is now housed in the Parker-Ellis Elementary site at 3875 Hilyard Street and was renamed 4J Young Parent Program. I met with Shea Donnelly who is the program supervisor and learned about how this program assists teens who become pregnant while in the Eugene school system. The first step for Summer is a meeting with her school counselor. During this meeting the counselor will offer her and her parents a referral to Julia Johnson, the Outreach Coordinator for 4J. If they accept the referral Ms. Johnson will contact the family with information about the 4J Young Parent Program and discuss other community resource options. Pregnant teens are automatically granted a transfer to the program if they wish to enroll. She will also receive an enrollment form for the state funded Healthy Start program locally. Parenting Now has a free educational program for Summer and Jake called the Young Parent Program. It is open to first time parents between the ages of 12 and 21. After their baby is born classes continue to be available based on the age of the child. The group program provides opportunities for Jake and Summer to meet other young parents and build community. This would also be a place where they could discuss their plans to live together in Summers parent’s home and receive advice and support in making this important decision. The couple is also eligible to enroll in the Incredible Infants course. New groups form each month and meet for 1.5 hours weekly over 10 weeks. Though they do not yet have their baby, this class would give them valuable experience observing new parents and babies and help to prepare them for caring for their child. In addition to or instead of Parenting Now classes, Summer could find information and resources online at www.info.parentingnow.org. The website is full of information and opportunities including a parenting helpline, drop in groups, archived register guard columns on parenting, breastfeeding information, a newsletter and a 2012 poster of community resources. The help line is staffed M-F 0900 – 1600 by trained parenting educators and is reached at 541-485-5211. Interestingly, the help line is staffed by United Way of Lane County. According to their website, “We convene and collaborate with partners from across the community - nonprofits, government, business, volunteers - to create opportunities for a better life for Lane County's most vulnerable residents.” http://unitedwaylane.org

Summer will continue with her classes up until she gives birth to her child. If she needs health care during the day she can receive it at her school health clinic. SHS does not offer prenatal care but they would be able to address symptoms such as pain, nausea or anxiety as well as psychological support through the school counselor. After delivery, because she needs child care to attend school, she will transfer to the young parent program at the Eugene Education Options campus to continue her education. The program offers a half day schedule three days a week and has a health center, child care center, access to a Certified Nurse Practitioner and Registered Nurse as needed. Curriculum includes high school classes in an alternative format and parenting education. Other on-site services include career counseling, personal counseling, academic counseling, meals, help with basic needs, Department of Human Services case management and door to door transportation.

Summer will receive her prenatal care through the Center for Women’s Health at 330 South Garden Way, North Building, STE 220 in Eugene. During her prenatal visits which will increase in frequency as the pregnancy progresses, she will receive routine prenatal care for the healthy development of the fetus and importantly, discussions with her physician about lifestyle and behavioral choices.

Summer may anticipate the costs of her prenatal care by contacting the Clinic for Women’s Health at Oregon Medical Group, 1200 Hilyard St, Ste 140, Eugene, OR, 97401, http://www.oregonmedicalgroup.com, 541 686-7007. I contacted the clinic and they outlined the following costs.
Labs $500.00
Ultra sound 1st tri $184.00
2nd tri $392.00
Hospital normal birth $4984.00
Hospital C Section $5,580
Total prenatal cost normal birth $6060.00
Total prenatal cost C Section $6656.00
These costs are low when compared to national averages. According to WEB MD http://www.webmd.com/baby/features/cost-of-having-a-baby, “When it all adds up, bringing your firstborn into the world can either break the bank if you don't have health insurance, or run the cost of a few important supplies if you do.”
Vaginal Birth $9,600
Uncomplicated Cesarean $15,800

It is not likely but it is possible that Summer’s prenatal care will be covered by her insurance. The following excerpt from the Washington Post reflects Summer’s likelihood of being covered by her parent’s insurance. http://www.washingtonpost.com/national/health-science/parents-insurance-covers-children-up-to-age-26--but-not-for-pregnancy/2012/08/06/2b59f160-6a2c-11e1-acc6-32fefc7ccd67_story.html. “Dan Priga, who heads the performance audit group for Mercer, a human resources consulting company, estimates that roughly 70 percent of companies that pay their employees’ health-care claims directly choose not to provide dependent maternity benefits.” If it turns out Summer is not covered by insurance she may call Oregon Mothers Care (541) 682-3926 to assist her in receiving Oregon Health Plan benefits. Her potential benefits are outlined on the web site. OREGON HEALTH PLAN, http://www.oregonhealthykids.gov. “Healthy Kids is a new program which offers more health coverage options to children and teens. The no-cost option builds on the success and expansion of the Oregon Health Plan for families who earn up to $46,300 annually. Due to the expansion, no child can be put on a waiting list or be turned away due to pre-existing conditions. To be eligible, a child must be uninsured, under the age of 19, live in Oregon and be a legal resident. Family income will determine whether the child qualifies for the no-cost, low-cost or full-cost option.
Enrollment Guideline Based on Family Size and Income No-Cost Low-Cost Full-Cost
Family of 2 $0 - $30,420 $30,420 - $45,552 $45,552
Family of 3 $0 - $38,376 $38,376 - $57,468 $57,468
Family of 4 $0 - $46,332 $46,332 - $69,384 $69,384
Family of 5 $0 - $54,300 $54,300 - $81,312 $81,312
Although there are exceptions, your child must have been without health insurance for two months prior to the date of your application for Healthy Kids. Exceptions to this waiting period include job loss or reduction in work hours, a child's serious medical need, if current or recent coverage is through COBRA, instances of domestic violence, very low income (less than $29,000 per year for a family of four), and other exceptions.” If it turns out that Summer is covered by insurance, one local company that does so is Pacific Source. http://www.pacificsource.com. 541 686-1242. Pacific source pays for the mother’s prenatal care and birth. They pay nothing for the grandchild/baby following birth and birth related expenses. The only conditions are that the insured be pregnant and age 26 or under. (end of questions a, b and c)
LTD Bus Routing

From: 21st and Potter
To: 3875 Kincaid
Nearest Bus stop - 19th and Patterson * Bus #28 – Hilyard St. (Summer will need to walk 8 blocks to the bus stop) * Bus Departs at 7:19 AM or if she misses that bus at 7:50 AM Transit time including walking, to the stop at her school is about 25 minutes

From: 21st and Potter
To: 330 Garden Way
Nearest Bus stop – 19th and Hilyard Bus #28 * Bus #28 to UofO station transit time 6 minutes * Transfer to the 76 Bus (20 to 40 minute wait time depending on the time of day) get off at 11th and Olive street and walk one block to the Eugene central station 4 minute bus ride and 5 minute walk. * Bus 13 from Eugene station – Centennial bus Transit from Eugene station to Garden Way 8-9 minutes

Total transit time including walking to arrive at her prenatal visits will vary with the bus schedule. Estimated travel time is between 1 hour and 1hour 15 minutes.