Downtown development and efforts to boost the city�s image point to renewed economic promise for Manchester.
But the city still suffers from its economic past.
In Manchester, 12% of all families with children under the age of 18 are in poverty. That�s almost twice the state average. 9% of all households make less than 10,000 dollars annual income. For 22 years, a nonprofit health care organization in Manchester has been working to provide a comprehensive menu of medical care for this underserved population. And some health officials say its unique model is one that all health care organizations should strive for. NHPR�s Lisa Peakes reports.
It isn't often that you'd think of a health care provider as a place to go for a cooking class or a theatrical performance.
BITE: �It happened when I was 17����
The Manchester Youth Theater is the very public face of Child Health Services. The teens performed for about 2 thousand adults and children last year. The members write their own skits on issues facing adolescents such as pregnancy and peer pressure, or suicide and self-esteem. The Manchester Youth Theater is just one way that Child Health Services tries to address public health in Manchester
BITE:��.it happened when I was just 17�
The more private face of Child Health Services is found at their main office on Elm Street.
AMBIENCE IN:
The clinic looks like many others - a waiting area with toys, brightly colored murals and a receptionist behind a sliding glass window. But a closer look reveals parenting magazines - in Spanish. Closer still, and one starts to realize that something special is happening here. It�s not often that a child rushes to hug his doctor:
AMBIENCE: (parent says �Dr. Deitch� - child says �ooooohhhh!�)
The Doctor is Selma Deitch, the pediatrician who founded Child Health Services, where the prevailing philosophy is that good patient care depends on a close relationship with the family.
BITE: " It's a model of care that things don't get lost....it's not just writing down: 'Child has earache. Amoxycillin. Here's the prescription" It means a lot of other things. Where are you going to get the prescription? How are you going to get there? How are you going to pay for it, and, by the way, did you notice he was a little sassy with his mother?'...those things are not built into an insurance plan..."
Doctor Deitch spent the early part of her career working in an emergency room where she kept seeing kids who didn't have a primary doctor, so she started Child Health Services. She set up clinics in North Conway, Charlestown, Exeter, and Suncook, but they didn�t last. Determined, she tried again in Manchester, and Child Health Services found a home:
BITE 24:20 "We had experience with the model. It was a great idea, because
it was not only the good ol' doc, but it was the nutritionist and the social
worker and much involvement with the nursing agency...and it seemed that it
was something that Manchester should be ready for"
Child Health Services opened its doors in 1980, and now serves about 12 thousand kids in the Manchester area. But not just any kids. Child Health Services treats kids from low income and uninsured families who meet certain qualifications for poverty. Sylvie Normand found herself without insurance and says that, without Child Health Services, she doesn�t know where she would have taken her kids:
BITE: �They told me, well, don�t worry about it. If you have no money, don�t think you can�t come to the doctor�s. We�ll take you anyways. I had no money for prescriptions and they took care of it. They paid for it so I wouldn�t go without. And other places wouldn�t do that.�
And it�s not as though Child Health Services rubber stamps its patients through the system with a once-a-year checkup and a booster shot. There�s a dental clinic, a media literacy program, workshops on bicycle safety, car seat safety, parenting and cooking classes, a snack program and a summer camp program. Doctor Sol Rockenmacher, the President of the New Hampshire Pediatric Society, says that Child Health Services is truly unique:
BITE: " I think Child Health Services really is the model for
what every primary care practice ideally should do - that is providing an
integrated system which meets not only the medical but the social and
emotional needs of families and children"
But this kind of comprehensive service is expensive. Child Health Services has an operating budget of just under 2 million dollars. The money comes from the United Way, the state, the city, several counties and numerous private contributions. Rockenmacher says Child Health Services does have an advantage over services that depend solely on reimbursement:
BITE: �It�s dollars. Practices would have to be compensated for those services. I think every practice, ideally, would like to do that, but it�s a matter of working out the finances�
It�s this ideal, says Executive Director Doctor Rob Nordgren, that allows Child Health Services to go above and beyond:
BITE: "I take care of one child who has..a disorder called neurofibromatosis, and
he has a brain tumor called an optic leoma. And we do things for this family
- for example, this child goes up to DHMC in Lebanon for chemotherapy
treatments. We will transport that family up there because they have no
means of transportation for themselves."
And Sylvie Normand says she was shocked when her doctor called to ask about the holidays:
BITE: �She called and asked me to choose 4 things that my kids would want for Christmas. And they each got 3 gifts, and she even gave a gift to my husband and I. I�ve never heard of a doctor�s office�I mean, my friends can�t believe it. They say �I want to switch� - They can�t believe that Child Health Services would do all that��
For NHPR, I�m Lisa Peakes in Manchester.
