Year-Round Community Resources

These are only a few of the resources available in this community year-round. For more information on available programs, services, and resources, contact Nancy Thome, RAHS Care Coordinator at (734) 998-2208 or at ntthome@med.umich.edu.

Food Distribution
Back Door Food Pantry, 2309 Packard St, Ann Arbor, (734) 663-5858 – every Thursday from 4 – 7pm
Bryant Community Center, 3 West Eden, Ann Arbor, (734) 662-2449 – Washtenaw County residents can access food pantry, produce, etc.
Brown Chapel AME Church, 1043 W. Michigan Ave., Ypsilanti – Fridays from 11am – 12:30pm
Calvary Bible Church, 8318 Carpenter Road, Ypsilanti – 2nd and 4th Saturdays of the month from 10am – 12pm
Collaborative Outreach Board (Community Church of God), 565 Jefferson Street, Ypsilanti – 1st and 3rd Fridays from 12pm – 2pm
Emmanuel Lutheran Church, 201 N. River St., Ypsilanti – Mondays, Wednesdays, Thursdays from 3pm – 3:45pm
St. Andrew Episcopal Church, 306 N. Division, Ann Arbor – Saturdays from 7am – 8:30am.

Meals
St. Andrew Episcopal Church, 306 N. Division, Ann Arbor – Hot/cold breakfast every morning from 7:30 – 8:30am.
Emmanuel Lutheran Church, 201 N. River St., Ypsilanti – Hot dinner on Tuesdays at 5pm
Brown Chapel AME Church, 1043 W. Michigan Ave., Ypsilanti – Hot lunch on Fridays from 11am – 12:30pm

Necessities
Friends in Deed, 1196 Ecorse, Ypsilanti, (734) 484-4357 or office@friendsindeed.info (no walk-ins) – Emergency help for basic necessities (Washtenaw County residents)
HOPE, 518 Harriet, Ypsilanti, (734) 484-2989 – Food Bank, Weekend Meal Program (4-5pm), Wash with Care Program, Care & Share Closet, Baby Care Program
Ozone House, 102 N. Hamilton,Ypsilanti, 734-485-2222 (4-8pm, weekdays) – a safe place for youth ages 13-20; provides housing, employment, and education help, crisis intervention, counseling, and meals

Coordination of Care to Meet Your Needs

CARE COORDINATION SERVICES
At our RAHS Health Centers, we try to work as a team to meet all of the care needs of a student. Sometimes, this means our Nurse Practitioner is referring a student to our Registered Dietitian to help address nutrition concerns for a student, or they are referring to our Social Worker to help address emotional and mental health concerns for a student. To help make sure students are seen for all of their care needs, I help provide a link between our RAHS health providers as well as your student’s Primary Care Physician. A big area this takes place is Asthma – making sure your student has up-to-date spirometry to make sure their prescription is working and an asthma action plan in the event of an asthma attack.

VISION AND DENTAL SERVICES
One of the cool things RAHS does is provide students with vision and dental services at their schools during the school day! This is particularly helpful if you have transportation issues or are unable to take time off work to bring your child to a dentist or eye doctor. We help students who have insurance, including all Medicaid plans, and those without insurance. If you are not eligible for a new pair of glasses yet, but lost or broke your pair of glasses please contact us! We have dental services and vision services coming to each of the schools this fall. Please contact your RAHS Health Center or the RAHS Care Coordinator at (734) 998-2208 to find out when these services will be at your student’s school!

RESOURCES
At RAHS, we have a variety of Resource Sheets that include information on various “tangible” needs – where you can access them and how:

• Food Pantries/Meals
• Clothing/Household Items
• Transportation Services
• Housing Needs (Eviction/Homelessness)
• Financial Assistance and Education
• Utility Bill Assistance
• Vision Services – listings for various Medicaid insurances and uninsured
• Dental Services – listings for various Medicaid insurances and uninsured
• Primary Care Services – listings for various Medicaid insurances and uninsured
• Holiday Assistance
• School Supplies

RAHS staff can help! Please call the RAHS Care Coordinator at (734) 998 -2208 or email at ntthome@med.umich.edu.

Dinner Menu Planning

With the holidays approaching and families constantly on the move, having a dinner menu plan can help your family to eat healthier, skip fast food, and save time and money. Sit down with your family at the beginning of the week and plan out your week together. Don’t forget to account for any activities you have after school and/or work. Use these charts to help set your plan in motion!

Tips for planning:

• Try to let family members pick one night of dinner each week
• Make sure each meal contains vegetables or fruit, protein and a grain/starch
  Here are some examples:
  • Baked chicken, collard greens, and mashed potatoes
  • Pulled pork sandwiches (on rolls) and broccoli
  • Spaghetti, meatballs and salad
• Try to choose no more than 1 day a week for restaurants, take out or fast food
• Make a grocery list and shop before the week starts to have ingredients ready
• Some nights can be planned leftovers or quick meals. Try to pick nights that are usually busy like weekends or work nights etc.

If you have any questions about healthy meal planning for your family, RAHS’ registered dietitians are available at RAHS clinics for family appointments.

Immunizations and Preventive Care

There has been a lot of news and social media coverage about immunizations. The UMHS Regional Alliance for Healthy Schools (RAHS) follows the American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) guidelines for vaccination schedules.

Many children receive recommended vaccines in early childhood. But what about adolescents? The AAP recommends that adolescents receive the following vaccines:

• Human Papillomavirus (HPV): HPV can cause cervical cancer and genital warts. It is recommended that adolescent girls AND boys get immunized against HPV.
• Meningococcal Disease: According to the AAP, “While it can strike anybody, the greatest risk (for meningococcal disease) is in individuals between 15 and 21 years of age”
• Tetanus, Diphtheria, and Pertussis: The AAP recommends that the first Tdap vaccine should be “given at age 11 or 12. People who did not get Tdap at that age should get it as soon as possible. Tdap is especially important for health care professionals and anyone having close contact with a baby younger than 12 months. Pregnant women should get a dose of Tdap during every pregnancy, to protect the newborn from pertussis. Infants are most at risk for severe, life-threatening complications from pertussis.
• Influenza (Flu): “Flu is a contagious disease that spreads around the United States every winter, usually between October and May. Flu is caused by influenza viruses, and is spread mainly by coughing, sneezing, and close contact. Anyone can get flu, but the risk of getting flu is highest among children.”

Don’t forget to wash your hands often! Wearing a mask while you are sick can help prevent spreading the flu.

For more information visit www.aap.org/immunization.

Do you have questions about immunizations? Talk to your RAHS care provider at your RAHS school-based health center! We are happy to answer all of your questions and address any concerns.

Dialectical Behavior Therapy

RAHS Scarlett Middle School this past year piloted an exciting therapy group that incorporated actors from Wild Swan Theater. The project was funded through MDCH and a Medicaid matching grant. The group met for 20 sessions throughout the course of the year and learned DBT (Dialectical Behavior Therapy) through interactive activities. DBT is a therapy model focused on building skills of mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance. Our approach in using actors is based off the knowledge that adolescents are here and now people and often need to experience in order to understand. We felt using role plays and scenarios would increase investment and likelihood our students would retain DBT skills.

Actors Sandy Ryder and Jenn Book Haselswerdt from Wild Swan Theater did an amazing job of making our group active and lively. The group loved the warm-up theater games like Kitty Wants a Corner where people have to swap chairs through eye contact and taking risks without the kitty getting their seat. Group members progressed to able to write scenes relevant to their life and act them out, editing and changing the scene to reflect DBT skills they had learned.

A highlight of the group was this past spring they presented in front of 300 health professionals at the Adolescent Health Initiative Conference in Ypsilanti, MI. The group had all 300 health professionals practicing theater games in the conference hall. One member of the group thanked all the professionals for their dedication to helping adolescents and received a standing ovation. The project will continue next year with a new set of students. A manual has also been developed and will be presented at several conferences with the hope that it will be duplicated at other health centers.

Preparing for Change

The summer is long and, hopefully, it was a lot of fun! Your child or adolescent has probably been sleeping in, and doing a lot of things on his/her own time. Back to school and all of the other routines that it entails can be a difficult transition. Here are some tips to make that transition a little smoother:

• Establish a Sleep Schedule: Two weeks before school starts, have your child or adolescent start adhering to a bedtime that will allow them to get at least 8.5 hours of sleep. In addition, try waking them up or having them use their alarm clocks to start waking up around the time that they will need to start waking up to get prepared for the school day. This will make the transition to the fall schedule a little easier.
• First Day Jitters: The first days can be chaotic, especially if your child or adolescent is adjusting to a new school. Try to arrange for your child or adolescent to visit his/her new classroom or new school before classes begin. Take a tour of the building and know where important places like the cafeteria, gymnasium, principal and counseling offices, the RAHS health center, and the bathrooms are located. If the school’s office provides a map, get a map of the school for your child or adolescent. Have your child or adolescent choose their outfit for the first day of school in advance or offer to help them put an outfit together. This will ease the transition of getting ready on the first day of school. In addition, have your child or adolescent bring in their backpack, stocked with supplies and any necessary paperwork on the first day of school. This will make the transition back to learning a little less stressful. Also, make sure there is a plan in place for lunch, whether they are bringing lunch or buying it in the cafeteria.
• Emotional Transition: Children and adolescents often feel anxious, scared, or excited about the beginning of a new school year. It’s normal to feel nervous the first day of school, especially if your child or adolescent is adjusting to a new school. Try to have your child or adolescent think back to previous “first days,” and how they got through them, in order to help them cope with their anxiety. Re-assure them that their feelings are normal. Also, make sure that your child or adolescent knows where the school counselors office and the RAHS health center are located, in case he/she needs to speak with someone about their feelings.
• Making New Friends: It can be difficult to make new friends or to become re-acquainted with classmates that we already know. Encourage your child or adolescent to take small steps, like saying hello to one or two new people a day, or asking a new person to sit with them at lunch. Also, encourage your child or adolescent to re-acquaint themselves with their classmates from last year. This can ease the transition back to school as well.

Getting back to school is an adjustment, but with some planning and support, the transition can be a smooth one!

Adolescent Centered Environments

“I kind of felt disrespected.” … ”I felt like they were babying me.” … “My doctor assumes [things] sometimes, and it’s kind of awkward. She talks to my mom, my mom talks to her, I’m just there. I’m just there to get poked.” If you ask a group of teens about whether they have had negative experiences at a health center or not, most of them will have at least one story that illustrates to providers and staff what NOT to do.

The Adolescent Health Initiative (AHI) did just that – we talked with our youth council, The Adolescent Champion Teen Advisory Council (TAC TAC) to hear about their areas of concern around adolescent health care. Many issues were raised, from the importance of confidential care for adolescents, to adults helping teen patients navigate payment systems and referrals, to the simple request that providers and staff behave non-judgmentally and treat teens with respect.

For professionals who work with adolescents (ages 10-21) in health centers, the fact that they often have negative experiences is probably not a surprise – but the negative experiences happen to adolescents somewhere else. Most providers and staff usually believe that they are adolescent-friendly and respectful of their adolescent patients. So where’s the disconnect? Why do teens so often still feel like they are treated as “less than” when it comes to their health care? And what can centers do to make sure they’re objectively reviewing their services, policies and standards of care to be as inclusive of all young people as they can be?

To address these questions, AHI developed the Adolescent Centered Environment self-assessment tool, a thorough, detailed, twelve section survey that is intended for regular assessment using a Plan/Do/Check/Act cycle, utilizing the accompanying recommendations guide and planning tool for improvement. The toolkit includes sections such as Access to Care, Parent Engagement, Adolescent Appropriate Environment, and Mental Health Clinical Practices, looking at a wide range of factors that make a clinic experience comfortable for adolescents. As AHI has piloted the toolkit, it’s become apparent that even the highest quality centers have areas of improvement.

This summer, all six of RAHS’s centers will conduct self-assessments using the ACE toolkit, looking at ways adolescent patients can feel at home in their school-based health center. The ACE review process encourages this through thoughtful reflection on ways policy and care can become even more centered on adolescents and their needs.

And of course, teens have a lot to say about positive experiences in their health centers too! A favorite quote from one of our TAC TAC members, talking about how she feels about her doctor, Maggie Riley (who is a RAHS provider), sums it up: “She’s absolutely amazing, and every time she sees me, she just makes sure that I’m healthy, she’s like, ‘If you ever need to come in, call me, this is my number,’ so it makes me feel she cares and she’s not just there for a paycheck. She’s actually there to help.”

Healthy Life Balance & Managing Stress

Just as it is important to eat a balanced diet, our minds and bodies benefit from a balanced lifestyle. Teenagers, as well as adults, have so much pressure from their daily responsibilities. For teens, this may include school, extracurricular activities, sports, part-time jobs, and responsibilities at home. This can cause a teenagers life to feel like a juggling act and ultimately lead to stress interfering with healthy functioning. If you do feel stressed or overwhelmed, it is important to first recognize this, acknowledge feelings of being overwhelmed and then strategize ways to bring life into balance.

What You Can Do:
Make sure to set priorities and realistic goals. Prioritize what needs to be done each week focusing on a few assignments a night versus worrying about doing them all at once. Also, set realistic goals that you can reach within a week. Setting goals that are too big or far away can make you feel more stressed out if they cannot realistically be achieved.

Life balance includes taking care of oneself. Do not forget the importance of healthy eating, regular exercise, and adequate amount of sleep to reduce stress. Set aside time to each day to do something that makes you feel good. Read a favorite magazine, ride your bike, hang out with a friend, do yoga, or play your favorite sport. Focusing some time each day on something you enjoy will help you focus when you sit down to do homework.

These tips will support you in finding the necessary life balance that helps you feel less stressed!

New Partnership – RAHS and UMHS Ypsilanti Pediatric and Family Medicine Health Centers

RAHS is pleased to announce a great partnership between RAHS health centers and University of Michigan Ypsilanti Pediatric and Family Medicine Health Centers.

Dr. Maggie Riley, RAHS co-Medical Director and UMHS Ypsilanti Health Center Medical Director Dr. Caroline Richardson are working together to ensure that adolescents receive the best care possible. Care is being coordinated between RAHS clinics and Ypsilanti Pediatrics and Family Medicine to help mutual patients receive necessary preventative health care including physicals, immunizations, and wellness screenings, in addition to having the best management possible for chronic illness, particularly asthma and obesity.

Youth and adolescents are encouraged to visit their primary care provider regularly, and RAHS can help fill in the gaps of care, having access to youth and adolescents during the school day. All mutual patients have been notified of this partnership, and these shared patients have already benefited from this coordination in care including:

• Asthma monitoring at RAHS including asthma education reinforcement, spirometry testing, and follow-up care in between PCP visits;
• Vaccine administration at RAHS to ensure vaccines are up-to-date;
• Nutrition and physical activity counseling by RAHS registered dieticians;
• Mental health therapy by RAHS counselors; and
• Assisting families with insurance enrollment, vision and dental care assistance, and other community resource needs.

RAHS and Ypsilanti Health Center staff are excited to be able to provide accessible comprehensive care to their clients in the community in this innovative way.

Spring means Asthma?

For many people Spring is a mixed blessing. If you have Asthma you are more likely to also have Seasonal Allergies. The budding trees, the flower pollen, the mold from the rainy days combine to make your Asthma worse. You can check online for pollen levels in your area, such as this one by IMS Health Inc. http://www.pollen.com/state.asp?id=mi. And there are apps for that as well!

You may have to “rev” up your asthma medication too. People that do well on using only the Albuterol rescue inhaler as needed may have to return to daily controller inhaler use. You may want to get a jump on the season and see your health-care provider for a check-up and to get your prescriptions renewed.

Don’t forget the basic precautions that Seasonal Allergies sufferers take: shower and change your clothes when coming home from school or work, avoid being outdoors between 5AM & 10AM and sleep with your windows closed tight!