o In 2008, 5,742 babies were born in Clark County.
o Of total births, 2,456 babies were born to patients on Medicaid, a federal health plan for low-income women and children.
o Of Medicaid births, 362 were to noncitizens, who are the least likely to receive early prenatal care.
Women typically suspect they are pregnant by the time they are six to eight weeks along, Marni Storey told Clark County commissioners this month. They take a home-pregnancy test and make an appointment to see a doctor.
At that first appointment, women are told they should be taking prenatal vitamins, eating well, exercising and not smoking, drinking or doing illicit drugs. They are screened for risk factors and told of warning signs.
o In 2008, 5,742 babies were born in Clark County.
o Of total births, 2,456 babies were born to patients on Medicaid, a federal health plan for low-income women and children.
o Of Medicaid births, 362 were to noncitizens, who are the least likely to receive early prenatal care.
Commissioner Tom Mielke questioned why they were even hearing about prenatal care. The April 7 work session was sandwiched between sessions on recycling and traffic signals, topics with which the board of commissioners is more familiar.
But Storey was updating commissioners on a problem that surfaced in 2008.
That’s when health officials learned Clark County ranked below state average in terms of expectant mothers who see a doctor in their first trimester, the first 12 weeks of pregnancy.
Disregarding the state’s least-populated counties (where numbers may be skewed by behavior of a handful of women) the county ranked the worst, said Storey, the county’s public health services manager.
Eighty-five percent of privately insured women in Clark County were going to the doctor in the first trimester, not far off the national target of 90 percent.
But only 58 percent of women on Medicaid were getting early prenatal care; that number dropped to 49 percent of non-citizens, who are eligible for Medicaid.
“This requires a community-level solution,” Storey told commissioners.
Storey showed them a guide she hopes will help low-income women see a doctor earlier. She said the county, with money from Legacy Salmon Creek Medical Center and Southwest Washington Medical Center, hired a part-time patient navigator in November. An AmeriCorps volunteer also works part-time as a patient navigator, helping women apply for health insurance and find a clinic.
The guide, titled, “You’re Pregnant! Now What?” stars Rita the Resource Diva, a colorful character full of easy-to-follow information. Storey has distributed 575 copies at social service offices, schools and pharmacies and has been receiving requests for more.
The guide covers applying for medical coverage, choosing a medical plan, finding a health care provider and tapping into the local Women, Infants and Children nutrition program.
It also includes a list of adoption agencies, clinics where abortions are performed and information on family planning.
Rita the Resource Diva, who was covered by a $3,500 state grant, was born after Storey met with low-income mothers to learn why they didn’t seek early prenatal care. There were a number of issues, from a lack of transportation and difficulty understanding how to apply for Medicaid to being in denial. Storey said delays are also caused by the fact it can take women 48 days to be assigned to a managed care plan after applying for Medicaid, and even clinics that do take new Medicaid patients won’t see them before they are assigned a plan.
She also said there was a widespread misbelief among women and providers that a woman needs to have her pregnancy confirmed at a doctor’s office before applying for Medicaid.
Jonathan Avery, chief administrative officer at Legacy Salmon Creek, said the hospital contributed $10,000 for first-year costs of the navigator and pledged $10,000 for the second year.
Patient navigators have proven to work in the health care industry, Avery said.
“A big part of the problem is that even though patients theoretically have access to insurance coverage and have access to providers, there are often many barriers to work through,” Avery said.
“First-trimester care is essential to a healthy pregnancy and a healthy birth,” he said.
Storey said the state estimates that Medicaid babies born at a healthy weight cost $5,803 for their first year of health care, while a low-birth weight (5.5 pounds or less) baby costs an estimated $30,600. Risks for having a low-birth weight baby include maternal smoking, drinking, doing drugs and chronic health problems.
“We want to provide people the right kind of care at the right time,” Avery said. With prenatal care, as with health care in general, costs are less “if you focus on prevention rather than treatment.”
Stephanie Rice: 360-735-4508 or stephanie.rice@columbian.com.
