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I cannot believe Team Medfest will come together for the last time tomorrow for our group presentation! I am so thankful for our time together, and for the collaborative impact we had on Medfest and Special Olympics of North Carolina. I cannot wait to work with SONC next semester!

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Team Medfest had a great meeting today to debrief with Dr. Tillman and our preceptor, Ellen, about our recent medfest event. I think we are all very excited to see what the upcoming Medfest events hold!

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Team Medfest is using our last few weeks of lunch together to plan our presentation for class. We are excited to share the work of Special Olympics of North Carolina and the amazing things we were able to take part in because of Medfest!

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Advocacy is a necessity in public health. Advocacy provides support and recommendations for specific causes, and this is needed in public health as we recognize the specific needs of individual groups and populations. Often times, these populations of interest have a difficult time advocating for themselves, and therefore rely on the public health system, their friends and family, and other community members to advocate for them.

The Medicaid Transformation is a topic of extreme interest to Team Medfest as it will directly impact individuals with intellectual and/or developmental disabilities in large-scale ways. The first day we met with our preceptor Ellen, we met an awesome member of the Special Olympics team who went into tremendous detail about the difficulty of obtaining sufficient health, vision, and dental care as a person with IDD. Unfortunately, this is a shocking reality of many individuals with IDD. Team Medfest chose to use a social media campaign to advocate for social and political policies which will improve our population of interest: individuals with intellectual and//or developmental disabilities. We created an instagram account and used daily Instagram highlights and Instagram posts to provide information about the Medicaid transformation, the ways that it will affect this specific population, and the steps that North Carolina should take to make the transformation more inclusive to better serve IDD individuals. Our campaign changed slightly as the platform we intended to use was no longer available to us, but we feel the week of social media content was still as success! Although the reach on our newly-founded Medfest Instagram account may not have been as broad as we intended, we hope our preceptor, Special Olympics organization, and future Medfest events may be able to use the content we brought together to provide information to individuals in the future.

Throughout our time on Team Medfest, our group spoke almost weekly with Ellen about the impact the Medicaid transformation would and will have on individuals with intellectual and/or developmental disabilities. We quickly became aware of just how little information was dispensed to affected families and individuals about what this transition would mean for them. Unfortunately, information that was provided may not necessarily have been in easily-comprehensible terms, and therefore Medicaid users may not have had adequate background to make informed choices about their plan of care when they were required to. Lack of adequate information was also observed in the rural population we served during Medfest. Teachers and parents had questions about when insurance was required, what services might be covered, and how covered services might be utilized. Additionally, several covered services for IDD individuals required a significant amount of time for transportation, and are therefore not utilized in ways meant to serve families and individuals with IDD. The move to managed care, implemented in the Medicaid Transformation, appears to be a significant step forward in bridging gaps to appropriate care and services for individuals with IDD. From the research our team conducted, we feel the Medicaid transformation is a positive step forward, and has the potential to give individuals access to more thorough care as covered benefits will fall under one of five plans individuals can choose from. Additionally, the Medicaid Transformation plan outlines services and benefits specifically for plan-members with intellectual and/or developmental disabilities. While the plan is in favor of our population of interest, it was clear to our group the information IDD individuals needed to make informed decisions about their care was not well-dispersed. We hoped our social media campaign would serve to disperse information more efficiently.

While the transformation is moving in the right direction, simply providing packets by mail to Medicaid members does not give affected members all of the information they need. This system assumes people are able to read and interpret policies put in place by government officials, and then make important decisions about their health care plans. Our group felt the need to break Medicaid Transformation down in the best way we could, to make it more easily interpreted by the individuals who need it. Additionally, we believed Medicaid Transformation information would be enhanced by offering opportunities and resources for people to seek counsel and ask questions about what the Medicaid Transformation means for them. How should individuals know which plan works best for them if the plan details are written in terms deemed difficult to understand by public health Masters students? Health care providers, teachers, families and IDD individuals should all have a mutual understanding of the changes that are being put into effect in the near future.

Although our advocacy week for the Medicaid Transformation just barely skims the surface of the impact this transition in Medicaid will have for members, we hope it serves as a foundation for basic information. We used social media as it is easily accessible, widely-available, and creates an eye-catching information brief for a perpetually “busy” audience. Unfortunately, if we are all honest, a lot of us do not have time to sit down and read pages and pages of policy, especially if the pages are full of sentences and ideas that are difficult to understand. To better advocate for our friends with intellectual and/or developmental disabilities, we sifted through information and found key elements about the Medicaid Transformation to share. We support the Medicaid Transformation, but feel the need for those affected to be better-informed, and therefore chose to show public support and recommendations for information-share. Due to the long-term nature of advocacy work, we hope our efforts will serve as a good first step in the spread of information. We can only hope Medicaid members and their families will utilize the information we synthesized and reach out to the resources we suggested if they have further questions. (F14)

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During my time with Team Medfest, we have spent several weeks researching barriers to care for those with intellectual and developmental disabilities. Although I began this research with some idea of the difficulty these diagnoses caused in health care utilization, I was quite surprised to learn the gravity of challenge these barriers presented. These access barriers are magnified for individuals living with intellectual and developmental disabilities in rural areas. Access barriers include; an insufficient number of primary care providers who see patients with intellectual or developmental disabilities, limited transportation, decreased financial stability, and limited specialized programming in schools and the community. Individually, each of these items serves as a significant barrier to access of care and health care utilization. Together, these barriers substantially affect the health of rural communities.

In the organization of the Harnett County Medfest event for the fall semester, our practicum team became aware of the limited number of providers who see patients with intellectual and developmental disability diagnoses. We quickly recognized the importance of reaching as many schools and Special Olympics athletes as possible with our event. Medfest allows individuals with these diagnoses to get pre-participation physical exams at no cost, during the school day, in their own county. Creating space for these check-ups to happen during school hours means parents are not required to take time out of work to take their individuals to their primary care provider as students are able to go with their peers and teachers to the event if their forms are properly filled out. As part of the Medfest event process, our group also provided referral information to students who had abnormal findings on their pre-participation exam. Finding providers in the area for various specialities who we could refer Special Olympics athletes to proved to be another heavy task. The insufficient number of providers creates additional stress on caregivers and can be detrimental in a patient’s health due to lack of proper health care. Limited access to primary care providers can also increase stress for the providers in the community that do see patients with ID and DD diagnoses as they take on more patients to help fill the gap in providers. Medfest serves to break down this access barrier by providing opportunities from specialized care from providers who genuinely want to examine and promote the health of individuals with intellectual and developmental disabilities. Each Medfest event has a special role in improving the issue of limited access to care.

Limited transportation resources also create access barriers to health care utilization, which affects the health of the rural community yet again. Medfest brings in volunteer providers from the community and surrounding areas, making access to care much more efficient as the providers come to the event with their equipment, instead of kids having to travel to a provider’s office. The event may help to relieve the stress of caregivers feeling overwhelmed by trying to find providers for their Special Olympics athletes to see so that they may participate in the Special Olympics games. With the elimination of significant travel time and distances, caregivers of Special Olympics students can feel more at ease as their children stay within the county and travel by school bus with their teachers and peers to another area school to have their pre-participation exam performed. Medfest helps to eliminate this barrier by bringing providers, equipment, and volunteers to a centralized location to essentially create a pop-up clinic that is convenient for the student athletes, teachers, and caregivers.

Decreased financial stability proves to be another barrier to care access and utilization. As with other access barriers to care, this issue is magnified in rural communities. The costs of regular primary care can serve as a huge burden to health care utilization, especially for individuals with intellectual and developmental disabilities. During one of our first meetings with our preceptor, a special olympics athlete came and spoke with us about the difficulties she has in accessing care and utilizing the few benefits she has. She spoke of the lack of coverage provided by medicaid, and told us that in her mid thirties, she finally received vision coverage for the first time and was able to purchase a pair of glasses. She lives in an urban county, so we can only imagine the added hardship of finding providers within rural communities even when coverage is provided. We conducted teacher interviews during the Medfest and there was an overwhelming response from teachers about lack medical screenings and care due to financial burden on parents. Teachers stated most students would not have physicals if it were not for the Medfest event. Medfest provides pre-participation physicals, optional oral health screenings and fluoride treatments, and the coordination of referrals all without having to use insurance and medicare. Additionally, Medfest saves parents from possible out-of-pocket expenses that may be associated with these visits. During the teacher interviews, it was very clear to our group that more information should be given to schools and teachers about what qualifies individuals to participate in Medfest, and the benefits that the event provides. Teachers reported they received questions about whether insurance cards were needed or if any costs were to be expected. These questions present the opportunity for Medfest organizers to give parents more information about the event and take any burden the parents may feel about expense or using insurance/medicaid off their shoulders.

Although several access to care barriers and health care utilization challenges exist within the rural community, specifically Team Medfest’s community of focus, we feel encouraged by the efforts we have observed that work to break down these barriers. Bringing providers to the community with a specialized practice model to see individuals with intellectual and developmental disabilities, decreasing transportation requirements for preventative visits, and increasing access to health care and oral health screenings are all benefits of Medfest that work against current access barriers. With the opportunity to host more Medfest events throughout the year, we are able to promote breaking down these barriers with continued care and outreach within the community. I am excited to see what the spring season holds for Medfest and Special Olympics, and can only hope even more pre-participation physicals and oral health screenings can be performed at the Medfest event in the spring. (R2)

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This week, Team Medfest was very excited to see the fruits of our labor of several weeks come together in our big event at Harnett Central High School. Our group successfully facilitated pre-participation physical examinations for Special Olympics athletes, the administration of oral fluoride treatments and the inclusion of interactive wellness fair activities for 44 students. We included elementary students from Lillington-Shawtown, middle school students from Harnett Central Middle and high school students from Harnett Central High. We utilized resources provided by Campbell Pharmacy and Health sciences programs and Campbell School of Medicine, to partner with students in other health sciences professions to make the Medfest event for fall 2019 a success. The partnerships brought together yesterday, and over the past few weeks allowed the event to run efficiently. The inter-professional involvement in Medfest also contributed to the increase in health care services offered, informative material provided, and numerous benefits provided to each student athlete.

Our team collaborated with other members of Campbell’s public health program, physician assistant students, Doctor of Osteopathic Medicine students, nursing students, physical therapy students, CUSOM and CPHS faculty and the teachers of elementary, middle, and high school students to enhance the caliber of the pre-participation physical exam for each student. The members of this inter-professional team also worked to promote oral health by administering fluoride treatments to athletes who chose to participate. The promotion of Medfest was surely enhanced due to the use of inter-professional teams as each group of different students helped to improve the event in ways which related specifically to their field. Nursing students worked to gather vitals and complete vision screenings. Physician assistant students administered flouride treatments and completed physical exams with the help of doctor of osteopathic medicine and physical therapy students. Faculty from all programs also provided sounding-boards for the health sciences and DO students to discuss any significant findings with. Additionally, other public health students served as volunteers and provided informative and engaging information for students as they took part in the “wellness fair” aspect of Medfest. Each individual’s involvement in Medfest contributed to a greater skill set while administering exams-and thus a more complete physical exam for the student athlete, a wider breadth of knowledge, and therefore a more thorough experience for each child.

Inter-professional teams are critical to expanding the impact of the public health and healthcare community on the individuals we come into contact with. Our recent Medfest event shows just one example of this impact. During the planning stages, we met with faculty representatives of CPHS and CUSOM programs to determine the correct number of personnel from each program, take note of the equipment that each program was able to supply, and what roles and expectations each program had of one another during the planning stages and the actual event. While the public health program supplied the organization contacts and networks to facilitate this event, we did not have the clinical staff, licensure, or equipment needed to complete pre-participation physicals nor did we have the knowledge provided by other public health practicum groups about health topics. Team Medfest is a group of competent and passionate individuals, but we did not possess the man-power needed to put on Medfest nor did we have the learned experience of previous events. With the help of inter-professional team work, all of the necessary parts of a fully-functioning event came together to promote healthy athletes and inclusion in physical activity events.

Even with a group of CUSOM and CPHS students at different levels in their education in different fields of study, our inter-professional team used effective communication and collaborative processes to efficiently move 44 students from their buses and classrooms through an oral health screening, physical exam and wellness fair. This would not have been possible without the combined knowledge of individuals from CPHS and CUSOM. Each team member brought a specific level of skill and worked in cooperation with one another to provide the best care and experience for each Special Olympics athlete. Past experiences, learned behaviors and knowledge, and various skill sets provided a strong and diverse group of individuals for our Medfest event. As noted, diverse backgrounds and knowledge provide an opportunity for engagement and enrichment for both the patient and the individual who is involved in the inter-professional team. Inter-professional teamwork is one of the best ways to improve patient care and outcomes. Working with individuals in different fields gives rise to opportunities and ideas that otherwise may have been missed due to lack of knowledge of other fields. While these benefits are extremely noteworthy, inter-professional teamwork is also breeds extreme intrinsic and extrinsic reward. Working with other team members to put on Medfest promoted positivity and respect among peers, learned skills and viewpoints, and proved to be really enjoyable and FUN for everyone involved. Medfest was successful only due to the efforts of all individuals involved, and I feel the success of our inter-professional teamwork over the past several weeks, and at the Medfest event speaks volumes to the importance Campbell University places on inter-professional relations. I look forward to engaging in other forms of inter-professional teamwork in the future! (Competency F21)

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This week involved a lot of organization and final planning for our big event next week! Team Medfest is so excited to be a week away from Medfest! We are also very excited to begin work on our advocacy project that we have been researching!

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It was fun to get a visit from Dr. Tillman during our weekly meeting this week! We used our time together to discuss our advocacy project with our amazing preceptor, Ellen. We are so excited that we are less than three weeks away from Medfest!

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Kicking off this week with a lot of volunteer prep! We are less than one month from #Medfest! Our team is very excited!

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#TeamMedfest met with clinical coordinators to determine the supplies and volunteers we will need in order to make our event a success! We are so excited for October 23rd!

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Week four with #TeamMedfest is staring off strong! We met with the Co-local coordinator for Special Olympcis of North Carolina in Harnett County. We also had the opportunity to meet two SONC athletes who are also part of the athlete council! It was great to hear about last year’s SONC Medfest event from parents and athletes themselves. We hope our Medfest event will be a HIT!

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Hurricane Dorian has nothing on Team Medfest! We Skyped with our fearless leader, Ellen to determine logistics of MedFest. With our specific roles, we will leave no stone unturned to make this a successful event! #teammedfest

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Loved learning about the history of Special Olympics, had a wonderful tour of the facilities and met our amazing preceptor Ellen yesterday! #TeamMedfest is off to a great start!

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Week one for #TeamMedFest has been full of research and learning the background of the amazing Special Olympics! We are so excited to meet with our preceptor next week!