Intersections of Mental Illness and Legislative Changes at Androscoggin County Jail

Since 2015, corrections officers and mental health providers in Androscoggin County, Maine have become increasingly concerned about the growing prevalence of mental illness among patients (inmates) at Androscoggin County Jail. These concerns have been exasperated by recent budget and policy changes within the County and throughout the State. In partnership with Androscoggin County Jail and Tri-County Mental Health Services, I analyzed a random sample of 686 patients’ medical files from Androscoggin County Jail, reviewing 1,154 individual bookings dated from 2013 to 2017. Over 70% of patients since 2015 were found to have a substance use disorder and/or another mental illness. Mental illness and substance use disorders were highly correlated to having a greater number of bookings and a history of violent offense. A triangulation approach was used to analyze these findings within the context of recent and proposed changes pertaining to MaineCare and Androscoggin County Jail. These analyses indicate numerous problems with the provision of community-based mental health treatment in Androscoggin County. Primary issues include insurance coverage gaps, biased MaineCare eligibility policies, a lack of treatment availability within the jail, poor continuity of care across county agencies, and a fear of collaboration between county agencies and the state administration. Based on these findings, I have made a number of policy, practice, and research recommendations that would improve the accessibility of community-based mental health treatment at the jail, county, and state levels

Androscoggin County Community Food Resources

Food resources found in Androscoggin County, Maine: Supplemental nutrition Food pantries Farm stands Farmers\u27 markets Mobile markets Community gardens Community centershttps://digitalcommons.usm.maine.edu/fsp-androscoggin/1000/thumbnail.jp

Addressing Non-Emergency Medical Transportation Needs in Androscoggin County

Public health and social equity hinge upon the accessibility of medical services to all. Lack of access to transportation for routine and non-emergency medical appointments poses a significant barrier to appointment attendance, a barrier that disproportionately impact low income people and other marginalized groups. Healthcare providers also suffer major financial losses when patients are unable to attend their appointments. Prior research and community forums in Androscoggin County, Maine have identified several shortcomings to existing local non-emergency medical transportation (NEMT) services, illuminating the need for transportation options that better address the specific needs of the local population. In this report, we identify unmet transportation needs in Androscoggin County, detail the findings of our research on alternative models of NEMT across the United States, and propose a pilot program for a NEMT system tailored to the local needs and resources in Androscoggin County. This project is conducted in collaboration with Community Concepts Inc. (CCI). We build on the work of a previous Environmental Studies Capstone group from Bates College that identified the specific shortcomings of the current NEMT ride brokerage system from the perspective of the New Mainer community. Through consultations and scholarly research, we found a number of elevated transportation barriers faced by New Mainer users, rural users, users with disabilities, and non-MaineCare users. Our comparative study of different NEMT programs in Maine, New York, Minnesota, and Oregon allowed us to identify the range of different vehicles, transport styles, scheduling services and payment options that exist in NEMT services on a national scale. We synthesize the findings of this research into a proposal for a six month NEMT pilot program to be implemented in Androscoggin County. The pilot program we propose would be operated by CCI as a means of testing out the viability of an alternative to the current LogistiCare system. The program would operate two vans, one as a demand responsive, taxi-style service, and one on a fixed route with pick-up points in the downtown Lewiston-Auburn area and drop-off points at major healthcare providers. In order to address local and cultural needs present in Androscoggin County, our proposal recommends a multilingual ride-scheduling service, driver trainings on implicit bias and mental health first aid, and a representative community board to receive feedback and implement changes in the program moving forward. Fare options and potential funding options are also discussed. We conclude with a set of recommendations for next steps for working towards more accessible, culturally appropriate NEMT services in Androscoggin County

04/12/1948 Letter from the Androscoggin County Republican Committee

04/12/1948 Letter from Joseph E. Croteau, Chairman of the Androscoggin County Republican Committee, to Louis-Philippe Gagné.https://digitalcommons.usm.maine.edu/fac-lpg-letters-1948-01-06/1028/thumbnail.jp

Androscoggin County Community Food Resources

Food resources found in Androscoggin County, Maine: Farm stands Community Gardens Food Co-operatives CSA Farms Farmer\u27s Market Harvest Bucks Retail Food Pantries Otherhttps://digitalcommons.usm.maine.edu/fsp-androscoggin/1001/thumbnail.jp

Pap Smears in the Somali Immigrant Population

Lewiston, Maine is home to a population of Somali refugees. Women within this community have faced cultural and language barriers that have prevented them from obtaining Pap smears. We have collaborated with a local health clinic, where a cultural broker and member of the Somali community who is familiar with this population, to understand challenges Somali immigrant women face in cervical cancer screening. Together, we developed a pamphlet and health resource card, both in Somali, to lower barriers to care.https://scholarworks.uvm.edu/fmclerk/1618/thumbnail.jp

Press Release - Muskie Hails Maine\u27s Immigrant Heritage

Speaking at the Androscoggin County Sesquicentennial celebration and Franco-American commemoration in Lewiston, Maine, Senator Edmund S. Muskie (D-Maine) stated that immigrants of many origins...have adopted Maine as their own, and they have given to Maine what has been the best of their past

1918-1919 Resident and Business Directory of Androscoggin County Maine

Full title: Resident and Business Directory of Androscoggin County, Maine, Including the Cities of Auburn and Lewiston and Towns of Durham, East Livermore, Green, Leeds, Lisbon, Livermore, Mechanic Falls, Minot, Poland, Turner, Wales, and Webster Compiled and published by Merrill & Webber Company, Auburn, Maine Copyrighted 1918 by Merrill & Webber Company This book has been separated into 50 page sections to improve access and download speed.https://digitalcommons.usm.maine.edu/androscoggin-county/1002/thumbnail.jp

1928 Directory of Androscoggin County Maine

Full title: Directory of Androscoggin County, Maine, Including the cities of Auburn and Lewiston and Towns of Durham, East Livermore, Greene, Leeds, Lisbon, Livermore, Mechanic Falls, Minot, Polant, Turner, Wales, Webster Combining Four Separate and Distinct Directories Governmental Directory — City, County, State, Federal Buyers\u27 Directory — Names, Occupations, Addresses Classified Directory — Business, Professional, and Social Published by Fred L. Tower Companies Formerly Portland Directory Company Member of Association of North American Directory Publishers Copyright 1928 by Fred L. Tower Companies, All rights reserved. This book has been separated into 50 page sections to improve access and download speed.https://digitalcommons.usm.maine.edu/androscoggin-county/1003/thumbnail.jp

Eat, Sleep, Console for Neonatal Abstinence Syndrome Babies

Neonatal Abstinence Syndrome (NAS) is a complex disorder that manifests with neurologic, gastrointestinal, and musculoskeletal disturbances and is most often associated with opioid withdrawal. In the US, 6 out of 1,000 babies are born to mothers who used opioids during their pregnancy. These babies go on to develop NAS. Androscoggin County, where Central Maine Medical Center is located, has an even higher rate of babies with NAS: 100 out of 1,000. Most institutions use the Finnegan Neonatal Abstinence Scoring System (FNASS) to guide pharmacologic treatment. This system assigns a score based on 21 clinical signs of withdrawal with a score ≥8 indicating a need for pharmacologic treatment. This system has never been validated nor has its score cutoffs been tested which may lead to over or under treatment of babies experiencing NAS. Eat, Sleep, Console is a novel approach which has shown to decrease average length of stay, pharmacologic treatment, and healthcare costs.https://scholarworks.uvm.edu/fmclerk/1503/thumbnail.jp