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Keystone Health offers Free Pap Tests

January is Cervical Cancer Awareness Month.

For most women between the ages of 21-65, Pap tests are one of the most important steps in keeping themselves healthy and protecting themselves from cervical cancer.

During the months of January and February, Keystone Health is offering FREE Pap screenings for women who are due for this important test. Show or mention the coupon below at Keystone Community Health Services (located at 111 Chambers Hill Drive, Suite 102, Chambersburg) and receive a Pap test free of charge. Each patient who is due for this test and completes an appointment will receive a $5 gift card!

Call (717) 709-7909 to schedule your appointment.

For more information about the importance of cervical cancer screenings, visit this blog post by Keystone provider Cathy McAfee.

Keystone Behavioral Health Receives Award

From left to right: Kelly Goshen, Director of Keystone Behavioral Health, Joanne Cochran, Keystone Health President and CEO, David S. Keller, Chairman for Franklin County Board of Commissioners, and Dave Grant, Keystone Health Chief Operating Officer

Keystone Behavioral Health was presented with an Agency Partner Award from Franklin Together Reentry Coalition on January 9, 2020. David S. Keller, Chairman for the Franklin County Board of Commissioners, presented Keystone with the award during a Franklin Together Reentry Coalition meeting held at St. Paul United Methodist Church.

Keystone Behavioral Health was nominated for this award due to its work with formerly incarcerated individuals while helping them to reintegrate into the community. These annual awards acknowledge the contributions of organizations or individuals in the community that serve this population.

“Keystone Behavioral Health provides psychiatric evaluations, medication management, and therapy to individuals with Medical Assistance or other insurance. Keystone has been a collaborative partner with many county programs including those that assist returning individuals such as the CARE (Case Assisted Re-Entry program for returning individuals with mental health issues) and IRCM program (Intensive Reentry Case Management which was a grant funded program that helped inmates with home plans). This partnership helps people gain access to services that would otherwise be delayed which could lead to a deterioration of mental health due to a lack of medication or monitoring. This imperative link to mental health services when released from the jail back to the community is extremely important for returning individuals. Keystone deserves to be recognized as an agency willing to work with individuals with criminal records and willing to collaborate with programs that case manage this population,” said Kimberly Eaton, Director of Reentry and Clinical Quality Assurance for Franklin County.

Newly diagnosed with Diabetes or Want to prevent Type 2 Diabetes? Click here!


The Prevent T2 program is through the CDC.  To be eligible for the program you must:

  • Be at least 18 years old and
  • Be overweight (Body Mass Index ≥25; ≥23 if Asian) and
  • Not be pregnant and
  • Have no previous diagnosis of type 1 or type 2 diabetes and
  • Have a blood test result in the prediabetes range within the past year:
    • Hemoglobin A1C: 5.7–6.4% or
    • Fasting plasma glucose: 100–125 mg/dL or
    • Two-hour plasma glucose (after a 75 gm glucose load): 140–199 mg/dL


    • Have a previous clinical diagnosis of gestational diabetes


Plantar Fasciitis – Facts and Treatment

Dr. David Pagnanelli Jr.

Those who have suffered from foot and ankle pain know the burden it causes. Everyday tasks that require standing or walking can become extremely difficult, and the pain can greatly affect a person’s quality and enjoyment of life. One of the most common causes of foot pain is plantar fasciitis.

Dr. David Pagnanelli Jr. of Keystone Foot and Ankle Center frequently treats patients with this condition and wants people to know they don’t have to live with this pain – help is available.

What is plantar fasciitis and what causes it?

Plantar fasciitis is inflammation of a thick band of tissue from the inner side of your heel to your toes. This band supports and holds up your arch in your foot. Sometimes it becomes so inflamed and tensed that you can get micro tears or even complete tears of the tissue.

What are the symptoms?

Symptoms include pain with the first step in the morning or after sitting/resting for some time, stabbing, sharp pain with walking, aching within the heel bone, aching with standing in place for long periods of time, and tight calf muscles.

Who is most at risk of developing it?

Plantar fasciitis is most often seen in people who have flat feet and do not wear orthotics or arch supports. Runners are typically most at risk. In addition, people who are overweight and those who wear shoes with inadequate support or no shoes at all on hard surfaces have an increased risk of plantar fasciitis.

Why is it important to seek treatment sooner rather than later?

Plantar fasciitis can lead to the formation of bone spurs as well tears within the fascial band which may require surgery. The inflammation can also cause pressure on adjacent nerves and muscles which can increase pain and cause temporary or permanent damage. The pain will likely not go away until the proper support or therapy is given.

What are the treatments and when is surgery needed?

I treat plantar fasciitis aggressively from the start. On average, 95% of my patients get better without surgical intervention. On the first visit you will get an x-ray to check for bone abnormalities and the overall alignment of your joints. Then, depending on the pain level and inflammation present, you may get a steroid injection to reduce the inflammation and pain. You will get stretching exercises to help reduce the tension and pull on the fascial band and Achilles tendon. The stretching exercises are the most important part of the treatment protocol. You will likely get athletically taped with a Lodi Taping. You may also get a night splint as well as a heel cushion.

You may require up to three injections, spaced two to three weeks apart, to relieve all the pain and inflammation. Some patients only require one injection, but others require a series. During this time, on the second visit, if the athletic taping helped with the pain we know then that custom orthotics will help consistently relieve the pain and support the fascial band. You will then be casted for custom orthotics. Some over-the-counter orthotics might be sufficient given the shape and alignment of your feet.

It may also be necessary in severe cases to send the patient to aggressive physical therapy to help loosen and stretch out the plantar fascia. Surgery is performed if complete relief of pain is not achieved with conservative therapy and orthotics. Surgery consists of endoscopically cutting the medial 1/3 of the plantar fascia. It is a 10-15 minute procedure with two ½ inch scars on either side of the heel. The patient can walk out of the surgery with a surgical shoe or large boot and will be back in shoes in three to four weeks.

Are there ways to reduce the pain with lifestyle changes?

Avoid walking barefoot or on hard surfaces. Try to always wear orthotics or arch supports. Stretching on the calf muscles daily, twice a day, will help reduce the tension of the plantar fascia.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

What You Need To Know About Marketplace Insurance Enrollment

Pam Laye

The enrollment period for 2020 Marketplace insurance coverage is now underway. While many people view the process as complicated, there are places to turn for help. Pam Laye, supervisor of outreach and enrollment at Keystone Health, answers some frequently asked questions in today’s article.

Why is it important to have health insurance?

No one plans to get sick or hurt, but almost everyone will need medical care at some point. Health insurance covers most costs, protecting you from unexpected, high medical bills and offers many other important benefits as well. You pay less for covered in-network health care, even before you meet your deductible. Without health insurance, you are faced with paying the bills yourself and those bills could amount to a lot of money and debt which could take you years to pay off.

A three-day hospital stay could cost you as much at $30,000 if you don’t have insurance; a broken leg from skiing, bicycling or playing sports could cost you $7,500 if you don’t have insurance. The American Diabetes Association estimates that the average cost of diabetes is $13,700 in medical expenses per person per year. To help address the affordability of health insurance, tax credits and cost-sharing subsidies are available from the government that may make premiums more manageable or may help lower out of pocket expenses such as co-payments at the doctor’s office or the pharmacy.

When is the open enrollment period?

The Marketplace opened November 1, and will remain open until December 15 for coverage to begin on January 1. After the Marketplace closes, you can enroll or change plans only if you qualify for a special enrollment period. Circumstances that may qualify you for special enrollment include: marriage, a birth, adoption or fostering of a child and a change in your current insurance, income or citizenship.

What are the main options when it comes to plans?

In Franklin County the only two options are Capital Blue Cross and Highmark. Capital Blue Cross plans which are  offered are Preferred Provider Organization (PPO) plans. This means if you go to a provider who accepts Capital Blue Cross insurance, you will pay a lower cost for care. If you go out of network (to a provider who does not accept your insurance plan) the cost will be higher than in network, but still lower than full cost. Highmark is offering only Exclusive Provider Organization (EPO) plans. This means if you go out of network, insurance is not going to cover your service and you will have to pay full price.

The deductible and out of pocket cost are about the same for both options which could be as high as $15,800 and as low as $2,000 depending on your plan.

When will my coverage begin?

If you enroll or change plans by December 15, 2019, your coverage will begin January 1, 2020.

Do I need to do anything if I enrolled last year?

If you do not update your application by December 15, 2019, you will probably be re-enrolled automatically. However, it is best to review your options every year. Prices and plans change annually and there may be a new plan that is more affordable for you. If the plan you selected last year is no longer available, you will likely be enrolled in a similar plan. It is important to make sure your healthcare provider accepts the plan you are using.

If I choose to be uninsured is there a penalty?

Starting with the 2019 calendar year, it was determined that there will not be a penalty for remaining uninsured. So if you do not have health insurance when you file your taxes after January 1, 2020, there will not be a penalty.

But keep in mind: No one plans to get sick, but most people will need health insurance at some point in their life. Health insurance covers most costs, protects patients from unexpected high medical bills and offers many other important benefits. Patients pay less for covered in-network health care, even before they meet their deductible or coinsurance, and pay a small co-pay when seeing a family physician. Without health insurance, patients are faced with paying health related costs themselves, which could amount to a lot of money and debt that could take years to pay off.

How do I enroll?

There are several ways you can enroll. Most people choose to enroll online at but you can also enroll by phone, with a paper application or with a trained helper or certified Marketplace counselor. The department I oversee, Keystone Health’s outreach and enrollment department, is one community resource that provides this service for free. Our certified enrollment navigators can meet with you and walk you through the process, and can also help you complete charity applications. You can call (717) 709-7969 for further information or to schedule a free appointment to meet with a Keystone Certified Assistance Counselor.

Marketplace agents can also help complete applications, but there is typically a fee for the use of this type of assistance. There is no cost or charge if you use a Keystone Certified Application Counselor.


Antibiotic Awareness

November 18-24 is Antibiotic Awareness Week. Antibiotics save countless lives every year, and have been one of the most significant developments in the medical field in the last century. However, using them too frequently or when not needed can have serious consequences. Dr. Raghavendra Tirupathi, Medical Director of Keystone Infectious Diseases, shares some important information about how to protect yourself by using antibiotics safely.

What are antibiotics?

Antibiotics are medicines that help to stop infections caused by bacteria by killing the bacteria or by stopping bacteria from reproducing. Many times when people are sick, they expect their medical provider to prescribe them an antibiotic. For certain types of infections, antibiotics are extremely effective. However, antibiotics can only treat bacterial infections; they do not help infections caused by viruses. If you take antibiotics when they not necessary, it can lead to antibiotic resistance.

What is antibiotic resistance?

Antibiotic resistance is when bacteria change or adapt to the antibiotic, meaning the antibiotic will no longer be helpful against the virus. This is usually caused by using antibiotics too often or when they are not needed.

Using antibiotics responsibly could save your life. When bacteria become resistant to certain antibiotics, there are fewer options to treat deadly infections. Even minor infections can have fatal outcomes when effective antibiotics aren’t available. In the United States, antibiotic resistant bacterial infections lead to 23,000 deaths and more than 2 million illnesses annually.

What causes antibiotic resistance?

Some of the main causes of antibiotic resistance are: patients not taking antibiotics as prescribed or taking someone else’s antibiotics, healthcare providers prescribing antibiotics when they are not needed, patients not finishing their entire dosage of antibiotics, poor infection control in hospitals and clinics, unnecessary antibiotic use in agriculture and poor hygiene and sanitation practices.

How do I know if I need an antibiotic?

If you are ill and think an antibiotic may be necessary, always consult your healthcare provider and let them make that decision. Many common illnesses are caused by viruses, and taking antibiotics for these infections can do harm.

Some common conditions that are caused by bacteria that do require antibiotics are: strep throat, urinary tract infections and whooping cough.

Some common conditions that may require antibiotics are: sinus infections and middle ear infections.

Some common conditions that are caused by viruses and do not require antibiotics are: common colds, runny noses, bronchitis or chest colds in otherwise healthy patients, the flu and sore throats (that are not strep).

What are some ways to feel better when I don’t need antibiotics?

Some people get upset when their provider does not prescribe antibiotics, but he or she is doing that in your best interest when antibiotics will not be helpful. For viral infections, you can try over-the-counter medications (make sure you follow the directions carefully) while getting a lot of rest and drinking plenty of fluids. Upper respiratory infections (including sinus infections, ear infections, colds and bronchitis), can be soothed by using saline nasal spray or drops, avoiding smoking and secondhand smoke, breathing in steam from a hot bowl of water or shower, taking an over-the-counter pain reliever or decongestant and a warm, moist cloth over aching sinuses or ears.

For sore throats, try drinking warm beverages, gargling with salt water, using sore throat spray, and sucking on ice chips, popsicles or lozenges (for those not at risk of choking). For coughs, humidifiers or vaporizers, breathing in steam, lozenges and honey may provide some relief. (Never give honey to a child under 1 year of age.)

What can I do to protect myself from antibiotic resistance?

If your provider does prescribe you antibiotics, make sure you are closely following the directions. Finish the entire dosage, even if you are starting to feel better. Your healthcare provider should prescribe you the shortest period of antibiotics needed. Talk to your doctor if you have any questions or develop side effects to your antibiotics, including diarrhea, as it could be a sign of infection.

To combat antibiotic resistance, people should never share antibiotics, should practice good hygiene (wash your hands frequently, cover coughs, stay home when sick, etc.) and get recommended vaccinations, including the flu vaccine.

If healthcare providers and patients work together to use antibiotics responsibly, we can cut down the number of deaths from resistance and can assure these life-saving medications will be available to future generations. Please do your part in our battle against antibiotic resistance.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

Breast Cancer Prevention

 Dr. Carolyn Benenati

On average, one in eight women in the United States will develop breast cancer in their lifetime. Breast cancer is the second-most common cancer in American women with only skin cancer having more diagnosed cases each year.

When you consider these numbers, it can be scary for women to realize there is a good chance that they, or a close friend or relative, will develop the disease. The good news is there are precautions which can be taken to reduce the chance of developing breast cancer, and to catch the cancer early before it spreads.

Dr. Carolyn Benenati, OB/GYN at Keystone Women’s Care, shares some important information all women should know about breast cancer.

Breast self-exams

Adult women should be familiar with what is their “normal” breast. Breast self-awareness makes it possible to detect any changes. These changes would include pain, a lump, nipple discharge (not after stimulation of the breast) and redness of the breasts. Although not all these findings indicate a woman has a cancer, they should seek care with a health care professional if any changes are detected.

Breast self-awareness could include self-breast exams. There are no current recommendations for how often or if self-breast exams should be performed as studies indicate for average-risk women it may not reduce the risk of death associated with breast cancer. But 50% or more breast cancers are detected by women themselves. If a woman is still menstruating, the best time to examine the breast would be the week after her period.

It is best to take your time. Inspect the breast, looking in a mirror with your hands on your hips. Check for any skin changes, change in size of the breasts and dimpling of the skin. Feel for any lumps by using the pads, not tips, of your middle three fingers. Move in small circles, applying different levels of pressure to feel just under the skin and also deeper. You should check the entire area from the collar bone to the breast bone to the armpit to the ribs under the breast.


A mammogram is an x-ray that is used as a screening test for breast cancer, and is covered by most insurance plans. This screening test is used to detect cancer early in women without symptoms to reduce risk of the disease. According to The American College of Obstetricians and Gynecologists and The National Comprehensive Cancer Network, regular mammogram screenings should begin at age 40. Other organizations recommend mammograms should begin at age 45 or 50.

As an OB/GYN, I recommend my patients have annual mammograms starting at 40. In high-risk patients, such as someone who has several family members with breast cancer or a close relative with breast cancer who is younger than 50, earlier screening with mammograms or MRI may be recommended.

Mammograms should be performed until at least age 75. Discontinuation of annual mammograms should take into account the health status and life expectancy of a woman. In healthy older women, it makes sense to continue annual screenings in order to detect any cancer early.

Reducing the risk of breast cancer

Women can also reduce their risk for breast cancer by maintaining a healthy weight (a BMI of 18.5 to 24.9), by getting regular exercise, limiting or avoiding alcohol and breastfeeding if possible.

Women who are at higher risk for breast cancer can undergo genetic testing to identify if they carry a gene that places them not only for higher risk of breast cancer but also other diseases such as ovarian cancer. These high-risk women would include those with a close relative who was diagnosed with breast cancer under age 50 or multiple relatives with cancer. This testing is available at Keystone Women’s Care and most other OB/GYN offices.

Obtaining care when uninsured

If you do not have insurance and would like to have a mammogram, there is a program through the Cumberland Valley Breast Care Alliance (CVBCA) called the MammaGift Project which provides free mammograms to those who are uninsured. For more information about this program, call 717-263-7191. The CVBCA also supports and assists women in our area diagnosed with breast cancer, with health care and other associated costs during treatment.

Breast cancer in men

Though not nearly as common, men can get breast cancer too. About 2,600 men in the United States will be diagnosed with breast cancer each year, and about 500 will die from the disease. If men notice any changes in their chest area, including the changes mentioned above, they should see their healthcare provider as soon as possible.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

Preventing Dental Problems In Kids

Dr. Nana Odoom

If you’re a parent, you likely have a lot on your calendar – doctor’s appointments, kids’ activities, school projects and more. It’s easy to put off taking your child to the dentist when they aren’t having any problems. However, helping your child get in the routine of caring for their teeth each day, including regular visits to the dentist, is a very important step for their future.

Dr. Nana Odoom, Pediatric Dentist at Keystone Dental Care, and her colleague, Dr. Victor Amarteifio, often see children who have dental conditions which could be prevented. In today’s article, she shares what parents can do to help their children have healthy teeth and avoid painful, and sometimes costly, dental problems in the future.

What conditions do pediatric dentists treat?

Pediatric dentists primarily focus on treating toddlers, adolescents and all special needs patients. After four years of dental school to treat not only growing children, but children with additional medical needs and special needs patients of all ages, we receive two to three years of extra training with a great focus on orofacial growth and development. Our training focuses on enhancing our skills to best address all forms of behavioral challenges that a child or a special needs patient may present at a dental office. Those skills include advanced behavior guidance and management techniques, and sedation and treatment in a hospital setting depending on the needs of the patient.

Some of the most common procedures we perform are routine checkups and cleanings, treating caries (cavities), abscesses and swelling. We also see patients for traumatic injuries that may sometimes include needing stitches to the mouth and face as well.

What can parents do to help prevent childhood dental problems?

The best thing you can do is to establish a dental home as early as possible – find a pediatric dentist to see your child for regular care as soon as your child has their first tooth. This dentist will be able to establish a relationship of trust with your child from an early age and get to know them and their needs.

With my patients, I try to remember their hobbies and interests so we have something to talk about when they visit. If your child feels comfortable around his or her dentist, appointments are more enjoyable and less intimidating. If an emergency situation would ever arise, children usually feel much more comfortable being treated by their regular dentist instead of someone they are meeting for the first time.

Nutritional counseling is a major part in preventing cavities from the standpoint of a pediatric dentist. We encourage discontinuing bottle-feeding at 12 months of age.  Not putting your child to sleep with a bottle with anything other than non-flavored water is also beneficial to limiting the rate at which your child can get cavities. Also, cleaning your child’s teeth after night-time feeding is highly recommended. Children should definitely not share utensils with siblings, parents and other caregivers who have had cavities before or have active cavities. Minimizing processed carbohydrate food products helps to decrease your child’s ability to get cavities. Limiting frequent snack intake as well as sugary drinks (flavored water, juice, soda, sport drinks and flavored milk products) during the day will decrease cavity formation in your child.

Cleaning your child’s teeth twice a day with a fluoride-containing toothpaste, especially at night time, will help prevent cavities from forming in their teeth.

Parents can check with their county about water fluoridation in their neighborhood and have a conversation with their dentist to determine if further fluoride supplementation is necessary for their growing child.

What dental habits should parents teach their children?

Parents should start cleaning their child’s teeth as soon as the first tooth appears. They can use a toothbrush or washcloth, or can buy a finger brush which is a small, soft brush designed to fit on the parent’s finger. Even if your baby only has one tooth, you should still clean it. Be consistent with brushing every day.

After brushing their teeth at bedtime, they should not eat anything else and should drink nothing other than water.

As your growing child becomes more independent, parents should follow up afterwards to check if the brushing has been properly done.

What should parents know about taking their child to the dentist?

Contrary to popular belief, you should not wait until your child is 2 years old for their first dental appointment. You should schedule your child’s first dental appointment when his or her first tooth appears, or no later than 12 months of age.

Don’t wait to see a dentist until problems arise. Instead, be proactive. Make caring for your child’s teeth a regular habit, and make time to see their dentist twice a year. By getting into good dental routine, many problems can be prevented.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

111 Chambers Hill Drive Opening

Starting Monday October 28, Keystone’s newest facility at 111 Chambers Hill Drive (on the corner of Norland and Fifth Avenues in Chambersburg) will be open for business!

The first floor of the building will be operational at that time. The practices on this floor are:

  • Keystone Urgent Care
  • Keystone Pediatric Therapies including Audiology and Speech (which will be renamed Keystone Pediatric Developmental Center) and
  • Keystone Infectious Diseases, HIV/STD Services, and Keystone Community Outreach (these practices will be combined into one office named Keystone Community Health Services)

In November, Keystone Administration and Keystone Pediatric Dental will move into the second floor of the building.

If you have any questions, you can contact us at 717-709-7900.

111 Chambers Hill Drive

Diabetes Health Fair!

Join us for this FREE event on November 16th, 2019!