IDOH all-in on transformative rural health effort
Story by Brent Brown, Indiana Department of Health
The changes won’t happen overnight and the results may take time to appear in data sets and expert analyses, but a five-year-long effort to transform the landscape of public health in rural Indiana communities is underway.
The federal Centers for Medicare and Medicaid Services announced in September the Rural Health Transformation Program (RHTP), which would allocate $50 billion among all 50 states to address issues specific to rural areas throughout the country. Indiana applied to receive at least $1 billion over the course of that span. The initial tally was up in the air until Dec. 29 when it was announced Indiana would net just shy of $207 million for the first year of the RHTP.
That’s 207 million reasons to be positive about the future of public health in the new year.
Thrilled may be the most appropriate word to describe how some of the leaders behind Indiana’s RHT, GROW (Growing Rural Opportunities for Well-being), welcomed the news. That’s how State Health Commissioner Lindsay Weaver, M.D., FACEP described how she felt when the funding amount was revealed.
Having requested $200 million, Dr. Weaver said receiving the additional funds is exciting and will further bolster the agency’s hopes for better health outcomes for rural Hoosiers.
The initial announcement followed “extensive feedback and collaboration” from and with “a broad network of rural residents, providers and provider organizations, community leaders and state legislators,” according to the RHTP summary, the results from which were incorporated into a dozen interconnected key initiatives by the Indiana Department of Health and the Indiana Family and Social Services Administration.
Click the following links to learn about each initiative:
- Initiative 1: Growing Care Coordination, Medical Operations Coordination Center (MOCC) and Alternate Payment Model Feasibility Study
- Initiative 2: Growing community connections through Indiana 211
- Initiative 3: Growing improved patient outcomes through enhanced interoperability and technology.
- Initiative 4:Growing pediatric and obstetric readiness in rural emergency departments
- Initiative 5: Growing cardiometabolic health standards of care in rural Indiana
- Initiative 6: Growing access to hospital post-discharge medications
- Initiative 7: Growing specialty provider access through expanded teleconsult capabilities
- Initiative 8: Growing telehealth access and infrastructure
- Initiative 9: Growing our rural health paraprofessional workforce
- Initiative 10: Growing clinical training and readiness
- Initiative 11: Growing our rural behavioral health workforce
- Initiative 12: Make Rural Indiana Healthy Again Regional Grants
With the funding defined, key initiatives identified, and a branding effort that reflects the transformative processes to come in place, the real work is set to begin. Dr. Weaver cautioned that the funding “isn’t meant to solve all of our problems,” but said issues that previously had to be put on hold due to financial constraints could have a renewed focus. There is much to do, after all, and each of the dozen initiatives, 10 of which are helmed by IDOH staff, presents its own unique challenges.
“We have big gaps to fill, but this will help us get over the edge to improve health outcomes,” she said.
That means enhancing technological infrastructure and digital connectivity, eliminating barriers to care and providing appropriate levels of care, enhancing maternal and newborn care, making sure patients receive their prescribed medications before they leave the hospital, growing and retaining the rural health workforce, regional grants for these initiatives and much more.
With the survey and application process alone, it was all-hands-on-deck before this proverbial ship even set sail, but now the course is becoming clearer, even if some of this is uncharted territory, and it will take the entirety of the IDOH crew aboard, piloting the vessel.
“We want everyone to spread the word and keep talking about it,” she said. “We want our staff to be familiar with the initiatives,” adding that one of the most important ways Indiana Department of Health staff can contribute is by sharing what they know and directing the public, stakeholders, and others interested to the relevant information sources.
The primary repository for that info is the brand new GROW website, which launched earlier this month and offers a wealth of information about the transformative project. Beyond that, IDOH staff can expect frequent updates on the project status via all-staff meetings, emails from the commissioner, and other means, including planned video testimonials about how this work is changing the landscape of public health in rural areas.
Now, the seeds are planted and the forecast is calling for plenty of sunshine and just the right amount of rain needed for a successful harvest. There are some clouds in the future as the annual amounts for the rest of the funding have yet to be determined for the forthcoming four years, but the optimism of the program leaders that shone through on that dead of winter day when the funding finally came to fruition is a feeling that’s always in season.
Perhaps most importantly, the “why” behind GROW matters as much as the “who, what, when and where” of it all.
“We need to know why this is so important,” Dr. Weaver said. “It’s because health is the cornerstone of the success of rural communities.”
In a given community, health outlooks and outcomes play a role in who chooses to live there, who works there, and what amenities are available. If certain services are not present – health care-related or otherwise – people may be less likely to make that place their home.
Challenges like these are on the horizon, but the program’s leaders are ready. Experience with Health First Indiana has helped make IDOH staff uniquely prepared for what’s to come through strong relationships built with local health departments and the knowledge garnered about what’s happening in public health in the Hoosier state. It’s a foundation ready to be built upon and one on which Indiana’s rural communities can GROW to depend.
The “all-in” nature and optimism for what lies ahead was captured in the funding announcement email from Dr. Weaver Dec. 31.
“I am incredibly excited to make these projects a reality and improve health outcomes for Hoosiers who live in rural communities,” she said, detailing transportation access to affordable and healthy foods, health education and literacy, and access to local providers as “top needs.”
“I look forward to taking on this challenge with you,” she said.
