How health partnerships can help rural communities prep for COVID

Yolanda Yoder M.D. and Priscilla Barnes PH.D.

Author: Priscilla Barnes, Ph.D. & Yolanda Yoder, M.D.
National Rural Health Association – See the story here

With stark images of urban hospitals overrun with patients, the national media coverage of COVID-19 has focused largely on cities. Less discussed and less understood is the impact on rural communities, which have been grossly underprepared for a pandemic. As we contemplate an additional wave of the virus, now is the time to assess how rural communities can achieve greater resilience.

We now know that having an adequate supply of ventilators, testing, and PPE is essential, but this alone won’t be enough. Just as important are the structures we have in place — specifically, community partnerships around health. In hindsight, it is increasingly clear that communities that developed relationships within their health network were able to respond faster and more effectively than communities where organizations operated in isolation.

Given the realities facing rural America — physician shortages, a dearth of health care resources, and a population that’s highly vulnerable to chronic disease — these partnerships were always important, but increasingly so during a pandemic. This virus has served as a wake-up call to strengthen these partnerships and tackle rural health challenges in a more committed and enduring way.

Building more resilient rural communities means maximizing existing resources, staging health interventions that address root causes, and thoughtfully sharing information. Partnerships are at the core of these interventions. We must find ways to incentivize and support community health networks that include health care providers, local and national nonprofits, businesses, and local government officials. Such partnerships, whether they are formal or informal, can help rural America whether the next wave of the virus and address underlying health challenges.

Fundamentally, rural health partnerships enable communities to more effectively address social determinants of health. As America’s experience with the pandemic has made clear, populations that were already experiencing health disparities have fared worse than those that were not. Rural health partnerships can help address social determinants of health that lead to disparities and remove some of the strain from health care providers.

When community health organizations band together to holistically address social determinants of health — as we have seen in Orange County and Daviess County, Ind., through the development of community health improvement plans — we can free up practitioners within the formal health care system to do what they do best. When patients are receiving help gaining access to housing or food from community partners, doctors and nurses are able to concentrate on treating the most serious cases. In rural America, where the proportion of providers to the general population is far below the federal recommended level, this type of coordination is especially needed.

Such coordination also applies to sharing resources like in-demand PPE between community health organizations. As we prepare for a potentially prolonged economic downturn, we need to extend this model to address other social determinants of health. If one community’s food pantry stock is bare, another town may have a surplus. We need to expand rural health partnerships to enable this type of coordination.

The impact of rural health partnerships can also be felt in less obvious ways. One of their most important functions is information sharing. Rural health practitioners often wear many hats and lack the ability to focus deeply on any one area of their practice. Health partnerships can ease this burden by delivering customized solutions. The Indiana University Center for Rural Engagement and Southern Indiana Community Health Care recently developed a new app to track the spread of COVID-19 in consultation with local physicians and public health leaders. Moving forward, it will provide surrounding communities with advance warning of an outbreak.

Information sharing can be as simple as sending daily or weekly updates and COVID-19 safety recommendations. Other groups have developed an online directory of financial and physical resources such as food and medication delivery services for individuals and families. Some respond directly to inquiries and manage social media channels dedicated to informing organizations and residents and supporting local needs.

Rural health partnerships yield tremendous value that we cannot afford to ignore. As we expand our work, we need local governments and community-based organizations to help us better shape our approach to fit individual rural communities. But this is just a start. We need continued investment and partnership from government to strengthen rural health networks.

If necessity is the mother of invention, then crisis is the mother of adoption. Rural health partnerships were providing value for rural Americans before COVID-19. Now that the pandemic is here, such partnerships are indispensable and should be greatly expanded.

Dr. Priscilla Barnes, Ph.D. is an associate professor at Indiana University Bloomington School of Public Health and an affiliate faculty member at the IU Center for Rural Engagement.

Dr. Yolanda Yoder, M.D. is a physician of family medicine at Southern Indiana Community Health Care.

Posted by Tim Meyers in Rural Healthcare

SICHC expands obstetrics services into Crawford, Martin counties, restores critical services to medically underserved areas

SICHC Obstetrics Team
NEW OB TEAM – Southern Indiana Community Health Care (SICHC) launches new OB services for expectant mothers and families in Crawford, Martin and Washington counties. From left: Dr. Karen Farris, Dr. Yolanda Yoder (SICHC Medical Director), Dr. Sean Sales, and Missy Ray, FNP.

New family practice physician will also join SICHC in August, serving families and OB patients in Orange County as SICHC also opens new facilities in Shoals and Salem.

PAOLI, Indiana – Long-time medical provider Southern Indiana Community Health Care (SICHC) formally launched its new obstetrics services in Crawford and Martin counties in early August. The new OB service will now provide a full spectrum of services, including well-woman visits, female health, birth control, pregnancy care (pre-natal and post-partum), well-baby care, tobacco cessation and other OB-related services.

“We are very pleased to introduce these new services locally in what has sometimes been described as a medical desert for critical OB services for pregnant mothers and babies,” said Dr. Yolanda Yoder, MD, SICHC Medical Director. “We are excited that our medical professionals will begin seeing obstetrics and gynecology patients this month in Crawford and Martin counties.” SICHC is also planning to bring OB services to the Salem area in Washington county later in August.

The new OB services will be provided at rural facilities in English, Marengo, and Shoals. The facilities provide convenient access and reduce barriers of transportation in securing quality health care, including being closer to under-served Hoosier mothers and segments of Indiana’s Amish population. The services in Shoals will take place at the Hoosier Uplands Health Department/WIC site, which is partnering with SICHC to provide a broad spectrum of services.

“Rural Indiana faces real challenges in combating infant mortality and securing quality pre-natal, pregnancy, post-partum and well-baby care, and we are grateful to see SICHC stepping up to deliver these important health care services where there is a demonstrated critical need,” said Indiana State Health Commissioner Kris Box, MD, FACOG. “SICHC’s demonstrated commitment to provide health care regardless of a patient’s ability to pay represents a real asset in these medically underserved and economically challenged areas of southern Indiana.” 

A traveling Family Nurse Practitioner (FNP), Missy Ray, MSN, will serve OB patients in the three offices. In addition to holding a master’s degree in nursing with her FNP certification, Ms. Ray has considerable experience in obstetrics. SICHC has also secured the services of Dr. Karen Farris, a family practice physician, who will begin taking appointments in mid-August for OB patients in the SICHC Valley Health Care office in West Baden Indiana (Orange County).

Service to OB patients will be directly coordinated with the selected delivering physician, including secure video, phone, and electronic connectivity with the physician during prenatal visits. Patients will transition to direct physician care at 36 weeks in SICHC’s Paoli or West Baden offices until delivery, which will take place at the IU Health hospital in Paoli, according to Dr. Yoder. Transportation assistance is available for patients in need.

“SICHC has a demonstrated passion for providing medical services to communities and regions in southern Indiana that sometimes face serious challenges in securing access to health care,” said Nancy Radcliff, SICHC CEO. “We are privileged to continue to do what it takes – even seeing patients in our facilities parking lots during this time of COVID-19 – to support the patients, families and rural communities in our southern Indiana region.”

SICHC OB services will be offered at three locations:

  • Uplands Health Department/WIC – 127 West Water Street, Shoals, IN 
  • Patoka Health Care – 307 S Indiana Ave, English, IN
  • Crawford County Health Care – 5604 E. White Oak Lane, Marengo, IN

Hours are 9 a.m. – 4 p.m. (EDT), with offices closed for lunch between noon and 1 p.m. To schedule an appointment, please call 812-723-3944 and specify the location.

Another new SICHC OB service site will be operational this fall in Salem, Indiana in Washington County.

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About the Southern Indiana Community Health Care (SICHC) nonprofit organization – Well-known as a high-impact health care provider committed to continuity of care, the nonprofit Southern Indiana Community Health Care (SICHC) organization is committed to providing high-quality, comprehensive, community-sensitive health care utilizing Christ-centered principles to medically underserved, rural communities.  As a Federally Qualified Health Center (FQHC), SICHC serves as a “safety net” provider for vulnerable populations and focuses on increasing access to primary care services for Medicaid and Medicare patients in rural communities. SICHC offers medical care in medically underserved areas of Crawford, Martin, Orange, and Washington counties. SICHC is a member of the National Health Services Corps and receives program funding from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services. SICHC offers services to all persons, regardless of the person’s ability to pay. For more information, please visit https://sichc.org/

Posted by Michael Snyder in Obstetrics, 0 comments