Volume 4 Number 2
PHOTO COURTESY OF MINNESOTA DEPARTMENT OF TRADE AND ECONOMIC DEVELOPMENT
Q U A R T E R LY
Summer 2002
The mission of the Office of Rural Health & Primary Care is to promote access to
quality health care for rural and underserved urban Minnesotans. From our unique position
within state government, we work as partners with communities, providers, policy makers
and other organizations. Together, we develop innovative approaches and tailor our tools
and resources to the diverse populations we serve.
Minnesota Rural Summit 2002 Succeeded in
Linking Health and Economic Development
By Karen Welle and Stefani Kloiber
The Rural Summit, held in Duluth on June 23-25, and hosted by the Office of Rural Health
and Primary Care, Minnesota Rural
Partners, and the Minnesota Rural Health
Association, focused on exploring the relationship between health care and economic health in rural communities. From all
accounts, it was a rousing success.
Approximately 450 participants came to
Duluth eager to learn more about what
health and health care mean to the economic vitality and survival of Minnesota
communities. The Summit also highlighted
actions communities can take to strengthen the health care workforce, prepare for
aging communities, capitalize on new techKeynote speaker Pam Solberg-Tapper.
nology, and welcome diversity to their
community. Attendees found the conference to be a valuable opportunity for them to network, share ideas and discover new ways of
thinking in making the connection between health care and economic health in rural communities.
Among the many events offered at the Summit were three keynote speakers, 31 breakout
sessions, 26 learning stations, 51 exhibitors, and an opportunity to dialogue with Minnesota’s
U.S. Senate and gubernatorial candidates. A learning station highlight was Jack Geller and
Gerald Doeksen’s “Healthcare and Economics 101,” which gave all participants the opportunity
to hear about the economic impact of the health sector on their communities. If all of this wasn’t enough, Summit participants also had the chance to participate in an online rural policy discussion and survey on integrating health care and rural development, and enjoy a dinner cruise
of the Duluth harbor.
Estelle Brouwer, Director
Karen Welle, Assistant Director
Stefani Kloiber, Editor
Kick off keynote speaker Pam Solberg-Tapper presented an energizing message calling on
participants to ask themselves what they wanted to gain from the Summit. The following day
began with a stimulating presentation by Christopher Freeman Adams on the Healthy
Community Agenda Campaign and the seven patterns of healthy communities. As Adams
explained, a healthy community practices ongoing dialogue, generates leadership, shapes its
future, embraces diversity, knows itself, connects people and resources, and creates a sense of
community.
The presentation of awards has been a highlight of past conferences, and this year’s awards
continued and expanded that tradition. In addition to the traditional Rural Health Awards (see
article on page 7), Minnesota Rural Partners recognized Ed Frederick with the Lifetime
Leadership Award for his work in providing leadership in many venues for the benefit of rural
Minnesota. Dr. Frederick is a senior fellow at the Humphrey Institute, and facilitator of the
2
Minnesota Agriculture Project, Minnesota Dairy Leaders
Roundtable, and the University of Minnesota Rural Development
Council.
Brand noted that the political climate for improving rural health is
positive; in her words, “these days, it’s cool to be country.”
Prior to and during the Summit, nearly 300 people responded
to an online survey, contributing their thoughts and opinions on
the relationship between health care and broader economic issues
in their communities. Minnesota Rural Partners presented their
key findings from the
online discussion and
survey. To find out
more about the results
of the online discussion
and survey visit the
Web site at
www.ruralpolicyforum.org
On behalf of MNSCU’s Healthcare Education - Industry
Partnership, Kris Juliar announced the first recipients of the Rural
Partnership Awards. The partnerships of Mercy Hospital, Moose
Lake, and the Moose
Lake and Barnum
High Schools;
Rochester
Community and
Technical College and
the Minnesota Home
Care Association; and
Mankato Area
Minnesota Job Skills
Partnership Project
and Rochester
Workforce Council
Julie Zenner of Duluth, host of public television’s Almanac North,
were recognized for
facilitated a question and answer discussion with top-level state officials,
their cooperative
including Director Dean Barkley, Minnesota Planning; Commissioner Jan
Malcolm, Minnesota Department of Health; and Assistant Commissioner of
efforts in addressing
Health Brian Osberg, Minnesota Department of Human Services.
healthcare workforce
issues in their communities.
Following the awards presentation, Rebecca Yanisch,
Commissioner of the Minnesota Department of Trade and
Economic Development, addressed participants about her department’s efforts to help businesses expand, create high quality jobs,
and upgrade the skills of our workforce to meet the needs of rural
Minnesota.
The final day of the Summit focused on rural policy. Keynote
speaker Marcia Brand, director of the federal Office of Rural
Health Policy, U.S. Department of Health and Human Services,
brought conference participants up-to-date on Secretary Tommy
Thompson’s recent rural health initiatives. Since Secretary
Thompson introduced the initiative for rural communities at the
Joint International Summit on Community and Rural
Development last year, many steps have been taken to strengthen
existing programs and provide new opportunities. In addition, Dr.
The Summit concluded with three
major party gubernatorial candidates squaring
off in a spirited but
friendly debate facilitated by Minnesota Public
Radio’s Lorna Benson.
DFLer Roger Moe,
Republican Tim Pawlenty, and the Green Party’s Ken Pentel
responded to questions about rural health and economic development and debated larger issues such as taxes, jobs, and the environment.
The Summit offered something for everyone. But more importantly, it accomplished what it set out to do: raise the awareness
of the important link between health care and economic vitality
in rural communities.
More Summit highlights and photos can be found at
www.minnesotaruralpartners.org/2002_summit.htm
Karen Welle is assistant director of the Office of Rural Health
and Primary Care. She can be reached at (651) 282-6336 or
[email protected]
Stefani Kloiber is editor of this publication, and can be
reached at (651) 282-6338 or [email protected]
3
COMMUNITY FOCUS
Public Health and EMS Working Together in Houston County
By Stefani Kloiber
Doing a lot with very little seems to be the motto of emergency medical services (EMS) in rural areas. Rural EMS is constantly challenged with providing quality services with very limited funding. Reduced budgets and recent changes in
Medicare reimbursement rates have forced rural EMS providers to seek out new sources of financial assistance and work
closely with community partners to provide the best possible services. One rural Minnesota county found a way to strengthen and integrate their EMS system through teamwork and a little help from the Minnesota Rural Flexibility Grant Program,
administered by the Office of Rural Health and Primary Care.
In 2001, Houston County Public Health Nursing received funding from the Rural Flexibility Grant Program. This program provides funding to support activities that promote the regionalization of health services, improve access to quality
health care services, and provide for the development and/or enhancement of rural
health networks, including emergency medical service networks. Rural hospitals,
The banquet and
rural health networks and rural emergency medical organizations are eligible to
other public relations
apply for these funds. For Houston County, the funding they received provided
them with the resources to implement the EMS Workforce Development Project.
efforts helped Houston
First, some facts about Houston County. The 2001 census tells us that Houston
County is 558 square miles in area with a population of 19,940 people. Nearly 16
percent of the residents are 65 or older. Seventy-five percent of all EMS calls in
Houston County are for Medicare patients.
County add nine first
responders and increase
the EMT staff in Spring
Grove from five to 12.
Caledonia added four
new EMT’s as well.
Houston County is now
at full staffing.
Linda Grupa, Houston County Public Health Nursing Director, looked at EMS
delivery in Houston County while completing her Community Health Services
Plan. Linda met with local ambulance directors and key partners, including the
hospital, ambulance services and the county sheriff to brainstorm ways of improving EMS services in their community. Issues identified included insufficient funding, the need for more advanced communication equipment and adequate staffing.
As the issues were identified, so were possible solutions. However, solutions cost
money and Houston County did not have the resources to carry out the solutions. The Houston County EMS Workforce
Development Project was born.
The goal of the Houston County EMS Workforce Development Project is to “assure access to quality rural ambulance
services for Houston County residents by strengthening and integrating the EMS system.” In order to accomplish this goal,
the group identified six specific objectives:
•
Establish joint trainings and a staff development program.
•
Enhance radio and cellular telephone communication capabilities for providers through the purchase of communication equipment and networking opportunities.
•
Explore inter-agency agreements to support shared staffing.
•
Conduct collaborative recruitment and training activities.
•
Conduct at least one retention activity for volunteer ambulance providers.
•
Explore an employer incentive program to support daytime call coverage.
While these may seem like lofty objectives, Houston County was able to accomplish each one with help from the grant.
Some of their accomplishments are described below.
4
Community Focus
The funding provided by the grant allowed Houston County to
arrange several training opportunities for their staff. Training activities included cold-water rescue awareness, air bag safety, agricultural trauma training, and emergency medical dispatch skills. Two
trained sheriff’s office staff provided in-service training to the
remaining 14 dispatchers. Four EMT’s attended trauma tactics
training and shared this information with emergency responders
from neighboring towns. Houston County now not only has staff
trained to respond to emergencies but has training capacity as well.
In order to address the issue of staffing shortages, Houston County explored a cooperative
agreement to share staff when necessary. They
found that while ambulance directors were
accepting of the concept, a couple of issues
arose, the first being the distance between the
staff and the proposed shared service area. The
second issue, concerning a combination of medical direction, worker’s compensation insurance,
general liability and medical malpractice liability
insurance coverage, will take more time to
resolve. Even though no agreements were
made, the discussion process alone was beneficial. The group plans to continue their discussion of the issues and ways to resolve them.
health officials acknowledged the valuable role emergency services
personnel play in the current environment. Over 174 service
providers from the region attended the event. The banquet and
other public relations efforts helped Houston County add nine first
responders and increase the EMT staff in Spring Grove from five to
12. Caledonia added four new EMT’s as well. Houston County is
now at full staffing.
Reliable communication equipment is vital in responding to
emergencies. Grant funds allowed the county to
update their equipment. With the funds,
Houston County purchased six pagers, six
portable radios and a 4-channel base radio with
paging capabilities. According to jail administrator
Mark Schlitz, “having a second console increases
our capability to respond and communicate timely during a disaster or multi-injury event.” The
next step, replacing the outdated central dispatch
equipment that services 19 counties across
Minnesota, Iowa and Wisconsin, will require further funding and partnering with other counties.
The Houston County EMS Workforce
Development Project is proud of their efforts in
accomplishing their objectives. As a group, they
met their goal of improving access to quality EMS
by strengthening and further integrating their
An employer incentive program was
EMS system, and they believe their community is
another issue targeted by the group. Emergency
healthier because of it. The partnership will conresponder staff in Houston County are almost all
tinue. Much emphasis lately has been placed on
volunteers. The team, in partnership with local
emergency preparedness and Houston County is
employers, identified incentives for employers to
ready for the next step in this planning process.
allow their employees to leave work to respond
Houston County
While other counties and regions are just beginto a call. Incentives identified include flextime,
EMS staff receive agricultural
ning to think about how to bring public health
time off, and compensation for time off during
trauma training.
and EMS together in order to join forces for the
an emergency response. During the grant perihealth of their community, Houston County is poised for the next
od, Houston County was able to increase the staff pool from five to
challenge.
eight. Houston County EMS recognizes the importance of partnerships with local employers and will continue to work on ways to
provide employers incentives.
Stefani Kloiber is the editor of this publication, and can be
reached at (651) 282-6338, or [email protected]
Houston County felt that it was especially important to recognize the efforts of their EMS staff by holding an appreciation banquet and dance. The fall banquet proved to be especially timely
after the September 11 attacks. Local political leaders and public
5
Something Remarkable Happened in June...
By Estelle Brouwer
DIRECTOR’S CORNER
Something remarkable happened in June in Duluth. No, I’m not referring to the cold and fog
followed by blistering heat followed by more cold and fog. Duluthians are used to that kind of
thing by now.
I’m referring to the unique gathering of economic development professionals, rural health professionals, government officials, non-profit representatives, businesspeople and other assorted folks
that was the Minnesota Rural Summit 2002. For the past year, we at the Office of Rural Health
and Primary Care and the leadership of Minnesota Rural Partners and the Minnesota Rural Health
Association had envisioned the 2002 Summit as an opportunity for folks from both sides of the
fence – community/economic development and health – to come together to think about the synergy between those two fields and how that relates to their communities. Based on everything we
have heard so far, the Summit was a smashing success. It not only highlighted synergy; it created
electricity!
Our hope is that the Summit was the beginning of some exciting new partnerships at the local,
regional and state levels — partnerships that will ultimately lead to action and positive change in
our communities. Thanks to all of you who participated in the Summit. Please let us know if there
are ways we can continue to support you in your efforts to bring your communities together for
better health.
Ambulance Services a Policy Focus in St. Paul and D.C.
Challenges facing rural ambulance services are receiving renewed attention in St. Paul and in
Washington, D.C. At the state level, a subgroup of the state Rural Health Advisory Committee, in
cooperation with the Office of Rural Health and Primary Care, has for the past year been working
on a study of Minnesota’s rural ambulance services. The 2001 Minnesota Legislature directed the
Committee to conduct a study and make recommendations regarding the workforce and fundingrelated challenges faced by rural ambulance services. Preliminary results of the research conducted
for this study affirm several points, including:
•
Most of Minnesota’s rural ambulance services rely heavily on volunteers for their staffing. In
many parts of the state, volunteer ambulance personnel are scarce and getting scarcer.
•
As Minnesota’s rural communities age, ambulance services are more needed than ever, yet
Medicare payments are insufficient to sustain the needed service.
•
Rural ambulance personnel are a dedicated lot. In a mini-survey conducted in several communities around the state, when ambulance staff were asked if they felt that being on the
ambulance service was a good use of their time, 91 percent said yes.
Look for more results from the rural ambulance services study later this year. In the meantime,
take a moment to say thanks to an ambulance service volunteer in your community!
Estelle Brouwer is director of the Office of Rural Health and Primary Care. She can be reached
at (651) 282-6348 or [email protected].
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PARTNERS PAGE
2002 Rural Health Awardees are
Shining Example in Their Communities
By Stefani Kloiber
A highlight of the Minnesota Rural Summit 2002: Linking Health and Economic Development was the presentation of the
2002 Rural Health Awards, recognizing Minnesota’s outstanding contributors to rural health. At an awards luncheon on June
24, two Rural Health Heroes and one Rural Health Team were acknowledged for their contributions. The Rural Health Hero
and Rural Health Team awards are given annually to individuals and teams
who demonstrate compassion, leadership, efficiency, coordination, innovation, collaboration, unselfishness and quality in contributing to the health care
system and/or community.
Mel Nefstead of Staples was presented with the Rural Health Hero Award
by Tim Rice, Lakewood Health System President, for serving as a rural health
advocate in his community and statewide since 1968. Mel began his work in
rural health with a series of basic and advanced first aid classes and went on
to become an instructor and a promoter of first aid training, industrial arts
Rural Health Hero Mel Nefstead
safety, vision and hearing for children, newborn hearing screening, youth
(second from left)
tobacco prevention and workforce recruitment, to name only a few of his
contributions. Mel has served as a member and chair of many health care related boards in his community and statewide,
including his appointment to the Region 4 Regional Coordinating Board from its inception in 1991 to its culmination in 1999.
Even after retiring in 1994, Mel has continued to be active in statewide policy influencing health care in rural Minnesota.
According to Representative Mary Ellen Otremba (D) of Long Prairie, “Mel is
selfless and passionate in his work on behalf of rural communities and I know that
his efforts have made a real difference in the lives of countless people.”
Rick Failing, administrator for Kittson Memorial Healthcare Center in Hallock,
also received the Rural Health Hero Award. Rick has been with Kittson Memorial
Healthcare Center since 1993; during that time, he has been instrumental in
securing nearly $2 million in funding for projects to increase access to quality
health care in his community. The largest of these projects was $1.5 million in
state funding for the renovation of the hospital and the construction of a new clinic. Rick has worked tirelessly to ensure that quality health care is available in his
community and continues to do so by participating in several regional and state
advisory committees as well as a federal rural healthcare taskforce.
Rural Health Hero Rick Failing
“Rick is a positive, energetic force for progressive health care in our community. He excels in the ability to ‘think outside the
box’. He is creative, progressive, innovative, futuristic, and growth oriented in focusing on ways to maintain and improve
healthcare services to the citizens of Hallock and the surrounding area,” said Patricia Swanson, a nurse with Kittson Memorial
Healthcare Center.
The Rural Health Team Award went to the Freshwater Education District Lakewood Health System Fetal Alcohol Diagnostic
Team in Staples. The Fetal Alcohol Diagnostic Team began in the spring of 2000 to address a need for more community understanding of the effects of fetal alcohol syndrome (FAS). Staff from the Freshwater Education District and Lakewood Health
System teamed up and received a grant to provide education and training to students, parents, and professionals on preventing
and recognizing the effects of FAS. Additional funding helped to develop a local clinic where individuals displaying symptoms of
FAS can be referred. When funds ran out, the team donated their time and resources in order to continue to provide diagnostic
See “Partners Page” (page 8)
7
To learn more about the
Office of Rural Health & Primary
Care programs, visit our Web site:
www.health.state.mn.us/divs/chs/
orh_home.htm
This information will be made
available in alternative format –
large print, Braille, or audio tape
– upon request.
Partners Page
(continued from page 7)
services for the residents of Crow Wing, Morrison, Otter Tail, Todd, and Wadena counties. Team
members include Drs. David Freeman and Sarah Israelson, nurses Cindy Sauber and Kathy Kelly,
psychologists Karen Hmielewski and Rebecca Patience, and occupational therapist Paula Peterson.
Other team members are clinic coordinator
Sue Nyhus, Julie Krause and Mary Jo Hofer.
Dr. Pi-Nian Chang, a physician at the
University of Minnesota, provides training
and direction for the clinic.
“It’s all about the kids. Many of the kids
who need extra help don’t qualify for services. With this information, schools are able
to provide them with the help they need.
In addition, it provides us the opportunity
Staples Rural Health Team
to educate families, school system staff, and
the community to help better understand
the effects of FAS/E and meet the needs of their kids, “ said team member and school psychologist,
Karen Hmielewski.
Stefani Kloiber is the editor of this publication, and can be reached at (651) 282-6338, or
[email protected]
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