Cathleen McElligott is the Director of the Massachusetts State Office of Rural Health.

What are two of the biggest challenges your SORH faces and how do you meet them?

A big challenge for us, as a relatively small SORH, is making sure we continue to develop effective strategies with the greatest impact when there are so many rural health needs, and so much happening in the healthcare environment. It would be really easy to get side tracked off to 100 different directions each year. But these would not necessarily be teed up over time to really make a difference. To address this we work hard to think and plan strategically, as a staff and with our advisory groups and partners; to be clear on our purpose and vision; and develop multi-faceted and multi-year strategies. We measure each new opportunity against whether or not it is within the defined purpose of our office and whether it will lead to our vision.  We determine what our role in the endeavor should be in order to make best use of our resources and those of our collaborators.  We conduct background research, review data, and confer with our advisory council and partners to plan more deeply.  Most important, we have learned that we need to engage in longer term, sequential, staged strategies to truly assess our options, develop multi-faceted approaches with partners, evaluate our progress, and sustain the successful parts of the effort over time.

A second big challenge is developing a rural voice that can be heard over the strong and pervasive urban thinking in our state. Our rural areas, of course, are furthest from the state capitol of Boston and its policy makers, and there are rather large healthcare organizations right in Boston that can easily dominate health care policy.  Our response to this challenge has  been to develop a strong network of rural health care leaders through our SORH rural health advisory group called MARCH (Massachusetts Rural Council on Health), build a communications and networking infrastructure using various modalities, and conduct activities to provide sound information, messaging, and tools to support rural health efforts.  With this, the SORH has been able to develop a rural voice using local rural health care leaders to successfully impact state policy and programs to better address rural health care needs in our state.


What are some of the positive things going on right now in health care in Massachusetts?

In our state, we have made a very conscious decision, supported by the people of the Commonwealth, to strive for universal access to affordable health care coverage. So over about 15 years, with a thoughtful and collaborative partnership of all stakeholders, the policy, resources, and hard work have been put into place piece by piece to make this happen. As of 2011, Massachusetts reached the milestone of 97% of our population being covered by insurance; and now with additional recent changes as a result of ACA, initial reports are that we may be at 99+% insured now. In addition to ensuring access to health insurance, we are fortunate to work in a state that believes in making investments in community based innovations such as the Community Hospital Acceleration, Revitalization, and Transformation Investment Program (CHART), the Health Care Workforce Transformation Fund, the Prevention and Wellness Trust Fund, and Patient Centered Medical Home, E-Health, and Broadband Initiatives, etc.  Our job in the State Office of Rural Health is to help to inform these new programs about the needs of rural providers and to assist our rural communities with accessing these important community health supports and performance improvement initiatives.