Pat Justis – August 2016

i Dec 22nd No Comments by

Patricia Justis
Director, Washington State Office of Rural Health

How did you get to where you are now?
I have a Master’s in Counseling Psychology and got into healthcare on an inpatient psychiatric unit where I worked for 14 years. The hospital was doing Total Quality Management and I ended up working another eight years in quality improvement at a semi-tertiary center that served five rural counties. I tried my own business for a few years doing consulting, writing and photography. I’ve now been with the Washington State Department of Health (DOH) since 2009 and in my current position for two years. In my first six years at the DOH, I ran statewide and regional PCMH collaboratives. The last one was in a rural area, which got me very hooked!

What is the most important thing you are working on right now?
We are getting ready to launch a palliative care integration project with the idea that no rural community can stand up a free-standing palliative care service. We’re working on a Project ECHO type service of case consultation and exploring the feasibility of using board certified palliative care to provide direct patient telemedicine to rural communities. We want to create rural Centers of Excellence and integrate a training and technical assistance package to clinical teams to help with the culture change and how to think differently about this aspect of care. The overall goal is to minimize the use of long-term care beds and decrease transfers to tertiary centers for people who are not going to get better. We want to help people stay in their communities for care so they have the support of loved ones, which everybody needs when they are vulnerable and sick. We also consider site visiting as one of the most important things we do. Rural constituents would say we are visible and attentive and that we show we care by going to them.

What are some great things about rural health in your state?
We are a super diverse state with strong leadership and a lot of wonderful supports out there. We have only had one CAH closure. The University of Washington Research Center is near to us and we get a lot of interaction with the researchers. We also have strong partnerships with the Hospital Association and the Washington Resources Group, which is made up of the DOH, our Primary Care Association and both AHECs. We meet and lay out a calendar of residency visitations and canvas every residency across the state.

You recently hired new staff. What skill sets do SORH staff need?
I look for a sense of passion and empathy for rural communities. I look for staff who get along with others and are resilient when faced with a challenge. Instead of saying something’s too big and we can never get it done, what can we say “yes” to? We are a relatively new team, which gives us the ability to see things in a new way and make changes thoughtfully and with respect for how things have been done. We can step away from “we’ve always done it this way” and really try some new things. They are all very dedicated professionals.

Mary Winar – July 2016

i Jul 18th No Comments by

Mary Winar
Manager of the Connecticut State Office of Rural Health

How did you get to where you are now?
I’m a nurse and worked in various health care settings, and I was looking for a different employment opportunity. I responded to an ad in the newspaper for a rural health assistant. I thought it sounded interesting, so I applied and got the job in July of 1999.

What are three (life or work) lessons you would like to share?
1. Be honest and sincere 2. Organization leads to efficiency 3. Stay focused, but be willing to adapt to change

What are you doing to ensure you continue to grow and develop as a SORH leader?
I read and research as much as I possibly can and ask questions if there is something I don’t know or understand. It’s important to learn from other people and to always be looking for resources and opportunities to share information.

What is the most important thing you are working on right now?
Promoting telehealth services in the state. Recent CT legislation will allow for telehealth services to be provided for Medicaid recipients. This provides an opportunity to create more awareness and potential to increase telehealth services in the state. Another priority is the opiate crisis, which is a tremendous strain on rural resources. I’m looking to support educational programs for rural providers. I sit on an Opiate Task Force that was created two years ago. The CT-ORH is assisting them with strategic planning and data collection to provide direction and substantiate the need for more resources and services.

What are some great things about rural health in your state?
Strong collaboration. Everybody learns to work together quite well because there are less resources. You’ll see so many partners working together on the same projects. We are a small state. You can get to one end of the state to the other in about 2 ½ hours. There are many great initiatives and trainings that occur with a very small amount of money. The office has funded very successful trainings for Narcan (Naloxone) community awareness and administration and SMART triage training for EMS providers. Another initiative was community CPR training for participants of a healthy heart program. Four rural volunteer EMS organizations conducted the trainings. EMTs who were training to be CPR instructors were utilized as part of their training experience. It was a great collaboration that benefited so many.

What do you do when you are not working?
I like to sew and love spending time with my family, especially my 29 month old grandson who lives about 2 ½ hours away in Wilton, NY.

Adrienne McFadden- June 2016

i Jul 6th No Comments by

Adrienne McFadden, MD, JD
Director of the Virginia Office of Minority Health & Health Equity (since January 2014)

How did you get to where you are now?

I was a clinically practicing emergency physician who had additional skill sets from a legal education, in addition to my medical education. I was looking for opportunities within the health realm and happened upon a job in Richmond that would allow me to utilize my additional skill set and pursue my passion in health policy. We are the only state that has all three state-designated offices (SORH, Primary Care and Minority Health) under one roof.

What inspires/excites you most about working at the Virginia Office of Minority Health & Health Equity?
Working among passionate people and knowing at the end of the day we do make a difference in multiple communities and individuals’ lives.

What is the most important thing you are working on right now?
Making sure health equity is always at the forefront of our decision makers’ and leadership’s minds. This goes for rural health equity as well as health equity with regard to racial and ethnic groups, socioeconomic groups, and other underserved groups in the Commonwealth.

What are you doing to ensure you continue to grow and develop as a SORH leader?
Maintaining humility and making sure you hire really great people you can continue to learn from as well. We are always looking at what’s going on not only in this state, but with our colleagues in other states and at a national level to see if we can learn best practices or learn from missteps or other things that are happening elsewhere.

What is the biggest challenge facing SORH leaders today?
Maintaining focus on the issues that impact rural health because the number of individuals that reside in rural Virginia communities is shrinking, but that doesn’t make their challenges any less important.

Brad Gibbens- May 2016

i Jun 8th No Comments by

Brad Gibbens
Deputy Director, North Dakota Center for Rural Health

How did you get to where you are now?
I had an attraction to the general idea of rural; it wasn’t my academic background. I grew up on a durum wheat farm in rural North Dakota. As a farm boy, rural was something I could relate to. I’m now in my 31st year at the Center for Rural Health. I started in 1985 out of grad school as a program assistant and then became a program coordinator. When the Center got their first rural health research center grant, I became a policy analyst. I was named Associate Director in 1991 and remained in that position until becoming Deputy Director in 2010.

What inspires/excites you most about working at the Center for Rural Health?
It’s the same thing in 2016 as it was in 1985 – an opportunity to try to make a difference. I want to be intellectually challenged, take what I learn and turn it around to help other people…help the people I grew up with. It makes a difference if you’re working in the state you grew up in because you truly understand the culture, norms, values, people and have a sense of the topography.

What is the most important thing you are working on right now?
I’m working with our Flex Program on a new round of Community Health Needs Assessments. I started 31 years ago by getting in a car in my first week and going to a small town to do interviews for recruitment and retention. What I enjoy more than anything is going to a rural community and doing something that directly benefits that town. I want to help them think through where they are now and where they want to go.

What is one characteristic that you believe every rural health leader should possess?
Flexibility. People who don’t understand rural health think of it as being simple, especially because of small areas and populations. They think it can’t be as complicated as urban issues. Rural has complex issues because of a small population spread out over a large area with unique access issues. SORHs have to know a little bit about a lot of things. Anybody interested in rural health should definitely spend part of their career as a generalist. Learn how to do a lot of different things. In the process you will figure out what stimulates you and what you’re good at. The more different things you can do, the more value you are to an organization.

What are you doing to ensure you continue to grow and develop as a rural health leader?
I operate from assumption that I don’t know everything. I go directly to rural communities to learn, attend conferences and talk with colleagues. I like to ask people what they are doing and learning. I want them to share it with me to keep me fresh. Never allow yourself to quit learning!

Keith Clark- March 2016

i Jun 8th No Comments by

Keith Clark
Director, Rural Programs
Nevada Office of Rural Health

Keith recently joined the NOSORH Board as a first-time Workforce Liaison. He is also our “Chief Photographer” for the group photo at the Annual Meeting each year. You can look for him photo shopped into last year’s group photo. Keith has an extensive background in photography, but lucky for us, he has a strong connection to his rural health colleagues.

How did you get to where you are now?
I have been with the University of Nevada School of Medicine for about 10 years, serving in many roles, including AHEC Director. I am also currently serving as the President of the Board of Directors for 3RNet.

What is 3RNet working on these days? 
If you haven’t seen 3RNet lately, you haven’t seen 3RNet! We are looking at new and innovative ways to attract healthcare providers to rural areas, offer value-added benefits, and be an education source to members.

What is the most important thing you are working on right now?
We have the opportunity to really make a difference in people’s lives. If you can bring one provider to one community, you have changed people’s lives.  I live in a rural area of Nevada, so I know firsthand how long it takes (500 miles roundtrip!) to get some of the healthcare my kids need. You can’t deliver a baby in my town.

I’ve been working under the leadership of Gerald Ackerman to expand rural residencies in the state. We have developed one of the first rural residency programs based out of CAHs. We need to increase and duplicate this where we can. We found that if we educate someone in the state and they do residency training here, we keep 80% of them in the state. We need to find places for them!

Check out the University of Nevada School of Medicine Rural Residency Video from National Rural Health Day 2015.

Michelle Hoffman- February 2016

i Jun 8th No Comments by

Michelle Hoffman
Flex and SHIP Program Manager, Wyoming Office of Rural Health

How did you get to where you are now?
My background is in higher education and I felt like I needed a change. When my youngest child graduated from college, I decided that was the time. I moved from South Dakota to Wyoming, not knowing a soul. I took a position at the Office of Rural Health and Sharla has been a great mentor over the years. I consider this an adventure and I love learning all that I can about rural health.

What inspires you and excites you most about working for a SORH?
The people. The people in small communities wear so many different hats and they are a wealth of knowledge.  I love to meet with new partners and stakeholders. When you put names and faces together, you make a better connection for both sides.

What is the biggest challenge facing SORH leaders today?
There is a constant struggle to do more with less. We are working with stakeholders on prioritization to help them stay afloat. Wyoming did not expand Medicaid, so it is important for us to work with our providers to help them remain viable and maintain access to care in these communities.

What is the most important thing you are working on right now?
Right now, I am learning how to input data into the Cart tool and looking at population health data. However, when the Flex grant comes out next month that will be the most important thing I am working on.

What do you do to unplug (and unwind)?
I love the sun. Anytime there is any sun, I am outside – even in windy Wyoming.  I like to garden, hike, ride bikes, and be with family. This year, I want to take more classes at the local community college.

Don Wood- January 2016

i Jun 8th No Comments by

Don Wood, Director, Utah Office of Primary Care and Rural Health

What are the most important things you are working on?
The most important things we are working on right now are implementing two new state loan repayment programs for providers, demonstrating success in two primary care grant programs, providing accurate and meaningful technical assistance, and hosting a meaningful and value laden rural hospital administrators summit.

What is the biggest challenge facing SORH leaders today?
The biggest challenge facing SORH leaders today (at least in our state) is funding and data. It is difficult to keep up to date on all of the rural health care changes. We could do a lot more and be more effective with increased funding and more data, including more timely analysis of data already being collected.

What characteristic should every SORH leader possess?
One characteristic I believe every SORH leader should possess is excellent communication skills – especially listening skill. Every single issue you deal with must begin with a dialogue. As a leader you have to be able to listen attentively, interpret accurately what you are hearing, and then articulate clearly your positions or solutions.

What is something great about rural health in your state?
There are 3 great things about rural health in our state:

1) We have a very talented and dedicated staff in our Office of Primary Care and Rural Health. It is a pleasure to work with individuals who get rural health and are motivated to do all they can to improve rural healthcare in every way possible. It is also a blessing to have an administration that supports our office and our efforts. They are knowledgeable and experienced in rural healthcare to a very exceptional degree. It is exciting to work in an environment that understands and supports your efforts and priorities.
2) Recognizing great work of our provider agencies and the accomplishments of their efforts. Utah has submitted applications for great works of our CAH hospitals to the National Rural Health Resource Center and their CAH Recognition program.  We have had a hospital selected in each of the first five competitions and are proud of their efforts and the recognition that followed their efforts. Additionally two more of our CAH hospitals were recognized this past year at the NRHA CAH conference S Top 20 Best practice Recipients in the areas of Patient Satisfaction Reporting and Financial Stability. Also, all of our hospitals are doing great work with HCAHPS, MBQIP, and ICD-10, which they have put a great deal of effort in over the past two years.
3) And the greatest thing about rural in our state is the collaborative relationships we have with our hospitals and clinics, organizations such as our state hospital association, our primary care association, our state rural health association, our local health departments, and many other partners and state agencies who all work with us to improve health care in rural and frontier Utah. It is refreshing to always deal with the positive attitudes and willingness to work together for the greater good.

Tammy Norville- December 2015

i Jun 8th No Comments by

Tammy Norville, Rural Health Operations Specialist for NCORH

What is the most important thing you are working on right now?
I am working on becoming a certified professional coder with an instructor certification and then certified compliance professional.  Building this skill set within the office has positioned us as a resource for safety net providers and other folks as well. Coding and documentation is such a big part of how clinics stay afloat.  ICD-10 put a spotlight on this.  We are helping RHCs understand the business aspect of healthcare and become a mission driven business.  When you have been in one clinic, you have been in one clinic.  You need understand the dynamics of the community to really be able to help them. Our work on this allowed us to grow our technical assistance with health departments and has led to our inclusion in Medicaid reform efforts in our state.

How did you get to where you are now?
I began by helping inner city childcare facilities with their financial operations.  I then worked for an organization to open assisted living facilities and get through all the inspections throughout four states.  I then applied for a job with the state to survey assisted living communities, but worked with mental health.  I applied for a job at the SORH in 2003 and am still here 12 years later.

What skill sets do you think SORH staff need?
I think flexibility and adaptability are important because things change fast.  Just because you provide things this way now, in five years things need to change. Personally, I think coding/billing/documentation is an important skill set – this is the root of the viability of the clinic.  You don’t need to be a coder, but you can understand the concepts.

What is something great about rural health in your state?
Medicaid Reform is having conversations across divisions.  Whatever happens with reform conversations will determine if we do expansion.  These conversations were a step that needed to happen.  ICD-10 training was also a cross-divisional effort.  When we all work together, then we can be successful.

Crystal Barter- November 2015

i Jun 8th No Comments by

Crystal Barter is the Director of Performance Improvement for the Michigan Center for Rural Health. She came to the Center through an AmeriCorps position a little over 6 years ago. Crystal grew up in the “Asparagus Capitol of the Nation” in Hart, MI on Lake Michigan.

Q. What is the most interesting thing you are working on right now?
We are working on three innovative projects that I am very excited about right now.

The MCRH is a partner in a Practice Transformation Network Award. As part of this three state initiative, we will be working with rural healthcare providers, including certified RHCs and rural private practices in achieving large-scale health transformation. This includes sharing, adapting and further developing comprehensive quality improvement strategies and operational efficiencies.

The MCRH is partnering with the Michigan Health & Hospital Association Keystone Group to participate in the Hospital Engagement Network 2.0. The MCRH will work with the 20 independent CAHs in Michigan as a quality improvement coordinator. The work focuses on the culture of patient safety within an organization.

The MCRH assisted in submitting two CMS ACO Investment Model applications as part of the Medicare Shared Savings Program. The ACO participants include 17 rural hospitals and 1 rural FQHC. They had their first joint meeting of rural ACOs in August and will be hosted their second one in November.

Q. What is one characteristic that you believe every SORH leader should possess?
Flexibility. Every day we are presented with new challenges and opportunities, so it’s important to be willing to change your planned course of action if it’s needed. Also, I think that building and maintaining partnerships is a vital characteristic of successful SORH leaders.

Q. What are you doing to ensure you continue to grow and develop as a SORH leader?
Saying yes to new opportunities and looking at them as learning opportunities instead of increased workload is something I strive to do.  It’s important to view new challenges as a way to build skills.

Q. What is the biggest challenge facing SORH leaders today?
I think prioritizing is one of the biggest challenges. There are so many resources that SORHs can offer, and so many competing priorities that one must be able to analyze and determine what makes the most sense for their state. Also, in my position, I cannot be a subject matter expert on everything and sometimes I find it frustrating not being able to answer a very technical question. But, working with partners, I know that we will be able to find the correct answer and get back to our SORH audience.

Q. What are your top three goals for 2016?

  1. Finishing my Master’s as I am two classes away from obtaining my Master’s in Healthcare Administration.
  2. Assisting John and the rest of the staff in expanding MCRH staff, resources, and diversifying our revenue stream
  3. Continuously improving leadership and management skills

Melissa VanDyne October 2015

i Nov 16th No Comments by
What was the biggest challenge for you when joining the Office of Rural Health?
Many of the performance measures were so broad, overarching and big picture that it was a little difficult for me since my career has focused on very quantitative instead of qualitative measures.  I spent nearly 13 years working on grants for communicable disease, STD, and HIV, so when I started, I asked how do you know if these programs are really making a difference?  I realigned our evaluative techniques to go back to the basics to make sure we are measuring what we are doing appropriately.  I created a logic model (click here to view) to focus our office activities.
What have you learned this past year?
I recognized that our relationship with our hospital association is one our strengths because they have the complete trust of our rural hospitals. We were only working with them on MBQIP.  We realigned our Flex grant to develop a new quality improvement program that includes MBQIP measures and financial measures.
What is the most important thing you are working on right now?
Every 2 years we provide a biennial report to the legislature (click here to view).  This year we are taking it a step further and adding rural and urban health disparities.  It will be a useful report when it is finished but it is a lot of work until then.
What are your 3 goals for the upcoming year?
1. I want to do more professional training to learn how to be a better supervisor and leader.
2. I want to try to strengthen collaborations.  We are trying this with a joint conference this year.
3. We are also rebuilding SORH activities to make them stronger.
If you weren’t doing this, you would be…?
I would still be working at the department of health.  I am very passionate about improving public health, mental health, and chronic disease.