Many Thanks!

A big thank you to our Platinum Sponsor United Healthcare, and our Conference Sponsors and Co-Sponsors:

• Missouri Department of Health and Senior Services (Office of Rural Health and Primary Care)
• Missouri Hospital Association
• Missouri Primary Care Association

And thank you to presenters, moderators, and attendees for supporting this year's event. See you at Old Kinderhook in 2022!

KEYNOTE ADDRESS

The Landscape of Rural Health

National Rural Health Association (NRHA) Chief Executive Officer Brock Slabach, MPH, FACHE, delivered Wednesday’s keynote address, “The Landscape of Rural Health.” In it, he addressed unprecedented challenges to a fragile rural health safety net; the pandemic’s impact; rural health inequities and a renewed focus on racial justice; and efforts to remain innovative amidst these challenges.

This landscape is accentuated by a new presidential administration and a season of unparalleled funding to vaccinate against COVID-19, tackle pronounced vaccine hesitancy, address systemic workforce shortages, rural provider closures, and broadband connectivity, among other challenges.

As rural health care’s fragility magnifies against the backdrop of this pandemic, the NRHA has remained steadfast in its advocacy for health policy issues, especially legislation that centers health equity for 2.2 million rural Missourians. Among NRHA’s policy agenda is:

• Accountable Care in Rural America Act (HR 3746)
• Assuring Access to 340B Drug Pricing Program (S773)
• Healthcare Workforce Resilience Act (HR 2255/S 1024)
• Protecting Rural Telehealth Access Act (S 1988)
• Resident Physician Shortage Reduction Act (S 834/HR 2267)
• Rural America Health Corps Act (S 924/HR 2130)
• Rural Hospital Support Act (HR 1887)

Nursing Shortages Go Way Beyond Headcount

When it comes to nursing shortages, it does in fact go way beyond headcount. Ron Hoppe, international recruiter, and immigration professional, presented the problem and a few solutions during a Wednesday (Aug. 18) session, “Nursing Shortages Go Way Beyond Headcount.” The presentation detailed, among many things, that headcount is only one factor. Hoppe delivered a simple equation to drive this point further: an increasing number of novice RNs matriculating through the health care pipeline, plus acuity increases of in-patient care (which decreases hospital stays), plus the growing importance of EHRs equals what he calls the experience-complexity gap.

Hoppe offers a variety of strategies to address nursing shortages and inherent experience gaps. One strategy he mentions is taking an international approach to recruitment efforts.

Mobility Management: A Collaborative Solution for a Complex Issue

Although Missouri’s infrastructure is ranked seventh in the nation, the state is 45th in revenue per mile. The result is transportation gaps throughout all communities – rural, suburban, and urban alike. Lack of access to transportation is a barrier to the fullness of life and goes beyond access to medical appointments.

Mobility management, which has no singular definition, is a coordinated, collaborative, and liberated approach to equitable transportation. Truly equitable transportation also includes reliable and affordable access to work, social events, required appointments (such as court dates), grocery stores and pharmacies, and more.

During “Mobility Management: A Collaborative Solution for a Complex Issue,” a session at the MRHA Get Link’d 2021 Conference, MRHA’s Mary Gordon and MU Extension’s Sherry McDonald detailed their creation of the Mobility Management Certification Program. The self-guided training prepares community leaders, health care workers, advocates, and more to be champions of transportation and find collaborative solutions in their area.

Transportation and its Impact on the

Social Determinants of Health

West Central Missouri Community Action Agency (WCMCAA) received a one-year HRSA grant to identify inequities and found barriers not only affecting access to health care, a prevalent issue in rural areas, but inequities across all facets of transportation. In collaboration with MRHA, WCMCAA invested in HealthTran in 2020 and began delivering rides in February 2021.

During the MRHA Get Link’d 2021 Conference, WCMCAA provided an overview of their successes with HealthTran. Free rides from friendly volunteer drivers not only bridge the transportation gap, but also build a sense of community during a time of overwhelming social isolation.

Community Supports for People Impacted by Dementia

In Missouri in 2020, caregivers of people with Alzheimer’s or other dementia provided over 292 million hours of unpaid care. Alzheimer’s caregivers often bear the financial and emotional weight of the changes that accompany the progressive brain disease, causing chronic stress which can impact one’s physical health and wellbeing.

The Missouri Rural Health Association (MRHA), Memory Care Home Solutions (MCHS), and the Greater Missouri Chapter of the Alzheimer’s Association have partnered to deliver the Customized Caregiver Training and Relief Program (CCTRP). Funded through the Department of Health and Human Services, this free program offers two tracks: a training program offering a customized blueprint for care, and a relief program offering financial reimbursement for dementia-related care costs.

During a breakout session at the MRHA Get Link’d 2021 Conference, program partners detailed the warning signs of dementia and Alzheimer’s, an overview of changes that will occur, and details about CCTRP.

Gun Violence Prevention & The Safer Homes Collaborative (SHC)

Empowering Health Leaders in Expanding Connectivity

It’s 2021, everyone in the U.S. has internet access. Right?

Wrong -- especially for Missourians, who fall in the bottom 5 ranks for access to low-cost internet.

This lack of broadband infrastructure and access goes far beyond missing out on the newest episodes of your favorite show. Restricted access to WiFi creates troubling barriers for healthcare providers and education systems alike.

At the #GetLinkd 2021 #MRHA Conference, Timothy Arbeiter discussed these concerns and how the COVID-19 pandemic and subsequent lockdowns exposed and magnified these broadband deficiencies.

Some recent initiatives have addressed these immediate needs such as the State CARES Act Program and State Broadband Grant Program. However, the funding for these programs came from government #COVID relief bills and isn’t currently sustainable.

Now is the time to act on this framework and build towards a healthier, more connected community.

COVID Vaccination Efforts in Rural Southeastern Missouri

Sheer tenacity, collaboration, and the will to keep a community safe drive COVID-19 vaccine efforts in Mississippi County, which has a population of about 14,000. The #GetLinkd 2021 MRHA Conference included a session on Thursday (Aug. 19) called, “COVID Vaccination Efforts in Rural Southeastern Missouri.”

The session was led by Richard Logan, Pharm. D., owner of L&S Pharmacy in Charleston, Mo. Logan, as well as the county health department, county government, local pharmacies, volunteers, and many others all committed to do what was needed to get shots in arms. By working together, they leveraged civic events, popup clinics, and house-call clinics to get folks vaccinated.

Logan’s no-holds-barred approach, even to the extent of preaching to a Southeastern Missouri congregation on a Sunday morning, continues to be instrumental in raising vaccine rates in an area that remains vaccine hesitant. As of mid-August, Mississippi County’s vaccine rate was 32%., but Logan will tell you that he’s not finished yet.

Where It Hurts: Telling the Rural Health Story

The MRHA Get Link’d 2021 Conference closed with a presentation titled, “Where It Hurts: Telling the Rural Health Story,” by Kaiser Health News senior correspondent Sarah Jane Tribble. Following the closing of a much-needed hospital in rural Kansas, near her own childhood home, Tribble documented the stories of community residents impacted through a personal, powerful, and emotional podcast series titled “Where It Hurts.”

Through interviews, 911 calls, and personal stories, Tribble highlighted gut-wrenching realities about the problems faced in rural areas and the resulting harm, paired with her own grappling with grief. “If we can bring this to the attention of people who have never been in a rural area, or don’t have a reason to care about rural issues, it helps create empathy,” Tribble said about the experience and the many tears involved.

Thank you to our sponsors, presenters, moderators, and attendees!

Look out for our post-conference editorial series covering these session highlights.

MRHA and Partners Offer Free Rides to COVID-19 Vaccine Appointments in 12 Rural Missouri Counties!

Special thanks to Bates County Transport, New Growth Women's Business Center, Own My Own, Inc., and West Central Missouri Community Action Agency.

Program Offers Relief and Respite for Dementia Caregivers

As of 2020, over 100,000 individuals over age 65 in Missouri are living with Alzheimer’s or other forms of dementia. This number is expected to increase to an estimated 130,000 within the next five years.

Alzheimer’s is the sixth leading cause of death. The disease directly impacts the number of hospitalizations and ER visits we see as well as raises the cost of Medicaid. Data from 2018 showed 1,530 emergency department visits per 1,000 people with dementia. Dementia patients also saw a hospital readmission rate of 22.6%. In 2020, the Medicaid costs of caring for people with Alzheimer’s grew to $973 million – a number expected to increase 16.8% by 2025.

Possibly most affected are the 194,000 caregivers – usually a family member, friend, or close acquaintance who unknowingly take on the emotional and financial burdens associated with dementia. To keep up with around-the-clock care, caregivers may sacrifice hours at work, opportunities for traveling positions, and even promotions. 

In 2020, Missouri caregivers provided over 292 million hours of unpaid care, despite 64.1% having chronic health conditions of their own.

In an effort to combat these statistics, the Missouri Rural Health Association has partnered with Memory Care Home Solutions and Alzheimer's Association Greater Missouri Chapter to deliver the Customized Caregiver Training and Relief Program (CCTRP). The program incorporates two tracks: educational training and financial relief.

Stay tuned for an upcoming editorial on this program featuring Get Link'd Conference speakers Amy Sobrino from Memory Care Home Solutions and Ben Molina from the Alzheimer’s Association Greater Missouri Chapter.

Emergency Regulation Will Require COVID-19 Vaccination for Nursing Home Staff

The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), is developing an emergency regulation requiring staff vaccinations within the nation's more than 15,000 Medicare and Medicaid participating nursing homes. This new requirement is a key component of protecting the health and safety of nursing home residents and staff by ensuring that all nursing home staff receive COVID-19 vaccinations. Over the past several months, millions of vaccinations have been administered to nursing home residents and staff, and these vaccines have shown to help prevent COVID-19 and have proven to be effective against the Delta variant. 

Foundation for Opioid Response Efforts: Grants Engaging Family and Communities

Apply by September 20

OMH: Challenge to Reduce HIV Stigma and Disparities

Apply by September 23

NIH Researching the Role of Work in Health Disparities

Apply by October 5

USDA Emergency Rural Health Care Grants

Apply by October 12

FCC Emergency Broadband for Individuals and Households

Ongoing

CFPB Rental Assistance Finder

Ongoing