Rural Network Leadership

NCHN Member
May 18, 2015 07:57 AM
Leadership is the capacity to help transform a vision of the future into reality. The significant challenges we face today in healthcare require a form of leadership that is less authoritative and more collaborative.
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Prince of Wales Health Network highlights work at the Annual Health/Wellness Fair

NCHN Member
Apr 21, 2015 09:19 PM

PoW Health Network Highlights Services at the Annual Health/Wellness Fair

The Prince of Wales Health Network (Craig, AK) is a collaborative effort between Southeast Alaska Regional Health Consortium (SEARHC) Alicia Roberts Medical Center, State of Alaska Craig Public Health Center, Community Connections, Alaska Island Community Services (AICS), and PeaceHealth Medical Group Prince of Wales, Whale Tail Pharmacy, and Southeast Dental Center Inc. The mission of the Prince of Wales Health Network is to build a strong and sustainable network of healthcare organizations collaborating to strengthen the healthcare system on Prince of Wales Island and increase access to quality healthcare for all island residents far into the future.

This weekend the island highlighted the many wonderful resources on Prince of Wales at the Annual Wellness/Health Fair in Klawock.  There was food, activities, labs, immunizations, door prizes, and 45 different exhibitors for the whole family.  There were Car Seat Safety Checks and a Fisherman First Aide Class held. In the spirit of helping get our hearts healthy there was also a 3/5K at the event.

One of the upcoming projects in a series of 10 objectives for the POW Health Network is to increase the proportion of children and adolescents who decrease their viewing time of television, videos, or play video games to under 2 hours a day.   We plan to survey students over a three year period and introduce fun alternatives to screen time. We are excited to get individuals committed to helping kids get out and be more active in all communities on POW.   If you have any ideas please email us at or contact us on our Facebook page.

The Prince of Wales Health Network is currently funded from local businesses, individuals, corporation, partnership, in-kind donations and a grant from the Health Resources and Services Administration (HRSA) Office of Rural Health Policy (ORHP).   The Prince of Wales office/conference area is located at West Wind Plaza Craig.


Gretchen Klein
POW Health Network

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Santa Cruz County Adolescent Wellness Network: Taking integrated vertical networking to a new level

NCHN Member
Apr 6, 2015 01:19 PM

This article was written by Cassalyn David, Network Director, Santa Cruz County Adolescent Wellness Network (AWN), for the “Networking News” monthly newsletter. The Network Technical Assistance Project is funded by the Federal Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services through a contract to Rural Health Innovations, LLC, a subsidiary of the National Rural Health Resource Center.

Even before the Santa Cruz County Adolescent Wellness Network (AWN) had a name or knew what an integrated vertical network was, it was exemplifying cross-sector collaboration. The first connections began between the schools and community organizations that wanted to eliminate disparities by promoting health literacy and healthy lifestyles for youth.

Early on, network members had ambitions beyond just creating a fitness or health literacy program that would last a few years. They saw the need for a lasting, holistic adolescent wellness infrastructure and wanted to be part of the budding nationwide movement for youth empowerment. Grant funding for school health initiatives can be very ephemeral and narrowly service-focused, so the Rural Health Network Development Grant Program has been key to AWN sustainability. With Federal Office of Rural Health Policy (FORHP) support and connections to other rural health networks and national resources, AWN has been able to set and achieve ambitious goals for our infrastructure and services. We could not have accomplished this if we had continued to work in silos. Our broad and well-connected coalition has been our key to success.

Member connections

Since we operate in a rural, small town atmosphere, it is both possible and necessary to have members that are well-connected throughout the community. Chris Bachelier, the representative from the County Superintendent of Schools, has been with the network from the very beginning. She is central to our school partnerships, serving as our liaison with every level of the school system. Through her we have fantastic buy-in from the County Superintendent of Schools, connections with all of the health and wellness programs housed in her office, and personal connections with individual school administrators and health and fitness staff.

Chris has facilitated many of the Network's key projects. Teachers, school health staff, and administrators are some of the busiest people I know, but Chris knows how to find time with them. For our school-linked health care planning, Chris helps the Network understand school and district-level needs and constraints. In order for AWN to reach our goals for school-primary care linkages, we need to be listening to everyone from the front-line service providers to the Superintendent. She conducted key informant interviews with school health staff that answered many of our questions. It was inspiring to hear about the service these nurses and nurse aides provide their students and validated many of the ideas we had about ways we could make their jobs easier. They know it is best in the long run if you can serve the 'whole child,' because they see every day how social and environmental factors are impacting student health. We learned about the challenges families face in accessing health and social services, and are working to create a seamless system of referrals across these disciplines.

Organizational culture

Every organization has its own systems and culture, and AWN has the additional layer of working across disciplines. The challenge for me has been to recognize the differences both between and within health, education and nonprofit service sectors. I actually made the mistake of assuming the three school district boards and administrations would have similar procedures and requirements for our partnership agreements. Fortunately, my members are experienced and supportive.

Talented evaluation

Another advantage for AWN is having an experienced evaluator. Rebecca Drummond is the Program Director for Family Wellness at the University of Arizona Mel and Enid Zuckerman College of Public Health. Rebecca has unique experience in the realms of coordinated school health and youth health systems, having served on the Board of Directors of the Arizona Public Health Association, chairing the School Health Section, and as a board member and President of the Arizona School Based Health Care Council, a state affiliate of the national School Based Health Alliance.

Both Rebecca and Chris have backgrounds that span health and education, so they are excellent at bridging the disciplines. They can relate to the teachers and be champions for schools' role in student wellness, despite funding and time constraints. This showed when AWN created the first-ever implementation and analysis of School Health Profiles at the county level in Arizona. School Health Profiles is a CDC survey that tracks school health and wellness policies and practices. AWN wanted to know where our local schools stood in comparison to their peer institutions and best practices. Through careful outreach, AWN obtained an excellent response rate. Even the process of distributing the surveys and results helped the school health movement gain momentum in our community.

A long history of integrated vertical networking

As a Network Director, it makes my job easier to have respected member organizations and well-connected representatives to provide wisdom and practical guidance. The impetus that brought partners together from the beginning was supporting schools' health and wellness efforts and creating a holistic paradigm for serving and empowering youth. It would have been more difficult if we had started in a narrow mindset and decided later on to expand to include schools. Our mission, vision, goals and programs were conceived and continue to evolve with this broad coalition at the table. To keep them at the table, we are challenging ourselves to continue providing valuable services for our members and community.


The Santa Cruz County Adolescent Wellness Network (AWN) is a group of local agencies that has been working to promote and improve adolescent wellness services through collaboration, education, and advocacy since 2007. The current partner organizations are Mariposa Community Health Center, the lead and fiscal agent, along with Southeast Arizona Area Health Education Center (SEAHEC), Santa Cruz County School Superintendent, Community Intervention Associates, Pinal Hispanic Council, Circles of Peace, and the University of Arizona Cooperative Extension Santa Cruz County. The Arizona State Office of Rural Health provides Technical Assistance. The AWN is a place for partners to collaborate and share resources to identify and respond to adolescent wellness needs. Our mission is to promote adolescent wellness through advocacy, education, and collaboration with schools and community organizations serving youth, ages 12-25. The AWN is funded by a Rural Health Network Development Grant through the Health Resources and Services Administration, Federal Office of Rural Health Policy. AWN has been an active member of NCHN (National Cooperative of Health Networks) since 2010.


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NCHN Member
Mar 6, 2015 11:08 AM

This article was written by Toniann Richard, Executive Director, Healthcare Collaborative of Rural Missouri, for the “Networking News” monthly newsletter. The Network Technical Assistance Project is funded by the Federal Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services through a contract to Rural Health Innovations, LLC, a subsidiary of the National Rural Health Resource Center.

At the Health Care Collaborative of Rural Missouri (HCC), having encountered both challenges and successes, we unequivocally say Friend!

The HCC is a rural health network, committed to improving the health status of underserved populations in a three county area. HCC was formally established in 2006 following a three year period of working informally together to address area health care needs. The purpose was to ensure that the health care needs of all citizens in our service area were met, particularly the needs of the under- and uninsured. Since forming, our focus has been to develop and implement programs that are responsive to the documented health needs of county residents, with specific health status indicators as benchmarks for progress on addressing those needs. Of course, this was how we embarked on our telehealth journey in 2011.

HCC applied for and received a USDA Distance Learning and Technology grant with network partner Lafayette Regional Health Center (a Critical Access Hospital).  We purchased several telehealth units for the rural health clinics as well as one for the emergency department and outpatient clinic.  The initial project was focused on integration of mental health services with HCC’s network partner Pathways Community Health, a Community Mental Health Center. 

Initially we had several bumps in the road. Let’s start with the obvious…high speed internet.  Our network is located in a very rural part of Missouri - think dial-up connectivity.  So, step one was finding a connection that was both fast enough and affordable enough for all of our partners.  We began by partnering with an information technology vendor who understood the value of purchasing connectivity in rural Missouri.  We then applied for Universal Service Administrative Company funding and were granted reduced cost connectivity.

With the connectivity problem overcome, we developed another problem…firewalls.  The point to point connection from A to B was a much bigger hurdle than we could imagine.  There were two firewalls, along with the bridge firewall at the HCC office.  It took three information technology consultants, a technology vendor and multiple staff from the network and network members to get the problem started and solved, multiple times.  Each time the firewall changed for the members, we had to bring the consultant team back together to troubleshoot the problem yet again.  It is an ongoing challenge for us, but we have learned how to work together to meet the requirements for connectivity.

The next phase of our project was even more interesting.  HCC had made a decision in 2012 to apply for a new access point (Community Health Center) funding for our network.  HCC was awarded this designation in late 2013 and one of our first orders of business was to launch our own telehealth project, which focused on behavioral health.  We were so excited to launch this program because there is a major lack of mental health providers in our area and psychiatry is definitely a major shortage. We partnered with long-term friend of HCC, Pathways Community Mental Health, for a behavioral health consultant (face to face) and a psychiatrist (telehealth).  As a result, Pathways is paving the way for telehealth statewide. On average, they currently do 3000 telehealth visits per month with over 30 of those visits being for HCC. 

You must be asking yourself, “But what do the patients think?”  Well, I am glad you asked!  Pathways conducts annual patient satisfaction surveys with their telehealth patients.  We were proud to learn that their overall satisfaction was over 90% and over 20% would choose telehealth as their form of treatment.  As healthcare leadership, this tells us that telehealth is being accepted more and more across rural America.

Last but never least, during implementation we were also working on policy.  Senate Bill 262 was introduced in 2012 and passed in 2013.  Senate Bill 262 prohibits health carriers from denying coverage for a health care service on the basis that the service was provided through telemedicine if the same service would be covered when delivered in person.  This was a major hurdle for rural Missouri and it is one of the areas where Missouri set the tone for the rest of the Midwest. 

We look forward to our next step in Telehealth, which will be the addition of a new unit at our second health center and plans to develop a comprehensive, vertical telehealth network with our partners.

About HCC

The Health Care Collaborative of Rural Missouri (HCC) has a mission to "Cultivate partnerships and deliver quality health care to strengthen rural communities." Since its inception, the HCC has developed into a comprehensive rural health network, with a wide variety of health, social services and community partners that provide health and wellness prevention and treatment programs for all citizens in our service area, and focused on the health care needs of low-income, under- and uninsured residents. The HCC's strength lies in developing collaborative relationships, utilizing the strengths of individual organizations to develop programs and services that are larger than any one organization. HCC is the first rural health network to receive HRSA's Bureau of Primary Health Care 330 funding to operate a community health center. HCC has been an active member of NCHN (National Cooperative of Health Networks) since 2010.  

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Michigan Rural EMS Network: Ten Rural Communities Receive MiResCu Community Awards, To Be Presented at EMS Summit

NCHN Member
Mar 2, 2015 10:37 AM

Ten Rural Communities Receive MiResCu Community Awards, To Be Presented at EMS Summit  

Frankenmuth, MI – February 6, 2015

Emergency Medical Services (EMS) face numerous challenges in responding to the needs of rural communities.  The Michigan Rural EMS Network was formed to help rural EMS professionals address these challenges in Michigan. 

In September 2014 Michigan Rural EMS Network received two federal grants from the Office of Rural Health Policy for its cardiac arrest initiative, the Michigan Resuscitation Consortium (MiResCu).  From there, the MiResCu Community Award program was established.  In its first cycle, the MiResCu Community Award program will provide support for 10 organizations representing residents in 21 rural counties across Michigan.   These communities will receive assistance to implement strategies that have been proven to increase cardiac arrest survival.  The MiResCu Community model is based on the system that was developed by the Resuscitation Academy, and first initiated in Seattle/King County Washington.  Today, someone who suffers cardiac arrest in King County is 4 to 5 times more likely to survive.  In 2013, Seattle/King County achieved a 62% survival rate for cardiac arrest in witnessed ventricular fibrillation, among the highest reported survival rates in the world.  Most cities experience rates in the single digits.  Through MiResCu Community awards, the Michigan Rural EMS Network will provide the support needed to help rural communities increase their survival rates from cardiac arrest. 

In January 2015, the Michigan Rural EMS Network received fifteen eligible applications for assistance.  An objective review panel assessed community need, readiness, and available resources to determine awards.  Awards will benefit approximately 510,000 rural residents.  The following communities will be presented with their awards at a luncheon on February 27, 2015 at the EMS Summit held at the Bavarian Inn Lodge in Frankenmuth, MI. 

  • Oceana County, Oceana County EMS
  • Menominee County, MidCounty Rescue 114, Inc.
  • Northern Michigan MCA
  • Alger County
  • Northwest Regional MCA
  • Tuscola County, Mobile Medical Response (MMR)
  • Plainfield Township, Plainfield Township Fire Department
  • Gladwin County, MidMichigan EMS
  • Northeast MI MCA
  • Missaukee County, Missaukee County EMS

The support provided through the awards will include High-Performance CPR (HP-CPR) Trainer Certification, HP-CPR provider courses, AED placement and registries, training for dispatch and law enforcement, and support for community education and events.  A variety of technical assistance in developing a community team, implementing system change, establishing a cardiac registry, and evaluating the impact on cardiac arrest survival rates will also be provided.   Communities will kick off their initiative through training at the first annual Michigan Resuscitation Academy to be held on March 20, 2015 in Mt. Pleasant.  Two additional award cycles are planned.  For information about this initiative contact Mark Becmer, MiResCu Community Outreach Coordinator at and (231) 350-3447 or Vincent Schwartz, MiResCu Training Coordinator at and (810) 844-1446.  For information about other rural EMS programs and initiatives, contact

HRSA Rural AED Grant: Federal funding provides 100% of program costs, or $150,000 per year.
HRSA Network Development Grant: Federal funding provides 80% of total program costs, or $300,000 per year.

Contact:  Leslie Hall, Executive Director, Michigan Rural EMS Network
Phone:  989-284-5345

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How Montana Health Network Saved over $38,000 on MRI Equipment

NCHN Member
Jan 19, 2015 12:09 PM

Montana Health Network in partnership with Northland Healthcare Alliance in North Dakota created the MonDak Imaging Services LLC. Their purpose was to provide mobile imaging services, specifically MRI, to rural facilities who either did not have adequate volume or could not afford to purchase their own equipment. Using this mobile structure, people in these rural communities no longer have to travel for MRI’s. The MonDak Imaging Services LLC started with one machine and in 10 years grew to five MRI’s. To remain flexible and competitive, MonDak also offers long term leased placements and financing services for other equipment, such as CT’s.

EMTS, Silver Business PartnerMaintaining high quality mobile imaging services requires constant equipment upgrades. MonDak was in a position where it needed to change out a trailer for a mobile unit. Based on expected downtime, it was more affordable to purchase a new MRI and sell the one needing the trailer replacement. Once a quote was received, MonDak contacted Brian Baca at EMTS, a regional partner of NCHN, and asked for a pricing review. EMTS then contacted the vendor directly to further negotiate the price. The vendor was not particularly receptive to this arrangement but MonDak and EMTS together, were able to reduce the price by $15,000. While in discussions with the vendor, EMTS contacted another vendor to see if they would buy MonDak’s machine instead of including it as a trade-in with the original vendor. Brian’s interest and efforts saved MonDak an additional $23,750 because of his contacts in the marketplace. The total savings were $38,750.

This entire transaction with EMTS took approximately one week. Brian researched the market and brought back viable solutions. MonDak could have broken a long term, valued relationship with a vendor and saved another $10,000 but wished to maintain that partnership. There was no pressure from EMTS to change vendors.

MonDak learned two things from this process. First, there is room for negotiation especially when a company like EMTS has such broad marketplace information. Second, to make this work MonDak and EMTS had to be a team and that made all the difference.

In a separate project, Montana Health Network was in the final stages of purchasing a patient simulator for educational purposes. Larry Canterano from EMTS worked on that project and MHN saved the staff training costs which amounted to approximately $3,000. The lesson on this transaction was that even small purchases should be considered as an opportunity to better negotiate and save resources with the help of EMTS.

For more information about Montana Health Network, contact:

Janet Bastian, CEO

For more information about EMTS, Silver Business Partner, contact:


Mark Martin, Director, Sales & Marketing, EMTS
720-875-0505 ext.9926


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Featured: Purchasing Program (Health Future, LLC)

NCHN Member
Nov 19, 2014 11:47 AM

Health Future, LLC's Purchasing Program

Our Purchasing Program uses multiple experience-based Councils to identify and implement initiatives to help drive costs down in the delivery of health care. Our Council disciplines include CIO, Lab, Pharmacy, Periop and Supply Chain. We often host joint sessions with our Councils as initiatives cross over discipline lines. Our most recent successes have resulted in annualized savings in excess of $2.5M in chemistry/immunoassay and custom procedural tray contracts. We are in the midst of centralizing our IV products (including sets, solution and devices) and estimate a reduction in costs of about 12% (vs. increases in the 20-50% range) as well as an allocated supply in a market that has been challenged to maintain capacity to meet demands.

We are in the process of developing long-term strategic plans that will include more collaboration as a group and possible development of shared services across certain supply chain functions.

Implementation and Results

Our resources have been, for the most part, internal staff with analytic and implementation assistance from our GPO partner, MedAssets. Our Purchasing Program is fully funded by our owner/member organizations. We return all savings, administrative fees and other value-added benefits directly to our participating members.

Lessons Learned

As always, getting all members committed to a unified direction is difficult. In the chemistry/immunoassay and custom procedure tray initiatives we settled on a dual award result. The ability to drive competition and use good criteria for analysis was key in achieving savings under this scenario. For IV initiative we have decided to solidify a long-term strategic partnership with a sole source due to the volatility of that market.

Plans for future projects include cardiac rhythm management devices (pacers, generators, etc), adoption of dedicated connector protocols to prevent harm, a refresh on orthopedic joint and spine implants and due diligence surrounding possible shared services development.

For more information, contact:

Leslie Flick
Executive Director
Health Future LLC (Medford, OR)

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Featured Program: Clinical Rotations in Rural Tennessee

NCHN Member
Nov 19, 2014 10:42 AM

TRP logoTennessee Rural Partnership’s Rural Success with HRSA Network Development Grant

TRP received the HRSA Network Development grant in 2010.  The goal was to provide 48 rotations for medical residents in 14 rural Tennessee counties and facilitate activities within the communities to promote maximum exposure to rural “life” during the rotations.

Implementation & Lessons Learned

Early into the grant activities, it became apparent that exposure needed to be provided for non-physician primary care providers and future providers.  The program was expanded through the Community Health Educational Experiences for Residents and Students (CHEERS) partnership with the Tennessee Primary Care Association (providing rotation experiences for advance practice nursing, medical and physician assistant students). Additional expansion was accomplished through a partnership with another Workforce Network Grantee (St. Thomas Healthcare) to develop the TRP Star Program for high school students.  TRP is now continuing this program along with the HOSA annual symposium.

The project also relied upon the relationships that already were established among TRP: the four allopathic medical schools in Tennessee (East Tennessee State University, Meharry Medical College, the University of Tennessee and Vanderbilt University), RHAT, THA, TPCA and Tennessee Department of Health to serve as the core network partners. 


The network development activities produced 104 completed rotations. The activities also resulted in additional partnerships, the inclusion of non-physician primary care health providers, and “pipeline” activities involving high school students.


    • TRP now operates as an effective healthcare workforce network. Through partner relationships, TRP connects clinicians to rural rotations opportunities and ultimately to permanent clinical practice in rural and underserved communities.
    • A total of 104 rural rotations have been completed. Sixty-six rural rotations were completed by medical residents and physician assistant students in 37 Tennessee counties. It is projected that an additional 17 CHEERS rotations will be completed by the end of 2014.
    • TRP hosted the first Annual TRP HOSA Symposium at the Vanderbilt University Center for Experiential Learning and Assessment (CELA).  55 high school students attended the symposium.  The 2014 Symposium is scheduled for November 24, 2014, with 52 attendees registered.
    • In September 2013, seven primary care residents and family members attended the TRP Tennessee Rural Perspectives weekend (TRP/TRP). This program, developed with the Tennessee Department of Health, TPCA and Veterans Health Administration, took place in Stewart County. The 2014 TRP/TRP weekend was held on September 25-27, 2014 in Linden, Tennessee. Five participants visited clinical facilities in Decatur, Hickman and Perry Counties and interacted with other local rural physicians through panel discussions and presentations.
    • TRP staff completed 39 visits to primary care residency programs, advanced practitioner nursing and physician assistant schools.  In addition, electronic information was provided to the audience of trainees (the 2013 PIMS report documented 1,064 trainees). Additionally, since January 1, 2014, the TRP staff has participated in 31 conferences or exhibits with physician and non-physician clinicians.


Cindy Siler
Deputy Director, Tennessee Rural Partnership
Ph: 615-401-7461

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Featured Project: Pediatric Developmental Center

NCHN Member
Nov 19, 2014 09:22 AM

NW Illinois Rural Health Network: Pediatric Developmental Center

The mission of the Pediatric Developmental Center (PDC) is the creation of a quality, coordinated, integrated, affordable and accessible system of care for children and youth who display developmental, emotional, social and/or behavioral concerns and their families who access services in Lee, Ogle, Carroll, and Whiteside Counties or surrounding areas who are in need of child/youth diagnostic services.

Our network is sustained in a medically underserved region of NW Illinois. Network partners have a long history of successful collaboration, becoming more integrated as innovative partnering occurs. In the past five years, Kreider Services has become a regional center for The Autism Program of Illinois (TAP). Kreider also houses an Early Intervention program and has served developmental disabled individuals for over 60 years. In 2009, Kreider and other community agency partners completed a year- long planning initiative on Autism Spectrum Disorders (ASD). The steering committee that spearheaded this initiative, united to apply for a HRSA Planning Grant to put their strategies into action. During the planning process, partners soon realized the scope of the project needed to expand beyond children and youth with ASD to embrace all children with complex needs. The group moved forward with the application for a Rural Health Development Grant. Being awarded the three-year grant network partners began providing expanded services effective July 1, 2014. Partners collaborated recently in building an application for a HRSA Outreach grant to expand the services of the PDC and to build a bridge between PDC and the Community That Cares (CTC) Project, grant funded to improve the system of care in the same four county area. The PDC concept provides the comprehensive, holistic treatment option for children and their families that was not previously available.

All partners that initially came on board in and before 2009 have remained committed to the project/s. Three main partners - Developmental/Behavioral/Medical providers are building the framework that will sustain the PDC. All partners will be active in the utilization of the PDC and will participate in multidisciplinary discussion/evaluation as indicated.

Resources Used

Network partners conducted community forums in the initial stages of the planning process. Surveys have been sent to professionals and families to assist in identifying local needs. Network partners have conducted internal evaluations and surveys as they related to the services they provided and the effectiveness of those interventions. Discussions between network partners continued through the CTC and the RHN Planning Grant with MOU's and By-Laws established. Boards were formed with steering committees addressing specific issues. Network partners have remained 100% committed to the CTC and PDC project bringing expertise from their profession, providing in-kind donation to the project - time, meeting rooms, office supplies, statistics, forms, etc. Partners utilized a consultant to participate in Plan Do Study Act and SWOT analysis in order to generate a strategic plan.


Service providers located in rural communities, by nature, find overlap when working with children/families through the system. Agencies tend to make referrals to local providers to meet the needs of community families. The service providers in this region began dialogue on how to fill gaps in service, provide follow through on referrals, provide a system of care that would embrace and support families. Discussion began as to how to pull resources together, pooling expertise to build a comprehensive support system. This led to the community forums and development of the CTC project mentioned. Having the history of dialogue and cooperative work laid, network partners see the benefit to families to their ability to provide effective treatment services in their community.

Lessons Learned

Network partners have learned the value of "the network", the strength and effectiveness of working together. It took time for partners to see beyond agency goals and focus on child/family goals and this is an ongoing part of discussion. It is difficult to meet funding, reporting and licensing requirements for multiple agencies while working together. Each agency must glean an understanding of the inner workings/governance of partner agencies and work to accommodate those. Secondly, sustainability remains a concern. Each agency has potential to bill for some services within specific guidelines. More work is required in our network to decipher how best to accomplish this without duplication of services and in an efficient, streamlined manner so as not to burden families nor agencies with additional cost. As the network grows in alignment with the strategic plan, we will need to determine how to bring new partners into the mix in an effective, efficient and rewarding manner. ROI is an area we need to explore and promote using data driven support. The process of locating a physical site adequate to maintain the PDC has taken more time than initially thought. Meeting the needs of multiple partners in one physical site has proven a learning experience in itself.


Network partners are near resolving the issue of where to house the PDC, at least on a temporary basis. Once square footage was determined, how many offices/storage space/restrooms/etc. minimally required, partners were able to move forward more quickly. Partners also developed a Release/Exchange of Information for multiple agencies to expedite and streamline procurement of documents. Flow Charts are being developed to provide overview of governance and treatment path within the PDC. By-Laws and MOU's have been established with plan for review on an annual basis Network partners are all proficient in grant writing and continue to investigate further opportunities for funding inclusive of grants/gifting/fund-raising events.

While much time has been spent of designating a physical site for the PDC and developing processes for treatment, inclusive of the release/exchange of information, progress toward objectives integrated in the strategic plan are being implemented. Trainings for parents have begun. Clinical and medical assessments have been conducted at one site in a collaborative effort. Referrals between partner organizations have been initiated. An outside evaluator has been contracted to collect and analyze data; forms have been condensed to accommodate network partners to avoid redundancy, yet provide needed information to the evaluator. The network director has begun the search for staff to be responsible for clinical oversight of the project. The network continues the synergy required to accomplish our goals in a collaborative effort.


Laura Watters
Network Director, NW Illinois Rural Health Network
Ph: 815-288-6691

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Featured Project: NEON Pathways Community Hub

NCHN Member
Nov 19, 2014 09:08 AM

NEON PathwaysThe Pathways Community Hub Program is a community wide, community based care coordination infrastructure that ensures the highest risk individuals in a community are connected to meaningful health and social services that contribute to positive health outcomes. The Northeast Oregon Network (NEON) serves as the neutral entity that is neither a payer nor a service provider. In the role of the Hub, NEON is dedicated to providing the partner coordination services that help reduce duplication of services, aids in identifying those most at risk, provides training, a community based data system, evaluation of outcomes, and, as the Hub model grows, contracting with payers. Project partners employ the trained community health workers who identify the at risk community members, provide assessment and determine which evidence based pathways to assign. Community Health Workers work with the identified community members to complete the assigned pathways, all with the intent of linking people in need with resources. Once a Pathway is complete, it generates a payment for outcome via a community based data tracking system.

Resources Used

The NEON Pathways Community Hub was planned and designed with resources form the Centers for Disease Control and Prevention through their Small Community Transformation Grant Program, and is being implemented with resources from the Meyer Memorial Trust and the HRSA Office of Rural Health Policy Network Development Grant. NEON staff and partners have worked with the Pathways Hub Model developer, Dr. Sarah Redding, from the Community Health Access Project in Redding, Ohio.


Through the efforts of the Small Community Transformation Grant, NEON was able to contract with Dr. Redding for intense project education and design, and had her on site for visits with community partners to help promote the model and generate interest. A Hub leadership team was formed with eight community partners from a three county area, who set to work defining the details of the Hub; which at risk population to focus on, which evidence based pathways to use, and development of the Hub manual that governs all Hub functions and operations. While the Leadership Team worked on defining and agreeing to the significant operational details, NEON staff worked on creating a community based data system to track Hub participant outcomes and provide the invoicing system for this pay for outcome model. NEON staff also worked with all health and social service providers in the area to present contracting options and negotiated rates for the payment for outcome portion of the project. Currently NEON is utilizing resources form the Meyer Memorial Trust and the HRSA Rural Health Network Development Program to provide initial outcome payments, calculate Return on Investment Analyses for specific payers, and negotiate ongoing contract payment rates with public and private payers.

Lessons Learned

NEON is only one of a few sites in the nation utilizing this evidence based practice, which initially developed with an early childhood population, with an adult chronic disease population. One of our lessons learned is that when significantly adapting a model, it is best to utilize a consultant, ideally the model developer, to work side by side to ensure adaptations are in line with fidelity to the model. A second lesson learned is that it will take significant time and effort to meet 1:1 and jointly with project partners in order to gain full support and engagement. NEON held over 450 meetings with 149 partners over an 18 month period in order to gain support for the project. Identifying who those key champion partners will be and working with them as a select group to start is a good way to build momentum.


Work to date on the project has achieved six contracted care coordination agencies, with 20 trained and certified Community Health Workers, seven evidence based pathways chosen, and payment rates and operational agreements negotiated. NEON is still currently in process of working with community members, and hopes to have an initial return on investment analysis by July of 2015. NEON has also successfully completed a robust sustainability plan, with significant input from potential payers as well as engaged partners.


Lisa Ladendorff
Northeast Oregon Network
Ph: (541) 624-5101



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