Rural Matters

Michelle chats with three experts on STEM education and robotics: Daniel Mehay, Dan Mantz, and Tim Heffernan.  Daniel Mehay is the owner and founder of FTW (For the Win) Robotics, which explores the STEM principles behind drones and their expanding use in society. Dan Mantz is the CEO of Robotics Education & Competition Foundation, and Tim Hefferman is the Tim has a accountProgram Manager at Pennsylvania Rural Robotics Initiative and the Gifted Support Teacher at Franklin Area High School in Pennsylvania. One of the real upsides of STEM is that the pay for employees is this field is considerably above the national average. Mehay discusses the FTW program, which focuses on the many uses of drones, including photography, crop management, and search and rescue operations — all important activities for rural communities. Heffernan notes that there are now 11 school districts in Pennsylvania participating in his program, but in the very near future, the number of high schools participating is expected to rise fairly dramatically. Mantz describes how once people in rural communities who are exposed to robotics competitions, they begin to understand the real upside for both students and the community. Anecdotally, he notes, on the first day of school this year, four teachers approached him about being involved in a robotics competition.

This episode was sponsored by Bryan Telemedicine,  https://www.bryanhealth.com/services/telemedicine; Phynd, www.phynd.com; and REC Foundation, www.roboticseducation.org. 

Michelle chats with Dr. Brian Bossard, the co-founder, President and CEO of Teledigm Health, Teledigm Physician Services, and Bryan Telemedicine, who also serves as Chief of Staff of Bryan Health, and is a  charter member of the physician editorial advisory panel for the Society of Hospital Medicine. When it comes to telemedicine, Bossard says it’s important to support the primary physician through new technology and to support patients in rural areas by enabling them to obtain quality care remotely. This is especially important for rural citizens who find it challenging to travel to a provider’s office. To achieve this end, Bossard’s organization participates in health fairs; demos the equipment and services when visiting rural communities; and brings their telemedicine providers on site. Typically, when a patient has a telemedicine encounter, there are mobile carts that include a monitor that is “articulating” or moving, at the direction of the provider, who might be hundreds of miles away. There is always a telepresenter, often a nurse, which connects the patient to the telemedicine experience. Equipment is not a one-size fits all situation but is dependent on the community involved.  Bryan Telemedicine now offers about 30 different telemedicine services.  Michelle and Bossard also discuss challenges to telemedicine, including broadband, licensing, and reimbursement. This episode was sponsored by Talem Health, www.talemhealth.com; Bryan Telemedicine, https://www.bryanhealth.com/services/telemedicine; and Phynd, www.phynd.com.

Michelle chats with Liz Carey, podcaster and freelance writer for Daily Yonder; Amanda MacDonald, festival co-ordinator for Frozen Dead Guys Days in Nederland, CO; and Kristopher Larsen, mayor of Nederland. Frozen Dead Guy Days started with a celebration of the cryogenic disposition of a local citizen and the running of hearse races almost two decades ago. It has now expanded to a wide assortment of exciting events, including a frozen T-shirt contest, and an attendance of between 20,000 and 25,000 for the weekend, according to MacDonald. The event is really at capacity at this point, notes MacDonald, who purchased the event from the local chamber of commerce. There are plusses and minuses of this event and other similar events, such as Synchronis Butterflies Day, according to Carey, who has written an outstanding piece on rural tourism for Daily Yonder. There is a definite economic boom for the town, which charges the festival for additional police and support and derives a benefit in terms of tourists spending money during the weekend and who also visit the town at other times because, well, it is the home of Frozen Dead Guy Days. But the festival is also taxing for the local police department and presents logistical concerns for both attendees and local residents, including backups on the highways.  Carey notes that the festival is extremely well organized, with specific instructions on how to best enjoy the festival.  Larsen notes that the event takes almost a year to plan, with challenges for the town of only 1,500 people, and includes outreach to citizens and local and state police and the fire and sheriff’s departments to ensure the safety and enjoyment of visitors. The event, which takes place in the second week of March, does offer opportunities for local businesses, explains Larsen. According to an informal survey he has taken, there is a doubling or tripling of their business during Frozen Dead Guy Days, compared to an immediate prior or post-event weekend. Finally, he notes, the event has produced a definite international notoriety, including from, you guessed it, the Netherlands. This episode was sponsored by Talem Health, www.talemhealth.com and 3RNet, www.3rnet.com

Michelle chats with the Laura Green and Anna Moot-Levin, award-winning filmmakers of the new feature documentary, The Providers, which recently aired on PBS, about the challenges and opportunities in health care in rural America.  The filmmakers spent almost three years in rural New Mexico building long-term relationships with those in the film. It’s clear from the film that the profiled health care professionals provided life-saving services to patients in rural America. According to Green and Moot-Levin, the documentary is now being used by rural organizations to help recruit health care professionals. The film has great potential to influence and educate lawmakers about the current situation that rural decision-makers face when it comes to health issues, including recruitment and retention and the shortage of medical practitioners familiar with dealing with substance abuse issues, including opioids. It’s very important to try to funding for wraparound care and cutting-edge initiatives in rural health, Green and Moot-Levin assert. This episode was sponsored by Talem Health, www.talemhealth.com and 3RNet, www.3rnet.com

Michelle chats with Mike Shimmens, executive director of 3RNet (National Rural & Retention Network), a nonprofit network that has had a health care job board for more than two decades, and Joyce  Grayson, a member of Kansas Recruitment and Retention Center, which works with 3RNet.  3RNet works in the “safety net” space, involved with several kinds of health care entities, such as local health clinics, who do not always have robust recruitment networks. Grayson, who is also chair of the 3RNet Board of Directors, notes that 3RNet seeks health care providers for rural communities who are in “for the long haul.” She talks about recently recruiting a psychiatric nurse to Kansas, which helped surrounding communities with critical behavioral health needs. Often, as was the case in this situation, the recruitment efforts involve working with the spouse of the health care provider. 3RNet is a “navigator” for providers by working with them on loan forgiveness or reduction, notes. Grayson. Shimmens says that the recruitment of health care providers for hospitals and clinics can have more than a $1 million impact on local rural communities. While there are certainly many challenges in recruiting health care providers into rural communities, it is also extremely challenging to retain these providers. The key to success is to try to have the provider and partner engaged in their new community and to work with them on achieving work-life balance. It’s also important for retention to make sure that the new employer’s culture, as well as the new community, is supportive of the health care professional who was recruited. This episode was sponsored by 3RNet, www.3rnet.com        

Michelle chats Jess Ames, director of outreach at Angel Flight East, an organization that provides free flights for patients who need medical treatment at a substantial distance from their home, and Greg Vallino, an optometrist who is a pilot for Angel Flight. Medically stable patients are eligible for the flight, for which there is absolutely no charge, according to Ames. For example, if a patient needs care that is best provided at a hospital, such as Shriner’s in Philadelphia, which specializes in particular diseases, air travel can be provided. In addition, Angel Flight East provides transportation services for patients who are so sick that they are not able to fly commercially as well as compassionate travel. The pilots for Angel Flight need 300 hours of actual flight time, notes Ames. Vallino speaks poignantly about the gratification he get from his service as a pilot. Under a program in its second year, Rural and Rare Outreach, Angel Flight East has established an initiative targeted to rural areas. This episode was sponsored by Angel Flight East, www.angelflighteast.org; Alliance for a Healthy Kansas, https://www.expandkancare.com; 3RNet, www.3Rnet.org; and Butler County ESC, www.bcesc.org.

Michelle chats with Barbara Yawn (“Dr. Barbara”), family physician and clinical researcher in the rural space and Eric Van Stone, founder and principal of Rural Medical Education Collaborative, a divisions of Talem Health, about the challenges facing rural health care providers today, including delivering care to patients without immediate access to care, particularly specialty care. Providers need to learn how to deliver care in a way they may not be used to, Yawn points out. That might include how to provide more with less, for example, through telehealth. One of the ways to engage busy rural primary clinicians about what’s happening today in health care is to make sure the information provided is practical and useful for both them and their patients, says Yawn. In general, Van Stone and Yawn notes, rural residents have higher rates of chronic diseases, including COPD, oncology, and diabetes, and mental illness than their urban counterparts. That requires a different population health approach, she says. For example, the environmental factors affecting rural patients might be quite different than those affecting urban patients. It’s critically important Yawn to provide preventative care in the rural setting. Finally, Van Stone notes, all the medical education his collaborative provides on a complimentary basis. This episode was sponsored by Angel Flight East, www.angelflighteast.org, the Alliance for a Healthy Kansas, https://www.expandkancare.com/, and 3RNet, www.3Rnet.org.

Michelle chats with Jason Cervone about his new book, Corporatizing Rural Education, which emanated from his college dissertation. According to Cervone, education is increasingly being privatized and influenced by a corporate viewpoint that emphasizes preparing students for future careers.  At the heart of the concept of school choice and charter schools, he notes, is competition among students to earn a place in their school of choice, but for economic reasons, not all students really have that choice. Cervone also discusses the growing involvement of corporate philanthropy in education, with programs such as Teach for America, which does not necessarily inure to the benefit of rural education. Many Teach for America teachers do not stay in the education area, Cervone says. According to Cervone, when we substitute career education for the pursuit of education goals for 14- or 15-year-olds, it is sometimes limiting to the student. In rural America, he asks, are we trying to create a worker for an agricultural company or are we teaching that student about agriculture? In general, he says, rural schools actually may have an advantage in education because there’s a real opportunity for teachers to engage with their students. The bottom line, Cervone says, is the future of rural education would not look like the past, but it is unclear exactly what it will look like. This episode was sponsored by the Alliance for a Health Kansas, www.expandkancare.com, and Butler County Educational Service Center, www.bcesc.org

Michelle chats with Sheldon Weisgrau, senior policy advisor for the Alliance for a Healthy Kansas, in the wake of a major report by CBS on the increasing number of rural hospital closures. Michelle and Sheldon discuss the fact that it is far more likely that hospitals in the 14 states (including Kansas) that have not expanded Medicaid coverage to experience closures than those in states who have expanded Medicaid coverage. Interesting fact: Kansas has more critical care hospitals than any other state; critical care is a significant element in determining hospital closures, Weisgrau notes. Another important element in determining closure involves unpaid compensation for services, according to Weisgrau; that is why, he says, we’re going through a second wave of closures, which is extremely troubling for local communities. More than 80 percent of the rural hospitals in Kansas are operating at a loss, he notes, which could be remediated through Medicaid expansion and innovation. Kansas and other similarly situated states are walking away from millions of dollars through a program that is primarily funded by the Federal Government, Sheldon and Michelle explain. This episode was sponsored by the Alliance for a Health Kansas, www.expandkancare.com, and Butler County Educational Service Center, www.bcesc.org

Michelle chats with Chris Brown, superintendent of the Butler County Educational Service Center in Butler County, Ohio, and Kirk Koennecke, superintendent of the Graham School District in Ohio and CEO of the Ohio Small and Rural Collaborative, about Educator Success, an app that enables teachers to interact with mentors who are not in same building and to access information for their own professional learning, which has particular applicability in the rural setting. Koennecke notes that as a former principal and current school district superintendent, he is acutely aware of the importance of human capital, especially in the rural setting. More than 75 percent of adults use apps on their phones, “so why wouldn’t we want teachers to tap into that [opportunity],” he says. The app makes the job of a district supervisor easier because the app documents the professional learning courses, certificates, and badges earned by staff, provides a platform for professional collaboration, and serves as a modeling tool for students. Brown notes that professional badges can be earned in STEM education, an area of increasing importance in K-12 education. Since launching this joint effort just over a year ago, the impact has been dramatic—teachers banked hours outside of regular workday and immediately put those ideas in to practice in the classroom, especially in the math area, where progress has been measureable. Teachers who are certified are teaching others, he adds. The app also has the potential for saving money in professional learning and there may be grants available to defray costs, Koennecke notes. This episode was sponsored by the Butler County Educational Service Center, www.bcesc.org.