Strengthening Fragile Rural Health Systems

In the summer of 2002, Peter House, director of Programs for Healthy Communities, got a call from the administrator of a small rural hospital. The hospital was financially vulnerable. The caller was frankly worried about going out of business. Could the university offer any ideas? Could House suggest alternative sources of funding?

House gets regular calls from rural towns in Alaska, Idaho, Montana, Washington, and Wyoming. The problems vary: a community is having trouble recruiting physicians or a rural hospital wants to connect with community public health services. Often these days, it’s a financial problem.

House’s job is to organize support. A clinical associate professor in the School of Medicine and the School of Public Health and Community Medicine, he and Associate Director Amy Hagopian work in partnership with the region’s Area Health Education Centers. Together they assist rural towns in the five-state WWAMI region in strengthening their health systems. That can mean offering expertise over the phone. It also means helping with strategic planning, sending in a financial consultant, organizing surveys of community health services, facilitating meetings and retreats, or putting together comprehensive community development projects.

“It’s straight-ahead consulting,” said House. “It’s a great way for the UW School of Medicine to stay connected to the small towns throughout the region.”

Petersburg and Wrangell, two towns in southeast Alaska, for example, asked for support in 2001 as they upgraded their hospital status. Partnering with the Alaska Center for Rural Health, Programs for Healthy Communities surveyed the scope of local health services, including physician availability, public health, mental health, and long-term care, as well as the strengths of the hospital organizations.

In 2002, the four rural Washington towns of Chelan, Brewster, Omak, and Tonasket asked Programs for Healthy Communities to help to find ways the towns could work together and save money by sharing resources, such as specialist services.

Every year for the past decade, the town of Red Lodge, Mont., has invited Programs for Healthy Communities to facilitate a governance retreat for its board of directors.

Rural health systems, though financially fragile, are stronger than ever in terms of the scope and quality of care, House said. Programs for Healthy Communities works to ensure that these health systems are strong enough to attract and retain UW medical school graduates.