News and Events


National Rural Health Day - Leadership Message from our Executive Director

posted Oct 12, 2017, 11:01 AM by Josie Maroney   [ updated Oct 13, 2017, 1:22 PM ]

National Rural Health Day

November 16, 2017 is National Rural Health Day. Please join the Rural Health Network of SCNY and rural health and health care providers across the United States in celebrating our rural communities, health professionals, hospitals, and clinics.

Here are just a few of many reasons why we celebrate and recognize our rural health practitioners and partners:

  • Health care professionals in rural America are able to focus on building personal relationships with patients and families.
  • Hospitals are the economic foundation of many rural communities. The 1,330 Critical Access Hospitals (CAHs) provide essential health care to rural communities across 45 states and on average bring 204 jobs to the local economy.
  • New models for community health workers, community paramedics, and oral health professionals have been incubated in rural America as a model throughout health systems.

Of the 3500 certified Rural Health Clinics, 95% accept new Medicaid patients. Federally Qualified Health Centers are focal points for services to underserved rural populations and Veterans Health Administration Community Based Outreach Clinics work to improve the health of 40% of the nation’s veterans.

As a Rural Health Network, our organization understands that improving the health and wellness of rural people and communities requires working across sectors and involving all who are willing to help. The “can do” and neighborly spirit of rural America is a strong foundation for improving rural but there are still many challenges confronting the continued delivery and improvement of health care in our rural communities, including:

  • Rural workforce education and training programs are needed to help recruit, retain, and increase the number of well-qualified medical providers for rural residents, including veterans.
  • Rural hospitals remain vulnerable to closure. Critical Access Hospitals make up 30% of acute care hospitals but receive less than 5% of total Medicare payments to hospitals. More than 60% of CAH revenue comes from government payers. All payment reductions to Medicare or Medicaid have an enormous impact on CAH’s ability to provide access in rural communities.
  • Emergency medical services are mostly volunteer dependent but are vital in rural America where 20% of the nation’s population lives and nearly 60% of all trauma deaths occur.

In conclusion, I would also like to recognize the staff, Board of Directors, and volunteers of the Rural Health Network of South Central New York, Inc. (RHNSCNY). Every day, there are opportunities for different members of the RHNSCNY team to be the “rural voice” at a meeting, to serve someone struggling to understand and navigate a complicated health care system, or to help ensure that the health-related needs of rural people and communities are considered and included in county, regional, and state initiatives. Thanks to all at RHNSCNY, our partners, and our supporters for putting National Rural Health Day into practice every day.

Note: Much of the material in this article is taken directly from information provided by National Organization of State Offices of Rural Health (NOSORH) in support of National Rural Health Day. If you would like more information on National Rural Health Day go to https://nosorh.org/nrhd-resources/

- Jack Salo, Executive Director of RHNSCNY

Northern Broome Addiction Awareness Upcoming Events!

posted Sep 12, 2017, 6:47 AM by Josie Maroney


Leadership Message: From our Executive Director, Jack Salo - August 2017

posted Aug 17, 2017, 10:45 AM by Josie Maroney

Is a Marriage Between Health Care and Community Services the Answer to Improving Health?

The evolution of health care in our country includes increasing recognition of the significant role that race, income, place, education, and associated lifestyles play in the health status of people and families. When considering what determines health status, research has shown that access to medical care accounts for only ten percent of the equation, while behavior (fifty percent) and environmental conditions (twenty percent) are the largest contributing factors.

It seems that, at all levels, there is increasing interest in how traditional, clinical health care providers can connect patients to the non-clinical services and supports essential to their health. I have been involved in many of these discussions through our work with Care Compass Network and the Medicaid reform process, as well as through our Population Health work in partnership with HealthLink NY and other rural health networks. 

As I have listened to my colleagues from the health care sector discuss the expectation that health care work more closely with the array of governmental and non-profit community health and human services providers to create a new system of care, I am left with several nagging questions. First and foremost is who pays? Where will the resources come from to connect patients to non-clinical systems and resources essential to their health? How will non-clinical health, human service, housing, transportation, food security, and other sectors meet an increasing demand for services generated by new referrals from the health care community? What value is there in collecting information on the non- medical health related needs of patients if there is a non-existent or limited service environment to support those needs?

The best illustration I can think of, where good intentions to initiate this new way of work had a reality check, was a meeting I attended early on in the formation of the East Regional Performing Unit (RPU) of Care Compass Network. Care Compass Network is our regional Medicaid reform organization and it has organized work into North, South, East, and West regions or RPUs. The East RPU is comprised of Chenango and Delaware Counties. The Care Compass Network facilitator leading the meeting was describing how the collection of community based organizations in the two-county service area could support individuals recently discharged from the hospital with an array of non-clinical but essential services to support their recovery and was genuinely excited and optimistic about this vision. What followed was an impassioned tutorial by several service providers, including the Director of Catholic Charities of Chenango County, on both the limitations of the existing safety net services (e.g., funding and associated staff cuts to support food pantries), the paucity of service providers in this rural region, and the logistical challenges and cost of serving a small, spread out rural population. Essentially, those in attendance made the point that their organizations could not meet the current need and certainly did not have the capacity to provide additional services to address new needs and referrals.

I do think having the health care and the community health and human services sectors working together in new and more strategic ways has the potential to improve the health of individuals and communities. However, we should not be naïve about the cost, time, and commitment that is needed to make this work. 

I would like to acknowledge and celebrate the opportunities that are readily available for health care and non-clinical service providers to work together, on behalf of patients, to improve health.  Sometimes a conversation can prompt a simple, inexpensive change that has a significant positive impact. Here is an example of how that can work: Bill Wagner, our Mobility Management Director, recently presented me with 2016 reports for our Mobility Management work in each of the five counties we serve. What caught my attention was the dramatic increase in the number of Chenango County cases (assistance with a specific transportation need). In 2015, Mobility Management of SCNY assisted with 70 cases.  In 2016 Mobility Management SCNY assisted with 174 cases. There were no other counties that saw such a dramatic increase in service. I asked Bill what changed in Chenango County? and he responded that after he met with Chris Kisacky, Vice President of Operations at UHS - Chenango Memorial Hospital, she had instructed staff responsible for discharging patients to attach information with the GetThere Call Center (transportation assistance) number to the discharge packet. Bill attributed this simple, inexpensive action to the dramatic increase in the number of individuals with transportation needs being assisted through the call center and the Connection to Care Program (assistance with transportation to health care appointments).

While we need to do a better job of harvesting the “low hanging fruit,” per the example above, addressing the significant non-clinical health related needs of low-income and other disparate populations will require both new resources and reallocation of existing resources. In our region, Care Compass Network has been the driver supporting this new way of work across sectors to improve individual and community health. While the work is just beginning and we have much to learn, this is a promising development that has the potential to improve the health of individuals and communities.

P.S. For those looking for the term “social determinants of health,” I intentionally left it out. I find this academic generalization to be confusing and less helpful than noting the specific non-medical factors that contribute to health or lack thereof.

 

-Jack Salo, Executive Director

2017 Broome County Summer Food Sites!

posted Jun 14, 2017, 12:13 PM by Josie Maroney

2017 Broome County Summer Food Sites have been announced!
Click the image below to see in full screen. 
https://sites.google.com/a/rhnscny.org/ideas/home/2017%20Broome%20County%20Summer%20Food%20Sites.jpg?attredirects=0

Leadership Message: from our Executive Director, Jack Salo - May 2017

posted May 11, 2017, 7:24 AM by Josie Maroney   [ updated May 11, 2017, 7:27 AM ]

The ALICE (Asset Limited, Income Constrained, Employed) Project has provided a framework to better understand the challenges of the working poor and, I would argue, the transfer of wealth in our country. The United Way ALICE Project began as a pilot in Morris County, New Jersey in 2007 and is now endorsed and supported by United Ways in fifteen states, including New York

In Broome, Delaware, and Tioga Counties, the percentage of ALICE households is 42%; 44%, and; 36% respectively. What does this mean? Essentially, four of ten households in our region are comprised of "... individuals and families who are working, but unable to afford the basic necessities of housing, food, child care, health care, and transportation."

What are the implications of having forty or fifty percent or more of the households and workers in your community unable to afford the basic necessities of life? 

While struggling with this injustice, I keep coming back to who pays for the gap between what it costs to live with dignity and some level of security (your children are safe and cared for, your home is safe and sufficient, you have a dependable way to get to work, you have enough healthy food to eat and can access health care when you need it) and what you get paid in this economy for service sector and other low-wage employment? It is not an easy or simple question. 

Part of the answer can be found with business owners and other employers whose mission includes not only the bottom line, but also the viability and well-being of their workers. The recent 60 Minutes story on Chobani founder Hamdi Ulukaya and his willingness to not only hire refugees, but to provide both transportation to employment and interpreters in the workplace, is an inspirational example of how one man and one business are investing in both the workers and the company. 

Another example of how business can play an important role in the well-being of their workers was provided by Shanna Ratner, a rural economic and community development practitioner, in a recent presentation to the Community Foundation for South Central New York Planning Committee. Ms. Ratner spoke of working with a rural electric cooperative (company) that had an onsite child care center for employees. She was engaged to evaluate the variety of returns the cooperative business received on its investments in its employees and the community, which yielded a surprising finding: the childcare center was not only a benefit to employees, but actually improved the cooperative's bottom line. The return on investment for the childcare center considered the longevity, attendance, and productivity of workers using the center, and showed a clear return on investment when costs associated with turnover and absenteeism were factored in. Not only did the business meet the basic need for childcare for their workforce, but the center also provided the business with a competitive advantage.

I also think part of the answer to how to close the gap between wages and the cost of meeting basic needs can be found in redirecting the resources of philanthropy. The focus of some United Ways on income and the promotion of the ALICE Project are both positive steps in this direction. Challenging United Ways and foundations to consider and direct resources to help close the gap between income and the cost of basic needs is an education and advocacy effort worth engaging in. 

Finally, public policy, economic policy, and governmental programs must consider the needs of our working people who work hard, but cannot make ends meet. Does our public policy help or hurt those that meet the ALICE criteria? Will the policy support or at least not have a negative impact on their ability to meet their basic needs and live with increased security and dignity? When the math is done who benefits and who loses when our elected officials legislate?

John C. Salo
Executive Director
Rural Health Network of South Central New York

Mothers & Babies Perinatal Network hosts FASHION GALA

posted Apr 11, 2017, 6:47 AM by Josie Maroney   [ updated Apr 11, 2017, 7:54 AM ]

Why Mobility is a Foundation of Rural Health

posted Feb 16, 2017, 7:47 AM by Josie Maroney   [ updated Feb 17, 2017, 6:27 AM ]

Why mobility is a foundation of Rural Health:

 

The term mobility is defined as “the ability to move or be moved freely and easily” (source: English Oxford Living Dictionaries). Most are familiar with the term “upward mobility” often used to describe the process of improving an individual or family’s economic status. The word mobility is also used in the context of describing an individual’s physical movement challenges or limitations. More recently, the transportation sector has introduced the concept of “mobility management” to describe an array of services and strategies that consider the unique transportation (mobility) needs of individuals. This individualized approach can inform and drive improvements in service at both the individual and systems levels as transportation gaps and duplication are factored into designing more responsive and efficient transportation solutions.

 

Why improving mobility “on the ground” is necessary to achieve better rural health outcomes:

 

Think of the array of trips that rural residents need to make to access employment or health care and to procure other essential goods and services. The extent to which these trips can be made in a safe, efficient, and affordable manner affects the extent to which rural residents can maximize health and wellness.

 

Considering the demographics of our region (aging, relatively low incomes, higher rates of chronic disease) and limited affordable transportation service options, there is a need to better address the mobility needs of many older, sicker, and/or lower income rural residents. Improved mobility and affordable transportation options help position rural residents for better health by improving access to healthy food, health care services, education, and social connections.

 

How addressing the second largest expense for most low income households can contribute to better health outcomes:

 

Transportation expenses are often the second highest expense to individuals and families after housing. [1] In some low income rural households, transportation can be the highest expense due to the cost of owning and maintaining a vehicle(s) and high operating expenses due to long distances travelling to employment, etc. So here are some ways that effectively addressing the high cost of transportation can have a positive impact on health:

 

·         Providing an affordable, dependable transportation option for accessing employment can make it possible for a rural worker to travel to a better job and potentially a job with health insurance benefits. Increased income and benefits can have a positive impact on health and wellness.

 

·         If the cost of transportation is reduced, income can be freed up for other expenses, including (healthy) food, clothing, household expenses, etc. Consider how reducing the need for two cars to one car in a household with two workers could significantly reduce expenses. This scenario is possible if there is public transportation, ride sharing, or a van-pool available.

 

Perhaps there is some irony here, but the high cost of mobility (transportation) can be a barrier to “upward mobility” for many rural residents. In order to move up, there needs to be access to education and employment opportunities that generally require dependable, affordable transportation. You could say that in order to move up one must first be able to move side to side…

 

How does Rural Health Network of SCNY (RHNSCNY) help improve the mobility of rural people and communities?:

 

Mobility Management of South Central New York (MMSCNY), a program of RHNSCNY, has been helping to address the transportation needs of individuals in our region since 2011. The point of entry for anyone in Broome, Chenango, Delaware, Otsego, and Tioga Counties, with a transportation need or question, is to call the GetThere Call Center at 1-855-373-4040, Monday – Friday, 7 a.m. – 6 p.m.  MMSCNY can also be accessed by calling 211.

 

MMSCNY provides training to individuals or groups that want to learn how to use public transportation. MMSCNY can also assist those who need help with transportation and related expenses to health care appointments through the Connection to Care Program. Other projects in development include The Rural Mobility Project (van-pool services to employment) and the Transportation to Health Toolkit (includes a searchable database to quickly access information on transportation services available for your specific need). For more information call the GetThere Call Center call 1-855-373-4040 or access more information about MMSCNY at the Rural Health Network SCNY Website: http://www.rhnscny.org/programs/mmscny .

 

1.       Federal Highway Administration. (Updated 2015). Transportation and housing costs.  Retrieved from: http://www.fhwa.dot.gov/livability/fact_sheets/transandhousing.cfm

Rural Health Week of Action

posted Dec 13, 2016, 12:17 PM by Josie Maroney

Rural Health Week of Action

 

During Rural Health Week of Action, the Rural Health Network of SCNY is working with community partners to remind people that the NYSOH Marketplace is open for business! From now until January 31, NYS residents can visit https://nystateofhealth.ny.gov/  to shop for affordable, quality health coverage.

 

Here are a few facts every American who lives in a rural community should know about open enrollment, now through January 31, 2017.

 

Rural Americans have affordable coverage options on the Marketplace.

 

Nearly 9 in 10 rural Marketplace consumers will be able to get tax credits to help pay for a plan that works for them and their families. Even people who didn’t qualify for tax credits last year may qualify this year, especially if their income changed or if they live in places where premiums have risen. 

 

As a result, 75 percent of rural Marketplace consumers will be able to find health coverage for less than $100 per month, after tax credits.

 

You and your family may be eligible for Medicaid (income at 138%) or the Essential Health Plan (200% above the Federal Poverty Level).

 

Rural Americans already covered through the Marketplace may save money by revisiting their options during Open Enrollment.

 

You have the right during open enrollment to shop for better plans, or a lower monthly premium.  Returning rural customers could save an average of $47 per month, or $564 a year, by coming back to the Marketplace and purchasing the lowest premium plan in their metal level.

 

It’s easy to find and enroll in a plan.

 

Visit the tools on https://nystateofhealth.ny.gov/ to compare plans based on your preferred health care providers and prescription drugs. You can also compare plans by how much you think you’d spend over the course of next year, based on you and your family’s personal health care needs.

 

Phone Assistance:

 

Call NYS Marketplace Help Line at 1-855-355-5777 or TTY 1-800-662-1220

Monday – Friday 8 am – 8 pm or Sat. 9 am – 1 pm

 

In-Person Assistance:

To find an in person assistor in your area, contact the Rural Health Network of SCNY at 607 692-7669, M-F, 8 am -4:30 pm.

 

Adapted from: http://www.hhs.gov/blog/2016/11/16/lets-get-rural-america-covered.html

Sound Rural Housing: A Condition for Safety and Health

posted Oct 12, 2016, 5:27 AM by Josie Maroney

Sound Rural Housing: A Condition for Safety and Health

Many years ago I learned some basics about rural housing from Richard L’Hommedieu, who, at the time, was Director of the Chenango County Planning Department. Richard was retired military and brought much of what he learned in his military career to his work at the Planning Department. He had a “can do” attitude and was focused on a strategy of making investments and improvements to address housing needs in Chenango County.

During the late eighties and early nineties, the Chenango County Planning Department accessed state and federal housing grants and initiated a mobile home replacement program, as well as programs to upgrade septic systems. I can remember Mr. L’Hommedieu explaining how each rural home requires its own infrastructure which makes rural housing, from construction to maintenance to renovation, an expensive proposition. While urban, and many village and suburban homes are connected to municipal water and sewer systems which share costs, rural homes generally require their own systems, resulting in significant initial and maintenance costs. When systems fail, replacement costs can be prohibitive for those on low or fixed incomes. If a well or septic system needs to be replaced, other home repairs and improvements may have to go by the wayside.

So how does this impact the health of rural homeowners? When you travel the countryside and see houses in disrepair, think beyond the peeling paint. Does the home have safe drinking water? Is there a septic system, and if yes, is it working properly? Is the wiring safe? Is there a heating system, and if so, is it safe?  Are there carbon monoxide and smoke detectors? This is not an extensive list but does suggest some of the ways substandard rural homes can impact health and safety.

With the economic challenges of our region and a significant and growing number of older residents living on fixed incomes, the age, quality, and safety of our rural housing stock is both an individual and community concern. While code enforcement can be helpful, especially with new construction and renovation oversight, many rural homes have safety and potential health issues that remain unresolved.  

The Rural Broome Counts (RBC) Housing Supplement published in July 2016 provides information on the state of housing in rural Broome County. Equally important, the RBC Housing Resource Guide for Rural Municipalities, also published in July 2016, provides information on local housing agencies, as well as New York State and Federal Housing programs that can help rural communities and homeowners with housing needs, including repairs, energy improvements, and funding for homeownership. I would encourage community leaders and local elected officials to consider how they can support housing needs in their community. An investment in rural housing services and programs is an investment in the health and safety of seniors and others who struggle to afford and maintain their homes. One final thought: There is an economic health benefit - a community with quality, safe, and affordable housing is a community people want to live and work in.


Jack Salo
Executive Director, Rural Health Network of SCNY

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