Meet a Member
Meet a Member: Andy Lowe

Andy Lowe, Chief Strategy Officer at Outer Cape Health ServicesAndy Lowe

Why rural?

I have lived in rural New England my entire life, growing up in grown-over farm country in Connecticut, then living in Vermont in college and after, and most recently in outer Cape Cod. People who live in rural places have a connection to the land and nature that you just don’t get even in suburban environments, let alone urban spaces, and that connection binds us together in a way that used to be universal but which is rapidly—and unfortunately—becoming antique. I find the challenges faced in rural environments, particularly those related to health, to be stimulating and thought-provoking. Solutions to rural challenges require thinking around corners, often by adapting solutions from urban/suburban spaces to fit the unique challenges of low-density environments. I wouldn’t—probably couldn’t—live anywhere else.

What does being a member of the RoundTable mean for you? 
The Association provides a focal point for raising awareness about rural health challenges and solutions and a forum for conversation, networking, and best-practice sharing. In terms of tangible benefits, I have had several funding and research opportunities sent my way by RoundTable colleagues. I also love the fact that the folks from the “rural nooks and crannies” in southern New England can contribute to and learn from their more “classically” rural northern New England colleagues. TheAssociation is ultimately a validation of the fact that we’re all in this together!

What does rural healthcare mean to you?

Rural healthcare means identifying and overcoming challenges that most of the country doesn’t even recognize. Many folks see rural landscapes and think of beautiful scenery, vacations, and getaways. I see places where invisible, underserved populations have been created by the forces of tourism and second home-driven economies. I see people who are living on subsistence-level incomes from two, three, or four jobs—snowplowing, commercial fishing, handiwork, snowmaking—while dealing with a variety of social determinant issues that their urban counterpoints couldn’t even fathom. These are people with an innate dignity, but for whom access to healthcare can require lengthy trips by car, if they are fortunate enough to own one, or ridiculously lengthy trips by public transportation, which is frequently inadequate to non-existent. Let’s not forget that limited cell coverage and broadband that can make rural places feel more like the 19th than the 21st century (OK, so that’s an attraction for some of us as well). We have essentially created a rural underclass that faces serious health disparities, and I find the challenge of reversing this trend to be stimulating and rewarding. 

Meet a Member: Marty Milkovic
Marty Milkovic, Connecticut Dental Health Partnership Marty Milkovic

Why rural? 

Most people don't think of rural and Connecticut together. While our state is small, there are significant areas that are rural and they have all the associated challenges: fewer services, transportation issues, isolation, cows, etc. I live in a small town on the edge of Connecticut's 'Quiet Corner', the northeast portion of the state. Farming is still an important business and we have one of the largest farmers markets in New England which hosts up to 5,000 people on a peak summer Sunday. I grew up in another rural Connecticut town with a chicken farm for a neighbor and I lived in a very rural area of Ohio for five years. So you can say I've had plenty of exposure to rural. 

What does being a member of the RoundTable mean for you?

The RoundTable has been a good forum for rural health issues and rural oral health issues in particular.  I got involved originally with the old 'Rural Oral Health' conference almost ten years ago and have stayed involved ever since.  It has been important to meet other folks from across New England, hear about their work and see how oral health fits in the overall picture.

What does rural healthcare mean to you?

Of course, for me, oral health care in rural settings is important.  Our data shows that dental utilization for clients in HUSKY Health (Connecticut Medicaid/CHIP) is lowest in the rural areas of our state, even though the American Dental Association's Health Policy Institute's analysis shows that physical access to dentists is very good throughout Connecticut.  Our hypothesis is that rural areas have unique problems that limit utilization: weaker social service networks, more isolation, and transportation issues.  There may even be cultural barriers, in our words, Yankee stubbornness. Our work is to figure out how we can overcome these obstacles.  It's a meaningful task.

Meet a Member: The New Hampshire Office of Rural Health

The New Hampshire Office of Rural Health

What is your organization's mission and/or purpose of your organization/department/program? How do your efforts support healthy rural communities?

The mission and function of the Rural Health and Primary Care section is to support communities and stakeholders that provide innovative and effective access to quality healthcare services with a focus on the low income, uninsured, and Medicaid populations of New Hampshire.

How does being a member of the RoundTable help you and your colleagues in your work? What resources/opportunities do you find valuable?

Being a member allows us to easily collaborate with and support similar programs in rural New England. It directly supports our responsibility as a State Office of Rural Health to offer technical assistance to rural health care providers and organizations, provide healthcare-related information to rural healthcare stakeholders, and serve as a liaison between rural healthcare organizations and many New Hampshire Department of Health and Human Services programs. We also maintain a clearinghouse for collecting and disseminating information on rural health care issues and innovative approaches to the delivery of healthcare in rural areas. 

Can you share an example of a project that you are working on that may be a valuable model/resource for other members of the RoundTable?

For the past three years we have been supporting a Rural Health Clinic Technical Assistance network for all of the RHCs in New Hampshire. The main purpose of this initiative is to directly benefit rural communities by equipping Rural Health Clinics with the tools and resources necessary to effectively and efficiently serve their rural populations. In addition to an annual needs assessment, the network has three main functions: technical assistance webinars, diabetes learning collaborative, and clinical measure data collection and reporting for both diabetes and hypertension.

New Hampshire Rural Health


Meet a Member: Grace Cottage Hospital

Grace Cottage Hospital

What is your organization's mission and/or purpose of your 

The mission of Grace Cottage Family Health & Hospital is to care for the healthcare needs of the community; to promote wellness, relieve stress, and restore health.organization/department/program? How do your efforts support healthy rural communities?

How does being a member of the RoundTable help you and your colleagues in your work? What resources/opportunities do you find valuable?

The Association coordinates the New England Performance Improvement Network (NEPI) - a collaborative project among the Flex programs and the State Offices of Rural Health in VT, MA, NH and ME.  With funding from the Flex program, NEPI has allowed members at Grace Cottage to receive certifications related to their jobs. We have taken advantage of CIC, CPHQ, CPHRM and CHC certifications. This has been a valuable benefit.  This year we are taking advantage of the TNCC certification for some of our nursing staff. Another benefit is having access to free, or sponsored webinars from the Association which allows us to keep up with this ever-changing field of Healthcare. 

Learn more about NEPI, click here.

Grace Cottage Hospital

Meet a Member: Charles Dwyer

dwyerCharles Dwyer of the Maine Health Access Foundation

What is your organization's mission and/or purpose of your organization/department/program? 

The mission of Maine Health Access Foundation is to promote access to quality health care, especially for those who are uninsured and underserved, and improve the health of everyone in Maine.

How do your efforts support healthy rural communities?

I am a Program Officer and I oversee two grants programs that provide funds for collective action. The Rural Health Transformation initiative is bringing together new partners in rural communities who are planning and piloting innovative ways of working together to deliver health care services that respond to community needs in sustainable ways. The MeHAF Healthy Community grants also encouraged partnership and collaboration, engaging residents, fostering leadership development and effecting systems changes that positively impact health.

How does being a member of the RoundTable help you and your colleagues in your work? What resources/opportunities do you find valuable?

I appreciate the network that I’ve developed as a result of my Association membership. As part of the Association's Policy Committee, I stay abreast of what’s happening with rural health policy in New England and nationally. I like being a part of the effort to inform our state and federal policy makers about what is important to us and other rural stakeholders. It’s important to make our voices heard.

What resources/opportunities do you find valuable?

This year MeHAF is sponsoring registrations for each of our Rural Health grantees, combining our grantee meeting with the 2018 New England Rural Health Conference. Whether people use the opportunity to present some of their learning or to learn from others, I know they will find the annual gathering to be valuable.  Having been a number of times it’s often a  chance for me to catch up with people that I know but don’t often see in a setting that allows for more informal conversation and connection. I’ve learned a lot in those brief one on one conversations over lunch or coffee.

Can you share an example of a project that you are working on that may be a valuable model/resource for other members of the RoundTable?

When we kicked off our Rural Health Transformation initiative in 2016 we worked with the Maine Rural Research Center at the USM Muskie School of Public Service to compile promising strategies in payment and financing, governance, workforce, and service delivery that are emerging in rural communities in Maine and around the country. They can be viewed and downloaded from the Learning Center on our website, where there are a number of other useful resources.

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