Network Spotlight: Mountain Health Alliance
The Mountain Health Alliance serves rural Appalachia in Allegany County, MD; Garrett County, MD; Mineral County, WV; Bedford County, PA; and the Hancock area of Washington County, MD.
|Network Name||Mountain Health Alliance|
|Key Contact||Kimi-Scott McGreevy, Network Director|
|Mission||The Mountain Health Alliance is a regional network dedicated to advancing a culture of health through collaboration and community engagement.|
|Vision||The Mountain Health Alliance envisions that the Region will achieve a culture of health and wellness.|
Kimi-Scott McGreevy, network director of the Mountain Health Alliance, was interviewed by NCHN’s director of member services to share information on the network’s characteristics, key learnings, accomplishments, and challenges.
Q: In a “nutshell,” how would you describe your network?
A: Our network is a grouping of people and organizations involved in providing health care in a rural community. Our members include hospitals, health departments, FQHC’s, private practitioners and non-profits. We work with the un- and under-insured and low-income population in a 3 state (PA, MD, WV), 5 county region. Members sign a Memorandum of Understanding (MOU) stating they want to be a part of the network. MHA envisions a region that will achieve a culture of health and wellness, and our mission statement reads: “Mountain Health Alliance is a regional network dedicated to advancing a culture of health through collaboration and community engagement.”
Q: What benefits do network members receive?
A: They really are helping the community overall by helping people who are under the radar in terms of health care. We focus on adults who have been shut out of the system - adults who are un- or under-insured and low income. By working to get this population access to the care they need, the Network is benefitting its partners. For instance, a benefit to our hospital partners is seen in improved efficiencies and costs as a result of the efforts we are making to reduce recidivism rates, for both oral and behavioral health patients, especially in the hospitals’ emergency departments.
Our service area is within the Appalachian Mountains, so we’re working within the Appalachian culture. This culture struggles with generational poverty; this population typically mistrusts authority figures and often are intimidated by people they see as being highly educated. So we have some significant cultural barriers in getting these folks to feel comfortable using the health care system. That’s where the community health workers play key roles. MHA has two community health workers on staff, one who focuses on oral health and another who focuses on behavioral health. These two areas of health care, oral and behavioral, were seen as the two areas with the greatest need in the MHA region. The Community Health Workers allow us to reach people we probably would not otherwise.
Q: What’s been a surprising insight or development as your network has grown?
A: In our oral health program, the number of dentists willing to accept referrals from us for $150 an hour. The dentists usually charge by procedure; by allowing us to pay them per hour, we are able to help far more people get the care they need. We set up meetings with each practitioner and asked if they’d be willing to see our patients at the $150/hour rate. We only had one who said no. We now have about ten we refer to. This allows people who would otherwise not be able to afford the service obtain oral health care. When the dentists bill us, they put down what they normally would charge for the service they provided as well as the amount of time involved. This allows us to track their donated services, which presently is at a 75% donation rate.
Q: How does being in a rural area affect the work of your network?
A: The lack of public transportation and the inability of people to get to a provider or any other type of resource are challenges we face in a rural community. We can’t do everything we’d like to do for people. It’s very difficult and frustrating when you see a need, and the way the system sometimes works—or doesn’t work—prevents people from getting the care they need. An advantage to the rural environment is the small-town kind of trust. The dentists to whom we refer people at the $150 rate have come on board with a shake of the hand and said sure, without anything in writing. That’s very rural.
Q: Tell us about a challenge your network recently overcame.
A: We had a network member looking for cultural competency training on working with the Appalachian populations and dealing with the different socioeconomic statuses within that culture. We started looking but really didn’t see anything specific enough for our area. Katie Salesky, the MHA workforce chair, lives in West Virginia and has many connections there. She contacted West Virginia University’s (WVU) Extension Service, which opened a dialogue about what we were looking for. They actually created a program for us based on Appalachian culture and socioeconomic status factors. They wrote the program and presented it to two of our partners. Now they will be giving us the program with instructor manuals so we can continue to provide this training, which will benefit all partners in the long run.
Q: What issues will your network face as it continues to grow?
A: Our biggest challenge is funding. There’s not a lot of money floating around in rural areas, and we don’t have the resources that you might find in larger cities. Our members decided long ago not to be a dues-funded organization. That said, the network itself will continue to exist beyond the life of our Network Development grant from HRSA, and we are working on the sustainability of our programs. Funding our community health workers is a big challenge.
Q: Based on your experiences as a network leader, what advice do you have for a developing rural health network?
A: The key is to get as many players on board as possible. The broader your support, the more successful you will be. It’s important to get buy-in and bring all the players to the table. Having a wide variety of players is important. Each has a different role and different way to connect with the community. Together, you can have a significant impact. It’s very gratifying to be part of something that is tangibly making a difference in people’s lives. MHA is making a difference.
Tony Michael, associate professor at the West Virginia University Institute for Labor Studies and Research, presents a training on cultural competency in Appalachia he and a colleague created for the Mountain Health Alliance.