This week’s guest is Don Kelso, the Executive Director of the Indiana Rural Health Association (IRHA). Don has been with IRHA since 2008. Previously, he served as Vice President of Operations at Daviess Community Hospital in Washington, Indiana from 2008-1998, and from 1994-1998, he served as Vice President of Human Resources. Don was also Director of Human Resources at Jasper Memorial Hospital in Jasper, IN, from 1991 to 1993.
“If I could change one thing in rural health, we would have many more psychiatrist and social workers.”
With a staff of 18, Don leads the largest state rural health organization in the United States. With over 3000 members, IRHA has demonstrated success and leadership in many rural health initiatives, such as: broadband connectivity through fiber construction, rural hospital networking, Telehealth adoption for mental health and stroke care services, Rural Health Clinic disaster preparedness/education and support, tobacco cessation education, E-Learning/education, and annually hosts one of the largest state rural association annual conference’s in the country. Don is also responsible for the management of $1,500,000 in federal grants from HRSA and ORHP (Office of Rural Health Policy).
Lara Brooks serves as a Rural Health Analyst with the Oklahoma Office of Rural Health, and Dr. Brian Whitacre is a Professor and Extension Economist in Agricultural Economics at Oklahoma State University. Lara and Brian have been working together since 2008 on increasing community and hospital engagement in rural areas. They focus on things like funding and grants, quality of life and technological advancements.
“I like to think of leadership as the x-factor and it’s something that’s not necessarily tangible, it’s not equipment that you can purchase or hardware or software. But it’s the x-factor that can really make the best of an organization, business or even government.”
Lara primarily works with Oklahoma Critical Access Hospitals within the Flex program, the Medicare Rural Hospital Flexibility Grant program. Brian generally works in the area of rural economic development, and also teaches an undergraduate class on rural development. Together they both work to help improve the quality of quality of life for people in rural America.
Brian Bauer is an attorney for Hall, Render, Killian, Heath and Lyman, PLLC, and works extensively in rural health. He has been an attorney practicing in the rural health field for around 25 years. He has served as general counsel to a number of hospitals, advising them on a wide range of legal, business and ethical issues. He also has experience in addressing medical staff, credentialing and peer review issues, including medical staff disciplinary actions and corrective action hearings.
“A thing that a lot of people especially in more urban areas don’t fully understand is that rural hospitals have all the same legal issues, all the same challenges, all the same need that a large system has without the resources.”
Brian earned his law degree from Valparaiso University School of Law in 1987. He has worked with over 40 ACOs and CINs across the country. The ACO/CIN clients include very large single system CINs that consist of medical centers and their physician groups, as well as ACOs that consist of a combination of hospitals, independent physician groups, federally qualified health centers and rural health clinics.
Michelle Mills serves as the Chief Executive Officer of the Colorado Rural Health Center, which is the State Office of Rural Health and Rural Health Association in Colorado. Colorado is a state that expanded Medicaid and has not had any rural hospital closures.
Michelle has a passion for quality improvement and collaboration, and won the Patient Safety Leadership Award in 2009. The Colorado Rural Health Center is set up as a non-profit, giving the organization flexibility in allocating resources and manpower to reach rural populations with education and tools for better health. Through her organization, Michelle and her team conduct healthy clinic assessments, which help rural health clinics to ensure they are foundationally sound.
“If you have a healthy foundation, then you’re able to build upon that foundation by adding in things like quality improvement and population health.”
Michelle is also a graduate of NORSORH’s Leadership Institute. Additionally, she serves in a number of advisory boards, including the NRHA Board of Trustees, NRHA Rural Health Congress and the RHC Consistency Group.
Tim Size has been the Executive Director of the Rural Wisconsin Health Cooperative since helping found the organization in 1979. The Rural Wisconsin Health Cooperative is owned and operated by forty rural acute, medical-surgical hospitals with the twin mission of shared services and advocacy. The organization focuses on building a collaborative network among freestanding hospitals and system affiliated rural hospitals, distinguishing it from other programs that utilize alternative approaches. Tim works to advocate for rural people and emphasizes the importance of good physician to population relationships.
“Rural Health is as important to the economy and the development of the local community as any other major economic sector.”
In addition to serving as the Executive Director of the Rural Wisconsin Health Cooperative, Tim is also co-chair of the National Health Association Foundation. Prior to his current roles, Tim worked in administration at both the University of Wisconsin Hospital and Clinics and the Hospital Metodista in La Paz, Bolivia.
Andy Fosmire serves as the Vice President for Rural Health for the Oklahoma Hospital Association. He has worked through cuts in the state of Oklahoma, as it was not an extension state with the Affordable Care Act, and discusses difficulties that they’ve had as a result.
“I look at leadership as being a person that is skilled at getting a team of people to move in the same direction and accomplish a mission, a vision as a group, not necessarily being out in front of that group, but working together with a team, and trying to accomplish the mission of the entity.”
Healthcare was a natural fit for Andy, and he earned a Master’s Degree in Therapeutic Recreation. Prior to working for the Oklahoma Hospital Association, Andy was Executive Director for Rural Health Projects, a nonprofit, and was also a Managing Director for the Rural Health Association of Oklahoma.
This week’s episode of Rural Health Leadership Radio is a special episode celebrating the program’s one-year anniversary. In this special episode, guest host Elise Auxier interviews the creator and regular host of Rural Health Leadership Radio, Dr. Bill Auxier. Bill shares his definition of leadership, how Rural Health Leadership Radio began, and lessons he has learned as a leader.
Coming from humble beginnings in Southern Illinois, Bill’s first job in healthcare was that of a nurse’s aide at a small rural hospital, Hamilton Memorial Hospital in McLeansboro, IL. From there he has had a successful career on the industry side of healthcare, working his way up to become the CEO of a surgical device company with a global presence. In addition to the real-life experience in healthcare leadership, Bill also continued his education, receiving a bachelor’s degree in business, a master’s degree in communication, and a doctorate in leadership. Bill likes to combine what he learned about leadership in the real world with what he learned about leadership in the academic world.
Rural Health leadership continues to grow. From a beginning one year ago of 24 downloads (download equals listener) in the month of July, Rural Health Leadership Radio has now surpassed 7,000 downloads, and this growth has been without promotion. While most listeners are in the United States, Rural Health Leadership Radio also has listeners in 22 other countries. Those countries include:
Thank you to all of Rural Health Leadership Radio guests, past and future, and all Rural Health Leadership Radio listeners!
Bill Finerfrock is one of the co-founders of the National Association of Rural Health Clinics (NARHC), and currently serves as the Executive Director. He also serves as the President of Capital Associates, a bipartisan government relations firm that specializes in health policy.
The NARHC has helped healthcare providers navigate Medicare and billing, among many other things, allowing them to help more people. They advocated for one PA in Michigan, who was having trouble gaining rural certification for his clinic, and as a result, started a conversation among government officials about empowering healthcare providers who are providing greater access to care by going into communities where others won’t to provide care.
“It’s not a national thing. It’s not a huge thing. But to look and know that one community was able to have healthcare because we’re able to intercede and help folks out. I think it was really kind of a neat experience.”
Bill became familiar with rural health while working with the American Academy of Physician Assistants in the late 1980s. Several PAs working in rural health would contact Bill with issues they were facing, and Bill realized how difficult it was to get information and answers. He worked closely with PA Ron Nelson, who was Chairman of the Government Relations Committee for the American Academy of Physician Assistants at the time, and together they formed the NARHC to address this issue.
The 2017 Minnesota Rural Health Conference, Shaping Sustainable Solutions, was held June 19 and 20, at the Duluth Entertainment and Convention Center in Duluth, MN. The annual event was hosted by the National Rural Health Resource Center, the Minnesota Rural Health Association and the Minnesota Department of Health Office of Rural Health and Primary Care. The conference objectives was to share and discuss innovative local and state solutions to challenges while encouraging informed and visionary collaborations for the future.
The conference provided the opportunity to:
Keynote speakers included:
Arne Vainio, MD
Family Physician, Min No Aya Win Human Services Center
Edward Ehlinger, MD, MSPH
Minnesota Commissioner of Health
Alana d. Knudson, PhD, EdM
Program Area Director and Co-Director of the NORC Walsh Center for Rural Health Analysis
Brock Slabach
Senior Vice-President for Member Services, National Rural Health Association
Raz Cook serves as administrator for two hospitals: East Texas Medical Center Trinity and East Texas Medical Center Jacksonville. Raz has been a registered nurse for 35 years, and a hospital administrator for 18.
“I think that leadership is artfully influencing people to do work for a common purpose. I think it has both quantitative and qualitative aspects to it. At its best, it's an effective symbiosis that accomplishes great goals. It's rather like being the director of a symphony of different voices and talents, and it creates beautiful music when it's done right.”
She has had a variety of roles throughout her career, including solid organ transplant, critical care nursing, academic nursing instructor and administrative leadership. Her experience took her from the bedside to the C-suite. Additionally, Raz has also served on multiple boards, including the Texas Hospital Association Executive Board, and is currently a non-trustee member on the Texas Healthcare Trustees board of directors.
Randy Dauby serves as the CEO of the Pickneyville Community Hospital District in Pinckneyville, IL. Prior to that, he was CFO then CEO at Hamilton Memorial Hospital in Illinois. His leadership style is authoritative, mixed with kindness and compassion, which trickles down throughout the organization among staff members and patient care.
“I think as a leader, we can tell people that respect, dignity, courtesy is something we need to have as managers. We've got to be authoritative, we've got to expect our managers to do their jobs, but also have a caring and concern for your employees, just as you should have that caring concern for their patients and visitors that come to the hospital.”
Randy started working in healthcare as a teenager, then went on to get a CPA degree and became CFO of Hamilton Memorial Hospital. He transitioned to become a CEO in 1999 and has held the role ever since.
Tune in to hear our conversation on leadership in healthcare and the thoughts on the current state of healthcare policy.
Marybeth Peña is the Nurse Program Specialist for the Florida Department of Health in Marin County. She is a registered nurse and a certified diabetes educator, and was recognized at the 2017 Rural Health Symposium for the work that she does with underserved populations. Currently, she oversees “The Program for Chronic Disease,” a preventative initiative designed to fight chronic conditions such as the obesity epidemic.
“I spent a lot of time just kind of observing, and looking, and listening, and using the model of knowledge, attitude, practice, and belief. So you kind of look at what the community has, what they're willing to change, what their belief systems are, and then work with the people who are already leaders, and the organizations that already have an impact in the community.”
Marybeth’s rural health journey began when she joined the Peace Corps, and worked in a small orphanage in Nicaragua. That experience is what sparked her passion for working with underserved populations in rural areas.
John Gill serves as President of the National Association of Rural Health Clinics. He received the Ron Nelson Award in 2014, presented by his peers; in honor of the positive impact John’s efforts have on the lives of the community that he serves. In this episode, John discusses the importance of connecting with the community, understanding the issues they face and promoting rural hospitals and clinics.
“[Rural is] a silent left out majority of our nation that, unfortunately, has been poorly focused on, because the louder voices, and certainly the majority of voices that are heard, tend to come from urbanized areas.”
John has been a Physician’s Assistant since 1974, and also served as a member of the United States Army for 40 years. He has worn many hats in rural health, as do many rural health leaders, and shares his knowledge and expertise with us in episode 46 of Rural Health Leadership Radio.
This week’s guest is Carolyn Bruce, Chief Executive Officer of Western Healthcare Alliance and Healthcare Management and the Executive Director for the California Critical Access Hospital Network, and Network to Network Strategies. A native of San Diego, CA, Carolyn started her career in healthcare in 1989 after attending San Diego State University and earning a Master of Business Administration Degree from Western State Colorado University. She worked for a 350-bed tertiary hospital as the Director of Planning and Community Health before taking her current position with WHA 20 years ago (this year!).
When we look at those successful CEOs, they've actually gone past and beyond looking for cost savings.
Carolyn currently manages a portfolio of consulting, programs and services designed to assist rural providers in reducing costs through their combined volume and purchasing power, while creating sustainability in their communities. She is a licensed Colorado Insurance Producer and currently serves on the advisory committees for the National Rural Health Association ACO Leadership Committee, Rural Health Center Health Information Informant Group, Rural Health Innovations with the National Rural Health Resource Center, the Mayo Clinic National Symposium of Healthcare Reform, Mesa County Community Health Assessment Taskforce, and the Community Board for the CU School of Medicine Clinical Campus Expansion. She has served as the President of the National Cooperative of Health Networks (NCHN). She was recognized as “2011 Network Director of the Year” by NCHN.
Today’s guest is Dr. Elisha Yaghmai, CEO of FreeState Healthcare, formerly known as Vigilias Telehealth.
Born in California, Dr. Yaghmai has lived in every major region of the United States, and logged time in Africa and Asia. He went into medicine to change the world, but found medicine changed him instead. FreeState Healthcare is his way of fighting back by bringing doctors to Rural America via telemedicine.
“How do we take the one doc and multiply their force to make them available to 20 communities simultaneously? How do we do that? Telemedicine seemed to be the answer to that question.”
Dr. Yaghmai is double-boarded in Internal Medicine and Pediatrics, and has worked in both rural Kansas and multi-hospital, tertiary referral centers. He has experience as an adult and pediatric hospitalist, urgent care physician, emergency medicine doctor, and rural primary care provider – all part of his informal master plan to learn as much as possible about as much as possible the better. Elisha believes telemedicine has the power to fundamentally change healthcare delivery for Rural America.
He completed his undergraduate work at Harvard University, earned his Masters of Public Health and Tropical Medicine at Tulane University School of Public Health and Tropical Medicine, and went to medical school at the University of Texas Southwestern Medical School of Dallas.
In this week’s episode of Rural Health Leadership Radio, we’re having a conversation with Dave Pearson, President & CEO of the Texas Organization of Rural & Community Hospitals, also known as TORCH.
TORCH is a professional association whose members consist of acute care hospitals with under 150 beds.
“…exciting things going on here and a lot of it is pointed toward that future where we're not all just doing fee-for-service healthcare anymore, we're doing something that's much larger…”
Before becoming CEO, Dave served as VP of Advocacy and Communications for six years. Prior to coming to TORCH, Dave was Director of Operations for the State Office of Rural Health. Before that he held management positions at a rural hospital co-op in Kansas and a major medical center in Kansas City.
Dave holds a Bachelors in Healthcare Administration and a Master’s in Public Administration from Texas State University. He is an ACHE Fellow and Board Certified in Healthcare Management.
Dave, his wife Laura and their two sons, David and Will, reside in Cedar Park, Texas.
In this episode of Rural Health Leadership Radio, we’re having a conversation with Lynn Barr, CEO of Caravan Health. Lynn is an energetic entrepreneur with thirty years of experience in healthcare, where she has shepherded four start-ups and twelve medical inventions through research, the FDA and on to worldwide markets.
Through Caravan Health, Lynn is a recognized leader in the development and execution of national scale programs that bring better care to patients and help health care practices succeed. Caravan Health supports more than 17,000 independent primary care providers making the transformation to value-based payments with affordable, simple solutions that achieve outstanding results. In 2015, Caravan Health ACO participants outperformed all other Medicare Accountable Care Organizations in reducing costs and improving quality.
“Leadership has a lot to do with courage. It's really about the courage to stand up and say what you believe, and to pick a path, and hope people will follow.”
While pursuing her Master’s Degree in Public Health, Lynn led the California Health IT and Exchange Strategic Planning Team under California Health and Human Services, formed the Rural Health Information Technology Consortium and assessed HIT status of California Rural and Critical Access Hospitals. She developed a $20 million rural hospital loan program with United Health Group and led 13 rural hospitals through vendor acquisition to meaningful use. While acting as the CIO of a critical access hospital, she created the National Rural Accountable Care Organization to overcome barriers for rural providers to participate in innovative payment models under healthcare reform.
The 2017 TORCH Annual Conference & Trade Show (TORCH = Texas Organization for Rural and Community Hospitals) was held in Dallas, TX, April 18 - 20. The title of the meeting was New Directions in Rural Healthcare.
“The environment for rural health, as you know, is very challenging. We have a lot of issues and things we need to think about.”
- Dave Pearson, CEO, TORCH
During the meeting, Rural Health Leadership Radio roamed the meeting rooms, hallways and exhibit hall, approaching attendees and simply asking what their key take-a-way was for the meeting. As you might imagine, there were a variety of comments from a variety of people. I hope you enjoy today’s special episode or Rural Health Leadership Radio.
You can learn more about TORCH by visiting www.torchnet.org.
Bill Jolley is Vice President for Rural Health Issues for the Tennessee Hospital Association (THA). In this role, Bill is responsible for the development and implementation of the Medicare Rural Hospital Flexibility Program and for expanding services, such as technical assistance and training, to rural hospitals.
He has won several awards, including the National Rural Health Association’s Rural Quality Award in 2007, the Rural Health Association of Tennessee’s Special Exemplary Project Award in 2006 and the Presidential Award in 2014-16. He was also presented with the Carl E. Carpenter Award by the Tennessee Primary Care Association.
“I think our rural hospitals are the cornerstones of their communities. They're such an integral part of our state's healthcare system and our healthcare system nationally.”
Bill also serves as the Executive Director of the Tennessee Rural Partnership (TRP), a subsidiary or THA. TRP’s mission is to maximize access to primary healthcare in rural and underserved areas of Tennessee through the recruitment of primary care providers and other support services.
John Barnas serves as the Executive Director of the Michigan Center for Rural Health (MCRH), a non-profit organization affiliated with Michigan State University. He has held this role since February of 2000. He also serves on the National Rural Health Association Government Affairs Committee and Medicaid Task Force.
In his current role as Executive Director of MCRH, John is responsible for the coordination of the State Office of Rural Health Program, the Flex and SHIP programs, policy, recruitment and retention services, distance education and other rural primary care and value-based programs.
“On a national level, I think with the guidance and support of NRHA, AHA, and NOSORH, we have a real good shot at continuing to be a part of the reform initiatives, improving our healthcare, succeeding in reducing costs and improving the quality of outcomes.”
Prior to working at MCRH, John was Director of Program Development at a Federally Qualified Health Center in Battle Creek, Michigan. He is also a past-president of the Technical Assistance Service Center (TASC) Advisory Council and National Organization of State Offices of Rural Health (NOSORH), and is currently a NOSORH board member.
Chris Clayton appeared as a guest on Meet the Press with Chuck Todd after the last presidential election to help explain how Donald Trump became the 45th President of the United States of America. Rural America made the difference. Chris is the Policy Editor and Interim Markets Editor for DTN/The Progressive Farmer, where he has worked since 2005. He has been recognized as writer of the year and won story of the year multiple times by American Agricultural Editors’ Association. He also won the Glenn Cunningham Agricultural Journalist of the Year Award from the North American Agricultural Journalists and served as the group’s president in 2012-13. Both The National Farmers Union and American Coalition for Ethanol have named Chris as communicator of the year.
If you close a hospital in a small town somewhere, it has a big drag on economic development, property values, things of that nature, that you're maybe not thinking about. And then just simple fact, that any kind of emergency now becomes even worse when you've got to drive longer to get some help.
In 2015, Chris self-published an e-book on Amazon entitled The Elephant in the Cornfield, the politics of agriculture and climate change, which details the debate in rural America around renewable energy, climate volatility, greenhouse gas emissions and cap-and-trade.
Joy Williams has spent the last six years working with a faith-based organization that helps improve health capacity in rural areas. Now she is writing a book about faith and patient advocacy while completing her Master’s of Divinity at Wake Forest University in Winston Salem. She has hands on experience educating rural populations on healthier living by teaching them how to grow their own food and other ways to make healthy food choices.
“I think, again, rural health is something that is a growing trend these days within public health because there's such a great need, but I know that I am invested in rural health because of what it reminds me of my childhood and of my family.”
Joy currently holds a Master’s Degree in Public Health from the University of North Carolina, Chapel Hill. Her passion for supporting people in rural areas stems from her childhood, where she grew up in farmland and helped her dad grow vegetables in their garden as a child.
Peggy Wheeler is the Vice President of the Rural Healthcare Center at the California Hospital Association. Peggy also serves on the National Advisory Committee on Rural Health and Human Services, which is an independent advisory body to the Department of Health and Human Services on issues related to how the department and its programs serve rural communities.
“Rural healthcare is an integral, vital component of all healthcare. You don't have urban healthcare without rural healthcare. It's an integral component of all healthcare in California and in the entire country.”
As Vice President of the Rural Healthcare Center at the California Hospital Association, Peggy develops, advocates and executes public policies, legislation and regulations on behalf of rural hospitals at the state and national levels. Peggy also serves as the Issue Manager for Language Access and Governance Issues, as well as Hospital-Prison issues.
Pat Schou is the Executive Director of the Illinois Critical Access Hospital Network and the Illinois Rural Community Care Organization. She was recognized for being among the Top 25 Women in Leadership for Peoria, Illinois in 2013, received a Women of Distinction award in Illinois Valley in 2013, and was recognized as the 2014 Illinois Rural Hero by the National Center for Rural Health Professions, University of Illinois School of Medicine, Rockford.
“I think the CEOs that are really excelling has to do with that they have a strong board support, they have good connectivity with their board in their community, and they have good connectivity with their medical staff.”
Pat also serves on the National Rural Health Association (NRHA) Rural Congress and Government Affairs Council, and was recently elected as NRHA Secretary. Additionally, she serves on the Accreditation Association for Hospitals/Health Systems Board, was recently Chair of the Technical Advisory Services Committee for National Rural Resource Center, and served as Co-Chair of Illinois’ State Health Improvement Plan Implementation Council from 2010-2015. She has served as Chair of the local health board for over 20 years, and is a Fellow member of the American College of Healthcare Executives.
Toniann Richard is the CEO of Health Care Collaborative of Rural Missouri (HCC). HCC is a rural health network dedicated to developing and implementing programs to respond to the health needs of local residents. Toniann also serves as the President of the Missouri Rural Health Association. Among many accomplishments, Toniann has raised more than $12 million in grant funding since 2008, that money going toward providing healthcare access to underserved populations.
“You can drive so much momentum and spirit, and sustainable systems, leadership programs and leadership teams, just by getting out of your office.”
Toriann grew up on a cattle farm in Central Kansas, which is still run by her father and brother to this day. She is an active member of her church, and a strong proponent for women in leadership. Her passion for rural health stems from roots working in the non-profit world and a desire to serve those in need.