Summaries of Rural Health Outreach Grant Program in North Dakota
June 2006
Southwestern District Health Unit-Dickinson, ND (FY 2006) - The “Pathways to Healthy Lives,” Project is a community effort of the Cancer Task Force of the Healthy 8 Communities Network. The project promotes healthy lifestyles to prevent cancer by providing awareness through education and screening for breast, colorectal, lung, prostate and skin cancer in the eight counties of Adams, Billings, Bowman, Dunn, Golden Valley, Hettinger, Slope, and Stark. The Project will provide public education focusing on making healthy dietary choices, getting physically active, protecting oneself from sunlight and chemical exposure and preventing initiation or cessation of tobacco products usage. Free breast, prostate, colorectal and skin cancer screening will be held in local communities within the eight county area.“Pathways to Healthy Lives” will positively impact the entire spectrum of cancer prevention, earlier cancer detection, survival and quality of life. The consortium sponsors of the Project are Southwestern District Health Unit, St. Joseph’s Hospital and Health Center and Community Action Partnership.
Mental Health First Aid, Fort Yates, ND (FY 2006) - The Rural Outreach Grant for Mental Health First Aid partners the Center for Rural Health with the Standing Rock Sioux Tribal Health and West River Health Services to prepare trainers in Mental Health First Aid, a program developed in Australia, and develop the curriculum for training in the Northern Plains. Like a first aid course provides help for physical injuries when health care providers are unavailable, Mental Health First Aid will help in the rural, frontier, and tribal areas where there are few mental health professionals are available. This project will help non-mental health professionals including primary care, first responders, educators, youth workers and other volunteers to recognize signs of various mental health issues, quickly assess for suicidality, de-escalate the situation, and connect the person with professional resources. It does not train people to be therapists, but it does help stabilize situations and get people to the therapists and other resources. Research in Australia has shown that this program reduces stigma about mental health, increases feelings of competence in dealing with mental health related situations, and improves the mental health of those that are trained. This program is a means to address the high suicide rate in North Dakota and the lack of mental health professionals to identify mental health issues. It is also important to reduce the stigma about mental health issues.
Wellness Interventions Lasting a Lifetime (WILL) Network, Langdon, ND (FY 2005) – The WILL Network will encourage wellness and healthy lifestyles, and provide education on disease awareness, management and prevention to residents of Cavalier County, the northwest section of Pembina County, and the northern portion of Ramsey County. The WILL Network’s goals are to: 1)Implement the WILL program, 2) Increase awareness of chronic disease conditions and educate and manage these conditions, 3) Promote wellness and lifestyle change programs, 4) Increase awareness of activity related injury prevention and wellness programs, 5) Increase awareness of overall occupational wellness, 6) Promote self-managed wellness programs.
The network consists of the Cavalier County Job Development Authority (CCJDA), Cavalier County Memorial Hospital, and the Cavalier County Health District. Existing and supportive community (ad hoc) members are North Dakota State University Extension Service-Cavalier County Office, Cavalier County Social Services, Walhalla Economic Development, Parish Nurse-Faith Based Organization, Cavalier County Senior Meals and Services, and the City of Langdon.
Healthy Lifestyle and Disease Management Program- Hettinger, ND (FY 2003)
Life Initiatives for Everyone (LIFE) - is a program to promote healthy lifestyle changes and assist individuals with preventing and managing chronic diseases. A community needs assessment revealed the following needs: Chronic disabling diseases, cardiovascular risk behaviors, chronic pain, mental health and mental health disorders, substance abuse and access to health care. The LIFE program will be conducted in collaboration with the West River Health Services, Southwestern District Public Health Unit and the UND School of Medicines & Health Sciences. LIFE will take a two-tiered approach to enhance and extend the quality of life for the residents of all ages from southwestern North Dakota and northwestern South Dakota. The program will increase awareness of five simple lifestyle changes to improve health status. The initiatives will be implemented through the Wellness and Healthy Lifestyle Center located in Hettinger, ND. The goal is to develop new healthcare management concepts, create a comprehensive approach to healthy lifestyles and change the “health culture” of this rural region.
Wellness in the Valley-Suicide Prevention Task Force - Valley City, ND (FY 2002)
The Wellness in the Valley-Task Force is a coalition that was formed in response to nine suicides and 14 reported suicide attempts in Barnes County within a 12 month period of time. The coalition represents public and private advocates, human service agencies, and clinicians who have joined forces to implement a community-based suicide prevention program. Network partners include Mercy Hospital, MeritCare Clinic, and City-County Public Health Department - all of Valley City. There are an additional 18 supporting agencies, including the schools, juvenile court, and law enforcement, actively committed to this project. The community-wide program is based on the Strategy for Suicide Prevention (a national program effort). From this, the task force will develop a comprehensive suicide prevention program that will serve the greater Barnes County area. Activities of the task force include a suicide prevention and educational program. Volunteers will be trained to assess and refer at-risk persons to needed services and support programs will be made available for those identified as being at risk. Suicide is often associated with or the result of domestic violence, relationship problems, post-partum depression, farming stress, chronic illness, or a history of mental illness. By addressing factors contributing to suicide, it is hoped that suicide attempts will be lessened.
Sakakawea Medical Center - Hazen, ND (FY2000)
Behavioral Health Services Network Model Project is an outgrowth of the Rural Mental Health Consortium, previously funded by an Outreach Grant. The major problems in behavioral health services are lack of access, stigmatization and difficulties in maintaining financial viability. The grant will assist Northland Healthcare Alliance (an organization representing health providers in central and western North Dakota) members to increase access to specific targeted communities and population groups. Further services access will be facilitated through the use of an existing Telemedicine network operated by St. Alexius Medical Center. The proposed project incorporates four additional factors to achieve long-term sustainability for the Behavioral Health Services Network. These factors are: 1) The consolidation of administrative functions, scheduling, billing, etc. in a central location to reduce program overhead; 2) The training and use of mid-level practitioners to expand availability of services; 3) Outcome measurement to build a data base that will assist in developing other successful models of treatment; and 4) The use of telemedicine to increase the cost effectiveness of mental health providers in rural North Dakota. The network developed for this project consists of Sakakawea Medical Center, Hazen; St. Alexius Medical Center, Bismarck, and the Rural Mental Health Consortium, headquartered in
Minot. Increased access will be provided to the communities of Ashley, Dickinson, Ft. Yates, Garrison, Hazen, Linton, Steele, Glen Ullin, and Turtle Lake. Additional services and coordination will continue with the communities of Bottineau, Harvey, Kenmare, Mohall, New Town, Parshall, Rolla, Rollette, Velva and Westhope.
Wishek Community Hospital & Clinics - Wishek, ND (FY2000)
Wishek Community Hospital & Clinics, in partnership with McIntosh District Health Unit, Medcenter One Health Systems, and Moser Drug Pharmacies of Wishek and Napoleon, have worked together to improve their communities through the establishment of mutual goals and integration of activities. The project will implement a continuum of care including: preventive care, early detection screenings, chronic disease management, and support services. This will be applied to the chronic disease states of diabetes, osteoporosis, heart disease, and cancer, which plague their elderly population.
Southwestern District Health Unit - Dickinson, ND (FY2000)
This project, “Pathways to Healthy Lives,” is a community effort of the Cancer Task Force of the Healthy 8 Communities Network. The project will increase awareness, education and screening of lung, prostate and female breast cancer in the eight counties of Adams, Billings, Bowman, Dunn, Golden Valley, Hettinger, Slope, and Stark. The project will work with its communities to heighten awareness for healthier lifestyles related to cancer prevention, and increase earlier detection of cancer through community sponsored screening events. “Pathways to Healthy Lives” will positively impact the entire spectrum of cancer prevention, earlier cancer detection, survival and quality of life. The three network sponsors are Southwestern District Health Unit, St. Joseph’s Hospital and Health Center and Community Action and Development, Inc.
Jacobson Memorial Hospital Care Center - Elgin, North Dakota, Richardton Health Center, Richardton, North Dakota & Medcenter One, Bismarck, ND (FY99)
This network will provide elder and Alzheimer’s care, education, and training to all area health care providers, volunteers, care givers, and community members. The two rural hospitals in the network will train two registered nurses in the specialty areas of elder and Alzheimer’s care. Adult day care and respite care services will also be expanded. The service is called the Regional Elder and Alzheimer’s Care Rural Health Network. Members are Jacobson Memorial Hospital Care Center, Elgin; Richardton Health Center, Inc., Richardton; and Medcenter One Health Systems, Bismarck.
Garrison Memorial Hospital, Garrison, ND (FY99)
The problem addressed with this project is diabetes identification, management and treatment. This formal network is made up of 13 rural hospitals and three nursing homes that belong to the Northland Healthcare Alliance, a regional network of providers in central and western North Dakota. The Alliance noted the prevalence of diabetes in the region and decided that a disease management model was the appropriate way to address the issue. The project will use a computerized care data-base that will help both the patient and the provider in treatment and follow-up care. In the second year the project will add heart disease to the computer data system.
Ashley Medical Center - Ashley, ND (FY98)
The “Community Emergency Medical Program” project is addressing the dire needs of the emergency medical assistance personnel in this rural, frontier area. Due to extreme weather for the past three years, the area to be served has been designated a disaster area. The population to be served is aging and poor. This project will enhance the Emergency Medical Services (EMS) system by developing a network of Emergency Medical Quick Response units to reduce response time for the outlying portions for the area. The project will provide advanced
EMT training, First Responder education and Certified Heavy Rescue and Extrication training. The network will also, develop and provide community emergency care training for area residents including CPR, Safe Baby Sitter Training and Farm Safety classes. The network includes the Ashley Medical Center, Ashley Ambulance Service, Ashley Fire Department, and the McIntosh County Health Agency.
Good Samaritan Hospital Association, Rugby, ND (FY98)
The “Golden Heart (Hour Emergency Access Response Team)” project is a cooperative effort to improve the Emergency Medical Services System in a four county area. The service area encompasses 3,500 square miles with 13,000 residents scattered in farms and clustered in small communities. The project is focused on strengthening the volunteer ambulance services, providing Advanced Life Support to accident (automobile and farm) victims, delivering advanced trauma care when needed, providing continuing and advanced emergency medical services education and community and farm safety education. The network is comprised of the Good Samaritan Hospital Association, the Heart of America Medical Center, the medical staff of the Johnson Clinic, volunteer ambulance services in seven area communities, and local fire/rescue first responder units.
North Dakota Hospital Research & Education Foundation - Minot, ND (FY98)
This project addresses a licensed practical nursing shortage in northeastern North Dakota. Project
TRANSCENDS will use distance education technologies and other distance-free education modalities to provide access for rural individuals, including residents of the Spirit Lake Sioux and Turtle Mountain Chippewa reservations, to an Associate of Applied Science in Practical Nursing Program. Educational institutions will work collaboratively to provide general education courses to accommodate rural working students, and a technical college will use distance-free education modalities, including laptop-assisted coursework. On-site field counselor support services will be provided and the nursing education curriculum will be enhanced to foster cultural competence. The network is made up of three educational institutions - Cankdeska Cikana Community College – a tribally-chartered community college, the University of North Dakota (UND) - Lake Region, and Northwest Technical College, and two nursing educational programs-North Dakota (Ladders in Nursing Careers) LINC and the Recruitment/ Retention of American Indians in Nursing (RAIN) program at UND.
St. Joseph’s Hospital and Health Center - Dickinson, ND (FY96)
Services at three rural health clinics will be expanded through this project. The new services will provide first responder training in isolated communities, a pager system to link responders to EMS personnel, counseling services for minors in group homes, and specialty services such as obstetrics, internal medicine and orthopedics. The project also addresses improved services for diabetics and provider needs of continuing medical education and recruitment problems. The populations targeted for services include Native Americans, farmers, and adolescents. The consortium includes a hospital, Fort Berthold Indian Health Services, a group home, and several
ambulance services.
Spirit Lake Sioux Mobil Prevention Project - Fort Totten, ND (FY95)
A consortium of health providers on the Spirit Lake Reservation established a mobile health clinic to provide preventive health services and education to the reservation’s 5,500 Sioux residents. The grant also implemented a community development program that focuses on decreasing substance abuse, child abuse, and domestic violence in the community and on building collaborative relationships among community agencies. Project staff took a 32-foot mobile clinic out to the small communities to provide nursing and preventive health care. The clinic was staffed with a registered nurse, licensed practical nurse, and a secretary. Services provided included head checks for lice, blood sugar checks, pregnancy tests, other nursing services and referrals to the Indian Health Service hospital in Fort Totten. The mobile staff also provided Early Periodic Screening Diagnostic and Treatment (EPSDT) screening in cooperation with the Early Childhood Tracking, Maternal and Child Health, and Healthy Start Programs. The consortium consisted of the Little Hoop Community College, the State Maternal and Child
Health Program; Early Childhood Health Tracking Program; Indian Health Service; Healthy Start program; and Family Health Coalition, an alcohol and other drug use prevention program.
North Dakota Rural Mental Health Consortium - Minot, ND (FY94)
The North Dakota Rural Mental Health Consortium received an outreach grant to provide high-quality, cost effective mental health care to its client-service area that covers 11,500 square miles. The project uses the “critical pathway” system, a case-management plan that reflects coordination of care, identifies key incidents and documents variances in care to help increase access to mental health services. Additionally, the project will support the education of two clinical nurse specialists in psychiatry. The consortium is composed of St. Aloisius Medical Center, Harvey; Kenmare Community Hospital, Kenmare; St. Andrew’s Health Center, Bottineau; and Presentation Medical Center, Rolla. The consortium was originally supported by a rural health care transition grant.
Kidder County District Health Unit - Steele, ND (FY94)
The Kidder County District Health Unit, Kidder County Social Services, and six public schools: Steele, Dawson, Tappen, Pettibone, Robinson, and Tuttle organized a consortium and received outreach grant funds to create a rural nursing center in each school. The nursing centers will provide health care for students as well as people in the surrounding community. The centers will be open to the public at least four hours a week. A nurse practitioner will provide the initial assessment, diagnosis and treatment of health problems. In addition, the nursing clinics will provide educational sessions. Special attention will be given to education, prevention and first
responder treatment of agricultural injuries.
Walsh County - Grafton, ND (FY94)
This project will build a regional emergency medical services system based on the Advanced Life Support ground transport intercept model. In addition to providing capabilities for higher-level assessment and treatment for patients at earlier points in trauma episodes, the project will also provide training to prehospital and hospital personnel. The consortium includes hospitals and emergency response services.
Oakes Community Hospital - Oakes, ND (FY94)
This project will expand services in an underserved community through the establishment of a rural health clinic. School-based services and community education activities will also be provided. The consortium includes a hospital, health unit, community development group, school district, social service agency, and others.
North Dakota Association of EMTs/ECTs - Cooperstown, ND (FY91)
This project was designed to encourage and assist volunteer ambulance team members to upgrade their skills to the level of Emergency Medical Technician (EMT). It promoted recruitment and retention of EMT’s through public service announcements, television, radio, newspapers and public speaking engagements. The innovative use of computer link to the Department of Emergency Health Services to improve membership database and created more accurate mailing system for members, training equipment was also purchased. The grant used Interactive Video Network (IVN) for education/training and sponsored a state wide EMS conference along with 12 regional mini-conferences for continuing education. The network included North Dakota Association of EMTs/ECTs, Department of Emergency Health Services, North Dakota EMT Association, North Dakota Advanced Life Support Society, North Dakota Instructors/Coordinators Society, and the North Dakota Test Team.
