Culture of Health Rural Population Draft Framework

Rural Population Group Member List

Contact Name / Organization / Email
Loretta Heuer / Steering Committee, Group Co-Lead /
Mary Sahl / Steering Committee, Group Co-Lead /
Gabrielle Petri / Steering Committee Member /
Denise Andress / Western North Dakota AHEC /
Brad Gibbens / Center for Rural Health /
Jody Ward / ND CAH Quality Network- /
Susan Mormann / Womens Way /
Doris Vigen / ND CAH Quality Network /
Pete Antonson / Northwood Deaconess Health Center /
Darrold Bertsch / Sakakawea Medical Center /
Gretchen Dobervich / ND Rural Health Association /
Sue Heitkamp / CHI Health at Home /
Jan Quandt / CHI Oakes Hospital /
Nikki Johnson / NDSU Extension /
Jane Myers / ND Department of Health /
Tracy Evanson / University of North Dakota College of Nursing and Professional Disciplines /
Katherine Dean / Essentia Insitute of Rural Health /
Tracee Capron / Hospice of the Red River Valley /
Amy Elliott / Sanford Rural Health Research Group /
Marilyn Yellowbird-Baker / Elbowoods Memorial and Health Center /
Jessica Thomasson / Lutheran Social Services /
Tavi Zacher / ND Association of Rural Electric Cooperatives /
Marsha Waind / Altru Health System /
Jennifer Nuelle-Dimoulas / Altru Health System /
MaDonna Azure / Otter Woman Consulting /
Tony Looking Elk / Otto Bremer Foundation /
Red Fox Sanchez / MHA Tribal Health /
Cynthia Lindquist / Candeska Cikana Community College /
Jolene Keplin / Quentin Burdick Health Care Facility /
Erik Holland / State Historical Society of North Dakota /
Ken Knight / North Dakota Home Schooling Association /
LloraKnight / North Dakota Home Schooling Association /
June Herman / American Heart Association- ND /
Stacie Garland / CHI Oakes Hospital /
Amber Bloomberg / Blue Cross/Blue Shield of ND Caring Foundation /
Cindy Gohner / Blue Cross/Blue Shield of ND /
Ben Gates / North Dakota Emergency Management Association /
Brianna Foote / MHA National Tribal Home Health /
William Hertz / ND Center for Nursing Board /
Shila Thorson / ND State Department of Health /

Making Health a Shared Value: How can individuals, families and communities work to achieve and maintain health?

Driver 1: Mindsets and Expectations: Awareness of how our individual health affects others- and how the health of our communities influences our own- is key to building a culture of Health. Do our policies reflect our communities needs and values? These measures reflect how we as individuals, families and communities, and as a nation- think about health and well-being.

Examples: Value on Health Interdependence, Value on well-being, public discussion on health promotion and well-being.

What is happening in North Dakota for this driver? Is there work being done in this area now? Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source
BCBS / Value based program, blue alliance for quality care and prevention, manage chronic patients.
Case managers coordinate community resources.
Education and coordination of benefits.
Disease management to help members become more engaged and manage diseases at home. / Statewide / Private
Social Services / Care management and support for seniors and families.
Counseling services. – SW
Inclusion Specialists for Behavioral and Mental health – SW
Empowering and capacity building that fills gaps for seniors. Senior companionships.
Home visiting support for young families for abuse and neglect -
Gambling addiction treatment.
Affordable Housing for seniors – SW
Long-term Recovery Assistance.
Therapeutic foster care. – Minority Youth / Statewide / State/Federal
USDA Rural Development / Grants to support job training. Technical assistance and financing for local grocery stores. Prove community economic development and financing – telepharmacy, safe housing, rental assistance, utilities, broadband. / Federal
North Dakota Rural Health Association / Advocating on the state and federal level for rural health Access to care. / State / State/Federal
Center for Rural Health / Community health needs assessment for hospitals and public health.
-Will be focusing on 5-8 communities to help strengthen community based palliative care with CAH network / Statewide / Federal/Private.
Local Public Health Units / Contribute to filling gaps in resources while providing a bridge to convene partners. / Statewide / county/state/federal

What are ND’s gaps (geographic and programmatic) for this driver?

  • Reservations
  • Provider gap – Southwest corner of the state
  • Behavioral health and mental well-being
  • Palliative Care (community based) is not covering the entire state at this time

Making Health a Shared Value: How can individuals, families and communities work to achieve and maintain health?

Driver 2: Sense of Community:Residents of socially connected communities are more likely to thrive. Research suggests that individuals who feel a sense of security, belonging, and trust in their environment have better health. People who don’t feel connected to the community are less inclined to engage in health-promoting behaviors or work together for positive change. These measures indicate to what extent people feel a part of their communities.

Examples: Sense of community, social support.

What is happening in North Dakota for this driver? Is there work being done in this area now?Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source
NDSU Extension / Community health and nutrition.
Family Consumer Science Agents.
Family Nutrition Program.
SNAP referrals.
Diabetes Prevention.
Community gardens.
Capacity building for teachers.
Smarter lunch rooms – creating a healthier environment.
Health insurance literacy program.
Community economic community program.
Rural leadership program and Rural Health grants. / State/County / State/Federal
Kiwanis, Lions Clubs / Service/educational clubs that organize volunteer hours and donations to strengthen communities and serve children. / Community based / Community/Private
Center for Rural Health / Be a resource, increase knowledge and improve the health in ND.
Emphasize partnerships with others because no one has enough resources or staff.
Building local capacity
Try to help communities find solutions.
Community Health Needs Assessments
Strategic planning with organizations and communities.
Grant writing workshops. / Statewide / Federal funds, ND legislature, private foundation funding (e.g. Cargill Foundation)
Amvets, Elks clubs / Promote membership from the community to strengthen relationships and serve as meeting places. / Community based / Community/Memberships
NDDOH / Cardiac ready communities – educate on CPR, 911, BP screenings, heart healthy lifestyles; go beyond the hospital, community grassroots efforts / State
Boys and Girls clubs on Reservations, youth recreation program / Promote family after school and weekend activities
Opportunities for volunteerism, Parent, Teacher Organizations (PTO), Support Groups (AA,Al Anon, Alzheimers Support Group, Parkinson Support Group) / Promote sense of belonging and community
Parish Nurse/Faith Community Nurse / Provided in home nursing services, typically, supported by a group of churches
Provide support, lead support groups / Community Based

What are ND’s gaps (geographic and programmatic) for this driver?

  • Sense of community in some areas is a gap because the post offices, grocery, and gas stations.
  • Hard to be poor in a rural community.
  • There is a lot of hidden poverty.
  • Won’t use some services such as food bank because they know people.
  • Senior centers can be used as a resource but limitation is in its size and audience.
  • Churches and faith-based communities can also serve as resources- education, financial barriers.
  • Churches and Senior Centers closing - e.g. daily wellness check
  • Not being able to recruit and retain young families and having jobs with good wages
  • Improved bandwidth – would be able to maintain people in their homes

Making Health a Shared Value: How can individuals, families and communities work to achieve and maintain health?

Driver 3: Civic Engagement- Civic engagement creates healthier communities by developing the knowledge and skills to improve quality of life. Voting and volunteering are among the many measures of an engaged population. In both cases, people’s actions show they care about the outcomes of their community or their nation, and they want to cultivate positive change. These Measures reflect whether individuals feel motivated and able to participate and make a difference.

Examples: Volunteer engagement, voter participation

What is happening in North Dakota for this driver? Is there work being done in this area now?Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source
North Dakota Public Health Association / This association is planning to do community education on legislative issues.
ND State Governor’s Office / Education Innovation Initiative – schools can seek waivers
Workgroup – examine the nursing shortage in ND.
Dollars for Doer’s / Go out and volunteer two days out of the year, can request the donation to be made.
North Dakota Rural Health Association / Advocating on the state and federal level for rural health Access to care.
As a legislator – passing legislation that is responsible, ethical, evidence based.
American Indian Public Health Resource Center
Develop public health needs, cultural competence, culturally sensitive policy.

What are ND’s gaps (geographic and programmatic) for this driver?

  • Issue voting vs. Party voting – are we electing people who value health and supporting health?
  • Do North Dakotan’s recognize the importance of health? – How engaged are North Dakotans in understanding a variety of issues?
  • Communities are not contacting their elected officials to tell them what the health needs are for the area.
  • Providing Information vs. Lobbying; providing information to citizens of ND and state employees alike.
  • Declining population in rural areas limit volunteers; generational differences in the value of volunteering.

Fostering Cross-Sector Collaboration to Improve Well-being: Are Individuals, institutions and communities doing all they can to prevent illness and promote health?

Driver 1: Number and Quality of Partnerships: Research indicates that building relationships among partners is the most challenging aspect of creating change. Measures look at how organizations are working together to improve health and well-being.

Examples: Health department collaboration with community organizations, school districts, workplace health promotion

What is happening in North Dakota for this driver? Is there work being done in this area now?Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source
BCBS / Worksite Wellness grants, Worksite Wellness tool kit available to employers
Physical Activity Grants / ND Community Foundation Gra / Private
NDDOH / Building Cardiac-Ready communities, building relationships in the community / Community / State
NDSU / Provides assessment of workplace employee health, assist in collaborating with other entities to address issues/concern areas / Workplaces statewide / State/Federal
Sanford Health / Providing screening opportunities and wellness incentivesto employees / Sanford facilities / Private
Center for Rural Health / Partnership development, creating alliances
Work with statewide organizations
Community Health Needs Assessments
Toolkit
Dakota Conference of Rural and Public Health
CAH Quality Network
ND Community Foundation Grants / Available to be used for health related activities

What are ND’s gaps (geographic and programmatic) for this driver?

  • Resources limited to be able to designate employees to go after these wellness and workplace assessment opportunities
  • Need a resource book listing the available coalitions, grants, foundations, etc.

Fostering Cross-Sector Collaboration to Improve Well-being: Are Individuals, institutions and communities doing all they can to prevent illness and promote health?

Driver 2: Investment in Cross-sector Collaboration: In addition to measuring the quality and quantity of cross-sector collaborations, it is important to track investments that support these partnerships. Corporate and federal contributions have the power to influence our nation’s health, both directly and indirectly. Measures help identify whether there is adequate financial support to enable cross-sector partnerships.

Examples: US Corporate Giving, Federal allocations for Health Investments.

What is happening in North Dakota for this driver? Is there work being done in this area now?Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source
Co-ops (USDA?) / Providing some loans at zero-rates, or low rates
Provide technical assistance
ND Dept. of Commerce / Workforce Development
Governor Burgum / Mainstreet Initiative
USDA Rural Development / Financing loans and grants for healthcare facilities, telehealth, telepharmacy
Community Facility Loan and Loan Guarantee program
Economic Development Corp./Job Development Corp.
Consensus Council / Through the Bush foundation, grants available to pull communities together for discussion/solutions
Reservations: Small business loans, small loans program, home mortgage programs / Financing available to tribal members backed by the tribe / Tribal / Tribal
QSP Workers that collaborate with county social services to travel off-reservation (Spirit Lake) Elders Programs that collaborate with many entities. / Tribal Nations

What are ND’s gaps (geographic and programmatic) for this driver?

  • Formal cross-sector partnerships seem to be missing
  • Educators
  • Law Enforcement
  • Community Health Workers
  • Listed above likely to work together on a case by case basis but are there formal partnerships anywhere?
  • Difficult to identify US corporate giving and federal allocations that facilitate rural community collaborations. Yes, there are federal dollars and programs operating in communities but most programs seem to be “silos”.

Fostering Cross-Sector Collaboration to Improve Well-being: Are Individuals, institutions and communities doing all they can to prevent illness and promote health?

Driver 3: Policies that Support Collaboration: Policies play a key role in encouraging and maintaining collaboration across sectors, as well as creating incentives for different sectors to contribute what they can to the cause of improving our nation’s health. Measures highlight some of the policies that have the potential to catalyze widespread improvement in health and overall well-being.

Examples: community relations and policing, youth exposure to TV ads, climate adaption and mitigation, support for working families

What is happening in North Dakota for this driver? Is there work being done in this area now?Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source
Department of Health / Fund marketing campaigns for health-related PSA’s, posters, take-home materials.
Manage Vaccine sites in rural communities.
Chronic disease, smoke-free communities, and Diabetes projects state-wide.
Policies in place that support flexible work schedules, family friendly environments. / Statewide / State/Federal/Grant
USDA Rural Development / Finance- telepharmacy, quality safe housing, rental assistance, all rural utilities, broadband, electricity. Grants to support job training.
Prove community economic development and financing. / Communities/State / Federal
Center for Rural Health / Building local capacity.
Try to help communities find solutions.
Community Health Needs Assessments for over half the hospitals in ND.
Strategic planning with organizations and communities. / Community/State / Federal

What are ND’s gaps (geographic and programmatic) for this driver?

  • Service limited/unknown/lack of understanding in Tribal communities
  • Behavioral and Mental health gaps
  • Workforce limits

Creating Heathier, More Equitable Communities: The places where we live, learn, work and play contribute to our ability to become and stay healthy.

Driver 1: Built Environment: Health-promoting environments are safe, affordable and provide access to exercise and nutritious food. Feeling safe in our neighborhoods will also allow us to take full advantage of the space around us. Measures gauge whether our physical environments support well-being.

Examples: housing affordability, access to healthy foods, youth safety

What is happening in North Dakota for this driver? Is there work being done in this area now?Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source
Lutheran Family Services / Childcare for employers.
Respite care/companion programs. / Community based / Private
ND Coalition for Food / Hunger-free ND initiative.
Food Pantries. / State
NDSU Extensions / Community health and nutrition instruction.
Family Nutrition Program, SNAP referrals.
Community Gardens.
Health insurance literacy program. / Community locations / State/Fed/Grant
Social Services / Care management and support for seniors and families.
Counseling services.
Affordable housing for seniors.

What are ND’s gaps (geographic and programmatic) for this driver?

  • Lack of resources, income guidelines, limited number of caregivers/volunteers
  • Housing income guidelines are too low for most working families to qualify for.

Creating Heathier, More Equitable Communities: The places where we live, learn, work and play contribute to our ability to become and stay healthy.