First Federally Qualified Health Clinic residency program opens in Kentucky, with hopes of bringing more rural doctors to state

Update, Aug. 8, 2024: Dr. Jerry Eddis has since resigned from the program. 

By Melissa Patrick
Kentucky Health News

Kentucky's first residency program operated by a Federally Qualified Health Center opened July 1 in Northeast Kentucky, with hopes that the resident doctors will set up practice in rural Kentucky after they complete their training. 

The PrimaryPlus Family Medicine Residency Program will be headquartered in Maysville, Ky.  The primary focus of the residency program will be family medicine with plans to use specialty services such as obstetrics and gynecology and pediatrics to provide residents with a well-rounded experience.

Dr. Tyler Elam

Dr. Tyler Elam, director of the residency program, said FQHCs can play an important role in training physicians because of the populations they serve, who are largely indigent, uninsured or underinsured.  

"I think there is a greater . . . mutual benefit for having the learners present in an FQHC," he said. "It helps us close care gaps for the indigent, while also being able to train new physicians."  

Kentucky's program is one of 81 Teaching Health Center Graduate Medical Education programs that operate in 24 states and Washington, D.C., said Elam. 

Research shows that medical students who trained in rural areas are almost twice as likely to practice in rural areas whether or not they grew up in a small town, a topic explored in a blog post from the National Rural Health Association. Further, studies shows that physicians from rural backgrounds were more than twice as likely to practice in a small town, compared to urban counterparts.

And that is the goal of the PrimaryPlus residency program. "That really is part of our mission, is to train them here and keep them here," Elam said. 

There is a great need for rural primary care physicians in Kentucky, according to the 2022 Kentucky Physician Report from the University of Kentucky Center of Excellence in Rural Health. The report says 43 of 120 Kentucky counties meet the criteria for a primary care physician Health Provider Shortage Area. Nearly 73% of of Kentucky's 2,741 primary care physicians practice in urban counties despite the majority of the population living in rural counties.  

PrimaryPlus's residency program will bring four new primary care residents into the state each year.

The first class of residents are Dr. Devaki Dravid and Dr. Jerry Eddis, both from Pennsylvania. Devaki received her medical degree from Philadelphia College of Osteopathic Medicine and Long received his from American University of the Caribbean School of Medicine. Dr. Brion Long is from Breckinridge County, Ky. and Dr. Sara Roberts is from Bath County, Ky. Both Long and Roberts attended the Kentucky College of Osteopathic Medicine at the University of Pikeville. 

Elam said the new residency slots will help to meet the ongoing demand for more primary care physicians, especially as baby boomers continue to need more care.  

"There's not necessarily enough residency spots to keep up with the increasing medical school class sizes. And so, you know, there's like a supply and demand mismatch as a result," he said. "So the more residency spots we can open up, it definitely closes that care gap downstream."

Already, Elam said the resident doctors have been able to close some of the care gaps in the community and have contributed to the wellness of the medical community, who often work short-staffed. 

"The residents are thriving and loving it here," he said. "They'll come to my office and be like, 'Man, this is so great. I didn't know that learning could be like this. I feel like I'm part of the team. I feel like I'm making a difference. And I feel like I'm learning simultaneously.'"

Mental-health care access can be a challenge in Eastern Kentucky; on top of that, the subject still carries stigma for some

Appalachian Regional Healthcare Behavioral
Health Facility (Photo submitted to WEKU)

By Stan Ingold

WEKU

Experts are concerned about a growing mental-health crisis nationally. This story looks at the struggles faced by those dealing with access to mental-health care in Eastern Kentucky.

“We're Appalachian people, so we're seen as being strong and that's how we want to portray ourselves, and if you have any kind of mental illness it is seen as a weakness," Kasey Wright says.

Wright is the system director of behavioral health, education, and psychological support for Appalachian Regional Healthcare. She said mental health carries a stigma for many people in Eastern Kentucky, and she and her colleagues try to persuade their patients otherwise.

“We try to tell our patients . . . if you have diabetes you have to treat that, its a medical condition. It's the same if you have depression, you have to treat that, it's a medical condition.”

For some, it takes a major incident for them to make the decision to seek help.

“I had a suicide attempt when I was 21,” said Valeri Jones of Morehead. She reached her tipping point almost 20 years ago. She said dealing with substance abuse and anxiety was getting to be too much for her to handle.

“I just couldn't live like that. I couldn't live feeling depressed and I couldn't function. I couldn't work. I lost my job. I just couldn't function,” she said. “So, that is when I was like, 'It's time to do something. It's a true, real chemical imbalance.'”

But it hasn't been an easy road. Once she started getting help, it was hard to find consistency with her treatment, she said: “My appointments would get canceled, they would get rescheduled and every third or fourth appointment that I would finally make it in for, now, some of that was my fault, I would have work or scheduling conflicts or whatever, when I would make it in, I was constantly with a new therapist.”

And she said seeing a new therapist every other visit was a struggle in and of itself.

Jones said it is frustrating because she is constantly told she needs to pair her medications with therapy.

“I'm told by my doctors that 'You need to pursue counseling, you need to be in therapy while taking these medications, because this is the most effective way to deal with your issues.' But then I'm trying to keep up my end of the bargain; but then I keep getting canceled and told, 'Basically, it doesn't really matter.'”

She said sometimes it makes her lose heart. “And it makes me not want to go, and I'm limited with what providers I have access to.”

Jones works in the mental-health field herself. She knows it isn't easy for those trying to help.

“I get it; the pay is not great, the work is demanding, it's mentally exhausting, but as someone on the other end of that, who is trying to get those services for myself, and someone with anxiety, it's hard to, it's hard to just go in and talk to someone period.”

This isn't the only hurdle people face. Kasey Wright, with ARH, said that in southeastern Kentucky, sometimes even just getting to an appointment is difficult.

“We don't have Uber. We don't have taxis here. We don't have things like that. Most of our people live in hollers and things like that, that aren't close to town, so it's really hard for our people to get a ride to any of their appointments.”

Paulina Jones is the director of counseling and psychological services at ARH. She said public transportation isn't much of an option either.

“Our public transportation, when you have to make an appointment for them to come and get you, you have to do it three days in advance. So, some of our patients don't even have telephones, and even for wi-fi, there isn't good wi-fi service either.”

Paulina Jones said another stumbling block for those seeking help is finances. Many of the people who get help from ARH are on Medicaid, but for others, it can be much more difficult to pay for treatment.

“But if you have Medicare, only certain providers can get paid for that. And if you have private or insurance, you're only allotted so many days of like, outpatient therapy, so you may be only getting like 10 days to clear up whatever the issue is. And if you have trauma and something like PTSD you're probably not going to get that healed up in 10 sessions.”

Both Paulina Jones and Kasey Wright say they are seeing more funding being directed toward mental healthcare, but they would like to see officials do more.

Jones said while they have several inpatient facilities for those dealing with substance use disorder, there needs to be something set up for long-term, lower-level mental-health care, for exemple, because there are few personal-care homes in the region.

She said there are "no nice facilities for our chronically mentally ill to go and live and live the rest of their lives and not have that high recidivism, keep coming into the hospital because of the living conditions or not having a safe place to go.”

Along with funding, other efforts are underway. Earlier this year, Gov. Andy Beshear signed into law House Bill 385, known as Seth’s Law. Officials say the law will result in fewer citizens needing to be placed under state guardianship to access health care.

The bill honors the memory of Seth Stevens, who was an advocate for mental health reform, who died by suicide in 2023.

Anyone who may be experiencing suicidal thoughts or any kind of mental health crisis can call or text 988, 24 hours a day, seven days a week to speak to someone qualified to help. Click here to learn more about the 988 Suicide and Crisis Lifeline. 

31% of Kentucky women live more than half an hour from a hospital with a maternity unit; across the U.S., only 9.7% do

Map from 2023 March of Dimes report

By John McGary, WEKU

“Estill Medical. This is Madisyn. How may I help you?”

It’s a few minutes before lunch at Estill Medical Clinic, in Irvine. The practice is owned by nurse practitioner and Estill native Donna Isfort. It offers many services, but, like every other medical facility in the county, no obstetrician/gynecologist.

Isfort said, “Many, many of my patients at least have to travel anywhere from 30 minutes to 60, 70, minutes just to get to obstetrical care. There's just not any here. We have no nurse midwives. . . . I do family practice, so I do a lot of women's health at my clinic, but not prenatal care.

Estill County does have a hospital, but a spokesman for Mercy Health-Marcum and Wallace Hospital said it hasn't delivered babies since 1986, not counting unplanned births in the emergency room.

According to a 2023 report by the March of Dimes, women living in what some call “maternity care deserts” like Estill and several nearby counties must travel more than twice as far to get the care they need. Multiple studies conclude that greater distance puts women, expectant and otherwise, at greater risk.

The report says 31 percent of Kentucky women live more than 30 minutes form a birthing hospital; the national figure is 9.7%.

Isfort says she and her staff work closely with the Estill County Health Department to provide the help they can and out-of-county referrals for services they can’t provide.

Some think Kentucky’s maternity care deserts may spread. At a June 24 rally in Lexington to mark the two-year anniversary of the Supreme Court’s toppling of Roe v. Wade, second-year medical student Shriya Dodwani painted a bleak picture.

“The Accreditation Council for Graduate Medical Education requires that OB/GYN residents have access to abortion training,” Dodwani said. “This isn't about politics. It's about ensuring that we have the comprehensive skills needed to provide the best possible care for our patients. Without this training in Kentucky, we're left with no choice but to leave and pursue our education elsewhere.”

In a recent survey of students at Kentucky’s three medical universities, 62 percent of respondents said they’re considering finishing elsewhere because of the state’s near-total abortion ban.

A week later, University of Kentucky HealthCare officials unveiled a plan that could help some women in rural areas. The outreach division of UK Women’s Health OBGYN announced they’d add services at 19 new sites, several in Eastern Kentucky, and expand telehealth services.

Dr. Emily DeFranco is chair of UK’s Department of Obstetrics and Gynecology, said “We'll send a sonographer with an ultrasound machine to the site, and they'll perform the ultrasound and then virtually, by telemedicine, the physician who is in Lexington is able to view the images from the ultrasound, and then have a video conference with the patient on that site and counsel her about the findings.”

That sort of outreach could eliminate some of the long trips many women must make for routine care. Another program, funded in part by Medicaid and tobacco-settlement dollars, helps expectant and new mothers: HANDS, which stands for Health Access Nurturing Development Services. It’s available to all women during pregnancy through a child’s third birthday.

At the Estill County Health Department, Teresa Talbott is the ongoing home visitor, dropping in weekly with 15 to 20 families per year for the last 17 years.

“We're not coming in to look at your home. We're not coming, you know, to tell you what t“o do, Talbott said. “We're just coming in and giving you the information and helping you along with it.”

One woman she’s helping now is Whitney Bingham, who happens to be the health department’s Women, Infants and Children program coordinator. Talbott, who Bingham calls TT, is assisting her and her two-year-old son through challenges ranging from potty training to car-seat installations.

But Bingham says that when it’s time for her to leave for an OB-GYN visit, she makes the hour-long drive to Lexington.

The state Cabinet for Health and Family Services declined our request for an interview with the Department for Public Health’s director of women’s health.

Bowling Green's Med Center Health acquires Russellville hospital

Sign on chain's flapship hospital in Bowling Green

Kentucky Health News

Med Center Health, the nonprofit hospital chain based in Bowling Green, is now the owner of 75-bed Logan Memorial Hospital, and has changed its name to The Medical Center at Russellville. That extends the chain to seven like-named hospitals in Southern Kentucky, from Russellville to Albany.

Med Center Health said the facility will have will have six ICU/CCU beds and 10 swing beds, and serve a population of about 45,000. The purchase, finalized July 1, also includes three medical office buildings on the main campus as well as rural health clinics in Russellville, Auburn and Elkton.

“Med Center Health’s mission is to care for people and improve the quality of life in the communities we serve,” President and CEO Connie Smith said in a news release. “This acquisition aligns perfectly with that mission as we look to further enhance healthcare services for residents of Logan County and surrounding communities. We have a proven track record of improving access to care and services in our rural communities, and we could not be more excited to do the same for our friends and family in Logan County.”

The hospital was owned by the county until 1989, when it was sold to Nashville-based Hospital Corp. of America, which had managed the facility for several years. HCA later became Columbia/HCA Healthcare. In 1999 the hospital was part of that company's spinoff of rural hospitals into a new firm called Life Point. In 2022, when Life Point acquired Kindred Healthcare, it became part of a new company call ScionHealth, which sold it to Med Center Health.

Dr. Kamal Singh of Russellville, a member of the hospital's board, said in the release, “We are proud of the quality patient care that we deliver at Logan Memorial Hospital to the local families, Individuals, and our neighbors, and we are very pleased with the progress we have made under ScionHealth’s ownership. We are confident that Med Center Health’s breadth and depth of care services will best serve the local community as they seek to expand services and offer the resources of the most comprehensive health system in the region.”

Med Center Health, which grew out of the government-owned Bowling Green-Warren County Hospital, says it has more than 3,500 employees and 150 employed health-care providers.

Rural Tennessee hospitals near Kentucky border remain closed as the Volunteer State keeps spurning expansion of Medicaid

Jellico Medical Center is defunct. (KFF News photo by Taylor Sisk)

By Taylor Sisk
KFF Health News

JELLICO, Tenn. — In March 2021, this town of about 2,000 on the Kentucky border in the shadow of Pine Mountain lost its hospital. It's in Campbell County, which ranks 90th of Tennessee’s 95 counties in health outcomes and has a poverty rate almost double the national average, so losing its health care cornerstone sent ripple effects through the region.

“That hospital was not only the health-care lifeline to this community,” said Tawnya Brock, a health-care quality manager and a Jellico resident. “Economically and socially, it was the center of the community.”

Since 2010, 149 rural U.S. hospitals have closed or stopped in-patient care, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. Tennessee has had the second-most closures of any state, with 15, and the most closures per person. Texas has the most, with 25. Neither state has expanded Medicaid under the Patient Protection and Affordable Care Act, as has Kentucky, where only four hospitals have closed.

Jellico Medical Center was a 54-bed, acute-care facility. When it closed, some 300 jobs went with it. Restaurants and other small businesses in Jellico also have gone under, said Brock, who is a member of the Rural Health Association of Tennessee’s legislative committee. And the town must contend with the empty husk of a hospital.

Dozens of small communities are grappling with what to do with hospitals that have closed. Sheps Center researchers have found that while a closure negatively affects the local economy, those effects can be softened if the building is converted to another type of health care facility.

In Jellico, the town owns the old hospital building, and Mayor Sandy Terry said it is in decent condition. But the last operator, Boa Vida Healthcare of Indiana, holds the license to operate a medical facility there and has yet to announce its plans for the building, leaving Jellico in limbo. Terry said local officials are talking with health-care providers that have expressed interest in reopening the hospital. That’s their preferred option. Jellico does not have a Plan B.

“We’re just in hopes that maybe someone will take it over,” Terry said. Meanwhile, the nearest emergency rooms are a half-hour drive away in LaFollette, Tenn., and in Corbin, Ky.

MapQuest map, adapted by Kentucky Health News

An hour and a half away in Fentress County, the building that once housed Jamestown Regional Medical Center has been empty since June 2019, when Florida-based Rennova Health — which also previously operated Jellico Medical Center — locked it up.

County Executive Jimmy Johnson said Rennova’s exit from Jamestown was so abrupt that “the beds were all made up perfectly” and IV stands and wheelchairs sat in the halls. About 150 jobs evaporated when the center closed.

Rennova still owed Fentress County $207,000 in taxes, Johnson said, and in April the property was put up for auction. A local business owner purchased it for $220,000. But Rennova was granted a year to reacquire the building for what it owed in back taxes, plus interest, and did so within a few days.

Abandoned hospital buildings dot the map in Middle and East Tennessee. In West Tennessee, some shuttered hospitals have found new life.

The closing of McKenzie Regional Hospital in 2018 was a blow to the local economy. But Baptist Memorial Health Care, which operates a hospital in nearby Huntingdon, bought the assets — including the building, land, equipment, and ambulance service — and subsequently donated the building to the town of McKenzie.

Cachengo, a technology company, ultimately took over the space. Because of hospitals’ electrical infrastructure, the site was a perfect fit for a business like his, said Ash Young, Cachengo’s chief executive. Young said Cachengo is now looking into repurposing abandoned hospitals across the country.

Jill Holland, McKenzie’s former mayor and a local-government and special-projects coordinator for the Southwest Tennessee Development District, believes the town can become a technology hub. “It’s opening a lot of doors of opportunity for the youth in the community,” she said.

But in Jamestown, the vacant hospital is “deteriorating,” said Johnson, the county executive. “It could have been used to save lives.” Rennova did not respond to a request for comment.

The University of Tennessee Medical Center opened a freestanding emergency room elsewhere in Jamestown, sparing residents a half-hour drive to the closest ER. Johnson believes the old hospital building could serve the community as housing for those who are homeless or as a facility to treat substance use disorder.

Brock, the health-care quality manager, thinks things will get better in Jellico, but the community has had its hopes dashed more than once.

Brock believes a freestanding emergency room could be a viable solution. She urges her community to be responsive to “a new day” in rural health in America, one in which a hospital must focus on its community’s most urgent needs and be realistic about what that hospital can provide.

“Maybe it is just the emergency room, a sustainable emergency room, where you could hold patients for a period of time and then transfer them,” Brock said. “And then you build upon that.”

She added, “There are options out there.”

KFF Health News, part of the Kaiser Family Foundation, is a national nonprofit newsroom producing in-depth journalism about health issues.

Remote Area Medical to offer free medical services, inlcuding dental and vision care, at clinic near Hazard Saturday and Sunday

Kentucky Health News

Remote Area Medical, a nonprofit group that provides free medical care, including dental and vision care, will hold a clinic Saturday and Sunday at East Perry Elementary School, 301 Perry Circle Road, Hazard, in collaboration with the University of Kentucky Center for Excellence in Rural Health.

The clinic will be open from 6 a.m. to 5 p.m. Saturday, 6 a.m. to 12:00 p.m. Sunday. The patient parking lot will open no later than 11:59 p.m. Friday night, June 7, and remain open. As patients arrive at the parking lot, they will be given information about the clinic.

Patients should be prepared with their own food, water, medicines, and clothing when arriving early. Bathrooms will be provided.

Health services are provided on a first-come, first-served basis. Due to time constraints, attendees should be prepared to choose between detal and vision services. Medical services are offered to every patient. All services are free and open to the public. No identification is required.

Given the possibility of inclement weather, volunteer cancellations, or other circumstances outside of RAM’s control, RAM encourages everyone who would like services, especially dental services, to arrive as early as possible. The clinic closing time may vary based on each service area’s daily capacity. Please check RAM’s clinic FAQ page for more information.

UK College of Dentistry faculty, residents, and dental students will provide serves including dental exams and cleanings, fillings, and extractions. The college has previously supported the dental care needs of Kentuckians at other RAM event locations, including Mayfield, Hazard, and Bowling Green.

Founded in 1985, RAM has treated more than 940,000 individuals with $200 million worth of free health-care services. More than 212,000 volunteers – licensed dental, vision, medical and veterinary professionals, as well as general support staff – have supported RAM’s mission.

Dr. Wendell Kingsolver, a doctor for more than half a century and an advocate for family medicine and rural health, dies at 96

Wendell Kingsolver, M.D.

Dr. Wendell Roy Kingsolver, a longtime physician and advocate for family medicine and public health, especially in rural Kentucky, died Thursday, May 30. He was 96 and lived in Nicholasville.

After graduation from the University of Kentucky and an internship and residency, Kingsolver set up a family practice at Carlisle in his home Nicholas County. He was one of the few physicians in the area and served patients of all ages at all hours in emergency, operating, and delivery rooms, He was among the first physicians certified by the American Board of Family Practice, and trained UK medical students in rural family practice as they lived in his home and learned what a diverse rural medical career was like. In the 1960s he was a medical volunteer in the Republic of Congo, and later on the Caribbean island of St. Lucia and the Newfoundland coast town of St. Anthony. After retiring from five decades of full-time private practice, he was a public-health doctor for the Wedco District Health Department in in Nicholas, Harrison, Bourbon and Scott counties.

Kingsolver was an early adopter of organic farming, and he and his first wife Virginia were founding members of the Sierra Club chapter in Kentucky, the group that built Lake Carnico in Nicholas County, and the First Christian Church in Carlisle, where he was an elder and sang in the choir. He was a board member of the Cane Ridge Meeting House, where the Disciples of Christ denomination began. He enjoyed birdwatching and served a term as president of the Kentucky Ornithological Society. He and Ginny, who predeceased him, established a KOS scholarship for young people interested in the study of birds, and worked to preserve natural land in Nicholas County, some of it donated to the Blue Licks Battlefield State Resort Park.

Kingsolver's survivors include his wife, Eva Lee (Lynam Kanatzar) Kingsolver; son Robert (Paula) Kingsolver; daughter and noted author Barbara Kingsolver (Steven Hopp); and Ann Kingsolver, former director of the Appalachian Center at UK. A viewing will be held Tuesday, June 4, at 2 p.m., followed by the funeral at 4 p.m., at Milward Funeral Home, 391 Southland Drive in Lexington.

Information for this article was taken from the obituary.

AMA president-elect, from Louisville, lays out his ideas for getting more physicians in rural areas, reforming prior authorization

By Melissa Patrick
Kentucky Health News

With about 46 million people in the U.S. living in rural areas and new research showing they are more likely to die early from the five leading causes of death than their urban counterparts, the American Medical Association is sounding the alarm. 

AMA President-elect Bruce Scott (AMA photo)

"Rural health is America's health," Dr. Bruce Scott of Louisville, AMA president-elect, told reporters in a May 9 press conference in conjunction with the National Rural Health Association annual conference in New Orleans. "We need policymakers to understand that the American Medical Association is deeply concerned about the ever-widening health disparities between urban and rural communities. disparities that are at the root of why rural Americans suffered disproportionately high rates of heart disease, cancer, stroke, respiratory illness, diabetes, and unintentional injuries." 

Scott, who is board-certified in both otolaryngology and facial plastic surgery, served as the Kentucky Medical Association's president in 2018-19. He will become AMA president in June. 

Scott pointed to several environmental, economic and social factors factors that put people who live in rural communities at a higher risk of death from these often preventable conditions. But the AMA's focus, he said, is on the health-care worker and the physician shortage and how this affects rural people's health. 

He added that these shortages are hitting rural areas the largest and are "creating health-care trends that are simply unacceptable. We need to reverse these trends for all individuals to live a long, healthy and active life."

Scott said rural areas have about 30 physician specialists for every 100,000 residents, compared to 236 per 100,000 in urban communities, and he noted that more than 130 rural hospitals closed from 2010 to 2021, with many more on the verge of closing today. 

Also, he said that in 2023, 65% of rural communities had insufficient access to primary-care physicians, including pediatricians. And, he said there are not enough residency spots to train doctors in rural areas. 

"History has shown us that residents, 80% of the time, tend to wind up practicing within 80 miles of where they've done the residency," Scott said. "So residency location becomes very important. In addition, medical schools are receiving fewer and fewer applicants from individuals from rural areas."

Call for Medicare reform

Scott said the AMA is working to build a stronger physician workforce, which he said starts with supporting physicians who are already in practice, to keep them practicing.

"AMA is focused on fixing the systemic issues of our health-care system that are known to be driving physician burnout, and contributing to early retirement and physicians leaving practice altogether," he said. "Highest among these problems are the broken Medicare physician payment system and the administrative burdens." 

The problem, said Scott, is that Medicare payments to doctors are not keeping up with inflation. He said that when adjusted for inflation, the payment rate to physicians has dropped 29% since 2001, and private payers and other insurers have linked their payments to the Medicare structure. 

"We need a system that is sustainable, predictable, and provides at least an annual inflation update that encourages patients choice rather than consolidation," he said. "We need Congress to act." 

Administrative burdens

Scott said physicians spend two hours on administrative work for every one hour with patients, contributing to burnout and hindering patient care. 

A key contributor to this is "prior authorization," which requires a physician to get approval from a third-party payer for care that the physician and patient have agreed on before it can be implemented.  

"On average, physicians complete 45 prior authorizations per week and it's even worse in primary care," Scott said. "The prior authorization process is overused, overly burdensome and wastes physicians' time. But I'm even more concerned about the fact that prior authorization hurts patients." 

He added, "We need Congress and payers and the administration to respond, because the result is that physicians are getting burned out and they're leaving practice, not because they don't want to practice medical care anymore, but because the system is making it more and more difficult for them to care for their patients." 

During the 2024 legislative session, Rep. Kim Moser, R-Taylor Mill, again filed a bill to address the prior authorization issue in Kentucky, but health insurers blocked it. It would have exempted from the process health-care providers who have had 90% or more of their claims approved. 

Scott said the AMA is "fighting for legislation fixes" to increase incentives for physicians to work in rural areas, to expand the number of residency spots, particularly in primary care and in rural areas, to make the pandemic's telehealth flexibilities permanent, and to allow qualified international medical graduates to keep practicing in America. 

Asked about the role of advanced-practice registered nurses and physician assistants to help increase access to care in rural areas, Scott said that "there is absolutely" a role for these "physician extenders" in a physician-led team model. 

"The AMA believes strongly in the concept of a physician-led medical team, where every component of the team is working to the highest level of their knowledge base and their experience," he said. "Now, we're not in favor of independent practice for nurse practitioners or PAs. We think that patients, no matter what ZIP code they happen to live in, deserve care by a physician." 

University of Kentucky will buy St. Claire Hospital in Morehead

University of Kentucky trustees Friday approved buying St. Claire HealthCare in Morehead. (UK photo)

The University of Kentucky Board of Trustees voted Friday to approve plans to acquire St. Claire HealthCare in Morehead. The targeted date for UK's takeover is July 1. 

The move will expand clinical and academic programs and provide more access to high-quality patient care for more Kentuckians, UK said in a news release.  

“UK is committed to growing clinical services in the Morehead area as well as expanding programs in many clinical areas to grow the future health care workforce for Kentucky,” President Eli Capilouto said in the release.  

St. Claire is one of the largest employers in the Morehead region, with more than 1,300 employees, including over 50 physicians and nearly 50 advanced-practice professionals in more than 20 medical specialties.

St. Claire has partnered with UK on a number of academic and clinical programs since the 1960s, co-developing the Rural Physician Leadership Program along with Morehead State University and establishing a training and residency site for UK's colleges of Medicine, Pharmacy and Health Sciences. It is also home to the College of Health Sciences's Physician Assistant Program.

St. Claire President and CEO Donald H. Lloyd II, who will remain in that position, said in the release that "UK identified as the natural partner that could carry forward the previous work and ongoing investment while growing the health-care workforce."

He added, “In an ever-changing health care landscape, both St. Claire and UK are deeply committed to accessible and high-quality patient care and strategic collaborations that will enhance services to benefit Kentuckians throughout northeastern Kentucky for many decades to come.”

According to the release, St. Claire HealthCare includes a hospital with 139 licensed beds and seven primary-care clinics in five counties, a multi-specialty medical pavilion, two urgent-care centers, a pediatrics clinic, a retail pharmacy, a counseling center, an outpatient center and a medical equipment and supply store. St. Claire also provides home health and hospice services in eight counties.

This is UK's second major foray into hospital care in northeastern Kentucky in recent years. In 2021, the university created a joint venture with King's Daughters Memorial Hospital in Ashland in which UK holds the assets and manages the hospital system.

Guthrie warns making telehealth expansion permanent must be paid for; costs uncertain, but projected to be several billion dollars

Kentucky Health News

If telehealth services are to remain expanded as they were in the pandemic, Congress must offset the cost, U.S. Rep. Brett Guthrie of Bowling Green said in opening a House subcommittee hearing Wednesday.

“Virtually overnight, our health-care system underwent a significant transition,” said Guthrie, a Republican who represents the 2nd Congressional District and chairs the health subcommittee of the House Energy and Commerce Committee, according to a press release from the committee.

“Seniors were allowed to use telehealth across the country and could now access their health-care providers from the comfort of their home. Additionally, the number of health care services Medicare would cover if performed through telehealth increased from 118 to over 260.

“Restrictions such as requiring seniors to have an established pre-existing relationship with a health-care provider to receive mental health services through telehealth were waived. Allowing patients to consult with a provider through a simple audio-only phone call if an audio-visual connection wasn’t available.”

All those things were a big help to rural communities, Guthrie said, so Congress has extended them through Dec, 31. But he added that before they can be extended again or made permanent, some problems need to be addressed.

“I want to remind my colleagues that the previous extension was estimated by the Congressional Budget Office to increase costs to the Medicare program by over $2 billion,” Guthrie said. “Making these authorities permanent is likely to cost much more than a short-term extension, and we want to make sure that whatever we move out of committee is paid for and is delivering the best value for seniors. I think that this committee can work together, to move legislation making sure seniors have access to telehealth when they want it while also including appropriate program integrity measures, addressing the costs of such access to the program.”

Politico Pulse reports, “Generally, lawmakers seemed willing to accept higher costs to expand access to virtual care.” Rep. Cathy McMorris Rodgers (R-Wash.), chair of the full committee, said extending telehealth rules would be a “significant investment” but “We can’t afford to go backwards.” Pulse notes, "Harvard researcher Ateev Mehrotra told lawmakers that expanded telehealth is associated with a 'modest' increase in spending but also improved outcomes, particularly in mental health."

Guthrie largely dismissed concerns about increases in waste, fraud, and abuse from telehealth. “It appears that telehealth can be used to deliver care without actually raising those serious concerns. According to the Office of Inspector General, of the over 700,000 providers they studied who provided telehealth care during the pandemic, less than 2,000 warranted further scrutiny resulting from their telehealth billing practices, and mostly because they charged facility fees and for the actual telehealth visit.”

The full committee's ranking Democrat, Rep. Frank Pallone of New Jersey, acknowledged the budget implications of extending telehealth, but noted that the CBO has not estimated the cost yet. "I would like to better understand the offsets for these proposals," he said, "and want to ensure that it would not result in significant funding cuts to the Medicare program or raise health care costs for seniors."

Pallone also said, "I believe that any further expansions of telehealth flexibilities in Medicare must meaningfully increase patient access to care and ensure high quality care for seniors.  . . . Congress must ensure that additional expansions of telehealth policies do not limit access to in-person care. It is important that we preserve patient choice and that Medicare beneficiaries continue to have access to high quality in-person care and robust consumer protections, including network adequacy standards."

The top-ranking Democrat on the subcommittee, Rep. Anna Eshoo of California, voiced concern about the health-care industry “gaming” telehealth to make it into a “cash cow.”

Half of rural hospitals lose money; firm says 418 could close; Ky. not a standout except in Medicare Advantage, which is a threat

Map by Chartis Center for Rural Health, labeled by Kentucky Health News

Kentucky Health News

Rural hospitals are in more trouble than ever, and 418 of them are “vulnerable to closure,” according to a study of their finances by Chartis, a Chicago-based health-care consultancy that specializes in tracking the business of rural health.

The Chartis Center for Rural Health says rural hospitals are entering "a startling new phase of this crisis as rural hospitals fall deeper into the red, 'care deserts' widen throughout rural communities, and the increasing penetration of Medicare Advantage could further disrupt rural hospital revenue."

The top warning signal cited in the study is that half of rural hospitals are losing money, up from 43 percent a year ago. That news is especially bad for independent rural hospitals, 55% of which are in the red, while only 42% of rural hospitals affiliated with groups are operating at a loss. "Nearly 60% of rural hospitals are now affiliated with a health system," Chartis reports.

Most people on Medicare now have Medicare Advantage, private insurance plans that get lump sums from Medicare to cover members and look for ways to attract customers while limiting claims. "Medicare Advantage now accounts for 35% of all Medicare-eligible patients in rural communities," Chartis reports, saying Advantage plans' share of rural residents has risen 48% since 2019. 

Chartis map, labeled by Ky. Health News; click on it to enlarge

That's a problem for rural hospitals designated as "critical access" because Medicare Advantage plans' net reimbursement to such hospitals "is often lower for similar services than that of traditional Medicare because Medicare Advantage does not follow cost-based reimbursement" as traditional Medicare does for such hospitals, Chartis reports. Insurance companies negotiate those rates with hospitals, and in many rural areas, hospitals are at a negotiating disadvantage because few insurers operate in their service areas.

Also, "Medicare Advantage may not cover all the services traditional Medicare does, including swing beds, which provide skilled nursing care for patients and are often a strong source of revenue stability for rural hospitals," Chartis notes. "Rural providers may not be equipped to efficiently navigate administrative requirements for payment introduced by Medicare Advantage, such as prior authorizations, which can lead to increased denials."

Since 2010, "167 rural hospitals have either closed or converted to a model that excludes inpatient care," Chartis says. The firm says its estimate that 418 are “vulnerable to closure” is based on "a new, expanded statistical analysis" of their finances, gleaned from cost reports they file with Medicare.

The report does not give details for each state, but places each one in certain ranges. It deems fewer than 10% of Kentucky rural hospitals "vulnerable to closure" but places the state in the highest range of rural Medicare Advantage growth. As for being in the red or the black, it puts Kentucky among the states where 41% to 60% of the rural hospitals are losing money.

Jaime Parsons is new Ky. Rural Health Assn. executive director

Jaime Parsons

The Kentucky Rural Health Association has a new executive director.

She is Jaime Parsons, "a seasoned leader with a proven track record in healthcare administration and a deep commitment to rural health," a news release from KRHA said.

Parsons has nearly 20 years of experience in health care, "with a strong focus on improving health-care access and outcomes in rural communities," the release says. "Her extensive background includes experience in rural health clinic administration and accreditation, grant writing and management, association management, rural advocacy and community engagement.

KRHA President Amanda Dennison said in the release, “Her passion for rural health, wealth of experience and strategic vision align with the association’s mission to improve healthcare for all rural Kentuckians. As a board, we are excited to work with Jaime to further the association's reach and relationships as we work together to tackle the unique challenges faced by rural communities in Kentucky.”

Parsons said, "Rural is in my blood and I am deeply committed to issues which impact rural areas. I look forward to collaborating with the dedicated members of KRHA as well as stakeholders and community leaders from across the commonwealth to enhance health and promote the well-being of individuals in rural Kentucky."

Parsons succeeds Tina McCormick, who was executive director for more than 10 years. McCoemich said in the release, “It is with great excitement that I leave my post as the executive director to a qualified rural-health leader.”

Mobile vans bring dental care to those who have trouble getting it

Kare Mobile serves patients in six states. (Photo provided) 

By Hayden Gooding
University of Kentucky

Good oral health is crucial for overall well-being and receiving dental services helps maintain it. But many people who need dental care are often unable to receive it, especially in rural areas or those in certain racial, ethnic and socioeconomic groups.

University of Kentucky College of Dentistry alumnus Kwane Watson founder and CEO of Kare Mobile Inc., strives to advance Kentucky by serving those who need dental care but often lack access.

While working as the state dental director for Community Dental of Kentucky, Watson gained a clearer view of access issues and demand for dental care while traveling between Western Kentucky and the West End of Louisville.

“Practicing in Western Kentucky was an eye-opener,” Watson recalled. “I didn’t realize the degree of need in Western and Eastern Kentucky, or how long people have to wait to get an appointment because there are no Medicaid providers available.”

Kwame Watson (Kare Mobile photo)

In 2017, Watson had a vision. He found a van and reached out to a friend who had experience in completing food truck renovations. From there, his first mobile dental operatory, Kare Mobile, was created.

Over the past six years, his practice has become dedicated to eliminating "dental deserts" to ensure that all patients can receive care regardless of their racial, ethnic or socioeconomic status.

Kare Mobile puts patients at the center of everything it does. Watson’s goal is to bring affordable, comprehensive dental services to low-income communities where services have been hit hard by the rising cost of dental operations.

The mobile dental service provides various services including adult and child cleanings, root canals, extractions, fillings and more.

What started as a dentist with a vision and a van in Louisville, has now expanded across multiple states. Kare Mobile currently serves patients in Kentucky, Ohio, Tennessee, Michigan, Georgia and Oklahoma. Watson plans to continue growing Kare Mobile to reach more underserved communities and individuals facing barriers to traditional dental services.

In recognition of his accomplishments, Watson was awarded a Torch of Excellence Award by the UK Alumni Association last fall. These awards celebrate alumni "whose faith, hard work and determination has positively affected the lives of people on the UK campus, the city, state or nation.

Learn more about Kare Mobile and services near you here.

Whipsawed by the system, dozens of independent pharmacies closed in Kentucky last year, and more are expected to follow suit

“No one can withstand this onslaught,” independent pharmacist Rosemary Smith of Beattyville told the Lexington Herald-Leader of the factors causing stores like hers to close. (H-L photo by Silas Walker)

Kentucky Health News

In the past year, at least 67 independent pharmacies have closed in Kentucky, and more are expected to close because of a recent change in the system that favors big pharmacy chains. 

So reports Alex Acquisto of the Lexington Herald-Leader, in a significant story for rural Kentucky. 

"Pharmacists are often the first – and most accessible – health-care-provider point of contact in their communities, particularly in rural parts of Kentucky," Acquisto writes. "Independent pharmacies in Kentucky filled more than half of all prescriptions statewide and before 2023’s closures, independents operated in all but one of the state’s 120 counties."

That's according to Rosemary Smith, who owns six pharmacies across Eastern Kentucky with her husband, Luther, and is co-founder of the Kentucky Independent Pharmacists Alliance. KIPA is seeking help from the Kentucky General Assembly, which has previously tried to insulate independent pharmacists from the middlemen between insurance companies and pharmacies, pharmacy benefit managers.

The sponsor of earlier bills aimed at PBMs, Sen. Max Wise, R-Campbellsville, told Acquisto that he will probably file a bill similar to the recent “commercial pharmacy PBM reform” bills in Tennessee and West Virginia. The Tennessee law "gives independent pharmacies greater control over the PBM contracts they agree to, including by mandating those groups reimburse no less than the actual cost for a prescription drug," Acquisto reports. "That is an aspect not currently mandated by law in Kentucky."

The system

Acquisto explains how it got this way: "Each time an independent pharmacist fills a patient’s prescription, how that pharmacy is reimbursed by insurance companies — and what amount in fees are levied for filling it — is decided by a somewhat arbitrary and complex tangle of decisions by entities outside a hometown pharmacy’s control. This lack of control and contractual obligation to pay every fee levied has paved the way for independents to be financially gouged from multiple angles: Low or break-even reimbursement rates set by insurance companies often blunts a pharmacy’s ability to make a profit on every prescription they fill."

Pharmacy benefit managers charge pharmacies direct and indirect remuneration fees. "Federal regulations have historically dictated these fees be collected retroactively, up to six months after a prescription is filled. But that changed Jan. 1, when DIR fees began to be collected at the point of sale," Acquisto reports. "Pharmacists told the Herald-Leader they expect this temporary overlap, where DIR fees from as far back as June 2023 continue to be retroactively deducted as new fees are levied on prescriptions filled currently, will inevitably force more closures."

“This increase in DIR fees has resulted in many independent pharmacies being left with little to no capital funds to survive 2024,” Maysville druggists Dr. Michael Berry and Elizabeth Berry wrote in a Dec. 31 email to Chiquita Brooks-LaSure, adminstrator of the Centers for Medicare and Medicaid Services. “Most independent pharmacies have been on life support for the last several years. We are witnessing the initial stages of an industry in collapse.”

Ky. health-care workers can apply for loan relief until Jan. 31

The UK Center for Excellence in Rural Health has the Health Care Worker Loan Relief Program, run by Rural Project Manager Sierra Williams (left) and Center Director Fran Feltner. (Photo by Beth Bowling)

By Beth Bowling
University of Kentucky

In just over a year, the University of Kentucky Center of Excellence in Rural Health has helped provide more than $1.3 million in loan relief for health-care workers.

The center is accepting the next round of applications for the Healthcare Worker Loan Relief Program of the Commonwealth through the end of January.

The legislature established the program in 2022 to increase the recruitment and retention of health-care professionals to practice in underserved areas of Kentucky.

“We are grateful for this much-needed funding and it is already making a positive impact in underserved communities across the state,” Center Director Fran Feltner said. “In just a little more than one year, we have been able to award more than $1 million in loan relief to more than 20 health professionals across 13 communities in Kentucky."

The program was designed to complement the state's federally funded loan-repayment program by filling in gaps and expanding eligibility to additional medical specialists including ophthalmologists, optometrists and audiologists. It is geared toward professionals who provide direct patient care in these disciplines and specialties: physicians, optometrists, ophthalmologists, audiologists, physician assistants, nurse practitioners, certified nurse-midwives, registered nurses, dentists, registered dental hygienists, licensed clinical social workers, licensed professional clinical counselors, health service psychologists, marriage and family therapists, psychiatric nurse specialists, alcohol and substance use disorder counselors and pharmacists. Additional specialties will be considered.

Applicants selected to participate could be awarded up to $100,000 depending upon provider type, level of loan indebtedness and sponsor commitment. Awardees are required to work 24 to 40 hours a week, up to 4,160 hours over a two- to three-year period. Participants receive tax-free student loan repayment in exchange for their service commitment.

Additional requirements include serving in an officially designated health-professions shortage area and working at an eligible clinical site that serves as a sponsor. Examples of eligible sites include federally qualified health centers, rural health clinics, community mental health agencies, health department clinics, prisons, private practices and critical access hospitals.

The deadline to apply is 5 p.m., Wednesday, Jan. 31. Apply or learn more about applicant eligibility, clinical site eligibility and program guidelines here, or contact Sierra Williams at HWLRPCommonwealth@uky.edu or 606-439-3557.

Community leaders interested in improving community health invited to apply for Community Leadership Institute of Kentucky

The program is offered by the University of Kentucky
Center for Excellence in Rural Health in Hazard.

Applications are being accepted until March 18 for the Community Leadership Institute of Kentucky, an intensive leadership development training program designed to enhance research and capacity-building competencies in community leaders, senior staff and administrators. 

As many as 10 positions are available for the 2024 class to be offered in Hazard by the University of Kentucky Center of Excellence in Rural Health and UK's Community Engagement and Research Program.

The institute's goal is to help leaders of community organizations reduce health disparities, leverage funding, and learn how to use data to improve services and programs. The center says the program includes "thought-provoking and interactive training activities" that help participants improve their grant writing, public speaking and presentation skills; finding and use data about local communities, creating databases and using a web-based data system; developing good surveys, making sure their programs are using techniques that work, and assessing whether programs are working.

The institute is also designed to help participants gain a broader perspective on community health issues; improve their abilities to partner with community or academic organizations to improve community health; network among community organizations in the state, particularly Appalachian Kentucky; enhance their leadership skills; become highly motivated community leaders who are better prepared to participate in community research projects; receive deserved recognition and prestige as a community leader making contributions to improve health in Kentucky, particularly Appalachian Kentucky; and address problems that affect the health of the community by implementing a project selected by the participant. A mentor will work in partnership with the participant.

Community and organizational leaders, administrators, directors, and other key program staff are invited apply. UK employees are not eligible. For other details and to request an application, click here.

UK students planning medical careers start student organization to steer rural students into college and health-care opportunities

Jackson Miller, left, and Ethan Morgan started HealthCare Cats to help other students from rural areas navigate the many health-care education opportunities at the University of Kentucky. (UK photo)

By Adrienne Clarke
University of Kentucky

Jackson Miller and Ethan Morgan, former Marshall County High School classmates and now best friends and roommates at the University of Kentucky Lewis Honors College, first arrived in Lexington feeling a bit overwhelmed of all the opportunities available to them UK.

Coming from a rural area where most high-school graduates enter the workforce or the military rather than college, Miller and Morgan felt they did not have a clear roadmap of how to pursue their career aspirations of becoming physicians. To help other students not feel so lost in navigating all of the health care education opportunities, Miller and Morgan created a student organization during their sophomore year to help other students like them. The organization, HealthCare Cats, is now “providing an avenue into college and health care opportunities for rural students of Kentucky in order to create a better commonwealth.”

To start their program, Miller, a psychology major, and Morgan, a biology major, worked with several UK colleges focused on the health-care industry including the College of Medicine, College of Dentistry, College of Pharmacy and College of Nursing, for information about how to present themselves as the best candidate for those types of degrees. The students then developed a presentation that has been shared with rural high-school and college students to encourage them to aspire to a career in health care and show them the different options and opportunities that are offered at UK.

“We wanted to help students who felt behind, didn’t have the greatest study habits and most certainly weren’t aware of many of the opportunities in health care,” Miller said. 

The organization, which already boasts over 160 students, will include guest speakers, networking opportunities and a mentoring program to connect first-year students with more experienced students.

“These opportunities for the members of the organization will allow us to not only reach the younger, rural generation, but also cultivate a community of future rural health leaders within the organization,” Morgan said.

Already, the organization has had speakers such as Dean Christian Brady from the Lewis Honors College, who spoke to the organization on discovering your “why” for health care and education, combating burnout, handling changes in the path of life, managing adversity in life, and more. The organization also held a graduate student panel with students from nursing, medicine, physical therapy, the physician assistant program, dentistry and pharmacy. The students shared application tips, pros and cons of their programs, and advice they would consider if they had to do it all over again.

This Friday, Dec. 1, HealthCare Cats, in partnership with the Appalachian Health Initiative, will welcome Dr. Michael D. Rankin to speak at 5 p.m. in the Lewis Honors College Scholars Lounge. Rankin, a graduate of UK, recently pledged $22 million to “advance the mission of the UK College of Medicine and expand the top-notch educational opportunities through the support of a new health education building and the funding of medical student scholarships,” as stated in the UKMedicine magazine.

Rankin had quite a non-traditional path to medicine, as he graduated from his undergraduate studies and spent six years in the electrical engineering field to accumulate enough funds to attend medical school. This was a common occurrence in Rankin’s life, as he explains how before attending UK for his undergraduate career, his family resorted to selling a cow to afford the tuition. Rankin has provided unconditional support for those with similar backgrounds to himself attempting to enter the medical field, as he understands the struggles of attending college from a rural environment.

“Dr. Rankin coming to speak with us will be great, for he will understand the backgrounds of our membership and be able to offer advice from the perspective of someone who has walked their paths,” Morgan said.

“Having worked with students Maddie Duff (president) and Ben Vickery in the past, it is clear that the missions of our organizations align in critical ways. Dr. Rankin speaks very highly of Appalachian students and often notes the need for them in Kentucky’s health care system. We are so excited to be able to bring in their diverse perspectives and work together to build a better commonwealth.”

Supplementing the event programming, HealthCare Cats initiated a mentorship program where rural first-year students are matched with an upper-class student to make the college/pre-health transition smoother. The first director of HealthCare Cats’ the program, Maya Moskal, is from Chicago and is considering a career in a rural market.

"Being from a bigger city, HealthCare Cats has broadened my knowledge on the health care disparities present in rural areas,” she said. “The program has opened many doors by encouraging me to give back to Kentucky, in addition to helping me personally succeed at UK in many ways.”

Through HealthCare Cats, Miller and Morgan hope to apply the common chemistry phrase “like dissolves like” by helping rural students achieve their medical aspirations — and then return to their hometowns.

Morgan asked, “Who better to serve rural populations in Kentucky than those who resided there for much of their lives?”

Center for Excellence in Rural Health celebrates Rural Health Day

Director Fran Feltner, front and center, poses with her staff at the University of Kentucky Center for Excellence in Rural Health in Hazard. (UK photo)

By Beth Bowling
University of Kentucky

HAZARD, Ky. — The University of Kentucky Center of Excellence in Rural Health and the Kentucky Office of Rural Health are proud to join communities across Kentucky and the nation in celebration of National Rural Health Day on Thursday, Nov. 16, 2023.

The National Organization of State Offices of Rural Health spearheads the event, held on the third Thursday of November each year. Rural-focused organizations throughout the state and nation are celebrating the “Power of Rural” and honoring the individuals and organizations dedicated to addressing the unique health care needs of more than two million Kentuckians living in rural areas and nearly 61 million people living in rural areas across the U.S.

"In Kentucky, over two million people live in rural and more than 100 Kentucky counties are designated as rural,” said Center for Excellence in Rural Health Director Fran Feltner. “It is vital that we ensure all rural Kentuckians have the opportunity to be healthy and have access to affordable, quality health care.”

Kentucky Office of Rural Health Director Matt Coleman said the mission for both the center and the KORH is to improve access to care and health outcomes for Kentuckians living in rural.

“Having a nationally and statewide recognized day to focus on rural health is extremely important to not only highlight the work being done across the state, but also to give an opportunity to stakeholders and providers to find out what’s going on in their communities,” said Coleman.

“KORH was established by the federal government in 1991 as a way to help support the health and well-being of Kentuckians in rural. We do this a number of ways by providing a framework that links small, rural communities with resources while working toward long-term solutions to rural health issues.”

Since its inception, the KORH has helped clinicians, administrators, and consumers find ways to improve access to and quality of health care through programs like the Rural Hospital Flexibility Program, the Kentucky State Loan Repayment Program, the Kentucky EMS Leadership Academy and many more, while ensuring that funding agencies and policymakers are made aware of the needs of rural communities.

The Center for Excellence in Rural Health, which is the federally designated state Office of Rural Health, has made strides in improving access to education by bringing degrees close to home and securing funding for health care worker loan relief programs. More than 1,000 students have graduated in recent years from rural programs offered at the CERH in Hazard, with most working in rural settings.

CERH Data Analyst Sydney Howard explained that rural health workforce studies conducted at the center highlight the continued need for rural health workers, including physicians, nurses, dentists, medical laboratory scientists, social workers, community health workers and more.

“We have been fortunate to see rural-based health care training opportunities expand in Kentucky in recent years, which is critically important given that more than 30 rural Kentucky counties are currently facing health professions shortages,” said Howard. “Rural Kentucky is also home to 29 critical-access hospitals and nearly 400 rural health clinics, all of which are key in reaching rural populations across the Commonwealth.”

Feltner said, “We are optimistic that Kentucky’s future will be bright with the continued dedication and investment of people and resources to address the needs of rural communities. CERH is proud to recognize the incredible rural health workers, researchers, teachers, students, volunteers and many others in our community on National Rural Health Day and throughout the year.”

CERH and KORH created a special rural health day video to highlight the dedicated individuals and important work going on across Kentucky. Watch the video here.

Ky. Rural Health Association to meet Nov. 16-17 in Bowling Green

The 25th annual Kentucky Rural Health Association conference will be held in Bowling Green Nov. 16-17 at the Sloan Convention Center, 1021 Wilkinson Trace. 

The keynote address will be given by Larry Weaver, an internationally touring motivational speaker and comedian.  This year's event will also include a reception to celebrate the association's 25th anniversary, and awards ceremony and a silent auction. 

For the agenda and other information, click here. For a limited time, the conference is accepting late registrations, along with non-KRHA member and student KRHA-member registrations. To register, click here.