Texas A&M University has been chosen as the sole recipient of a five-year, $4 million grant to help rural hospitals and health care networks throughout the country through the creation of the Center for Optimizing Rural Health, a technical advisory center based out of the A&M Rural and Community Health Institute.

The grant, which will send A&M $800,000 a year for five years from the Vulnerable Rural Hospitals Assistance Program, is funded by the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services. The center will actively help rural communities maintain their hospital or create other means of access to care after hospitals close.

Nancy Dickey, A&M Rural and Community Health Institute executive director, said rural communities in Texas and across the country face myriad challenges, including distance from major hospitals, costs of care and more.

"Much of today's medicine is not available or supportable in smaller towns and cities," said Dickey, who is also president emeritus of the Texas A&M Health Science Center. "As medicine has become more and more technologically and specialty oriented, specialties have pushed much of care in major cities. The days of your [general practitioner] carrying 90 percent of what you needed in his or her bag are mostly gone, and that kind of care may today not be possible for every town,"

Dickey said that through the grant, the new center will be able to assist 25 communities -- five communities per year -- for "boots on the ground" in-person consultation, and that 125 communities, or 25 per year, will receive virtual counsel and other assistance, especially technical assistance. Online resources will be available to all who seek them, Dickey said.

"The goal is to develop communities -- to have a community look at what they perceive their needs to be," Dickey said. She said that the program is not designed to help a community with a funding shortfall, but rather to help rural communities nationwide to better understand themselves -- how many hospital beds they have, how many they need, and how health care options might improve with some guidance and assistance. 

Last year, the A&M Rural and Community Health Institute released a study outlining practical options for rural communities facing hospital closures. This new center will allow them to put that research -- and other work done at Texas A&M and across the country -- into practice.

In addition to Dickey, the new center's leadership team includes Jane Bolin, director of the Texas A&M Southwest Rural Health Research Center and newly named associate dean of research at the Texas A&M College of Nursing, and Bree Watzak, clinical associate professor at the Texas A&M College of Pharmacy. They will be hiring program managers and involving students in a variety of health disciplines in the evaluation and recommendation process.

"I've always been a country girl, and I've had to get care in a rural hospital," Watzak said. "Rural communities are resilient, and I know what it meant to me to have care in that setting. It's exciting to offer some solutions to those who aren't as fortunate as I was." 

One solution for rural health care providers, Dickey said, might be telemedicine, in which people in rural communities can connect with geographically distant providers. Another might include different reimbursement models to adequately compensate providers who are in rural areas and often have to operate on a much smaller margin. 

"Our job is to gather the information and figure out how to create functional options and tools for health care professionals to do better with their jobs," Dickey said. "The center will need to continuously innovate, because the issues now may not be the same ones that we will see in five years."

The diverse health disciplines represented by the center's leadership team and students is intentional, Dickey said.

"Health care has always been interdisciplinary, but in the last decade or so, we have really started to recognize the importance of interprofessional work," she said. "This is demonstrated most powerfully in rural communities, where the hospital pharmacist may be the community pharmacist, and the school nurse is an active member of the community's health care team and may even serve at times as the head of the emergency room."

Dickey said she grew up in small towns, and that Texas A&M's existence as a land grant university means research needs to go toward assisting citizens who support it with their tax dollars.

"This is the academic community giving back -- health professionals, demographers, people from many different professions -- to people from rural communities," Dickey said.

She credited Texas A&M AgriLife Extension for its work for and with rural Texans.

"This is one way we can say to people from rural areas that they matter. You're 20 percent of the population, of this country, and you're 90 percent of the geography of this country -- you matter. You're where our food comes from, where a lot of our oil and gas comes from -- you matter. It matters to all of us," Dickey said.

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