RHI expands to envelop four more counties

The ThedaCare Rural Health Initiative (RHI) will have the opportunity to expand its program to reach hundreds of farms across additional counties in Wisconsin with the support of two grants.

The two grants, which total nearly $5.5 million directed toward health care and preventive services for farm workers and rural residents, were received after the Wisconsin Office of Rural Health at UW-Madison applied on behalf of the program.

“We are honored to receive these grants to help our teams continue the work that is critical to support the health and well-being of farm families,” said Rhonda Strebel, RHI manager. “The recognition is a testament to the innovate outreach that is being done to address the social determinants of health, and improve the lives of those who call rural Wisconsin home.”

RHI began after a need was recognized in the rural communities. According to Strebel, who has been leading the program since its inception, explained often, farmers only access medical facilities for critical care. In 2003, ThedaCare’s Community Health Action Team model hosted a plunge on the health of farm families, recognizing the stress and limited access to care for those families.

The solution was to take health care to the farm, meeting people where they live and work. Further discussions determined that several health tests could be done outside clinics and hospitals, and RHI’s “Kitchen Wellness” program was born.

While the number of farms in Wisconsin has dropped from nearly 16,000 in 2004 to 7,000 in 2021, the number of cows has remained the same – meaning farms are much bigger, and making easy access to health care that much more important for farms and farm workers.

Rural populations face a variety of demographic, economic, social and environmental factors, that can put them at greater risk for common health problems. As most farmers are self-employed, the cost of health insurance can sometimes also create a barrier to affordable health care. Strebel also noted many farmers don’t regularly visit their providers for other reasons.

“It’s a very unique program,” Strebel said. “We sit down with people right there in their home, and talk about their health concerns. We check their blood pressure, do blood sugar and cholesterol testing and do a body mass index rating. We also discuss their diet, exercise and general lifestyle.”

The screenings discover one or more of these issues 52% of the time, catching them before the patient requires a visit to the emergency room, she said.

The program expanded to Outagamie and Waupaca counties in 2012, and became an official program of ThedaCare as of Jan. 1, 2021. It is available to anyone working in agriculture and/or living in a rural area. This can include family farms, single residents/former farmers, Amish farms and large-scale farms with a diverse population of workers.

As of June 1, the ThedaCare RHI received a $985,000 Health Equity Grant through the Centers for Disease Control and Prevention.

The grant, which continues through May 31, 2023, allows the expansion of the ThedaCare RHI from the initial three counties to another four, adding Green Lake, Marquette, Waushara and Winnebago.

The funding also allows the program to hire six new community health workers to conduct health screenings, provide coaching, prevention and referrals for rural residents. Staff may include those with a nursing or dietary/nutrition background. Additionally, it is highly recommended that new team members have a rural background, understanding health disparities between rural and urban populations, Strebel said.

“Knowing the cultural perspective of farming communities will help our health care workers understand the specific needs of families,” said Strebel. “We hope they consider a farmer’s lifestyle, work ethic and responsibilities. All of these aspects play a role in a farmer’s health.”

In addition to a farmer’s physical health, RHI also provides a check-in on mental and emotional well-being.

“We discuss topics that are sometimes difficult to talk about – stress and depression, other things that may be going on with family or finances – factors that can contribute to a person’s mental wellness,” Strebel said. “Our community health care workers will be familiar with resources within the community that can help farm families achieve a better quality of health.”

The ThedaCare RHI also received a $4.5 million CDC Vaccination Supplement Grant as a part of the American Rescue Plan Act, which started July 1 and continues through June 2024.

This grant allows an increase of coordinated care services throughout all seven counties covered by the program, expanding health care access and preventive services where it’s needed most, Strebel said.

“Through this grant, the RHI will have the opportunity to add a physician, a pharmacist, a dietitian and a mental health counselor,” said Strebel. “Those caregivers will either come to the home with our team, or visit with families through a virtual option.”

That helps remove the barrier to virtual health visits as the community health care worker will be there to facilitate.

For information about the ThedaCare Rural Health Initiative, call 715.524.1488 or visit thedacare.org/about-us/community-health/rural-health-initiative/.