In addition to grant making, the foundation funds initiatives that bring together funding, technical assistance, multiple grantees, foundation partners, and focused collaboration over several years in an effort to achieve substantial improvements in a particular area.

The REACH Foundation’s Rural Health Initiative (RHI) was formulated to bring an intensive focus to reducing barriers to health care access and quality and improving health outcomes in the three rural counties that are part of the foundation’s service area. The goal of the RHI is to substantially expand access to health care by expanding community capacity to identify and implement solutions that present the best potential for success in rural settings.

The RHI was introduced in 2012, starting with dialogue among foundation staff and small groups of grantees and local leaders from the three counties to better understand the health disparities in their communities and potential avenues for positively influencing those conditions. As a resource to REACH and the counties, the foundation pulled together a team of national and regional technical assistance providers with expertise in facilitation, strategic planning, community capacity building and network weaving to work with the rural health teams to guide them in identifying health care needs and promising strategies.

RHI funding for 2013 totaled $450,016 – $380,000 in grants and $70,016 to support technical assistance, evaluation and convening. Investments included:

In Lafayette County, Missouri, the RHI core leadership team focused on creating new health access points. The RHI project supported the opening of a health clinic in the town of Waverly, with plans to add oral health and behavioral health care by 2014. Lafayette County’s RHI team conducted forums around the county to educate residents about the Affordable Care Act and support enrollment through the marketplace. The RHI team also began a “community connectors” pilot program, training individuals to inform and connect residents with information and referrals on available health and social services.

In Allen County, Kansas, the RHI core leadership team focused on expanding its Circles of Allen County project, an anti-poverty program that builds support networks and facilitates relationships with allies who help people living in poverty build a personal network and gain a foothold toward economic stability.

A small group of health, mental health, education and community leaders comprising the Cass County, Missouri, RHI core leadership team focused on growing their network, identifying partners interested in health issues and identifying avenues for engaging the county in addressing health conditions.

Community capacity building remains a key strategy for addressing long-term health access needs. As the RHI moves into its second full year of implementation, REACH will maintain a significant investment in technical assistance for the three counties, with emphasis on leadership development and network building to assist local leaders as they work to engage people from multiple communities and across sectors in health improvement efforts.

For years, the Health Partnership Clinic of Johnson County served as the county’s free health clinic, delivering acute and chronic disease care at no cost or by donation to adult patients. In 2013, the clinic was approved as a Federally Qualified Health Center (FQHC), propelling the organization forward in its quest to improve patient access and care.

The Health Partnership Clinic participated in the foundation’s Medical Home Initiative, which provides technical assistance and coaching to help safety net clinics make the substantial practice changes required to achieve a patient-centered medical home designation. To date, six clinics involved in the initiative have received medical home recognition from the National Committee for Quality Assurance (NCQA).

Executive Director Jason Wesco says the journey to become a medical home pushed the clinic staff to think differently about the patients they served and how they delivered care. To achieve continuity of care for the patient, the clinic shifted from a largely volunteer model to a paid staff model. The clinic implemented an electronic medical records system that, with REACH grant support, is now integrated with the clinic’s dental operations. As a “free clinic,” Health Partnership generally did not serve children. Now, as an FQHC, the clinic provides pediatric care and screenings at the clinic and in Head Start, WIC clinics, a local shelter and multiple school sites around the county.

REACH invested $95,693 in the Initiative in 2013, along with $162,040 in program and discretionary grants to support technology and staffing needs.

Wesco says the NCQA recognition, coupled with the FQHC designation, invigorated the staff to be proactive about patient engagement and outreach, care coordination, behavioral health integration, and establishing quality measures to guide their efforts. According to Wesco, the most important change at the clinic is the shift in organizational culture: “We’ve stopped thinking and talking about providing basic access to care – we now ask questions about quality, and what it takes to deliver it, measure it and
prove it.”