Portfolio Summer 2000

Summer 2000

Despite Obstacles, Rural Health Clinics Keep Their Doors Open

n addition to its large, well-known cities of Los Angeles, San Francisco and San Diego, California also boasts a vast and varied rural landscape—from the mountains to the sea with thousands of acres of desert in between. The isolation and sparse population that give these areas their charm, however, also present challenges for health care providers.

Thirteen percent of the state’s population reside in areas that qualify as rural, as defined by the California Rural Health Policy Council, with fewer than 250 people per square mile; 7 percent of this rural population lives in locales of six or fewer people per square mile.

"Small health centers are lifelines in rural areas, and they face many challenges that put their roles as safety-net providers at risk, such as remote locations and a lack of resources," said Gary Yates, president and CEO of The California Wellness Foundation (TCWF).

"Accessing health care in these areas can require long trips over rugged terrain to reach metropolitan areas with comprehensive facilities."

TCWF has provided grants to a number of rural health care providers, often in the form of core operating support, to maintain and expand their services.

"When rural clinics with small staffs are struggling to keep their doors open and provide basic medical services, they don’t have time or resources to practice preventive medicine and develop strategic plans," said Alicia Procello, TCWF program officer.

The clinics have used the funding to strengthen their services in a number of ways, such as forming partnerships, adding staff, securing additional funds, developing medical expertise and addressing emergency care needs.

Seeking Partners To Expand Services

Networking is often key to expanding services at these small, nonprofit, rural clinics that serve all residents, Procello said.

Sharing of medical personnel, for example, is often a necessity. The Canby Family Practice Clinic in mountainous northeastern Modoc County shares a family nurse-practitioner with Modoc Medical Clinic about 20 miles away, and Canby’s medical director comes twice a month from Greenville, which is more than a two-hour drive away. Butte Valley-Tulelake Rural Health Projects in Siskiyou County, which hugs the Oregon border, used a two-year, $75,000 grant from TCWF to expand preventive health care programs ranging from drug and alcohol abuse counseling to dental exams and family planning. Although a large health center exists nearby in Klamath Falls, Oregon, Butte Valley-Tulelake Rural Health Projects is forming an alliance with a smaller clinic in California that has similar goals and concerns.

"Larger, urban health care facilities often don’t want to affiliate with us because of the costs involved in serving our largely low-income patients," said Dave Jones, Butte Valley-Tulelake’s executive director.

Partnering also takes place with different types of area agencies. The Sierra Kings Hospital Foundation in the central valley community of Reedley, just west of the High Sierra Mountains, is working with area senior service agencies to provide information on Medicare supplemental insurance. In the process, a senior resources collaborative has formed to meet the needs of a growing elderly population, many of whom are Latino.