RHIhub's Human Services Support Guide for Rural Healthcare: Everything Connects

by Kathleen Belanger

It's in rural America that everything connects. Our lives there are often so interwoven that the roles blur, yet the silos of service delivery are so rigid that services themselves cannot be delivered for lack of scale. Rural people are left with more hospital and school closures, fewer opportunities to escape poverty, and an increasing struggle to maintain control of their natural resources—all while resources for health and education dwindle.

Navigating the web to find these resources can be cumbersome and time-consuming. However, information about human services that support rural health is now available in the new RHIhub Topic Guide, Human Services to Support Rural Health. RHIhub has gathered in one site an overview of human services as they relate to health, with information for healthcare providers, patients, and those of us who would like to improve our communities by understanding the role that human services plays in health.

The guide is organized into topic areas, and provides a list of Frequently Asked Questions, such as: How do income assistance programs help rural low-income families? and What types of job training programs are available in rural communities? Programs and linked sites are bulleted for ease of use. The Guide explains differences between rural and urban human services delivery, and even explores the social determinants of health as applied to the Affordable Care Act. It also provides guidance from national funders, like the Robert Wood Johnson's Aligning Forces for Quality. One particularly insightful section in the guide provides linkages to publications, including reports from the National Rural Health Association, the Carsey School of Public Policy, USDA's Economic Research Service, the National Advisory Committee on Rural Health and Human Services, and the Rural Policy Institute.

The term "integration" can have many meanings. Several of the papers and reports listed in the guide focus on integrated services, examples of integrated services and links to communities and programs that are successfully integrating human services, including strategies for implementing integrated care, one of the most critical issues faced by clients and providers. For example, the guide links us to the RUPRI Human Services Panel's paper, Stimulating Local Innovation for Rural Health and Human Services Integration: A Critical Review of ORHP Outreach Grantees, which analyzes the promising practices of 38 grantees, focusing on five programs that integrated human services in a variety of ways. While asking many questions, highlighting a number of promising practices and providing recommendations, the paper also provides a chart that describes the degree of service integration on five dimensions including methods of bridging health and human services, delivery methods of the bridged services (formal partnerships, multidisciplinary teams, and one-stop or co-located services), location (from agency to home care) and targeted level of integration (the individual, the family, the organization or the community) for both health and human services.

Two additional links in the guide to reports on services integration are worth noting. One link provides access to a fascinating and practical report by the Commonwealth Foundation, Care Management for Medicaid Enrollees through Community Health Teams. The Commonwealth Foundation highlights characteristics for these teams developed in eight states and examines very specific strategies for program development, program delivery, program financing, and program monitoring and evaluation. In essence, the full report provides something like a blueprint for the crucial strategy of service delivery using the team approach including human services. Another link is to a comprehensive study by Andrew Coburn and Eileen Griffin, Integrated Care Management in Rural Communities. Their report reviews models of long-term services and supports through Medicaid-funded programs, and highlights challenges, opportunities and promising strategies for implementing integrated care, which is holistic, seamless and tailored to the patient's needs. Coburn and Griffin found that integrated care must adapt to the local community, and depend at least in part on the existence or ability to provide a continuum of care and support to be successful. They also found that wraparound models can be helpful, but that can't overcome gaps in infrastructure, particularly in health information technology and exchange.

There are also many other papers and links to a variety of resources related to human services that support health. The guide can be scanned for the appropriate links to other RHIhub topic guides and resources, or to federal program information, publicly available scholarly articles and news. Instead of having to search all over the Web, information about rural human services that impact health are provided in an organized, easy-to-use format. Now everything connects, and challenges us to even further connections.

I'm reminded of a saying attributed to Albert Einstein: "Everything should be made as simple as possible, but not simpler." That's exactly what the RHIhub Guide to Rural Human Services does: clarifies, simplifies and connects us to a variety of ideas about human services.

Hats off to the Rural Health Information Hub staff, for their fantastic work, and to RHIhub for once again providing us with a site that remains informative and easy-to-navigate, and that links us to information we might otherwise have not known exists.

Disclosure: While I am listed in the credits for supporting the creation of the guide, my contribution was minimal compared to the final product.

Kathleen Belanger, Ph.D., is Professor of Social Work at Stephen F. Austin State University in Nacogdoches, Texas, and is a member of the RUPRI Human Services Panel, and recipient of CWLA's Champion for Children award in 2005 for her work in rural child welfare. Belanger has published and presented on rural human services issues in a variety of publications and forums. In addition, she has worked for more than 20 years with rural communities, where she has helped found several non-profit organizations and advocated for rural resources.

Opinions expressed in this column are those of the author and do not necessarily reflect the views of the Rural Health Information Hub.

Back to: Winter 2015 Issue