As we reflect on 2022 and look forward to the work ahead, it is important to celebrate where we have been and the partnerships that we have forged to improve health. Inside:
Applications due: The next nationwide cohort begins in January 2024.
The Good Neighbor Experiment (GNE) is a cohort-based learning process for congregations who wish to engage their community as neighbors. GNE is rooted in the practices of Asset-Based Community Development and the Christian Faith. The material has been used in congregations since 2017 and the Neighboring Movement team has refined the material with each cohort led. The process includes a 4 week worship series, online events with other participating churches from across the country, 3 action-based “Labs” of small group materials you do with your own congregation (each 5 weeks long) and congregational coaching for churches; all occurring over a 4 month period.
The Health Fund is excited to partner with NeighboringMovement.org and the Lilly Endowment to offer Great Plains United Methodist Churches a special opportunity for current or new signup Healthy Congregations (HC) teams to participate in the The Good Neighbor Experiment (GNE) at no cost. Not a Great Plains United Methodist Church? You are still welcome participate in GNE – please visit https://neighboringmovement.org/gne to learn more.
To get started, please fill out the below interest form. There is no obligation – staff will reach out to you to guide next steps and answer questions. To learn more about GNE first, please visit the GNE website. Questions? Please email dashinika@healthfund.org or ian@neighboringmovement.org.
GNE was created for local congregations of Christian churches. It is done best when 4-12 people from a church are willing to commit to the full scope of the training, including attending all the online kickoff events and personally participating in all 15 weeks of the small group curriculum.
While some congregations do experience numerical growth, GNE is not intended to increase attendance on Sunday mornings or financial contributions. Instead, GNE is meant to create renewed vitality and to help the congregation become more deeply embedded within its community. GNE is for churches that are tired of creating programs that nobody wants to come to. Many of us have been taught that you can only engage your neighbor through evangelism or by providing a service to them; GNE offers another option. Throughout the experiment, churches are invited to move from scarcity to abundance and to see their role shift from service provider to community connector.
GNE offers two ways to participate in a cohort:
Learn more about the GNE curriculum and alumni program on their website.
Responsibility for Churches
Responsibilities of Individuals
Kansas workers, health providers and employers increasingly rely on broadband access for their jobs, health care and enterprises. Held December 12 in Topeka, “Broadband Access and Telehealth: Exploring Policy Approaches for Kansas” engaged state policymakers, hospital and health system leaders, insurers and rural network directors during a presentation of recent studies and program developments followed by a policy leader panel offering perspectives on future broadband expansion and telehealth usage.
The program was hosted by the United Methodist Health Ministry Fund, REACH Healthcare Foundation, and the Kansas Health Institute.
Featured speakers:
Policy leader panel:
This opinion piece by Health Fund President David Jordan originally appeared in the Kansas Reflector on November 17, 2022, the second in a two-part series on current and emerging challenges and how Kansans are looking ahead to develop innovative solutions and ensure health care for generations to come.
Health care is vital for our communities — and under increasing pressure. In part 1 of this series, we looked at challenges Kansas faces in supporting the health care systems and workforce needed for our communities to thrive.
By recognizing shifting demographics, workforce challenges and changes in health care delivery, we have the opportunity to build a sustainable health care system for the future.
To plan ahead and better understand the health care workforce crisis, United Methodist Health Ministry Fund commissioned research examining the current health professional education pipeline in Kansas. KU School of Medicine and McPherson College researchers analyzed 2019 program completion data using the National Center for Education Statistics’ Integrated Postsecondary Education Data System (IPEDS).
As health care faces significant staffing shortages, the report illustrates an opportunity for Kansas — with health profession programs located throughout the state — to strengthen that foundation and increase our homegrown workforce.
In 2019, 11,804 students graduated from 459 health profession programs located across 51 Kansas institutions. Most (62.7%) completed degree programs of two years or less in duration. The largest number of graduates completed degree programs in nursing or allied health.
With most graduates from programs with two years or less of training, to reduce credit loss and barriers to additional training and degree attainment we need to ensure accessible transfer pathways from two-year to four-year post-secondary institutions. We also should examine policies to require credit transfers between Kansas higher education institutions.
Likewise, we need to align secondary, technical education and postsecondary education programs, and ensure health care training completed in high school is transferrable and aligned with degree programs and employer needs.
We should continue to invest in nontraditional workforce development programs such as Gov. Laura Kelly’s recently launched Office of Apprenticeship, which seeks to develop and train new talent in critical industries such as healthcare.
We need to examine scope of practice and payment policies to best use our workforce, and implement smart systems and policies enabling every provider on the team to practice to the top of their scope.
One example is the newly-recognized community health worker program in Kansas, which trains community members in a certificate program to provide crucial health coaching, resource and care coordination services, education, and navigation services. CHWs help consumers better navigate systems and reduce use of high-cost services. They allow providers to focus on practicing to the top of their scope, reducing burdens on overworked staff. While CHWs are now certified, we need to change Medicaid reimbursement policies to ensure providers can be paid for their services.
We have an opportunity to better leverage providers such as physician assistants, dental therapists and others to provide care under doctor-led teams. Expanding team members’ scope of practice can increase capacity and address workforce challenges.
We can leverage technology to maximize our workforce and better serve Kansans. Telehealth provides that opportunity. Before COVID-19, just 11% of US consumers were using telehealth, but in 2020 its unique advantages (especially in rural areas) became clear. Now, consumers and providers agree telehealth is here to stay, playing a key role in integrated, patient-centered systems of care.
Ensuring all Kansans have access to reliable broadband allows us to distribute workforce and re-design our health system in a different way. Residents can access hard-to-recruit specialty care in their communities, benefiting them while reducing burdens of recruitment. However, we must change policies to foster this innovation for the long term.
Workforce competitiveness requires a financially viable system. Kansas is one of only 11 states that has not expanded Medicaid, putting hospitals and other providers at financial risk. Expansion would eliminate high levels of uncompensated care, helping prevent further hospital closures and benefitting all Kansas health providers.
Changing needs require new approaches. Under the Rural Emergency Hospital model, hospitals continue providing emergency services and routine care but discontinue acute inpatient care.
Beyond direct workforce and health system issues, we need to ensure Kansas has community supports to ensure health care workers remain in Kansas, including child care. A 2020 study reported only 3% of Kansas counties met desired capacity — before COVID-19. While solving the child care crisis requires sustained work at all government levels, we can take steps today, including better use of child care subsidies.
There is no single solution. Increasing our health care workforce requires research, collaboration, policy change and willingness to change the status quo. Kansans, working together, can ensure our communities have health care and thrive for generations. Join the conversation at https://communityconversationsks.com.
This opinion piece by Health Fund President David Jordan originally appeared in the Kansas Reflector on November 10, 2022, the first in a two-part series on current and emerging challenges and how Kansans are looking ahead to develop innovative solutions and ensure health care for generations to come. View part 2: Looking ahead, here’s how we can support the health care workforce of a changing Kansas
To plan for the future and better understand the health care workforce crisis, United Methodist Health Ministry Fund commissioned research examining the current health professional education pipeline in Kansas.
Health care is vital for our communities, but our ability to maintain the workforce needed to adequately deliver that care is under pressure. In this two-part series, we look at current and emerging challenges, as well as how Kansans are looking ahead to develop innovative solutions and ensure health care for generations to come.
Kansas faces many challenges in delivering health care, especially in rural areas. The state is experiencing shifting demographics, uninsurance rates higher than the national average, and difficulty attracting and retaining workers.
As we plan for the future, we need to consider how outside factors will affect demand for workers, who we are recruiting to the health care workforce, where and how they will be trained, how technology will impact care delivery, and where providers will need to be located.
Our population is growing slowly, mostly in cities, and older, as depicted below. WSU CEDBR projects by 2064 a 33% decline in rural population, a 6.5% decline in micropolitan areas and that one quarter of Kansas residents will be over age 65. Older and rural populations tend to be less healthy and require additional care.
At the same time, over the past 20 years, the Kansas population has grown more diverse, a trend expected to continue. A 52.5% increase in minority populations (any group other than non-Hispanic White) generated the only population growth in Kansas this century.
That trend makes it critically important for Kansas to address longstanding racial and ethnic disparities in health, poverty rates and educational attainment. Training and hiring culturally competent health care workers will become increasingly important to addressing health inequities and building a health care system to meet future needs.
Before COVID-19, many Kansas counties already had an inadequate supply of health professionals. As the below Kansas Department of Health and Environment figures depict, the majority are considered health professional shortage areas (HPSAs) for both primary and mental health care — lacking the health professionals necessary to meet their population’s health care needs.
COVID-19 exacerbated that existing workforce challenge. In a 2021 KFF report, 3 in 10 health care workers said due to the pandemic they have considered leaving health care. Earlier this year, McKinsey and Company reported 32% of RNs surveyed in November 2021 said they may leave in the next year.
Provider retirements will create additional pressure – a Kansas Health Institute brief illustrates that in 2020, nearly 4 in 10 (39.2%) of primary care providers in Kansas were over the age of 55, rising to nearly half in some regions (45.2% in southwest Kansas and 42.5% in southeast Kansas).
Uninsured patients and resulting uncompensated care complicate financial sustainability for health systems, impacting daily operations and long-term viability of health care — especially in rural communities and communities of color.
Kansas is one of 12 states that have not expanded Medicaid, evidenced in our stagnant uninsurance rate. According to KHI, as the national uninsurance rate declined to 8.6% in 2021, Kansas’ rate remained at 9.2%. This was the first time in decades our uninsurance rate exceeded the national average. The difference in 2021 primarily reflects a higher uninsured rate in Kansas versus the U.S. among working-age adults.
Historically, uninsured rates in rural counties are among the highest in Kansas. There are also significant disparities among Kansas residents by race and ethnicity. Those identifying as Hispanic or Black are more likely to be uninsured in Kansas than the United States. In Kansas, uninsurance rates were 20.3% for Hispanic residents and 14.1% for Black or African American, versus 17.7% and 9.6% U.S. averages, respectively.
Before implementation of the Affordable Care Act, Kansas boasted a better uninsurance rate than the national average but now lags.
Beyond higher-than-national-average uninsured rates, the failure to expand Medicaid negatively affects hospital finances and results in more uncompensated care. In fact, 44.3% of uncompensated care in critical access hospitals in Kansas could be eliminated by expanding Medicaid. Because Kansas has not expanded Medicaid, we have more financially vulnerable hospitals than any other state.
The high uninsured rate and financial instability make us less competitive in recruiting providers versus surrounding states that have all expanded Medicaid.
In part two of this series, we’ll move beyond the challenges and explore how Kansans are collaborating to develop innovative solutions. To learn more, visit https://communityconversationsks.com.
Access to behavioral health is a top concern for all Kansans. We all benefit when behavioral health services are better integrated into our health care system.
For more than 30 years, Kansas has ensured that each county received safety net mental health services provided by a community mental health center. Community mental health centers have faced increased demand for services coupled with workforce shortages.
To better meet demand and serve their communities, community mental health centers will transition to an integrated care approach. The Certified Community Behavioral Health Clinic (CCBHC) model was designed so that all individuals can access coordinated comprehensive behavioral health care, such as outpatient mental health and substance use services. CCBHCs also provide care coordination to help patients navigate the health care and social services systems. CCBHCs must provide services regardless of where patients live or their ability to pay.
Transforming from a community mental health center to a CCBHC takes time, planning, and money. That takes capacity in the form of staff, resources, and knowledge. Rural communities typically have less capacity to apply for federal grants than metropolitan areas. Kansas is one of the 10 states with the most limited community capacity—it’s not surprising that Kansas ranks 47th in drawing down federal funds.
To create greater access to behavioral health services, especially in rural and under-served areas in Kansas, the United Methodist Health Ministry Fund (Health Fund) provided technical assistance to community mental health centers to bring back federal grant dollars to support their efforts as they seek CCBHC status.
The Substance Abuse and Mental Health Services Administration (SAMHSA) recently awarded CCBHC planning, development, and implementation (PDI) grants to 10 Kansas community health centers, including the following four that received technical assistance from the Health Fund:
Over the course of the four-year grants, we expect more than $15 million to return to Kansas to support these four community mental health centers as they transition to the CCBHC model.
“This is a big lift for community mental health centers to increase capacity to meet the new requirements,” said Kyle Kessler, Executive Director of the Association of Community Mental Health Centers of Kansas. “The grant funding awarded by the Substance Abuse and Mental Health Services Administration provides the support they need to recruit and retain staff, complete necessary trainings, and implement new programs. We are thankful to the United Methodist Health Ministry Fund for assisting our members to successfully apply for the grant funding; it is a huge win not only for the centers but most importantly for the communities they serve who will now have easier access to a broader array of behavioral health services.”
The Health Fund has been providing grants in Kansas for more than 35 years, but recently began providing technical assistance and grant writing support to partners working in our strategic areas of interest. This new strategy leverages resources and expertise to bring crucial federal dollars back to Kansas to improve access to care and early childhood services while making the systems more financially sustainable.
Altogether, the Health’s Fund investments in technical assistance in 2021 and 2022 have helped bring back more than $30 million in federal funding to Kansas to improve access to health insurance and behavioral health services.
“The Health Fund is always working to leverage our resources most effectively to increase access to sustainable health care for Kansans,” said David Jordan, president and CEO of the United Methodist Health Ministry Fund. “These newest grants will strengthen access to behavioral health care and support an innovative delivery model—which represent two major priorities for the Health Fund. I’m proud we’re able to help bring critical funds back to Kansans to strengthen behavioral health care in rural communities and create a healthier future for all Kansans.”
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The United Methodist Health Ministry Fund is a statewide health foundation that facilitates conversation and action to improve the health and wholeness of Kansans—especially those in rural and under-served communities. Through funding programs and ideas, providing hands-on expertise, and convening influencers, the Health Fund advances innovative solutions to improve Kansans’ health for generations to come. Located in Hutchinson, Kansas, the Health Fund has provided more than $75 million in grants and program support since its inception in 1986.
The United Methodist Health Ministry Fund (Health Fund) has launched a “Faith in Vaccines” campaign to promote COVID-19 vaccination and help ensure Kansas families are as prepared and protected as possible against emerging COVID-19 variants.
The campaign has highlighted the efficacy of the current vaccines and has included voices from trusted sources, such as pediatricians, faith leaders and rural community leaders, as well as testimonials from individuals who have been directly impacted by COVID-19.
“The decision to be vaccinated is a personal one,” said David Jordan, Health Fund president and CEO. “We hope this campaign will provide Kansans with the additional information they need from trusted sources to consider if the vaccine is right for them. Ultimately, we want to see more people choose to be vaccinated and limit their chances of severe illness or death due to COVID-19.”
This commentary by Health Fund President David Jordan on strengthening rural health care through KanCare expansion originally appeared in the Wichita Eagle on March 9, 2022.
Kansas is a rural state with nearly one-third of the population living in rural communities. As Kansans we take pride in self-reliance and taking care of our own.
Yet Kansans living in rural and frontier areas are more likely to be uninsured than those in more populated communities. Kansans living in frontier communities have the highest uninsured rate in the state (12.9%). When it comes to health care and sustaining rural health systems and communities, we need more than self-reliance. We need health insurance.
Many of our uninsured neighbors are hardworking Kansans who earn too much to qualify for KanCare, the state’s Medicaid program, and too little to qualify for health insurance through the Affordable Care Act. In fact, a single parent of two kids earning more than $4.00 an hour earns too much to qualify for KanCare.
These hardworking Kansans are our neighbors. Kansans like Jim, an uninsured farmer who enjoys working with crops and large machinery. He lost his health insurance after a seasonal job ended. Getting insurance now is beyond his means.
He’s dealing with diabetes and an injured foot. The bones were broken, but Jim hasn’t been able to get it addressed. He calls it a “Catch-22.” He was hurt and needs money to get well, but he can’t work to make money because of the injury.
Without health insurance, Jim is scraping by and going without regular care.
Emergency room care is often the only option for uninsured Kansans like Jim. But hospital bottom lines and viability are threatened if uninsured patients can’t pay bills. Currently, 70 rural Kansas hospitals are financially vulnerable and categorized as at-risk of closing, more than in any other state.
Rural and frontier towns rely on hospitals for health care and to anchor communities.
According to the Kansas Hospital Association, in 2020, 12% of Kansas employment was in the health services sector. The health care sector was the fifth largest producer of total income and of total sales.
For health and prosperity, a sustainable health system is crucial to the future of our rural regions and our rural way of life.
Kansas can take an immediate step to strengthen rural health systems and communities by expanding KanCare, the state’s Medicaid program.
Multiple studies show that hospitals, particularly rural ones, are at significantly higher risk of closure in states that have not expanded Medicaid. A 2018 study published in Health Affairs found “Medicaid expansion was associated with improved hospital financial performance and substantially lower likelihoods of closure, especially in rural markets and counties with large numbers of uninsured adults before Medicaid expansion.”
Expanding KanCare would cut our uninsured rate in half. Expansion would boost hospital finances by covering 25% of the uncompensated care in rural hospitals and 44% in frontier hospitals.
Kansans know expanding KanCare is the right thing to do. Expansion has broad support across geography and political party. A new survey finds almost 8 in 10 Kansas voters (78%) support expanding KanCare.
All neighboring states have expanded their Medicaid programs. Expanding KanCare would keep us competitive — adding nearly 23,000 new jobs to the state’s economy and increasing economic output by $17 billion.
Expanding KanCare would strengthen rural health care and help ensure rural Kansans get the health care they need while improving their economies. The time to expand is now.
This commentary originally ran in the Kansas Reflector on March 8, 2022. About the authors: Dr. Tiffany Anderson, superintendent of Topeka USD 501, and Dr. Shannon Portillo, associate dean and professor at the University of Kansas, served as co-chairs of the Governor’s Commission on Racial Equity and Justice; David Jordan, president and CEO of the United Methodist Health Ministry Fund, chaired the subcommittee on healthcare.
In the summer of 2020, amidst national calls for racial justice and criminal justice reform, Gov. Laura Kelly established the Governor’s Commission on Racial Equity and Justice.
She brought together 15 Kansans with expertise in law enforcement, education, health advocacy, local and state government, policy, philanthropy, and community organizing.
Given the historic need to review justice-related issues in Kansas, the commission started its work by examining law enforcement and the criminal legal system to identify opportunities to address inequities in Kansas’ system. We also sought to understand how to address systemic issues that affect education attainment, economic opportunity and health. The commission met every other week, hosted learning sessions with relevant professional associations and experts, and held community listening sessions.
The commission issued its first of three reports in December 2020. These recommendations addressing criminal justice aim to prevent disproportionate contact with law enforcement for communities of color and decrease inequities in justice outcomes.
Some recommendations related to law enforcement hiring and training were included in Senate Bill 247, which was introduced in 2021 in Senate Judiciary. This includes prohibiting fired officers from being hired at different law enforcement agencies; mandating review of records during the hiring process; requiring psychological testing of officers be performed by a licensed professional before certification (current standards require psychological tests before certification, but not by an independent, licensed professional); and requiring that officers have completed KLETC training before they are issued a firearm for use in the line of duty. We must engage with our legislators and advocate for this legislation.
Kansas law is more restrictive than military eligibility requirements, prohibiting law enforcement agencies from hiring noncitizens with legal status as officers. Aligning law enforcement eligibility with military eligibility would support hiring goals for agencies and engage immigrant populations to better reflect Kansas’ population.
Law enforcement and leaders agree that access to behavioral health care is a criminal justice issue. It’s estimated that nationally 44% of jail inmates and 37% of prisoners have a mental illness, compared with 18% of the general population. Many law enforcement encounters are the result of substance use or mental health issues, and they cause county jails and prisons to become de facto behavioral health service providers. Increasing access to early intervention options by expanding Medicaid in Kansas would improve policing outcomes and reduce state general fund spending on law enforcement and behavioral health.
Financing mobile crisis response models would provide crucial support to law enforcement in responding to behavioral health calls. Mental health professionals who work alongside law enforcement officers, or respond to mental health calls on their own, can contribute to positive outcomes and promote treatment over incarceration for individuals experiencing mental health crises.
The Johnson County co-responder program boasts positive outcomes — the rate of hospitalization fell dramatically, and the percentage of police calls that ended up in jail fell slightly. Kansas and local communities should implement appropriate co-responder and mental health crisis programs where possible.
More than 85% of Kansans facing a felony charge rely on appointed counsel. We must do more to support the Kansas Board of Indigent Defense Services and expand public defender offices to our largest counties. BIDS recently voted to expand offices in Wyandotte and Douglas Counties. To better serve residents throughout Kansas, BIDS is asking the Legislature for increased funding to open these offices, increase public defenders’ pay throughout Kansas and provide better training for their attorneys. Data demonstrate supporting BIDS offices in Douglas and Wyandotte Counties will save money.
We will not rid the justice system of inequities immediately, so we must ensure Kansans know how to report racial and bias-based policing, and we must have systems that take these reports seriously. In 2011, racial and bias-based policing policies were updated in statute. The commission recommended that the Legislature review the policies to determine if they are serving their intended purpose. The Legislature should address the process for filing a complaint of racial or bias-based policing, what entity is most appropriate to manage the process, and the availability of data related to such complaints and responsive action taken.
There are more than 50 other recommendations in the Commission’s first report. A few recommendations are making their way into legislation, but we must continue to push for them at the statehouse, in local governments and in administrative agencies. For more recommendations to become reality, we urge you to let your legislators and local governmental bodies know that these issues matter and encourage them to act.
In June 2020, Governor Laura Kelly signed Executive Order 20-48, forming the Governor’s Commission on Racial Equity and Justice. The Commission studied issues of racial equity and justice across systems in Kansas, focusing first on policing and law enforcement and then on economic systems, education, and health care. The Commission developed recommendations for state agencies, the Legislature, and local governments. Through the end of 2022, Commissioners will dig deeper into the Commission’s recommendations in a monthly series.
Governor’s Commission on Racial Equity and Justice reports
Governor’s Commission on Racial Equity and Justice webinar series
2022 opinion series on commission recommendations
Advocacy can inform how American Rescue Plan Act (ARPA) dollars transform your community. Learn more in this webinar recorded on Thursday October 14 with experts from Community Catalyst. They presented their toolkit on how advocates can use ARPA funds to spur transformative change and address the unique needs of communities.
Community Catalyst is a leading non-profit national health advocacy organization dedicated to advancing a movement for health equity and justice. They partner with local, state and national advocates to leverage and build power so all people can influence decisions that affect their health.
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