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Public_Pioneer

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​PCAT COMMUNITY COALITION KEARNY COUNTY 

COMMUNITY OVERVIEW

Kearny County is a frontier, primarily agrarian, community located in Southwest Kansas approximately 50 miles from Colorado and 70 miles from the Oklahoma border.  The county is largely made up of two primary communities, Lakin which is the county seat as a population of 2184 and Deerfield, population 746.  The total population of the county as of 4/21/16 is 4001.  The county consists of 2027 males and 1974 females.  

While the county has a diverse population, 95% of the County's population is made up of two ethnic groups are Caucasian, population 2601 - 65%, followed by Hispanic with a population of 1201 - 30%.  Additionally, 160 individuals identify as mixed ethnicity, 18 people identify as American Indian, 14 individuals are Black, and 7 identify as Asian.  There are 1450 families, with an average size of 2.7 people.  Of the 4001 residents, 1071 reside outside of the city limits of Lakin and Deerfield.  There are 245 children ages 0-4, 132 ages 5-6, 198 ages 7-9, 187 ages 10-12, 188 ages 13-15, and 127 ages 16-17.  Young adults consist of 214 ages 18-20, 505 ages 21-29.  There are 462 people ages 30-39, 447 between the ages of 40-49, 508 ages 50-59, and 788 residents 60 years of age and older.  

There are two public school Districts in Kearny County, USD 215 Lakin and USD 216 Deerfield.  Each District consists of a grade school, middle school, and high school.  Kearny County Hospital (KCH) is the lone hospital serving the community.  The facility includes a 25-bed critical access hospital, 4 nursery beds, 40 long-term care beds, and 35 beds for assisted living. KCH presently sees patients from over 20 Kansas and Colorado counties. Patients travel from all over Southwest Kansas and even neighboring states to get medical care at our facility. 

Currently 11 health care providers practice at KCH, including 5 physicians, 5 physician assistants, and 1 advanced practice registered nurse. KCH is also home to the only Otolaryngology specialist, commonly known as an Ear, Nose, and Throat (ENT) doctor in western Kansas and a Physician Assistant who assists the ENT.  Seven specialists provide care at KCH on a monthly basis including: Cardiology, General Surgery, OB/GYN, Audiology, Maternal & Fetal Medicine, Urology, and Orthopedics services. There are 3 medical clinics, all associated with KCH, 2 located in Lakin and one in Deerfield.  In addition, there is one Dentist, 2 Chiropractors, and a massage therapist located in Lakin.  Lakin has 2 convenience stores, one which offers on-site fried foods and pizza.  Lakin also has a Subway restaurant, 6 privately owned restaurants, and options to eat at the Kearny County golf course and the bowling alley. A Dollar General just opened in May 2016 and Deerfield has one convenience store that also offers fried foods and pizza.  

Major employers in the community are the KCH, Kearny County, the City of Lakin, the City of Deerfield, Tyson Foods, Midwest Energy, Production Gas Company, Wheatland Electric, and Pioneer Communication, USD #215, and USD #216.  There is one grocery store, which is located in Lakin and independently owned.  Kearny County is steeped with diverse religious organizations consisting of fourteen churches, including a large Mennonite contingent.  Community based organizations primarily consist of the Lakin and Deerfield Recreation Commissions, and four 4H clubs.  Additionally, there is a Migrant Education Program, and an extension agent providing family and consumer services, the Pride Committee, County Health Department, the Senior Center, and Meals on Wheels.     

Kearny County is a community with strong rural values, where neighbors still believe in helping and supporting neighbors.  It is a close knit community exuding a passion for improving and growing services to enhance the quality of life for all residents.  Kearny County Hospital is significant in making the community standout as it is unique to most frontier hospitals.  To address the increasing shortage of primary care providers in the region, KCH began a unique strategy of recruiting mission-minded healthcare providers whose passion is to serve vulnerable populations.  

Many of these doctors have spent time serving in developing nations overseas, and they recognized the opportunity to meet a serious need for improved health in Southwest Kansas.  These providers care greatly for those who are poor, immigrants, refugees, isolated from the resources of urban areas, and in need.  This part of the country is also home to a considerable number of immigrants and refugees.  

Recent data collected by Dr. Debra Bolton, a researcher at Kansas State University, shows that in Kearny County, 24% of the population speaks a language other than English, 32% are non-Anglo, and 10% were born outside of the United States.  In addition, Kearny County is home to two school districts that are top-rated in the state for academics, athletics and fine arts. 

Recreational opportunities abound from hunting for deer, upland game birds, migratory birds and small animals to fishing, camping and riding ATVs.  Kearny County maintains a number of essential services and provides for quality of life with beautiful parks, a golf course, and an aquatics center with both an indoor and outdoor pools.​

COALITION OVERVIEW

The Pioneer Care Advocacy Team (PCAT) Task Force was created in 2015 to develop a Coordinator position and to develop initial program parameters, goals, and measurable outcomes geared toward increasing medical clinic use, while decreasing potentially preventable hospitalizations, and non-emergent emergency department (ED) use that are partially as a result of a fragmented healthcare delivery system. The purpose of the PCAT Task Force was primarily to support the new coordinator and to provide feedback and suggestions for amending the intervention strategies of PCAT.  The task force has existed for approximately one year. 

With the implementation of PCAT, it has become very apparent that there are numerous reasons and issues that lead to individuals accessing the ED for non-emergent issues.  Many additional issues lead to individuals being hospitalized for potentially preventable situations as well.  While the Task Force participated in excellent work, the original task(s) have essentially been completed; however, due to the work of the Task Force and because of the work conducted by the PCAT program, it has become abundantly clear that the PCAT Task Force and PCAT need to move from being a task group to creating an additionally inclusive coalition.  This will allow for enhanced services, new service creation, and a strong movement to further and more fully address community needs, especially in creating a culture of health throughout Kearny County.  

Strengths of the Task Force are that the original members are still very passionate about the community and the work of PCAT.  The group is also motivated to create opportunities to improve access to healthcare and other services, while improving the overall health of the community.  Another strength is that PCAT is now operational and the PCAT coordinator is willing to take the lead for creating a coalition with the avid support of the original task force.  Weaknesses are identified as needing to bring several new stakeholders on-board who were not identified during the formation of the original task force.  

The Task Force has recognized that several important stakeholders were overlooked in the original group, but have since been identified as important​ to strengthen the move toward a coalition and important in strategizing  and the overall success of improving the community.   While the weakness is identified as not having all of the necessary stakeholders at the table originally, the strength is that the group has identified the need to change and has a passion to move forward.  The PCAT Task Force has been very successful since its inception, which will be highlighted in another section of this application.  
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The PCAT Community Coalition Kearny County ​was establised in 2016 to address specific health needs identified in the Community Health Improvement Plan. Our coalition includes members from various community organizations as well as healthcare providers. Together we're working to make Kearny County more healthy.  We meet on the XXXXXXX  in the XXXXXXX in Room XXX. To learn more about the coalition or to become a member, please contact Kendal Carswell at 620-355-7111 ext. 1343 or ​

OUR WORK

​One of the greatest challenges is that there has not been this type of program in the past and little has been done around prevention and healthy living; therefore, while community members may have a desire to be healthy, they often times don't know how to live healthy.  Additionally, the restaurants and eating establishments tend to only offer higher calorie meals, often times primarily fried foods.  Much of this is likely as a result of cultural systems where particular unhealthy foods are the norm and there is a lack of understanding about healthy cooking and healthy lifestyles.  Because there is only one grocery store in the county with the closest alternatives being nearly 30 miles away, food costs tend to be higher.  

Therefore, those on a fixed budget often find it very difficult to purchase enough healthy foods to prepare regular meals that are healthy.  Those residents who rely upon food stamps to purchase food find it impossible to afford healthy foods such as fresh fruits and vegetables because of the higher costs.  The low amount of assistance provided is a barrier, as is the policy in Kansas to resist Medicaid expansion.  While this would likely cost additional money, it would likely save money in the long run as the individuals who aren't currently covered by health insurance often wait to access healthcare until a condition has become unbearable and as a result the treatment costs are much higher.  Another barrier is that our healthcare system is designed to treat illnesses rather than to prevent the onset of diseases.  While this is a barrier, it is exciting that Pathways is providing an opportunity to approach prevention and to make it a priority. The funding from the Pathways Grant will help expand the bandwidth of the PCAT Program, which will allow for new programs to be developed and implemented.  

The funding will significantly support efforts to educate residents about healthy lifestyles and to create healthy environments in which residents can actively participate.  The funding will also provide a platform for innovative ideas to be introduced throughout the community such as schools purchasing fresh fruits and vegetables locally, residents being able to raise their own vegetables in community greenhouses, giving them access to healthier foods.  There will also be opportunities for prevention programs to be developed and implemented.  Because Pathways will span 3 years, ample time will exist to test the programs and to make them self-sustaining so that the new lifestyles can become a part of the social fabric in Kearny County.  Some of the identified barriers can't be changed necessarily as a direct result of Pathways, but Pathways makes it possible to work around the barriers with innovative services, and collaborative efforts that will overcome what has often been viewed as insurmountable.  

Pathways will provide the necessary support for PCAT to take the existing innovative strategies and and move the process forward through implementation, increasing the potential footprint of the program beyond current capacity.  This will allow the team to expand service opportunities and to touch a larger segment of the community.  It will also increase the ability of PCAT to develop and implement collaborative efforts with multiple entities, further improving outcomes and generating additional interest in a culture of health.  
 
Our goal is to create a culture of health in the Kearny County community. To learn more about the PCAT Community Coalition Kearny County, please contact Kendal Carswell at 620-355-7111 ext. 1343 or kcarswell@kearnycountyhospital.com.

COALTION MEMBERS AND PARTNERS
​​Kearny County Hospital​Lakin Pride Committee​International Rescue Committee
​KU School of Medicine - Wichita​KU School of Social Welfare​Kansas Foundation for Medical Care - KFMC
​Deerfield Recreation​Episcopal Church of the Upper Room​Southwest Research - Extension Center

This material was prepared by the Great Plains Quality Innovation Network, the Medicare Quality Improvement Organization for Kansas, Nebraska, North Dakota and South Dakota, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 11SOW-GPQIN-KS-C3-02/0516