Rural Health Care Services Outreach Grant Program - Neighborhood Health Center (NHC) is proposing a Rural Services Outreach Program that aims to improve access to essential health care services for rural, underserved populations in Union County and rural areas of Wayne and Fayette Counties in eastern Indiana. The project will utilize a fully equipped mobile health unit to conduct outreach to at-risk populations, as well as to deliver primary care, health screenings, immunizations, and telehealth specialty services directly to vulnerable populations. These efforts are bolstered by a strong consortium of community partners, including Reid Health, McCullough-Hyde Memorial Hospital, Union County Health Department, Gleaners Food Bank, and Union County Library, who will collaborate to integrate preventive care with telehealth specialty care delivery, health education, food access, and social services. Residents in Union County experience barriers to accessing comprehensive health care due to geographic, economic, and social factors. The population of Union County is 100% rural, composed of individuals impacted by various health-related challenges, including rural isolation, limited health literacy, and lack of access to healthy food, among other challenges. Only an estimated 53.4% of Union County residents have access to high-speed internet, compared to almost 94% of residents across Indiana. This overall poor connectivity further restricts access to telehealth services and can exacerbate disparities in health outcomes due to poor utilization of preventive and specialty care. Of great concern is food access as 11.8% of Union County residents are facing food insecurity, 71% of whom are ineligible for SNAP. 14% of Union County children (1 in 7) are food insecure, with almost half being ineligible for federal food assistance programs. Chronic condition prevalence is compounded by poor health literacy, health behaviors, and access to healthy foods. Approximately 16% of Union County residents (18% of Wayne, 20% of Fayette County) report having fair or poor health, compared to 14% of the U.S., many due to chronic conditions. NHC’s program, engaging under the Regular Track, is developed under the model of evidence-based practices that are appropriate for connecting rural populations to health and social services: Engagement of Mobile Health Clinics and Community Coalition Action Theory NHC’s program aims to: - Conduct targeted outreach to increase community engagement and awareness of available health care services. - Expand access to comprehensive health care services for underserved rural populations in Union County and surrounding rural areas. - Address social determinants of health (SDOH) by integrating health care delivery with food access, transportation support, and health education. - Improve health outcomes for patients with chronic conditions by delivering evidence-based and innovative health interventions. - Build a sustainable model for rural health care delivery through collaboration with consortium partners and community engagement. As a FQHC-LAL, NHC has demonstrated its capacity for effective program implementation, having grown strategically from serving 1,800 patients in 2018 to 5,815 in 2023. Of the 5,815 patients served, 930 were children and youth, 1,321 were adults 65+, 4,464 (78.47%) had incomes below 200% of the federal poverty level, 448 were self-pay, 2,031 utilized Medicaid/CHIP, 1,649 utilized Medicare, 610 (10.49%) were experiencing homelessness, 35 were agricultural workers or family members, and 2,229 were served at a public housing site or Health Center easily accessible by a public housing site. NHC qualifies for Funding Preferences 1, 2, and 3. The NHC service area is located in a Health Professional Shortage and Medically Underserved Area, and is focused on primary care and wellness across the service area population.
