HELLO & WELCOME TO PRAIRIE PULSE COMING UP A LITTLE LATER ON THE
SHOW, WE'LL PROFILE KELLY FARMS IN MINNESOTA.
BUT FIRST, JOINING US IS GARY HART.
GARY IS THE DIRECTOR OF THE UNIVERSITY OF NORTH DAKOTA
CENTER FOR RURAL HEALTH. THANKS FOR JOINING US.
--> THANKS FOR HAVING ME.
--> TELL THE FOLKS A LITTLE ABOUT YOURSELF AND YOUR BACKGROUND.
--> WELL, I HAD ORIGINALLY FINISHED AND GOT MY PH.D. AT THE UNIVERSITY OF WASHINGTON.
HAD GONE ON THERE TO BE THE DIRECTOR AT THE MEDICAL SCHOOL
THERE, THE CENTER FOR HEALTH WORK FORCE STUDIES AND FOR THE
NATIONAL CENTER FOR RURAL HEALTH RESEARCH.
SO I SPENT ABOUT 22 YEARS THERE AS A RESEARCHER.
DOING VARIOUS KINDS OF RESEARCH. EVENTUALLY TOOK A JOB IN TUCSON
AND WAS A DIRECTOR OF THE RURAL HEALTH OFFICE FOR THE STATE OF
ARIZONA FOR ABOUT THREE OR FOUR YEARS. AND THEN MOVED UP HERE.
--> WELL, THAT TELLS US A LITTLE ABOUT THE BACKGROUND.
HOW DID YOU COME TO BE OR MAKE THE CHOICE TO COME TO THE UNIVERSITY OF NORTH DAKOTA.
--> I WORKED WITH THE FOLKS HERE FOR A LONG TIME.
THEY HAVE A NATIONAL REPUTATION AS BEING ONE OF THE ELITE PLACES
THAT DO RURAL HEALTH SERVICE AND RESEARCH.
AND IT WAS AN OPPORTUNITY. MARY WAKEFIELD HAD BEEN HERE.
SHE HAD GONE ON TO RUN THE HEALTH SERVICES RESEARCH SOURCES
ADMINISTRATION AT THE FEDERAL GOVERNMENT.
SO THEY WERE DOING A SEARCH. THOUGHT IT WOULD BE A GREAT PLACE TO COME.
RIGHT SIDE OF TOWN AND GAVE US AN OPPORTUNITY TO GET AWAY FROM
THE BIG CITIES AND GET INTO A SMALLER PLACE.
--> THE PAST WE'VE HAD MARY WAKEFIELD ON THE SHOW.
SO FIRST OFF, WHAT IS THE CENTER FOR RURAL HEALTH?
--> IT'S MISSION IS IN A SHORT BRIEF VERSION OF ITS MISSION, IT
IS TO INCREASE THE HEALTH STATUS OF RURAL FOLKS LIVING IN NORTH DAKOTA.
--> JUST THAT SIMPLE. --> IT'S -- YOU KNOW, YOU CUT IT
DOWN TO ITS PIECES. DIFFERENT WAYS WE TRY TO DO THAT.
THAT'S THE BOTTOM LINE.
--> MAYBE WE'LL COVER SOME OF THAT I KNOW YOU TALKED ABOUT
YOUR BACKGROUND IN RURAL HEALTH CARE.
TELL US ABOUT THAT AND HOW THAT PREPARES YOU FOR THIS POSITION.
--> TWO PARTS. THE FIRST PART OF MY CAREER WAS REALLY RESEARCH.
THAT'S OUT -- PART OF WHAT I NEED TO DO BE DOING HERE AT THE CENTER.
IT'S NOT AS MUCH AS THE OTHER ACTIVITIES.
I PREPARE THAT WAY. IT'S A BROAD SPECTRUM OF
KNOWLEDGE ABOUT RURAL HEALTH CARE AND WORK FORCE ISSUES.
AND THEN THE EXPERIENCE IN ARIZONA WAS THAT I WAS A
DIRECTOR OF A RURAL HEALTH OFFICE WITH ALL OF THE FEDERAL
AND STATE PROGRAMS THAT ARE DUPLICATED HERE.
THERE'S THE SMALL RURAL HOSPITAL FLEXIBILITY PROGRAM.
TRIES TO HELP SMALL HOSPITALS SURVIVE IN A TOUGH ECONOMIC TIME.
AND SOME OF THOSE KIND OF PROGRAMS.
SO WE'RE -- I'VE GAINED THE RESEARCH SIDE OF THINGS AND THEN
THE SERVICE SIDE AND THE EDUCATION SIDE.
I TAUGHT PUBLIC HEALTH IN ARIZONA AND BEEN PARTICIPATING
IN OTHER KINDS OF THINGS. SO PART OF WHAT WE DO NOW IS TRY
TO HELP THE MEDICAL STUDENTS AND THE PHYSICAL THERAPISTS AND
OTHERS TRY TO GET THEM TO GO TO RURAL AREAS AND TRAIN THEM IN
SUCH A WAY THAT IT'S NOT A BIG TRANSITION FOR THEM.
--> YOU SAID YOU DID A SIMILAR JOB IN ARIZONA.
I MEAN, DOES THE ROLE DIFFER AT DIFFERENT ORGANIZATIONS FOR THE DIRECTOR?
--> WELL, IT IS. THIS OFFICE IS BIGGER AND THE
STATE OF NORTH DAKOTA IS MORE RURAL.
IN TERMS OF THE PERCENTAGE AND THE POPULATION, YOU KNOW, NORTH
DAKOTA DOESN'T GET MORE RURAL THAN NORTH DAKOTA DOES.
BIG CITIES ARE NOT THAT BIG. IT'S A BIG EMPHASIS.
MORE EMPHASIS THAN A PLACE LIKE ARIZONA WHERE THE LEGISLATURE IS URBAN CENTRIC.
80% OF THE POPULATION IS IN TWO CITIES.
AND HERE, IT'S DIFFERENT. WHEN YOU'RE HERE, IT'S MORE A
LEGISLATURE AND A MEDICAL SCHOOL. RURAL IS A HIGH PRIORITY.
--> AND I UNDERSTAND YOU STUDIED EXTENSIVELY SOMETHING CALLED RURAL GEOGRAPHIC TAXONOMY.
CAN YOU TELL US WHAT THAT IS? WHAT DOES IT MEAN?
--> THAT'S GOT TO SOUND POINTY HEADED FOR ACADEMICS EVERY WHERE.
ONE OF THE PROBLEMS HAS BEEN WITH THE FEDERAL GOVERNMENT AND
STATE GOVERNMENTS IN ALLOCATING RESOURCES TO PLACES.
AND WHAT IS RURAL. YOU KNOW, IT'S LIKE WHAT IS LOVE.
WHAT IS RURAL?
IT'S A HARD THING. SO OVER THE LAST 15 YEARS, I'VE
WORKED WITH PEOPLE FROM THE DEPARTMENT OF AGRICULTURE.
WE HAVE COME UP WITH DEFINITIONS OF WHAT FRONTIER MEANS, WHAT
DIFFERENT KINDS OF DEFINITIONS ARE RURAL ARE.
ONE IS CALLED A RURAL URBAN COMMUTING AREAS.
THEY'RE USED THROUGHOUT THE FEDERAL GOVERNMENT AND NOW.
IT'S ZIP CODES AT LEVELS AND DEFINES WHAT RURAL IS.
SO WHEN A GOVERNMENT AGENCY HAS MONEY AND THEY WANT TO HIT THE
MOST REMOTE PEOPLE, THEY CAN IDENTIFY THEM.
HISTORICALLY JUST SAID METRO OR NONMETRO, WHICH IS 50 MILLION PEOPLE BEING RURAL.
IT'S BETTER TO SPEND MONEY EFFECTIVELY IF YOU CAN HONE DOWN
ON THOSE THAT ARE MOST -- HAVE THE POOREST ACCESS TO CARE.
THAT'S WHAT THESE DEFINITION DOS.
--> BOY, I DON'T KNOW IF YOU CAN DO THIS.
HOW ARE YOU DEFINING RURAL IN THIS REGION?
--> WELL, IT'S -- AGAIN, I HAVEN'T BEEN HERE ALL FOUR MONTHS.
WE'RE SORT OF -- WE'RE JUST BUYING DIFFERENT DATA AND
GETTING THE THINGS TOGETHER TO LOOK AT SOME OF THAT.
BASICALLY IT'S USUALLY A COMBINATION OF HOW POPULATIONS,
DENSITY IS, HOW FAR IT IS FROM FARGO AND BISMARCK AND THOSE
KIND OF PLACES BY ROAD SHORTAGE TRAVELED, COMMUTING PATTERNS AND STUFF LIKE THAT.
IT ALL SOUNDS NOT VERY INTERESTING UNTIL YOU REALIZE
THAT LITERALLY TENS AND HUNDREDS OF MILLIONS OF DOLLARS ARE
EXCHANGING HANDS BASED ON BILLS AND THINGS THAT ARE PASSED IN
THE CONGRESS THAT SAYS PEOPLE WITH THIS DEFINITION CAN GET
THIS MONEY AND PEOPLE WITHOUT THAT DEFINITION CAN'T. YOU'D THINK NOBODY CARES.
BUT WHEN WE HAVE MEETINGS WITH PEOPLE LOOKING TO SEE THE
DEFINITIONS, IT'S STANDING ROOM ONLY.
IT SOUNDS OFF THE PATH, BUT IT ISN'T.
--> WELL, YOU ALSO HAVE EXTENSIVE EXPERIENCE IN ISSUES OF RURAL
HEALTHCARE FOR ELDERLY, INFANTS AND UNDERSERVED.
CAN YOU TALK ABOUT THIS AND HOW IT PERTAINS TO NORTH DAKOTA AND THESE DEMOGRAPHICS?
--> ALL OF THOSE GROUPS EXIST IN NORTH DAKOTA.
THERE'S A REAL GEOGRAPHIC DISTRIBUTION PROBLEM WITH THE
HOSPITALS AND ESPECIALLY PROVIDERS.
THE RURAL AREAS -- THE STATE ISN'T PARTICULARLY UNDER --
DOESN'T HAVE ENOUGH OF CERTAIN TYPE OF PROVIDER TYPES BUT
THEY'RE NOT DISTRIBUTED WELL. THEY TEND TO BE IN A FEW BIGGER PLACES.
THERE'S LARGE AREAS. I DON'T KNOW.
3/4s THE STATE IS DESIGNATED AS NATIONAL PHYSICIAN SHORTAGE AREAS.
AND SO THE IDEAS THAT -- FOR US TO FACILITATE GETTING PROVIDERS
OUT THERE, WE HAVE THE MEDICAL SCHOOL TOO, BUT WE DO IT FOR OTHER ENTITIES.
I MENTIONED PHYSICAL THERAPY AND THE OTHER ALLIED HEALTH GROUPS.
PHYSICIANS ASSISTANTS AND OTHERS.
AND THE STATE IS -- NORTH DAKOTA HAS A HIGH PERCENTAGE OF ELDERLY.
SO THEY ARE THE PEOPLE THAT NEED THE CARE THE MOST.
THEY USE THE MOST CARE. AND BECAUSE THE OLDEST PARTS OF
THE STATE ARE PARTS OUT THERE IN THE RURAL AREAS, THE PEOPLE THAT NEED IT THE MOST ARE FAR FROM IT.
THAT'S NOT A GOOD FORMULA FOR HAVING GOOD OUTCOMES.
WE'RE TRYING TO HELP WITH THAT.
--> LET'S TALK ABOUT HOW HAS OR HOW WILL THE HEALTHCARE OVERHAUL
BILL AFFECT THE RURAL AREAS IN OUR REGION?
--> THE ACCOUNTABLE CARE ACT, YOU KNOW, WHICH IS LAW FOR NOW, BUT
IT'S GOING TO MORPH. WE KNOW IT'S GOING TO MORPH IN SOME WAYS.
SO IT'S HARD TO NAIL DOWN EXACTLY WHAT'S GOING TO HAPPEN TO IT.
THERE ARE -- THE ONE AREA WHERE WE'RE -- WE NEED A LOT OF HELP
IN THIS SORT OF TIER OF NORTHERN MINNESOTA AND NORTH DAKOTA IS WITH WORK FORCE.
AND THE BILL IS FILLED -- EVEN THOUGH THERE'S NO RHETORIC ON
TELEVISION OR ANYBODY ELSE THAT IS TALKING ABOUT IT, THAT'S --
IT'S GOT SOMETHING LIKE 150 PIECES TO IT THAT DEAL WITH
GETTING MORE PROVIDERS, INCLUDING PUBLIC HEALTH
PROVIDERS AND PHYSICIAN ASSISTANTS AND NURSE
PRACTITIONERS AND FAMILY PHYSICIANS.
PROBABLY ONE OF THE MOST IMPORTANT PARTS, IT RESTRUCTURES
HOW WE PAY FOR RESIDENCY PROGRAMS.
THAT'S WHERE THE PHYSICIANS GET THEIR LAST TRAINING.
THAT -- IT'S CALLED GME MONEY, GRADUATE MEDICAL MONEY.
IT'S GOING STRAIGHT TO MEDICAL SCHOOLS.
BUT THE ACCOUNTABLE CARE ACT HAS THAT MONEY GOING TO SMALL RURAL
HOSPITALS SO IT'S MORE DIRECT TO SUPPORT THOSE PROVIDERS.
SO THERE'S POSITIVE THAT WAY. THE NEGATIVE SIDES, EVERYBODY KNOWS ABOUT.
MORE PEOPLE GETS COVERED BY INSURANCE AND THERE'S A LOT OF
POORER PEOPLE IN RURAL AREAS SO THEY'RE LESS LIKELY TO BE
COVERED SO IT HELPS IN THOSE WAYS.
THERE'S ALL THE THINGS THAT YOU HEAR ABOUT IN NEWSPAPERS AND
ELSEWHERE ABOUT THE -- YOU KNOW, THE MANDATE AND WHETHER OR NOT THAT IS CONSTITUTIONAL.
THERE'S ALL THE PARTS THAT ALL OF US DON'T KNOW ABOUT.
--> SO SOME PROVISIONS MAY BE HARDER TO IMPLEMENT AND MAY BE PROPMATIC?
--> RIGHT. THERE'S PARTS OF THE BILL -- THE BILL IS LAW NOW.
BUT WHILE IT'S PASSED, LOTS OF -- PARTS OF IT AREN'T FUNDED.
FOR INSTANCE, THERE'S A BUNCH OF WORK FORCE THINGS LIKE HAVING A
NATIONAL PLANNING COMMISSION. AND THAT COMMISSION HAS BEEN
FORMED, BUT THE MONEY HAS NEVER BEEN APPROPRIATED FOR THEM TO MEET.
SO THERE'S PARTS OF IT THAT ARE JUST AT A STANDSTILL UNTIL
CONGRESS DOES OR DOES DON'T SOMETHING ABOUT IT.
--> CAN YOU TALK ABOUT THE CURRENT STATE OF RURAL HEALTHCARE IN THE REGION?
OF COURSE YOU SAY YOU'VE BEEN HERE A FEW MONTHS.
SO A SHORT TIME. HAVE YOU HAD A CHANCE TO TOUR ANY OF THE FACILITIES?
--> A LITTLE BIT. I'M SORT OF TRYING TO GET OUT OF
MY DRIVEWAY WITH MY 12-FOOT DRIFT.
I LIVE OUT ON A FIVE ACRE PLOT OF LAND, WHICH IS A GREAT IDEA.
WE GOT CHICKENS AND, YOU KNOW, WE'VE SEEN SOME OF THE HEALTHCARE.
MY DAUGHTER FELL OFF THE ROOF OF THE CHICKEN COOP AND THINGS LIKE THAT.
BUT WE'RE -- I'M MEETING MOST OF THE PEOPLE AT THE UNIVERSITY AND
THINGS RIGHT NOW AND SPENDING MY TIME RE-ORGANIZING THE CENTER.
AS SPRING GOES, WE'RE GOING TO GO ON A FEW FIELD TRIPS OUT
THERE AND JUST DO SOME BIG LOOPS AROUND THE STATE AND VISIT AS MANY OF THE PLACES.
THERE'S 36 CRITICAL ACCESS HOSPITALS IN RURAL AREAS.
I'M GOING TO TRY TO VISIT ALL OF THEM BEFORE THE YEAR IS OVER.
--> YOU MENTIONED THE DELIVERY AND THE ACCESS AND LOCATION
BEING THE BIG FACTORS IN TERMS OF PEOPLE NOT BEING AS CLOSE TO
HOSPITALS AND CLINICS AND THOSE OF NEWS THE MAJOR CITIES.
HOW DO YOU LOOK AT THAT OR ADDRESS THAT?
--> AGAIN, WE KNOW SOME THINGS ABOUT -- I TALK ABOUT PHYSICIANS.
THERE'S ALWAYS OTHER PROVIDER TYPES.
FOR PHYSICIANS, SOME OF THE THINGS WE KNOW IS THAT IF YOU
RECRUIT RURAL KIDS AND YOU PUT THEM THROUGH A MEDICAL SCHOOL
THAT IS ORIENTED RURAL AND THEY DO A RESIDENCY THAT IS RURAL AND
THERE IS PRIMARY CARE, THE ODDS OF THEM GOING TO A RURAL PLACE
ARE FIVE, SIX, SEVEN, EIGHT TIMES MORE PLACES THAN IT WOULD
BE TRUE IF YOU TOOK A CAN IT FROM MANHATTAN AND PUT HIM IN
HARVARD AND TRIED TO GET HIM TO COME OUT HERE IN THE CAN-DO.
IF THAT MAKES SENSE. BUT WE DON'T DO IT MUCH.
NOT “WE”. THE UNIVERSITY OF NORTH DAKOTA IS PRETTY GOOD AT IT.
AS A U.S. POLICY, THAT ISN'T HOW WE ADDRESS THINGS.
JOHNS HOPKINS GETS THE SAME MONEY FOR TRAINING PEOPLE TO
HELP THE POOR AS THE UNIVERSITY OF NORTH DAKOTA.
SO WE DON'T DIFFERENTIATE. SO THERE'S A LOT WE COULD DO AT
THE FEDERAL LEVEL TO POINT THE MONEY BETTER, BUT WE -- AGAIN,
IT'S PICKING THOSE KIDS, TRAINING THEM SO THEY DON'T JUST
GO AWAY TO A CITY AND GET THEIR TRAINING AND THEN DON'T WANT TO GO BACK.
IF YOU -- IT KEEPS -- BEING A THORACIC SURGEON IS THE ONLY
THING TO BE AND YOU HAVE TO HAVE THIS HAWAII -- HUGE HIGH TECH
AND THIS BIG HOSPITAL, THEY'RE GOING TO STAY THERE.
SO THEY NEED THE TRAINING, GOING OUT WITH A RURAL DOC.
YOU HAVE TO DEAL WITH THE AM BUIGITY OF NOT BEING A SPECIALIST.
IN NORTH DAKOTA AND NORTHERN MINNESOTA FOR THAT MATTER, WE
NEED MORE OF THOSE FEMALE PHYSICIANS TO GO TO RURAL AREAS
OR WE'RE GOING TO BE MORE SHORT THAN WE ARE.
--> ARE WE SEEING HOSPITALS IN RURAL AREAS AND CLINICS BEING
ABSORBED -- AGAIN, NOT NECESSARILY IN THIS REGION.
WE'RE SEEING SOME OF THAT. AGAIN, IN OTHER PLACES, ARE THEY JUST BEING TAKEN OVER?
--> YOU KNOW, VARIES A LOT BY WHERE YOU ARE.
IN SOME AREAS -- IT'S A -- PLACES THAT ARE HIT THE MOST
ECONOMICALLY BY THE RECESSION HAS NOT BEEN TAKING PLACE.
YOU DON'T MAKE A LOT OF MONEY OUT OF THOSE PLACES.
HOSPITALS THAT ARE STRUGGLING FOR THEIR SURVIVAL ARE NOT
RUNNING AROUND BUYING -- TAKING OVER SMALL HOSPITALS AND THINGS.
IN THIS REGION, HASN'T BEEN SO MUCH THAT AS A LOT OF -- THEY DO
THINGS WHERE THEY HELP THE HOSPITALS IN TERMS OF BUYING DIFFERENT THINGS.
BULK BUYING. THEY HELP THAT WAY.
SOME DO MANAGEMENT CONTRACTS WITH THE HOSPITAL SO THEY HELP
WITH THE TECHNICAL PART OF HAVING THE RIGHT MANAGEMENT
TEAMS WITH THE RIGHT TRAINING AND THINGS AT SOME HOSPITALS.
THEN THERE'S SOMEWHERE THEY HAVE ACTUALLY -- THEY DON'T LIKE TO USE THE WORD MERGE BUT HELP.
SO WITH THEORY, WITH THAT TAKING PLACE, IS WHEN TIMES GET BAD.
WHAT DO YOU JETTISON FIRST? IT'S NOT THE BIG HOSPITAL IN THE CITY.
IT'S A RURAL PLACE. THERE'S NOT MUCH EVIDENCE I'VE SEEN SO FAR.
BUT AGAIN, I'M NEW. IT'S ALTRUISTIC TO ME.
--> HOW DOES RURAL NORTH DAMAGE AND THE PRAIRIE REGION DIFFERENT
FROM PLACES BEFORE LIKE ARIZONA, WASHINGTON?
THE RURAL POPULATIONS AND HOW HEALTHCARE IS ACCESSED.
--> IT'S OLDER IN GENERAL. PARTS OF WASHINGTON --
WASHINGTON IS REALLY TWO STATES. THERE'S THE SEATTLE, TACOMA,
THAT AREA THAT IS VERY URBAN. IF YOU GO TO THE EASTERN PART OF
THE STATE, IT'S NOT ALL THAT DIFFERENT.
IT IS WHEAT FIELDS AND ORCHARDS AND THAT SORT OF AGRICULTURAL ENTITY.
IT'S A LOT LIKE HERE. AGAIN, THAT I HAVE SHORTAGES OF
PROVIDERS JUST LIKE EVERYWHERE ELSE IN RURAL AMERICA.
ARIZONA IS A VERY DIFFERENT KIND OF PLACE.
LIKE I MENTIONED, IT'S RURAL. PLACES ARE MORE DISTANCE.
THERE'S LESS OF THEM. THAT'S A SMALLER PERCENTAGE OF THE POPULATION.
AND WE'RE TALKING ABOUT, YOU KNOW, 180 MILES TO THE NEAREST
ANYTHING KIND OF PLACES. SO THEY HAVE TO BE MORE
SELF-SUFFICIENT THAN SOME OF THE ONES THAT DO HERE.
IT'S A MUCH LARGER PART OF THE POPULATION.
--> YOU MENTIONED THE ELDERLY POPULATION IN NORTH DAMAGE AND THE RURAL AREAS AND SMALL TOWNS.
HOW MUCH OF A CHALLENGE IS THAT FOR YOUR CENTER?
--> IT'S -- THE OLDERLY -- WE SORT OF ALLUDED TO IT EARLIER.
THE ELDERLY ARE THE FOLKS -- WHO USES THE PIE OF ALL THE RESOURCES?
IT'S THE ELDERLY. VERY DISPROPORTIONATE SHARE.
IF YOU ARE STARTING TO GET OLDER LIKE ME, YOU UNDERSTAND WHAT THAT'S ABOUT.
MORE AND MORE YOU NEED TO SEE DOCTORS AND GETS SERVICES.
AS PEOPLE GET OLDER, THEY HAVE ALL THESE CHRONIC DISEASES AND
THEY HAVE TO SEE PROVIDE ORS MORE OFTEN.
DURING THE LAST YEARS OF LIFE, I FORGOT THE NUMBER, BUT I THINK
IT'S -- THE LAST TWO YEARS OF LIFE TAKE UP SOMETHING LIKE 70%
OF THE HEALTH RESOURCES IN THE COUNTRY.
SO THOSE ARE THE USERS. THEY NEED LOTS OF CARE.
OF COURSE, THEY'RE THE LEAST LIKELY TO TRAVEL AND THEY HAVE
THE LEAST RESOURCES IN THE AREA IS WHERE THEY ARE.
SO IT'S AN ISSUE. TRANSPORTATION IS AN ISSUE FOR THEM.
WHEN YOU TAKE THEM TO THE CITY AND THEY'RE SEPARATED FROM THE
KIDS AND THEIR FAMILIES, THEY'RE NOT GOING TO DO AS WELL EITHER.
THERE'S A LOT OF ISSUES AROUND THAT.
--> OKAY. LET'S GO BACK TO THE CENTER.
HOW IS UND RURAL HEALTH FUNDED AND TELL US ABOUT ITS HISTORY IF YOU CAN.
--> THE CENTER -- THE CENTER IS FUNDED MOSTLY WITH FEDERAL MONEY.
SOME GRANTS FROM FOUNDATIONS IN ALIKE.
ACTUALLY THE STATE OF NORTH DAKOTA PAYS ABOUT 5% OF THE
INCOME OF THE CENTER. SO IT'S AN IMPORTANT 5%.
WE USE A LOT OF THAT FOR THE RECRUITMENT, RETENTION KINDS OF THINGS WE'RE DOING.
A LOT OF THE MONEY WE GET IS FEDERAL MONEY THAT COMES TO DO
STATE -- THAT DO PROGRAMS FOR THE FEDS TO HELP STATES.
FOR INSTANCE, I THINK I MENTIONED THE SMALL RURAL
HOSPITAL FLEXIBILITY PROGRAM. THERE'S 36 CRITICAL ACCESS HOSPITALS.
WE GET GRANT MONEY EVERY YEAR AND HAVE FOR A DECADE TO GO OUT
AND HELP THOSE HOSPITALS FIGURE OUT WAYS OF SURVIVING, HELP THEM
WITH QUALITY RE-ASSURANCE, EMERGENCY ROOMS.
WE HAVE PEOPLE IN THE FIELD. A LOT OF THE STAFF HELPS IN THE FIELD.
SOMETHING FROM ANOTHER STATE THAT HAS THE EXPERTISE MIGHT BE BROUGHT IN TO HELP.
--> AND SO YOU'RE MAKING AN IMPACT THEN IN NORTH DAKOTA?
--> THAT'S THE -- THAT PARTICULAR PROGRAM THAT I'M NAMING THERE IS ONE OF THOSE.
THE STATE OFFICE OF RURAL HEALTH GRANT SYSTEM THAT IS PAID FOR BY
THE FEDERAL OFFICE OF RURAL POLICY ALSO DOES A LOT OF RECRUITMENT AND RETENTION.
WE DO SCRUB CAMPS. KIDS GROWING UP IN RURAL PLACES
CAN SEE THE VISION OF THEIR BECOMING A HEALTHCARE PROFESSIONAL.
THEY CAN BE WITH DOCTORS AND CALL THEM SCRUB CAMPS WHERE THEY
SCRUB UP, WEAR MASKS AND EVERYTHING. BUT THAT'S INTO MIDDLE SCHOOL.
--> SO WHAT ARE YOUR MAIN GOALS AS CENTER DIRECTOR AS YOU TAKE OVER THIS POSITION?
--> I ALWAYS KID NOT TO SCREW IT UP.
IT'S WELL-KNOWN. IT'S NATIONALLY KNOWN AND DOING A VERY GOOD JOB.
HAS A 60 FTEs. THAT'S A FULL TIME EQUIVALENT. 60 PEOPLE.
AGAIN, IT'S THE AREA THAT IS MY BIGGEST CHALLENGE AND THE
MOST -- IT'S GETTING THE RESEARCH SIDE OF IT TO BE STRONGER.
YOU SAY THAT'S KIND OF, AGAIN, POINTY HEADED.
THE IDEA OF DOING THE RESEARCH IS ONE IT BRINGS MONEY INTO THE
STATE THAT WE WOULDN'T HAVE OTHERWISE.
THAT MONEY COMES FROM THE FEDS OR OTHER SOURCES, FROM FOUNDATIONS.
SECONDLY WE HAVE THE ABILITY TO TAYLOR IT TO ANSWER QUESTIONS
THAT THIS LEGISLATURE WANTS TO KNOW, HELPING FACILITATE WHICH
THINGS WORK AND WHICH THINGS DON'T.
--> IF PEOPLE WANT MORE INFORMATION, WHERE IS THE BEST PLAY TO GO?
--> IF YOU LOOK AT THE CENTER FOR RURAL HEALTH, YOUTH OF NORTH
DAKOTA ON THE WEB, YOU'D HIT OUR PAGE.
WHEN YOU'RE THERE, YOU'LL FIND OUT WE HAVE TWO OTHER PAGES.
WE RUN THE BIGGEST WEBSITE IN THE WORLD ON RURAL HEALTH CALLED
THE RURAL ASSISTANT CENTER. WE RUN THE BIGGEST ONE ONHEALTH
WORK FORCE THAT THEY PAY US TO RUN, TO PROVIDE TECHNICAL
ASSISTANCE ALL OVER THE COUNTRY. WE HAVE THOSE THERE.
WE GAIN FROM THAT BECAUSE WE GAIN ALL THE EXPERTISE IT TAKES TO DO IT.
--> WE THANK YOU SO MUCH FOR JOINING US TODAY.
WE WISH YOU THE BEST IN YOUR NEW POSITION.
--> THANKS VERY MUCH. GLAD TO BE HERE.
--> IN ELK RIVER, MINNESOTA, THERE'S A PLACE THAT ALLOWS PEOPLE TO WALK INTO THE PAST.
THROUGH A LIVING HISTORY PROGRAM AND HANDS-ON LEARNING
EXPERIENCES, THE KELLY FARM OFFERS PEOPLE THE CHANCE TO NOT
ONLY LEARN ABOUT MINNESOTA'S AGRICULTURAL HISTORY BUT THEIR
--> THE KELLY FARM STARTED IN 1850 WHEN OLIVER AND LUCY KELLY
CAME UP FROM ST. PAUL AND TOOK A CLAIM OF 160 ACRES ON THE MISSISSIPPI RIVER.
OLIVER AND HIS WIFE DID NOT INTEND TO FARM.
IT WAS MORE OF A LAND SPECULATION ACTIVITY.
THE KELLIES OWNED THE PROPERTY FROM 1888 TO 1901.
IT WAS A RENTAL PROPERTY. THEY SOLD IT.
1935, THE FARM WAS PURCHASED BY THE NATIONAL GRANGE IN A
FORECLOSURE SALE AND TURNED INTO A HISTORIC SITE.
THE MINNESOTA HISTORICAL SOCIETY OWNERSHIP TOOK OWNERSHIP IN 1961.
THE CURRENT LIVING HISTORY PROGRAM STARTED IN 1981.
--> I LOVE THE LEARNING ASPECT OF IT.
BECAUSE AS MUCH AS I GET TO TELL OTHER PEOPLE AND TEACH THEM AND
GET THEM TO LEARN AND ENGAGE IN HISTORY AND GET EXCITED ABOUT
HISTORY AND THE DIFFERENT WAYS TO DO THINGS, I LEARN JUST AS
MUCH IF NOT MORE FROM THE OTHER PEOPLE THAT I GET TO WORK WITH
ON AN EVERYDAY BASIS. SO I GET TO COMMUNICATE JUST A
FRACTION OF WHAT THERE IS FOR ME TO LEARN AS A PERSON AS WELL.
--> THE KELLY FARM TODAY AS ONE OF THE STATE'S HISTORIC SITES IS AN EDUCATIONAL FACILITY.
WHAT WE DO IS WE TELL PEOPLE IN ESSENCE TEACH MANY OF THEM, WHAT
LIFE IS LIKE IN MINNESOTA'S VERY EARLY STAGES.
--> WE HAVE EIGHT VERY LARGE ANIMALS.
FOUR HORSES AND FOUR OX, PIG, SHEEP.
ALL OF THAT TAKES QUITE AN EFFORT IN TERMS OF DAY-TO-DAY
CHORES AS WELL AS RAISING THE FOOD TO KEEP THE CRITTERS GOING
SO EITHER THEY GO TO MARKET OR BECOME OR MOMMAS OF THE FUTURE OR WHATEVER.
SO THE LIVESTOCK ARE ONE OF THE SPECIAL THINGS HERE.
--> WE FOLLOW THE CYCLE OF THE SEASONS.
IN THE SPRING WE PLANT WITH OUR VISITORS.
IN THE SUMMER WE HARVEST WITH THE VISITORS.
IN THE FALL WE HARVEST AND PROCESS AND START A PLANTING CYCLE AGAIN.
IN THE WINTER MONTHS, WE TEND LIVESTOCK AND DO, AGAIN, SOME OF
THE SAME TASKS THAT FARMERS DID ON THE FARM 100 YEARS AGO.
WE ARE A 12-A-MONTH SITE. IT'S A HANDS-ON WORKING PLACE TO
FIND OUT MORE ABOUT AGRICULTURE AND MINNESOTA'S HISTORY AND ONE'S OWN HISTORY.
--> WE GET ALL KINDS OF PEOPLE ACTUALLY.
A GOOD MAJORITY OF WHAT WE GET ARE SCHOOL GROUPS.
IN THE SPRING AND THE FALL, WE HAVE LARGE GROUPS OF KIDS COMING THROUGH.
WE HAVE A LOT OF KIDS THAT -- DESPITE WHERE THEIR PARENTS ARE
ON THE FARM, THEY'RE SITTING IN THE HOUSE AND THEY JUST WANT TO DO SOMETHING.
THEY WANT TO BE HELPFUL, LEARN THROUGH THE EXPERIENCE.
THEY ENJOY DOING WORK. THAT'S THE ONE COMMENT WE GET FROM MOST PARENTS.
IT'S LIKE, I CAN'T GET THEM TO DO THIS JOB AT HOME.
THEY'LL COME AND DO IT ALL DAY. SO FOR KIDS, IT'S A LOT OF DOING.
THE PARENTS COME IN AND THEY LIKE TO LEARN THE HISTORY OF THE
KELLIES AND WHAT LIFE WAS JUST LIKE AND HOW DIFFERENT AND HOW
THINGS HAVE COME SO FAR OVER TIME.
--> WE GET SENIOR MEMBERS WHO REMEMBER BEING RAISED ON A FARM AND ARE NOSTALGIC.
THEY'RE JUST A TON OF FUN. THEY PROBABLY HAVE AS MANY
EXPERIENCES AS ANY OF THE INTERPRETERS.
WE LEARN FROM THEM. THEY CAN LEARN FROM US AS WELL.
--> WE HAVE 189 ACRES HERE. WE HAVE THIS VERY MAGICAL LIVING
HISTORY SITE THAT TRANSPORTS PEOPLE IN SOME WAYS BACK TO AN
EARLIER TIME PERIOD AND LET'S THEM COME VERY CLOSE TO AGRICULTURE.
--> IT'S SO UNIQUE AND SO SPECIAL IN THE HISTORY.
AND I GUESS I'M BIASED A LITTLE BIT BECAUSE I WAS A FARM KID WHEN I WAS GROWING UP.
AND IT WASN'T 150 YEARS AGO QUITE WHEN I WAS GROWING UP.
BUT IT REALLY SEEMS LIKE OUR GENERATION CONTINUES TO GET MORE
DISTANCE AND AWAY FROM WHERE DOES THE FOOD COME FROM, WHERE DOES OUR CLOTHING COME FROM.
HOW DOES THAT WORK. SO MANY YOUNG PEOPLE I DON'T
THINK HAVE ANY CHANCE MAYBE TO LEARN ABOUT THAT.
AND THIS IS A PLACE WHERE MAYBE THEY CAN GET A TOUCH OF THAT ANYWAY.
IN SOME WAYS, WE WANT TO BECOME MINNESOTA'S FAMILY FARM FOR
GENERATIONS OF MINNESOTANS. WE'RE GOING TO TELL MORE OF AN AGRICULTURAL STORY.
--> PEOPLE A LONG TIME AGO ARE THE SAME THEY ARE TODAY.
THEY JUST HAD TO DO THINGS DIFFERENTLY.
YOU CAN GET EXCITED ABOUT THE WAY THINGS WERE DONE THEN JUST
ABOUT THE SAME WAY AS YOU CAN THE NEWEST CELL PHONE OR COMPUTER.
--> I LOVE THE PLACE.
--> WELL, THAT'S ALL WE HAVE ON PRAIRIE PULSE FOR THIS WEEK.
--> FUNDING FOR MINNESOTA LEGACY PROGRAMS ARE PROVIDED BY A GRANT
FROM THE MINNESOTA ARTS AND CULTURAL HERITAGE FUND WITH
MONEY FROM THE VOTE OF THE PEOPLE OF MINNESOTA. ON NOVEMBER 4th 2008.