Organization Newsletter

March 2018

In this issue...

  1. Executive Director Update
  2. Getting to Know Your Board Member - Jeff Sund 
  3. Meaningful Work - Get Involved (2018 NRHA Policy Institute)
  4. New Appointment in WWAMI AHEC Office
  5. Welcome New & Returning Sponsors and Organizations!
  6. Telepsychology to Support Physicians and Their Patients By Trevor Davis, PsyD
  7. Helping Our Community Thrive
  8. Keeping You in the Know
  9. Know Your Heart and Signs of Heart Disease
  10. Rural Issues in Washington's Behavioral Health Workforce
  11. Last But Not Least


Welcome to the
March 2018 issue of the Washington Rural Health Association e-Newsletter.
Inside this issue you will find news and information from the Executive Director and board of directors, members, and community partners from across the state of Washington. 

If you would like to submit your own story, please click here.

The WRHA e-newsletter is a publication of Washington Rural Health Association, a not-for-profit association composed of individual and organization members who share a common interest in rural health. This e-newsletter seeks to disseminate news and information of interest to rural health professionals and stakeholders to help establish a state and national network of rural health care advocates.

WRHA Members

WRHA members include administrators, educators, students, researchers, government agencies and workers, physicians, hospitals, clinics, migrant and community clinics, public health departments, insurers, professional associations and educational institutions. If you are interested in joining or renewing your membership with WRHA click here.


Executive Director Update

Submitted by:  Beionka Moore
[email protected]

Washington states rural voice was heard in Washington D.C!  For a second year in a row members of Washington Rural Health Association’s leadership team served as the state contact, to represent interests of WRHA members at NRHA’s 29th Rural Health Policy Institute.  We were joined by over 400 fellow rural health stakeholders.  One of the important functions was to reach out to members of Congress to schedule Capitol Hill meetings. The Rural Health Policy Institute is the largest rural advocacy event in the country and brings together members of Congress, the administration, public health officials, and health care experts from across the nation.

Many interesting events happened this year as you might imagine. Not sure how this happened, however it was a delight to witness.  We managed to be on the Hill at the same time House Minority Leader Nancy Pelosi (D-Calif.) set a record for the longest speech in the chamber history.  In her speech, Pelosi read letters from recipients of the Deferred Action for Childhood Arrival (DACA) program who have found jobs using the program's work permits.  Reading a note from a colleague, Pelosi noted shortly after 5 p.m., that she had set the record for the longest House speech on record since at least 1909, breaking the record held by former Speaker Champ Clark (D-Mo.), who held the floor for five hours and 15 minutes to protest tariffs.  What a day February 6th was!  It will go down in history in more ways than one.
It was no surprise that a mass of legislation to support rural providers and facilities passed the same week that we showed up to advocate for the needs of underserved rural communities across our country.  The work was difficult yet rewarding on many levels. I felt like they were listening and we were being heard.  The message and one of the asks was for members to renew their commitment to rural Americans and reauthorize funding.  

As Congress begins to construct their infrastructure package, we stressed that it is critical that we build small rural health investments into this legislation.  Hospitals are often the first or second largest employer in the community.  If the hospital cannot keep its doors open, we lose thriving, healthy communities.  Since 2010, 83 rural hospitals have closed. 674 additional facilities are vulnerable and could close—this represents over 1/3 of rural hospitals in the U.S.  And over a hand full of those are right here in our state.  After a brief government shutdown, Congress finally acted on their promise to support rural providers and facilities.

The bipartisan budget agreement includes a two-year extension for community health centers, Medicare dependent hospitals, low-volume hospital adjustments, rural ambulance payments, Medicare therapy caps, and the geographic index floor under the Medicare physician fee schedule.  Additionally, the legislation provides for a full 10-year extension of the Children’s Health Insurance Program and 6 billion in additional funding to address the opioid crisis.  As Congress begins to construct their infrastructure package, it is critical that we build small rural health investments into this legislation.  As Congress begins to construct their infrastructure package, it is critical that we build small rural health investments into this legislation.  Hospitals are often the first or second largest employer in the community… if the hospital can keep its doors open.  Since 2010, 83 rural hospitals have closed. 674 additional facilities are vulnerable and could close—this represents over 1/3 of rural hospitals in the U.S.  Some of those are right here at home.  

Beionka Moore and Jacob Thatcher     Beionka Moore and Maeve McClellan

We couldn’t have chosen a better time to tell your stories and advocate for rural health care.  The following advocates accompanied me on Capitol Hill visits:  Geri Forbes, CEO, Whidbey Health; Krystal Guzman, Reimbursement & Quality Analytics Coordinator, RHCAW; Sarah H. Huling, Sonographer, RHLR Board, Forks Community Hospital; Jacob Thatcher, Pacific Northwest University of Health Science School of Medicine; Weston Davis, Executive Director, Rural Health Initiatives, Inland Imaging; and Maeve McClellan, Director, Practice Transformation, Caravan Health, National Rural Accountable Care Consortium.

Beionka Moore & Krystal Guzman                 Beionka Moore, Maria Cantwell, and Weston Davis

We were fortunate to meet with the following: 

Co-Chair of the House Rural Health Care Coalition: Representative Cathy McMorris Rodgers, 5th Congressional District
Representative Rick Larsen, WA-02, Erin Schneider Press Assistant & Scheduler
Representative Suzan DelBene, 1st Congressional District
Representative Pramila Jayapal, Ven Neralla, Legislative Assistant
Senator Maria Cantwell and Nico Janssen, Legislative Assistant

Washington Rural Health Association is passionate and dedicated to what we do.  We are privileged to have members that show commitment to rural, it is truly commendable.  Finding people that want to work or volunteer in rural communities is one of our greatest challenges.  We are grateful for our relationship with you, and we continue to look forward to interacting with you over the coming months and years.  As a strong and diverse rural community, the WRHA does a fantastic job of pulling all rural stakeholders together; thereby, making rural’s voice louder, stronger and heard.  Let us know how we can continue to best serve you!

Thank you.


Beionka Moore

return to the top

Getting to Know your Board Member!

With each publication, we would like to introduce a member of the WRHA Board of Directors.
This edition features the Board of Directors Member, Jeffrey Sund:

Please tell me your name, where you work, title, your role with WRHA and how long you have been a board member?
Jeff Sund, Nuvodia, LLC, Sr. Account Executive.  Board Member  - 1.5 years

Q:     How did you first become involved with the Washington Rural Health Association?
Attended WRHA Annual Conference as an exhibitor.

Q:      There are several rural health organizations in Washington State. Why did you choose to work with WRHA?
The area and organizations/members served by WRHA aligned well with the organization I work with in my every day job and my personal interests in serving/bettering the needs of rural health across the NW region.

Q:      Why is Rural Health important to you?
Because I believe all Americans---regardless of where they live---should have access to equal level of healthcare at similar cost.

Q:     What has surprised you most about working with Washington Rural Health Association?
The breadth / wide diversity of rural healthcare needs.

Q:     What is the best part of working with WRHA?
Ability to engage with folks who have strong knowledge / expertise in rural health and are passionate about improving rural health across the region.

Q:     What do you see as some of the most challenging issues facing WRHA and Rural Health in our state?
The ability to have enough highly skilled / specialized providers serving in rural health locally, and cost effectively.

Q:     What do you wish other people knew about Washington Rural Health Association?
The vast knowledge available regarding currently rural health issues + challenges across the region.

Q:     If you could change one thing about Washington Rural Health Association what would it be?
A:     Nothing jumps out at me just now....

Q:    Do you volunteer for any other organizations? Why do you feel it is important to volunteer?
Not currently.  It’s important as a way to give back / to serve the needs of the community you are part of.

Q:    How do you like to spend your time outside of work and volunteering?
A:    Doing things with my family and all things outdoors.

Q:    What might (someone) be surprised to know about you?
That I’m a twin.

Q:    What do you think will change about Washington Rural Health Association over the next five years?
A:    That there will be even greater challenges / needs for rural health brought to or identified by WRHA.

return to the top

Meaningful Work - Get Involved! (2018 NRHA Policy Institute)

Submitted by:  Sarah Huling, BS. ARRT, ARDMS,
2017 NRHA Fellow, MBA Rural Healthcare (2017-2019)
Forks Community Hospital

I am honored and grateful for my experience over the last year with the NRHA Fellows program.  I come from the “trenches” - a self-help junkie with X-ray vision, and ultrasonic super-tech powers.  My rural roots originate from the coal mines of West Virginia, to the suburban sprawl of the Willamette Valley, and back to where “the mountains meet the sea”---the beautiful Olympic Peninsula of Washington State is where I currently reside.  My original intent was to help for a year in this modest isolated rural logging community, but that has turned into 12 years, two dogs, two houses, two kids, and luckily so far, one husband later.  I think I might stay for a while!  Forks, Washington was put on the global map as “the Logging Capital of the World” in the 1970’s to current day in the famous “Twilight” saga.  The Forks Community and its hospital were well established by 1947, before its 15 minutes of fame.  I am endearingly referred to by the “true” locals, yes; these are my in-laws, as an “eternal transplant”.  The community’s hospitality, grit, self-sufficiency, and “can-do” attitudes are what inspire me to advocate for rural health.  I look forward to this opportunity, to continue in the learned leadership and advocacy skills this fellowship has provided to help lead the future of rural health in my community and set a standard for America’s healthcare.

For more than 30 years, the National Rural Health Association has been serving rural communities by advancing and publicizing rural health issues and seeking to solve rural health care challenges.  NRHA is the only national organization with a clear mission to:
Improve the delivery of health services in rural areas through its many members and staff.
Help rural citizens build, maintain, and improve the institutions that can meet their health care needs by providing research, education, leadership and informational support.

NRHA’s activities bring together:

·       Residents of rural communities
·       Rural health professionals of all specialties
·       Representatives of state, local and national governments
·       The full range of private sector rural health organizations

During the NRHA’s 2017-2018 Fellows program I was assigned along with three of my fellow fellows to research, write, and present a rural specific EMS policy for the NRHA.  Once the EMS policy is agreed upon by the collaborative rural specialists in the Congress, it then is officially policy of the NRHA and utilized on Capitol Hill with State and Federal Legislators to help guide their decisions with a rural perspective.   My experience over the last year has truly helped develop my professional leadership skills and molded my rural advocacy passion.  

Again, my heart is full of gratitude for organizations like the Washington Rural Health Association and NRHA.  Washington Rural Health Association coordination of my experience over the last year has been an invaluable resource for me, as well as, your encouraging support providing a source of strength.  Your efforts are refreshing and enduring.  I know I am not alone in this fight for my rural community. 

First Picture:  Senator Maria Cantwell; Sarah H. Huling, Sonographer, RHLR Board, Forks Community Hospital

Second Picture:  Cathy McMorris Rodgers;Geri Forbes, CEO, Whidbey Health; Krystal Guzman, Reimbursement & Quality Analytics Coordinator, RHCAW; Sarah H. Huling, Sonographer, RHLR Board, Forks Community Hospital; Weston Davis, Executive Director, Rural Health Initiatives, Inland Imaging; Maeve McClellan, Director, Practice Transformation, Caravan Health, National Rural Accountable Care Consortium; and Beionka Moore, Executive Director, WRHA

       New Appointment in the WWAMI AHEC Program Office!

Submitted by: Stacey Morrison
[email protected]

Stacey Morrison, M.L.I.S., of Seattle, Washington, has been named the University of Washington School of Medicine (UWSOM) Program Operations Specialist for the WWAMI AHEC Program Office.  As a key member of the Washington, Wyoming, Alaska, Montana, and Idaho Area Health Education Center (WWAMI AHEC) team, Ms. Morrison will be responsible for the oversight of five AHEC centers in Washington and Idaho, managing the day-to-day operations of the WWAMI AHEC Program Office and the strategic growth of the WWAMI AHEC program.  Ms. Morrison reports directly to Dr. John McCarthy, the Assistant Dean for Rural Programs. 

In her new role, Ms. Morrison is tasked with working with the WWAMI AHEC Program and Centers to improve the quality and distribution of all health professionals in our mostly rural region.  This includes implementing and evaluating primary care education and training activities, promoting community-based experiential training, and delivering professional education and support, including continuing clinical education for rural health professionals across the region.  Ms. Morrison will also lead the development and implementation of the new WWAMI AHEC Scholars Program.  The Scholars Program will be one of the most robust inter-professional education experiences in the UWSOM.  Following an initial planning year, the program will enroll cohorts of 90-130 inter-professional students each year. 

Additionally, she will serve as the primary liaison and point of contact for the WWAMI AHEC Program Office, fielding inquiries from health sciences students, faculty, staff, community partners, stakeholders, and the public while continually supporting and assisting the regional AHEC Centers.  Ms. Morrison previously held the position of Project Manager of the Healthier Washington Practice Transformation Support Hub Resource Portal (The Portal), in the UW Family Medicine Research Section. Developed as a partnership between the University of Washington's Department of Family Medicine Primary Care Innovations Lab (PCI-Lab) and the Washington State Department of Health, the project was supported by the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. 

Prior to her work on The Portal (, Ms. Morrison managed the UW Family Medicine required third-year six-week medical clerkship, disseminating online curriculum, testing and evaluation of medical students and providing support and continuing medical education to their preceptors across the five-state WWAMI region.  Ms. Morrison moved to Seattle from Bloomfield, New Jersey in 2011 to attend the University of Washington's graduate program in Library and Information Science.  She also holds a Master of Arts degree in English, with a concentration in rhetoric and composition.

return to the top

Welcome and Thank you to New & Returning Sponsors!

Submitted by:  Beionka Moore
[email protected]

In 2017, Kaiser Permanente acquired Group Health Cooperative and its subsidiaries, which have been caring for members in Washington since 1947.  Now Kaiser Permanente Washington serves more than 710,170 members and supports the health of communities in Northwest Washington, Central Washington, Eastern Washington, the Coastal and Olympic region, and Puget Sound.

 Our mission:
Kaiser Permanente exists to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve.

Our vision:
We are trusted partners in total health, collaborating with people to help them thrive and creating communities that are among the healthiest in the nation.

Founded in 1896, MultiCare Deaconess Hospital has a legacy of providing outstanding care to the Inland Northwest. Our dedicated staff and physicians provide not only excellence in clinical care, but also personal, compassionate service to patients and their families. We strive to do the right thing each and every time, and aim to be a place of healing, caring and connection for our community. We believe responsiveness, efficiency and innovation create value in everything we do.

Our 388-bed facility offers high-quality inpatient, outpatient, diagnostic imaging, medical, surgical and emergency services. As an acute care hospital, we have a Level III Trauma Center, a Certified Chest Pain Center, a Certified Total Joint Restoration Center, an accredited Primary Stroke Center and are the only hospital in the area to be nationally accredited in bariatric surgery. Deaconess also features a Maternal Fetal Medicine program and Level III Neonatal Intensive Care Unit. Deaconess Hospital — along with MultiCare Valley Hospital and MultiCare Rockwood Clinic — is proud to be a part of MultiCare Health System, a locally owned, not-for-profit health care system, and to be a part of MultiCare's mission of Partnering for Healing and a Healthy Future.

People Come First
Amerigroup focuses on improving health and wellness one member at a time, by doing the right thing for every member every time. We engage and support members and their families to be active participants in their care and to help them make healthy, informed decisions.

Whole Person Care
Integration is at the heart of our philosophy and approach to the coordination of benefits and services. Our person-centered model helps members access the full array of comprehensive high-quality services and supports they need.

Getting Results
Amerigroup seeks out new and better ways to improve member health outcomes, quality of life, and access to high quality, cost-efficient care and services. We achieve positive outcomes for members and generate value for states through our innovative approaches.


Columbia Valley Community Health, Wenatchee
Forks Community Hospital, Forks
Snoqualmie Valley Hospital, Snoqualmie
WhidbeyHealth, Coupeville


Mary Danner, Premier Insurance Management Services, Inc.
Heidi Desmarais, Preventive Health Specialists
Trisha Killany, Diligent Anesthesia
Stacey Morrison, WWAMI AHEC Programs
Marica Naillon, North Valley Hospital
Phil Slaton, The Icon Group

return to the top

 Telepsychology to Support Physicians and Their Patients By Trevor Davis, PsyD


Submitted by: Bobbi Meins
[email protected]

An urgent issue in mental health care today is how to increase access to psychological services for individuals who are unable or unwilling to use such services (Yuen, Goetter, Herbert, & Forman, 2012).  Telehealth can be used to provide effective and meaningful services to treat an array of mental and behavioral health needs.  Telehealth (aka, telemedicine, telemental health, video-conferencing) has been shown to effectively address access to care issues.   For behavioral and mental health needs there have been various demonstrations of the positive diagnostic accuracy, satisfaction, and technological implementation success (Aoki, Dunn, Johnson-Tropp, & Truly, 2003).  Findings also include demonstration of improved outcomes and cost-effective service delivery (Richardson et al., 2009).

Implementation of telemental health services has occurred through various models, including consultation, integrative primary care, psychotherapy, and telepsychiatry (Hilty, et al., 2013).  Most typical concerns addressed in face-to-face services can be also be addressed via telehealth.   For example, Hilty and colleagues reviewed the use of telehealth for depression,  anxiety,  posttraumatic stress disorder,  substance use,  developmental disabilities, and medication adherence.   It has also been demonstrated that psychologists can far better maintain continuity with patients, assess and respond to urgent needs, and quickly consult with colleagues using videoconferencing and telehealth modalities (Maheu, Pulier, McMenamin, & Posen, 2012).  

Even very low-end user technology and friendly telecommunication can augment traditional psychology services for individuals and families experiencing chronic conditions (Maheu, et al, 2012). Services that can be offered via telehealth include:  

  • Identifying risk factors that may compromise care and impact rehabilitation or healing.
  •  Providing clinical pre and post-surgical patient assessments.
  •  Providing a route for quickly responding to patients in chronic or acute crisis.
  • Offering support around life transitions and emotional response to illness.
  • Offering patient support that can decrease resistance or non-compliance and speed their recovery.

 Telehealth offers many advantages for the patient:

  • Flexible and tailored to the needs of individual patients and their families.
  • An effective way to support behavioral change that can improve health.
  • Practical for patients with barriers due to transportation, geographic, or physical limitations.
  • Access to licensed psychologists who understand chronic illness.

Telehealth offers many advantages for the healthcare provider:

  • Able to offer self-sustaining integrated behavioral health as a clinic service.
  • Cost effective, as telehealth has minimal overhead and good reimbursement for services.
  • Staff  have regular contact with licensed psychologists with specialties in the treatment of chronic illness.
  • Scalable services depending on patient and clinic needs.
  • Improved treatment compliance for challenging patients.
  • Readily available technical support before, during, and after clinical services.

With the rapid changes in technology, the implementation and use of telehealth has become both accessible and cost effective.   Behavioral health services can be integrated into various clinic settings. Licensed Psychologists from Pacific Rehabilitation Centers can become collaborative team members so that patients can address issues that impede their overall health.

Trevor Davis, PsyD

return to the top

Helping our Community Thrive

Submitted by:  Amy Yaley
[email protected]

Proud to be part of such a vibrant community, Jefferson Healthcare in Port Townsend invests time and resources into the physical, social and economic health of our region.  Taking a holistic approach to the health of the community begins by partnering with like-minded organizations whose missions align with helping the whole community thrive.  Jefferson Healthcare continues to support the Jefferson County Farmers Markets (JCFM) because both organizations have a role in improving the health of our community. 

Communities with access to healthy food have a lower risk for chronic health conditions such as asthma, diabetes, heart failure, high blood pressure and depression.  Kids with adequate amounts of healthy food get sick less often, recover more quickly from illness and concentrate better in school - and these effects last well into adulthood.  This year Jefferson Healthcare applauds their local farmers markets as they celebrate 25 years of giving the community the chance to buy local, fresh and healthy foods.  On a given Saturday spring through fall, people of all ages bustle about to the sounds of live music, surrounded by a vast diversity in products: mixed vegetables, chicken, eggs, duck, berries, bread, pastries, cider and so much more.  This is the Jefferson County Farmers Market: an outlet for food vendors from Jefferson and surrounding counties to sell their goods, full of life and full of healthy foods.  "It's pretty amazing - the Jefferson County Farmers Market holds market on Saturdays, Sundays and Wednesdays.  We offer people the opportunity to eat fresh, local foods all week long," says Amanda Milholland, the Executive Director of the Jefferson County Farmers Market. 

JCFM hosts three county farmers markets: the Port Townsend Wednesday and Saturday Farmers Markets and the Chimacum Sunday Farmers Market.  Running nine months out of the year, JCFM's three markets generated more than $1,211,000 in sales in 2016 for participating local farms and small businesses.  These thriving markets support local jobs and keep more money circulating in the local economy.  While the economic benefits are great, the core mission of JCFM is to support sustainable farming and increase access to nutritious and delicious foods that build healthier communities.

From a hospital's perspective, equitable access to these foods make preventing or managing conditions like diabetes or high blood pressure less difficult.  "Food security is an important issue in our community.  JCFM strives to support nutritious food access for all people in our community, regardless of income.  We want more than just full bellies; we want to support community health through local food access," Milholland says.  JCFM has numerous programs that aid in accomplishing the goal of increasing access to nutritious foods.  JCFM not only accepts EBT and WIC tokens and vouchers, but they also have programs to match some of the money that is spent at the market.  For example, WIC packets come in $20 increments, and JCFM matches that $20 so shoppers are walking away with $40 in delicious foods.  Other programs, such as the Gimmie5 and Fresh Bucks programs, also help match funds spent at JCFM markets.  JCFM provided more than $13,000 in matching funds to families, senior citizens and individuals last year.  These matches are made possible by grants and partnerships with community organizations like Jefferson Healthcare.  "Community sponsorships make up 1/3 of our annual budget.  They allow us to do so much more for our community than we could otherwise.  We're thankful for our community partners who help support the growth of local farms, our economy, and enhance local food access," Milholland says. 

Stop by the Jefferson County Farmers Market and you might even see Jefferson Healthcare's famous Chef Arran Stark giving a cooking demonstration! 




return to the top

 Keeping You in the Know


Submitted by: Pat Justis
[email protected]

Recent "reset" of the Health Professional Shortage Area (HPSA) scores at the national level was intended to standardize the methodology across states in response to the high variability.  HPSA scores open the door to many federal opportunities including National Service Corps site eligibility and the Federal Loan Repayment Program.  This work is under the Primary Care Office (PCO) grant from HRSA.  The PCO focuses on access for underserved populations including rural, with an emphasis on workforce, integrated in the work of the Rural Health team at the Department of health. 

Washington met the rigorous timelines to scrub and reload the entire system with some assistance on contract from the Eastern WA Area Health Education Center (EWAHEC).  Scores stayed quite stable with a few increases and rare decreases.  Hats off to Health Analysts Laura Olexa, Randy Saylor and the EWAHEC team for the very hard work.  The reset had placed a moratorium on new surveys for HPSA and now the survey process is set to begin again, surveying for primary care, mental health (psychiatry) and dental.  Those furthest out from their last survey will be surveyed first. 

Tip: Make sure you capture Medicaid even if a secondary payer for Medicare, so that you can fully capture low income patients in your clinic panels.

For more information about HPSA, visit HERE.


On another topic, the WRHA Board of Directors currently has three unfilled positions and expects to have one more before our annual meeting in March.  This leaves four opportunities for members to serve as Directors. 

A full complement of board members would give the Board more power and flexibility to get the job done.  I invite any member who thinks they might have an interest in serving on the Board to view the structure and duties of Board members by looking at the eligibility requirements on the WRHA website at  Scroll down to Article III.  Submit a resume through this email address: [email protected] or mail it to:  Washington Rural Health Association, PO Box 882, Spokane, WA, 99210.  Please include a statement about why you want to serve and what you could add to the group.  We could use your help!


Our website now has a newer, fresher look and even more resources to assist you.  Take a look at today!

 Help demonstrate your commitment to rural health today!


Make a difference and show your rural pride and consider a tax-deductible donation to the future and sustainability of the Washington Rural Health Association. 

It's never been easier to donate to WRHA. Go to our website and click on the Donate Now link, or to our Facebook page and click on the blue donate button at the top of the page. And don't forget to select WRHA as your charity of choice on Amazon Smile. Proceeds from your online shopping will go directly towards helping us improve healthcare for our rural communities across the State!

Your investment generates dividends for WRHA by supporting its mission of advocacy. Over the past year WRHA has been gaining momentum, and this just simply wouldn’t be possible without people like you. Through your donation, you will be demonstrating your commitment to rural health care while increasing your exposure to Washington’s hospitals, health systems, rural health clinics, public health departments and many other rural health organizations. Your support makes a difference in rural Washington State.

Shop at and Amazon will donate to Washington Rural Health Association.


WRHA members now have a new way to share community events affecting rural health in and around Washington State.  As members, you can now post your community event on the WRHA website calendar so that others from across Washington can stay current and share information about what is happening in your town.

To submit a calendar event, simply click here or go to and hover over “Events” and select “Calendar of Events”.  You can view current events on the WRHA calendar or submit your own event by clicking “Submit an event” in the bar just above the calendar. 

Once you have submitted your event, the WRHA support team will review and approve it for posting.

Know Your Heart and Signs of Heart Disease

Submitted By: Meagan Pierluissi
[email protected]

At 35 years old, Casey Bantz of Spokane isn't who many would expect to be at St. Luke's Outpatient Cardiac Rehabilitation program after suffering a heart attack at a young age.  Casey is sharing her experience to help others realize heart disease can happen at varying stages of life.  "I never imagined this would have happened to me at my age," Casey says.  "I want others-women-to talk with their doctors, listen to their bodies and take symptoms seriously."  "I was getting ready for work, just like any other morning, when I suddenly had the worst heartburn I could imagine," Casey remembers about the first sign something was wrong.  "It was incredibly painful; I started sweating, getting hot flashes and then my arm felt numb."  Casey says she initially figured nothing was really wrong, but she increasingly felt pain as she continued to get dressed.  By the time she realized she needed to call 911, she was shaking and crying in pain.  "It felt like someone was sitting on my chest," she says.  First responders told Casey she needed to go to an emergency room immediately.  She let them know exactly where she wanted them to take her, "I told them to take me to Sacred Heart," she says.  "I couldn't imagine being taken anywhere else." 
Once at Providence Sacred Heart Medical Center, Casey says she was given medicine to help her calm down and was told she was having a heart attack.  "I just kept thinking, I'm 35 years old," she says.  "I couldn't believe this was happening.  I thought I was doing everything I was supposed to do at this point to be healthy."  Casey says she was told there were no blockages or plaque buildup, nothing cuing the providers on the cause of the heart attack.  "I'm not your typical patient," she adds.  "Everyone's symptoms and causes are different, and I'm an example of that." 

Casey came to St. Luke's outpatient program three times a week for three months, receiving heart education, monitor exercise routines, heart disease prevention and management and support from therapists, dieticians and other patients enrolled in the program.  "When you're at St. Luke's Cardiac Rehabilitation Program, therapists work very closely with your cardiologist," Casey says of the collaborative effort to make patients the center of care.  "And I just adored everyone there. I was really sad when my time was done."  "While it's not as common to see patients as young as Casey in our cardiac program, we know that heart disease can affect even young adults," says Shelley Schmidt, one of St. Luke's Exercise Physiologists.  "Our goal is to empower our patients to make lasting lifestyle changes with diet and exercise, and it was inspiring to see Casey do just that. 

It's stories like Casey's, that remind me of the positive affect cardiac rehab can have both mentally and physically on those we serve."  "My warning signs aren't going to be the same as others," Casey says.  "Don't shrug it off when you think something is wrong, even at a young age.  It's better to be safe."

Learn more about how St. Luke's Outpatient Cardiac Rehabilitation program can help you by visiting HERE.

return to the top

 Rural Issues Identified by Assessment of Washington's Behavioral Health Workforce

Submitted by: Rachelle McCarty
Written by: Rachelle L. McCarty, Susan Skillman, & Nova E. Gattman
[email protected]

In June 2016, the Governor’s Office charged the Washington State Workforce Training and Education Coordinating Board (Workforce Board) with developing a plan to help ensure enough licensed or certified health professionals are available to meet the demand for behavioral health in the state.  The University of Washington Center for Health Workforce Studies (UW CHWS) and Agnes Balassa Solutions, LLC assisted the Workforce Board in assessing barriers and potential solutions to workforce-related challenges in meeting this demand. 

Increasing Medicaid reimbursement was the leading recommendation from the assessment, drawn from extensive stakeholder input and data analysis. Stakeholders identified low reimbursement rates for behavioral health services as a root cause for recruitment and retention challenges in the behavioral health workforce, especially in safety net settings. Some of the additional 16 policy recommendations included promoting team-based and integrated health care through payer contracts, credentialing standards, and access to integrated service training; increasing behavioral health trainees’ access to clinical training and supervised practice sites; expanding the workforce available to prescribe psychiatric medication and medically assisted treatment for chemical dependency treatment; and promoting career opportunities in the field. 

Stakeholders confirmed that rural settings are particularly difficult to recruit providers to, and hiring qualified support staff was also challenging in some areas.  The percentage of providers in rural areas was lower than the percentage of rural population, and the rates of providers per population were consistently lower in more rural regions.  Recommendations to improve rural behavioral health care included increasing training opportunities in rural areas, providing greater technical assistance to integrate behavioral health care with primary care, and removing barriers to implementing technology-based extension of care.

The Workforce Board testified about the project team’s preliminary recommendations in the 2017 legislative session, during which bills were passed expanding telemedicine reimbursement to any site of origination, and requesting the review of documentation policies to reduce paperwork. Suggested by stakeholders, these actions may improve access in rural areas.

The need for this 18-month project grew from the enormous transformation efforts being guided by the Healthier Washington initiatives. The project team communicated with other behavioral health workforce efforts around the state during the course of the project.  In all, nearly 250 individuals from diverse settings and occupations contributed their experiences and insights to the project and final report. Stakeholder and key informant interviews improved understanding of workforce-related barriers to delivering behavioral health care services in the state, and background quantitative and qualitative research contributed to detailed occupation profiles of behavioral health providers licensed or certified in Washington.  The final project report was submitted to the Governor’s office in December, 2017. 

This project was made possible by Governor Inslee's Workforce Innovation and Opportunity Act discretionary funds.  All reports from the project can be found on the Workforce Board website and the UW CHWS website.  Project staff will also be presenting at the 2018 Northwest Rural Health Conference in Spokane. 

MAP of Washington Psychiatrists Population.

return to the top

Last but not Least, More Items of Interest....

REMINDER! The deadline for submitting the Provider Application is March 15, 2018.

The Health Professional Loan Repayment Program was established by the Legislature to address health professional shortages in rural or underserved urban communities.  The program helps the state attract and retain licensed health professionals to serve in our state by providing financial support to applicants who are awarded and commit to serving at an eligible site in our state.  The current 2018-19 Eligible Approved Site List is posted on our website.  In return for the funds, recipients sign a contract committing them to either a two-year (Federal/State funded- FSLRP) or a three-year (state funded - HPLRP) service obligation.  Award amounts vary based on the contract type (see Reference Guides for full details). 


January 31

Provider Application Opened

March 15

Provider Application Closes

May – June

Award Notifications start to go out

July 1

Provider Contract Begins

Oct 1

Provider Contract Begins (for those who were in residency status between July 1 – Sept 30, 2018)

If you are a provider wishing to apply for the Loan Repayment Program, please go to our website: to:

*Please note – We have simplified the application, and applicants are no longer required to submit a job description, letters of recommendation, or employment contract.

If you have technical difficulties logging in, after following the instructions posted on the webpage, you can contact staff at [email protected], or by calling 1-888-535-0747 option 5.

The Northwest Rural Health Conference for 2018 is March 26-28 in Spokane at The Davenport Grand!  With the theme, “Crossing to the Future of Sustainable Rural Health”.  Once again, sessions are content-rich and delivered by experts doing the work. Join more than 400 conference goers, it is a robust atmosphere, filled with hard-working rural health advocates sharing best practices and ideas to leverage valuable resources and achieve organizational and community goals.  Complete details are available online at: CONFERENCE, register now!   We do hope you can join us at one of the largest gathering of rural health professionals in the Northwest.

Also, you are cordially invited to join us at Washington Rural Health Association’s Annual Membership Meeting.  The meeting of the membership will be held Tuesday, March 27, 5:15 to 6:15 PM, at the Davenport Grand, Birch Room.  The WRHA is the primary resource for professionals and advocates for rural health in the state.  The Association is a 501(c)3 non-profit, and aims to provide resources, education, and advocacy in support of rural health-related matters.  Our members are the visible embodiment of our commitment to protecting rural healthcare and the people that reside in those communities.  It is through your desire and dedication to your profession that the organization flourishes.  We count on devoted citizens, like you, who are willing to give the time and effort necessary to make a difference.

The Washington Rural Health Association seeks to continue to increase its influence in the state over the coming years by further increasing benefits to members and outreach to the state and local communities.  Meeting is open to all attendees of the Northwest Rural Health Conference, invite a friend.  We welcome your feedback so we can continue to grow.


Join the discussion, connect with us! Share your stories and ideas, get the latest news, and act to help preserve rural health care and access in Washington state!  Please head over to Facebook, Twitter or LinkedIn and look us up at WASHINGTONRURALHEALTH!  

return to the top

  Thank you to our sponsors!

Please consider sponsoring the Association today.  Click Here.