What good can a town of less than 1,000 do? That is exactly the question of many living the rural panhandle of Nebraska. The answer? Not as much at 90,000 can.
The Panhandle Partnership for Health and Human Services, a region-wide collaboration to promote a coordinated system of care for community health in the rural communities of the Nebraska panhandle, has been working for what the Panhandle Public Health District Director (PPHD) Kim Engel calls, “an effective solution for a rural, remote area.” The organization, which is a “collaboration of collaborations” links the citizens and groups working for positive community change in 11 counties across the panhandle in order to reach common goals through a unified regional view. By creating sustainable partnerships between local agencies and larger coalitions, PPHHS can successfully facilitate improved community health in the Nebraska panhandle. Regional challenges, including lack of influence on the state and national level, distance from services and resources, and even lack of personnel, could otherwise hinder community goals.
PPHHS has adopted the Healthy People 2010 plan, a set of federal health objectives established by the Centers for Disease Control and the state of Nebraska, and has developed benchmarks for progress in their particular region. These goals include improvements in mental and reproductive health, underage alcohol use, and cardiovascular disease prevention, as well as the creation of viable public health infrastructures unique to the remote panhandle to improve the quality of health services, increase rural workforce capacity, and effectively use resources within the local economy.
How do they do it? “This is a culture,” Engel says, “More than a staff, more than a building, it’s a culture of collaboration, a new way of behaving.” Engel prides the members of the organization on their communication skills, which are especially important to linking the rural areas to the coalition. The group has a modified listserv and uses e-mail to communicate. “I can honestly say that we have a very effective system to communicate with over 1,800 people over an area of 15,000 square miles.”
Obtaining the resources to facilitate community development, however, is more difficult. “Funding restraints are often the primary setback,” Engel says. The grant process is tedious, and, as an organization working for a large region of rural towns rather than an urban center or dense neighborhood, the definition of “community” is often a source of tension between the group and its funders. However, PPHHS has never lost sight of its vision: “It’s not about sustaining jobs or agencies, but sustaining the goals,” Engels says, “Sustainable community health is never compromised.”
Nevertheless, PPHHS has received approximately $11 million to promote community change. The group uses about 5% of the money for organizational expenses while the vast majority goes directly to the panhandle communities. Engel notes that the group’s goal is to “use funds to set up a sustainable [public health] system.” When a hospital in the region began a home visit program for newborns and the community expressed its support, PPHHS worked to have similar programs set up at other hospitals as well. “Everyone has something good – a success – so we try to replicate it in other places,” Engel comments. The funding for this program has long since ceased, but it is still up and running in the panhandle. This is the sustainability for which PPHHS strives.
To work toward sustainability, any organization working for community health must have a way to measure the progress of its initiatives. For PPHHS, project evaluations are conducted to measure progress toward goals and for the effectiveness of the collaboration itself, but Engel notes, “One of the things we are very interested in about the Community Tool Box is the tool that works to allow everyone to evaluate a project.” This form of evaluation allows every opinion to be recorded, so an idea for improvement is never lost.
The lesson to be learned from PPHHS is that small towns can make a big difference when they collaborate. “It’s about moving toward goals,” Engel concludes, “It’s amazing that there are so many devoted people to see it go.”
In mid-July, PPHHS, in conjunction with Panhandle Public Health District (PPHD), is planning a meeting of health coalitions to discuss the prevention of cardiovascular disease. For more information on the organization, its goals, and its latest projects, visit the PPHD website at www.pphd.org.
Relevant CTB materials:
Chapter 24, Section 3: Promoting Coordination, Cooperative Agreements, and
Collaborative Agreements Among Agencies
Chapter 24, Section 4: Developing Multisector Collaborations
Chapter 24, Section 7: Developing and Increasing Access to Health and Community
Services
Chapter 36, Section 2: Community-Based Action Research
Services and Products: Online Documentation System
For other featured Tools in Action Stories, visit the CTB homepage at http://ctb.ku.edu
