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Grant focuses on expanding rural health care with nurse practitioners

Nurse practitioner students at the College of St. Scholastica will have more opportunities to train in rural communities, thanks to a $1.4 million federal grant.

"Our ultimate goal, of course, is to reduce the health disparities of those who are living in rural areas, or underserved areas," said Julie Anderson, dean of St. Scholastica's School of Nursing.

The two-year grant, announced last week, is from the Health Resources and Services Administration (HRSA), an agency within the U.S. Department of Health and Human Services that focuses on underserved areas.

The agency is awarding 50 of what it calls Rural Academic Practice Partnership grants this year.

Under the grant, St. Scholastica will collaborate with Essentia Health to recruit primary care physicians to act as preceptors for nurse practitioners in training in rural communities.

Preceptors aren't paid for their service, but the grant money will allow the nursing school to provide tuition assistance for students who participate in the program, Anderson said. It also will pay for "field development days" to provide additional training for doctors and students at the sites.

All of the participating students will be training for primary care roles, Anderson said, including family care, adult general care and psych-mental health care.

The program initially will target the Virginia-Aurora, Grand Rapids-Deer River and Brainerd-Baxter areas as well as the Bois Forte, Leech Lake and Fond du Lac reservations, Anderson said.

Karen Diver, former chairwoman of the Fond du Lac Band and former special assistant for Native American affairs in the Obama White House, begins a faculty fellowship at St. Scholastica this month, and her expertise will be helpful in working with that population, Anderson said.

Rural communities not only have medical care shortages, they face special health challenges, she said.

"They have transportation issues, isolation, lack of access to healthy foods ... health risks associated with their jobs, because some of them are in mining, which comes with its own health risks," Anderson said. "Plus the loss of income due to the layoffs that have occurred in this part of the country. That all leads to detriments to your health."

Nurse practitioners, who like medical doctors can diagnose illness, manage treatment and prescribe medications, have been seen as one way to answer a shortage of primary care physicians, particularly in rural areas. The HRSA, in a 2013 report, projected a shortage of more than 20,000 primary care physicians by 2020. But the report added that increased use of nurse practitioners and physician assistants could "somewhat alleviate" that shortage "if they are effectively integrated into the health care delivery system."

Terry Hill, senior adviser to the Duluth-based National Rural Health Resource Center, said the grant was good news for the region.

"We're woefully short of primary care physicians in particular, so nurse practitioners have been increasingly part of the lifeblood of many clinics throughout rural America," Hill said. "I think it's a great program. ... It's helping to fill an extremely important need."

St. Scholastica, which has the second-largest nursing school in the state, offers a doctor of nursing practice degree and will launch a physician assistant program with 30 students in the fall.

The school currently has 191 nurse practitioner students enrolled in its four-year program. The program allows them to maintain their employment as registered nurses while preparing to advance to the next level, Anderson said.