Networking for Rural Health: TARGETED CONSULTATIONS

Service area	Yancey and Mitchell Counties, NC: 17,774 pop.
Project director	Suzette Renfro
Contact info for project director (address, phone, and e-mail)	PO Box 1298 Burnsville, NC 28714 828-682-7825 gchstr@hotmail.com
Date formed	1997
Date of incorporation (if applicable)	1998 (non-profit)
Annual budget/funding sources (for most recent fiscal year)	$90,000 from private grants Facility space/in-kind support provided
Amount funded	$6,000
Consultant/Consulting Firm	Mountain Area Health Education Community Health Resource Services
Purpose of Targeted Consultation	Conduct an in-depth data collection effort in order to better address the gaps in services or needs for children and youth in a two-county area.

Network Composition

1 Hospital
1 Physician practice
1 Health department
3 Non-profit clinics
1 Public mental health clinic
1 Department of social services
1 School system
14 Individuals representing business and geographical areas in the county

The primary goal of Graham Children's Health Services of Toe River is to improve the health and quality of life of the children of Yancey County, North Carolina. To accomplish this, the network fosters collaboration among many community systems and promotes children's health initiatives.

One of the network's early activities was to conduct a needs assessment of the Latino population in Yancey County. Recent projects include a Child Dental Health Initiative that provides free dental sealants to 6th graders who need them and a community playground program that targets childhood obesity.

In 1999, Graham Children's Health Services of Toe River applied for a targeted consultation grant from the Networking for Rural Health Project. The goal of the project was to identify areas of children's health care in need of improvement, assess the community's overall perception of its health needs, and work toward strategies of addressing those needs. The network was awarded $6,000 to administer a community needs assessment and the Youth Risk Behavior Survey-a children's health measurement tool that Yancey County officials had previously administered in 1998. The network hired two consultants to help them conduct the project: the Mountain Area Health Education Community Health Resource Services and the Center for Assessment and Research Alliances at Mars Hill College.

The network administered the Youth Risk Behavior Survey to the county's middle schools in March 2001. The results indicated that certain health problems-including depression and obesity-were relatively common and had changed little in the three years since the previous survey. However, some risky behaviors had decreased, including smoking, alcohol ingestion, and the use of inhalants. The rate of students carrying weapons to school was also reduced between 1998 and 2001.

In collaboration with the consultants, the network also facilitated listening sessions and focus groups with local residents to determine the community's most pressing health needs. The issue of greatest concern was the lack of an urgent care center in the county. To address this, the network formed an urgent care committee and held several meetings to weigh the pros and cons of two possible long-term solutions: extending or adjusting physicians' office hours and redefining the emergency room at Spruce Pine Hospital as an Urgent Care/ER system. The committee agreed that interim interventions might include improving staff's scheduling skills based on the availability of mid-level providers, and improving public education about clinic hours and the capabilities of mid-level providers.

As a result of the targeted consultation, the urgent care committee will continue their discussions about how to improve urgent care services in Yancey County. The network is also developing future projects informed by their 2001 survey results, including an initiative to strengthen mental health services at middle-school health centers and a conflict resolution program for local middle and high schools.