Dr. Bryant Smalley helps direct Georgia Southern University’s efforts to improve health care for rural residents. Last week, he went to the White House to advise high-ranking federal officials on the subject.
Smalley, a psychologist and one of the two executive directors of GSU’s Rural Health Research Institute, took part in a meeting May 1 with White House Rural Council members. Health and Human Services Secretary Kathleen Sebelius and Agriculture Secretary Tom Vilsack were there to listen. Although the meeting was not a grant ceremony, the university’s recent landing of a $450,000 grant for diabetes education outreach to four rural counties earned Smalley a seat at the table.
In the morning session, 24 rural health stakeholders from around the nation – including physicians, nurses, dentists, hospital administrators and mental health providers – talked to the Cabinet members and other federal officials in a conference room at the Eisenhower Executive Office Building. In the afternoon, they went to the Health and Human Services headquarters for further discussions with Sebelius and staff members.
“I was certainly impressed with the level of attention being paid to improving health in rural communities at the highest levels of federal administration, and Secretary Sebelius was very clear about her intention to really listen to the rural stakeholders,” Smalley said.
Georgia Southern officials learned in April that the university will receive $150,000 annually for three years from the Rural Health Care Services Outreach program – the maximum amount given under the grant program. Administered by the Office of Rural Health Policy at the Department of Health and Human Services, the grant will fund “telehealth” classes for diabetics planned by the GSU Rural Health Research Institute.
Beginning in August, Smalley said, the project will use videoconferencing to reach people with diabetes at clinic locations in Candler, Emanuel, Tattnall and Toombs counties. Called ADEPT, for Applied Diabetes Education Program using Telehealth, its sessions will originate on the Georgia Southern campus.
“The diabetes educator will connect with the patients at these centers – and that can be either on an individual basis or in small groups – and there will be a curriculum that the diabetes educator will go through with the patients,” Smalley said.
Not all of the 24 stakeholders at the May 1 meeting are involved in grant projects. But Smalley was one of six representatives invited from the 70 organizations recently awarded Rural Health Care Services grants, said Tom Morris, associate administrator of the Office of Rural Health Policy. He said Sebelius had not publicly announced the latest grant winners before the meeting.
From 287 applications received, fewer than one-fourth were approved for grants in a highly competitive process, Morris said.
“We provide the funding during that three-year project period with the hope that we can get a project up and going and that it continues to operate after the federal funding ends,” he said. “Our recent studies have shown that anywhere between 60 to 80 percent of (projects) that we fund continue after the grant ends, and that’s certainly our hope with the diabetes project that Dr. Smalley is heading up.”
Smalley shares leadership of the project with the other co-executive director of the Rural Health Research Institute, Dr. Jacob C. Warren. Warren is an epidemiologist in GSU’s Jiann-Ping Hsu College of Public Health.
Formed about two years ago, the institute is an interdisciplinary effort of the colleges of Public Health, Liberal Arts and Social Sciences, and Health and Human Sciences. The institute’s mission is to improve health in rural areas through both research and outreach.
Smalley, a licensed clinical psychologist, also serves as associate director of clinical training in the psychology department in the College of Liberal Arts and Social Sciences. Originally from a rural community in Middle Georgia, he became interested in improving access to health care in rural areas while working on his master’s degree in clinical psychology at Georgia Southern. Before receiving the degree in 2003, he completed a one-year practicum in Millen.
“At that time, I recognized the incredible need in our region related to rural health issues and specifically, at that time, related to the mental health professional shortage issue that certainly impacts the rural areas of our state,” Smalley said.
He received his doctorate in psychology from Nova Southeastern University in 2008, the year he joined the GSU faculty. Georgia Southern, meanwhile, added a doctoral program in psychology, which is now in its fifth year.
But a continuing shortage of doctoral-level training programs in psychology and residency programs for psychiatrists was one concern Smalley expressed to officials in Washington.
“In our region of the state, we’re certainly within a mental health professional shortage area, and there are many regions of Georgia that are classified that way,” Smalley said.
The Department of Health and Human Services recognizes 88 of Georgia’s 159 counties as having a shortage of mental health professionals. All of those 88 counties are designated rural or semirural.
President Obama formed the White House Rural Council by executive order in June. Chaired by the secretary of agriculture, the council also includes the heads of 12 other federal departments and officials from about 15 agencies, commissions and offices. Although the May 1 meeting focused on health care, council members convene to discuss various issues related to life in rural America.
A Health and Human Services news release stated that the role of the Affordable Care Act in addressing rural needs would be a topic for the May 1 discussion. Rural Health Care Services Outreach grants were not created by the controversial 2010 legislation but have existed for about 15 years.
However, projects such as ADEPT mesh with the health care reform law’s emphasis on prevention, Morris said.
“This fits with the emphasis of the Affordable Care Act, and that is we’ve got to do a better job of keeping people healthy on the front end and being more focused on prevention and managing people’s health in a way that keeps them out of the hospital,” he said.