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Noble Care & Wellness

Mental health challenges are real and exhausting. People want someone who understands that, especially the person they are seeking support from. Finding a provider who is a good match for your needs shouldn't be another challenge in your life. You should leave each session with a plan of care that fits specifically to you, feeling hopeful and confident for the future. People wish to be seen, heard, and given solutions to their concerns - solutions that actually work.

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I want you to know that you are not alone! In the days after COVID, a big majority of the population is struggling with mental health issues. You've already taken one of the harder steps by seeking that extra support. Your journey to wellness begins now, and I am here to support you!

Editorial: Rural Hoosiers Need Quality Health Care

The (Fort Wayne) Journal Gazette

State officials have recognized Angola's Cameron Memorial Community Hospital and a physician with Parkview Health for their commitment to rural communities, which are suffering through a health care crisis.

Dr. Eric Reichenbach, a family medicine physician at the Parkview Wabash Health Clinic in North Manchester, won the Outstanding Rural Health Provider Award. Cameron Memorial won the Quality Improvement and Critical Access Hero awards. The two received the commendations through the Indiana Department of Health and State Office of Rural Health Critical Access Hospital Award program.

Unfortunately, such health oases are rare in rural America. Since 2015, nine rural Indiana hospitals have closed including four since 2022. IU Health Blackford is the latest to close its doors in October.

"One of the challenges for rural communities is the ability to recruit and retain health care providers, especially obstetricians," said Laura Kracher, vice president of public affairs and communication for the Indiana Hospital Association. "In Indiana, 87% of rural residents live in areas with a primary care shortage."

The U.S. Department of Health and Human Services lists Noble, DeKalb, Whitley, Huntington and Adams counties as health professional shortage areas.

In looking at data from the federal Rural Health Information Hub, the counties that collar Fort Wayne and Allen County have a shortage of physicians per 10,000 people. For example, Allen County has 28.7 physicians per 10,000 residents. Huntington is at 13.3, while Adams is at 5.3 doctors per 10,000. Both counties have about 36,000 residents, showing the disparity isn't about county size.

The numbers are even more stark when looking at the availability of nurse practitioners and physician's assistants in those counties. NPs and PAs are graduate-level trained and licensed professionals who can provide primary care.

According to National Rural Health Association data, 25% of Indiana's 55 rural hospitals have "negative operating margins," 13 have pulled back service and seven hospitals considered closing. The association did not mention facilities by name.

Meanwhile, the health disparities between rural and urban areas are pronounced and startling, with the people in the former being older and more prone to chronic conditions such as lower respiratory disease, heart disease, stroke and cancer. Rural men and women will live about three years fewer than their urban counterparts.

Cancer care, mental health and dialysis are the most difficult services to access for rural Hoosiers.

Indiana Hospital Association's Kracher points to low Medicaid reimbursement as a significant challenge for hospitals, particularly in rural areas where more than half of annual births are covered by Medicaid. In Indiana, hospitals are experiencing significant financial losses due to inflation and rising costs, she said.

Medicaid expansion — Indiana was the first red state to expand in 2015 — improved the financial performance of hospitals and other providers particularly for rural and small hospitals, according to the Kaiser Family Foundation survey of research released in June.

But the amount paid by Medicaid has not changed in 30 years to keep up with costs, Kracher said.

According to an outside analysis the Indiana Hospital Association commissioned surveying inpatient operating base rates, the standard amount of Medicaid reimbursement paid in Indiana is $3,524. Kentucky and Michigan, which have compiled complex methodologies that include legislatively approved base rate increases, paid average amounts of $5,796 and $4,996, respectively. Ohio's base rate is just over $5,000.

"Policy solutions are needed to raise Medicaid reimbursement for hospitals now so that we don't erode access to vital health care services or see our rural and urban safety hospitals close," Karcher said. "Policymakers in neighboring states like Kentucky and Illinois have successfully enacted policies to raise their reimbursement levels just in the last year. Without immediate financial support, Medicaid shortfalls will only exacerbate the emerging trends of service reductions and facility closures across the state."

Indiana can't hold itself as inclusive and equitable if we're telling 1 million rural Hoosiers that the choice for living in the country is to submit to a growing health care desert.

Send comments to [email protected].

School Board Hears Pitch To Redirect Child Care Center To Ligonier

LIGONIER — West Noble's school leaders listened Monday night to a pitch for a partnership to bring a new child care center to the community.

Jenna Anderson, Early Childhood Coalition coordinator for Thrive by 5 of Noble and LaGrange counties, Ligonier public safety director and Police Chief Bryan Shearer and Ligonier Mayor Earle Franklin brought new information to the board about the need for child care in Ligonier and the opportunity to build a new center.

Anderson and Shearer asked the board to consider becoming a partner in building a 50-seat child care center in Ligonier by perhaps providing a building site on school property near West Noble Primary School or on the main West Noble campus.

Shearer said he contacted Anderson after reading news stories about the town of Albion withdrawing from a plan to build a child care center there. He said he envisioned a partnership with the city, the school district and Thrive by 5 to address care needs and alleviate short staffing at many workplaces. He noted that housing and manufacturing are expanding in Ligonier.

Anderson also shared good news she received Monday. The $315,00 Lilly Endowment Gift 8 grant for child care that had been intended for the Albion project can be transferred to the Ligonier project.

Potential funding could also come from Ligonier's application for an Office of Community and Rural Affairs grant, and a request for TIF funds from the city's Redevelopment Commission.

Other partners could be employers, educators and state legislators as plans become more defined.

Anderson distributed a handout showing that Ligonier has just 5% of the capacity it needs to care for infants and toddlers. Data gathered shows that there are 837 children in just the Ligonier zip code who need care, and there are just 44 openings at regulated providers.

Preliminary plans are to build a free-standing new building with 50 child care seat and room for expansion. The center would have a bilingual options and a potential preschool for children with autism.

Potential partners include Ligonier's mayor, clerk-treasurer, council, and redevelopment commission; Be Noble economic development corporation, Community Foundation of Noble County as a funding partner, and Thrive by 5 as the consulting partner.

The school board agreed to hear more as plans develop.

In other action, the board agreed to begin livestreaming the school board meetings for public access in January. The district has tested the technology during a trial run this fall.

The livestreaming is view-only, and not interactive. The video will use the Google Meet platform and be accessible on a YouTube channel. Any presentation materials during the meeting will be linked to the channel for the public to see.

The board also increased the meal allowances for staff travel and reimbursement. The allowances are $10 to $15 for breakfast, $15 to $20 for lunch, and $20 to $30 for dinner.

The board approved a trio of policy updates discussed at the Nov. 27 meeting. Two policies passed unanimously: the policy for public complaints added a new section, including a form, for the challenge of library materials; and the Title I performance report policy updated the language.

West Noble's library materials challenge policy is based in a new law from the Indiana General Assembly that will take effect Jan. 1. The policy defines the two reasons library materials may be challenged; "obscene" materials and "materials harmful to minors."

West Noble policy permits materials challenges only from parents of West Noble students or from people who live in the West Noble corporation limits.

The school board will be immediately notified when a materials challenge is filed. The district will assemble a materials review committee which will have 30 days to read the materials and make a decision. Each school building will have its own review committee, but the committee will only take up one challenge at a time.

The policy update for electronic monitoring and recording drew dissent. The update passed 6-1, with board president Joe Hutsell opposed.

The update states that viewing access may be granted by the administration, but a copy of the recording will only be given with a written request and a subpoena from a court.

Hutsell, who is a law enforcement officer, said at the Nov. 27 that he believes that recordings should be released to law enforcement in the case of a criminal investigation.

The board approved thee personnel changes:

Retirements: Jennie Allen, elementary kitchen manager, effective Jan. 12.

Resignations: Megan Iddings, primary food service, effective Nov. 27; Brandi Schultz-Wallace, middle school head custodian, effective Nov. 28; Makayla Lee, elementary applied skills assistant, effective Dec. 8; Rusty Emmert, middle school assistant track coach, effective Dec. 8; Clyde Patrick, transportation-activity bus, effective Jan. 23.

Certified Hiring: Deb Hagan, middle school temporary special education teacher, Jan. 18-March 22.

Classified Hiring: Madison Smith, elementary applied skills assistant, effective Jan. 8; Kent Saggars, activity bus driver-Bright Horizons, effective Jan. 23; Stacey Lang, high school head gymnastics coach; Amy Kinney-Trowbridge, high school assistant gymnastics coach; and Josh Trowbridge, high school volunteer gymnastics coach.

Ina separate motion, the board approve a high school professional stipend of $1,000 for Erik Mawhorter so that his salary complies with state law on the base salary for teachers.

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