Provider Perspectives: Overcoming Health Equity Challenges in Monroe County (Part 2)

December 16, 2024

Bloomington Health Foundation’s President & CEO, Michelle Gilchrist, recently sat down with a panel of leaders from IU Health, HealthNet Bloomington and the Monroe County Health Department as part of the Monroe County Health Equity Council’s Health Summit to discuss achievements and challenges when it comes to health equity in Monroe County. 

Read part 1 of this conversation here. Quotes have been lightly edited for clarity and length.

Michelle Gilchrist: Denzil, during your time in your role, what has been the biggest challenge in Monroe County’s healthcare system? 

Denzil Ross, IU Health South Central Region President: If you’ve been to our facility over the last year or two, you’ve seen that we can have long wait times in the Emergency Department. We are actively working to fix this challenge – and specifically, we are working to improve boarding times, which is the ability to get a bed in one of our units in a timely manner after being seen in the emergency department.

We also are facing a growing need. We have an aging community – all our data points to that. People are living longer and with multiple comorbidities. We face a challenge in meeting that need, and continue to innovate on how we can craft a physical space that improves our ability to do so.

In general, we could also do a better job of educating our community about how they can utilize us, which is why we’re very happy to have the opportunity to talk about the things we offer. For example, we recently opened a Saturday clinic that focuses on adult primary care, which offers an extra day outside of the work week that patients are able to access our services. 

And on the staffing front, while there are some staffing challenges on the inpatient side, I think we’ve done a lot of great work in improving the hiring process. For example, we’ve cut our time to get a nurse in the door from 20 days to just two days. We’ve increased our ability to get staff on board and trained to be able to care for patients. 

In short, we’re doing all of these things – but it’s a process. I would like for it to go a lot faster than it’s going, but we understand that there are a lot of other mitigating factors that slow it down. But let me say, we have an amazing team of people who are committed to our mission, which is making Indiana one of the healthiest states. So I’m very proud of the work that we’ve done in the short time since I’ve been here, and I’m very energized about the work that we will continue to do to meet that need. 

Michelle Gilchrist: Lori, talk to us about some of the challenges you encounter at the Department of Health – either that we can provide support to or that we need to be aware of in terms of maintaining a strong, healthy, and thriving community.

Lori Kelley, Health Administrator for the Monroe County Health Department: One of our main challenges is ensuring that we have steady and reliable funding. We know that we have additional funding that was provided in 2024 and will be provided in 2025, but 2026 and beyond is uncertain at this time. It’s a challenge that we are constantly having to consider and address. For example, while we were able to add additional positions right now, we don’t know whether those positions can be sustained over the long haul.

In addition to that, grant funding comes and goes. So, while we did receive funding through the state with Health First Indiana both during and post covid—the grants that provide our harm reduction services or STI testing services—a lot of those grant funds have gone away or they’ve been reduced.

And I would also say another challenge is workforce development and sustaining a workforce that’s capable and ready to respond.

Michelle Gilchrist: I think that is a challenge for Indiana as a whole, in terms of attracting workers and staying competitive. So it’s great that you all were able to hire over 100 individuals, but at the same time, I can see how it’s a complex issue to sustain this workforce.

And I know that for HealthNet, it took a while to find the right person to do the work that’s needed in our community for the Street Medicine program. So, Shelley, here’s my question to you: what do you wish we knew about HealthNet and what you do in the community, and how can we support that great work?

Shelley Sallee, Center Manager at HealthNet Bloomington Health Center: For 12 years, we had the volunteers and medicine clinic. Then we started the Street Medicine program, which I always say is the clinic on steroids, because we can do so much more. But then, of course, the pandemic hit, and it was very hard for us to get our information out there. So that’s our challenge.

But what do I want you to know? We have such a compassionate organization and caring group of people. When patients come to us, we are pretty darn good at keeping them out of the ED. That’s because we work on building those relationships, and we have staff that are willing to put in the extra time. So what we need now is to get that information out to the people that need to hear it so that we can continue to do more of this good work.

Additionally, I will say ditto to the challenges of grant funding. Our Homeless Initiative Program is grant funded, and it’s always a nightmare to think about how that program is going to continue, because those are very special people. You’re not going to find every physician or every nurse practitioner that says, “Let me go truck through the woods in the mud, sit on a tree stump and clean wounds.” My team does, and they do it extremely well. And the thing I’m so proud of is that those people who are in the woods are starting to come into the clinic. Before, they would come when there was a crisis, but then they would leave. But we’re able to keep them coming consistently through that trust building. 

I’m proud of my team. I love my team. And I want to work with the community more. I want to work with everyone on the panel more too, because together we can really make this community shine. 

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