Recent studies have established a dire need for palliative care in rural areas, and the state of Michigan is no stranger to this situation.

To respond to the need, the Michigan Center for Rural Health (MCRH) is partnering with Stratis Health, a nonprofit consulting firm that specializes in assisting rural communities with providing palliative care services. The two organizations, which have partnered on projects related to critical care hospitals and Medicare beneficiaries, will choose five rural communities in the state with the goal of increasing their capacity to provide palliative care. In the current phase of the project, Stratis will be training MCRH staff to apply their framework for implementing palliative care programs in the target areas.

The program, titled Cultivating Comfort: Enhancing Palliative Care in Rural Michigan Project, is funded by a grant from the Michigan Health Endowment Fund. During phase 1 of the process in 2024, Stratis and MCRH conducted a statewide assessment and gleaned insights from a diverse advisory council. MCRH launched phase 2 on Jan. 1. The goals of this second two-year phase are to address disparities and enhance access to palliative care in rural Michigan by developing new programs (or strengthening existing ones) and providing stability through reimbursement, with an eye to long-term expansion.

This two-year effort begins by soliciting applications from rural communities, of which five will be chosen based on several criteria, including rurality, community engagement and commitment to the program, multidisciplinary approach, need for palliative care services and existing palliative care efforts.

Palliative Care News caught up with MCRH’s Amanda Saint Martin and Aleah Huse. Saint Martin, hospital programs manager, works with 35 critical access hospitals in Michigan and is the lead for the project. Huse serves as the rural health projects assistant. 

Of the program’s design, Saint Martin said, “The program is advancing a community-driven, flexible, locally adaptable model, tailored to work with the target communities. So we’re focusing on leveraging local resources and their community needs.”

MCRH and Stratis will work with local community organizations, which will provide care in close collaboration with the local health care provider. Huse and Saint Martin cite interest in a multidisciplinary approach, including physicians, nurses, community health workers, chaplains, and social workers, as well as family caregivers.

After five communities are selected, MCRH and Stratis will conduct gap analyses, identify assets and needs, and assist with creating a plan to implement the Stratis framework. This phase will also include cross-collaboration among communities to share best practices and lessons learned.

Saint Martin cited the importance of educating providers about palliative care: A grand round of no-cost webinars will cover this need and provide continuing education credits. MCRH hopes that at the completion of the current phase each of the five communities will have a plan in place, and they anticipate that some of the community programs will have begun seeing patients. Throughout this process, Saint Martin and Huse will use the training they have gained from Stratis to provide support as needed.

Currently Saint Martin and Huse are accepting grant applications, which are due by Feb. 16, 2025. Saint Martin and Huse said they look forward to assessing the applications and determining which communities they will be assisting in the process. Rural communities are not all the same, and Saint Martin specifically mentioned a desire to work with Native American communities in the state.

“It’s going to be exciting to see the diversity we’re going to get,” she said. “We have a fun road ahead of us, and we’re just scratching the surface. We’re really excited to see who’s going to apply and who’s going to lead the charge, who will jump in and really want to bring palliative care to their communities.”