McDonald County, in the rural far southwest corner of Missouri, ranked last in the 2014 County Health Rankings for clinical care compared to other Missouri counties, a measure which includes access to doctors, dentists, number of residents who are uninsured, and a few other factors.
This is the second of a series of health stories coming from rural McDonald County, Missouri. You can read Part One of the series – here.
In an effort to improve the situation, Crowder College, a community college based in neighboring Newton County, opened a satellite campus in McDonald County in 2014 to provide certifications and degrees in nursing, as well as a few other associates degrees.
The McDonald County Instruction Center, in the tiny village of Jane, Missouri, has been open a little more than a year. Its construction was partially funded by grant from MoHealthWINS, a state program intended to provide education for careers in healthcare -- jobs that are in high-demand in Missouri.
Campus director Aaron Divine calls the new campus a “win-win” for both Crowder College and the community. “You have an opportunity to address one of the fastest growing job fields in the country in healthcare, and in an area that is traditionally underserved and under-employed,” Divine says.
The Jane campus has so far graduated one class of 25 registered nurses, and has held two nurse assistant certification classes since the campus opened last year. A few new medical certifications will be available this fall - emergency medical technician and certified nursing assistant specialist.
But Judy Lewallen, the coordinator of the nursing program at the McDonald County Instructional Center, said there is one problem. There are few jobs for RNs within the county borders.
"They hire mostly LPNs and nurse's aids, not a lot of RNs. The Health Department has, I think, three or four RNs on staff. The doctor's offices don't hire RNs,” Lewallen says.
The rural clinics hire certified nursing assistants, who have less training and clinical experience due to cost – it's simply cheaper to hire someone with less training.
Some students who completed their nursing assistant certifications at the Jane campus have found jobs in the county at an assisted living center in Anderson. But most graduates are leaving the county to work.
Lewallen said she doesn’t think that is a bad thing. She said McDonald County residents are used to driving 30 minutes or more each day to get to work. She also said that her students are getting jobs at the nearby hospitals – in Neosho, Missouri, in Arkansas and in Oklahoma, which treat McDonald County residents.
“The associate’s degree nurses are what [sic] staff these smaller, local county hospitals like the one in Neosho,” Lewallen said. “If they didn't have those local people that would stay in the area and work, they couldn't man those hospitals. And the hospitals wouldn't have any staff without the associate degree nurses that will stay, want to stay here and work,” she says.
Hillary Garmin is currently a nursing student at the Jane campus. She said she is pursuing a degree in nursing because it gives her options in her career, and while she may not find work in McDonald County, she won’t be going far. “I really like this area,” she says. “It's where my family is from and I want to stay here.”
Adina Ballard, lives in Pineville – the county seat with a population of 788 people – and is also a nursing student at the McDonald County Instructional Center. She said that she also wants to work in the area, at least for a while, and said that before the new campus opened, educational opportunities for residents were lacking.
Divine admits that the campus hasn’t yet done much to improve health care access within the county borders, but he said education alone won’t solve the county’s health care access troubles.
“One of the challenges is that accessibility in the area,” Divine says. “You have to have infrastructure, so while you have to look at education, just because we have the degree doesn't mean we can just rush out and say the nurses have places to go,” he says
Yet he remains hopeful that the programs at Crowder can help fuel economic growth in the county that will eventually lead to new opportunities for healthcare jobs.
“So as the county continues to grow and we get to see a work force that is better trained through our Crowder programs... you'll see the opportunities increase there as well,” says Divine.
Sharon Gulick is the director of the Community Economic and Entrepreneurial Development program (EXceed) for the University of Missouri Extension. She said that Divine is one the right track, and that having more county residents with education could attract new employers into McDonald County.
“In general, as you raise the educational capacity of your citizens, I think it’s going to have a ripple effect across the economy,” Gulick said.