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Post Conference Article Series

The 2021 Get Link’d Missouri Rural Health Conference was a crash course in innovations improving access barriers to quality health care in rural communities. This post conference series takes a deeper look at some of the issues discussed. 

Rural Pharmacist Shares Relentless Pursuit to Give COVID Shot


More than 70 million Americans remain unvaccinated against COVID-19 as hospitals reach capacity and death tolls rise. The Delta variant is slated to be more than two times as infectious as previous strains, with a viral load (a measure of the density of viral particles in the body) of at least 1000 times higher than other variants, according to some reports. The Centers for Disease Control and Prevention (CDC) described Delta as more transmissible than the common cold and flu – as well as the viruses that cause smallpox, MERS, SARS, and Ebola – and called it as contagious as chickenpox. This determination comes from a CDC internal document obtained by and reported on in a recent New York Times article.

If that’s not enough, the young and unvaccinated are among the patients landing in hospital ICUs – many of whom are in their 20s and 30s. According to a recent NPR article, 94,000 child cases of COVID-19 were reported in early August, a 31% increase compared with just one week earlier.

Hope deferred

These optics are far different than early 2020, when most severely ill COVID-19 patients in ICU beds were older adults. During the recent Get Link’d 2021 Missouri Rural Health Association Conference, Richard Logan, Pharm. D. – ESPhA, talked about COVID-19 vaccine efforts in Southeast Missouri – an area that is flagrantly vaccine hesitant. Dr. Logan, along with his son Tripp, own and operate three independent pharmacies in Mississippi County, which sits on the far Southeast corner of Missouri.

Charleston, Missouri is Dr. Logan’s lifelong home. It’s also where his L&S Pharmacy is headquartered, and is 20 miles from the closest hospital. Charleston and neighboring East Prairie are the only two cities in the county with clinics, pharmacies, and the county health department.

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Safer Homes Collaborative Encourages Awareness in Suicide Prevention


Although many factors contribute to high rates of suicide in Missouri, the turning point between suicidal ideation and completion is access to lethal means. Suicide by firearm is the leading cause of death for people 10 to 34 years old, a rate that continues to increase. Of youth suicides, 82% of them used a firearm that belonged to a family member.

The Safer Homes Collaborative (SHC) brings together individuals and organizations with a broad range of views on gun ownership who share a commitment to safety and preventing suicide. The group includes gun shop owners and firearm instructors, injury prevention and mental health practitioners, and public health researchers, among other committed volunteers.

Secure storage of firearms is the most important preventive safety measure families can take to help decrease the growing rate of suicides, especially among adolescents, in Missouri. Katie Ellison, project director at SHC and trainer of a program called Counseling on Access to Lethal Means (CALM), hosted a two-part breakout session during the Missouri Rural Health Association’s Get Link’d 2021 Conference held Aug. 17-19.

The first presentation, “Gun Violence Prevention,” discussed the importance of suicide prevention and the increased risk involved in having firearms in the home. The second presentation, “CALM: Conversations on Access to Lethal Means,” provided an overview of the CALM program’s goals to educate the gun community about warning signs of suicide and protecting vulnerable individuals in their home.

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Dementia Caregiving is Like Learning

a New Language


A breakout session during the Missouri Rural Health Association (MRHA) Get Link’d 2021 Conference highlighted the unique challenges faced by those living with dementia and their caregivers. “Community Supports for People Impacted by Dementia” provided an in-depth look at dementia and Alzheimer’s across Missouri and the assistance available to help caregivers bear the weight of dementia-related changes. The session was moderated by MRHA mobility management coordinator Sandra Morris, and featured presenters Amy Sobrino from Memory Care Home Solutions (MCHS) and Ben Molina from the Alzheimer’s Association (AA) Greater Missouri Chapter.

Amy Sobrino, MSW, LCSW, started with MCHS in 2014 as a graduate practicum intern providing education to caregivers. After earning her Master of Social Work degree from St. Louis University, she is now a social worker at MCHS providing customized training and support to people with dementia, their loved ones, and their caregivers. She and her family also operate Effingham Area Alzheimer’s Awareness, a not-for-profit organization in central Illinois providing education and support for families, caregivers, and people affected by Alzheimer’s and dementia.

Ben Molina, MSW, earned his Masters of Social Work degree from Washington University in St. Louis. He now serves as client services manager for AA Greater Missouri Chapter, providing confidential support and information to people living with dementia, caregivers, and the public.

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Mobility Management Aims to Create

Equitable Transportation

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The Missouri Rural Health Association (MRHA) Get Link’d 2021 Conference featured several breakout sessions breaking down the role transportation plays within social determinants of health. Speakers highlighted the impacts inadequate transportation has on rural, suburban, and urban communities alike and what equitable transportation may look like.

During “Mobility Management: A Collaborative Solution for a Complex Issue,” Sherry McDonald, Ed. D. and Administrative Consultant II, MU Extension and School of Medicine’s Office of Health, Outreach, Policy, and Education (HOPE) detailed her collaborative efforts expanding transportation access across Missouri. McDonald, along with MU Extension and MRHA, spent 2020 developing curriculum for a Mobility Management Certification Program. Mobility management does not have a singular definition, but possesses four key pillars: coordination, collaboration, advocacy for the unheard, and liberated access to transportation.

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Lead Exposure and Poisoning Pose Health Risks for Children's Cognitive Development


Lead poisoning, often thought to be an issue of the past, continues to be a very prevalent problem that is damaging the health and cognitive abilities of entire communities.

Whether at home, at school, or in other environments where lead is present, children are especially vulnerable. Exposure to high levels of the toxic substance is absorbed in the teeth and bones. This level of absorption not only has serious side effects on people, but has the potential to cause generational health risks.

Female children exposed to lead store it in their teeth and bones. It remains there through adulthood. During pregnancy, the female body releases stored calcium, often from bones and teeth, to support the developing fetus. When calcium is released, the lead that is stored in the bones and teeth is also released, directly impacting the health of the mother and child.

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Thank you to our sponsors, presenters, moderators, and attendees!

A big thank you to our Platinum Sponsor United Healthcare, and our Conference Sponsors and Co-Sponsors:

See you at Old Kinderhook in 2022!

MRHA and Partners Offer Free Rides to COVID-19 Vaccine Appointments in 12 Rural Missouri Counties!

Download Details

Special thanks to Bates County Transport, New Growth Women's Business Center, Own My Own, Inc., and West Central Missouri Community Action Agency.

COVID-19 Updates

CDC Guidance on

COVID-19 Booster Shots

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On Thursday, September 23, CDC recommended a booster shot of the Pfizer-BioNTech COVID-19 vaccine in certain populations:

  • People age 65 and older;
  • People at high-risk for severe COVID-19; and
  • People who work in a high-risk job.

Individuals in these groups who previously received the Pfizer-BioNTech COVID-19 vaccine are eligible for a booster starting at least 6 months after their second shot. See the CDC statement.

This recommendation follows FDA's authorization of the Pfizer-BioNTech COVID-19 vaccine to be administered as a booster for certain populations. FDA's authorization applies only to the Pfizer-BioNTech COVID-19 vaccine, as does CDC's recommendation.

The following resources are available to help health centers understand what this means and assess readiness:

The following upcoming opportunities can also help clinicians learn more:

What Clinicians Need to Know about the Latest CDC Recommendations for Pfizer-BioNTech COVID-19 Booster Vaccination: CDC's Clinician Outreach and Communication Activity (COCA) Call will give clinicians an overview of the Pfizer-BioNTech COVID-19 booster vaccination. Tuesday, September 28, 1:00-2:00 p.m. CT

Join the Day of the Session

COVID-19 Booster Readiness Webcast: HRSA and CDC will provide guidance for health centers on boosters for older adults and those at high risk of severe COVID-19. HRSA Chief of Staff Jordan Grossman will be introducing CDC speakers who will cover booster guidance, best practices to prepare for flu season, and vaccine co-administration. Friday, October 1, 1:00-2:00 p.m. CT

Join the Day of the Session

Today with Macrae: Health Center Program Updates: The webcast will include a segment with Peter Marks, M.D., Ph.D., the director of FDA's Center for Biologics Evaluation and Research, who will provide the latest guidance for health centers on COVID-19 vaccines and other updates on vaccine safety and efficacy. Tuesday, November 9, 2:00-3:00 p.m. CT

Join the Day of the Session
Read: Do Employers Have A Responsibility to Combat Vaccine Hesitancy?


  • Delta is currently the predominant strain of the virus in the United States.
  • It is 2x more contagious than previous variants.
  • It may cause more severe illness than previous strains.
  • Unvaccinated people are the most at risk.

Stay up to date on the science behind the Delta variant.

In Missouri, the highly infectious Delta is causing more than 96% of new cases, the data shows.

The Delta variant accounts for more than 80% of new coronavirus infections in Kansas, Arkansas, Connecticut, and Missouri, according to data compiled by Scripps Research's Outbreak.info, which is supported by the Centers for Disease Control and Prevention (CDC) and the National Institute for Allergy and Infectious Diseases.

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Program Offers Relief and Respite for Dementia Caregivers

As of 2020, over 100,000 individuals over age 65 in Missouri are living with Alzheimer’s or other forms of dementia. This number is expected to increase to an estimated 130,000 within the next five years.

Alzheimer’s is the sixth leading cause of death. The disease directly impacts the number of hospitalizations and ER visits we see as well as raises the cost of Medicaid. Data from 2018 showed 1,530 emergency department visits per 1,000 people with dementia. Dementia patients also saw a hospital readmission rate of 22.6%. In 2020, the Medicaid costs of caring for people with Alzheimer’s grew to $973 million – a number expected to increase 16.8% by 2025.

Possibly most affected are the 194,000 caregivers – usually a family member, friend, or close acquaintance who unknowingly take on the emotional and financial burdens associated with dementia. To keep up with around-the-clock care, caregivers may sacrifice hours at work, opportunities for traveling positions, and even promotions. 

In 2020, Missouri caregivers provided over 292 million hours of unpaid care, despite 64.1% having chronic health conditions of their own.

In an effort to combat these statistics, the Missouri Rural Health Association has partnered with Memory Care Home Solutions and Alzheimer's Association Greater Missouri Chapter to deliver the Customized Caregiver Training and Relief Program (CCTRP).

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Learn More and Enroll


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Medicaid & Other State Agencies Telehealth Policies for Patients with Disabilities

October 1

Learn more.

2021 6th Annual National Summit on the Social Determinants of Health

October 4-6

Learn more.

Alcohol is STILL a Drug: An Exploratory Webinar Series

October 5

Learn more.

More Upcoming Missouri Events


Specialty Care in the Age of COVID: Using Specialty Inpatient Teleconsults to Deliver the Best Patient Care Locally

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October 28th, 12:00pm - 1:00pm CT, Zoom

OVERVIEW: Many hospitals can't staff out all clinical lines, especially non-procedure based services like infectious disease, neurology, pulmonology, psychiatry, non-invasive cardiology, etc. This can be for lack of volume, lack of funds, lack of needed specialists locally, or all of the above. While this has always harmed patients and hospitals in a wide variety of financial and medical ways, in the age of COVID-19, this lack of specialist access has become catastrophic for small and rural medical facilities. With the recent changes in telemedicine coverage driven by CMS, however, hospitals have a new solution to this medical access problem: multi-specialty teleconsults. This webinar will cover the importance and benefits of offering such non-procedure based specialties locally, especially at hospitals dealing with the influx of COVID-19 patients; explore how recent coverage changes for multi-specialty teleconsults allow hospitals to bridge the medical access gap in a financially attractive manner; and answer questions around the logistics and implementation of such a service.


  1. Understand the various negative medical and financial impacts of not offering key non-procedure based specialties locally, especially during COVID.
  2. Understand the recent changes in Medicare and other Payors' telemedicine coverage and what that means for hospitals' physician coverage options.
  3. Understand the options available for specialty teleconsults, especially for hospitals looking to provide immediate access to commonly needed specialty support for COVID patients, specifically in infectious disease & pulmonology (proper treatment and drug protocols, vent management for hospitals unused to keeping intubated patients, etc.) Additional telespecialty coverage options to deal with COVID-19 driven peripheral needs, such as neurology, cardiology, nephrology, and psychiatry, will also be covered.
  4. Understand the logistics and technology involved in setting up a multi-specialty teleconsult service, and best practices for implementation.
  5. Understand what medical and financial benefits hospitals that have implemented remote specialty coverage have seen, including how this type of support can help facilities treat higher acuity patients locally, and related best practice takeaways.



Meena Mallipeddi, CEO, T SQRD

Meena co-founded T SQRD after many years of working on the business side of the healthcare industry and seeing the need (both medically and financially) for more specialty access in small and rural hospitals. Before that, she managed a multi-billion dollar portfolio of healthcare businesses for many years, including hospitals and healthtech companies, at both Royce & Associates and Wyper Capital. Meena started her career as a consultant at Bain & Company, working in both the San Francisco and New York offices. She earned her BA in International Relations/Computer Science with Honors at Stanford University, and her M.Phil in Technology Policy at the Judge Business School at Cambridge University, where she was a Gates Scholar.


Anand Nathan, CPO/COO, T SQRD

Anand co-founded T SQRD with the mission to connect medical facilities, no matter where they are, to the specialists they need to deliver the best patient care. Driven by the opportunity to use technology to solve medical access problems for places like his rural hometown, he is building the first multi-specialty, turnkey platform for inpatient specialty teleconsults that is simple and cost-effective to set-up, and fits in seamlessly to existing clinical workflows. Before T SQRD, he had 15+ years of experience in executive roles in strategy, operations, and finance. Most recently, Anand was a Senior Director at LinkedIn/Microsoft where he led a number of key strategic initiatives including determining LinkedIn's approach to healthcare. Prior to LinkedIn/Microsoft, Anand was COO/CFO of another tech business that he led to a successful sale, and also led key teams at KKR and Bain & Company. Anand has a B.S.E. degree in Biomedical Engineering and a B.S. in Economics from Duke University, where he graduated Magna Cum Laude.

Join the Day of the Webinar

Meeting ID: 889 7714 7714 Passcode: 641919

Funding Opportunities

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NIH Researching the Role of Work in Health Disparities

Apply by October 5

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USDA Emergency Rural Health Care Grants

Apply by October 12

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American Rescue Plan Program for Community Development

Apply by October 19

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Academic/Scholarly Research Grant

Apply by October 29

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Community Outreach/Education Grant

Apply by October 29

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3RNET Recruitment and Retention Assistance


Calling Suicide by its Name May

Save New Mothers

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“You know you’re not okay, right? You’re going to have to talk to somebody.”

These words, uttered by a concerned coworker, were the turning point for April Scott to seek help for her suicidal thoughts. Scott’s first pregnancy was a breeze, but her second brought relentless doubt, fear for her ability as a mother, and severely worsened mental health symptoms. She knew she was in danger when she began obsessively thinking about the handgun in her purse, but providers missed several opportunities to intervene.

Out of fear of being labeled an unfit mother and being separated from her children, she refused to speak up about what she was experiencing. It wasn’t until her coworker confronted her directly that she realized she needed to be honest with her loved ones. Even then, access to treatment and other resources took months to receive, prompting a further discussion about the responsibility of providers in suicide prevention.

In honor of Suicide Prevention Awareness Month, observed annually each September, the Missouri Behavioral Health Council and Missouri Department of Mental Health are hosting a webinar series highlighting risks associated with suicide.

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