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In Rural Indiana, Volunteers Outnumber Staff In Some COVID-19 Vaccine Clinics

If volunteers hadn’t stepped up, Greene County’s health department would have been operating with just one full-time staff member at its vaccine clinic. (Alex Paul, WTIU/WFIU News)

After months of contact tracing, local event approvals and trying to keep schools open Greene County Health Department Administrator, Shari Lewis’ next task might be her largest yet.

Rural health departments like Lewis’s are working to distribute COVID-19 vaccines, and many are running into issues beyond hesitancy. 

Data from the Kaiser Family Foundation reveals rural residents are more likely to view vaccines as a personal choice and are less likely to be worried about contracting COVID-19.

While vaccines offer hope for an end to the global pandemic, it’s another task already taxed local health officials are managing.

To make matters worse, public health resources and staff tends to be limited in these areas.

“We started off slow for the first two weeks,” Lewis admits. “January 11, we were vaccinating every other day, with one vaccinator

READ MORE: Indiana COVID-19 Hospitalizations Continue To Decline

But the department quickly increased local efforts—thanks in large part to a group of 20 volunteers.

“Without our volunteer staff in Greene County, we would be vaccinating 100 people,” Lewis said volunteers helped the health department increase its weekly throughput to 500.

Among those volunteers is retired nurse Peggy Wolfe. She has volunteered after other disasters, but never this close to home.  

Wolfe said watching a press conference where State Health Commissioner Dr. Kristina Box asked former healthcare workers to step up gave her the incentive to help.

“I've done sort of things like this before, but I just I said, ‘That's enough!’” Wolfe recalled.

The 42-year healthcare veteran said she began assisting the department with contact tracing, “and then we went from there to sort of form a volunteer army for this vaccine clinic.”

While Wolfe insists she’s not going anywhere, other volunteers can’t or won’t be so generous with their time.  

If volunteers hadn’t stepped up, Greene County’s health department would have been operating with just one full-time staff member at its clinic.

Greene County's Challenges Are Symptoms Of Larger Problems

Similar challenges are felt across the state, according to Kerry Thomson, the executive director at Indiana University’s Center for Rural Engagement. She says the center and other thought leaders are doing their best, but resources targeted for rural communities are rare.

“We're all in this alone, almost,” she said. “If we could develop some best practices and disseminate them quickly, in a trusted meant manner, and allow the people on the ground who are innovating well, to share what's working in their communities, then I think that we could have gotten a faster response.”

Thompson doesn’t blame any single entity, but insists the current challenges are a result of systemic issues that have plagued rural healthcare for decades.

“It's something that we should learn from,” Thompson said.

Thompson, Lewis and other experts say the lack of broadband internet has made it harder for individuals in rural parts of the state to register for vaccines—or even access basic telehealth services.

Studies have shown rural communities reap a 4:1 return on broadband infrastructure investments, but communications providers don’t often benefit. Providers often don’t have incentive to build in rural communities because of the limited number of customers, high initial build cost and low population density.

READ MORE: With Telemedicine On The Rise, Black Americans Risk Being Left Behind

But other barriers exist too. The pandemic has cast additional uncertainty on health system finances—especially those located in rural communities.

June data from the Indiana Hospital Association shows hospitals across Indiana averaged a negative operating margin of more than 8%, but in rural critical access hospitals that’s acutely felt.

Indiana’s 35 critical access hospitals reported spending 27.7 percent more than they made. 

Indiana Hospital Association President Brian Tabor said if action isn’t taken to help these facilities, cuts and closures could be inevitable.

"If some of these small, rural hospitals or even some of our urban safety net hospitals – if they start to falter, there isn’t that same level of strength [present anymore]," Tabor said.

Thompson and local health officials agree more funding from state and federal partners could unlock new opportunities to reach more residents with vaccines.

“If federal and state aid are going to be made available, it will be put to great use,” she said. “We always we are firm believers that communities know what they need best.”

Late last year, Indiana sent funds to local health departments in hopes of bolstering staffs. Up to $40,320 went to Indiana’s smallest counties, but in many, resources are still scarce.  

Box insisted during a call with reporters this week additional funding and members from the Indiana National Guard are available for vaccine administration.

“We are absolutely willing and able to help you with that,” she said.

In Greene County, Lewis insists she’s going to continue searching everywhere for funding to compensate her volunteers.

“They're coming, they're spending 20 hours or more in the clinic at you know, completely free,” she said. “So, I would like to be in a position to at least compensate them for gas, for lunch or some type of stipend.”

Local health officials in multiple Indiana counties have admitted they could vaccinate more people if additional funding was readily available. 

In the meantime, Wolfe is going to continue going to the pop-up vaccine clinic at the First Baptist Church in Bloomfield. On Wednesday morning, they vaccinated 58 people in four hours.

READ MORE: Out-Of-State Residents Not Eligible To Receive COVID-19 Vaccine In Indiana

And Wolfe’s work doesn’t stop there. In addition to making runs for treats to the local Dairy Queen for volunteers, she’s also taken up lobbying her neighbor.

“I have a neighbor who is on the county council, and I've solicited him to say, ‘You need to get them more money,’” she said. Many volunteers take turns bringing in meals, and all look out for each other. 

“We have a wonderful team here,” Wolfe said smiling.

Lewis insists these volunteers have given Greene County a shot in the arm.

“If the volunteers pulled away, then we would definitely not be able to vaccinate the numbers that we’re vaccinating,” she said.

For the latest news and resources about COVID-19, bookmark our Coronavirus In Indiana page  here. 

Want to contact your legislators about an issue that matters to you? Find out how to contact your senators and member of Congress here.

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