Elise Bur, Director of NMU Center for Rural Health

David Haynes sits down with Elise Bur, who was selected to be the first director of the NMU Center for Rural Health after the program received a $100,000 grant in 2020. The NMU Center for Rural Health is a collaborating center for the Michigan Center for Rural Health aiming to create an integrated health care network that better serves U.P. residents and improves their health outcomes, as well as to identify related academic programs to meet regional demand.

In this episode, David and Elise discuss what the NMU Center for Rural Health does, the things it's responsible for, and ways they are helping people right now. They also discuss how the Center is working with local healthcare organizations, working to improve food insecurity in the U.P., and the efforts to impact healthcare-related legislation both in the state and in Washington DC.

Transcript

David Haynes:

Welcome to this edition of Rural Insights Podcast. We are pleased today to have as our guest, Elise Bur, who is the Director of the NMU Rural Health Center. Is that correct, Elise?

Elise Bur:

NMU Center for Rural Health.

David Haynes:

NMU Center for Rural Health. I'm sorry. I should have looked at my notes better. Thank you. Are you Doctor Elise Burr? Did I not do that right, too?

Elise Bur:

I am not a doctor. No.

David Haynes:

I didn't think so, but I wanted to make sure so people... I don't want to... So welcome, Elise. You and I have visited. And I've been reading about this great program, and tell me if I'm wrong, that Dr. Kerri Schuiling, the interim President of Northern started, or at least worked on the grant for. And I think this even might have started while she was Dean of the School of Nursing and Provost. And it resulted in this new wonderful program. So tell us a little bit about, what does the center do?

Elise Bur:

Well, thanks. Thanks, I appreciate you asking me to be a part of this podcast. Appreciate the opportunity. So the Center for Rural Health was founded in July 2020. So it started right in the very beginning of our pandemic. It was a heck of a time to start a new position and then a new thing built around health. The project really entails improving the health and wellbeing of Upper Peninsula residents, and how can that happen? So it's kind of a not only on campus initiative, but it extends way beyond campus. And there are opportunities to tie Northern into helping with some of the challenges that the Upper Peninsula residents are facing when it comes to their health and wellbeing.

I work very closely with the Michigan Center for Rural Health. They are the state office of rural health located down in East Lansing, Michigan. They have a number of resources and different programs and educational opportunities that they provide. And I kind of think of it as though there are ways to expose people in the Upper Peninsula to some of these opportunities without having to necessarily duplicate or replicate. And overall, it's going to really strengthen our rural healthcare system as a whole.

David Haynes:

So what kind of things would you connect people with?

Elise Bur:

I could give you a couple examples. It really isn't one particular avenue. It's kind of multiple different branches that touch different things. One of the first projects I got engaged with was a couple of community action agencies had reached out to me from different geographic regions of the Upper Peninsula. They had indicated that they had CARES Act funding that they wanted to spend, but they weren't sure exactly what they could do. And we came up with an idea that we could use Northern's purchase power to buy iPads for their clients and also contract Northern for one year of the broadband access to the EAN network. And then we could then connect their clients to not only supports, but community resources and telehealth opportunities so that their clients could maintain connections and have telehealth appointments during the pandemic.

So I thought that was a great starting point that we hadn't planned, that just kind of fell into our lap. But it worked out really well. We were able to connect about 150 residents throughout the UP with this type of service.

David Haynes:

So one of the things that I think that makes maybe the UP as a rural area different than some others and the same as some others, but we are blessed with some very wonderful physicians, and specialists, and nurses, and nurse practitioners, and technicians, the whole healthcare people industry, the people in the healthcare. Do you partner with doctors, nurses, hospitals? How does that work? How do they relate to the NMU Center?

Elise Bur:

I have every intention of connecting with them, but it hasn't been the right time to even try to connect with them during this pandemic. So how I initially thought this would go, as far as rolling out this Center, it has not gone the ideal way I thought it would've gone. I will be connecting with CEOs of hospitals. One of the things I want to do over the next year is actually work with them to find out what are some of the challenges they're facing. Some of the initiatives that I've been working on with Michigan Works over the last year is healthcare workforce recruitment and retention initiatives. We know that we have an aging population and a declining population in the Upper Peninsula. It's making it extremely hard to recruit. That problem actually existed prior to the pandemic. And this pandemic has only exasperated the whole situation. So now, it's even harder to solidify healthcare workforce in the Upper Peninsula.

So I have attended the Critical Access Hospital Conference this past year. I was able to meet probably about a third of the CEOs of hospitals at that particular conference. But my intent is to actually go around and travel, tour facilities, meet with people at the different locations at hospitals and clinics up here. And then find out what some of those challenges are. A couple examples would be, I think that there could be certifications or programs, majors or minors, that we could look at putting at Northern, that don't currently exist. That would help meet some of our regional need. I also think we really need to engage with youth right now. We're producing a lot of different graduates in different programs, but how do we maintain those students in the Upper Peninsula? How do we ensure that we're able to support our region at the same time while educating students?

David Haynes:

And how have you begun to connect students on our campus to the Center who are interested in the issue of health, and health services, and sciences, and service?

Elise Bur:

Well, there's a lot of students that will come here because of particular majors or minors. And I'm not necessarily stepping on their toes or getting in the way of that. What I'm trying to do is connect faculty with different community resources. And where there could potentially be engagement, there could potentially be student placement, internship opportunities. I'm going to be working on an apprenticeship opportunity for community health workers in the future here. So it's understanding what currently exists and then what opportunities are in the communities. And then just really trying to link them together. I have had a number of faculty reach out with interest in doing research topics, but they don't necessarily know who would be a good agency to partner with in the community. And so I'm helping with some of those linkings as well.

One example that I can give you would be NorthCare Network was doing a project based on hepatitis C. And so I talked to one of our professors, Mark Shevy, who was teaching a communications course here at Northern. And his students actually took on the project to create kind of a cartoon character named Lenny the Liver. And the students learned all about hepatitis C, which they otherwise really didn't know about, sitting in their marketing class. But they had to learn everything about hepatitis C. And then they created this character and an online platform that talked about this character.

And then we used that to educate other students in the community about hepatitis C. So when you think about who pertains to hepatitis C, it wasn't necessarily the population of our students that need to be concerned about that. But my hope was they would go home at Thanksgiving and talk about this project with their parents, who are then more inclined to be educated more about hepatitis C. And so if we can show that we could roll out something like that on this campus, the next level is how do we roll that out in the communities? And I have been working with a lot of the universities and colleges in the Upper Peninsula, because I haven't been able to really get in with the hospitals right now. So we have been working with education systems.

David Haynes:

Okay. So one of the topics I'm interested in is what I would call, as a non-health professional, underserved communities that need health. And what issue I think about is single parents with children and childcare and getting your child into the right kind of healthcare and services. Is there something that you do in that area?

Elise Bur:

I'm really actually focusing a lot right now on social determinants of health. And these are the challenges and the barriers that prevent people from accessing health. And it could be anything tied from, you take a look at the environment where people exist and so it's their overall environment of education, housing, access to food. These types of things. Child care, obviously, can impact whether or not somebody is able to go to work. Everything kind of triggers and connects at some point. And it all relates back to health, so.

David Haynes:

We are working with a professor at Northern. And one of our student researchers on the issue in the UP of food deserts, of lack of food, et cetera. Is that an issue from your perspective in the Upper Peninsula?

Elise Bur:

It is a huge issue. And I can tell you right now, there's two projects I'm working on related to food insecurity. The first one is we received a $200,000 grant from the Michigan Health Endowment Fund this past fall to work on a two-year project. And we're doing a feasibility study, a business plan, and a capital campaign plan to research the concept of putting in a light produce processing facility in the central part of the Upper Peninsula. So what this means is that this type of facility doesn't exist right now in the Upper Peninsula. So it means that we can engage with farmers over the next year. Find out what they're currently growing, Find out, could they grow more? Or could they grow alternative crops if there was such a facility that was able to actually freeze the produce that they're providing?

And then we talked about, will this building have freezer space for farmers to rent? Because then this can give them income year round, whereas right now, their income is primarily during their growing season or their harvesting season. And so it could really have an impact on the availability of food in the Upper Peninsula. The other part of this is going to be the distribution component related to food. And we have had a couple places reach out to us saying, "Let us know when you're ready to break ground," because we know if this kind of facility existed, it's going to impact how food is reaching other areas of the Upper Peninsula, because then it won't necessarily be trucked in for a day or two from down state.

The second project is with Feeding America. And they are a partner on that initial project as well. And this has to do with the Feeding America trucks coming to the Upper Peninsula. The frequency of these trucks have almost doubled in the last few years. I think last year they had about a hundred trucks that came to the Upper Peninsula. This year, they're shooting for about 140. So there is a need for food in the Upper Peninsula. And it's how we reach people about that need. Our project is going to be to develop... The market co-op is going to be doing food demonstrations of what people can do with the produce that's on those trucks. And then I'm going to be filming those demonstrations.

And we're going to put a QR code on recipe cards that will then be made of available to people who are able to receive their food at the Feeding America trucks. So it'll be nice to show people what they can do with different fruits or vegetables that otherwise they may not have known.

David Haynes:

So the Feeding America trucks go all over the UP, the eastern and the western end?

Elise Bur:

Yes. And I haven't updated my website yet. But once they finalize their schedule for this calendar year, we will provide a link where people can enter their county to see how often the truck will be coming and where it'll be coming.

David Haynes:

That's great. Do you work at all with native American communities yet and what they're doing with healthcare and their needs? They're our largest minority group in not only in the UP, but in rural America. I was wondering what you're doing with them.

Elise Bur:

I've had some interaction. Prior to coming to Northern I worked at a federally-qualified health center. So I worked pretty closely with Bay Mills over on the east side of the Upper Peninsula. I'm very familiar with the [Baraga 00:13:43] location. And I have toured and worked with some people at Lac Vieux Desert as well. So I still have more getting around to do. I've not been down to Hannahville yet. So it's been somewhat limited. I've been making sure they're aware of what resources are available to help them. And I've passed along some grant opportunities in the event that they were in need of funding sources.

David Haynes:

That's great. That is wonderful. Of course, we have the Head of the Bureau of Indian Affairs that is from up here now and from Northern, so that's a great connection. What about your connection with other universities? I think at the University of Michigan, I know when I was president, we partnered with them on a number of projects. And I don't mean just to limit it to them. Are there connections with other universities?

Elise Bur:

Besides our universities in the Upper Peninsula, who I've been working with, I do have some ties right now with University of Michigan, as well as Michigan State University. I've gotten to know some of the people that work in... One person is a psych nurse practitioner at MSU. And she's written some grants, where she's written in my Center, as well as some local hospitals or outpatient clinics where we might be able to provide behavioral health to patients. Some of the grant applications haven't panned out as far as getting those funding sources. But those doors are open. And it's been great to have those connections. I am on MSU's Advisory Committee for MSU Extension. So I've been on that for probably about seven, eight years now. And I've continued that engagement with MSU Extension. So that's been nice. Also, getting to know more people at University of Michigan and working with them in different areas as well.

David Haynes:

Great. Well, it's only been, what, since, it's two years, 18 months you've been going. And you've gotten a lot done in the middle of a pandemic and everything else going on in the world. Is there anything I haven't asked you about that I should have asked about what you do? Did I miss something that you want to talk about?

Elise Bur:

Well, I mean, there's a lot of people who don't know who I am, I guess, and what we're trying to do. And I think it's going to take a while until that kind of gets around. The other part of this is that I'm one person and I can only do so much. So I'm trying to connect people with other people and determine who can help me get some work done within the region. Sometimes it's not about me lifting my finger to do the work. Sometimes it's about me just connecting people with other resources. I'm not here to necessarily do everything myself. But I want to understand what challenges we're faced with and then try to figure out solutions for those. And sometimes it's outside of the box thinking. Sometimes it's not that traditional path. I do not want to duplicate and replicate efforts that are already happening in the Upper Peninsula. So my goal is just to understand what exists and then try to figure out more solutions.

More recently, I've been accepted into a Center for Health and Research Transformation Fellowship at University of Michigan. Actually, I leave town tomorrow to start the first session. And that's going to take place a couple days a week, every week through May. And my hope really is to understand more about how we can work on health policy development, what that means to the Upper Peninsula. My whole focus is going to be on the Upper Peninsula with this. I have seen things happen. I've seen legislation take place in front of me. I've been involved in that. I've gone to Washington, DC in the past. I've worked with state legislators. I have every intention of continuing those efforts and doing whatever I can to move the needle, so to speak, on efforts that will help to support our healthcare.

David Haynes:

Well, I think that's really great. I mean, I hope that our thousands of subscribers and listeners and readers, I hope this will help get the word out about who you are and what you're doing. That's why I wanted to do this. It's one of those projects that Northern is doing that is really important to the Upper Peninsula and rural issues. And we focus a lot on rural policy development as well. So I'm really excited about this.

And they're exciting projects at Michigan Tech, at Lake Superior State. But this one, in particular at Northern, is a wonderful opportunity. I was really pleased when I read about your fellowship, because it's such a great networking opportunity with the University of Michigan and their huge health system and their academic health sciences. It's phenomenal. Well, thank you very much for doing this with me. I hope you'll be willing to come back in a few months and tell us some more about what's happened, as people are starting to get out.

Elise Bur:

Absolutely, absolutely.

David Haynes:

And a friend of mine, an academic who was planning a research project, planned a Zoom meeting with 50 people. And not a lot showed up. And I said to her, "It's because, I think, people are Zoomed out." Their whole life is spent sitting in front of a computer. So one of these days we'll all get to see each other and meet each other. So, Elise, thank you very much. This is just fascinating. And thank you to you and Dr. Schuiling for doing this, because it's a wonderful project for people in the Upper Peninsula, one of the state's leading rural areas. So thank you very much. Stay warm. Stay safe.

Elise Bur:

Thank you. Appreciate the opportunity. And I look forward to coming back.

David Haynes:

Thank you so much. Have a good day.

Elise Bur:

Thanks.