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Public Statements

Addressing Rural Health Care Needs


Location: Pierre, SD

By Dennis Daugaard

Last year, an analysis of photos posted on the Internet determined that South Dakotans smile more than people in any other state. That doesn't surprise me. Living in a rural state inclines us to be trusting and friendly people. After living in Chicago for several years in the 1970s, I found myself missing the friendliness of South Dakota people.

Preserving our rural way of life is important, and that means, in part, ensuring that health care providers exist in our smaller communities.

Most of our state's health professionals are concentrated in the more populated areas, while rural areas have been struggling to recruit and retain providers. Fifty-seven of the state's 66 counties are federally designated as health professional shortage areas, either partially or completely.

If we do nothing, it's likely the shortage will increase as time goes by. As many of our current providers near retirement age, South Dakota will need over 8,000 new health care workers by 2020. This will be a challenge given that our elderly population is expected to double by 2025.

But it's a challenge I believe we can handle. In fact, we've already made important strides.

We know that health care providers who were raised, educated and trained in rural South Dakota are more likely to stay in those smaller communities. That is why we've expanded rural health care incentives programs and increased the capacity of our educational programs.

Two years ago, we allocated funding to establish the Frontier and Rural Medicine, or FARM, program to give third-year medical students a nine-month experience in rural communities. We also increased the rural payment incentives for those who practice in rural areas. As a result of this expansion, we have 120 health care professionals that were successfully recruited to 49 rural communities, including communities like Faulkton, Scotland, Mission and Timber Lake.

In Fiscal Year 2013 we increased the class size at the medical school by four students, and in my budget this year I am proposing that we add another 11 students, per class. That means, in five years, we will have 60 more medical students being trained in our state than we did before the expansion began.

We have also increased the capacity of the physician assistant program at USD, from 20 to 25 students and reserved 20 of those spots for South Dakota residents. For the first time, we are now paying preceptors who provide practice experiences for physician assistants. This has increased the number of willing preceptors in our state. In my budget proposal I'm proposing that we provide the same financial incentive for Nurse Practitioner Preceptors.

I know we still have a long way to go -- eliminating provider shortages in our rural communities will require a continuous effort. Still, through beginning to address the issue now, we have taken an important step in preserving our identity and way of life.

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