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Concept Paper
Introduction
Colorado STRIDES - or Sustainable Towns: Rural Innovation, Development, Expansion, and Success - is a new collaborative program
created by the Colorado AHEC System (AHEC) and the Colorado Rural Health Center (CRHC). This program entails a partnership
between two innovative, statewide healthcare organizations working together, and collaborating with others, to enhance the
ability of communities in rural Colorado both to recruit and to retain quality healthcare providers through locally driven
community, economic, and leadership development efforts.
The Colorado AHEC System Office and the five AHEC offices in the North Eastern, South Eastern, Central, Western, and San Luis
Valley regions of the state serve as liaisons between the University of Colorado Denver (UCD) and local communities - particularly
frontier, rural and urban underserved communities - in order to develop UCD educational outreach and support systems and to link
university resources with local planning, education, and clinical and community based resources. Funded by a combination of
federal, state, and local dollars, the Area Health Education Centers situated around the state provide a host of educational,
public health, and capacity building services all over Colorado.
The Colorado Rural Health Center serves as Colorado's non-profit State Office of Rural Health. CRHC's mission is to enhance
healthcare services by providing information, education, linkages, tools and energy toward addressing rural healthcare issues.
CRHC provides or helps arrange for technical assistance to rural communities so they can take full advantage of federal, state,
public, and private resources. CRHC builds linkages among rural programs and communities and urban and rural colleagues toward
identifying and addressing healthcare issues. CRHC has a statewide membership of over 2,500 diverse people and organizations.
Problem:
Colorado is a rural state: 73% of Colorado's counties are designated rural or frontier (fewer than 6 people per square mile.)
Moreover, our average rural county covers 1,632 square miles; more than the state of Rhode Island. Of Colorado's counties, eight
have only one full-time primary care physician - four of those are not accepting new Medicaid patients. Six additional rural
counties lack even one full-time primary care physician. One rural county has no primary care physician at all. 14 rural
counties do not have a dentist accepting Medicaid, while seven have no dentist at all. Almost every county in rural Colorado is
designated as a Medically Underserved Area or a Health Professional Shortage Area, showing access to care is severely limited.
At the same time, recruiting and retaining healthcare professionals to rural Colorado is a tremendous challenge. Even
healthcare providers who originate from rural areas become accustomed to urban amenities during their education and training,
which generally takes place in urban settings. This helps account for the geographic disparities in physician placement in
Colorado: Of physicians responding to a 2005 Colorado Health Institute workforce survey of Colorado physicians, 89% reported
practicing in an urban setting compared to 11% who reported practicing in a rural Colorado community - That's 11% of Colorado's
physicians for 73% of the state!
In short, Colorado's rural and frontier counties in Colorado have extreme difficulty recruiting and retaining an adequate number
of primary healthcare providers.
Solution:
To address this recruitment and retention problem, Colorado STRIDES, which draws from existing models, such as West Virginia's
Recruitable Communities program, Economic Gardening programs around the country, and Asset Based Community Development, is as
unique as the needs and environments found across rural Colorado. The program depends on the collaboration of members from all
facets of the local community, working in tandem with state, federal and philanthropic resources offered through Colorado STRIDES.
This partnership identifies and builds upon community assets while addressing opportunities for community improvement.
AHEC and CRHC partner with other organizations in order to provide a full-service approach to asset-based community development for
rural Colorado.
These organizations could include: Colorado Department of Public Health and Environment, Colorado Community Health Network,
Community Health Association of Mountain Plains States, University of Colorado Denver's College of Architecture and Planning,
University of Colorado Denver's health sciences programs, The Governor's Office, Colorado Office of Economic Development and
International Trade, Colorado Rural Development Council, Downtown Colorado Inc, Colorado Center for Community Development,
Regional Advocacy Groups - Action 22, Club 20, and Progressive 15, and local communities.
For more information, please contact Clint Cresawn, Colorado STRIDES Program Director, AHEC Associate Director at
303-724-2480 / clint.cresawn@uchsc.edu or Lou Ann Wilroy, Colorado Rural Health
Center Executive Director at 303-832-7493 / lw@coruralhealth.org.
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