Focus on Fellows: Checking in with three rural leaders

By: Angela Lutz | 11/22/23

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Since 2007, NRHA’s Rural Health Fellows program has given rural communities reasons to be proud. The goal is simple: This yearlong intensive training aims to develop leaders who can articulate a clear and compelling vision for rural America. Each year, NRHA selects 10 to 15 highly motivated individuals who have proven their dedication to improving the health of rural Americans through their educational or professional experience.

Over the years, NRHA has developed a network of diverse rural leaders who have stepped forward to serve in key positions in affiliated advocacy groups, as well as local and state legislative bodies with health equity as a main focus. We recently sat down with NRHA Rural Health Fellows graduates Vicki Brooks, Joni Nelson, and Thad Shunkwiler to discuss how the program benefited them and why others should consider applying.

Vicki Brooks	Joni Nelson	Thad Shunkwiler

Where are you living and working now?

VB: I am an assistant professor of professional practice and director of advanced practice registered nurse programs at Texas Christian University in Fort Worth. I am chair of the Health Policy Education special interest group at the National Organization for Nurse Practitioner Faculties, where we developed a health policy toolkit for university professors to use when teaching policy to nurse practitioner students.

I am the elected American Association of Nurse Practitioners Texas liaison representative, the only rural health voice. I am also on NRHA’s Government Affairs Committee, representing the allied health and nursing workforce.

JN: I’m living in Charleston, S.C., but my hometown is in rural South Carolina. I’m at the Medical University of South Carolina as a researcher and associate professor, and I’m also deputy director in the Division of Population Oral Health.

"Working in the rural public health setting was eye-opening for me as a nurse practitioner."

– Vicki Brooks

All of our work has a large priority on rural health access, community engagement, and oral health improvement. We have a large research portfolio that includes improving head and neck cancer literacy, and we also have a priority for schoolbased oral health and interprofessional oral health.

TS: I live in Mankato, Minn., and I’m an associate professor in the Department of Health Science at Minnesota State University. I’m also the founding director of the Center for Rural Behavioral Health.

I’ve been a faculty member for nine years, and the center is just over a year old. We are an academic research center that has the mission to improve access to behavioral health care in rural Minnesota. We do that through research, workforce development, and education. We’re the only academic research center in the country that is exclusively looking at rural behavioral health workforce issues.
 

What inspired you to choose a rural-focused career?

VB: I was from a large urban area for the first 10 years of my life, and then my family moved to a rural area with 800 people. It was a significant adjustment as a kid. As an adult, I love the feeling of a smaller population and a slower pace. I still live in a rural area, far west of Fort Worth.

The people who live in rural areas are good, hardworking, friendly people who tend to be sicker, older, and poorer. Having limited resources in rural areas makes us more aware of what we do have and how to be innovative when lacking resources. Once I became a family nurse practitioner, I helped start the first rural mobile health clinic. The mobile clinic traveled through the county, targeting five different school districts and delivering much-needed primary care.

"When it comes to setting those leadership goals and following through – it was like they took the training wheels off and allowed us to practice those skills we were taught."

– Joni Nelson

As an educator, it’s nice to teach nurse practitioner students about rural and help them discover the possibilities. The aim of exposing students to rural environments is to encourage them to work there, or at least gain a better understanding of patients from rural areas. By being exposed to rural clinical settings, students can begin to understand social determinants that can affect the rural population.

JN: My maternal grandmother had a lot of different oral health issues. She lived in a rural area during a time when there was a low level of literacy and educational access. The pinnacle moment was when I was in a dental office with her, and there was a low level of communication and engagement. She had a lot of oral health disease burdens that were causing other health issues such as diabetes and high blood pressure, and that brought about this niche in my research for interprofessional oral health.

TS: I was born and raised in rural Minnesota. It’s home – my family is here. I never left other than my military service. I always intended to have my career and family here. Before becoming an academic I practiced and provided care in rural Minnesota and saw firsthand the impact that lack of services had on our rural communities. My work now is truly a labor of love.
 

When were you a Fellow, and what did you focus on while in the program?

VB: I was a Fellow in 2021. We focused on rural public health. Working in the rural public health setting was eye-opening for me as a nurse practitioner. Rural public health is pretty much nonexistent, which is why one of our main goals with our policy paper was to advocate for the creation of an Office of Rural Health within the CDC – and that’s now happening, so I’m super excited.

"To anyone who is considering applying, I would say they should take full advantage of this opportunity to learn from the best at rural health advocacy."

– Thad Shunkwiler

JN: I was a Fellow in 2017. My priority was a ruralfocused advocacy project on health care access and rural oral health outcomes. The emphasis was rural oral health interprofessionalism as a key facilitator for improving oral health outcomes.

TS: I graduated in February of 2023. Our policy paper was on reducing burnout among rural health care professionals. Personally, I focused on learning as much as I could about federal policy and its impact on state-level policy. I knew that to broaden my understanding I had to see it from the top end, and there’s nobody better in the country doing that than NRHA.
 

How did the Fellows program make you a better rural health advocate and leader?

VB: It helped educate us on what’s out there across the nation for rural health, and it also helped create a louder voice for all of us working together. Having collaboration and knowing other people are working for rural populations and issues gave that power to our voice.

JN: It enhanced my communications with legislators, key state personnel, and local leaders. It also developed my leadership through engaging with NRHA members and gave me unique experience for education and advocacy on the Hill.

"Having collaboration and knowing other people are working for rural populations and issues gave that power to our voice."

– Vicki Brooks

NRHA’s Rural Health Policy Institute allows all of the Fellows to do Hill visits. I’ve done Hill visits before, but this time we were equipped with our specific area of interest. It helped me share meaningful health data and outcomes with our representatives regarding their constituents in a way that meant something.

TS: It gave me a deeper understanding of the issues and the language to talk about them, and it gave me the tools to take back to the state level and advocate. I also had the opportunity to collaborate with people not just in Minnesota but across the country who share similar passions and backgrounds.

You can’t replicate the personal and professional connections you can make through the conferences and Fellows team you get to work with.
 

How did the Fellows program give your career a boost?

VB: I’m still connected to the other Fellows who were in my group, and in a broader way to the other committees within NRHA. There’s a lot of support through NRHA – I am surrounded by likeminded friends who give us a voice that’s a little bit stronger. Everyone at NRHA is so friendly, warm, and welcoming.

Rural Health Fellows helped me develop the skills to challenge health care barriers and increase collaboration for improving rural health in Texas and enhancing policy education across the nation. NRHA also provided me with knowledge and skills for local policy work that includes community organizing to create a climate-safe neighborhood coalition in Fort Worth.

JN: I’ve been able to maintain relationships with legislators and representatives and effectively present information. Working alongside NRHA to continue to improve health outcomes for my state is the main skill that I continue to use. Here on campus, we have direct contact with some of our representatives, and I still have documents and templates from the program that I use in my communications.

"Working alongside NRHA to continue to improve health outcomes for my state is the main skill that I continue to use."

– Joni Nelson

Continuing to engage with NRHA has helped me continue to elevate my leadership. I serve on NRHA’s Government Affairs Committee as an expert in oral health, and I’m on the Health Equity Council and the Journal of Rural Health Editorial Board. I don’t know that I would have had such a close-knit engagement with NRHA if it weren’t for the Fellows.

TS: I took back what I learned and authored an appropriation bill at the Minnesota legislature, and we got an appropriation to establish a training clinic at my institution. I convinced our legislature how important access to rural behavioral health services is, and I can’t imagine I would have had the confidence or the push to do that without having been around people who do this full time.

I gave [NRHA Chief Policy Officer] Carrie Cochran-McClain and [NRHA Program Services Coordinator] Ally Zimmerman credit – I’m here because I had this experience, and I don’t think without it I would have been ready for something like this.
 

Why should other rural health pros consider becoming a Fellow?

VB: I think it helps open anyone’s eyes to what’s going on in rural health care, as well as what resources are available and who’s on our side to help support and initiate any changes that we need to happen.

JN: There are two areas that NRHA’s Rural Health Fellows program provides. One is a competence in career development from being among peers who are seeking to advance their leadership. The second is creating an opportunity to achieve leadership goals. In the Fellows program, there is not a lot of handholding. There are a lot of skills and technical assistance given, but when it comes to setting those leadership goals and following through – it was like they took the training wheels off and allowed us to practice those skills we were taught.

"I convinced our legislature how important access to rural behavioral health services is, and I can’t imagine I would have had the confidence or the push to do that without having been around people who do this full time."

– Thad Shunkwiler

TS: I think it’s a great opportunity to add to your leadership bucket. Anyone who’s interested in the program is probably already in a position where they’re doing the work, so why not add to your toolbox with what NRHA can give you through the program? To anyone who is considering applying, I would say they should take full advantage of this opportunity to learn from the best at rural health advocacy.
 
 

Support rural health leaders

NRHA’s Rural Health Fellows program is supported in part by the association’s National Rural Health Foundation, which is committed to building a permanent endowment to aid emerging leaders from and for rural communities.

With your help, we can provide rural leaders with training and resources to play a lead role in ensuring access to quality health care for rural Americans. For more information or to donate, contact Brandon Brook.
 

Join Fellows and fellow advocates in D.C.

NRHA’s 35th Rural Health Policy Institute is your chance to guide the future of rural health policy with NRHA leadership and advocate for issues you care about with new and returning members of Congress and the administration Feb. 13-15.

It’s also where the new class of NRHA’s Rural Health Fellows meets as the previous class graduates, having presented their policy paper project before NRHA’s Rural Health Congress and their peers.

We hope to see you there, so register early to save.