The Rural Health Development Council was created in the Department of Commerce in 1989 through statutory language found in s. 15.157 (8). According to the statute, there are fifteen members on the Council. The governor nominates thirteen of the members, who are appointed through the advice and consent of the senate. These members serve five-year terms. In addition, the Secretaries of Commerce and Health and Family Services or their designees serve on the Council. The appointed members include:

• A representative from the University of Wisconsin School of Medicine and Public Health,
• A representative from the Medical College of Wisconsin,
• A representative of the Wisconsin Health and Educational Facilities Authority (WHEFA),
• Two representatives of private lenders that make loans in rural areas,
• Two representatives of health care facilities located in rural areas,
• A physician,
• A dentist,
• A nurse,
• A dental hygienist, and
• A representative of public health services.
• A representative of the farmer’s home administration is also included in the statute; however, no one has ever been appointed in this position.

In s. 560.185 the purpose of the Rural Health Development Council is described. It is to:

• Advise the Department of Commerce on matters related to the Wisconsin Loan Assistance Program for physicians, dentists, dental hygienists, and non-physician providers such as nurse practitioners, physician assistants, and certified nurse mid-wives.
• Make recommendations to the Department of Commerce on ways to improve the delivery of health care in rural communities, and on ways to evaluate linkages between rural health facilities and economic development
• Make recommendations on ways to coordinate the policies of state and federal programs pertaining to rural health care delivery.
• Perform other advisory functions at the request of the Secretary of Commerce related to rural health development

Since its start in the early 1990s, the Council has focused on improving access to primary health care in rural areas by:

• Recommending statutory language changes to make the loan assistance program a more effective recruitment tool.
• In 1993, studying primary care workforce need, which resulted in a number of recommendations that have since been implemented. These include an assessment by the state’s two medical schools to increase interest in primary care careers, the establishment of a school of nurse midwifery, and the expansion of educational programs for physician assistants and nurse practitioners.
• Having periodic dialogue with the state’s two medical schools, encouraging them to continue and expand their efforts in primary care, focus on rural health issues, and engage in joint planning.
• Discussing with the Dean of Marquette School of Dentistry, the expansion of the number of dental students, particularly those from Wisconsin.
• Producing an issue paper on “Access to Health Insurance for Farm Families, which led to the Wisconsin Farm Health Summit in April 2002.
• Making recommendations to equalize Medicare physician payments between rural and urban communities, which improves recruitment and retention in rural areas.
• Was catalyst for the initiative that resulted in the creation of a single statewide Medicare payment area for physicians, significantly reducing a historic anti-rural payment bias.
• Was catalyst for Wisconsin’s business community and its Congressional delegation understanding that Medicare underpayment was costing the state nearly a billion dollars a year due to being below average in dollars per beneficiary returned to Wisconsin. This understanding contributed to the passage of the 2003 Medicare Modernization Act.
• Was catalyst for the creation of the State’s Private Employer’s Health Care Coverage Board. While implementation of the insurance pool envisioned in the statute was blocked, awareness of the challenges facing small employers was substantially enhanced.

Recent Council Changes

The Council recently adopted the following updated statement of its mission, vision and strategic planning values:

Mission: To optimize the health of rural citizens and the economic wellbeing of rural communities by identifying, enabling and advocating actions which add value to both.

Vision: Health, economically vibrant communities across rural Wisconsin.

Focus: To encourage and engage meaningful participation and interactive support from key mission-supportive collaborators and to focus its efforts on a select number of key strategic initiatives.

The literature of rural economic development documents its interdependent linkage with the development and availability of quality rural health services to attract, sustain, and retain a healthy, productive rural business workforce.

The Council’s strategic planning effort has identified a number of public, quasi-public and private entities whose key responsibilities deal with one or more elements of rural health development and/or economic development, and who make both unique and complementary contributions to both sectors.Some of these entities have well-designed, effective linkages with collaborative entities within or between the sectors. Others may be just arriving at an awareness of the value of this kind of collaboration. As a result, there are missed opportunities, unattended needs and inadvertent consequences that a representative and collaborative body could help identify and address.

After discussion as to the most appropriate mechanism to explore this idea, the Council decided to create an interim Rural Health & Economic Development Forum (hereafter referred to as the Forum) comprised of current Council members and representatives of potential collaborative entities to test the promise of this strategic initiative.Four categories of collaborators whose perspectives and programs relate to the rural health development and/or rural economic development sectors are represented on the Forum, including:

• State Agencies/Offices/Authorities
• Rural Health Workforce Educators, Trainers, Developers and Researchers
• Practicing Rural Health Professionals, System Managers and Associations
• Public/Private Business and Rural Development Programs