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Rural Health Information Hub

Great Plains Senior Services Collaborative

  • Need: To help rural, low-income older adults in rural Minnesota, Montana, and North Dakota maintain their independence and improve their health and well-being.
  • Intervention: The Great Plains Senior Services Collaborative improves service coordination, promotes social engagement, and provides programs like healthy cooking classes and caregiver support.
  • Results: Phase I served more than 1,550 vulnerable older adults in 80 communities, who reported lower stress and better quality of life.


Older adults in rural areas can struggle to access aging-related services, transportation to medical appointments, and social opportunities. To support older adults living in Minnesota, Montana, and North Dakota, Lutheran Services in America created the Great Plains Senior Services Collaborative. The Collaborative is geared toward older adults living alone, who often are living with multiple comorbidities and/or have high levels of social isolation and depression.

Lutheran Services in America logo

The Collaborative brings together needed training, technology, and creative sources of funding – all of which are too often in short supply in rural America. It combines outside funding and expertise with strategic rural partners to improve seniors' health and well-being.

The first phase of the collaborative (2015-2018), which served Minnesota and North Dakota, was funded by a $2.5 million grant from a national philanthropic partner. Phase II began in 2019 with an additional $3.4 million grant and expanded to include Montana.

Services offered

This collaborative offers the following programs:

  • Aging Life Care Management in Minnesota and North Dakota — connects participants with an advisor to navigate later life care. Services include care coordination, crisis management, patient advocacy, and transitional care.
  • At Home in Montana — a membership program that provides access to educational programs, fitness clubs, home maintenance, computer support, and other services
  • Friends in the Kitchen in Minnesota — teaches participants how to cook healthy meals on a limited budget and how to cook if they have limited mobility (on pause due to the COVID-19 pandemic)
  • LSS Meals in Minnesota – provides meals and groceries "to-go" or delivery for older adults and families in need
  • Remote Caregiver in Minnesota and North Dakota — uses technology to support senior caregivers as they take care of older loved ones
  • Volunteer Companions in North Dakota — provide social engagement and help with household chores


Phase I, which targeted seniors in Minnesota and North Dakota, helped improve the health and quality of life for over 1,550 older adults in 80 rural communities in each state. More than 130 partners and stakeholders were actively engaged in the Collaborative's related programs. Volunteers (including 25 Volunteer Companions) logged in over 6,000 hours and 63,000 miles. An evaluation of the participants found that:

  • 88.4% of participants reported improved health and quality of life
  • 90.2% reported reduced stress
  • 96.5% reported that the program improved their situation
  • 98.6% described the program as high-quality

Phase II expands the Collaborative's reach to include Montana (with Collaborative members providing services in 33 communities in Minnesota, North Dakota, and Montana). In Phase II, Collaborative members partner with North Dakota State University and the nonprofit Wilder Research for program evaluation and sustainability. Results will be available in early 2022.


The programs delivered through this Collaborative are reaching some of the lowest-income, most vulnerable seniors in the service area. As a result, program interventions frequently last longer than originally anticipated and, in some cases, a broader set of services is required. This affects how many caseloads can be taken on and how many people can be served.

Additionally, program sustainability is a challenge, especially in rural communities. To achieve success, programs need to focus on creatively engaging new funding sources and standardizing programs to help with efficiency and service delivery scaling. Focused time and effort are required to achieve sustainability, and access to outside technical expertise plays an important role in providing a framework for creating new financial partnerships with health systems and other payers.


In smaller rural areas, even well-intended programs designed to fill community gaps cannot happen without local stakeholders, so it's important to invest in them. Developing local partnerships takes time and flexibility, and results are not immediate.

Technology infrastructure for client tracking and follow-up is recommended. Technology equipment and internet access is also needed for access to virtual programs, and funds are needed to provide and deliver these programs.

Contact Information

Ashley Washington, Director of Aging Services
Lutheran Services in America

Aging and aging-related services
Community and faith-based initiatives
Community engagement and volunteerism
Elderly population
Social determinants of health

States served
Minnesota, Montana, North Dakota

Date added
November 5, 2019

Date updated or reviewed
November 3, 2020

Suggested citation: Rural Health Information Hub, 2020. Great Plains Senior Services Collaborative [online]. Rural Health Information Hub. Available at: [Accessed 2 February 2023]

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.