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Implementation Challenges

There are many possible challenges that can arise when implementing a program to improve access to care for people with disabilities in a rural community. Challenges will be specific to each program. Broad challenges that may be encountered include:

Acceptance of a new program or strategy requires community, provider, and staff buy-in. If providers, healthcare staff, community members, and the target population are not accepting of the program's goals and vision, the long-term sustainability of the program will be limited. Cultural barriers, social issues, languages, and program objectives can affect acceptance.

Possible Solutions: Partnerships, Staff

Funding or financial sustainability leads to both short-term and long-term advancement of program goals. Having adequate financial resources can help with long-term sustainability. Funding and financial resources are necessary for space, supplies, staff salaries, and outreach and engagement activities. Other funding challenges include:

  • Cost of renovation and construction to implement accessible building features
  • Cost of disability-appropriate medical equipment
  • Cost of travel for program participants and program staff
  • Reimbursement for transportation, home care, care coordination and other services; flexibility in obtaining reimbursement for non-standard care

Possible Solutions: Partnerships, Financial Resources

Provider shortages include shortages of primary care physicians and specialty providers. These shortages can also reduce provider ability to network and keep up-to-date on standards of care. Provider shortages are not limited to physicians; people with disabilities often require complex care from multiple types of providers that are less readily available in rural communities such as:

  • Physical, occupational, or speech therapists
  • Specialized physicians and advanced practitioners
  • Nurses, nurse practitioners, and nurse case managers
  • Dietitians and nutritionists
  • Community health workers
  • Rehabilitation specialists
  • Mental health and behavioral health providers

Possible Solutions: Partnerships, Staff

Technology is a common challenge in rural communities. Barriers to implementing and using technology to improve access to care stem from financial constraints and limited availability of technology infrastructure such as broadband, high-speed internet, and Wi-Fi. These barriers exist in individual households as well as in larger healthcare settings, which limit the flexibility to use telehealth technology and provider ability to share patient information across clinics. 

Possible Solutions: Technology Infrastructure, Financial Resources