Dr. Frank Newman Rural Health Award

Born and raised in Billings, MT Tara Salley, started her medical career journey in a fast paced, urban environment, working as an RN at RiverStone healthclinic and at the now Intermountain Health St. Vincent's Regional Hospital. A valued RN who worked in a variety of positions, Tara continued her education and earned her Physician Assistant (PA) license in 2006 when she graduated Rocky Mountain
College with honors. At the time, fewer than 500 Montana PA licenses had been issued. Tara could have worked anywhere; whether
by happenstance or design Tara has dedicated the last 15+ years to rural medicine.

Dr. Tara Salley, PA, DMSc exemplifies Dr. Newman's commitment to rural health---as a provider at the critical access ambulatory
Indian Health Service clinic Northern Cheyenne Service Unit (NCSU) in Lame Deer, MT. According to the 2019 Montana PA Practice profile from the American Academy of Physician Assistants (AAPA), "In Montana... a typical PA completes 50 patient visits per
week." I have personally worked as part of Dr. Salley's team when she has provided care to more than 50 patients in a day. Whomever first linked urban with fast paced has never worked at the only health clinic in a 50 mile radius. Through these busy days,
she studied and earned her DMSc. I am honored to call her Doctor.

Dr. Salley is a committed life long learner and has perfected many roles over the years. She is a trusted provider across the life span
from newborn, including presiding over precipitous births, to geriatric care and palliative care. She is licensed by the International Association of Forensic Nurses as a Sexual Assault Nurse (or Advanced Provider) Examiner (SANE) provider for both adults and pediatrics. She regularly works her shifts in our very busy 24 hour Urgent Care, but also covers Primary Care clinic and Midwifery clinic. She recently completed 18 months as the NCSU Acting Medical Director and still serves as the Northern Cheyenne Ambulance
Service Director, a ground ambulance BLS w/ALS authorization service employing 10 full time EMT's and 1 paramedic.

Dr. Salley works closely with local and regional stakeholders, including her alma mater. A favorite clinical rotation among Rocky PA
students, she averages 4 PA students per semester. Tara has offered her own on campus housing for students during clinicals, aswell as driving students to and from Billings--100 miles away--reducing transportation barriers and maximizing mentorship time. Dr. Salley is a great recruiter for our clinic and Indian Health Service in general. Just this year, she has recruited at least 1 permanent and 1 locum provider to our hard to staff clinic.

Dr. Salley has a deep knowledge of the community and the respect of patients and staff. She works through wildfires, snowstorms, road closures, and water outages while guiding and mentoring the PA's of tomorrow. It is a privilege to have this opportunity to nominate her for the Dr. Frank Newman Rural Clinical Leadership Award.

Lynn and Janice co-direct the Dawson County Family Planning program which provides sliding fee scale sexual and reproductive healthcare services like birth control, STI testing, cervical cancer screening, pregnancy testing, preconception healthcare, and services to assist in achieving pregnancy. The program is not an easy one to run, both because strict federal requirements are often overwhelming for a rural health department's infrastructure and underfunding, and because of increasing politicization of the program's services. But they work with care and intention to provide high-quality and needed care for their community members who would otherwise be left without. Lynn is a Registered Nurse who manages the clinical side of the program and Janice handles program administration and operations. Together they lead with a unique blend of collaboration, creativity, and deep relationships that exemplifies the beauty and strength of rural health.

Lynn and Janice are dedicated to ensuring the program is available for the people of Eastern Montana, so they support a network of satellite sites in four other cities to expand access points. Dawson County manages administrative requirements and centralizes program operations so that other local health departments can offer the program with a more limited scope of responsibility. Recently, the Rosebud County Health Department was at risk of losing their program, and Lynn and Janice extended support to bring Rosebud County within their satellite network. The task would only add to their workloads, but they did it without question an with a sense of responsibility for supporting ones neighbor. For all members of their satellite network, they provide helpful guidance, organization, and community that allows each health department to better serve their local population.

They are also both eager to learn and grow to better meet the needs of their clients. Lynn is constantly finding opportunities to increase the scope and quality of clinical care so that clients feel welcome and can access more services from their hometowns. She is a fierce advocate for her clients who works closely with local providers and within the healthcare system to ensure clients’ needs are met. Janice is diligent about creating a more resilient program through building organized systems and increasing financial support so that staff can focus on caring for clients rather than checking boxes. They are the first to jump at an opportunity to innovate and grow, for example through their recent participation piloting a person-centered satisfaction metric meant to revolutionize how we assess the quality of care.

Lynn and Janice embody the spirit of rural health leadership through their unwavering commitment to expanding access to sexual and reproductive healthcare in Eastern Montana. For their exceptional leadership and thoughtful collaboration, Lynn and Janice are truly deserving of the Frank Newman Rural Health Leadership Award.

Kate is deeply committed to rural healthcare in Montana. She has served as a community-based advocate with Domestic and Sexual
Violence Services for over 13 years, providing support, resources, and encouragement to more than 1500 survivors of interpersonal violence in Carbon and Stillwater counties. Born and raised in Joliet, MT and raising her own family there as well, Kate brings the benefit of her community roots to her work empowering others.

As a member of the Board of Directors for Montana’s Coalition Against Domestic and Sexual Violence, she fights for improved legislation and funding for survivor health statewide. Appointed by the Attorney General in 2020 to serve on the Montana Fatality Review Commission, Kate joins leaders in healthcare, justice, and legislation to identify gaps in Montana’s system for protecting domestic violence victims and better coordinate efforts to protect those most at risk of domestic homicide. Notably, she assisted in successful efforts to categorize intimate partner strangulation as a felony in Montana, and helped agencies and public officials understand the risk of lethality associated with strangulation. She then ensured rural community partners were properly trained to recognize the signs and symptoms of strangulation.

Kate believes in the capacity of rural communities to provide belonging and connection to those who need support. Her work exemplifies how rural communities can take the lead in improving our own healthcare options. She has led dozens of trainings to improve community response to domestic and sexual violence and has been instrumental in coordinating law enforcement, emergency
medical responders, mental health professionals, and public assistance navigators to improve services for survivors. With her leadership, DSVS has streamlined processes for law enforcement to connect survivors to our services within 48 hours and set up a volunteer driver program to ensure survivors of sexual assault have confidential transportation to and from Billings Clinic for a Sexual Assault Nurse Exam (SANE). She has trained over 20 advocates in our rural area, and more across the state. She also manages our
helpline volunteers – a noteworthy effort, as DSVS is one of the only domestic and sexual violence organizations in Montana that
maintains a 24/7 emergency helpline with trained, local volunteers, ensuring the help survivors receive is rooted in the community and specific to our rural area. DSVS can provide the volunteer helpline because volunteers feel supported by Kate – she sets up excellent training for them monthly, talks with them daily, and enthusiastically organizes our annual volunteer appreciation brunch to recognize
and celebrate their efforts.

Kate embodies qualities that are difficult to train – empathy, conviction, and bravery. She has helped so many reclaim their confidence and pursue their goals. She has influenced healthcare policies and procedures that have improved the safety of Montana and make us hopeful for the future. For these reasons, we enthusiastically nominate Kate Croft for the Frank Newman Rural Health Leadership
Award.