Tag Archives: Lillie Greiman

Skilled Nursing Facilities in Rural Communities: Opportunities for partnering on COVID-19 response efforts

Guest blog post by Dr. Meg Ann Traci, RTC:Rural Knowledge Broker


The devastating and disproportionate rates of novel coronavirus (COVID-19) cases and deaths in institutional settings continues to be part of the national crisis. With data from the 23 states that publicly report data on deaths within long term care facilities, such as nursing homes, skilled nursing facilities and assisted living facilities, the Kaiser Family Foundation estimates more than one in four COVID-19 related deaths in those states (27%) occurred in such settings. The threat within these medical and personal care settings put people with disabilities and others unable to maintain and manage independence in the community, at increased risk. In rural areas, the threat to such institutionalized populations is likely even greater.

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COVID-19: An increased threat to people with disabilities living in rural institutions

Guest blog post by Dr. Meg Ann Traci, RTC:Rural Knowledge Broker.


While rural America is already known to experience higher rates of health disparities than urban, state and local public health data underscore that the current novel coronavirus (COVID-19) pandemic will  continue to harm rural people. COVID-19 is making its way to some of the most rural states of the nation. Just this past week,  Alaska’s Kodiak Island Borough had its first diagnosed case of COVID-19 (April 16, 2020); Wyoming experienced its first fatalities (April 15, 2020); and South Dakota is managing 518 cases identified in a meat processing facility (April 17, 2020).  

Additionally, local and national news headline stories revealed the increased burden of the virus among residents and workers in group quarters such as prisons, nursing homes, and juvenile group homes (non-correctional). The high rates of infection and deaths at a long term care facility in Kirkland, Washington, caught the nation’s attention and refocused the public health response efforts on institutional settings.

Because people living in institutional settings are more likely to report disabilities than the general population and these settings are not evenly distributed between urban and rural areas across the United States, rural people with disabilities have a lot at stake in efforts to address the pandemic and outbreaks in institutional settings.

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RTC: Rural research shows higher risks for rural people during COVID-19

“Not only do you have to travel far to get to beds,” Grieman said, “You’re going to a place where there are more people, where there is also an outbreak, and those beds may also still be in high demand. So, that’s what I find particularly disconcerting.”

RTC:Rural Project Director Lillie Grieman in a recent news article on Public News Service, on why rural people with disabilities are at higher risk during the COVID-19 pandemic.

Rural people with disabilities and barriers to hospital access

Icon of a person in a hospital bed. There is a cross in a map symbol above the bed to symbolize a hospital.
Hospital Bed by Sergey Demushkin from the Noun Project

Rural people with disabilities face many barriers to accessing health care, particularly Intensive Care Units and hospital beds. Hospital capacity varies greatly, as does the prevalence of people with disabilities. Typically, there are fewer hospital beds and higher rates of disability in rural places than urban ones.

Project Director Lillie Greiman discusses some of these barriers in a recent news article- read or listen to the news story through the following link:

Rural Montanans with Disabilities Face Challenges from Home to Hospital

Travis Hoffman, advocacy coordinator for Summit Independent Living, was also interviewed in the article. Summit is a long-time RTC:Rural partner.

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Identifying potential hospital bed shortages for people with disabilities

Recent models from ProPublica, Imperial College, and others predict that millions of people who contract COVID-19 will be hospitalized and many hospitals across the country may not be prepared to treat the influx of patients.

COVID-19 molecule

People with disabilities are particularly vulnerable to impacts from COVID-19, both directly and indirectly. While data about how this virus will impact the health and well-being of people with disabilities is currently limited, people with disabilities are often at greater risk of chronic health conditions, and thus may be more susceptible to infection. People with disabilities also face disruptions in services for daily needs, which could exacerbate conditions unrelated to COVID-19.

Overall, individuals who experience disability are at greater risk for being hospitalized either because they have contracted COVID-19 or because pre-existing health conditions have worsened.


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Disability Statistics Compendium recordings now available

Christiane von Reichert, Lillie Greiman, and Catherine Ipsen at the 2020 Annual Disability Statistics Compendium event in Washington DC.
Left to right: Christiane von Reichert, Lillie Greiman, and Catherine Ipsen.

On February 11, 2020, RTC:Rural Director Catherine Ipsen and Research Associate Lillie Greiman presented as part of a panel at the Annual Disability Statistics Compendium. Their presentation was titled “Uncovering the intersection of rural and disability.”

Christiane von Reichert, professor of Geography at the University of Montana and a RTC:Rural research partner, was also part of the panel. Her presentation was titled “Using the ACS PUMS to examine disability and migration.”

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New article- How proposed SSDI changes may impact rural people with disabilities

screen shot of a map of the US showing locations of Social Security Administration offices in every state. Click on the image to link to the article.

Project Director Lillie Greiman and RTC:Rural Director Dr. Catherine Ipsen recently co-authored an article in The Conversation about proposed changes to disability benefits and how those could make it harder for people with disabilities, especially those in rural communities, to maintain federal benefits.


Read the article here:

February 7, 2020: How Trump’s proposed benefits changes will create hardship for rural people with disabilities


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Research Snapshot: Expanding the Availability and Quality of Rural Data

Lillie Greiman speaking at a conference
Lillie Greiman

In order to create policies and programs that serve the needs of people with disabilities in rural communities, it is important to know things about them, such as demographic information and location. The federal government maintains several large data sets that collect this information. However, it can be difficult to access rural disability data from these data sets (see Data Limitations in the American Community Survey: The Impact on Rural Disability Research).

To address this, RTC:Rural is conducting rural analyses of existing large data sets to contribute to a national disability statistics resource.

Lillie Greiman, RTC:Rural Project Director, explains the project and its goals, and gives a quick progress update.

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RTC:Rural travels to Grand Rapids for 25th annual APRIL conference

25th Annual APRIL National Conference on Rural Independent Living. 1995-2019. The Power of Rural.

RTC:Rural heads to Grand Rapids, Michigan this week for the 25th annual Association of Programs for Rural Independent Living (APRIL) conference. The conference will be October 25 – 28, and the theme is “The Power of Rural.” 

Harnessing the theme of this year’s conference, Project Directors Dr. Rayna Sage and Lillie Greiman, Director of Knowledge Translation Tracy Boehm Barrett, and Research Advisor Dr. Craig Ravesloot will give a presentation titled, “Using Rural IL Power to Address the Needs of People with Disabilities Living in Poverty.” In their presentation, they will discuss how poverty affects Independent Living (IL), rural resources that Centers for Independent Living (CILs) can leverage to help address poverty, and how community development strategies can address poverty among people with disabilities living in their community. Dr. Sage will also briefly describe a number of new opportunities for CILs to get involved in RTC:Rural’s research and rural community development projects to address local issues that affect IL services.

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RTC:Rural fact sheet explores insurance coverage rates before and after ACA and Medicaid expansion

Screenshot of the first page of the ACA and Medicaid Expansion Associated with Increased Insurance Coverage for Rural Americans with Disabilities fact sheet.

The passage of the Patient Protection and Affordable Care Act (ACA) and adoption of Medicaid expansion was associated with substantial increases in insurance coverage across the United States (see Changes in coverage and access, MACPAC 2019). However, RTC:Rural researchers wanted to know how ACA policy changes and Medicaid expansion impacted people with disabilities, particularly those who live in rural areas.

To explore this question, RTC:Rural researchers analyzed microdata from the 2008-2013 American Community Survey from IPUMS-USA. Using these data, they were able to compare how insurance coverage has changed over time for people with and without disabilities in rural and urban places, and in expansion and non-expansion states.

Graphic sharing stats from analysis, which are in previous paragraphs.
[text description] The number of rural people with disabilities with health insurance in expansion states increased by 10.7%. The number of rural people with disabilities with health insurance in non-expansion states increased by 5.3%. Difference = 5.4%.
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The Return of Map Monday

#MapMonday over a background of colorful maps.Your favorite disability map series has returned!

RTC:Rural is excited to share that we’re relaunching #MapMonday, our weekly map series. Every Monday, we’ll share a new map on our social media channels. Follow RTC:Rural on Facebook, Twitter, or LinkedIn so you don’t miss a map! (But don’t worry if you do miss one—they’re all available on our website).

In the coming weeks, we’ll share maps with overall disability rates, disability rates by difficulty and functional limitation (such as vision, hearing, mobility, and self-care difficulty), veterans, poverty, and employment rates. Continue reading