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May 2025
Spotlight: Windom Area Health Path-to-Value
Between 2019 and 2024, the Minnesota Medicare Rural Hospital Flexibility (Flex) Program led a Path-to-Value project to help four hospitals to develop strategies to improve care and increase healthcare access. Each hospital partnered with community organizations to address the most pressing Drivers of Health (DOH) in their area. |
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How one community is addressing mental health disparities in rural Minnesota
Bringing people together
In Windom, Minn.—a small city in Cottonwood County—mental health care is getting a much-needed boost. Windom Area Health, an 18-bed critical access hospital serving more than 11,000 residents across 649 square miles, recognized a growing concern that people were turning to the emergency department for mental health needs because local resources were limited.
This realization sparked an internal conversation among hospital staff that quickly grew into a broader partnership between schools, law enforcement, public health agencies and local organizations. The alliance was further strengthened through coming together to develop a Path-to-Value project with the goal of improving access to mental and behavioral health care.
A key outcome of this partnership was the creation of a walk-in mental health clinic—something the region desperately needed with the closest similar service being nearly 90 miles away.
Building a shared vision
Identifying potential allies who also see an issue that needs to be addressed is an important step. It’s also important to recognize that building consensus on an approach to solving it can take time--and sometimes needs a more structured approach.
“It’s important to align yourself with organizations and stakeholders that have the same goals,” noted Jessica Schmit, Behavioral Health Manager at Windom Area Health. “But with that many people involved, it’s also essential to have someone guide the process.”
That’s where the Path-to-Value facilitator made a major impact. With a large team offering ideas from different perspectives, the facilitator helped keep everyone focused on a shared vision and organized meetings that allowed the group to break the larger goal into smaller, achievable steps. “Once you start making progress on those little steps,” Schmit explained, “big things start to happen.”
The group was able to set clear objectives: reduce emergency department visits related to mental health and substance use; increase outpatient mental health visits; and build enough demand to expand services. Everyone played a role, from planning and promotion to coordinating resources and staffing.
Getting off the ground
Launching the walk-in clinic wasn’t without its challenges. The team secured grant funding to help with staffing, community education and outreach—but it still took time for residents to start using the new service.
“The hardest part was getting buy-in from patients,” said Schmit. “Even though community organizations were supportive, it took a while for people to feel comfortable coming in.”
Adjusting the schedule to balance walk-ins with outpatient appointments was another hurdle. Continued community outreach and education helped break down barriers.
Once the clinic opened, the impact was immediate. People who previously would have gone to the emergency department were now able to speak with a mental health provider.
“Especially in rural areas, where mental health stigma is still strong, having this option made a significant difference,” Schmit explained. “We had older farmers and their spouses coming in who never would have considered therapy before.”
Measurable progress
Since opening, the clinic has served more than 140 patients for both crisis intervention and ongoing therapy or medication management. Emergency room visits for mental health issues have decreased by more than 10% from 2023 to 2024. Mental health holds--short-term emergency interventions--dropped nearly 25%.
The clinic has since expanded hours and added staff—though not without some setbacks. Recently, the clinic’s therapist left, and services have been carried solely by a psychiatric nurse practitioner. While medication management visits have increased, walk-in visits declined, and many patients must be referred to facilities with long waitlists.
Despite this, the team remains hopeful. This month, the clinic will move into a new space attached to the hospital, allowing room for additional services and the potential to hire more staff. Plans are in place to add group therapy and to lower the age for walk-in care to include adolescents, who currently must book appointments.
Looking ahead
Schmit emphasized that the work is far from over. Mental health provider shortages remain a challenge across rural Minnesota. “The need is never going to go away,” Schmit said, stressing the importance of continued investment in mental health services and staff recruitment.
Windom Area Health’s journey shows how community collaboration, strategic planning and determined effort can make a real difference. It’s a model others can look to as they navigate the complex challenges of expanding mental health care access.
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