HENRY COUNTY – The only executive director ever to guide the Martinsville Henry Coalition for Health and Wellness has retired. Barbara Jackman has stepped down after 13 years with the coalition and a decades-long career in health administration. She is being succeeded by Michael Farley, formerly of Texas, who joined the coalition September 1. Jackman was the first employee hired when the coalition was formed in 2005 by the Harvest Foundation with a five-year, $4.5 million grant. Harvest was created three years earlier from the proceeds of the sale of Memorial Hospital, where Jackman had worked since around 1990, mostly as chief operating officer. Harvest invests the proceeds of the hospital sale and uses the income from those investments for economic development through three areas: health, education and community vitality. Those areas have to move forward together, Jackman said, and “The Harvest Foundation recognizes that.” “We wouldn’t be anywhere” if it was not for The Harvest Foundation, Jackman said. In 2003, Harvest partnered with local leaders and organizations to conduct a community health assessment to identify key health priorities that needed to be addressed. From that assessment, the Coalition for Health and Wellness was formed to serve as a community convener in addressing those identified issues. “Over the last 13 years, strong systems and networks have been formed that have strengthened our local healthcare system,” said Sheryl Agee, impact officer and team leader at The Harvest Foundation. “Barbara Jackman has been an integral part in making that happen. She has been a visionary leader, with an innate ability to see health issues from a holistic approach and understand all the factors that have to work together in order to address health challenges. Her innovation has made the Coalition a strong organization and a legacy to be proud of.” OBJECTIVES UNCHANGED Since its beginning, the Coalition for Health and Wellness has had two main objectives: to promote health throughout the community and to improve access to health care, Jackman said. Those objectives have remained despite what Jackman calls dramatic changes in health care since 2005. She cited such things as the Affordable Care Act and the upcoming expansion of Medicaid in Virginia as well as the rise in “social determinants of health,” such as housing, financial stability, transportation, access to food and access to nutritious food. “We were working in those areas before they became a ‘thing,’” she said. “Over a decade later they became part and parcel in improving primary health care.” From the start, the coalition developed partnerships to target such things as obesity by helping develop trails with the Dan River Basin Association and healthy eating with the farmers market, Jackman said. It provided fitness equipment, programming and nutrition information to after-school programs, held exercise programs, started a golf program for disadvantaged children, worked with the MedAssist Program that provides help getting medications, and other efforts, according to news articles at the time. A “game-changer” occurred in 2007 when the federal government began accepting grant requests for health centers in underserved areas, Jackman said. This area received such a grant and the coalition opened the Bassett Family Practice in January 2008. “It enabled us to bring on primary care providers, physicians and nurse practitioners” to provide patient care, she said. As a Federal Qualified Health Center, it operates on a sliding scale, with people paying what they can afford, possibly as little as $15 a visit. “We don’t turn anyone away who can’t pay but they are asked to pay what they can,” Jackman said. Everything the coalition does is open to all residents of Martinsville and Henry County or people who see providers in the city or county, she said. That “community-wide care coordination” resulted from the Harvest Foundation’s initial grant to the coalition and it sets it apart from other areas, she added. In December 2017, the coalition expanded with a second clinic in Ridgeway. That facility is on the PART public bus system while the Bassett center is not, and that was a key factor in the expansion, Jackman said. Combined, the two centers probably will see more than 6,500 to 6,600 patients this year, Jackman said. Office visits likely will total 17,000 to 18,000 in the year, she added. Those numbers reflect changes in the focus of health care from acute care to primary care, Jackman said. With acute care, “you don’t feel good; you’re bleeding. You go somewhere, get it fixed and go back to life,” she said. With primary care, people need to value their health and be involved in it, Jackman said. That means learning to cook and eat healthy foods, exercising regularly, coping with stress and practicing preventive care for the patient and also his or her family, she said. For instance, people with diabetes cannot expect medications alone to fix their problems, Jackman said. “No medication is going to fix it all. They have to look at diet and exercise” and other factors, she said. “It is a journey, not a one-time thing,” she said, adding that health issues change as people age. “At 50 you can’t eat the way you did at 20. There is a mindset (of) ‘I’ll worry about that when the time comes.’ We’re trying to say, ‘You can’t do it then because you’re in crisis.’ We don’t want to be in crisis” because it is more expensive and diverts resources — such as emergency room treatment — from others. When people have a medical home, such as the clinic, they can get resources to deal with questions about their health and learn how to prevent problems, she said. “People need everything from cheerleading” to help with finances, transportation, access to services and more, Jackman said. “As we’ve grown more than a decade (old), we’ve put in place programs and services to reach out to people to say it’s important to have a medical home and stay with it,” Jackman said. SERVICES, OPTIONS The coalition has worked to provide extensive services and options to help people become healthy and stick with their new lifestyles. For instance, there now are more options for people to use trails and urban loops so they can walk even if they don’t have sidewalks near their homes. There are classes on topics such as healthy foods and cooking and extensive, varied exercise programs. Cookbooks and videos are available at all area libraries, Jackman said. “We’re trying to make people aware of and use resources that are available. Many are free,” she added. “One of the things we’re proud of is our work with the chamber at the farmers market to encourage people to go there,” Jackman said. If residents are on SNAP or food stamps and they buy $5 worth of fruit or vegetables, they get $5 match in matching funds there. “It may have tripled in people taking advantage” of that, she added. The Health Connect Center in uptown Martinsville is a one-stop shop offering classes, scheduling assistance and resources to link people with services they need, Jackman said. Five community health advocates go to the libraries, YMCA and other facilities to advise people on how they can access medical care. The coalition also partners with faith-based groups and organizations, many of which have health ministries, and it works at health fairs and events to distribute information. Another feature of the Bassett and Ridgeway clinics is integrated behavioral health services, she said. They address depression, anxiety, screenings and other basic mental health services. “It surprised me initially, though it shouldn’t have, how great the mental health needs are in the general public,” Jackman said. “That is a reflection of society” as people struggle economically and deal with other stressors, she added. Having a medical home can help people make lifestyle changes one step at a time and with consistency, Jackman said. “If they fall off the wagon they have to get back up and start again. It’s not just the old message of ‘you need to do this.’ It’s ‘here are the resources to help you,’” she said. WORKING TOGETHER Partnerships are the keys to many of the coalition’s services, Jackman said. For instance, transportation is provided through Mobility Management, the Southern Area Agency on Aging and the PART bus. The coalition worked with the Virginia Health Care Foundation to expand access to medication services. It works with the local hospital, SOVAH, and its Julius Hermes Breast Care Center as well as Susan G. Komen Virginia Blue Ridge to help women get mammograms. And mostly with another Harvest grant, it works with local optometrists in the Eyes Forward program to provide eye exams as a diagnostic tool for people whose insurance does not cover them or who have large insurance deductibles for them. The coalition also recently completed a four-year initiative with the Centers for Disease Control and the Health Department called Go Healthy, in which health services the West Piedmont District worked together on shared goals such as healthy eating, fitness and learning about medications at pharmacies. Jackman said the coalition’s success in the past 13 years is its growth into an organization big enough to be financially strong and diverse enough to carry on its objectives. Harvest Foundation grants now account for less than half its funding, and with more diverse funding the impact is lessened if one funding source goes away, she said. Also, the coalition’s partnerships mean many people are working together on shared goals, she added. In the future, Jackman said she expects more “virtual visits, tele-everything” so patients can get help via a computer or phone rather than going to a doctor’s office. “We’re teaching people to do that,” she added. She also expects the coalition will continue to focus on growing the Bassett and Ridgeway health centers so everyone can have a medical home. Other issues in local health care are the need for more dental services, linking the private sector to the coalition, developing support services and the schools creating ways to show children healthy lifestyles, she said. “Everyone who wants to improve their health can get it done in this community, between our health centers and other resources,” Jackman said. As for her own future, she is planning to travel and spend time on her hobbies of quilting and genealogy. And she does not rule out returning to work at some point, possibly on a part-time basis, but she is not certain what area of health care she would pursue. She is pleased that she has helped create something — the coalition — that people value. “I’ve done what I can do and will pass the torch to someone else,” she said, noting that health care is changing on the local, state and federal levels. “It’s really someone else’s time to take it into the next generation.”