NRHA’s Rural Health Fellows: Where are they now?
 Nikki King, MHSA,DHA, Zinnia Health chief of staff |
The next generation of rural health leaders has a growing influence on where rural health is heading. They have the dynamic skills and diverse perspectives needed to shape the health care systems of the future. To harness this potential, the National Rural Health Association’s Rural Health Fellows program provides a springboard for turning ideas into action through health policy. Alumni of the Fellows program have gone on not only to shine in their fields but to transform them.
Nikki King, MHSA, DHA, chief of staff for NRHA member Zinnia Health, is one of the leading voices in the rural opioid crisis in rural America. Her story demonstrates the power of creative thinking combined with a relentless drive to discover what’s possible when facing steep challenges.
Roots in Appalachia
Growing up in eastern Kentucky, King saw the devastating impact of the opioid crisis in Appalachia. These life experiences shaped King’s career path in rural health advocacy. “It was clear to me that we needed to take a step back and look at a system where people are dying of diseases of despair and poverty,” King says.
After graduating from the University of Kentucky in 2014 with a bachelor’s degree in economics with a focus in theory, King started her career as an economic analyst, studying models of sustainability in rural communities with a single economic engine. Her research was inspired by growing up in communities where a coal mine is the largest employer — and the devastating effects on the local economy when those mines shut down.
“I wanted to understand how the government can intervene in those critical first two months after the closure of a coal mine to prevent a domino effect of business closures,” King says. “It became clear that the point of no return for these towns is when they lose their community hospital.”
King found her purpose as she connected the dots between social determinants of health, economic opportunity, and health care access. “I fell in love with the health care administration side and the programs I was building in mental health — and I never looked back,” she says.
King went on to earn her master’s degree in health services administration from Xavier University in Cincinnati in 2017. She earned her doctorate of health administration from Medical University of South Carolina’s College of Health Professions in 2021.
Rural Health Fellows program
Like many others working in rural health, King wears a lot of hats — from data analyst and researcher to program manager and mental health advocate. She says NRHA’s Rural Health Fellows program “provided a great opportunity to work alongside people from all across rural America, each with a unique set of experiences in clinical practice and the policy world.”
The Fellows program is a yearlong, intensive training that develops leaders who can articulate a clear and compelling vision for rural America. The Fellows meet three times throughout the year for intensive advocacy training and participate in monthly conference calls. Ultimately, the goal is to educate and create a network of diverse rural leaders who will step forward to serve in key positions in rural health advocacy, with health equity as a main focus.
“The Fellows program provides an introduction to health care policy and why that matters, but even more important is the networking aspect that comes from collaborating with other rural health leaders,” King says.
Forward-thinking solutions
Since completing NRHA’s Rural Health Fellows program in 2017, King has been on a mission to improve access to treatment for substance use and mental health in rural populations. In her previous role as manager of behavioral health and addiction services at NRHA member Margaret Mary Health in Batesville, Ind., King developed an innovative opioid addiction treatment program in partnership with the local hospital and the court system. The Courts Addiction and Drug Services (CADS) program provides court-ordered probationers with medicationassisted treatment, cognitive behavioral therapy, job coaching, meditation training, and other services.
“We recognized the unique challenges of solving substance abuse problems in rural settings where transitional housing and full-service mental health services often aren’t available,” King says. The CADS program has been a success in Franklin County and has also served as a model for similar programs in neighboring counties.
Expanding services in underserved areas
King continues to influence strategies for better rural health access in her new role as chief of staff with Zinnia Health, a national substance use and mental health treatment company. She works with the CEO and others in developing long-term strategies for expanding services into areas with unmet needs and reaching people who need care most in ways that make sense economically. “We’re partnering with government organizations to creatively figure out how to provide quality care for all patients within the confines of existing payer systems,” King says.
“It happens all too often in rural communities: A person enters the emergency department with a mental health crisis, and they leave the hospital without a treatment option. Social workers and health care professionals can do everything in their power to connect this person with treatment, but in many cases, services aren’t available when and where they’re needed — and it’s heartbreaking,” King adds.
She wants to tackle these big, complex problems with robust solutions, strategic planning, and collaboration at all levels of health care. “I have a dream to build a system of care where absolutely nobody ever leaves their local hospital without a treatment option for substance use or mental health problems,” she says.
King has a vision to transform behavioral health care, but she understands it takes a village. She sees the value each person brings collectively when working to improve rural health access. “Our strength is our community, and we can leverage those relationships for the greater good,” she says. “We have a microphone, and we have to use it to elevate rural voices and continue conversations about health equity.”