Bringing Health Care to the Applachians

Hometown Heroes, People
on November 13, 2005

When nurse practitioner Mona Counts moved to a farm just outside of Mount Morris, Pa., in 1985, it didn’t take her long to realize that the people of the impoverished Appalachian region needed better health care.

“People would come in my driveway and say, ‘Could you check Johnny’s ear? Could you come see my grandma?’” says Counts, 63, who also works as a professor of nursing at Pennsylvania State University.

In the early 1990s, Mount Morris (pop. 1,966) had no medical center and only two part-time doctors—one who came in from out of town periodically and one who was preparing to retire. That’s when Counts saw an opportunity to offer affordable and accessible health care by employing and training nurse practitioners (NPs).

In 1994, she took a second mortgage out on the 260-acre farm she owns with her husband, John, and used the money to open the Primary Care Center of Mount Morris, a nonprofit health center. “It was scary, but my husband and I sat and talked about it and thought it would be fine,” says Counts of risking her farm to start the clinic. “I thought, ‘If you really believe in it, then do it.’”

On its first day, the health center had two patients, including one of Counts’ neighbors. To make sure that everyone could afford medical care, she decided to bill patients on a sliding scale based on their income. Today, the clinic serves more than 5,000 people from Mount Morris and the surrounding region.

Part of Counts’ mission is to demonstrate that NPs can provide primary care when a doctor isn’t available. Counts and her staff, including four NPs, a medical assistant, a receptionist, a billing clerk, a social worker and several of Counts’ nursing students, have dedicated themselves to offering the best care possible.

NPs tend to focus on providing preventive health care, but they also can diagnose illnesses, order some medical tests and prescribe certain medications. Many of Counts’ Penn State students work at her center, and she encourages them to go out and establish similar clinics in rural areas elsewhere.

“Mona is such a neat person to work with,” says Lori Blackwell, the center’s CEO. “I’ve learned a tremendous amount from her. She’s a pioneer in everything she does.”

Thus far, local residents have responded favorably to the clinic, in part because of Counts’ open and understanding attitude toward the Appalachian people she serves. To her patients, she’s not an outsider, even though she grew up in Miami, Fla.

“They wanted someone who understood the culture and didn’t talk down to them,” says Counts, who eventually hopes to build a new facility with a pharmacy and optometric services. “They were all excited that they had someplace close that would help them, that would listen.”

In return, patients remain fiercely loyal to the health center, its employees and Counts. Jeannie Russell, a Mount Morris resident who also serves as chairperson on the center’s board, echoes the sentiments of many other patients. “They’re always there when you need them,” Russell says. “They work with you as a patient, not as a number, or a case file.”

The center’s employees have a similar sense of loyalty, both to the clinic and to Counts. “Everyone loves Mona,” says Rhonda Snyder, a nurse at the clinic since 2004. “I think Mona is just amazing. What she’s done is incredible.”