What happens when healthcare systems are designed without considering the realities of rural communities?
In this season finale episode of the Accessible Podcast, hosts George Gotto and Amelia Reighard sit down with Libby Trammell, Community & Digital Advocacy Manager at the Missouri Rural Health Association (MRHA), to explore the state of rural health in Missouri and what it means for people with disabilities.
Drawing from MRHA’s newly released 2026 Rural Health Needs Assessment, Libby shares data-driven insights about healthcare access, workforce shortages, hospital closures, transportation barriers, and the unique challenges facing rural Missourians with disabilities.
The conversation also explores how policy decisions—including proposed Medicaid changes—could impact rural healthcare systems, why disability inclusion must be part of rural health transformation efforts, and how advocates can engage in meaningful policy conversations at the local, state, and federal levels.
Plus, learn about The Causeway, MRHA’s statewide online community connecting rural healthcare providers, advocates, students, and community leaders to share resources, solve problems, and strengthen rural systems across Missouri.
Meet Our Guest
Libby Trammell
Community and Digital Advocacy Manager, Missouri Rural Health Association
Libby is a Licensed Clinical Social Worker with a background in rural advocacy, political lobbying and trauma-informed case management, serving survivors of human trafficking and intimate partner violence.
Originally from South Dakota, Libby grew up seeing the impacts of rural health disparities first-hand. She is passionate about building connections and breaking down stigma and isolation in healthcare. She was drawn to the disability fields when it became clear early on in her career how many people with disabilities are left behind or outright hurt when policies and services don’t center their experiences.
While earning her MSW at Wash U, Libby took a class where they partnered with Paraquad clients to teach sex ed, saying, “it was some of the most important learning I’ve ever done. Adults with disabilities are full humans deserving of education and collaboration, especially in spaces that they haven’t been before. Sexual education is one of those spaces.”
When Libby isn’t working, you can find her hanging out with her many pets, enjoying the outdoors or reading.
Episode Details
Key Takeaways
- Key findings from Missouri’s 2026 Rural Health Needs Assessment
- Disability trends and health disparities in rural communities
- Healthcare workforce shortages and hospital closures
- Transportation and access barriers for rural residents
- Medicaid policy changes and potential impacts
- The importance of preventive care and care coordination
- Rural health advocacy and legislative engagement
- The Causeway and other resources for rural professionals
Acronym Guide
DD Act: Developmental Disabilities Act
FQHC: Federally Qualified Health Center
LEND: Leadership Education in Neurodevelopmental Disabilities
UCEDD: University Center for Excellence Developmental Disabilities
Resources
- Missouri Rural Health Association Website
- MRHA’s 2026 Missouri Rural Health Needs Assessment
- Rural Health Transformation Information
- MRHA Bill Tracker
- Find your legislators
- MRHA’s The Causeway
- Frameworks Institute
- University of Missouri’s Rural Scholars Program
