HIGHLAND – When Chris Dickey saw gaps in Sullivan County’s healthcare system, he thought that someone should fix it. And then he thought, why not me? 

As a public health professional, he worked to create clinics in rural areas of India and Africa, seeing firsthand the unique challenges that rural communities face, and saw that it wasn’t all that different from home. 

“The healthcare system is non-functional for people living in rural America,” Dickey said. “It’s much closer, in a way, to countries that are economically less well-developed than the United States. It’s a shock to people… and I think it’s led to a lot of disconnect and distrust.” 

So he got to work, building a team to look at how they can create a better healthcare system to those who are underserved in the Town of Highland, where he lives part-time. 

As a Clinical Assistant Professor at NYU School of Global Public Health, he tasked his students with calling people in the Town of Highland community and asking them what they thought about the current healthcare system and what they hope to see.

They learned that people have to drive too far, it’s too expensive, impersonal and confusing, and that people are moving away and there are people who don’t want to move here.

“We want to be driven by the community—talk to people about what they want and what they’re worried about, so it’s in a sense co-created with them,” Dickey said.

The proposed community health model, which is projected to open by January, will be located in the old Dr. Daboul facility on Route 97 in Barryville. Dr. Daboul’s practice as well as Dr. Petkus’ office across the river in Shohola, Pa. were a frequented resource for residents in the Town of Highland but closed in recent years.

Dickey says a large factor to the decline of rural healthcare systems is that family doctor’s offices are closing, largely because it is not economically viable and factors like health insurance reimbursement are too complex.

“People in rural communities remember having a family doctor—they knew your family, you could go to them when things were tough, they knew who had co-morbidities, they knew who was food insecure… People felt like there was someone in the town who knew them,” Dickey said.

And if they had a serious medical issue, the family doctor would connect them with other resources. 

Now, residents have limited access to information and support. “What happens is people give up, they don’t engage [with healthcare professionals] at all,” Dickey said, adding that they often wait until they are landed in the emergency room.

Foundational support

Dickey isn’t working alone. In addition to utilizing his students and NYU cohorts, he also originally reached out to Town of Highland Supervisor John Pizzolato to see what they could do. 

Pizzolato loved the idea of seeing a healthcare facility in Highland again and secured a $100,000 SAM grant from Assemblywoman Paula Kay. The grant, which must pass through a municipality, will be used for capital improvement of the building, with work expected to begin on November 1. 

A resolution authorizing the grant passed unanimously at the Town of Highland’s board meeting on Tuesday night (Councilmember Kaitlin Haas was absent). 

Pizzolato mentioned that such a facility is crucial at this time, with expected healthcare budget cuts from the Trump administration’s “Big Beautiful Bill” and also regional groups potentially closing.

“We’re seeing the constant pushing of [regional services] further away from home,” Pizzolato said. 

Many residents at the town board meeting supported the project and added their input including a need for domestic violence support. 

The initiative is also being supported by the New York Health Foundation, which provided start-up funding, and Sullivan 180, which is assisting with administration of the New York Health Foundation grant and supporting outreach. 

“A process like this sometimes brings to light things that are already available; but may not be known or accessible. It also should show us where the gaps and opportunities are,” said Denise Frangipane, Chief Executive Officer of Sullivan 180. “This is a chance to be innovative and creative.”

A holistic model 

Dickey cautioned that he wants residents to have realistic expectations, and that a fully-staffed facility with doctors waiting for them won’t happen as soon as they open the doors. 

The idea is to have community health workers and nurses on site, with oversight by physicians, to provide care, while also connecting patients to resources.

“It will be a place where people will feel comfortable coming to see us, and learn how to manage [their health],” Dickey said.  

There are also opportunities for holistic health, such as utilizing the building’s existing gym for physical therapy appointments and yoga or meditation classes. 

“We’ll become a magnet for people who would like to engage around their health,” Dickey remarked. “I want people in our community to feel like it’s theirs.” 

He added that the goal is that it becomes not dependent on government or grant funding and to become a fully sustainable model.