Professional Development 

EDUCATION

• MS, Health Administration, 1990 
• BA, Human Resources Management, 1988
• Registered Nurse, 1976

CERTIFICATIONS/LICENSES                               

• ND Registered Nurse
• American Nurses Credentialing Center Nurse Executive
• WELCOA Worksite Wellness Faculty Status
• Agrisafe Provider status                     

PROFESSIONAL RECOGNITIONS

• National Rural Health Office Rural Voices Fellowship Program, 2006
• ND Outstanding Rural Health Professional, 2002
• ND Epsilon Sigma Phi Award, 2002
• ND Council on Nursing Administration Award, 1995
• Cover Article in Modern Healthcare Magazine, 1993

Decisions
I made a mindful decision (1990) to support wellness and healthy living instead of repairing poor healthy choices.  My WELCOA certification process gave direction to accomplish my personal and career goals. 

Demonstrated Success 

1. As a Nurse Executive Melana was successful writing a federal rural health outreach grant- Healthy Lifestyle and Disease Management Program- Hettinger, ND (2003), a program to promote healthy lifestyle changes and assist individuals with preventing and managing chronic diseases. A community needs assessment revealed the following needs: Chronic disabling diseases, cardiovascular risk behaviors, chronic pain, mental health and mental health disorders, substance abuse and access to health care. Melana and her associated staff directed the LIFE program which was conducted in collaboration with the West River Health Services, Southwestern District Public Health Unit and the UND School of Medicines & Health Sciences. LIFE took a two-tiered approach to enhance and extend the quality of life for the residents of all ages from southwestern North Dakota and northwestern South Dakota. The program increased awareness of five simple lifestyle changes to improve health status. The initiatives were implemented through the Wellness and Healthy Lifestyle Center located in Hettinger, ND. The goal developed new healthcare management concepts, created a comprehensive approach to healthy lifestyles and changed the “health culture” of this rural region of 24,000 square miles.
2. The various business ‘challenges’ and development of basic worksite wellness programing with a discount to fitness centers were the most successful interventions.
3. In 2006, Melana received her certification in Agri-Safe along with 8 other ND Registered Nurses to develop a network of providers knowledgeable in managing agriculture workers in health promotion, prevention and treatment of worksite illness and injuries in the largest and highest risk occupation in North Dakota. Soon, the ND Division of Community Health consulted West River Health Services Life Program experts to develop a state-wide initiate for worksite wellness. 

• Locally, health status improved through business challenges and education, locally, the community Of Hettinger, ND lost hundreds of pounds in less than a year. In some cases, major medical issues were caught before the individual needed significant medical care and with associated expense.
• Behavior changed in community and regional businesses and educational centers.  Schools offered break healthy choices, in dispensing machines and sporting events.  The medical center cafeteria meal options have ‘heart healthy’ designations and educational messages are offered in numerous venues.  The deep-fat fryer in the hospital kitchen was eliminated. Businesses implemented worksite wellness committees and did baseline assessments (metrics/ health histories) before targeted programing.
• The ND businesses culture changed locally and statewide.  The ND Department of Health developed Healthy ND Worksite Wellness and has numerous activities and website information now in place.

4. All 7 benchmarks were used implementing the Life Program and in 2008, when another hospital outreach project was developed Dakota Healthy Living) program, which consisted of education courses (tobacco cessation, hydration, alcohol consumption, healthy eating, and movement) and an initial health screenings. Partners were 6 rural hospitals in western and central ND. Melana was the Program Director and taught Wellness Coordinator RNs the 7 benchmarks of WELCOA and how to implement a Worksite Wellness Programs in their communities.

Leadership 
Melana is presently CEO of Howe Enterprises LLC, a community and business development firm.  As a healthcare executive, her expertise is extensive especially in rural communities and regions.  Her past work in both clinical practice and management gives her insight into organizational design and function.  Howe’s professional network encompasses colleagues and organizations representing healthcare, legislative, academic and community economic development and tribal.  She is considered a pioneer in community health and wellness.  

As a leader, she exemplifies  ‘high level’ worksite wellness.   She began her consulting firm in 2008 to support other organizations as they pursue healthy cultures and practices. Melana believes supporting employees is essential in healthy organizations. Utilizing her vast network of healthcare and business professionals, she is able to work within organizations as a change agent.   A believer in stewart leadership, trust development through conscious organizational  team-building, Melana can model and offer her  experiences to others with  deep insight and strength in individual and organizational behavior change.

Innovation 

1. Melana was instrumental in bringing Worksite Wellness to North Dakota and specifically instrumental implementing strategies into the healthcare organizations that focused primarily on illness (hospitals/clinics). She used grants for capacity-building and sustainability of healthy living and wellness practices utilizing her vast healthcare inprofessional and business network to support the worksite wellness concept. 
2. Capacity-building changes happened as systems moved from illness/sickness to wellness/health management at a very high level (state). This was a huge culture change in the medical and public health communities. It took a behavioral change in leadership through education and knowledge of the transition of healthcare in the United States (this was before the Affordable Care Act). Cost savings are just now being seen on the corporate and individual levels. North Dakota was ranked as the #1 healthiest state in the country in 2014 measuring work, home, mental, physical and financial   (community health in ND).

Compelling Vision 

1. The biggest opportunities are the ability to continue to work with the insurance industry and businesses as they develop their programs to capture data healthcare interventions. Monitored utilization data identifies the successes or failures of healthy living strategies.
2. In the next 5 years, continued ‘high level’ work includes a partnership with ND BC/BS to study the financial impact of fitness coaches for populations. 
3. An collaboration  with Healthy North Dakota and Worksite Wellness and pursuing development of a comprehensive worksite health and safety program for ND  including current  worksite safety programing such as ergonomics, safety education and policy with worksite wellness strategies. It could have significant economic impact on the ND Injury and disability numbers (which are climbing due to natural resource development in ND). Currently ND Employee Health and Safety offer a financial incentive for a workplace safety programing and could be expanded if positive return on investment.