From injury to independence, how Bothwell ToRCH program support made a difference

Thanks to a newer funding source available to eligible Pettis County Medicaid recipients and help from an area contractor, a young man who suffered life-changing injuries has a more accessible home.

Adam Larsson, 19, lives in southern Pettis County with his parents Kevin and Miranda Dillon. On Sept. 21, 2025, all three of their lives changed forever when Adam was seriously injured in a car accident.

“Adam borrowed a friend’s car, and we think he fell asleep while driving,” Kevin Dillon said. “He was ejected from the driver’s side window and wasn’t found for almost three hours.”

Adam was flown by air ambulance to University Hospital in Columbia. After undergoing surgery to stabilize his spinal injuries, doctors told the Dillons that Adam was paralyzed from the waist down. After a 10-day hospital stay and three weeks in rehabilitation, Adam came home on Oct. 24.

Kevin Dillon said he didn’t know where to turn for help getting a permanent wheelchair ramp so Adam could safely get in and out of the house.

“I was told there was help, but that I would have to find it on my own,” he said. “The first thing we did was to sign Adam up for Medicaid, which was approved.”

Medicaid is a federal and state program that helps people with limited income or resources with health care costs. Adam qualified because of his disability and being part of the program qualified him for additional support through Bothwell Regional Health Center’s ToRCH program.

Kevin visited Mercy Services United, a centralized walk-in center where people can access a network of social services, including those with Bothwell.

“The person I spoke with told me about Bothwell’s ToRCH program,” he said. “I learned that the program would pay for up to $4,000 for home modifications.”

ToRCH stands for Transformation of Rural Community Health and is a rural health program sponsored by the MO HealthNet Division, which manages the Missouri Medicaid program. Bothwell is one of six rural hospital community hubs to participate in the pilot program. ToRCH funding directs resources to these rural hubs to address non-medical factors like safe housing, reliable transportation and access to nutritious food for Medicaid recipients.

Elizabeth Green, Bothwell ToRCH program manager, helps oversee the program along with a team of care coordinators, a social worker and a volunteer leadership board.

“We know that if people have safety issues in their homes, can’t get around, don’t have reliable transportation or don’t have access to healthy food, they’re more likely to end up in the emergency room or hospitalized,” Green said. “ToRCH allows us to address those everyday needs that play a major role in long-term health.”

Turning approval into action

Once Adam received ToRCH approval for home modifications, the search began for a contractor to build a wheelchair ramp. United Way of Pettis County assists the ToRCH program with finding contractors. The third or fourth company reached was Solid Value Contracting in Lowry City.

“I liked that their owner, Jesse, was commenting on reviews and seemed very down to earth,” Kevin said.

Kevin connected with Traci Miller, Solid Value’s general manager, who said Adam’s story immediately made an emotional connection with her.

“My daughter suffered a traumatic brain injury while playing softball in high school,” she said. “She later had a stroke and had to relearn how to walk and talk. I really empathized with Adam’s story. He’s so young and has his whole life ahead of him.”

Miller said that service to others is an important value for the company, and they didn’t hesitate to help. They even expanded the ramp project to include a deck so Adam could enjoy the outdoors. Although the total cost exceeded the $4,000 ToRCH maximum, Miller said the goal was to provide the best access possible.

“The budget didn’t matter to us,” Miller said. “We were going to make it work.”

The deck and ramp were built over a weekend right before Thanksgiving.

“It’s very hard for me to ask for help,” Kevin Dillon said. “I was floored by everything Elizabeth and Kendra (ToRCH social worker) and Jesse and Traci did for our family. It meant more than I can say, and we are very thankful.”

Building for long-term independence

At the start of 2026, Adam qualified for another round of ToRCH funding, which was used to renovate the family bathroom, again by Solid Value Contracting. Improvements include a roll-in shower, a lowered countertop and an accessible toilet.

“Adam’s mom found some additional funding through the Live With It Foundation in Kansas,” Kevin said. “Combined with the ToRCH money, we came closer to paying for the actual costs.”

Solid Value Contracting again covered the difference between the available funding and actual costs.

“We’re really honored to partner with the ToRCH program,” Miller said. “It’s such a worthwhile program and a great opportunity for us to give back. All of our employees have raised their hands to be a part of helping people.”

Today, Adam is working on getting stronger through occupational and physical therapy. His mother, Miranda, no longer works outside the home and has become his primary caregiver.

“He has a long journey ahead of him, but he is progressing really well,” she said.

Before the accident, Adam bought a 1986 Ford F-250 4×4, was working on his GED and had dreams of becoming a mechanic.

“He still has those goals,” Kevin said. “He’ll just get to them a little differently. When he bought the truck, I told him it belonged in a junk yard, but I was young once, and I know why he wanted to fix it up. Now, it’s my project. I’m putting money in it when we can, and we’re getting some help from Terry Randolph at Flatline Automotive. It needs more work, but I can’t wait to get it running and take Adam for a drive.”

Real lives, real impact

Green said since Bothwell became the ToRCH hub for Pettis County in early 2024, the program has made over 1,300 service referrals serving more than 500 people.

“About 17% of Pettis County residents qualify for Medicaid,” Green said. “There is significant need, and ToRCH has helped connect people to resources that support them so they can avoid preventable medical care. I’m really proud of the work we’re doing to help Adam and so many others stay safe and healthy.”

A model recognized beyond the community

The success of Bothwell’s ToRCH program helped influence Missouri’s application for federal funding through the $50 billion Rural Health Transformation Program, created under the One Big Beautiful Bill Act signed into law in 2025.

In December, Missouri was awarded $216 million to expand the model statewide through a new initiative called ToRCH Care. The program will include seven regional coordinating networks and up to 30 community hubs.

“It validates the importance of this work in Pettis County and across rural Missouri,” Green said. “We’re excited to continue helping people stay safe and healthy where they live.”

Learn more about the Bothwell ToRCH program at brhc.org/torch.