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Rural Health Briefing Vol 2, No. 2 June 8, 2001
An E-Health Newsletter published by the Arizona Rural Hospital Flexibility Program of the Rural Health Office of The University of Arizona
Table of Contents
1. Update: Critical Access Hospitals Program
a. National Progress
- HUD 242 Mortgage Insurance Program
- JCAHO Proposed Standards for CAHs
- CAH Quality Assurance Programs in Other States
b. State Action
- Increased Medicaid Funding for Arizona CAHs
- Capital Construction Funds
- Statewide CAH Conference July 30-31
2. Arizona News
a. Rural Health Office Joins UA College of Public Health
b. Award for Arizona Telemedicine Program
c. Arizona Annual Rural Health Conference
3. National News
a. National Rural Development Partnership Healthcare Task Force
b. HIPPA Comment Period Reopened
c. Recent Federal Legislation Relevant to Rural Health
- Federal Office of Rural Health Policy List of Bills
- Rural Priorities of National Advisory Committee on Rural Health
d. Medicare Reform Happenings
- National Advisory Committee on Rural Health Report
- Medicare Reform: A Rural Perspective
- Increased Medicare Reimbursement for Rural Labor Costs
- HCFA Administrative Reforms Possible
- Medicare Prescription Drug Coverage
- Bush Proposed Reforms for HCFA
4. How to Contact Your Representatives
a. Congressional Delegation
b. State Legislators
5. Grant Opportunities
a. Rural Health Outreach/Network Grants
b. Community Technology Centers Program
c. Distance Learning and Telemedicine Loan and Grant Program
d. Other
6. Conferences Relevant to Rural Health
7. Other Useful Information
a. NRHA Issue Papers Online
b. HCFA and Other Websites
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Editor’s Note: This online newsletter is a project of the Arizona Rural Hospital Flexibility Program, a project of the University of Arizona Rural Health Office supported by the Federal Office of Rural Health Policy. The goal of the Flex Program is to improve the financial viability and stability of rural hospitals by creating a new designation for Critical Access Hospitals (CAHs). Designated CAHs are eligible for cost-based reimbursement for services provided to Medicare patients, as well as additional reimbursement for Medicaid patients. For more information, please visit the project web site: http://www.rho.arizona.edu/cah/azruralflex.html
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1. Update: Critical Access Hospitals Program
a. National Action
(1) HUD 242 Mortgage Insurance Program: This program provides insurances for “urgently needed loans” to acute care hospitals. CAH designation is considered sufficient poof of need to qualify and cost-based reimbursement for CAHs is considered to provide enhanced credit-worthiness and financial ability to pay off the debt. The program provides mortgage insurance, without which hospitals cannot get financing for capitol projects. CAHs get the same interest rate they would receive if they had a AA credit rating. The program insures loans for construction, modernization, equipment, expansion, remodelling, and refinancing. This topic will be covered at the CAH Conference in July (see below). Additional information about the HUD 242 Program website can be accessed through the Arizona Rural Hospital Flexibility Program website’s CAH Resources links
(2) JCAHO Proposed Accreditation Standards for CAHs: These proposed standards have been temporarily withdrawn, based on the perception that because the CAH designation is still a relatively new program, the rural hospitals affected are not yet ready to implement new standards.
CAHs: These proposed standards have been temporarily withdrawn, based on the perception that because the CAH designation is still a relatively new program, the rural hospitals affected are not yet ready to implement new standards.
(3) CAH Quality Assurance Initiatives in the States: TASC is the technical assistance agency for the national Rural Hospital Flexibility Program. Ongoing information about program developments and national project initiatives is available from TASC through the Arizona Rural Hospital Flexibility Program website’s CAH Resources links. Although JCAHO has put new CAH standards on hold, other states are initiating their own quality assurance programs. These initiatives are highlighted in the February 14, 2001 TASK Flex Program Hour Highlights (see our website):
In Montana, a Quality Improvement Network was created for CAHs to address quality improvment, credentialling, joint peer review, clinical policies and procedures, and annual program reviews. A contractor was hired to create standard forms and policies and procedures, while customizing them somewhat to each facility, and also to provide training and monitor performance and compliance
In Idaho, the hospital association is the contractor for QI support for CAHs. They are currently using the Maryland Quality Indicator Project to gather data, with individual quarterly reports to be generated from a set of pre-selected indicators. The reports can be customized (e.g., stratifying findings by similar facilities). Hospitals forward indicator scores to the hospital association for review and recommendation. Combined with an agreement for an external physician review of 10% of the hospital’s peer review cases, the program meets all the Flex Program quality provisions
In Arkansas, a CAH Quality Initiative Advisory Committee, working with the PRO (Arkansas Foundation for Medical Care), utilizes discharge data supplied by the CAHs, focusing on 4 DRGs that comprise top utilization diagnosis for the CAHs. There are 11 performance indicators from these 4 DRGs. Monthly, each hospital submits all their discharge data to the PRO. Abstracts are run and sent to the facilities for completion. Quarterly “report cards” are provided to the individual hospitals showing their performance benchmarked against the totality of the CAHs, as well as the majority of the acute care facilities in the state. This information can be used by the hospitals for their internal QA initiatives.
b. <![endif]>State Action
(1) Increased Medicaid Reimbursement for Arizona CAHs: In May, the Arizona Legislature approved and the Governor signed House Bill 2585, which included an amendment authorizing increased Medicaid reimbursement for small rural hospitals in Arizona that are designated as Critical Access Hospitals. A total of $1,700,000 was appropriated to the Arizona Health Care Cost Containment System administration in each of the fiscal years 2001-2002 and 2002-2003, including $800,000 from the medically needy account (ARS 36-774) and $900,000 from federal Medicaid matching funds.
(2) Capital Construction Funding: House Bill 2459, also passed by the Legislature in May, provides $3 million from the medically needy account in FY 2001-2002 and 2002-2003 to the Department of Health Services for capital construction of community health centers and public and private nonprofit hospitals in medically underserved and rural areas. $150,000 is provided annually to assist health service districts.
Capital projects include purchase or lease of land, builidngs, mobile medical or dental clinics, equipment and furnishings, and other costs associated with construction, expansion, or renovation of facilities to expand primary care or dental services.
The legislation caps a medical capital project at $500,000 and a dental capital project at $350,000 and outlines preference provisions and limitations. Limits eligibility for a recipient to one capital project grant in any two-year period and a maximum of two capital project grants. The legislation also reduces the required number of signatures to form a health service district from persons owning collectively 25 percent of the assessed valuation down to 10 percent.
(3) Arizona CAH Conference July 30-31: The Arizona Rural Hospital Flexibility Program will host a conference July 30-31 at the Hyatt Regency Hotel in Phoenix for rural hospitals in Arizona that are planning to seek, or are interested in exploring, Critical Access Hospital designation. The conference will address issues related to the CAH designation process, as well as issues of concern for the long-term success of the state’s rural hospitals. Conference registration fee is $75.00.
National presenters will include: (1) Eric Shell, Northland Health Group, Inc., a consultant performing financial feasibility studies for Arizona hospitals interested in CAH designation, on the “Financial Future of Critical Access Hospitals;” (2) Julie Sadovich, Region IX, HCFA, in a panel discussion of CAH reimbursement issues with Maria Ross, Blue Cross Blue Shield of Arizona (Fiscal Intermediary for Medicare) and Shelli Silver, AHCCCS; (3) Charles Ervin, AMI Capital, on capital financing opportunities for CAHs through the HUD 242 mortgage insurance program; (4) John Udell, Manager, New Mexico Trauma System of the Injury Prevention and EMS Bureau of the New Mexico Department of Health, on EMS issues related to CAH program requirements; (5) Wayne Hillerstadt, CEO of the Helen Newberry and Joy Hospital in Upper Peninsula, Michigan, on development of Rural Health Networks; (6) John Yao (invited), Baltimore headquarters of the Indian Health Service, on issues related to IHS and 598 CAHs; and (7) Fred Moskol, Director of the National Rural Recruitment and Retention Network (3RNet) on staff recruitment and retention issues for rural hospitals and their network partners.
In addition, the conference agenda will include discussion of the state site survey for CAH applicants, economic analyses of the impact of Arizona’s rural hospitals on their communities, telemedicine technology for CAHs and their network partners, and grant opportunities for CAHs.
For further information about the conference, or to receive conference registration materials, please contact Joyce Hospodar, Field Coordinator, Rural Health Office, 2501 E. Elm Street, Tucson, AZ 85716; (520) 626-7946; hospodar@u.arizona.edu.
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a. Rural Health Office Joins UA College of Public Health: The Rural Health Office is transitioning from the UA College of Medicine’s Department of Family and Community Medicine into the College of Public Health. This transition will become effective on July 1, 2001. The Arizona Rural Hospital Flexibility Program is situated in the Rural Health Office and will join in this transfer.
b. Award for Arizona Telemedicine Program: The American Telemedicine Association recently honored the Arizona Telemedicine Program with its Presidential Award for “its contributions to the advancement of telemedicine.”
c. Arizona Rural Health Conference - July 23-25: This year’s annual Rural Health Conference will be held in Prescott, Arizona at the Prescott Resort and Conference Center. Advance registration at reduced rate is due prior to June 25.
The conference agenda includes:
Day One: Keynote Plenary Session on “A Vision for Rural Health in the 21st Century;” issue forum sessions on implementation of Proposition 204 (Healthy Arizona II), behavioral health issues, and skilled nursing facilities and nursing homes; plenary session on the Turning Point Project and Public Health; simultaneous sessions on pesticides and migrant workers, public health in Native American communities; and dental opportunities for Arizonanas.
Day Two: Plenary session on “Bioterrorism vs. Public Health Infrastructure;” simultaneous sessions on oral health issues in the migrant community, HIV?AIDS - a community approach with migrant populations; and new dimensions in the treatment of diabetes; continued issue forum sessions; Rural Health Service Awards Luncheon; simultaneous sessions on citizen advocates; hazardous material - taking a toxic exposure history; and tele-psychiatry; and a plenary session on implementing House Bill 2050 (State Health Insurance Task Force).
Day Three: Issue Forum Resolutions Breakfast; simultaneous sessions on the economic impact of critical access hospital providers; family violence; and border safety net providers; and a penary luncheon on county health directors role and responsibility.
Other conference events will include a pre-conference grantwriting workshop on July 22 from 2-5 pm; an optional social event, including dinner provided by the Rafter 6 and served from a 100 year old chuck wagon and a melodrama featuring a musical group, Blue Rose; exhibitor networking; an Arizona Rural Health Association Board meeting, election of Board officers, and a general membership meeting; and Rural Health Service Awards for Legislator of the Year, Professional of the Year, Project of the Year, and Volunteer of the Year.
Advance registration fee is $200.Regular and on-site registration is $230. Group registration is $180 each for three or more individuals from one organization. Student registration is $100. Daily registration fees are $75 for July 23; $85 for July 24; $70 for July 25. For further information, contact Rebecca Ruiz, conference coordinator, at the UA Rural Health Office (520) 626-7946; aruiz@ahsc.arizona.edu.
5. National News
a. National Rural Development Partnership Healthcare Task Force: The Healthcare Task Force of the National Rural Development Partnership sponsors monthly teleconferences on various topics related to rural health issues. On June 13, the NRDP will host a presentation on “Building Better Systems of Care for the Rural Underserved Using NHSC (the National Health Service Corps). If you would like to participate in this conference call, or receive information about future teleconferences, contact Helen Huarca at helen.huarca@hhs.gov or call (202) 205-3505.
b. HIPPA Comment Period Reopened: In two weeks, the comment period on HIPPA regulations will be reopened. To stay on top of these and other HIPPA developments, see: http://aspe.os.hhs.gov/admnsimp/Index.htm.
c. Recent Federal Legislation Relevant to Rural Health: The Federal Office of Rural Health Policy provides a listing of legislation relevant to rural health or having the potential to affect rural health care delivery through changes to programs such as Medicaid and Medicare. See http://ruralhealth.hrsa.gov/legislate.htm.
Another good source to stay on top of current developments is the Kaiser Daily Health Policy Reports: http://kaisernetwork.org/dailyreports/healthpolicy
The Subcommittee on Health of the House Ways and Means Committee will hold a hearing on Tuesday, June 12, 2001, beginning at 10:00 am, on Rural Health Care in Medicare. Tentative list of witnesses to appear at the hearing include Glenn M. Hackbarth, Chairman, Medicare Payment Advisory Commission, Bend, Oregon; Kathleen Dalton, Fellow, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill; Curt D. Mueller, Director, Project Hope, Walsh Center for Rural Health Analysis, Bethsda, Maryland; and Keith J. Mueller, Director, RUPRI Center for Rural Health Policy Analysis, Omaha, Nebraska.
(1) Patients Bill of Rights: Current news says that the Senate will now take up consideration of two Patients Rights bills: SB 872, sponsored by Sen. John McCain (R-AZ), Edward Kennedy (D-MA), and John Edwards (D-NC), and SB 889, sponsored by Sen. Bill Frist (R-TN), John Breaux (D-LA), and Jim Jeffords (I-VT). Both bills would guarantee access to emergency and specialty care, permit appeal of decisions of HMOS, and prohibit gag clauses interfering with physician communications with patients. The McCain/Kennedy/Edwards bill would allow patients to sue in state or federal courts for unlimited economic damages, civil damages for pain and suffering up to $5 million, and would allow states to set caps on liability. The Frist/Breaux/Jeffords bill would limit patients to federal courts only, with unlimited economic damages but capping non-economic damages (pain and suffering) at $500,000.
(2) Rural Priorities: In addition, at its annual meeting June 3-5, 2001, the National Advisory Committee on Rural Health reviewed several bills specifically relevant to rural health. Alison Hughes, Acting Director of the Rural Health Office and Program Director of the Arizona Flex/CAH Program is a member of the committee, which is appointed by the U.S. Secretary of Health and Human Services.
(3) Home Health Fairness Act of 2001: S 326 was introduced in the Senate on February 14, and HR 975 was introduced in the House on March 13. The purpose of the legislation is to eliminate the 15 percent reduction in payment under the PPS and to increase payments in rural areas. Sponsor in House: Rep Watkins, Wes. Latest Major Action: 3/20/2001 House committee/subcommittee actions; Committees: House Energy and Commerce; House Ways and Means. Sponsor in Senate: Collins, Susan M. Latest Major Action: 2/14/2001 Referred to Senate committee; Committees: Senate Finance.
(4) Sustaining Access to Vital EMS Act of 2001: S 587 was introduced on March 21, and HR 1353 was introduced in the House on April 3. The legislation provides funding to sustain vital EMS services in rural areas.
Sponsor in House: Rep Kennedy, Mark R. Latest Major Action: 4/25/2001 Referred to House subcommittee; Committees: House Energy and Commerce; House Ways and Means. Sponsor in Senate: Sen Conrad, Kent Latest Major Action: 3/21/2001 Referred to Senate committee; Committees: Senate Finance.
(5) Nursing Employment and Education Development Act: S 721 was introduced in the Senate on April 5. The legislation addresses the nursing shortage by establishing a Nurse Corps for recruitment and retention strategies. S.706 and HR 1436 also address ways to alleviate shortages in nursing professions, Sponsor in Senater: Sen Kerry, John F Latest Major Action: 4/5/2001 Referred to Senate committee; Committees: Sponsor in House: Rep Capps, Lois. Latest Major Action: 4/25/2001 Referred to House subcommittee; Committees: House Energy and Commerce; House Ways and Means.
(6) Rural Mental Health Accessiblity Act of 2001: S 859 was introduced in the Senate on May 10 to establish a mental health community education program. Sponsor: Sen Thomas, Craig. Latest Major Action: 5/10/2001 Referred to Senate committee; Committees: Senate Health, Education, Labor, and Pensions.
(7) Broadband Expansion Grant Initiative of 2001: S 428 was introduced in the Senate on March 1, and HR 1416 was introduced on April 4, to promote new communication technologies in rural areas through incentives such as grants. other purposes. Sponsor in Senate: Sen Clinton, Hillary Rodham. Latest Major Action: 3/1/2001 Referred to Senate committee; Committees: Senate Commerce, Science, and Transportation.
d. Medicare Reform News Happenings
(1) National Advisory Committee Report: Various news sources report ongoing dialogue in Washington DC regarding Medicare reform. As these events unfold, rural health advocates should review the report to the Secretary of the U.S. Department of Health and Human Services of The National Advisory Committee on Rural Health: “Medicare Reform: A Rural Perspective.” The report, published in May 2001, is available from the Federal Office of Rural Health Policy: http://www.ruralhealth.hrs.gov/wnew.htm
(2) Increased Medicare Reimbursement for Rural Labor Costs: On April 30, U.S. Secretary of Health and Human Services, Tommy Thompson, announced that the Bush administration is willing to use federal surplus revenue to raise labor-related Medicare reimbursement to rural hospitals by raising the wage index for hospitals in low-labor-cost areas as part of a larger structural reform of the program. Payments to urban hospitals would not be cut.
(3) HCFA Administrative Reforms Possible: The Congress Daily (May 15, 2001) reported a recent release from the House Ways and Means Health Subcommittee (Chairwoman Nancy Johnson, R-CN and ranking member Pete Stark, D-CA) of a 17-page list of recommended Medicare reforms HCFA could make without new legislative authority, including implementation of a double-entry bookkeeping system; a schedule for issuing new regulations and program changes; streamlining cost reporting and other documentation requirements for providers; and consolidating all regulatory authority for the Medicare+Choice program in a single office. The recommendations received support from representatives of healthcare provider groups, including the Federation of American Hospitals and the American Association of Health Plans.
(4) Medicare Prescription Drug Coverage: A report in the Congressional Quarterly on June 4 indicated President Bush’s Medicare reform package would double the percentage of beneficiaries enrolling in private managed care plans. A June 5 Congressional Quarterly reports that incoming Senate Finance Committee Chairman, Sen. Max Baucus (D-Mont.) Is seeking consensus from panel Democrats on a Medicare drug benefit, and also working on a bipartisan compromise with outgoing Chairman Charles E. Grassley (R-Iowa). The challenge is to come up with a bill that would fit within the $300 billion Congress set aside over 10 years in the fiscal 2002 budget resolution (H Con Res 83) to transform Medicare and add prescription coverage. Sen.
John Rockefeller IV (D-W. Va.) argues that $300 billions is too little to offer a worthwhile drug plan without drastically cutting other Medicare benefits or double premiums or double co-payments and take out catastrophic coverage. This assessment is based on a Congressional Budget Office analysis last month that put a price tage of $400 - $450 billion on a bill (S 10) adding drug coverage to Mediare that Rockefeller cosponsored with incoming Majority Leader Tom Taschle (D - S.D.). The CBO is expected to release actual scoring on Friday, June 8, on the cost of creating a drug benefit under a variety of benefit and cost-sharing assumptions.
(5) Bush Proposed Reforms for HCFA:The Congress Daily reported on June 6 that the Bush administration plans to unveil a major package of HCFA reforms, including a name change, in the next few weeks. One of the proposed changes will incude increased education of seniors about Medicare, particularly the Medicare+Choice plans run largely by managed care organizations that provide the prescription drugs the regular Medicare program does not.
6. How to Contact Your Representatives
a. Arizona Congressional Delegation: Available through the Publication Technology Project at Arizona State University: http://aspin.asu.edu/~pctp/azdeleg.html. To get Congressional Handbook, http://www.congresshandbook.com. Links to Representatives are available at http://www.house.gov. Links to Senators are available at http://www.senate.gov.
Senate:
John McCain (R-AZ) DC Phone 202-224-2235; DC Fax 202-228-2862State Offices: Phoenix 602-952-2410; Tucson 520-670-6334; Mesa 602-491-4300; Email: John_McCain@mccain.senate.gov
Jon Kyl (R-AZ) DC Phone 202-224-4521; DC Fax 202-224-2207 State Offices: Phoenix 602-840-1891; Tucson 520-575-8633; Email: info@kyl.senate.gov
House of Representatives:
Matt Salmon (R-1-AZ) DC Phone 202-225-2635; DC Fax 202-225-3405; Tempe 480-946-3600; Email: msalmon@mail.house.gov
Ed Pastor (D-2-AZ) DC Phone 202-225-4065; DC Fax 202-225-1655; Tucson 520-624-9986; Phoenix 602-256-0551; Yuma 520-726-2234; Email: edpastor@mail.house.gov
Bob Stump (R-3-AZ) DC Phone 202-225-4576; DC Fax 202-225-6328; Phoenix Phone: 602-379-6923.
John Shadegg (R-4-AZ) DC Phone 202-225-3361; DC Fax 202-225-3462; Phoenix 602-263-5300; Email: j.shadegg@mail.house.gov
Jim Kolbe (R-5-AZ) DC Phone 202-225-2542; DC Fax 202-225-0378; Tucson 520-881-3588; Sierra Vista 520-459-3115; Email: jim.kolbe@mail..house.gov
J.D. Hayworth (R-6-AZ) DC Phone 202-225-2190; DC Fax 202-225-3263; Mesa 602-926-4151; Flagstaff 520-556-8760.
b. Arizona State Legislators: Available through the Arizona Legislative Information System (ALIS): Call 1-800-352-8404 http://www.azleg.state.az.us/members/members.htm.
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7. Grant Opportunities
a. Rural Health Outreach/Network Grants: The Federal Office of Rural Health Policy has announced the deadlines for new Rural Health Outreach and Rural Health Network Development grant proposals.
(1) Rural Health Outreach Grants: This program emphasizes service delivery through creative strategies requiring the grantee to form a network with at least two additional partners. To be eligible, the grant receipient’s headquarters must be a public or nonprofit private entity and be located in a designated rural county, or exclusively provide services to migrant and seasonal farmworkers in rural areas, or be a Native American tribal or quasi-tribal entity. Outreach grant applications are due September 14, 2001.
(2) Rural Health Network Development Grants: This program is designed to develop organizational capacity in the rural health sector through formal collaborative partnerships involving shared resources and possible risk-sharing. Funds will be used to develop formalized, vertically integrated networks of providers that in combination may offer a range of primary and acute care services. Grant funds might be used to acquire staff, technical experts, and other resources needed to “build” the network. A grant may be made to support either a one-year planning phase, or a three-year implementation process. To be eligible applicant organization must be a public or nonprofit enetity that represents a network which includes at least three health care providers or other entities that provide or support the delivery of health care services. Additionally, the applicant’s administrative headquarters must be located in a rural area, or exclusively provide services to migrant and seasonal farm workers in rural areas. Network grant applications are due September 21, 2001.
(3) How To Apply: To get on the mailing list to receive application kits, which will be available this month, call the HRSA Grant Application Center at 1-877-477-2123. For the Outreach grant application, cite the reference number 93.912A; for the Network grant application, cite the reference number 93.912B.
b. <![endif]>Community Technology Centers Program: The U.S. Department of Education, Office of Vocatinal and Adult Education, Division of Adult Education and Literacy, has published an RFP for Community Technology Centers grants. The deadline for submitting a grant proposal is July 16, 2001. The purpose of the program is to promote the use of technology in education through the development of model programs that demonstrate the educational effectiveness of technology in low-income or economically distressed urban and rural communities. The FY 2001 program provides support for access to computers and technology and technology-based educational learning activities for adults and children in low-income communities who otherwise would lack that access.
Priorities: Invitational priorities include: (1) projects that demonstrate substantial community support of and commitment to the community technology access center or centers with evidence of community assets the applicant has leveraged or plans to leverage; (2) projects that exemplify effective strategies in overcoming participant retention barriers (such as special needs, language proficiency, childcare needs and staff development) and best practices for instructing with technology (such as computer instruction related to school or work activities, encourages collaboration and develops complex thinking skills) to improve educational and employment outcoes for low-income youth and adults; (3) projects that use program funds to operate a community technology access center or centers in an Empowerment Zone.
Eligible Applicants: State and local educational agencies, tribal governments, colleges, institutions of higher educatin, libraries, museums, and other public and private nonprofit or for-profit agencies and organizations. Although a single applicant is eligible, applications from partnerships that incude local community organizations or agencies are encourage.
Funding: Approximately $32.3 million is available for YF 2001. The estimated range of awards is $75,000-$300,000. The estimated average award is $180,000. An estimated 170 to 190 awards will be made, with projects not to exceed 12 months. There is a 30 percent cost share requirement, which must be made in nonfederal contributions, in cash or in kind.
Contact: Education Publications Center: 1-800-877-8339 or http://www.ed.gov/pubs/edpubs.html or email: edpubs@inet.ed.gov for application packets.
c. Distance Learning and Telemedicine Loan and Grant Program: The Distance Learning and Telemedicine Program (DLT) is a grant program of the U.S. Department of Agriculture’s Rural Utilities Service. The program is designed specifically to meet the educational and health care needs of rural America through advanced telecommunications technologies that provide enhanced learning and health care opportunities for rural residents.
For FY 2001, $25 million in grants and $300 million in loans will be made available for distance learning and telemedicine projects serving rural America. The funding will be provided in three categories: (1) $15 million will be available for grants; (2) $200 million will be available for loans; and (3) $110 million will be available for combination grants and loans ($10 million in grants paired with $100 million in loans).
Deadline: Loan Applications and Combination Loan and Grant Applications are due September 30, 2001.
Contact: Orren E. Cameron, (202) 690‑4493 or http://www.usda.gov/rus/telecom/dlt/dlt.htm
d. Others
(1) Current federal grant opportunities related to rural health are available at http://www.nal.usda.gov/ric/richs/grants.htm
(2) Foundations: Current Funding Programs and Master List is available at http://www.nal.usda.gov/ric/richs/foundat.htm
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8. Conferences Relevant to Rural Health
June 11-13: National Flex/CAH Conference for the Medicare Rural Hospital Flexibility Program, Technical Assistance and Services Center (TASC), Seattle, WA. For more information, contact: TASC 600 E. Superior Street, Suite 404, Duluth, MN 55802; (218) 720-0700; Fax: (218) 727-9392; E-Mail: tasc@ruralresource.org
June 22-26: 21st Century Rural Mental Health: Challenges and Opportunities National Association for Rural Mental Health Wilmington, NC. For more information, contact: NARMH, 3700 W. Division St., Suite 105, St. Cloud, MN; (320) 202-1820; Fax: (320) 202-1833; E-Mail: narmh@facts.ksu.edu; Web Site URL: http://www.narmh.org/2001.htm
June 25‑27: National Flex/CAH Conference for the Medicare Rural Hospital Flexibility Program, Technical Assistance and Services Center Cincinnati, OH. For more information, contact: TASC, 600 E. Superior Street, Suite 404, Duluth, MN 55802; (218) 720-0700; Fax: (218) 727-9392; E-Mail: tasc@ruralresource.org
June 28-30: 2001 National Health Care for the Homeless Conference Health Care for the Homeless Information Resource Center (HCHIRC) Washington, DC. For more information, contact: HCHIRC, Policy Research Associates, 345 Delaware Avenue, Delmar, NY 12054 (888) 439-3300 ext.247; Fax: (518) 439-7612. E-Mail: hch@prainc.com
July 19- 21: 6th Annual Skill Building Workshop, National Rural Health Association (NRHA), Kansas City, MO. For more information, contact: Rosemary McKenzie, NRHA, One West Armour Blvd., Suite 203, Kansas City, MO 6411; (816) 756-3140: Fax:(816) 756-3144; E-Mail: rmckenzie@NRHArural.org
August 9-10: 2nd National Conference on Drug Abuse Prevention Research: A Progress Update, National Institute on Drug Abuse (NIDA) Washington, DC . For more information, contact: Mildred Prioleau NIDA, 6001 Executive Boulevard, Room 5213, Bethesda, MD 20892 (301) 468-6008 x 431; Web Site URL: http://www.nida.nih.gov/Meetings/Preventionmeeting.html
August 23-24: Hospital Accreditation Standards and Survey Process for Small and Rural Hospitals Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Austin, TX. For more information, contact: JCAHO, One Lincoln Center # 1340, Oak brook Terrace, IL 60181 (630) 268-7400; Fax: (630) 268-7405; Web Site URL: http://www.jcrinc.com/edcal/haspsrur.pdf
September 23-26: Connecting Vision, Values and Technology: National AHEC Organization Workshop 2001: National AHEC Organization, HRSA, and Arkansas AHEC, Little Rock, AK. For more information, contact: Dr. Yvonne L. Lewis; E-Mail: LewisYvonneL@uams.edu Web Site URL: http://rpweb.uams.edu/NAO2001/menu.htm
October 11-12: Hospital Accreditation Standards and Survey Process for Small and Rural Hospitals, Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Orlando, FL. For more information, contact: JCAHO, One Lincoln Center # 1340, Oak Brook Terrace, IL 6018; (630) 268-7400; Fax: (630) 268-7405. Web Site URL: http://www.jcrinc.com/edcal/haspsrur.pdf
December 6-8: Rural Minority Women: Reaching Out and Reaching Goals in the New Century, NRHA's 7th Annual Rural Minority Health Conference, San Antonio, TX. For more information, contact: Rosemary McKenzie, Minority Affairs Director, NRHA ; One West Armour Blvd., # 203, Kansas City, MO 6411. (816) 756-3140; Fax: (816) 756-3144. E-Mail: rmckenzie@NRHArural.org
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9. Other Useful Information
a. NRHA Issue Papers Online: The National Rural Health Association’s Rural Health Policy Board regularly develops issue papers regarding issues impacting the nation’s rural health care delivery system. Issues papers are available online: http://www.nrharural.org/dc/a7.html. Copies are available through the NRHA Communications Department, One West Armour Blvd., Suite 203, Kansas City, Missouri 64111; Fax: (816) 756-3144; Email pubs@nrharural.org. If you have ideas for future issue paper topics or would like to contribute information on papers being drafted, email the NRHA Government Affairs Office at: dc@nrharural.org.
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b. Other Useful Websites: A kind source with the National Organization of State Offices of Rural Health, Steven Hirsch, has compiled the following sites:
Helpful HCFA Websites:
www.medicare.gov Site for Medicare Beneficiaries (1-800-633-~227)
www.hcfa.gov Site for HCFA program information
www.hcfa.gov/medlean Medicare computer-based training modules
www.hcfa.gov/medlearn/emdoc.htm E & M Documentation Guidelines for carrier claims
www.hcfa.gov/audience/planprov.htm Medicare coding and payment systems
www.hcfa.gov/pubforms/default.htm Basic Site for HCFA Publications and Forms
www.hcfa.gov/pubforms/progman.htm HCFA Manuals and transmittals
www.hcfa.gov/stats HCFA Data and Statistics
www.hcfa.gov/stats/pufiles.htm Public Use files (locality fee schedules,etc.)
www.hcfa.gov/coverage Medicare Coverage Policy ~ Home Page
www.hcfa.gov/medicare/edi/edi.htm EDI Formats(electronic data interchange)
www.hcfa.gov/stats/rvucrst.htm Medicare Physician Fee Schedule Data Base EVUs, global surgery, and file indicators)
www.hcfa.gov/medicare/payment.htm Links to Medicare payment systems including state specific fee schedules for physician services.
www.hcfa.gov/medicare/edi/edi5.htm Claim Forms and Instructions for UB-92(part A),HCFA-1491 (Ambulance), and HCFA 1500 (Part B) -electronic claims
www.lmrp.net All local Medicare coverage policies
www.ntis.gov/siteindex.htm Correct Coding Initiative Information
www.cpg.mcw.edu/www/upin.html UPIN Directory
www.hcfa.gov/medicare/fraud Medicare's Program Integrity Home Page
www.hcfa.gov/medicare/snfpps.htm SNF PPS Site
www.hcfa.gov/medicare/hhmain.htm Home Health Site
www.hcfa.gov/medicare/ascmain.htm Ambulatory Surgery Center Site
www.hcfa.gov/medicare/hopsmain.htm Hospital Outpatient PPS Site
www.hcfa.gov/medicare/ambmain.htm Ambulance Fee Schedule Site
www.hcfa.gov/medicare/pfsmain.htm Physician Fee Schedule Information
www.medicaretraining.com Training on HCFA-1SOO, HCFA-14S0 (UB--92),home health,ICD-9 coding,frontoffice management
Flu and Pneumococcal Sites:
www.nationalpneumonia.org Consumer and Provider flyers
www.cdc.gov Flu Vaccine Supply, Vaccineshoppe.com,Pandemic update, Provider flyers
www.hcfa.gov/quality/3g.htm HCFA's Influenza and Pneumococal Campaign
HIPAA Sites:
http://aspe.hhs.gov/admnsimp/Index.htm Posting of law, process, regulations and comments
www.wpc-edi.com/hipaa Posting of x l2N implementation guides, data conditions and the data dictionary (except for retail pharmacy) for Xl2N standards
www.wedi.org Posting of information on EDI in the healthcare industry, and availability of resources for standard transactions
www.hcfa.gov/medicare/edi/edi.htm Medicare ED! Information
Other Helpful Sites:
www.hhs.gov/oig.new.html HHS-Office of Inspector General(Compliance Guidance for Physicians, etc.)
www.insurekidsnow.gov State Children's Health Insurance Program information (also, l-877-KIDS-NOW)
www.access.gpo.gov/nara/cfr/index.html Code of Federal Regulations
www.gpo.ucop.edu/search/fedfld.html Univ. of California-Federal Register pubs
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Please address comments, questions, requests,contributions, and suggestions to ahughes@u.arizona.edu. If you know of someone who would like to be added to our distribution list, or if you wish to be removed from the list, please contact atromble@rho.arizona.edu.
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