Rural Health Briefing
Volume XI September 10, 2007
Rural Health Office
UA Zuckerman College of Public Health
in conjunction with the Arizona Rural Health Association, Inc.
National News
- Nurse-Owned Clinics Replace Country Doctors
- AHIC Successor Public Technical Assistance Meeting
- 12 States Lead the Way in Medicaid Health IT Adoption
- HRSA Awards $31.4 Million to Expand HIT at Health Centers
- Rural Health Information Technology Conference 2007
Across Arizona
- Attention
Health Care Safety Net Providers
- Introduction Letter From the Rural Health Office Director
- Arizona Health-e Connection Update- Executive Director Named
Grants and Opportunities
- Scholarships Available to Attend 2007 APHA Conference
- Rural Health Network Development Planning Grant
- Rural Health Network Development (RHND) Grant Program
Calendar
Sept 5-7, AzPHA Annual Meeting and Fall Conference, Sedona, AZ
Sept 12-14, Rural Health Information Technology Conference, Kansas City, MO
Mark Your Calendar
Oct 2-3, Rural Health Clinic Conference, San Antonio, Texas
Oct 3-5, Critical Access Hospital Conference, San Antonio, Texas
Oct 7-9, NOSORH Annual Meeting, Charleston, South Carolina
Nov 3-7, APHA Annual Meeting and Exposition, Washington, D.C.
Nov 5-7, HRSA HIT Grantee Meeting, Arlington, Virginia
National News
1. Nurse-Owned Clinics Replace Country Doctors
According to a recent press release by the Associated Press dated August 28, 2007 nurse owned clinics are replacing country doctors. The press release continued by stating that “residents across rural Missouri who once relied on the country doctor to treat their everyday aches and pains are increasingly turning to clinics owned by nurses with advanced training. More than a dozen have opened in the past several years, according to the university's Sinclair School of Nursing.” In addition, the release mentioned that Missouri State law requires nurses to regularly consult with supervising physicians, most of whom work elsewhere. The release noted growth in nurse-owned clinics in Missouri “dovetails with a national increase in walk-in medical clinics in supermarkets, drugstores and strip malls. Those clinics, while largely owned by corporations such as Wal-Mart, are primarily operated by nurse practitioners and physician assistants.” As a result of this, such alternatives to hospitals and doctor offices has “caught the attention of the American Medical Association, which recently asked state and federal regulators to investigate potential conflicts of interest between nurse practitioners prescribing drugs and the pharmacies filling those prescriptions.”
Click here for full announcement
2. AHIC Successor Public Technical Assistance Meeting
A public technical assistance meeting will be held on September 5, 2007, in order to answer detailed questions related to a Notice of Funding Availability (NoFA) and to resource an entity designated to design and establish the AHIC successor by Spring 2008. More information will be provided about the concepts and illustrative model described in the NoFA, about the requirements for the applications, and the evaluation criteria.
Date: September 5, 2007
Time: 9:30 a.m. to 12:00 p.m. Eastern
Location:
Hubert H. Humphrey Building
200 Independence Ave., SW, Room 705A
Washington, DC 20201
If you will be attending in person, you are invited to remain after the meeting to meet fellow attendees. Alternatively, the public may participate remotely via an audio webcast and submit questions or comments via phone or email. More instructions regarding remote participation will be made available soon.
Click here to for more information and to register online.
3. 12 States Lead the Way in Medicaid Health IT Adoption
According to a federal report released by HHS' Office of Inspector General, 12 state Medicaid agencies in particular stand out for their health IT efforts. The efforts highlighted include claims-based electronic health records, e-prescribing, remote disease monitoring and personal health records. The report urges CMS to continue to work with states and other federal agencies to help expedite health IT adoption.
Click here to learn more.
4. HRSA Awards $31.4 Million to Expand HIT at Health Centers
According to a press release dated August 27, 2007, HRSA Administrator Elizabeth M. Duke announced $31.4 million in grants to help health centers prepare to adopt and implement Electronic Health Records (EHR) and other health information technology (HIT) innovations. Duke’s announcement mentions twenty-five grants totaling more than $27 million to support implementation of EHRs at health centers and in networks that link multiple health center grantees. These grants can be viewed in the full press release in two tables: the Electronic Health Record Implementation Initiative, and the High Impact - Electronic Health Record Implementation Initiative.
Eight grants worth almost $1 million are to help health centers in planning activities that will prepare them to adopt EHR or other HIT innovations. Thirteen grants worth more than $3 million are to help health center networks implement HIT other than electronic health records. Other HIT advances may include electronic prescribing, physician order entry, personal health records, community health records, health information exchanges, smart cards, and creating interoperability with outside partners such as health departments and other HRSA grantees.
Click here for full announcement
5. Rural Health Information Technology Conference 2007
Online registration is now open for the upcoming Rural Health Information Technology: Navigating the Road to Performance Improvement. The Conference will be held September 12 – 14, 2007 at the Westin Crown Center in Kansas City, MO. Online Registration, hotel information, draft agenda, sponsor and exhibitor information are all available at the website link featured below. Please feel free to share this with others you think may be interested!
Click here for more details and a link to the webpage.
Across Arizona
1. Attention Health Care Safety Net Providers
The Centers for Medicare and Medicaid Services (CMS) has recently issued new information and requirements that affect health care safety net providers. HRSA is providing the following information to keep you aware of the six recent developments:
Medicare Prescription Coverage (Part D) Late-Enrollment Penalty Waiver for LIS-Eligibles
CMS announced Tuesday (Jan. 9) that it will waive the penalty for Medicare beneficiaries who qualify for the low-income subsidy (LIS) but sign up late with a Part D plan. The agency hopes the move will encourage an estimated 3 million or more Medicare beneficiaries to sign up for the drug benefit. For more information please visit:
http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=2070&intNumP.
Medicare Part D Enrollment Still Available for Certain Beneficiaries
Certain other Medicare beneficiaries are still eligible to enroll in Medicare Part D without penalty. Additional information about Medicare beneficiaries who are still eligible to apply can be found at http://www.hrsa.gov/medicare/ by selecting "Special Enrollment Periods 2007." Also posted on HRSA’s website is information issued by CMS for pharmacists serving dual eligible patients who present without their prescription card or other documentation. We encourage you to visit http://www.hrsa.gov/medicare/ periodically for updates and important Part D-related links to CMS’ website.
National Provider Identifier (NPI)
The NPI will be used when processing claims for Medicare, Medicaid and private health insurance. The mandatory compliance date for the NPI is May 23, 2007, meaning that all electronic transactions, including claims, must then use the NPI to identify covered healthcare providers. The NPI will help minimize claim errors and delays in payment; therefore, you should obtain and begin using the NPI prior to May 23, 2007. Each Provider Site and each Provider will need their own unique NPI. The time frame associated with applying, obtaining and making operational the NPI is estimated to be rather lengthy; it would serve in your best interest to begin the process as soon as possible.
For additional information on the National Provider Identifier and how to obtain it, please visit: http://www.cms.hhs.gov/NationalProvIdentStand/.
Medicare Enrollment Application (CMS-855A)
Effective May 1, 2006, CMS revised the CMS-855 Medicare enrollment application. Providers and suppliers must submit this 2006 version of the Medicare enrollment application in order to bill as a Medicare provider (under Part A of Medicare). All institutional providers, including Federally Qualified Health Centers, Rural Health Clinics, and Critical Access Hospitals must fill out form CMS-885A for each new service delivery site.
In addition to submitting a completed application, each provider or supplier is required to submit all applicable supporting documentation at the time of filing. This includes professional licensure, business licenses and the National Provider Identifier (NPI) notification received from the National Plan and Provider Enumeration System (NPPES). CMS requires providers and suppliers to obtain their NPI prior to enrolling or updating their enrollment record with Medicare.
NOTE: This is a case which requires the NPI in advance of the May 23, 2007 compliance date. Obtaining an NPI number is a separate process from the Medicare provider enrollment. Providers must enter their NPI on the CMS-855 application and submit a copy of the NPI notification letter received from the NPPES.
Please visit the following site for additional information and requirements: http://www.cms.hhs.gov/cmsforms/downloads/cms855a.pdf.
For questions related to the processing your enrollment application, please contact the appropriate Medicare contractor.
Click on the link below for their contact list: http://www.cms.hhs.gov/MedicareProviderSupEnroll/downloads/contact_list.pdf.
Medicaid Transformation Grants
The CMS guidance was issued on July 25, 2006 for DRA Section 6081 Medicaid Transformation Grants. See: http://www.cms.hhs.gov/smdl/downloads/SMD072506.pdf.
Applications from States were reviewed and awards were announced on January 25, 2007. For more information on the Transformation Grant awards please click on the following link: http://www.cms.hhs.gov/medicaidtransgrants/.
We encourage HRSA grantees to work closely with their State during the implementation of Medicaid Transformation Grants to support Medicaid changes that will undoubtedly involve safety net providers in underserved communities.
As the Department continues to modernize Medicare and Medicaid, we strongly encourage that you work closely with your State Medicaid Agency and other partners on key State initiatives that support the HRSA mission and your mission.
Link to CMS Partner Listserv
We at HRSA will continue to ensure that you receive relevant information from us, but encourage you to use the link below to sign up for the CMS Partner Listserv. The Listserv will allow you, and those you work with, to receive notices on CMS training, CMS products, issuance of new CMS policies, and other notices enabling your providers and the people they serve to make better use of CMS programs.
See: http://www.cms.hhs.gov/apps/mailinglists/default.asp?audience=6.
For additional information on any of the above topics please contact Na’Im Moses, Office of Planning and Evaluation/Health Systems and Financing group at 301-443-6841 or nmoses@hrsa.gov.
2. Introduction Letter From the Rural Health Office Director
Dear Colleagues in Rural Health,
By now many of you have heard that I assumed the position of Rural Health Office Director in July. I arrived in Tucson with my wife Shelly, three year-old daughter, and two teenagers just a few weeks ago after spending over two decades in Seattle where I headed the Rural Health Research Center and served as a Professor at the University of Washington’s School of Medicine. In addition to selecting a new home, moving, and getting children settled into schools, my immediate tasks have been to get to know colleagues here at the Mel and Enid Zuckerman College of Public health, and in particular at the Rural Health Office.
Arizona’s current and projected population growth patterns are generating a number of challenges that impact rural health care. These include increasing demands for health care professionals, new health care facilities, additional housing, transportation, and community infrastructure. These issues invariably extend to the tribal populations in the state, as well as to the populations located at the US-Mexico border area.
One of my goals is to build the capacity of the Rural Health Office to impact the health of Arizona’s diverse populations, through policy analysis and programmatic interventions. To do this I need to learn more about the day-to-day issues and problems faced by the advocates, the research community, the health care providers, the health care reimbursement system, and most importantly, the people seeking health care. I am trying to meet as many folks as I can and to travel as much as time permits to visit the rural parts of the state.
I invite you to contact me with your ideas and comments. You can help me shape the future of the Rural Health Office and the services it provides to the residents of our state.
L. Gary Hart, Ph.D.
Professor, Public Health
Director, Rural Health Office
Mel and Enid Zuckerman College of Public Health
The University of Arizona
Roy P. Drachman Hall, Room A247
1295 N. Martin Avenue
P.O. Box 245177
Tucson, AZ 85724-5177
Tel: (520) 626-6258
Fax: (520) 626-3101
garyhart@email.arizona.edu
www.publichealth.arizona.edu
3. Arizona Health-e Connection Update- Executive Director Named
In a press release dated August 28, 2007 the Arizona Health-e Connection announced the selection of Brad Tritle as the organization’s first executive director. The press release continued by stating that “Tritle’s appointment is part of the Arizona Health-e Connection’s plan to advance the delivery of health care in Arizona by promoting a new health information infrastructure across the state, including electronic medical records. Widespread use of health information technology (HIT) could save lives and the state’s health care system approximately $2.6 billion annually.”
Click here for full announcement
Grants and Opportunities
Note: Technical assistance is available for the development of grant proposals and other funding applications from the professional staff of the Rural Health Office and the State Office of Rural Health Program. Please contact Jennifer Peters.
1. Scholarships Available to Attend 2007 APHA Conference
The Community-Based Public Health (CBPH) Caucus - the "home" for CBPR at the American Public Health Association - is offering scholarships for community-based organizations (CBO)s to attend the APHA conference, "Politics, Policy and Public Health," November 3-7, 2007 in Washington DC.
The letter of explanation and application can be found on the Caucus's website at http://www.cbphcaucus.org.
For more information, please contact Barb Watson, Caucus Administrator at
734-936-1226 or at bjwatson@umich.edu
2. Rural Health Network Development Planning Grant
Application Deadline: October 5, 2007
The purpose of the Rural Health Network Development Planning Grant Program (HRSA-08-003) is to provide support to entities that need assistance to plan, organize and develop a health care network because they do not have a significant history of collaboration and are not sufficiently evolved to apply for a three year Rural Health Network Development Grant. This support may be sufficient to jumpstart a network into becoming operational and developing strategies for becoming sustainable. The grant program supports one year of planning to develop and operationalize health care networks, consisting of at least three health care providers, in rural areas.
Please note that there is a conference call for potential network grant applicants on August 23 at 2:00 pm Eastern Time. However, you must register to participate in the call by writing to Mary Collier via mcollier@hrsa.gov and simply requesting a reservation to be on the network grant technical assistance call.
Click here for further details.
3. Rural Health Network Development (RHND) Grant Program
Application Deadline: October 15, 2007
The purpose of the Rural Health Network Development (RHND) Grant Program (HRSA-08-004) is to support the development of rural health networks, whose purpose is to increase access to care by overcoming the fragmentation and vulnerability of providers in rural areas. Grant funds are used to support activities that strengthen capabilities of these networks.
Arizona applicants: Please note that there is a conference call for potential network grant applicants on September 19 at 9:00 am Mountain Standard Time. However, you must register to participate in the call by writing to Mary Collier via mcollier@hrsa.gov and simply requesting a reservation to be on the network grant technical assistance call.
Furthermore, letters of support from the Arizona State Office of Rural Health is a requirement for these grant applications. Your contact at the SORH for support is Jennifer Peters at petersjs@u.arizona.edu and (520) 626-2254.
Click here for further details.
Contact Your Representatives
a. Arizona Congressional Delegation: Links to Arizona members of the U.S. House of Representatives are available at: U.S. Representatives. Links to Arizona members of the U.S. Senate are available at: U.S. Senate
b. Arizona State Legislators: Available through the Arizona Legislative Information System (ALIS): Call 1-800-352-8404 or follow links at Arizona Legislature.
Important Links
Editor's Note: This online newsletter is a joint project of the Rural Health Office housed at the UA Zuckerman College of Public Health, and the Arizona Rural Health Association, Inc. The mission of the Rural Health Office is to promote the health of rural and medically underserved individuals, families, and communities through service, education and research. The Arizona Rural Health Association, Inc. advocates on behalf of the health needs of rural Arizonans at national, state and local levels. Its multidisciplinary membership provides a respected and highly effective group of rural health practitioners and rural community residents. For example, the AzRHA, Inc. has actively and successfully advocated with the state legislature for funding for tele-medicine and mobile clinics in all fifteen counties of the state.
Your questions (or answers) are always welcome. Please send them as well as address changes to Taya Waltke, Administrative Associate, Rural Health Office.
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