|
Rural Health Briefing April 27 2005
Special Calendar of Events for Arizona Rural Health
*May 13
Swing Bed Training for Critical Access Hospitals, Phoenix
Swing bed utilization is an easy service to implement in a critical access hospital. It is also the fastest way to increase hospital revenues without increasing staff or other costs by simply increasing Medicare days in a cost-reimbursed system such as CAH. This workshop will provide an intensive learning opportunity on how to more effectively use CAH swing beds. It will also demonstrate how to apply for these beds if they do not currently exist. Click here for details.
*May 17
Medication Reconciliation in Rural Hospitals, videoconference in Phoenix and Tucson
Medication reconciliation is a superb opportunity to improve hospital quality and safety. This learning session will demonstrate valuable processes and tools to directly enhance patient safety. The Arizona Rural Hospital Flexibility Program in partnership with Health Services Advisory Group sponsors this workshop. Click here for details.
*May 24
EMS Training for ER Nurses and First Responders, Benson
This six-hour training session will include five modules of computer-based educational programs on the following topics: 1) Critical Decisions in Prehospital Trauma Care; 2) Pediatric “Red Flags”; 3) Burns; 4) Traumatic Brain Injury; and, 5) HazMat/WMD. (Another session of this training will be held on July 15 in Winslow.) Click here for details.
*June 8-10
3rd Annual Western Region Flex Conference, Phoenix
The 3rd Annual Western Region Flex Conference draws together many of the nation's foremost experts on critical access hospitals. The purpose of this conference is to enable the participants to exchange valuable information that contributes to shaping the future of rural health care. Click here for details.
*June 14
Rural Hospital Quality Managers Roundtable, Phoenix
A nationally known authority on hospital quality, Darlene Bainbridge, will be applying some of that knowledge in Arizona. Bainbridge will be serving as facilitator and catalyst to a roundtable session of rural hospital quality managers. This group – Arizona Rural Quality Network Group (ARQNG) - began with a series of conference calls and now is expanding their range beyond a “virtual network” by meeting face-to-face.
Everyone engaged in quality efforts in rural hospitals is invited to join in this active day of open dialogue and learning. Topics will include creating, building and sustaining effective teams, tracking progress and measuring performance improvement in addition to bringing the components together in support of a well-rounded, effective quality program.
Click here for details.
*July 15
EMS Training for ER Nurses and First Responders, Winslow
This six-hour training session will include five modules of computer-based educational programs on the following topics: 1) Critical Decisions in Prehospital Trauma Care; 2) Pediatric “Red Flags”; 3) Burns; 4) Traumatic Brain Injury; and, 5) HazMat/WMD. Click here for details.
*CMS Training in Billing and Coding: date will be announced soon
National News
1) CMS Seeks Comments On CAH Necessary Provider
Designation
2) Report to Congress: Critical Access Hospitals Successful
3) AHRQ Launches Online Patient Safety Network
4) Health Information Technology Survey
Across Arizona
1) First Marshall Rural Hospital Quality Awards
2) Arizona Medicaid Rankings
3) Arizona Rural Health Plan Approved
4) Nichols Award
5) Notes on the Current Arizona Legislative Session
6) Governor OKs School Junk Food Ban and Additional Newborn
Screening; Vetoes Guns in Bars
Grants and Opportunities
1) New Access Points for Health Centers
2) John M. Eisenberg Award for Patient Safety and Quality
3) Scholarships for Students in Health Information
4) Rural “Community Connect” Grants Target Broadband
5) Health Disparities Among Minority and Underserved Women
6) Research on Rural Mental Health and Drug Abuse Disorders
7) Funding for Rural Telecommunications
8) Innovative Approaches to Vulnerable Populations
9) Public Health Scholarship for Arizona
10) 2005 Funds Announced by Public Welfare Foundation
Calendar
Mark Your Calendars!
- July 15, EMS Training for ER Nurses and First Responders, Winslow
- July 17-19, 2005, 32nd Annual Arizona Rural Health Conference, Payson
- August 4-5, 16th Annual Southwest Regional Trauma Conference, Tucson
- August 22-26, ORPH’s All Programs Meeting: The Crossroads of Rural Health, Washington, D.C.
- September 30, 3rd Annual Arizona Women’s Conference, Tucson
National News
CMS Seeks Comments On CAH Necessary Provider Designation
Revisions to CAH necessary provider designation have been proposed by CMS. They could affect CAHs with construction or relocation plans.
One provision of serious concern to CAHs is that even if a CAH meets the requirement of maintaining 75% of services and staff, it must have begun construction-related planning prior to December 8, 2003 (passage of MMA 2003).
Comments are due by June 24, 2005 and should include the caption “Critical Access Hospitals” at the beginning of the comment and refer to file code CMS-1500-P. Comments may be sent electronically via: http://www.cms.hhs.gov/regulations/ecomments
The following section is proposed as an addition to §485.610 of the regulation.
(d) Standard: Relocation of CAHs with a necessary provider designation. A CAH that has a necessary provider certification from the State and places a new facility in service after January 1, 2006, can continue to meet the location requirement of paragraph (c) of this section based on the necessary provider certification only if the new
facility meets either the requirement for replacement in the same location in paragraph (d)(1) of this section or the requirement for a relocation of a CAH in paragraph (d)(2) of this section.
(1) A new construction of a CAH will be considered as a replacement facility if the construction is undertaken within 250 yards of the current building or contiguous to the current CAH on land owned by the CAH prior to December 8, 2003.
(2) A new facility CAH will be considered as a relocation of a CAH if, at the relocated site--
(i) The CAH serves at least 75 percent of the same service area that it served prior to its relocation, provides at least 75 percent of the same services that it provided prior to the relocation, and is staffed by 75 percent of the same staff (including medical staff, contracted staff, and employees); and
(ii) The CAH provides documentation demonstrating that its plans to rebuild in the relocated area were undertaken prior to December 8, 2003.
(3) If a CAH that has a necessary provider certification from the State places a new facility in service on or after January 1, 2006, and does not meet either the requirements in paragraph (d)(1) or paragraph (d)(2) of this section, the action will be considered a cessation of business as described in §489.52(b)(3).
Report to Congress: Critical Access Hospitals Successful
The Medicare Payment Advisory Commission is reporting to Congress on the critical access hospital (CAH) program's success in preserving rural hospitals and rural beneficiaries' access to care. The commission also reviewed data on CAH quality that showed that smaller CAHs have lower patient complication rates, while larger CAHs have lower mortality rates.
The report also highlights two issues of concern about the CAH program -- swing-bed payments and the number of CAHs located within close proximity of another hospital. It will not include recommendations, saying it is too soon to recommend major changes to the relatively young program.
AHRQ Launches Online Patient Safety Network
HHS' Agency for Healthcare Research and Quality (AHRQ) has launched a national "one-stop" portal of resources for improving patient safety and preventing medical errors. The site, AHRQ's Patient Safety Network, or PSNet, can be found at http://psnet.ahrq.gov/.
PSNet will help health care providers, administrators, and consumers learn about many aspects of patient safety including resources, tools, and conferences. PSNet users can customize the site around their unique interests and needs by creating a "My PSNet" page. For example, a pharmacist interested in how bar coding can help prevent medication errors will be able to set up the site to automatically collect the latest articles, news, and conferences on this topic.
In addition, weekly PSNet updates are available to subscribers on recent patient safety findings. The site was developed by the same team of researchers at the University of California, San Francisco, that developed AHRQ's popular WebM&M online patient safety journal, which will now be accessible on PSNet.
Health Information Technology Survey
The Rural Health Resource Center is asking for assistance from rural hospitals to gather data on Health Information Technology (HIT). The five minute survey will ask what barriers exist for rural hospitals and what opportunities for assistance their might be at a national level.
To complete the survey simply click here.
Across Arizona
First Marshall Rural Hospital Quality Awards
On April 19, three hospitals received the Carter L. Marshall 2005 Rural Hospital Quality Awards in recognition of the outstanding care they provide their communities. Northern Cochise Community Hospital in Willcox, Page Hospital and Tuba City Regional Health Care Corporation were given the awards by the Health Services Advisory Group for providing “the highest quality of care to patients with pneumonia.” Pneumonia care was defined according to eight quality indicators set nationally by CMS.
Northern Cochise Community Hospital and Page Hospital are both critical access hospitals.
In addition, 23 hospitals were recognized with Participation Awards for submitting at least two quarters of quality data and joining in the Hospital Quality Alliance.
Arizona Medicaid Rankings
A recent update of state Medicaid expenditures (2003) reveals that Arizona ranks 22nd among all states in total state Medicaid spending ($1.237B) and 20th in Federal per capita Medicaid spending, at $627 per person.
Breaking it down further, Arizona ranks 6th in the nation in terms of the percentage of total Medicaid dollars allocated for acute care (68.3%), but ranks 46th in the percentage of dollars allocated for long term care (27.8%).
Arizona is one of the leaders in the nation in community-based care and keeping people in their homes instead of expensive nursing home facilities. This translates into lower long-term care expenditures for the state.
See the recent state Medicaid rankings and more at statehealthfacts.org.
Arizona Rural Health Plan Approved
Arizona Rural Health Plan was approved by CMS on April 4, 2005. The result of a multi-stage process of input and deliberation, the implications and implementation of the plan will be discussed at the Arizona Rural Health Conference, scheduled for July 18-19 in Payson.
The comprehensive, statewide effort resulted in adoption of 38 strategic objectives within five focus areas. Click here for the Arizona Rural Health Plan 2005-2007.
Awards Made to Nichols Scholars
Awards of $1,000 each have been made to three graduate students in the UA Zuckerman College of Public Health for their proposals to improve rural or border health.
Xochitl N. Coronado will work in Mulukuku, Nicaragua with the Maria Luisa Cooperative and Women’s Center to help develop culturally appropriate prevention strategies that promote non-violence and reproductive health education for women.
Alma Shacter plans to study car crashes along the U.S. Mexico border.
Kristina Luther is traveling to Minas Gerias, in the remote northeastern region of Brazil, to investigate cardiovascular risk factors among a sample group of 200 adults.
This is the first set of awards made by the Andrew W. Nichols Initiative of the college. Andrew Nichols, MD, MPH, was the founding director of the Rural Health Office. He sponsored and inspired many positive changes along the border and rural areas of the Southwest during his lifetime.
Notes on the Current Arizona Legislative Session
The First Regular Session of the 47th Arizona State Legislature has produced some results of importance to rural health.
Some bills of particular interest:
SB1294- nursing education demonstration project; appropriation - Appropriates $4,000,000 annually from the state General Fund in FYs 2005-2006 through 2009-2010 to increase the number of nurses in Arizona. Establishes the Arizona Partnership for Nursing Education Demonstration Project. An amendment was added in the Senate, which instructs the Department of Commerce to award grants to community colleges based on recommendations from a statewide board that represents community colleges. No movement.
SB 1036 Medical Malpractice Procedural Reforms - Changes medical malpractice statutes by including a list of qualifications for a physician to be an expert witness. Expands law regarding Dr/patient privilege by disqualifying a provider's statements of sympathy, compassion, etc. from evidence against interest. Passed out of Senate final read 23-6-1 on 4/18 and signed by the Governor, 4/25/05.
SB 1137 AHCCCS; certified providers - Conforms state statutes with the Medicare Modernization Act of 2003 (MMA) by authorizing the Arizona Health Care Cost Containment System (AHCCCS) to certify Medicare health plans and requiring persons who are dually eligible for Medicaid and Medicare to begin receiving prescription drugs from Medicare authorized entities beginning January 1, 2006.
Passed 29-0 on final read and was signed by the Governor, 4/25/05.
SCR1027- NOW truth in budgeting - The bill requires the State legislature to ensure that the state's annual budget is balanced by not exceeding ongoing or permanent state revenues to pay for obligations for state operations. It also states that fiscal year ending cash balances shall not be considered permanent revenues and the fiscal year ending cash balance shall be at least one per cent of the fiscal year state general fund balance. Passed out of Committee of the Whole on 4/19/05.
HCR2021-Health care decisions week- Proclaims the week of November 6th 2005 as Health Care Decisions Week in Arizona. The resolution encourages citizens to consider and discuss with loved ones, their wishes for medical care. Health care directives, also known as advance directives, include a Living Will and a Health Care Power of Attorney. Transmitted to the Secretary of State.
The bill statistics are as follows:
Total number of House Bills, Memorials and Resolutions - 860
House bills and joint resolutions transmitted to the Governor - 123
House bills and Joint resolutions enacted into law - 85
House bills vetoed by Governor - 5
House memorials/resolutions sent to the Secretary of State - 13
Total number of Senate Bills, Memorials and Resolutions - 579
Senate bills and joint resolutions transmitted to the Governor -155
Senate bill memorials and joint resolutions enacted into law - 81
Senate bills vetoed by Governor - 20
Senate memorials/resolutions sent to the Secretary of State - 6
(Notes provided by Tara McCollum Plese, Director of Government and Media Relations, Arizona Association of Community Health Centers, with our appreciation.)
Governor OKs School Junk Food Ban and Additional Newborn Screening; Vetoes Guns in Bars
Gov. Janet Napolitano has signed a bill that bans the sales of soft drinks, candy and gum during the school day, beginning in July 2006. High schools are exempt.
The bill requires the Arizona Department of Education to develop nutrition standards for school snacks and drinks. Schools may still be able to sell potato chips and candy bars provided they switch to lower-fat versions or smaller portion sizes. Texas and West Virginia have banned soft drinks and candy from their elementary and junior high schools.
The Arizona Newborn Screening Program of the Department of Health Services (DHS) identifies babies with hearing deficiencies as well as babies who have certain serious medical conditions. This has now been expanded to include tests for certain congenital disorders. According to DHS, the program may be expanded to include up to 29 tests. The cap on fees has been increased to $30 for the first specimen and hearing test and up to $40 for the second specimen and hearing test.
Gov. Janet Napolitano vetoed a bill that would have allowed people to carry guns in bars and restaurants if they weren't drinking alcohol and if the businesses didn't ban them from doing it. The bill would have rewritten an Arizona law that bans possession of firearms in bars and restaurants that sell alcohol.
The bill was not supported by law enforcement organizations. This veto followed the earlier signing of a bill backed by gun-rights activists to allow Arizona public schools to offer an elective course in marksmanship and gun safety.
(Adapted from various news sources.)
Grants and Opportunities
New Access Points for Health Centers
HRSA 05-101
Application deadline: May 23, 2005
The New Access Points program supports the establishment of new service delivery sites for each type of Health Centers funded under Section 330 of the Public Health Service Act. Each application for support to establish a new site must identify a population in need of primary health care services, and propose a specific plan to increase access to care and reduce disparities identified in the population or community to be served.
The program includes: 1) Community Health Centers, section 330(e); 2) Migrant Health Centers, section 330(g); 3) Health Care for the Homeless program, section 330(h); 4) Public Housing Primary Care, section 330(i); and 5) School Based Health Centers, section 330.
Full details available here.
John M. Eisenberg Award for Patient Safety and Quality
Submission deadline: May 27, 2005
The 2005 John M. Eisenberg Award nominations are being sought by the sponsors, the National Quality Forum (NQF) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
The Eisenberg Award recognizes major achievements of individuals and organizations in improving patient safety and quality. The annual Awards include an individual lifetime achievement award and awards in the categories of system innovation (local and national) or research.
Download the 2005 Eisenberg Nomination Form here.
Scholarships for Students in Health Information
Application deadline: May 27, 2005
American Health Information Management Association’s Foundation of Research and Education (FORE) offers merit scholarships to outstanding undergraduate students pursuing degrees in health information administration and health information technology. Scholarships are also available to credentialed health information management (HIM) professionals pursuing graduate degrees to further their careers in HIM. Scholarships range from $1,000 to $5,000 and are awarded based on academic achievement, work and volunteer experience and the quality of references provided. Click here for details.
Rural “Community Connect” Grants Target Broadband
Application Deadline: May 31, 2005
The Rural Utilities Service will fund $8.9 million to provide currently unserved areas with broadband transmission service that fosters health care, economic growth, education and public safety services. Minimum grants will be $50,000.
Grants are to be used to deploy broadband service to extremely rural, lower-income communities on a “community-oriented connectivity” basis. This should stimulate practical, everyday uses and applications of advanced technologies.
Applicant may be an incorporated organization, Indian tribe, state/local government or other legal entity including cooperatives or private corporations or limited liability companies organized on a for- profit or not-for-profit basis.
Funding may be used to finance construction, acquisition or lease of facilities; end user equipment needed to carry out the project; operating expenses incurred in providing the broadband transmission service to critical community facilities for the first 2 years of operation and to provide training and instruction. Funds can also be used to cover the purchase of land, buildings, or building construction.
For full details click here.
Health Disparities Among Minority and Underserved Women
PA-04-153
Application deadline: June 1, 2005
This initiative aims to stimulate research aimed at reducing health disparities among racial/ethnic minority and underserved women. More specifically, it seeks applications for: (1) research related to health promotion or risk reduction among minority and underserved women age 21 and older; and, (2) intervention studies that show promise for improving the health profile of minority and underserved women.
Proposals should focus on enhancing the body of knowledge of a variety of factors (e.g., social, economic, demographic, community, societal, personal, cultural) influencing the health promoting and health compromising behaviors of racial and ethnic minority women and underserved women and their subpopulations. Full details here.
Research on Rural Mental Health and Drug Abuse Disorders
PA-04-061
Application deadline: June 1, 2005
The purpose of this program is to stimulate research on mental health or drug abuse problems in rural and frontier communities that will enhance understanding of structural (including community risk and resilience factors), cultural, and individual factors that may limit the provision and utilization of prevention and treatment services in these communities. It also proposes to generate knowledge for improving the organization, financing, delivery, effectiveness, quality, and outcomes of mental health and drug abuse services for diverse populations in rural and frontier populations.
Applications may focus exclusively on mental disorders, drug abuse disorders, or on the co-occurrence of these and related disorders. Sponsors are the National Institute of Mental Health and the National Institute on Drug Abuse. Full details here.
Funding for Rural Telecommunications
Submission deadline: June 30, 2005
The Rural Health Care Division (RHCD) of USAC now accepting applications for July 1, 2005-June 30, 2006. These funds assist health care providers in rural areas to obtain the benefits of the Internet and current telecommunications technology. RHCD is posting information on changes in the program to its website. These changes will include new application forms, which are currently under review by OMB. However, to help ensure that applicants have sufficient time to post Form 465 before the Funding Year starts July 1, 2005, RHCD has authorized the using the old Form 465 for Funding Year 2005.
Health care participants may be eligible to receive a 25% discount on their monthly Internet service charges. Emergency Departments of for-profit rural hospitals are also eligible. A complete list of eligible services for both Internet and telecommunications services is available from USAC.
Further details at the USAC website.
Innovative Approaches to Aid Vulnerable Populations
Application deadline: June 30, 2005
Local Initiative Funding Partners is a partnership program between Robert Wood Johnson Foundation and local grant makers that supports innovative, community-based projects to improve the health and health care for society's most vulnerable people. Of special interest are projects that address community violence, children’s mental health, the needs of new immigrants and others whose health status is affected by social factors.
$6 million will be awarded in this cycle in amounts of $100,000 t0 $500,000. Details at: http://www.rwjf.org/files/applications/cfp/cfp-lifp2006.pdf
Public Health Scholarship for Arizona
Application Deadline: July 1, 2005
The Arizona Public Health Association is seeking applications for the Lloyd E. Burton Scholarship to be awarded at its annual meeting in September 2005. The $500 scholarship is for current, higher education students enrolled in a program related to public health (e.g. nursing, medicine, public health, health administration, etc.).
Click here for details.
2005 Funds Announced by Public Welfare Foundation
Applications continuously accepted.
The Public Welfare Foundation supports organizations that address human needs in disadvantaged communities. In 2005, they have earmarked the following grant amounts: $3 million for health; $2.5 million for community development; $2.5 million for reproductive and sexual health; and, $1.5 million for youth. They have a strong emphasis on organizations that include service, advocacy and empowerment in their approach. Examples are services that remedy specific problems; advocacy that addresses those problems in a systemic way through changes in public policy; and strategies to empower people in need to play leading roles in achieving those policy changes.
The Foundation provides both general support and project-specific grants and support organizations that link their community and local work to other efforts to affect broader public policy change. Applications are continuously reviewed and begin with a detailed letter of inquiry. 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 project of the Arizona Rural Hospital Flexibility Program, housed in the Rural Health Office at the UA Zuckerman College of Public Health, and supported through a grant from HRSA (Office of Rural Health Policy). The Rural Hospital Flexibility Program was created by Congress to improve the financial viability and stability of health care in rural areas, including creation of a new designation for rural hospitals as Critical Access Hospitals (CAHs). Designated CAHs are eligible for cost-based reimbursement for services provided to Medicare patients. In some states, including Arizona, additional reimbursement is also available for CAH services provided to Medicaid patients.
Your discerning comments, invaluable suggestions or enigmatic questions are always welcome. Please send them as well as address changes to Jim Laukes, Editor, Rural Health Briefing.
|
