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Rural Health Briefing, Vol. 3, No. 2 April 5, 2002
Update: Rural Hospital Flexibility Program
a. National Action
- 2002 National Conference of Flex Programs
- HIPAA Compliance
b. State Action
- Status of Arizona Critical Access Hospital Designations
- Status of Critical Access Hospital Designation Applications
- Status of State Legislation
- Flex Leadership Advisory Group
- 2002 Arizona Flex Program Conference
Arizona News
a. Border Health Lifetime Achievement Award
b. ADHS Preparedness Advisory Committee
c. State Consolidated Plan – Economic Development
d. Arizona Native American Primary Care Workshops
e. Forum on American Indian Research
f. Rural Health Conference: Surgeon General Nominee g. Reminder – Border Health Workshop
h. Another Ballot Initiative
National News
a. Status of J-1 Visa Waiver Programs
b. Nursing Education Loan Repayment Program
c. Public Hearings on Regulatory Reform – Input
d. New HRSA Administrator
e. Gateway PC Donation Program
f. Kaiser Foundation Reports
- President’s Fiscal Year 2003 Health Care Budget
- Prescription Drug Discount Programs
- State Health Facts Online
- The Uninsured in Rural America
- The Uninsured and Their Access to Health Care
g. Agency For Health Quality Research
4. How to Contact Your Representatives
a. Congressional Delegation
b. State Legislators
5. Grant Opportunities
a. Reminder – Rev. PS398 Grant Application Packet
b. Reminder - New HRSA Grants App. Center
c. Reminder - Reminder: Rural Outreach/Network Grants
d. Selected Grant Opportunities
6. Conferences Relevant to Rural Health
a. Rural Health Conference for State/Local Officials
b. Web-Assisted Audio Conferences
c. Calendar of Conferences
7. Other
a. What is Rural?
b. Databases Useful to Researchers
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1. Rural Hospital Flexibility Program
National Action
(1) 2002 National Conference of Flex Programs: This conference will be held April 15-17 in Washington DC. Five participants from each State Flex Program are invited to attend. Arizona’s participants will include: Alison Hughes, Director; Joyce Hospodar, Sr. Program Coordinator; Chris Cronberg, CEO, Northern Cochise Community Hospital, Willcox; Judy Crume, Bureau Chief, ADHS Bureau of Emergency Medical Services. The conference program agenda includes: (i) Rural Health Policy and Regulatory Matters; (ii) Network Development; (iii) State Rural Health Planning/CAH Management Strategies; (iv) Quality Improvement; (v) EMS Integration. Members of the Senate Rural Health Caucus and representatives from the Centers for Medicare and Medicaid Services are invited guests.
(2) HIPAA Compliance
The Technical Assistance and Service Center (TASC) has compiled a comprehensive list of web resources to assist rural hospitals and other rural health care providers in achieving compliance with the requirements of the Health Insurance Portability and Accountability Act (HIPAA). The compliance date for Electronic Transactions and Code Sets is October 16, 2002. The compliance date for Health Information Privacy Standards is April 13, 2003.
Website: http://www.ruralresource.org/hipaa.asp.
A CMS HIPAA Model Compliance Extension Form is available on the TASC website. This form can be used by covered entities to request a one-year extension to the October 16, 2002 compliance date for standard transactions and code sets. This form must be completed by October 16th. The form is simple, and the extension is automatically granted if the form is submitted on time.
Website: http://www.cms.gov/hipaa
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b. State Action
(1) Status of Arizona Critical Access Hospital Designations: Four rural hospitals in Arizona have now received new provider numbers as critical access hospitals – Wickenburg Regional Medical Center, Benson Hospital, Northern Cochise Community Hospital (Willcox), and Southeast Arizona Medical Center (Douglas). One additional designation application is pending for Page Memorial Hospital.
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(2) Status of Critical Access Hospital Designation Applications: Financial feasibility studies are underway for La Paz Regional Hospital in Parker and White Mountain Regional Medical Center in Springerville. In addition to Parker Indian Hospital, San Carlos Indian Hospital, and the Hopi Health Care Center, the Indian Health Service has approved routing of the Ft. Yuma Indian Hospital’s application through the Arizona Flex program (Ft. Yuma IHS is actually located in California, at the border with Arizona).
Community meetings in the last month were held in Holbrook, Ganado, and Parker. In Holbrook, findings from a recent community needs assessment were presented, showing large community support for reopening Petrified Forest Medical Center as a hospital. The Arizona Flex program is assisting in this process, including simultaneous application for designation as a critical access hospital. A presentation to the Board of Directors of Sage Memorial Hospital in Ganado resulted in preliminary approval to seek designation as a critical access hospital; the Navajo Kinlichee District 17 board will consider the issue at a meeting on April 13. In Parker, presentations were given to hospital staff and board members of the Parker Indian Hospital and La Paz Regional Hospital.
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(3) Status of State Legislation:
(i) Re-Designation of Critical Access Hospitals: Senator Marsha Arzberger sponsored SB 1238 which modifies state licensure statutes to address concerns related to the status of rural hospitals that convert to critical access hospital status and later wish to revert to a its previous status. This could happen, for example, in circumstances where the average daily census of a rural hospital today is within the bed limitation requirements for critical access hospital designation, but which may in the future increase substantially. The problem for such hospitals would be that they could not revert without meeting new licensure requirements, such as newer life safety codes. This legislation would permit such rural hospitals to revert based on the licensure standards in effect when they became critical access hospitals. Alison Hughes, Director of the Arizona Rural Hospital Flexibility Program, testified on behalf of this legislation. The bill has passed the Senate and House Health Committees.
The text of the proposed legislation follows:
THE DIRECTOR SHALL NOT REQUIRE A HEALTH CARE INSTITUTION THAT WAS DESIGNATED AS A CRITICAL ACCESS HOSPITAL TO MAKE ANY MODIFICATIONS REQUIRED BY THIS CHAPTER OR RULES ADOPTED PURSUANT TO THIS CHAPTER IN ORDER TO OBTAIN AN AMENDED LICENSE UNDER THE SAME LICENSURE CLASSIFICATION THE HEALTH CARE INSTITUTION HAD BEFORE IT WAS DESIGNATED AS A CRITICAL ACCESS HOSPITAL IF BOTH OF THE FOLLOWING ARE TRUE:
1. THE HEALTH CARE INSTITUTION HAS SUBSEQUENTLY TERMINATED ITS CRITICAL ACCESS HOSPITAL DESIGNATION.
2. THE HEALTH CARE INSTITUTION WAS IN COMPLIANCE WITH CERTIFICATION REGULATIONS OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES PURSUANT TO TITLE XVIII OF THE SOCIAL SECURITY ACT, AS AMENDED.
(ii) Medicaid: Concerned legislators last year approved a $1.7 million appropriation for the state’s Critical Access Hospitals, but with the state’s current fiscal crisis, these funds were drastically reduced for the current fiscal year. Continuation of the funding in 2003 is uncertain. Rural leaders concerned about the future of Arizona’s fragile rural hospitals should contact their state legislators if they want to see the funding continued.
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(4) Flex Leadership Advisory Group: The CEOs of Arizona’s first five critical access hospitals have been invited to join the Flex Leadership Advisory Group (FLAG). This group includes representatives of the state hospital association, the state health department, the peer review group, the Medicare fiscal intermediary, and AHCCCS, among others, and provides guidance for program development and implementation, including planning for the statewide Flex Program conference.
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(5) 2002 Arizona Flex Program Conference: Planning is currently underway for this year’s Flex Program conference. Please mark your calendars for August 1-2 at the Hyatt Regency Phoenix Hotel.
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2. Arizona News
a. Border Health Lifetime Achievement Award: Jill Guernsey de Zapien, Associate Dean for Community Practice, Arizona College of Public Health, was awarded the New Mexico Border Health Council’s "Border Health Lifetime Achievement Award," on March 15, 2002. The award was established to recognize those persons who have devoted years to the improvement of health of the New Mexico and other border state populations and whose work has significantly impacted the long-term health status improvements in the U.S.-Mexico border area.
The award was presented to Ms. de Zapien for "her exceptional work in the development of the premier promotore programs on the border; for her personal commitment to improving the lives of the migrant farm worker family; and, for her exemplary leadership in the many critical issues and actions impacting the entire border region."
b. ADHS - Bioterrorism Preparedness Advisory Committee: Alison Hughes, Director of the Rural Health Office, was recently appointed to serve on the advisory committee for the Arizona Department of Health’s development of a statewide bioterrorism preparedness plan. The U.S. Department of Health & Human Services has allocated $18.6 million in special funds for Arizona to support the plan.
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c. State Consolidated Plan Update - Housing and Economic Development: The State of Arizona FY 2002 Consolidated Plan Update is now available for review and comment through the Governor’s Office of Housing Development: www.housingaz.com. Public comment will be accepted through the end of the business day, May 1. In addition to housing, the plan addresses the use of funds for rural community development through the Community Development Block Grant (CDBG).
d. Arizona Native American Primary Care Resources Workshop Series: The "Working Together for Community Wellness" series of workshops are sponsored by the Health Resources and Services Administration of the U.S. Department of Health & Human Services, and the Bureau of Primary Care Region IX Office, San Francisco. A $9,000 grant the Arizona Department of Health Services supported development of the workshops. A northern workshop was held in San Carlos on March 14. A southern workshop will be held on April 23 in Peach Springs. A statewide forum will be held on May 30 at the Hon Dah Resort. Planning committee organizations included the Arizona Association of Community Health Centers’ Native American Program; the Hualapai Tribal Health Department; the Navajo Area IHS; the Navajo Nation Division of Health; the San Carlos Tribal Health Department; the Native American Community Health Center; the White Mountain Apache Tribal Health Authority, and the Arizona Rural Health Office. Workshop topics include: (1) data and information sharing; (2) program evaluation; (3) access to primary care issues; (4) workforce needs; (5) partnerships and collaborations; (6) integration of mental health and primary care; (7) traditional medicine; and (8) telemedicine. For more information, contact Michael Allison, Native American Liaison, Arizona Department of Health Services, (602) 364-1041; malliso@hs.state.az.us.
e. Forum on American Indian Research: The American Indian Research Center for Health, the Inter-Tribal Council of Arizona, the University of Arizona, the Hualapai Tribe; and the Pascua Yaqui Tribe will host a forum on April 19 on American Indian Research: Issues and Challenges. The forum will be held from 9-3 at the DuVal Auditorium, University of Arizona Health Sciences Center, and will cover the following topics: (1) Overview: ITCA/UA American Indian Research Center for Health; (2) Tribal Perspectives on Research in Indian Communities; (3) University Perspectives on Research in Indian Communities; (4) Perspectives from the National Institutes of Health and the Indian Health Service; (5) The Research Agreement - Negotiating a University/Tribal Partnership in Research. For further information, contact Yvette Roubideaux, MD, MPH, at (520) 318-7280 or yvetter@u.arizona.edu.
f. Another Ballot Initiative: Several organizations have launched a campaign for another tobacco-funded ballot initiative. The American Cancer Society, Southwest Division, the American Health Association of Arizona, and the American Lung Association of Arizona have formed the campaign, "the Coalition to Protect Kids from Tobacco." They are collecting signatures on petitions to have the initiative placed on the November, 2002 ballot. The proposed initiative will:
(i) increase taxes on those who smoke by 150%;
(ii) provide for deposit of tobacco tax revenues in specific accounts;
(iii) create a new administrative body to control distribution of
funds raised through tobacco tax revenues.
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g. Rural Health Conference Program -- Surgeon General Nominee: The President’s nominee for Surgeon General, Richard Carmona, MD, is invited to keynote this year’s Annual Rural Health Conference, scheduled to be held July 22-24 at the Hilton Resort in Sedona. For further information about the conference, contact Rebecca Ruiz at the Rural Health Office, (520) 626-7946, Ext. 161; aruiz@rho.arizona.edu.
h. Reminder -- Border Health Information Conference: The fourth annual Border Health: Information for Action Conference is scheduled to be held at the Rio Rico Resort September 26-27, 2002. Conference planners have issued a call for abstracts in April 2002 on conference themes: Adolescent and Children; Environmental Health; Gender & Health; and Community Health. Binational organizers of the conference include: in Arizona – the Arizona Department of Health Services, the Border Health Foundation, the University of Arizona, the Arizona College of Public Health, and the Arizona Health Sciences Center Office of Minority Affairs; in Sonora – Servicos de Salud de Sonora, El Colegio de Sonora, Associacion Sonorense de Salud Reproductiva, A.C., Mexfam, La Red Fronteriza de Salud y Ambiente, A.C. For further information, contact Mary Contreras, College of Public Health, (520) 318-7270, Ext. 10 or ContrerM@u.arizona.edu.
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3. National News
a. Status of J-1 Visa Waiver Program: The recent decision by the U.S. Department of Agriculture to eliminate its J-1 visa waiver program may impact rural hospitals nationwide. According to USDA officials, the decision was related to "security considerations" in the aftermath of the September 11 attacks on the World Trade Center and the Pentagon (Dvorak, Kansas City Star, 3/25).
A review of the J-1 visa waiver program by USDA and other government agencies participating in the program preliminarily found that the USDA lacks the authority to conduct background checks on the foreign-born doctors whom it recommends receive waivers, and an investigation by USDA Acting Inspector General Joyce Fleischman revealed an "apparent scheme" in which nearly 160 foreign-born physicians provided false information to work at nonexistent clinics or employers. Some federal lawmakers are criticizing this decision, because the program has allowed more than 2,000 foreign-born physicians to practice in rural hospitals and clinics, where they are needed.The lawmakers have requested a meeting with administration officials to discuss the future of the program. (Scripps Howard News Service/Richmond Times-Dispatch, 3/28). Arizona had six physicians practicing in rural areas since 1998 with USDA J-1 waivers.
The State 20 Program, sometimes referred to as the Conrad 20 Program (for Senator Kent Conrad of North Dakota, who sponsored the original legislation) is an alternative way for foreign-born doctors to practice in rural communities. The law allows states to recruit 20 foreign-born doctors per year to practice in underserved communities. Forty-two states have such programs. In Arizona, the State 20 Program is administered by the Arizona Department of Health Services. Arizona has placed 90 J-1s in the past five years through the State 20 Program.
The J-1 visa program allows immigrants to be admitted to the United States to participate in educational exchange programs. They are required to return to their home country for two years after participation in the program before they can apply for an immigrant visa, permanent residence in the United States, or another non-immigrant visa. "Interested Government Agencies," however, can request a waiver of the two-year home residence requirement through the "Waiver of Recommendations for Foreign Physicians" program run by the state department. If waivers are granted, foreign-born doctors must agree to work in underserved areas for three years.
Several national organizations (e.g., Offices of Primary Care, National Rural Health Association) are asking state affiliates to investigate the status of J-1 visa waiver placements in their states in order to determine the probable impact on rural and other medically underserved areas if the program is eliminated entirely. An article in the Denver Post (April 1) reports that since 1994, 3,000 foreign-born doctors have been placed nation-wide through the J-1 visa waiver program. According to the Colorado Rural Health Center, there are currently 40 physicians working in the state with J-1 visa waivers. Hospital administrators in the state rely heavily on J-1 docs, a reflection of the nationwide problem that American physicians cannot be "lured away from the amenities and stellar salaries that come with practicing in bigger cities." Federally funded clinics in southeastern Colorado are also heavily dependent on J-1s for specialities critical to the clinics’ operations.
A recent alert from the National Rural Recruitment and Retention Network (3RNet) advised that a bill introduced by Sen. Brownback of Kansas last year through the Judiciary Committee/Immigration Subcommittee has language that supports reauthorization of the State 20 program with features that may increase the numbers from 20 and that provides for a sharing arrangement in which states that don’t use their full allotment can "trade" their unused slots to states that need more than the allotment. Another alternative mentioned in recent conversations is the possibility of additional placements through the National Health Service Corps.
Stay tuned.
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b. Nursing Education Loan Repayment Program: The Division of Nursing in the U.S. Department of Health & Human Services’ Bureau of Health Professions recently distributed information about the Nursing Education Loan Repayment Program (NELRP). The program received a $10.2 million appropriation for fiscal year 2002 ( an $8 million increase in funding for two years), and offers registered nurses substantial economic assistance to repay their educational loans in exchange for service to the underserved in eligible health facilities. All NELRP participants must enter into a contract agreeing to provide full-time employment in an approved eligible health facility. In return, the NELRP will pay 60 percent of the participant’s total qualifying loan balance for a two-year commitment or 85 percent of the participant’s total qualifying loan balance for a three-year commitment. The funding increase is expected to support approximately 600 new nursing education loan agreements. Applications will be available online in mid-April and are due June 14. A listing of eligible health facilities and nursing shortage counties are available through the website: http://www.bhpr.hrsa.gov/nursing/
c. Public Hearings on Regulatory Reform – Call for Input: The Secretary of the U.S. Department of Health & Human Services established an Advisory Committee on Regulatory Reform to provide findings and recommendations regarding potential regulatory changes that would reduce regulatory burdens in health care and provide faster response to the concerns of health care providers, state and local governments, and individual American who are affected by HHS rules. The advisory committee is addressing regulatory reform in four broad areas: (1) health care delivery; (2) health systems operations; (3) biomedical and health research; and (4) development of pharmaceuticals and other products.
The committee is currently conducting hearings around the country, and will focus on rural issues at a meeting in Pittsburgh April 17th and 18th and in Denver on May 15th and 16th. The Federal Office of Rural Health Policy issued a call for input regarding these hearings, seeking suggestions for speakers from those geographic areas or possible site visits for the committee. To offer input, contact Tom Morris, Policy Coordinator, Federal Office of Rural Health Policy, (301) 443-4269 or tmorris@hrsa.gov. For further information, including transcripts of hearings completed in January, February, and March, see the website at:
http://www.regreform.hhs.gov
d. New HRSA Administrator: HHS Secretary Tommy G. Thompson named Elizabeth M. James Duke, PhD, to serve as administrator of the Health Resources and Services Administration. She was acting administrator from March 2001 to March 2002. Before going to HRSA, she served from 1997 to 2001 as deputy assistant secretary for administration in HHS’ Administration for Children and Families. From 1986 to 1997, she was principal deputy assistant secretary for management and budget at HHS. Before joint HHS, Ms. Duke spent eight years at the U.S. Office of Personnel Management. She was deputy assistant director and director of policy and systems in OPM’s Office of Training and Development from 1984 to 1986 and was director of the Government Affairs Institute in OPM’s Office of Executive and Management Development from 1978 to 1984.
e. Gateway PC Donation Program: The National Rural Health Association forwarded information about the Gateway Olympic Sponsorship PC Donation Program. Through this program, Gateway will donate up to 4,500 computers that were supplied to the Salt Lake Organizing Committee for use during the 2002 Olympic Winter Games to non-profit organizations, with priority given to schools and community centers whose programs help enhance access to technology for traditionally underserved communities. Online applications will be available beginning on April 8, 2002.
Website: http://www.gateway.com/olympics/donations.shtml
f. Kaiser Family Foundation Reports:
(i) President’s Fiscal Year 2003 Budget: An Overview of Health Programs: A new chartbook describes the government’s overall budget situation and examines the health policies and programs proposed in the President’s latest budget.
Website: http://www.kff.org/content/2002/4041
(ii) Prescription Drug Discount Programs: Implications for Medicare Beneficiaries: Testimony at a Senate Finance Committee hearing on the Bush Administration’s proposals for Medicare Modernization.
Website: http://www.kff.org/content/2002/6031
(iii) State Health Facts Online: This website provides detailed data by state for the following topics: Demographics and the Economy; Health Status; Health Coverage and Uninsured; Medicaid & Chip; Medicare; Health Costs & Budgets; Managed Care & Health Insurance; Providers & Service Use; Women’s Health; Minority Health; and HIV/AIDS.
Website: http://www.statehealthfacts.kff.org
(iv) The Uninsured in Rural America: A fact sheet issued April 2001, available at http://www.kff.org/content/2001/14020b.
(v) The Uninsured and Their Access to Health Care: A fact sheet issued February 2002 at http://www.kff.org/content/2002/14003/ A more comprehensive review of Health Insurance in America: 2000 Data Update is available at http://www.kff.org/content/2002/4007.
g. Agency for Healthcare Research and Quality: The Agency for Health care Research and Quality supports an electronic newsletter that may be useful for health care providers. To subscribe, send an e-mail message to: listserv@list.ahrq.gov. In the subject line type: Subscribe. In the body of the message type: sub public_list-L your full name. You will receive an e-mail confirmation. New subscribers or those seeking reference information in a previous issue can view archives of the newsletter on AHRQ’s website: http://www.ahrq.gov/
4. How to Contact Your Representatives
a. Arizona Congressional Delegation: Links to Representatives are available at http://www.house.gov. Links to Senators are available at http://www.senate.gov.
b. Arizona State Legislators: Available through the Arizona Legislative Information System (ALIS): Call 1-800-352-8404
http://www.azleg.state.az.us/
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Grant Opportunities
a. Reminder – Revised PS398 Grant Application Packet: If you will use the PS398 grant application this year, you need to be aware that it was revised as of 5/2001 and as of 1/10/02, the NIH will no longer accept applications on the old form. The 5/01 version is not being ent out in a hard copy format any more. It is only available at this link: http://grants.nih.gov/grants/funding/phs398/phs/398.html.
b. Reminder – HRSA’s New Grants Application Center
New Address ( Effective December 1, 2001)
HRSA Grants Application Center
Attention: Grants Management Officer
901 Russell Avenue, Suite 450
Gaithersburg, MD 20879
c. Reminder – Rural Health Outreach/Network Grants
APPLICATIONS AVAILABLE: JUNE 2002
DUE DATE: SEPTEMBER 13, 2002 - OUTREACH
DUE DATE: SEPTEMBER 20, 2002 - NETWORK
Please contact the HRSA Grant Application Center (HRSA GAC) at 1-877-477-2123, FAX 1-877-477-2234 or E-mail HRSAGAC
@hrsa.gov immediately and ask to be placed on the mailing list to receive the Rural Health Outreach or Network Development official application kits as soon as they are available. For the OUTREACH GRANT cite the reference number 93.912A For the NETWORK DEVELOPMENT GRANT cite the reference number 93.912B. The most up-to-date ORHP information is posted on Office of Rural Health Policy web site at: www.ruralhealth.hrsa.gov/
For information regarding funding for the Outreach and Network grants go to: www.ruralhealth.hrsa.gov/funding.htm#providers
Although most of the application materials are posted on the web, you must still call HRSA GAC at 1-877-477-2123 to receive the official application packet. For additional information contact Lilly Smetana at lsmetana@hrsa.gov or by calling 301-443-6884.
d. Selected Grant Opportunities
Information about grant opportunities with deadlines between March-July 2002 are available through the Federal Office of Rural Health Policy’s Rural Information Center Health Service. Grants Relevant to Rural Health webpage is:
http://www.nal.usda.gov/ric/richs/grants.htm
Some grant opportunities of interest for rural health issues include the following:
(i) TITLE: Reducing Oral Health Disparities
AGENCY: National Institute of Dental and Craniofacial Research, National Center on Minority Health and Health Disparities, and the National Institute of Nursing Research, NIH
SCOPE: Pilot research focusing on the determinants, prevention/
reduction, or impacts of oral health disparities in populations currently under-represented (includes low-income rural population, special needs population, and all race/ethnic population). RFA issued concurrently with two other RFAs ("Planning Grants for Research to Prevent or Reduce Oral Health Disparities" (DE-02-005) and "Research Infrastructure and Capacity Building for Minority Dental Institutions to Reduce Oral Health Disparities (DE-02-003).
DEADLINES: April 18, 2002
CONTACT: For inquiries regarding programmatic issues, Dr. Ruth Nowjack-Taymer, Program Director, 45 Center Drive, Room 3AN-44D, Bethesda, MD 20892-6401; Phone: (301) 594-5394; Fax: 301-480-8254 Email: Ruth.Nowjack-Raymer@nih.gov; Jean Flagg-Newton, Deputy Director, 6707 Democracy Blvd., Suite 800, MSC 5465, Bethesda, MD 20892-5465; (301) 402-1366; flagnej@od.nih.gov or jf41v@nih.gov/ Janice Phillips, Program Director, National Institute of Nursing Research, Build 45, Room 3AN12, Bethesda, MD 20892-6300; 301-594-6152; Fax 301-480-8260; email Janice.Phillips@nih.gov. Website: http://grants.nih.gov/grants/guide/rfa-files/RFA-DE-02-004.html.
(ii) TITLE: Excellence in Partnerships for Community Outreach, Research on Health Disparities and Training (Centers of Excellence) (NIH Guide, February 8. 2002)
AGENCY: National Center on Minority Health and Health Disparities (NCMHD)
SCOPE: The National Center on Minority Health and Health Disparities (NCMHD) announces the availability of support for a new program that is intended to promote minority health research as well as support the Department of Health and Human Services initiative to address and ultimately eliminate health disparities.
DEADLINES: April 24 for letters of intent; May 24 for applications
CONTACT: For program information: Dr. Jean L. Flagg-Newton, Deputy Director, NCMHD 6707 Democracy Blvd., Suite 800, MSC 5465, Bethesda, Maryland 20892-5465, (301) 402-1366. (301) 480-4049 (fax), Email: Flaggnej@od.nih.gov. For grants information: Ms. Usha Ganti, Acting Grants Management
Officer, NCMHD, 6707 Democracy Blvd., Suite 800, MSC 5465, Bethesda, MD 20892-5465, (301) 402-1366, (301) 480-4049 (fax), Email: GantiU@od.nih.gov http://grants.nih.gov/grants/guide/rfa-files/RFA-MD-02-001.html.
(iii) TITLE: Health Risk Reduction: Community-Based Strategies (NIH Guide April 5, 1996, PA-96-037)
AGENCY: National Institute of Nursing Research (NINR)
SCOPE: To support research on the clinical application of intervention strategies designed to reduce health risks at the community level. NINR is particularly interested in community-
based strategies targeting health problems of rural residents and of underserved minority groups. Eligible applicants include domestic and foreign, for-profit and non-profit organizations, public and private.
DEADLINES: June 1, October 1.
CONTACT: Applications: Grants Information Office, NIH Office of Extramural Outreach and Information Resources, (301) 435-0714. Programmatic Information:
NINR, Division of Extramural Programs, (301) 594-6906.
(iv) TITLE: Health Services Research On Rural Health, (NIH Guide May 1, 1992, PA-92-71)
AGENCY: Agency for Health Care Policy and Research (AHCPR)
SCOPE: Grants will be awarded to non-profit institutions to support the development of new research in the areas of delivery, organization, and financing of rural health services. Key areas of research include: access, health professions, emergency care delivery systems, rural hospitals, alternative delivery systems, provision of primary health care, technology, special populations, health promotion and disease prevention, and special populations including elderly, rural poor, people with HIV/AIDS, and the homeless.
DEADLINES: June 1, October 1.
CONTACT: NIH Office of Grants Information, Division of Research Grants, (301) 435-0714.
(v) TITLE: Mental Health in Rural Areas Research Grant
AGENCY: National Institute of Mental Health (NIH)
SCOPE: Research on mental health problems and risks associated with rural and frontier communities to undertake studies that will (1) improve our understanding of barriers that place limits on the provision of care in these areas; and (2) provide information that will improve the organization, financing, delivery, quality, effectiveness, and outcomes of care for persons with mental disorders living in these diverse communities.
DEADLINES: June 1, 2002, October 1, 2002.
CONTACT: Anthony Pollitt, PhD, Office of Rural Mental Health Research, 6001 Executive Boulevard, Room 7130, MSC 96317, Bethesda, MD 20892-9631; Phone (301) 443-4525; fax (301) 443-4045. http://grants.nih.gov/grants/guide/pa-files/PA-00-082.html
(vi) TITLE: Self-Management of Chronic Diseases
AGENCY: Office of Extramural Research (NIH), National Institute of Nursing Research, National Heart, Lung, and Blood Institute, the National Institute on Aging, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Mental Health, and the National Institute of Neurological Disorders and Stroke).
SCOPE: Investigate the applicability of effective self-management interventions to a broad spectrum of multiple chronic diseases across the life-course. Chronic disease is defined as illnesses that are prolonged, are rarely cured completely, and require self-management behaviors by affected individuals and/or their caretakers.
DEADLINES: June 1, 2002, October 1, 2002
CONTACT: Extramural Outreach and Information Resources Office, Office of Extramural Research, 6701 Rockledge Drive, MSC 7910, Room 6207, Bethesda, MD 20892-7910. Phone (301) 435-0714; Fax 301-480-8443. Email: grantsinfo@nih.gov
Website: http://grants.nih.gov/grants/guide/pa-files/PA-00-109.html.
(vii) TITLE: Local Initiative Funding Partners (LIFP) Program
The LIFP program is a matching grants program designed to establish partnerships between the Robert wood Johnson Foundation and local grantmakers in support of innovative, community-based projects that improve health and health care for underserved and at-risk populations. In 2003, up to $8 million will be awarded through the program.
Under LIFP, a local grantmaker (e.g., community foundations, family foundations, corporate grantmakers, and others) proposes a funding partnership with the Robert Wood Johnson Foundation on behalf of a local applicant for grant funds to support projects that are consistent with the foundation’s two main areas of interest: health and health care.
Projects designed to improve health may promote healthy communities and lifestyles; address community and social factors that affect individual health such as social isolation; work to increase the adoption of healthy behaviors such as physical activity and proper diet; or seek to decrease the use and adverse health and social consequences of tobacco, alcohol, and illegal drugs. Projects designed to improve health care may enroll more Americans in health insurance programs; remove or reduce cultural and economic barriers that create disparities in care; expedite the adoption of best practices in the care of people with chronic disease; provide supportive services to help vulnerable older persons stay in their communities; or increase the number of people who receive high quality care at the end of life.
Grants may be made to community nonprofit organizations or institutions. LIFP will provide 36-month or 48-month grants of $100,000 to $500,000. Grants must be matched dollar-for-dollar by local sources.
DEADLINE: Online pre-registration will be available July 1, 2002 and must be completed by July 26, 2002. Final applications will be due August 1, 2002.
CONTACT: Local Initiative Funding Partners Program, c/o Health Research and Educational Trust of New Jersey, 760 Alexander Road, Princeton, NJ 08543-0001. Tel: (609) 275-4128. Information about funded projects in Arizona, together with additional program information, is available on the project website: http://www.lifp.org/
(viii) TITLE: Telehealth Interventions to Improve Clinical Nursing Care (NIH RECORD, Sept. 22, 2000, PA-00-138)
AGENCY: National Institute of Nursing Research (NINR); National Library of Medicine (NLM)
SCOPE: The goal of this Program Announcement is to stimulate clinical research on innovative nursing telehealth interventions, particularly their use among a wide variety of clinical situations, diverse patient populations, and different clinical settings.
DEADLINE: Ongoing.
CONTACT: Applications: (301) 435-0714. Programmatic Information: Carole Hudgings, NINR, (301) 594-5976; Milton Corn, NLM, (301) 496-4621.
(ix) TITLE: Community Facilities Loans
AGENCY: Rural Development Administration, USDA
SCOPE: To construct, enlarge, extend, or otherwise improve community facilities providing essential services to rural residents. Facilities include fire and rescue services, transportation, health facilities, schools, municipal buildings, industrial park sites, access ways and utility extensions. There are direct loans and guaranteed
loan programs. Some types of facilities that have used these loans include: hospitals, assisted living units for the elderly, nursing homes, mental health clinics, drug treatment centers, and physician/dental clinics.
DEADLINE: Ongoing.
CONTACT: Applications are available from USDA Rural Development (formerly FmHA) State Offices, which can be located at: http://www.rurdev.usda.gov.
(x) TITLE: H-1B Technical Skills Training Grant Program (Federal Register, April 13, 2001)
AGENCY: Employment and Training Administration, Department of Labor
SCOPE: Local Workforce Investment Boards are eligible to apply for this skills training program that provides a long term solution to domestic skill shortages in high skill and high technology occupations. Funds may be used for technical skills training for employed and unemployed American workers. Training must focus on occupations that are experiencing skills shortages in the domestic job market. [Special note: This program has been used to address nursing workforce needs.]
DEADLINE: Ongoing.
CONTACT: Programmatic Information: Fax questions to Le Phan, (202) 693-2879 (notice ID # SGA/DFA 01-105). Additional information: http://www.doleta.gov/h-1b.
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6. Conferences Relevant to Rural Health
a. Rural Health Care Conference for State and Local Officials A calendar of conferences scheduled in the next few months that may be of interest is listed below.
One of the Rural Health Briefing E-Newsletter’s "gentle readers" also provided information about a conference scheduled June 3-5 in Denver, Colorado for state and local offficials: "Rural Health Care: Readiness to Function Effectively in Times of Fiscal Restraint." The conference sponsor is the Agency for Healthcare Research and Quality. Intended workshop audience includes state and local health officials responsible for the financing and delivery of population-based health programs, EMS, primary care, rural hospital services, and behavioral health services in rural areas. State legislators and legislative staff; Governors’ health policy advisors; and executives in health departments. Medicaid, planning offices, and other agencies, and directors and staff from state offices of rural health.
The workshop will cover the following topics:
(1) New approaches for training health professionals for rural practice and lessons from past workforce recruitment and retention efforts;
(2) The advantages and barriers facing rural providers in structuring quality improvement and patient safety initiatives and new partnerships involving Peer Review Organizations (also known as Quality Improvement Organizations) and other entities;
(3) Ways to improve hospital financial performance, including payment options under Medicare and Medicaid, insights from the national evaluation of critical access hospitals (CAHs), and networking strategies;
(4) Opportunities to strengthen the public health infrastructure and emergency medical services systems, especially in light of federal and state initiatives to protect against potential bioterrorism events;
(5) Models for expanding the availability of mental health services in rural areas, including the integration of primary care and behavioral health services; and
(6) How states can work with Medicaid to improve the delivery of services for vulnerable populations (e.g., elderly, children, chronically ill, disabled, and minorities.
Conference registration payment is due May 1, 2002. Five travel scholarships to state legislative branch officials or their staff are available on a first come, first served basis. For further information contact: Bahar Morid, Program Assistant, Academy for Health Services Research and Health Policy, 1801 K Street, N.W., Suite 701-L, Washington DC 20006. Phone: (202) 292-6700; Fax: (202) 292-6800 or E-mail ULP@ahrq.gov.
b. Web-Assisted Audio Conferences: The User Liaison Program within the Agency for Healthcare Research and Quality and the CDC are sponsoring a series of web-assisted audio conference calls entitled "Bioterrorism and Health System Preparedness: Emerging Tools, Methods and Strategies," to be held April 29, 30, and May 1. Each call will begin at 2:00 pm and run until 3:30 pm EST. The calls are free and you can register by going to the website: http://www.hsrnet.com/meeting/bioterrorism.
The April 29 audio conference will address "Enhancing Public Health, Health Care System, and Clinician Preparedness: Strategies to Promote Coordination and Communication."
The April 30 audio conference will address "Clinican Readiness."
The May 1 audio conference will address "Assessing Hospital and Health System Preparedness and Response."
c. Calendar of Conferences
(i) Third National Congress on Childhood Emergencies
April 15-17
HRSA's Maternal and Child Health Bureau and National Highway Traffic Safety Administration
Dallas, TX
For more information, contact:
Emergency Medical Services for Children
Children's National Medical Center
111 Michigan Avenue, NW
Washington, DC 20010-2970
(202) 884-4927
(ii) World Rural Health Conference
April 30-May 3
World Organization for Family Doctors
Melbourne, Australia
For more information, contact:
The Meeting Planners Pty Ltd
91-97 Islington Street, Collingwood VIC 3066
Ph: 61 3 9417 0888 Fax: 61 3 9417 0899
ruralhealth@meetingplanners.com.au (email)
(iii) National Rural Health Association (NRHA) Annual Conference
May 15-18
Kansas City, MO
For more information, contact:
National Rural Health Association (NRHA)
One West Armour Blvd.; # 203
Kansas City, MO 64111
(816) 756-3140; Fax: (816)756-3144
mail@NRHArural.org (email)
http://www.NRHArural.org/pagefile/eo.html
(iv) National Conference on Health Education and Health Promotion
" Strengthening America Through Health Education and Health Promoting Alliances"
June 5-7
CDC and ASTDHPPHE
New Orleans, LA
For more information, contact:
Professional and Scientific Associates
(800) 772-8232 ext. 220
HEHP2002@psava.com (email)
(v) Annual Meeting Rural Sociological Society
"The Community Effect in Rural Places"
August 14-18
Chicago, IL
* For more information, contact:
Rural Sociological Society
211 Mumford Hall,
University of Missouri
Columbia, MO 65211-6200.
(573) 882-9065
(573) 882-3958 (fax)
ruralsoc@missouri.edu (email)
http://www.RuralSociology.org/annual-meeting/2002/index.html
(vi) National Association for Rural Mental Health's Annual Conference
"Riding the Winds of Change: Alternatives for the Journey"
August 26-29
Santa Fe, NM
For more information, contact:
NARMH
3700 W. Division Street
Suite 105
St. Cloud, MN
(320) 202-1820
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7. Other
a. What is Rural? To be sure that you are located in a rural area if you are applying for a grant, a job, a scholarship, or for some other purpose is not an easy task. For your reference, the following websites may help:
For a map of Arizona’s MSAs (as defined by the Office of Management and Budget): http://policom.com/state.htm.
For the "Goldsmith Modification" ("Improving the Operational Definition of ‘Rural Areas’ for Federal Programs"): http://ruralhealth.hrsa.gov:80/Goldsmith.htm.
For a list of rural counties and designated eligible zip codes in metropolitan counties: http://ruralhealth.hrsa.gov:80/sitemap.htm. Look under "Funding Opportunities."
For an example of one state’s guidelines for applying a Rural-Urban Commuting Area standard in public health assessments:
http://www.doh.wa.gov/Data/Guidelines/RuralUrban.htm.
b. Databases Useful to Researchers: Lists are available through the Arizona Health Sciences Center Library Online:
http://www.ahsl.arizona.edu.
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