|
Rural Health Briefing April 8 2004
National News
1. Critical Access Hospitals – New Rules Explained
2. Revised Critical Access Hospital Designation Packet Available
3. Health Insurance Access in Rural America
4. Changing Metropolitan/Rural Designations
5. CMS Will Match Costs of Disease Management Programs
6. Innovation and Demand in Telehealth
7. 340B Discount Drug Program - Not for Critical Access Hospitals
8. Reviews of Quality Improvement Strategies
9. Health Policy Information from Kaiser
Across Arizona
1. Celebrating 75 Years of the Voice for Arizona Public Health
2. Grants Reward Innovative Programs Aimed at Nursing Shortage
3. Rural Health Clinic Designation Guide
Grants and Opportunities
1. AHRQ Grants for Rural Telecommunications
2. USDA Offers Telemedicine Loans and Grants
3. Substance Abuse Treatment Grants for Rural Areas
4. Local Initiative Funding Partners Program 2005
5. 2004 Grant Opportunities Notebook
6. ORHP to Pilot Extended Stay at Frontier Clinics
Events
- April 15-16 - Celebrating Public Health in Arizona, Arizona Public Health Association Spring Conference, Tempe
- April 19-20 – Alliance of Minority Medical Associations Leadership Summit, Washington, D.C.
- April 29-May 1- National Farmworker Health Conference, Miami, Florida
- May 2-5 - Ninth Annual American Telemedicine Association meeting and exposition, Tampa
- May 5-6 – Quality-Based Health Care Purchasing Conference, Madison, Wisconsin
- May 16-18 – National Cooperative of Health Networks Conference, Austin, Texas
- May 20-21, Developing Strategies to Improve U.S.-Mexico Border Community Medical Access, El Paso, TexasMay 20-21 - New Frontiers in Diabetes and Preventive Care, Phoenix
- May 25-29 – National Rural Health Association Conference, San Diego
National News
1. Critical Access Hospitals – New Rules Explained
A report on the provisions important to rural health in the 2003 Medicare Act, highlights several in Section 405 that apply to Critical Access Hospitals (CAHs).
The full report, Policy Paper P2004-1 by Keith J. Muller is available at
http://www.rupri.org/healthpolicy.
2. Revised Critical Access Hospital Designation Packet Available
The Rural Health Office has revised the Critical Access Hospital designation application forms and guidance to reflect the most recent regulations covering CAHs. Hospitals interested in finding out if they should consider the designation can get a copy by contacting Jim Laukes or by downloading a copy from our http://azflexprogram.publichealth.arizona.edu/.
3. Health Insurance Access in Rural America
NRHA has released a six-page policy brief summarizing the challenges, the data and recommendations of health insurance access in rural America. Because living in rural areas increases the risk of being uninsured, NRHA encourages policy-makers to fund demonstration projects, examine current efforts in rural communities to provide coverage, and explore alternatives. The briefing is available at:
http://www.nrharural.org/dc/policybriefs/insurance.pdf
4. Changing Metropolitan/Rural Designations
In June 2003, the Office of Management and Budget (OMB) released new county-based designations of Care Based Statistical Areas (CBSAs), replacing Metropolitan Statistical Areas. CBSAs identify two categories: metropolitan and micropolitan. Such changes have an important impact on rural areas regarding eligibility to receive federal resources. An article in the Winter, 2004 issue of the Journal of Rural Health raises some questions about this system. The central problem is that it tracks the urban growth of the nation and its tendency toward agglomeration of markets but pays little attention to the places that are outside theCBSAs altogether. There are better alternatives. Readily available census tract data could be used to more accurately classify populations and areas using the fundamental concepts of adjacency and urban influence. This should reflect both the character of the urbanization as well as that of rural places. To go even further, a “rural-centric” classification scheme might “start with those places that are farthest from urban centers and then work toward them, yielding a completely different view of the nation as one where primary production was considered the source of wealth and the urban centers as places where that wealth was transformed.” The full article is available at:
http://www.nrharural.org/JRH/JRH20-1/rurh-20-01-01.pdf
5. CMS Will Match Costs of Disease Management Programs
CMS, in a letter to state Medicaid officials, announced it will match state costs of running “disease management” programs aimed at improving health outcomes while lowering the medical costs associated with the diseases.
The new Medicare Prescription Drug, Improvement and Modernization Act
(MMA) establishes two new programs-the Voluntary Chronic Care Improvement Program and the Care Management Performance pilot program to further explore the potential of diseasemanagement techniques. The Voluntary Chronic Care Improvement program will provide guidance to beneficiaries with chronic diseases that could be responsive to disease management interventions. The Care Management Performance Demonstration will establish a pay-for-performance 3-year pilot with physicians to promote the adoption and use of health information technology to improve quality and reduce avoidable hospitalizations for chronically ill patients. At this writing, it is not know what Arizona groups are applying. More details at: http://www.cms.hhs.gov/media/press/release.asp?Counter=967
6. Innovation and Demand in Telehealth
Long-distance diagnostics and treatment, and improved access to health information and education are just some of the benefits of telehealth. That is good news for consumers and the country as a whole, especially in rural America. Telehealth could improve access, boost health care quality, cut costs and contribute significantly to homeland security, but the sector is fraught with barriers hindering its further adoption, according to a new Commerce Department report. A patchwork of state policies for licensing and reimbursement, as well as other legal and financial hurdles create some difficulties.
So although technology now enables doctors to talk to and treat patients across state lines, some state laws actually forbid that. "It may be like practicing without a license," said Phillip ond, Commerce's undersecretary for technology.
There needs to be a greater coordination among the public and private sectors as well as a greater adoption of information technology by the health care industry, which is still heavily reliant on paper, according to the report. That could help propel the market for such technologies. There are also no industrywide telehealth standards that contribute to a lack of interoperability among systems. However, the American Telemedicine Association and National Institute of Standards and Technology have teamed up to develop and market adoption of such standards, starting with diabetic retinopathy as a test case. In Arizona, Tuba City Hospital has been collaborating with the Arizona Telemedicine Program on diabetic retinopathy with great success. The report, titled "Innovation, Demand and Investment in elehealth," is available at http://www.technology.gov/reports/TechPolicy/Telehealth/2004Report.pdf.
7. 340B Discount Drug Program – Not for Critical Access Hospitals
Tom Morris, Acting Deputy Director of HRSA’s Office of Rural Health Policy, cleared up some confusion for Critical Access Hospitals (CAHs). Rural hospitals are now eligible, if they have a Medicare Disproportionate Share Adjustment of 11.75% or greater, to take part in the 340B discount drug program to receive discounts on their outpatient drugs. However, CAHs are not ligible for this program since they are not paid under the DRG system of the Medicare Inpatient Prospective Payment system and therefore do not receive DSH funds.
8. Reviews of Quality Improvement Strategies
AHRQ has announced a new initiative, Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies. This new initiative will result in a series of technical reviews on quality improvement strategies, tools, and processes aimed at reducing gaps in quality. The reviews will be produced by the AHRQ Evidence-based Practice Center at the University of alifornia, San Francisco/Stanford and will explore the human and organizational factors influencing quality improvement in a number of areas, including hypertension, diabetes, coordination of care, medication management, and other topics. The first report in the series will outline the challenges to translating research into clinical practice and the methodologies used by the EPC for the reviews. Volume 2 will focus on improving the treatment of patients with diabetes, and volume 3 will cover hypertension. Further details on this resource are available at http://www.ahrq.gov/clinic/epc/qgapfact.htm.
9. Health Policy Information from Kaiser
The Kaiser Family Foundation has developed a new website www.kaiserEDU.org that is a onderful new resource for health policy information. It includes substantial amounts of basic health-related data, tutorials on various health policy topics, course syllabi form leading experts at many different universities, bibliographies, and many other topics. It is worthwhile investigating the wealth of information on the site.
Across Arizona
1. Celebrating 75 Years of the Voice for Arizona Public Health
Continuing both the activities of Public Health Week and a 75-year tradition of service and advocacy, the Arizona Public Health Association is sponsoring its spring conference, April 15-16 in Tempe. A series of workshop, keynote, showcase and movie sessions will focus on celebrating public health. The conference is also supported by the American Indian Prevention Coalition, ADHS, the Maricopa County Department of Public Health and the March of Dimes – Arizona chapter. A full schedule and a registration form can be found at www.azpha.org.
2. Grants Reward Innovative Programs Aimed at Nursing Shortage
The Campaign for Caring (CFC) of the Arizona Hospital and Healthcare Association has awarded a total of $316,000 in grants to seven Arizona community colleges to address a chiefcontributor to the state’s shortage of nurses: the lack of capacity in Arizona’s nursing education programs. The Nursing Education Program Grants (NEPG) also are supported by Blue Cross Blue Shield of Arizona and Johnson & Johnson along with matching funds from the Arizona Area Health Education Centers Program (Arizona AHEC). Grant recipients include:
-
Arizona Western College, Yuma¾$50,000
-
Cochise College, Douglas¾$50,000
-
Coconino Community College, Flagstaff¾$46,000
-
Mohave Community College, Lake Havasu City¾$50,000
-
Northland Pioneer College, Holbrook¾$45,000 Pima Community College, Tucson¾$50,000
-
Yavapai College, Prescott¾$25,000
3. Rural Health Clinic Designation Guide
In April the Rural Health Office will publish a new manual on how to get rural health clinic designation. If you would like to obtain a copy of the manual, send an email to Jim Laukes, Rural Health Office. The manual provides a step-by-step instruction guide on the designation process, and a question-answer guide to help determine if this designation is right for your clinic.
Grants and Opportunities
Note: Technical assistance is readily available for the development of grant proposals and other funding applications from the experienced staff of the Rural Health Office and the State Office of Rural Health Program. Please contact Jennifer Peashock by email at peashock@email.arizona.edu.
1. AHRQ Grants for Rural TelecommunicationsApplication deadline: April 22, 2004
AHRQ currently has $26 million earmarked specifically for patient safety projects in rural and small community hospitals. Three RFAs have been issued to fund projects directly related to health information technology initiatives to improve patient safety and quality of care. Health information technology includes electronic health records, personal health records, e-mail communication, clinical alerts and reminders, computerized provider order entry, computerized decision support systems, handheld computers, information resources, and electronic monitoring systems.
The three RFAs can be found at the following sites:
Transforming Healthcare Quality through Information Technology Planning Grants
http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-04-010.html
Transforming Healthcare Quality through Information Technology Implementation Grants
http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-04-011.html
Demonstrating the Value of Health Information Technology
http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-04-012.html
2. USDA Offers Telemedicine Loans and Grants
Grant application deadline: April 30, 2004 (Combination loan-grant applications are accepted at any time.)
The Distance Learning and Telemedicine (DLT) Program (administered by the DLT Branch of the Rural Utilities Service (RUS)) funds the use of advanced telecommunications technologies to help communities meet the needs of rural America. The grants, which are awarded through competitive process, may be used to fund telecommunications, computer networks and related advanced technologies. Applications for loans and combination loan-grants are not competitively scored. In addition to the items listed for grants, loans (and theloan portions of a combination loan-grants) may be used to fund construction of necessary transmission facilities on a technology-neutral basis. Agency Contact Person: Joan Keiser, Management Analyst, Distance Learning & Telemedicine Branch, Phone (202) 720-0413, Fax (202) 720-1051, Email dltinfo@usda.gov. Complete details can be found at: http://www.usda.gov/rus/telecom/dlt/dlt.htm.
3. Substance Abuse Treatment Grants for Rural Areas
Application deadline: May 25, 2004
The Substance Abuse and Mental Health Services Administration (SAMHSA) will fund programs for treatment in rural areas and for minority populations in its 2004 Targeted Capacity Expansion (TCE) grants. The program will focus on early identification and interventions for persons with substance abuse disorders that have not progressed to the dependence. It also seeks to encourage linkages among community agencies in state, local and tribal settings. Details of this funding opportunity TI 04-003 are available at: http://www.grants.gov.
4. Local Initiative Funding Partners Program 2005
Application Deadline: July 14, 2004
Local Initiative Funding Partners is a partnership program between Robert Wood Johnson Foundation and local grantmakers that supports innovative, community-based projects to improve the health and health care for society's most vulnerable people.
To be considered for LIFP funding, projects must offer community-based services that are new and innovative for the community, if not for the county, state, or nation. Significant program expansions-such as a major expansion into new regions or to new populations-also areacceptable. Applicants may be either public entities or nonprofit organizations that are tax-exempt under Section 501(c)(3) of the Internal Revenue Code.
To learn more about this program and the projects already funded, to see a list of frequently asked questions (FAQs) or pose your own question, please visit the Local Initiative Funding Partners Web site at: http://www.lifp.org/.
5. 2004 Grant Opportunities Notebook
HHS has published a guide to this year's federal funding opportunities for faith-based and community organizations. Included in the notebook is grant information on the following areas: At-Risk Children and Youth, Economic Development, Health, Substance Abuse, and significant Block and Formula Grants. Also included is information on the Compassion Capital Fund and web resources for organizations interested in federal funding. Download the notebook from: http://www.hhs.gov/fbci/
6. ORHP to Pilot Extended Stay at Frontier Clinics
The Office of Rural Health Policy (ORHP) will be funding a pilot program to allow extended stays at frontier clinics that are located 75 miles from facilities that offer inpatient services. The announcement is anticipated in April. When they become available, details can be found at: http://ruralhealth.hrsa.gov/.
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 Mel and Enid Zuckerman Arizona 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.
Comments, suggestions, questions, as well as address changes and additions to distribution list or removal from distribution list should be sent to Rural Health Briefing.
|
