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Rural Health Briefing, February 1, 2006
Page One
Leadership Workshop for Arizona Rural Hospitals
Developing effective teams and leaders can be a challenge. Building the skills to do that is the purpose of a workshop being offered in Phoenix on February 23 and 24 by the Arizona Rural Hospital Flexibility Program.
Strategies and practical methods of leadership, communication, team building and problem solving will be demonstrated.
Hospitals are strongly encouraged to send two or more people because the train-the-trainer format supports the approach of carrying the lessons back to the home hospital.
Darlene Bainbridge, an experienced trainer and former CAH CEO, will be the workshop leader. Limited mileage reimbursement will be provided for critical access hospitals.
Click here for a complete agenda and registration form.
National News
1. CAHs Negotiate with Medicare Advantage Plans
2. HRSA Goes HIT
3. New U.S.-Mexico Border Health Web Site
4. Best Practices for Regional Health Information Organizations
5. Broadband Can Deliver Health Services Economically
6. EHR Adoption Could Be Slow
7. Medication Safety in Rural Hospitals
8. New Chair of AHA Rural Section
9. HeartPartners Project To End
10. CMS Solving Medicare Part D Problems
Across Arizona
1. Shelton to Lead University of Arizona
2. EHR for Physicians Opening in Phoenix
3. La Voz de la Cosecha/The Voice of the Harvest
4. Telemedicine Grant to La Paz
5. Patient Safety Workshop
6. Brody Wins Distance Learning Award
7. Telemedicine Training
8. Medical Education Legislation Pending
9. AzPHA Targets Legislative Issues
10. Ballot Initiatives On Health
EMS
1. Cochise County Strengthens Fire and EMS Departments
Grants and Opportunities
1. Native American Summer Health Fellowships at Harvard
2. Telemedicine Technical Assistance for Rural Health Clinics
3. Indian Health Professions Scholarships
4. Reducing Cardiovascular Risks in American Indians and Alaska Natives
5. Kaiser Media Fellowships Focus on Health
Calendar
February 3, Improving Medication Safety Using Information Technology, Tucson
February 6-7, National Health Policy Conference, Washington, D.C.
February 14-16, Annual Meeting and Legislative Day, Arizona Association of Community Health Centers, Phoenix
February 15, Medicare Beneficiary Ombudsman Open Door Forum, conference call
February 24-26, Annual Meeting on Health Philanthropy: Improving Community Health, Inspiring Community Action, Phoenix
February 27-March 1, NRHA Rural Health Policy Institute, Washington, D.C.
March 7-9, 11th Annual Arizona Interagency Farmworker Coalition Conference, Yuma
March 14-16, Annual Conference of the Association for Community Health Improvement, Phoenix
March 17, Abstract submissions due for National Rural Women’s Health Conference, to be held in San Antonio, Texas, November 16-18
March 28-31, Fourth Annual Western Region Flex Conference, Las Vegas, Nevada
April 1, Interdisciplinary Women’s Health Conference, Tucson
April 6-7, Carrying the Torch for Patient Safety, Mesa, Arizona
Mark Your Calendar
April 17, Southern Arizona Women’s Health Forum, Nogales, Arizona
April 17-19, Culturally Based Substance Abuse Treatments for Native American, Alaska Natives and Latinos, Tucson
May 15-19, NRHA Annual Conference Week, Reno, Nevada
May 15-19, 2006, 3rd Annual Rural Nurse Conference, Coeur d'Alene, Idaho
National News
CAHs Negotiate with Medicare Advantage Plans
A new Rural Health Policy Brief examines how administrators of Critical Access Hospitals (CAHs) have handled contracts with Medicare Advantage (MA) plans. Most contracts (after negotiation) specified that payments would be cost-based but there were some notable exceptions across lines of service. Some administrators voiced concern about retaining patients if MA contracts were not accepted.
Click here for the 8 page report.
HRSA Goes HIT
HRSA’s new Office of Health Information Technology is being headed by Cheryl Austein Casnoff. The office will help grantees use health information technology (HIT) to improve the quality of care and concentrate on developing an HIT strategy that benefits safety-net providers responding to the needs of the uninsured, underserved, and special needs populations.
The new office will have three major entities. Two are new: a Division of HIT Policy and a Division of HIT State and Community Assistance. The third entity already exists -- the Office for the Advancement of Telehealth, which was recently housed in the HIV/AIDS Bureau.
New U.S.-Mexico Border Health Web Site
A new U.S.-Mexico Border Health web site has information on sources of health funding, grant-writing for health projects, health topics, links to health agencies in each border state, an overview of federal activities, and a searchable resource database.
The website, funded by HRSA, was created and will be administered by the University of North Dakota’s Rural Assistance Center (RAC).
Click here to go there.
Best Practices for Regional Health Information Organizations
The Center for Health Transformation (CHT) and IDX Systems Corporation recently reported achievable recommendations to spur the adoption of electronic health records and regional health information organizations (RHIOs), based on the best practices of successful health data exchanges. Drawn from discussions among technology experts, public policy analysts, and leaders of thriving regional networks at the CHT Connectivity Conference, held October 18, 2005, the white paper, "Accelerating Transformation through Health Information Technology", highlights proven and practical strategies for health care providers, federal and state policymakers and other stakeholders.
Click here for the 54 page report.
Broadband Can Deliver Health Services Economically
Accelerating Internet broadband deployment in the United States could deliver better health services to elderly Americans and individuals with disabilities and slash overall health care costs, according to a new report from the New Millennium Research Foundation.
The report claims that the most important way broadband may be used is through integrated monitoring and intervention systems for patients with chronic illnesses such as a Veterans Administration chronic disease monitoring program, which has cut hospital admissions by as much as 60 percent and prevented illnesses from getting worse. Broadband is currently not reaching rural areas as quickly as urban areas.
Click here for the 36 page report, Great Expectations: Potential Economic Benefits to the Nation from Accelerated Broadband Deployment for Older Americans and Americans with Disabilities.
EHR Adoption Could Be Slow
The Bush administration's goal of having electronic health records
(EHRs) for most Americans by 2014 is likely to take nearly another
decade to achieve, a study has concluded. Although viable EHR technologies have been available for some time, adoption has been slow.
At the slowest likely rate of EHR adoption, 86.6 percent of physicians in small practices will be using EHRs in 2024 - a decade beyond the target date that President Bush set in 2004.
The study is detailed in an article, "Predicting the Adoption of Electronic Health Records by Physicians: When Will Health Care Be Paperless?" in the January/February issue of the Journal of the American Medical Informatics Association. It acknowledges that “no single tactic will successfully address all the barriers to adoption…”
Medication Safety in Rural Hospitals
What are medication safety practices in small rural hospitals in relation to pharmacist staffing and available technology? A recent national study finds that, depending largely on patient volume, JCAHO accreditation and financial condition, these hospitals face important limits on hours of on site pharmacy coverage and clinical computer availability.
The majority of hospitals have implemented key safety practices including a do-not-use-abbreviations list, using two patient identifiers for administering medications, having two health professionals independently check doses of high alert medications and a high alert drug list. Only half of the hospitals had implemented all four practices.
According to the study, these significant relationships between financial condition and medication safety practices support continuation of Medicare policies of ensuring financial stability of small rural hospitals.
Click here for the 51 page study, Pharmacist Staffing and the Use of Technology in Small Rural Hospitals: Implications for Medication Safety.
New Chair of AHA Rural Section
Richard Slusky, CEO of Mt. Ascutney Hospital and Health Center in Windsor, Vermont will lead the American Hospital Association's (AHA) Section for Small or Rural Hospitals in 2006. The 23-person governing council represents small or rural hospitals in the AHA's policy process and member services initiatives. Mt. Ascutney Hospital is a critical access hospital, with 23 acute (medical/surgical) and swing beds; 10-bed distinct-part rehabilitation unit; and 50 nursing home beds. It has been recognized for many years as a leader in community health education and prevention programs.
HeartPartners Project To End
Due to changing priorities in Medicare coverage, the HeartPartners demonstration project will come to an end late in February 2006. The goal of the project had been to reduce the incidence of acute hospital stays while improving medical outcomes and the quality of life for seniors suffering from congestive heart failure.
CMS Solving Medicare Part D Problems
Problems with beneficiary prescriptions? CMS has assigned regional caseworkers for such problems as eligibility, enrollment, authorization and lack of PDP follow up. The email address for Region 9 is Ro9drugteam@cms.hhs.gov.
In addition, a Pharmacy Helpline is available only to pharmacists who encounter problems verifying beneficiaries' eligibility/enrollment in a plan. That number is 1-866-835-7595.
Across Arizona
Shelton to Lead University of Arizona
Dr. Robert N. Shelton has been selected as the next President of the University of Arizona. He is currently serving as Executive Vice Chancellor and Provost and Professor of Physics at the University of North Carolina, Chapel Hill. Prior to that he was at the University of California, Davis for fourteen years. As Executive Vice Chancellor at the University of North Carolina at Chapel Hill, Dr. Shelton is the chief operating officer and is responsible for the university's budget. As Provost, he is the chief academic officer, responsible to the Chancellor for the conduct, coordination and quality of the University's academic and research programs.
EHR for Physicians Opening in Phoenix
Starting in February 2006, HSAG is offering "EHR University", a series of five sessions on EHR implementation (2 hour evening sessions including dinner) at their offices in Phoenix. The program will include tools to assess readiness, selecting systems, planning implementation and improving care.
The series is offered at no charge and open to small- and medium-sized physician offices. Because EHR University is made available at no charge, space is limited to approximately 100 of the eligible 1,460 primary care practices throughout Arizona.
This Arizona Doctors' Office Quality Information Technology program at HSAG has ties to the newly created Arizona Health-e Connection Roadmap Steering Committee in addition to the state medical societies.
Click here for enrollment details.
La Voz de la Cosecha/The Voice of the Harvest
Arizona Interagency Farmworker Coalition, Inc. has chosen the title, "The Voice of the Harvest / La Voz de la Cosecha," for their eleventh annual conference. It takes place March 7-9, 2006 at the Yuma Civic and Convention Center.
Sessions will address issues of education, health, housing, immigration, labor laws, and advocacy. Special events will include community and scholarship awards. The early registration fee of $125 applies until February 17.
Click here for registration and program details.
Telemedicine Grant to La Paz
La Paz Regional Hospital was awarded $458,061 in November 2005 from the USDA Rural Development Distance Learning and Telemedicine Grants. The funds are earmarked for teleradiology equipment including a Picture Archive and Communications System (PACS) unit and a Radiology Information System (RIS). This was the only RUS grant awarded this year to an Arizona applicant.
In recent years, grants from this program have been awarded to Tuba City Regional Health Care, Arizona Western College and Tohono O’odham Community College.
Patient Safety Workshop
A workshop, Carrying the Torch for Patient Safety, sponsored by the Arizona Hospital and Healthcare Association, will be held at the Phoenix Marriott Mesa on April 6-7. The featured speaker will be Jim Bagian, M.D., director, VA National Center for Patient Safety (NCPS). With its emphasis on “prevention not punishment,” NCPS uses a systems approach in the development and implementation of techniques designed to reduce avoidable injuries and deaths throughout VA’s 163 medical centers.
Dr. Bagian, a former NASA physician and astronaut, has received numerous national awards for his work, including the Institute for Quality in Laboratory Medicine’s Inaugural Patient Safety Award in 2005.
For more information, e-mail edservices@azhha.org or call 602-445-4356.
Brody Wins Distance Learning Award
Dr. Eric A. Brody of the I.H.S. Native American Cardiology Program has received a 2005 Excellence in Teaching Award from the United States Distance Learning Association (USDLA) for his innovative “EKG Jeopardy” distance education approach to teaching. Dr. Brody’s videoconference approach is modeled after the popular television game show and generates enthusiasm for learning complex cardiology concepts among his students at a variety of sites connected by the Arizona Telemedicine Program.
Telemedicine Training
The University of Arizona’s Telemedicine Program (ATP) offers one and two day training conferences for health systems considering involvement in using telemedicine. These introduce multiple aspects of telemedicine in areas including clinical applications, distance learning, administration, reimbursement and HIPAA.
Tuition is waived for Arizona healthcare workers. For more information and to register, please visit their website at www.telemedicine.arizona.edu or contact Janae Cooley at 520-626-4785.
Medical Education Legislation Pending
Support for medical education has been introduced in this second session of the 47th Legislature of the Arizona State Legislature Graduate medical education programs (SB1224) would appropriate $5 million in FY06-07 to expand existing residency and fellowship programs, develop new ones and recruit physicians to Arizona. The proposal includes establishing an office to help develop a rural physician network.
AzPHA Targets Legislative Issues
The Arizona Public Health Association (AzPHA) is supporting several issues for consideration in the current session of the Arizona State Legislature. These include expanding high-risk prenatal and newborn screening programs, breast and cervical cancer treatment programs, adding $1.4 million for pneumococcal vaccines for uninsured adults and providing $3 million in funding to Community Health Centers.
Click here for their website.
Ballot Initiatives On Health
Two initiatives relating to health may come before Arizona voters in November.
Smoke-Free Arizona is a statewide voter initiative that aims to protect the health of Arizonans from secondhand smoke by banning smoking in most public places. Gathering signatures until the July filing deadline, it would be financed by a 2 cent per pack tobacco tax. Sponsors include the American Lung Association, American Heart Association, American Cancer
Society and Arizona Hospital & Healthcare Association.
Click here to visit their website.
Also in the stage of gathering signatures and support is First Things First, an initiative to fund early childhood development and health.
It proposes outcome-based programs that offer voluntary access to early learning and health screenings funded by a tobacco tax. Sponsors include Bashas’ Supermarkets, Vanderbilt Farms and Fulton Homes.
Click here to visit their website.
EMS
Cochise County Strengthens Fire and EMS Departments
The Cochise County Fire Chief’s Association and the Cochise County EMS Council have received a federal grant of $666,272 from the Office of Domestic Preparedness. Over 20 fire and EMS agencies are participating. An estimated 455 hand held radios and 255 mobile radios will be in operation by the end of the year. Their goal is to have all fire and EMS organizations (both private and tax-based organizations) linked with interoperable communications.
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.
Native American Summer Health Fellowships at Harvard
Application Deadline: February 27
The Four Directions Summer Research Program is seeking undergraduate students with a demonstrated commitment to the health of Native American communities and evidence of motivation to achieve the highest goals possible. Applicants are not chosen by highest grades or prior research experience. The program requires the following:
- Minimum 1 year of undergraduate studies completed prior to start of program (June 2006);
- Demonstrated interest in careers in medical sciences; and,
- At least 1 introductory science course (can include biology or chemistry).
The goal of the program is to introduce talented young Native American students to the world of medicine and to provide them with the necessary tools to take the next step in their career. The students each take on their own research project (under the supervision of senior medical school faculty), as well as participate in weekly seminars to inform students about careers in medicine.
Students stay at the Harvard Medical School dormitory for the 8 week summer program, June 19-August 12, 2006, and receive stipends for living and travel.
Click here for applications and more details.
Telemedicine Technical Assistance for Rural Health Clinics
Application deadline: February 28
The National Rural Health Association is seeking proposals from Community Health Centers and Migrant Health Centers which would like to apply for professional consulting to assist in planning telemedicine services. Applicants must demonstrate a credible need for telemedicine and a capacity to develop a plan during the grant period. Awards will be announced in April and plans must be completed by August 15, 2006.
The proposals should follow the Seven Steps for Telehealth Program Planning included with other information in this RFP.
Click here for details and the RFP.
Indian Health Professions Scholarships
Application deadline: February 28
The Health Professions Pregraduate Scholarship awards encourage entry into the health professions. They are made to American Indians (federally recognized Tribal members, state recognized Tribal members, and first and second degree Tribal members), or Alaska Natives. Requirements include a high school diploma or enrollment in an accredited baccalaureate degree program in pre-medicine, pre-dentistry or pre-podiatry.
Click here for details.
Reducing Cardiovascular Risks in American Indians and Alaska Natives
Application deadline: March 10
The National Heart, Lung, and Blood Institute (NHLBI) invites applications for cooperative agreements to conduct five-year studies in American Indian/Alaskan Native (AI/AN) communities to test the effectiveness of behavioral interventions to promote the adoption of healthy lifestyles and/or improve behaviors related to cardiovascular (CV) risk, such as weight reduction, regular physical activity, and smoking cessation.
The program, Community-Responsive Interventions to Reduce Cardiovascular Risk in American Indians and Alaska Natives, intends to develop and test culturally appropriate interventions that could be incorporated into clinical programs of the community health care systems or delivered through public-health approaches in Native communities.
Click here for details.
Kaiser Media Fellowships Focus on Health
Application deadline: March 16
The Kaiser Family Foundation is accepting applications for its redesigned Kaiser Media Fellowships in Health program. Up to ten fellowships will be awarded to print, television, radio and online journalists to research and report on health policy issues. The program will provide journalists a chance to pursue individual in depth research projects and features group site visits and briefings on a wide range of health policy issues. Fellowships can run for as long as nine months or as short as a few months.
Stipends will be awarded based on the length of the fellowship, up to $50,000 for a nine-month fellowship. The program also covers expenses based on the needs of the project.
Click here for 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 astute queries or comments are always welcome. Please send them as well as address changes to Jim Laukes, Editor, Rural Health Briefing.
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