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Rural Health Briefing February 24 2005

National News

1, Medicare Provider Responses Needed on Satisfaction Survey

2. Making Bright, Healthy Futures for Young Women

3. Action for Pedestrian Safety in Native America

4. Diabetes Care Guide and Workbook from AHRQ

5. Hospitals Measure and Improve Patient Safety Culture

6. Quality Tools Focus on Saving 100,000 Lives

7. Rural and Urban Physician Incomes Not So Different

8. Medicare-covered Preventive Services Explained

 Across Arizona

1. Arizona Rural Health Conference Seeks Presentations

2. Spring Training for CAHs

    • CAH Hospital Board Training
    • Medication Reconciliation through the Continuum of Care

3. Expanding Nursing Education Draws Support

4. New Bureau Chief at BEMS

5.Willcox Young Guns

 Grants and Opportunities

1. Prescription for Health - Round 2

2. Community Participation in Health Disparities Intervention Research

3. Cancer Prevention and Treatment for Ethnic and Racial Minorities

4. Executive Training for HRSA-Funded Organizations

5. Health Professions Scholarship Programs for American Indians

6. Cultural Competence Leadership Fellowship

7. Investigator Awards in Health Policy Research Program

8. Mattel Foundation Grants to Serve Children in Need

9. New Access Points for Health Centers

10. Health Disparities Among Minority and Underserved Women

11. Research on Rural Mental Health and Drug Abuse Disorders

 

Calendar

 

 

Mark Your Calendars!

National News

 

Medicare Provider Action Needed on Satisfaction Survey

  In January, CMS recently sent out the Medicare Contractor Provider Satisfaction Survey (MCPSS) to a random sample of Fee-for-Service (FFS) contractors. This new initiative will collect data on provider satisfaction. The survey asks providers to rate their Medicare contractor on seven administrative functions: provider communications, provider inquiries, claims processing, appeals, provider enrollment, medical review, and provider reimbursement.  The MCPSS represents an important opportunity for providers to be heard. It was sent by CMS through Westat, a survey research firm.

  Providers who received the survey notification packet can access the survey instrument on a secure Internet Web site or may request a paper copy and submit their responses via mail or fax.  All information collected will be kept completely confidential. Data collection for the pilot will continue through March 31, 2005.

  For questions regarding the MCPSS, please contact the MCPSS information

line at 1-888-863-3561 or MCPSS@westat.com.  For further information and

updates, please visit http://www.cms.hhs.gov/providers/mcpss/default.asp

Making Bright, Healthy Futures for Young Women

  Bright Futures is a national health promotion initiative based at the Maternal and Child Health Library at Georgetown University dedicated to optimal children’s health and a trusting relationship between the health professional, the child, the family, and the community.  They will be presenting online training and resources for delivering and documenting Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services to Medicaid-eligible children and teens in addition to other publications, distance education and training tools. Details here.

  Currently available is the booklet, My Bright Future: Physical Activity and Healthy Eating for Young Women. It provides checklists and tables in which readers and their health care providers can record information and discuss setting realistic goals. Free copies can be ordered from HRSA by clicking here.

 

Action for Pedestrian Safety in Native America

  American Indians have the highest rates of pedestrian injury and death per capita of any racial or ethnic group in the United States according to a recent study by the US Department of Transportation. Pedestrian Safety in Native America is a report that identifies contributing factors such as alcohol involvement on the part of the pedestrian or driver, rurality, poverty and lack visibility and traffic control devices.

American Indian communities require community-specific injury prevention intervention activities. Focus groups conducted during the study period identified successful strategies for addressing pedestrian injury among American Indian communities.

  Successful strategies identified included pedestrian facility improvements, law enforcement interventions and education. For example, to take advantage of the long tradition of running and walking in these communities, Walkable Community Advocacy groups have been started in some tribes. To download the complete report, click here.

  Another effort is the Just Move It (JMI) campaign to promote physical activity for American Indians and Alaska Natives. Just Move It includes several partners, including Indian Health Service, Nike Corporation, National Indian Health Board, National Congress of American Indians among others. Their website offers many ways to learn how to start an activity in your own community, share information about ongoing programs, and contribute your own stories. Click here to go to their website.

Diabetes Care Guide and Workbook from AHRQ

  Diabetes Care Quality Improvement: A Resource Guide for State Action and its companion workbook have been released by AHRQ, in partnership with the Council of State Governments. They provide an overview of the factors that affect quality of care for diabetes and present the core elements of health care quality improvement. They also describe a variety of best practices to assist state policymakers in using the data from AHRQ's 2003 National Healthcare Quality Report for planning state-level quality improvement activities. Click here to read the guide.

 

Hospitals Measure and Improve Patient Safety Culture

  HHS' Agency for Healthcare Research and Quality has made a new tool available to help hospitals and health systems evaluate employee attitudes about patient safety. The Hospital Survey on Patient Safety Culture guides the measuring of organizational conditions that can lead to adverse events and patient harm.

Included are the hospital survey, a survey guide as well as a feedback report template in which hospitals can enter their data to produce customized feedback. These provide the basic knowledge and tools needed to conduct a safety culture assessment and suggestions about how to use the data.

  The survey can be found online at www.ahrq.gov/qual/hospculture/. Printed copies may be ordered by calling (800) 358-9295 or by sending an E-mail to ahrqpubs@ahrq.gov.

 

Quality Tools Focus on Saving 100,000 Lives

The 100,000 Lives Campaign of the Institute for Healthcare Improvement is now enlisting thousands of hospitals across the country in a commitment to implement changes in care that have been proven to prevent avoidable deaths. They have begun with these six interventions:

  • Deploy rapid response teams at the first sign of patient decline
  • Deliver reliable, evidence-based care for acute myocardial infarction
  • Prevent adverse drug events (ADEs) by documenting medication reconciliation
  • Prevent central line infections
  • Prevent surgical site infections by delivering correct preoperative antibiotics at the proper time
  • Prevent ventilator-associated pneumonia

Materials in support of the interventions include start-up guides, success stories and other resources. Informational conference calls are regularly scheduled through March 30. There is no cost and only minimal data submission of data already known to hospitals. Complete details here.

 Rural and Urban Physician Incomes Not So Different

  Lower incomes are an oft-cited obstacle to recruiting rural physicians, but average physician incomes in rural and urban areas do not differ significantly, according to a new Health Systems Change (HSC) study. After adjusting for cost-of-living differences, rural physicians have 13% more purchasing power.

  The study also notes that the higher purchasing power of rural physician incomes may be needed to compensate physicians for other disadvantages of rural practice, including less control over work hours, professional isolation and a lack of amenities associated with urban areas.

  Rural areas have fewer physicians per capita than urban areas, prompting persistent concerns about inadequate access to medical care in many rural areas. The study's findings are detailed in an HSC Issue Brief—Physician Incomes in Rural and Urban America. The study is based on results from HSC's 2001 Community Tracking Study Physician Survey, a nationally representative survey involving about 12,000 practicing physicians.

 

Medicare-covered Preventive Services Explained

  CMS has available new publications designed to promote awareness and increase utilization of Medicare-covered preventive services including billing requirements and educating beneficiaries.  Some examples are:

  The Guide to Preventive Services for Physicians, Providers, Suppliers, and Other Health Care Professionals - This guide provides information on Medicare's preventive benefits including coverage, frequency, risk factors, billing and reimbursement.

  Expanded Benefits - This brochure gives a basic overview of Medicare's three new preventive benefits: the Initial Preventive Physical Examination (IPPE), cardiovascular screening blood tests, and diabetes screening tests.

  Adult Immunizations - This brochure has an overview of Medicare's Influenza Vaccine, Pneumococcal Polysaccharide Vaccine (PPV), and Hepatitis B Vaccine benefits.

  Cancer Screenings - This brochure is a guide to Medicare's mammography screening, screening Pap test, pelvic screening examination, colorectal cancer screening, and prostate cancer screening benefit.

  The publications can be found at the Medicare Learning Network's web site.

Across Arizona

 

Arizona Rural Health Conference Seeks Presentations

Submission deadline: March 18

  The 32nd Annual Arizona Rural Health Conference has opened their call for presentations and workshops. Proposal may be submitted directly online at http://www.rho.arizona.edu/rhc2005 or by fax.

This year’s conference "Rural Community Health Matters," July 17-19, 2005 in Payson, will address such topics senior health care, economics of rural health, integrating primary care and behavioral health, workforce issues, rural health facilities, chronic disease prevention and control, rural clinical practice issues, and how to be heart healthy.

  The Rural Health Office of the UA Zuckerman College of Public Health, and the Arizona Rural Health Association sponsor the conference.

  For further information, please call Rebecca Ruiz at 520-626-7946, ext. 254.

 

Spring Training for CAHs

CAH Hospital Board Training

April 15-16, 2005, Phoenix Airport Hilton Hotel

A detail-oriented training from Barry Bader tailored to small, rural hospital boards will be offered April 15-16. Topics will include fiduciary responsibility, board management and leadership, strategic action and networking. All Arizona small, rural hospitals may send representatives of their boards of trustees or community health advisory boards. Three members from each designated Arizona CAH will receive travel and lodging support. The meeting starts at 5:00 p.m. on Friday, April 15 and finishes at 4:30 p.m. on Saturday, April 16. The Arizona Hospital and Healthcare Association is offering the training with sponsorship from the Arizona Flex Program.

Medication Reconciliation Through the Continuum of Care

May 17, 2005, Phoenix and Tucson videoconference

Medication reconciliation is the focus of this latest quality training sponsored by the Arizona Flex program and offered by Health Services Advisory Group. Both the JHACO requirements and the process of implementation at rural hospitals will be addressed. The 8th Scope of Work will also be covered. It seeks to accelerate the pace of improvement in nursing facilities by promoting organizational culture change and the use of redesigned care processes. Quality managers, directors of nursing and related staff are encouraged to attend. A full array of training materials will be included. The registration cost is $50.00 for the daylong learning session. Fee waivers and travel reimbursement are available for two people from each Arizona CAH.

Expanding Nursing Education Draws Support

Arizona's nursing shortage may be line for some relief with a new bill making its way through the legislature. Arizona's Partnership in Nursing Education (APNE), introduced by Sen. Carolyn Allen as S.B. 1294, is a demonstration project seeking a total of $40 million in state and federal dollars over a five-year period to pay for additional faculty at Arizona's community colleges and universities. It proposes to double nursing school enrollment by 2010. The Arizona Hospital and Healthcare Association has asked members of Arizona's congressional delegation to introduce similar legislation at the federal level in 2005. 

New Bureau Chief at BEMS

  After 20 years of emergency planning, logistics management and strategic planning for the U.S. Air Force, Gene Wilke began his new job on January 24 as the new Bureau Chief of Emergency Medical Services for the Arizona Department of Health Services.

Wikle was a Senior Military Consultant serving at the Iraq Ministry of Defense just prior to taking this new job. Wilke plans to expand BEMS services and educational programs in rural Arizona.

  Before his military career, he was an Emergency Medical Technician (EMT). He also served as a police officer and a fireman in Coolidge and a police officer in Paradise Valley.

  ADHS’s EMS Bureau is responsible for the training, certification and enforcement issues of all emergency medical technicians and paramedics in the state.

Willcox Young Guns

  The Northern Cochise Community Hospital Board of Directors, a critical access hospital in Willcox, knew it was important so they directed their staff to lead a community economic development effort. The lack of participation by younger members of the community in decision-making positions was identified by a focus group at the hospital as a problem – and, a problem that could be addressed.

  Twenty participants – named the Willcox Young Guns -- were selected from the community and from April 2004 through February 2005 attended monthly, daylong workshops looking into local government, education, healthcare, and economic development.  Strategic planning, parliamentary procedure, and facilitation skills were also included. Upon graduation they became Willcox Top Guns.

  A local advisory group included the school superintendent, the editor of the local paper, the city manager, and representatives from local industry and was chaired by Chris Cronberg, hospital CEO. They assisted in developing curriculum, finding funding, making presentations to the participants and encouraging their own employees – and their friends – to participate.

 

Grants and Opportunities

 Prescription for Health - Round 2
Application deadline: March 7, 2005
  The Robert Wood Johnson Foundation has announced Round 2 of funding for Prescription for Health: Promoting Healthy Behaviors in Primary Care Research Networks. This five-year national program is designed to develop, test, evaluate and disseminate creative, practical strategies to promote healthy behaviors in primary care practices by targeting four behaviors: lack of physical activity, poor diet, tobacco use and risky use of alcohol.   The program is in collaboration with the Agency for Healthcare Research and Quality.   Details at: http://www.prescriptionforhealth.org. 

Community Participation in Health Disparities Intervention Research

(RFA-MD-05-002)
Letters of Intent Deadline: March 14, 2005
Application Deadline: April 14, 2005
  The goal of this RFA is to support community-based participatory research (CPBR) in planning, implementing, evaluating and disseminating effective interventions for a disease or condition to reduce and eventually eliminate health disparities through partnerships between minority health populations, subpopulations, and other heath disparity populations and researchers.

  This initiative will start with a three-year planning grant, followed by a competitive five- year intervention grant, and conclude with a competitive three-year dissemination grant. Subsequent grant awards will be based on scientific merit, progress, quality of the research proposal, and availability of funds.

  This RFA is inviting applications for a three-year planning grant proposal. The first year of the grant is devoted to partnership development, community needs assessment, identifying the disease/condition for intervention research, and planning the intervention methodology with substantial input from the community. During the second and third year, a pilot intervention research study will be conducted with community participation.

Successful partnership development with a defined community and developing a plan for intervention research including a pilot intervention research study using CPBR principles are required for participating in the competition for the next stage of funding for the intervention research grant. Click here for details.

 Cancer Prevention and Treatment for Ethnic and Racial Minorities (CMS-5036-N)Application deadline: March 23, 2005  The program calls for proposals to design and implement demonstration projects for racial and ethnic minorities. These projects will of develop models and evaluate methods that reduce disparities in early detection and treatment of cancer, improve clinical outcomes, and eliminate disparities in the rate of preventive cancer screening measures. They will promote collaboration with community-based organizations to ensure cultural competency of health care professionals and linguistic access for persons with limited English proficiency.    The activities to be funded under these demonstration projects will focus on three areas of potential cancer disparity reduction: screening, diagnosis, and treatment. Click here for details.

Executive Training for HRSA-Funded Organizations

Application deadline: March 25, 2005

  The Johnson and Johnson/UCLA Healthcare Executive Program is a management development program exclusively for executive directors and leaders of community-based healthcare organizations. Executives of the following HRSA-funded organizations are invited to apply:

  • Health Centers funded by the Bureau of Primary Health Care
  • Healthy Start Programs funded by the Maternal and Child Health Bureau
  • Nurse Managed Centers (Nurse Practice Arrangements) in Schools of Nursing funded by the Bureau of Health Professions
  • Title III, Title IV, and planning grants funded by the HIV/AIDS Bureau
  • Outreach and Network programs funded by the Office of Rural Health Policy

  This program offers to provide participants with the leadership and management skills to maximize the quantity and quality of care provided to the population, particularly the underserved and those living in vulnerable communities.  It will also help participants identify and expand the quantity and quality of the scarce resources, both human and financial, available to HRSA grantees.

  Two sessions, June 20 – July 1, 2005 and July 24 – August 5, 2005, will cover the same material and will be held on the UCLA campus in Los Angeles. 

For additional information, go to J&J/UCLA.

Health Professions Scholarship Programs for American Indians

HHS-2005-IHS-SP-0001

Application deadline: March 28, 2005

  This program provides scholarships to encourage American Indians and Alaska Natives to enter the health professions and to assure the availability of Indian health professionals to serve Indians. Both full and part-time student opportunities are available. Pregraduates are also encouraged to apply.

For further details click here.

Cultural Competence Leadership Fellowship
Application deadline: April 1, 2005

  The Health Research and Educational Trust, the Institute for Diversity in Health Management, Health Forum, and the National Center for Healthcare Leadership are offering the Cultural Competence Leadership Fellowship.  The Fellowship proposes to help leaders enhance their abilities to improve the quality and safety of care for racial and ethnic minorities, and maximize cultural diversity within their institutions.  Through executive leadership retreats, self-study modules and a virtual learning community, Fellows explore their leadership and cultural competency abilities through assessment, feedback, and coaching as well as an individualized leadership development plan.      Further information at: www.hret.org.   

Investigator Awards in Health Policy Research Program
Letters of Intent Deadline: April 1, 2005
  The Investigator Awards in Health Policy Research, a program of the Robert Wood Johnson Foundation funds highly qualified individuals ready to undertake broad studies of America's most challenging policy issues in health and healthcare.  Grants of up to $275,000 are awarded.  Successful proposals combine creative and conceptual thinking with innovative approaches to critical health problems and policy issues. 

  Click here for complete details.

Mattel Foundation Grants to Serve Children in Need

Application Deadline: April 8, 2005

  The Mattel Children's Foundation Domestic Grants Program makes grants to organizations that serve children in need. New or ongoing programs are eligible. Priorities include:

  1) Health: Supporting the health and wellbeing of children through programs that directly address the physical or mental health of children that community or increasing access to health care services for children in need.
  2) Education: Increasing access to education, promoting literacy to children in need and resources that promote after-school educational & achievement.
  3) Girls Empowerment: Promoting self-esteem of girls and increasing access to education, health and community resources for girls.

  Full details available here.

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.

 

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.

 

 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 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. 

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.
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