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Rural Health Briefing  June 16 2004

 

National News

1. Critical Access to Clinical Lab Services Act Introduced in Congress

2. Measuring Rural Hospital Quality

3. Medicare Establishes Advisory Group on Emergency Medical Treatment

4. Telemedicine Developments in California, Texas, Washington and Arizona

5. Model Relationships Between Rural Community Health Centers and Hospitals

Across Arizona

1. Quality Assurance Training Offered in Phoenix and Tucson

2. 31st Annual Arizona Rural Health Conference, July 19-21

3,. Trauma Care Training for Nurses

4. Staff Change at ADHS

5. Recent Administrator Changes at Critical Access Hospitals

Grants and Opportunities

1. Rural Health Care Services Outreach Grant, HRSA-05-011

2. Tribal Management Grants

3. Telecom and Internet Discounts for Rural Health Providers

4. HRSA Grants Available

Calendar

 

National News

1. Critical Access to Clinical Lab Services Act Introduced in Congress

  Congress is considering legislation that would require that Critical Access Hospitals (CAH) receive cost-based reimbursement for off site lab services they provide to patients. This legislation, the Critical Access to Clinical Lab Services Act, would assist patients by enabling them to continue to receive laboratory services at a health care facility near where they live and work.  Last October, CMS stopped reimbursing CAHs for outpatient laboratory services at cost, making it prohibitive for some CAHs to continue offering off-site laboratory testing.

  The House bill (H.R. 4257) was introduced by Representatives Butch Otter, R-Idaho, and James Oberstar, D-Minnesota. The Senate bill (S. 2426) was introduced by Senators Ben Nelson, D-Nebraska, and Susan Collins, R-Maine. 

2. Measuring Rural Hospital Quality

  Determining quality in rural hospitals may require different measures than those applied to other hospitals. A recent working paper from the University of Minnesota Rural Health Research Center offers a model with a focus on special issues (e.g. smaller scale, greater reliance on generalists, constrained resources, importance of linkages with the local community and with referral centers) posed by rural hospitals.
  Based on this analysis, they recommend an initial core set of quality measures relevant for rural hospitals with less than 50 beds. This core set of 20 measures includes 11 core JCAHO measures related to community acquired pneumonia, heart failure and acute myocardial infarction; one measure related to infection control; three measures related to medication dispensing and teaching; two procedure-related measures; one financial measure and two other measures related to the use of advance directives and the monitoring of ER trauma vital signs.  Building on these special measurement needs, the report also offers future quality measures for core rural hospital functions (e.g. triage; stabilization and transfer; emergency care; integration of care with other local providers) not considered in existing quality measure sets. Their stated goal is to help rural hospitals with less than 50 beds to start building quality measurement capacities in small definable parts, and experience the value of using data quality for internal and external purposes, before they expand the scope and sophistication of their quality measurement systems.
  The report can be downloaded from the Rural Health Research Center.

  In Arizona, six Critical Access Hospitals have adopted the Balanced Scorecard methodology to manage their organization’s quality improvement strategy. They are Benson Hospital, Ft. Yuma IHS Hospital, Hopi Health Care Center, Parker IHS Hospital, Southeast Arizona Medical Center and Whiteriver Indian Hospital.

3. Medicare Establishes Advisory Group on Emergency Medical Treatment

  CMS is establishing a technical advisory group to review regulations affecting hospital responsibilities under the Emergency Medical Treatment and Labor Act (EMTALA) to individuals who come to the hospital requesting treatment for what may be emergency medical conditions. The advisory group will help CMS develop rules that will protect individual rights while minimizing unnecessary burdens on hospitals and physicians.

Nominations for the advisory group should be submitted to CMS no later than July 12, 2004. The notice was published in the May 28 Federal Register.

 

4. Telemedicine Developments in California, Texas, Washington and Arizona

              California Virtual Reality Nurse Education

 To try to solve the urgent nursing shortage, California State University, Long Beach, with Long Beach Memorial Medical Center and Miller Children's Hospital has opened a first-of-its-kind, virtual reality Health Skills Education Center with replica hospital rooms and human-like adult and child simulators hooked up to a computer, that react to medical treatment.

  The prototype nursing partnership between the medical center and university enables students to complete the nursing component of their RN/bachelor of science in nursing (BSN) degree in just two years instead of three and more than doubles the number of nursing students in the RN/BSN degree program.

              Automating EMS Data in Texas

  What’s the next frontier for improving EMS? It could be the Enhanced Crash Notification Safety system now operating in south Texas. The project delivers vehicle location, crash data and occupant's voice to the correct 9-1-1 dispatch center, plus the occupant's medical information to the responding EMS vehicle. This information helps to reduce first responder response time and can improve medical care at the scene of an accident. Piloted in 2002 and 2003, the system enables the transfer of critical voice and data communications to 9-1-1 dispatch centers, mitigates limitations in the current 9-1-1 infrastructure, and enables 9-1-1 centers throughout the country to more effectively dispatch mergency services to motorists in need. Since accident survival rates are directly linked to the speed and accuracy of the victim's medical care, the Enhanced Crash Notification Safety system can significantly impact the outcome of a vehicle crash.

  Greater Harris County Emergency 9-1-1 Network, in partnership with Cross Country Automotive Services, Intrado, Inc. and Roadside Telematics Corporation, developed the system and was awarded the 2004 Telematics in Action Award for best use for safety.

              Wireless Blood Glucose Meters in Rural Washington

  Combining wireless blood glucose meters with automated data collection technology will help simplify the routine task while creating a historical health database for care providers in rural Washington. Mobile Diabetic Inc. has launched secure diabetes health monitoring with automated collection of blood glucose meter data. New blood glucose meters are capable of sending messages or glucose readings through wireless communication. This new telemedicine technology retrieves the data and creates a logbook record without manual data entry or cable downloads.  Simplifying the process of recording and tracking glucose data is a key issue. Incorporating automated retrieval of glucose meter data is a vital step in real-time health monitoring and diabetes management, especially in the honeymoon phase of Type-1 patients. With this approach, physicians may be able to provide better advice to patients about medication, diet, or exercise.

              Teleradiology Reduces Air Evacuations of Accident Victims in Arizona

  Automobile accidents cause many injuries that result in air transport for patients from rural communities. Often patients are evacuated to a trauma center because emergency radiology services are unavailable on-site. Today teleradiology services are provided by University of Arizona College of Medicine staff on a 24/7 basis to 22 hospitals in rural Arizona. In emergency cases, initial diagnoses can be rendered in an hour or less. This can save unnecessary and costly air evacuations. And in these cases, saving time can also mean saving lives. University physicians diagnosed more than 70,000 radiology cases in 2003. By the end of 2004, over 40 hospitals in the Southwest will be linked to receive these essential services.

5. Model Relationships Between Rural Community Health Centers and Hospitals

  A recent study supported by the National Rural Health Association describes successful collaborations between rural hospitals and Community Health Centers (CHCs) then lists common characteristics of these collaborations and makes policy recommendations.

  A common feature of all sites studied was the limited number of available providers. This meant that there was no history of significant competition for health care business. In several cases, a key enabling factor was grant funding designed to promote network development. All cases benefited from leadership that had a strong commitment to a model of coordinated care.

  While the impetus for collaboration may have been external forces such as grant funding or competition from urban hospitals, there was a common vision for providing seamless care, for serving the community with appropriate levels of care, and for making the needs of the community the paramount concern, overriding narrow organizational interests of survival and expansion.  The study lists the following examples of successful collaborations:

  • Joint training, recruitment, human resources and clinical direction;

  • Shared case managers;

  • Working together on “disease collaboratives;”

  • Shared medical laboratory;

  • Hospital taking advantage of the 340b program for significant savings for drugs;

  • Qualifying for grant funds for which they would otherwise not be eligible; and,

  • Shared electronic patient medical record system.            

The full report can be found at: http://www.nrharural.org/blasts/CHCStudy.pdf.

Across Arizona

 

1. Quality Assurance Training Offered in Phoenix and Tucson, July 8

  Congestive heart failure (CHF) is the most common diagnosis in hospitalized patients over 65 years of age, and represents a significant and increasing public health concern.On July 8, a group of distinguished professionals will address the issues of quality improvement in Arizona’s critical access and other rural hospitals for patients hospitalized with CHF in a live videoconference with sites in Phoenix and Tucson.  Learn about the current understanding of CHF pathophysiology, and the latest developments in diagnosis and treatment. Be introduced to the Chronic Care Model. Bring your questions! Leave more confident in your quality improvement efforts.  Useful tools and valuable intervention ideas will be provided.

  The focus of this seminar will be on each of the CHF quality indicators from the Centers for Medicare & Medicaid Services (CMS):

  • Left ventricular function (LVF) assessment

  • Angiotensin converting enzyme (ACE) inhibitor for left ventricular systolic dysfunction (LVSD)

  • Adult smoking cessation counseling

  • Discharge instructions (activity level, diet, discharge mediations, follow-up appointment, weigh monitoring, what to do if symptoms worsen). The Arizona Rural Hospital Flexibility Program in partnership with Health Services Advisory Group, the Quality Improvement Organization (QIO) for the state of Arizona, sponsors the workshop. Further details and a registration form can be found here.

2. 31st Annual Arizona Rural Health Conference, July 19-21

 This year’s conference, entitled “Making Our Voices Count” is designed to bring everyone interested in improving rural health in Arizona together to determine how we can use our voices to make a difference around four themes:

  • Rural Clinical Practice Issues

  • Changing the Rural Health Environment Rural Health Workforce Issues Media Matters: Stories, Education and Advocacy

 Conference participants will enjoy distinguished speakers  -- such as David Warner, Ph.D., who will deliver the Andrew Nichols lecture --  in addition to a beautiful conference venue, the Pointe South Mountain Resort in Phoenix, which offers many opportunities for work and play.  Bring your family to enjoy some playtime and be prepared to work and share at a stimulating and action-oriented conference.

 As in prior years, there will be a supplemental workshop on Rural Health Outreach and Network Development grants. You can register for this workshop at the same time you register for the conference. The workshop will be limited to 30 participants.
 As you plan to attend this year’s conference, remember that your registration fee will include a one-year membership in the Arizona Rural Health Association (AzRHA) which continues to be active in advocacy efforts on behalf of rural health needs and issues. You can register on-line this year.  So don’t delay; do it now and take advantage of the early birddiscount before June 30.  Click here to enter the conference website.

3. Trauma Care Training for Nurses, July 24-25 and October 23-24

Advanced Trauma Care for Nurses is being offered in two-day courses at the University Medical Center in Tucson on July 24-25 and again on October 23-24. This course is designed specifically for registered nurses who want to increase her/his knowledge in the management of the multiple trauma patient.  The course is taught concurrently with a physician ATLS course. The Society of Trauma Nurses and the American College of Surgeons sponsor the course. The Society of Trauma Nurses provides continuing education credit for successful completion of the ATCN course.

  The first day will cover the following:

  • Initial Assessment & ManagementAirway and Ventilatory ManagementShock

  • Thoracic Trauma

  • Abdominal Trauma

  • Rotation in Practical Skills Stations:  Airway & Ventilatory Management, Hemorrhagic, Shock and Initial Assessment

  The second day’s training will include:

Head Trauma

Spine and Spinal Cord Trauma

  • Musculoskeletal Trauma

  • Rotation in Practical Skills Stations:

  • Spine and Extremity Injury, Pediatric Trauma and Head Trauma

  • Injuries due to Burns and Cold

  • Pediatric Trauma & Trauma in Women

  • Transfer to Definitive Care

  • Written Examination & Triage Case Scenarios

  • Initial Assessment Skills Stations  A registration form and further details can be obtained from Melody Pelot at 626-5095 or mailto:melodyp@email.arizona.edu.

 

4. Staff Change at ADHS

Kneka P. Smith has resigned as Chief, Office of Oral Health, Arizona Department of Health Services to pursue other ventures, including consulting on dental and dental public health issues. A search will be conducted for a new Chief. Tina Strickler will serve as Acting Chief. Strickler previously managed a grant project directed to improve access to dental services for children from low-income families.

5. Recent Administrative Changes at Critical Access Hospitals  Please note the following staff changes at Arizona CAHs.

  Sage Memorial Hospital recently announced a new administrative team to serve for the next six months: Rudy Snedigar, CEO; Laureen Bernally, Assistant CEO; and, Fredrica Martinez, CFO.

  At Southeast Arizona Medical Center, Tom Summers is now Interim CEO. 

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 mailto:peashock@email.arizona.edu. 

1. Rural Health Care Services Outreach Grant, HRSA-05-011

 

Application Due Date: September 13, 2004

  The Office of Rural Health Policy's Rural Health Care Services Outreach Grant Program encourages the development of new and innovative health care delivery systems in rural communities that lack essential health care services. The emphasis of this grant program is on service delivery through creative strategies requiring the grantee to form a consortium with at least two additional partners.   Through consortia of schools, churches, emergency medical service providers, local universities, private practitioners and the like, rural communities have managed to create hospice care, bring health check-ups to children and provide prenatal care to women in remote areas. To be eligible, the grant recipient's organizational headquarters must be a rural public or rural nonprofit private entity and be located in a designated rural county, eligible ZIP Code of an urban county, exclusively provide services to migrant and seasonal farmworkers in rural areas or be an American Indian Tribal or quasi-tribal entity.

  The Outreach program supports projects that demonstrate creative or effective models of outreach and service delivery in rural communities. Applicants may propose projects to address the needs of a wide range of population groups including, but not limited to, low-income populations, the elderly, pregnant women, infants, adolescents, rural minority populations and rural populations with special health care needs. All projects should be responsive to the unique cultural, social belief and linguistic needs of the target population.

  Applicants may propose to deliver many different types of services. These include primary care, dental care, mental health services, home health care, emergency care, health promotion and education programs, outpatient day care and other services not requiring inpatient care.

These grants are available for the delivery of health care and related services to defined population groups in rural areas. These may be new services in the community or an xpansion of existing services. A primary purpose of the program is to foster the development of new collaborative efforts for the delivery of health care in rural areas. Consequently, a consortium of three or more separately owned health care organizations working together must plan and implement the grant project activities. The participating organizations may be similar (e.g., all hospitals) or diverse providers (e.g., hospital, home health agency, public health departments, mental health providers, rural health clinics, community or migrant health centers.

Individual grant awards will be limited to a total amount of $200,000 (direct and indirect costs) per year. Applicants may propose project periods up to the maximum of three (3) years.

  The legislation for this program states that applications should be prepared in consultation with your State Office of Rural Health (SORH).

Rural Health Outreach Grant Program Conference Call 

  HRSA is holding a technical assistance conference call regarding the Rural Health Outreach Grant Program on July 29 at 2:00 p.m. EDT. E-mail or call Mary Collier at mcollier@hrsa.gov .  Provide your name, telephone number, and fax number, if available, and confirm you want to participate in the Outreach Conference Call.  If you do not have e-mail you can phone 301/443-0836 and slowly leave the information requested above.  All reservations must be made by noon EDT, July 29, 2004.

 

2. Tribal Management Grants

 

Application deadline: August 20, 2004

  The Tribal Management Grant (TMG) Program is a national competitive discretionary grant program established to assist federally-recognized tribes and tribally-sanctioned tribal organizations in assuming all or part of existing Indian Health Service programs, services, functions, and activities.

  In addition, TMGs are available to tribes/tribal organizations under the authority of Public Law (Pub. L.) 93-638 section 103(e) for (1) obtaining technical assistance from providers esignated by the tribe/tribal organization (including tribes/tribal organizations that operate mature contracts) for the purposes of program planning and evaluation, including the development of any management systems necessary for contract management and the development of cost allocation plans for indirect cost rates; and (2) planning, designing, and evaluating Federal health programs serving the tribe/tribal organization, including Federal administrative functions. Awards are estimated to range from $50,000-$100,000 per year.

  The TMG application kit is available from: Ms. Deanna J. Dick, Office of Management Support, Indian Health Service, 801 Thompson Avenue, TMP 625, Rockville, Maryland 20852, (301) 443-6290; Ms. Patricia Spotted Horse, Grants Management Branch, Indian Health Service, 801 Thompson Avenue, TMP 100, Rockville, Maryland 20852, (301)443-5204. The entire application kit is also available online at: http://www.ihs.gov/NonMedicalPrograms/tmg/index.asp

 

3. Telecom and Internet Discounts for Rural Health Providers

 

Deadline: June 30, 2004

  The Universal Service program, which provides telecommunication discounts to assist rural health care access, is now accepting applications for new funding.

  There are some changes for this funding year that are important to highlight.

  * Twenty-five per cent (25%) of the monthly charge for Internet access, web addresses and/or web hosting is now supported. To apply for this support please check the appropriate box on Line 30 in your FY 2004 Form 465 and submit the new form 466-A. Please read the instructions for both forms and example (466-A EZ) provided.

  *  Also new for FY 2004 is a change in applicant eligibility. A revised list of eligible entities is provided.

  *  For telecommunication carriers and Internet service providers (collectively know as "Service Providers") there is an updated PDF entitled, "Procedures for Service Providers." lease refer to this document for helpful information.

  As a result of recent Federal Communications Commission (FCC) action, health care participants may be eligible to receive a 25% discount on their monthly Internet service charges. These services are limited to the monthly Internet net access charge, monthly charges for web hosting and web addresses. Eligibility for this discount is open to all rural non profit HCP's in addition Emergency Departments of for profit rural hospitals are eligible. A complete list of eligible services for both Internet and telecommunications services is provided.

  Dedicated Emergency Departments of for-profit hospitals and not-for-profit providers located in rural areas are also now eligible. Over the past six years, several thousand rural providers have taken advantage of this program.

  Call Rural Health Care Division at 1-800-229-5476 with any questions. Hours of operation are 8AM to 8PM, Eastern Time, Monday through Friday.

http://www.rhc.universalservice.org/whatsnew/032004.asp

  To learn more about the capacities of this program, join in the monthly outreach conference call for applicants and service providers on the second Thursday of each month at 2 P.M., ET. These calls are a forum in which applicants and service providers can raise issues and concerns or seek clarification of program rules or requirements. The RHCD provides an agenda for the calls, followed by a general question and answer period. RHC officials moderate the calls. If you would like to submit a topic for discussion to add to the agenda, please send an e-mail to rhc-admin@universalservice.org

Participants may begin calling in 10 minutes before the call begins.

Phone Number: 1-800-240-9939   Pass code: 6772932

 

4. HRSA Grants Available (repeated from May 2004 Rural Health Briefing)

Rural Health Care Services Outreach Grants (HRSA-04-001)

Application deadline: September 13, 2004

 

  The Rural Health Care Services Outreach Grant Program supports projects that demonstrate creative or effective models of outreach and service delivery in rural communities. Applicants may propose projects to address the health care needs of a wide range of population groups and to deliver many different types of health care and health care related services in rural communities.

  Eligibility:  1) The applicant organization must be a public or nonprofit private entity located in a rural area or in a rural ZIP Code of an urban county (list included in application materials) and all services must be provided in a rural county or ZIP Code; or 2) The applicant organization exists exclusively to provide services to migrant and seasonal farm workers in rural areas and is supported under Section 330g of the Public Health Service Act or 3) The applicant is a federally recognized Native American Tribal or quasi-Tribal entity hat will deliver services on Reservation or Federally recognized Tribal lands (documentation of status must be included). The entity must represent a consortium composed of members that include three or more health care providers and that may be nonprofit or for-profit entities.

  A funding preference will be given to any qualified applicant that can demonstrate one of the following three criteria:

1) At least one of the consortium members is located in officially designated health professional shortage areas (HPSAs) OR medically underserved communities (MUCs) OR serve medically underserved populations (MUPs). To ascertain HPSA and MUP designation status, please refer to the following website: http://bhpr.hrsa.gov/shortage/index.htm.

2) Ambulatory practice sites designated by State Governors as serving medically underserved communities; OR

3) Propose to develop project with a focus on primary care and prevention and wellness.

The applicant must request and identify the particular preference they are eligible for to receive a funding preference.

  The Office of Rural Health Policy seeks to expand the outreach program into geographic areas not currently served by the program. Consequently, HRSA will consider geographic location when deciding which approved applications to fund.Contact: Lilly Smetana, 301-443-6884, lsmetana@hrsa.gov

Rural Health Network Development Grants (HRSA-04-002)

 

Application Deadline: September 20, 2004

 

  The Rural Health Network Development Grant Program 330A(f) supports development of rural health networks. Grant funds are used to support activities that strengthen the organizational capabilities of these networks whose purpose is to overcome the fragmentation and vulnerability of providers in rural areas. This program is designed for rganizations that wish to further ongoing collaborative relationships to integrate systems of care administratively, clinically, financially, and/or technologically. The goal of the Rural Health Network Development Program is to achieve efficiencies; expand access to, coordinate, and improve the quality of essential health care services; and strengthen the rural health care system as a whole.

  The applicant must be a public or nonprofit entity that represents a network that includes at least three or more health care providers. In addition, the grantee must meet at least one of three following requirements:

1) The applicant organization must be located in a rural area or in a rural ZIP code of an urban county (list included in application materials and on program website) and all grant-funded activities must support rural areas; OR 2) The applicant organization exists exclusively to provide services to migrant and seasonal farm workers in rural areas and is supported under Section 330(g) of the Public Health Service Act OR 3) The applicant is a federally recognized Native American Tribal or quasi-Tribal entity that will deliver services on Reservation or Federally recognized Tribal lands (documentation status must be included.)

 

Contact: Katherine Bolus, 301-443-7444, mailto:kbolus@hrsa.gov or Michele Pray-Gibson, 301-443-7320, mpray@hrsa.gov.

Rural Health Network Development Planning Grant (HRSA-04-003)

 

Application Deadline: September 8, 2004

 

  The Rural Health Network Development Planning Grant Program supports one year of planning activities to develop integrated health care networks in rural areas. The Planning Grant Program provides support to rural entities that seek to develop a formal health care network and that do not have a significant history of collaboration. Formative networks are those that are not sufficiently evolved to apply for a 3-year planning implementation grant and do not yet have a formalized structure.

  The program is designed to support organizations that wish to develop formal collaborative relationships among health care providers to integrate systems of care administratively, clinically, financially, and/or technologically. The goal of the Rural Health Network Development Program is to achieve efficiencies; expand access to, coordinate, and improve the quality of essential health care services; and strengthen the rural health care system as a whole. The Planning Grant Program supports this overall program goal by providing support to entities in the formative stages of planning and organizing a rural health network.

  The applicant must be a public or nonprofit entity that represents a network that includes at least three or more health care providers. In addition, the grantee must meet at least one of three following requirements:

The applicant organization must be located in a rural area or in a rural ZIP code of an urban county (list included in application materials and on program website) and all grant-funded activities must support rural areas; OR the applicant organization exists exclusively to provide services to migrant and seasonal farm workers in rural areas and is supported under Section 330(g) of the Public Health Service Act; OR the applicant is a federally recognized Native American Tribal or quasi-Tribal entity that will deliver services on Reservation or Federally recognized Tribal lands (documentation status must be included.)

  A funding preference will be given to any qualified applicant that can demonstrate either of the following two criteria:

  1. Those applicants for which at least 50% of the proposed rural health network's service area is located in officially designated health professional shortage areas (HPSAs) OR medically underserved communities (MUCs) OR serve medically underserved populations (MUPs).

OR

  1. Those applicants whose projects focus on primary care, and wellness and prevention strategies.

Contact: Michele Pray-Gibson, 301-443-7320, mpray@hrsa.gov.

Rural Health Best Practices and Community Development Cooperative Agreement (HRSA-04-091)

 

Application Deadline: June 21, 2004

 

  The purpose of this program is to develop and continue a number of projects that:

  • help identify and promote best practices for rural health care providers in terms of quality of care and economic viability by addressing needs related to access to care, workforce, networking and performance improvement through a variety of approaches, including workshops, conferences, technical assistance and other outreach efforts;

  • provide resources to communities for help in shaping their local health care systems to best meet community need;

  • promote best practices to help rural communities with health quality initiatives;

  • identify and translate the key points from emerging policy issues to rural health care providers, researchers and policymakers; and

  • work with State based entities such as State Offices of Rural Health and State Rural Health Associations to provide technical assistance in identifying key rural health challenges and programs and resources that will assist rural communities in addressing these challenges.

  Eligibility is open to public and private non-profit organizations, faith-based and community-based organizations, State Governments and their agencies such as universities, colleges, research institutions, hospitals, State and local governments or their bona fide agents along with federally recognized Indian tribal governments, Indian tribes, and Indian tribal organizations.

  Applicants who currently receive funding through the HRSA Office of Rural Health Policy Rural Health Research Center Cooperative Agreement program are not eligible.

Contact: Jennifer Riggle, 301-443-7530, jriggle@hrsa.gov.

 

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 comments, editorial suggestions, and discerning questions are welcome. Please send them as well as address changes to Jim Laukes, Editor, Rural Health Briefing.

 
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