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Rural Health Briefing, Vol 3, No. 3 June 6, 2002
Update: Rural Hospital Flexibility Program
National Action
- Medicare Fiscal Intermediary CAH Manual
- Rural Hospital Performance Improvement
State Action
- Status of AzCAH Designations
- Status of State Legislation
- 2002 Arizona Flex Program Conference
Arizona News
-
Nat’l Advisory Committee on Rural Health Mtg
- Health Care Bills Passed In Legislative Session
- Arizona Telemedicine Program Award
- Reminder – Arizona Rural Health Conference
- Reminder – Border Health Info Conference
National News
- HHS Grants to Address Nurse Shortage
- More About J-1 Visa Waivers
- National Survey of Physicians
- HMO Performance in Medicare Program
- Child Health Toolbox
- RxAssist: Free Medications Online
- Monograph on Rural Homelessness
- HRSA Clearinghouse Merger
- US Census 2000 Data Available
- CMS Quarterly News Update
- Public Health Professionals Website
- Medical Reserve Corps to Promote Volunteerism
- How to Contact Your Representatives
- Congressional Delegation
- State Legislators
Grant Opportunities
- New: Rural Hospital Grants Program
- New: Rural Access Emergency Devices Grants
- New: Oral Health Access Grants
- Substance Abuse Grants
- Reminder - Rural Outreach/Network Grants
- Other Selected Grant Opportunities
Conferences Relevant to Rural Health
- State Rural Health Associations Skill-Building
- Rural Minority Health Conference
- Summit to Eliminate Racial and Ethnic Disparities in Health
- Others
-What is Rural? The Sequel
1. Rural Hospital Flexibility Program
a. National Action
(1) Medicare Fiscal Intermediary Online CAH Manual: One of the Medicare Fiscal Intermediaries for critical access hospitals, Trailblazer Health Enterprises, LLC, has published an on-line CAH Manual that may be of use to those whose FI have not provided one to them. The manual provides background information about the Medicare Rural Hospital Flexibility Program and critical access hospital designation; certification improvements to critical access hospital benefits resulting from the Medicare Balanced Budget Refinement Act; and rules related to critical access hospitals, including: (a) provider number components; (b) type of bill; (c) Part A deductible; (d) Part B deductible; (e) Coinsurance; (f) split billing; (g) UPIN; (h) inpatient reimbursement; (i) swingbed reimbursement; (j) outpatient reimbursement; (k) CAH revenue coding; and, (l) CAH billing examples. The manual can be downloaded in PDF format and is available through the Trailblazer website:
http://www.trailblazerhealth.com/parta/downloads/critical-access-hospital.pdf.
(2) Delta Rural Hospital Performance Improvement Project Website: The Delta Rural Hospital Performance Improvement Project is designed to bring needed consultation and information to small rural hospitals in the Mississippi Delta Region. The goals include performance improvement to ensure continued access to rural hospital services; to make available tools and information that support performance improvement; and to increase state and regional capacity to provide consultation to targeted hospitals. See the project website at: http://www.rhpi.org.
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b. State Action
(1) Status of Arizona Critical Access Hospital Designations: Five rural hospitals in Arizona have now received new provider numbers as critical access hospitals – Wickenburg Regional Medical Center, Benson Hospital, Northern Cochise Community Hospital (Willcox), Southeast Arizona Medical Center (Douglas), and Page Memorial Hospital. One additional designation application is pending for the Hopi Health Care Center.
(2) Medicaid Appropriation Reinstated: Last year, the Legislature appropriated $1.7 million for the 2002 and 2003 fiscal years for enhanced reimbursement to critical access hospitals for services provided to Medicaid patients. The FY02 appropriation was reduced by AHCCCS administration, due to cuts in its overall budget. The Legislature has reinstated a $1.7 million appropriation for critical access hospitals in the AHCCCS budget for the next fiscal year.
The pool of funds available for critical access hospitals in this fiscal year is $368,333, which will be split among the five designated critical access hospitals. The hospitals have already received their first payment checks, and will receive another by mid-July. It is not anticipated that there will be any new critical access hospitals before June 30, 2002.
The formula for distribution of the funds, developed by AHCCCS administration, calculates that approximately $14,167 is available per hospital per month in FY02. Actual payments to each hospital will vary by month based on how many designated critical access hospitals there are each month, and on each hospital’s percent of total inpatient and outpatient utilization among the designated hospitals.
In FY03, AHCCCS anticipates making quarterly payments to critical access facilities, with the same distribution policy implemented FY02. The quarterly payments are intended to assist the hospitals with cash flow issues, while minimizing the administrative effort of the AHCCCS Division of Business and Finance.
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(4) 2002 Arizona Flex Program Conference: This year’s Arizona Rural Hospital Flexibility Program Conference will feature several distinguished national speakers, including two who will be making site visits with some of our newly designated critical access hospitals: Forrest Calico, MD, MPH, who is the Project Officer for the Medicare Rural Hospital Flexibility Program of the Federal Office of Rural Health Policy, and Terry Hill, Executive Director of the Technical Assistance Service Center (TASC), the TA organization for the national Flex Program. Dr. Calico’s conference presentation will focus on operational and performance improvements that are appropriate for the small low-volume rural healthcare environment. Mr. Hill’s presentation will focus on what the national evaluation tracking system is learning from critical access hospitals about rural hospital improvement.
Other presenters will include:
Eric Shell, Financial Consultant, Stroudwater Northland Health Group, Inc.: Strategies for Rural Hospital Improvement;
Kurt Patton, Executive Director, Joint Commission on the Accreditation of Healthcare Organization: New JCAHO standards for critical access hospitals and JCAHO’s responsibilities for implementing the standards;
Kate O’Brien, Associate Consultant, The Balanced Scorecard Collaborative: How to link strategies with operations in a way that integrates financial measures with other key performance indicators around customer (patient, physician, payer) preferences, internal clinical and business processes, and personal learning, development, and growth; and,
Julie Sadovich, Region IX Representative, Center for Medicare and Medicaid Services: Current issues related to Medicare reimbursement.
Kristen B. Rosati, Coppersmith Gordon Schermer Ownes & Nelson, PC: HIPAA privacy regulations as they impact rural health providers;
Andrea Silvey, Director of Health Care Quality Program, Health Services Advisory Group, Inc.: New quality improvement initiative for rural hospitals;
Alette Thompson, Quality Manager, USPHS Whiteriver Indian Hospital: Indian Health Service quality improvement standards and issues;
Judy Crume, Chief, Bureau of Emergency Medical Services, Arizona Department of Health Services: The role of critical access hospitals in the state emergency preparedness and trauma plan, as well as other emergency medical services issues related to rural hospitals.
In addition, a panel of administrators of critical access hospitals that have been awarded Arizona Flex Program Small Grants will describe the projects being implemented in their hospitals.
Finally, the meeting will feature a special segment on how to write rural health outreach and network grants.
The conference will be held Thursday, August 1, 2002 to Friday, August 2, 2002 at the Hyatt Regency at the Civic Center in Phoenix. "Mark Your Calendars" brochures were mailed last week, with an Early Bird Registration Form (discounted registration rate from $110 to $95 for registrations received before June 30). Group rates will be $95 each for three or more persons from the same organization. Hotel registration fees are $105 single/double (plus 12.07% tax). The block rate will be in effect until July 1. To make hotel reservations, call (602) 252-1234.
A full program brochure will be mailed in June. For further information, please contact: Joyce Hospodar, Conference Coordinator, Rural Health Office, 2501 E. Elm Street, Tucson, AZ 85716; Phone (520) 626-7946; Fax (520) 326-6429; Email: hospodar@u.arizona.edu.
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2. Arizona News
Meeting of the National Advisory Committee on Rural
Health: On Sunday, June 9, 2002, the National Advisory Committee on Rural Health will hold a meeting at the Sheraton El Conquistador Hotel in Tucson to examine the status of health care at the U.S.-Mexico border. On June 10, the Committee will continue its deliberations at the Bisbee Convention Center in Bisbee.
The committee is chaired by the Honorable David Beasley, former governor of South Carolina, and is composed of notables in health care from throughout the country. The committee reports directly to the Secretary of Health, the Honorable Tommy Thompson, to whom it makes recommendations regarding rural health policy. The committee is staffed through the Federal Office of Rural Health Policy, Marcia Brand, PhD, Director.
The Sunday agenda will cover chronic disease at the border, health issues in general at the border, and the impact of undocumented aliens on the health care system in the Tohono O’odham reservation.
On Monday, June 10, the committee will travel by bus to Bisbee to continue its deliberations at the Bisbee Convention Center. The Copper Queen Community Hospital will host a reception for the committee. Committee deliberations will continue, with a review of the impact of undocumented aliens on border hospitals and the impact of uncompensated care, as well as the effects of obstetrics closures on area clinics.
Tucson speakers will include Jill DeZapien, Rural Health Office, College of Public Health; Cecilia Rosales, MD, Arizona Department of Health Services; Eva Moya, Acting Director of the U.S.-Mexico Border Health Commission; and Darrell Rumley and Mark Adams of the Indian Health Service and the Tohono O’odham Nation. Bisbee speakers will be Ginger Ryan of the Chiricahua Community Health Center in Elfrida; Jim Dickson, CEO of Copper Queen Community Hospital; and George Hooper, CEO of the Southeast Arizona Medical Center.
Alison Hughes, Director of the Rural Health Office in the University of Arizona College of Public Health, is a member of the committee. For further information, please contact her by email: ahughes@u.arizona.edu.
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b. Health Care Bills Passed In the 45th Second Regular Session of the Arizona Legislature:
(1) SB 1238 Passed: SB 1238, sponsored by Senator Marsha Azberger, passed in this session of the legislature. The new law modifies state licensure statute, allowing rural hospitals that have become designated critical access hospitals to revert to their previous status based on the licensure standards in effect when they received critical access designation.
(2) HB 1240 rural physicians; study committee
* Establishes an eight member Rural Physician Study Committee to examine matters affecting the practice of medicine in rural areas of Arizona.
(3) HB 2709 health; budget reconciliation; 2002-2003:
* Expands AHCCCS to include approximately 20,00 KidsCare-eligible parents beginning October 1, 2002. State will receive 75% match from the federal government. Arizona was the first state to receive the Health Insurance Flexibility and Accountability (HIFA) waiver;
* Provides continued funding for Premium Sharing and Healthcare Group.
(4) HCR 2047 tobacco tax products tax; health services:
* Allows voters to increase tobacco tax to provide funding for Level I Trauma Centers and Emergency Rooms;
* Other funds would be used for continuing to provide health through Proposition 204 (Medicaid Expansion), Healthcare Group, Premium Sharing, KidsCare, etc.
(5) HB 2464 Arizona prescription drug advisory council:
* Develops the infrastructure for a non-profit coalition of healthcare organizations to provide purchasing and management assistance to persons who need prescription drugs.
* The mission of the Arizona Prescription Drug Advisory Council is to consolidate all of the prescription drug purchasing and management assistance resources within Arizona into a non-profit network. These resources include Pharmaceutical Assistance Programs (PAP) through pharmaceutical companies, prescription management services provided by pharmacy colleges and pharmacists, direct mail order/rebates, patient assistance programs and health care providers. By combing all of the resources available into one network, prescription drug assistance programs can be easier to locate and utilize.
(6) HB 2044 enhanced surveillance advisory; bioterrorism:
* Establish interagency and intergrovermental procedures through the Department of Health Services to address bioterrorism threats or attacks.
(7) SB 1192 DHS; dental services:
* Allows DHS to provide dental health services and receive reimbursement for such services through AHCCCS. This will enable DHS to expand their program and provide sealants to Title XIX and Title XXI eligible children at the school site, instead of just uninsured children. This will provide more dental services to low-income children.
(8) SB 1260 nursing education programs; expansion:
* Establishes a coalition between universities, community colleges, private educational institutions, hospitals and healthcare organizations to develop a caregiver and resource expansion program to double the number of nurses graduating in Arizona from 1,000 to 2,000 per year.
* According to the Arizona Hospital and Healthcare Association (AzHHA), the number of students graduating from Arizona’s nursing schools has remained steady at approximately 1,000 graduates per year for the past decade. AzHHA reports that the average age of a registered nurse in Arizona is 47 years. Arizona has 628 nurses per 100,000 people compared to the U.S. average of 782 nurses per 100,000 people.
(9) HB 2234 contraceptive coverage:
* Requires insurers that cover prescription drugs to cover all five FDA approved methods of contraception at an equal level with other prescriptions;
* In December 2000, the Equal Employment Opportunity Commission (EEOC) ruled that an employer’s failure to cover prescription contraceptives as part of an employee’s health plan constitutes unlawful sex discrimination under Title VII of the Civil Rights Act (1964) and the Pregnancy Discrimination Act (1978). The bill modifies insurance laws to make them consistent with the federal ruling.
(10) HB 2542 physician assistants:
* Provides for the expansion of prescribing authority for phsycian assistants from 72 hours to 14 days for schedule II or III controlled substances. This allows for better access to care for patients by removing burdens within the system. The legislation makes Arizona’s laws consistent with 45 other states.
(11) HB 2359 dialysis technicians; standards:
* Requires dialysis technicians to obtain certification to improve the quality and safety of dialysis services provided.
(12) HB 2286 task force; health care system:
* Creates a Statewide Health Care Task Force to continue the efforts of the Statewide Health Care Insurance Task Force created by Laws 2000, Chapter 320;
* The bill enables the Task Force to explore the feasibility of expanding and improving state and federal health insurance programs and enhance rural health care infrastructure.
(13) SB 1238 critical access hospitals; redesignation:
* Allows a health care institution that terminates its Critical Access Hospital (CAH) designation to return to the provisions of its original licensure.
* The bill specifically provides an exemption from the law that requires a facility with a license that needs to be modified to be compliant with current building codes if it does not exceed its previously approved licensed capacity.
c. Arizona Telemedicine Program Award: The Arizona Telemedicine Program recently won a national award from the U.S. Distance Learning Asssociation for "Excellence in Distance Learning Programming Healthcare/Telemedicine." The award recognized the collaborative efforts of many Arizona Health Sciences Center departments and programs, including: numerous clinical and academic departments that provide distance-learning content in the form of courses and grand rounds; AHSC Biomedical Communications for training faculty in distance education teaching techniques, producing the educational events and routing them to the telemedicine network; the network and distance learning coordinating staff in the telemedicine program; and the numerous remote site coordinators who facilitate these programs at locations throughout Arizona. To date, the program has provided almost 9,500 credit hours to health care professionals throughout Arizona.
d. Reminder – Arizona Rural Health Conference: Final program brochures for the Annual Arizona Rural Health Conference, scheduled to be held July 22-24 at the Hilton Resort in Sedona, are scheduled to be mailed in the next few weeks. If you did not receive a "Mark Your Calendar" brochure, Rebecca Ruiz at the Rural Health Office to get on the mailing list (520) 626-7946, Ext. 161; aruiz@rho.arizona.edu.
e. 5th National Community Health Workers/Promotores
Conference: The 5th National Community Health Workers/
Promotores Conference, "Community Health Workers: An Emerging Workforce," will be August 28-30, 2002 in San Antonio, Texas. The annual conference originated with the Western Arizona Area Health Education Center (WAHEC) in Yuma, which continues to cosponsor the conference. For more information contact: National Community Health Workers/Promotores Network. Phone: (877) 743-1500; Email: chwnetwork@wahec.com.
h. Reminder -- Border Health Information Conference: The fourth annual Border Health: Information for Action Conference is scheduled to be held at the Rio Rico Resort September 26-27, 2002. For further information, contact Mary Contreras, College of Public Health, (520) 318-7270, Ext. 10 or ContrerM@u.arizona.edu.
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3. National News
a. HHS Awards $30 Million to Address Emerging Nurse Shortage: On June 4, U.S. Secretary of Health Tommy Thompson announced a series of grants totaling more than $30 million to increase the number of qualified nurses and the quality of nursing services across the country. HHS’s Health Resources and Services Administration (HRSA) will award grants totaling more than $22 million to colleges, universities, and other organizations to increase the number of nurses with advanced degrees and to help improve the quality of care for elderly patients.
In addition, another $8 million will be designated to repay educational loans of clinical care nurses who agree to work for two or three years in designated public or nonprofit health facilities facing a critical shortage of nurses. HRSA estimates that more than 400 new contracts will be made under the Nursing Education Loan Repayment Program. APPLICATIONS ARE DUE JUNE 14. Details are available by calling 1-866-813-3753 or online at:
http://www.bphc.hrsa.gov/programs/NELRProgramInfo.htm.
The $22 million grants include:
(1) 324 Advanced Education Nursing Traineeship grants, totaling more than $18.5 million, which support registered nurses in graduate programs who are studying to become nurse practitioners, clinical nurse specialists, nurse-midwives, nurse anesthetists, nurse educators, nurse administrators, and public health nurses.
(2) 71 Advanced Education Nurse Anesthetist Traineeship grants, totaling more than $3 million, which support registered nurses enrolled full-time in a master’s nurse anesthesia program.
(3) Nine Geriatric Nursing Knowledge and Experiences in Long Term Care Facilities grants, totaling nearly $225,000, which helps schools of nursing provide hands-on clinical training for senior nursing students caring for elderly individuals.
(4) Three Nurse Faculty Development in Geriatrics grants, totaling nearly $760,000, which help nursing schools, nursing centers, academic health centers, and state or local governments develop effective geriatric nursing education programs.
b. More on J-1 Visa Waivers: The U.S. Department of Agriculture recently announced it will process the pending 86 J1 visa waiver applications (in 21 states) for interested government agency sponsorship. The White House has announced its intention to form an interagency task force to review the J-1 visa program for foreign physicians.
A new policy paper is available from the RUPRI Center for Rural Health Policy Analysis: The Immediate and Future Role of the J-1 Visa Waiver Program for Physicians: The Consequences of Change for Rural Health Care Service Delivery. To download the policy paper, go to: http://www.rupri.org/pubs/archive/reports/P2002-3/P2002-3.pdf
c. National Survey of Physicians: The Kaiser Foundation’s biennial survey examined doctors’ views of their profession. The survey is based on a nationally representative random sample of 2,608 physicians. The complete survey results will be released later in 2002. Highlights of the survey results are available at:
http://www.kff.org/content/2002/20020426c/
d. Study of HMO Peformance in the Medicare Program: A new study funded by the Agency for Healthcare Research and Quality compared the performance of fee-for-service health plans and Medicare HMOs in 13 states with regard to structural features such as organizational and financial access to primary care, continuity of care, and integration of patients’ medical care. The researchers also compared quality of physician-patient interaction, such as physicians’ knowledge of their patients, preventive counseling, and patient trust of their provider. Overall, the findings reveal that primary care performance favors the traditional fee-for-service Medicare system over Medicare HMOs for 9 of the 11 features of care examined. Findings were based on the results of CMS surveys conducted in 1998 and 1999. The results of the study were published in the April 8 issue of the Archives of Internal Medicine, available online at:
http://archinte.ama-assn.org/issues/v162n7/toc.html
e. Child Health Toolbox Online Evaluation: The Agency for Healthcare Research and Quality has developed a Child Health Toolbox as a web-based resource on children’s quality and other performance measures. The Toolbox is designed to be useful to state policymakers and others concerned about the quality of children’s health care. It provides concepts, tips, and tools for evaluating quality of health care in Medicaid, the State Children’s Health Insurance Program (SCHIP), Title V, and other health care service programs for children. See: http://www.ahrq.gov/chtoolbx/
f. RxAssist: Free Medications On-Line: RxAssist is an online tool created to assist health care providers in locating sources of free pharmaceuticals for their uninsured patients. The web site contains a searchable database with up-to-date information on how to apply. RxAssist is a program of Volunteers in Health Care to aid health care professionals who care for the uninsured and is supported through a grant from the Robert Wood Johnson Foundation. Website: http://www.volunteersinhealthcare.org.
g. Monograph on Rural Homelessness: The National Health care for the Homeless Council has publsihed a 32 page monograph, "Hard to Reach: Rural Homelessness and Healthcare." The pdf file is available at: http://www.nhchc.org/
h. Merger of National Clearinghouse for Maternal and Child Health with the HRSA Information Center: HRSA’s National Maternal and Child Health Clearinghouse recently merged with the HRSA Information Center. Materials produced by all HRSA programs are now available from the HRSA Information Center. To order publications, contact the HRSA Information Center by phone, toll free, at 1-888-Ask HRSA (275-4722), by e-mail at ask@hrsa.gov or visit the website, www.ask.hrsa.gov
To receive the HRSA Information Center monthly e-mail update, containing a list of new publichations, send an e-mail message to Maiser@circlesolutions.com with the phrase SUBSCRIBE HRSAINFOCENTER in the body of the message.
Maternal and Child Health Publications Recently Acquired by the HRSA Information Center:
(1) Child Health USA 2001 (MCHN091)
(2) Cultural Competence Works: Using Cultural Competence to Improve the Quality of Health Care for Diverse Populations and Add Value to Managed Care Arrangements (HRS00249) 2000
Note: Bright Futures publications are now handled by the National Center for Education in Maternal and Child Health, Bright Futures Distribution Center. Phone: (301) 229-8890; Fax: (301) 559-5167. Website: www.brightfutures.org.
i. US Census 2000 Data Available: The U.S. Census Bureau recently released the first two major sets of data from the 200 Census: Redistricting and the "Short Form: (SF1). Data is available through Geolytics: 1-800-577-6717 or http://www.uscensus.info.
j. CMS Quarterly News Updates: The Center for Medicare and Medicaid Services (CMS) publishes a "CMS Quarterly Provider Update" that is a single source of national Medicare provider information. The first issue was published April 22, 2002. Future issues will be released the first work day of each subsequent calendar quarter. The publication is available online at http://www.cms.hhs.gov/providerupdate/default.asp
k. Public Health Professionals Website: The Partners in Information Access for Public Health Professionals has established a website at http://nnlm.gov/partners to provide public health professionals a one-stop site to line to relevant public health resources. The partnership is a collaborative project of the American Public Health Association; the Association of Schools of Public Health; the Centers for Disease Control and Prevention; HHS’ Health Resources and Services Administration; the National Library of Medicine; the National Association of County and City Health Organizations; the Association of State and Territorial Health Organizations; the Public Health Foundation; and the Society for Public Health Education.
l. Medical Reserve Corps to Promote Volunteerism: The Bush administration is planning the formation of a Medical Reserve Corps (MRC) to coordinate the skills of practicing and retired physicians, nurses, and other health professionals who are eager to volunteer during emergency situations. For more information, see: http://www.citizencorps.gov/medical.html
4. How to Contact Your Representatives
a. Arizona Congressional Delegation: Links to Representatives are available at http://www.house.gov. Links to Senators are available at http://www.senate.gov.
b. Arizona State Legislators: Available through the Arizona Legislative Information System (ALIS): Call 1-800-352-8404
http://www.azleg.state.az.us/
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Grant Opportunities
New -- Small Rural Hospital Grants Program: The dead-
line for submitting grant applications for a new Small Rural Hospital Improvement Grant Program (SHIP) award is June 21. Applications must be submitted through the State Office of Rural Health (in Arizona, this is the University of Arizona Rural Health Office). The Federal Office of Rural Health Policy is the funding agency. The grant application and list of eligible hospitals, by state, is available online: http://www.ruralhealth.hrsa.gov/ship.htm
The grant will provide funding to small rural hospitals to help them: purchase technical assistance, services, training, and information technology. Hospitals are encouraged to form consortiums and pool grant funds to help maximize purchasing power through economies of scale. To be eligible for the grants, a hospital must be: (1) small is defined as 49 available beds or less, as reported on the hospital’s most recently filed Medicare Cost Report; (2) rural is defined as located outside a Metropolitan Statistical Area (MSA) or located in a rural census tract of an MSA as determined under the Goldsmith Modification, and (3) the hospital is defined as a non-Federal, short-term, general acute care facility. There is about $15 million available for grants in FY 2002.
For the new Rural Small Hospital Grant, a list of specific eligible hospitals by states is included with the online application packet. The Arizona hospitals listed as eligible include: 1) Parker Community Hospital (Apache County); 2) Sage Memorial Hospital (Apache); 3) White Mountain Communities Hospital (Apache); 4) Benson Hospital (Cochise); 5) Southeast Arizona Medical Center (Cochise); 6) Cobre Valley Community Hospital (Gila); 7) Mt. Graham Community Hospital (Graham); 8) Navapache Hospital (Navajo); 9) Winslow Memorial Hospital (Navajo); 10) Hu Hu Kam (Sacaton); 11) Carondelet Holy Cross Hospital, Inc. (Santa Cruz). A hospital not on the list can include a "Hospital Form to Appeal Non-Eligibility" with its application.
For further information, please contact Alison Hughes or Joyce Hospodar. Phone: (520) 626-7946; ahughes@u.arizona.edu; hospodar@u.arizona.edu.
b. New – Rural Access Emergency Devices Grants: Letters of Intent are due June 7 and grant applications are due July 15 for the new Rural Access to Emergency Devices (RAED) Grant Program. The grant will provide funding to rural communities to purchase automated external defibrillators (AEDs) and provide training in their use and maintenance. The funding agency is the Federal Office of Rural Health Policy. The application packet is available online: http://www.ruralhealth.hrsa.gov/funding/aed.htm
Awards will made to community partnerships, which are defined as a consortium of first responders (e.g., EMS, law enforcement, and fire departments) and local for and non-profit entities that may include, but are not limited to, long-term care facilities, rural health clinics (includes community health centers, and federally qualified look-alikes), post offices, libraries and other civic centers, athletic facilities, senior citizen and day care facilities, faith-based organizations and schools without AEDs. The ADHS Bureau of EMS will be the lead applicant for the funding and is currently organizing a collaborative partnership for this purpose. The University of Arizona’s Rural Health Office is working closely with the Bureau in this effort.
An applicant must be part of a statewide, regional, or multi-county consortium of rural community organizations applying as a community partnership. Each community partnership must have a designated lead applicant as the grantee of record and to act as the fiscal agent for the partnership. In order to qualify as a statewide community partnership, all eligible counties do not have to be included. However, a state level office must be the lead applicant. State Offices of Emergency Services are considered an ideal lead applicant. Collaboration with the State Office of Rural Health is also encouraged. For further information, contact Judy Crume at the Bureau of Emergency Medical Services, Arizona Department of Health Services at (602) 861-0708.
c. New -- Oral Health Access Grants: Grant applications are due June 21 for up to seven State Action for Oral Health Access grants of up to $1 million for innovative programs designed to improve access to oral health services. The Center for Health Care Strategies (CHCS) is the funding agency. Eligible applicants must be health, social services, or education agency within a state that is best positioned to execute the demonstration project and is designated as such by the governor. The agency must also show collaboration among key constituencies in the orgal health delivery system and have demonstrated experience in improving access to oral health services for underserved populations. With funding from the Robert Wood Johnson Foundation, the program will support state-based model demonstration projects, including local system pilots, to test innovative and comprehensive approaches to expanding access to low-income, minority, and disabled populations served through medicaid, SCHIP, and the public health system. Program guidelines are available online at:
http://www.chcs.org/grantinfo/applyoralhealth.html
d. Substance Abuse Grants: Grant applications are due June 19 for four new grant programs sponsored by the U.S. Substance Abuse and Mental Health Services Administration. Grant application information is available at: http://www.samhsa.gov/grants/grants.html
(1) Native American Treatment Plan: $1.5 million is available to fund six awards to support community-based planning, resulting in the development of a local substance abuse treatment plan, for American Indian, Alaskan Native, and rural communities. Applicants may request up to $250,000 in total project costs for a project period of up to 18 months. Contact: Maria Burns at (301) 443-7611 or mburs@SAMHSA.gov. Announcement TI 02-005.
(2) Community Treatment for the Homeless: $9 million is available to fund 15-17 grants to expand and strengthen community treatment services for homeless individuals with substance abuse disorders, mental illness or with co-occurring substance abuse disorders and mental illness. Average awards are expected to range from $450,000-$600,000 per year in total costs. Contact: Joanne Gampel at (301) 443-7945 or jgample@SAMHSA.gov. Announcement No. TI 02-006.
(3) Residential Treatment for Youth: Approximately $8 million is available to fund up to 16 grants to enhance or expand residential treatment services for youth aged 21 and under who are referred for drug and alcohol treatment. The average award is expected to range from $400,000-$500,000 per year in total costs and will be awarded for up to three years. Contact: Randolph Muck at (301) 443-6574 or rmuck@SAMHSA.gov. Announcement No. TI 02-007.
(4) Treatment Services By Drug Courts: Approximately $10 million is available to fund grants to enhance or expand substance abuse treatment services provided by family, juvenile, or adult treatment drug courts. Approximately 25 awards will be funded, ranging from $300,000-$400,000 per year for up to three years. Contact Bruce Fry at (301) 443-0128.
c. Reminder – Rural Health Outreach/Network Grants
Rural Health Network Development Grant Guidelines and Application Packet will be available online this month: http://ruralhealth.hrsa.gov/funding/network.htm
Rural Health Outreach Grant Guidelines and Application Packet will also be online this month:
http://ruralhealth.hrsa.gov/funding/outreach.htm.
If you haven’t already done so, contact the HRSA Grant Application Center (HRSA GAC) at 1-877-477-2123, FAX 1-877-477-2234 or E-mail HRSAGAC @hrsa.gov to be put on the list to receive Rural Health Outreach or Network Development official application kits as soon as they are available. For the OUTREACH GRANT cite the reference number 93.912A For the NETWORK DEVELOPMENT GRANT cite the reference number 93.912B. Although most of the application materials are posted on the web, you must still call HRSA GAC at 1-877-477-2123 to receive the official application packet. For additional information contact Lilly Smetana at lsmetana@hrsa.gov or by calling 301-443-6884.
d. Selected Grant Opportunities
Information about grant opportunities are available through the Federal Office of Rural Health Policy’s Rural Information Center Health Service. Grants Relevant to Rural Health webpage is:
http://www.nal.usda.gov/ric/richs/grants.htm
Some grant opportunities of interest for rural health issues include the following:
(1) TITLE: Rural Community Development Initiative
AGENCY: Rural Housing Service, USDA
SCOPE: The Rural House Service announces that grants will be made to qualified intermediary organizations that will provide financial and technical assistance to recipients to develop their capacity and ability to undertake projects related to housing, community facilities, or community and economic development.
DEADLINE: July 2
CONTACT: Beth Jones, Rural Housing Service, STOP 0787, Room 0183, 1400 Independence Ave. SW., Washington, DC 20250-0787, (202) 720-1498.
(2) TITLE: Lifestyle and Cultural Practices of Tribal Populations and Risks from Toxic Substances in the Environment
AGENCIES: U.S. Environmental Protection Agency and the Agency for Toxic Substances and Disease Registry
SCOPE: The two agencies are seeking applications for research on lifestyle and cultural practices of Tribal populations and risks from toxic substances in the environment
DEADLINE: July 10
CONTACT: Nigel Fields, (228) 688-1981. fields.nigel@epa.gov. The solicitation is available at http://es.epa.gov/ncer/rfa/02trib_risk.html
(3) TITLE: Targeted Injury Intervention Program
AGENCY: Centers for Disease Control and Prevention (CDC)
SCOPE: CDC's National Centers for Injury Prevention and Control (NCIPC), announces the availability of funds for a cooperative agreement for the Targeted Injury Intervention Programs, a program that addresses the ``Healthy People 2010'' focus areas for Injury and Violence Prevention.
DEADLINE: June 24
CONTACT: For questions concerning program issues: John Hemphill, Project Officer, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Division of Injury Disability Outcomes and Programs, 4770 Buford Highway, NE, Mailstop KO2, Atlanta, GA 30341-3724, (770) 488-1285.. For questions regarding grants management issues: Nancy Pillar, Grants Management Specialist, Grants Management Branch, Procurement and Grants Office, Centers for Disease Control and Prevention, 2920 Brandywine Road, Room 3000, Atlanta, GA 30341-4146, 770-488-2721, nfp6@cdc.gov.
(4) TITLE: MultiPlan Rural Health Initiative
SCOPE: Multiplan, in partnership with the National Rural Health Association, has launched a program to help rural hospitals in obtaining accreditation from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
CONTACT: Alissa Foglia, (800) 677-1098. Email: rural@multiplan.com. Internet: http://www.multiplan.com
(5) TITLE: Telehealth Interventions to Improve Clinical Nursing Care
AGENCY: National Institute of Nursing Research (NINR); National Library of Medicine (NLM)
SCOPE: The goal of this Program Announcement is to stimulate clinical research on innovative nursing telehealth interventions, particularly their use among a wide variety of clinical situations, diverse patient populations, and different clinical settings.
DEADLINE: Ongoing.
CONTACT: Applications: (301) 435-0714. Programmatic Information: Carole Hudgings, NINR, (301) 594-5976; Milton Corn, NLM, (301) 496-4621.
(6) TITLE: Community Facilities Loans
AGENCY: Rural Development Administration, USDA
SCOPE: To construct, enlarge, extend, or otherwise improve community facilities providing essential services to rural residents. Facilities include fire and rescue services, transportation, health facilities, schools, municipal buildings, industrial park sites, access ways and utility extensions. There are direct loans and guaranteed
loan programs. Some types of facilities that have used these loans include: hospitals, assisted living units for the elderly, nursing homes, mental health clinics, drug treatment centers, and physician/dental clinics.
DEADLINE: Ongoing.
CONTACT: Applications are available from USDA Rural Development (formerly FmHA) State Offices, which can be located at: http://www.rurdev.usda.gov.
(7) TITLE: H-1B Technical Skills Training Grant Program
AGENCY: Employment and Training Administration, Department of Labor
SCOPE: Local Workforce Investment Boards are eligible to apply for this skills training program that provides a long term solution to domestic skill shortages in high skill and high technology occupations. Funds may be used for technical skills training for employed and unemployed American workers. Training must focus on occupations that are experiencing skills shortages in the domestic job market. [Special note: This program has been used to address nursing workforce needs.]
DEADLINE: Ongoing.
CONTACT: Programmatic Information: Fax questions to Le Phan, (202) 693-2879 (notice ID # SGA/DFA 01-105). Additional information: http://www.doleta.gov/h-1b.
(8) TELEHEALTH FUNDING GUIDE: http://telehealth.hrsa.gov/grants/funds.htm
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6. Conferences Relevant to Rural Health
a. State Rural Health Associations Skill-Building: The National Rural Health Association will sponsor a skill-building workshop for state rural health associations in Washington DC July 19-20. Contact Robyn Henderson for more information at (816) 756-3140 or henderson@NRHArural.org. (Jack Beverage, President-Elect of the Arizona Rural Health Association, will attend this workshop.)
b. Rural Minority Health Conference: The 8th Annual Rural Minority Health Conference, "Race, Culture, Technology: Impact on Rural Minority Health," will be held December 5-6, 2002 in San Diego, CA. Contact Rosemary McKenzie for more information at (816) 756-3140 or rmckenzie@NRHArural.org.
c. Summit to Eliminate Racial and Ethnic Disparities in Health: The HHS Office of Minority Health will hold a National Leadership Summit to Eliminate Racial and Ethnic Disparities in Health in Washington DC July 10-12. The summit will be organized around three tracks: (1) access to care; (2) health professions; and (3) research/data. The issue of culturally and linguistically appropriate services will be incorporated into five plenary sessions and 80 workshops. For additional information call 1-888-516-5599 or see http://www.summit.omhrc.gov
d. Others
(1) Annual Meeting Rural Sociological Society, "The Community Effect in Rural Places;" August 14-18, Chicago, IL
* For more information, contact: Rural Sociological Society
211 Mumford Hall, University of Missouri, Columbia, MO 65211-6200. (573) 882-9065 (573) 882-3958 (fax)
ruralsoc@missouri.edu (email)
http://www.RuralSociology.org/annual-meeting/2002/index.html
(2) National Association for Rural Mental Health's Annual Conference, "Riding the Winds of Change: Alternatives for the Journey;" August 26-29; Santa Fe, NM
For more information, contact: NARMH, 3700 W. Division Street
Suite 105, St. Cloud, MN (320) 202-1820
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7. Other
a. What is Rural? The Sequel: The Federal Office of Rural Health Policy has redesigned its website. For its rural health grants, the FORHP has provided specific standards for determining whether an applicant is "rural" and therefore eligible to apply.
For the Rural Health Outreach Grant Program, the Rural Health Network Development Program, and the Rural Access to Emergency Devices Program, each program web page provides a list of rural counties and designated eligible zip codes in metropolitan counties.
The FORHP explains the new method of determining "rural" eligibility as follows: "As in prior years, all counties that are not designated as parts of Metropolitan Areas (Mas) by the Office of Management and Budget (OMB) are considered rural. This year, the Office of Rural Health Policy has used the Rural Urban Commuting Area Codes (RUCAs), developed by the WWAMI Rural Research Center at the University of Washington and the Department of Agriculture’s Economic Research Service, to designate "rural" areas within MAs. The WWAMI Rural Research Center has mapped Census Tracts to ZIP codes and organizations whose headquarters are in the designated ZIP codes are eligible to apply for Rural Health grants, provided they meet all other requirements. More information on RUCAs is available at:
http://www.fammed.washignton.edu/wwamirhrc/."
Note: The new Rural Small Hospital Improvement Program (SHIP) grant has different criteria for eligibility (see section on Grant Opportunities above).
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