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Rural Health Briefing October 8 2004
National News
1. Indian Health Care Improvement Act Near Reauthorization
2. HRSA Reorganization
3. Redefining “Rural” Could Aid EMS
4. New Patient Safety Newsletter from AHRQ
5. American Indian and Alaska Native Healthcare Discussed in Webcast
Across Arizona
1. Nursing Education Shortage Focus of AzHHA Effort
2. College Ranks Among Top 10 in Minority Enrollment
3. Mobile Health Program Applies Telemedicine
4. Advance Directives Registry Starting
Grants and Opportunities
1. Technical Assistance Funding Available from NRHA
2. HRSA 2005 Funding Review
a) Rural Emergency Medical Service Training and Assistance Program
b) Public Access Defibrillation Demonstration Projects
c) One Year Rural Health Research Grant Program
3. Partnerships in Implementing Patient Safety
4. Arizona Dollars for Young Scholars in Healthcare
5. Health Funding Watch Newsletter
6. Health Care Training from Department of Labor
Calendar
- October 12, U.S.-Mexico Border Health Commission Binational Health Week Inaugural Events, Nogales and Rio Rico, ArizonaOctober 12, Screening for Depression and Suicide, Noon, Rural Mental Health Grand Rounds Webcast
- October 13, Fourth Annual Northern Arizona Rural Health Forum, Flagstaff
- October 14-15, 19th National Hispanic Women’s Conference “Latina Power!” Phoenix
- October 14-15, Access to Health Care in the U.S.-Mexico Border Region: Models, Research, Policy and Action, El Paso, Texas, contact Sonia R. Medina at 520-626-7946, ext. 244 for registration details
- October 19, Media & Children: Effects on Behavior, Attitudes, and Policy Implications, Noon-1:00 p.m., a public health seminar videoconference ponsored by the Arizona Telemedicine Program
- October 21, 2004 Public Health Leadership Forum, Phoenix to Jennie Mullins, 626-3200, ext 106, or mullinsj@u.arizona.edu
- October 24-27, 23rd Annual Expo of National Association of Home Care and Hospice’s, Phoenix
- October 27-29, 12th Annual EPA-Region 9 Tribal Environmental Conference, San Francisco, California
- October 29, Arizona Rural Health Association Board Meeting, 10:00 a.m.-Noon, teleconference, contact Mary Riordan.
- November 4-5, Healthcare without Harm: Taking it to the Top, Arizona Hospitaland Healthcare Association Annual Leadership Conference, Phoenix
- November 6-10, American Public Health Association 132nd Annual Meeting, Washington, D.C.
- November 18, The Sustainability Toolkit: 10 Steps to Maintaining Your Community Improvements, audioconference sponsored by the Association for Community Health Improvement
- November 19, Southern Arizona Rural Health Forum, Tucson
- December 8, Arizona Healthcare Forecast 2005: Crisis or Opportunity?, St. Luke’s Health Initiatives, Phoenix
- December 9, Surveillance of Vaccine-Preventable Diseases, CDC udioconference
Mark Your Calendars!
- January 12, 2005, Health Policy Forum, Phoenix
- March 21-23, 2005, Rural Health Policy Forum, Washington, D.C.
- June 8-10, 2005, Third Annual Western Region Flex Conference, Phoenix
National News
Indian Health Care Improvement Act Near Reauthorization
Described as the first substantive step forward in Indian health care in over a decade, the Indian Health Care Improvement Act of 2003 passed through House and Senate committees as thousands of Indians converged on Washington to celebrate the opening of the new National Museum of the American Indian. The legislation, if enacted, would allow tribes to recruit and retain more health professionals and put more resources into disease prevention. The House bill, H.R. 2440, would elevate the I.H.S. Director to Assistant Secretary of Indian Health. The Senate bill is S-556. The original Indian Health Care Act was enacted in 1976 and expired in 2001.
HRSA Reorganization
Recent organizational changes at HRSA placed the Division of Border Health under the administrative jurisdiction of the Office of Rural Health Policy.
Other organizational changes include moving the 340B Drug Pricing Program to the Healthcare Systems Bureau.
Redefining “Rural” Could Aid EMS
"An Alternative Approach to Defining Rural for the Purpose of Providing Emergency Medical Services," is a 21-page report recently released by The Technical Assistance and Services Center (TASC) for the Medicare Rural Hospital Flexibility Program. The report suggests an alternative to the method currently used by CMS for Medicare reimbursement and it includes a method of tiering "ruralness" for ambulance services. It builds on the general consensus in the ambulance industry that a definition of rural for ambulance payment must be made at the sub-county level. Maps of the model for each state are also posted on the web site. The document and maps may be accessed by going to the EMS Section of the TASC web site and then scrolling down to Resources.
New Patient Safety Newsletter from AHRQ
The Agency for Healthcare Research and Quality (AHRQ) has announced a new electronic newsletter that will include important patient safety news. It will feature concise descriptions of findings from AHRQ’s published research, announcements of new products and tools, as well as updates on initiatives, meetings and developments in the quality and safety field. Subscription information available at http://www.ahcpr.gov/qual/ptsflist.htm
American Indian and Alaska Native Healthcare Discussed in Webcast
Charles Grim, Director, I.H.S. joined with Yvette Roubideaux of the University of Arizona and Jim Crouch of the California Rural Indian Health Board to examine the state of healthcare in the American Indian and Alaska Native communities. The discussion ranged from the adequacy of funding to meeting the unique needs of both rural and urban populations. It also highlighted efforts to improve access to other health care resources.
The webcast was sponsored by the Kaiser Family Foundation and can be viewed at http://www.kaisernetwork.org/health_cast/.
Across Arizona
Nursing Education Shortage Focus of AzHHA Effort
The Campaign for Caring Awareness & Attraction (A&A) Work Group of the Arizona Hospital and Healthcare Association (AzHHA) is starting a grassroots advocacy outreach initiative to focus on the lack of capacity in Arizona's nursing education programs. The initiative will coincide with the 2005 legislative session. A&A Work Group members are identifying and recruiting hospital representatives-executives, healthcare professionals, physicians and volunteers-who will meet with business and service organizations as well as editorial boards and legislators about lack of capacity in Arizona's nursing programs.
Prior to launching the grassroots outreach initiative, A&A Work Group members will host training sessions with the selected participants to review the project materials and messages. For more information, contact AzHHA's Bridget O'Gara at 602-445-4300, ext. 4318, or bogara@azhha.org.
College Ranks Among Top 10 in Minority Enrollment
The Mel and Enid Zuckerman Arizona College of Public Health (MEZACOPH) ranks first in American Indian students enrolled and sixth in Hispanic students enrolled among 33 accredited schools of public health, according to recent data from the national Association of Schools of Public Health (ASPH).
In ASPH’s most recent annual data report (published May 2004), about 35 percent of students enrolling in fall 2003 at MEZACOPH were from minority populations; 13 percent identified themselves as Hispanic and 9.1 percent identified themselves as American Indian/Alaskan Native. The College also provides 20 fellowships a year to minority students through Project EXPORT.
Mobile Health Program Applies Telemedicine
The Rural Health Office Mobile Health Program (MHP) is expanding its diabetes self-management program by applying the tools of telemedicine. Building on the network of partners in underserved communities in Marana, Morenci, Cochise and Pinal counties among others, the MHP will offer eye and foot screening in their program of improving patient education and self-management of diabetes. A non-mydriatic camera will be used for retinal screenings and the Aung foot-screening tool will allow standard measurements for proper referral for pathology.
The Office of Health Systems Development, Arizona Department of Health Services (ADHS) funded the project, with Susan Woodruff as the principal investigator. This pilot project is called ADHS’s Continuing Care Clinic Model and runs from September 2004 to June 2005.
Advance Directives Registry Starting
Arizona will soon have a statewide Advance Health Care Directive Registry. Beginning in December, Arizonans will be able to access a website to indicate their wishes for medical treatment if they become too injured or too ill to speak to medical staff. The registry will contain residents’ advance healthcare directives, including a living will, medical power of attorney and mental health power of attorney. Arizona is the fourth state in the nation to offer this service and only the second to do it at no cost to its citizens. The registry will be housed on the Arizona Secretary of State’s website.
Families, physicians and hospitals would have access to the documents only through a code and password, to maintain confidentiality. To cover the costs, estimated at $60,000 per year, Hospice of the Valley is coordinating a fundraising effort. For more information, contact Barbara Volk-Craft, Health Care Decisions, the non-profit arm of Hospice of the Valley, at 602-287-7053 or e-mail mailto: bvolkcraft@hov.org.
Grants and Opportunities
Technical Assistance Funding Available from NRHA
The Community and Migrant Health Center (C/MHC) program enables rural primary care providers and rural communities to obtain federal assistance to pay for care for low-income individuals who do not have health insurance. C/MHCs are comprehensive local health care providers that are governed by a community board.
The National Rural Health Association (NRHA) is offering technical assistance to all rural communities interested in learning more about this program and/or applying to become a C/MHC. They will answer basic questions and can send C/MHC experts to educate local leaders about the program. NRHA can also provide funds to help write and/or edit applications. Direct all inquiries to Shelly Ten Napel at mailto:tennapel@NRHArural.org or 703-519-7910.
HRSA 2005 Funding Review
HRSA has released application guidance preview information for a range of 2005 competitive grant programs including several in rural health. Further details can be found at ftp://ftp.hrsa.gov/guidance05/preview.pdf. Note: The programs are not included in the current Federal budget for FY 2005. Potential applicants for these funds should consider this announcement provisional until final Congressional action on appropriations is taken.
(a) Rural Emergency Medical Service Training and Assistance Program (REMSTEP)
HRSA-05-116
Application deadline: January 10, 2005 (Application available on November 10)
The REMSTEP program seeks to fund entities that propose to develop improved emergency medical services in rural areas. To be eligible, the entity must be located in or serve residents of a non-metropolitan statistical area, an area designated as a rural area by any law or State regulation, or the most recently published Goldsmith Modification.
For further information, contact Evan Mayfield, 301-443-0835.
(b) Public Access Defibrillation Demonstration Projects (PADDP)
HRSA-05-006
Application deadline: January 10, 2005 (Application available on November 10)
This program will support projects that will increase public access to emergency medical services and devices. Applications will be evaluated based on how well the project: (1) demonstrates the greatest community need for services and programs, (2) uses innovative, comprehensive, community-based public access to defibrillation, or (3) proposed an effective mechanism for the collection of data regarding resuscitation, defibrillation, and survival rates within the setting served by the project.
For further information, contact Blanca Fuertes, 301-443-0835.
(c) One Year Rural Health Research Grant Program
HRSA-05-005
Application deadline: March 11, 2005 (Application available on January 14, 2005)
Recipients of these grants will conduct and disseminate policy-relevant research on issues of national significance in the area of rural health services. Recipients will examine critical issues facing rural communities in their quest to secure adequate, affordable, high quality health services. Research findings will be of interest to national, state and local decision makers with concerns about rural communities.
For further information, contact Nisha Patel, 301-443-0835.
Partnerships in Implementing Patient Safety
RFA-HS-05-012
Application deadline: January 19, 2005
The partnerships in implementing patient safety grants are to assist health care institutions in implementing safe practice interventions that show evidence of eliminating or reducing medical errors, risks, hazards, and harms associated with the process of care. These implementation projects will inform AHRQ, providers, patients, payers, policy makers, and the public about how safe practice interventions can be successfully implemented in diverse health care settings and lead to safer and better health care for all Americans.
In FY 05, AHRQ intends to commit up to $3 million in total costs to fund up to 10-15 new grants. Because the nature and scope of the projects will vary from application to application, it is anticipated that the size and duration of each award will also vary. Applications can be up to 24 months in duration with a budget supported by AHRQ not to exceed $300,000 per year in total costs to the government.
Applications must be prepared using the PHS 398 research grant application instructions and forms. The PHS 398 is available at http://grants.nih.gov/grants/funding/phs398/phs398.html in an interactive format. For further assistance contact GrantsInfo, 301-435-0714, Email: GrantsInfo@nih.gov.
Arizona Dollars for Young Scholars in Healthcare
Arizona Hospital and Healthcare Association’s Campaign for Caring has developed a descriptive listing of scholarships available for students seeking careers in health care. Awards range from $7,000 (BHHS Legacy Foundation Scholarship) to $500 (John C. Lincoln Hospital – Deer Valley Volunteers Scholarship). The institutional sponsors start with the Arizona Heart Hospital and end with Yuma Regional Medical Center. Many programs are targeted for nurses, lab technologists, pharmacists and respiratory therapists but other health professions are also included. Other criteria apply to individual programs. See full information at the Dollars for Scholars program http://www.azcaringcareers.com/loc.cfm?page=dollschol.
Health Funding Watch Newsletter
In Health Funding Watch, a newsletter from the Foundation Center devoted to the nonprofit health sector, you'll find an item on a study of high-deductible plans often touted as the answer to rising healthcare costs; links to other health-related news items from Philanthropy News Digest; funding opportunities for individuals and organizations; and health-related job opportunities. Register to receive this free newsletter at http://www.fdncenter.org/.
Health Care Training from Department of Labor
Application deadline: November 2
The Department of Labor is offering $10 million in demonstration grants to address labor shortages, innovative training strategies and other workforce challenges in the health care and biotechnology fields. Health care applicants are encouraged to submit projects that address shortages if qualified faculty to teach nursing and other health care-related skills in community colleges, focus on new or untapped labor pools, or competency models and career ladders for specialty nursing and allied health fields.
Further details are available at http://www.doleta.gov/BRG/JobTrainInitiative/RecentNews.cfm.
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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