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Rural Health Briefing, September 29, 2003
1) Update – Rural Hospital Flexibility (Flex) Program
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Arizona Flex Grant Award
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2003 Flex Grant Highlights
2) National News
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Medicare Reform Legislation
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Indian Country News – IHS Reorganization Comments Sought
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CMS Open Door Forum
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Language Services Action Kit Is Now Available
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HRSA Office of Rural Health Policy All-Programs Meeting
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Universal Service Administrative Company Board of Directors Opening
3) Arizona News
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Telehealth Grant Received
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STEPS Grant Received
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Arizona SHIP Grant Received
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Arizona Rural Health Association News
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Advocacy Training Workshop
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Southern Apache County Public Hearing
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30th Annual Arizona Rural Health Conference
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Governor Napolitano Announces Decline in Smoking Rates
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Legislative Internships Available
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Communicable Disease Reporting Under HIPAA
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Southern Arizona Alliance of Non-Profits
4) Grant Opportunities
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Rural Health Outreach Grant Program Deadline Extended to September 30
5) Services Available through the Rural Health Office
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Arizona Health Provider Resources
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Grant Writing Assistance
6) Upcoming Events
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Northern Arizona Forum
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10th Annual Minority Health Conference, September 30-October 1, 2003
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Interdisciplinary Conference to Address Disparities in Health Status, October 2-4, 2003
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NRHA Critical Access Hospital Conference, October 9-10, 2003
1) Update – Rural Hospital Flexibility (Flex) Program
a) Arizona Flex Grant Award:
The Rural Health Office at the Mel and Enid Zuckerman Arizona College of Public Health received notification of continued funding from the Office of Rural Health Policy (HRSA) to implement the Flex Program. The FY 2004 focus is on quality improvement initiatives, strengthening of emergency medical systems in critical access hospital geographic areas, and helping hospitals to get critical access designation.
b) 2003 Flex Grant Highlights:
- Five hospitals received critical access designation (Hu Hu Kam Memorial Hospital, Parker IHS Hospital, Hopi Health Care Center, Ft. Yuma IHS Hospital, and White River PHS Hospital)
- Initiated Balanced Scorecard quality improvement initiative in five collaborating rural hospitals (Southeast Arizona Medical Center, Parker IHS Hospital, Hopi Health Care Center, Ft. Yuma IHS Hospital, and White River PHS Hospital)
- Initiated an EMS improvement pilot project in southern Arizona with five ambulance services
- Completed a survey of Arizona’s critical access hospitals that sets the stage for the 2004 grant activities
- Sponsored a Western Regional Flex Conference in Phoenix which drew over 180 participants
- Sponsored a rural EMS track at the Arizona Emergency Medical Services Conference in Phoenix, and formed a rural EMS working group to develop a rural EMS strategy for the future
- Generated a comprehensive rural health needs assessment for Arizona (due for publication in winter, 2003)
- Provided mini-grants to critical access hospitals to assist them with quality improvement and HIPAA compliance activities
- Promoted network development activities for critical access hospitals and their partners in the southern area of the State
- Promoted HIPAA training for critical access hospital personnel
- Sponsored quality improvement training in Pneumonia through the state’s Quality Improvement Organization (QIO)
2) National News
a) Medicare Reform Legislation
The Medicare Reform debate continues in Congress, with Senator Jon Kyl being the only member of the Arizona delegation serving on the Senate-House Conference Committee for the Medicare Reform bill.
The National Rural Health Association reports that the conferees met on September 9 to ratify a number of agreements reached by staff over the August recess. Some of the agreements affecting rural provisions relate to improving critical access hospital.
While these agreements have been reached, everything is subject to change until the entire package is agreed to and voted upon. Discussions continue on outstanding issues, including a number of rural provisions. Final agreement is not expected until late this year. For further information check the NRHA website at www.nrharural.org
b) Indian Country News – I.H.S. Reorganization Comments Sought
The Federal Register gave notice on September 17 that the Bureau of Indian Affairs will conduct consultation meetings to obtain oral and written comments regarding issues in the organizational structure of the BIA’s 12 regional offices. Informational sessions were held throughout the country in June to brief Indian Tribes and interested parties about the reorganization. Upcoming consultations will permit interested parties an opportunity to provide comments. Briefings will be at the MGM Hotel in Las Vegas, October 27-30, with the Southwest and Navajo Regional Offices scheduled for October 28. For further information contact the regional director for the Southwest, Rob Baracker at 505-346-7590, and for Navajo, Elouise Chicharello at 505-863-8314, or Denise Desiderio at 202-208-6772.
c) CMS Open Door Forum
The next Centers for Medicare & Medicaid Services Open Door Forums are on September 29 (Forum on Disability) at 2:00 pm, and September 30 (Forum on Skilled Nursing Facility / Long Term Care) at 4:00 pm. (All times are Eastern.) Information on all CMS Open Door Forums can be found at http://www.cms.hhs.gov/opendoor/. To register for these or future Forums by conference call, go to http://www.cms.hhs.gov/opendoor/listservs.asp to subscribe to the invitation list for Open Door Forum Information. The forums are archived and can be listened to after the event. For any questions and concerns contact Alikia Brown or Teresa Mundell at 410-786-9176.
d) Language Services Action Kit Is Now Available
The Access Project and the National Health Law Program have developed a language services action kit for advocates working to ensure that people with limited English proficiency in their state get appropriate language assistance services in medical settings. The kit is available in English and Spanish and costs $25. To order, go to www.accessproject.org and click on the link for Language Services Action Kit.
e) HRSA Office of Rural Health Policy All-Programs Meeting
HRSA’s Office of Rural Health Policy conducted the first ever All-Programs Meeting in Washington, D.C. August 18-22, 2003. The Office of Rural Health Policy, State Offices of Rural Health and Rural Health Research Centers joined grantees from the FLEX, Network Development, Outreach, Delta, Small Hospital Improvement Program, Rural Access to Emergency Devices and the Quentin Burdick Grant Programs. The Arizona contingent was well represented with over 20 participants. Dr. Elizabeth Duke, HRSA Administrator, joined the Arizona State Meeting and listened to the discussion of top health issues in Arizona.
f) Universal Service Administrative Company Board of Directors Opening
The Universal Service Administrative Company has seven openings for the Board of Directors. One of the positions will be filled by a representative for rural health care providers eligible to receive discounts. Nominations must be filed with the Office of the Secretary by October 27, 2003. The Federal Communications Commission contractor, Vistronix Inc., will receive hand-delivered or messenger-delivered paper filings for the Commission’s Secretary at 236 Massachusetts Avenue, N.E., Suite 110, Washington, DC 20002. For further information, contact Sheryl Todd, Telecommunications Access Policy Division, Wireline Competition Bureau at 202-418-7400.
3) Arizona News
a) Telehealth Grant Received
The Arizona Telemedicine Program at the University of Arizona has received a grant from the Office for the Advancement of Telehealth (HRSA) for $250,000 to establish the Arizona Diabetes Virtual Center of Excellence (ADVICE). The grant will establish a virtual diabetes learning center. Grant partners include the Mobile Health Program at the Rural Health Office at the Mel & Enid Zuckerman Arizona College of Public Health; St. Elizabeth’s of Hungary Clinic in Tucson; Tuba City Health Care Corporation; Mariposa Community Health Center in Nogales; Carondelet Health Network Diabetes Center; Children’s Clinics for Rehabilitation Services; Arizona Foundation for the Eye; and the American Diabetes Association.
b) STEPS Grant Received
The Arizona Department of Health Services received $1.4 million from U.S. Department of Health and Human Services to fight diabetes, asthma, and obesity in school-age children and adults in border communities. The project is one of 12 nationally receiving a total of $13.7 million under the U.S. DHHS “Steps to a HealthierUS” Program. The proposed interventions build on existing state and local models, and will involve the Arizona Department of Health Services, the Department of Education, the University of Arizona, and Santa Cruz, Yuma, and Cochise Counties. The lead agencies in each county will be the Cochise County Health Department; Mariposa Community Health Center in Nogales; and Yuma County Cooperative Extension.
c) Arizona SHIP Grant Received
The Arizona State Office of Rural Health Program at the Rural Health Office at the Mel & Enid Zuckerman Arizona College of Public Health received the second year of funding under the Small Rural Hospital Improvement Program. Funds will be distributed to fourteen eligible hospitals to support Quality Improvement and HIPAA compliance activities. In the previous year, $101,000 was distributed to eligible hospitals to support these activities.
d) Arizona Rural Health Association News
New officers were elected to the Board of Directors of the Arizona Rural Health Association. They are:
Edie Faust, President, edithf@imxinc.com
Jack Beveridge, Past President, jbeveridge@pgbha.org
Rhonda Johnson, President-Elect, Rhonda.Johnson@nau.edu
Bob Ohlfest, Treasurer, salbob12@msn.com
Mary Riordan, Secretary, mriordan@ahsi.arizona.edu
The Arizona Rural Health Association has launched a website which includes a job bank. Check it out at www.azrha.org.
The Association passed a number of resolutions dealing with rural health issues at the 30th annual Rural Health Conference in Tucson in July 2003. The Board is in the process of disseminating them to AzRHA members. The resolution issues include Rural Health Payment Issues, Workforce Development, and Tribal-State-County Relationship Building.
e) Advocacy Training Workshop
In collaboration with the three Tribal Rural Health Network Development Program Grantees in Arizona, the Rural Health Office at the Mel and Enid Zuckerman Arizona College of Public Health, held a training on “The Art and Crafting of Indian Health Policy” on August 8 in Phoenix. The grantees are Ndee Health Web at White Mountain Apache Health Department, Gila River Indian Community Department of Public Health, and Southwest Alliance of Navajo, Inc. Two dozen participants from the three programs benefited from presentations by representatives of the Commission on Indian Affairs, The Governor’s Office, Arizona Department of Health Services, AHCCCS, Intertribal Council of Arizona, and Jamieson and Guttierez, a Phoenix public relations group.
f) Southern Apache County Public Hearing
The Arizona State Office of Rural Health Program at the Rural Health Office at the Mel & Enid Zuckerman Arizona College of Public Health collaborated with the Apache County Health Department to hold a public hearing on the “Status of Health Care in Rural Arizona.” The public hearing was conducted on July 14, 2003, in Springerville. Testimony was presented before State Representative Jake Flake; State Senator Jack Brown; Congressman Rick Renzi (representative); Cathy Eden, Arizona Department of Health Services Director; Don Foster, Apache County Health Department Director; David Brown, District III Supervisor; and Alison Hughes, Rural Health Office Director.
g) 30th Annual Arizona Rural Health Conference
The 30th Annual Arizona Rural Health Conference, “Preserving Arizona’s Rural Health Safety Net,” was held July 21-23 in Tucson. Four Plenary Sessions were held, over 25 workshops were presented across the four conference themes, and the Annual Arizona Rural Health Service Awards were presented. The conference was sponsored by the Rural Health Office at the Mel and Enid Arizona College of Public Health in partnership with the Arizona Rural Health Association. Cosponsors included the Community Partnership of Southern Arizona, and the Eastern, Northern, Southeast, and Western Arizona Area Health Education Centers. Many of the conference workshop presentations and other information can be found at www.rho.arizona.edu.
h) Governor Napolitano Announces Decline in Smoking Rates
The 2003 Arizona Student Health Survey shows that an increasing number of Arizona high school and middle school students are avoiding tobacco use and the deadly addiction that comes with it. Governor Napolitano announced the results of the survey on September 18 in Phoenix. The Arizona Department of Health Services conducted the Survey during the spring semester 2003 in Arizona Public and Public Charter Middle and High Schools. The survey also revealed a new trend – that girls are now smoking as much as boys. ADHS Director Catherine Eden said the data points to the need for more gender specific anti-tobacco efforts, such as the Department’s “It’s a Girl Things” campaign. For more information on Arizona anti-tobacco effort, visit www.tepp.org
i) Legislative Internships
The Arizona Legislature provides many internship opportunities for qualified applicants. Legislative Internships are available to candidates for a BA or MA degree with a GPA of 3.0 or higher at one of Arizona’s universities. For more information, go to http://www.azleg.state.az.us/ and click on “2004 Internship Opportunities.”
j) HIPAA Regulations and Communicable Disease Reports
Elizabeth MacNeill, Chief Medical Officer for Pima County Health Department, issued a statement on August 18 regarding healthcare providers’ concerns that the new HIPAA regulations prevent them from making communicable disease reports to their local health departments. The reporting of communicable diseases, as required by state and federal laws, is exempt from HIPAA, as is other required reporting – such as births and deaths. Go to www.cdc.gov/mmwr/preview/mmwrhtml/su5201a1.htm for the rule on Permitted PHI Disclosures Without Authorization.
k) Southern Arizona Alliance of Non Profits
This is new organization whose purpose is to strengthen the capacity and collective power of the non-profit sector, to enhance quality of life in communities. There is a particular interest in rural communities. For more information contact the website at: www.progressivist.org, or Kevin Muir at
kevmuir@progressivist.org
4) Grant Opportunities
a) Rural Health Outreach Grant Program Deadline Extended to September 30
The Application Deadline for the Rural Health Outreach Grant Program has been extended to September 30, 2003. To read more about the Outreach Grant Program, go to www.ruralhealth.hrsa.gov/funding/outreach.htm.
5) Services Available through the Rural Health Office
a) Arizona Health Provider Resources (AHPR) Program
The AHPR Program works on recruitment and retention issues for physicians and other healthcare providers. For more information, contact Marcos Rodriguez, Senior Program Coordinator, marcos@u.arizona.edu.
b) Grant Writing Assistance
The Arizona State Office of Rural Health (SORH) Program offers technical assistance to rural communities for grant writing, leveraging funds, and building collaborative partnerships. For more information, contact Jennifer Peashock, Instructional Specialist Coordinator, peashock@u.arizona.edu.
6) Upcoming Events
a) 10th Annual Minority Health Conference, September 30-October 1, 2003
“People of Color Celebrating Healthier Communities While Addressing Treatment”
Holiday Inn and Convention Center
Kearney, NE
HHS Office of Minority Health
(402) 471-0152
b) Interdisciplinary Conference to Address Disparities in Health Status, October 2-4, 2003
“Making Connections/Conexiones: An Interdisciplinary Conference to Address Disparities in Health Status in the American Southwest”
Las Cruces, NM
New Mexico State University Campus, Las Cruces
www.nmsu.edu/CHSS/connectconf/
c) NRHA Critical Access Hospital Conference, October 9-10, 2003
Kansas City, MO
Westin Crown Center
www.nrharural.org
d) Northern Arizona Forum on Rural Healthcare, October 14, 2003
Contact: Rhonda Johnson: Rhonda.Johnson@NAU.EDU
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