Public News Service Reports on CRHC's New Story-Collecting Project

Stories to put in the bank might help ensure better health-care quality and access for everyone. Starting next year, Coloradans will be invited to record their health-related stories, which will be categorized and shared with the public.  PNS Reporter Deb Courson explains...

Letter from the CEO: CRHC Engages in Effort to Reduce Rural Hospital Readmissions

Lou Ann Wilroy, CEO
One of the top focus areas currently for CRHC’s Program Director, Michelle Mills, is leading our iCARE program. I’m very excited about this effort because it represents a new high point for our quality improvement work.

The iCARE (Improving Communication and Readmission) project’s focus is on reducing costly hospital readmissions among our state’s Critical Access Hospitals (CAHs). Readmission is often considered to be an urban problem. While it is true that the smaller healthcare systems don’t struggle as much with hospital readmission as larger ones, systems large and small can improve on this front.

For hospitals of all sizes, readmissions are especially a problem for patients struggling with pneumonia and heart failure. Unplanned readmission to hospitals cost the government about $17 billion annually, according to a recent study in the New England Journal of Medicine. The study found 2.3 million, or 20%, of Medicare beneficiaries were readmitted to the hospital within 30 days. The majority of those readmissions were related to issues such as heart failure and pneumonia.

At CRHC we understand that rural hospitals operate differently than their urban peers, so our readmissions/care transitions program is different too. In short, iCARE is not as prescriptive as many other readmission efforts because we appreciate that rural facilities need more flexibility in how they participate in quality improvement programs.

While communications in rural facilities might be less challenging due to their smaller size, the handoff to large urban facilities is a different equation, one that too often results in readmissions. The iCARE program is focused on implementing protocols that make the rural/urban transfer more predictable and thus less likely to result in a readmission.

Because paramedics play such a critical front line role in rural areas, Michelle Mills and the other members on our iCARE team are intent on making sure these professionals are part of the solution to readmissions. According to Michelle, “the iCARE program is based on CRHC’s strong understanding that the entire community plays a role in offering patient centered care.”

Of course our care transitions team is not skipping past the basics. Discharge instructions and medication reconciliation are being scrutinized, as well as an examination at how closely those instructions are understood and followed. Because our rural facilities run from border to border, we will be using webinars to make program content accessible to all.

If you have questions, or would like to learn more, please get in touch with Michelle Mills at mm@coruralhealth.org. Michelle is participating in a statewide Hospital Readmissions Task Force that has been formed by the Center for Improving Value in Health Care. The Task Force is coordinating efforts like CRHC’s iCARE with other readmissions work such as the Colorado Hospital Association’s Project RED and the Colorado Foundation for Medical Care’s Care Transitions Program.

Apply now for up to $50,000 of rural health infrastructure funding!


The deadlines have been set for the fourth cycle of the Colorado Rural Health Care Grant Program, with letters of intent due on January 14, 2011 and applications due on March 9, 2011.  Organizations that are located outside of Colorado’s urbanized areas that provide outpatient primary care services—including medical, oral, and mental health services—are eligible to apply.  Grants will be funded for projects that support the rural health infrastructure and strengthen the capacity of rural entities to provide outpatient primary care services now and in the future.  This grant program is funded by the UnitedHealth Group with $2 million in grant funds available for this grant cycle. The maximum award amount is $50,000 per applicant.

Contact Shelly Collings at sc@coruralhealth.org or 720.248.2742 with questions.

Happy Holidays!


'Tis the season to be grateful, and we at the Colorado Rural Health Center want to thank you for all your support in 2010.  We wish you a happy and healthy holiday season and a fantastic new year!

If you are not currently an Investing Member, we encourage you to consider joining now or renewing your membership for 2011.  As a CRHC Investing Member, you can get discounts to our many events, access to countless rural health resources, and become eligible for programs that can save your organization money. To learn more about Investing Membership, visit the CRHC website.

Happy Holidays!
From the CRHC Board & Staff

Read Now: the Colorado Behavioral Health Workforce Report

The Colorado Health Foundation and the WICHE Mental Health Program joined forces to produce The Behavioral Healthcare Workforce In Colorado: A Status Report 2010. The report details current behavioral healthcare workforce issues in Colorado and discusses how to capitalize on the existing energy and expertise in the state to develop a more coordinated and focused effort to enhance our behavioral healthcare workforce.

St. Anthony Summit Medical Center named '2010 Top Hospital' for outstanding achievement in patient safety and quality care

This is an excerpt from a news release posted to PR Newswire. To access the full article, click here.

The Leapfrog Group's annual class of top hospitals was announced on December 2 in Washington, DC at Leapfrog's 10th anniversary meeting and named St. Anthony Summit Medical Center, a Centura Health hospital, in Frisco, Colorado. St. Anthony Summit Medical Center was selected as one of only five rural hospitals nationwide.

The 2010 list includes 65 hospitals nationally; 53 urban, 5 rural, and 7 children's hospitals. The selection is based on the results of The Leapfrog Group's national survey that measures hospitals' performance in crucial areas of patient safety and quality. It is the most complete picture available of a hospital's quality and safety.

"Being named among the top hospitals in the country by Leapfrog is a tremendous honor. That recognition means that St. Anthony Summit Medical Center has demonstrated that it saves lives by delivering safe and high quality health care. That's health care with true value; the kind of health care that we all want and expect from the health care delivery system every day. The Colorado Business Group on Health congratulates St. Anthony Summit Medical Center and its CEO, Paul Chodkowski, for their ongoing dedication to patient safety and quality as indicated by this award," said Tammy Kirk, President, Colorado Business Group on Health.

The Hospital Survey focuses on four critical areas of patient safety: the use of computer physician order entry (CPOE) to prevent medication errors; standards for doing high-risk procedures such as heart surgery; protocols and policies to reduce medical errors and other safe practices recommended by the National Quality Forum; and adequate nurse and physician staffing. In addition, hospitals are measured on their progress in preventing infections and other hospital-acquired conditions and adopting policies on the handling of serious medical errors, among other things.

For a complete list of 2010 Leapfrog Top Hospitals, visit http://www.leapfroggroup.org/.

To access the full article, click here.

Fall 2010 CROP Awardees Announced!

Congratulations to these providers, who were awarded Colorado Rural Outreach Program (CROP) retention grants!

AwardeeProvider TypeType of AwardAward Amount
Grand River Hospital District, RifleRegistered NurseLoan Repayment$10,000
Delta Memorial HospitalEmergency Medicine PhysicianLoan Repayment$10,000
Plains Medical Center, LimonFamily Practice PhysicianLoan Repayment$10,000
Valley-Wide Health Systems, AlamosaPhysical TherapistLoan Repayment$5,000
Valley-Wide Health Systems, AlamosaPharmacistLoan Repayment$5,000
Fort Morgan medical Group, Fort MorganPhysician AssistantLoan Repayment$5,000
Lincoln Community Hospital, HugoPhysician AssistantLoan Repayment$5,000
Rocky Mountain Family Practice, LeadvilleTwo Physician AssistantsBonuses$3,250 each
Telluride Medical Center, TellurideRegistered NurseLoan Repayment$3,000
Gentle Dental, GunnisonDental HygienistLoan Repayment$2,000
TOTAL AWARDSFall 2010$63,250

Revitalizing Julesburg

This is an excerpt from an article in the Julesburg Advocate.  To access the full article, click here.

A team of six professionals who deal with the inner-workings and the infrastructure of municipalities converged on Julesburg last Tuesday. They had one focus on their mind...Julesburg.

The assessment was paid for through a grant provided by DOLA, the Town of Julesburg, and the Sedgwick County Commissioners.

The team met with representatives from the business community, local foundations, elected officials , healthcare providers, historical society, housing authority, library board, school system, welcome center, service organizations, financial institutions along with farmers and ranchers from the area over the course of six “group” meetings. They also toured the town, businesses, and surrounding area to get a feel for the community.

Julesburg can expect a full report in 6 weeks. The matrix will outline specific steps to be taken as well as the best suited organization to perform it and timeline to follow. Focus areas will include organization, promotions, economic restructuring, design, healthcare and funding. The team will do a follow up in six months then and will interject suggestions as needed.
 
To access the full article, click here.

Community Paramedics Widen Medical Services in Rural Areas

Photo courtesy of
the Rural Monitor Newsletter.
This is an excerpt of an article from the Rural Monitor Newsletter. Click here to access the full article.

Chris Berdouly is excited about the new challenges he will encounter this fall when he begins going into homes in western Colorado as a community paramedic, providing primary care for patients with chronic illnesses and medical needs.

“We’ll still be EMS providers doing what we normally do but adding this service in our counties will be great, saving money and ultimately giving people better care,” said Berdouly, who works for the Western Eagle County Ambulance District (WECAD) in Colorado’s Eagle and Garfield counties. “We’re in this job because we’re all people persons and we think it will be satisfying to help people in a different capacity.”

Paramedics Kevin Creek, Kate Hawthorne, and Eric Gundlach are participating in the community paramedic program in Colorado state.WECAD and a Minnesota EMS program have been selected for a five-year pilot program by the Community Paramedic Program, a program run by the Community Healthcare and Emergency Cooperative that focuses on expanding the EMS role by training emergency personnel to provide primary care and public health in underserved areas.

To access the complete article, click here.

2011 Public Policy Agenda from the Colorado Health Professions Workforce Policy Collaborative

The Colorado Health Professions Workforce Policy Collaborative has released their 2011 Public Policy Agenda, which is an update to the 2010 document--the first of its kind.  This year's version includes policy changes from last year, newly available data and plicy analysis, and the ongoing inter-professional dialogue among members and participants of the Collaborative.

Letter from the CEO: Creating patient-centered medical homes in rural Colorado

Photo from Spanish Peaks
www.sprhc.org/clinic.html
Spanish Peaks Regional Health Center in Walsenburg has something to crow about. On November 1st the facility learned it is the first Critical Access Hospital in Colorado to obtain National Committee for Quality Assurance (NCQA) patient-centered medical home certification for its outpatient primary care clinic.

Bill Bolt, CIO/Practice Administrator, Spanish Peaks Regional Health Center, said the process of gaining the certification is allowing the facility to deliver better care. “Perhaps the most important new processes we have now are the ones that focus on patients being full partners in working to improve their own health,” Bolt said. He said NCQA-required data measurement processes will also be critical to their continued success.

A look at the websites below will demonstrate how much energy is being funneled toward the medical home concept in Colorado. The sites also give you a sense of the importance healthcare leaders put on the successful implementation of medical home systems. But first, what is a medical home? And what does it look like in rural Colorado?

It’s you (or could be you). Here’s why: you know your patients and their families; you don’t deliver duplicative care because you know what care you’ve delivered. Your patients know to come to you for care coordination (okay, often in your rural community there is nowhere else for them to go); you keep track of their tests and immunizations so you can alert them when one or both are recommended; you are their one-stop medical shop.

NCQA certification provides an opportunity to adopt evidence-based practices and track and measure clinical outcomes. Hopefully, as the adoption of this model becomes more widespread, it will lead to payment reform that is focused on reimbursement based on patient outcomes instead of fee for service.

While none of this sounds especially over-the-top in terms of innovation, it is different in urban areas. In larger communities it is not unusual for patients to receive care from a myriad of facilities, none of which communicate especially well (or at all) with each other. Diagnoses are missed. Expensive tests are performed multiple times. Patients are left confused at what to do or who to see and miserable due to the many hours spent waiting for appointments and for the drain the appointments put on their bank account. Payers aren’t happy; the whole merry-go-round costs a fortune. Employers, watching their productivity tank, are wondering why all their workers seem to need endless amounts of care for what are often very treatable maladies.

Medical homes first appeared on the scene as a concept back in the late 1960s, with a pediatric focus. The idea emphasized the importance of centralized medical records for children with special healthcare needs. Since that time the concept has migrated to influence the delivery of care to patients of all ages, and includes incorporation of evidence-based guidelines, referral coordination, cross-cultural sensitivity, and a sophisticated health information technology platform. Medical homes provide accessible, family-centered, continuous care that recognizes the patient as a whole person.

CRHC is honored to be working with rural health facilities across Colorado in pursuing medical home status through our Rural Health Clinic technical assistance programs. We are currently in the second year of a three-year, $1.5 million grant from the Colorado Health Foundation. In close partnership with Health TeamWorks, the work involves 22 clinics in southeastern Colorado. CRHC’s Matt Guy, based in Pueblo, is our point person for this effort. The ultimate goal is for these clinics to become NCQA certified as patient-centered medical homes.

We are working in partnership with the Colorado Community Health Network and ClinicNET on an initiative funded by the Commonwealth Fund, focusing on 13 Colorado safety net clinics pursuing medical home status.

For more information about other Colorado medical home initiatives you can visit the following websites, or contact Matt Guy at mg@coruralhealth.org so he can help you understand more about what is happening with medical homes in Colorado and nationally.

Renew your CRHC membership for 2011

CRHC is pleased to introduce a revised structure for the 2011 membership campaign. We crafted the changes to balance the cost of membership investment with the financial strength of each member organization. We have done this by basing membership rates on a Full Time Employee (FTE) model. For organizations with multiple sites, only one membership is necessary under the parent organization for total number of FTEs across all sites.

We thank the members who contributed their best thinking to help ensure the revised membership program is balanced, equitable and capable of cultivating healthy and vibrant communities throughout rural Colorado.

As an Investing Member, you will enjoy numerous benefits--click here to read more about these benefits.

To renew your investment as a CRHC member, please click here.

Thank you again for your continued support!

BIG NEWS! Spanish Peaks Family Clinic achieves Level 1 Patient Centered Medical Home status!

Photo from Spanish Peaks
www.sprhc.org/clinic.html
Spanish Peaks Family Clinic in Walsenburg is the first primary care clinic in Colorado owned by a Critical Access Hospital to receive the prestigious recognition as a Level 1 Patient Centered Medical Home by the National Committee on Quality Assurance (NCQA).  Spanish Peaks Family Clinic is one of only three non-urban clinics in Colorado to receive this designation, and will be the only federally designated Rural Health Clinic (RHC)  in Colorado with this recognition upon completion of RHC designation process.  The providers and staff at Spanish Peaks Family Clinic have been working with staff at the Colorado Rural Health Center for the past year and a half to change the way they approach patient care.  The designation at a Level 1 Patient Centered Medical Home is a reflection of Spanish Peaks Family Clinic’s efforts in transforming the care provided to the people of Walsenburg, Huerfano County, and the surrounding area.  Spanish Peaks is planning to continue to improve their patient focus over the next few months, and is looking forward to apply for the highest NCQA recognition, Level 3 Patient Centered Medical Home recognition, in 2011.

Colorado Health Service Corps loan repayment award applications due November 30

Primary care physicians, physician assistants, advanced practice nurses, licensed mental health professionals and oral health professionals may be eligible for significant educational loan debt forgiveness of up to $105,000 through the Colorado Health Service Corps. To participate in this program, health professionals must be employed or seeking full-time employment, in an outpatient primary care practice in an area of Colorado with a health professional shortage. Successful applicants will demonstrate a commitment to caring for underserved people and agree to a term of service of two or three years. Primary health providers who practice in rural and urban underserved communities may qualify. The new applications period runs from November 1 to November 30.

For more information on specific eligibility requirements and to complete the online application, visit http://www.coloradohealthservicecorps.org/ or call 303.692.2466.

$9.6 Million Grant to Increase Understanding, Support for Health Care Improvements in Colorado

The Colorado Trust announced today that it has made grants to 14 organizations to increase Coloradans' understanding of health care issues, and their support for improved health coverage and a more effective, cost-efficient health care system. Research conducted by The Colorado Trust shows that Coloradans want to count on the health coverage and care they need to stay healthy, but that they are distrustful of both profit-driven health care and government involvement.

With $7.6 million in support from The Colorado Trust, and an additional $2 million from the Colorado Health Foundation, these grants will support communications, advocacy and leadership activities over three years to help Coloradans gain a better understanding for how health care can be strengthened.

The Colorado Rural Health Center, in partnership with ClinicNET and the Colorado Coalition for the Medically Underservered will be collecting and sharing stories of Coloradans' experiences in the health care system about what works, challenges encountered and possible improvements

For additional information, contact Christie McElhinney, Vice President of Communications and Public Affairs for The Colorado Trust.

Rural Health Care Leadership Conference: Jan 30-Feb 2, 2011

January 30-February 2, 2011; Phoenix, AZ
Health Forum and the American Hospital Association are presenting the 24th Annual Rural Health Care Leadership Conference in Phoenix, AZ next year. Details on the conference can be found at www.healthforum.com/rural. Please click here to download the conference brochure.

Colorado Business Districts Receive Grant Award

Main Street of Fowler, CO
Three rural communities, along with the Five Points neighborhood in Denver, will receive $1.28 million in Federal grant dollars from the U.S. Department of Housing and Urban Development and the Department of Transportation to help revitalize their downtown business districts. This funding will support production of sorely needed housing and clean-up in the community’s historic “Main Street” area, allowing for renovation of historic buildings and improvements for downtown walkways in the Five Points neighborhood of Denver, the City of Rifle on the West Slope, the City of Monte Vista in the San Luis Valley and the Town of Fowler in the southeast.

Wayne Snider, Administrator for the Town of Fowler, noted that this grant will help fund both the rehabilitation of their historic 1911 theater and extension of solar power to many stores in the main street area. Solar is already an important component of Fowler’s energy use, allowing for their energy rates to run between 40 and 50 percent of the state average. Fowler believes that these factors will influence the decisions of healthcare providers that the town is trying to recruit through CRHC's Colorado Provider Recruitment program.

We have been watching the Sustainable Main Streets Initiative closely, due to the connection between developing and maintaining community amenities and recruiting and retaining healthcare workforce. Our Colorado STRIDES Program Manager, Clint Cresawn said, “It’s my job to help healthcare providers fall in love with rural Colorado. I know healthcare providers are attracted to communities that develop and maintain their unique assets, so when two communities are competing for the attention of the same healthcare provider, amenities such as walkability, historic preservation, and housing can be the deciding factor on which community the provider chooses.”

In areas all across rural Colorado, community amenities are important not only to healthcare providers, but also to other professionals such as educators and business owners. The improvements that Fowler, Monte Vista, and Rifle will be able to make will certainly enhance their ability to recruit and retain professionals!

Congratulations, rural Colorado, on this major grant award!

Flu Prevention Toolkit

For the fifth year, CDPHE is providing a Toolkit of resources about influenza prevention. The goal is to mobilize and support the immunization of healthcare providers and the patients whose health they protect.

This year’s toolkit has two major improvements:
  1. The toolkit content is available exclusively on line at http://www.immunizecolorado.com/;
  2. We are pleased to offer a variety of newly designed marketing materials to educate Colorado’s providers and patients about the importance of getting a seasonal flu vaccination.
The “No Excuses” campaign materials can be ordered from our printing partner by going to: flutoolkit.thinkbigsolutions.com or by selecting “Order 2010-11 Marketing Materials” on the left hand menu of the Colorado Adult Immunization Coalition website http://www.immunizecolorado.com/. There is no charge for most of these materials but supplies are limited, so act soon!

Denver Post spotlights healthcare in one rural Colorado community

In Saturday's article, "In tiny Crawford, health reform has one face: "Our Jenny," nurse practitioner", the Denver Post highlights Crawford, Colorado's sole healthcare provider and her struggle to serve her community.  Although health reform is intended to help people just like them, many residents are still opposed to the idea of forced insurance coverage.  Click on the link above to access the entire article and read about the challenges they're facing and how they're working to overcome them.

One CRHC staff member was able to attend the fundraising benefit mentioned in the article, and was so impressed by the spirit of community and commitment Crawford showed.  CRHC is proud to support all of our hard-working rural clinics and hospitals!

EHR Vendor Symposium

The EHR Vendor Symposium, presented by CRHC and ClinicNET, and sponsored by the Colorado Health Foundation, COPIC, and the High Plains Research Network, was held October 13-14 in Aurora, and showcased the many different Electronic Health Record products available.  Nearly 140 attendees watched demonstrations by nine different EHR vendors and learned from the educational sessions on process improvement, encryption, and the EHR implementation process.  NextGen Healthcare and Meditech demonstrated their EHR solutions for both hospitals and clinics, while Amrita, Allscripts, Cascade Systems, Clinic Service, eClinicalWorks, HMS, MDM Group / RT Welter & Associates each specialize in one or the other, and demonstrated their solutions.  Representatives from over 25 hospitals and clinics from around Colorado were in attendance, and several left the event knowing which product they wanted to implement in their facility.

Julie from Havens Family Clinic in Cañon City and her coworkers attended the event, and commented,"We needed help and the vendors and staff gave us what we needed threefold.  The Symposium was so informative.  It was so refreshing to have helpful friendly people there to answer any questions we had and to make sure we found our way around the event."

Thank you to all who attended and helped make this event possible!  Presentations and information will be posted in the coming days at http://coruralhealth.org/programs/hit/vendorfair.htm for those who could not make it to the event.

Automatic External Defibrillators Placed in Rural Colorado Communities

Colorado Rural Health Center (CRHC) received a $100,000 grant from the Health Resources and Services Administration (HRSA) in the Spring of 2010 to distribute Automatic External Defibrillators (AED) in remote rural areas throughout Colorado. In rural areas where travel time to hospital intervention is often lengthy due to vast distances, mountainous terrain and/or weather hazards, early use of AEDs on heart attack victims has been shown to save lives. In Summit County this summer, a patient’s life was saved after Summit County Ambulance Service first responder personnel used an in-vehicle AED on a heart attack victim in a local restaurant.

Through the HRSA grant funding, CRHC issued a total of 54 AEDs and accessories to Colorado’s Regional Emergency Trauma Advisory Councils (RETAC) who in turn placed the AEDs in strategic public locations in their rural regions. In addition, many of the RETACs purchased and distributed additional AEDs in the community with their own funds. Each AED is valued between $1,350 & $1,500 per unit depending on accessories ordered.

CRHC has been the recipient of similar AED grant programs through HRSA in the past, and over 500 AEDs have been placed over the past several years. This year’s funding allows communities to continue to ensure all first response agencies such as ambulance services, fire departments, and law enforcement vehicles have the devices, and also allows for strategic placement of AEDs in additional public priority areas such as public parks and community centers.

In spite of these federal grant programs to purchase AEDs, immediate access to an AED is still an issue in many rural communities. CRHC is committed to continue to look for grant and funding opportunities to increase access to the devices in rural areas. For questions regarding this grant program, please contact Ron Seedorf at rs@coruralhealth.org.

Gunnison Valley Hospital begins outpatient services addition and remodel project

Gunnison Valley Hospital’s plan to expand and revitalize healthcare services in its community is beginning to take shape.

Construction of a $5.1 million hospital addition and renovation began in early August 2010. The project includes a new 14,000 square foot addition to the hospital, and a 4,500 square foot renovation of existing space. The addition will house the relocated and expanded lab and radiology departments and a new outpatient registration area. The renovation will provide expanded space for a visiting physicians clinic and a new oncology treatment clinic.

The addition and renovation are the initial phase of a five-year master facilities plan for Gunnison Valley Hospital. By focusing on outpatient services and creating a patient-centered care environment, the hospital is improving access for area patients and is positioning to keep more healthcare dollars in the Gunnison community.

“We are a $50 million economic engine in the Gunnison community. This project supports our growth, which is important to the economic vitality of our area,” said Randy Phelps, Gunnison Valley Hospital Chief Executive Officer.

The Neenan Company, a CRHC Corporate Member, is providing integrated design and construction services on the project through the design-build delivery model.

The GVH addition and remodel is scheduled to be completed in August 2011.

For more information on the new facility, please contact Kate Hagdorn at 970.416.3521 or kate.hagdorn@neenan.com.

AirLife Denver named Air Medical Program of the Year

Congratulations to AirLife Denver for being named the Air Medical Program of the Year--a huge, national honor!  Thank you for continuing to provide such a high caliber of patient care, leadership, and safety.

Learn more at www.airlifedenver.com.

Retain Your Healthcare Professionals!

CROP Deadline: November 1, 2010

Are you working hard to retain the healthcare professionals at your medical facility? Would you like some assistance doing so? The Colorado Rural Outreach Program (CROP) provides grants for loan repayment or bonuses, to assist in the retention of your valuable healthcare professionals. CROP is unique compared to other loan repayment programs because it is available to a wide range of healthcare professionals - all healthcare professionals are eligible, including, but not limited to, physicians, nurse practitioners, physician assistants, nurses, providers of mental health services, providers of dental health services such as dentists and dental hygienists, allied health professionals such as lab or radiology technicians, and pharmacists.

Please note that this fall’s round of CROP is different from rounds in previous years – rather than being for recruitment and retention grants they are only for retention grants. And, rather than the incentive being used for loan repayment only, this year’s awards also may be used to pay bonuses to healthcare professionals who no longer have student loan debt.

The deadline for the fall Colorado Rural Outreach Program (CROP) grants is November 1, 2010 with awards being made around December 1. To learn more or for an application click here. To talk with someone about CROP please contact Cherith Flowerday, Grants Manager, at 303.996.9698 or cfl@coruralhealth.org.

A Student Perspective on Rural Immersion Week

Written by Pharmacy students Chutima J. Harichaikul and Gbemileke K. Renner, SOP


The Summer 2010 Rural Immersion Week program was sponsored and organized by the University of Colorado Denver, Colorado AHEC, the Colorado Trust, and Caring for Colorado Foundation. Professional students and faculty from the University of Colorado Anschutz Medical campus got to investigate a rural community, meet with key community members, and experience what family and personal life was like in a rural setting. The goals were to recruit professional interdisciplinary students to live and work as healthcare providers and to make a difference in the lives of the people of rural communities.

During the week in Delta, CO, small interdisciplinary groups were assigned to investigate a specific area of focus (i.e. healthcare, education, community and economy, mental health, criminal justice and law enforcement, and public health and safety) within the community. On the last day, our findings were presented to the entire group along with some key members of the community. We visited many fun and interesting places such as the Pioneer Town in Cedaredge, Hotchkiss Fish Hatchery, Mtn Coal Company West Elk Mine, and Zephyros Farm. We also had a delightful buffalo dinner at Delicious Orchards. An impression was made on all of us that the Delta community was all about catering to the needs of the community and to one another. We would like to say thank you to all of the sponsors who made this rewarding experience available for students; to the Delta community and to all of our hosts for welcoming us with great hospitality!

Colorado Receives $1.05 Million for Workforce Development

Colorado has recently been awarded $1.05 million from HHS for Workforce Development.  The University of Colorado, Denver, was awared two separate grants totaling $555,432 for equipment purchases and the Colorado Department of Public Health and Environment received $500,000 for loan repayment.  Grant award tables are available by state.

Cut Services. Raise Taxes. You Decide.


Backseat Budgeter® is a simulation tool that enables you to experience for yourself what it is like to manage a public budget. Elected officials ultimately are in charge, but with Backseat Budgeter you can see the effects of your decisions, gain a better understanding of the challenges officials face, and appreciate the complexities of the public budgeting process.

Furthermore, the choices you make about the budget will be shared with public officials. You can let them know if you think they should step on the gas, put the brakes on spending or change direction altogether.

Backseat Budgeter is a public service tool created by Engaged Public to help citizens understand the tradeoffs associated with spending our public dollars. It is offered as a community service by Engaged Public at cost to any public entity wishing to educate and engage its constituents.

NOSORH Video Tribute to Denny Berens

Denny Berens, director of the Nebraska Office of Rural Health, was recently honored by the National Organization of State Offices of Rural Health (NOSORH) for his many years of service and important accomplishments in rural health.  Denny also recently made a gift of $20,000 to NOSORH to create a new community leadership program.  According to the NOSORH newsletter, the community leadership program "will cultivate the next generation of community-based rural health leaders who can champion ideas and initiatives that lead to community-appropriate health solutions." The initial focus will be on identifying leaders and building alliances in order to improve community health.  As part of their thank-you to Denny, NOSORH made a great little video tribute--check it out!

Health, Healthcare, and Healthy Living Assessments for Rural Communities

Colorado STRIDES, a program of the Colorado Rural Health Center, has recently been spending some time in rural communities and holding meetings to assess the health and healthcare of the area.  Check out this article in the Glenwood Springs-Post Independent about the results of Garfield County's SWOT (Strengths, Weaknesses, Opportunities, and Threats) Analysis: Your community health care input, by Kay Vasilakis.  The analysis is the Community Action Plan, which will be created at the next meeting, scheduled for November.

If your community is interested in working with Colorado STRIDES, contact Clint Cresawn, at ccr@coruralhealth.org or 720.248.2745.

Letter from the CEO: CRHC continues to support the Opt Out

Lou Ann Wilroy, CEO
I want to thank the Denver Post for their excellent editorial on September 9, 2010 urging Governor Ritter to allow Colorado to become the 16th state to opt out of the Medicare rule that requires nurse anesthetists to work under the supervision of a physician, dentist or podiatrist.

In the same issue of the newspaper Dr. Daniel Janik, president of the Colorado Society of Anesthesiologists, has a guest commentary warning against the opt out. The Colorado Rural Health Center agrees with Dr. Janik that having a physician present when anesthesia is administered is preferable. But what is also relevant, and is not discussed in the column, is that sometimes physicians are not immediately available in the rural setting.

Certified Registered Nurse Anesthetists are qualified to deliver anesthesia care for trauma stabilization before transport, pain management, obstetrics (especially epidurals), and in many other situations. These highly trained and skilled nurses are doing critical work in our rural hospitals, and they deserve our thanks and support. As the Denver Post notes, “in Colorado's 42 rural hospitals, 38 provide anesthesia services, but 24 of them don't have anesthesiologists on staff.” In 63% of the rural hospitals where anesthesia services are available, the care is delivered solely by CRNAs.

What neither the editorial nor the guest commentary from Dr. Janik do not shed light on is the fact that opting out of the Medicare rule does not change the way anesthesia is delivered today in rural Colorado. With the opt out, high quality anesthesia services will continue to be provided by CRNAs and attending physicians will continue to be involved and responsible for patient care. However, rural hospitals in Colorado will no longer be subject to this federal regulatory burden that causes barriers to access to care due to compliance challenges. Patients will have access to anesthesia care in a more seamless and timely manner at the local rural community level.

The Colorado Rural Health Center has advocated for the opt out since it became available as an option for states in 2001 and we continue to urge Governor Ritter to decide in favor of the opt out provision. As the Denver Post persuasively stated, “Allowing nurse anesthetists to work without the supervision of a doctor is an acknowledgement of the difficulties that rural hospitals face in providing access to care. Such a move would give them the flexibility to deliver services without lowering the standard of care that is expected.”

Senate Candidates Speak on RHC Funding during CLUB 20 Debate



Recently, CRHC staff member Clint Cresawn sat on the panel for the CLUB 20 Senatorial debate.  He asked candidates Michael Bennet and Ken Buck a great question about funding for Rural Health Clinics.  Watch their debate and hear what the candidates have to say about improving rural healthcare!

Rural Immersion Week in Delta County, Colorado

An excerpt from the AHEC Health Matters Newsletter

A group of fourteen health professions students learned a great deal about work and life in a rural community by participating in the “Rural Immersion Week” program in June. The group consisted of five MD students, 4 nursing students, 2 pharmacy students, one psychology intern and two premed students, led by Mark Deutchman MD, director of the Rural Track with local coordination by Evan Cummings who teaches school in Delta.

The students were oriented to the community by a number of local speakers who emphasized how community members in rural areas collaborate to solve problems and maximize resources. The students also learned that healthcare providers in small towns need to wear many hats, and in the process, can have a positive impact on both the lives of individuals and the community overall.

In addition to small group activities, the entire group toured several local businesses including an organic farm, an orchard, the fish hatchery, a re-created pioneer village and the coal mine. The coal mine tour included an extensive safety training session followed by an underground tour. The group was also treated to a gumbo dinner with wine-tasting hosted by the economic development council and to a ranch dinner that included a discussion of the impact of healthcare payment reform on rural areas.

The program was patterned after last year’s equally successful week in Sterling, Colorado. The program will be repeated in June, 2011, probably in the San Luis Valley. Interested students should contact brenda.baumgarten@ucdenver.edu.

Read the Delta County Independent's article on the program: In a small community, relationships are everything

Last day to register for the Third Annual Colorado Entrepreneurship Marketplace at the early registration price!

October 15, 2010; Limon, CO
The Third Annual Colorado Entrepreneurship MarketPlace is coming to Limon!  Register now to save!  The This event offers an opportunity for learning and networking among youth and adults interested in starting or growing their own business.  Information sessions will include: Technology, Marketing, Financing, Diversity in Agriculture, Business Development, and Community Development.  Registration includes MarketPlace sessions, two Keynote Speaker sessions, continental breakfast, lunch, access to the Exhibit Hall, access to "Colorado Corners - The Store at MarketPlace," and the Taste of the Eastern Plains Reception. An incredible experience full of education, networking, and access to resources awaits you in Limon!

Scholarships Are Available!
Over 60 scholarships have been purchased by organizations throughout the state. If you would like to apply for a scholarship please contact Michelle Alcott via email at malcott@ruralcolorado.org. If you or your organization would like to purchase scholarships for members of your community, please click here.

Apply now for the Marva Jean Jackson (MJJ) Scholarship!

CRHC created the Marva Jean Jackson (MJJ) Rural Community Health Scholarships Program to encourage rural facilities and communities to “grow their own” healthcare professionals and, when possible, support local scholarship programs. Studies show that persons from rural communities are more likely to return to rural communities for work. Applications can be for anyone pursuing any type of healthcare education (administrative training not included). Examples would be someone studying to be a technician, an employee training to be a diabetes educator, an LPN pursuing an RN degree, or an RN studying to be a Nurse Practitioner, etc. If you are unsure of your applicant’s eligibility, please call and ask. Along the lines of “grow your own”, awards preference will be given to applicants who show a strong likelihood of practicing in your community when they finish their education. CRHC will match, two-to-one, the support provided for the education of a local healthcare professional, up to $1,000 a year.

Eligibility & Application: Download Application

Only rural facilities and communities are eligible to apply, meaning facilities located outside one of Colorado’s 17 metropolitan counties. The Board of Directors will occasionally consider compelling applications from smaller, isolated communities within the larger metropolitan counties. Awards are made for one year, but applicants may reapply in subsequent years. The scholarship recipient must be either currently enrolled in classes or start training within three months of the application date. Applications are accepted year-round. For additional information or with questions please contact:

Cherith Flowerday
303.996.9698
800.851.6782
cfl@coruralhealth.org

Nursing schools, students prepare for healthcare reform’s effects

An excerpt from the Rockford Register Star

A doctor’s appointment may not feel much like a traditional doctor’s appointment pretty soon.  Local health systems will be relying on a broader mix of providers to handle the load of uninsured patients that health care reform will add, particularly primary care and family doctors, whose numbers already are dwindling as young doctors are lured away by higher-paying specialty practices.

Nurse practitioners and physician assistants can perform duties similar to those of physicians, including diagnosing and treating illnesses and educating patients about disease prevention. The Bureau of Labor Statistics expects the fields to be two of the fastest-growing professions in the coming decade.

Advanced degrees are as lucrative, career- and salary-wise, as they are for schools and hospitals. Saint Anthony’s program offers a mix of online and on-campus classes and clinicals so students can still work and learn.  Rockford College and Rock Valley College also offer nursing degree programs, and the Northern Illinois Online Initiative for Nursing program offers a hybrid creation that’s a mix of online and on-campus classes through a partnership between local colleges, area hospitals and health systems.

“It’s a model to give patients the best access at the time they need it,” Shannon Lizer, dean of graduate affairs and research, said. “There aren’t enough physicians, and partnerships work.”

Rural areas are the most innovative when it comes to dealing with provider shortages, because they are the ones with the greatest needs and challenges--so how does your community handle it?  If you're in need of help recruiting providers, contact Colorado Provider Recruitment, your nonprofit recruiting experts, today!

Patient Safety Campaign Prepares to Launch

The Colorado Medical Society, Citizens for Patient Safety, Colorado Hospital Association, and Rocky Mountain Patient Safety Organization are preparing to launch a new initiative in 2011 called Think About It Colorado.

They hope to serve as the catalyst for a statewide dialogue on patient safety.  They've tapped the expertise of a diverse network of groups and individuals and are formulating their plan to promote statewide awareness of patient safety concerns and opportunities and to engage consumers and providers in fostering a culture of patient safety.

The Think About It Colorado campaign will raise awareness about the ongoing initiatives, needs and opportunities to improve patient safety and create the will to move towards an improved system that:
  • Holds health professionals and health care facilities accountable for the quality of the care they provide.
  • Assists injured patients and their families compassionately and fairly.
  • Improves safety by ensuring that health professionals and health care facilities share the learning from problems that occur in the course of health care.
  • Provides information to patients and their families to become active participants in their own health care.
If you're interested in learning more or signing on as a supporter, click here.

Funding for Emergency Medical & Trauma Services Education and Training


APPLY TODAY!

CREATE is a grant program designed to assist private and pulic organizations in improving and expanding emergency medical and trauma systems in Colorado. Eligible applicants must have as their purpose the provision of emergency medical and trauma services in Colorado to be eligible.

Visit us online: www.coruralhealth.org/programs/create

Rural Healthcare in Colorado to See Improvements

An exerpt from the Public News Service-CO

Photo courtesy of Mountain
Family Health Center
Under the new federal health care reform plan, medical services are expected to become more patient-friendly for the more than 700,000 Coloradans who live in rural areas. Among its provisions: the plan will pay an increased share of doctor bills for seniors, lower costs for outpatient prescriptions, and offer better reimbursement for rural ambulance services. Nearly 10 percent of rural patients have no regular source of health care or advice. Federal health care reform also provides $11 billion in funding nationwide to help build and improve community health center service.

To access the full article, with audio, click here.

Treating the Invisible Wounds of War Series: Part 1 - Post-Traumatic Stress Disorder

This course is designed to help primary care physicians, case workers, mental health providers - who may see a veteran or family member on an unrelated issue - develop a better understanding of the culture in which veterans and their families live and work, and provide best practices for identifying, assessing and treating mental health disorders that result from the trauma of war.

Objectives:
At the conclusion of this course, you should be able to identify:
  • Strategies for establishing and maintaining a therapeutic alliance with combat veterans and their families by examining military structure and culture and the combat experience
  • Combat Operational Stress Injury (COSI) symptoms and assessment techniques
  • Post-traumatic Stress Disorder (PTSD) symptoms and assessment techniques
  • Treatment options for Post-traumatic Stress Disorder
  • Frames of mental health assessment and treatment options for military personnel
  • How family relationships are impacted by mobilization, deployment and redeployment
  • Services available for veterans and their families, including those provided by the U.S. Department of Veterans Affairs and TRICARE
Target Audience:
Primary care physicians, physician assistants, nurse practitioners, psychiatrists and other interested mental health providers.

Length: 3 Hours

Credit Type(s): 3.0 AMA PRA Category 1 Credit, 3.0 Contact Hours NBCC - Provider #5470, 3.0 Contact Hours, 0.3 CEU

Cost: $0.00

Instructions:

  • From your browser, go to www.aheconnect.com/citizensoldier
  • Click on New Users tab at the top of the screen
  • Create a personal user account following the instructions on the screen (be sure to enter your Army OneSource referral code in the space provided: AOSCO13)
  • Login to the system using your new id and password
  • Click on Courses tab at the top of the screen
  • Select a course you wish to complete.
  • Click on Register
Once you complete a course, your CE credit will be recorded, and you will have access to download and print a Certificate of Completion.

Consultant Needed for Nonprofit Dental Start-up

The Aspen to Parachute Dental Health Coaltion (APDHC) is looking for a consultant to walk them through the process of becoming a sound, sustainable, dental health organization that will one day become a free standing 501(c)(3). The goal is to have an organization that will provide dental healthcare to all ages in the Garfield County and Pitkin County area. They are looking for a firm that will have the skills to help begin this type of organization and guide the group towards making the best choices when it comes to timing, finances, local factors, business models, etc. The Coalition is a very dedicated and hard working team -looking for knowledgeable insight, leadership, financial expertise, and guidance from an experienced outside agency.  A basic business plan has already been developed, and the Coalition is now accepting bids.

Please contact Carrie Godes, of Garfield County Public Health, with questions and to submit a bid, at 970.625.5200 x 8122, or cgodes@garfield-county.com.

Summit County Care clinic celebrates being a safety net for locals without insurance

By the Summit Daily News
Summit Community Care Clinic, along with Colorado's other community-funded safety net clinics, is celebrating Safety Net Clinic Week through Friday. And, as part of the celebration, state policy makers and candidates for office will visit the Care Clinic facility this week in Frisco.

“Our facility is a critical part of Colorado's medical safety net and Safety Net Clinic Week provides us with a welcome opportunity to proudly share our contributions and commitments to the Coloradans we serve,” said Sarah Vaine, executive director of the Summit Community Care Clinic.

Due to complexities of the federal funding for safety net providers, non-federally qualified clinics often struggle for resources, and their role and contributions are commonly undervalued. ClinicNET's executive director Sharon Adams said people often think all parts of the critical health-care safety net are supported by federal funds.

To access the complete article from the Summit Daily News, click here.

CO Benefits from Affordable Care Act

From Colorado's Public News Service
Federal health care reform provided by the Affordable Care Act is helping increase access to medical care for the nearly 15 percent of Coloradans who live in rural communities. Dr. Amy Barton, associate dean of clinical and community affairs at the University of Colorado School of Nursing, says the San Luis Valley is one model of excellence.

"If we could replicate that with some of these moneys in areas across the state, it would enhance health care in those regions."

Part of an $11 billion fund will be used to strengthen 160 community health centers across Colorado, such as those in Limon and Aurora, which received grants last week. Another chunk of the federal funds will be used to train advanced nursing techniques for those working in rural areas. Barton oversees that training at CU.

"As we increase access to primary care, it's important that we also increase the number of primary care providers that are available."

One type of primary care worker being trained via the Affordable Care Act is the nurse practitioner - an advanced practice nurse who can handle routine checkups and certain emergency care, Barton explains.

"Oftentimes in rural areas, there's not a physician. A nurse practitioner is available to see patients within that community."

More than 720,000 Coloradans live in rural communities, and nearly 10 percent of them have no regular source of health care or health advice.

Click here to access the article and the audio that accompanies it.

$32 million awarded to support rural health priorities

Secretary Kathleen Sebelius announced on Monday $32 million in funding for rural hospitals, workforce, veterans and telehealth to increase access to healthcare for Americans living in rural areas. The funds reach across seven programs administered by the Office of Rural Health Policy in HHS’ Health Resources and Services Administration (HRSA).

The Colorado Rural Health Center received $566,000, which will go to supporting Critical Access Hospitals and HIT implementation. Another Colorado facility, Plains Medical Center in Limon, also received a grant of $199,897 for rural health workforce development.

Lists of awards from HRSA’s 2010 appropriation can be found here.

2010 Seasonal Influenza Q&As

It's that dreaded time of the year again...flu season is upon us, and we need to be ready!

The Colorado Immunization Program has released a list of 2010 Seasonal Influenza Q&A’s. To access the document, click here.

Safety Net Provider Story in the Denver Post Deserves a Read

by Lou Ann Wilroy, CEO
Thank you to the Denver Post’s Jennifer Brown for an impressive story on Colorado’s safety net providers.

The article focuses on the eight urban Community Health Centers owned by Denver Health. There are many Community Health Centers (also known as Federally Qualified Health Centers - FQHCs) in our urban and rural areas and they are quite deserving of appreciation and concern for the burdens they face trying to accommodate uninsured and underinsured patients, and the growing number of newly insured in search of medical homes. However, at CRHC we are acutely aware that the state’s safety net facilities that run from border-to-border come in all shapes and sizes and, unlike the federally-qualified urban centers that were the focus of this article, do not have the federal qualification that entitles them to increased funding levels.

As health reform implementation begins to provide coverage to more Coloradans, “non-federally qualified” providers such as Rural Health Clinics and Community-Funded Safety Net Clinics are going to be even more challenged to meet the needs of their growing patient populations. As mentioned in the Denver Post article, FQHCs such as those operated by Denver Health, often have long waiting lists. When these lists get lengthy, patients in need understandably migrate to other safety net facilities. This includes family medicine residency training programs, faith-based clinics, free clinics, and Rural Health Clinics with a variety of ownership structures such as privately owned, county owned, or governed by a special district.

These different types of safety net facilities are extremely important in serving across Colorado’s diverse geographic and cultural landscape. The FQHC model is not a fit for every community. The federal regulations can be daunting, if not impossible, to comply with in some cases, especially in isolated rural and frontier communities. It is extremely important for communities to become educated on the different options for delivering primary care and strategize to best meet the needs of the population. Recently, the Health Resources and Services Administration released a new funding opportunity for creating new FQHC access points.  Interested community leaders and healthcare facilities should contact CRHC to explore the feasibility of applying for this funding. We are making every effort to collaborate with the Colorado Community Health Network, Colorado’s Primary Care Association, to identify opportunities.

Additionally, CRHC is continuing to actively advocate at the state and national levels for increased funding and additional resources and support for the non-FQHC safety net clinics that are extremely crucial components of the healthcare infrastructure.

Announcing Safety Net Clinic Week: Aug. 30 - Sept. 3

In efforts to raise awareness of Colorado's healthcare safety net providers and clinics, ClinicNET in partnership with the Colorado Rural Health Center, is declaring August 30th - September 3rd as Safety Net Clinic Week. The week will be devoted to educating the public and policymakers about Community Funded Safety Net Clinics and federally-certified Rural Health Clinics.

There are currently 26 identified Community Funded Safety Net Clinics (CSNCs) in Colorado. These clinics tend to be nonprofit, rural & urban, privately funded and provide primary care services to uninsured and underinsured individuals. Colorado has 52 federally certified Rural Health Clinics (RHCs) that provide primary care services in some of the most rural and remote areas of Colorado. During 2009, CSNCs and RHCs collectively provided services to approximately 250,000 inidividuals in Colorado.

If you are a CSNC or an RHC and are interested in participating in Safety Net Clinic Week, please contact Brooke Powers at brooke.powers@clinicnet.org.

Apply now for the Marva Jean Jackson (MJJ) Scholarship!

CRHC created the Marva Jean Jackson (MJJ) Rural Community Health Scholarships Program in 2003 to encourage rural facilities and communities to develop or support local scholarship programs. Evidence shows that one of the factors that can influence a provider’s decision to practice in a rural area is if he or she grew up in a rural area. Programs that support healthcare training and education for students from rural areas have proven to be effective tools in addressing rural workforce shortages.  Small grants that help pay for the training and/or education of a local healthcare provider are available for rural facilities or community groups. CRHC will match the support provided, two-to-one, up to $1,000 a year.

Eligibility & Application: Download Application

Only rural facilities and communities are eligible to apply, meaning facilities located outside one of Colorado’s 17 metropolitan counties. The Board of Directors will occasionally consider compelling applications from smaller, isolated communities within the larger metropolitan counties. Awards are made for one year, but applicants may reapply in subsequent years. The scholarship recipient must be either currently enrolled in classes or start training within three months of the application date. Applications are accepted year-round. For additional information or with questions please contact:

Cherith Flowerday
303.996.9698
303.832.7493
cfl@coruralhealth.org

Renewed effort to lure doctors to rural areas faces obstacles

This is an excerpt of an article in the Washington Post.  Click here to access the full article.

Sarah Carricaburu slipped her sleek new iPhone into her purse for the day. With no signal here deep in the woods, it's useless. She swiveled away from her desktop computer, which can't access the Internet, and glanced at the manila folders of patient records neatly stacked on a shelf by nurses.

"I grew up in the age of electronic medical records," said Carricaburu, 33, a primary care physician who was raised in the Washington suburbs. "Coming here was like stepping back in time. I would like to stay in a community healthcare setting, but here I didn't feel like I had the resources to do my job. You're cut off."
Carricaburu's choice of whether to stay or go is not just about her own career satisfaction. Her 12 colleagues at the Southern Albemarle Family Practice have a vested interest in her staying on, as the clinic's director and its one full-time physician, beyond the three years that she is under a contract with the federal government that will help pay off school loans. She is also a test case for the Obama administration's goal, under the new healthcare law, to bring thousands of young primary care doctors to underserved areas such as this unincorporated town of 1,200 -- and keep them there.

But after facing decisions similar to the one Carricaburu is weighing, several young doctors who were interviewed said they are struggling with whether to spend a career in rural settings. Experts said they expect retention to be a problem.

Read the rest of this article on the Washington Post's website.

Video: The Country Doctor of Today



Being a healthcare provider in rural Colorado is both challenging and rewarding.  Check out this video of Dr. Donald Regier and his work in Sedgwick, CO.

Climbing for Wellness: Spanish Peaks Regional Health Center

As part of the activities of the Wellness Committee at Spanish Peaks Regional Health Center, 13 brave staff members decided to hike West Spanish Peak--all 13,626 feet of it!  Despite the cold, fog, and rain, they trudged for six hours up the mountain on July 25th, and all 13 made it to the top.  They may not have gotten the great view they were hoping for, but what an accomplishment!

The Colorado Trust Partners to Strengthen Colorado’s Healthcare Workforce


This video by The Colorado Trust describes how the Colorado Health Professions Workforce Policy Collaborative, which is administered by CRHC and funded by The Colorado Trust, is working to create policy solutions to the healthcare workforce shortage Colorado is facing.  The Collaborative has brought together policymakers, healthcare providers, educators, and other importnt voices who are dedicated to strengthening Colorado's healthcare system by addressing this issue. (Video is large, please allow time to load.)

View this video on The Colorado Trust's website >

Local impact of health reform uncertain

An exerpt from the Fort Morgan Times, by Dan Barker

Just how the new Affordable Care Act health care reform will impact Colorado, Morgan County and the eastern plains is not certain yet.  Analysts are still trying to figure it all out, said Terri Hurst of the Colorado Rural Health Center, who was reporting to Progressive 15 members at the organization's annual standing committees meetings last week.

"Nothing's very defined yet," said Sally Henry of the Centennial Area Health Education Center, who gave a report along with Hurst for the health and human services committee. What is known is that certain sectors of the public will be added to Medicaid, which will mean an increase in that budget area for Colorado, Hurst said. Colorado already has a $75 million deficit it needs to deal with, and probably more of a deficit to come, she said.

Traditionally, states pay 50 percent of Medicaid, although recently the American Recovery and Reinvestment Act stimulus money has meant that Colorado has only paid 40 percent, Hurst said. Unfortunately, that stimulus money expires at the end of December, she said. Since the state made a budget assuming the 40 percent funding level, it may be facing an additional $240 million shortfall with no idea where the money will come from, Hurst said.

To read the complete article, please visit the Fort Morgan Times website.

Kit Carson, Colorado Awarded $1 Million Grant

Kit Carson, Colorado – population 250 – will get a housing makeover due to a $1 million grant announced in July by the U.S. Department of Housing and Urban Development. The funding will support production of sorely needed housing and clean-up in the community’s historic “Main Street” area.

The Kit Carson Main Street Affordable Housing Project will develop five detached homes for rental or homeownership, depending on the community’s needs. The grant will cover rehabilitation of two presently uninhabitable houses; construction of two new homes on empty lots; and demolition of a house on a fifth property and building of a fifth home on that site. Kit Carson Rural Development, a non-profit organization whose mission is rural economic development in the area, will manage the grant.

Amy Johnson with Kit Carson Rural Development explains that when rural communities work to recruit professionals, their “impression of the town” plays an important role, with housing, amenities, and parks and recreation all being intertwined in creating that impression. With 250 residents and a very small Main Street area, the three uninhabitable homes in Kit Carson contributed to a negative first impression of the town. That, coupled with a lack of housing for young professionals, makes recruitment a very difficult task. With five of Kit Carson’s 12 teachers nearing retirement age, recruitment of teachers is increasingly on the minds of town leaders like Johnson.

In areas all across rural Colorado, housing crops up as an impediment to recruiting professionals – not only educators, but healthcare professionals, as well. This sort of improvement project has a tremendous positive impact on how someone considering relocation perceives the community!

The path leading to this $1 million award began with Kit Carson Rural Development successfully implementing the $180,000 Prairie Park enhancement project, funded by Great Outdoors Colorado, or GOCO. Then, they turned their attention to a 6,500 square foot gas station / liquor store / auto sales and service center that had been abandoned roughly 20 years ago. In partnership with Colorado Brownfields Foundation, they were able to get funding from the Colorado Department of Public Health and Environment and the U.S. Environmental Protection Agency to assess and clean up this blighted and polluted site, making way for a business ready site, for which the community is now actively recruiting a business to occupy. Having a proven track record of successfully completing grant-funded projects, Kit Carson Rural Development was ready when Darlene Scott with the Office of Economic Development brought the grant opportunity to the town’s attention.

A total of six grants were awarded by HUD, through their HOPE VI Main Street program. Johnson indicates that these six grantees were chosen from only 38 applicants, many of which were ineligible for various reasons. For more information on the HOPE VI Main Street program, click here.

Congratulations, Kit Carson, on this major grant award!

Save the date for The Forum 2011!

The Forum 2011: Essential Perspectives for Safety Net Providers
Save the date for next year's Forum! It will be held April 19-21, 2011 at the Red Lion Hotel in Aurora. More details will be posted as they become available.

CRHC's 2009 Annual Report

Click to download (PDF)
Check out CRHC's 2009 Annual Report!  It was a busy year of program growth and enhancement for us, and we are excited to share with you what we've accomplished and what we've got on tap for 2010.  Enjoy!

Health Insurance Exchange Forums

As part of federal health care reform, Colorado has the responsibility for the implementation of a new Health Insurance Exchange. The 2011 general assembly and the next governor will need to make some key decisions about the structure, governance and role of the exchange in Colorado.

CCHI, the Colorado Coalition for the Medically Underserved (CCMU) and the Health Reform Implementation Board (Department of Health Care Policy and Finance) are working together to host a series of community forums, facilitated by Gretchen Hammer from CCMU, to discuss the options for our state, as well as to seek and collect input from stakeholders and consumers.

We invite and encourage you to attend any/all of these forums scheduled for the following dates and times:
  • Friday, July 23, 2010; 9–11am at National Jewish Hospital, Molly Blank Center
  • Thursday, August 12, 2010; 9–11am, location TBD
  • Monday, August 30, 2010; 3–5pm, location TBD
  • Monday, September 13, 2010; 3–5pm, location TBD
  • Wednesday, September 29, 2010; 9–11am, location TBD
  • October meetings outside Denver metro area
All of the information including locations, fact sheets, and summary information on the state’s health reform website will be available at www.colorado.gov/healthreform.

All meetings are open to the public and we look forward to seeing you there!

2010 Do No Harm X Conference

Friday, November 19th, 2010
The Colorado Patient Safety Coalition is hosting a conference this November, entitled "Ten Years Into the Patient Safety Movement: Where Do We Come From? Who Are We? Where Are We Going?"  It will be held at the University of Colorado Denver, Anschutz Medical Campus in the Hensel Phelps Auditorium.  The Keynote Speaker will be David Lawrence, MD, Former Chairman & CEO Kaiser Foundation Health Plan, Inc and Kaiser Foundation Hospitals.
  • Sign up early for special rates
  • Nominate colleagues for safety awards
  • Exhibit in the vendor expo area
  • Feature your activity with a poster
For more information, click here.

Annual Conference Reflections, by Lou Ann Wilroy

Wow! Thanks everyone for a terrific conference!

As the State Office of Rural Health, our Annual Conference serves as Colorado’s premier rural healthcare meeting of the year. Every year we challenge ourselves to top the previous year’s conference, understanding how important this meeting is for our members and everyone who cares about the health of rural Coloradans. This year, I feel we achieved our goal at our conference in Breckenridge July 1-2. Conference evaluations were very generous in expressing appreciation for the incredible networking opportunities, and high caliber speakers. Thank you to our elite sponsor, The Colorado Health Foundation, premier sponsor, HealthONE, and our classic sponsors, Centura Health, Colorado Hospital Association, COPIC Companies, and The Colorado Trust without whose support the event would have been impossible!

Keynote speaker Brian Lee, founder of Custom Learning Systems, did an excellent job of getting everyone focused on proactively tackling healthcare reform and making it a positive for patients and providers . The work we do is difficult and often frustrating, and it’s all too easy to fall into the trap of being cynical about the challenges we’re presented with from the legislative arena. Brian showed us that the right attitude and a focus on the goal of providing excellent patient care makes anything possible.

Joan Henneberry, Director of the Colorado Department of Health Care Policy and Finance, continued the theme. (This is all the more impressive if you understand even a tiny portion of the challenges that this leader confronts at work each day!) Joan discussed how federal healthcare reform legislation has already benefitted us significantly in our work, and how 2014 – admittedly still a good bit down the road – will allow us to add 130,000 more Coloradans to Medicaid and Child Health Plan Plus (CHP+) enrollment.

Brock Slabach, senior vice-president with the National Rural Health Association, urged us to push the envelope on the Health Information Technology (HIT) front. “Those who have deployed HIT systems beyond Meaningful Use and leveraged these systems to control costs and improve quality demonstrably will survive the coming storm,” Brock predicted. Despite the technological and financial challenges contained in his challenge, I saw a lot of heads nodding around the room when Brock made this point. What’s truly important is never easy.

Thank you to all the wonderful speakers and conference attendees, especially those in rural Colorado who traveled long distances to join us for our Annual Conference. Thank you also to my staff for exceeding my expectations for this meeting. I left the mountains more energized and ready to do our part to take on healthcare reform together and achieve the mission of providing rural Coloradans with access to high quality healthcare services. If you were there with me, I hope it was a good meeting for you too.

Sincerely,
Lou Ann Wilroy
CEO, Colorado Rural Health Center

Grants Available for CHP+/Medicaid Enrollment

MORE grant funds are now available to provide outreach, enrollment and application assistance to enroll children and pregnant women up to 250% Federal Poverty Level (FPL) in Child Health Plan Plus (CHP+) and low-income parents qualifying for Medicaid up to 100% FPL. You have the opportunity to receive funding to help your community in the way that you know works.
The first year of funding for the MORE Grant Program is $640,000, with each grantee eligible for up to $100,000.

Applications are due August 9, 2010 by 3:00 p.m.

Eligible recipients:
Certified Application Assistance Sites, PE sites, Medical Assistance sites, county departments of human/social services, or other community-based organizations serving families or individuals that may be eligible for CHP+ or Medicaid.

If you are interested in applying for MORE Grant Program funding, please click here or contact Cindi Terra.