The Colorado Rural Health Center is proud to acknowledge two clinics in the Southeast region of the state for achieving Level III Patient Centered Medical Home ( PCMH) recognition. Way to go!!! Both St. Thomas More Physician Group of Canon City, CO and Spanish Peak Family Clinic in Walsenburg, CO have been working hard to reach this goal since 2009. These two clinics have successfully traveled the difficult journey toward this achievement and are leading the way in transforming patient care and healthcare services in Colorado! Thank you for your dedication to the patients you serve in your rural communities and keep up the good work!
Colorado Health Benefit Exchange (COHBE) Update
A new website was for the Colorado Health Benefit Exchange (COHBE), the state health insurance marketplace for Colorado, was launched last month. The website contains information and resources for consumers and small businesses, as well as updates on the development of the state health insurance marketplace and COHBE board activities. Click here to read more.
Last month officials from the U.S. Department of Health and Human Services came to Denver to listen to local stakeholder groups discuss their views about the types of medical care that should be covered by qualified health plans sold on new state and federal health insurance exchanges. The first proposed rules are expected to be released for public comment in the spring.
Also in November, the Board elected Gretchen Hammer to serve as the Chair of the Board. Previously, she had been serving in that position in an interim capacity. Richard Betts of Telluride was elected Vice-Chair, and Arnold Salazar of Alamosa was elected Secretary.
Patty Fontneau started her position as the Executive Director and Chief Executive Officer of the COHBE this week. Fontneau will lead the development and implementation of the state health insurance marketplace. The press release can be viewed here.
The Implementation Review Committee is scheduled to meet today to discuss and take action on the Board’s application for a Federal Planning and Establishment grant due December 30th. The Review Committee declined to approve an earlier version of the grant due September 30th.
The Colorado Rural Health Center will continue to monitor the development of the Exchange and provide input as it relates to rural needs. For more information, contact Alicia Haywood at ah@coruralhealth.org or by calling 720-248-2748.
Only a Few Weeks Left in 2012 Membership Drive!
Thank you to those who have already renewed your membership!
With your support, we can continue to ensure all Coloradans have access to high quality healthcare services in 2012 and beyond.
CRHC has three levels of membership to suit your organizational/individual needs:
Joining is easy. Click here to join today!
Educate | Advocate | Collaborate | Innovate
Cultivate Rural Colorado
Cultivate Rural Colorado
NPR on CAHs: An Overlooked Perspective
by Brock Slabach, National Rural Health Association
The December 8 NPR piece produced by Kaiser Health News (KHN) didn’t report that Medicare costs are lower for rural patients than their urban counterparts. Medicare spends 4.5% less per beneficiary for rural residents compared to those living in urban areas, according to a recent Stroudwater report which used 2008 Dartmouth Atlas data. The value that rural providers (including Hood Memorial Hospital in Amite, La.) bring to the Medicare program is evident, even including alternative payment methodologies applied to small, rural facilities. Closing Critical Access Hospitals (CAHs) and sending their patients to large, urban hospitals will in fact not save money, but cost more.
Rural communities struggle with disproportionate share of poverty, obesity and chronic conditions when compared to an urban environment. Independent studies have affirmed the quality of rural health care providers. For example, rural hospitals have lower risk-adjusted rates of potential safety-related events (Jollife, 2003), rural hospitals have significantly lower adverse event rates than urban counterparts (Whitener and McGranahan, 2003) and rural hospitals have significantly lower rates of post-operative hip fracture, hemorrhage and hematoma (Cromartie, 2002).
The article accurately portrays the difficulty that small, rural hospital administrators have in running a hospital located in a rural environment. NRHA congratulates Hoppie Jones, Hood Memorial CEO, for doing an outstanding job in the midst of daunting circumstances.
Fall 2011 CROP Awardees Announced!
Congratulations to these providers, who were awarded Colorado Rural Outreach Program (CROP) retention grants!
| Awardee | Provider Type | Type of Award | Award Amount |
| Colorado West, Inc. | Psychiatrist | Loan Repayment | $10,000 |
| Grand County EMS | EMS/Prehospital Care | Loan Repayment | $4,170 |
| Kremmling Memorial Hospital District | Physical Therapist | Loan Repayment | $4,876 |
| Rio Grande Hospital | Emergency Room Physician | Loan Repayment | $10,000 |
| Valley-Wide Health Systems, Inc. | Physical Therapist | Loan Repayment | $5,000 |
| TOTAL AWARDS | Fall 2011 | $34,047.00 | |
Colorado Rural Health Care Grant Program Application Available!
The application and materials for the fifth cycle of the Colorado Rural Health Care Grant Program, administrated by the Colorado Rural Health Center, are now available.
- DEADLINE: Online Intent to Apply Forms — January 13, 2012 ; Applications — Noon (12:00 pm) February 15, 2012
- ELIGIBILITY: Organizations that are located outside of Colorado's urbanized areas that provide outpatient primary care services—including medical, oral, and mental health
- FUNDING PRIORITIES: Projects that support rural health infrastructure and strengthen the capacity of rural entities to provide outpatient primary care services
- AWARD AMOUNT: Maximum award is $50,000 per applicant
For more information on the grant application process, additional eligibility requirements and complete timeline, visit www.coruralhealth.org/programs/crhcgp.
Questions? Contact Shelly Collings at 720.248.2742 or sc@coruralhealth.org.
Tax Credits Available for Rural Facilities for Capital Projects
by Ronald A. Bell, Partner, Peck, Shaffer & Williams LLP and Mary L. Groves, Partner, Peck, Shaffer & Williams, LLP, CRHC Classic Sponsors
The New Markets Tax Credit Program (“NMTCP” or “Program”) and the applicability of new markets tax credits (“NMTCs” or “tax credits”) as a financing tool for healthcare facilities is a new trend under discussion in many circles. The NMTCP may be used to finance various types of capital projects related to the healthcare industry (e.g., data centers, surgical units, clinics, expansions) if located in eligible jurisdictions. This article gives a general overview of how NMTCs may be used to help meet capital financing needs.
Letter From the CEO
Ok, everyone take a deep breath. Feels good, right? Okay, let’s take another one. Good. (Repeat this as necessary.)
We are entering the legislative season here in Colorado, and I know anxiety is running high. Hey, I’ll admit to a bit myself!
And it’s not just paranoia. We are without question in the cross hairs of federal budget cutters and tax reformers. Of course, the same could be said for at least the last few legislative sessions. As before, I can promise you that our legislative folks will be closely monitoring what happens at the Capitol, and will be keeping you informed. Of course, we will also continue to alert you if we think you need to speak up on a specific issue.
Before we get into all the legislative craziness, I want to recognize three facilities for reaching an important milestone. Heart of the Rockies Medical Center in Salida and Spanish Peaks Regional Medical Center in Walsenburg are the first two critical access hospitals in Colorado to attest for Stage 1 Meaningful Use of their electronic health records. MidValley Family Practice in Basalt is one of the first rural clinics to attest to meaningful use in our state. This attestation means all three facilities are now eligible for Medicare EHR incentive funds.
In addition to congratulating these facilities, I want to thank CRHC’s Technology for Healthcare Excellence (THE) Consortium team for providing the support the staff at these facilities needed to obtain Meaningful Use. As the Regional Extension Center for 33 rural hospitals and over 300 rural and Community-funded Safety Net Clinic providers, we are actively working with many CRHC and ClinicNET constituents so that they too can reach this important milestone.
Before I sign off I want to thank everyone for the warm welcome I’ve received since taking the helm here in October. I’ve appreciated your thoughtfulness and sage counsel and look forward to many more discussions on how CRHC can best support its members. For those I haven’t yet connected with, please call me at 303.832.7493 or write to me at ceo@coruralhealth.org.
CRHC’s 2012 Membership Drive Is Underway!
Over the past 20 years, CRHC has become our state’s most trusted resource for rural healthcare. In the current economic landscape, it is more important than ever that we continue to support and advocate on behalf of rural healthcare and the safety net community. We remain loyally committed to ensuring our members have the resources and support they need to keep their communities healthy and vibrant. CRHC is well positioned to provide 20+ more years of support to ensure access to healthcare for all Coloradans, and we recognize that our work would be impossible without the dedication of our loyal members.
CRHC has three levels of membership to suit your organizational/individual needs:
Joining is easy. Click here to join today!
At the Classic Sponsor and Partner level memberships, your organization is given additional opportunities to support and reach out to rural healthcare providers. Please visit our website for more information on the benefits of each level. Feel free to contact Cari Fouts, Director of Communication & Development (cf@coruralhealth.org, or 303-565-5847) if you have questions about your membership or visit our website for more information.
With your support, we can continue to ensure all Coloradans have access to high quality healthcare services in 2012 and beyond.
Celebrate the Power of Rural with National Rural Health Day - November 17
November 17 is the first annual National Rural Health Day, a day to “Celebrate the Power of Rural “and the community-minded, creative spirit that makes our country thrive. One in five Americans call a rural community home. Here in Colorado, 20 percent of our population lives in rural or frontier counties and these counties make up nearly 80 percent of the landmass.
Rural communities are wonderful places to live and work. They are also some of the best places to start a business and test one’s “entrepreneurial spirit.” These communities provide the country with a wealth of services and commodities. Rural doesn’t necessarily mean “remote” – diverse economic, cultural, and recreational opportunities abound in rural Colorado. With a strong agricultural and ranching foundation, Colorado’s rural economies include small businesses and larger industries.
Rural communities face unique healthcare needs. We must address accessibility issues, healthcare provider shortages, the needs of an aging population experiencing a greater number of chronic conditions, and larger percentages of un- and underinsured residents. Rural hospitals and clinics are essential resources to meet the healthcare needs. Colorado’s 29 Critical Access Hospitals serve as healthcare anchors for their communities, offering an array of services to meet the local needs. Our 52 Rural Health Clinics, rural Community Health Centers, Community-funded Safety Net Clinics, and private practitioners reach beyond geographical boundaries to deliver essential quality care in remote areas. These healthcare facilities provide a solid economic base for their communities, employing local residents and generating $2.30 in additional business revenue with every dollar spent.
Being a rural healthcare provider offers tremendous opportunities to develop close relationships with patients and the community. Due to their limited numbers, rural providers frequently take a holistic, patient-centered approach and provide comprehensive care to patients with diverse needs. From implementing electronic health records to becoming recognized patient-centered medical homes, Colorado’s rural providers are making extraordinary transformations to meet the healthcare needs of their communities, with limited capital and human resources.
As the State Office of Rural Health, Colorado Rural Health Center is proud to support Colorado’s rural communities and health providers and has showcased some exceptional efforts for National Rural Health Day. While we face great challenges in addressing the healthcare needs in rural Colorado, National Rural Health Day reminds us to celebrate the spirit and ingenuity that epitomizes rural health.
Apply Now for Loan Repayment and Locum Tenens Funds
Do you have a healthcare provider at your facility who is interested in loan repayment? Let them know that the Colorado Health Service Corps (CHSC) Loan Repayment Program fall 2011 application cycle will open November 1st, 2011. The application cycle is open for one month, closing on November 30th, 2011.
Up to $105,000 for a 3-year commitment is available to your primary care healthcare providers!
CHSC provides loan repayment to fully trained primary care providers in exchange for either a two or three-year full-time service obligation in an underserved community. After completing their initial years of service, loan repayors may apply for additional years of support! Eligible providers include primary care Family Physicians, Internists, OB/GYNs, Pediatricians, Dentists, Psychiatrists, Physician Assistants, Nurse Practitioners, Certified Nurse Midwives, Dental Hygienists and licensed mental health professionals.
Many types of healthcare facilities are CHSC eligible sites including Critical Access Hospitals, Rural Health Clinics, Community Health Centers, and safety-net clinics.
To find out more about the CHSC Loan Repayment Program, please visit us online. Would you like to speak with someone to find out if your facility is eligible for loan repayment? Contact Colorado Provider Recruitment (CPR) at cpr@coruralhealth.org or 303.832.1668.
Locum Tenens Scholarship Available
The Colorado Rural Health Center is offering Physicians, PA’s, Nurse Practitioners, and Dentists with an opportunity to get scholarship money for locum tenens pay, and/or travel costs associated with attending local, statewide, or national conferences or additional trainings. Funding cannot be used to pay for the cost of attending the conference, or registering for the program.
Criteria & Eligibility
- Applicants must be located in a rural, or non-metropolitan county in Colorado.
- The applicant organization can be a public or private entity, including FQHC’s.
- All awards are paid to the organization, and not the scholarship recipient.
- You can apply for Locum Tenens costs (no limit, but within reason), travel (up to $1,500 dollars) or both.
- Available to Physicians, Physician Assistants, Nurse Practitioners, & Dentists.
- Applications may be submitted for retro expenses dating back to March 2011 to the present.
Applications will be accepted throughout the year, but reviewed and awarded on a quarterly basis. The next cycle due date is December 15th, 2011. Applications can be downloaded online.
Questions? Contact Erica at ep@coruralhealth.org, by phone at 303.996.9698 or fax 303.832.7496.
Governor Hickenlooper Appoints New Colo. Rural Health Care Grant Council Members
Governor John Hickenlooper recently appointed Susan Hall of Grand Junction and Janette Kochis of Matheson as new members of the Colorado Rural Health Care Grant Council. Both will serve terms through December 31, 2013. The Colorado Rural Health Care Grant Council oversees the Colorado Rural Health Care Grant Program. The purpose of the program is to fund projects that support Colorado’s rural health infrastructure and strengthen the capacity of rural entities to provide primary care services.
The Grant Program is funded by UnitedHealth Group. Grant information for the fifth and final round of this program will be available in early December. For more information, please contact Shelly Collings at sc@coruralhealth.org.
We Can't Wait: Health Care Innovation Challenge
We Can't Wait: Health Care Innovation Challenge will improve care, save money, focus on health care jobs
New funding available for next generation of health care innovations
WASHINGTON, DC-- Up to $1 billion dollars will be awarded to innovative projects across the country that test creative ways to deliver high quality medical care and save money. Launched today by the Department of Health and Human Services, the Health Care Innovation Challenge will also give preference to projects that rapidly hire, train and deploy health care workers.
“We’ve taken incredible steps to reduce health care costs and improve care, but we can’t wait to do more,” said HHS Secretary Kathleen Sebelius. “Both public and private community organizations around the country are finding innovative solutions to improve our health care system and the Health Care Innovation Challenge will help jump start these efforts.”
Funded by the Affordable Care Act, the Health Care Innovation Challenge will award grants in March to applicants who will implement the most compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and the Children’s Health Insurance Program, particularly those with the highest health care needs. The Challenge will support projects that can begin within six months. Additionally, projects that focus on rapid workforce development will be given priority when grants are awarded.
Read the full release here.
For more information, including a fact sheet and the Funding Opportunity Announcement, please see the Health Care Innovation Challenge initiative web site at www.innovation.cms.gov.
Webinar: “Place Matters”: A Conversation about Rural America and Social Determinants
This webinar will introduce four broad types of rural places, and explore their relationship to social determinants of health, as a way to present useful and practical information that can be beneficial to rural communities working to promote behavioral health equity for children and their families. Presenters will explore how this information can help communities achieve their desired outcomes. Participants will be engaged in discussion about the challenges and opportunities ahead for leaders and their partners across systems who are working to reduce disparities in rural communities.
Date: November 16, 2011
Time: 1:00 – 2:30 p.m. MST
Presenters:
- Jessica Ulrich, Research Assistant, Carsey Institute, University of New Hampshire
- Lynn C. Todman, Ph.D., Executive Director, Institute on Social Exclusion, The Adler School
- Alison Scott, Ph.D., Assistant Professor, Community Health and Program Director, Jiann Ping Hsu College of Public Health, Georgia Southern University
- Joyce Sebian, Senior Policy Associate, National TA Center for Children's Mental Health Georgetown Center for Child and Human Development
Event Registration: To register for this event, please click here. You will need to register to receive information on how to attend the event. Please note that registration for this event will close Tuesday, November 15, at 5:00 p.m. Eastern Time. All participants will need to download the software to ensure that they have the latest version installed.
If you have any questions about the Live Meeting technology or these Webinars, please contact Yorkmit Mendieta by email at ymendieta@air.org or by phone at 202.403.5366.
Colorado Hospitals Have $18.8 Billion Impact on State Economy
Colorado hospitals contributed $18.8 billion in economic output in 2010 — including $9.8 billion in direct jobs and spending — according to a study released Wednesday that is designed to help buffer hospitals against potential cuts in federal and state health care funding.
The study, commissioned by the Colorado Hospital Association (CHA) and conducted by Colorado State University, is the first examination of the economic impacts of the state’s hospitals since the beginning of the recent recession.
It shows that Colorado’s 108 hospitals added 4,900 jobs between 2007 and 2010, a time frame in which the overall state economy lost more than 123,000 jobs.
Those facilities directly employed 71,700 people last year with average salary-plus-benefit compensation figures of $69,900, according to the report, titled “Examining the Impacts of Hospitals on the Colorado Economy.”
Rural Health Care Leadership Conference
For 25 years, Health Forum and the American Hospital Association’s Rural Health Care Leadership Conference has both informed and inspired rural health care leaders and this coming year is no exception. The 2012 conference brings a unique focus on innovative ideas, thoughtful insights, and proven strategies for improving rural hospitals and developing rural health care leaders.
The Rural Health Care Leadership Conference will be held February 5–8, 2012 in Phoenix, AZ. For more information visit www.healthforum.com/rural or click here to download the conference brochure.
Healthy Living Initiatives: Tool Kits for Health Promotion
The Department of Health Care Policy and Financing has identified four priority areas for health promotion and disease prevention. These are the Healthy Living Initiatives, which include oral health; behavioral health (with a focus on depression); nutrition and fitness (with a focus on obesity); and tobacco cessation.
The Department has released tool kits that provide guidance on how to effectively document and address health promotion for Medicaid/ CHP+ clients in the primary care setting. The tool kits provide information on coding and reimbursement for screening, diagnosis, treatment and referral in the following areas:
- Preventive oral health for children at well-child visits
- Addressing depression in the primary care setting
- Focusing on issues of overweight and obesity
- Reducing tobacco use
The tool kits are located on the Department’s Healthy Living web page.
Contact Lisa Waugh with any questions at Lisa.Waugh@state.co.us or 303-866-2029.
Centura Health Connects to the CORHIO Health Information Exchange Network
All Centura facilities went live on CORHIO on October 24, 2011. By connecting its current electronic health record with CORHIO’s secure network, Centura's physicians and other medical care providers from across the state are linked to important real-time health information about their patients.
Centura Health Uses Industry-Leading Technology to Improve Care Coordination For Residents in Metro Denver, Boulder, Colorado Springs, Pueblo, Summit County and Cañon City.
To read Centura Health's press release, click here.
To read CORHIO's press release, clickhere.
Letter From the CEO
As the new CEO of the Colorado Rural Health Center, I have been overwhelmed by the positive feedback I have received about the organization and mission we serve. Prior to accepting this position, I had a strong appreciation for the quality of CRHC, but I did not realize the vast reach of the organization and the extent of the services we provide to rural communities. It has been wonderful getting to know our partner organizations and catching up with friends from organizations that I previously worked with and now have the opportunity to collaborate with in a different capacity. I thank everyone for the warm welcome that I have received and the outpouring of messages of congratulations on the position I now have the honor of serving. For those of you I have yet to meet, I look forward to getting to know you soon.
As you are all aware, one of the biggest challenges facing CRHC and rural healthcare providers are the imminent cuts to our national budget. Critical Access Hospitals and other important healthcare programs face significant decreases to revenue as policymakers in Washington work on reducing the deficit and cutting federal spending. The Budget Control Act of 2011 calls for $1.2-$1.5 trillion reduction in federal expenditures over the next ten years. A bipartisan “Super Committee” of 12 members of Congress has been created to develop recommendations for reaching the $1.2+ trillion goal. If this Committee cannot produce a proposal to Congress by November 23, or if Congress fails to approve any proposal by December 23, automatic 2% cuts, or sequestration, will be applied to Medicare provider rates, defense, and other programs.
One of CRHC’s top priorities is ensuring Congress understands the devastating impact these cuts could have on our state’s most vulnerable populations and the facilities who serve them. Colorado’s Congressional delegation needs to hear from you about the impact these cuts will have on rural providers and access to care in rural communities. We have several resources on our website and in this Special Delivery for more information to assist you with making your voice heard. We will continue to keep you updated continually as November 23rd approaches.
Rural communities are known for their “can do” attitude and their ability to rally together in times of need. Thank you for joining CRHC in this time of need and helping us provide the support that allows all Coloradans, rural and urban, to have access to high quality healthcare services. Our mission during the past 20 years has been to support rural healthcare by meeting the needs proactively and immediately and we will continue to keep one step ahead to ensure our members can continue to serve their communities.
Colorado Health Benefit Exchange Board Update
The Colorado Health Benefit Exchange (COHBE) Board recently approved a planning grant proposal for funds to continue developing the Exchange. The enacting legislation passed last year required the Legislative Implementation Review Committee to review and approve any grants prior to their submission. Due to concerns regarding the state’s ability to create a Colorado-specific Exchange and the proposed salaries of the COHBE staff, the Review Committee, split evenly between Democrats and Republicans, was unable to come to an agreement about the terms of the grant. The arguments played out in the Denver Post after their editorial board accused the Republicans of "politicking" and Colorado Republican Senator Kevin Lundberg responded to the editorial stating the grant would require Colorado to conform to federal requirements.
Currently, the COHBE Board, and the Review Committee are working together with the hope that a grant can be submitted by December 30th, but in the meantime, the Governor’s office requested supplemental funding from the current grant in order to support the COHBE activities until an agreement can be reached.
The COHBE Board continues to meet and is in the process of creating their by-laws, defining their relationship with the Attorney General’s office and hiring an Executive Director.
Dr. Jonathan Gruber of Wakely Associates presented data on the profile of the Exchange customers, as well as anticipated premiums. He received feedback from the Data Advisory Workgroup (DAWG), the Board and other stakeholders, and is in the process of compiling a final report. To view those findings, click here.
The Institute of Medicine recently released guidance on the Essential Health Benefits (EHB). The Affordable Care Act requires that insurance plans participating in the exchanges cover, at a minimum, a package of EHBs. The ESBs will likely be available for comment to HHS by late spring 2012.
For more information on the Exchange, the COHBE Board, workgroups of the Review Committee, you can visit www.ColoradoHealthInstitute.org or contact Alicia Haywood of the Colorado Rural Health Center at ah@coruralhealth.org.
CROP Application Deadline Oct. 31
Do you have a healthcare provider at your facility who is interested in loan repayment, or would you like to recruit a provider through loan repayment incentives? The Colorado Rural Outreach Program (CROP) Loan Repayment Program fall 2011 application cycle will be closing on October 31, 2011. Spring applicants who were not awarded are invited to reapply. CROP is a CRHC grant program for healthcare facilities to apply for on behalf of a healthcare clinician. Funding for the fall cycle is generously supported by Caring for Colorado and the El Pomar Foundation.
Eligibility requirements for facilities:
- Public, non-profit or private healthcare facility.
- Located in a designated rural county.
- Ability to contribute a monetary award: Colorado Rural Health Center (CRHC) will “match” this award amount up to $10,000, making the total amount awarded to the clinician $20,000. Award may be funded through other avenues in the community, e.g., a local business, community college, fundraiser, etc.
- Retention grant - facility may apply for CROP on behalf of a clinician already employed.
- Recruitment grant – facility may apply for CROP to assist in recruitment by guaranteeing loan repayment.
- Award may be used for a different financial incentive to a clinician if they do not have loan debt, e.g., a bonus or other community request.
- Any clinician providing medical, dental or mental healthcare. Must be providing direct patient care.
- Clinician may be employed at facility or be in the process of being hired
Facility may re-apply for same clinician for up to three years. Facility may apply for more than one clinician, but preference will be given to only one applicant. Awardees will be notified four weeks after application cycle closes.
Please download the application packet and coversheet for more information. Please complete and save the coversheet in Microsoft Word. You may submit your application via e-mail or postal mail. If submitting via e-mail, please make the narrative and all attachments ONE inclusive document. The coversheet may be separate. To resubmit your application please send an email along with healthcare professionals' updated loan repayment documents to rp@corrualhealth.org. Please send your CROP application to:
Attn: Grants Manager
Colorado Rural Health Center
3033 S. Parker Rd., Suite 606
Aurora, CO 80014
rp@corrualhealth.org
Main: 303.407.2031
Fax: 303.832.7496
http://www.coruralhealth.org/programs/loanrepayment/crop.htm
Rural Facilities and Healthcare Programs Targeted in Deficit Reduction Activities
Critical Access Hospitals and other important healthcare programs face significant challenges as policymakers in Washington work on reducing the deficit and cutting federal spending. The Budget Control Act of 2011, passed earlier this summer, calls for $1.2-$1.5 trillion reduction in federal expenditures over the next ten years. A bipartisan “Super Committee” of 12 members of Congress has been created to develop recommendations for reaching the $1.2+ trillion goal. If this Committee cannot produce a proposal to Congress by November 23, or if Congress fails to approve any proposal by December 23, automatic 2% cuts, or sequestration, will be applied to Medicare provider rates, defense, and other programs.
Rural hospitals and Medicaid have been targeted in various proposals to the Super Committee and to Congress as a whole. Proposals include eliminating the Critical Access Hospital (CAH) program, removing CAH designation for any facility within 10 miles of another hospital, reducing CAH reimbursement to 100% of costs, lowering the federal matching rate for Medicaid to the states, and reducing the Medicaid Hospital Provider Fee. Earlier this month, CRHC co-hosted a webinar with the Area Health Education Centers that outlined the proposals under consideration by the Super Committee and the potential impacts of these proposals and sequestration. If you could not attend, a recording of the webinar and the presentation is available online.
Colorado’s Congressional delegation needs to hear from constituents about the impact these cuts will have on rural providers and access to care in rural communities. Please contact the healthcare staff for your representative, Senator Udall, and Senator Bennet today with these messages:
- Cuts in federal healthcare programs may be inevitable, however, certain deficit reduction proposals being discussed are disproportionately harmful to rural communities and will impact access to care.
- Medicare payments to rural safety net providers, including cost-based reimbursement for critical access hospitals, should be shielded from cuts.
- Ask them to share their concerns with members of the Super Committee and their caucus leaders and encourage them to reach agreement to avoid sequestration.
- Across-the-board cuts required by sequestration will fall harder on rural communities.
CRHC has posted several resources on its website to assist you and thank you for your efforts on behalf of rural providers and communities. Please contact us if you have any questions.
CME Locum Tenens Scholarship Available
The Colorado Rural Health Center is offering Physicians, PA’s, Nurse Practitioners, and Dentists with an opportunity to get scholarship money for locum tenens pay, and/or travel costs associated with attending local, statewide, or national conferences or additional trainings. Funding cannot be used to pay for the cost of attending the conference, or registering for the program.
Criteria & Eligibility
- Applicants must be located in a rural, or non-metropolitan county in Colorado.
- The applicant organization can be a public or private entity, including FQHC’s.
- All awards are paid to the organization, and not the scholarship recipient.
- You can apply for Locum Tenens costs (no limit, but within reason), travel (up to $1,500 dollars) or both.
- Available to Physicians, Physician Assistants, Nurse Practitioners, & Dentists.
- Applications may be submitted for retro expenses dating back to March 2011 to the present.
Applications will be accepted throughout the year, but reviewed and awarded on a quarterly basis. The next cycle due date is December 15th, 2011. Applications can be downloaded online.
Questions? Contact Erica at ep@coruralhealth.org, by phone at 303.996.9698 or fax 303.832.7496.
CRHC Offers Free Lean/Six Sigma and QI Education to CAHs
Through CRHC’s iCARE (Improving Communication and Readmission), Colorado CAHs have access to free training in Lean/Six Sigma concepts and Quality Improvement Practices education. Participating CAHs receive technical assistance through webinars, online modules, and one-on-one consultations to help guide them through process improvement related to one of the iCARE projects three primary goals: Improving Communication in Transitions of Care; Maintaining Low Readmission Rates, and Improving Clinical Processes that contribute to readmissions, particularly for heart failure and pneumonia patients.
For more information about participating in iCARE , contact Jen Dunn at jd@coruralhealth.org or Michelle Mills at mm@coruralhealth.org.
CRHC Hosts Rural Health Works Community Health Needs Assessment and Economic Impact Training
CRHC and Colorado STRIDES are hosting the only Rural Health Works Western U.S. regional training slated for 2011-2012. Rural Health Works, which operates out of Oklahoma State University, trains in economic impact studies, community health needs assessment, and budget studies for new or expanded services. Training will take place at CHRC on Tuesday, December 13.
Click here or more information, or to register.
Centura Health Presents Injury Prevention Summit on Friday, November 11th
If you’re interested in injury prevention, come join us for Centura Health’s Injury Prevention Summit on Friday, November 11th at the Julie Penrose Health and Education Center in Colorado Springs. This one-day event promises to be a day of networking and learning with trauma experts and others in the field from around the state. Continuing education credits will be available. Anyone is invited to RSVP and attend.
When: Friday, November 11, 8 a.m. to 4:30 p.m.Where: Julie Penrose Health and Education Center, next to the St. Francis Medical Center North Care Building (6071 E. Woodmen Rd., Colorado Springs)
Details: Lunch and CE credits provided
Cost: $25 registration fee
Topics include:
- Injury Prevention – How Far We Have Come
- Data Collection – A Necessary Evil
- How Do You Assess Your Community
- Implementation – Getting to Work
- A Program That Works – Case Study
- It Takes a Village! Tapping Into Existing Resources & Building Community Partners
- Show Me the Money!
- Navigating the Federal and State Grant Process
- Are We Making a Difference?
For more information about the event, visit www.centuratrauma.org or see the flyer. To register, please contact Sherrie Rozwick, sherrierozwick@centura.org or 719-776-5926.
About the Centura Health Trauma System
Centura Health’s Trauma System provides an integrated network of specialty care designed to deliver optimal care of the trauma patient through dedicated leadership, expertise and best practices. With our 14 designated trauma centers, Flight For Life® Colorado and the state’s largest EMS support system, our patients have access to a dedicated network of hospitals and operating entities that provide the highest level of care at the most critical time of need. We partner with the communities we serve to provide inter-facility transport, quality and trauma designation review assistance, along with a wide variety of educational, injury prevention and research opportunities. This robust system of care promotes both our pre-hospital and facility partners’ success while providing optimal care to those we serve across the state of Colorado.
Dr. Don: The life of a small-town druggist
In the southwestern corner of Colorado, where the Uncompahgre Plateau descends through spruce forest and scrubland toward the Utah border, there is a region of more than four thousand square miles which has no hospitals, no department stores, and only one pharmacy. The pharmacist is Don Colcord, who lives in the town of Nucla. More than a century ago, Nucla was founded by idealists who hoped their community would become the “center of Socialistic government for the world.” But these days it feels like the edge of the earth. Highway 97 dead-ends at the top of Main Street; the population is around seven hundred and falling. The nearest traffic light is an hour and a half away. When old ranching couples drive their pickups into Nucla, the wives leave the passenger’s side empty and sit in the middle of the front seat, close enough to touch their husbands. It’s as if something about the landscape—those endless hills, that vacant sky—makes a person appreciate the intimacy of a Ford F-150 cab.
Don Colcord has owned Nucla’s Apothecary Shoppe for more than thirty years. In the past, such stores played a key role in American rural health care, and this region had three more pharmacies, but all of them have closed. Some people drive eighty miles just to visit the Apothecary Shoppe. It consists of a few rows of grocery shelves, a gift-card rack, a Pepsi fountain, and a diabetes section, which is decorated with the mounted heads of two mule deer and an antelope. Next to the game heads is the pharmacist’s counter. Customers don’t line up at a discreet distance, the way city folk do; in Nucla they crowd the counter and talk loudly about health problems.
Read the full article published in The New Yorker here.
Letter from the COO
Although the coming months are sure to bring uncertainty and changes for rural health as policymakers in Washington D.C. address our nation’s fiscal challenges, the Colorado Rural Health Center and rural providers still have much to celebrate. CRHC, in conjunction with the Spanish Peaks Regional Health Center in Walsenburg, CO is very proud to announce a new funding award from the Office of Rural Health Policy. One of just 40 Rural Health Information Technology Network Development (RHITND) awards, this funding will be used to develop a virtual data center network and IT staff support cooperative for rural providers across the state. This has been on the drawing board for a long time, and it is gratifying to see it finally come to fruition. Congratulations to all involved and to Telluride Medical Foundation for also being an RHITND award recipient in Colorado. To read more about the grant program, click here.For several months I have traded phone calls and e-mails with the staff of the National Organization of State Offices of Rural Health (NOSORH), including Teryl Eisinger, NOSORH's Executive Director. I finally was able to meet Teryl and other fine representatives of the organization at the NOSORH Annual Conference, held in Denver last week. It was a privilege and pleasure to host this conference in our own state and to welcome representatives from across the nation to Denver. Cari Fouts and I had the honor of opening the conference with our greeting and welcome and facilitating several sessions throughout the two-day event. Those in attendance benefitted from the presentations and the connections with staff of other State Offices of Rural Health. The theme throughout the conference was "Celebrating the Power of Rural!"and building moment to the National Rural Health Day, November 17, 2012. Now more than ever, state offices and our national partners must band together to ensure rural programs remain intact and support the amazing care being provided to vulnerable communities.
At our Annual Rural Health Conference last month we were pleased to celebrate our 20 year history as the State Office of Rural Health with our members, collaborators and supporters. If you were unable to attend the conference, please take a moment to view our 20th Anniversary Video and an artists rendition of our 20 year timeline through the "Long and Winding Road" resulting in where we are today. We cannot begin to thank all of our funders and members who have supported us and guided us throughout the years, and it's incredible to look back on how much our office and rural healthcare has changed from 1991 to now. Rural healthcare providers and communities are strong and vibrant and we know that together we can ensure 20+ more years of vitality and access to care for rural Coloradans. Please take our annual survey today to help us shape our legislative priorities for the future.
CME Locum Tenens Scholarship Available
The Colorado Rural Health Center is offering Physicians, PA’s, Nurse Practitioners, and Dentists with an opportunity to get scholarship money for locum tenens pay, and/or travel costs associated with attending local, statewide, or national conferences or additional trainings. Funding cannot be used to pay for the cost of attending the conference, or registering for the program.
Criteria & Eligibility
- Applicants must be located in a rural, or non-metropolitan county in Colorado.
- The applicant organization can be a public or private entity, including FQHC’s.
- All awards are paid to the organization, and not the scholarship recipient.
- You can apply for Locum Tenens costs (no limit, but within reason), travel (up to $1,500 dollars) or both.
- Available to Physicians, Physician Assistants, Nurse Practitioners, & Dentists.
- Applications may be submitted for retro expenses dating back to March 2011 to the present.
Applications will be accepted throughout the year, but reviewed and awarded on a quarterly basis. The next cycle due date is September 15th, 2011. Applications can be downloaded online.
Questions? Contact Erica at ep@coruralhealth.org, by phone at 303.996.9698 or fax 303.832.7496.
Complete CRHC's Policy and Advocacy Survey Today
Please inform the Colorado Rural Health Center’s (CRHC) policy & advocacy efforts for 2012 by completing our annual survey. Your feedback is invaluable and will help guide our work. The survey should take approximately 5 minutes to complete and can be accessed by clicking here. The survey will be open until Friday September 30, 2011. Please complete the survey only once per person. Your responses are greatly appreciated!
CROP Fall Application Cycle Opens in October
Do you have a healthcare provider at your facility who is interested in loan repayment, or would you like to recruit a provider through loan repayment incentives? The Colorado Rural Outreach Program (CROP) Loan Repayment Program fall 2011 application cycle will be open from October 1, 2011 to October 31, 2011. CROP is a CRHC grant program for healthcare facilities to apply for on behalf of a healthcare clinician. Funding for the fall cycle is generously supported by Caring for Colorado and the El Pomar Foundation.
Eligibility requirements for facilities:
- Public, non-profit or private healthcare facility.
- Located in a designated rural county.
- Ability to contribute a monetary award: Colorado Rural Health Center (CRHC) will “match” this award amount up to $10,000, making the total amount awarded to the clinician $20,000. Award may be funded through other avenues in the community, e.g., a local business, community college, fundraiser, etc.
- Retention grant - facility may apply for CROP on behalf of a clinician already employed.
- Recruitment grant – facility may apply for CROP to assist in recruitment by guaranteeing loan repayment.
- Award may be used for a different financial incentive to a clinician if they do not have loan debt, e.g., a bonus or other community request.
- Any clinician providing medical, dental or mental healthcare. Must be providing direct patient care.
- Clinician may be employed at facility or be in the process of being hired
Facility may re-apply for same clinician for up to three years. Facility may apply for more than one clinician, but preference will be given to only one applicant. Awardees will be notified four weeks after application cycle closes.
Please download the application packet and coversheet for more information. Please complete and save the coversheet in Microsoft Word. You may submit your application via e-mail or postal mail. If submitting via e-mail, please make the narrative and all attachments ONE inclusive document. The coversheet may be separate.
Please send your CROP application to:
Attn: Grants Manager
Colorado Rural Health Center
3033 S. Parker Rd., Suite 606
Aurora, CO 80014
rp@corrualhealth.org
Main: 303.407.2031
Fax: 303.832.7496
http://www.coruralhealth.org/programs/loanrepayment/crop.htm
CRHC's iCARE Program On the Cutting Edge of Quality Improvement
CRHC’s Improving Communications and Readmissions (iCARE) is on trend with national quality improvement efforts. Recently, The Institute for Healthcare Improvement (IHI) announced their Executive Director of Performance Improvement Bob Lloyd will speak at the National Forum in December on “Building an Integrated Approach to Improvement with Lean, Six Sigma, and the Model for Improvement.”
Five of Colorado’s Critical Access Hospitals have already been engaging with CRHC in efforts to integrate with Lean, Six Sigma and the Model for Improvement through the iCARE Initiative and with the assistance of SigmaMed Solutions, LLC. CRHC created iCARE as an opportunity to engage CAHs in a statewide improvement initiative aligning with national trends, funding priorities, and with a rural focus. Michelle Mills, Director of Programs states, “It is more important than ever because of impending budget cuts federally that Congress and entities like HRSA and ORHP understand the great work being conducted in rural Colorado.”
The 3 primary goals of iCARE are to 1) maintain low readmission rates, 2) improve communication in transitions, and 3) improve clinical processes, especially for heart failure and pneumonia patients. Each iCARE hospital chooses an individual goal relating to one of these primary topics that will be focused on during the year (Sept 2011-Aug 2012).
CRHC provides participating hospitals with resources and education to address their individual goals including becoming Lean Sigma Healthcare Yellow, Green or Black Belt certified. All trainings and education are offered remotely through Webinar and online training modules, and individual mentor follow-up occurs regularly to ensure success.
To join iCARE, or to learn more, please contact Jen Dunn at jd@coruralhealth.org or 303.832.7492 or Michelle Mills at mm@coruralhealth.org or 303.407.0410.
Five of Colorado’s Critical Access Hospitals have already been engaging with CRHC in efforts to integrate with Lean, Six Sigma and the Model for Improvement through the iCARE Initiative and with the assistance of SigmaMed Solutions, LLC. CRHC created iCARE as an opportunity to engage CAHs in a statewide improvement initiative aligning with national trends, funding priorities, and with a rural focus. Michelle Mills, Director of Programs states, “It is more important than ever because of impending budget cuts federally that Congress and entities like HRSA and ORHP understand the great work being conducted in rural Colorado.”
The 3 primary goals of iCARE are to 1) maintain low readmission rates, 2) improve communication in transitions, and 3) improve clinical processes, especially for heart failure and pneumonia patients. Each iCARE hospital chooses an individual goal relating to one of these primary topics that will be focused on during the year (Sept 2011-Aug 2012).
CRHC provides participating hospitals with resources and education to address their individual goals including becoming Lean Sigma Healthcare Yellow, Green or Black Belt certified. All trainings and education are offered remotely through Webinar and online training modules, and individual mentor follow-up occurs regularly to ensure success.
To join iCARE, or to learn more, please contact Jen Dunn at jd@coruralhealth.org or 303.832.7492 or Michelle Mills at mm@coruralhealth.org or 303.407.0410.
CRHC Receives Rural Health Information Technology Network Development Funding
CRHC, in partnership with Spanish Peaks Regional Health Center in Walsenburg, CO, was awarded one of 40 Rural Health Information Technology Network Development (RHITND) on Sept. 1, 2011. The three year Office of Rural Health Policy (ORHP) funding will be used to develop a virtual data center network and IT staff support consortium for rural providers across the state. This has been a long-standing goal for CRHC's strategic plan driven by the Board, leadership, and rural members. Through this data center consortium, large economies of scale will be realized to greatly reduce costs and support adoption and ongoing operations of health information technology across rural healthcare facilities.
Congratulations to Telluride Medical Center Foundation in Telluride, CO who was also awarded funding. To view the full HHS release and list of awardees, click here. To learn more about this funding or to see how your facility can participate, please contact Cari Fouts at cf@coruralhealth.org.
Congratulations to Telluride Medical Center Foundation in Telluride, CO who was also awarded funding. To view the full HHS release and list of awardees, click here. To learn more about this funding or to see how your facility can participate, please contact Cari Fouts at cf@coruralhealth.org.
Colorado HealthStory Visits Rocky Ford
Colorado HealthStory, a three-year project of the Colorado Rural Health Center, ClinicNET and the Colorado Coalition for the Medically Underserved, recently completed the pilot phase of their story collecting project. Colorado HealthStory, funded in late 2010 by The Colorado Trust and The Colorado Health Foundation, is working to create an appreciation of our shared experiences of health, one conversation at a time. Everyone has a story to tell, whether it be the joyous birth of a baby, the moving experience of sitting with a dying parent, a journey of remarkable healing, the perspective gained from providing care or struggling to navigate our complicated healthcare system.Colorado HealthStory staff began gathering audio recordings this summer in three focus communities: Rocky Ford, Summit County and Aurora. After collecting and editing a body of stories in each community, HealthStory gathered community members together for a local forum and listening session. During the forums, storytellers, providers, elected officials, advocates and other members of the community were able to listen to collected stories and speak about local shared health issues. Health profiles for the region were presented at each forum which highlighted recorded stories and local health data. This fall, HealthStory staff will hit the road again to record stories in three additional communities.
To learn more about the Colorado HealthStory project, to hear the stories, or to view the community health profiles, visit the HealthStory website at http://www.coloradohealthstory.org/.
Colorado Rural Health Care Excellence Award winner for 2011 –David Arnett, MD
Colorado Rural Health Center awarded David Arnett, MD, with the 2011 Rural Health Excellence Award at the 20th Anniversary Annual Rural Health Conference, August 11-12, 2011. Dr. Arnett was awarded this prestigious honor because of his extensive dedication to providing rural healthcare to underserved Coloradans for over 30 years. Dr. Arnett started a solo family practice in rural Salida, Colorado after graduating from Colorado University Medical School in 1979. Believing in rural outreach and the need to deliver high quality healthcare, he opened community clinics in Saguache, Colorado and Coaldale, Colorado in the 1980’s. He and his partners have traveled 50-100 miles to these clinics, once or twice a week for the past 30 years.
Dr. Arnett offers full family focused healthcare to all patients including pediatrics, obstetrics, geriatrics and sports medicine. He volunteers at local schools to improve adolescent healthy behaviors and has sponsored 9Health Fairs for over 10 years. Dr. Arnett serves as a preceptor for CU School of Medicine medical students, hoping to instill rural health concepts into the education of future physicians. CRHC was proud to present Dr. Arnett with this year’s Rural Health Excellence Award as he has truly made a significant and outstanding contribution to the healthcare of rural Colorado residents.
Paramedics filling health care gap as need grows
A select group of paramedics in several states is helping to provide primary health care by making house calls — an initiative encouraged by the federal health care law to address shortages in primary care and cut down on expensive visits to doctors and emergency rooms.
In Colorado's Eagle County, paramedic Kevin Creek makes house calls to take electrocardiograms, check patient prescriptions, check blood pressure, change dressings, draw blood and make other observations that used to require a doctor's visit.
"We all get into this because of the adrenaline rush," Creek said of his career as a paramedic. "I've done the car accidents. I've done the shootings and the stabbings. Instead of taking out the blood and guts, this is a move into preventative care, so people don't have to call 911."
Creek and a colleague participating in the pilot project through the Western Eagle County Ambulance District work full time under the supervision of doctors who refer them to patients. The doctors evaluate information provided by the paramedics and decide the next steps of care.
The Community Paramedic Program is free for anyone in Eagle County, which has an uninsured rate of 26 percent. But it is funded so far by $700,000 in grants from the Colorado health department, two private health organizations and the ambulance district, said district program coordinator Lisa Ward.
"We're the eyes and ears of the primary care physician in the home," said Ward. "It's out-of-the-box health care, and it's the future."
Colorado approved the five-year pilot program to determine how much money the state and federal government might save in Medicare and Medicaid spending in the county, which has a population of about 52,000, many of them in rural areas.
Connecting Health Education to Service: A Comprehensive Networking Event
This event, held October 13 at the University of Colorado, Anschutz Campus in Aurora, is an opportunity for your site to directly recruit healthcare professionals and network with Colorado healthcare professional school staff and faculty. This is also an opportunity for healthcare professional students and residents to learn about your site and the options that are available to them in the healthcare safety-net. We hope this opportunity to directly recruit and also network across organizations will stimulate innovative solutions to the workforce issues facing Colorado, specifically, the shortage of primary care healthcare providers in Colorado’s safety-net.
Providers in attendance will include Physician Residents, Nurse Practitioner, Physician Assistant, and Dental students as well as other students from different disciplines.
We encourage you to have two to three people from your site, including an administrator or HR personnel and a healthcare provider, attend this event. Please plan to arrive 30-45 minutes early to set up your booth. Travel reimbursement is available for organizations with staff travelling over 50 miles.
Contact Sara Leahy with questions or for more information.
- Click here to register if you are a staff member at a hospital or clinic
- Click here to register if you are a faculty member, resident or student
USDA Community Facilities Loan and Grant Program
Community Programs, a division of the Housing and Community Facilities Programs, is part of the United States Department of Agriculture's Rural Development mission area. Community Programs administers programs designed to develop essential community facilities for public use in rural areas. These facilities include schools, libraries, childcare, hospitals, medical clinics, assisted living facilities, fire and rescue stations, police stations, community centers, public buildings and transportation. Through its Community Programs, the Department of Agriculture is striving to ensure that such facilities are readily available to all rural communities. Community Programs utilizes three flexible financial tools to achieve this goal: the Community Facilities Direct and Guaranteed Loan Program, the Community Facilities Grant Program, and the Rural Community Development Initiative.
Community Programs provides grants to assist in the development of essential community facilities in rural areas and towns of up to 20,000 in population. Grants are authorized on a graduated scale. Applicants located in small communities with low populations and low incomes will receive a higher percentage of grants. Grants are available to public entities such as municipalities, counties, and special-purpose districts, as well as non-profit corporations and tribal governments. Loans and guarantees are available to public entities such as municipalities, counties, and special-purpose districts, as well as to non-profit corporations and tribal governments.
Applications are accepted on an ongoing basis through USDA-RD field offices. Read more about the grant program here.
Funding Announced for Rural Health Networks Planning Grants
As part of the Governor’s Bottom Up Economic Development Initiative, a number of counties and regions identified supporting healthcare as a goal. Recognizing how important healthcare is as an economic driver, Colorado STRIDES and the Colorado Rural Health Center applaud this focus on healthcare, and seeks to support counties, regions, healthcare providers and facilities moving in this direction!
Health Resources and Services Administration recently announced funding for Rural Health Networks Planning Grants. These grants support the development Rural Health Networks designed to achieve efficiencies, expand access to quality medical services, and strengthen the rural healthcare system as a whole. Applications are due October 31, 2011. For more information, please visit their website.
For information about how Colorado STRIDES and Colorado Rural Health Center might be able to support your application and application process, please feel free to contact Clint at 800.851.6782, ext 255 or ccr@coruralhealth.org.
Letter from COO
Last week’s CRHC Annual Conference was a big success. It was gratifying to see and meet so many people and to hear such positive comments about the conference – the subject matter, the speakers, the accommodations, the food, and the networking. I also received positive feedback from the exhibitors who felt that they made some good contacts. My sincere thanks go to a talented and hardworking staff who teamed up to deliver an excellent conference.
Many people especially enjoyed the 20th anniversary celebration reception. We saw a meaningful and sometimes moving video that tells the story of the CRHC and portrays its value to the health of rural Coloradans. It was a great time to celebrate what this organization has been, is, and will continue to be in the future.
During the week, we will be adding the presentations from the conference to our website, so please check for those updates using the login information provided at the conference. We will soon have the video posted as well.
Thanks to all who attended. I look forward to working with you in the future.
Happy Safety Net Clinic Week!
Colorado State Governor John Hickenlooper has proclaimed August 22-26 as the second annual Safety Net Clinic Week!
Sponsored by ClinicNET and the Colorado Rural Health Center, the week is devoted to educating the public and policy makers about these vitally important health care clinics - Community-Funded Safety Net Clinics (CSNCs) and federally certified Rural Health Clinics (RHCs). During the week, state representatives will be visiting rural communities throughout Colorado.
Contact Sara Schmitt or Alicia Haywood for more information.
Patient-Centered Medical Home: An Overview and Colorado’s Landscape
A Patient-Centered Medical Home (PCMH) is not a place but a concept. PCMH facilitates partnerships between individual patients, their personal physicians or care providers, and the patient’s family. It is a way of coordinating all health services in a quality, cost-effective and accessible manner through use of a team approach to health care that is centered on patient and family needs.
This type of patient centered care is often created in some manner by default in rural and safety-net communities, but is not always cohesive or well documented. Additionally, team-centered care is especially important given significant workforce constraints in most rural communities where physician-led care may not be available. The Patient-Centered Medical Home encompasses five functions and attributes:
- Patient-centered
- Comprehensive care
- Coordinated care
- Continuous access
Quality care delivered in a PCMH model is enabled by health information technology, health information exchange and the use of registries and other tools to assure that patients get culturally and linguistically appropriate care when and where they need it, provided at an appropriate health literacy level. For uninsured and underinsured patients, especially those with chronic diseases and complex needs, this philosophy allows for continuity of care with better outcomes and potential decrease in utilization of urgent and emergent care services. ClinicNET and the Colorado Rural Health Center (CRHC) support the PCMH model and provide services to assist clinics in pursuing PCMH certification or designation.
Colorado Health Benefit Exchange Board Updates
The Colorado Health Benefits Exchange (COHBE) board will hold its next meeting this Thursday, August 11th from 9:30 AM – 1:00 PM in the Legislative Services Building (200 E. 14th Ave., across the street from the State Capitol). It has not been determined if the meeting will be broadcast on the web.
The by-laws committee of the Exchange Board had a conference call yesterday to discuss legal counsel and the process for developing the by-laws. Committee members Steve Erkenbrack, Ken Lund, and Richard Betts will make recommendations to the Board during its meeting Thursday. The Board is also expected to appoint a Chair.
The workgroups continue to meet. To follow their work or to join a group, check out the Colorado Health Institute’s website, or contact Alicia at CRHC for more details.
The Colorado Center on Law and Policy, John Snow, Inc. and CoPIRG are holding focus groups around the state with likely Exchange users to test their perceptions and expectations for the marketplace. CRHC will post the information learned from those meetings when the report is available.
Joel Ario, the Director of the Office of Insurance Exchanges at the U.S. Department of Health and Human Services resigned. Ario’s deputy Tim Hill and Steve Larsen, Director for the Center for Consumer Information and Insurance Oversight, will lead the Exchange after Ario’s departure Sept. 23rd.
Peter Marcus of The Colorado Statesman, a weekly nonpartisan political paper, wrote a great article yesterday detailing the Board’s process to date and some of the controversy surrounding its appointments and funding. Click here to read the article.
Work, Education and Lifelong Learning Simulation (WELLS) Center
Highly specialized training for rural hospitals in Colorado: Training is investment in health care training and patient safety
A training initiative from the University of Colorado Hospital (UCH) and Colorado Division of Labor and Employment (CDLE) will provide customized, no-cost medical training to Colorado's rural health care providers. The initiative, made possible by CDLE funds, will offer highly sophisticated simulation training using technology from the WELLS Center located on the Anschutz Medical Campus and operated by UCH. The training will be available solely to 29 Critical Access Hospitals in rural Colorado.
The WELLS Center provides education and training for health care workers using life-sized mannequins, otherwise known as human patient simulators. The center has the ability to recreate real-life situations and demonstrate alternate ways of reacting to improve outcomes and hospital safety. The "patients" can be programmed to simulate a wide variety of scenarios that test both clinical and critical-thinking skills. Each patient simulator breathes, has a pulse, heart and lung sounds, and responds to appropriate stimuli. The mannequins can be programmed for almost any clinical situation including child birth, heart attacks and head injuries.
Rural hospitals in Colorado treat high-risk patients but health care workers may not see those patients very often. The WELLS Center will provide four hours of training at no-cost to workers in rural hospitals to prepare for low-volume, high-risk events without exposing any patients to risk. The center can provide training at its facility on the Anschutz Medical Campus. WELLS Center staff also can provide on-site training focusing on interaction and communication at the hospital as well as that particular hospital's processes and systems.
For more information on this training program, contact Heidi Miller, Business Specialist at the WELLS Center, 720-848-5444 or via email at Heidi.miller@uch.edu.
Med schools seek right fit for rural practice
Family physician Frank Swisher, DO, is up every day at 4:30 a.m. to see patients at the nearby hospital before heading to his office. He works an average of 80 hours a week at his solo practice in Jane Lew, W.Va., a rural town with a population of less than 500. Many patients drive more than an hour to see him, and he's always on call.
But Dr. Swisher loves his community and his patients, and he says there are many rewards to being a small-town doctor. "You get to know the patients better," he said. "I know their families, where they work and the kind of work they do. I'll see grandkids, parents and grandparents."
Small-town doctors throughout the U.S. say they are drawn to rural practice for the sense of community and personal connections with patients. Yet physician shortages have been a persistent problem in rural America for decades.
Medical schools nationwide are trying to tackle the problem. In the past decade, many have developed programs aimed at steering physicians toward rural practice. "Medical schools all around the country have developed rural-track programs," said Randy Longenecker, MD, clinical professor of family medicine and assistant dean for Rural Medical Education at Ohio State University College of Medicine.
UnitedHealth Group Report Identifies Innovative Solutions for Rural Health Care Coverage, Access and Quality Challenges
Rural Americans experience more chronic health conditions such as diabetes and heart disease than urban and suburban residents, have greater difficulties accessing high-quality care, and from 2014 millions more of them will likely participate in Medicaid and government-subsidized insurance, according to a new paper released today by the UnitedHealth Center for Health Reform & Modernization.
At the same time, more use of technology, such as broadband access that would increase telehealth solutions, can help ease strain on the system and further promote healthier outcomes in rural communities.
The paper, titled “Modernizing Rural Health Care: Coverage, Quality and Innovation,” explores how health reform implementation, particularly health insurance expansion, will increase the need for innovative care models and points to technology and a stronger role for rural primary care as promising solutions. It also reports the results of a new Harris Interactive survey of 2,000 patients and more than 1,000 primary physicians in rural and urban areas.
“The next few years will be times of considerable stress on rural health care, but also times of great opportunity, since across the country there are already impressive examples of high-quality care, tailored to the distinctive needs of the local community,” said Simon Stevens, UnitedHealth Group executive vice president and chairman of the UnitedHealth Center for Health Reform & Modernization. “The challenge for all involved in rural America now is to build on that track record of innovation and self-reliance, so as to ensure that all Americans – wherever they live – can live their lives to the healthiest and fullest extent possible.”
CCHIT offers certifications for 'homegrown' EHRs
Certification of electronic health record products is the first step toward achieving meaningful use. But what if you are a healthcare system operating under legacy software, customized commercial products or homegrown EHR systems that would cost hundreds of millions to replace with a new product already certified by the vendor? Some healthcare organizations, particularly teaching hospitals, have discovered that certifying their own system through a special CCHIT program is the best alternative.
The Certification Commission for Health Information Technology (CCHIT) announced last week that five new organizations joined Beth Israel Deaconess Medical Center in certifying complete or modular EHRs under its EHR Alternative Certification for Healthcare Providers, or EACH, an ONC-ATCB 2011/2012 certification program for already-installed EHR technology. They are: Health Management Associates, New York University Langone Medical Center, Northwestern University, Tenet Healthsystem Medical and the University of North Carolina Health Care.
“There are many myths about what is required to achieve certification and meaningful use,” said John Halamka, MD, Beth Israel Deaconess’s chief information officer. "The major challenge is not technology; it’s education. Partner as soon as you can with an authorized testing and certification body and get educated about the requirements because you will find it’s quite doable,” he said.
Dental Event in Morgan County
The Colorado Mission of Mercy, or COMOM, is scheduled for October 21 & 22 in Brush. This event aims to serve adults of all ages, as well as children, but particularly aims to treat patients who are unable to afford care. This large scale 2-day dental clinic will have more than 100 dental chairs, and will see an estimated 1,500 patients for cleanings, fillings, root canals and extractions. Spanish, Somali, and American Sign Language interpreters will be available. While the event is primarily targeted at Morgan, Kit Carson, Lincoln, Logan, Phillips, Sedgwick, Washington, and Yuma Counties, no one will be turned away based on geographic location.
In addition to getting the word out to patients, COMOM is looking for volunteers to make this event a success, including all sorts of health professionals, as well as general volunteers to help make this event a success! For more information, or to volunteer, visit the website.
Defining Rural: Too Many Definitions Cause Problems
Too many federal definitions of "rural" make it hard for local officials to figure out what programs they qualify for, so Ag Secretary Tom Vilsack said he will ask the White House Rural Council and Congress to try to reduce the number.
After a participant in the Council on Foundations conference on rural philanthropy said that variations in qualifications for various rural development programs make it difficult for communities to participate, Vilsack said he would be glad to take the issue to the White House Rural Council, an Obama administration innovation composed of Cabinet officers and leaders of other federal agencies.
Vilsack jokingly asked the audience if they were bothered that USDA has 11 different definitions of rural America. The varying definitions, which depend on population and other characteristics, "provide a convenient excuse not to do something," he said.
Operations Assistant Position at CRHC
The Operations Assistant provides organizational support for human resources administration, contact database management, and administrative assistance for the Operations department in order to make certain CRHC meets its obligations to its members, Board of Directors and grantors.
The Colorado Rural Health Center (CRHC) is a nonprofit organization that serves as the State Office of Rural Health. CRHC’s mission is to enhance healthcare services in Colorado by providing information education, linkages, tools and energy toward addressing rural healthcare issues.
Read more about the position responsibilities, requirements and how to apply. Start date is open. Application deadline: August 15, 2011.
Share Your Opinion About Buying Health Insurance in Colorado
Health Insurance Exchanges are online marketplaces where consumers can shop and buy health insurance products in the independent and small business markets. Given the high number of ranchers, farmers and small business owners in rural areas, it is crucial the experiences and ideas of rural Coloradans are heard in order to ensure the Exchange works for residents from all parts of the state. The Colorado Center on Law and Policy is hosting focus groups around the state to better understand the consumer needs, opinions and perspectives of the Exchanges. This is a great opportunity to provide the rural voice in the process. A list of the meetings outside the Denver-metro area is below.
Check out the flyer or find more information on Facebook at: Colorado Insurance Exchange Focus Groups.
- Grand Junction, August 1st and 2nd
- Time: 6-8 pm
- Place: Mesa County Workforce Center
- Address: 2897 North Avenue
- Sterling, August 8
- Time: 6-8pm
- Place: CSU Extension Room
- Address: 508 S. 10th Avenue
- Greeley, August 1st
- Time: 6-8pm
- Place: Centennial Park Library
- Address: 2227 23rd Avenue
- Pueblo, August 3rd
- Time: 6-8pm
- Place: Rawlings Library (Thurston Room)
- Address: 100 E. Abriendo Ave
NHSC: Now Accepting Site Applications Online
Today, the National Health Service Corps (NHSC) begins accepting applications from sites interested in becoming NHSC approved through an online application process. Qualifying sites interested in becoming an NHSC-approved site can apply online. Interested sites are strongly encouraged to read the NHSC Service Site Reference Guide before applying to the Corps.
To apply to become an NHSC approved site, follow these steps:
- Visit the website and click on the "Apply Here" button.
- Click "Create a Site Administrator Account."
- Complete the required fields and click "Register."
- The site will receive an email with account information. You will need to click the link in the email to activate your account. If you do not see this email in the inbox, check the junk or spam folder.
- Upon clicking the link, you will be redirected to the login page. Use the account credentials previously entered to login to the NHSC site portal. Make note of these login credentials for future use.
- Click the "Apply for a New NHSC Site" button, in the "Apply for a New NHSC Site" section.
- Follow the screen-by-screen instructions to complete and submit the official NHSC site application for review.
- The application will be processed and the applicant will be notified electronically once their application is approved.
Prospective NHSC sites may contact the NHSC Recruitment, Training, and Support Center (RTSC) at 877-313-1823, Monday-Friday 8:00 a.m. to 6:00 p.m. EST (except Federal holidays) with questions regarding the online site application.
CRHC’s Partner Program Featured in HealthLeaders Media
CRHC’s new Partner Program and first Partner-level sponsor, Centura, were featured in an article by HealthLeaders Media. Writer Alexandra Wilson Pecci noted, “If the road to economic viability, meaningful use, and accountable care organizations is a rocky one for most healthcare facilities, it’s perhaps even bumpier for rural ones. That’s why the Colorado Rural Health Center (CRHC) has created the “Partnership Program,” which will allow larger organizations to invest in a fund that will be used to provide free support services to small, rural health facilities.”
To read the full article, click here.
Centura Health Partners with Colorado Rural Health Center
A new partnership between Centura Health and CRHC enhances management and administration of healthcare in rural Colorado.
With more than 70 percent of Colorado counties classified as rural or frontier, the challenge to extend quality, accessible, affordable health care beyond city boundaries is growing. Changes in reimbursement models, regulatory and compliance issues, electronic health management and clinical services have never been more challenging.
Centura Health, Colorado’s largest health care provider, is committed to building systems of care that connect its operating entities and rural health partners via a seamless network of excellence. By coordinating efforts across the state, they are enhancing the health status of all Coloradans, delivering health care at the right time, in the right place.
In 2011, CHRC created the exciting new “Partnership Program” to provide organizations with an opportunity to support rural health care in Colorado in a meaningful and direct way. As the first official “Partner,” Centura Health is investing in the expansion of CRHC programs that positively improve the impact of rural health care providers and facilities including clinical assessments, billing/coding assistance, health information technology, quality improvement, policy and advocacy support and much more.
“The Rural Health Center has been a key resource for rural health in Colorado since 1991,” said Bob Wallace, Centura Health’s service line director for health outreach. “Our common vision and commitment to improving the delivery of health care allows us to combine resources in a targeted fashion knowing that critical needs in rural communities will be met. ”
About Centura Health
Centura Health, Colorado’s health care leader, is focused on connecting Coloradans to affordable, world-class care in every corner of the state. Centura Health’s integrated statewide network includes 13 hospitals, seven senior living communities, medical clinics, affiliated partner hospitals, Flight For Life® Colorado, and home care and hospice services. Approximately 14,500 of the best hearts and minds in medicine, along with 6,000 physician partners, have access to the most technologically advanced tools available. For Coloradans, this means the top expertise and technology is right where you need it – close to where you are. We reach beyond hospital walls to connect with people at every stage of life to bring them life-enriching compassion and life-affirming hope. Connections that only Centura Health can make. For information on Centura Health or any of the facilities in our network, please visit www.centura.org.
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