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.

Eligibility requirements for healthcare providers:

• 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.

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.

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.

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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.