CRHC at IHI’s 15th Annual International Summit on Improving Patient Care

At the Institute for Healthcare Improvement’s (IHI) International Summit on Improving Patient Care this March, CRHC will have the opportunity to present some of the work it and clinics throughout the state have been doing in the areas of improving operations and quality improvement. CEO, Michelle Mills will present about CRHC’s Improving Communication and Readmissions (iCARE) program and the work clinics throughout the state have been doing through this initiative to work with Critical Access Hospitals to improve communication in transitions of care, improve clinical processes, and reduce readmission rates.  At the Storyboard exhibit, CRHC will also have the opportunity to showcase some of the work being done across the state though Healthy Clinic Assessments, which work with clinics to improve efficiencies and workflow in their basic business operations.  For a sneak peak at the Storyboard, click here.

Member of the Month: Sedgwick County Health Center

Julesburg, CO located in the most northeast corner of Colorado is the first town in our state to greet travelers heading west to the Rocky Mountains. With a population of 2,341, it is a small town, but is the hub of the healthcare community for the county. Sedgwick County Health Center is the umbrella organization for five distinct business lines: Sedgwick County Memorial Hospital (25-bed Critical Access Hospital), Sedgwick County Memorial Nursing Home, Valley Medical Clinic (Rural Health Clinic), Jacob J. and Anne B. Walter Memorial Living Center, and Valley Medical Clinic in Big Springs, NE. This health center is the largest employer in the county and works closely with its community to provide quality and compassionate healthcare to its residents.  

Sedgwick County Health Center participated in many innovative and exciting programs with Colorado Rural Health Center this past year! Some highlights of their activities include two Healthy Clinic Assessments where their overall score improved from 87% to 96% - a huge accomplishment! Both the hospital and clinic are participating in iCare, Improving Communication and Readmission and have completed a process mapping as part of this project.

"We are using the iCARE diabetic collaborative as not just a gathering of information but to make a definite change for a diabetic patients to improve their overall care." Deb Nail, Clinic/Business Office Manager

In 2012, Sedgwick hospital and the community of Julesburg participated in a Community Health Needs Assessment (CHNA). A CHNA uses data sets to identify needs within the community.  Community stakeholders identify issues they feel are important and develop solutions in which they want to participate. Key positive findings of Sedgwick County’s CHNA are:

• Up to 20% of the health center’s patient population come from outside of Sedgwick County
• Between 2012 and 2017 it is predicted that there will be a 11.91% increase in population of individuals ranging in age from 65-74
• Sedgwick County ranks in the top 25 counties for overall health in Colorado
• Sedgwick County ranks 1 in Colorado for least amount of tobacco use, 1 in best environmental quality and 7 in lowest unemployment rate.
• Violent crimes were at a rate of 1.8 per 1,000 people between 2007-2009 compared to 3.5 in Colorado overall
• Between 2006 and 2010, Julesburg had a population of 10% of people who smoked. Healthy People 2020’s goal is at 12% and Colorado has a percentage of 17.2.

If you are interested in learning more about Sedgwick County Health Center, click here to visit their website. Sedgwick County Health Center is a close collaborator and has been a Colorado Rural Health Center Member for nearly 10 years.  We thank them for their support and continue to work closely with this amazing health center and community. 

Update from the CEO: Engagement in 2012

As the year starts to come to a close and I think of the accomplishments of the Colorado Rural Health Center team, I know these accomplishments would not have been possible without the engagement of our members, sponsors and partners. This year CRHC tracked over fifteen bills and was successful in the passage of our first piece of major legislation, House Bill 1052 concerning the collection of health care workforce data from healthcare professionals. Thank you to our Policy and Legislative Committee for lending us your time and expertise. We are looking forward to the 2013 session and encourage you to continue to share your voice. As you think about sharing your voice, many communities engaged in Community Health Needs Assessments through our STRIDES Program. These communities took engagement and collaboration to a new level with Critical Access Hospitals, Rural Health Clinics, Federally Qualified Health Centers, and public health participation. As new partnerships are formed CRHC encourages you to continue to reach out to your community members and together you can continue to innovate and accomplish great things. As Dan Heath says, “Identify the bright spots and grow them!” One bright spot that should be pointed out is CRHC staff placed thirteen providers in safety net communities in Colorado. With the workforce shortages that Colorado is facing we are proud of these placements and the ability to contribute to the healthcare of the community. Rural communities have always had a strong sense of connection and collaboration. This collaboration can be seen through the participation of fourteen Critical Access Hospitals and six Rural Health Clinics in CRHC’s Improving Communications and Readmissions (iCARE) Program. In 2012, the participating hospitals readmission rate was only 2.8%. Some of the innovative interventions that were put into place are standing orders for pneumonia vaccinations, collaboration with social workers to follow-up with patients discharged to ensure understanding of medications and instructions, scheduling of appointments with the Primary Care Office, and home visits conducted by the Director of Nursing for patients that do not have an identified primary care physician. Finally, rural hospitals and clinics have been heavily engaged in implementing electronic medical records and remain committed. To date, 18 rural hospitals and 18 rural clinics have attested to stage 1 meaningful use. Congrats to all! I wish everyone Happy Holidays and CRHC staff look forward to working with each of you in the new year to identify your Bright Spots!

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.

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.

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.

Continue reading...

Health IT Workforce Development Opportunity

College of Nursing, University of Colorado Anschutz Medical Campus

The U.S. Department of Labor has identified Health IT as a high growth and emerging industry sector. A recent study from the University of California San Diego Extension listed Health IT as the number one career opportunity in 2010. As the nation moves toward a more technologically advanced health care system, providers are going to need highly skilled health IT experts to support them in the adoption and meaningful use of electronic health records. Health IT professionals are in demand, and there is estimated to be a shortage of as many as 200,000 Health IT workers by 2015.

This shortage is critical because it may impact organizations’ ability to demonstrate meaningful use of electronic health records and obtain the financial incentives promised. The Office of the National Coordinator (ONC) is trying to address this shortage by funding Health IT Workforce Development programs for both Community Colleges and Universities. These programs are graduating high-caliber health information technology professionals interested in supporting the growing and evolving health IT industry.

One of the most important workforce shortage needs to address is providing Health IT education to rural and medically underserved communities. The University of Colorado Denver has received a grant from the ONC to provide graduate-level Health IT education to 132 healthcare professionals. This grant covers the tuition and fees up to $10,000, which covers most of the costs for the student.

Rural and medically underserved communities are given first priority for this funding. This brochure and website provide more information about the program. Applications are being accepted until July 10, 2011, for fall admission. Please forward this information to anyone in your organization that might be interested in this opportunity. These funds will only be available until the positions are filled, which is anticipated to occur within the next 6 months. If you have questions about the program, please contact Donna DuLong, Colorado HITEC Program, at 303.724.5515 or send an email to HITEC@ucdenver.edu.

More than 150,000 New Adults to Qualify for Medicaid in 2012 - Are You Prepared?

By Aubrey Hill, CCMU

In 2012, Colorado will be offering Medicaid for adults without dependent children, who have been categorically ineligible for the program in the past. According to the Colorado Health Institute, 157,805 Colorado adults without dependent children with incomes up to 100% of the federal poverty level are currently uninsured and are likely to be eligible for this program.

Thanks to great foresight on the part of our legislature, an historic expansion will occur in the state’s Medicaid program to provide coverage for this population with funding from a hospital provider fee and federal matching dollars. When it is fully implemented, it will cover uninsured adults without dependents between 19 and 65 years of age with incomes of up to $900 a month (for a single adult).

In the interest of ensuring this expansion’s success, the Colorado Coalition for the Medically Underserved has established the Connect to Coverage, Connect to Care Campaign. The Connect Campaign is a group of stakeholder organizations working together to support the expansion as the state works to develop and implement it, and the Colorado Rural Health Center has been playing an active role in this group.

Read more about how the Connect Campaign is following the state’s progress to ensure effective decision-making.

New Position: Recruitment Specialist

We are now accepting applications for a Recruitment Specialist! The Recruitment Specialist supports the daily recruitment and retention activities of the Colorado Provider Recruitment (CPR) Program by providing direct assistance to the recruitment coordinators and program staff. This position reports to the Director of Workforce Programs. Applications are due by June 14, 2011. Learn how to apply and read the full position description here.

CROP Applications Due May 16th

Colorado Rural Outreach Program (CROP) grant money can be used to recruit new healthcare professionals or retain the ones already on your staff by repaying portions of the healthcare professional’s educational loans, or by giving a retention bonus if all educational loans are paid off. CROP currently offers two grant cycles per year as funds are available, in the spring and the fall.

Applications are currently being accepted for the spring grant cycle. Applications MUST be postmarked by May 16th, 2011 to be considered for funding.

Please download the application packet and coversheet online. Please fill out, and save, the coversheet in Microsoft Word. You may submit your application via email, or postal mail. If submitting via email, 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
ep@coruralhealth.org
Main: 303.832.7493 x 234
Fax: 303.832.7496

For more information on the CROP program and to see if your organization is eligible, please click here. For questions, contact Erica Petramala at ep@coruralhealth.org.

Making Integrated Care the Standard in Colorado

By Cassidy Smith, Public Policy Officer, Colorado Health Foundation

Integrated care health services engage individuals and their caregivers in the full range of physical, psychological, social, preventive and therapeutic factors needed for a healthy life. Integrated care has become "all the rage" in Colorado health circles. To illustrate the proliferation of the concept, the Colorado Behavioral Healthcare Council mapped some of the numerous efforts underway to integrate physical health and behavioral health care services.

Supporting the delivery of integrated care is a funding priority for the Colorado Health Foundation. Yet, while grantees rave about the positive impact integrated care has had on Coloradans' health, they consistently report it is difficult to maintain these kinds of services.

Read more about how the Colorado Health Foundation, Collaborative Family Healthcare Association, Colorado Psychological Association and the Colorado Association of Family Physicians are working together to make integrated care health services a sustainable option for Colorado providers.

Primary Care Fund application released!

Primary Care Funding is now available for primary care clinics. The 2011-12 application is now online, and is due Monday, June 13, 2011. The Primary Care Fund provides an allocation of moneys to health care providers that make basic health care services available in an outpatient setting to residents of Colorado who are considered medically indigent. Commonly asked and specific questions pertaining to the Primary Care Fund grant and/or completion of the application will be addressed during the Pre-Bid Conference on Wednesday, June 1, 2011.

If you would like assistance with applying for this funding, CRHC’s Grants Research Opportunities and Writing (GROW) program can help! Please contact Erica Petramala, Grants Coordinator, for more information.

New UCCS Grant Aims to Boost Rural Nursing Programs

A new $2.2 million grant from the Colorado Health Foundation will enable nursing students to take classes at their local community colleges and online through a partnership with University of Colorado at Colorado Springs. Many classes will be offered in real time using Cisco Telepresence conferencing technology to connect distance learners to UCCS via high-definition video and other interactive features.

The newly created Southern Colorado Rural Nursing Education and Practice Collaborative will help students earn a Bachelor of Science in Nursing, a degree not currently offered through the community college system. The new partnership aims to increase the number of nursing professionals serving rural Southern Colorado and will be offered at Lamar Community College, Otero Junior College, Pikes Peak Community College, Pueblo Community College and Trinidad State Junior College.

Read more

Stipends Still Available! Register Today for The Forum, April 19-21, 2011, Aurora, CO

It’s not too late to register for The Forum 2011: Essential Perspectives for Safety Net Providers! There are a few spots left for attendees, exhibitors, and sponsors. The Forum is being held April 19 – 21 at The Red Lion Southeast and serves as an essential educational, training, and networking event for all safety net clinics, members of the clinic team, and other interested parties.

Rural Health Clinics are eligible for a stipend of $500.00 per person for up to two people per RHC to attend. Stipend eligibility requirements include attendance at the 2011 Forum, attendance at both “Emergency Preparedness” sessions, and receipt of session attendance certificates. The stipend is intended to offset expenses incurred while attending the Forum and is to be paid on a reimbursement basis. A reimbursement form and procedure will be available at the end of the last Emergency Preparedness session at the Forum.

Click here for detailed event information. Click here to register. Click here to exhibit or sponsor.

Estes Park Medical Center Increases Patient Safety Through Bar Code/Scanning System Software

Congratulations to Estes Park Medical Center for completing their FY-2010 Small Hospital Improvement Program Quality Improvement Project! EPMC chose to purchase and implement a medication bar code/scanning system as their QI Project – leading to achievement of Electronic Health Record Meaningful Use. Through implementation of a medication bar code and scanning system, EPMC will increase patient safety and reduce medication errors. This project contributes to EPMC achieving three critical EHR Meaningful use objectives: Drug-Drug and Drug-Allergy Interaction Checks, Medication Reconciliation, and Drug-formulary Checks Watch for more SHIP project results in upcoming newsletters.

Policy Brief: Use of Health Information Technology in Support of Patient-Centered Medical Homes Is Low among Non-metropolitan Family

A new policy brief is available from the RUPRI Center: Use of Health Information Technology in Support of Patient-Centered Medical Homes Is Low among Non-metropolitan Family Medicine Practices.

By creating a medical home program within Medicare, the Patient Protection and Affordable Care Act of 2010 gave momentum to growing interest in the concept of a patient-centered medical home (PCMH). Are physician practices, especially non-metropolitan primary care practices, ready to become PCMHs? We use a nationwide survey of physician practices to partially answer this question, focusing on the use of health information technology.

Please click here to download a copy of this brief.

Two Positions Available on the Colorado Rural Health Care Grant Council

The Colorado Rural Health Care Grant Program currently has two open positions on its Governor-appointed Council. The Council is responsible for developing and providing oversight for the Grant Program funded by UnitedHealth Group. The Grant Program offers competitive grants to non-urbanized organizations that provide outpatient primary care services--including medical, oral, and mental health services.

The positions are Members-At-Large. The Council currently meets 8-10 times per year. The program will be active for approximately 18 more months. Both rural and urban citizens are encouraged to apply. More information about the Grant Program and the Council can be found on CRHC's website or by contacting Shelly Collings, Grants Manager, sc@coruralhealth.org or 720-248-2742.

Application information can be accessed on Governor Hickenlooper’s website.

Partnership for Patients: National Initiative Launched April 12th

Health and Human Services Secretary Kathleen Sebelius, joined by leaders of major hospitals, employers, health plans, physicians, nurses, and patient advocates, today announced a new national partnership that will help save 60,000 lives by stopping millions of preventable injuries and complications in patient care over the next three years. The Partnership for Patients: Better Care, Lower Costs has the potential to save up to $35 billion, including up to $10 billion for Medicare. Already, more than 500 hospitals, as well as physicians and nurses groups, consumer groups, and employers have pledged their commitment to the new initiative. This initiative is an exciting opportunity to save lives, and fits in with the current ORHP Flex grant program activities around quality, specifically, the Medicare Beneficiary Quality Improvement Project’s Phase 3 measure that engages a pharmacist within the critical access hospital to reduce preventable injuries related to medication errors. Rural facilities are encouraged to sign the pledge!

Website resources:
For more information about the Partnership for Patients, click here.
For a fact sheet on the announcement, click here.
For more information about the Community-based Care Transitions Program funding opportunity, click here.
The National Advisory Committee for Rural Health and Human Services presented options for engaging Critical Access Hospitals in Community Based Care Transitions Programs. Click here for more information.

CRHC’s Role in NRHA’s Rural Health Congress

National healthcare issues directly impact rural providers and communities. Several CRHC staff currently serve on the National Rural Health Association’s (NRHA) Rural Health Congress and constituency groups and are committed to advocating on behalf of the interests of rural healthcare providers in Colorado and nationally to ensure NRHA policy positions are strategically designed to promote providing high quality healthcare services to rural areas.

CRHC has a long-standing, 20 year history as an organization with active membership in NRHA. CRHC founder and former Executive Director, Denise Denton, served as NRHA President in 1993. CRHC staff have held leadership roles in NRHA’s Constituency Groups (CG) which ultimately advise the Rural Health Congress in taking positions on key advocacy and policy positions for rural healthcare. Lou Ann Wilroy, CRHC CEO, has served for ten years on the Frontier Constituency Group, addressing healthcare issues in the nation’s most sparsely populated communities. Michelle Mills, CRHC’s Program Director for Critical Access Hospitals and Rural Health Clinics, has been a member of the Rural Health Clinics Constituency Group since late 2010. Michelle is also the RHC CG representative on the Rural Health Congress. Cari Fouts, Communication & Development Director for CRHC, is a member of the State Association Council CG for NRHA and was appointed a position on the Rural Health Congress in January 2011 to represent the needs of all rural communities and state rural health associations across the nation.

Specific topics that are being addressed by the Rural Health Congress this year include:
• Health reform implementation
• Accountable Care Organizations
• Medicaid Payments
• CAH, RHC, Frontier Stay Extended Stay Clinics– discussion of potential development of new certification and payment methods (spearheaded by Tom Henton, CEO of Conejos County Hospital in Colorado; also a member of the Congress)
• Primary Care Shortages
• Rural General Surgeon Shortages
• EMTALA & Telehealth
• Mental Health in Rural America (expand to include substance abuse)
• Welfare impact on Rural Multiracial & Multicultural Populations
• Network Neutrality
• Broadband – Rural Access
• Tobacco Use in Rural America

As the Rural Health Congress moves forward in adopting positions, CRHC will seek input from our members to ensure the policy briefs meet the needs of our constituents. CRHC’s Policy & Legislative Council (PLC) guides and informs CRHC’s state and federal policy activities. If you would like more information about the PLC or are interested in participating, please contact Sara Schmitt at ss@coruralheatlh.org. If you have any questions about the Rural Health Congress, please contact Michelle Mills, mm@coruralhealth.org, or Cari Fouts, cf@coruralhealth.org. For more information on NRHA’s Rural Health Congress, please click here.