Federal Update: The Office of Rural Health Policy

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Federal Update The Office of Rural Health Policy

• Jennifer L. Riggle, J.D.
• U.S. Department of Health and Human Services
• Health Resources and Services Administration
• Office of Rural Health Policy
• Focus on the Future 2006 National FLEX
  Conference
• August 15, 2006

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About the Office of Rural Health Policy

• Created in 1987 serves as the voice for rural
  within the Department of Health and Human Services

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This Presentation

• Changes in the Office
• Staffing
• Priorities for 2006
• Rural Program Update
• Continuing and New
• ORHP Resources

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Changes In the Office

• New Staffing Model
• Issue Focused for Community-Based Programs
• Regional Focus for State-Based Programs
• Dedicated Staffing to Policy Role

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Changes In the Office

• New ORHP Responsibilities
• Black Lung Clinics
• Radiation Exposure Screening and Education
  Program
• Intergovernmental Affairs

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The Federal Health Care Environment in 2006

• HHS focus at the Secretarys level
• Modernize Medicare and Medicaid
• Secure the homeland
• Advance Medical Research
• Transform the Health Care system

HHS Headquarters
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Presidents HIT Goals

• Presidents vision of Healthcare IT
• Widespread adoption of interoperable EHR by 2014
• Medical information follows the consumer
• Clinicians have complete, computerized patient
  information
• Quality initiatives measure performance and drive
  quality-based competition
• Public health and bioterrorism surveillance are
  seamlessly integrated into care

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Secretarys Goals

• Secretarys Vision of Healthcare IT
• Create an electronic network that promotes
  privacy while connecting patients, providers and
  payers
• Position HHS at the forefront of the HIT
  interoperability movement
• Results of HIT adoption lower cost, fewer
  medical mistakes, increased health care quality

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HRSA Priorities for 2006

• Oral Health
• Border health
• Quality
• HIT

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HRSAs Goals

• HRSAs vision of Healthcare IT
• Promote distance learning, IT and telehealth by
  HRSA grantees enhance grantee sites with
  electronic data transmission and electronic links
  with experts in distant communities
• Support development of EHR
• HRSAs Office of Health Information Technology
  (OHIT)

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ORHP Primary Priorities for 2006

• Health Information Technology
• Pharmacy Access
• Performance Measurement

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Health Information Technology

• NAC Report Chapter
• Collaboration with AHRQ
• Collaboration with HRSA OHIT
• And

A physician in a CAH that uses the VA Electronic
Medical Record system
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HIT A First Step for ORHP

• HIT Rural Providers Roadmap to Quality
• Kansas City, KS, September 21 23, 2006
• Focus on Small providers in the early stages of
  planning or implementation
• Contact Carrie Cochran, ccochran_at_hrsa.gov

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HIT Conference- Purpose

• To education rural providers on
• The benefits of HIT adoption and its link to
  quality improvement
• basic components of HIT, focus on initial steps
  on strategic planning for HIT investment
• understanding how to find appropriate
  technology, sharing best practices and lessons
  learned

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Pharmacy Access

• Track Medicare Part D
• Concerns about viability of community pharmacies
• Enroll eligible rural hospitals in 340B
• Some progress opportunities remain

A pharmacist in Jordan, MT
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Pharmacy Access
Estimated Prices For Selected Public Purchasers,
as Percent AWPvon Oehsen Pharmaceutical
Discounts Under Federal Law State Program
Opportunities
0
20
40
60
80
100
100.0
AWP
80.0
AMP
340B Potential Cost Saver on Outpatient, ER Drugs
67.9
Medicaid (Min.)
60.5
Medicaid Net
51.7
FSS
Private Sector Pricing
49.0
340B
47.9
FCP
34.6
VA Contract
Stephen Schondelmeyer, PRIME Institute,
University of Minnesota (2001)
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Performance Measurement
A Lesson Learned Rock-Paper-Scissors Outcomes
top anecdotes which top good intentions The
Need for Measures for all ORHP Programs
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New Grant Program

• Small Health Care Provider Quality Improvement
  Grants
• Eligible rural health clinics, critical access
  hospitals, small rural providers
• Types of activities chronic disease management,
  patient registries
• Approximate amount available for two years -
  50,000 (total of 100,000)
• Number of awards 10 - 15
• Application cycle closed expect another
  competition in Spring of 2008 (No competitive
  cycle in 2007)
• Contact Heather Dimeris (301-443-0835) or
  hdimeris_at_hrsa.gov

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ORHPs Community-Based Grants

• Rural Health Care Outreach Services Grants
• Three-Year Demonstration Grants
• Up to 375,00 over the project period
• Network Development
• Three-Year Demonstration Grants
• Up to 540,000 over the project period
• Network Planning
• One-Year Grants
• Up to 85,000 Awards

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ORHPs Community-Based Grants

• Black Lung Clinics Program
• Radiation Exposure, Screening and Education
  Program
• Delta Health Initiative
• New Focus on Capital and Population Health
• Delta Network Development
• Limited to Eight Delta States
• Rural Access to Emergency Devices
• Denali Commission
• Focused solely on Alaska and construction

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Community Based Programs FY 2006
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Reauthorizations

• Outreach
• Programs (Part of CHC authority)
• H.R. 5201 (only CHCs so far)
• Conrad 30
• J-1

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Hospital State Focus

• Rural Hospital Flexibility Grants
• 45 States, Non-Competing in 2006
• Small Hospital Improvement Grants
• Grants of _at_ 8K for gt 1,500 small rural hospitals
• State Offices of Rural Health
• All 50 States, non-competing applications in 2006

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Rural Health Research

• Eight Rural Health Research Centers
• Helps to inform ORHP and HHS policy
• Focus areas range from rural health finance to
  health disparities to rural mental health
  services
• Single-Year Policy Oriented Rural Health Research
• Annual Competition

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Resources and Tools

• Exploring and Quantifying the Link Between Rural
  Health Care and Rural Economic Development
• Want to Know More?
• http//www.ruralhealthworks.org
• 405-744-6083

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Resources and Tools
The Rural Assistance Center

• One-Stop Shopping
• Funding Info
• Resource Guides
• Best Practices

http//raconline.org
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National Advisory Committee on Rural Health and
Human Services

• Issues an Annual Report to the Secretary
• 2006 Report Health Information Technology
  pharmacy access, family caregiver support
• 2007 Report Substance Abuse, Medicare Part D,
  Head Start

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Resources and Tools
http//www.3rnet.org
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Resources and Tools

• Workforce
• Getting or Updating a Shortage Designation
  HPSAs and MUAs
• Contact Information 1-888-275-4772 (Press
  option 1, then option 2 or contact the Shortage
  Designation Branch at sdb_at_hrsa.gov or
  301-594-0816
• Contact Your State PCO
• (http//bphc.hrsa.gov/OSNP/PCODirectory.htm)

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Resources and Tools for Rural Hospitals

• Access to capital
• Working with CMS to develop strong but common
  sense relocation guidelines
• Working with HUD, USDA
• Model Plans Available Free
• Contact Jerry Coopey (301-443-0835
  jcoopey_at_hrsa.gov)

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Contacts

• Contacting HRSA
• http//www.hrsa.gov
• Contacting ORHP
• http//ruralhealth.hrsa.gov/ 301-443-0835
• Policy Questions Carrie Cochran and Erica
  Molliver
• Flex Steve Hirsch
• State Office and SHIP Keith Midberry

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Community level programs

• Outreach Jennifer Chang Nisha Patel
• Network Sherilyn Pruitt
• Black Lung Kristi Martinsen
• Radiation Vanessa Hooker
• Delta Network Lakisha Smith
• Delta Health Initiative George Brown or Shelia
  Tibbs
• Rural Access to Emergency Devices Sheila Warren

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Questions?

• Jennifer L. Riggle, J.D.
• Associate Director
• jriggle_at_hrsa.gov
• 301-443-7530