The New York Office of Rural Health (NY SORH) is playing an essential role in a new commission that is looking at how to develop an effective, integrated health care delivery system that will serve all communities in New York’s North Country. (The North Country is composed of nine counties in the northern part of the state, encompassing 13,100 square miles.)

The North Country Health System Redesign Commission (NCHSRC) was created by Governor Andrew Cuomo in December 2013 to examine preventative, medical, behavioral and long-term care services in the region. “When my boss (the Deputy Commissioner for the Office of Primary Care and Health Systems Management) informed me that the Governor created the Commission, we put together a team of folks from various Centers and Divisions in the Department and we were off and running,” said Karen Madden, director of the NY SORH.

For its involvement so far, Madden said the NY SORH has set the agendas with the Commission Chair and Co-Chairs, identified speakers to address local initiatives, handled meeting logistics, prepared background information, and worked with other Department of Health staff to clarify data and organize presentations. Additionally, the SORH contributed to the final report, which was issued in April.

That report, Toward an Integrated Rural Health System: Building Capacity and Promoting Value in the North Country, found that the region’s health is “sub-par” and that its health care delivery system is highly fragmented. It recommended the development of an integrated approach to care and a system that emphasizes prevention, increases primary care, builds more community-based options, strengthens coordination and communication, supports critical safety net providers, and monitors and rewards quality.

Madden said that despite the many negatives stated in the report, some positives were found. “I think the positives are the various local initiatives that were underway, and building upon those activities to create a stronger, financially viable system. But,” she added, “the most challenging issue remains the rurality of the region and its low population density.”

As the work of the Commission goes forward, Madden said that she and her Office “are building on our previous activities of supporting networks and encouraging all providers to develop strong affiliations. New York recently received an $8 billion Medicaid waiver to restructure the entire system and we are working with rural providers to ensure that their communities are actively engaged in those efforts. The programs included in the waiver are a major component of the recommendations in the North Country report.”

In addition, the NY SORH is working on the NCHSRC Action Plan to help implement the report’s recommendations, which Madden thinks will take approximately two years, and will be involved with a report that will detail the progress.


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