Loan Repayment Programs in Nebraska Yielding Huge Payoffs
Loan repayment programs in rural Nebraska are showing huge payoffs: family medicine providers who participate in them are significantly less likely to leave small towns and rural areas than those who don’t. “We’re trying to maximize the impact and the opportunities for loan repayment in rural and urban underserved areas in the state,” said Thomas Rauner, Program Manager at the Nebraska Office of Rural Health (NORH). “So we are assessing how effective the programs are, and how are they working.”
Team Effort in Idaho Achieves New Funding for Physician Repayment Program
Remarkably, less than a year after the Idaho State Office of Rural Health (ID SORH) set a goal to find new funding for a physician loan repayment program, the state legislature appropriated $640,000 annually for it. “It’s something we’re thrilled about,” said Mary Sheridan, ID SORH Director. “I think it points to the reasons we take advantage of new opportunities, even though we may be unsure of the ultimate outcome.” That opportunity was a three-day meeting in June 2017, convened by the National Conference of State Legislatures (NCSL), on “Challenges and Innovations in Rural Health Policy.”
Texas SORH’s Handheld Ultrasound Project – An Innovative Approach to Providing Training & Technology to Small Rural Hospitals
At a rural hospital in Texas last year, a woman’s life was saved when doctors, using a handheld ultrasound device, determined that her abdominal pain was due to a ruptured ectopic pregnancy and were able to act quickly to address it. The hospital had the handheld unit on-loan as part of an innovative pilot project run jointly by the Texas State Office of Rural Health (TX SORH) and the Texas Tech University Health Sciences Center (TTUHSC). The devices, as well as accompanying training, were offered to Small Hospital Improvement Project (SHIP) hospitals in the state.
Alabama SORH Collaborates with VA to Provide Telehealth Care for Vets
A chance encounter at a local store sparked a telehealth partnership between the Alabama Office of Rural Health (AL SORH) and Alabama Veterans Affairs (VA). “A couple of years ago, I was out shopping on a Sunday night and ran into Dr. Randall Weaver, whom I hadn’t seen in awhile,” said Chuck Lail, AL SORH Director. Lail, a military veteran, already knew Weaver from the VA hospital where Lail has gone for his annual physicals. “I said to him, ‘We really need to get something going with the VA—I think there are good opportunities for telehealth.’ And he said, ‘Why don’t you call me and we’ll explore it.’ ”
Summits Tackle Opioid Misuse and Treatment in Rural Illinois Illinois is tackling the opioid crisis in its rural communities through a series of opioid summits sponsored by the Illinois Center for Rural Health (ICRH). “We realized there were no coalitions or groups working on opioid misuse in rural Illinois,” said Julie Casper, ICRH Director. “Community Health Needs Assessments have consistently listed drug use and addiction as problems in their communities, so making opioid misuse a priority was a natural conclusion.”
Michigan Center for Rural Health Plays Unique Role in Hospital Quality Improvement In the quest for hospital quality improvement, the Michigan Center for Rural Health (MCRH) is playing a unique role, serving as a liaison between independent Critical Access Hospitals (CAHs) in the state and the state’s hospital association. “Usually we hear of SORH Flex programs subcontracting work to their local hospital association,” said Crystal Barter, MCRH Director of Performance Improvement. “This is the opposite situation—the hospital association subcontracts with our Flex program.”
Utah SORH Saves Rural Hospital by Obtaining GSDA Certification In his first week as director of the Utah Office of Primary Care and Rural Health, Matt McCullough faced a potential crisis: a Rural Health Clinic (RHC) in the southeastern part of the state was in danger of losing federal certification. Fortunately, McCullough found the solution—obtaining a Governor’s Designated Shortage Area (GDSA).
Reaching Out to Rural New Jersey Although most folks don’t think of New Jersey as “rural,” the New Jersey Office of Primary Care and Rural Health (NJ SORH) is working hard to reach out to the more than 700,000 residents who live in what the state defines as its non-metro areas. As part of that ongoing effort, in September the NJ SORH launched a statewide celebration, New Jersey Rural Health Weeks.
Rural Health Summits Bringing People Together Across Vermont to Exchange Ideas Bringing people together to learn from one another is the goal of collaboration—a goal that’s being achieved in Rural Health Summits held across Vermont. At the request of the Vermont State Office of Rural Health and Primary Care, leaders from rural hospitals and local public health district offices have co-convened the Rural Health Summits to explore better ways of sharing resources, information, and priorities.
Helping Rural Hawaii THRIVE Residents in rural communities across the Hawaiian Islands have been sharing their “stories of health” in community meetings as part of an effort to build a framework of health derived from community values and practices.
Advisory Group in Washington State Works to Bring Palliative Care to Rural Patients An advisory team run by the Washington State Office of Rural Health is looking at ways to bring palliative care to rural patients through telehealth and better community engagement. Palliative care aims to relieve the suffering of patients with terminal or life-limiting illnesses. But in rural areas, palliative care isn’t always available locally, especially for patients who don’t immediately qualify for hospice services.
Virginia SORH Taking Aim at Opioid Overdose Through lay rescuer training and the distribution of lifesaving kits, Virginia is taking aim at opioid overdoses in the state. Now it is increasing its outreach into rural parts of the state through the Virginia State Office of Rural Health.
Georgia SORH Looks at the Feasibility of EMS Regionalization in the State A study commissioned by the Georgia State Office of Rural Health is looking at the feasibility of regionalizing 911 emergency services in rural counties in the state. Between 2010 and 2016, six rural hospitals closed in Georgia, and others reduced their service lines in an effort to save money. As a result, emergency services were left to fill the gap.
Michigan Center for Rural Health Helps Rural ACOs Get Off the Ground The goal of Accountable Care Organizations (ACOs) is to reduce costs while improving patient care. The Michigan Center for Rural Health (MCRH) is helping two ACOs in their state do just that. “This is all about changing from volume to value in primary care outpatient settings for Medicare fee-for-service beneficiaries,” said John Barnas, executive director of MCRH.
Screening Program in Connecticut Works to Stem Drug Abuse and Misuse Like many other states, Connecticut is facing a drug crisis. The number of drug overdoses in the state nearly doubled between 2014 and 2015. More people die there from drug overdoses than from car accidents or firearms. To combat this, the CT SBIRT (Screening, Brief Intervention and Referral to Treatment) program is training students who are enrolled in health profession programs to screen for substance misuse and to refer patients for treatment.
Pennsylvania SORH Coordinates Unique Agricultural Worker Safety Program For the last 12 years, Jim Harvey has been “poking along the back roads” of Pennsylvania, visiting agricultural producers across the state. The visits are both friendly and educational. Harvey, the state’s Rural Health Farm Worker Protection Safety Specialist, is there to teach farmers about the safe storage and use of agricultural pesticides, and to help them comply with the Environmental Protection Agency’s (EPA) Worker Protection Standard (WPS), which aims to reduce the risk of pesticide poisoning and injury.
Kansas SORH Builds Internal Partnership to Reach RHCs What started with a simple conversation between two programs within the same bureau, has turned into an annual rural health clinic statewide survey with an incredible response rate. Since 2013, the Kansas State Office of Primary Care and Rural Health has partnered with the Kansas Health Facilities Program to survey the more than 160 rural health clinics across the state.
Wyoming Telehealth Network In July 2015, the Wyoming Department of Health’s Office of Rural Health, through the Wyoming Telehealth Network (WyTN), began offering telehealth technical assistance grants with the goal of connecting rural Wyoming facilities to telehealth services.
Arizona:Partnering Toward Success The work of the Arizona SORH was recently highlighted by 3RNet for their exceptional collaboration with other state partners using the state 3RNet membership to work on improving access to health care in rural and underserved areas across the state.
Wisconsin Recognizes Need to Engage Girls in EMS Rescue Divas is a camp for middle-school girls that aims to attract new recruits to the field of emergency medical services. The Ashland Bayfield county areas, like many rural areas, has a difficult time recruiting volunteers for EMS services. They decided to change their focus to recruiting women, who are underserved in EMS, and to develop a pipeline system, getting girls interested in becoming EMTs or working in emergency medicine.
ICD-10 – Now what? NC SORH Dedicated to Supporting Rural Providers ICD-10 became a reality for all providers on October 1, 2015. It is too early to fully assess the impact from the transition. Over the next 6 months, the needs of rural providers will be better understood. If providers in your state still require assistance, look to the North Carolina Office of Rural Health (NCORH) for resources.
Nevada SORH Uses Public Health Column to Bring Attention to Important Rural Health Issues Frustrated with the lack of media coverage on public health issues, John Packham of the Nevada SORH approached the local Nevada Gazette to establish a bi-monthly column devoted to public health issues. The newspaper was very interested in this idea since they had recently reduced staff and were eager for anyone to provide local content. Since 2008, John has written over 100 articles with topics ranging from health reform to tobacco tax.
The SORH Role in Advancing Telehealth Policy in Arizona Arizona is already seeing the benefits of SB 1353 that went into effect this past January. SB 1353 requires health care insurers to cover services provided through telemedicine, if those services would be covered if provided in-person. The AZ SORH helped make this bill a reality by providing information and data to underscore the need especially in rural areas.
Simple Approach to Convening Important Partners The Louisiana Office of Rural Health gets together with rural health partners every quarter for an informal luncheon to discuss the latest issues and to identify areas of collaboration. Tracie Ingram, SORH Director, says, “We communicate so often anyway that we decided we needed a day set on the calendar to all get together.” Invited are those with a statewide rural interest.
Free and Secure Incident Reporting Systems for all Emergency Medical Services Safety advances have been broadly implemented in many healthcare settings, similar to aviation and other high-consequence fields. Aviation, with its long history of reporting systems, has shown that event reporting systems can yield previously unknown, but safety-critical information for developing a proactive approach to managing human error. Despite many similarities between health care and aviation, event-reporting systems have not been well received in health care.
Using Technology to Reach New Audiences Americans are watching increasing numbers of videos online. According to comScore, this number has jumped over 43% to 100 million daily views (that’s roughly one-third of the U.S. population watching a video online each day). The CO SORH has embraced this technology and uses video and digital media in a number of ways to reach constituents.
Implementing Community Paramedicine: One Community at a Time Community Paramedicine (CP) is an evolving model of community-based health care in which paramedics function outside their customary emergency response and transport roles in ways that facilitate more appropriate use of emergency care resources and/or enhance access to primary care for medically underserved populations. Taking a closer look at how Maine implemented their CP program across the state provides examples of best practices and the role of the State Office of Rural Health.
South Carolina Reaches Out to Uninsured Residents Through the Healthy Outcomes Plan (HOP) In an effort to provide consistent medical care to thousands of underserved residents, South Carolina’s “Medicaid System” has implemented a statewide program designed to coordinate care and provide a medical home for some of its most at-risk residents. Now in its second year, the Healthy Outcomes Plan (HOP) asked every hospital in the state to identify a predetermined number of low-income, uninsured residents who visited the emergency department at least five times in the last year, and who suffered from a chronic condition such as diabetes, cardiovascular disease, hypertension, sickle cell or HIV/AIDS.
Florida State Office of Rural Health Helps Rural Hospital Modernize With its leaking roof, numerous building code violations and lack of modern technology, everyone agreed that Madison County Florida’s 60 year old hospital desperately needed to be replaced. Thanks to a sales tax referendum passed by Madison County residents, and financial assistance from Florida’s State Office of Rural Health, the brand new, state-of-the-art Madison County Memorial Hospital is proof of what can be achieved when residents and local and state officials work together.
Minnesota Awarded State Innovation Model (SIM) Grant The future just got healthier for millions of Minnesotans, thanks to being one of seven states to receive a $45 million State Innovation Model (SIM) testing grant through the Center for Medicare and Medicaid Innovation. “We are very excited to receive this grant,” said Mark Schoenbaum, Director of the Minnesota Office of Rural Health and Primary Care. “It’s a great opportunity for rural communities to get new support and build on the kinds of innovations that already take place in rural areas.”
Promising Practices: Georgia It was a big loss to the state of Georgia when four rural hospitals closed over the course of two years. The closures gained state and national attention, and started a much needed conversation among rural health care leaders: How to help a rural community after a hospital closure. “Four hospitals is a lot to lose in our rural communities,” said Charles Owens, Executive Director of the Georgia State Office of Rural Health. In May 2014 Georgia enacted regulations that would allow a closed rural hospital to be reopened as a freestanding ER department within 12 months of the initial closure.
Hawaii SORH Addresses Rural Oral Health with Hawaii Smiles Program With funding from a Centers for Disease Control and Prevention (CDC) Oral Health Infrastructure Grant, the Hawaii SORH has partnered with the Hawaii State Department of Health (DOH), Family Health Services Division to assist in rebuilding its oral public health program.
New York SORH Plays Active Role in State’s North Country Commission The New York Office of Rural Health 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.)
Project in Massachusetts Helps Rural Hospitals Prevent Medication Errors A project sponsored by the Massachusetts State Office of Rural Health (MA SORH) is helping rural hospitals in the state learn how to reduce the possibility of medication-related patient harm. With the Medication Safety Performance Improvement Project, the MA SORH has contracted with the Institute for Safe Medication Practices (ISMP) to perform one-day targeted medication safety risk assessments at the hospitals.
New Hampshire SORH Participates in State Workforce Commission Given its emphasis on access to care and workforce development, it was a natural fit for the New Hampshire State Office of Rural Health to be a part of the NH Legislative Commission on Primary Care Workforce Issues. The five-year commission is working to coordinate workforce as a part of Affordable Care Act (ACA) activities in the state.
Michigan RHC Network Puts Emphasis on Quality Peer-to-peer sharing is one of the benefits of the Michigan Rural Health Clinic Quality Network, sponsored by the Michigan Center for Rural Health. What started as a small, informal quality network with only 15 active members in June 2011 has continued to grow and gain enthusiastic members. Today, representatives from over 50 of Michigan’s 170 clinics participate in the network and attend its quarterly meetings held in Mt. Pleasant, Mich.
Iowa SORH Works for Rural Veterans Through Collaboration with VHA If rural veterans are going to get more access to good care, there must be more collaboration between the Veterans Administration and non-VA providers, according to Gloria Vermie, Director of the Iowa State Office of Rural Health (IA SORH). To aid in that effort, Vermie has worked to develop a collaborative relationship between her Office and the Veterans Rural Health Resource Center-Central Region, (VRHRC-CR) located in Iowa City.
Delaware Partnership Yields New Mental Health Service An ongoing partnership between the Delaware State Office of Rural Health and the Delaware Rural Health Initiative, which serves as the state rural health association, has helped forge new ways of helping the mentally ill and those experiencing psychiatric crises in rural areas of the state.
Arizona SORH Pushing to Make Logic Model Use More Widespread Lynda Bergsma, SORH Program Director at the Arizona State Office of Rural Health, believes that rural programs must learn to prove their worth, especially in today’s funding climate. “Many people in health and public health are starting to understand that they will no longer get money to fund programs for which they cannot show specific impacts and outcomes,” Bergsma explained. “There’s no way of knowing if a program is effective without evaluating it.”
New Mexico Hosts Provider Retention Summit A Health Professional Workforce Summit, held on April 12 in Albuquerque, NM, gave participants an opportunity to meet in person and develop strategies for retention of clinicians in the state. The one-day event sparked discussions based upon real data, as opposed to supposition and/or anecdote.