JUNE 2013



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Don't miss out! Registration is still open
for the 2013 Minnesota Rural Health Conference coming up June 24-25 in Duluth.

This year's conference will take an in-depth look at workforce, delivery models, patient and community engagement, value and access. Join us!


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The MERC program, which distributes grants to clinical training sites around the state, announced the allocation of its 2012 grants. MERC was created by the Minnesota Legislature in 1997 to distribute grant funds to hospitals, clinics and other clinical sites to support training for medical students/residents, advanced practice nurses, pharmacy students/residents, dental students/residents, physician assistants and chiropractic students. For more information about MERC, which is part of ORHPC, visit the MERC website.

New data on poverty and income in Minnesota is available through MDH's Minnesota Public Health Data Access system. Interactive charts allow users to view data on median household income, childhood poverty and poverty by year and age.

MDH's Office of Statewide Health Improvement Initiatives (OSHII) seeks applicants for the position of Director. This position leads state-level population health improvement activities to address the leading causes of chronic diseases, including obesity, physical inactivity, poor nutrition, alcohol misuse, and tobacco use and exposure. A fuller job description and application information are available online (link no longer available).

MDH's Office of Health Information Technology has released a new summary on the adoption and use of electronic health record (EHR) systems and health information exchange (HIE) in rural areas of the state. Minnesota e-Health Brief: Rural Providers assesses use of EHRs and HIE in four settings: ambulatory clinics, hospitals, nursing homes and local public health agencies. Overall, the rate of EHR adoption in rural Minnesota is strong, though rural providers still underutilize EHRs compared to their urban counterparts and the exchange of health information continues to be a challenge statewide.


Graph - Minnesota health providers with EHRs installed

Source: Minnesota Department of Health, Office of Health Information Technology (OHIT). Data are from 2012 clinic and hospital surveys, 2011 nursing home survey, 2010 lab and local health department surveys, and 2012 pharmacy data provided by Surescripts.

Note: For clinics and nursing homes, rural and urban categories are based on Rural-Urban Commuting Areas (RUCAs). For hospitals, rural is defined as Critical Access Hospital (CAH) and urban as non-CAH. For local public health departments, rural encompasses the non-metro regions defined by the State Community Health Services Advisory Committee (SCHSAC) and urban is the Twin Cities metro region defined by SCHSAC.

For more information and data on Minnesota's health information technology adoption and use, visit the Minnesota e-Health website.


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Application materials for the Minnesota State Loan Repayment Program (MN SLRP) are now available. The program provides funds for repayment of qualifying educational loans of up to $20,000 annually for full-time primary care providers and up to $10,000 annually for half-time primary care providers. For fiscal year 2013-2014, an estimated 5-10 loan repayment awards will be available. Applications due by August 19.


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The Medica Foundation is accepting letters of inquiry for Cycle 2 of its 2013 funding program. This cycle has two priorities: early childhood health and organizational core mission support. The core support grants are awarded to regional and rural ares of Medica's service area (see the foundation's Giving Guidelines for more information on geographic limitations). Letters of inquiry due June 14.

The federal Office of Rural Health Policy seeks applications for Rural Access to Emergency Devices (RAED) grants. RAED supports community partnerships in purchasing automated external defibrillators (AEDs); providing defibrillator and basic life support training; and placing AEDs in local rural organizations. Applications due June 17.

The Centers for Disease Control and Prevention (CDC) is accepting applications to its Tribal Public Health Capacity Building and Quality Improvement grant program. Eligible applicants include American Indian tribal governments and tribally designated organizations such as tribal health systems, tribal epidemiology centers and tribal colleges and universities. Letters of inquiry (optional) due June 17; full applications due July 15.

The Centers for Medicare & Medicaid Services (CMS) is accepting proposals for round two of its Health Care Innovation Awards. This round seeks new payment models for service delivery models that improve care and lower costs for Medicare, Medicaid and Children’s Health Insurance Program (CHIP) enrollees. Letters of intent to apply due June 28.

The Bush Foundation has announced Community Innovation Grants to support "community-powered problem-solving" that is inclusive and collaborative. Grants will range from $10,000-$200,000 and will support a wide variety of issues, communities (including affinity or racial/ethnic communities) and stages of innovation. First round of applications due July 11; a second round will open in December.

MNsure, Minnesota's health insurance exchange, is accepting applications to its new Outreach and Infrastructure Consumer Assistance Partner Grant Program (link no longer available). A wide variety of entities are eligible to apply to provide outreach and/or establish infrastructure for in-person application and enrollment assistance. Applications due by July 19.

The American Academy of Pediatrics seeks proposals for its Community Access to Child Health (CATCH) grant program. CATCH supports pediatricians in collaborating with communities to increase children's access to health services and medical homes. Planning, implementation and resident grants are available. Applications due July 31.


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The 9th Annual Minnesota e-Health Summit, e-Health: Connecting, Optimizing, Transforming, will take place June 13 in Bloomington. A pre-summit workshop on June 12 will focus on health reform preparedness.

Learn the general principles of patient activation and engagement, along with specific ways you can help patients become meaningful and valuable partners in their health care, by participating in an Institute for Clinical Systems Improvement (ICSI) Patient Activation and Engagement Learning Collaborative. Kick-off meetings in Mankato on June 13 and St. Cloud on June 28 still have openings, and registration is open to ICSI members and non-members.

MDH, the Minnesota e-Health Initiative and the Laboratory Interoperability Cooperative (LIC) present a free workshop to Minnesota hospitals on June 14 to provide Electronic Laboratory Reporting (ELR) Laboratory LOINC® Mapping Guidance. To participate in the workshop and access additional LIC online education resources, facilities complete a Hospital Participation Letter.

The Center for Healthcare Innovation (CHI) at the College of St. Scholastica is offering training on the conversion to ICD-10-CM/PCS on June 4 and 5 in Duluth. Register on the CHI website.

The National Association of Community Health Centers (NACHC) will host a free webinar on June 4: "Success Stories: Hiring Veterans at Health Centers." More information and registration is on NACHC's website (link no longer available).

The Rural Hospital Performance Improvement (RHPI) project of the National Rural Health Resource Center provides recorded webinar trainings on a variety of performance improvement topics. This free library of trainings covers such issues as ICD-10, revenue cycle management and quality reporting.


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The Centers for Medicare & Medicaid Services (CMS) announced that Critical Access Hospital (CAH) II physicians are now eligible for the Medicare Electronic Health Record (EHR) incentive program. Participation can begin in calendar year 2013, but attestations cannot be submitted until January 2014.

West Side Community Health Services, the largest Community Health Center in Minnesota, opened the doors to its new East Side Family Clinic (ESFC) facility in St. Paul. The newly constructed building, supported in part by a major federal grant, replaces and doubles the space of the older ESFC site, and incorporates new dental and mental health services.

The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services announced a national compliance review initiative, Advancing Effective Communication in Critical Access Hospitals (CAHs), to ensure language access for individuals with limited English proficiency (LEP). The review will involve compliance reviews and technical assistance for CAHs.

Minnesota was one of 11 states profiled in a recent report from the Center for Health and Health Care in Schools on children's access to mental health services. Improving Access to Children's Mental Health Care: Lessons from a Study of 11 States highlights Minnesota's efforts to provide telepsychiatry in rural areas, as well as the state's requirement that educators have mental health training for their five-year reaccreditation.

The Spring issue of The Rural Monitor features an interview with Dr. Clint MacKinney, who works both as an emergency department physician in Little Falls and as a professor at the University of Iowa.

A new report from Beyond the Bottom Line (link no longer available), a partnership of six Minnesota foundations, highlights Hennepin Health and Southern Prairie Community Care as case studies of exemplary "transformative redesign" of public services in Minnesota. Both are demonstrations projects with the Minnesota Department of Human Services (DHS) intended to improve care and reduce costs for Medical Assistance patients. A Star Tribune editorial also touted the initial successes of Hennepin Health.

The Aitkin Age newspaper featured an interview with Riverwood Healthcare Center's Mike Hagen. Mike will retire in July after 12 years as Riverwood's CEO.

The National Association of Community Health Centers (NACHC) announced a new initiative to boost the number of veterans employed at Community Health Centers (CHCs). The joint effort between NACHC, the White House and the Department of Health and Human Services has an initial goal of employing an average of one veteran per CHC by the end of next year, or around 8,000 veterans total.

The American Indian Patient Advocacy program at Hennepin County Medical Center (HCMC), a project supported in part with an ORHPC Indian Health Grant, was profiled in the Star Tribune.

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Health ownership in American indigenous communities (Rural and Remote Health).
Population patterns: Rural trends changing (Daily Yonder).

Health disparities and inequalities report, 2011 (Centers for Disease Control and Prevention).
Diffusion of preventive innovation: Racial and rural differences in cervical cancer prevention and control practices (link no longer available) (South Carolina Rural Health Research Center).
Commentary: Human services deserts (The Rural Monitor).

Health reform
Essential Community Providers: Tips to connect with marketplace plans (National Academy for State Health Policy).
Health care marketplace board members ready to work (link no longer available) (Capitol Chatter).
"Care guides'' show another face of health reform (Star Tribune).

Primary care
Three models of primary care teaming (TL, CC and ET): An unexplored feature of the medical home (Disease Care Management Blog).
Addressing the social determinants of health within the patient-centered medical home: Lessons from pediatrics (JAMA).
The value of strong primary care (The Commonwealth Fund Blog).

Bond ratings pressure smaller hospitals as NFP sector falters (HealthLeaders Media).
Utilization and outcomes of inpatient surgical care at Critical Access Hospitals in the United States
(JAMA Surgery).
The decline of emergency care (The Atlantic).
Critical Access Hospitals need to expand role in prevention and be paid for it, expert says (The Rural Blog).
The evolving role of emergency departments in the United States (Rand).

Oral health
First analysis of dental therapists finds increase in access for children, low-income adults (Science Codex, citing new report by Community Catalyst).

Luring doctors and lawyers to rural America (National Public Radio).
The changing face of medical school admissions (New York Times).
A new breed of doctor, from new school (Hartford Courant).
5 findings on nurses and quality (Becker's Clinical Quality and Infection Control).
Commentary: Rural health care can entice the best and brightest (HealthLeaders Media).
• Perspectives of physicians and nurse practitioners on primary care practice (link no longer available) and a related Editorial: Putting aside preconceptions - Time for dialogue among primary care clinicians (link no longer available) (New England Journal of Medicine).
Expanding the role of advanced nurse practitioners: Risks and rewards (New England Journal of Medicine).
Doctor shortage hits hard in rural America (NBC Nightly News).

Health information technology
Rural EHR system promotes population health (Modern Healthcare).
Telemedicine is retail health clinics’ newest tool (HealthLeaders Media).
Achieving meaningful use as a rural solo nurse practitioner (Health IT Buzz).
For ailing vets In rural areas, telemedicine can be the cure (Minnesota Public Radio).

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Two ORHPC staffers received MDH's inaugural "Star Awards." Executive Assistant Cirrie Byrnes received the Superior Sustained Performance Award, and workforce research assistant Laura Grangaard received the Outstanding Student Award. Congratulations, Cirrie and Laura!

Macalester College profiled ORHPC intern and recent Macalester grad Rachel Gunsalus in the article "River Runner." Rachel credits her work at ORHPC with influencing her honors thesis on the effects of the Affordable Care Act on Minnesota’s migrant farm workers.

Tom Major has accepted a new role at MDH and will now be in the Managed Care section of the Compliance and Monitoring Division.

Judy Bergh conducted a site visit at CentraCare Health System - Long Prairie and a mock survey at North Valley Health Center in Warren. ORHPC’s Flex Program conducts mock surveys to help Critical Access Hospitals prepare for their Medicare Survey and ensure the highest quality of care at their facilities.

Tammy Peterson conducted numerous trauma system site visits in May, including a Level 3 visit to Cuyuna Regional Medical Center in Crosby and Level 4 visits to Mayo Clinic Health System - Cannon Falls; Redwood Area Hospital; Sibley Medical Center; Mayo Clinic Health System - Waseca; CentraCare Health System - Long Prairie; Mayo Clinic Health System - Albert Lea and Austin; and Owatonna Hospital. Jo-Ann Champagne also conducted a Level 4 site visit to Lake View Memorial Hospital.


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Rural Wisconsin Health Cooperative (RWHC) will hold two educational sessions in St. Croix Falls in July: Pediatric assessment/emergencies on July 10 and Lateral violence: Empowering staff to stop bad behaviors on July 11.

National Health Center Week will be celebrated August 11-17.

The 2013 Community Mental Health Conference will take place September 25-27 in Duluth.

The Fifth Annual Rural Behavioral Health Conference will be held October 11 at the University of Minnesota - Morris and group webcast sites. Email for more information.


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View online all previous issues of the Office of Rural Health and Primary Care publications.

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Minnesota Office of Rural Health and Primary Care
P. O. Box 64882
St. Paul, Minnesota 55164-0882
Phone 651-201-3838
Toll free in Minnesota 800-366-5424
Fax: 651-201-3830

Our mission
to promote access to quality health care for rural and underserved urban Minnesotans. From our unique position within state government, we work as partners with communities, providers, policymakers and other organizations. Together, we develop innovative approaches and tailor our tools and resources to the diverse populations we serve.