Contents:

SEPTEMBER 2013

 

 

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MDH & ORHPC NEWS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HEALTH REFORM
The Affordable Care Act provision requiring Medicare-equivalent rates for primary care Medicaid services went partly into effect last month. As of August 13, specific fee-for-service primary care Medicaid services are eligible for the enhanced rates. Similar hikes have not yet been implemented for managed care or Prepaid Medical Assistance Program (PMAP) enrollees. The Department of Human Services (DHS) still awaits federal approval to implement increased rates for those groups. More information is available on the DHS Primary Care and VFC (Vaccines for Children) Incentive Program page.

PATIENT EXPERIENCE SURVEYS
Results from more than 230,000 patient-completed surveys on their experience of care - known as the Clinician and Group Surveys–Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) - from 651 clinics are now available. The data is collected as part of Minnesota's Statewide Quality Reporting and Measurement System and is the most comprehensive look at patient experience on a statewide basis in the country. The system emerged from Minnesota's 2008 health reform law, which requires clinics to report their performance on a standard set of quality measures. To collect the data, MDH partners with Minnesota Community Measurement, which reports results at http://www.MNHealthScores.org.

DISCHARGE OF LATE PRETERM INFANTS
Commissioner of Health Dr. Edward Ehlinger encourages health care professionals to adopt a new checklist as part of discharge procedures for late preterm infants (34 0/7 – 36 6/7 weeks completed gestational age). The Discharge Checklist for Late Preterm Infants was developed by the Minnesota Prematurity Task Force, a group of over 100 community members, organizations and health care professionals, to help improve outcomes of infants born before 37 weeks. 

HEALTH WORKFORCE ANALYSIS
ORHPC's Health Workforce Analysis Program and the MDH Oral Health Program have released a new issue brief: Dental Hygienists in Minnesota: A Snapshot of the Employment Market, 2011-2012. The report summarizes findings from three studies: interviews with dental hygiene education program directors, a survey of dental hygienists and a survey of dental clinics. More information about the Health Workforce Analysis Program, as well as additional publications and workforce data, are available on the Office of Rural Health and Primary Care website.

SNAPSHOT

Graph - Trends in Residency Positions in Minnesota for Primary Care Physicians, 2003-2013

Source: National Residency Matching Program, Main Residency Match: Match Results by State and Specialty, 2003-2013.

Over the past 10 years, Minnesota's graduate medical education programs have collectively provided more first-year residency slots in internal medicine (IM) than in either family medicine or pediatrics. The number of family medicine residency positions has dropped 20 percent, from a high of 96 in 2004 to the current 77 in 2013. Both IM and pediatric residency positions have remained relatively steady between 2003 and 2013. Minnesota Statutes section 137.38 includes all three of these fields in its definition of "primary care physician." It is important to note, however, that most IM and pediatric residents go on to specialize rather than practice primary care. Recent studies suggest that 39 percent of pediatric residents and only 22 percent of IM residents remain in primary care (JAMA 2012;308(21):2241-2247 and 2012 American Academy of Pediatrics Survey).

For more information and data on Minnesota's health workforce, visit the ORHPC Health Care Workforce Analysis Program site or contact Angie Sechler at angie.sechler@state.mn.us or 651-201-3862.

 

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ORHPC GRANTS AND LOANS

Application materials are now available for the Indian Health Grant Program, which helps applicants establish, operate or subsidize clinic facilities and services to offer health services to American Indians who live off reservations. Nonprofit organizations, governmental and tribal entities are eligible to apply. Applications due September 18.

Application materials for the Community Clinic Grant Program are now available. These grants support clinical capacity to serve people with low incomes, reduce current or future uncompensated care burden, or improve care delivery infrastructure. Pre-applications are due October 4. If invited, full applications will be due January 8.

 

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OTHER GRANTS AND LOANS

The U.S. Department of Veterans Affairs (VA) is accepting applications for grants for transportation of veterans in highly rural areas. Eligible organizations should use innovative approaches to assist veterans with transportation to VA and non-VA facilities for medical care, serving veterans who would not otherwise be able to obtain medical care through conventional transportation options. Applications due September 9.

The Rural Veterans Coordination Pilot program seeks applications for grants to organizations that will assist veterans and their families in transitioning from military service to civilian life in rural or underserved communities. Applications due September 19.

The NBCC Foundation is currently accepting applications for scholarships to students working toward a graduate counseling degree who commit to practicing in rural areas after graduation. Applicants must be enrolled in a CACREP-accredited master's degree counseling program. Eligible programs and more information is available on the NBCC Foundation website. Applications due November 1.

The DentaQuest Foundation's Innovation Fund for Oral Health is accepting concept papers for projects addressing barriers to oral health. Priority will be given to projects that focus on specific communities, non-traditional partners, interprofessional collaboration, financing of care and technology. Concept papers are accepted on the fourth Thursday of each month, with selected organizations invited to submit full proposals on the second Thursday of the following month. Find eligibility and application guidelines on the DentaQuest website.

 

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OPPORTUNITIES

The Veterans Administration Office of Rural Health, the Rural Health Professions Institute and the Virtual VA eHealth University (vVeHU) will present "Chronic Care Management: Meeting the Challenge in Rural Settings" on September 12 from 12:00-1:10 p.m. Register for the free online broadcast on the MyVeHU Campus website.

MDH and other partners will host Creating Accountable Communities for Health: Common Vision, Common Language on September 17 at the Duluth Entertainment and Convention Center (DECC). The conference will work to accelerate implementation of community-based preventive health care by exploring tools to improve community benefit, develop community collaboratives, support an effective Community Health Needs Assessment (CHNA) process, and respond to the requirements of an Accountable Care Organization (ACO) model.

The MDH Community Transformation Grant program, Health Care Homes program and community partners will present workshops for southwest and west central Minnesota titled "Teamwork and Skill-Building to Transform Hypertension Management: Screen, Counsel, Refer and Follow-up." The free workshops will take place in Willmar on September 17 and in Marshall on September 18. Clinic direct care providers and administrative staff will learn current best practices, team-based, patient-centered screening, counseling, referral and follow-up, and how to develop supportive clinic systems for optimal hypertension management. CEUs available. Register online. For more information, contact eileen.weber@state.mn.us.

The annual Childhood Injury Summit will take place September 19 at the Como Park Visitor Center in St. Paul. Presented by Safe Kids Minnesota, the Minnesota Safety Council and MDH, the event will offer tools and strategies to help prevent unintentional injuries among Minnesota’s children and is designed for those in public health and health care, public safety, nonprofit organizations and any program with a focus on children. Registration information available online or contact Erin Petersen, Safe Kids Minnesota/Minnesota Safety Council, at 651-228-7314 or 800-444-9150.

The Rural Palliative Care Networking Group will feature a special presentation, "Symptom management at end-of-life," on September 19 from 10:00 a.m. to noon at United Family Home Care and Hospice in Little Falls. To register for in-person attendance or conference call, contact Matt Ellis by September 12 at mellis@stratishealth.org or 952-853-8539.

The Health Care Homes (HCH) Learning Collaborative is hosting a webinar series titled "Introduction to Health Care Homes" to increase knowledge of innovative practices and standards in primary care and help equip clinics to begin the transformation process. The webinar series will help clinic teams identify and plan for closing the gaps in care, and will prepare teams for patient-centered, team-based coordinated care. The series includes four webinars that will run through October. Learn more and register on the HCH website.

The Grant Writing Institute of NOSORH (National Organization of State Offices of Rural Health) kicks off October 3 with bi-monthly webinar training sessions. Registration ends October 1 and class size is limited. Registration form and more information available online through NOSORH (link no longer available).

The Fifth Annual Rural Behavioral Health Practice Conference: "Advances in Rural Practice," will be held October 11 at the University of Minnesota - Morris and through group site and individual webcasts. Multiple rural organizations have collaborated to present evidence-based training on state-of-the-art rural clinical practices and current behavioral health care policy. Up to 7 hours of American Psychological Association (APA) continuing education credit is available. For more information and to submit posters on rural behavioral health research, contact Conference Co-chair Willie Garrett, Ed.D.at wilgarrett@comcast.net or fax/phone 651-646-8594.

The MN Health IT Training Program (MNHIT) is accepting applications for the six-month, professional Health IT training program at Normandale Community College. The program is designed to prepare individuals to work in the health IT industry and to develop on-site, internal health IT expertise within an organization. Applications for the November-December session due October 11. Visit www.mnhealthit.com or call 952-358-8035 for more information or to complete the program application.

 

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NEWS OF OUR PARTNERS

Community Health Centers (CHCs) across the country celebrated National Health Center Week in August. In Minnesota, the Duluth News-Tribune published a letter (link no longer available) on the value of CHCs by Mavis Brehm, Executive Director of Lake Superior Community Health Center (LSCHC). Also check out the infographic from the National Association of Community Health Centers (NACHC) titled Going Beyond Primary Care: Health Centers Transform Health Care in Local Communities.

The Rural Assistance Center published an interview with Terry Hill, who is stepping down as CEO of the National Rural Health Resource Center in Duluth for a more limited role at the organization. As of October 1, Sally Buck will be the Center's new CEO after 20 years serving in other positions there, most recently Associate Director.

The Rural Homeless Youth Listening Sessions Project, a partnership of the Office of Economic Opportunity, Minnesota Department of Human Services (OEO-DHS), rural homeless youth service providers and the Otto Bremer Foundation, released a Summary Report based on listening sessions conducted in 10 rural and tribal communities in greater Minnesota. The report includes recommendations to invest in prevention, outreach and education; enhance service delivery; strengthen partnerships; and improve grantmaking programs.

The Rural Health Systems Analysis and Technical Assistance (RHSATA) project, a collaboration between the Office of Rural Health Policy, the RUPRI Center for Rural Health Policy Analysis (RUPRI Center), and Stratis Health, launched a new website: Rural Health Value. The site offers tools, resources and information to assist rural communities and providers transition to a high-performance rural health system, as well as analysis of rural implications of policy changes.

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NOW READ THIS

The role of community culture in efforts to create healthier, safer, and more equitable places: A community health practitioner workbook (Prevention Institute).
Fighting for an American countryside in Minnesota (Ground Level, Minnesota Public Radio News).

Health reform
Rural America and the Affordable Care Act (Center for Rural Affairs).
Report: Health overhaul could benefit rural residents, who pay more for insurance than others (link no longer available) (Star Tribune on report by the Center for Rural Affairs).
ACA likely to deliver bigger bang in rural areas (Medpage Today).

Clinics
Improving primary care/specialty care collaboration (California Improvement Network).
The Frontier Extended Stay Clinic model: A potential health care delivery alternative for small rural communities (RUPRI Center for Rural Health Policy Analysis).
Community Health Centers celebrate decades of service (HealthLeaders Media).

Hospitals
Q&A: An independent hospital CEO talks about the future
(HealthLeaders Media).
Federal recommendation could whack rural hospital budgets (Ground Level, Minnesota Public Radio News).
Meaningful use progress 'uneven' for hospitals (FierceEMR).

Pharmacies
Causes and consequences of rural pharmacy closures: A multi-case study (RUPRI Center for Rural Health Policy Analysis).

Emergency Medical Services (EMS)
Rural EMS providers fill many roles, face tough financial picture
(The Anniston Star via EMS1.com).
• Paramedics not just for emergencies in new trend
(link no longer available) (Omaha World-Herald).

Oral health

• In search of dental care: Two types of dentist shortages limit children’s access to care (link no longer available) (Pew Charitable Trusts).

Mental health
Mental health resources for rural communities
(Substance Abuse & Mental Health Services Administration).

Aging
Digital gap widens for rural elderly, poor (Daily Yonder).
Rural seniors prefer self-care over doctors (Health Behavior News Service on article from the Journal of Health Care for the Poor and Underserved).
Visualizing health policy: A short look at long-term care for seniors (Kaiser Family Foundation).

Workforce
The Rural Blog: Oklahoma doctor says key to increasing number of rural doctors begins with high school programs (The Rural Blog).
A summer in the country can inspire physicians to practice in rural areas, study finds
(Medical Xpress).
Path to United States practice Is long slog to foreign doctors (New York Times).
California looks for a new generation of culturally sensitive health care workers (The Sacramento Bee).
Recruitment and retention: A single process built on trust (link no longer available) (Health Workforce News).
While telehealth workforce expands, barriers slow availability (The Rural Monitor).

Health information technology
The promise of mobile: Connecting to underserved populations (Healthcare Informatics).
Health IT is an opportunity for job creation in rural communities (HealthIT Buzz, Office of the National Coordinator for Health Information Technology [ONC]).
Telemedicine helps improve care for kids seen in rural EDs (Reuters).
Talking scales and telemedicine: ACO tools to keep patients out of the hospital (Minnesota Public Radio via Kaiser Health News).
Rural telehealth capabilities and outreach continue to grow (The Rural Monitor).
Telehealth versus telemedicine (The Rural Monitor).
Technology in rural human services: The good, the bad and the ugly (The Rural Monitor).

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STAFF NEWS

ORHPC held a Rural Health Community Forum in St. Peter on August 22. Anne Schloegel, Kristen Tharaldson, Katie Schleiss and other ORPHC staff heard from a wide range of community members about health issues and priorities in their area.These regional community forums help ORHPC gather information and make recommendations regarding rural health care in the state. Stay tuned for details on additional forums planned for Breckenridge and Little Falls in October.

Deb Jahnke visited Scenic River Health Services and toured its medical and dental clinics in Cook as well as its Tower clinic, which provides both medical and dental services. Deb also assisted at a Midwest Retention Toolkit training in Duluth on August 6.

Mark Schoenbaum visited the Family Medicine Residency Clinic in Duluth after attending a board meeting of the National Rural Health Resource Center on August 27.

This month, Will Wilson conducted site visits and toured five clinics in the Twin Cities for the Clinical Dental Education Innovations grant program: Open Cities Health Center; Native American Community Clinic; Children's Dental Services; Hennepin County Medical Center (HCMC) dental clinic; and Apple Tree Dental.

 

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SAVE THE DATE

The 24th Annual National Adult Protective Services Association (NAPSA) conference will be held October 2-3, followed by the Annual Summit on Elder Financial Exploitation on October 4. Both events will be in St. Paul.

The 14th Annual Greater Northwest EMS Conference, "Welcome to the Jungle," will take place October 4-5 in Mahnomen.

The 2013 Got Your Shots? Immunization Conference will take place October 10-11 in Bloomington.

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

The Sixth Annual Minnesota Breastfeeding Coalition Statewide Meeting will take place October 11 in Glencoe.

The 2013 Minnesota Asthma Alliance Meeting: Optimizing Asthma Care will take place October 23 in Brooklyn Center. Registration is free and includes lunch and refreshments, but register early as space is limited.

The annual conference of the Minnesota Council of Nonprofits will be held in Duluth on October 24-25.

The Minnesota Stroke Registry will hold its 2013 regional workshop, "Stroke Program Development: Getting Ready to be Ready, Meeting the Designation Criteria," in three locations: Mankato on October 30, Brainerd on November 19 and Duluth on December 17.

The Innovation to Equity: Eliminating Tobacco Disparities in Minnesota conference will take place November 21-22 in Bloomington.

 

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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
http://www.health.state.mn.us/divs/orhpc/index.html

Our mission
To promote access to quality health care for all Minnesotans. We work as partners with policymakers, providers, and rural and underserved urban communities to ensure a continuum of core health services throughout the state.