Contents

 
May 2017
MONTHLY UPDATE
    Office of Rural Health and Primary Care graphic
   

MDH & ORHPC NEWS

 

REGISTER FOR THE

2017 MINNESOTA RURAL HEALTH CONFERENCE!

2017 Minnesota Rural Health Conference


Online registration closes at 4:00 p.m. Wednesday, June 7.
Onsite registration fees are $25 higher than the regular registration rates.

Make sure you are aware of important 2017 conference information by subscribing to receive email updates!


Video from the 2016 Conference

We asked last year's attendees to the Minnesota Rural Health Conference about their work and why rural health is important to them in three words:


This year the conference will provide the opportunity to:

  • Discover approaches to improve and integrate mental health access in rural communities;
  • Provide timely information on making value real for rural;
  • Learn about supporting rural populations with best practices from around the state;
  • Share community-based solutions to address health disparities and inequities; and
  • Develop and access a network of colleagues, students and partners to support the rural workforce.

Rural Health Advisory Committee (RHAC)
Governor Mark Dayton announced five appointments to the Rural Health Advisory Committee (RHAC): Andrew Johnson of Olivia (midlevel practitioner member); Sen. Mary Kiffmeyer of Big Lake (Senate majority member); Sen. Tony Lourey of Kerrick (Senate minority member); Rep. Joe Schomacker of Luverne (House majority member); and Rep. Clark Johnson of North Mankato (House minority member). Mr. Johnson and Sen. Kiffmeyer are new appointments to RHAC; the others are re-appointments. Thanks to all for their service! For more information, email Darcy Dungan-Seaver or visit the RHAC website.

Three ORHPC Briefs Available
Three new briefs are now available from the Office of Rural Health & Primary Care, all looking at changes in rural Minnesota since implementation of the Affordable Care Act.

Key findings from Health care access in rural Minnesota: Results from the Minnesota Health Access Survey, produced in partnership with the Health Economics program:

  • The uninsurance rate dropped dramatically in rural Minnesota between 2013 and 2015.
  • Dental uninsurance rates were higher in rural than in urban areas.
  • Despite higher rates of health insurance, affordability and access issues remained in rural parts of the state, and disparities within rural Minnesota based on income and education persisted.

Key findings from Public and individual health insurance trends in rural Minnesota: Enrollment during implementation of the ACA:

  • Both before and after ACA implementation, rural Minnesota had a greater share of its nonelderly population enrolled in both Medical Assistance (MA) and MinnesotaCare than urban areas did (27 percent compared to roughly 20 percent).
  • In the individual market between 2015 and 2016, entirely rural counties had a much higher proportion of enrollees than other county types, with 14 percent of their population covered by individual policies compared to 6 percent of the state overall.
  • While individual enrollment via MNsure increased across county types, it did so most substantially in entirely rural counties (where enrollment via MNsure tripled) and in small town/rural mix counties (where enrollment increased by 70 percent).

Key findings from Finance in rural and urban hospitals:

  • From 2011 to 2015, the percent of total charges billed to public insurance programs (both Medicare and Minnesota state programs) increased among all Minnesota hospitals.
  • Compared to urban hospitals, rural hospitals continued to receive a larger percentage of their revenue from self-pay charges.
  • Both CAHs and urban hospitals saw an increase in operating margins between 2011 and 2015, but non-urban hospitals had a lower median operating margin than urban hospitals.
  • More CAHs had a negative operating margin than other types of hospitals, and the number of CAHs with negative margins increased from 2011 to 2015.

The Medical Education and Research Cost (MERC) Grant
The Minnesota Department of Health is pleased to announce the recipients of the Medical Education and Research Cost (MERC) Grant totaling $59.1 million. Three recipient reports are available on the department’s MERC webpage. All distribution reports can be found under MERC Publications webpage.

HPSA Shortage Designations
The Health Resources and Services Administration (HRSA) is currently developing a new, more automated process to score Health Professional Shortage Areas (HPSAs). The first National Shortage Designation Update based on the new process will occur in July 2017. ORHPC staff are continuing to provide data, local context and input to federal staff as these changes are discussed and implemented to ensure that all HPSA designations are accurate and reflect the reality of provider shortage in Minnesota. For more information about the Update, visit our HPSA and MUA/P shortage designation webpage. If you have questions on a HPSA designation in your area, please contact Keisha Shaw at 651-201-3860 or Deb Jahnke at 651-201-3845.

 

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MDH & ORHPC GRANTS AND LOANS

The International Medical Graduates (IMG) Career Guidance and Support Grant Program
The International Medical Graduate (IMG) Career Guidance and Support Grant Program is one aspect of a comprehensive program authorized by the Minnesota Legislature to address barriers to practice and facilitate pathways to assist immigrant international medical graduates (IIMGs) and other foreign trained health care professionals to integrate into the Minnesota health care delivery system, with the goal of increasing access to primary care in rural and underserved areas of the state. The application is due June 12. For more information contact Yende Anderson at 651-201-5988.

Minnesota State Loan Repayment Program
Minnesota's State Loan Repayment Program (MN SLRP) was created to improve access to primary care by assisting underserved communities with recruitment and retention of primary care providers. Applications are due August 2017. For more information contact Deb Jahnke at 651-201-3845.

 
 

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OTHER GRANTS And funding

Apprenticeship Workforce Grants
Minnesota employers can apply for a grant through June 14 to help them develop a registered apprenticeship program to recruit, train and retain their 21st century highly skilled workforce. The Minnesota Apprenticeship Initiative (MAI) targets employers in five high-growth industries including healthcare.

Distance Learning and Telemedicine Funding
The U.S. Department of Agriculture's (USDA) Rural Utilities Service (RUS) has announced that they will be offering grants of up to $500,000 through their Distance Learning and Telemedicine (DLT) Grant Program in order to improve rural access to education and healthcare. Special consideration will be given to "Promise Zones" or areas that have been identified as particularly vulnerable. Applications are due July 17.

Rural Health and Safety Education Grant
The U.S. Department of Agriculture’s (USDA) National Institute of Food and Agriculture (NIFA) will invest a total of $2.8 million in rural health and safety education “to promote and enhance rural health, strengthen economic vitality and, in the long run, mitigate the effects of rural poverty.” Applications are due June 30.

Behavioral Health Workforce Education and Training Program
The BHWET Program aims to develop and expand the behavioral health workforce serving populations across the lifespan, including rural and medically underserved areas. The program includes interprofessional training for students/interns, faculty, and field supervisors to provide quality behavioral health services. Applications are due June 12.

 

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OPPORTUNITIES

Behavioral Health Integration with Primary Care Resources
Primary care settings have become a gateway for many individuals with behavioral health and primary care needs. The Health Resources and Services Administration (HRSA) Health Center Program has listed resources that highlight what to consider if you are looking to integrate behavioral health into your primary care setting.

Mental Health Programs Aired
May is Mental Health Month. During the month of June, Twin Cities Public Television (TPT) will air a number of programs to create more public awareness of mental illnesses. The half-hour programs were produced by the National Alliance on Mental Illness Minnesota (NAMI), in partnership with the MakeItOk Campaign and TPT. The programs will be shown in the metro and statewide via all six greater Minnesota public television stations.

Successful Models and Resources to Support Opioid Abuse Prevention and Treatment Webinar
The Health Resources and Services Administration (HRSA) Bureau of Health Workforce is hosting a webinar on Successful Models and Resources to Support Opioid Abuse Prevention and Treatment, Tuesday, June 13, 2-3:30 p.m. CDT. Register here

What Do We Know About Agricultural Workers' Social Determinants of Health Webinar
This webinar on June 8, from 1:30 p.m. to 2:30 p.m. CDT, will focus on agricultural-worker demographic and employment characteristics that may be important social determinants of the health of agricultural workers and their families. The presentation will discuss how groups of agricultural workers face different social determinants of health as well as how health insurance coverage, health care utilization and disease burden differ among these groups. Register now.

Food Insecurity by County
The hunger-relief organization Feeding America has created an interactive map of county level food-insecurity rates in the United States.

 

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NEWS OF OUR PARTNERS

Older Americans Month 2017
May is Older Americans Month (OAM) and June 15 is World Elder Abuse Awareness Day. The Administration for Community Living (ACL) promotes the well-being of older adults through programs designed to help them live independently in their homes and communities. While 32% of urban Minnesotans are age 50 or above, that rate rises to 38% of large town residents, 41% of small town residents, and 44% of rural Minnesotans. In addition, residents of rural and small town Minnesota are more than twice as likely to be age 80 or older than residents in urban parts of the state. More than 1 in 20 residents in rural and small town areas are 80+ presently, and given the high shares in the 65-79 age group, these rates and numbers are anticipated to continue rising. It is essential to plan for the needs of older adults, as remote areas face challenges delivering health and other services. This year's theme for Older Americans Month is Age Out Loud. Read about several people's Age Out Loud stories including Elmer and Louise from Winona Friendship Center, Minnesota.

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ORHPC Staff News

IMG Coordinator Yende Anderson and Shortage Designation Coordinator & Grant Program Manager Keisha Shaw have been selected to be a part of the Minnesota Department of Health's Everyday Leaders Program. Congratulations!

The spring site visits for the Minnesota Statewide Trauma System staff – Chris Ballard, Marty Forseth, and Tammy Peterson – began in March this year. On average, a trauma system site visit takes about 6 hours and it is one of two components hospitals undergo to obtain trauma hospital verification. All hospitals must submit an application and then undergo a verification site visit. So far, staff have visited the following Level 3 facilities: Lake Region Healthcare, Fergus Falls; St. Francis Regional Medical Center; Sanford Worthington; and Fairview Southdale Hospital, Edina (focused visit). Staff have also visited the following Level 4 facilities: St. Joseph’s Area Health Services, Park Rapids; Essentia Health Virginia; Mercy Hospital, Moose Lake; and Mayo Clinic Health System - St. James.

Flex Program Coordinator Judy Bergh attended the Integrated Behavioral Health project meeting at Sanford—Jackson with staff from Rural Health Initiatives, a subsidiary of the National Rural Health Resource Center, as they facilitated a meeting with the hospital and community partners to help Sanford Jackson and their partners develop a plan for integrating behavioral services in their community. The project is funded by the Flex Program. Judy met with Iowa's Flex Coordinator, Amanda Ramirez, and with the CEO (Tammy Loosbrock) of Sanford Luverne and Sanford Rock Rapids at the Sanford hospital in Rock Rapids, Iowa, to find out what it is like for a CEO to work with Flex Programs from two neighboring states. Judy made site visits to United Hospital District, Blue Earth; St. Francis Health Campus, Breckenridge MN; Ortonville Area Health Services, Ortonville; Pipestone County Medical Center, Pipestone; Mercy Hospital, Moose Lake; and Cass Lake IHS Hospital, Cass Lake.

Reimbursement Fiscal Analyst Craig Baarson and Joe Schindler from the Minnesota Hospital Association presented new charge comparison reports (funded by the Minnesota Flex Program) at the Health Care Delivery Strategies for Rural Hospitals In-Person Program. Craig is also working with Crown Medical Center in Minneapolis on developing new service lines.

Rural Health Policy Researcher Emma Distel and Flex Program Coordinator, Judy Bergh made a site visit to Mahnomen Health Center, Mahnomen, MN.

Senior Research Analyst Laura McLain attended the 2017 Inter-Professional Education Summit – High Performance Innovation Teams: An Interprofessional Approach to Health.

Shortage Designation Coordinator & Grant Program Manager Keisha Shaw volunteered at the People of Color Career Fair.

Supervisor of our Financial and Technical Assistance Unit Will Wilson attended the SIM Learning Days Conference in St. Cloud; the Flex-funded Integrated Behavioral Health project meeting; Representative Collin Peterson's Town Hall meeting in Moorhead which focused on health care; and a meeting with the CDC to develop criteria for a Community Health Worker (CHW) pilot to coordinate epilepsy care in Atlanta, GA.

Policy Planner Darcy Dungan-Seaver was a panelist at a rural health policy event on the University of Minnesota - Duluth campus organized by the Minnesota Rural Health Association’s student chapter, an inter-professional group of students representing multiple institutions and health care roles.

Deputy Director Tim Held, LUCAS Grant Coordinator Jodi Millner and Flex Program Coordinator Judy Bergh attended the NOSORH National Rural EMS Conference in Fargo, ND.

 

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NOW READ THIS

Health Equity
Houston hospital checking to see if patients’ cupboards are bare (Health Leaders Media).
Life expectancy can vary by 20 years depending on where you live (Minnesota Public Radio).
The dental crisis across Minnesota and the country (MPR News).
Understanding cancer health disparities (Hutch News).

Rural Health
The role of public versus private health insurance in ensuring health care access & affordability for low-income rural children (Maine Rural Health Research).
Mental health: The next farm crisis in rural America (High Plains/Midwest AG Journal).
ECHO helps New York's rural elderly (Federal Telemedicine News).
Resources to reduce adverse drug events in rural hospitals (U of MN Rural Health Research Center).
Medical barriers to nursing home care for rural residents (U of MN Rural Health Research Center).

Workforce
Where the jobs are: Rural hospitals desperately need more nurses (CNBC).
How some Minnesota employers are successfully tapping into 'hidden' talent pools (MinnPost).
Why I left the hospital system and started working in telemedicine (MIT Technology Review).
Three takes on honing nurse management teams (Health Leaders Media).
Integrating community health workers into complex care teams: Key considerations (Center for Health Care Strategies, Inc.).
Wisconsin Express program teaches students about health care in underserved areas. (University of Wisconsin-Madison).

Miscellaneous
Changes in the supply of physicians with a DEA DATA waiver to prescribe buprenorphine for opioid use disorder (Rural Health Research and Policy Centers).
Paging Dr. Siri (Real Clear Health).
Family physicians report considerable interest in, but limited use of, telehealth services (Journal of the American Board of Family Medicine).

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SAVE THE DATE

The Minnesota e-Health Summit Connectivity. Equity. Health. will be held June 15 in Brooklyn Center.

The Minnesota Department of Health's 2017 Minnesota Stroke and Cardiace Emergencies conference will be held June 15-16 in Bloomington.

The Minnesota Rural Health conference Shaping Sustainable Solutions will be held June 19-20 in Duluth.

The fourth annual Comprehensive Advanced Life Support on Rural Emergency Care will be held September 29 in St. Paul.

 

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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.