Rural Health Advisory Committee Meeting Minutes

Rural Health Advisory Committee Meeting Minutes

Tuesday, November 24, 2009 10 a.m.-2 p.m.

Location: Minnesota Department of Health-Snelling Office Park, St. Paul, MN

Members Present: John Baerg, Tom Boe, Deb Carpenter, Ray Christensen, M.D.,Tom Crowley, Jode Freyholtz, Jeffrey Hardwig, Margaret Kalina, Rep. Mary Ellen Otremba, Nancy Stratman.

Members Absent: Rep. Steve Gottwalt, Diane Muckenhirn, Tom Nixon, Sen. Yvonne Prettner Solon, Sen. Julie Rosen.

MDH Staff Present: Doug Benson, Jay Fonkert, Jill Myers, Tamie Rogers, Mark Schoenbaum, Angie Sechler, Karen Welle.

Guests: Sue Abderholden (National Alliance on Mental Illness-Minnesota), Tom Day (Minnesota Dental Association), Matt Lemke (Minnesota Pharmacists Association), Sara Noznesky (Minnesota Medical Association), Liz Quam (Minnesota Rural Health Association), Lance Ross (Minnesota Ambulance Association), Sue Stout (Minnesota Hospital Association ), Kari Thurlow(Aging Services of Minnesota)


RHAC Chair Margaret Kalina started the meeting by welcoming members and guests and asking everyone to introduce themselves.


John Baerg (Consumer Member) – The St. James Hospital and Clinic have collaborated on a new cardiac rehabilitation unit.

Thomas Boe (Licensed Health Care Professional) – Monitoring interest in a dental therapy program.

Deb Carpenter (Consumer Member) – Area Career Day attracted approximately 50 eight and ninth grade students who participated in workshops related to careers in health care, manufacturing and agriculture-related business.

Ray Christensen (Higher Education Member) – The Rural Physician Associate Program currently has 40 participants; applications are now being accepted for next year. A new curriculum being developed for 2011 includes placement of students in rural communities for a longer period of time. Housing in these communities will be needed. Thank you to all involved in the Summer Internship Program.

Thomas Crowley (Hospital Representative) – Saint Elizabeth’s “field of dreams” was recently harvested, raising funds toward two new operating rooms in the hospital. The hospital is collaborating with local public health on H1N1 vaccines. The Internet-based licensed practical nurse program the hospital sponsors in collaboration with a technical college is going well. 
Jode Freyholtz (Consumer Member) – The first graduates of the new Certified Peer Specialist program have completed training. 

Jeffrey Hardwig (Physician Member) – Still moving forward with the “Depression Care Package,” which provides screening, evaluation and treatment protocols.

Margaret Kalina (Registered Nurse Member) – Douglas County Hospital is moving along with its building project. Registered Nurse programs are still busy.

Nancy Stratman (Long Term Health Care Member) – The Minneapolis Star Tribune recently published a series of articles on patient falls in nursing homes. Patient safety (and reducing patient falls) has always been a concern for nursing homes; policies, procedures and staff training are frequently being evaluated. The nursing home industry sees the exposure of the issue in these articles as an opportunity for increased quality improvement. Home and community based services are facing rate decreases.


Note:  The elimination of General Assistance Medical Care (GAMC) was the top concern for all panelists.  Additional issues are summarized here.

Sue Abderholden (National Alliance on Mental Illness-Minnesota): The elimination of GAMC and its impact on the criminal justice system tops the list of NAMI’s legislative issues for 2010. A detailed handout documents additional legislative issues. 

Tom Day (Minnesota Dental Association): Low reimbursement rates create many problems in providing dental services in rural Minnesota, including recruitment, retention, student interest, and safety net services.

Matt Lemke (Minnesota Pharmacists Association): Reimbursement issues continue to plague pharmacists. There has been an increase in independent pharmacy closures in rural Minnesota. The Pharmacists Association is continuing to highlight the importance of the Rural Pharmacy Preservation Act.

Sara Noznesky (Minnesota Medical Association):  State public programs’ reimbursement rates are based on 1989 charges.  Physicians are struggling with these rates.  Seeing an increase in primary care doctors retiring. 

Liz Quam (Minnesota Rural Health Association): Restated MRHA’s 2009 priorities, including: universal coverage, medical interpreters, rural opportunity assessments, long term care viability, behavioral health, and virtual accountable care areas.

Lance Ross (Minnesota Ambulance Association): Regional EMS funding is in jeopardy and needs to be continued. Supporting the Community Paramedic program and the Returning Veterans Paramedic program.

Sue Stout (Minnesota Hospital Association): Focused on GAMC funding, and the hardships for hospitals and patients if the cuts are not resolved.

Kari Thurlow (Aging Services of Minnesota): Fifty-four skilled nursing facilities have closed since 2000; one-third of the remaining facilities are in danger of closing in the next year. Elderly Waiver rates are not keeping up with inflation and costs. Aging Services is supportive of PACE (Program of All Inclusive Care for the Elderly) starting in Minnesota.


ORHPC staff and RHAC members discussed the draft RHAC Work Plan. RHAC members agreed on the suggested topics and approaches, and made some recommendations for enhancing the work plan.  

Also, staff and RHAC members discussed the timing and format of future RHAC meetings. Based on a survey of RHAC members, it was decided that RHAC will continue to meet approximately five times a year, and that meetings in the winter months will be available via videoconferencing. 


Mark Schoenbaum provided an update on activities, programs and news from the Office of Rural Health and Primary Care (see handout). 


Agenda (PDF: 31KB/1pg)
Aging Services 2010 Legislative Issues (PDF: 805KB/5pgs)
NAMI 2010 Legislative Issues (PDF: 789KB/3pgs)
Draft RHAC Work Plan (PDF: 12KB/2pgs)
General Surgery Preliminary Analysis (PDF: 12KB/2pgs)
Health Information Technology Regional Extension Center Fact Sheet (PDF: 23KB/2pgs)
ORHPC Report (PDF: 34KB/2pgs)

Updated Tuesday, November 16, 2010 at 12:28PM