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Tuesday, December 29, 2009

Compare the Senate & House Health Reform Proposals

The Kaiser Family Foundation has an online tool where you can look at a side-by-side comparison of the final Senate and House healthcare reform proposals. Once Congress convenes in January, these two proposals will have to be meshed before a final version is sent to the President to sign.

Click on the title of this blog to visit the Kaiser Family Foundation website.

Monday, December 28, 2009

Health Reform Update 12.28.09

The Senate voted for passage of the Patient Protection and Affordable Care Act at 7am on December 24 by a party-line vote of 60-39. Upon returning from recess in January, Congress will have to reconcile the differences between the House and Senate bills. The final healthcare reform bill will most likely resemble what is in the Senate bill. The tentative goal is to have a final bill to the President's desk by the State of the Union (mid to late January), though the White House has acknowledged that Congress has many priorities to tackle early in the year.

The National Rural Health Association has been working hard to ensure there are strong rural provisions in any healthcare reform proposal. Please visit the NRHA website to see specifics of what is included in the Senate and House proposals.

Tuesday, December 22, 2009

Health Reform Update 12.22.09

Well, it appears that the Senate will be voting on the Patient Protection and Affordable Care Act before Christmas. As of right now, the Senate is expected to vote at 8am on Christmas Eve. Senate Majority Leader Harry Reid has a Manager's Amendment that is 383 pages long and adds some important rural provisions to the bill. As soon as details come forth of what is included in the Manager's Amendment, I will be sure to post that information here.

Once the Senate passes their bill, a conference committee will occur between select House and Senate members to reconcile differences between the two healthcare reform bills coming from each respective chamber. It is believed a final healthcare reform bill will resemble the Senate's version since once a final bill is produced from the conference committee, the Senate will need 60 votes to ensure the bills passage before it can be sent to President Obama to sign.

The fun continues........stay tuned.......

Health Reform would Reduce Uninsured in Rural America from 8.1 Million to 3.2

As Congress continues to analyze and debate key details of health reform, the numbers of people covered under the current plans is receiving increased attention. According to a new analysis by the Rural Policy Research Institute (RUPRI), if fully implemented, the approach to covering the uninsured presented in H.R. 3590, the Patient Protection and Affordable Coverage Act, would reduce the number of uninsured from 8.1 to 3.2 million in rural areas. This increase in coverage would lead to a slightly higher coverage rate for people living in rural areas than for their urban counterparts (93.4% compared to 92.7%), largely because a lower proportion of rural persons are non‐citizens who would not be covered under any of the proposed reform approaches but also because the reform proposal reaches more low‐income persons who are more represented among the rural uninsured.

The report also provides state-by-state estimates of the effects of the legislation on overall health insurance coverage rates (for both rural and urban persons), as well as estimates of how the previously uninsured would be covered under the provisions of the legislation.

Please click HERE for the report in its entirety.

Monday, December 21, 2009

Healthcare Reform Update & Colorado State Revenue Forecast

Federal Healthcare Reform:
At 1 a.m. this morning, the Senate voted 60-40 to invoke Cloture on Majority Leader Reid's manager's amendment to health reform, limiting debate to 30 hours and ensuring its up or down vote. Monday morning's cloture vote was a procedural one that allowed Reid to make certain changes to the bill. It wasn't the big cloture vote, or even the last of the procedural votes that will be held -- there are four more to come, with the last scheduled for Christmas Eve. But the outcome of those is now not in doubt.

There is one big test remaining, of course -- after the Senate passes its version of the bill, it will have to iron out its differences with the House. That could mean more wrangling.

State Budget Revenue Forecast:
The most recent budget revenue forecast shows the state is $40 million short of what was projected in September. Revenue available for spending in the General Fund is $600.6 million below the amount budgeted for expenditure in FY 2009-10. It is already projected that the state is $1.5 billion short for FY10-11.

The upcoming legislative session will be tackling the FY10-11 budget. The General Assembly convenes Wednesday, January 13th.

Friday, December 18, 2009

Healthcare Update 12.18.09

The fun continues!

The House voted this week to pass an amended defense appropriations bill (H.R. 3326), that temporarily delays the scheduled 21.2% Medicare physician payment cut that was set to occur January 1st. Congress now has until Feb. 28th to come up with a plan to keep these cuts from happening. The bill provides a 0 percent update to the Medicare physician payment formula to allow Congress to establish a new permanent Medicare physician payment system upon returning in the new year. The Senate is poised to approve the defense spending bill in the coming days. Both the House and Senate tried to include a permanent fix in their healthcare reform proposals to the Sustainable Growth Rate (SGR), which is the reason these Medicare cuts were set to occur in the first place, but due to the fiscal impact of fixing the SGR, neither healthcare reform proposal addresses this issue.

The Senate will begin working on the healthcare reform bill again this weekend and there is still talk that something will be voted on by Christmas. What that "something" is remains to be seen.......
Stay tuned......

Thursday, December 17, 2009

Senate Health Reform Vote by Christmas in Doubt....

Kaiser Health News has pulled together news articles from across the country regarding the issues that the Senate still faces in trying to get a vote on healthcare reform prior to Christmas next week.

Please click HERE to read up on the obstacles the Senate is facing in reaching its deadline.

Wednesday, December 16, 2009

Senate Healthcare Reform Update - 12.16.09

Senate Majority Leader Harry Reid (D-Nev.) and the White House are still negotiating with key senators to reach agreement on outstanding issues so a manager's amendment can be finalized this week. This amendment is being designed to garner the 60 votes needed to pass H.R. 3590, the "Patient Protection and Affordable Care Act," before the holidays. So far, more than 430 proposed amendments to the bill have been submitted, although only a handful will be presented for a vote on the Senate floor.
A proposal circulated last week that would have allowed uninsured individuals between the ages of 55 and 64 to purchase Medicare coverage has been abandoned after generating opposition from centrist Sens. Joe Lieberman (I-Conn.) and Ben Nelson (D-Neb.), as well as from a group of Democrats representing states with relatively low Medicare payment rates.

It remains to be seen if there will be a vote before Christmas as originially planned. Stay tuned.......

Friday, December 11, 2009

Some Rural Communities Concerned Reform Provisions Could Hurt Medicare Services

Newspapers in Alaska and Washington state explore how health reform provisions might affect Medicare services in rural areas, while a Colorado newspaper looks at one senator's efforts to increase the number of doctors in rural areas.

Please click HERE to read these stories in their entirety.

Wednesday, December 9, 2009

12.9.09 - Healthcare Reform Update

The fun continues as the Senate moves into its 10th day of the healthcare reform debate. As of this writing, Senate Majority Leader has pulled the public option and has offered a compromise instead. The compromise consists of offering a private plan that is similar to the Federal Employee Health Benefit plan, which is the plan offered to members of Congress. The compromise also would allow those who are uninsured and between the ages of 55 - 64 years old to buy into Medicare. Even with this compromise being offered, there are some Senators who are still talking of allowing a "trigger" for a public option that would come into effect by a certain date if this compromised plan does not alleviate healthcare costs and reduce the number of uninsured.

There are still numerous amendments, including rural provisions, that have been officially filed, but not yet brought to the floor. There is no distinct timeline as to when the rural amendments will be offered, though Senator Reid is still claiming the Senate will have a complete bill before Christmas. Stay tuned.........

Tuesday, December 8, 2009

Critical Access Hospitals and Healthcare Reform

Critical Access Hospitals not only play a vital role in providing healthcare services to our rural and frontier counties, but they are also a main ecomonic driver in rural communities. The Patient Protection and Affordable Care Act does not adequately address some key provisions that would help increase the ability of CAHs to offer quality, comprehensive healthcare services. Now is the time to contact your Senators to ensure all of the following are addressed:

Reinstate "Necessary Provider" for Critical Access Hospitals - This would allow states to once again waive the 35-mile requirement and deem a hospital as a "necessary provider" based on unique conditions often only realized by local and state entities.

Allow Critical Access Hospitals flexibility in their bed count - CAHs currently are limited by a hard 25-bed cap. Allowing CAHs to maintain an average bed count of 20 improves patient access, especially in the case of seasonal or other unexpected influxes of patients.

Ensure Rural Access to Anesthesia Services - CAHs frequently use certified registered nurse anesthetists to provide anesthesia services in a cost-effective way. However, Medicare reimbursement is currently unreliable due to a lack of clarity in current legislation. Current legislation (S. 1585) would solve this problem and must be included in the final health reform bill. Additionally, H.R. 3151 seeks to close current loopholes and ensure that Critical Access Hospitals (CAHs) are properly reimbursed for their anesthesiology services.

Eliminate CAH "Isolation Test" for Ambulance Reimbursement - Under current law, CAHs can only receive cost reimbursement for ambulance services if they are the only provider of ambulance services within a 35-mile drive. This provision would eliminate the 35-mile requirement, ensuring that CAHs are appropriately reimbursed for providing emergency medical services.

To contact Senator Bennet click HERE or call: 202-224-5852
To contact Senator Udall click HERE or call: 202-224-5941

Senate Healthcare Reform Update

The Senate is currently debating H.R. 3590, the Patient Protection and Affordable Care Act. As of Sunday evening, a total of 165 amendments had been formally submitted, the vast majority of which will not be voted upon. There are many rural provisions that have been submitted, though it is unknown when or if these amendments will be voted on. Colorado's Senator Bennet has submitted an amendment entitled the Rural Health Access and Improvement Act, which would prioritize Critical Access Hospitals to receive grants to implement Health Information technology, expand participation in Drug Pricing Agreement program under Section 340B of PHS Act, provide for a study and report on Pharmacy Dispensing Fees under Medicaid, and provide continuing funding for the State offices of Rural Health. Colorado's Senator Udall also plans to submit an amendement that would create a grant program for medical schools to offer Rural Training Tracks, which encourages and trains medical students to practice medicine in rural areas.

Stay tuned for more updates as the Senate is expected to continue debating the healthcare reform proposal and the plethora of amnedments throughout the next few weeks. You can also visit the National Rural Health Association to stay on top of current healthcare reform news.

Monday, November 23, 2009

Senate to Begin Debating Healthcare Reform on Monday, November 30th

After months and months of waiting, the Senate finally has a healthcare reform proposal, The Patient Protection and Affordable Care Act, that will begin being debated on Monday, November 30th. The Senate voted this past Saturday to invoke cloture and had the magic number of 60 votes, which means there is no opportunity for those opposed to the legislation to filibuster. It also means there will eventually be a floor vote in the Senate. When that will occur and how the bill will look by the time a floor vote comes; remains to be seen.

There are many rural provisions and amendments that our national partner organization, the National Rural Health Association, hope are added to the Senate bill. For a specific list of these rural provisions, please click HERE.


Now is the time to contact Senator Udall and Senator Bennet and urge their support for these rural amendments.

I'd like to contact Senator Udall.
I'd like to contact Senator Bennet.

Friday, November 20, 2009

House Passes Medicare Fix for Physicians

The House of Representatives passed HR 3961 yesterday (11.19.09). This bill eliminates the 21% cuts to Medicare Payments that would have started in January and provides a long term fix for the Sustainable Growth Rate formula. The bill passed by a vote of 243 to 183. Colorado's Democratic Representatives voted in favor of this legislation, while the two Republican Representatives (Lamborn & Coffman) voted no.

Even though this legislation has passed in the House, its outlook in the Senate remains in doubt. Though the Senate's most recent health reform bill holds off the 21% cut from this year, it offers no long-term solution to this problem; but rather simply prevents cuts from taking place this January.

Stay tuned......

Thursday, November 19, 2009

Senate Bill is finally (maybe) Moving Forward

Finally, the wait is over. The long-anticipated Senate health reform bill (a bill blended from the two bills reported from the Finance Committee and Senate HELP Committees) has been filed. The bill number is HR 3589. It is over 2,000 pages, so not a quick & easy read! It is believed that most of the rural provisions that were gained during the Senate Finance Committee debate are still included. Preliminary discussions of the bill have begun on the Senate Floor - - but there will be a few procedural hurdles that must be overcome before we get to the actual debate where amendments will be offered.

The bill has been scored by the Congressional Budget Office (CBO) at $849 billion over ten years, ie, within the target that the Democrats were shooting for. CBO indicates that the bill will actually reduce the deficit by $127 billion over ten years and $650 billion over the following ten years. The bill is also projected to insure 94% of the population.

As of right now, it looks like the Senate will work on procedural maneuvers through the weekend. Majority Leader Reid will file a procedural motion know as “cloture” today. The purpose of the vote is to end current debate and allow a motion to proceed to the health reform bill -- the first of these two procedural votes will be Saturday and the second will be Sunday. However, this is very fluid and may change. One current roadblock that may delay this strategy is that Senator Baucus (D-MT) is in Montana due to a family matter - - if he is unable to return for the weekend votes, it will be delayed.

If 60 votes can be gained in the motion to proceed, the Senate rules then require the Clerk to read the bill. It is standard operating procedure that this perfunctory move is waived - - however, because we anticipate a Republican filibuster, the motion to waive the reading of the bill is expected to fail. This will require the Clerk to read out loud the full 2000+ page bill - - which could easily take until next Wednesday. The Senate will then be in recess on Thursday and Friday for Thanksgiving. This means that actual debate will not begin until the following Monday (November 30).

Thanks to our friends at the NRHA for providing this information. Stay tuned for more up to the minute information as it becomes available to us!

Monday, November 16, 2009

Center for Rural Affairs - Health Reform Reports

The Center for Rural Affairs recently highlighted some reports that specifically address how health reform will impact rural America. Please click HERE to access the reports in full.

Tuesday, November 10, 2009

H.R. 3962 - How Will the House Reform Bill Impact My Community?

The Committee on Energy and Commerce prepared, for each House member, a district-level analysis of the impact of House Bill 3962: Affordable Health Care for America Act. This analysis includes information on the impact of the legislation on small businesses, seniors in Medicare, health care providers, and the uninsured. It also includes an estimate of the impacts of the surtax that will help to pay for the legislation.

You may access this information by clicking HERE.

Monday, November 9, 2009

House Passes Health Care Reform Bill

On Saturday, the House passed the Affordable Health Care for America Act (H.R. 3962) with a vote of 220-215. Even with the passage of the House bill, overall healthcare reform has some hurdles to clear. The Senate bill is still awaiting a score (cost) from the Congressional Budget Office (CBO). Once the CBO provides its analysis, the Senate will have a floor vote, which will most likely be contentious. If and when the Senate passes its reform bill, the House and Senate reform proposals will have to be merged before anything is sent to the President to sign.

To learn about the key points of the Affordable Health Care for America Act, please visit The Kaiser Family Foundation.

Stay tuned......

Wednesday, November 4, 2009

Health Reform Update 11.4.09

National health reform is still moving along, though where it is going to end up still reamins to be seen. Here is a quick update on both the House and Senate side as to where the two proposals stand......

House: The House has merged the three committee proposals that were passed this summer and the total price tag of the compiled House bill is close to $1 trillion dollars, according to the Congressional Budget Office. There are still some sticky issues in the House proposal that are being worked out and a floor vote is expected this Saturday, November 7th. Some key rural health provisions are not included in the House bill and it is unlikey that there will be many (if any) floor amendments offered. This means the Senate is the key focus of adding any rural health provisions. Some of these provisions include: improving reimbursement for Rural Health Clinics, allowing Critical Access Hospitals more flexibility with their bed count (currently capped at 25 occupied beds per day), and allowing CRNAs to be reimbursed at cost through Medicare.

For a complete list of the rural health amendments that are hoping to be addressed on the floor of the Senate, please visit the National Rural Health Association Health Reform page.

Senate: The Senate has compiled both proposals that were passed this summer/fall and have sent their bill to the Congressional Budget Office (CBO). The CBO will analyze the bill and provide a price tag to the proposed reforms. It is still unknown when the Senate will have a floor vote on their reform bill and there is talk it may be pushed into 2010.

Keep checking back regularly for updates!

Monday, November 2, 2009

Expanding Health Insurance Coverage for Rural Residents through Health Reform

The Rural Policy Research Institute recently released a report entitled "Assuring Health Coverage for Rural People," which was funded by the Robert Wood Johnson Foundation. The Health Reform brief suggests that the challenges that rural people face in obtaining health insurance are partly due to the structure of the rural economy: 64 percent of adults working in rural are employed in jobs where health insurance is provided, compared to 71 percent of their urban counterparts. At the same time, rural workers are far more likely to be self-employed. Rural businesses also pay higher premium costs than urban businesses for similar health insurance plans.

Please click HERE to access the report.

Monday, October 26, 2009

The Commonwealth Fund: Comprehensive Congressional Health Reform Bills of 2009

The Commonwealth Fund has relased a report that provides an overview of the key provisions in the health reform bills currently being considered in Congress.

Please click HERE to access The Commonwealth Fund website and report entitled: The Comprehensive Congressional Health Reform Bills of 2009: A Look at Health Insurance, Delivery System, and Financing Provisions.

Senate Health Bill Could Come This Week, 'Compromise' Public Option Now Seems Likely

The following is from Kaiser Health News.

Senate Democrats will need to move quickly if they want to pass some version of health overhaul legislation by the end of the year.

The Associated Press: With "time growing short," Senate Democratic leaders "still face key decisions..." In the Senate, that "means deciding whether legislation will give the government a role in the marketplace at all, and if so, what rights individual states would have in deciding whether to participate." The Senate is weighing its final choices as negotiators work to merge the bills from Senate Finance and from Health, Education, Labor and Pensions Committees. The latest talks have focused around getting rid of any mandate on businesses to provide health insurance for their employees (Espo, 10/26).

The Wall Street Journal reports that the Senate's finalized health bill could be ready as soon as early this week, when the leaders will submit the bill to the Congressional Budget Office for scoring. Senate Majority Leader Harry Reid "spent the weekend shoring up support for the bill from Democrats in the chamber. But some key moderate Democrats signaled Sunday that they remain uneasy about main planks of the legislation." Although some details could change, the "broad outlines are becoming more clear" (Adamy and Hitt, 10/26).

Politico reports that Sen. Chuck Schumer also believes 60 votes are within sight. But "Senate Minority Leader Mitch McConnell said that Democrats still have work to do in rallying support within their ranks, pointing to last week’s overwhelming vote to strike down a so-called doc fix to Medicare physician reimbursement that would have added nearly $250 billion to the deficit. A group of Democrats crossed party lines on the vote" (Isenstadt, 10/25).

The New York Times: "Several Democratic senators voiced optimism on Sunday that Congress would pass a health care bill containing at least the germ of a government-run insurance program. Their expectations were grudgingly seconded by Senator John McCain, the Republican presidential candidate in 2008. 'I think the Democrats have the votes, and in the House, Blue Dogs bark but never bite,' Mr. McCain said on CBS’s 'Face the Nation,' using the nickname for conservative Democrats."

Democrats who said they see a public plan passing include Sens. Claire McCaskill, of Missouri; Chuck Schumer, of New York; and Russ Feingold, of Wisconsin. Sen. Ben Nelson, D-Neb., said he was willing to look at the proposal if the Senate allows states to opt out of that part of the plan (Berger, 10/25).

Friday, October 23, 2009

Senate Fails to Pass Permanent Fix to Medicare Physician Payments

On Thursday, October 22nd, the Senate voted to limit debate and bring S. 1776, the Medicare Physicians Fairness Act of 2009 to the floor for a full vote, but failed to get the 60 votes needed to do so. The final vote tally was 57 no votes to 43 yes votes. Both Senator Bennet and Senator Udall voted yes on the bill.

The cost of the bill, the reason it was defeated, was $245 billion over the next ten years and did not provide any offsets. This means that the Finance Committee’s Health Reform bill (S 1796), which included a temporary “fix” to the 21.5 percent payment cut via the sustainable growth rate (SGR) formula for Medicare physician pay, will most likely be included in the final bill brought to the Senate floor.

Wednesday, October 21, 2009

Colorado Backseat Budgeter

If given the opportunity, how would you go about balancing the state budget? With our state approaching a $1.8 billion deficit for Fiscal Year 2009-2010, state budget cuts are imminent. Due to certain constitutional mandates, balancing Colorado's state budget is no easy task; especially if you'd like to raise revenue. Colorado's Backseat Budgeter is a great tool to use to better understand Colorado's fiscal situation. Please visit the site by clicking HERE and enjoy!

Health Bills in Congress Won't Fix Doctor Shortage

Health Bills In Congress Won't Fix Doctor Shortage

By Phil Galewitz, KHN Staff Writer
Oct 12, 2009

Even as Congress moves to expand health insurance coverage to millions of Americans, it's doing little to ensure there will be enough primary care doctors to meet the expected surge in demand for treatment, experts say.

The American Academy of Family Physicians predicts that the shortage of family doctors will reach 40,000 in the next 10 years, as medical schools send about half the needed number of graduates into primary care medicine. The overall shortage of doctors is expected to grow to nearly 160,000 by 2025, according to the Association of American Medical Colleges.

Click HERE to read this article in its entirety.

Tuesday, October 20, 2009

Provide Feedback about Medicare to the Center for Medicare & Medicaid

On Thursday, October 29th, the Center for Medicare & Medicaid (CMS), Medicare Provider Feedback Group will be holding a town hall meeting that you can participate in via teleconference. You must register by 3pm (MST) on Friday, October 23rd.

For more information and to register please click HERE.

Monday, October 19, 2009

Call Senator Bennet & Senator Udall Today!

The U.S. Senate is finally moving on a bill (S.1776) that would eliminate Medicare's sustainable growth rate (SGR) formula. The SGR formula essentially cuts Medicare payment rates. For more information on SGR and S.1776 click HERE.

The Senate was set to vote on the bill today (Monday, October 19th) but the vote has been delayed for at least 24 hours.

Because the Senate's first vote could occur as early as tomorrow, Tuesday, Oct. 20, please call Sen. Mark Udall and Sen. Michael Bennet NOW and urge them to VOTE YES on S. 1776. You may use the American Medical Association's (AMA) hotline to contact them by calling: (800) 833-6354.

Never called a congressional office before? Check out the AMA guide to "Communicating with Congress."

To see how the cuts impact patients and physicians in Colorado, click HERE.

Friday, October 9, 2009

Health Reform Update

After receiving a final “score” from the Congressional Budget Office, the Senate Finance Committee has scheduled a meeting to vote on the America’s Healthy Future Act on Tuesday, October 13. The bill will likely pass out of the Committee, then move into a conference between Finance and HELP Committee leadership to bring one single version of the bill for the Senate floor.

Given the controversial issues surrounding health reform from either side of the aisle, there will likely be considerable action on the Senate floor. Here are a few of the rural amendments that NRHA expects to be offered on the floor during debate:

S. 307 – Wyden – Allows flexibility in the CAH bed count
S. 1355 – Barasso/Wyden – Raises the RHC Cap to $92
S. 1171 – Pryor – Would waive the 35-mile rule for CAH designation

For copies of both Finance and HELP Committee bills, please see below:

Senate Finance Committee Links

Senate HELP Committee Bill (S.1679 – The Affordable Health Choices Act)

You may also click here to read the House's proposal (H.R. 3200: America's Affordable Health Choices Act of 2009)

Thursday, October 8, 2009

Gov. Ritter to hold Town Hall Meetings - Oct. 8th - 10th

Governor Ritter will be holding public town hall meetings in Idaho Springs, Alamosa, San Luis, Antonito, Saguache and Monte Vista the next few days, and he's inviting you to attend and participate.

Thursday, October 8, 2009 - 11:30 a.m.
City Hall, 1711 Miner St., Idaho Springs

Friday, October 9, 2009 - Noon
Adams State College, Student Union Building, Banquet Room A-130,
Corner of 1st Street and Stadium Drive, Alamosa

3 p.m.
Centennial High School, 901 Main Street, San Luis

5 p.m.
Dos Hermanas Restaurant, 435 Main St., Antonito

Saturday, October 10, 2009 - 9:30 a.m.
Saguache Community Building, 525 7th Street, Saguache

11:30 a.m.
Gov. Ritter will visit veterans and community members at the Colorado State Veterans Center at Homelake and host a town hall meeting, 3749 Sherman Ave., Monte Vista.

Wednesday, September 30, 2009

Senate Finance Amendment Passes - Equity for Rural Providers

Finance Committee Focuses on Physician Payment
By Emily P. Walker, Washington Correspondent, MedPage Today
Published: September 30, 2009

WASHINGTON -- A GOP amendment that would pay rural doctors more money passed by unanimous consent during Tuesday evening's Senate Finance Committee markup.

The amendment, sponsored by ranking Republican Sen. Chuck Grassley of Iowa, would adjust the Geographic Practice Cost Index, or GPCI, helping to level the current payment differential between physicians in rural and urban areas for the same procedures.

The GPCI is part of the formula used by CMS to determine physician payments and reflects regional differences in practice costs, such as rent and employee wages.

"It's getting harder and harder for seniors to find doctors serving in rural areas," Grassley said in a prepared statement. "Part of the problem is Medicare payment policies that shortchange rural states. It's a question of fairness and accuracy to fix the problem of rural physicians getting paid less for performing the same procedures than doctors in other areas."

The amendment would not take money away from physicians practicing in urban areas.

Please click HERE to read this article in its entirety......

Wednesday, September 23, 2009

Booze, Guns, and the Rise in Rural Suicides

Daily Yonder article by Bill Bishop

Rural and urban suicide rates were about the same in the early 1970s. By the late 1990s, rates of suicide were 54% higher in U.S. rural areas than in U.S. cities.

Attempted and completed suicides take place at higher rates in rural communities, especially in areas that have more bars and taverns than other rural places, according to a new study.

The numbers of suicides were highest among white men.

Suicide rates were higher in both urban and rural places with concentrations of bars and taverns, according to the report by Fred Johnson, Paul Gruenewald and Lillian Remer. The authors speculate that a wide range of factors contributed to higher suicide rates in rural areas, including widespread use of firearms, local economic problems and alcoholism. Three out of four rural suicides involved firearms, according to the report.

Click HERE to read the story in its entirety.

Tuesday, September 22, 2009

Senate Finance Committee Health Care Proposal

Earlier today, the Senate Finance Committee began marking up the proposed bill that was introduced last week by Chairman Max Baucus (D-Mont). With over 500 proposed amendments to the bill, some interesting debate should ensue the next couple of weeks. To see a list of the proposed amendments, please click HERE.

The Washington Post reports: The bill would expand health coverage to millions without adding to federal budget deficits, and despite criticism of the measure from both parties, it has attracted the support of more moderate Democrats than any other proposal.

After a year-long effort to build a bipartisan consensus around the plan, Baucus has so far been unable to persuade any Republicans to sign on, and fellow Democrats have accused him of wasting his time courting conservative Sens. Charles E. Grassley (Iowa) and Mike Enzi (Wyo.).

The New York Times stated: The chairman of the Senate Finance Committee, Max Baucus, said Monday that he would modify his health care bill to provide more generous assistance to moderate-income Americans, to help them buy insurance.

Monday, September 21, 2009

Side-by-Side Comparison Tool of Major Health Care Reform Proposals

The Kaiser Family Foundation website has an interactive tool where you can compare the current health care reform proposals that are being debated at the national level. Please click HERE for more information.

Wednesday, September 16, 2009

Senate Finance Committee introduces America's Health Future Act

The long awaited health reform proposal from the Senate Finance Committee was introduced today by Committee Chairman Max Baucus (D-Mont.). The bill would require most invididuals to have health insurance and would require insurance companies to cover any individual, regardless of a pre-exisiting condition. The proposal does not have a public option plan, but instead creates health insurance "exchanges" where individuals may buy insurance. The proposal also creates a system of health "co-ops."

You can access the 220 page document by clicking HERE.

I will be digesting this document along with the H. 3200 (House health reform proposal) and how these will impact rural healthcare in the upcoming days. Keep checking back here for updates.

If you have feedback, comments, concerns, and/or gripes, please feel free to email me at th@coruralhealth.org

Monday, September 14, 2009

Your Voice is Needed to Achieve Health Reform in Rural America

Facing criticism that he has not offered specifics on his health reform strategy, President Obama spoke before a joint session of Congress last night outlining the details of his newly-formed plan. In the speech, the president touched on the importance of health reform for rural America and specifically mentioned one of the National Rural Health Association's (NRHA) long-time member organizations, Geisinger Health System in rural Pennsylvania. He emphasized that rural providers like Geisinger offer “high-quality care at costs below average.” Though only a small component of his speech, the very mention of a rural provider like Geisinger implies his willingness to give rural America a seat at the health reform table.

Now it is our job to remind Obama that ensuring access in rural America is vital to achieving true health reform.

• Join NRHA's Grassroots Working Group and participate in weekly conference calls, get updates on reform progress, and strategize going forward. To join, send a blank e-mail to
join-grassroots@lists.wisc.edu

• Check out the Rural Health Voices blog and the Health Reform page for the latest news from NRHA's government affairs staff in Washington, D.C.

Friday, September 11, 2009

Health Reform by Thanksgiving?

As you all know, on Wednesday night, President Obama spoke to a joint session of Congress outlining his health reform plan. In response to this speech, Max Baucus, Chairman of the Senate Finance Committee said, the health reform bill his committee has been working on all August will be released the middle of next week and the committee has scheduled a mark-up for Monday, September 21st. Given this information, Vice-President Joe Biden has said that the target date to have health care reform completed by is now Thanksgiving Day, whether this will hold or not however, remains to be seen.

The National Rural Health Association (NRHA) has a comprehensive health reform section on their website and information on how the current health reform proposals will impact rural America. I will be including some of the key health reform documents and information here, but you may also access the NRHA site by clicking HERE.

Tuesday, September 8, 2009

Rural Mental Health Funding Doubtful, Even as Farm Stress Worsens

As stress in the farming sector rises across Colorado and nationwide, some mental health professionals are hoping the federal government will step in to fund mental health services through the 2010 Farm Bill.

But proponents of the Farm and Ranch Stress Assistance Network have just one last chance to convince Congress to fund — and not just authorize — a comprehensive mental health program for the agriculture sector. Its passage looks doubtful at best.

(Please click on the title of this article to read in its entirety)

Wednesday, September 2, 2009

Obama to Address Joint Session of Congress on Heathcare

The White House is apparently not kidding around with its new strategy to regain the upper hand in the fight over healthcare reform.

President Obama's big speech on healthcare, intended to restart the debate in Congress and nationally, won't be your run of the mill affair. Instead, he's going to address a joint session of Congress -- that is, both the House and the Senate -- next Wednesday, Sept. 9th, in prime-time.

There'll be a lot of pressure on him with this speech, of course. It could end up as a big win, but with the debate having gone badly for Democrats recently, he'll be watched closely on this one. Plus, you can expect Republicans to pitch a fit, and if their claims end up holding water after the address, this could turn out to be a net loss.

Rural State with Much To Gain Under Reform Also Feature Most Vocal Opponents

Rural States With Much To Gain Under Reform Also Feature Most Vocal Opponents
[Sep 02, 2009]

The biggest opponents of a health care overhaul predominantly reside in rural states. The Los Angeles Times reports: "Some of the most vociferous opposition to the proposals before the House and Senate comes from residents of rural states that could benefit most if the present system is revamped. ... Although there is a consensus in Congress for keeping the current employer-based system of medical insurance, that system is riddled with holes in coverage that disproportionately affect rural states."

"In addition, both in the West and South, such states tend to set higher thresholds for Medicaid eligibility, leaving few options for low-income earners who can't afford individual insurance coverage. Moreover, residents of rural states often have lower incomes than those in other parts of the country. It's more difficult to find healthcare providers. And they have little, if any, choice in the private insurance market. ... Given that reality, it may not be surprising that senators from these states have been the most active in the effort to salvage a bipartisan compromise on healthcare" (Oliphant, 9/2).

Monday, August 31, 2009

Bennet Tours Walsenburg, Custer County Health Spots

Tuesday, August 25, 2009
By ANTHONY A. MESTAS
THE PUEBLO CHIEFTAIN

August 25, 2009 12:03 am

WALSENBURG - U.S. Sen. Michael Bennet met with doctors, nurses and administrators at three Southern Colorado health care facilities Monday to discuss rural health care and to hear concerns and problems facing small facilities.

In Walsenburg and other rural areas across the nation some people who can afford doctors often can't find them and others are too poor to afford care. It's a problem that took up most of the hourlong discussion at Spanish Peaks Regional Health Center.

Bennet heard from about 20 medical personnel, physicians and nurses that the problem was at times overwhelming.

He started his trip Monday morning making stops at the Spanish Peaks Regional Health Center and the Colorado State Veterans Nursing Home, which are located on the hospital campus three miles west of Walsenburg.

He then traveled to Westcliffe to meet with doctors at the Custer County Medical Center.

The sweep through Southern Colorado was part of the senator's tour over Congress' August break.

“In Colorado’s rural areas, doctors and nurses do everything they can to make sure their patients get the best care possible. As we talk about health care reform, we need to make sure they have a voice in the debate and that any reform makes sense for rural Colorado," Bennet said in a statement released Monday afternoon.

Dr. David Zehring, chairman of the hospital district board in Walsenburg, said that financial viability is a large problem in Huerfano County.

"Huerfano County is one of the poorest counties in the state per capita by income. We have a large number of people with no insurance and a large number of people covered by Medicare, which ordinarily does not cover the cost of rendering patient's care," Zehring explained.

"Nevertheless, unlike primary care practices in more affluent communities like Colorado Springs, Fort Collins, Denver and even Pueblo, our physicians can't turn anyone away based on their ability to pay. We are a special district hospital therefore we are mandated and we are happy to take care of everyone who comes to us with medical problems."

Zehring, who is not currently a practicing physician, said that the rule results frequently in the hospital's inability to get paid for treatment, "the main struggle that rural health care deals with on a daily basis."

He said that he and others would support an adjustment of the reimbursement schedule for Medicare and Medicaid.

"That adjustment would increase reimbursement for primary care and balance that with a reduction in payment for some of the medical and surgical specialties that frequently receive sometimes 10 times as much on a per-hour basis for their services than primary care does."

Zehring, who spent his career in Seattle, said rural medicine also confronts a difficulty in recruiting primary care physicians, many of whom "don't see themselves living in a small town" and even if they do, cannot make a living.

Dr. Michael Moll, a Walsenburg hospital physician, said that he thought the meeting showed the problems on Colorado's rural medical front.

He said that primary care has been undermined by health insurance companies denying payment for services to physicians and hospitals.

"Private practice primary care can no longer survive with the payer-mix population that exists in rural Colorado, Moll said.

Moll, who has been a Walsenburg physician for the past 12 years, said the few instances he sees that this works is when doctors can go to a big city and "cherry pick" their insurance companies.

Bennet addressed the need to improve access to care in rural areas, the shortage of primary care physicians and other health care providers and the need to improve the use of clinical preventive services.

He also talked about the Bennet-Roberts amendment to the budget resolution, which ensures that health reform increases funding to fix access problems in rural communities, including access to primary care and outpatient services, hospitals and an adequate supply of providers in the work force.

Additionally, Bennet co-sponsored the Murkowski-Murray amendment to the budget resolution, increasing funding by $100 million for the National Health Service Corps program, which supplies primary care and mental health providers to rural and medically underserved communities through scholarship and loan repayment assistance. Bennet also co-sponsored the Craig Thomas Rural Hospital and Provider Equity Act, which would provide much needed improvements to Medicare reimbursements for rural providers.

Zehring said that he and others who attended the meeting Monday were happy with Bennet's efforts.

"He was very open and he asked excellent questions and I felt like he was genuinely interested in what we had to say," Zehring said.

anthonym@chieftain.com

Friday, August 21, 2009

Why Rural America Needs Health Care Reform

Why Rural America Needs Health Reform

Rural Problem: Rural Americans are uninsured and underinsured at higher rates than their urban counterparts.
• In the smallest and most remote rural areas, the uninsured rate is 23% compared to an urban rate of 19%.
• A greater proportion of self-employed workers living in rural, areas are uninsured (40%), compared to self-employed workers in urban (32%) areas.

Health Reform Solution: Health reform legislation will improve accessibility and affordability of health coverage for all rural Americans.
• Provisions for the guaranteed issue and renewability of coverage and the prohibition of pre-existing condition exclusions will ensure that insurance coverage is available to all Americans, even if they are already sick.
• Provisions to control insurance companies’ rating practices, prohibit annual or lifetime limits on benefits and place a cap on consumer cost sharing will keep health costs under control for rural Americans.

Rural Problem: Rural Americans are sicker, with higher rates of chronic disease.
• Conditions such as hypertension, high cholesterol, diabetes, chronic bronchitis, stroke and arthritis are more prevalent among rural populations than urban. Some of these conditions are also risk factors for other diseases.

Health Reform Solution: Health reform legislation improves primary care and preventive measures.
• Provisions to prohibit cost-sharing for preventive services will encourage individuals to seek care early for better treatment of their conditions.

Rural Problem: Rural America is already experiencing a health care workforce crisis.
• Less than 10% of physicians serve 25% of the country’s population.
• When more individuals have health insurance and are able to afford health care, the strain on the existing providers will be even greater.


Health Reform Solution: Health reform legislation will develop a robust rural health care workforce.
• A strong investment in the National Health Service Corps provides additional funding for scholarships and loan repayments for medical students who choose to practice in underserved areas.
• Changes to Medicare Graduate Medical Education funding can influence residents’ future career choices. Exposure to rural areas during residency is significant predictor for future rural practice.
• Increased support for Title VII and VIII workforce programs is an investment in the long term health of the rural provider pipeline.

Rural Problem: Rural hospitals and providers struggle financially because of inequitable Medicare reimbursement rates, low patient volumes and other reasons.
• The average payment per discharge for rural hospitals in FY 2009 was $7,432; for urban hospitals the average payment per discharge for the same time period was $10,274.
• Some categories of rural hospitals receive special Medicare reimbursement to protect them from financial losses as a result of serving Medicare patients and help them remain in business, serving the community.

Health Reform Solution: Health reform legislation is an opportunity to improve rural Medicare reimbursement rates and strengthen rural safety net providers.
• A number of changes are necessary to ensure that provisions that help rural providers continue to do so and that new provisions are created to better the system.
• For more information on specific rural Medicare provisions needed in health reform, please visit http://www.ruralhealthweb.org/go/left/policy-and-advocacy/health-reform or contact the NRHA Government Affairs Office at 202-639-0550.

Rural America needs health reform. These solutions or variations for rural America are included in a health reform bill currently in Congress. Congress must ensure that health reform works for rural America. For more information about why health reform is important for rural, please contact the NRHA Government Affairs Staff at 202-639-0550.

State Budget Cuts and Impact on Rural Healthcare Services

Governor Ritter announced over $300 million in budget cuts this week. We applaud his efforts in trying to reduce the impact on rural healthcare and safety net services, but these cuts will impact our rural communities, nonetheless. These budget cuts will begin being implemented on September 1st.

There will be a 1.5% reduction in Medicaid Reimbursement Rates and $15 million cut from Amendment 35 funds. The breakdown is as follows:
$7 million from the Tobacco Education Program Fund
$7 million from the Prevention, Early Detection, and Treatment Fund
$1 million from the Health Disparities Grant Program Fund

The Breast and Cervical Screening Program and the Quitline were spared any cuts.

For a breakdown of the Governor's cuts, please click HERE.

More detailed information will be posted here in the upcoming days.

Thursday, August 13, 2009

Representative Markey to discuss Healthcare Reform Proposals

Representative Betsy Markey (4th District) will be traveling throughout the month of August discussing the many healthcare reform proposals being debated at the national level. Look for her visit in a town near you!

08/18 Congress on Your Corner Ft Collins 9am – 12pm
08/19 Congress on Your Corner Greeley 11am – 1pm
08/20 Congress on Your Corner Longmont 3pm – 5pm
08/21 Seniors Day Event Greeley 1pm – 3pm
08/22 Congress on Your Corner Ft Lupton 10:00am – 12:00pm
08/24 Tele-Town Hall Meeting District-wide 7:30pm – 8:30pm
08/26 Congress on Your Corner Ft Collins 10:30am – 12pm
08/28 Congress on Your Corner Ft Morgan 9am – 10:30am
09/01 Congress on Your Corner Johnstown 8:30am – 10am
09/02 Congress on Your Corner Windsor 1pm – 3pm
09/03 Congress on Your Corner Estes Park 3:30pm – 5pm

For more information, please contact Ben Marter:
Ben Marter | Communications Director
Congresswoman Betsy Markey (CO-04)
P 202.226.8416 | C 202.503.7888
ben.marter@mail.house.gov

Monday, July 27, 2009

Accountable Care Collaborative Request for Information Released

The Colorado Department of Health Care Policy and Financing (HCPF) has issued a Request for Information (RFI) for the Accountable Care Collaborative. The Accountable Care Collaborative is part of the state's Medicaid reform effort, and is envisioned to consist of a statewide data organization and a number of regional care coordination organizations. These regional organizations will be charged to offer care-coordination services and to support the local participating providers and clients in the regions. HCPF is relying on input from managed care organizations, clients, advocates and other stakeholders, and will move forward with a health care delivery system changing from a traditional fee-for-service model to a regional, outcomes-focused, whole person-centered, coordinated system of care for clients in fee-for-service Medicaid.

To view the RFI and provide input, please click HERE.

Friday, July 24, 2009

July 23, 2009 - Health Care Reform Stalls until September

Today the push to overhaul the nation's health care system faced another setback. The day after a President Obama had a news conference urging for a vote before the August recess, Senate Majority Leader Harry Reid announced that there would be no health care vote on the floor of the Senate until September, however a bill is still due out of the Senate Finance Committee before the break, though talks are still going on amongst committee members and no draft has yet been released.

On the House side, Chairman Waxman, who yesterday said the Energy and Commerce Committee would continue marking-up their bill with or without Blue Dog support, has still yet to schedule a mark-up for the remainder of the week. Speaker of the House Nancy Pelosi, today, indicated that the House may well have a deal within the next few days but there has been no floor vote scheduled thus far and so it seems the House may be waiting until after August to take this up as well.

Thursday, July 23, 2009

President Obama Nominates Rural Health Clinic CEO for Surgeon General Post

President Obama announced his intent to nominate the following individual today:

Regina M. Benjamin, Nominee for Surgeon General, Department of Health and Human Services.

Regina M. Benjamin, MD, MBA, is Founder and CEO of the Bayou La Batre Rural Health Clinic in Bayou La Batre, Alabama. She is the Immediate Past-Chair of the Federation of State Medical Boards of the United States, and previously served as Associate Dean for Rural Health at the University of South Alabama College of Medicine. In 2002, she became President of the Medical Association of the State of Alabama, making her the first African American woman to be president of a State Medical Society in the United States. Dr. Benjamin holds a BS in Chemistry from Xavier University, New Orleans. She was in the 2nd class at Morehouse School of Medicine and received her MD degree from the University of Alabama, Birmingham, as well as an MBA from Tulane University. She completed her residency in family medicine at the Medical Center of Central Georgia. Dr. Benjamin received the Nelson Mandela Award for Health and Human Rights in 1998, and was elected to the American Medical Association Board of Trustees in 1995, making her the first physician under age 40 and the first African-American woman to be elected. Dr. Benjamin was previously named by Time Magazine as one of the "Nation's 50 Future Leaders Age 40 and Under." She was also featured in a New York Times article, "Angel in a White Coat", as "Person of the Week" on ABC's World News Tonight with Peter Jennings, and as "Woman of the Year" by CBS This Morning. She received the 2000 National Caring Award which was inspired by Mother Teresa, as well as the papal honor Pro Ecclesia et Pontifice from Pope Benedict XVI. She is also a recent recipient of the MacArthur Genius Award.

Tuesday, July 7, 2009

Rural Health Clinic Legislation Introduced in the Senate

On June 25, Senator John Barrasso (R-WY) and Senator Ron Wyden (D-OR) introduced S. 1355, the Rural Health Clinic Patient Access and Improvement Act of 2009. The bill addresses long-standing underpayments to rural health clinics, introduces a quality improvement program to RHCs, and provides incentives to recruit and retain medical professionals to rural areas.

The bill also raises the all-inclusive Medicare payment cap for RHCs to $92, a greater than 20 percent increase over the previous cap, which was set in the 1970s. Currently, rural health clinics are hamstrung by low reimbursement rates that pay them less than what it costs to deliver care. This legislation allows for better collaboration between community health centers and rural health clinics. It will also create a five-state demonstration project to determine whether medical professionals would be incentivized to practice in rural areas if RHCs subsidized a portion of their medical liability costs.

CRHC has contacted Colorado's Senators to urge their support and co-sponsorship of this legislation. Please click HERE for more information and to read the bill in its entirety.

Tuesday, June 30, 2009

Federal Health Care Reform

With the talk of federal health care reform changing daily, there are a few tools that can help you sort through the mess.....

CRHC is keeping track of the discussion at the federal level and will be following how reform efforts will impact rural health care providers and consumers.

The Kaiser Family Foundation has an interactive tool where you can compare and contrast the different proposals that have been introduced in both the House and the Senate: Kaiser Family Foundation

The New York Times also has a thorough website devoted to health care reform: Key Challenges in Health Care Debate

Thursday, May 21, 2009

2009 CRHC Legislative Recap

Thank you Colorado Rural Health Center members for your help in making the 2009 Legislative Session a success. CRHC took positions on 9 pieces of legislation and were involved altogether with 11 bills. Please click here for a recap of some of the bills CRHC worked on this year.

Tuesday, May 12, 2009

The Legislative Session is Over!

Hooray! We all can finally breathe a sigh of relief as the 2009 Legislative Session is over. Stay tuned as I will be posting an overview of the bills CRHC tracked this session and how your legislator voted on rural health issues.

Thanks to all of you for your help and support this session!

Monday, April 27, 2009

Final stretch......

Well, we're down to the last days of the 2009 legislative session and there is still a lot that needs to be done!

The Good News:
  • SB09-002 (increase funding for EMTS from $1 to $2) passed the General Assembly and is off to the Governor for his signature. THANK YOU to all of you who helped with getting this legislation passed!
  • SB09-129 (duties concerning dental hygenists) became law! Dental hygenists can now diagnose cavitities and perform other oral health services that were previously restricted.
  • HB09-1293 (medicaid hospital provider fee) was signed by the Governor! Now the fun really begins! An advisory board will be established and work with the Centers for Medicare & Medicaid to hash out what this provide fee will look like and truly mean for Colordans. Stay tuned for more information as this process unfolds.
  • Medicaid provider cuts, which were originally set at 4.33%, have been reduced to 2%. Not sure you can call this good news, but the cuts are less severe then originally expected.

What still needs to be done:

  • SB09-271 proposes taking $35 million from Amendment 35 funds, in particular $15 million from the Primary Care Fund. Approximately $2 million of those Primary Care Funds are allocated to safety net clinics that are not federally qualified health centers (also known as community health centers). CRHC and a host of our partner organizations have been working to stop the General Assembly from taking these Primary Care Funds. Focus is targeted specifically on Joint Budget Committee members right now, which include:
    Senator Moe Keller, Senator Abel Tapia, Senator Al White, Rep. Jack Pommer, Rep. Mark Ferrandino, Rep. Don Marostica

  • HB09-1111 (health resources for underserved areas) is scheduled to be heard tomorrow (Tues. April 28th) in Senate Appropriations. Click HERE for more information on this bill.
  • HB09-1119 (rural substance abuse grant program) is scheduled to be heard by the entire Senate tomorrow (4.28).

Please contact your Senator NOW to urge their support on these two very important pieces of legislation! For an up to date list of contact information, please click HERE.

Again, thanks for all of your help and support this legislative session! We're almost done!

Friday, April 17, 2009

Call Your Senator and urge them to oppose cutting healthcare dollars!

In order to balance the budget, the General Assembly is proposing to take $35 million from healthcare programs, which include Primary Care Funds, tobacco cessation, and wellness & prevention programs. They are also proposing 4.33% provider rate cuts. These proposed cuts to healthcare services have already been approved by the House and it is now up to the Senate to vote on these. Please contact your Senator and urge them to oppose these cuts! 

Friday, April 10, 2009

Contact Your Representative Now! Support SB09-002!

SB09-002 which would increase funding for Emergency Medical & Trauma Services is up for its almost-final hurdle in the House Appropriations Committee next Friday, April 17th and we need your help, especially if your Representative sits on this Committee. It is also extremely important to begin reaching out to the House Committee of the Whole as once this passes the Appropriation Committee it will be off to the House of the Whole.

Please click HERE to get a current contact list of the General Assembly or visit http://www.votesmart.org/ to learn who your Representative is and find out contact information.

Thank you in advance for your continued support and help!

House Appropriations Committee
Jerry Sonnenberg: 303-866-3706; jerry.sonnenberg.house@state.co.us
John Kefalas: 303-866-4569; john@kefalas2008.com
Don Marostica: 303-866-2947; don@donmarostica.com
Jim Riesberg: 303-866-2929; jim.riesberg.house@state.co.us
Sal Pace: 303-866-2968; sal.pace.house@state.co.us
Jim Kerr: 303-866-2939; jim.kerr.house@state.co.us
Andy Kerr: 303-866-2923; andy@andykerr.org
Bob Gardner: 303-866-2191; bob.gardner.house@state.co.us
Jack Pommer: 303-866-2780; jack.pommer.house@state.co.us
Beth McCann: 303-866-2959; beth.mccann.house@state.co.us
Joel Judd: 303-866-2925; repjoeljudd@joeljudd.com
Mark Ferrandino: 303-866-2911; mferrandino@yahoo.com
Glenn Vaad: 303-866-2943; gvaad@gmail.com

Wednesday, April 1, 2009

Stay up to Speed on the Bills CRHC is Tracking!

The 2009 Colorado General Assembly is almost a month away from adjourning. Stay up to speed on what bills CRHC is tracking and how they may impact rural healthcare.

Please click HERE for the CRHC Bill Tracking Tool.
You can also visit the CRHC Policy & Advocacy page for more information.

Monday, March 30, 2009

Contact House Appropriations Members - Urge Support for HB09-1111 and HB09-1119!

Two bills that CRHC supports are scheduled to be heard this Friday, April 3rd in House Appropriations and we need your help to move them through!

HB09-1111: Health Resources for Underserved Areas is an extrememly important bill that will greatly impact rural healthcare access and services by strengthening the Primary Care Office. For detailed information on this bill, please visit the CRHC Legislative Update page.

HB09-1119: Rural Substance Abuse Grant Program: would establish the rural alcohol and substance abuse grant program that would provide alcohol and substance abuse treatment and prevention services to youth who reside in rural areas of the state. Rural is defined in this bill to be a county with less than 30,000 people.

Please contact your Representative and urge their support for these bills!

House Appropriations Committee Members
Jack Pommer: 303-866-2780; jack.pommer.house@state.co.us
Mark Ferrandino: 303-866-2911; mferrandino@yahoo.com
Bob Gardner: 303-866-2191; bob.gardner.house@state.co.us
Joel Judd: 303-866-2925; joeljudd@aol.com
John Kefalas: 303-866-4569; john.kefalas.house@state.co.us
Andy Kerr: 303-866-2923; akerrhd26@earthlink.net
Jim Kerr: 303-866-2939; james.kerr.house@state.co.us
Don Marostica: 303-866-2947; don@donmarostica.com
Beth McCann: 303-866-2959; beth.mccann.house@state.co.us
Sal Pace: 303-866-2968; sal.pace.house@state.co.us
Jim Riesberg: 303-866-2929; jim.riesberg.house@state.co.us
Jerry Sonnenberg: 303-866-3706; jerry.sonnenberg.house@state.co.us
Glenn Vaad: 303-866-2943; glenn.vaad.house@state.co.us

Friday, March 20, 2009

SB002 - Passed another hurdle.....almost there! Please Contact your Representatives!!

SB09-002 passed both the House Transportation & Energy Committee and the House Finance Committee this week! Thanks to all of you for your help and support! The bill now awaits the House Appropriations Committee, which will most likely hear the bill sometime next week. Once it passes Appropriations, it will only have two more steps to go (2nd Reading in the House Committee of the Whole and then 3rd & Final Reading in House Committee of the Whole). While this bill has had a long and tenuous journey, we need your help to push it through the final hurdles! Please contact the House Appropriations members to express your support of this extremely important piece of legislation!

Please read some of the other posts on this site to learn more about SB09-002.

House Appropriations Committee
Jerry Sonnenberg: 303-866-3706; jerry.sonnenberg.house@state.co.us
John Kefalas: 303-866-4569; john@kefalas2008.com
Don Marostica: 303-866-2947; don@donmarostica.com
Jim Riesberg: 303-866-2929; jim.riesberg.house@state.co.us
Sal Pace: 303-866-2968; sal.pace.house@state.co.us
Jim Kerr: 303-866-2939; jim.kerr.house@state.co.us
Andy Kerr: 303-866-2923; andy@andykerr.org
Bob Gardner: 303-866-2191; bob.gardner.house@state.co.us
Jack Pommer: 303-866-2780; jack.pommer.house@state.co.us
Beth McCann: 303-866-2959; beth.mccann.house@state.co.us
Joel Judd: 303-866-2925; repjoeljudd@joeljudd.com
Mark Ferrandino: 303-866-2911; mferrandino@yahoo.com
Glenn Vaad: 303-866-2943; gvaad@gmail.com

Wednesday, March 18, 2009

Contact your Representative Now to Support SB09-002!!!

SB09-002, which would increase the motor vehicle registration fee by $1 to support Emergency Medical Services in Colorado has passed the Senate and is now up for consideration in the House Fianance Committee. After passing in the House Transportation & Energy Committee by a 10-1 vote yesterday the bill is scheduled to be heard TODAY (March 18th) by the House Finance Committee. If your Representative is on the Finance Committee, please call them today to urge their support of this very importatnt piece of legislation!
For more information about SB09-002, please visit: http://www.coemsandtraumafunds.org/

Finance Committee Members:
Joel Judd (Chair): 303-866-2925; repjoeljudd@joeljudd.com
Jerry Frangas (Vice-Chair): 303-866-2954; jerry.frangas.house@state.co.us
Dennis Apuan: 303-866-3069; dennis@dennisapuan.com
Debbie Benefield: 303-866-2950; debbie.benefield.house@state.co.us
Cheri Gerou: 303-866-2582; cheri.gerou.house@state.co.us
John Kefalas: 303-866-4569; john.kefalas.house@state.co.us
Andy Kerr: 303-866-2923; andy@andykerr.org
Kent Lambert: 303-866-2937; repkentlambert@comcast.net
Ellen Roberts: 303-866-2914; ellen.roberts.house@state.co.us
Ken Summers: 303-866-2927; ken.summers.house@state.co.us
Spencer Swalm: 303-866-5510; spencer.swalm.house@state.co.us

Friday, March 13, 2009

HB-1293: Colorado Healthcare Affordability Act

HB-1293: Colorado Healthcare Affordability Act is a first step in helping to insure more than 100,000 Coloradans, while at the same time ensuring that hospital providers have adequate reimbursement rates. This bill will begin the process of establishing a hospital provider fee in Colorado that is estimated to bring in a net revenue for the state at $1.2 billion dollars. These funds will be redistributed to hospitals in effort to improve reimbursement rates for Medicaid, CHP+, and CICP patients. Please click HERE for a fact sheet.

The CRHC supports this legislation. If this bill passes, CRHC will be working with the Colorado Hospital Association and the Hospital Provider Fee Oversight and Advisory Board to ensure that rural hospitals benefit from this legislation.

The bill is scheduled to be heard Friday, March 13th in the House Health & Human Services Committee. We encourage you to contact your Representative and urge their support.

Chair: Jim Riesberg: 303-866-2929; jim.riesberg.house@state.co.us
Vice-Chair: Sara Gagliardi: 303-888-2962; sara.gagliardi.house@state.co.us
Cindy Acree: 303- 866- 2944; cindy.acree.house@state.co.us
Gwen Green: 303-866-2951; gwengreen@yahoo.com
John Kefalas: 303-866-4569; john.kefalas.house@state.co.us
Jim Kerr: 303-866-2939; james.kerr.house@state.co.us
Kevin Lundberg:303-866-2907: replundberg@gmail.com
Anne McGihon: 303-866-2921; anne.mcgihon.house@state.co.us
Dianne Primavera:303-866-4667; dianne.primavera.house@state.co.us
Ellen Roberts: 303-866-2914; ellen.roberts.house@state.co.us
Spencer Swalm: 303-866-5510; spencer.swalm.house@state.co.us

Wednesday, March 4, 2009

SB09-002: Contact your Representative!

SB09-002, which would increase the motor vehicle registration fee by $1 to support Emergency Medical Services in Colorado has passed the Senate and is now up for consideration in the House Transportation & Energy Committee. A hearing date has not been set, but it is not too early to begin contacting your Representatives to encourage them to support this very importatnt piece of legislation!

Website: http://www.coemsandtraumafunds.org/
SB09-002 fact sheet

House Transportation & Energy Committee Members
Chair: Buffie McFadyen: mcfadyen2002@hotmail.com; 303-866-2905
Co-Chair: Gwen Green: gwyngreen@yahoo.com; 303-866-2951
Randy Baumgardner: randy.baumgardner.house@state.co.us;
303-866-2949
Randy Fischer: randyfischer@frii.com; 303-866-2917
Jerry Frangas: kjerry.frangas.house@state.co.us; 303-866-2954
Steve King: steve.king.house@state.co.us; 303-866-3068
Marsha Looper: marshalooper@gmail.com; 303-866-2946
Frank McNulty: 303-866-2936
Michael Merrifield: michael.merrifield.house@state.co.us;
303-866-2932
Dianne Primavera: dianne.primavera.house@state.co.us;
303-866-4667
Glenn Vaad: glenn.vaad.house@state.co.us; 303-866-2943

Wednesday, February 25, 2009

Keep up to date on bills CRHC is tracking

CRHC is updating its legislative tracking list on a weekly basis. Keep up to date on bills that we are following by visiting our site: CRHC Policy & Advocacy

Monday, February 23, 2009

SB09-002 Passes Senate!

Today SB09-002 (Increase Motor Vehicle Fee for Emergency Services) passed in the Senate!
Thank you to everyone who contacted their Senator to urge their support. As soon as the voting record is made public, I will post that information here. The bill will now cross over to the House and I will post more information as soon as it is made available.

Thank You!

Wednesday, February 18, 2009

Please Contact your Senator!

SB09-002: Increase Motor Vehicle Fee for Emergency Services is expected to be heard tomorrow (Thurs. Feb. 19th) by the Senate as a Whole. SB09-002 would help improve the capacity of EMS services in Colorado, in particular rural areas of the state. Please contact your Senator to urge their support of this important piece of legislation! We thank you for your help!

Contact your Senator now!

SB09-002: Background Information
SB09-002 would increase the motor vehicle registration fee that funds Emergency Medical Services (EMS) from $1 to $2. Since 1989, EMS has received $1 from each motor vehicle registration fee though there has not been any funding increase since then. These funds are used to support the administration of EMS, to fund the 11 Regional Emergency & Trauma Advisory Councils (RETACs), and fund grant programs. The proposed fee increase will generate an additional $5 million for EMS. From FY2005 through the current year, 70% of the grant funding from EMS was disbursed to rural counties. With the majority of the EMS grant funding supporting EMS in rural Colorado, it is important to help strengthen these vital services.

Wednesday, February 11, 2009

Bills in House Appropriations - Contact Your Representative

Two bills that CRHC is in support of (HB-1111: Health Resources for Underserved Areas & HB-1119: Rural Substance Abuse Grant Program) have both passed their first hurdle and now await the House Appropriations Committee. Please contact your Representative and urge their support of these two bills. If you would like more information about either of these bills, please feel free to contact Terri Hurst, Policy Analyst, at th@coruralhealth.org or 303-407-2031.

House Appropriations Committee Members
Jack Pommer: 303-866-2780; jack.pommer.house@state.co.us
Mark Ferrandino: 303-866-2911; mferrandino@yahoo.com
Bob Gardner: 303-866-2191; bob.gardner.house@state.co.us
Joel Judd: 303-866-2925; joeljudd@aol.com
John Kefalas: 303-866-4569; john.kefalas.house@state.co.us
Andy Kerr: 303-866-2923; akerrhd26@earthlink.net
Jim Kerr: 303-866-2939; james.kerr.house@state.co.us
Don Marostica: 303-866-2947; don@donmarostica.com
Beth McCann: 303-866-2959; beth.mccann.house@state.co.us
Sal Pace: 303-866-2968; sal.pace.house@state.co.us
Jim Riesberg: 303-866-2929; jim.riesberg.house@state.co.us
Jerry Sonnenberg: 303-866-3706; jerry.sonnenberg.house@state.co.us
Glenn Vaad: 303-866-2943; glenn.vaad.house@state.co.us

HB09-1119: Rural Substance Abuse Grant Program

HB09-1119 would establish the rural alcohol and substance abuse grant program that would provide alcohol and substance abuse treatment and prevention services to youth who reside in rural areas of the state. Rural is defined in this bill to be a county with less than 30,000 people. Rural areas of Colorado are sorely lacking in treatment and prevention services geared specifically toward youth and this bill is the first step in encouraging and providing funds for these much needed services. CRHC supports this bill and we encourage you to contact your Representative to urge their support.

Friday, February 6, 2009

Two Bills that CRHC Support Pass First Legislative Hurdle

HB-1111: Health Resources for Underserved Areas unanimously passed the House Health & Human Services Committee yesterday! Thanks to all of you who contacted your Representative to help move this bill forward. It will now go to House Appropriations. I will keep you up to date as to when the bill will be scheduled for its next hurdle.

SB09-002: Increase Motor Vehicle Fee for Emergency Services passed 4-3 in the Senate Transportation Committee. It now is in the Senate Appropriations and is up for hearing on Friday, Feb. 13th. Public testimony is not allowed at Appropriation hearings, but you can still contact your Senator by phone or email prior to the hearing and urge them to support SB09-002. Members of the Senate Appropriation Committee and their contact information is listed below:

Senator Abel Tapia: 303-866-4878 - abel.tapia.senate@state.co.us
Senator Moe Keller: 303-866-4856 - moe.keller.senate@state.co.us
Senator: Bob Bacon: 303-866-4841 - bob.bacon.senate@state.co.us
Senator Ted Harvey: 303-866-4881 - ted.harvey.senate@state.co.us
Senator Mary Hodge: 303-866-4855 - mary.hodge.senate@state.co.us
Senator Keith King: 303-866-2318 - keith.king.senate@state.co.us
Senator Mike Kopp: 303-866-4859 - mike.kopp.senate@state.co.us
Senator Paula Sandoval: 303-866-4862 - paula.sandoval.senate@state.co.us
Senator Al White: 303-866-5292 - al.white.senate@state.co.us
Senator Suzanne Williams: 303-866-3432 - suzanne.williams.senate@state.co.us

Monday, February 2, 2009

Keeping doctors in Rural Areas

Keeping doctors in rural areas
By Mark Deutchman, MD
Posted: 01/29/2009 12:30:00 AM MST

The Denver Post's Sunday article about the town of Wellington losing its only doctor serves as a reminder of Colorado's increasing crisis in rural health care. This is an important issue that the state must address.

The University of Colorado Denver School of Medicine tries to do its part through its Rural Track and Rural Scholars programs. Both programs aim to supply physicians to underserved areas.

To read the rest of this article, please visit: http://www.denverpost.com/guestcommentary/ci_11574410

Saturday, January 24, 2009

HB09-1111: Health Resources for Underserved Areas

HB09-1111 would help improve healthcare workforce recruitment and retention efforts in rural and underserved areas of Colorado. The bill would create the Primary Care Office (PCO), which is in charge of designating areas of the state as Health Professional Shortage Areas. The PCO also manages programs that place healthcare providers in rural and underserved parts of our state. HB09-1111 also improves access to the state health professions loan repayment program and establishes a healthcare community board who will be charged with assessing and making recommendations on how the state can improve upon the five healthcare loan repayment programs currently being offered in Colorado.
For more detailed information on HB09-1111, please visit the Policy & Advocacy section of the CRHC website: www.coruralhealth.org/crhc/programs/policy/leg_updates.html

This bill has been introduced in the House Health & Human Services Committee. A hearing is scheduled for THURSDAY, FEB. 2nd in LSB-A.
CRHC supports this legislation and we encourage you to contact your Representative to urge their support:

Members of the House Health & Humans Services Committee and their contact information are listed below:
Chair: Jim Riesberg: 303-866-2929; jim.riesberg.house@state.co.us
Vice-Chair: Sara Gagliardi: 303-888-2962; sara.gagliardi.house@state.co.us
Cindy Acree: 303- 866- 2944; cindy.acree.house@state.co.us
Gwen Green: 303-866-2951; gwengreen@yahoo.com
John Kefalas: 303-866-4569; john.kefalas.house@state.co.us
Jim Kerr: 303-866-2939; james.kerr.house@state.co.us
Kevin Lundberg:303-866-2907: replundberg@gmail.com
Anne McGihon: 303-866-2921; anne.mcgihon.house@state.co.us
Dianne Primavera:303-866-4667; dianne.primavera.house@state.co.us
Ellen Roberts: 303-866-2914; ellen.roberts.house@state.co.us
Spencer Swalm: 303-866-5510; spencer.swalm.house@state.co.us

Thursday, January 8, 2009

SB09-002: Increase in Motor Vehicle Fee for Emergency Medical Services

SB09-002 would increase the motor vehicle registration fee that funds Emergency Medical Services (EMS) from $1 to $2. Since 1989, EMS has received $1 from each motor vehicle registration fee though there has not been any funding increase since then. These funds are used to support the administration of EMS, to fund the 11 Regional Emergency & Trauma Advisory Councils (RETACs), and fund grant programs. The proposed fee increase will generate an additional $5 million for EMS. From FY2005 through the current year, 70% of the grant funding from EMS was disbursed to rural counties. With the majority of the EMS grant funding supporting EMS in rural Colorado, it is important to help strengthen these vital services.

This bill has been introduced and assigned to the Transportation Committee.
A HEARING IS SCHEDULED FOR THURSDAY, JAN. 29th.
CRHC supports this bill and we encourage you to contact your Senator to support this legislation.
Members of the Senate Transportation Committee and contact information is as follows:
Chair: Dan Gibbs - 303-866-4873; dan.gibbs.senate@state.co.us
Vice Chair: Suzanne Williams - 303-866-3432; suzanne.williams.senate@state.co.us
Mike Kopp - 303-866-4859; mike.kopp.senate@state.co.us
Scott Renfroe - 303-866-4451; scott.renfroe.senate@state.co.us
Chris Romer - 303-866-4852; chris.romer.senate@state.co.us
Nancy Spence - 303-866-2935; nancyspence@qwest.net
Jennifer Veiga - 303-866-4861; jennifer.veiga.senate@state.co.us

Governor Ritter's State of State Tour

Governor Ritter's State of State Tour
From Friday, January 9th until Tuesday, January 13th, the Governor and appointed Senate leader Michael Bennet will be traveling throughout Colorado (Loveland, Fort Collins, Colorado Springs, Steamboat Springs, Grand Junction, Pueblo, Alamosa) discussing the economy and other issues facing Coloradans. See the schedule below.

Friday, Jan. 9, 2009: Denver, Loveland and Fort Collins
11:15 a.m. to Noon: Gov. Ritter will attend the annual Boots 'N Business luncheon at the National Western Stock Show. He will enter the arena on horseback as part of the Color Guard procession, and then provide remarks prior to the start of the luncheon. Location: National Western Stock Show, 4555 Humboldt, Denver.

1:30 to 2:30 p.m. Gov. Ritter and Michael Bennet will host a community gathering at the Loveland Museum, 503 N. Lincoln Ave., Loveland.

4:15 to 5:45 p.m. Gov. Ritter and Michael Bennet will host a community gathering at the Aztlan Community Center, Eagle Room, 112 Willow St., Fort Collins.

Saturday, Jan. 10, 2009: Glendale, Colorado Springs
9 to 9:45 a.m. Gov. Ritter will address the Metro Mayors Caucus, Infinity Park Events Center at 4400 E. Kentucky Ave., Glendale.

Noon to 1 p.m. Gov. Ritter and Michael Bennet will host a community gathering at Colorado Springs Library/Penrose Library, 20 N. Cascade Ave., Colorado Springs.

2 to 3 p.m. Gov. Ritter and Michael Bennet will meet with the Colorado Springs Chamber of Commerce, local businesses and others to discuss the economy and state and federal recovery efforts. Location: Colorado Springs Conservatory and Galileo Math & Science School, 1600 N. Union Blvd., Colorado Springs.

Monday, Jan. 12, 2009: Steamboat Springs and Grand Junction
8 to 9:30 a.m. Gov. Ritter and Michael Bennet will host a community gathering and pancake breakfast at the Sheraton Steamboat Resort, 2200 Village Inn Court, Steamboat Springs.

3:45 to 5:15 p.m. Gov. Ritter and Michael Bennet will meet with community members and students at Mesa State College, Science Center, Room SL 100, 1100 North Ave., Grand Junction.
Tuesday, Jan. 13, 2009: Pueblo and Alamosa
8 to 9:30 a.m. Gov. Ritter and Michael Bennet will host a community gathering and pancake breakfast at the Pueblo Union Depot, 132 West B St., Pueblo.

9:45 to 10:30 a.m. Gov. Ritter and Michael Bennet will dedicate the Colorado State University-Pueblo's new solar park with Black Hills Energy and BP Solar. From I-25 South, take Exit 101.Turn left onto Colorado 47 East. Take Bonforte Boulevard exit, then turn left (North) onto Bonforte Boulevard. Turn right on Bartley Boulevard, stay on Bartley Boulevard as it bends around to the North.

2 to 3:30 p.m. Gov. Ritter and Michael Bennet will host a community gathering, discussing the economy and local, state and federal recovery efforts. Location: Alamosa Family Recreation Center, 2222 Old Sanford Road, Alamosa.