Challenges for Improving Health Care Access in Rural America

Rural Health Research and Policy Centers, funded by the Federal Office of Rural Health Policy, recently released a compendium entitled Challenges for Improving Health Care Access in Rural America.

This compendium is a great tool to continue discussions surrounding healthcare reform and the challenges faced in rural communities as implementation moves forward. As previously stated in The Rural Voice, some of the rural and workforce provisions in federal healthcare reform were authorized, but not funded. This point must not be forgotten as Colorado and the rest of the country move forward with implementation efforts.

CCHI Seeking Healthcare Stories

The Colorado Consumer Health Initiative (CCHI) is seeking stories from rural residents who are having or have had a difficult time finding primary care services in your community. If you or someone you know has had trouble accessing primary care healthcare services and you would like to share your story, please contact Christina Yong at christina@cohealthinitiative.org

Vote No on Proposition 101, Amendment 60, and Amendment 61

As Colorado gears up for elections this November, the Colorado Rural Health Center has decided to oppose a trio of ballot initiatives that would severely impact Colorado's fiscal situation: Proposition 101, Amendment 60 and Amendment 61. If you think the past few years have been tough (keep in mind, our state isn't even close to being finished with budget cuts and I know all of us have been impacted by the current cuts that have occurred) these three ballot measures would severely cripple state and local services.

We encourage all of our members to get the word out and vote no on these! Tell your friends! Contact your elected officials! Vote NO on Proposition 101, Amendment 60 and Amendment 61!!!

During the next few months, CRHC will be providing you more information on these measures or you may visit the Looking Forward website to learn more. You can find county specific data as to how much your county will lose if any of these three passed. You may also sign on to oppose these measures, along with a host of other organizations including our rural partners Club 20, Action 22, and Progressive 15 by visiting Don't Hurt Colorado. I will be providing continued information about these ballot initiatives in the upcoming months in efforts to ensure these do not pass this November.

Below is a quick synopsis of what these three measures would do to local & state services.

Proposition 101 would eliminate taxes and revenue collected from car registrations and vehicle fees. This revenue helps fund local school districts, emergency medical services, and maintenance of roads & bridges. If passed, the state would lose about $2 billion a year (approximately $600,000 of that would impact local communities). This would greatly impact healthcare services by eliminating the ability of communities to have ambulance and emergency services.

Amendment 60 would overturn prior local election decisions regarding taxes & fees, cut local support for schools and charge new taxes on public services. This measure would greatly impact local funding for school districts who would expect to lose about 50% of their propery tax revenue. In total, A60 would cut over $1 billion of local funding. It would also charge new taxes on public universities & colleges, water authorities, and the Division of Wildlife.

Amendment 61 would bar the state from borrowing money, including short term loans, which are used for construction projects, roads, universities, and hospitals. Basically, the state of Colorado would freeze once this was enacted as the state would be unable to upgrade, build, or improve any infrastructure in the state.

All together these three measures would cause the state to lose about $6.3 billion annually from state and local goverment. This means that healthcare services would be greatly impacted as the state would not be able to completely fund Medicaid, reimburse providers (who have already been cut by 5.5% the past two years) and greatly diminish emergency medical services in the state. Colorado cannot afford any of these measures to pass.

Stay tuned for more information about these three and how you can mobilize your communtity, friends, and family members to vote NO!!!!

Safety Net Clinic Week: Aug. 30th - Sept. 3rd

In efforts to raise awareness of Colorado's healthcare safety net providers and clinics, ClinicNET in partnership with the Colorado Rural Health Center (CRHC), is declaring August 30th - September 3rd as Safety Net Clinic Week. The week will be devoted to educating the public and policy makers about Community Funded Safety Net Clinics and federally certified Rural Health Clinics. While there is a plethora of entitites that comprise the healthcare safety net, this week will focus on the often overlooked clinics that are affiliated with ClinicNET and CRHC.

There are currently 26 identified Community Funded Safety Net Clinics (CSNCs) in Colorado. These clinics tend to be non-profit, rural & urban, privately funded and provide primary care services to uninsured and underinsured individuals.

Colorado has 52 federally certified Rural Health Clinics (RHCs) that provide primary care services in some of the most rural and remote areas of Colorado. During 2009,CSNCs and RHCs collectively provided services to approximately 250,000 inidividuals in Colorado.

If you are a CSNC or an RHC and are interested in participating in Safety Net Clinic Week by hosting a site visit with policy makers, please contact Terri Hurst at: th@coruralhealth.org.

Doctors for America Health Reform Conference Call with Mary Wakefield

On Tuesday, July 27th, Doctors for America will be holding a conference call with Mary Wakefield, HRSA Administrator, to discuss health reform implementation. HRSA plays a large role in healthcare workforce programs and rural healthcare services. Participants on the call are encouraged to submit questions about healthcare provisions and how they will impact your community.

As most of you know, federally certified Rural Health Clinics and Community Funded Safety Net Clinics, providers of primary care services in rural and underserved areas that are an essential part of the healthcare safety net, were largely overlooked in healthcare reform. This is a great opportunity to ask HRSA what support and resources will be available for these rural healthcare safety net providers as health reform is implemented.

For more information and to register for the call, please visit Doctors for America.

Centura Health: Rural Health Video

Centura Health just created a Rural Health Video about the programs and services they offer to improve access to healhcare services in rural Colorado, such as Flight for Life, which provides critical care transport services, and Connected Care , which is expanding specialty care to four rural communities through the use of telemedicine.

Health Insurance Exchange Forum: Friday July 23rd

The Colorado Coalition for the Medically Underserved (CCMU), the Colorado Consumer Health Initiative (CCHI), and the state's Health Reform Implementation Board will be holding community forums regarding Colorado's efforts to create health insurance exchanges. Under the Affordable Care Act, states are responsible to develop health insurance exchanges – virtual marketplaces -where thousands of currently uninsured Coloradans will seek information to select and purchase health insurance. Many of these individuals and families will be eligible for federal subsidies to help them pay their insurance premiums.

The community forums will give stakeholders and the public an opportunity to learn more about health insurance exchanges and provide input as Colorado begins moving forward on health reform implementation efforts. The first forum will be held on Friday, July 23rd from 9a-11a in Denver at the National Jewish Hospital (1400 Jackson Street) in the Molly Blank Center.

New High Risk Pool: GettingUSCovered

Beginning July 6th, the state began accepting applications for Colorado's new federally funded high-risk pool to cover uninsured individuals who have pre-exisitng conditions. GettingUSCovered is administered by Rocky Mountain Health Plans and Cover Colorado. GettingUSCovered stems from the Accountable Care Act and will cover apporoximately 4,000 Coloradans who have been denied access to insurance due to their health status. To be eligible for GettingUSCovered, you must have been uninsured for 6 months prior to enrolling into the program. GettingUSCovered will become effective on September 1, 2010.

Director of Colorado's Primary Care Office Appointed to National Rulemaking Committee

Health & Human Services Secretary Kathleen Sebelius announced the 24-member negotiated rulemaking committee that is tasked to review criteria & methodology for designating Health Professional Shortage Areas (HPSA) and Medically Underserved Areas (MUA). Congratulations to the Director of Colorado's Primary Care Office, Steve Holloway, who will be serving on the committee!!

HPSA and MUA methodologies date back to the 1970's and have not been updated since. HPSA and MUA designations allow clinics, hospitals, and healthcare providers access to a host of incentives, which include: loan forgiveness programs, Medicare bonus payments, increased reimbursement rates, and the ability to be designated as a Rural Health Clinic, just to name a few. Fifty-seven (57) out of Colorado's 64 counties have been designated for primary care health professional shortage.

For more general information on HPSAs and MUA, please visit the Health Resources & Services Administration website.

Click on the following to learn more about Colorado's Primary Care Office and HPSA & MUA desingations in Colorado.

Did you know........

Medicare payments to hospitals with 50 beds or fewer represent less than 2% of the overall Medicare budget?!?!?

For more facts on rural healthcare, visit our national partner organization the National Rural Health Association.

The White House Project - CO Rural Go Lead 2010

The White House Project is a non-profit agency that seeks to advance women's involvement in the political process. On Saturday, July 31st, The White House Project will be holding an event in Montrose, Colorado entitled: Colorado Rural Go Lead 2010. It will be held from 10a - 4p at the Montrose Pavillion. Cost is $25.

Rural Go Lead participants can expect to learn more about The White House Project, hear from other women in the community about their paths to leadership, and to dispel some of the myths about running for office.

The Magnitude of Underinsurance in Colorado

The Colorado Trust recently published an issue brief entitled The Magnitude of Underinsurance in Colorado. The brief discusses the current state of Coloradans who are underinsured and how the underinsured experience similar problems faced by those who are uninsured. Underinsurance is defined as, "having public or private insurance coverage that does not adequately cover the costs of medically necessary services relative to family income, resulting in out-of-pocket expenses that exceed an insured individual's ability to pay."

Approximately 13% of the state's population is considered underinsured. Unfortunately, a majority of the underinsured reside in rural counties. Using the 21 Health Disparities Regional Profiles established by CDPHE, 13 of the regions reported an underinsurance rate higher than 13%. Seven of those regions were rural counties with Region 5 (Cheyenne, Elbert, Kit Carson, Lincoln) reporting 23.2% of the population being underinsured.