Current News

Child Welfare Information Gateway Links
January 31, 2007
In 2006, the National Clearinghouse on Child Abuse and Neglect Information and the National Adoption Information Clearinghouse were consolidated and expanded to become Child Welfare Information Gateway.

A service of the Children's Bureau, USHHS, Child Welfare Information Gateway provides professionals with the latest resources and information on child welfare topics ranging from child abuse prevention to adoption.

We are writing to request that you update the information on your website to reflect our new name and contact information. Below is the recommended language to use in your link to Child Welfare Information Gateway.

Child Welfare Information Gateway connects professionals and concerned citizens to timely, essential information and resources targeted to the safety, permanency, and well-being of children and families.

To download our logo, go to http://childwelfare.gov/linking.cfm

New from the RUPRI Center: "Enrollment in Medicare Part D for Rural Beneficiaries Is Encouraging"
January 31, 2007
A new policy brief is available from the RUPRI Center:

Enrollment in Medicare Part D for Rural Beneficiaries Is Encouraging

This brief provides findings about Medicare beneficiary enrollment in prescription drug plans in rural and urban areas across the United States, updating early findings from an analysis of plans presented in a previous RUPRI Center policy brief (PB2006-8). As of June 2006, over half (53.2%) of all rural Medicare beneficiaries were enrolled in a Medicare Part D prescription drug plan, compared to 51.2% of urban beneficiaries.

Please click on the following link to download this document: http://www.rupri.org/healthpolicy/Pubs/PB2007-1.pdf

Pfizer Announces Online Toolkit to Reduce Racial Health Disparities
January 31, 2007
The drug company Pfizer on Wednesday announced that it has launched a no-cost, online toolkit to help community health centers reduce racial health disparities, particularly among minorities who have diabetes, United Press International reports (United Press International, 1/17). The toolkit is an online version of a program -- called Friends in Health, launched by the Pfizer subsidiary Pfizer Health Solutions -- that helps community-based health workers become a "bridge" between people with diabetes and community and health system resources. The program's goal is to try to improve residents' health and lower health costs. A new Web site, www.AmigosEnSalud.com, provides detailed steps that health organizations can take to recruit and train community-based workers, develop and implement the program, and measure results. Culturally appropriate educational materials, a graduation toolkit, a database for program evaluation and tips on how to advertise the program also are available on the Web site. Pfizer Health Solutions has tested the program in Hartford, Conn.; Laredo, Texas; and Los Angeles (Pfizer Health Solutions release , 1/17). Pfizer Health Solutions Vice President John Sory said, "By making the program available online, we hope that organizations across the (United States) will adopt" the program (United Press International, 1/17).

Rural Beneficiaries Enrolling in Medicare Drug Benefit, But Have Fewer Options
January 31, 2007
(Washington, D.C.) - The National Rural Health Association (NRHA) is cautiously optimistic about the enrollment rate of rural beneficiaries in the Medicare Drug Benefit Program, but has concerns about the smaller range of options available to rural beneficiaries. A new policy brief released by the RUPRI Center for Rural Health Policy Analysis provides the latest overall enrollment numbers for rural beneficiaries and enrollment according to type of plan.

The RUPRI study updated earlier findings about rural and urban Medicare beneficiary enrollment in prescription drug plans. A key finding of the report is that rural beneficiaries are signing-up for the drug benefit at a slightly higher rate (53.2 percent) than their urban counterparts, (51.2 percent). NRHA President, George Miller, Regional President/CEO, Community Mercy Health Partners, said, "The NRHA is pleased that we were joined by so many partners in our Medicare drug benefit outreach and education efforts, and that those efforts paid off. However, this report raises questions about the availability and generosity of Medicare Advantage products in rural America, given that enrollment of rural seniors in those products is quite low."

The RUPRI study found that rural beneficiaries are much more likely to choose stand-alone prescription drug plans (33 percent) as compared to their urban counterparts (22 percent). Meanwhile, urban beneficiaries enroll in Medicare Advantage prescription drug plans at a higher rate (16 percent) than rural beneficiaries (4 percent) Reasons for the disproportionately higher rural enrollment in stand-alone plans include:

Less availability of choices for Medicare Advantage plans in rural communities. Comparable choices of stand-alone plans for urban and rural beneficiaries, due to national and regional plans. Lower rates of drug coverage for rural beneficiaries prior to creation of the Medicare drug benefit.

Alan Morgan, NRHA CEO, added "Another potential reason for the lower enrollment in Medicare Advantage plans is that these plans provide a less generous benefit in rural America, or at least they did in 2006. We eagerly await a pending RUPRI analysis on the generosity of the 2007 benefit offerings, and hope for an improvement, but fear we will continue to see this disappointing trend of less generous MA options for rural seniors."

The study may be accessed at NACo is now accepting applications for Rural Health Works
January 31, 2007
NACo is now accepting applications for the 2007 cycle of Rural Health Works technical assistance awards. As part of the Rural Health Works program, NACo will select a limited number of counties to receive technical assistance awards on a competitive basis. The award includes intensive TA on the Rural Health Works model. Rural Health Works is a community engagement process that assists counties to evaluate their healthcare system and to generate county-specific data on the importance of the health care sector to the local economy. The ultimate goal of the project is to strengthen rural economies by increasing the use and expansion of health services.

At the end of the project, participating counties will receive the following county-specific reports:

• An economic impact report describing economic activity in terms of both dollars produced and jobs produced by the health care sector;
• A directory of health and human services provided in the local service area;
• A survey of the health services utilization patterns of the community and the reasons for those patterns;
• A compilation of secondary data regarding the community. This report includes health data such as local leading causes of death compared to the state, infant mortality and related data, local disease issues, as well as other demographic data including incarceration rates, graduation rates, etc.

To apply, download an application from www.naco.org/techassistance under health. The deadline to apply is 2/5/2007, and awards will be announced 2/12/2007. More information is available in NACo's County News, or from www.ruralhealthworks.org.

If you have any questions about the application process or the Rural Health Works program, please do not hesitate to Christina Rowland at crowland@naco.org or 202-942-4267

Agreement on NationalHealth Coverage Plan Announced
January 31, 2007
Agreement on NationalHealth Coverage Plan Announced

Washington, D.C. ­Most of the nation’s largest health care organizations today announced that they have agreed on a proposal that would significantly expand health coverage for America’s almost 47 million uninsured, starting immediately with expanded coverage for children in 2007. Calling itself the Health Coverage Coalition for the Uninsured (HCCU), the group is made up of 16 influential, national organizations that have played leading roles in every federal health policy debate of the last 30 years, often on opposing sides. Despite their divergent political and ideological views, the groups today committed to immediately and jointly press lawmakers to act on their historic, two-phased consensus proposal.

HCCU signatory organizations include:

• AARP
• American Academy of Family Physicians
• American Hospital Association
• American Medical Association
• American Public Health Association
• America's Health Insurance Plans
• Blue Cross and Blue Shield Association
• Catholic Health Association
• Families USA
• Federation of American Hospitals
• Healthcare Leadership Council
• Johnson & Johnson
• Kaiser Permanente
• Pfizer Inc.
• United Health Foundation
• U.S. Chamber of Commerce

For more: http://www.coalitionfortheuninsured.org/news/news.html

Governor Rendell Announces Plan to Provide Health Care Coverage for All Pennsylvanians
January 31, 2007
On January 17, 2007, Governor Rendell announced his "Prescription for Pennsylvania: Right State. Right Plan. Right Now." At a briefing at the Governor's Residence in Harrisburg on January 17th, PHLP learned the following:

The Prescription for Pennsylvania is a two pronged plan to address the drastically increasing healthcare costs impacting the Pennsylvania economy (such as the 75.6% increase in healthcare premiums over the past 6 years versus a 13.3% increase in median wages) and to address the problem faced by Pennsylvania's 900,000 uninsured turning to emergency rooms for care that would have been far less costly if delivered before their conditions worsened.

The first prong of the plan is an array of steps designed at Driving Down Health Care Costs in the Commonwealth. The Governors Office of Health Care Reform has identified numerous areas where it says unnecessary healthcare dollars are being spent, and savings can be achieved.

• Reducing Unnecessary Emergency Room Use. Tremendous dollars are spent on this most costly care, often when the needs of the patient require urgent but not emergent care. As part of the Prescription for Pennsylvania, the Governor would require every hospital to have a non-emergent care center open for 24 hours a day to complement the emergency room and improve efficiencies. The urgent care center would be staffed by nurse practitioners for half the cost. Pennsylvanians use the emergency room 11% more than the national average. Similarly, financial incentives would be created for medical practices to maintain weekend and evening hours for patients with urgent but not emergent problems to deliver care but avoid the costly and unnecessary emergency room visit.
• Increasing Disease Prevention and Management. The Governor proposes incentivizing or requiring insurers to engage in greater disease management to reduce the unnecessary hospitalizations of individuals with chronic disease. The adoption of the "wagner model" of chronic care management would be implemented with a projected savings in the millions.
• Reducing Hospital Acquired Infections. Because large sums are spent on unnecessary readmissions or extensions of hospital stays as a result of Hospital Acquired Infections (an additional $150,000 cost per stay), the plan would work to require reductions and, eventually, impose financial penalties for failures to reduce Hospital Acquired Infection rates.
• Maximizing Healthcare Professionals Scope of Practice. Another area for cost-savings proposed includes maximizing the practices of nurse practitioners, pharmacists, and other healthcare professionals so that the scope of practice takes advantage of the full range of skills and training these professionals have had.
• Encouraging workforce development and healthcare access in underserved areas. Money will be spent to facilitate development or expansion of FQHCs or nurse managed health centers in underserved areas. Money will be used to provide loan forgiveness to healthcare professionals as well.
• Paying Insurers and Providers for performance. The plan would undertake payment shifts to hinge payment levels on quality of care.
• Insuring quality of care. The plan would require all hospitals to have quality management and error reduction systems as a condition of state licensure.
• Communicating Healthcare Costs. The plan would call for transparency in pricing of pharmaceuticals - so that pharmacists would publish their price to consumers.
• Reducing health insurance premiums. Coupled with the steps in the second prong of the plan, the Prescription for Pennsylvania would require that insurance premium rates be devised without reference to certain demographic characteristics, and for small businesses, insurers would have to spend at least 85% of premiums to pay for health care.
• Making Pennsylvania SMOKEFREE. The plan would prohibit smoking in all workplaces, restaurants, and bars to improve overall health and reduce second hand smoking deaths.
• Improving wellness. The plan would incentivize reduced healthcare costs based on achieving wellness goals. Additionally, public education curricula would be revised to include wellness education and public school breakfasts and snacks would be revamped to include more nutritious foods.

The second prong or part of the Prescription for Pennsylvania is the Cover All Pennsylvanians or "CAP" program. The Governor framed that as an expansion to adults of the new Cover All Kids program and explained CAP as relying on the same basic principles. Because 770,000 of the 900,000 uninsured Pennsylvanians are adults and 71% of these are employed but low-wage earning adults, the plan would subsidize the low-wage earners' employers purchase of CAP insurance. The CAP insurance would be available through the Blue Cross Plans, and would include coverage similar to that which is currently available to working adults under 200% of the federal poverty level through the adultBasic program. However the benefit package would be expanded to include prescription drug coverage and behavioral health coverage. The existing adultBasic coverage program would be subsumed by the new Cover all Pennsylvanians program.

The CAP program would be available to small employers, individuals, and self-employed persons. Individuals under 200% of the Federal Poverty Level (FPL), would have to have been uninsured for at least 3 months to be eligible and individuals under 300% would have to have had no insurance for 6 months or more to dissuade employers from simply discontinuing health coverage. For employers with less than 50 employees and an average wage less than the state average, CAP could be purchased at an employer cost of $130 for each employee. Employees would pay a monthly premium of between $10 and $70, depending on income and family size. And, the state would pay the remainder of the premiums. Uninsured spouses could also purchase the coverage. Individuals with household income under 300% of the federal poverty level could purchase the insurance directly with premium amounts ranging from $10-70. (Under 100% FPL at $10/month; from 100%-200% FPL at $40/month and from 200-300% at $60/month). And, individuals with household income over 300% of the federal poverty level could purchase the insurance at the state's cost which is reported as being approximately $280/month..

The revenue source for the state premiums would be:

• federal dollars available through a state Medicaid 1115 waiver for serving individuals up to 300% FPL
• a new tax on smokeless tobacco and cigars
• an increased cigarette tax
• an assessment of 3% of payroll that would be charged to all "free riders" i.e. employers who do not provide health insurance
• Tobacco Settlement dollars for adultBasic and uncompensated care

The Governor commented that this plan is more comprehensive than the Massachusetts or California plans. At this point, the Commonwealth would like to encourage everyone to get health insurance by making it affordable; however the Governor noted that he is not ruling out a mandate that all individuals with income over 300% of the Federal Poverty Level, and 4-year college and graduate students purchase health insurance.

Governor Rendell described his plan as a work in progress. He will be going to 25 localities in the coming weeks to explain the plan, and additional workgroups and planning meetings will occur. The plan has many parts, and will require, he says, some 47 separate pieces of legislation for full implementation. More information from the Governor's Office of Health Care Reform is available on the GOHCR website www.ochr.state.pa.us < http://www.ochr.state.pa.us>. And, more detail is said to be forthcoming in the Governor's February 6th budget announcement.

PND News Briefs - Central & Northeastern PA Edition
January 17, 2007

A group of Pennsylvania health care providers and insurers has formed a new organization, the Pennsylvania Health Care Quality Alliance, to foster transparency in health care and improve patient health. During the next year, the goals for the Alliance are to develop a consistent, uniform, statewide approach to measuring health care quality, and to report useful information to both providers and the public using measures that have already been developed and endorsed at a state or federal level, and leveraging existing data sources. The Alliance seeks to enable consumers and businesses in Pennsylvania to compare provider performance, help providers evaluate and improve the quality of their patient care, and enable insurers to evaluate the performance of their provider networks.

Alliance participants include the Hospital & Healthsystem Association of Pennsylvania (HAP), the Delaware Valley Healthcare Council (DVHC) of HAP, the Hospital Council of Western Pennsylvania (HCWP), the state's four Blue plans (Blue Cross of Northeastern Pennsylvania, Capital BlueCross, Highmark Inc., and Independence Blue Cross), the Pennsylvania Medical Society, and representatives from the Governors Office of Health Care Reform, and the U.S. Department of Health and Human Services. The alliance intends to focus on measures that are evidence-based and actionable, using methods of measurement, data collection, and reporting that are statistically sound and not unreasonably burdensome for providers or insurers. The measures will be drawn from those already developed and endorsed by such groups as the Hospital Quality Alliance, the Ambulatory Quality Alliance, the National Quality Forum, the Centers for Medicare & Medicaid Services, the Joint Commission, the National Committee for Quality Assurance, and specialty societies.

Available Now! Audio recording of sessions from HIT: A Rural Provider's Roadmap to Quality!
January 17, 2007
Audio recording of key sessions and other materials from HRSAs Office of Rural Health Policy-sponsored conference HIT: A Rural Providers Roadmap to Quality that occurred September 21-23, 2006 in Kansas City, MO are now available on the Rural Assistance Center website at http://www.raconline.org/HIT_Conf2006/. Recorded session topics include HIT 101, financing, leadership, implementation, and workforce. Other available items include conference agenda, speaker powerpoint presentations, and conference primer A Roadmap for the Adoption of HIT in Rural Communities. For additional information please contact Carrie Cochran at 301.443.4701 or ccochran@hrsa.gov.

HRSA Calls for Comment on Proposed Clarifications to 340B Drug Pricing Program
January 17, 2007
HRSA Solcitis Comments on 340B Drug Pricing The Health Resources and Services Administration (HRSA) on January 15 published two notices in the Federal Register soliciting public comment relating to proposed guidelines under the 340B Drug Pricing Program. All interested individuals and organizations are encouraged to review the proposed guidelines and submit comments to HRSA by March 13, 2007. For more information, please access this link:
http://newsroom.hrsa.gov/NewsBriefs/2007/FedRegNotices.htm

Study of CHCs
January 13, 2007
Community Health Center (CHC) Quality of Care Studied
Publicly funded community health centers (CHCs) provide care to more than 15 million Americans, including many minority patients, and this number is likely to grow. In a new Health Affairs study, " The Quality of Chronic Disease Care in U.S. Community Health Centers," a research team led by Harvard Medical School's LeRoi S. Hicks, M.D., examined the medical records of patients in 64 CHCs who received care for asthma, diabetes, or hypertension. They found that while CHCs provide care that is on par with other care settings, gaps in quality exist, particularly for uninsured patients.

Foundation Launches News Report on Racial and Ethnic Health Disparities
January 13, 2006
Commonwealth Fund staff and grantees published more than 100 important policy papers during 2006. Below is a list of the 10 most-read publications on the Fund's Web site over the last year. Take the opportunity now to re-read pieces of particular interest­or catch up on publications you may have missed. Also check out the Fund's top 10 health policy stories of the year.

SAMHSA announces the availability of Technical Assistance Publication (TAP) 28
January 13, 2007
KAISER FAMILY FOUNDATION LAUNCHES FREE NEWS REPORT ON RACIAL AND ETHNIC HEALTH DISPARITIES ON KAISERNETWORK.ORG

Webcasts of interactive panel discussions, interviews, and policy-oriented conferences and events featured in new online report

Washington, D.C. ­ Recognizing the need for greater awareness and understanding of racial and ethnic disparities in health and health care, the Kaiser Family Foundation announced today the launch of a news summary report ­ the Kaiser Health Disparities Report: A Weekly Look at Race, Ethnicity and Health. The report is available through a free weekly email, with stories updated daily online on kaisernetwork.org (http://kaisernetwork.org/disparitiesreport), the Foundation’s news and information service.

Following the model of three other popular Kaiser news summary reports on health policy, HIV/AIDS and women’s health policy, this new report summarizes and synthesizes news coverage of minority health issues from hundreds of print and broadcast news sources, including outlets serving racial and ethnic communities. The report will also highlight studies, initiatives and journal articles that don’t receive mainstream news coverage, and provide a calendar of upcoming events on health disparities.

Along with the new report, kaisernetwork.org will expand its coverage to include webcasts of policy-oriented conferences and events on racial and ethnic health issues and provide related original broadcast programming such as interviews and interactive panel discussions.

“With this new report, our aim is to bring news and developments on health disparities on a real-time basis to people working in the field, especially outside the beltway,” said Drew Altman, president and CEO of the Kaiser Family Foundation.

Each story in the report provides links to the original news sources and to resources for further information. Individuals can sign up to receive the free report via weekly email at http://www.kaisernetwork.org/email. The report will also be available online at http://kaisernetwork.org/disparitiesreport and through RSS feeds and Google News. Organizations will be able to “syndicate” the headlines and/or full summaries on their websites, through Kaiser’s free syndication service, http://kaisernetwork.org/about/syndication.

In addition to the new weekly report, the Foundation engages in a wide range of activities related to minority health, including its policy and survey research; broad-based activities on HIV/AIDS and public programs such as Medicaid that affect minority populations; its Barbara Jordan Health Policy Scholars Program, which brings talented African American, Latino, American Indian/Alaska Native, Asian and Native Hawaiian/Pacific Islander college seniors and recent graduates to Washington, D.C., where they are placed in Congressional offices; and a summer internship program for young minority journalists interested in specializing in health reporting.

The Kaiser Family Foundation is a non-profit, private operating foundation dedicated to providing information and analysis on health care issues to policymakers, the media, the health care community and the general public. Kaisernetwork.org is a free online news summary and information service operated by the Kaiser Family Foundation. The Foundation is not associated with Kaiser Permanente or Kaiser Industries.

SAMHSA announces the availability of Technical Assistance Publication (TAP) 28
January 13, 2006
SAMHSA Announces Availability of The National Rural Alcohol and Drug Abuse Network Awards for Excellence, 2004—Submitted and Award-Winning Papers

The Substance Abuse and Mental Health Services Administration (SAMHSA) announces the availability of Technical Assistance Publication (TAP) 28, The National Rural Alcohol and Drug Abuse Network Awards for Excellence, 2004—Submitted and Award-Winning Papers. This TAP presents seven papers submitted to the 2004 National Rural Alcohol and Drug Abuse Network (NRADAN) Awards for Excellence. Each paper describes effective and innovative models of treatment and prevention services in rural populations. This publication seeks to promote and showcase research addressing the unique and special challenges of providing treatment services to individual in rural areas and their families.

The first place paper describes the effectiveness of a self-funded drug court. The second place paper highlights effective strength- and home-based substance abuse treatment and recovery support programs. The third place paper provides presents a substance abuse prevention program for lower income mothers. The topics of the other four papers include treatment outcomes of people who use methamphetamine, a discussion of faith- and community-based reentry services, a comparison of people who use drugs in rural and very rural areas, and a description of an electronic version of the Addiction Severity Index.

To order your FREE copy of TAP 28, contact SAMHSA’s National Clearinghouse for Alcohol and Drug Information (NCADI). Ask for publication order number BKD552.

TAP 28 is also available online at www.kap.samhsa.gov.

Funding for Rural Health Safety Net Update
December 19, 2006
Democratic Leaders Announce Plans for FY07 Appropriations Work

On Monday, the incoming Democratic Appropriations Committee Chairmen, Senator Robert Byrd (D-WV) and Representative Dave Obey (D-WI), announced their plan to finish the fiscal year 2007 appropriations work. Fiscal year 2007 began on October 1, 2006, but Congress has only passed two of the eleven spending bills. The rest of the government is funded under a stop-gap funding measure or continuing resolution (CR) that will expire February 15, 2007.

The incoming Chairmen announced that they plan to adopt a “joint resolution” for the remainder of fiscal year 2007, with “limited adjustments”. Obey and Byrd pledged to remove all earmarks from the resolution and to place a moratorium on earmarking until a new system was developed. Such a move could free up additional money for federal programs under the budget cap of $873 billion for discretionary spending programs.

Departments and programs slated for increases in the fiscal 2007 bills reported out of the House and Senate Appropriations Committees – such as veterans’ health care – are likely recipients of additional funding. Obey, who was the ranking Democrat on the Labor-HHS-Education Appropriations Subcommittee, is expected to seek funding increases for programs covered by that bill. An increase may present an opportunity for rural health as this bill covers the programs in the rural health safety net.

Despite the possibilities of additional funding, it is unclear whether the “joint resolution” will be a modified version of the nine spending bills or a modified version of the continuing resolution, which sets funding at the 2006 levels. NRHA will continue to update the membership and will need your help in advocacy efforts early in the new year.

Under the current stop-gap measure, funding for the rural health safety net programs will continue at the same level as fiscal year 2006. For information on the appropriations funding levels for fiscal year 2006, please see: http://www.nrharural.org/advocacy/sub/07appropriations.html

FCC Pilot Program - Rural Health Care
December 19, 2006
Federal Trade Commission Announces New Nationwide Broadband Pilot Program
The Federal Communications Commission (FCC) - new Rural Pilot Program to facilitate the creation of a nationwide broadband network that will support dedicated to health care, connecting public and private non-profit health care providers in rural and urban locations. Applicants are encouraged to form statewide or regional consortia that may include academic health centers. In awarding funds, the FCC will consider how the applicant plans to:

• Aggregate (pool) the specific needs of health care providers, including providers that serve rural areas, within a state or region.
• Leverage (utilize) existing technology to adopt the most efficient and cost effective means of connecting those providers.
• Fully utilize a newly created dedicated broadband network to provide health care services.
• In addition, the FCC will consider:
• Whether the applicant has a successful track record in developing, coordinating, and implementing a successful telehealth/telemedicine program within their state or region.
• The number of health care providers that would be included in the proposed network, with considerable weight to be given to applications that propose to connect the rural health care providers in a given state or region. A proposal that connects only a de minimis (insignificant) number of rural health care providers will not be accepted.

What is the Rural Health Care pilot program?

The pilot program is an enhanced funding initiative intended to help public and non-profit health care providers construct state- and region-wide broadband networks to provide telehealth and telemedicine services throughout the nation. The program will fund up to 85% of the costs of constructing those networks, as well as the costs of advanced telecommunications and information services that will ride over these networks. If selected, up to 85% of the cost of connecting to Internet2, a dedicated nationwide backbone, may also be funded by the pilot program. Connection to Internet 2 is not required, but may be requested by the applicants.

What are the benefits of this pilot program?

• A broadband network that connects multiple health care providers will bring the benefits of innovative telehealth and, in particular, telemedicine services to those areas of the country where the need for those benefits is most acute.
• Linking statewide and regional networks to a nationwide backbone will connect a number of government research institutions, as well as academic, public, and private health care institutions that are important sources of medical expertise and information.
• Health care providers will gain increased access to advanced applications in continuing education and research.
• A ubiquitous nationwide broadband network dedicated to health care will enhance the health care community’s ability to provide a rapid and coordinated response in the event of a national crisis.

Who is eligible to receive funding under this program?

Public and not-for-profit health care providers are eligible to receive funding. For purposes of the pilot program, the definition of “Health Care Provider” is the same as that of Section 254(h)(7)(B) of the Communications Act and the FCC’s rules for the existing Rural Health Care program. Eligible health care providers include:

• Post-secondary educational institutions offering health care instruction, teaching hospitals, or medical schools;
• Community health centers or health centers providing health care to migrants;
• Local health departments or agencies including dedicated emergency departments of rural for-profit hospitals;
• Community mental health centers;
• Not-for-profit hospitals;
• Rural health clinics, including mobile clinics;
• Consortia of health care providers consisting of one or more of the above entities; and
• Part-time eligible entities located in otherwise ineligible facilities.

Non-eligible health care providers include any for-profit institutions (except as noted above), or any health care provider types not listed above. Examples of non-eligible providers include:

• Private physician offices or clinics;
• Nursing homes or other long-term care facilities (e.g. assisted living facilities);
• Residential substance abuse treatment facilities;
• Hospices;
• Emergency medical service facilities (e.g., rescue squads, ambulance services);
• For-profit hospitals;
• Home health agencies;
• Blood banks;
• Social service agencies; and
• Community centers, vocational rehabilitation centers, youth centers.

Will for-profit health care providers be allowed to connect to the network?

Yes. Applicants may include for-profit health care providers in their proposals as network participants. However, for-profit health care providers will be required to pay for their own costs of connecting to the network. In fact, one of the criteria specified in the order is that applicants describe how for-profit network participants will pay their fair share of the network costs.

New from MedPAC
December 19, 2006
Medicare Payment Advisory Commission (MedPAC) Releases Rural Payment Report

MedPAC announces the release of its December 2006 Report to the Congress: Rural Payment Provisions in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. You may go to our website at http://www.medpac.gov to view the report, or follow the direct link below.

(Note: Files are in Adobe PDF format and require Adobe Acrobat Reader 6 or later for viewing.)

Direct Link

[CYFAR] Kids Count Data on Children in Poverty
December 19, 2006
Recent data from the U.S. Census Bureau’s American Community Survey shows that in 2005, nearly 29 million U.S. children lived in low-income families. The majority of these children, or nearly 15 million, had at least one parent who worked regularly (see definition of low-income working families). These families are living on the economic edge­despite regular employment­and struggling to make ends meet. Access the full report at:
http://www.aecf.org/kidscount/sld/snapshot_working.jsp

Final Action on Health Legislation for the 109th Congress
December 19, 2007
Final Action on Health Legislation for the 109th Congress
Congress will wrap up its lame duck session this week and adjourn the 109th Congress. Final votes are expected in the House on Friday, December 8, while voting in the Senate may last through the weekend.

MEDICARE LEGISLATION
House and Senate negotiators agreed earlier this week on a Medicare package that will avert a scheduled 5.0 percent payment cut to physicians, and make other changes to Medicare. The House passed the Tax Relief and Health Care Act of 2007 (H.R. 6408) earlier today, while a Senate vote is expected before the Senate adjourns sometime this weekend. Thanks to the hard work of so many NRHA members, the package does extend some expiring provisions for rural providers. The bill includes the following key health components:

• Provides a zero percent update for physicians for 2007. Starting July 1, 2007, eligible professionals who report quality measures, as identified under the CMS Physician Voluntary Reporting System, will receive a bonus payment of 1.5 percent.
• Extends the floor on the work component of the physician geographic adjustor through 2007. The extension of this provision is an important victory for rural providers in the fight for payment equity, as it continues a hard-fought provision that helps to level the playing field for rural physician payments.
• Extends cost-based reimbursement for lab tests furnished in small rural hospitals (under 50 beds) in low density population rural areas through cost reports beginning before July 1, 2007.
• Continues direct billing for the technical component for pathology services by independent laboratories through 2007.
• Provides for a technical correction to the rural Program of All-Inclusive Care for the Elderly (PACE) provider grant program that allows the program to retain funds provided for outlier payments through 2010. The NRHA was a major sponsor of the rural PACE program’s inception.
• Extends the Section 508 wage index reclassifications for six months, through September 30, 2007.
• Other provisions include: a 2 percent reduction in payments for outpatient services provided by hospitals and ambulatory surgical centers that do not report certain quality measures, starting in 2009; a 1.6 percent update to End State Renal Disease facilities for 2007; payments to providers for administering Part D vaccines in 2007 and subsequent years; an extension through 2007 of an exception allowing additional reimbursement of outpatient therapy services not performed in a hospital; and setting a maximum Medicaid provider tax of 5.5 percent, to name a few.

Additional information on the Tax Relief and Health Care Act of 2007 can be seen at: http://waysandmeans.house.gov/ResourceKits.asp?section=2544

ERS/USDA Pubs: Rural America at a Glance
December 19, 2006
The Economic Research Service (ERS) is a primary source of economic information and research in the U.S. Department of Agriculture. ERS conducts a research program to inform public and private decision making on economic and policy issues involving food, farming, natural resources, and rural development. Access the link to see chart books on rural America, rural poverty, and rural children. http://www.ers.usda.gov/Emphases/Rural/ataglance.htm

Take Action on Possible Rural Medicare Extenders
December 19, 2006
Contact Your Members of Congress Now!

Key congressional staff are currently trying to negotiate a short-term fix for Medicare physician payments, with the hope of bringing a package up for a vote in the House and Senate this week. CQ reported yesterday that this bill may include "a package of provisions for rural providers valued at $2 billion." While it is unclear if the negotiations will succeed, this potential package of Medicare legislation is the best and only chance for any rural Medicare-related legislation during the remainder of this Congress. Absent Congressional action, physicians will face a 5.0 percent cut in Medicare payments starting January 1, 2007.

While NRHA’s rural agenda is extensive, there is limited opportunity here to attach additional provisions. NRHA is asking for an extension of important rural Medicare provisions from the Medicare Modernization Act (MMA) that are scheduled to expire at the end of this year or next. The MMA provisions were critical in putting payments to rural providers on more of a level playing field and helping to address provider shortages and we do not want to lose any of the hard-fought ground in our pursuit of payment equity.

NRHA members with Representatives and Senators on key congressional committees ( House Ways and Means Committee, http://capwiz.com/nrha/callalert/index.tt?alertid=9185031&type=TA, and the Senate Finance Committee), have received an action alert last week. Please take action as directed in those alerts.

For the rest of the NRHA membership, please ask your Representative and Senators to tell leadership and chair and incoming chairs of committees with jurisdiction over Medicare (the House Ways and Means Committee, the House Energy and Commerce Committee, and the Senate Finance Committee) to make sure any final package includes rural extenders.

New Joint Publication from the North Carolina Center and the RUPRI Center: "The Experience of Sole Community Rural Independent Pharmacies with Medicare Part D: Reports From the Field"
December 19, 2006
A new joint publication is available from the North Carolina Rural Health Research & Policy Analysis Center and the RUPRI Center for Rural Health Policy Analysis:

The Experience of Sole Community Rural Independent Pharmacies with Medicare Part D: Reports From the Field
The implementation of the new Medicare Part D benefit during 2006 created new experiences for both rural beneficiaries and the providers that serve them. Many rural beneficiaries gained important financial access to medications they previously struggled to afford. The effects on an important group of rural providers, local independent pharmacies, have been less positive. This study reports results from interviews conducted in the spring of 2006 of 12 rural independent pharmacists located at least 10 miles from the next closest pharmacy. The pharmacists interviewed are experiencing decreases in payment, increases in administrative burden, and changes in their interaction with patients as a result of the shift of patients from Medicaid or non-covered cash into new private-sector prescription drug plans.

Please click on one of the following links to download this document:

http://www.rupri.org/healthpolicy/Pubs/P2006-3.pdf

http://www.shepscenter.unc.edu/research_programs/rural_program/WP87.pdf

Medicare Drug Plans Troubling for Rural Pharmacies
December 19, 2006
(Washington, D.C.) - Medicare Part D Plans could have a negative effect on the finances of rural pharmacies across the nation, according to the National Rural Health Association (NRHA) after reviewing a newly released study. The study, The Experience of Sole Community Rural Independent Pharmacies with Medicare Part D: Reports from the Field, was released this week by The North Carolina Rural Health Research and Policy Analysis Center and The RUPRI Center for Rural Health Policy Analysis.

This study gathered first-hand reports from 12 rural independent pharmacists located at least 10 miles from the next nearest pharmacy. Some important findings from the study are that at the time of the interviews (summer, 2006):

• Payment per prescription was lower from Medicare PDPs than from either Medicaid or cash amounts paid by individuals who previously lacked drug coverage. In some instances payment from PDPs was less than the combined cost of stocking the medications and dispensing them. The time from service to receipt of payment was longer when PDPs were involved, as compared to Medicaid and most commercial plans. Pharmacies had few opportunities to negotiate payment rates with PDPs. Pharmacists had difficulty communicating with Medicare PDP representatives, with problems including excessive amounts of time on hold and an inability to reach someone knowledgeable about the problem.

NRHA president-elect, Paul Moore, D.Ph., President, Pharmacy & Consulting Management Company and Pharmacist/Owner, Roy's Discount Pharmacy, Wilburton, Oklahoma, said, "We are concerned about the financial effect Medicare Prescription Drug Plans are having on rural pharmacies, We must work to ensure a fair reimbursement system and continued access to these local pharmacies that cater to the needs of more than 20 million rural residents." If the financial stress on sole community pharmacies observed in the study is representative of conditions facing other pharmacies across the country, protections for these providers will need to be put in place in order to realize the full benefit of the Part D program.

The study's recommendations include creating a category of safety-net rural pharmacies that receive reimbursement at a level that equals or slightly exceeds their costs, developing a grant program to provide financial assistance to small independent pharmacies that need to implement new information systems, and other steps designed to decrease administrative burden and ease interactions between pharmacies and PDPs.

The Study may be accessed at www.NRHArural.org/opporty/sub/research.html

New Findings Brief from the Flex Monitoring Team
December 19, 2006
http://flexmonitoring.org/documents/CAHFindingsBrief1.pdf

The Flex Monitoring Team has released a new Findings Brief discussing how the financial performance and condition of Critical Access Hospitals changed as a result of converting to CAH status. Researchers at the University of North Carolina-Chapel Hill have developed 20 financial ratios, seven of which are analyzed in this Findings Brief.

The authors of this Findings Brief conclude that overall, financial performance and condition improved after hospitals converted to CAH status.

Findings include the following:

• Most CAHs had higher profitability post conversion
• About half of CAHs had higher liquidity post conversion
• Most CAHs had greater ability to meet debt obligations post conversion
• CAHs providing long-term care were less likely to improve their profitability than CAHs not providing long-term care

The authors of this Findings Brief are Mark Holmes, PhD, George H. Pink, PhD, and Rebecca T. Slifkin, PhD of the University of North Carolina at Chapel Hill

Help End Hunger in Pennsylvania!
December 19, 2006
The Governor's Inter-Agency Council on Food and Nutrition is initiating a process to create, a blueprint to end hunger in Pennsylvania. The Council, which includes the secretaries of the departments of Agriculture, Aging, Community and Economic Development, Education, Health and Public Welfare, wants your advice. Based on your experience, what do you think are the most important actions state government should take to end hunger in Pennsylvania?

You are invited to give your answer to this question on Thursday, January 18th, at a public hearing convened by the Governor's Council in the VIP Room at the Farm Show Complex, Harrisburg, PA.

You will be given five minutes in which to speak; written testimony also will be accepted. The summit will run from 9 a.m. to approximately 3 p.m.

The day's event will also include breakout sessions designed to address specific issues related to hunger and food security.

If you would like to attend this event, please RSVP to Ann Kier of the Interagency Council on Food and Nutrition by December 15th at akier@state.pa.us, or by calling 717-772-2694.

NRHA Observes World Aids Day
December 19, 2006
(Washington, D.C.) - As we observe World AIDS Day 2006 today, December 1st, an estimated 38.6 million people are living with HIV worldwide. In 2005, 4.1 million people became infected with HIV. World AIDS Day is an opportunity for us to learn more about the impact of HIV/AIDS throughout the world and within our own rural communities (1).

In the United States, an estimated 1,185,000 Americans are living with HIV, with approximately 40,000 new infections every year. HIV/AIDS continues to infect and affect members of our rural communities. Over the years, 5-8% of HIV cases in the U.S. have been in rural areas. I want to share some alarming facts about HIV in our rural communities1 :

• 68% of all AIDS cases among rural populations are in Southern states. In some rural areas, HIV/AIDS diagnosis rates are almost as high as those in urban areas. African Americans represent 50% of rural AIDS cases, followed by Whites (37%), Latinos (9%), and American Indian/Alaska Natives (2%). While 75 % of rural AIDS cases are among men, rates among rural women, particularly among African American women, are increasing. Most women are becoming infected with HIV through heterosexual contact. Among rural men, men who have sex with men (MSM) comprise approximately 60% of rural AIDS cases and injecting drug users (IDUs) about 20%. In 2000, in the rural South, 28.5% of men were infected through heterosexual contact.

(1) Adapted from "What are rural HIV prevention needs?" CAPS Fact Sheet, 5/06, prepared by UCSF Center for AIDS Prevention Studies. Available at http://www.caps.ucsf.edu/pubs/FS/revrural.php

To help address the needs of our rural communities, the National Rural Health Association, with support from the Department of Health and Human Services, Office of HIV/AIDS Policy, have developed the following resources: Rural HIV/AIDS Care: Resources for Providers presents web-based resources on delivery of HIV care to help minimize "digging" for online help. Specific resources for rural settings include provider training venues and ways to co-manage a client with an HIV expert. More general HIV care resources, such as treatment guidelines, are also provided. Best Practices in Rural HIV/AIDS Care provides insights on delivery of services in rural settings based upon interviews with rural HIV care programs around the nation.

• Transportation and Provider Training will be released on World AIDS Day. Future best practices will cover such topics as co-managing clients, techniques for delivering clinical care to rural clients, and addressing HIV/AIDS stigma.

In honor of World AIDS Day, I encourage all of you to learn more about HIV/AIDS and the new rural health provider resources we have developed. Although World AIDS Day is just one day, it serves as a reminder to all of us that we must continue to increase HIV/AIDS prevention, testing, and treatment in our rural communities and beyond.

For additional information please visit or call the following: National Rural Health Association: www.NRHArural.org World AIDS Day Resources: www.omhrc.gov/hivaidsobservances/world/index.html HIV Testing Locations: www.hivtest.org Centers for Disease Control and Prevention's National AIDS Hotline at 1-800-342-AIDS

GAO report on J-1 visa waivers issued today
December 19, 2006
The National Health Policy Forum announces the availability of Issue Brief 819 EPSDT: Medicaid's Critical But Controversial Benefits Program for Children. Click on the paper title to download a copy or visit NHPF's Web site.

The Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program under Medicaid provides the most comprehensive set of health benefits for children and adolescents in the public or private sector. A cornerstone of early childhood preventive and treatment services in the nation's health care "safety net," the EPSDT program serves nearly 30 million low-income children, including children with disabilities and special needs. Over the years, states have expressed frustration with the administrative burdens of EPSDT requirements. Rising Medicaid costs have put all Medicaid benefits, including the EPSDT program, in the budgetary crosshairs. This issue brief reviews the fundamental characteristics of the EPSDT program and highlights some of the challenges it has faced over the years. This paper also describes some of the changes proposed to preserve access to comprehensive care while controlling costs and encouraging administrative simplification and flexibility.

This issue brief provides background for a December 8, 2006, NHPF meeting on children with special health care needs and EPSDT. For more information about the meeting and how to register, click here.

GAO report on J-1 visa waivers issued today
December 19, 2006
The GAO report, "FOREIGN PHYSICIANS: Data on Use of J-1 Visa Waivers Needed to Better Address Physician Shortages," was issued today.

The report can be found on the GAO web site at the following links:

Full report - http://www.gao.gov/cgi-bin/getrpt?GAO-07-52

Highlights - http://www.gao.gov/highlights/d0752high.pdf

New Rural Health Chartbook
December 19, 2006
The Health and Well-Being of Children in Rural Areas: A Portrait of the Nation 2005,

A new HRSA data report indicates that children in urban and rural areas are equally healthy, with about 84 percent in both groups reported in excellent or very good health. But children living outside urban areas are less likely to be breastfed and more likely to live in households with a smoker, the report says.

SC Rural Health Research Center
December 9, 2006
The South Carolina Rural Health Research Center at the Arnold School of Public Health, University of South Carolina is pleased to announce the release of a new findings brief. The publication, entitled Rural Hospitals and Spanish Speaking Patients with Limited English Proficiency, is authored by Myriam E.Torres, PhD, MSPH; Deborah Parra-Medina, PhD, MPH; Amy Brock Martin, DrPH; Andrew O. Johnson, MPH; Jessica D. Bellinger, MPH and Janice C. Probst, PhD.

** The Fact Sheet is attached.

** The following is a link to the Executive Summary http://rhr.sph.sc.edu/report/SCRHRC_LimitedEnglishProficiency_Exec_Sum.pdf.

** The full report is available through our Online Report Request System at http://rhr.sph.sc.edu . You may elect to receive a paper or electronic copy of the full report. The requested report will be sent to you via postal mail (paper copy) or email (electronic copy) within 7~10 days.

The Implementation of Pay-For Performance in Rural Hospitals: Lessons from the Hospital Quality Incentive Demonstration Project
December 9, 2006
A recently completed study reveals that the conditions for successful participation in pay-for-performance initiatives affect rural health care providers differently than urban providers. The study calls for future initiatives to include technical assistance for participating rural hospitals and also ensure that clinical areas that are tied to payment are relevant to the type of services delivered by small rural hospitals. The Policy Brief is available at http://www.uppermidwestrhrc.org/pdf/policybrief_p4p.pdf The full report is available at http://www.uppermidwestrhrc.org/pdf/pay_for_performance.pdf

These findings are part of a report just released by the Upper Midwest Rural Health Research Center (UMRHRC), a partnership between the University of Minnesota and the University of North Dakota, in collaboration with Premier, Inc.

FCC LAUNCHES "RURAL HEALTH CARE PILOT PROGRAM" WEBSITE
December 9, 2006
The FCC has launched a website (http://www.fcc.gov/cgb/rural/rhcp.html) that provides a consolidated source of information about the FCC's recently announced Rural Health Care Pilot Program. The FCC's pilot program is an innovative, enhanced funding initiative intended to help public and non-profit health care providers construct state- and region-wide broadband networks to provide telehealth and telemedicine services throughout the nation. For further information go to http://hraunfoss.fcc.gov/edocs_public/attachmatch/DOC-268591A1.doc

New Supplies of Flu Vaccine Now Available
December 9, 2006
The Centers for Disease Control and Prevention (CDC) announced the designation of the week after Thanksgiving (Nov. 27 ­ Dec. 3, 2006) as National Influenza Vaccination Week. This event is designed to raise awareness of the importance of continuing influenza vaccination, as well as foster greater use of flu vaccine through the months of November, December and beyond. CDC is recommending that people take this opportunity to be vaccinated and is hopeful that flu vaccine providers will use this time to enhance flu vaccine availability by scheduling additional clinics and extending clinic hours.An estimated 800,000 doses of Fluarix (Inactivated Adult Flu Vaccine) have been made available for order through the 340B Prime Vendor (PVP) based on the pharmaceutical manufacturer’s (GlaxoSmithKline (GSK)) production schedule. This vaccine offer is for late season doses and is intended to address participants unanticipated or unmet flu vaccine needs and is not intended to replace pre-committed orders that you may have in place.

As a reminder, Prime Vendor participants can place Fluarix orders direct with GlaxoSmithKline on a first-come, first-served basis. For more information, call GSK at (866) 475-8222 or to join the Prime Vendor call (888) 340-2787.

Spending Bills Will Not Be Completed During the 109th Congress
December 9, 2006
Lawmakers will not finish the remainder of the fiscal 2007 spending bills before adjourning this session. Instead, Congress will enact a short-term continuing resolution, or stopgap spending measure, that will last through January. This action will take place when Congress returns to Washington the week of December 4th.

This continuing resolution has the effect of pushing the unfinished fiscal 2007 spending bills into the next Congress, when Democrats will be in charge. Democrats will face the challenge of finishing the prior year’s work and preparing an expected supplemental spending bill for the war while simultaneously preparing for the President’s fiscal year 2008 budget, which will be submitted to Congress at the beginning of February.

Under the current continuing resolution, programs that are a part of the Rural Health Safety Net are funded at the FY 2006 level. For a full chart of FY 2006 funding levels, go to http://www.nrharural.org/advocacy/sub/07appropriations.html

Because the appropriations bills were the primary agenda item for lawmakers to consider in December, they will likely recess by December 8th, before the current continuing resolution expires.

New Flex Monitoring Team Paper Offers States Abundance of Ideas to Consider
December 9, 2006

(Washington, D.C.) A new paper released this week by the Flex Monitoring Team compiled an in-depth description of the proposed 2005 Flex Program grant applications on quality and performance improvement activities. The National Rural Health Association (NRHA) commends the Flex Team on the usefulness of this paper and encourages all CAH facilities to review it for ideas on how to further quality improvement in their own facilities and communities.

"The grant making capacity of the Flex Program has supported a wide range of local initiatives to improve the quality of patient care and hospital operations of Critical Access Hospitals. These initiatives have included projects on balanced scorecards, health information technology, patient safety and satisfaction, as well as participation in national quality improvement efforts, renewed relationships with state Quality Improvement Organizations, and efforts to ensure the efficiency of their business operations. The Flex Program goes well beyond ensuring the financial stability of Critical Access Hospitals - it is promoting a new level of hospital functioning", said Jennifer Lenardson, MHS, research analyst, University of Southern Maine, and lead author of the study.

This briefing paper examines quality improvement activities proposed by 45 states during fiscal year 2005 Flex Program grant applications to the federal Office of Rural Health Policy. The paper describes projects and activities that were requested in the most recent grant cycle. Some of the activities were a continuation of existing activities, while others were new. The paper organizes the activities by categories: improving clinical, operational, and financial performance; financial and organizational performance; promoting a culture of quality improvement; participating in national quality efforts; implementing HIT systems; and addressing patient safety and satisfaction issues. Together these proposals represented 30 percent of the total $7.7 million funding requested by the 45 states eligible for Flex Program grants.

A link to the paper is available on the NRHA web site at: http://www.nrharural.org/opporty/sub/research.html

Emerging Leaders in Public Health Fellowship
December 9, 2006
Managing in Turbulent Times: Emerging Leaders in Public Health

FYI

The Emerging Leaders in Public Health Fellowship is now accepting applications. All interested individuals should visit our website at www.publichealthleaders.org < http://www.publichealthleaders.org> to fill out an application before December 16th, 2006.

*Target Audience*

The Emerging Leaders in Public Health fellowship is designed to prepare the next generation of public health leaders by identifying and training those individuals with the talent to serve in significant leadership capacities to address health disparities, diversity, and crisis management in the next decade.

The Emerging Leaders in Public Health curriculum offers its fellows the essential skills necessary for leading and managing in a turbulent public health environment:

• Dealing with crises in finances, human resources, and communications
• 360 degree assessments
• One-on-one executive coaching
• Individual development planning
• Action learning teams
• Complex case study project

All interested individuals can visit the Emerging Leaders website at www.publichealthleaders.org or contact Mekeisha Williams, Director of Emerging Leaders for Public Health at 919-843-8541 or mpwillia@email.unc.edu

GOVERNOR RENDELL SIGNS HISTORIC 'COVER ALL KIDS' LEGISLATION
November 20, 2006
The South Carolina Rural Health Research Center at the Arnold School of Public Health, University of South Carolina is pleased to announce the release of a new findings brief.

The publication, entitled Rural Hospitals and Spanish Speaking Patients with Limited English Proficiency, is authored by Myriam E. Torres, PhD, MSPH; Deborah Parra-Medina, PhD, MPH; Amy Brock Martin, DrPH; Andrew O. Johnson, MPH; Jessica D. Bellinger, MPH and Janice C. Probst, PhD.

The Fact Sheet is attached, and the full report is available through our Online Report Request System at http://rhr.sph.sc.edu. You may elect to receive a paper or electronic copy. The requested report will be sent to you via postal mail (paper copy) or email (electronic copy) within 7~10 days.

GOVERNOR RENDELL SIGNS HISTORIC 'COVER ALL KIDS' LEGISLATION
November 20, 2006
PITTSBURGH ­ Governor Edward G. Rendell today signed into law his Cover All Kids initiative, making Pennsylvania one of six states to make sure that every child has health care coverage.

“Living in the world’s most affluent society, it shocks the conscience that any child should be forced to live without access to basic medical care,” Governor Rendell said. “With Cover All Kids, Pennsylvania parents will no longer need to make the impossible choice between paying the rent and taking their child to see a doctor.

“Cover All Kids will provide peace of mind to parents because it offers a brighter, healthier future for our commonwealth’s most treasured resource: our children,” Governor Rendell added. “I thank the General Assembly for honoring its commitment to Pennsylvania families by passing this significant bill.”

Under Cover All Kids, parents will be able to afford to insure their children because the monthly premiums will be based on family income. Currently, the Childrens’ Health Insurance Program –known as CHIP – is free for children from families with annual incomes under $40,000 (family of four – 200 percent of the federal poverty level) and available at a reduced cost for children from families with incomes up to $47,000 (family of four - 200 percent - 235 percent of FPL).

Under Cover All Kids, 100 percent of the parents who currently cannot afford to insure their children will get assistance from the state to ensure that the cost of health insurance for their children is reasonable.

Under the new law, the approximate monthly cost for parents is based on a sliding scale:

• $36 a month per child for a family earning 200 percent – 250 percent of FPL (under $50,000 for a family of four)
• $50 a month per child for a family earning 250 percent -275 percent of FPL ($50,000- $55,000 for a family of four)
• $57 a month per child for a family earning 275 percent - 300 percent of FPL ($55,000-$60,000 for a family of four)
• Families that cannot find or afford private health insurance for their children who are earning above 300 percent of the FPL ($60,000 a year for a family of four) can purchase the coverage at the state cost, based on certain eligibility requirements. These families must show that coverage was denied due to a pre-existing condition, or that the cost of private coverage totals more than 10 percent of the family’s annual income, or that the cost of private insurance is one and a half times (150 percent) more than the state monthly per child cost for Cover All Kids.

If parents can buy employer-sponsored coverage for their children but cannot afford the full premium, the state will help the family to pay the premiums for private insurance, rather than enrolling the child in CHIP – if the cost of private coverage is lower.

To discourage parents from canceling private coverage to take advantage of the state subsidy, Cover All Kids has a waiting period that requires families show that their child has not had coverage for the last six months, unless the child is two years of age or less. The so-called “go bare” period is not required for infants, for children who have lost coverage because a parent lost a job or for kids who are moving from another public insurance program.

The 2006-07 state budget includes $4.5 million for Cover All Kids, which will be used to draw down additional federal funds. The bill the Governor signed today allows the state to step up outreach for existing programs for children, such as CHIP and Medicaid (MA), to ensure every qualified child is enrolled.

Pennsylvania’s CHIP program is one of the most successful children’s health insurance programs in the nation, covering a record 148,355 children during October. CHIP was created under legislation signed in late 1992 by Governor Robert P. Casey. The program served as a model for a federal CHIP program enacted by President Bill Clinton in 1997.

More information on the CHIP program can be found at www.chipcoverspakids.com or by calling 1-800-986-KIDS.

USDA Report on State Differences in Food Security
November 20, 2006
WHAT FACTORS ACCOUNT FOR STATE-TO-STATE DIFFERENCES IN FOOD SECURITY?

States differ in the extent to which their residents are food secure­meaning that they have consistent access to enough food for active, healthy living. The prevalence of food security in a State depends not only on the characteristics of households in the State, such as their income, employment, and household structure, but also on State-level characteristics, such as average wages, cost of housing, levels of participation in food assistance programs, and tax policies. Taken together, an identified set of household-level and State-level factors account for most of the State-to-State differences in food security. Some State-level factors point to specific policies that are likely to improve food security, such as policies that increase the supply of affordable housing, promote the use of Federal food assistance programs, or reduce the total tax burden on low-income households.

Released Wednesday, November 15, 2006

See http://www.ers.usda.gov/Publications/EIB20/

National Influenza Vaccination Week, November 27-December 3
November 20, 2006
The U.S. Department of Health and Human Services is holding National Influenza Vaccination Week on November 27-December 3. This event is designed to urge people to get flu shots and to encourage providers to make a greater effort to increase the availability of the vaccine. Free posters, flyers, educational handouts, and other materials are available for easy printing at http://www.cdc.gov/flu.

Available Now! Conference Materials from HIT: A Rural Provider's Roadmap to Quality!
November 20, 2006
Roadmap available here! http://www.raconline.org/HIT_Conf2006/

Families in Pennsylvania Resource Web Site Announced
November 20, 2006
Harrisburg (November 16, 2006). According to a report released yesterday by the U.S. Department of Agriculture (USDA), 481,000 Pennsylvania households struggled to keep themselves fed last year. Most avoided hunger through a variety of coping strategies such as smaller portions, less variety in the diet or help from local food pantries. But in 142,300 Pennsylvania households, those efforts failed and at least one individual in the household experienced hunger because of the inability to secure food.

Each year, the Census Bureau measures food security in the United States by interviewing a sample of nearly 150,000 households about their ability to obtain enough food for an active, healthy life for all household members. Since 1996, the USDA has annually reported the data to the public. This year’s report, Household Food Security in the United States, 2005, is posted on the web at .

Nationally, last year 35 million individuals lived in households that were at risk of hunger, down from the 2004 record high of 38 million. This improvement in food security – measured as a decline in the rate of food insecurity from 11.9 percent in 2004 to 11.0 percent in 2005 – was the first since 1999.

To report state data, the USDA uses 3-year averages that compensate for limited sample sizes and give a better estimate of the number of households at risk. The Pennsylvania data shows modest improvement in food security with the portion of households at risk falling from 10.2 percent in 2002-2004 to 9.8 percent in 2003-05. This is the first such improvement in four years.

“After three consecutive reports from the USDA showing Pennsylvania losing ground in the effort to end hunger, this is good news,” said Berry Friesen, executive director of the Pennsylvania Hunger Action Center. “On this vital indicator our state has gone from being a national leader to being mediocre. This slide has taken a toll on families and on the public in lost productivity, health and learning. Maybe this latest report indicates we’ve stopped the bleeding. I hope and pray that’s true.”

According to a second report published by the USDA, a variety of state-level factors account for differences in food security among the states. In rough order of importance these factors include wage levels, rental costs, participation levels among children in publicly-funded summer meal programs, unemployment levels, residential stability, participation levels in the Food Stamp Program, and the state and local tax burden.

In Pennsylvania, the portion of households that experienced more severe food insecurity - with hunger affecting at least one family member - remained unchanged at 2.9 percent. Approximately 336,000 individuals live in these households. The historic low for this indicator was in 1999-2001 when hunger affected 2.2 percent of households.

Nutrition policy will be front and center as the 110th Congress convenes in January. High on the agenda will be reauthorization of the Farm Bill, the legislation that governs the Food Stamp Program. “It will be a test of our nation’s resolve,” said Friesen. “Are we willing to do what it takes to end the scourge of hunger?”

Additional opportunities to learn about food insecurity and hunger in Pennsylvania are available by calling the Pennsylvania Hunger Action Center at 717-233-6705 or by visiting www.pahunger.org .

Families in Pennsylvania Resource Web Site Announced
November 20, 2006
Penn State Cooperative Extension announces the Families in Pennsylvania Web Site! This resource is intended as a resource for anyone who wants information about child, youth, and family related issues in Pennsylvania. Check out the most popular feature of the site, the Informational Maps link that has information on family poverty levels, public assistance usage, population change, and educational attainment levels for every county and school district in Pennsylvania. It also includes recently developed fact sheets from the Penn State Rural Youth Education Project, and lots of PowerPoint presentations related to youth risk taking behaviors, teen pregnancy and child bearing, and a host of other Children, Youth, and Family topics.

New Briefing Paper on Quality Improvement Activities of State Flex Programs
November 20, 2006
In this newly released briefing paper from the Flex Monitoring Team, the authors provide an in-depth description of quality and performance improvement activities proposed by states during the 2005 grant year, representing 30 percent of requested funding. This briefing paper provides Flex administrators and other stakeholders ideas to consider as they address their own state issues.

Categories of quality improvement activities included improving clinical, operational, and financial performance; financial and organizational performance; promoting a culture of quality improvement; participating in national quality efforts; implementing health information technology (HIT) systems; and addressing patient safety and satisfaction issues.

State activities acknowledge the different quality measurement needs of rural hospitals through the development of benchmarks and transfer protocols specific to CAHs and other small, rural hospitals. Some state programs proposed activities to build in-state knowledge and capacity and to assess current conditions, particularly in the areas of balanced scorecards, HIT, and patient safety.

Daily Health Policy Report
November 20, 2006
Pennsylvania on Tuesday became the first state to report publicly the number of patients who acquired infections in hospitals in 2005, a move that might "boost efforts for public reporting of hospital quality data nationwide," USA Today reports (Appleby, USA Today, 11/15). The report, released by the Pennsylvania Health Care Cost Containment Council, examined 1.6 million patients in 168 hospitals in the state in 2005. For the report, PHC4 grouped hospitals to account for differences in the severity and complexity of their cases and excluded certain patients with conditions that placed them at high risk for infection (Goldstein, Philadelphia Inquirer, 11/15). State law requires hospitals to report four broad forms of infections: surgical site, urinary tract, pneumonia and blood stream. According to the report, 19,154 patients acquired infections in 2005. An average of 12.2 per 1,000 patients acquired infections, and those who acquired infections cost private heath insurers an average of $59,915 for hospital care, compared with $8,311 for those who did not acquire infections, according to the report (USA Today, 11/15). The report also found that:

• Patients who acquired infections spent almost 400,000 additional days in hospitals at an estimated cost of $1 billion (Philadelphia Inquirer, 11/15);
• The average cost of hospital care for patients who acquired infections was $185,260, compared with $31,389 for those who did not acquire infections;
• The average length of hospital stays for patients who acquired infections was about 23 days, compared with about five days for those who did not acquire infections (Fahy, Pittsburgh Post-Gazette, 11/15);
• 2,478 patients who acquired infections died during their hospital stays, although PHC4 did not determine whether the infections caused their deaths; and
• The mortality rate for patients who acquired infections was 12.9%, compared with 2.3% for those who did not acquire infections (Philadelphia Inquirer, 11/15).

Comments
Marc Volavka, executive director of PHC4, said, "This first hospital-specific report demonstrates Pennsylvania's robust commitment to reducing these serious, costly and largely preventable infections" (Pittsburgh Post-Gazette, 11/15). He said that such infections result from "flawed processes" of care and hygiene, not from the treatment of sicker patients (Philadelphia Inquirer, 11/15). Roger Mecum, executive vice president of the Pennsylvania Medical Society, said, "There are too many infections, which are increasing mortality and hospital lengths of stay while adding billions of dollars in hospital charges." Lisa McGiffert, director of the "Stop Hospital Infections" campaign at Consumers Union, said, "This is really the first report of its kind in the U.S., where hospitals have actually identified infections and reported them to a state agency" (Pittsburgh Post-Gazette, 11/15). Health care quality experts said that the report might prompt additional efforts by hospitals to prevent infections. However, "controversy dogs efforts to report infection rates on a national level, with debate about what should be reported and how" and whether reports "should ... be hospitalwide or just in selected areas," among other issues, according to USA Today (USA Today, 11/15).

Broadcast Coverage

ABCNews' "World News" on Tuesday reported on the study. The segment includes comments from McGiffert; Volavka; Charles Wagner, chief medical officer and senior vice president of Holy Redeemer Hospital and Medical Center; and the families of patients who acquired infections in hospitals (Stark, "World News," ABCNews, 11/14). A related ABCNews story and expanded ABCNews coverage are available online.

PND News Briefs - Central & Northeastern PA Edition
November 20, 2006
Jersey Shore Hospital received a $1 million state grant for its expansion project.

The grant is part of the Redevelopment Assistance Capital Program, which provides funding for the acquisition and construction of regional economic, cultural, civic and historical improvement projects, reported the Williamsport Sun-Gazette. The hospital’s $18 million project is divided into two phases: construction of a 45,000-square-foot addition, which will take about 15 months, and renovation of the existing facility, which is expected to take six to eight months, the Sun-Gazette added. Williamsport Sun-Gazette, November 13, 2006
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The Bush administration said that it would strenuously oppose one of the Democrats’ top priorities for the new Congress: legislation authorizing the government to negotiate with drug companies to secure lower drug prices for Medicare beneficiaries.

Michael O. Leavitt, the secretary of health and human services, said that federal price negotiations would unravel the whole structure of the Medicare drug benefit, which relies on competing private plans, and that government could not do a better job than an efficient market, reported the New York Times. The 2003 Medicare law explicitly prohibits the federal government from negotiating drug prices or establishing a list of preferred drugs, while Rep. Nancy Pelosi, the California Democrat who is in line to become the House speaker, has said the House will take up legislation to repeal that ban in its first 100 hours under Democratic control, and Senate Democrats have expressed a similar desire, the Times added. New York Times, November 13, 2006
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Hundreds of hospitals around the country are joining a project to give faster emergency room care to people having major heart attacks.

Fewer than one-third of such patients now get their blocked arteries reopened within 90 minutes of arrival, as guidelines recommend, while hospitals participating in a new project designed by the American College of Cardiology pledge a "door-to-balloon" time of 90 minutes for angioplasty, reported the Associated Press. The campaign involves making internal procedural changes such as prompting early action to call in staff and activate the cath lab, and having hospitals act on paramedics’ pre-hospital electrocardiograms, the Associated Press added. Associated Press, November 13, 2006
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Common Threads from the RTC: Rural
November 20, 2006
Rural Independent Living and Physical Therapy: Exploring Collaborations

Centers for Independent Living provide skills training to individuals with disabilities that helps them to increase their community participation. However, most centers do not have the staff or facilities to help individuals increase their physical capacity. In rural areas, collaboration between physical therapists and Centers for Independent Living promises to increase the availability of physical activity for people with disabilities.

To explore that possible solution, RTC: Rural researchers interviewed rural physical therapists about their knowledge and beliefs regarding service delivery. We then examined their responses for compatibility with independent living philosophy. To learn more about our findings, please visit Rural Disability and Rehabilitation Research Progress Report #33: Rural Independent Living and Physical Therapy: Exploring Collaborations at http://rtc.ruralinstitute.umt.edu/health/PT.htm (Please note: some e-mail programs will not allow links to open from messages - if you experience this, please copy the URL and paste it into the address window of your web browser) Message distributed to Area Health Education Centers, Association of Programs for Rural Independent Living members, and Health Interest Group, by:

Diana Spas, Information Coordinator
Research and Training Center on Disability in Rural Communities
The University of Montana Rural Institute
52 Corbin Hall, Missoula, MT 59812-7056
(888) 268-2743 (RTC office)
(406) 243-5760 (my office) (406) 243-2349 fax
dspas@ruralinstitute.umt.edu
http://rtc.ruralinstitute.umt.edu
http://mtdh.ruralinstitute.umt.edu

Update from the New York Center for Health Workforce Studies
November 20, 2006
Five Articles on the Health Workforce in the United States
The World Health Report of 2006 provided an expert assessment of the current crises in the global health workforce, with attention to the impacts of health worker migration on the health status of poor countries. The World Health Assembly requested that "Human Resources for Health" become a priority program area for the World Health Organization in the next decade. In recognition of growing international interest in the health workforce, The Centre de Sociologie et de Demographie Medicales (CDSM), a workforce research center in Paris, France, focused its quarterly journal to spotlight health workforce research around the world. The Center for Health Workforce Studies was invited to represent the U.S. and publish its work in the bilingual CDSM journal that was released in June 2006. The five papers prepared by the Center that appeared in the journal are:

• U.S. Physician Workforce Forecasting: A Tale of Two States
• Trends in Foreign-Trained Registered Nurses in the United States
• Characteristics and Employment Patterns of Licensed Social Workers in the United States
• The Impact of the Aging Population on the Health Workforce in the United States
• Excerpts from the United States Health Workforce Profile.

The NIH LRP Deadline is approaching!
November 20, 2006
The National Institutes of Health (NIH) is now accepting applications for its five Loan Repayment Programs (LRPs) for Fiscal Year 2007, but only until December 1, 2006.

Did you know that the success rate for new applicants was 40% last year and may be even better this year?

The five LRPs offered by the NIH include the Clinical Research LRP, Clinical Research LRP for Individuals from Disadvantaged Backgrounds, Contraception and Infertility Research LRP, Health Disparities Research LRP, and Pediatric Research LRP. Through these programs, the NIH offers to repay up to $35,000 annually of the qualified educational debt of health professionals pursuing careers in biomedical and behavioral research. The programs also provide payment for Federal and tax liabilities.

To qualify, applicants must possess a doctoral-level degree, devote 50% or more of their time (for an average of 20 hours per week during each contract quarter) to research funded by a domestic non-profit organization or government entity (Federal, state, or local), and have educational loan debt equal to or exceeding 20% of their institutional base salary. Applicants must also be U.S. citizens, permanent residents, or U.S. nationals to be eligible.

Please share this e-mail with the researchers and other individuals in your organization who may benefit from LRP participation. All applications for 2007 awards must be submitted online by 8:00 p.m. EST, December 1, 2006.

For an online application, program information, or other assistance, visit the LRP Web site at www.lrp.nih.gov, telephone the Help desk at 866-849-4047, or send email inquiries to lrp@nih.gov.

Best regards,

NIH Division of Loan Repayment
www.LRP.nih.gov

Dr. Susan Mowatt Returns Home To Practice
November 5, 2006
(Honesdale, October 18, 2006)…Born at Wayne Memorial Hospital, raised in Hawley, Susan Simpson Mowatt, MD, is back home and excited about opening her Family Medicine practice in her hometown.

“Both my husband and I are from this area and our children’s grandparents—both sides—are here,” said Dr. Mowatt, “and I’m just thrilled to be back. I can’t wait to get to work!”

And working now she is—officially. Dr. Mowatt opened “Keystone Family Practice” and began seeing patients this week out of her new office on Main Avenue in Hawley (formerly occupied by Dr. Marilyn Pardine).

Dr. Mowatt received a Bachelor of Science degree from Georgetown University in Washington, DC, and later earned her Doctor of Medicine (MD) degree from Penn State College of Medicine in Hershey. She began her professional career in Williamsport, finishing up a Family Practice residency program and then joining a private practice affiliated with Susquehanna Health System. Dr. Mowatt was Medical Director of Loyalsock Family Practice before she decided to return home to Hawley.

A recipient of many honors and awards, Dr. Mowatt received her board certification in Family Practice in 2001. She joined the staff of Wayne Memorial Hospital this month.

“We welcome Dr. Mowatt to Wayne Memorial and the community,” said David Hoff, Chief Executive Officer of Wayne Memorial Health System. “It is especially gratifying to see a local resident come back to share her knowledge and skill with her hometown community. It is a reflection of respect on both sides, and we at Wayne Memorial are very pleased to benefit.”

Dr. Mowatt will have office hours from 9am – 6pm Monday through Friday, with some evening hours yet to be decided. Her address is 227 Main Avenue, Hawley and her phone number is (570) 226-6077.

Viral Hepatitus Conference
November 5, 2006
It's my pleasure to share this invitation to our First Ever Hepatitis (HIV/Substance abuse) annual Conference in Pennsylvania. The conference is packed with interesting topics/speakers, has sessions for dialogue about 'what works and how', and opportunities for peer/program exchange. This is the only statewide opportunity in Pennsylvania, apart from the AASLD 2006 Liver meeting, for program managers, clinicians, policy makers, legal entities, human services workers, public health workers, funding agencies, drug manufacturers and the general public to share concerns and resources about increasing access to testing, treatment and prevention of viral hepatitis with its co occurring conditions such as substance abuse and HIV. This conference should allow us to translate emerging scientific findings and policy advances into action. Learn about model programs and funding resources from national experts.

A State-by-State Approach to High Performance
October 17, 2006
Anyone who has traveled around the United States is keenly aware that regional differences, from cooking to music, still exist. While some of these differences should be preserved, other variations, such as those affecting the quality of people's health care, must be eliminated. In a new column, titled The Role of States in Achieving a High Performance Health System, Commonwealth Fund president Karen Davis maintains that no matter which state they call home, all Americans deserve high-quality and efficient care.

While every state has room to improve its health care system, it is especially critical that low-performing states learn from the innovative strategies being tested in higher performing states. States can look to Rhode Island, for example, where the Office of the Health Insurance Commissioner is implementing a plan to promote affordable coverage, and where the Department of Health and the Rhode Island Quality Institute are collaborating on an initiative to promote access to electronic health information data across the state.

"By observing these states' creative strategies in action," Davis says, "every state can develop initiatives tailored to its health care needs and unique circumstances."

Visit Chart Cart to review selected slides from Karen Davis's Oct. 16 keynote presentation, on the role of states in a high performance health system, at the National Academy for State Health Policy annual conference.

WMH Receives USDA Grant
October 17, 2006
Honesdale, October 16, 2006)…Congressman Don Sherwood (R) and officials from the Rural Development Office of the U.S. Department of Agriculture (USDA) presented Wayne Memorial Hospital with a ceremonial check today for $155,213. The monies, under the Distance Learning and Telemedicine Grant Program, will be used to help Home Health patients, Maternity patients and physicians, and patients who visit the new Waymart Medical Center due to open in early 2007.

“We are extremely grateful to receive this money,” said Virginia Fries, RN, Director of Patient Care Services. “Because of this funding, we will be able to help many chronically ill patients, who often require a lot of intervention, as well as mothers and fetuses experiencing difficulties as birth approaches.”

“This is exciting,” added WMH Home Health Manager Mary Lou Hoffner, RN. She explained how her department will use the grant money to buy tele-monitors for 40 patients. “These monitors will help keep conditions more stable for our patients and help avoid repeat hospitalizations and complications.”

Patients who use the monitors will have a cuff to take their blood pressures, a scale to take their weights and a pulse oximeter for oxygen readings. Once the measurements are taken, the patients press a button and the information is tele-transmitted to WMH Home Health.

The grant will also fund expansion of the Perinatal Monitoring program in New Beginnings to monitor laboring mothers and fetuses in the hospital. This program helps nurses in New Beginnings attend directly to patients and provides real-time telemetry to obstetrician/gynecological healthcare providers at their offices in the community.

Congressman Sherwood praised Wayne Memorial for “embracing the new technology and stepping up to today’s healthcare challenges.

“Change is tough, and access to healthcare in a rural area can also be tough,” Sherwood said, “A Home Health nurse might have to visit a patient in Masthope (Pike County) and then turn around to attend to a patient in Starrucca (in northern Wayne County). Tele-medicine technology makes it easier to deal with situations in rural areas.”

“We are very appreciative of this aid from the U-S-D-A,” said David Hoff, Chief Executive Officer of Wayne Memorial Health System. “Wayne Memorial is committed to growing with the community and the federal government’s help is affirmation of this commitment.”

Gary Groves, Pa State Director of the USDA’s Rural Development program, noted that only 100 grants of this kind were distributed nationwide at this time and “Pennsylvania received six of them, including this one at Wayne Memorial.”

Curtis Anderson, Deputy Administrator of Utilities for the USDA, said the Bush Administration is committed to “hooking up rural America” by making loans and grants available to provide broadband facilities to rural schools, hospitals and medical clinics. He also applauded Congressman Sherwood, who is on the House Appropriations Committee for helping to provide the funding.

Other Significant Grants Announced:

Wayne Memorial Hospital qualified for a $44,499.05 grant from the Hospital Quality Care Investment Grant Program/Department of Public Welfare out of Harrisburg. The funds are linked to the Hospital’s Medication and Patient Safety Initiative. They are to be used for Medical Assistance programs and must be used within 12 months.

The Blue Ribbon Foundation of Blue Cross of Northeastern Pennsylvania also recently awarded $20,000 to Wayne Memorial Health System for its Waymart Medical Center project. This is a new primary-care center being built in Waymart, adjacent to Wayne Woodlands Manor, Wayne Memorial Long Term Care’s skilled nursing facility on South Street. The building will also house an office of Pediatric Practices, as well as WMHS x-ray and lab services.

In just over a year, Wayne Memorial has received more than $1 million in public and private grants. Grants and Development Manager Jack Dennis said the aid is “essential for the future of healthcare access for the community and access to the latest technologies for the hospital and providers in an area of high growth such as ours.”

AgrAbility Press Release
October 17, 2006
Attached and below, please find a press release from AgrAbility for Pennsylvanians. Today we are announcing speaking engagements for a riveting and resourceful producer who has survived paralyzation by bullet and a house fire to become a successful farmer, disability advocate, and entrepreneur. Please share this story with your readers. As always, we are grateful for your help in telling the public about the resources of AgrAbility for Pennsylvanians.

click to open press release here

Application Materials for Barbara Jordan Health Policy Scholars Program Now Available
October 17, 2006
Applications will be accepted Oct. 15, 2006 through Dec. 15, 2006 for the summer 2007 session

Washington, D.C. - The Henry J. Kaiser Family Foundation has begun accepting applications for participation in the 2007 Barbara Jordan Health Policy Scholars Program. Operated in partnership with Howard University, the Scholars Program brings talented African American, Latino, American Indian/Alaska Native, and Asian/Pacific Islander college seniors and recent graduates to Washington, D.C., for placement in congressional offices to learn about health policy.

The application deadline for the Barbara Jordan Health Policy Scholars Program is 5:00pm ET on December 15, 2006.

Through the nine-week program (May 21- August 3, 2007), Scholars gain knowledge about federal legislative procedure and health policy issues, while further developing their critical thinking and leadership skills. In addition to gaining experience in a congressional office, Scholars participate in seminars and site visits to augment their knowledge of health care issues, and write and present a health policy research paper.

The Henry J. Kaiser Family Foundation established the Barbara Jordan Health Policy Scholars Program at Howard University to honor the legacy of former Foundation Trustee and Congresswoman Barbara Jordan and to expand the pool of students of color interested in the field of health policy. As a member of the United States Congress and the Texas State Legislature, Barbara Jordan's distinguished career was exemplified by her tireless advocacy on behalf of vulnerable populations. She brought this passion to her work, inspiring others to become involved in addressing challenging health policy issues.

"The Barbara Jordan Health Policy Scholars Program is an exceptional opportunity for these talented students to gain firsthand experience on Capitol Hill, learn about critical policy issues and undertake in-depth policy analysis projects," Foundation President and CEO Drew E. Altman said. "I encourage all qualified students to apply to be a part of this exceptional congresswoman's legacy as they prepare to take on leadership roles in the health policy arena."

Eligible candidates must be U.S. citizens who will be seniors or recent graduates of an accredited U.S. college or university in the fall of 2007. Currently enrolled law, medical, and graduate students are not eligible for participation in the program. Candidates are selected based on academic performance, demonstrated leadership potential, and interest in health policy. Scholars receive approximately $7,500 in support, which includes a stipend, a daily expense allowance, airfare, and lodging during their time in Washington.

Application materials are available online at: www.bjscholars.org . If you have questions about the application process, please contact the Barbara Jordan Health Policy Scholars Program Manager, Jomo Kassaye at (202) 238-2385 or jzkassaye@howard.edu . If you need more information about the administration of the program or have other questions that are not directly related to the completion of application materials, please contact the Program Director, Cara V. James, Ph.D., at (202) 347-5270 or cjames@kff.org.

The Henry J. Kaiser Family Foundation is an independent, national health philanthropy dedicated to providing information and analysis on health issues to policymakers, the media and the general public.The Foundation is not associated with Kaiser Permanente or Kaiser Industries.

New PHC4 Hospital Performance Report; Hospital Mortality Rates Decline at PA Hospitals; Readmission Rates Rise
October 17, 2006
The Pennsylvania Health Care Cost Containment Council (PHC4) is pleased to announce the release of its latest Hospital Performance Report.

The PHC4 Hospital Performance Report includes risk-adjusted mortality rates, lengths of hospitalization (stay) and hospital charges for patients admitted to 178 Pennsylvania hospitals from October 1, 2004 through September 30, 2005. The new report evaluates hospital performance across 49 common medical procedures and treatments.

To view and/or download the report, visit us on the web by clicking the following link: Hospital Performance Report 2005

Copies of the report can also be ordered by calling PHC4 at (717) 232-6787.

New PBS Series: Remaking American Medicine
October 17, 2006
http://www.remakingamericanmedicine.org/airdates.html

REMAKING AMERICAN MEDICINE is a four-part television series for PBS that follows pioneering individuals struggling to fix our broken health care system.

PROGRAM 1 - SILENT KILLER profiles individuals who are committed to fixing a health care system that is estimated to kill up to 98,000 people a year.

PROGRAM 2 - FIRST DO NO HARM focuses on efforts to eliminate hospital-acquired infections and medication errors.

PROGRAM 3 - THE STEALTH EPIDEMIC looks at groundbreaking efforts to create effective chronic disease management programs.

PROGRAM 4 - HAND IN HAND shows how a unique partnership between patients, families and providers is transforming a teaching hospital.

New from the RUPRI Center: "Medicare Physician Payment: Impacts of Changes on Rural Physicians"
October 17, 2006
A new policy brief is available from the RUPRI Center:

Medicare Physician Payment: Impacts of Changes on Rural Physicians In this policy brief, we present the effects of the MMA on physician payment rates in rural areas. Specifically, we examine the impact of creating a floor of 1.00 in the geographic practice cost index for work expense. We also show the effects of the Medicare incentive payment for providing services in shortage areas and of the bonus for practicing in a physician scarcity area.

Please click on the following link to download this brief:
http://www.rupri.org/healthpolicy/Pubs/pb2006-2.pdf

This policy brief completes a series of RUPRI Center analyses of the rural issues embedded in physician payment policy. To download the other briefs in the series, please click on the links below:

Medicare Physician Payment
http://www.rupri.org/healthpolicy/Pubs/PB2003-2.pdf

Medicare Physician Payment: Practice Expense
http://www.rupri.org/healthpolicy/Pubs/PB2003-9.pdf

The Pennsylvania Commission for WomenTurns State Fountains Pink to Kick-Off Breast Cancer Awareness Month
October 2, 2006
Monday, October 2, 2006 Noon
State Capitol Fountain, Harrisburg

Please Join:
Leslie Stiles, Executive Director,
PA Commission for Women

and

Lieutenant Governor Catherine Baker Knoll
Secretary James Creedon, Department of General Services
Pat Halpin Murphy, President and Founder,
PA Breast Cancer Coalition

Tuesday, October 3, 2006 9 AM
Point State Park Fountain, Pittsburgh

Please Join
Leslie Stiles, Executive Director,
PA Commission for Women

and

Mary Robb Jackson, Reporter, KDKA-

Elsie Hillman

Holly L. Lorenz, RN, MSN,
COO and Vice President of Clinical Services,
UPMC Cancer Centers

Lou Ann Weil, Director,
Statewide Cancer Programs, Adagio Health

Jo Ann Meier, Executive Director,
Pittsburgh Komen Affiliate

Penn State Extension Proram Honored by National 4-H
October 2, 2006
UNIVERSITY PARK, Pa. -- A multi-level alcohol and drug-prevention program that brings together representatives from Penn State Cooperative Extension, local school districts and community service agencies with parents, youth and other community members has been cited as a Program of Distinction by the National 4-H Headquarters.

The PROSPER (Promoting School-Community-University Partnerships to Enhance Resilience) program, a collaborative, community-based initiative, has been inducted into the National 4-H Programs of Distinction database (http://www.national4-hheadquarters.gov/about/pod.htm), a searchable Web-based resource containing descriptions of high-quality youth development programs in communities across the United States.

"We're happy that National 4-H has added PROSPER to its national database," says Claudia Mincemoyer, associate professor in Penn State's agricultural and extension education department and co-investigator on the PROSPER research team. "This added exposure will help communities and their families become aware of this quality youth prevention program.

"The PROSPER project underscores the potential of the community-university partnership model," says Daniel Perkins, Penn State professor of agricultural and extension education and PROSPER co-investigator, who says PROSPER's status as a Program of Distinction also demonstrates the value of the work of Pennsylvania program teams.

The program uses the partnership model to reduce rates of youth substance use and other problem behaviors, as well as to foster positive youth development, according to Perkins. These goals are accomplished through teaching skills that foster improved family life and parent-child communication, along with providing students with skills for planning, problem-solving and peer resistance against problem behaviors.

Statewide, PROSPER reaches about 6,000 youths in seven school districts: Bradford, West Perry, Littlestown, Carbondale, Jim Thorpe, Salisbury and Wyoming Valley West. In each location, a local community team led by an extension educator oversees project activities to assure that programs are well-received within schools and communities and implemented with the highest quality to assure maximum positive impact.

Studies show PROSPER participants are less prone than their peers to youthful experimenting with drugs, tobacco or alcohol and less likely to have used marijuana or inhalants in the last year compared to nonparticipants. Recent economic studies also show that this type prevention program is cost-effective to communities.

"Because there is less need for the use of the court system and drug and alcohol rehabilitation services, PROSPER communities are saving money," says Mark Greenberg, distinguished professor and prevention scientist at Penn State and co-principal investigator for the project. "For every dollar the community spends on prevention programming, they are potentially saving $9.60 in related services." He estimates that the partnership prevents between five and six future cases of alcohol abuse for every 100 participating students.

"Schools do not have to deal with these issues alone; evidence-based programming and technical support come from the local PROSPER team," says Greenberg, who notes that PROSPER is reaching its goal of reducing rates of youth substance use and problem behavior, fostering positive youth development and improving family communication.

Early results from the PROSPER study indicate that youth who participated in the programs report their parents are using improved child management techniques (e.g., effective discipline), as compared to youth not in the program. In addition, youth reported stronger skills, such as refusing to use substances, greater intention to avoid substance use and improved problem solving.

PROSPER is funded by the National Institute on Drug Abuse and the National Institutes of Health and is being conducted in collaboration with Iowa State University. For more information, visit the PROSPER project Web site (http://www.prosper.ppsi.iastate.edu) or contact Perkins at (814) 865-6988 or Mincemoyer at (814) 863-7851.

NIH Loan Repayment Online Applications Available Today
September 25, 2006
The National Institutes of Health (NIH) is now accepting online applications for its five Loan Repayment Programs (LRPs).

The five LRPs offered by the NIH include the Clinical Research LRP, Clinical Research LRP for Individuals from Disadvantaged Backgrounds, Contraception and Infertility Research LRP, Health Disparities LRP, and Pediatric Research LRP.

Through these programs, the NIH offers to repay up to $35,000 annually of the qualified educational debt of health professionals pursuing careers in biomedical and behavioral research. The programs also provide coverage for Federal and state tax liabilities.

To qualify, applicants must possess a doctoral-level degree, devote 50% or more of their time (20 hours per week based on a 40-hour work week) to research funded by a domestic non-profit organization or government entity (Federal, state, or local), and have educational loan debt equal to or exceeding 20% of their institutional base salary. Applicants must also be U.S. citizens, permanent residents, or U.S. nationals to be eligible.

Please share this e-mail with the researchers and other individuals in your organization who may benefit from LRP participation.

All applications for 2007 awards must be submitted online by 8:00 p.m. EST, December 1, 2006.

For an online application, program information, or other assistance, visit the LRP Web site at www.lrp.nih.gov, telephone the Help desk at 866-849-4047, or send email inquiries to lrp@nih.gov.

Health Care Access and Rural Equity Act of 2006 Unveiled
September 25, 2006
(Washington, D.C.) Today, the National Rural Health Association (NRHA) joined the Honorable Greg Walden (R-OR) and the Honorable Earl Pomeroy (D-ND), and many of their colleagues from the House Rural Health Coalition, to unveil a new rural health care bill designed to increase equity and improve access to high quality care in rural America.

The Health Care Access and Rural Equity Act of 2006 (H-CARE) contains many important rural health provisions, including fair rural representation on the Medicare Payment Advisory Commission (MedPAC). Despite an existing requirement for balance between rural and urban representation, MedPAC currently has only one rural health commissioner, out of the 17 appointed, to represent the nearly 27 percent of Medicare beneficiaries that live in rural America. H-Care would ensure proportional representation of rural health interests on MedPAC.

The bill also furthers the Institute of Medicine's (IOM) recommendation to implement demonstration projects in rural communities that test innovative ways to improve health care quality. "We know from experience that collaboration within and among communities is key to high quality care, and that change in small communities and organizations can often be more readily accomplished than at larger facilities," said Hilda R. Heady. Heady spoke on behalf of the NRHA and is the immediate past president of the National Rural Health Association, and associate vice president for rural health at West Virginia University. She continued, "We strongly believe that rural health care providers can not only achieve high performance standards, but can be leaders in the national quality movement. H-CARE gives us the resources to continue these efforts, and to pave the way to higher quality care in rural America and across our land."

The new H-CARE bill incorporates all of the provisions of the The