ORHP Update

National Association of State EMS Officials2008 Mid-Year Meeting Program

LCDR Heather Dimeris, MS, RD, CLC

U.S. Department of Health & Human Services (HHS)Health Resources & Services Administration (HRSA)

Office of Rural Health Policy (ORHP)June 24, 2008

• Overview of Presentation– ORHP’s Role as an EMS Partner– HHS, HRSA, and ORHP Priorities– National Advisory Committee on Rural Health and

Human Services– Rural Health Research – Regulatory Issues– ORHP Grant Programs

• Hospital/State Based Grants• Community-Based Grants

– Rural Health Resources and Tools

ORHP Update

ORHP Update

• Role of the Office of Rural Health Policy– Voice for Rural within HHS– Supports Rural Health

Research– Supports Rural Health

Grant Programs

• ORHP’s Role as an EMS Partner– Rural EMS Committee– Critical Access Hospital Partnerships– National Organization of State Offices of Rural

Health (NOSORH)– National Rural Health Association (NRHA)

ORHP Update

ORHP Update• ORHP Priorities for 2008

– Workforce– Quality Improvement– Health Information Technology (HIT)

ORHP Update• ORHP Policy Activities

– Conduct rural health services research– Review and comment on regulations– Review Legislation and Reports to

Congress– Work with the Centers for Medicare and

Medicaid Services (CMS) & HHS to provide a rural context

– Serve as HHS wide resource on rural health services and data issues

– Staff the National Advisory Committee on Rural Health and Human Services

• HRSA Goals– Improve Access to Health Care– Improve Health Outcomes– Improve the Quality of Health Care– Eliminate Health Disparities– Improve the Public Health and Health Care

Systems– Achieve Excellence in Management Practices

ORHP Update

ORHP Update• HHS Priorities

– Every American Insured– Insurance for Children in Need– Value-Driven Health Care– Information Technology– Personalized Health Care– Health Diplomacy– Prevention– Louisiana Health Care System– Preparedness– Emergency Response– Ongoing Initiatives

HHS Hubert Humphrey Building

Washington, D.C.

ORHP Update• The National Advisory Committee

on Rural Health & Human Services – An External Policy Voice – Public advisory panel of 21 nationwide

rural health experts for HHS Secretary – Chaired by former South Carolina

Governor David Beasley – Produces an annual report

• 2008 Report is a 20-Year Retrospectivehttp://ruralcommittee.hrsa.gov

• The National Advisory Committee on Rural Health & Human Services– An External Policy Voice – Public advisory panel of 21 nationwide

rural health experts for HHS Secretary– Chaired by former South Carolina

Governor David Beasley– Produces an annual report

• 2008 Report is a 20-Year Retrospectivehttp://ruralcommittee.hrsa.gov

Chairman David Beasley

ORHP Update

• Rural Health Services Research– New Rural Health Research

Gatewayhttp://www.ruralhealthresearch.org/

– Rural Health Listservwww.ruralhealthresearch.org/listserv/

• Targeted Research Grant• Up to $150k/ 18 months• Applications available Feb 2009

A sampling of recent research products

ORHP Update

• Recent Research Report: Issues in Staffing Emergency Medical Services: A National Survey of Local Rural and Urban EMS Directors– Rural EMS directors were more likely than their urban

counterparts to report designated medical director (DMD) recruitment problems, but specific barriers did not differ significantly across geographic areas. Almost two-thirds (62%) of all directors reported that local physicians did not want to serve as DMD.

• Freeman, V.A., Patterson, D., Slifkin, R.T. Issues in Staffing Emergency Medical Services: Results from a National Survey of Local Rural and Urban EMS Directors. May 2008. North Carolina Rural Health Research and Policy Analysis Center.

Key Rural Regulatory Issues• Inpatient Hospital

Payment• Outpatient Hospital

Payment• Physician Payment• Rehab Payment• Psych Payment• Skilled Nursing Facility

and Long Term Care Payments

• Ambulance Fee Schedule

• Medicare Advantage• Medicare Part D• Rural Health Clinics• Federally Qualified

Health Centers• Medicaid Waivers• Medicare GME

ORHP Update

ORHP Update

FY 2008 Budget: $177.9 Million

1%4%

93%

2% Grant Awards and TA($165.4 M)Rural Health Research($4.4M)HRSA Costs ($7.3 M)

Other ($906 K)

ORHP Update

Grant Award Trends

377

350 371

441

$80

$90

$100

$110

$120

FY 05 FY 06 FY 07 FY 08

Fiscal Year

Bud

get i

n M

illion

s

ORHP Update

72 M

ore G

rant

s

• FY 08 Community-Based Grants

• ORHP Grants– Targeted Technical Assistance Workshops

• Seven states have not received an ORHP Grant in the past 5 years (UT, WY, PA, OK, ID, CO & TN)

• Grant Workshops will be coordinated through State Offices of Rural Health

ORHP Update

• Hospital-State Grants– State Offices of Rural Health (SORH)– Rural Hospital Flexibility Grant (Flex)– Small Rural Hospital Improvement Program

(SHIP)– Critical Access Hospital HIT Network Grants

(CAH-HIT Network)

ORHP Update

ORHP Update

• Flex Program Goals– Development of State Rural Health Plan– Designation of CAHs in the State– Development and Implementation of Rural

Health Networks– Improvement and Integration of EMS Services– Improving Quality of Care

ORHP Update• Community-Based Grants

– Rural Health Services Outreach – Rural Health Network Development – Rural Network Development Planning– Rural Access to Emergency Devices (RAED) – Delta States Development Network (Delta)– Rural Quality Improvement– Radiation, Exposure, Screening and Education

Program (RESEP)– Black Lung Clinic Program (BLCP)– Delta Health Initiative (DHI)– Frontier Extended Stay Clinic (FESC)

ORHP Update• Community-Based Grants for FY 2009

– Rural Health Outreach• Up to $150k, $125k, $100k/Year for Three Years• Applications available in July • Expect to make up to 90 Awards

– Rural Network Planning• Up to $85,000 for One Year• Applications available in July• Expect to make up to 20 Awards

– RAED• Up to $100,000• Applications available in December• Expect to make up to 10 Awards

– Rural Quality: next competition in FY 2010– Network Development: next competition in FY 2011

• Community-Based Grants for FY 2009– Rural Health Outreach

• Up to $150k, $125k, $100k/Year for Three Years• Applications available in July • Expect to make up to 90 Awards

– Rural Network Planning• Up to $85,000 for One Year• Applications available in July• Expect to make up to 20 Awards

– RAED• Up to $100,000• Applications available in December• Expect to make up to 10 Awards

– Rural Quality: next competition in FY 2010– Network Development: next competition in FY 2011

http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm#providers

ORHP Update

• Tools and Resources– Applying for Grants– Must go through:

www.Grants.gov – Register early

• Tools and Resources– Applying for Grants– Must go through:

www.Grants.gov– Register early

http://www.Grants.gov

ORHP Update

http://www.ems.gov/

A EMS Resource

ORHP Update

http://www.3rnet.org

• National Rural Health Association– Rural Medical Educators– State Rural Health Associations– Quality Initiative

ORHP Update

ORHP Update

One-Stop Shopping– Funding Info– Resource Guides– Best Practices

http://raconline.org

The Rural Assistance Center

ORHP Update

Contact Information:

Heather DimerisAssociate DirectorHRSA, ORHPhdimeris@hrsa.gov

ORHP Web Site: http://www.ruralhealth.hrsa.govORHP Phone Number: (301) 443-0835