The National Advisory Committee
on Rural Health and Human Services
U.S. Department of Health and Human Services
News
and Updates
From the National Advisory Committee
September, 2007
The National Advisory Committee
on Rural Health and Human Services held second and final field meeting from September 12-14, 2007 in Madison, Wisconsin.
The Committee continued work on the 2008 Report to the Secretary by conducting a site visit to Sauk City, rural communities in Wisconsin. Subcommittees heard from speakers related to health, human services, and/or community development in rural communities. The speakers included the Secretary of the Wisconsin Department of Health and Family Services, the Secretary of the Wisconsin Department of Workforce Development, as well as the Dean of the University of Wisconsin’s School of Medicine and Public Health and the Medical Advisor for Toyota Motor Engineering and Manufacturing, North America.
Subcommittees continued work on their respective sections of the report. The Committee will work to finish the 2008 Report and will begin work on the 2009 Report to the Secretary. This work will continue at the Committee's winter meeting February 20-22, 2008, in Washington, D.C.
June, 2007
The National Advisory Committee
on Rural Health and Human Services held the first of two field meetings June10-12, 2007 in Fort Collins, Colorado.
The Committee continued work on the 2008 Report to the Secretary by conducting a site visit to Brush and Fort Morgan, rural communities in Colorado. Subcommittees heard from speakers related to health, human services, and/or community development in rural communities. The speakers included the directors of local organizations, as well as the Associate Dean for Rural Health at the University of Colorado’s School of Medicine, and County Administrator for Health and Human Services.
Subcommittees continued work on their respective sections of the report. The Committee will continue work on the 2008 Report to the Secretary at the second field meeting in Madison, Wisconsin, September 12-14, 2007.
March, 2007
The National Advisory Committee on Rural Health and Human Services held its winter meeting February 28-March 2, 2007 in Washington, DC.
The Committee heard that the 2007 Report to the Secretary is nearing release from an internal clearance process and will soon be on the NACRHHS website. The Committee continued work on its 2008 Report to the Secretary, a 20-year review of major changes to the rural health and human services landscape. To complete this task, subcommittees were formed for the following issues:
- Health
- Human services
- Integration (which will look at how to better integrate health and human service delivery)
The Committee heard testimony from policy and research experts on rural issues from both inside and outside the Federal Government. The Commitee will continue its work on the 2008 Report to the Secretary at its summer meeting in Ft. Collins, Colorado.
September, 2006
The National Advisory Committee on Rural Health and Human Services held its second and final field meeting September 28-30, 2007, in Grand Forks and Devils Lake, North Dakota.
The Committee continued work on the 2007 Report to the Secretary by conducting site visits in Devils Lake and Cando, rural and frontier communities in North Dakota. Each subcommittee visited a site related to one of the three topics for the 2007 Report to the Secretary: Medicare Advantage, Head Start, and substance abuse in rural communities.
Subcommittees continued work on their respective sections of the report. The Committee will work to finish the 2007 Report and will begin work on the 2008 Report to the Secretary. Next year will be the 20th anniversary of the Committee and the Committee decided to look at changes in the rural health and human services landscape in the last 20 years. This work will continue at the Committee's winter meeting February 28-March 2, 2007, in Washington, D.C.
June, 2006
The National Advisory Committee on Rural Health and Human Services held the first of two field meetings June 11-13, 2006, in Camden, Maine.
The Committee continued work on the 2007 Report to the Secretary by conducting site visits in Bucksport and Ellsworth, rural communities in coastal Maine. The Committee also heard speakers on each of the three subjects selected prior to the January meeting: Medicare Advantage, Head Start, and substance abuse. Speakers included directors of local organizations and representatives from an insurance company.
Subcommittees continued work on their respective sections of the report. The Committee will continue work on the 2007 Report to the Secretary at the second field meeting in Grand Forks and Devils Lake, North Dakota, September 28-30, 2007.
January, 2006
The National Advisory Committee on Rural Health and Human Services held its winter meeting on January 29-31, 2006 in Washington, DC.
The Committee finalized its work on the 2006 Report to the Secretary through a final vote of approval. This report focuses on the rural implications of health information technology, access to pharmacy and pharmaceutical services and family caregiver support for the rural elderly. The report will now go through an internal review process with an expected publication date of late April/early May.
Following the report's approval, the Committee began work on the three new topics for the 2007 work plan. They are the following:
- Medicare Advantage in rural communities
- Head Start in rural communities
- Substance abuse in rural communities
At the meeting, the Committee heard testimony from experts from both inside and outside the Department of Health and Human Services on each subject both from policy and research standpoints. The Committee will continue work on the 2007 Report to the Secretary at the summer meeting in Camden, Maine in June.
June, 2005
The National Advisory Committee on Rural Health and Human Services held its summer meeting in Johnson City, Tennessee on June 12-14.
The Committee continued work on its 2006 Report to the Secretary by conducing site visits in regional rural towns such as Johnson City, TN; Mountain City, TN; and Big Stone Gap, VA. The Committee also heard from expert speakers in the three areas of focus that were selected at the meeting in March (health information technology in rural areas, access to pharmaceutical services in rural areas, and family caregiver support in rural areas). The speakers included directors of local organizations as well as the President of East Tennessee State University, Dr. Paul Stanton, and the University's Vice President of Health Affairs, Dr. Ron Franks.
At the meeting, the Committee also recognized the passing of longtime rural health advocate Jim Bernstein. Bernstein committed more than 30 years of his life to improving rural health. He was responsible for the establishment of the first State Office of Rural Health, the opening of 83 health clinics across North Carolina, and a recruitment service that has resulted in more than more than 2,200 physicians, nurse practitioners, physician assistants, certified nurse-midwives, dentists, and other providers beginning practice in the state. His work has also impacted national rural health policy-making. Bernstein's leadership in rural America will be missed.
The next meeting of the Committee will be in Wilson, Wyoming in September.
March, 2005
On March 20-22, the National Advisory Committee
on Rural Health and Human Services held its winter 2005 meeting in Washington, D.C. The first line of business at the meeting was approval of the 2005 Report to the Secretary of Health and Human Services. Exactly one year earlier, the Committee began work on the report, which includes three issue-specific chapters on access to obstetrical care, obesity, and welfare reform in rural areas, as well as one over-arching chapter on collaborations to enhance community and population well-being in rural communities. At the end of each chapter, the Committee makes several recommendations to the Secretary and provides examples of models that are working in rural communities.The 2005 Report is now available at: ftp://ftp.hrsa.gov/ruralhealth/NAC2005.pdf
Following the report's approval, the Committee selected three new topics for the 2006 work plan. They are the following:
- Health Information Technology in Rural Areas
- Access to Pharmaceuticals in Rural Areas
- Family Caregiver Support in Rural Areas
At the meeting, the Committee heard testimony from experts from both inside and outside the Department of Health and Human Services on each subject, and will continue work at the summer meeting in Johnson City, TN in June.
September, 2004
The National Advisory Committee continued work on its 2005 report to the Secretary at its Fall meeting in Tupelo, Mississippi on September 12 - 14.
David Beasley, the Chair of the Committee and former Governor of South Carolina, began the meeting by welcoming four new members to the Committee who had been selected by Secretary Thompson.
- Julia Hayes, M.S., R.D., deputy director of minority health, Alabama Department of Public Health, Montgomery
- Michael Meit, M.P.H., director of the University of Pittsburgh's Center for Rural Health Practice in Bradford, Pa
- Patti Patterson, M.D., M.P.H., vice president for rural and community health at Texas Tech University Health Sciences Center, Lubbock
- Thomas Ricketts, Ph.D., professor of health policy and administration and social medicine, University of North Carolina School of Public Health and UNC School of professor at the UNC School of Public Health and the UNC School of Medicine, Chapel Hill
While in Tupelo, the Committee had the opportunity to hear from experts in the health care arena, including Dr. Warren Jones, Director of Medicaid for Mississippi, and Dr. J. Edward Hill, president-elect of the American Medical Association.
The Committee members also conducted site visits to the rural communities surrounding Tupelo and met with local health and human service providers. These visits will help inform the 2005 report.
"This meeting was extremely informative, and the Committee is now poised to make meaningful recommendations to the Secretary in its next report that address the challenges of rural health and human service delivery," Beasley said.
The Committee is expected to review and approve a final draft of the report at its Winter meeting in Washington, D.C. in March.
June, 2004
The National Advisory Committee on Rural Health and Human Services held its summer meeting in Nebraska City, Nebraska on June 6 - 8.
The Committee began work on its 2005 report to the Secretary by conducing site visits in rural Nebraskan towns such as Beatrice, Crete, Tecumseh and Syracuse, and hearing from speakers on the four areas of focus, as selected at the winter meeting in February.
The Committee will be examining the following:
- Improving Health and Human Service Program Collaboration for Serving Rural Communities
- Temporary Assistance to Needy Families (TANF) and its Effects on Rural America
- Obesity in Rural Communities
- Access to Obstetrical Care in Rural Communities
While one of the four selected topic areas deals specifically with collaboration across health and human service programs, the Committee will emphasize the importance of connectivity between health and human service care throughout the report, and hopes to highlight, via recommendations to the Secretary, the potential for further collaboration on each topic both within the Department of Health and Human Services and across various federal agencies.
February, 2004
The National Advisory Committee on Rural Health and Human Services held its Winter 2004 meeting on February 22 - 24 in Washington, D.C. At this meeting the Committee approved its 2004 report and recommended forwarding it to the Secretary of Health and Human Services. The 2004 report focused on the integration of primary care and behavioral health services, access to oral health care and serving the rural elderly. It also makes several recommendations to the Secretary and provides examples of models that are working in rural communities.
"I am pleased with the effort put into this report," said the Chair, David Beasley, former Governor of South Carolina. "It captures the not only the barriers faced in rural communities regarding these issues, but it also highlights examples of programs that are working in spite of the many obstacles they encounter."
The Committee will undertake four new topics for the 2005 workplan. They are the following:
- Options for Improving Health and Human Service Program Collaboration for Serving Rural Communities
- Rural Technical Assistance Considerations in Temporary Assistance to Needy Families (TANF)
- Obesity in Rural Communities: Impact on Families
- Access to Obstetrical Care in Rural Communities
The Committee believes that these topics represent important issues and challenges for rural communities across the health and human services spectrum.
The Committee will continue its work at the Summer meeting in Nebraska City, NE in June.
October, 2003
The Committee held its Fall meeting in Charleston, West Virginia September 7-9 and continued work on its 2004 report which is due to the Secretary in February of 2004.
The 2004 report will focus on three key issues. The first is access to oral health services in rural communities. The second is the integration of behavioral health and primary care in rural communities. The third focuses on serving the rural elderly.
During the September meeting, the Committee heard testimony from a number of West Virginia officials related to the Committee topic areas. The Committee also visited a number of clinics and area agencies on aging to help provide information for the 2004 report. The Committee will continue work on the report through the Fall and it is expected to approve the report at its February 22-24th in Washington D.C. at the Grand Hyatt Hotel.
March, 2003
Committee approves quality report and recommendations
The National Advisory Committee on Rural Health and Human Services approved its quality report at its meeting March 2-4th and recommended forwarding the report to Secretary Tommy Thompson.
The report, which has been a year in the making, looks at the issue of health quality in rural areas and makes several recommendations to the Secretary on this issue. The report is undergoing final editing and formatting and should be sent to the Secretary by early April. The Committee also approved a short white paper on the allied health workforce needs in rural areas and will also forward that to the Secretary along with the quality report. Both document will be available publicly within the next few weeks.
"We think both of these documents will highlight important issues for the Secretary," said David M. Beasley, the Committee chair and former Governor of South Carolina. "In both cases, we took a look at key health policy issues and then focused in on some of the important rural considerations."
The Committee will now turn its attention to its work plan for 2003 and 2004. This will include an examination of the integration of behavioral health and primary care in rural settings and access to oral health care services in rural communities. The Committee will also focus on issues affecting the rural elderly.
Fall 2002
The National Advisory Committee on Health and Human Services held its fall meeting in Pray, Montana Sept. 8-10th and continued work on its report on health quality in rural areas.
The report is expected to be reviewed and approved at the Committee's meeting March 2-4th in Washington, D.C. In addition to the quality report, the Committee is also continuing work on a white paper that looks at the challenges facing the allied health workforce in rural areas. The white paper is also expected to be reviewed and approved at the March meeting. Both documents will then be sent to HHS Secretary Tommy G. Thompson for review.
"Both of these projects focus on issues that are important to rural America," said David Beasley, the former South Carolina governor who chairs the Committee. "We're hopeful that the Quality report will help provide some needed rural perspective in the larger discussion about quality in our health care system. We also feel like the workforce white paper will bring a needed focus to the challenge rural communities are facing in recruiting and retaining allied health care providers."
July 9, 2002
HHS Names New Members to Rural Health Advisory Committee
HHS Secretary Tommy G. Thompson today announced the appointment of five rural health experts to serve on the National Advisory Committee on Rural Health.
"The five new members of the committee are national leaders in rural health," Thompson said. "Their input will ensure that HHS and its many programs serve and support rural communities as strongly as possible."
The selections are:
- Evan Dillard, administrator of the Walker Baptist Medical Center in Jasper, Ala.,
- Joellen Edwards, a nurse practitioner and educator from East Tennessee State University in Johnson City, Tenn.,
- Michael Enright, a psychologist and nurse practitioner from Jackson, Wyo.,
- Raymond D. Rawson, a dentist and state legislator from Carson City, Nev.,
- Glenn D. Steele, administrator of the Geisinger Health System in Danville, Pa.
The 16-member committee, chaired by former South Carolina Governor David Beasley, meets three times a year and prepares annual reports for the Secretary on key health issues that affect rural communities. This year the committee will focus on two issues - rural health quality and workforce.
The committee will also play a key role in a new Department-wide initiative designed to strengthen rural health care. Initiative staff received more than 450 comments from members of the public on rural health issues; among the most critical issues identified were access to mental health and oral health services. The committee's new members, who will serve four-year terms, include rural experts in both these fields.
March, 2002
Committee Approves Safety Net Report, Looks Toward Workforce and Quality
The National Advisory Committee on Rural Health approved its safety net report at its meeting March 3-5th and will soon begin work on reports on quality and workforce.
The March meeting featured the introduction of a new chair, former South Carolina Governor David M. Beasley, who replaced former Kansas Senator Nancy Kassebaum Baker. Under Governor Beasley's leadership, the Committee decided to take on the task of writing two reports in 2002. One report will focus on rural health care quality while the other will focus on research. The Committee will spend the next few months research both topics to define the particular focus of each report.
In the meantime, the Committee approved a report on the rural health care safety net that it has been working on for the past year. The report is awaiting final edits and will be sent to Secretary Thompson in early April.
May, 2001Committee Sends Medicare Reform Report to the Secretary
Group Begins work on FY 2001 TopicThe National Advisory Committee on Rural Health sent a report on the rural implications of Medicare reform to Tommy G. Thompson, the Secretary of the U.S. Department of Health and Human Services, that calls for a move toward greater equity of benefits for all beneficiaries and steps to address the payment gap between rural and urban providers.
The report, which was a year in the making, provides a range of recommendations to the Secretary in the hope that a rural voice will be heard in any possible redesign of the Medicare program, which has been discussed by both the new Administration and the 107th Congress. The report looks at Medicare issues related to four key areas: finance, access, quality and workforce. It argues that Medicare, as currently configured, does not serve rural beneficiaries well and that any redesign of the program should address current problems. Among the highlights of the report are a call for an equity of benefits for Medicare beneficiaries regardless of where they live and strengthening and protecting the fee-for-service delivery system.
We hope this report can help inform the debate on Medicare reform by providing a rural perspective, said Nancy Kassebaum Baker, outgoing chair of the Committee and a former U.S. Senator from Kansas. The Committee felt strongly that its important that a rural voice be heard in any discussion about Medicare reform.
The Committee now turns its attention to its next project for 2001, which is a targeted look at the rural health care safety net. In the past few years, issues affecting the health care safety net have garnered significant attention. This has been driven by concerns about continued increases in the number of Americans who are uninsured and underinsured as well as the impact of changes in the health care system brought about by managed care along with payment reductions in Medicare and Medicaid. The focus on the safety net, to date, has been largely global in nature. Few studies have looked at these issues from the rural perspective. The National Advisory Committee on Rural Health decided at its February 2001 meeting chose to take a targeted look at the rural health care safety net for its annual report to the Secretary of the U.S. Department of Health and Human Services in FY 2001. The Committees intent is not to duplicate work on this issue that has already been produced by recent reports from either the Institute of Medicine or the Urban Institute but to instead focus on several discrete rural safety net issues that fall within the scope of existing Federal statutory authority.
February, 2001
Committee Putting Final Touches on Report on Key Rural Issues in Medicare Reform
The National Advisory Committee on Rural Health is putting the final touches on its report on the rural implications of Medicare reform and expects to submit the document to Tommy G. Thompson, the Secretary of the Department of Health and Human Services, sometime in the Spring of 2001.
The Committee reviewed the report at its most recent meeting, Feb. 4-6, and gave approval to the overall tone of the report and issued some final suggestions to staff to revise the report in preparation for release. The report focuses on issues related to financing, workforce, quality and access for rural Medicare beneficiaries.
The report, which the Committee has been focusing upon for the past year, will contain recommendations to the new Secretary on key rural issues to be addressed in any redesign of the Medicare program. The issue of Medicare reform has been raised by both Congress and the White House, but it is not clear when or if any definitive action will take place. The Committee's report, according to the chair, is an attempt to raise issues that affect the health care delivery system for Medicare beneficiaries who live in rural areas.
"Hopefully, this report will shed some light on some important issues for rural beneficiaries," said former Senator Nancy Kassebaum Baker, the group's former chair. "Should Medicare reform take place, this will help ensure that rural concerns have a voice."
While final work on the report takes place, the Committee is also looking ahead to its topic for the 2001 calendar year. The group voted during its February meeting to focus its next report on the rural safety net.
November, 2000
Committee Developing Report on Key Rural Issues in Medicare Reform
The National Advisory Committee on Rural Health, chaired by former Senator Nancy Kassebaum Baker, continues work on a report examining the rural implications of Medicare reform that will be sent to the Secretary of Health and Human Services early in 2001.
The report will lay out the key rural issues that must be addressed in any major redesign of the Medicare program. The report and subsequent recommendations offer the Committee an opportunity to highlight key rural issues identified by the 16-member Committee.
We think its important to highlight some of these issues, Kassebaum Baker said. Rural Medicare beneficiaries have a lot at stake in terms of access to care and affordability. The Committee will try to bring some attention to the particular rural concerns in this report.
The Committee, which developed the framework for the report at its September 2000 meeting in Hazard, Kentucky, will meet again February 4-6 in Washington, D.C. The Committee hopes to have the report ready for that meeting and to forward it to the Secretary shortly thereafter. The document is the culmination of a years work by the Committee, which focuses on one key topic each year that is the focus of an annual report and recommendations.
July, 2000
Committee Continues Focus on Medicare Reform
The National Advisory Committee on Rural Health calls on the Administration and the Congress to give special attention to rural issues in any possible reform to the Medicare program.
The Committee, which is chaired by former Kansas Senator Nancy Kassebaum Baker, met in Eufala, Oklahoma June 4-7 and produced a set of rural guiding principles on key Medicare reform issues that have been forwarded to Donna Shalala, the Secretary of the U.S. Department of Health and Human Services. That document, "Key Issues for Medicare Reform," recommends that policymakers take into account the key differences in the rural health care delivery system in redesigning the 35-year-old Medicare program. Rural areas tend to have fewer health care providers serving sparse populations spread out over large geographic areas, which makes it hard to rely on a standard competitive model to deliver services.
"This is part of the Committees ongoing effort to highlight some of the important rural concerns that need to be addressed in any reform or revision of the Medicare program," Kassebaum Baker said. "We cant assume that a one-size-fits-all solution will work."
During the June meeting, the Committee reviewed the leading Medicare reform plans put forward by the Administration and the Congress with the help of a background document, "A Rural Assessment of Leading Proposals to Redesign the Medicare Program," which was prepared by the Rural Policy Research Institutes (RUPRI) Health Panel.
The Committee also forwarded to the Secretary a recommendation on the issue of prescription drug coverage for Medicare beneficiaries. The Congress and the Administration both have introduced drug coverage proposals and the issue continues to dominate the debate on Capitol Hill. The Committees recommendation calls on the Administration to offer some protection to small, rural pharmacists in any possible drug coverage benefit that might be added to the Medicare program. The Committee expressed concern that these important local providers might be bypassed by large pharmacy benefit managers or private insurers. The failure to include local pharmacists in any new delivery system could deprive rural communities of a local source of urgently needed prescriptions.
The Committee will continue to address the issue of Medicare reform at its September meeting in Hazard, Kentucky September 10-12.
March 5, 2000
Committee Will Examine Rural Aspects of Medicare Reform
The National Advisory Committee on Rural Health will spend the next year examining the rural aspects of Medicare reform along with several other related issues.
"It's important that we make sure that rural concerns are part of the ongoing debate about Medicare reform," said Nancy Kassebaum Baker, who chairs the Committee. "We hope the Committee can bring some important issues to the table over the next year as the Administration and the Congress begin discussing ways to improve and modernize the Medicare program."
Each year, the Committee chooses an issue to study. Last year, the Committee focused on rural public health. The decision to focus on Medicare reform came out of discussions at the February 6-9, 2000 meeting. The Committee will spend the next 12 to 18 months working on this initiative, which will culminate in the release of a report and a set of recommendations for the Secretary of the U.S. Department of Health and Human Services.
In addition to Medicare reform, the Committee will also continuing studying several other critical issues, including rural mental health, the rural uninsured, collaboration with the VA in rural communities and continued work on rural public health.
January 12, 2000
New Chair Begins Tenure with NAC
Former Kansas Senator Nancy Kassebaum Baker takes over leadership of National Advisory Committee on Rural Health when she chairs the February 6-9 meeting of this group of national rural health experts at the Washington Court Hotel in Washington D.C.
A strong advocate for rural health issues during her time in Congress, Senator Kassebaum Baker brings a wealth of experience to her job as chair of the Committee. She served three terms as a Republican Senator from Kansas and is a former chair of the Labor and Human Resources Committee. Since retiring from the Senate, Kassebaum Baker has remained active on health issues, serving on the boards of the Robert Wood Johnson Foundation and as chair of the Kaiser Family Foundation.
Senator Kassebaum Baker and the Committee will have an ambitious agenda during her initial meeting as chair. The Committee will hear presentations on a range of issues including the work of the Kaiser Commission on Medicaid and the Uninsured, mental health and Medicare payment. In addition, the Committee will begin discussing its annual project for the coming year, which will focus on collaborative models of health care delivery in rural areas with the Veterans Administration and the Indian Health Service.
The National Advisory Committee on Rural Health is a 16-member board that advises the Secretary of Health and Human Services on issues concerning the provision and financing of health care services in rural areas.
For further details on this appointment, see the February 7, 2000 HRSA press release.
October 1999
NAC Meets with Secretary, Completes Public Health Report
The National Advisory Committee on Rural Health voted to forward its report on the Rural Public Health Infrastructure to the Secretary at the close of its September meeting along with a handful of recommendations on issues related to the impact of the Balanced Budget Act (BBA) on rural health care providers.
The meeting, which was held September 12-15 in Washington, D.C., was highlighted by a visit from Donna E. Shalala, the Secretary of the U.S. Department of Health and Human Services. Secretary Shalala addressed the Committee and discussed ongoing negotiations with the Congress to mitigate some of the more harmful impacts of the Balanced Budget Act of 1997 and asked Committee members for suggestions on how to address key rural concerns.
"We're just not going to have a rural America if we don't have health care in rural America," the Secretary said.
The meeting also marked the final meeting for Chair Robert D. Ray, a former Iowa Governor, and four committee members (Frank Newman, Jay Wheeler, Barbara Doty and Jennifer Frary). Governor Ray, who has chaired the Committee since its inception in 1987, will be succeeded by former Kansas Senator Nancy Kassebaum Baker.
By the close of the September meeting, the Committee approved two recommendations on public health issues, five recommendations on Medicare payment issues related to the BBA and a pair of recommendations on rural hospitals. Each of the recommendations, as well as the public health report, will be available on this web site as soon as they are forwarded to the Secretary. The Committee's next meeting will be February 6-9 in Washington, D.C.