CHAIR:
Nancy Kassebaum Baker
Burdick, KS
MEMBERS:
James Ahrens
Helena, MT
Stephanie Bailey, B.C., M.D., MSHSA
Nashville, TN
H.D. Cannington
Swainsboro, GA
David L. Berk
Anacortes, WA
Shelly L. Crow
Eufala, OK
Steve Eckstat, D.O.
Clive, IA
Dana Fitzsimmons, R.Ph.
Houston, TX
Rachel Gonzales-Hanson
Uvalde, TX
Alison M. Hughes
Tuscon, AZ
John L. Martin
Fort Kent, ME
Keith J. Mueller, Ph.D.
Omaha, NE
Thomas S. Nesbitt, M.D., M.P.H.
Sacramento, CA
Sally K. Richardson
Charleston, WV
Monnieque Singleton, M.D.
Bamberg, SC
Mary Wakefield, Ph.D.
Fairfax, VA
EXECUTIVE SECRETARY:
Wayne Myers M.D.
Rockville, MD |
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October
3, 2000
The Honorable Donna Shalala
Secretary,
Health and Human Services
200 Independence Avenue, SW
Washington, D.C. 20201
Dear Secretary Shalala,
The National Advisory Committee
on Rural Health recently completed its September meeting in Hazard, Kentucky
September 10-12, 2000 and I would like to share with you some highlights
of our discussion. The Committee continued its year-long focus on Medicare
reform and its potential impact on rural health care. We also learned
a great deal about how this Appalachian community has developed an innovative
approach to improving its local health care delivery system.
As you know, the Committee
has a continuing interest in Medicare reform. The Committee believes this
issue will generate a considerable amount of debate during the next year
and that the concerns of rural beneficiaries and rural providers need
to be taken into account in any potential redesign of the Medicare program.
During the September meeting, the Committee developed a framework for
a report on the rural dimensions of Medicare reform. We expect that the
report will be presented to the Committee for the February meeting and
may serve as the basis of a series of potential recommendations.
On behalf of the Committee,
I also want to share with you what we learned about an innovative approach
to rural health care delivery in Southeastern, Kentucky that might serve
as a model for other communities. As you know, central Appalachia is one
of the poorest regions in the country with some distressing health indicators
and a long-standing problem attracting and retaining health care professionals
to provide adequate access to care. Despite these challenges, this area
of Kentucky has found a way to begin addressing these problems by tapping
into a variety of sources. The core of the local health care system is
Appalachian Regional Healthcare Inc., a not-for-profit integrated system
operating hospitals, clinics and home health agencies in poor coal towns
of Kentucky and West Virginia. The Pikeville (KY) College School of Osteopathic
Medicine recently graduated its first class of physicians trained in and
for rural Appalachia. The University of Kentucky Center for Rural Health,
now in its tenth year in Hazard, trains place-committed rural people in
advanced practice nursing, physical therapy, clinical lab sciences and
family practice. More than 90 percent of its graduates remain in rural
practice. The Center just received a DHHS Community Access Program ("CAP")
Grant based on its experience in community organization and the training
and employment of lay health workers. The combination of Federal, State
and local resources under aggressive rural leadership, is making a difference
and the Committee felt this model might be replicable in other areas.
Thank you again for your
support of rural health. We appreciate your active support of important
rural health issues during your tenure as Secretary and we look forward
to working with you and the Department to improve health care services
in rural areas. I look forward to hearing from you soon.
Sincerely,
Nancy Kassebaum Baker
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