ALASKA
Alaska State Hospital & Nursing Home Association
(ASHNHA)
D06RH04308
Randall Burns
ASHNHA / ASHPIN
943 West Sixth Avenue, Suite 120
Anchorage, AK 99501
Phone: (907) 269-4595
Fiscal Year 2005 2006 2007
Grant Award $180,000 $180,000 $180,000
The Alaska Small Hospital Performance Improvement
Network (ASHPIN or Network) is a rural hospital network with eleven
of Alaska's smallest frontier hospitals. Rural hospitals formed
the Network to improve the quality of healthcare in their communities.
ASHPIN received an ORHP RHND Planning Grant in 2003 to assist in
formation of the Network. The Alaska State Hospital and Nursing
Home Association (ASHNHA) now provides continuing support to the
Network.
Substance abuse and suicide in Alaska are at two
and three times the national rates. These rates are even more disparate
in the Alaska Native population and especially for young males.
Alaska also struggles with violence and abuse rates above national
norms. In addition, an abundance of dangerous occupations often
place Alaska's occupational injury (and related death) rates above
national norms. Over the last ten years, many of Alaska's rural
hospitals have found themselves between a rock and a hard place,
facing a downturn in the economic well-being of their communities
and a concomitant rise in their healthcare costs, manpower concerns,
and the need to replace aging hospital facilities.
ASHPIN's goal is to advance the Network by focusing
on strategic planning that develops new network tools to overcome
the hurdles presented by Alaska's unique frontier environment (i.e.,
Alaska's size, transportation issues, isolation, high cost of living,
etc.) or tailors existing network enterprise programs. In order
to support this goal, the project will: 1) back ASHPIN's development
as an increasingly important voice on behalf of rural hospitals/rural
communities in healthcare policy circles in Alaska through support
for ASHPIN's ongoing organizational and administrative maturity;
2) seek expertise to assist ASHPIN's desire to lead an effort to
create the statewide healthcare provider recruitment collaborative
called for by distressed employers; 3) complete the work started
in 2003 with respect to the creation by ASHPIN of the Alaska Rural
Telehealth Network, beginning with the short-term goal of providing
state-of-the-art teleradiology services to those Network hospitals
and partner clinics who either have lost, never had, or have tenuous
service at this time, and the longer term, more broad telehealth
goal of providing distance education through real time video conferencing,
telepharmacy, specialty consults, emergency consults, etc.; and
4) carry out financial and strategic planning.
CALIFORNIA
North Coast Clinics Rural Health Network
D06RH00223
Tim Rine
North Coast Clinics Network
517 3rd Street, Suite #36
Eureka, California 95501
Phone: (707) 442-6066
Fiscal Year 2003 2004 2005
Grant Award $198,995 $198,864 $198,856
The North Coast Clinics Network (NCCN) is composed
of eight federally qualified health centers (FQHCs), two rural health
clinics (RHCs), a family planning clinic, and a county public health
agency. The network's service area is approximately the size of
New Jersey and encompasses three northern California counties. Humboldt
and Del Norte Counties on the Pacific Coast and Trinity County to
the east extend from 200 miles north of San Francisco to the Oregon
border.
Hidden among the area's natural beauty of unspoiled
beaches and ancient redwood forests are pockets of economically
depressed, socially disenfranchised, and medically underserved residents
who depend on NCCN's clinics for health care. Low education levels
and lack of alternative employment have impeded economic recovery
from the decline in the area's timber and fishing industries. In
addition to economic depression, the area also experiences problems
with violence, substance abuse, and mental illness at levels usually
associated with inner cities. Poverty, mountainous topography, harsh
winter weather, and lack of public transportation pose significant
barriers to health care for area residents. In addition, telephone
and other
communication and connectivity devices are often marginal or unreliable.
These constraints, along with limited staff time and resources,
impede coordination and information-sharing between clinics without
the intermediation of the network. More than one-third of the service
area population depends on member network clinics for primary health
care. These clinics are small, widely dispersed, and often understaffed
and overworked. They depend on NCCN to assist them in information-sharing,
community education, joint purchasing, technical assistance, staff
training, and planning and expanding capacity.
The major purpose of NCCN's proposed project is
to build and strengthen network fiscal and operational capacity
while fostering parallel growth and development in each of the network's
member clinics. Most importantly, the project strives to respond
to the needs and concerns of patients to build confidence and trust
in the community. Specifically, the project will create and implement
an integrated disaster preparedness and emergency response plan;
create a networkwide staff training plan to ensure that staff are
appropriately trained in emergency response and disaster preparedness,
financial management, and administration; and offer continuing education
for health care providers. Other project activities include establishing
an employee training and development center that also will be open
to health and human service providers; extending the availability
of basic telehealth and telemedicine training and operations to
all clinics; and expanding network capacity to provide access to
specialists, workshops, and conferences outside the area that are
not now available. The network will ensure its own sustainability
by updating and expanding its strategic plan and developing alternative
income sources, including fees for services, fiscal sponsorships,
rents, and service contracts, thereby decreasing its dependency
on grants.
Rural Health Design Network
D06RH04192
Kathy Yarbrough
Rural Health Design Network
P.O. Box 1542
San Andreas, California 95249
Phone: (209) 754-4181
Fiscal Year 2003 2004 2005
Grant Award $200,000 $200,000 $200,000
The Rural Health Design Network (RHDN) is a seven-county
integrated network of rural
California hospitals comprising hospital leaders, health care professionals,
trade organization representatives, State agency representatives,
facility design representatives, and rural community leaders. RHDN
acts under governing bylaws to explore a uniform approach to using
compliance with SB 1953 (California's current legislation pertaining
to hospital seismic safety) as a "disruptive innovation"
opportunity to redesign how and where health care is delivered in
rural California. RHDN seeks to work in collaboration with 12 California
rural hospitals, providers, and organizations to establish a health
care delivery model that will (1) provide continued access to appropriate
and affordable primary medical, dental, and behavioral health services,
(2) promote positive changes in communities with respect to economic
and personal health, and (3) establish linkage with specialty and
tertiary centers. Using established criteria to identify the most
at-risk rural facilities in the State, the network implemented membership
standards to include hospitals that have an average daily census
of fewer than 15 patients, are farther than 30 miles or longer than
30 minutes from the nearest acute care facility, and are not meeting
seismic regulations.
Approximately 75 percent, or 117,000 square miles,
of California's landmass is rural. Health care in this vast area
is delivered in an uncoordinated manner by small rural hospitals,
community-based clinics, sole practitioners, and allied health professionals
who provide service to approximately 2.6 million residents. These
rural hospitals and clinics serve a culturally diverse and ignored
population, many of whom are underinsured or uninsured. Inadequate
capitalization, narrow operating margins, and sweeping legislative
changes further challenge rural health care providers. Poor financial
conditions mean that rural hospitals do not have the resources to
stay technologically current or to compete for dwindling professional
resources, such as registered nurses, respiratory therapists, radiology
technologists, pharmacists, and
clinical laboratory scientists.
The RHDN project plan is to establish a framework
for the redesign of rural health delivery. The framework is based
on engaging communities to participate in specific research data,
service inventories, analysis of existing and potential linkages,
needs assessments, and economic impact analysis. Results of the
research will be used to redesign rural community services and their
delivery, including the design of a rural core health facility to
serve as the hub of the new system. In short, the project hopes
to create a stabilized health care continuum that ensures access
to basic health and wellness services throughout rural California.
Health Leadership Network
D06RH00258
Susan Jen
Sutter Lakeside Hospital
3274 Skyline Drive
Kelseyville, California 95451
Phone: (707) 279-8827
Fiscal Year 2003 2004 2005
Grant Award $200,000 $200,000 $200,000
The Health Leadership Network (HLN) is a consortium
of 10 health care service providers in Lake County, California,
dedicated to improving the health of pregnant women and young children.
The network aims to serve as a think tank, infrastructure builder,
quality enhancer, and systems integrator to support programs and
policies that will elevate the well-being of the network's target
population, thereby creating a healthier community overall. Specifically,
the network's goal is to ensure delivery of prenatal care and access
to oral and mental health services for the county's scattered pockets
of people living at or near the poverty level. Through its activities,
the network's members hope to make a positive impact on the essential
development that transpires during a child's earliest years.
HLN members represent both of the local hospitals
and all of the key organizations that interface with children and
pregnant women in the community. They include Sutter Lakeside Hospital,
Adventist Health Redbud Community Hospital, Lake County Department
of Health Services, Children and Families Commission/First Five,
Sutter Lakeside Community Services, Easter Seals, Lake County Office
of Education, Employment Development, and two direct-care providers.
Because resources are limited, these entities already work together
in some way. However, a no formal structure in the community identifies
shared goals, a common vision, or a mission to interlink and coordinate
services, pool resources, and develop consistent, holistic health
policies. The network grant will be used to create such a formalized
network to provide these activities in Lake County. The grant will
support development of a comprehensive strategic plan to identify
service priorities, duplication and gaps in service, outreach and
intervention methodology based on the county needs assessment, shared
services tracking, coordinated marketing activities, and development
of a sustainable infrastructure for countywide health promotion
programs.
Lake County's population of 55,300 enjoys an environment
of natural beauty with a lake view from nearly every perspective.
However, Clear Lake, the picturesque centerpiece of the community,
is also a major transportation barrier, making access to health
services difficult. It is nearly 100 miles around Clear Lake's periphery,
and 45 percent of residents do not have adequate transportation.
In addition, Lake County currently ranks 55 among 58 counties for
the poorest health status in the State of California. The most recent
statistics from the Lake County Children's Report Card indicate
that an estimated 56 percent of the area's children live in families
without self-sufficient income, and an estimated 30 percent live
in poverty. The county recently ranked lowest for late or no prenatal
care. Approximately 50 percent of mothers younger than age 15 receive
no prenatal care in their first trimester; 18 percent of the county's
total births are to teen mothers. More than half the mothers enrolled
in the Family Resource Center Birth to Five programs suffer from
depression, as determined by a standardized depression screen, and
incidents of domestic violence and child abuse and neglect are on
the rise. These factors, coupled with the area's depressed economic
conditions, have led to Lake County being labeled the Appalachia
of the West.
FLORIDA
Healthcare Services Integration Demonstration
Project
D06RH00252
Kelly Johnson
Heartland Rural Health Network
1200 West Avon Boulevard, Suite 109
Avon Park, Florida 33825
Phone: (863) 452-6530
Fiscal Year 2003 2004 2005
Grant Award $199,008 $193,008 $193,008
The Heartland Rural Health Network consists of
more than 25 organizations, including 1 Critical Access Hospital
and 4 other hospitals, all of the county health departments from
the 5-county service area, the Area Health Education Center, federally
qualified community health centers, and representatives from consumers,
local government, and other organizations. The network covers an
area of 4,870 square miles of some of the most rural counties in
Florida-Highlands, Hardee, DeSoto, Polk, and Charlotte; nearly all
of the five counties are Medically Underserved Areas and Health
Professional Shortage Areas. The region depends on a strong agricultural
base and therefore has a significant number of migrant and seasonal
workers. Patient outmigration is rampant. In Hardee County alone,
92 percent of inpatient hospital care is rendered outside the county,
resulting in a $42 million annual loss.
In 1993, the State of Florida passed legislation
authorizing the creation of rural health networks. That legislation
was very specific in delineating the purpose of these networks:
(1) to provide an effective continuum of care for all patients in
the network, (2) to ensure the availability of a comprehensive array
of services, (3) to reduce outmigration and increase the use of
rural health care providers, (4) to enhance access to and efficient
delivery of high-quality health care, (5) to support the economy
and protect the health and safety of rural residents, and (6) to
serve as laboratories to determine the best way to organize rural
health services.
Believing that few, if any, rural health networks
in Florida have come close to meeting the intent of this legislation
and that networks need to reinvent themselves, the Heartland Rural
Health Network Health Care Services Integration Demonstration Project
will use network grant funds to conduct a 3-year pilot study. The
network will become a "laboratory," as suggested by Florida
legislation, and organize into an integrated health care delivery
system, initially in the two most rural counties in the network,
Hardee and DeSoto. The network designed the Health Care Services
Integration Model, which if properly implemented will ensure that
the network effectively meets the legislative intent for which it
was created. Specifically, network leadership and staff will work
side by side with health care providers in resolving delivery issues
common to all rural areas. It will also align network activities
with the needs and interests of its members, thus ensuring sustainability.
The project strives to reduce outmigration, expand services, increase
revenues to local providers, greatly enhance access to care, and
ensure efficient delivery of care. The network's goal is to create
a model so effective that other networks in Florida will want to
replicate it.
Rural Health Network of Monroe County (RHNMC)
D06RH02564
Mark Szurek
P.O. Box 4966
Key West, Florida 33041-4966
Phone: (305) 293-7570
Fiscal Year 2004 2005 2006
Grant Award $200,000 $200,000 $200,000
RHNMC is an established and mature network working
to address its two most challenging strategic goals: 1) the establishment
of a comprehensive and county-wide network for oral health targeted
at the uninsured, and 2) the establishment of an endowment fund
to ensure future operations / services and to directly support a
health insurance task force to create an equitable and affordable
insurance product for all residents. RHNMC has already made significant
strides as a single-county rural health network. RHNMC consists
of 36 agencies and individuals. It includes the county's three hospitals,
three physician-hospital organizations, state and county government
representation, the county health department and health providers,
the faith community, consumers, mental health and substance abuse
treatment facilities, special healthcare providers (i.e. AIDS, woman
and children), three chambers of commerce, and members at large.
RHNMC offers health planning, primary care and oral health services
over a 120 mile area. RHNMC plans to enhance its network development
and complete the final stages of its infrastructure capacity building
in addition to supporting a four part system for county-wide oral
healthcare.
GEORGIA
Turner County Connection Health Network
D06RH00262
Brenda Lee
Turner County Board of Education
330 Gilmore St.
Ashburn, Georgia 31714
Phone: (229) 567-8762
Fiscal Year 2003 2004 2005
Grant Award $196,160 $195,210 $198,099
The Turner County Connection
is a 501(c) (3) grassroots community collaborative consisting of
representatives from safety net providers, government agencies,
civic organizations, ministerial associations, the business community,
consumers, and service organizations in Turner County, Georgia.
Through grant funding, the Turner County Connection supports a variety
of local health, education, and social services projects. The Turner
County Connection Health Network functions as a committee of the
collaborative and comprises all of the more than 20 local and regional
health care providers and key service organizations. Turner County,
Georgia, has no local hospital. Like so many other rural areas,
the county suffers from high rates of poverty and unemployment,
lack of health insurance, and health provider shortages. All these
factors contribute to a lack of access to adequate health care and
social support services for area residents. Because of decades of
ignoring prevention activities and the effect of deleterious decisions
made during childhood and adolescence regarding lifestyle and personal
behavior, many of the county's residents have deteriorated health
status by middle age. Cardiovascular disease, stroke, and diabetes
are all causes of death that can be delayed or prevented through
education and a change in lifestyle choices.
In response to the region's serious health care
access issues, the Turner County Connection Health Network has developed
a three-pronged local health care strategic plan that includes (1)
community health education, screenings, and enrollment, (2) comprehensive
case management services for individuals with special needs and
chronic conditions, and (3) community service coordination and resource
development. With network grant funds, the project will develop
an infrastructure that maintains an integrated health system and
coordinates care for the area's underinsured and uninsured residents.
Specifically, the project will seek to enroll 100 percent of Turner
County school system students and at least 20 percent of adults
in health screening and education classes, workshops, and activities
yearly. In addition, the project will provide access to appropriate
community health support services for 100 percent of the adults
enrolled in chronic -disease case management programs. Other project
activities involve establishing a community volunteer program and
preparing five grant proposals, including a Health Resources and
Services Administration (HRSA) Community Access Program (CAP) grant
proposal. The project also will develop a chronic -disease case
management database capable of long-term tracking of enrolled patients
and will create an accepted set of shared clinical protocols and
a standard enrollment/patient intake process for local comprehensive
interdisciplinary case
Coastal Medical Access Project (CMAP)
D06RH04305
Francis Selgrath
Goodwin Community Health Center, Inc.
PO Box 1357
Brunswick, Georgia 31521-1357
Phone: (912) 554-3559 ext.11
Fiscal Year 2005 2006 2007
Grant Award $180,000 $180,000 $180,000
The Coastal Medical Access Project (CMAP) network
includes a regional health system, health departments, private physicians,
local employers, school systems, a technical school, city and county
governments and the faith community. The mission of CMAP is to generate
improvements in health status and access to care for local residents
through the development of a comprehensive and coordinated system
of care in Camden, Glynn and McIntosh Counties for the under and
uninsured. CMAP has systematically worked to support access expansions
through the formation of horizontally and vertically integrated
systems of care. The goals of CMAP include:
- Create a focus for coordination and
development of cost effective regional chronic disease prevention
and treatment services that are easily accessible for consumers
and providers
- Assure a continuum of services and programs
from pre screening and risk factor reduction through intervention
and rehabilitation,
- Expand access to chronic disease services
so that they are available to all, regardless of insurance status
- Involve the community in the planning, implementation
and evaluation process of CMAP.
In order to reach these goals, CMAP is working
on three objectives; increasing access to pharmaceutical services
with a Medbank Patient Assistance Program; providing chronic disease
case management services and providing access to primary care through
network of free clinics. With Network Development funding, CMAP will
improve the capacity for care by providing administrative support
for increased physician provider and volunteer hours each week. The
Medbank patient assistance program will increase the number of patients
being served clinically with medications as well as the number of
trained volunteers and referring physicians. Training offered to all
CMAP providers will increase quality of care across the network. Technology
implementation under the program will utilize GIS mapping, web based
training calendar and web hosted, norm based health assessment for
CMAP's patient population.
Georgia Healthcare Systems (GHS)
D06RH04307
Herman Thompson
East Georgia Healthcare Center, Inc.
316 North Main Street
Swainsboro, Georgia 30401-3535
Phone: (478) 237-2638
Fiscal Year 2005 2006 2007
Grant Award $180,000 $180,000 $160,000
The Georgia Healthcare Systems (GHS) is a statewide,
horizontal network of 330 funded Community Health Centers created
in 2003. Originally, GHS addressed integration of a practice management
system among each network member in support of risk management activities,
patient support systems and strengthening primary care provider
capacity. This project will take the GHS into its next phase. Funding
will support a regional pilot of four of GHS's rural member health
centers in conjunction with the Network to develop and implement
a collaborative electronic medical record system. The project goals
are to:
- enhance technical and financial support
to 4 member-organizations in the GHS network as a pilot project
to implement and evaluate the use of Electronic Medical Records
(EMR);
- provide state-level technical expertise in
support of collaborating network members for tracking improved
health status among patients in the Eastern region, which indicates
many of the worst health indicators in the state;
- convene opportunities that assist providers
within the piloted project in maximizing access to more comprehensive,
accurate and timely electronic patient information.
The target population of the project is among
the Community Health Center (CHC) patient populations who suffer disproportionately
from chronic diseases. According to the Georgia Healthcare Coverage
Report, 17-21 % of the population of the targeted region age 64 and
younger, do not have any type of health insurance. This is significantly
higher than the state rate of 13% who are without coverage. Glacock
County, which is among the targeted region, has the 2nd highest diabetes
related death rate in the state (76.5 deaths per 100,000) according
to the 2000 Georgia Diabetes Report.
The implementation of a pilot electronic medical
record system will afford testing on a small scale and in an area
where resources remain most scarce and are hardest hit during Medicaid
budget crisis. It will also allow the GHS to learn about and determine
the needs for statewide implementation.
ILLINOIS
Community Health Action Team Technology Network
D06RH00236
M. Elaine Wilcoxen
Graham Hospital Association
210 West Walnut Street
Canton, Illinois 61520
Phone: (309) 647-5240 ext. 2726
Fiscal Year 2003 2004 2005
Grant Award $188,914 $188,914 $186,928
The Community Health Action Team (CHAT), a partnership
between Graham Hospital, the Fulton County Health Department, and
the Fulton-Mason Crisis Service, was formed in 1995 to conduct health
care needs assessments and to address priority health needs in rural
Fulton County, Illinois -population 38,250. Priority health care
issues identified through the assessments were (1) the need for
an improved health care delivery system for the medically indigent,
e.g., access to health information and services, (2) the need to
decrease the incidence of chronic diseases such as heart disease,
cancer, and respiratory disease, and (3) the need to reduce the
incidence of domestic violence. An ongoing needs assessment by CHAT's
steering committee also indicates a lack of service connection between
providers and consumers. Inadequate access to health information
and services, combined with no central location for storage and
dissemination of updated information that can aid providers in referring
a client to appropriate services, results in vulnerable populations
being left alone to navigate a frustrating maze of services. Failure
to provide referrals during the time of expressed need leads to
unresolved health issues that manifest as untreated chronic illnesses,
financial deterioration, and social isolation. Other factors that
serve as barriers to adequate health coverage coordination include
Fulton County's large geographic area (866 square miles), lack of
public transportation, aging population (18.3 percent aged 65 and
older), increasing unemployment rates, lack of health insurance,
high incidence of family violence, and absence of a countywide computer
network.
In response to the need to effectively connect
consumers with health information and services, CHAT formed a technology
committee consisting of five major social service agencies, a hospital,
a public health department, a college, emergency medical services,
a pharmacy, the CHAT coordinator, the regional office of education,
and a computer technology consultant. With network grant monies,
the project will develop a computer network to connect service providers,
create a Web site and a provider intranet service, and utilize Palm
PCs for home visit programs. The project's key components will include
Web site promotion, online service updates, enrollment of member
organizations, long-term sustainability planning, assessment of
unmet needs, and seamless access to services for consumers-especially
vulnerable citizens in Fulton County.
INDIANA
Affiliated Service Providers of Indiana, Inc.
D06RH00230
Kathy Lynn Cook
Affiliated Service Providers of Indiana, Inc.
d.b.a. ASPIN
1015 Michigan Avenue
Logansport, Indiana 46947
Phone: (574) 722-5151
Fiscal Year 2003 2004 2005
Grant Award $199,680 $199,698 $199,694
ASPIN is a 6-member network of providers in 32
rural Indiana counties, with a total population of approximately
1 million persons. The network aims to sustain and enhance mental
health services for residents and providers through training and
cost-effective cooperative administrative measures. A serious barrier
to accessing mental health care services in the area is the distance
residents must travel to a midsized city to see mental health providers.
On average, rural residents are separated from care by up to a 45-minute
drive. A lack of public transportation leaves rural residents isolated
from centrally located health care providers who often serve multiple
counties. Three of the counties are designated Mental Health Professional
Shortage areas. An additional barrier for many rural residents is
the stigma of receiving care for mental health needs. Anonymity
and privacy are lost when a person passing by a rural community
mental health center can recognize every care or truck in the parking
lot. Another barrier is the high turnover rate of caseworkers and
other midlevel mental health professionals in rural centers. Rural
isolation interferes with services, patients find it difficult to
navigate the maze of social services, and case managers face language
barriers and cultural differences -the Hispanic population has increased
by 202 percent in the past decade.
The network has developed a program to respond
to the mental health needs of uninsured and indigent residents and
to improve the lot of mental health care providers in the rural
communities of Indiana. The focus of the program is to provide education
and training on how to diagnose behavioral health disorders, understand
the treatment options available, and use cost-effective cooperative
administrative measures. In particular, the program will explore
the possibility of voice, video, and data systems to enhance education
and training opportunities for rural mental health workers and will
aim for a 10-percent reduction in staff turnover. The first year
of the program will include evaluation and development of training
needs, broadening strategic plans for the network, and setting initial
plans for group purchasing and combined administrative needs. The
second and third years will focus on implementing and evaluating
the program initiatives. One goal is to increase the number of case
managers by 20 percent over the 3-year period.
IOWA
AgriSafe Network
D06RH04306
Natalie Roy
AgriSafe Network
1200 1st Ave E
Spencer, IA 51301-4342
Phone: (712) 264-6579
Fiscal Year 2005 2006 2007
Grant Award $179,592 $179,404 $179,198
The AgriSafe Network is a 501 (c) 3 organization representing 23
rurally-based hospitals, health clinics, and county health departments
that provide preventive occupational health services to Iowa farmers.
These organizations operate AgriSafe clinics staffed by nurses who
have received specialized training in the field of agricultural
occupational health. AgriSafe clinic nurses provide early detection
and prevention of agriculturally-related health and safety problems
through clinical screenings, environmental assessments, appropriate
referrals and educational programs.
The objective of this project is to meet the following
goals outlined in the Network's strategic plan:
1) Increase the network's financial capacity to serve AgriSafe providers.
2) Ensure that educational programs meet the needs of the health
and safety professionals.
3) Increase the number of farmers served by AgriSafe providers.
4) Promote of AgriSafe network and clinic services.
5) Increase clinic membership to the AgriSafe network.
6) Provide quality assurance for AgriSafe providers.
In addition to the 23 member AgriSafe clinics,
the Network will collaborate with State Universities, mental health
organizations, migrant health providers, farm commodity
associations and other public health entities to accomplish these
goals. The anticipated outcome of reaching these goals is increased
access to affordable and effective AgriSafe services for farmers
in Iowa. The Network's sustainability plan is based on diverse revenue
from corporate sponsors, foundations, health insurance companies
and increase utilization of services.
Patient Safety Health Care Network of North
Iowa (PSHCN)
D06RH00283
Denise Dow
Mercy Medical Center - North Iowa
1000 4th Street SW
Mason City, Iowa 50401
Phone: (641) 422-5429
Fiscal Year 2003 2004 2005
Grant Award $199,943 $199,467 $199,913
The Patient Safety Health Care Network of North
Iowa (PSHCN) is a coalition of nine small primary care hospitals
and a larger secondary referral center. The network serves 14 sparsely
populated counties in north-central Iowa. These counties have a
very high percentage of elderly residents (19 percent), a depressed
farm and agricultural business economy, and low wages. All 14 counties
are Health Professional Shortage Areas and 7 also are Medically
Underserved Areas. The network seeks to develop, implement, and
evaluate an integrated patient safety plan that will significantly
improve the quality of patient care and reduce medical errors in
network hospitals, clinics, and pharmacies. Many factors make patient
safety a high priority for network members and necessitate an integrated,
system-wide approach to patient safety. These factors include the
area's high percentage of elderly residents at risk for experiencing
medication errors, especially adverse drug reactions, who have limited
transportation options and inadequate knowledge of their medications;
the language barrier in the small but growing population of Spanish-speaking
residents; a shortage of nurses, surgeons, and pharmacists; budget
deficits that lead to staff cuts, leaving remaining network staff
with too many responsibilities; and the relatively low occurrence
of serious medical errors, making them especially difficult to track
in small health care facilities.
During the past 5 years, all network hospitals
and clinics have monitored some types of medical errors in their
facilities. These monitoring efforts have improved patient safety
in scattered areas and raised awareness of patient safety among
providers. However, because of a lack of standardization, these
improvements have not adequately or substantially increased patient
safety across the network. PSHCN will develop standardized documenting,
tracking, and data analysis systems that will generate accurate,
actionable information about sources and types of medical errors;
establish common benchmark goals; implement and evaluate best clinical
practice guidelines and protocols to improve major patient safety
processes and reduce medical errors; and prepare a well-researched
plan to acquire and implement targeted, cost-effective, and appropriate
information technologies to support safe patient care. Through these
efforts, PSHCN hopes to lessen pain and suffering, save lives, minimize
lost productivity and household income, improve confidence and satisfaction
in the rural health care system, and reduce medical costs over time.
Tri-Co Health Network
D06RH02563
Jean Drey
Sioux Central Community School
P.O. Box 98
Albert City, Iowa 50510
Phone: (712) 843-5416
Fiscal Year 2004 2005 2007
Grant Award $199,723 $199,420 $199,305
The Tri-Co Health Network is comprised of 22 members,
including local hospitals, public health, mental health, human service
and education agencies. The geographic area served consists of thirteen
small communities, all under a population of 1,900, located in northwest
Iowa in the three rural counties of Buena Vista, Clay and Pocahontas.
The health care network builds on the concept that school districts
are the connecting point between children and local community health
care and human service providers. The vision of the Tri-Co Health
Network is to develop and implement a collaborative streamlined
network providing all children, ages three through eighteen and
their families, with access to balanced health care. The purpose
is to expand and formalize current efforts to increase access to
health care for youth residing in the network area. The mission
is to weave health care supports for children and families into
an integrated, comprehensive system of health, human service and
education systems. The design for the TriCo Health Network is simple,
yet the implementation of this project is unique. All parents will
complete an annual health screening during school registration each
fall. The form gathers basic data about access to care, recent services,
and health promotion items. The purpose of gathering this data is
for the Tri-Co Health Network to fully implement a prevention-focused,
school based identification and referral system through which every
child in the thirteen target communities are assessed regarding
the annual status of their health care. This involves analyzing
the way families currently access health care services, bringing
health care and service providers together to examine the systems
and to recommend ways to streamline service delivery to children
and their families.
The data collected will be used for purposes
as defined by the following four components. Component #1 will focus
on students in need of service who will be prioritized for care
and assisted in finding medical and dental homes. Network staff
will make referrals, assist with appointments, and provide case
management. In component #2, health promotion data will be used
to plan and implement family and community education sessions and
to adapt existing K-12 curriculum to help students take responsibility
for their health care. Through component #3 efforts, all parents
will receive a report card telling them whether or not their child
has attained the recommended health standards and benchmarks for
their age group. In addition, the community will receive regular
information on the health care status of all children in the community.
Component #4 is the heart and soul of the project. Project data
will be regularly shared with physicians, dentists, and other health
care providers for use in community planning efforts. Not only will
the data collected in this project help connect students to services;
the data will be used to support a community planning process.
KANSAS
Northwest Kansas Health Alliance
D06RH00218
Jodi Schmidt
Hays Medical Center
2220 Canterbury Drive
Hays, Kansas 67601
Phone: (785) 623-2301
Fiscal Year 2003 2004 2005
Grant Award $179,849 $173,227 $151,575
The Northwest Kansas Health Alliance, founded
in 1991 in response to the Essential Access Community Hospital/Rural
Primary Care Hospital (EACH/RPCH) Program, serves 15 counties and
is composed of 14 Critical Access Hospitals and Hays Medical Center,
the support hospital. All of the partner members are located in
northwest Kansas except for one, which is in southcentral Nebraska.
As small rural hospitals face more and more financial challenges,
addressing quality-of-care issues is a priority for these hospitals,
regulators, and consumers. A major concern in rural communities
is access to high-quality patient care services, especially in light
of the closure of nearly 200 rural hospitals over the past decade.
After 11 years of successful operation, the Northwest Kansas Health
Alliance has the capability and commitment to develop a performance
improvement (quality of care) model that is responsive to the needs
of its member hospitals and the communities they serve. Using a
network approach, the alliance will develop a sustainable, replicable
model by which rural hospitals can create and sustain strong performance
improvement programs. The alliance will use the network grant to
offer participating hospitals the ability to improve their delivery
of health care services by restructuring and stabilizing their performance
improvement programs to meet the challenges of today's demanding
health care environment.
While young people migrate from small towns
across America to the large cities in search of employment, middle-aged
and elderly residents tend to stay put. This situation holds true
in northwestern Kansas where between 1990 and 2000, each of the
15 counties in the project service area lost population, except
for 1, which increased by 6 people. During that time, the average
net population loss in northwest Kansas was 6.33 percent. As the
region's population decreases, the average age of residents increases.
Concurrently, the number of employed residents decreases, thus reducing
the area's tax base. As a result, even Critical Access Hospitals
in northwest Kansas are experiencing financial difficulties. In
this environment, it is a challenge for rural hospitals to remain
open. Working as a partnership to leverage resources, expertise,
and commitment, the Northwest Kansas Health Alliance will develop
tools, techniques, and practices to support improvement programs
at individual rural hospitals. The project will address the area's
specific top-10 trouble areas as identified by the alliance that
originally placed hospitals in the network at risk. In addition,
the alliance will share the lessons learned from this project with
other rural communities and health care providers nationwide so
that others can benefit from these efforts.
MICHIGAN
Medical Care Access Coalition (MCAC)
D06RH05060
Stacie Kucera
Medical Care Access Coalition, Inc.
1414 W Fair Ave STE 26
Marquette, Michigan 49855-2675
Phone: (906) 226-4400
Fiscal Year 2005 2006 2007
Grant Award $180,000 $180,000 $180,000
The Upper Peninsula (UP) of Michigan is a low income rural region
sitting just below Lake Superior. With a population of over 300,000
persons and largely designated as underserved and severely underserved,
the UP lacks medical services in both direct care and medical infrastructure.
The result is that the uninsured, especially the chronically ill,
must navigate transportation issues, lack of uniform charity services,
lack of government services, and a lack of organization among volunteer
services.
Upper Peninsula Health Care Access Consortium
(UPHAC) is a network of access agency coalitions. Each access agency's
mission is to increase access to health care for the uninsured and
underinsured residents of the counties they serve. UPHAC's overall
vision is that all residents of Michigan's Upper Peninsula (UP)
have access to quality health care with dignity.
Upper Peninsula primary care and specialist physicians
who currently volunteer their time to care for low-income/Medicaid
ineligible persons often experience fragmented intake/eligibility
processes, lack of administrative support, absence of equitable
distribution of uninsured persons, lack of available ancillary services,
lack of appreciation/recognition, and lack of medications to complete
their care for the uninsured. The UPHAC will work to meet needs
of these physicians. UPHAC's multi-county direct care program approach
consists of leveraging and expanding healthcare for the low-income
uninsured through the coordination of donated and volunteer medical
services in a UP community. The project will foster regional coordination
that is necessary for the volunteer medical programs that provide
effective and organized medical care to every uninsured/Medicaid-Medicare
ineligible person under 200% of the Federal Poverty Level. Overall,
it will establish, expand and integrate the volunteer medical programs
in the Upper Peninsula of Michigan to increase access to quality
health care for residents of the UP.
Upper Peninsula Health Care Network (UPHCN)
D06RH04342
Gerald A. Messana
Upper Peninsula Health Care Network, Inc.
228 West Washington Street, Suite #2
Marquette, Michigan 49855-4823
Phone: (906) 225-3146
Fiscal Year 2005 2006 2007
Grant Award $179,934 $179,991 $179,977
Managing Prescribing Cost and Quality seeks to
strengthen the viability of health care entities by addressing one
of the factors influencing the financial challenges of health care
organizations - the rising cost of pharmaceuticals. The issue of
drug expenditures was chosen because pharmaceuticals are currently
the most influential driver of health care inflation. For hospitals,
pharmacy services represent 5.2% of direct hospital expenses - the
third largest component of hospital costs. After years of double-digit
increases, drug costs were projected to increase in 2003 by 10-12%
for inpatient settings and 14-16% for outpatient settings.
The providers to be served by this project include
16 independent health care organizations that are members of the
Upper Peninsula Health Care Network (UPHCN). This Network includes
eight Critical Access Hospitals, five rural hospitals, a regional
referral center, a behavioral health organization and a tribal health
center. The viability of the partners will ultimately serve 317,616
residents in Michigan's Upper Peninsula (UP) through access and
quality of care. On an outpatient basis, the region's only Medicaid
managed care plan is has the.
This project joins the UPHCN with the Upper Peninsula
Health Plan (Plan), a state-designated qualified health plan serving
the Medicaid population of Michigan's Upper Peninsula, which had
the highest per member per month pharmaceutical costs in Michigan.
The union will promote rational, clinically appropriate, safe and
cost-effective pharmaceutical care to residents of Michigan's Upper
Peninsula.
Process objectives are to develop and implement
a region-wide cooperative pharmacy formulary management system and
to implement evidence-based clinical practice guidelines that include
pharmaceutical recommendations for a target of 10 disease states
associated with major drug classes. Outcome objectives seek to increase
the percent of Network drug expenditures on negotiated contract
from 58% to 75%, and reduce the Plan's per member per month pharmaceutical
costs to 3.7% below the state average (currently 42% above).
Northwest Upper Peninsula EMS Network
D06RH 04344
Gary Wadaga
Baraga County Memorial Hospital
P.O. Box 1
Baraga, Michigan 49908
Phone: (906) 353-6196
Fiscal Year 2005 2006 2007
Grant Award $144,900 $152,145 $159,752
The purpose of the Northwest Upper Peninsula EMS Network (Network)
is to promote optimal care of injured patients in the Northwest
Upper Peninsula region of Michigan, by ensuring the availability
of high quality, accessible, and affordable emergency medical services.
The northwest region of Michigan's Upper Peninsula is a rural, sparsely
populated region. The counties targeted by this grant are served
by two federally designated Critical Access Hospitals (CAH) and
five private ambulance services. As the economy has reduced the
county's ability to subsidize local ambulance services, as insurers
have reduced payments, and as fewer people are willing to volunteer,
all rural ambulance services are faced with finding a way of doing
more with less. In particular, both Counties share problems in the
recruitment, retention, and training of their EMS volunteers and
in the maintenance of equipment. At the same time, numerous statewide
initiatives in Bioterrorism response, EMS Medical Control responsibilities,
homeland security issues, and new protocols for Michigan's trauma
care system all combine to overwhelm local EMS resources that are
scarce and volunteer-based to begin with. As a result of these factors,
two of the region's five emergency medical services are expected
to close within the next two years.
The Network's goals for year one of the project
include:
1. Organizing the Regional EMS Network.
2. Providing EMS training programs for EMS staff and volunteers.
3. Conducting a coordinated volunteer recruitment / marketing campaign
to increase EMS volunteers in their local communities.
4. Assessing the operational and financial viability of all EMS
services in the region.
5. Assessing regional improvements and enhancements to local EMS
medical control.
6. Conducting an EMS strategic planning process.
7. Seeking Federal and State funding support for implementation
activities identified in the regional EMS strategic plan.
In years two and three of the project, the Network
will:
1. Implement the goals and activities detailed in the EMS strategic
plan;
2. Continue to assess the region's EMS needs, issues, and the results
of strategic initiatives;
3. Assess the inclusion of additional counties and organizations
as consistent with the regional EMS the strategic plan.
Grand Traverse Regional Health Care Coalition
D06RH05052
Arlene Brennan
Grand Traverse Regional Health Care Coalition
3155 Logan Valley Rd.
Traverse City, Michigan 49684
Phone: (231) 935-0799
Fiscal Year 2005 2006 2007
Grant Award $179,720 $179,720 $179,720
The Grand Traverse Regional Health Care Coalition
(GTRHCC) will build on an existing volunteer-based health services
program to increase both the number of low income, uninsured individuals
served and the efficiency of the services provided. The service
area includes three counties in rural, northern Michigan (Benzie,
Grand Traverse and Leelanau Counties). Membership in the GTRHCC
includes representatives from an existing community-based clinic,
the public health departments, a regional hospital system, a dental
clinic, the chamber of commerce, faith-based organizations, a medical
society, a family practice residency, a state family service agency
and a regional telehealth network. Members of the network share
a strong collaborative history and demonstrate a commitment and
vision to improve the currently fragmented health care system for
the low-income uninsured residents of rural, northern Michigan.
The GTRHCC was created in 2003 to develop and implement a system
of care to serve the low-income uninsured persons who live in Grand
Traverse, Leelanau and Benzie Counties. Within these three counties,
slightly over 10% or 10,279 of the 98,146 residents under 65 years
of age do not have health insurance. Additionally, 5,895 persons
under 65 years of age are living below the Federal Poverty level
and nearly 30% of these persons have no health insurance.
During the course of this project, GTRHCC will
formalize the network by implementing a strategic and financial
sustainability plan, implement a system of care to provide the low-income
uninsured population with access to quality health care, develop
a dental network, expand the pharmacy program and operate an effective
and efficient network for the uninsured that will include systems
of evaluation and monitoring of both end users (providers and network
partners).
MINNESOTA
Northern Minnesota Network
D06RH04346
Jackie Ann Moen
Northern Minnesota Network
908 Rum River Drive
P.O. Box 328
Cambridge, MN 55008-0328
Phone: (763) 444-8283
Fiscal Year 2005 2006 2007
Grant Award $180,000 $180,000 $180,000
The Northern Minnesota Network consists of three
members that operate 20 sites providing primary health care services
to the uninsured, underinsured, migrant and seasonal farm workers
in rural areas of Minnesota and eastern North Dakota. The centers
are often the only primary care providers in the area. The health
centers in the Network provide care to approximately 25,800 people
annually with over 102,200 patient encounters. The combined service
delivery areas of the Network centers encompass more than 14,000
square miles.
Community and Migrant Health Centers are widely
separated and often isolated by geographic features and winter weather
conditions. The geographical distance between health care centers
in the Northern Minnesota Network and the isolation of rural areas
present two needs regarding access to quality health care. One is
timely access to a patient's medical record. The second problem
is tracking and managing medical information with a patient population
that is transitory and widely scattered across the state. In order
to improve access to and delivery of health care to people in rural,
sparsely populated areas, the Network will implement a "medical
informatics" approach. This approach integrates medical records
and information technology expertise in the context of quality assurance
to better manage patient information, tracking, and ultimately,
care.
The Network's strategy to accomplish these goals
is to establish a single network-wide Management Information System
(MIS). The MIS will include shared network hardware and software
as well as discrete partner hardware and software. The process of
moving to the network-wide system involves implementing a unified
practice management system, and standardizing all partner clinical
sites' local area networks (LANs) in order to develop a wide area
network (WAN). The significant outcomes anticipated from this project
include an increased capacity for the collaborators to manage and
track medical information, enhance the continuum of care, share
staff expertise across network members, and achieve economies of
scale and cost efficiencies with information management systems
integration and centralized purchasing.
Central Minnesota Health Information Network
D06RH02553
Douglas Reker
Central Minnesota Health Information Network
1424 S. Broadway, Suite 271
Alexandria, Minnesota 56308
Phone: (320) 634-3704
Fiscal Year 2003 2004 2005
Grant Award $200,000 $200,000 $200,000
The Central Minnesota Health Information Network
(CMHIN) is a 7-county consortium of rural health care providers
composed of 10 hospitals and 3 medical centers. CMHIN was formed
to respond to the tenuous survival of rural health care facilities
in central and west-central Minnesota. Over the past 20 years, more
than 30 rural hospitals have closed in the State of Minnesota. Currently,
20 percent of rural Minnesota hospitals are financially troubled
and face increased emphasis on cost containment because of a general
decline in vital resources. Specifically, the lack of access to
information technology causes expensive inefficiencies, professional
staff shortages, and measurable declines in reimbursements. In addition
to the decline in resources, local rural facilities are finding
it difficult to respond to the complex health care needs of an aging
population. (An average 19 percent of the seven-county population
is older than age 64 with three counties ranging from 22 to 26 percent.)
At the same time, local rural facilities are struggling to meet
the demands of a changing health care environment that requires
more sophisticated services, cost accountability, and expanded documentation
of health outcomes. The Minnesota Hospital Healthcare Partnership
reports that 5 of the hospitals in the network with 50 beds or fewer
average a 2.9 percent bottom line, leaving them with insufficient
funds to invest in electronic technology or to attract the professional
workforce needed to serve their local communities.
Geographic conditions and the remote locations
of the seven counties mean that many communities in the target service
area do not have access to primary health services. All seven counties
are Medically Underserved Areas (MUAs), and three communities in
the region are Health Professional Shortage Areas (HPSAs). Distance
issues also make connectivity a financial impossibility for most
small providers in the network. CMHIN is developing a strategic
plan for the formation of a health information network that will
(1) implement connectivity between providers, (2) bring contemporary
electronic information technology exchange to the rural environment,
(3) support providers in the design of systems that comply with
security and information privacy requirements, and (4) provide a
regional intranet for data-sharing and online access to information
resources for health care providers and students. Using network
grant funds, CMHIN will enable providers to work collaboratively
and efficiently with each other and help them overcome the barriers
of limited financial, technical, and information resources that
will ultimately enhance the continued viability of central and west-central
Minnesota health care providers.
Itasca County Health Network
D06RH00278
Lois McCarron
Itasca County Health and Human Services
1209 SE 2nd Avenue
Grand Rapids, Minnesota 55744
Phone: (763) 784-9773
Fiscal Year 2003 2004 2005
Grant Award $198,965 $197,841 $197,327
The Itasca County Health Network involves key
participants from a broader network of health care providers who
participate in the Itasca County Medical Care (IMCare) program.
The IMCare program has been operating in Minnesota for 20 years
and has established extensive collaboration and cooperation among
all the health care providers in Itasca County. However, communication
and coordination among network service providers are currently limited
to physical and facsimile transfer of information. The network grant
will enable the Itasca County Health Network to cooperatively design
an electronic information system to support and expand provider
communication protocols, consumer information and education, and
an enhanced continuous quality improvement system. Electronic transmission
of information will increase the efficiency and viability of health
providers. The network also seeks to increase the use of telehealth
technologies for electronic transmission of client and system information.
This improvement is especially important in a county that has only
11.3 physicians per 10,000 residents.
Itasca County, located
in the central part of northern Minnesota, has a population of 43,992
and covers 2,665.06 square miles. Of 21 communities in the county,
only 5 have a population greater than 900 residents. The area's
median annual family income is $6,000 below the State average, and
the county frequently experiences the highest unemployment rate
in northeastern Minnesota.
The Itasca County Health Network members
include the newly merged Itasca Medical Center and Grand Rapids
Clinic, Northern Itasca Health Care Center, Northland Counseling
Center, a dentist, a pharmacist, and the Itasca County Health and
Human Services Department. A design team, with participants from
each network member, will develop the information system, which
can then be expanded for use among all IMCare program providers
and all health care consumers. The first phase of development will
target families and children; the second phase will target persons
with chronic and mental illness; and the third phase will target
the elderly. The project also will produce a Web site to provide
health information, education, and resources for consumers and providers.
MISSISSIPPI
G.A. Carmichael Family Health Care Clinic
D06RH00277
John Bierma
G.A. Carmichael Family Health Care Clinic
1668 West Peace Street
P.O. Box 588
Canton, Mississippi 39046
Phone: (662) 347-0209
Fiscal Year 2003 2004 2005
Grant Award $200,000 $200,000 $200,000
The Greater Delta Health and Human Services Network
(GDHHSN) is a collaborative of more than 40 health, education, and
social service provider organizations involved in the development
and implementation of an integrated health and social services support
delivery system in a 10county area of the Mississippi River Delta.
In support of GDHHSN efforts, the G.A. Carmichael Family Health
Care Clinic, a 330-bed federally funded health center, together
with the Delta Area Health Education Center, Delta State University,
and Delta Health Ventures, is spearheading an initiative to develop
and implement a coordinated case management and outreach system
among network members. The initiative will enhance patient and client
access to quality primary health care, human support services, and
follow-up by linking network members electronically.
High poverty levels, low educational status, low
accessibility to health care, and a large African American population
characterize the Mississippi River Delta. Health outcome indicators
in the area reveal infant mortality and chronic disease rates that
far exceed those in the rest of the State and the Nation. Recently,
Mississippi earned the dubious distinction of having the most obese
population in the United States. Statistically, the Mississippi
River Delta region is the poorest in the Nation.
Throughout the 10-county region, the project strives
to develop a coordinated case management protocol for patient/client
assessment, referral, and follow-up; provide training for using
the system; identify and train 20 community volunteers as lay community
outreach workers to facilitate the case manager's service plan;
connect network providers electronically using a wide area network
(WAN) to enhance communications and the sharing of information;
and develop a video conferencing/distance learning network for staff
training. The project also will deliver a consumer-based education
and training service and provide orientation and training to member
organizations' staff regarding HIPAA rules and regulations and their
implications for electronic transfer of information. Project stakeholders
believe these goals and activities correlate with the purpose of
the integrated rural health network, which is "to foster collaboration
and integration of functions among network entities to strengthen
the rural health care system.
MISSOURI
Mercer Putnam Sullivan Rural Network Consortium
D06RH00281
Martha Gragg
Sullivan County Memorial Hospital
630 West Third Street
Milan, Missouri 63556
Phone: (660) 265-4212
Fiscal Year 2003 2004 2005
Grant Award $199,437 $203,455 $200,216
The Mercer Putnam Sullivan Rural Network Consortium
(MPSRNC) seeks to establish a rural health network in Mercer, Putnam,
and Sullivan Counties in Missouri. The consortium's primary goal
is a vertically integrated health care system in the three-county
area that enhances coordination and continuity of care, improves
access to quality health services for the underserved population,
and ultimately provides better health status to residents. The consortium
comprises nine nonprofit health care and social service agencies
located in rural north-central Missouri.
All three counties in the target service area
are designated geographic and low -income Health Professional Shortage
Areas. According to the 2000 census, population density in Mercer,
Putnam, and Sullivan Counties is 8.3, 10.1, and 11.1 residents per
square mile, respectively, compared with the overall State density
of 81.2 persons per square mile. Approximately 20.5 percent of the
population in the three-county area is 65 years of age and older
compared with the State level of 13.5 percent. Sullivan County has
a very high Hispanic population compared with the State (8.8 percent
versus 2.1 percent). The poverty level in all three counties is
higher than the State average. The two hospitals serving these three
counties, Sullivan County Memorial Hospital and Putnam County Memorial
Hospital, are Critical Access Hospitals. Mercer County does not
have a hospital. Additional barriers to care include prescription
medicine costs for the elderly, a language barrier in the Hispanic
population, lack of transportation, lack of reimbursement, travel
times, and lack of communication among health care providers due
to a lack of linkage.
MPSRNC will develop information systems
to support patients and clinicians in decisionmaking, analyze practices,
and explore opportunities for improvement. The consortium also will
develop and establish evidence-based patient education services
and care management services to provide coordination among and information
support to health care providers and agencies. Other specific activities
include developing nursing care assessment and patient education
tools; initiating accessibility to software at local hospitals,
clinics, health departments, and the Latino Center to identify sources
of free pharmaceuticals; developing and providing bilingual (English-Spanish)
patient instruction during care services; and providing education
and training for clinicians who care for the Hispanic population.
Lastly, the consortium will be open for enlargement and will continuously
seek new partners for health care improvement in the tri county
area.
MONTANA
Montana Health Research and Education Foundation
D06RH05059
Kipman Smith
Montana Health Research and Education
PO Box 5119
Helena, MT 59604-5119
Phone: (406) 442-8802
Fiscal Year 2005 2006 2007
Grant Award $178,570 $178,545 $179,840
The grant will be used to support extensions of
the Montana Rural Healthcare Performance Improvement Network (PIN)
activities in Montana's rural hospitals. Specifically, grant funding
will be used to address expansion of rural-relevant, context-appropriate
clinical peer review studies and implementation of a "modified"
Balanced Scorecard management system in low-volume, frontier hospitals.
Since February 2001, MHREF and Montana's Critical
Access Hospitals (CAH) have been working together through a voluntary
network to ensure Montana's CAHs have the ability to meet Medicare
Conditions of Participation related to quality assurance/improvement.
During the nearly four year history of the Network, membership has
grown from the original 14 members to the current 39.
Given the rapid growth in membership, the success
of initial activities and mounting pressures from national quality
initiatives, the Network began a strategic planning process in December
2002. This planning effort resulted in adoption of a three-year
strategic plan and a new governance structure to allow PIN members
to move forward with an aggressive work-plan. Several PIN activities
focus on Healthy People 2010 goals and objectives. Planned PIN programs
are specifically designed to address increased national attention
on quality of care and patient safety issues while recognizing that
many of these initiatives need to be modified if they are to be
relevant and applicable to low-volume, rural providers. The purpose
of this grant is to assist the PIN in moving these plans forward
into reality.
Nationally, a "Framework for Rural Quality"
has been proposed by the Roundhouse Group. The Network works to
accomplish two of the Framework's agenda items - developing relevant
measures for quality and performance in the rural/low volume health
care environment and developing quality/performance improvement
programs. Montana is an excellent laboratory for demonstrating these
agenda items.
NEVADA
Nevada Public Health Foundation, Inc.
D06RH00219
Rota Rosaschi
Nevada Public Health Foundation, Inc.
305 N Carson St, Suite 200
Carson City, Nevada 89701
Phone: (775) 884-0392
Fiscal Year 2003 2004 2005
Grant Award $200,000 $200,000 $200,000
The Carson City Network for Health was established
in 2002 with the goal of procedurally linking and integrating the
health services in Carson City, Nevada. Although network members
represent a wide variety of health service providers and have been
working together for years, to date their services have been fragmented.
Even among agencies providing similar or complementary services,
lack of coordination can lead to duplication of services. The inefficiencies
created by this lack of linkage result in barriers to complete service,
a health system that is difficult to navigate, and hardships for
clients and providers alike. This project strives to provide collaborative
relationships among all health organizations to increase efficiency,
cost-effectiveness, and quality of care for clients in Carson City.
Members of the network include the Nevada Public Health Foundation,
the Consolidated Municipality of Carson City, the Carson City Mental
Health Coalition, Carson-Tahoe Hospital, Nevada Health Centers,
Inc., HealthSmart, and the Nevada State Health Division Bureau of
Community Health.
Carson City, the capital of Nevada, is located
in northwestern Nevada at the foot of the Sierra Mountains. In terms
of area, the Consolidated Municipality of Carson City (both a city
and a county) is Nevada's smallest county, with 146 square miles.
But the growing population- 52,359 in 2000, up 23 percent from 1999-makes
Carson City the third largest county and the largest rural county
in the State. Carson City's population density of 346 residents
per square mile is 2 times and 5 times greater than Clark and Washoe
Counties, respectively, the only 2 counties in Nevada classified
as urban. Roughly 10 percent of Carson City residents and 13.7 percent
of its children live in poverty; 17.6 percent are uninsured. The
growing population puts a strain on government services in this
uniquely "urban" rural area because revenues have not
kept pace with population growth. In addition, the city has enough
water to support a population of only 80,000.
To allay some of the burden on the Carson
City government, the Carson City Network for Health strives to achieve
unity of health care services. The project will create two products
to improve health care delivery to all Carson City residents. The
first product is customer-oriented, no wrong-door entry and referral
procedures that simplify client navigation of Carson City health
services, improve coordination among agencies, and improve access
to services, especially for the area's underserved residents. The
no-wrong-door system will allow clients to obtain all the services
they need in an efficient, cost-effective manner, no matter where
they enter the system. The second product is a strategic plan for
continuous maintenance and improvement of the network. The strategic
plan will provide Carson City with a systematic approach to evaluate
future improvements to the health services system and an assessment
tool to evaluate Carson City's capability to create a regional health
district. The project also plans to provide a needs assessment and
a blueprint for developing a public health department for Carson
City and its vicinity.
Nevada Rural Hospital Partners (NRHP)
D06RH00275
Robin Keith
Battle Mountain General Hospital
535 South Humboldt St.
Battle Mountain, Nevada 89820
Phone: (775) 827-4770
Fiscal Year 2003 2004 2005
Grant Award $199,705 $192,139 $180,629
The Nevada Rural Hospital Partners (NRHP) is a
consortium of all 11 of Nevada's small, rural, not-for-profit hospitals
serving 13 counties over a vast geographic area of 58,000 square
miles. The target service population is 200,000 people, with a density
of approximately 3.4 persons per square mile. Distance, isolation,
and low population density create challenges to Nevada's rural health
care delivery system; the rural hospitals in the network are the
only hospitals serving the target service area. Ten of NRHP's 11
member hospitals will participate in the NRHP Shared Information
Technology Project to address the basic "dis -integration"
of management information systems, a technologic issue common to
small rural hospitals. Management information systems often are
cobbled together from disparate components because the facility
lacks the necessary financial resources to buy a fully integrated
system or because the fully integrated system does not serve departmental
needs. The resulting management information systems are inefficient
and lead to an increased risk of error in patient information, a
reduction in staff productivity because a tremendous number of staff
hours are dedicated to inputting patient information by hand, billing
errors and increased claims rejections, and a squandering of resources
that could be spent on clinical rather than administrative issues.
The NRHP Shared Information Technology Project
builds on network successes using shared database technology and
internal, hospital-specific solutions. Upon completion, the project
expects that patient identifier and billing information in at least
3 departments in the 10 participating network hospitals will be
automatically posted to billing software, greatly increasing productivity
and decreasing cost. Using an existing virtual private network and
an existing wide area network (WAN), the project will provide access
to centralized, shared database information. The WAN enhances the
network's ability to increase focus on delivery of health services
in two ways. First, it brings greater technologic and administrative
integration to the frontier and rural hospital system. Second, coupled
with NRHP members' commitment to the strength of group effort, it
opens the door to shared information system applications that enable
individual member hospitals to improve the integration of internal
management information systems and to share more complex applications.
Existing interactive compressed video technology will be used to
communicate and coordinate the project.
NEW HAMPSHIRE
North Country Health Consortium (NCHC)
D06RH02571
Martha McLeod
646 Union Street, Suite 400
Littleton, NH 03561
Phone: (603) 444-4461
Fiscal Year 2004 2005 2006
Grant Award $198,863 $195,706 $193,275
The North Country Health Consortium (NCHC) was
developed in 1997 and is a vertically integrated health and human
services network located in Northern New Hampshire. The network
is composed of four Critical Access hospitals, one rural hospital,
two community health centers, a region-wide network of community
mental health centers, two home health agencies and the Community
Action Program that serves the area. NCHC members are safety net
providers serving patients that display all the characteristics
of an under-served population including morbidity and mortality
considerably higher than the state average and household income
30 percent below the state average. In addition, a substantial portion
of the population has no access to health care reimbursement. Thirty-seven
percent of the NCHC service area lies within the boundaries of the
White Mountains National Forest. The rural, mountainous terrain
creates substantial barriers to the services enjoyed by the residents
of the rest of the state. The Consortium has been successful in
developing initiatives ranging from the development of the North
Country Health Information Network to programs focusing on community
care coordination and public safety. In accomplishing these activities,
NCHC members have displayed a willingness to adopt a regional, collaborative
approach to reducing barriers to access while attempting to keep
their individual organizations financially
viable.
The Goal of the NCHC is to build on the
success already achieved by the vertically integrated NCHC. The
initiative will strengthen the health care delivery system available
to North Country residents by strengthening the viability of NCHC
members, all of which are safety net providers. NCHC will leverage
individual and collective resources to create programs that are
regional in nature and will respond to the special needs of the
rural population. Three objectives are envisioned for the project.
1) Develop community and public health initiatives to increase wellness
and decrease disease. Initiatives will include chronic disease management
with emphasis on obesity, diabetes and asthma. 2) Develop the infrastructure
necessary to expand the capacity of NCHC provides and allow regional
delivery of services such as oral health to populations in need.
3) Develop education and training to North Country health care providers
by focusing on the use of telemedicine technology to improve access
to care and decrease cost for providers.
NEW YORK
Genesee Valley Health Partnership
D06RH00254
Reid Perkins
Livingston County Department of Health
10950 County Road 92
Wayland, New York 14572
Phone: (585) 728-5738
Fiscal Year 2003 2004 2005
Grant Award $200,000 $126,460 $121,460
The Genesee Valley Health Partnership (GVHP) consists
of 32 government and human service organizations, health care providers,
insurers, and educational institutions in Livingston County, New
York. GVHP's guiding mission is to improve the health outcomes of
Livingston County residents through collaboration, education, prevention,
and practice. Specific partnership objectives include strengthening
the local health system by building community coalitions and using
the Mobilizing for Action through Planning and Partnership (MAPP)
process, and improving health care access for residents, including
prehospital care, primary care, hospital, and aftercare health services.
Livingston County, located directly south
of Rochester, New York, has a population of 64,328 and comprises
17 towns and 9 villages. More than 11 percent of the general population
lives below the poverty level; 16.1 percent of the region's children
live at or below poverty. Forty physicians and 21 dentists practice
in Livingston County, but none accepts new Medicaid patients. Using
health assessments, GVHP and the local health department have identified
the region's most significant health care problems. They include
chemical dependency, lack of immunization, violence, mental health
problems, teen pregnancy, inactivity and poor nutrition, lack of
respite care, inadequate access to health care, exposure to toxins
and infectious agents, and five leading screenable causes of death.
Past, current, and future partnership activities
are driven by studies conducted in the county. They include lack
of nonemergency transportation to and from health care appointments;
difficulty recruiting and retaining volunteer emergency medical
services personnel; difficulty in retaining health care professionals;
a lack of dentists accepting Medicaid; lack of an efficient, user-friendly
referral system between aging service providers; lack of health
prevention and education for school-age children addressing violence,
teen pregnancy, and substance abuse; and lack of outreach materials
concerning environmental health hazards. The 5-year-old partnership
strives to continue offering services to Livingston County that
fill the gaps in these community services.
OREGON
South Coast Rural Health Integrated Provider
Team
D06RH02565
Kathy Laird
Waterfall Clinic, Inc.
1890 Waite St., Suite 1
North Bend, Oregon 97459
Phone: (541) 756-6232
Fiscal Year 2004 2005 2006
Grant Award $180,035 $136,185 $125,095
South Coast Rural Health Integrated Provider Team
(SCRIPT) is a two-county regional network which is comprised of
the members of three smaller, community-based networks. The members
of SCRIPT include three rural hospitals (two of which are critical
access hospitals), two public health departments, one free-standing
safety net primary health clinic, three participating Rural Health
Act clinics and an area Health Education Center. The network has
engaged in strategic planning and has developed a logic mode, project
matrix, and strategic plan that will focus on governance, operations,
personnel, and programs. The network will develop resource development
and sustainability plans which will be superimposed on the existing
strategic plan to create a single document.
The project is situated in Coos and Curry Counties
of southwestern coastal Oregon. Collectively, these two counties
comprise a rurally-isolated area of 3,277 square mile and support
a population base of 83,916 of which 35% are publicly-insured through
Medicaid and Medicare; 16.7% are medically uninsured; and 29% have
health insurance with deductible limits that exceed 10% of household
income. The region is classified as health professional shortage
and medically underserved areas. As a result of unmet need, the
population has multiple health disparities at rates which are significantly
above Oregon statewide means. The project will work to solidify
horizontal integration of four classes of members; build teamwork
and expertise that evolves around the creation of a learning community;
work toward the eventual attainment of vertical integration; integrate
primary and mental health care with the safety net system of care;
and engage in feasibility and program planning related to health
professional recruitment and retention. The learning community will
focus on practice management strategies that enhance organizational
efficiencies thereby constraining the costs of providing healthcare.
The project's evaluation plan calls for summative and formative
processes which measure five outputs, four outcomes, management
functions, cost-to-benefit ratios, and levels of engagement among
network members.
PENNSYLVANIA
The Susquehanna Valley Rural Health Partnership
D06RH00259
Susan Browning
Jersey Shore Hospital
1020 Thompson Street
Jersey Shore, Pennsylvania 17740
Phone: (570) 321-3000
Fiscal Year 2003 2004 2005
Grant Award $200,000 $200,000 $200,000
The Susquehanna Valley Rural Health Partnership
(SVRHP) is a three-county network comprising The Williamsport Hospital
(TWH), Muncy Valley Hospital (MVH), Jersey Shore Hospital (JSH),
and Bucktail Medical Center (BMC). This horizontal network of providers
has a long history of working together to improve health care in
rural north-central Pennsylvania and sharing similar patient demographic
and health statistics. Although network development is a relatively
new concept for providers in rural Pennsylvania, SVRHP believes
that further collaboration will enhance the sustainability of the
fragile local rural health infrastructure. One of the network members,
TWH, has been ranked among the 100 Most Wired Hospitals every year
since 2000 and is committed to sharing its expertise with rural
providers in the region. The network's three other members transitioned
to Critical Access Hospitals in the last year and use TWH as their
network facility.
The tri-county service area served by SVRHP
covers 2,576 mainly rural square miles. Over the past 10 years,
rural health care providers in the Susquehanna Valley of north-central
Pennsylvania have experienced trends common to rural providers throughout
the United States. Reductions in reimbursement levels and a shift
from inpatient to outpatient care have diminished cash flow, resulting
in shortages of nurses and allied health professionals. These financial
and staff constraints bridle the ability of individual rural hospitals
to provide easy access to primary and specialty health services,
invest in technology, provide preventionfocused outreach, and comply
with regulations such as HIPAA. Working together, the network strives
to benefit the local community by providing an integrated electronic
information system that will (1) improve inpatient care by allowing
even the most rural health care providers in the network to access
accurate medical record information simultaneously, (2) improve
access to specialty physicians, (3) develop a referral network that
expedites patient care, and (4) enhance the ability of network members
to share resources and information on compliance issues and other
patient/administrative concerns. The project also strives to conduct
joint recruitment and retention of key medical personnel and to
improve patient care through the development and implementation
of collaborative performance improvement initiatives based on the
balanced scorecard methodology. In addition, Web portals will be
implemented throughout the network to provide access to a medical
digital library and lifetime clinical records of network patients.
TENNESSEE
Community Health Network
D06RH00235
Keith Williams
P.O. Box 14083
Bolivar, Tennessee 37814
Phone: (423) 587-5263
Fiscal Year 2003 2004 2005
Grant Award $199,479 $199,479 $199,479
The Community Health Network is composed of 13
separately owned community health centers serving 23 counties in
rural Tennessee. The membership consists of eight federally funded
health centers located in Tennessee, one federally funded health
center in Mississippi, two rural health clinics, two federally qualified
health center (FQHC) look-alikes, and a network of birthing centers.
All of the network members provide primary health care services.
The consortium was formed to address the economic burden placed
on Tennessee's rural community health centers by the demand for
constant attention to information systems used for billing, record-keeping,
and data reporting. The expense of maintaining and upgrading hardware,
training staff, choosing vendors, purchasing software, and troubleshooting
network and connectivity problems has put significant strain on
network members' financial and personnel resources.
The Community Health Network will serve
as the central organization that handles information system needs
for the entire network. Acting as a collective, the network will
purchase in quantity to receive lower prices, bargain with vendors
for services and software, maintain a centrally located training
and help desk, and share a chief information officer. Using network
grant funds, the project will integrate the health centers' systems
beginning with business technology. The anticipated benefits include
achieving economies of scale and cost efficiency; sharing staff
expertise across network members; improving access to capital and
new technologies; and enhancing members' ability to respond to changes
in business and health care reporting requirements, such as HIPAA,
shifts in reimbursement, and new Government regulations. Though
still in its formative stage, the network will use Federal funding
to become a selfsustaining organization that strengthens the health
care delivery system in rural and medically underserved communities
in Tennessee.
TEXAS
East Texas Behavioral Healthcare Network
D06RH00238
Rex Menasco
The Burke Center
4101 South Medford Drive
Lufkin, Texas 75901
Phone: (936) 634-5557
Fiscal Year 2003 2004 2005
Grant Award $200,000 $200,000 $200,000
The East Texas Behavioral HealthCare Network (ETBHN)
is a 7-member collaboration of community mental health and mental
retardation centers. The centers serve 34 counties in rural East
Texas with a total population of approximately 2 million residents.
Because of the rural nature and low income of many parts of the
service area, privately funded services for persons with mental
illness or mental retardation are not available or are inadequate.
More than 17 percent of the total population in the service area
live below the Federal poverty level and depend solely on the community
mental health centers for services and medication. State funding
limitations add to the challenge of providing mental health care
services to the target population of adults and children diagnosed
with mental illness, serious emotional disturbance, mental retardation,
or developmental disability. In addition, behavioral health professionals
of all types are significantly underrepresented in rural East Texas.
The network partners face unique challenges
in delivering care effectively and efficiently to the region's residents.
The mission of ETBHN is to improve the quality of service, enhance
the operating efficiency, and expand the capacity of behavioral
health care in the communities of East Texas. This goal will be
achieved through greater integration of center clinical and administrative
activities. ETBHN will provide services in the areas of increasing
access to care, ensuring continuous quality improvement, cost savings,
data gathering and reporting, and coordinating center efforts. Services
range from 24-hour crisis care, including crisis stabilization and
respite, to supported employment opportunities, supported housing,
in-home assistance, and more. Among the expected outcomes are an
integrated telemedicine system, provider service evaluations, best
practices, a community needs assessment, a cultural and linguistic
competency survey, and pharmacy benefit management. A specific project
goal is the establishment of a remote patient monitoring and interactive
video system for center patients in inpatient facilities.
East Texas Health Access Network (ETHAN)
D06RH04304
Carlene Wilson
Jasper Newton County Public Health District
108 West Lamar Street
Jasper, Texas 75951
Phone: (409) 384-2099
Fiscal Year 2004 2005 2006
Grant Award $105,630 $199,783 $195,089
The ETHAN was formed to assist residents of five
rural and economically disadvantaged counties gain access to medical
services at the most appropriate and cost-effect level of care.
The service area encompasses approximately 3,600 mille and includes
Jasper, Newton, Sabine, San Augustine and Tyler counties. Located
in deep East Texas along the Texas/Louisiana border, the counties
exist in relative geographic isolation from the major medical centers
of Houston and Galveston. The ETHAN service area is in rapid economic
decline with unemployment and uninsured rates significantly higher
than the states average rates. The counties of Sabine, San Augustine
and Tyler are classified as Health Professional Shortage and Medically
Underserved Areas. In the 2000 HRSA Community Health Status Report,
all five counties received an unfavorable rating with respect to
heart disease. Medical and social services in these counties have
been focused solely on acute resolution of medical or emergency
need rather than prevention and coordination of care.
ETHAN was formed in 2001 as a multi-county
collaborative to address the issues which prevent county residents
from accessing health care and social service programs at the most
cost effective and appropriate level of care. ETHAN includes representatives
from each of the five counties, a public and state health department,
a federally funded health center, three rural hospitals, a hospital
based rural health clinic, a home health agency, a dialysis center,
a woman's health nurse practitioner, various social service agencies
and a faith based non-profit organization. The members have been
collaborating for over two years to develop an integrated system
of care that can effectively triage patients in to primary, secondary,
and tertiary levels of care. ETHAN is further developing its capacity
to assume a lead role by developing and implementing activities
such as: recruitment of additional ETHAN staff; development of leadership
within the community and among ETHAN members to support future sustainability;
linkage between safety net providers through the use of web-based
information system; expansion of current health promotion and prevention
activities; implementation of a chronic disease case management
system targeting the uninsured and underinsured; and the improvement
of the health status of the target population by implementing a
patient tracking, evaluation and program adjustment system.
VIRGINIA
Our Health Network's Community Health Initiative
(CHI)
D06RH00232
David Ziegler
Our Health, Inc.
329 N. Cameron St., Suite 200
Winchester, Virginia 22601
Phone: (540) 535-1551
Fiscal Year 2003 2004 2005
Grant Award $191,468 $199,927 $195,114
Our Health Network's Community Health Initiative
(CHI) is a 13-member consortium that aims to expand and improve
health and social service delivery to underserved rural, uninsured,
low income, and minority populations in Frederick and Clark Counties
in Virginia, as well as the City of Winchester. Network membership
includes public and private health care providers; government, human,
and social services; and one health screener. Through a three-phase
process, the network will use the grant to execute a capacity-building,
marketing and outreach, and program/service refinement and expansion
initiative among the region's major health and social service providers.
The target service area population is 95,000,
and the network expects to serve 20,000 residents annually. According
to the 2000 census, more than 13 percent of the Winchester population
lives below the Federal poverty level compared with the Virginia
State poverty rate of 9.6 percent and the U.S. poverty rate of 11.3
percent. Poverty and lack of education represent the primary factors
in a population's hardships, particularly in terms of its health,
and also pose significant barriers to access to health care services.
Many medical visits and expensive procedures can be avoided by providing
citizens, especially parents of young children, with access to information
and basic medical services.
To reach its target clients, the CHI project
will be headquartered in the new, state-of-the-art, 27,000 square
foot Community Services Building (CSB), located in a low -income
area of downtown Winchester, Virginia. The CSB will be home to 7
of the 13 Our Health Network members and will offer an innovative
one-stop-shopping model for service delivery. CHI's major goals
are to increase the number of underserved residents receiving health
and social services in a quality manner; to enhance public awareness
of the CHI, the CSB, and their services; and to improve health and
social service provider productivity and efficiency. The network
will achieve these goals by expanding its infrastructure and organizational
capacity, conducting a comprehensive marketing and outreach effort,
and refining and improving the area's health and social service
delivery network so that it is more productive, cost-effective,
and focused on quality customer service.
WASHINGTON
Twin Harbors Pharm-Assist Network
D06RH00227
Gary Rand
Mark Reed Hospital
2409 Pacific Ave SE
Olympia, Washington 98501
Phone: (360) 493-5563
Fiscal Year 2003 2004 2005
Grant Award $197,460 $197,460 $199,054
Twin Harbors Pharm-Assist is a formative, vertical
network created to address the growing problem of access to pharmaceutical
drugs for the underinsured and uninsured populations in four rural
counties of southwestern Washington State. Using the network grant,
the project will engage in strategic development, pilot telehealth
equipment, and manage network expansion that will culminate in improved
access to pharmacy services for residents in four rural counties.
In the first year of the project, network membership will include
rural Grays Harbor and northern Pacific Counties, with phased expansion
into two neighboring counties in the second and third years. The
members are Mark Reed Hospital of McCleary, Shoalwater Indian Tribal
Clinic, Willapa Harbor Hospital of South Bend, South Bend United
Pharmacy, Coastal Community Action Program of Grays Harbor County,
and CHOICE Regional Health Network.
Residents of the sparsely
populated Grays Harbor and Pacific Counties are sicker, poorer,
and more likely to be uninsured than residents in other parts of
Washington State. Lack of health insurance, high poverty rates,
decreasing Medicaid reimbursements to pharmacists, lack of prescription
drug coverage for Medicare enrollees, and the threatened solvency
of local pharmacies all contribute to fewer and fewer people having
consistent access to the prescription medications they need. Low
-income and elderly residents are especially affected by these factors.
The Twin Harbors Pharm-Assist project strives
to address and ameliorate the medication challenges faced by residents
in these rural areas. Because the project is still in its formative
phase, the network does not yet have a strategic business plan or
specified activities. However, network members have experience in
developing business plans and will complete one within the first
10 months of the project. Specific goals are to develop a network
to collectively implement a prescription assistance program in the
target service area; centralize the application, certification,
and reorder processes for manufacturers' pharmacy assistance programs
(PAPs); improve pharmaceutical access capacity for rural areas;
identify efficiencies and opportunities for expanded access as a
result of the project's initial work; and investigate and pilot
infrastructure and resources to accommodate sites for telehealth
and other developing technologies.
Eastern Washington Rural Critical Access Hospital
Network
D06RH00270
Ronald Gleason
Lincoln Hospital
10 Nichols Street
Davenport, Washington 99122
Phone: (509) 725-7101
Fiscal Year 2003 2004 2005
Grant Award $200,000 $195,680 $193,243
The Eastern Washington Rural Critical Access Hospital
(CAH) Network is composed of six federally designated CAHs in four
rural counties of eastern Washington State. Each hospital faces
common challenges and opportunities in the areas of Government regulation,
organizational administration, and service delivery. By addressing
these challenges and opportunities in the form of a collaborative
rural network, CAH Network members will achieve significant economies
of scale, cost efficiencies, continuous quality improvement, enhancement
of local continuums of care, and stabilization of local rural health
care systems for the service area's entire population. To achieve
these goals, the CAH Network plans to develop a shared chief financial
officer resource to implement a standardized financial system; create
centralized network resources, standards, and systems to improve
clinical efficiency and outcomes; facilitate and ensure corporate
compliance (HIPAA and Medicare) by all network members; develop
an organizational performance benchmarking capability; and enable
a joint contracting capability for medical specialty services and
business consulting services. The six founding CAHs anticipate that
other CAHs in eastern Washington will join the network in the future.
Eastern Washington is a dry, sparsely populated
region characterized by small, remote communities and extreme variations
in climate. This intensely rural area relies on resource based industries
made possible by Federal dams and land reclamation projects. The
network area's total population of 44,701 has a disproportionately
large and growing percentage of seniors aged 65 and older (17 percent
versus 11.5 percent statewide), a significant Native American population
(6 percent), and a significant Hispanic population, which is projected
to grow by 48 percent between 2001 and 2006. At least one of the
counties in the network is a designated frontier county. Most of
eastern Washington is characterized by economic distress. In the
network's service area, per capita income runs from 29 to 38 percent
lower than statewide per capita income. Aside from the network member
organizations, the nearest available significant hospital and health
care services for most residents in the service area are in Spokane-up
to 100 miles away. The region's highways are typically icy in winter,
and portions are frequently closed because of blowing snow or whiteout
conditions.
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