. Adequate funding for outreach efforts to educate and enroll rural and frontier people in programs such as CHIP and Medicaid for which they may be already eligible. Better data on the uninsured and underinsured and about how their care is being provided. Graphic and cultural, as well as economic factors should closely be analyzed. Banishing Categorical health care and social services are essential in rural communities, where resources and providers are limited.
To attain this state of equilibrium in Medicare provision in rural America as in urban-policy making should not differentiate data as rural or urban instead they should demand impeccable data that describes rural programs and outcomes in order to have a clear picture of what is happening on the ground. HHS has the audacity to integrate its own programs and policy initiatives that would rather help the states and rural communities to do the same. Support of rural and Policy Making.
The application of “rural agency” across HHS program that involve consumers in the policy as a channel to gathering a true rural voice in consultative consensus process that considers both social services an health as pinnacles of a given society. Hailing high the recognition that GPRA measures that value the most people served for the money may disadvantage rural communities because of lower volume of people served. State, local and tribal governments Partnership. Support State or regional rural summits.
Build on the strength of existing partnerships with community Action agencies, state offices of rural health, etc, to better connect HHS programs with communities they serve. Foster better relationships between Tribal governments and state agencies who receive HHS funding. “As former governors of states with large rural populations, President Bush and I know how important it is for people outside of urban center to have access to quality healthcare and social services. We have carried that understanding to the White House and HHS. ” Secretary Tommy Thompson. Comprehensive Policy Strategy.
Obtaining equal reimbursement level for rural health care services including managed care plans in alleviating problems created by geographic, cultural and other rural specific barriers. Providing necessary adequate infrastructure in sparsely populated areas, including special services such as telecommunications, small emergency hospitals, EMS services, containing education, etc. the expansion of hospital based or organizational based(AHA,AMA, foundations, etc) programs to serve indigent population. Examples include the American hospital Association’s” Campaign for Coverage” or the Robert Wood Johnson Foundation-funded “Access Project.
” Implementing reasonable regulation systems that ensure quality and safety, and modifying regulations that are inappropriate for rural and fronties areas and that curtails access in those areas inhibiting rational planning. Integrating management and delivery systems to make them more efficient and able to deliver adequate and cost-effective services to rural and frontier residents. Integrating all of the above with a comprehensive financing system. Incremental policy Strategies. New types of safety met providers for rural and frontier areas beyond the current community health centers, free clinics and well-known charity organizations.
This measure could help ensure the availability of resources to provide uncompensated care for the medically indigent. Now grant monies or incentives for providers who provide more uncompensated care than other providers, or a subsidy for providers who see more than their share of Medicare and Medicaid patients. As a starting point, the recommendations of the Medicare payment Advisory Commission (1999) could be adopted, leveling the playing field in the disproportionate share payment program.
Increased resources made available, either on federal or a state level, to strengthen and adapt the emergency safety net, which is especially important in rural areas. The definition of “safety net provider” should be more broadly defined to include not only those who provide indigent care and have a sliding fee scale, but also providers serving remote geographic areas, locations that serve culturally diverse populations, and areas with a limited number of providers where no patient can be turned away.
A concerted state-by state effort to get state funds to subsidize care for the indigent, especially in rural and frontier areas where access to care is more problematic. Expansion of tax options, including a broad- based national vs. state-to-state medical indigency tax, or use of the tobacco settlements to pay for indigent care. Special recognition that certain populations especially in rural and frontier areas, require special services including transportation, meeting social-cultural access issues, or improving access to specialists. Special funding to meet these special needs should be provided for all rural and frontier residents.
Community-based solutions for the uninsured aimed at covering entire communities and based on pilot projects. The creation of more widespread use of local taxing districts to fund indigent care. References: USDA Economics research service (2000) “Rural Population and migration Rural Population Change” Racketss, TC, Johnson-Webb, K, Randolph RK (1999) “Population and places in Rural America in Rural Health in the United States. NY Oxford University Press. United States Census Bureau (2001) “Estimates of population of Countries by Age, sex, and Hispanic Origin.
Eberhardt MS, Ingram DD, Malo DM et al (2001) urban and Rural Health Chartbook Health, United states, Hyattsville, MD National Center for Helath Statistics. USDA Economics Research Service (2000) Rural Population and migration Race and Ethinicity Areas. ” Fluharty, Charles (2001) “ Rural America: Challenges and Opportunities”. Presentation to the NCSI, Annual Meeting Assembly. On Federal Issues Committee on Agriculture and International Trade San Antonio, Texas. West Virginia Dept of Health and Human Services, (1999) West Virginia Works case closure study.
Economic Research Services, USDA (1999) Rural Conditions and Trends. Rural Policy Research Institute Center for Rural Health Policy Analysis (1999) Operation Rural Health works Projects briefing. Weber B, Duncan G (2001) “Welfare Reform reauthorization and Rural communities’ The urban institute of Recent Research’ Joint center for poverty Research. Centers for Disease Control and Prevention (1999) National center for health Statistics National Helath Interview Survey. Schur CL, Francisco SL. (1999) Access to health Care” in Rural Health in the United States New York.
Oxford University Press. National advisory Committee on Rural Health (2001) “Medicare Reform A Rural Perspective. National Association of Social Workers (2001) Social Work in Rural Areas” in Social Work Speaks, National Association of Social workers, Washington D. C. Medicare Payment Advisory Commission (2001) Report to the Congess Medicare in Rural America. Centers for Disease Control and Prevention, (1997-1998) National Center for Health Statistics National Health Interview Survey. Newburger EC, curry A (2000) Educated attainment to the United States current population reports.
Centers for Disease Control and Prevention (1998) National Center for Health statistics national Vital Statistics System. National center for Health Statistics (2000) Vital statistics of the United states Volume II Mortality. National Association of County and Community health Officials (2001) “Local Public Health Agencies: The Rural Experience ‘Presentation for the National Rural Helath Association Meeting, Dallas. National Advisory Committee on Rural health (1999) “Rural Public health Issues and Considerations. Toscano GA. Windau JA (1999) Profile of fatal work injuries in the Bureau of Labor Statistics Compensation and Working Conditions.