By Stephanie Innes | Arizona Daily Star
Front Page of the Sunday Edition Jan 21, 2017
Until she got health insurance through the Affordable Care Act, Tucson real estate broker Jennie James routinely spent $12,000 per year in health bills related to the chronic illness she’s had since childhood.
If this election made anything clear, it may be that there’s a very large divide between rural America and urban America.
Most rural voters cast their votes for President Donald Trump, while the vast majority of people living in major cities — especially on either coast — voted for Democrat Hillary Clinton.
But that divide goes beyond the ballot box. A new study by the Centers for Disease Control and Prevention shows a striking gap in health between rural and urban Americans.
According to the CDC, about 46 million Americans, or about 15 percent of the population, live in rural areas. And they are at higher risk of death from heart disease, cancer, unintentional injuries and stroke.
So, what’s behind this? According to the CDC, rural Americans tend to be older and sicker than people who live in cities. There are higher rates of poverty in rural areas of the country, and fewer people have access to health care or health insurance.
And, according to Dan Derksen, director for the Center for Rural Health at the University of Arizona, poverty has a lot to do with this.
“In rural areas, there’s often not the job opportunities that there may be in other areas,” he said. “The jobs that tend to be available may not pay as well as other jobs that might be available in a more urbanized setting, and there may not be, if you are employed, the employer may not offer health insurance.”
And, he said, the effect of poverty has ripple effects on the health-care network in rural communities.
In Arizona, he said, we have cut the number of uninsured people in half since the Affordable Care Act went into effect.
“And that really helped these safety net, rural health providers and clinics and hospitals because it dramatically reduced their uncompensated care, what also called charity care,” he said. “When you have more people covered and there’s a payment source, it tends to help keep a healthy bottom line for these facilities and the health providers in these rural communities to continue to take care of people.”
Derksen also says the opioid epidemic has hit rural communities hard, but he thinks Arizona is taking a proactive approach to try to stop the rising numbers of heroin-related deaths.
Another big challenge facing rural communities is that there just aren’t enough health-care providers, according to Dr. Carlos Gonzales, assistant dean at the University of Arizona, where he runs the Rural Health Professions Program.
He spent much of his career, before coming to UA, working as what he calls a “frontier doc” in Patagonia, a small town south of Tucson.
And, he said the problem for patients in rural communities is simple: they’re rural. “Often, it takes them half-hour, 45 minutes to get to my office,” he said. Then, after an evaluation and waiting for an ambulance or helicopter, they’ll make it to a hospital to be taken care of.
"So, that golden hour that they often speak about for these acute problems, is long gone,” he said.
The other problems, Gonzales says, is the cost of health care. Even after the Affordable Care Act meant that more low-income people could get health insurance, he said that many people couldn’t afford expensive deductibles on their plans.
The physician shortage in Arizona is another important factor. Since he left his clinic in Patagonia in 2006, they have not been able to find another full-time provider to fill his role.
The Rural Health Professions Program at UA, which Gonzales is in charge of, works to get medical students into rural areas for training with the hope they’ll stay and work in those areas.
But, he said, “We need them in all fields. We need family physicians, we need pediatricians, we need internal medicine specialists, we need Ob-gyns, we need surgeons,” he said.
Don’t miss this opportunity to learn how to write better grant proposals, turn rurality to your advantage, learn to connect with funders, and more. Participants will benefit from learning about a range of approaches to grant writing from an array of rural health partners. This series is perfect for beginners seeking to gain the skills to research and draft winning proposals from various agencies.
The NOSORH Rural Health Grant Writing Institute was developed to meet the unique needs of rural grant writers — like you!
Participants in the course will benefit from:
- Learning assignments to apply what they learn to their everyday work and build a personal grant resource library.
- Regular updates on upcoming grant opportunities.
- A certificate of completion at the end of the class series after completing 6 of 9 classes and 4 of 6 homework assignments.
- Connecting with other grant writers via the NOSORH Grant Writing group to learn about the latest hot topics in grant writing.
Registration ends March 29th, 2017 — class size will be limited and will be offered on a first-come basis, with a limit of 50 students, so ensure your place in this one-of-a-kind training. This is an opportunity for anyone looking to enhance their grant writing skills!
Registration Fee: $500
For more information contact Kassie Clarke (888) 391-7258 ext. 105 or at email@example.com
Don’t miss your chance to participate. Sign up today!
At least 85 percent of patients at Banner Page Hospital responded on their surveys that nurses always communicated well. In Arizona, the average is 77 percent, slightly lower than the national average of 80 percent.
The figures are from CMS' Hospital Compare website and represent HCAHPS scores collected from January 2015 through December 2015, the most recent data available.
Page Hospital — 85 percent (I made a change from below, because our reports from the Federal Office say 85%)
Note: Hospitals with fewer than 100 completed surveys were excluded from consideration for this list. (which is most of the Critical Access Hospitals)
Presentation of the award to the Holy Cross Hospital team on Wednesday, Jan. 18, 2017. From left to right – Dina Rojas-Sanchez, Director of Support Services, Holy Cross Hospital; Mark Valenzuela, Board Chair, Holy Cross Hospital; Debra Knapheide, Chief Executive Officer/CNO/COO, Holy Cross Hospital; Joyce Hospodar, Senior Advisor, Rural Programs, Center for Rural Health, The University of Arizona Mel and Enid Zuckerman College of Public Health; Les Caid, Fire Chief, Rio Rico Fire; Matt Eckhoff, Program Director, Rio Rico Fire Community Integrated Paramedicine Program.
Nogales, AZ – January 18, 2017 – Carondelet Holy Cross Hospital has received national recognition for demonstrating innovation in emergency medical services (EMS) that benefit patients and members of rural communities. The hospital – one of only four in the nation to be honored in this round of nominations – received the Critical Access Hospital Recognition certificate from the National Rural Health Resource Center for its work with the Community Healthcare Integrated Paramedicine Program (CHIPP).
The certificate was established by the Center and the Federal Office of Rural Health Policy (FORHP) to recognize the excellent work performed by critical access hospitals (CAHs) and other rural safety net providers throughout the country. The recognition promotes excellence and innovation and honors the achievements and results of rural safety net providers while publicizing successful strategies.
The CHIPP program, which was developed to help address the needs of individuals who frequently use the 911 system and hospital Emergency Department, is intended to ensure these indivuals are treated in a more proactive and cost-effective manner. Holy Cross Hospital is a key stakeholder in the success of this program, acting as an advisor and promoter and as a key contact for providers in the medical community, and providing referrals to the program upon discharge from the hospital.
“Holy Cross Hospital is a proud partner in the Community Healthcare Integrated Paramedicine Program and continues to find innovative models of care to provide quality healthcare for all Santa Cruz County communities,” said Debra Knapheide, CEO/COO/CNO at Holy Cross Hospital, “We are proud to be recognized for our work in this collaborative effort to deliver healthcare that is affordable, high-quality and necessary for the good of our community. Holy Cross Hospital is committed to keeping pace with healthcare transformation, which is key to sustaining access to health services for rural communities.”
Matt Eckhoff, Director of Rio Rico Medical and Fire District’s Community Integrated Paramedicine Program, added: “Today’s healthcare system is working hard to connect the dots between all the different folks who provide healthcare. From the ambulance to the emergency room to the primary care provider, the more we all talk to each other, the better we can provide excellent care to those we serve. Carondelet Holy Cross Hospital’s engaged leadership team has been instrumental in connecting those dots to better serve the Santa Cruz County community.”
Posted Jan 17, 2017, 11:46 pm
By: Arren Kimbel-Sannit | Cronkite News
These are the two reports on the impact of funding cuts by state should the Prevention and Public Health Fund be eliminated as part of ACA repeal:
Three UA faculty members have been appointed to the national advisory board for the third national Telemedicine and Telehealth Service Provider Showcase, which brings together companies that provide medical specialty services through telemedicine technology with hospitals and health care providers. Dr. Joseph Alpert, professor of medicine in the College of Medicine – Tucson, Dr. Daniel Derksen, director of the Arizona Center for Rural Health, and Dr. Joe G.N. "Skip" Garcia, professor of medicine, will join the 25-member board, whose members are nationally recognized as thought leaders, health care innovators and champions who have made major contributions in telemedicine. The showcase will be held Oct. 2-3 in Phoenix. Click here to see the full list of board members.
JANUARY 13, 2017 AT 8:44 AM ET BY KRISTIE CANEGALLO
Summary: Today, leaders from nearly 60 of those campuses will attend Healthy Campus Challenge Day at the White House.
The final open enrollment period of this Administration started on November 1, and since then, more than 11.5 million people nationwide have signed up for health insurance through the Health Insurance Marketplace. As part of our Administration’s ongoing efforts to reach the remaining uninsured, the White House launched the Healthy Campus Challenge in September, hoping to engage college and university campuses in enrollment efforts. Campuses opted in by agreeing to undertake a series of best practices, like emailing all students and faculty with information about open enrollment, amplifying deadlines on social media, holding enrollment events, and producing creative online content to reach community members.
White House staff members worked with administrators, students, faculty, staff, alumni, local community leaders, and elected officials across the country to spread the word about open enrollment and the Marketplace, sharing best practices with them honed over the last four years.
More than 350 campuses from all 50 states, Washington, D.C. and Puerto Rico participated in the Challenge and carried out some enrollment activities, with nearly 100 campuses completing all the criteria. Today, leaders from nearly 60 of those campuses will attend Healthy Campus Challenge Day at the White House. We can’t wait to congratulate them for their hard work during the ongoing open enrollment period, hear creative ideas from these schools, and brainstorm ways for them to work together moving forward. Our hope in holding the Challenge was to institutionalize these enrollment practices on campuses nationwide for future open enrollments. Healthy Campus Challenge Day will be streamed live from South Court Auditorium at 10:30 a.m. on Friday, January 13 at www.whitehouse.gov/live.
AGENDA JANUARY 13, 2017 HEALTH CAMPUSES HELP STUDENTS GET COVERED
Valerie Jarrett, Senior Advisor to the President, the White House
PANEL I: HEALTHY CAMPUSES SHARE WHAT WORKS
Moderator: Bess Evans, Senior Associate Director and Senior Policy Advisor, White House Office of Public Engagement and Domestic Policy Council
Stephanie Blaisdell, Ph.D, Assistant Vice President, University of Memphis
Jessica Koscelnak, Director of Health Services, Keystone College
Jessica Lauritsen, Dir. of Student Life & Career Development, Hennepin Technical College
Alyssa Padilla, Special Projects Coordinator, University of Arizona
Susan Quinn, Director of Student Health Services, Santa Rosa Junior College
Jodi A. Ray, Director of the College of Public Health, University of South Florida
Brett Rowlett, Director of Governmental & Community Relations, Lane Community College
PRESENTATION OF CERTIFICATES
Kristie Canegallo, Assistant to the President and Deputy Chief of Staff for Implementation, the White House
PANEL II: NATIONAL ORGANIZATIONS WORKING TO IMPACT LOCAL EFFORTS
Moderator: Bess Evans, Senior Associate Director and Senior Policy Advisor, White House Office of Public Engagement and Domestic Policy Council
Amaris Bradley, MPH, RD, Sr. Manager of Partnerships, Partnership for a Healthier America
Erin Hemlin, National Director of Training and Consumer Education, Young Invincibles
Kyle Lierman, Senior Associate Director and Senior Policy Advisor, White House Office of Public Engagement and Domestic Policy Council
Ebonee Rice, National Director of Strategic Partnerships, Enroll America
Bess Evans, Senior Associate Director and Senior Policy Advisor, White House Office of Public Engagement and Domestic Policy Council
The following schools will attend Healthy Campus Challenge Day:
Ashland University (Ashland, OH)
Augsburg College (Minneapolis, MN)
Bakersfield College (Bakersfield, CA)
Bethune-Cookman University (Daytona Beach, FL)
Bowie State University (Bowie, MD)
Bunker Hill Community College (Boston, MA)
California State University, Los Angeles (Los Angeles, CA)
Concord University (Athens, WV)
Cottey College (Nevada, MO)
Delta College (University Center, MI)
DePaul University (Chicago, IL)
Durham Technical Community College (Durham, NC)
Florida Memorial University (Miami Gardens, FL)
George Mason University (Fairfax, VA)
Harold Washington College (Chicago, IL)
Hennepin Technical College (Brooklyn Park, MN)
Kean University (Union, NJ)
Keystone College (Factoryville, PA)
Los Angeles Pierce College (Los Angeles, CA)
Lane Community College (Eugene, OR)
Livingstone College (Salisbury, NC)
Long Beach City College (Long Beach, CA)
Mansfield University of Pennsylvania (Mansfield, PA)
Mercy College (Dobbs Ferry, NY)
Millersville University of Pennsylvania (Millersville, PA)
Missouri State University (Springfield, MO)
Monroe Community College (Rochester, NY)
Nash Community College (Rocky Mount, NC)
Norwalk Community College (Norwalk, CT)
Notre Dame De Namur University (Belmont, CA)
Orange Coast College (Costa Mesa, CA)
Pacific Lutheran University (Tacoma, WA)
Pierpont Community & Technical College (Fairmont, WV)
Princeton University (Princeton, NJ)
Rider University (Lawrence Township, NJ)
Santa Rosa Junior College (Santa Rosa, CA)
Southern California University of Health Sciences (Whittier, CA)
Spencerian College (Louisville, KY)
Sullivan University (Louisville, KY)
The University of Arizona (Tucson, AZ)
The University of New Orleans (New Orleans, LA)
The University of Southern Mississippi (Hattiesburg, MS)
Trocaire College (Buffalo, NY)
United Tribes Technical College (Bismarck, ND)
University of Delaware (Newark, DE)
University of Hawaii at Hilo (Hilo, HI)
University of Memphis (Memphis, TN)
University of Michigan (Ann Arbor, MI)
University of South Florida (Tampa, FL)
University of Wisconsin - River Falls (River Falls, WI)
University of Wisconsin-Milwaukee (Milwaukee, WI)
Upper Iowa University (Fayette, IA)
Virginia Commonwealth University (Richmond, VA)
Western Michigan University (Kalamazoo, MI)
Western Washington University (Bellingham, WA)
William Rainey Harper College (Palatine, IL)
Xavier University of Louisiana (New Orleans, LA)
Kristie Canegallo is the White House Deputy Chief of Staff for Implementation.
By Howard Fischer | Capitol Media Services | January 7, 2017 | Arizona Daily Star
PHOENIX — Saying he fears harm to Arizonans, Gov. Doug Ducey is urging Congress to not to rush repeal of the Affordable Care Act.
“I don’t want to see any Arizonan have the rug pulled out from underneath them in terms of changing this law,” the Republican governor told an audience of business executives, lobbyists and lawmakers on Friday.
See more at link below:
The ECHO Act aims to make the University of New Mexico's groundbreaking Project ECHO telemedicine program a national model for healthcare collaboration.
The Republican surgeon from Georgia, tapped to head the Department of Health and Human Services, espouses a more privatized approach to healthcare.
Francine Kiefer, Staff writer | NOVEMBER 29, 2016
WASHINGTON — Donald Trump is indeed serious about repealing and replacing the Affordable Care Act. And to show just how serious he is, on Tuesday he chose conservative Rep. Tom Price to lead the Department of Health and Human Services.
Rep. Price, a Republican doctor from Georgia, not only stridently opposes Obamacare. He has also put forward legislation to replace it in every Congress since the bill was passed in 2010.
President-elect Trump’s other healthcare nominee, Seema Verma, would play a particularly important role. Ms. Verma was nominated Tuesday to head the Centers for Medicare and Medicaid Services, a division of HHS.
Increasing the income threshold to qualify for Medicaid has been the ACA’s main tool to get more poor people health coverage. The Supreme Court made that expansion of Medicaid optional for states, and many red states have decided against Medicaid expansion.
But some went ahead, on their own terms. Verma worked with Vice President-elect Mike Pence when he was governor of Indiana to design a Medicaid expansion in keeping with his Republican principles. To some, her appointment signaled pragmatism. “To me, the Verma announcement was reassuring. It’s not just ‘let’s throw a couple hundred thousand people off Medicaid rolls and let them fend for themselves,’ ” says Daniel Derksen, director of the Center for Rural Health at the University of Arizona in Tucson.
Dr. Derksen, who once practiced medicine as a family physician, says that Medicaid expansion has greatly helped to cover more people and directly eased the bottom line of hospitals that treat uninsured patients – “charity” cases. States have been able to somewhat customize the expansion and that has helped it gain acceptance in some Republican states such as his own. He says he appreciates the “personal responsibility” aspect of Indiana’s program, where residents have to contribute to the cost of their coverage. Those above a certain income level who fail to make their payments are dropped and not allowed back for six months.
Repeal first, then find a replacement - Critics – and not just Democrats – point to weaknesses in the Better Way plan. Medicaid grants to the states run the risk of failing as a safety net during times of recession, for instance. States are required to balance their budgets, yet the number of poor people who would need Medicaid increases during hard times.
Also, high-risk pools were tried before the ACA fully took effect, and didn’t work particularly well, says Derksen, who is a Republican. “It’s hard to make insurance work when you’re only covering sick people,” he says. He also worries about insurers and Big Pharma having too much sway if the marketplace exchanges are eliminated. He prefers to see the exchanges modeled along the lines of Tricare, the military plan that goes out to bid among insurers.
By Allie Bice | Cronkite News | Tuesday, Nov. 29, 2016
WASHINGTON – Diabetes, hypertension and depression are the biggest problems facing Arizona counties, according to a new nationwide health index map that also scored counties on whether they tend to be more healthy or less. The report Tuesday by the Blue Cross Blue Shield Association looked at every county where the insurer has clients and was issued, sponsors said, to help local governments focus health improvement efforts where they can do the most good.
…the director of the University of Arizona’s Center for Rural Health said he was not surprised by its findings on the biggest challenges facing counties in the state. Dr. Daniel Derksen said it is not unusual for the state’s rural counties to have health issues related to diabetes, noting that counties with large numbers of Latino or Native American residents “tend to have higher rates of diabetes.” He pointed to two counties in the report where diabetes is the No. 1 problem, Yuma and Navajo, that have high numbers of Latinos and Native Americans respectively.
But he also said that many counties in the state face a combination of problems that include diabetes, hypertension and hypercholesterolemia that “contribute significantly to poorer health outcomes and much higher costs of care. Focusing public and population health interventions in these higher-risk populations and areas … would improve outcomes and control cost growth” in medical spending, he said.
Deadline: Jan. 19, 2017
To provide University of Arizona graduate health sciences/health professions students, medical interns and residents with an opportunity to gain experience in rural and urban medically underserved Arizona communities through research and/or scholarly projects;
To address community needs specific to the five Arizona AHEC regional centers through health promotion and disease prevention research and relevant projects;
To demonstrate interprofessional education or practice models.
Eligibility: University of Arizona graduate health sciences/health professions students, interns, residents, and faculty, as well as AzAHEC regional centers may apply. Projects should demonstrate interprofessional education or practice models and address community needs specific to one or more of the AzAHEC regional centers.
Funding period: One year, beginning in March 2017
Available grants: Up to five projects will be funded in amounts up to $5,000.
Please see the attached RFA for full details.
Please direct questions to:
Arizona AHEC Staff
2017 AzAHEC Research and Project Small Grant Program RFA
By Stephanie Innes | Arizona Daily Star | November 12, 2016
Nov. 12--The election results will not change anything about open enrollment in Obamacare health insurance for 2017 coverage, local, state and federal officials say. The Affordable Care Act is still the law of the land and until it’s not, consumers are being urged to continue enrolling on the government-run marketplace as usual. Open enrollment on the marketplace, created by the 2010 Affordable Care Act, began Nov. 1 and goes through Jan. 31. The enrollment is for coverage in 2017. People who want coverage by Jan. 1 should enroll by Dec. 15. Last enrollment season, 11 million Americans got their insurance through the federal and state marketplaces.
On Wednesday, the day after the election, more than 100,000 Americans signed up for health insurance via the marketplace, which is also known as the health exchange. U.S. Department of Health and Human Services director Sylvia Burwell tweeted that it was the highest number of plan selections since this season's open enrollment began.
“Consumers want affordable coverage, and are naturally apprehensive about the unknown,” said Dr. Daniel Derksen, a professor in the public health policy and management program at University of Arizona's Mel and Enid Zuckerman College of Public Health. “Until things are sorted out by the new administration and Congress, many want to be sure they have coverage.”
“For now, the prudent path would be for consumers to understand their current options, and do what is best for their own coverage and for their families," Derksen said. “It would be very difficult, for many reasons, to leave 11 million without a viable alternative.”
Nogales International | Nov 1, 2016
Open enrollment for the Affordable Care Act (ACA) health insurance marketplace starts Tuesday, Nov. 1, and the University of Arizona Center for Rural Health Navigator Consortium says it has two “navigators” in Santa Cruz County ready to help.
“The Arizona Center for Rural Health Navigators in Santa Cruz County are trained to provide impartial and unbiased assistance to help review your health insurance options and eligibility, and enroll in coverage,” the center said in a news release. “They provide assistance in English and Spanish and their services are free of charge.”