Dr. Howard Eng talks with KJZZ News about the concerns that rural hospitals face with with implementation of a federal health insurance exchange, as opposed to state .
TUCSON, Ariz.—Governor Janice Brewer’s Healthcare Policy Advisor, Don Hughes addressed important healthcare issues in his lecture, Tuesday, Nov.13.
The Center for Rural Health in the Mel and Enid Zuckerman College of Public Health hosted Hughes’ talk, “Major Healthcare Policy Issues Facing Arizona” at The University of Arizona Medical Center to kick off National Rural Health Week.
Throughout his lecture, Hughes covered the benefits and issues concerning the Affordable Care Act and its effects on Medicaid expansion. In July, The Supreme Court upheld the Affordable Care Act. This decision has left states like Arizona questioning what to do with Medicaid expansion.
“Now that it’s voluntary it changes the rules of game and if nothing is done with the federal waiver and enrollment into Proposition 204 we lose federal authority to tie down federal dollars to pay for the remaining population,” Hughes said.
Proposition 204 has raised the Federal Poverty Limit (FPL) to 133% and with the Affordable Care Act, it is estimated that 16 million people nationwide will be eligible for health insurance. With this increase, Arizona faces the challenges to facilitate the demand for resources and to provide enough health professionals for the state.
The Government of the State of Arizona is currently looking at ways to modernize the healthcare infrastructure. “We want to implement reform strategies that lower costs by promoting quality of care and by maximizing personal responsibility through innovative cost-sharing designs,” Hughes said. However, they are also focusing their efforts on improving the incentives to prove the quality of healthcare.
“If nothing is done it will have a tremendous impact on the healthcare delivery system not just in urban counties like Pima and Maricopa but in rural Arizona as well. That will be a big issue that we need to deal with,” Hughes said.
The Arizona government plans on finalizing their decisions on their Medicaid plan and on the health insurance exchange by December 14th. Arizona has also submitted their plans for the health insurance exchange to the federal government that include 10 EHB Statutory Services such as emergency services and hospitalization.
Governor Janice Brewer has not yet decided if she intends to move forward with a state-based exchange or shift towards a federally facilitated exchange. In the lecture, Hughes talks about the differences and benefits of the state vs. federal exchange based system. In a state based exchange, Arizona will decide the number of insurers, how to fund the exchange and what benefits, providers and plans will be offered with the exchange. According to Hughes, a state-based exchange will also include better customer support.
If the Governor decides to run the federal exchange, the U.S. Department of Health and Human Services (HHS) will determine how Arizonans will pay for the exchange costs as well as which benefits, providers and plans will be offered on the exchange.
The planning and design work we have done has put Arizona in a position where whether or not she decides on a state-based exchange we will be ready, Hughes said.
Due to steep budget cuts, Arizona faces challenges funding its health care system, according to Gov. Jan Brewer’s chief health adviser.
Don Hughes, Brewer’s health care policy adviser, delivered a lecture hosted by the Mel and Enid Zuckerman College of Public Health to kick off Natural Rural Health Week. During the lecture, he described challenges Arizona will encounter with the expiration of the temporary one-cent sales tax created by Proposition 100.
The tax, set to expire in May, funds education, public safety and health and human services.
The Affordable Care Act expanded the coverage for Medicaid, and the national system is estimated to grow by about 16 million benefactiaries. In June, the Supreme Court ruled that states can voluntarily issue the expansion. Arizona opted to expand early on, hurting the state’s funding, Hughes said.
By Gerri Kelly, Mel and Enid Zuckerman College of Public Health | November 15, 2012
Rural communities in Arizona are wonderful places to live and work, which is why 900,000 people (16 percent of the population) call them home. These small towns, farming communities and frontier areas are places where neighbors know each other, listen to each other, respect each other and work together to benefit the greater good.
Rural communities provide the rest of the country with a wealth of services and commodities, and they are the economic engine that has helped the United State become the world economic power it is today.
National Rural Health Day is Nov. 15, and the Center for Rural Health, or CRH, at the Mel and Enid Zuckerman College of Public Health, is celebrating all week long.
Gov. Jan Brewer proclaimed the week of Nov. 12-16 as Rural Health Week to recognize Arizona’s growing rural population and to honor the work that is being done to assist these communities.
Kingman Regional Medical Center (KRMC) and the Mohave County Department of Public Health have begun a major initiative to identify healthcare needs in Mohave County. As part of the initiative, they are performing a community health assessment, involving:
- Collecting local statistics and data related to health and quality of life within Mohave County communities.
- Obtaining perspectives and identifying community health needs via in-depth interviews with key community stakeholders.
- Using surveys to obtain input and perspectives from County residents regarding health, quality of life, and needs for health-related services in their community.
The health assessment will be a first in the area— never before has there been a comprehensive study of community health done with community member input at a local level. The effort will provide a realistic picture of the actual health needs and issues unique to our population, geography, and economy. In turn, this will allow for better planning and policies that address true health concerns and needs in Mohave County.
To date, Kingman, Bullhead City and Lake Havasu City have engaged in collaboration to form their own community coalitions. In addition, they have formed a larger coalition that is comprised of community members throughout Mohave County. The coalition includes over 100 individuals who represent a broad spectrum of community interests, including city and county government, local Indian tribes, healthcare, education, law enforcement, public services, business, media, charities, faith-based services, youth, senior citizens, minorities, and special needs groups.
For further information about the Mohave County Community Health Improvement Initiative, please visit the KRMC website at www.azkrmc.com (listed under the “Community Partnerships” tab) or contact:
Mohave County Department of Public Health
928-753-0794 ext. 4165
Kingman Regional Medical Center
By Lorri Allen
TUCSON – A $1.3 million federal grant will allow a University of Arizona center to expand a regional program helping hospitals and health care providers get into or make better use of telemedicine. The Southwest Telehealth Resource Center, part of the Arizona Telemedicine Program and one of 14 regional centers around country, serves Arizona, Utah, Colorado, New Mexico and Nevada. The resource center shares information on a variety of topics from technology to techniques for assessing patients remotely. It also offers educational modules. The four-year grant, awarded by the U.S. Department of Health and Human Services’ Office for the Advancement of Telehealth, will allow the center to expand that mission, said Elizabeth Krupinski, its program director. “We have the strategies down, so the next four years is going to allow us to provide more webinars and more training,” she said. “It also allows us to interact more with the other Telehealth Resource Centers.”
By Trisha Maldonado (Douglas Dispatch)
Officials for Southeast Arizona Medical Center announced that Annie Benson has been promoted to chief officer executive on Oct. 17.
BENSON – Teresa Vincifora, chief nursing officer at Benson Hospital, received a second role in April overseeing quality assurance. That was after recruiting to replace a retiring employee came up empty.
“In rural hospitals, we wear many hats,” Vincifora said. “Jobs are really hard to fill.”
Then a program administered by the University of Arizona provided funds for her to attend a quality directors’ boot camp in Nashville.
“We don’t have the resources that large hospitals do, so that was just such an opportunity for me and so helpful,” she said. “There’s so much to learn. It got me fired up for the position.”
The Center for Rural Health, part of the Mel & Enid Zuckerman College of Public Health, has been helping hospitals in those kinds of ways for 25 years. Vincifora’s assistance came from the center’s Flexibility Program, called “Flex” for short, established by Congress in 1997 to address the disparity in Medicare reimbursement between urban and rural hospitals.
By David Bui
Dr. Graciela Silva, Assistant Professor in the College of Nursing, will be the Center for Rural Health’s inaugural Courtesy, Adjunct, and Affiliate Appointments Program member. Her research background, expertise, and interest in working on U.S.-Mexico Border issues will be a beneficial addition to the Center’s mission.
Dr. Silva first learned about the affiliate program shortly after joining the College of Nursing and thought of it as an opportunity to stay connected with public health research on the U.S. Mexico Border. “I was very excited to learn about this opportunity so I could continue collaborating with the College of Public Health,” she said.
Dr. Silva completed her bachelors in Guadalajara, Mexico and also at the University of Arizona, studying Medical Technology. She went on to obtain her Master of Public Health at the University of Arizona and eventually her PhD in Epidemiology as well.
As a doctoral student, Dr. Silva was awarded an NIH Minority Fellowship to research asthma and respiratory diseases, and she has also conducted post-doctoral research in sleep disorders. She has published numerous studies in these areas and has a depth of experience in working with longitudinal cohort data.
More recently, Dr. Silva worked on an evaluation of the Healthy Border 2010, a health promotion plan similar to Healthy People 2010, and focused primarily on the U.S. side of the U.S.-Mexico Border. Having lived in Nogales, Arizona, border health issues are very important to Dr. Silva. “The issue of border health is dear to my heart, and I wish to make some sort of impact in reducing morbidity in this area,” she said.
As a Center for Rural Health affiliate, Dr. Silva would like to continue her work in respiratory diseases, especially in drug-resistant tuberculosis along the Mexican border. She has a CDC fellowship in emerging infectious diseases and would like to find a way to integrate her research into her work with the Center for Rural Health.
The Arizona Strategic Enterprise Technology Office (ASET) is launching an Unconnected Providers’ grant program for the purpose of supporting Health Information Exchange (HIE) planning and implementation for health care organizations. The grant program is aimed at stimulating the adoption of HIE for healthcare providers who currently have not planned or implemented an information exchange solution.
Highlights of ASET Grant Program
- Total amount of funding available for distribution is up to $1.1 million.
- Estimated award amount for a single organization application is up to $25,000 for implementation planning, and up to $50,000 if implementing an HIE solution, with joint applications being eligible for up to $50,000 for implementation planning and up to $100,000 for implementing an HIE solution.
- Period of performance of the grant is six (6) months – January 2013 to June 2013.
- Matching requirements – cash or in-kind of at least 50% of the grant award.
- Individual providers are not eligible for this grant award.
- The target for this grant program is healthcare organizations and facilities.
- Grant applications are due to ASET by Friday, November 16, 2012.
Please see the attachment for guidance.
Healthcare coverage for low-income and sick patients in Arizona is extremely limited. One of the few relatively affordable options for the uninsured is the Pre-existing Condition Insurance Plan (PCIP). PCIP coverage is intended to serve as bridge for coverage until 2014 when health insurance exchanges become operational and the regulation ensuring people can no longer be denied coverage based on their health status is in place.
More than 70,000 people are now covered by PCIP since the program started in 2010. PCIP enrollment has not been as successful as it could be due in large part due to the lack of a marketing campaign. Grassroots efforts in Arizona and other states have helped increase PCIP enrollment, but they have had only limited success.
The Arizona Hospital and Healthcare Association, along with other healthcare partners, have produced commercials in English and Spanish to help generate public awareness of the program. The commercials are captivating, appeals to a wide audience and it has tremendous potential to grow PCIP enrollment at a faster pace.
These commercials are free for anyone to download and link to the YouTube versions. Here is the link to a background webpage with downloadable and online versions of the commercials:
- PCIP English Version: http://www.youtube.com/watch?v=Y6k-w5Kw9FM&feature=relmfu
- PCIP Spanish Version: http://www.youtube.com/watch?v=1d5rnA_med0
We hope everyone – healthcare providers, community groups and the general public – will help promote the commercials so patients with pre-existing conditions will learn about PCIP and enroll in the program.
Please consider using the commercials in the following ways:
· Distribute this memo to all of your contacts;
· If you are a healthcare provider, show the commercials to patients in waiting areas in healthcare settings;
· Add the link to the YouTube version of the commercials on your web pages, Facebook, Blogs, etc.;
· Distribute the commercials through electronic media and encourage others to do the same;
· and, make a donation to air the commercials on television.
For additional information about the commercial and ways to donate to purchase air time, please contact Pete Wertheim at firstname.lastname@example.org or at the following phone numbers: (602) 445-4318 (office) or (602) 515-3847 (cell).
By David Bui
According to the Arizona Rural Health Workforce Trend Analysis report, rural Arizona areas have proportionally less healthcare professionals per capita than urban areas in Arizona—for nearly all health professions analyzed in the report. This shortfall in workforce has huge implications for healthcare delivery and health status for rural populations since health workforce distribution directly influences access to care.
Moreover, the authors of the report suggest that the passage of the Patient Protection and Affordable Care Act of 2010 to rapidly increase the demand for patient services with resulting expanded coverage. The impending retirement of the ‘baby boomer’ generation is also expected to increase the demands on Arizona’s healthcare system. Arizona’s health workforce—especially in rural areas—will need to find strategies to meet this growing demand for health services.
A policy brief, prepared by Kimberly Ryan for the Center for Rural Health, summarizes the issues put forth by the Arizona Rural Health Workforce Trend Analysis report and offers several short-term and long-term strategies to address the expanding healthcare demands in rural Arizona. You can review the brief on our website, here.
The Southwest Rural Policy Network (SWRPN) has been awarded a grant from the Rural Policy Action Partnership to initiate a project in Rural Digital Advocacy. The grant provides support to rural advocacy groups like the SWRPN to leverage technology and social media tools to strengthen their rural policy work and campaigns.
The SWRPN has proposed to build an online “Rural Southwest Digital Community Center” as a platform to foster collaborative efforts between community-based projects in the rural Southwest. The website will replace their current site, and serve as a repository of shared resources for the rural communities in New Mexico and Arizona.
You can read more about the grant and the “Rural Southwest Digital Community Center” proposal here.
The Arizona AHCCCS has announced on their website that KidsCare II, a new children’s healthcare coverage program, will be available May 1, 2012 through December 31, 2013 for a limited number of eligible children.
KidsCare II has the same benefits and premium requirements as KidsCare, but with a lower income limit for eligibility. The income limit for KidsCare II is 175% of the Federal Poverty Level (FPL), based on family size.
Beginning June 25, 2012, all applications will be considered for eligibility in the KidsCare II program. Children will no longer need to be on the KidsCare waiting list.
Arizona’s Children's Health Insurance Program, known as KidsCare, operates as part of the AHCCCS program and is for children in households with incomes between 100%-200% of the federal poverty limit (FPL). Benefits and premium requirements for KidsCare II are the same as the regular KidsCare program.
The recent recession severely impacted Arizona's economy and led to a state budget shortfall, which required difficult decisions across all of state government. One of these decisions was to freeze enrollment into the KidsCare program on January 1, 2010. Since then, all KidsCare applicants have been placed on a waiting list in the event that enrollment could be re-opened.
KidsCare II is temporary and will end December 31, 2013. AHCCCS will assist children enrolled in KidsCare II to transition to the Health Insurance Exchange, which will be open for enrollment and coverage by that date.
The Pima County Women’s Health Review is the result of a collaborative effort among three groups: The Pima County/Tucson Women’s Commission, The University of Arizona Mel and Enid Zuckerman College of Public Health Center for Rural Health, and the University’s Southwest Institute for Research on Women.
The report was developed from information gathered at five structured discussion groups involving elderly women living in the Green Valley area, and economically disadvantaged women living in Tucson’s south side area. The aim was to find out if targeted groups of women experienced equal access to health care services, and also to discover information about their issues and challenges.
The report finds that the lack of access to health care services is devastating to both physical and mental health when a woman in Pima County cannot afford to pay for health care for herself or her minor dependents. When a person does not have the financial resources to pay for medical and/or diagnostic care, medications, dental or visual care, these problems and concerns do not go away. Instead, they usually worsen until serious problems develop and the individual then is forced to seek care in the emergency room, a far more expensive solution than if the problem had been dealt with in the first place. The report also addresses the seriousness of issues that face elderly women raising children. These are women whose struggle is enormous. In their so called “golden years” they find themselves raising grand children who they have adopted or are fostering in order to keep their families together.
To help to resolve some of the issues identified in the report, recommendations are made for action by Pima County Government, the Arizona Division of Aging and Adult Services, the Pima Council on Aging, the University of Arizona, the Kinship and Adoption Resource and Education (KARE) Family Center, the Tribal nations of Pascua-Yaqui and Tohono O-odham, and the Women’s Foundation of Southern Arizona. All recommendations are delineated in the report.