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The following summary of strategies resulted from the Center for Rural Health’s (CRH’s) 2013 Strategic Planning process.
I) Clearly articulate the Center’s Mission, Vision and its assumptions related to its Principles and to all rural stakeholders, as well as within the Mel and Enid Zuckerman College of Public Health and the University of Arizona.
II) Retain management of the Arizona State Office of Rural Health (AzSORH), the Arizona Rural Hospital Flexibility Program (FLEX), and the Small Hospital Improvement Program (SHIP)1
A) Improve the integration of these programs and develop more unifying complementary strategies to support:
1) Improving rural oral, behavioral and primary health services.
2) Supporting the development of flexible, locally-relevant, models for multi-organizational “networks”, while enhancing ability to make strategic, successful, partnership choices (collaboratives, consortiums, networks, partnerships).
3) Supporting the development of local health leadership capacity and strengthen rural, place-focused organizations
4) Strengthening the capacity of “Safety Net” providers to offer fundamental services to vulnerable populations
5) Expanded issue awareness and education
III) Remain involved with Tribal and Border populations by continuing to extend the Center’s services and exploring other options
A) Continue the Border Health Research focus, but reassess the Center’s Border Health strategies
1) Conduct an evaluation of Border Health Program and assess the opportunity to reorganizing the program within the College to create a more unified approach to Border, Migrant, and Immigrant Health. Include consideration of urban population needs.
a) Evaluate the opportunities to become a national resource addressing the effects of the affordable Care Act (ACA) on Border populations, including the effects of expanded Medicaid.
b) Identify gaps in Border Health research and opportunities for funding.
B) Assess opportunities and funding that would support a greater role in assisting Tribal populations
1) Further assess how tribal needs fit within the Center’s existing programs or other program expansions as addressed in this plan and develop a Tribal-specific business plan, considering the following:
a) Discuss opportunities for the Center to play an expanded role with the Tribal Nations, the Arizona Department of Health Services, the Arizona Commission of Indian Affairs, and the Indian Health Service
b) Consider the Center’s roles in assessing Tribal needs related to:
- The implementation of the general and tribal-specific provisions of the ACA
- Expansion of tribal access to fundamental services for rural and non-rural tribal populations
- Access to specialty services
- The extension of Medicaid benefits and the eligibility of tribal populations
- The development of expanded public health and prevention programs
- Workforce strategy development
- The expanded development of oral health and behavioral health services
- Uses of remote access technology
- How expanded involvement in Tribal issues fits with the faculty and research objectives of the Center and University
IV) Become the University of Arizona’s and the Mel and Enid Zuckerman College of PublicHealth’s recognized and supported integrator and facilitator of rural health strategies and initiatives
A) This will include:
1) Being a critical partner and supporter of any program addressing rural health issues
2) Facilitating the development of College of Public Health and university-wide rural health strategy plans (or strategy maps) and guidelines for internal University collaboration and coordination
3) Continuing to support for the University’s and College’s academic and educational plans
4) The development of a collaborative relationship with the University-affiliated Arizona Health Network and its various clinical centers
V) Improve the connectivity and working relationships with other rural stakeholders and become more highly recognized as a value-adding organization
A) Become recognized as a leading catalyst for improving rural health status and addressing population-based health strategies, including the reduction of health disparities
B) Leverage current efforts, to better position the Center to be a leading force in the development of network or systems of rural health care
C) Use a combination of the Institute for Healthcare Improvement’s Triple Aim concept, the Institute of Medicine’s rural quality study, the National Rural Health Association’s policy on the Future of Rural Health, and National Organization of State Offices of Rural Health’s future of rural health initiative, as the vehicles for stimulating multi-party collaboration on the issues of access, quality, cost, patient experience, and population health.
1) This will include defining and articulating the scope of rural services and delivery approaches to assure appropriate access for rural populations, including:
a) Promotion of a set of fundamental rural health services and relationships to which clusters of rural communities should have access, with particular emphasis on primary health services
b) Rural Population Health Improvement Strategies including public health strategies and other approaches for addressing health disparities
VI) Establish the Center (in conjunction with other College of Public Health colleagues) as a hub/clearinghouse on how the ACA will be implemented in rural Arizona and the impacts on rural populations
VII) Establish a clearer role for the Center in addressing the definition and integration of rural workforce strategies and rural workforce research consistent with the fundamental services
A) This will include expanding discussions with the Arizona Area health Education Centers, consideration of trends in rural delivery systems design, the use of telemedicine, the evolving roles of various primary care providers, and workforce needs that extent beyond primary care.
VIII) Become the leader in rural data aggregation and analysis/analytics
A) Conduct a study and business plan development process to assess the feasibility of the Center further developing as a more recognized Rural Data Organization. This will include:
1) Consideration of opportunities to become the primary source of rural data, issue analysis, policy advice, and policy research for the all rural stakeholders, including all rural providers and communities, university programs (faculty, research, service needs), and the Executive and Legislative branches of State government
2) Assessment of revenue generation possibilities, including grants, contracts, and fee-for-service activities
IX) Become a nationally recognized Rural Research Center serving Arizona’s population as well as national and global needs
X) Become the recognized expert in rural project/study design and project monitoring and evaluation (within the Center, with the College, and for rural stakeholders)
This will include:
a) Improving internal evaluation processes related to Center programs, considering:
(1) More standardized approaches for program evaluation, stressing outcome evaluation and greater consistency of application
(2) Better use of other College and University resources
b) Conducting a needs assessment and feasibility study for further developing marketable services
XI) Improve the Center’s ability to lead, support and to have influence with rural stakeholders and other associated organizations, and to leverage the Center’s resources. This will include:
A) Developing an enhanced identification and tracking system to better identify all key organizations and individuals as well as key works-in-progress, such as grants or other projects.
B) Further assessing the role of the Arizona Rural Health Association and its relationship to the Center and create a joint plan for future collaboration
C) Further assessing factors that determine probable project success and considering the need for selective partnering to increase the effective allocation of limited resources
D) Developing a client relationship and marketing plan to build relationships with other stakeholders. This will include:
- The Arizona Department of Health Services
- Arizona Health Cost Containment System
- The Governor’s Office
- Legislators (especially those from rural areas)
- Local governments and public health departments in rural communities
- The Indian Health Service
- Rural economic development agencies
- The Southwest Rural Policy Network and its associated role with the Center
XII) Established a prioritized research agenda and seek research funding
This will be consistent with high priority rural needs, the Center’s Plan, and the College’s and University’s research goals.
XIII) Assess additional, potential sources of expanded funding
This will include:
A) Additional grants and contracts
C) Fee-for service options
XIV) Assess operational issues to improve effectiveness and efficiency
This will include addressing the utilization of human and financial resources, and the needs for any changes in organizational structure to support current and expanding programs. Center for Rural Health Strategic Plan Core Strategies 2013 4
A) Specific attention will be given to developing a management plan that will address the needs for expanding management depth for the Center’s multi-faceted strategies.
XV) Continually explore changing issues and the need to adjust strategies and priorities. Center for Rural Health Strategic Plan Core Strategies 2013 5
1. Broad program strategies are outlined in the Center’s plan, but detailed program strategies are found in the Center’s grant applications and periodic reports.