ORH Newsletter Vol. MMVII Ed. V
- 24th Annual Oregon Rural Health Conference: Set No Limits
- 2007 Legislative Update
- New Carsey Institute Report Finds that Over One-Third of Rural Children Rely on SCHIP and Medicaid
- Study Finds 1.8 Million Veterans Are Uninsured
- NRHA Official Policy on Health Disparities and Rural Veterans
- Great News for Rural Health Funding
- Call Your Members of Congress Now to Support Rural Health
- HIT and Quality Grants in Farm Bill
- NRHA Comments on the Proposed Hospital IPPS Regulations
- Rural Health Research
- Coming Events
Innovation * Creativity * Leadership
Register Now!!
The 24th Annual Oregon Rural Health Conference is almost here. This year’s conference will be held in September, making it just around the corner. “This year’s conference is based on Innovation, Creativity and Leadership,” says Scott Ekblad, Director of the Office of Rural Health. “We think the conference will help give people an opportunity to be creative and focus on the important areas in rural health.” This year will focus on Quality, HIT, EMS and more.
The ORHC is the largest gathering in Oregon dedicated to the important issues of rural health care. Bringing together providers, administrators, patients, activists, policy makers and others who are concerned about health care in rural Oregon, it is an opportunity to help set the agenda. In collaboration with the Oregon Rural Health Association, Oregon Area Health Education Centers (AHEC) and the Oregon Rural Practice Research Network (ORPRN), the Office of Rural Health strives to bring you the most innovative approaches to addressing today’s needs.
You will notice two changes in the conference this year — new date, new location. Finding a date and time that can accommodate the many people who want to attend the conference can be a challenge. A number of conference attendees have expressed concern about the late fall timing of past conferences and its conflict with a rural tradition — hunting season. To accommodate hunting season, ORH moved the conference this year to September 13-15th.
The second big change is the location. The conference rotates among the coast, the valley and east of the mountains. This year's conference will be held at the Salem Conference Center in downtown Salem. We think you will be as thrilled as we are about the new location.
We are also excited about the line up of topics and speakers this year! There is never a lack of important issues that confront rural health care providers. With the help of an outstanding planning committee, we think we have a great program scheduled!
This year, an honored national guest speaker will be a participant in the entire conference. Hilda Heady is Executive Director of West Virginia Rural Health Education Partnerships (WVRHEP) and Vice President for Rural Health at the Robert C. Byrd Health Sciences Center of West Virginia University. She is also a former President of the Board of Trustees of the National Rural Health Association. Ms. Heady is known as a tireless worker on behalf of rural communities across her state.
WVRHEP has been nationally recognized as a model partnership between communities, higher educational institutions and government agencies by the New York Times, the Wall Street Journal and the Journal of Rural Health.
The Partnership's outcomes are impressive: From 1999 to 2004, the number of rural physicians increased by 88 percent from 88 to 165. In 2002, WV health professional students participated in community service activities involving more than 158,000 rural residents. Health professional students have opportunities to serve and learn in 28 community health centers, 30 small rural hospitals, 25 dental offices, 37 pharmacies, 13 county health departments, 20 physical therapy agencies or rehabilitation centers in under served areas, and 16 county boards of education. Nearly 700 rural field faculty members are involved in health professional education.
There will be a day of pre-conference meetings on Thursday centered on Critical Access Hospitals, Oregon Rural Health Quality Network, statewide AHEC meeting, FLEX Advisory, Rural Health Clinic Workshop, ORPRN steering committee meeting and the Oregon Rural Health Association Board Meeting.
Friday is packed with informative sessions. The day begins with the Oregon Rural Health Association Annual membership meeting, followed by a welcome from Dr. Joe Robertson, President, OHSU. Back by popular demand, Scott Ekblad, Director, Office of Rural Health, Dr. Lisa Dodson, Director, AHEC, Dr. Bruce Carlson, ORHA, and Dr. L. J. Fagnan, Director, ORPRN will introduce you to their organizations and the work of each.
Other sessions include: Pay for Performance — with the federal government moving quickly to implement a pay for performance program for providers, it is essential that rural providers be prepared; Quality — key to offering successful health care services! Quality is a buzz word that people use to judge the providers they are searching for and the care they receive; Mental Health — always a challenge in Oregon and more so in rural areas; Dental Health — more and more, we are learning the importance of oral health in kids and adults; Recruitment & Retention — a challenge for clinics and hospitals. How do we attract the right providers to our communities? And Partnerships for Health — learn how partnerships can help make communities healthier.
During this legislative session, health care reform has been high on everyone's list. Come hear from legislators what happened during the 2007 Legislative Session and what will be addressed during the February 2008 session. It is vital that rural Oregon be part of that reform process.
The 2007 Legislative Session adjourned on June 29, 2007, ending one of the shortest sessions in history. As in all sessions, there are winners and losers. You can find copies of legislation at http://www.leg.state.or.us/index.html. Follow the link below for a list of bills affecting rural health care and how they did this session.
SB 37 Rural Safety Net Bill
Status: Failed
SB 37 would have funded the Emergency Medical Services Enhancement Account. In addition, it would have assisted isolated Rural Health Clinics in the forms of technical and financial support as well as provided seed money for Rural Health Viability Grants, which were authorized by the 2001 Legislature but never received the authorized appropriation.
A portion of SB 37 was included in the Healthy Kids Initiative, which passed as SB 3. That proposal will now go to voters in the 2007 November election. In addition to expanding coverage for children, passage would fund and direct the Office of Rural Health to award to rural health care providers grants that promote any of the following goals: (1) Replacement or renovation of aging rural hospitals. (2) Modernization of capital equipment. (3) Preservation of access to local health services in rural areas through short-term support of vulnerable rural health care providers. (4) Expansion of community health educational opportunities. (5) Providing incentives for the development of long-term, sustainable approaches to providing improved health care services and increased access to quality health care in rural areas. (6) Development of collaborative approaches that sustain access to quality rural health care. (7) Expanding or sustaining health care for financially and physically vulnerable rural populations. (8) Providing operational support for rural health centers that are not federally qualified health centers.
SB 162 Modifies EMS Trauma Systems Program
Status: Failed
SB 162 was introduced to address recommendations contained in a recent National Highway Transportation Safety Administration (NHTSA) assessment of Oregon emergency medical services system. The bill would: better define the general duties of Emergency Medical Services/Trauma Systems Program (EMS/TS); increase the scope of authority of EMS/TS to include all level of EMS providers and types of response vehicles; provide for medical direction and oversight that supports local service providers; require the development of a comprehensive state EMS plan that focuses on systems of care for life-threatening illness and injury; create meaningful definitions where none existed before; create the State Critical Illness and Serious Injury Steering Committee and clarify roles of existing EMS/TS committees and subcommittees; mandate a comprehensive reporting and data management system that will be linked to quality improvement; allow for enhanced provider reimbursement subject to availability of funds; create a Board of Emergency Responders similar to other health professional boards; and allow the Governor to deploy EMS personnel and equipment during a declared emergency. SB 162 died in committee.
SB 183/HB 3630 Extends Professional Liability Insurance Subsidy
Status: Passed
SB 183 continues the Medical Malpractice Reinsurance Program created with the passage of HB 3630 in 2003. Created as a temporary solution for high insurance premiums that were driving rural physicians from practice, the program was originally set to sunset December 31, 2007. The program is now extended to 2011 with changes.
SB 183 will continue to use SAIF funds to reduce the premiums for: doctors specializing in obstetrics and nurse practitioners certified for obstetric care at 80%; for doctors specializing in family or general practice who provide obstetrical services at 60 percent; and 40% for doctors and nurse practitioners engaging in one or more of the following practices: Family practice without obstetrics, General practice, Internal medicine, Geriatrics, Pulmonary medicine, Pediatrics, General surgery, Anesthesiology. Those who do not practice in one of the above areas are covered as follows: 35 percent for calendar year 2008, 25 percent for calendar year 2009, 15 percent for calendar year 2010, 15 percent for calendar year 2011. Funds are estimated to last until 2011. No funds are expected to remain after 2011.
In addition, providers must be willing to serve patients with Medicare and/or Medicaid coverage in at least the same percentage as the Medicare and Medicaid populations in the counties in which they practice.
The ORH will work with SAIF Corp to finalize rules. Program information will be posted on the ORH website in early fall.
SB 188 Oregon Rural Health Services Loan Repayment Program
Status: Passed
The Oregon Rural Health Services loan repayment program was created in 1989 (ORS 442.550 – 442.570). It was funded at a level of $400,000 per biennium, and remains at that level today. The program benefits primary care physicians, nurse practitioners, physician assistants, pharmacists and, with the passage of SB 188, dentists.
Since 1994, the first year that loan repayment awards were made, 122 health care professionals have been awarded loan repayment through this program. 38% are physicians, 38% are nurse practitioners, 22% are physician assistants and 2% are pharmacists. Of the 122 awardees, 20% are currently receiving payment, 38% have fulfilled their obligation and completed the program, and 42% either declined or forfeited their award.
SB 188 made programmatic changes in the statute to enable communities to use this program as a direct recruitment incentive, facilitate a higher rate of compliance by loan repayment awardees, encourage donations to the program by rural communities (and enable OSAC to invest those contributions in those same communities) and add dentists to the list of eligible awardees. Additional funds were requested in the Governor’s budget (part of the Oregon Student Assistance Commission budget, HB 5044) but they were not approved by the legislature.
HB 2500/SB 459 Expands tax credit to Firefighters First Responders
Status: Failed
Oregon’s current EMT Tax Credit Program, passed in the 2005 legislative session, grants up to $250 in a personal income tax credit for EMTs who volunteer their services to rural Oregon communities. However, the program unintentionally poses eligibility barriers for those who both work as a rural EMT and volunteer their time providing emergency medical services. HB 2500 and SB 459 were introduced to fix the problem. While there was support for the changes, they did not make it through the legislature and the bill died at the time of adjournment.
HB 2201/ SB 3 Creates Oregon Healthy Kids Program
Status: Referred
The Governor’s signature health reform, the Healthy Kids Program, was designed to expand coverage for uninsured children. The bill was defeated in the House. Supporters were unable to get the necessary 2/3rd vote to increase the cigarette tax. To keep the plan alive, legislators have referred the measure, passed as SB 3, to the voters this November. In addition, the legislature added portions of SB 37, the Rural Safety Net Bill. If passed by voters, this measure would provide money to the Office of Rural Health to award grants that promote any of the following goals: replacement or renovation of aging rural hospitals; modernization of capital equipment; preservation of access to local health services in rural areas through short-term support of vulnerable rural health care providers; expansion of community health educational opportunities; providing incentives for the development of long-term, sustainable approaches to providing improved health care services and increased access to quality health care in rural areas; development of collaborative approaches that sustain access to quality rural health care; expanding or sustaining health care for financially and physically vulnerable rural populations; providing operational support for rural health centers that are not federally qualified health centers.
SB 329 The Healthy Oregon Act
Status: Passed
SB 329 was developed by the interim Senate Commission on Health Care Access and Affordability, chaired by Sen. Ben Westlund and Sen. Alan Bates. It is the result of work from the Commission along with components of Governor John Kitzhaber’s Archimedes plan (http://www.archimedesmovement.org/), Governor Kulongoski’s Oregon Health Policy Commission and the Oregon Business Council Proposal. In addition, there was input from citizens throughout the state.
SB 329 did pass with a number of changes. The bill creates the Oregon Health Fund Board, with a mandate to develop a plan for an affordable health system to be acted upon by the 2009 legislature.
The Health Fund Board would be charged with developing a plan to provide essential health services to all Oregonians. The board will consist of seven members appointed by the Governor and confirmed by the Senate. Board members will be aided by professional staff from the Oregon Health Policy Commission, the Office for Oregon Health Policy and Research, the Health Services Commission, and the Medicaid Advisory Committee.
The Oregon Health Fund Board will create subcommittees that examine financing, the delivery system, benefits, and eligibility and enrollment of health care policies. They will also establish a federal policy committee to study the impact of federal laws on health care goals and ask the Oregon congressional delegation to take action.
A higher percentage of children in rural areas depend on Medicaid or the State Children’s Health Insurance Program (SCHIP) for health insurance than children in urban areas, a new study by the Carsey Institute at the University of New Hampshire finds.
The Carsey Institute found that in 2005, 32 percent of children in rural areas relied on SCHIP or Medicaid compared to 26 percent of children in cities. The report also found more rural children living in economically vulnerable families, with 47 percent of rural children living in low-income families in 2005, compared with 38 percent of urban families.
Nationwide, approximately 28 million children receive health insurance from Medicaid, with an additional six million covered by SCHIP. Enacted in 1997, SCHIP serves children in low-income families that generally earn too much to qualify for Medicaid, but too little to afford private health care coverage. “SCHIP plays a vital role in the health of rural children,” said Mil Duncan, director of the Carsey Institute at the University of New Hampshire. “Every year, public health insurance becomes increasingly important to low-income families as employers drop private coverage or jobs are lost due to changes in the rural economy.”
From 1996 to 2005, the number of children covered by private health insurance steadily declined, while those covered by SCHIP and Medicaid steadily increased. This trend was found in both urban and rural America. In rural communities, the steady loss of manufacturing jobs has contributed to the loss of private health insurance coverage.
“Among rural children living in low-income families, we saw private-sector insurance coverage fall from 45 percent to 37 percent between 2000 and 2005,” said William O’Hare, report author and senior fellow at the Carsey Institute. “These families have little option but to seek government-funded coverage for their children. This shift away from employer-based insurance is likely to continue, resulting in increased reliance on SCHIP and Medicaid.”
The U.S. Congress is due to reauthorize the SCHIP program in 2007. Under consideration are proposals to expand coverage to more families and increase funding.
“This year Congress has a historic opportunity when it reauthorizes the SCHIP program to expand health coverage to America’s nine million uninsured children,” said Ron Pollack, executive director of Families USA. “Both the Senate and House of Representatives have passed a budget resolution setting aside $50 billion in additional funding for SCHIP over the next five years. This report demonstrates how important it is to expand coverage to uninsured children in rural communities.
"Above all, today's report reinforces the fact that SCHIP must be reauthorized and its funding must be increased,” said Bruce Lesley, president of First Focus, a bipartisan organization dedicated to advocating sound healthcare policies to protect America's children. “With trends showing a continuing decline in the number of children covered by private sector health insurance, urgent attention must be given to America's rural communities, as they have become the neediest in the country. As the study points out, more children in rural communities are relying on SCHIP and Medicaid than those in urban regions, underscoring the need to increase the number of kids eligible for SCHIP and to expand outreach and enrollment efforts in all areas across the nation."
While Medicaid and SCHIP are covering more children each year, more than eight million children under 18 still lack health insurance. In rural America, the Carsey study found that a majority of uninsured children – 54 percent – live in families where the head of the household works full-time year-round.
Studies have found that as many as 20 million children live without health insurance at some point in the year. This is especially true in families in which a parent is employed in seasonal or cyclical work, which can be more prevalent in rural areas.
“There are a number of reasons why eligible children are living without health coverage,” said Mil Duncan. “In some cases, families are unaware that their children qualify or don’t know how to apply. In rural areas, many people have to travel long distances to apply, which isn't an option for many low-income families. It’s clear that solutions are needed in rural America, including making private insurance more affordable and expanding public health insurance programs.”
The Carsey Institute at the University of New Hampshire conducts research and analysis on the challenges facing rural families and communities in New Hampshire, New England, and the nation. The Carsey Institute sponsors independent, interdisciplinary research that documents trends and conditions affecting families and communities, providing valuable information and analysis to policymakers, practitioners, the media, and the general public. Through this work, the Carsey Institute contributes to public dialogue on policies that encourage social mobility and sustain healthy, equitable communities. The Carsey Institute was established in May 2002 with a generous gift from UNH alumna and noted television producer Marcy Carsey.
Figure Has Grown by 290,000 Since 2000, Professor Tells House Veterans Panel
By Christopher Lee | Washington Post Staff Writer
Thursday, June 21, 2007; Page A09
As the nation struggles to improve medical and mental health care for military personnel returning from Afghanistan and Iraq, about 1.8 million U.S. veterans under age 65 lack even basic health insurance or access to care at Veterans Affairs hospitals, a new study has found.
The ranks of uninsured veterans have increased by 290,000 since 2000, said Stephanie J. Woolhandler, the Harvard Medical School professor who presented her findings yesterday before the House Committee on Veterans Affairs. About 12.7 percent of non-elderly veterans — or one in eight — lacked health coverage in 2004, the most recent year for which figures are available, she said, up from 9.9 percent in 2000. Veterans 65 and older are eligible for Medicare.
About 45 million Americans, or 15 percent of the population, were uninsured in 2005, the Census Bureau reports.
"The data is showing that many veterans have no coverage and they're sick and need care and can't get it," Woolhandler said.
Woolhandler's findings are based on data from two national surveys — the Current Population Survey administered by the Census Bureau and the National Health Interview Survey administered by the Department of Health and Human Services. Veterans who said they had neither health insurance nor veterans or military health care were counted as uninsured.
Woolhandler is a well-known advocate of guaranteeing access to health care for all Americans through a government-run national health insurance program. Republican lawmakers seized on that association to question whether she was trying to advance that goal with her study.
"The difficulty would be that because of your desire for universal health care, that could influence how you felt about veterans," Rep. Cliff Stearns (R-Fla.) said.
Woolhandler said the data are sound. She has firsthand experience with the issue as well, she said, because as a physician she has seen uninsured veterans with untreated high blood pressure, diabetes and other conditions.
"It breaks my heart," she said. "The VA should be an important safety net for my patients, and it's not."
Nearly 8 million veterans were enrolled in the VA health system in 2006. The focus of the hearing was whether to open VA hospitals' doors to so-called Priority 8 veterans, who have no service-connected disabilities and whose earnings generally are above 80 percent of the median income where they live. Doing so would add significantly to VA's caseload and costs — estimates range from $366 million to $3.3 billion annually — and some veterans groups and lawmakers are concerned that it would make it harder for veterans with serious service-related health problems to get timely care.
Only about half of the 1.8 million uninsured veterans are classified Priority 8, Woolhandler said. The rest may technically be eligible for some VA care but live too far from its facilities for it to be a real option, she said.
The Rural Health Policy Board is the policy-making body of the National Rural Health Association. It is made up of elected representatives from each of the association's nine constituency groups, its State Association Council, its State Office Council, and its Issue Groups, the Minority and Multicultural Committee and the association's officers. This gives the board grassroots representation that reflects the concerns of the NRHA's membership. The Rural Health Policy Board determines the association's positions on public policy through a series of Policy Briefs and Issue Papers. During its two most recent meetings (February and May), a number of new policies were discussed and passed. Two of those are now available on our website.
Policy Statement defining "Health Disparities" An updated Issue Paper on "Rural Veterans" that includes the most recent data from our soldiers serving in Iraq and Afghanistan. To view these and other official NRHA policies, go to: http://www.nrharural.org/advocacy/sub/PolicyBrf.html.
The House Appropriations Subcommittee marked up the Labor-HHS appropriations bill on Thursday, June 7. This is the bill that funds the "rural health safety net" programs. The bill has good news for many of the programs that the NRHA monitors! We're delighted to see that our efforts paid off and the subcommittee included large increases to Outreach and Network Grants, Rural Health Research, State Offices of Rural Health, the National Health Service Corps, Area Health Education Centers, and Community Health Centers!
On the other hand, we will continue to work to reinstate programs such as the Community Access Program Grants, Health Education and Training Centers, Quentin Burdick Rural Training, and Rural EMS/Trauma that are still not funded by this Congress.
We expect the full House Appropriations Committee to vote on the bill in early July, followed by the full House of Representatives. The Senate is expected to look at the Labor-HHS appropriations bill later this month. The Senate has nearly $2 billion less slated for the Labor-HHS bill than the House, but we believe that these Rural Health programs will be protected. We will continue to update you and may need your help in order to secure these funds through the Senate and any possible Presidential veto.
To view the funding chart with the Subcommittee, go to: http://capwiz.com/nrha/issues/alert/?alertid=9894381
In the Senate, a major comprehensive rural health care bill has been introduced. Senators Conrad, Roberts, Harkin, Domenici and others introduced a large package of provisions for rural health. This package, the Craig Thomas Rural Hospital and Provider Equity Act, honors Senator Thomas, who passed away recently. He spent his career as a champion of rural health care and served as a co-chair of the Senate Rural Health Caucus!
The House Rural Health Care Coalition is expected to introduce the Health Care Access and Rural Equity (H-CARE) Act of 2007 soon.
Both packages have significant improvements to the rural health care landscape. Some of the provisions found in the two bills include:
- Hospital Reimbursement Improvements - removal of the DHS cap;
- Critical Access Hospital improvements, re-basing the Sole Community Hospital formula, and the creation of the Rural Community Hospital program;
- Physician Reimbursement Improvements - mental health, physician pathology services, ambulatory trips, and the work geographic adjustment to a 1.0 floor;
- Rural representation on the Medicare Payment Advisory Commission;
- Raises the Rural Health Clinic encounter rate cap;
- Prompt payment of pharmacists by Medicare Prescription Drug Plans and MA-PD plans under Medicare Part D;
- Extension of 5% Medicare adjustment payment for home health services provided in rural areas;
- Grants for Health Information Technology, Quality Improvement, and the reauthorization of the Outreach and Network grant programs
- Expansion of the 340B program to rural hospitals
In order to help generate momentum on this legislation, we need your members of Congress to be co-sponsors of this important legislation. Please call your Senators and Representative today and ask them to become cosponsors of this legislation!
The NRHA has been a leading voice in the Campaign for a Renewed Rural Development to support passage of a flexible and fully funded Rural Development Title in the next Farm Bill. In addition, we have been working with Congressional leaders to make sure the Farm Bill includes provisions that will help strengthen the rural health system. Studies have shown that strengthening health care in rural America can have a major impact on the economic viability of our communities. The NRHA is pleased to see that the House Agriculture Subcommittee, working on the next Farm Bill, has included grants for the purchase of Health Information Technology and Quality Improvement. We will be working with the full committee and the Senate to include similar provisions.
To read more about the Campaign for a Renewed Rural Development, go to http://www.ruralcampaign.org/.
The NRHA submitted comments on June 12, 2007 on the CMS proposed rule on the Hospital Inpatient Prospective Payment System (IPPS). In the rule, CMS proposes to create 745 new severity-adjusted diagnosis-related groups (DRG) to replace the current 538 DRGs. Overall, payments under the inpatient prospective payment system to hospitals would increase by an average of 3.3% in fiscal 2008 for those hospitals that report quality data to the CMS, though hospitals' payments will vary depending on the patients they serve.
The NRHA commented that while CMS spent a tremendous amount of time and effort to adjust the DRG system with a severity-adjustment system, that we were concerned with the implementation of this system by the fall. This is a short time frame to allow hospitals time to figure out the new system and to report secondary diagnosis. We believe this puts rural hospitals at a disadvantage. In our comments, we supported the American Hospital Association's proposal to have a four year phase-in of the system and other supports of rural facilities.
In addition to the new severity-adjusted DRG, the NRHA also weighed in on a number of topics including urging CMS to allow Critical Access Hospitals to keep their former provider number if they become PPS hospitals so that they can apply for Medicare Dependent Hospitals or Sole Community Hospital status and that CMS should not require Rural Referral Centers to keep their status for one calendar year. Both of these would be CMS using their authority in new ways that would affect policy around rural hospitals.
To read the full comments, please go to: http://www.NRHArural.org/advocacy/pdf/CMS-IPPS.pdf.
New Briefing Paper on Critical Access Hospital Quality Measure Results available from the Flex Monitoring Team
This briefing paper examines the second year participation and quality measure results for Critical Access Hospitals (CAHs) in the Centers for Medicare and Medicaid Services Hospital Compare public reporting database. Overall, 53% of CAHs were participating in Hospital Compare by submitting data on at least one measure for 2005 discharges as of September 2006. The paper concludes that CAHs still have room for improvement on these quality measures, especially with regard to recommended care for acute myocardial infarction (AMI) and heart failure patients. However, it is encouraging that the group of CAHs that reported Hospital Compare data for both years significantly improved their performance on almost all pneumonia, heart failure, and surgical infection measures.
For more information, please contact Michelle Casey at mcasey@umn.edu. To request a hard copy, please contact Jane Raasch at raasc001@umn.edu.
The full report may be viewed or downloaded from the Flex Monitoring Team website at: http://flexmonitoring.org/documents/BriefingPaper16_HospitalCompare2.pdf.
- 2 day Provider or 1 day Recertification ALCS Course
July 21 & 22, 2007
Harney General Hospital
Burns OR
For more information, click here. - The Telehealth Alliance of Oregon (TAO ) in-service trainings for Critical Access Hospitals & Rural Health Clinics
August 3, 2007
6 Sites Statewide
For more information, click here. - Rural Women’s Health Conference
August 13-15, 2007
Omni Shoreham Hotel, Washington DC
Registration and conference details, click here. - 24th Annual Oregon Rural Health Conference
September 13th - 15th, 2007
Salem Conference Center
For more details, click here. - The Telehealth Alliance of Oregon (TAO ) in-service trainings for Critical Access Hospitals & Rural Health Clinics
October 5, 2007
6 Sites Statewide
For more information, click here. - 30th Annual Oregon Nurses Association's Nurse Practitioners of Oregon (NPO) Education Conference
November 2-4, 2007
Salishan Lodge on the Central Oregon coast
For more information, click here.
