The 35th Annual Oregon Rural Health Conference
Oregon Office of Rural Health Recognizes Top Quality Performers
The Oregon Office of Rural Health (ORH) recognizes top performing Critical Access Hospitals (CAHs) and their Quality Improvement Officers each year. This year, a recognition category for Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) reporting was added and the Most Improved Reporting award was again won by one CAH that has consistently improved reporting in all areas of the Medicare Quality Improvement Program (MBQIP).
The Federal Office of Rural Health Policy created MBQIP in 2011 to implement rural relevant quality measures specific to low volume CAHs. MBQIP helps CAHs look at the quality data that makes sense for them and develop quality improvement activities that ensure the highest quality of care for their patients. MBQIP is a voluntary program and all 25 of Oregon’s CAHs participate. It is a proactive approach to ensure CAHs are prepared to meet future reporting requirements as well as performance-based payment models.
To recognize these hospitals for their commitment to quality reporting and quality improvement efforts, the ORH awarded one scholarship to the Quality Officer at each CAH to attend the 35th Annual Oregon Rural Health Conference and a $5,000 award towards quality improvement efforts specific to MBQIP reporting.
Congratulations to Oregon’s MBQIP Top Performers
Overall MBQIP Top Performer
Namrata Dave at Lake District Hospital
For Reporting on Emergency Department Transfer Communication Measures
Addie Demaris at Samaritan Pacific Community Hospital
For Reporting on Outpatient Measures
Jen Klausmeier & Tami Youngblood at Curry General Hospital
For Reporting HCAHPS
Karyn Temte Lloyd at Providence Hood River Memorial Hospital
For Most Improved MBQIP Reporting
Tara Blohm at Lower Umpqua Hospital
For more information about MBQIP or these awards, please contact Stacie Rothwell | (971) 235-3978 | firstname.lastname@example.org.
Rural Oregon Hospitals Take Top National Honors!
Grand Ronde Hospital, La Grande and Wallowa Memorial Hospital, Enterprise, have been recognized among the Top 20 Critical Access Hospitals in the areas of Quality and Patient Satisfaction from The National Rural Health Association (NRHA). The NRHA awarded the top 20 hospitals from a list of the top 100 based on results from the Hospital Strength INDEX®. This consists of eight performance indices including inpatient market share, outpatient market share, quality, outcomes, patient perspectives, cost, charge and financial stability.
Congratulations to Grand Ronde Hospital and Wallowa Memorial Hospital – Oregon’s rural hospitals leading the way!
2018 Oregon Areas of Unmet Health Care Need (AUHCN) Report Released
ORH released the 2018 Oregon Areas of Unmet Health Care Need (AUHCN) Report.
ORH revamped the AUHCN report last year to improve the measurement for access to primary care, dental care, and mental health care and to be more closely aligned with an integrated care model. With the input from other public health stakeholders, ORH produced nine variables that measure the availability of care, the affordability of care, and the utilization of care in all of the 130 primary care service areas in the state. The breakdown of results are by rural, frontier and urban regions. The variables are:
- Travel Time to nearest Patient Centered Primary Care Home (PCPCH)
- Primary Care Capacity (Percent of primary care visits able to be met)
- Mental Health Providers per 1000 Population
- Dentists per 1000 Population
- Percent of Population Between 138% and 200% of the Federal Poverty Level
- Ambulatory Care Sensitive Conditions/Preventable Hospitalizations per 1000 Population
- Inadequate Prenatal Care per 1000 Births
- Emergency Department Non-Traumatic Dental Visits per 1000 Population
- Emergency Department Mental Health/Substance Abuse Visits per 1000 Population
A one-page summary is included in the beginning of the report. Each variable has a short explanation and a map showing the results. Users can utilize the overall Unmet Need map that ranks all the service areas, and/or use each of the variable maps individually. A table is also included to help you quantify how well your community is able to access physical, mental, and oral primary health care.
If you have questions about the report, please contact Emerson Ong | (503) 494-5226 | email@example.com.
ORH Develops CAH Telemedicine Mapping Tool
The role of telehealth in providing access to healthcare continues to grow. A 2012 report by the Institute of Medicine for National Academies, entitled The Role of Telehealth in an Evolving Health Care Environment, found that telehealth drives volume, increases quality of care and reduces costs by reducing readmissions and unnecessary emergency department visits for rural communities.
As part of the work on assessing telehealth services at Oregon’s Critical Access Hospitals (CAHs), ORH has created an interactive mapping tool to show what telehealth services are provided by and at which of Oregon’s CAHs.
This, along with other telehealth resources, are updated regularly on our website. For questions contact, Rose Locklear | firstname.lastname@example.org.
Second Round 2018 HERO Grants Awarded
ORH awarded a second round of Helping EMS in Rural Oregon (HERO) Agency Training grants. Five EMS agencies- including three from frontier counties- received awards:
- Butte Falls Volunteer Fire and Rescue
- Christmas Valley Rural Fire Department
- Kellogg Rural Fire District
- North Lake County EMS
- Paisley Disaster Unit
HERO awards will be used to fund training of local emergency medical services (EMS) staff to become First Aid, CPR, Blood Borne Pathogen and AED Instructors, to train new volunteers as emergency medical responders (EMRs), and to help current EMRs certify as EMT-Intermediates, among other work.
Many strong applications were submitted, and agencies who have not received HERO grants within a full year of application are strongly encouraged to apply during the next award cycle, anticipated to occur in early 2019. For details about the application, or more information about the HERO program, please visit the ORH website. For questions about the award, contact Field Services Program Manager Rebecca Dobert | email@example.com | (971) 271-0481.
ORH Supports CAH Trauma Simulation Pilot Trainings
Four real-time trauma simulation pilot trainings concluded this summer at Critical Access Hospitals (CAHs) around the state. Trauma teams from Grande Ronde, Lake District, Lower Umpqua and Wallowa Memorial Hospitals, and their partner first responder agencies, participated in practice scenarios run by the Idaho Simulation Network (ISN). The CAHs chose their preferred scenario- including pediatric and obstetric traumas- and responded in real-time as ISN provided minute-to-minute case developments for teams to assess and treat. All trauma “patients” received stellar care - including those whose simulated trauma events occurred simultaneous to LIVE ones!
ORH will open competitive application in October 2018 for five additional simulation trainings in Fiscal Year 2018-19. Details will be posted on the ORH website and sent to CAH leadership. If you have questions about the simulations or submitting an application to participate, please contact Field Services Program Manager Rebecca Dobert | firstname.lastname@example.org | (503) 494-6627.
ORH Promotes Oregon Practice Opportunities at National AAFP Residency Conference
Stacee Reed, Program Manager for Recruitment Services, promoted rural Oregon practice opportunities at the 2018 American Academy of Family Physicians (AAFP) Residency Conference in Kansas City. The AAFP Conference brings together family medicine residents and medical students to attend workshops, procedural skills courses and access residency programs from across the country in one place. ORH, in partnership with 3RNet, the national non-profit linking health professionals with practice opportunities in rural and underserved communities, encouraged medical students to attend Oregon based residency programs and Oregon family medicine residents to stay and work in rural Oregon.
Oregon residency training programs were well represented! Working together, Oregon’s family medicine residency programs worked together to promote Oregon has a great place to work, live and play! You can find out more about Oregon’s family medicine residency programs below:
Oregon Health Authority (OHA) and OHSU Announce HOWTO Grant Program
The Healthy Oregon Workforce Training Opportunity (HOWTO) program is an $8 million grant program designed to ensure that the distribution of the healthcare workforce appropriately meets the needs of all Oregonians no matter where they live. HOWTO, a partnership between OHA and OHSU is now accepting applications.
The HOWTO grant program is intended to expand health professional training within the state to address current and future shortages in the healthcare workforce in rural and medically underserved areas of Oregon. The program is designed to support innovative, community-based training initiatives that will address local healthcare workforce shortages and expand the diversity of the health professional workforce. HOWTO seeks applications from Oregon community-based educational institutions, consortia, health care service organizations, and others seeking funding to help launch new, innovative training initiatives to address documented shortages in specific areas of their local healthcare workforce.
Applicants are strongly encouraged to propose health care professional training programs that:
- Address health disparities and social determinants of health,
- Support greater ethnic and linguistic diversity in Oregon’s health care workforce,
- Expand current health professional training already in existence in a local area, which may include Graduate Medical Education,
- Develop new health professional training programs in a local area, which may include Graduate Medical Education.
Applicants in collaboration with established programs elsewhere in the state are encouraged.
Applicants must leverage existing community resources and demonstrate a financial investment beyond the funds sought in the application.
Applicants must also provide information on how the new initiative will continue to be supported in a sustainable manner once the grant has expired.
Applicants must clearly demonstrate a data-supported healthcare workforce shortage in their community and describe how the proposed initiative will address this shortage.
All applications must include a detailed evaluation plan for their initiative.
Funding may be requested for up to 3 years. At this time, the program foresees funding about 8 -10 projects of up to $500,000 and about 3-4 projects ranging from $500,000-$1 million. However, the number of funded projects may change depending on the resources required to support those applications ranked highest by the grant review panel. The application must include all costs, including leveraged funding and in-kind support.
For those interested in applying, please refer to the Application Guidelines that outlines eligibility requirements, expected contents of the application packet, review process and timeline.
Rural Providers—Making a Difference in the Lives of Oregonians
My parents live in Halfway, Oregon, on the far eastern side of the state. It looks like this.
On July 2 my mom was packing the final supplies for a three week road trip when she was struck by a sudden, debilitating headache. She was conscious but semi-responsive. The Halfway-Oxbow volunteer ambulance transported her to the critical access hospital in Baker. The emergency room staff diagnosed her with a cerebral aneurism and called LifeFlight air ambulance to transport her to the neurosurgical team at the tertiary hospital in Boise, Idaho.
Fortunately, it was a small bleed and they were able to stabilize the aneurism with a catheter procedure. Mom is already home from the hospital and doing better than anyone expected after a subarrachnoid hemorrhage. It is going to take time but we have every hope that she will make a full recovery.
I am sharing Mom’s story because I want to say thank you. We are very lucky that Mom’s condition was treatable. We are also tremendously lucky that all of the parts of the rural health care system were ready and waiting when she needed them. Many times the work you do suffers from the classic public health dilemma—you never know the people you help and they never know what you did. But despite that dilemma, never forget that you are helping people and making a difference.
On behalf of all the people you will never know and never see, and especially on behalf of Kay Young and our family, I want to say thank you for working to maintain and improve rural health care.
Sarah Young is a Public Health Analyst at the Federal Office of Rural Health Policy and a former Board Member of Pine Eagle Clinic in Halfway Oregon.
Oregon Rural Provider Spotlight: Andrew White, PA
Oregon Health Care Provider Loan Repayment awardee Andrew White, PA, grew up in Holmes County Ohio. He completed most of his undergraduate training at Ohio State University before moving to Oregon with his wife to enroll in the doctor of chiropractic program at the University of Western States. While there, he completed the requirements for his bachelor’s degree. During this time, he developed an interest in providing the full scope of primary care and made the decision to pursue medicine. He completed his master’s degree in Physician Assistant studies at Pacific University in 2015. He currently works for Orchid Health’s Wade Creek Clinic, a Rural Health Clinic in Estacada. He took some time to talk about practicing in a rural Oregon community.
What made you decide to practice medicine?
While working on my undergraduate degree I considered a number of careers, but ultimately medicine made the most sense to me as a tangible and practical expression of my faith to those around me.
Did you always know that you wanted to practice in a rural community?
I did not enter PA school knowing for sure that I would practice rural medicine but it was always a desire I had. I grew up in a very rural and medically underserved part of Ohio. Rural medicine is the medicine I grew up receiving as a patient, and when I started shadowing providers it was rural family medicine PAs that gave me my first taste. So in many ways it’s what I feel most comfortable with.
What do you like most about your community?
The resilience and creativity of the people who live there.
Who is someone in your life who influenced your medical career or path? How did they influence you?
Dr. Bruce Douglas. He was my first supervising physician and one of the most compassionate people I have ever known. He taught me that people are what really matters, not policies, procedures, or even science when it comes down to it. Patients were never numbers or pathologies to him. They were always, each one of them, a person of unimaginable worth. His example continues to inspire me as a medical provider.
If you could give advice to people who are recruiting providers for positions in rural Oregon, what would it be?
Search for people with a sense of adventure. Rural medicine requires a lot of adaptability, and you need providers who enjoy that.
If you could give advice to a provider who is considering working in a rural community, what would it be?
I will address family medicine providers here specifically since I think they are the lifeblood of rural medicine. Be prepared to wear the hats of a pediatrician, an internist, a psychiatrist, a dermatologist, an endocrinologist, an outpatient orthopedist, and an emergency room provider. To me, family medicine is about extending yourself to provide the most comprehensive care possible to the entire population in your community, not about being a “health manager” whose job is to allocate referrals to an endless number of sub-specialists. Don’t get me wrong, I am so grateful for specialists, but I’ve seen some primary care clinics in urban settings where seemingly every problem is managed by a different specialist and the PCP becomes more of a travel guide than a treating provider. In rural medicine, that is not an option. Not only are specialists often far away, but patients in rural communities often are more resistant to traveling to see a specialist. As a rural provider, you are going to have to treat things that are new to you on a pretty regular basis. That means you are going to have to call specialists and ask questions, consult with colleagues and ultimately trust yourself to provide the best care. It is a challenge for sure but so gratifying. If you want to hyper specialize in one area, rural medicine is going to overwhelm you, but if stretching your boundaries and forming deep relationships with your patients is in your blood, nothing will feel quite as true as rural medicine.
Welcome New Providers Serving Rural Oregon
Nicholas Blake, MD, Family Medicine, Madras Medical Group, Madras, OR
Lina Castillo, MD, Pediatric Gastroenterologist and Hepatologist, Good Shepherd, Hermiston, OR
Gina Martin, MD, Family Medicine, Samaritan Family Medicine, Lebanon, OR
Around the State
Asante has been named one of Watson Health’s 15 Top Health Systems in the Nation.
Grande Ronde Hospital announced that Tammy Winde has been promoted to Senior Director of Provider Services, joining the hospital’s Executive Leadership team.
Lake District Hospital has promoted Namrata Dave to Director of Primary Care. Replacing Namrata in her previous role in Quality Improvement is Gauri Pande.
OHSU and Sky Lakes Medical Center have teamed up to build the Sky Lakes Collaborative Health Center, where primary care providers will collaborate with OHSU students and residents to better meet rural health care needs in Klamath Falls.
PeaceHealth Cottage Grove Community Medical Center was one of 14 hospitals nationwide to be a finalist for the High-Value Healthcare Award by Premier, Inc.
Oregon Partnership State Loan Repayment Program (SLRP)
SLRP is an incentive program for primary care providers working at approved Oregon practice sites in federally designated Health Professional Shortage Areas. SLRP is funded by the Health Resources and Services Administration (HRSA), and matched by an awardee's practice site.
SLRP requires a minimum initial two-year service obligation for full time providers, and a minimum 4-year service obligation for part time providers.
There have been several changes to SLRP that will take effect this year, including the removal of the tiered award system and the addition of Certified Alcohol Drug Counselor IIIs as an eligible provider type. Full time providers may receive up to of 50% in loan repayment on their qualifying educational debt, up to a maximum of $35,000 per obligation year, for an initial two-year obligation. Part time providers may receive up to 50% in loan repayment on their qualifying educational debt, up to a maximum of $17,500 per obligation year, for an initial four year obligation.
Practice site eligibility remains the same, including the requirement that a practice site have Site Application on file with ORH that is not more than one year old.
SLRP provider applications can be found on the SLRP website.
Oregon Provider Incentive Loan Repayment Program
Deadline: October 26, 2018
Applications and award cycle information for Providers and Oregon Practice Sites can be found on the Oregon Office of Rural Health's website.
Oregon Health Care Provider Incentive Loan Repayment Program Overview
In 2017 the Oregon Legislature created the Healthcare Provider Incentives Program (HB 3261) in the Oregon Health Authority. The purpose of the program is to support access to health care for underserved communities throughout Oregon. One program offering is loan repayment for health care providers who commit to serving patients in underserved areas throughout the state.
Eligible provider types include:
- Dentists in general or pediatric practice;
- Expanded Practice Dental Hygienists;
- Physicians (MD, DO or ND) who practice in the specialties of family medicine or general practice, general internal medicine, geriatrics, pediatrics, or obstetrics and gynecology;
- Nurse Practitioners who practice in the specialties of adult health, women's health care, geriatrics, pediatrics, psychiatric mental health, family practice, or nurse midwifery;
- Physician Assistants who practice in the specialties of family medicine or general practice, general internal medicine, geriatrics, pediatrics or obstetrics and gynecology;
- General, child and adolescent or geriatric Psychiatrists;
- Clinical Psychologists;
- Licensed Clinical Social Workers;
- Licensed Professional Counselors;
- Marriage or Family Therapist
Providers must practice at an eligible Oregon site, providing primary care in an outpatient setting.
Eligible sites must:
- Be located in a Health Professional Shortage Area (HPSA), or have a Facility HSPA; AND
- Be serving Medicaid and Medicare patients in no less than the same proportion of such patients in the county; AND
- Have a Site Application on file with the Oregon Office of Rural Health and have received confirmation of site qualification.
If the majority of providers at a site are not eligible for reimbursement from both Medicaid and Medicare, the site may qualify if it is located in a HPSA AND serves either Medicaid or Medicare patients in no less than the same proportion of such patients in the county.
Site Applications are valid for one year and can be found on the Oregon Office of Rural Health’s website.
Award Amounts and Commitment
Providers practicing full time must commit to a 3-year minimum service obligation in exchange for a tax-free award of 50% of their qualifying educational loan debt balance, up to $35,000 per obligation year.
Providers practicing part time must commit to a 3-year minimum service obligation in exchange for a tax-free award of 25% of their qualifying educational loan debt balance, up to $25,000 per obligation year.
For more information and answers to specific questions, please contact the Oregon Office of Rural Health | email@example.com | 503-494-4450 | toll-free 866-674-4376.
State Health Assessment (SHA) and State Health Indicators (SHI) Now Available
Since Oregon published its last SHA in 2012, Oregon has experienced tremendous gains in access to health insurance with the passage of the Affordable Care Act and the formation of coordinated care organizations (CCOs). However, some measures of health in Oregon have worsened, especially related to the social determinants of health.
The assessment and annually updated indicators provide a comprehensive, data driven summary that describes the health of people in Oregon. The SHA is a tool for anyone interested in improving population health in Oregon, including governmental and community public health agencies, CCOs, hospitals, health systems, private insurers, businesses, and social service agencies.
The SHA describes health within five categories: social determinants of health, environmental health, prevention and health promotion, access to clinical preventive services and communicable disease. The SHA also provides analysis to highlight health disparities for people of color, people with disabilities, people with low-income, people who identify as LGBT, and people who live in rural/frontier areas of the state. You can view the complete State Health Assessment and the annually updated State Health Indicators on the Public Health Division website.
The PartnerSHIP, or steering committee, will convene this fall to develop the next SHIP. More information about the PartnerSHIP and mini-grant process is available online.
You can email questions and comments to firstname.lastname@example.org.
SHIP (Small Rural Hospital Improvement Program) Grant 2018-2019
SHIP grants assist eligible hospitals in meeting the costs of implementing data system requirements established under the Medicare Program, including using funds to assist hospitals participating in improvements in value and quality to health care.
The Federal Office of Rural Health Policy will release the Fiscal Year 2018-19 SHIP grant application on an earlier schedule than previous cycles. The Office of Rural Health expects the application period to begin in October, rather than January.
Eligible small rural hospitals are located in the United States and its territories and include hospitals with 49 available beds or less. They may be for-profit, not-for-profit or tribal organizations. Critical access hospitals are eligible for the grant program.
For questions about eligibility or the application process, contact Field Services Program Manager Rebecca Dobert | email@example.com | (503) 494-6627.
Rural Health Network Development Planning Program
This is a one-year, community-driven program to assist in the planning and development of health care networks at the local level and strengthen the rural healthcare system as a whole.
The Federal Office of Rural Health Policy’s Network Development Planning program is open and receiving applications until November 30, 2018. The technical assistance webinar is Tuesday, October 16, 2018 from 2 - 3 p.m. ET.
- Call-In Number: 888-378-4398
- Participant Code: 267667
- Weblink: https://hrsa.connectsolutions.com/rural_health_network_planning_ta/
If you have any questions about the program, please contact Sara Afayee | SAfayee@hrsa.gov | 301-945-4169.