July 7, 2010

Coming in September

5th Annual New England Rural Oral Health Conference
Featuring Laurie Norris, Esq., Pew Children's Dental Campaign

Improving Access Through Advocacy and Public Health/Private Partnerships

Friday, September 24, 2010 8:30 a.m. - 3:45 p.m.
Westford Regency - Westford, MA 01886

The RoundTable gratefully acknowledges the sponsorship of Northeast Delta Dental Foundation, Inc., which has generously contributed $2500 to the Conference.

Reserve your place at this key meeting now! You can Register online. Additional sponsorship opportunities are available.

View Flyer (PDF/151KB)

Looking Ahead to October

13th Annual New England Rural Health RoundTable Symposium
at the Inn at Mills Falls, Meredith, NH

Connecting Personal Health and Public Health in Rural New England

Registration - 2009 Review - Sponsorships

A highlight of the Symposium is the presentation of awards. If you would like to nominate a person or a group for an award, you see full descriptions and the Nomination forms on the website.

Here is a snapshot of the award descriptions:

Volunteer Award - Recognizes excellence in the volunteer provision of health services to rural communities.

The President's Award - Presented to a group or individual whose efforts have had an impact on the alliance of organizations and individuals who work to make the RoundTable a strong consortium.

Clinician Award - Honors a direct service provider for leadership in bringing health services to citizens in rural New England.

Leadership Award - Acknowledges contributions of an individual who has shown policy support for assuring healthcare services to people living in rural New England.

Please submit your nominations before July 31, 2010.

Dear Round Table Members:

Dear Members: Here's a quiz: do you notice something missing on our outline map of the New England states? If you said, "where are Martha's Vineyard and Nantucket," - you've got the right answer! Some map images omit Massachusetts' two most famous islands, on which are located both a Critical Access Hospital (on Martha's Vineyard) and a rural hospital (on Nantucket.) We're still looking for the right map. (Photo Shop, anyone??)

Dot Bergin, Editor

UMASS Rural Health Scholars - Where They Work

The interprofessional Rural Health Scholars program at UMass Medical School graduated its first class in 2005. Where are they now? Here is the follow-up:

• 59% of 29 medical students have gone into primary care, including obstetrics/gynecology.


• When emergency medicine and psychiatry are included, 76% of the medical graduates are entering residencies that train physicians in high need in rural areas.

If your site is interested in learning about what is needed to host college level, pre-med and pre-nursing students for a summer, please contact: Suzanne.Cashman@umassmed.edu.

Patient Safety Academy

The Maine Critical Access Hospital Patient Safety Collaborative invites Maine health care colleagues to:

The Patient Safety Academy
Monday, August 2 9 a.m. - 3:15 p.m.
University of Southern Maine/Portland Campus

Carol Haraden, PhD, Institute for Healthcare Improvement, will give the keynote address. See the full program. For more information, contact Judy Tupper.

Summer Meetings Keep Us Busy!

The NRHA Quality and Clinical Conference promises free lobster at their Portland, Maine meeting on July 21-23 (see their Facebook page).

RoundTable Executive Director Marion Pawlek and consultant Greg Wolfe will review "New England's Performance Improvement Initiative: A Regional Collaboration to Improve Critical Access Hospital Quality."

Board member Jonathan Sprague will present "The Developing Crisis in Rural General Surgery."

Maine Telehealth Summit

Board Member Charles Dwyer reminds us to save the date for the Maine Telehealth Collaborative Conference on Tuesday, August 17 at Wells Conference Center, University of Maine, Orono, 8 a.m. - 5 p.m.

Dr. Dale Alverson, President of the American Telemedicine Association, will give the keynote address.

Who Should Attend:

• Health care providers (primary care, specialty, hospital, home health, and more) - Hear and see how telemedicine can provide a cost effective, easy way to provide care without a big investment or a high level of tech knowledge and with a good ROI.


• Patients - Learn how telemedicine can improve access to quality health care.


• Employers and public and private payors - Find out how telemedicine can reduce costs and improve utilization of services.

Attendees will hear what's happening in law and policy regarding telemedicine in Maine and will learn how to get started using telemedicine in their own organizations.

Registration fee is $50.00 per registrant and will include all materials and lunch. For more information, see Maine Collaborative Website.

Good News from the IRS!

Affordable Care Act Provides Expanded Tax Benefit to Health Professionals Working in Underserved Areas

As part of a larger Administration announcement on efforts to strengthen the health care workforce, the Internal Revenue Service announced on June 16 that under the Affordable Care Act health care professionals who received student loan relief under state programs that reward those who work in underserved communities may qualify for refunds on their 2009 federal income tax returns as well as an annual tax cut going forward.

"Doctors and nurses who choose to practice in underserved areas make a great contribution to their local communities," Commissioner Doug Shulman said. "By expanding the tax exclusion for student loan forgiveness, the Affordable Care Act provides an even greater incentive to practice medicine in areas that need it most."

The Affordable Care Act included a change in the law, effective in 2009, that expands a tax exclusion for amounts received by health professionals under loan repayment and forgiveness programs. Prior to the new law, only amounts received under the National Health Service Corps Loan Repayment Program or certain state loan repayment programs eligible for funding under the Public Health Service Act qualified for a tax exclusion.

The Affordable Care Act expands this tax exclusion to include any state loan repayment or loan forgiveness programs intended to increase the availability of health care services in underserved areas or health professional shortage areas and makes this exclusion retroactive to the 2009 tax year.

For details on eligibility and filing for a refund, see the website.

National Health Service Corps Loan Repayment

Applications are being accepted until July 29 for National Health Service Corps loan repayment. The National Health Service Corps recruits primary care medical, dental and behavioral and mental health clinicians who are dedicated to providing care to the Nation's underserved people. In return, they can reduce or eliminate their health professions student debt by providing care at a National Health Service Corps-approved site.

The Full-Time Program starts with an initial award of $50,000 for 2 years of service. The new Half-Time Pilot Project starts with an initial award of $50,000 for 4 years of service. Participants may apply to extend their service until their debt is paid. Full-Time Service: Apply by July 29.

Sign up to be notified by e-mail when the 2011 application cycle opens. Visit the website for complete information.

Harvard Professor to Help Design VT Health Options

Dr. William Hsiao, who helped design the healthcare system for Taiwan, has been chosen to help create three options for redesigning Vermont's healthcare system. His task is to give lawmakers three road maps the state could follow to achieve a more efficient but less expensive healthcare system One must be government financed, and another must include a public option for health coverage along with private insurance.

The Vermont Health Care Reform Commission recommended on June 28 that the Legislature hire the Harvard economist for a six-month, $300,000 health research project for Vermont. Dr. Hsiao was chosen from three finalists.

Read reporter Nancy Remsen's article in the Burlington Free Press.

NEW from the Maine Rural Health Research Center

RoundTable President John Gale and colleagues have issued
"The Provision of Mental Health Services by Rural Health Clinics"
May 2010, Working Paper #43

John A. Gale, MS, Barbara Shaw, JD, David Hartley, PhD
Cutler Institute for Health and Social Policy
Muskie School of Public Service
University of Southern Maine
Stephenie Loux, MS, Department of Psychiatry
Beth Israel Deaconness Medical Center, Boston, MA

Executive Summary
Due to chronic shortages of mental health services, much of the burden of care for mental health issues in rural areas has shifted to the primary care sector (Gale & Lambert, 2006). The National Advisory Committee on Rural Health and Human Services recognized the important role played by the primary care sector in meeting the mental health needs of rural residents in its 2004 report to the Secretary of the Department of Health and Human Services (National Advisory Committee, 2004). With almost 3,800 clinics in operation, Rural Health Clinics (RHCs) are an important rural primary care resource (CMS, 2009). An earlier study of RHCs found that few offered mental health services (0.12% employed a doctoral-level psychologist and 0.07% employed a clinical social worker) (Gale & Coburn, 2003).

The number of Rural Health Clinics (RHCs) providing specialty mental health services remains limited. This study examined changes in the delivery of mental health services by RHCs, their operational characteristics, barriers to the development of services, and policy options to encourage more RHCs to deliver mental health services.

Key Findings

• Approximately 6% of independent and 2% of provider-based RHCs offer mental health services.


• 38% of study RHCs reported their mental health services were not profitable but continued to provide them in response to community and patient needs.


• An important factor in the development of RHC mental health services is the presence of a local "champion" who spearheads the development effort.

Bi-State PCA Receives $2.2 Million HRSA Grant;
VT Residents to Benefit from Health Information Technology

HRSA recently awarded Bi-State Primary Care Association a $2.2 million competitive grant that will enable Vermont's eight health centers to share patient records electronically via the state's Health Information Exchange Network.

Tess Stack Kuenning, Bi-State's Executive Director said, "This two-year project will enable health centers to conduct quality improvement activities and will ensure their maximum participation in state and federal health care reform opportunities, including a role in the forefront of the statewide expansion of the Vermont Blueprint for Health."

This grant is an investment in the Health Information Exchange (HIE) system that is necessary to enable health records to be shared. It will also be possible to populate the statewide Clinical Data Repository (CDR) with patient data from all eight VT health centers through the State's Health Information Exchange Network (HIEN).

All eight health centers are members of the Vermont Rural Health Alliance (a program of Bi-State Primary Care Association), a Health Center Controlled Network."

Vermont's Federally Qualified Health Centers (FQHC) include Community Health Center of Burlington, Community Health Centers of the Rutland Region, The Health Center (Plainfield), Community Health Services of the Lamoille Valley, Little Rivers Health Care, Northern Counties Health Care, Northern Tier Center for Health, Springfield Medical Care Systems, Inc.

Read the Bi-State Press Release.

NH Center for Public Policy Studies Wins Award to
Conduct Health Impact Assessment

In June The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, announced more than $1 million in grants to six projects that will conduct health impact assessments at the state and local levels.

One winner was the NH Center for Public Policy Studies, a non-partisan, independent organization that pursues data-based research on public policy issues. It will develop an HIA that will inform state lawmakers on the budget process beginning January 2011 and ending in June 2011. The HIA will evaluate proposed state budget changes and show how funding changes in these areas might affect the health of residents. A synthesis of HIA findings and recommendations will be presented at a policy forum in mid-2011 and will be made available to legislators for their consideration during the budget process.

Read more.

Sen. Sanders Says Investment in Health Centers will Save Billions

Sen. Bernie Sanders (I-Vt.) joined George Washington University researchers in releasing a report that projects billions of dollars in savings from a major new investment in community health centers. The senator was one of the chief backers of a provision in the health care law to double the number of Federally Qualified Health Centers. The GWU analysis showed the $11 billion in additional federal grants for community health centers will:

• Reduce total national medical costs by more than $180 billion over the next 10 years, including savings of more than $50 billion in federal Medicaid spending and more than $30 billion in reduced state Medicaid expenditures.


• Increase the number of patients receiving primary care at health centers by at least 18 million by the end of the decade, effectively doubling the number of people served.

Please send your news to Dot Bergin – dobergin@gmail.com or 781-275-7071.