Dear RoundTable members:
Fall is off to a great start. Our 8th Annual Rural Oral Health Conference on September 10 drew 120 enthusiastic participants. We heard a rousing keynote speaker and in the break-out sessions, we learned of innovative ways in which our colleagues are tackling issues of access to oral health.
Now it's time to make your plans for attending our annual Symposium on October 24 and 25. You may register now and review the full program here.
Register Now for the 16th Annual RoundTable Symposium
and Federal Day
Date: October 24 (Federal Day) 1-4 p.m.
October 25, Symposium, 8:15 a.m.- 3:30 p.m.
Place: Radisson Hotel Nashua, Nashua, NH
Theme: Blazing New Trails: Innovative Health Care Strategies from Rural New England
Keynote speaker: David Reynolds, DrPH, "Vermont Health Reform: Lessons Learned for Other States"
There is still opportunity for sponsorship, to showcase the work of your business or organization. Vendors are also invited to exhibit. For more information, contact:
Julie Arel, Executive Director
To see register and to review the full program, please click here. Please register on or before October 18.
Note: on October 24, from 9 a.m. to noon, there will be a free pre-conference VA workshop: "Demystifying the Enigma of Coordinating Care for Veteran Patients." Please indicate on your registration form if you would like to attend.
Critical Access Hospitals are at Risk! RoundTable Takes a Stand:
Read Julie Arel's Letter to the Editor
After reviewing the August 15 report from the Office of the Inspector General, HHS, which proposed changes that threaten the participation by many of New England's rural hospitals in the Critical Access Program, your Policy Committee drafted a response which has been sent to the leading newspapers in our area.
"If adopted, the proposed changes could remove the majority of critical access hospitals across New England from this vital program and could potentially affect the lives of those who in these communities."
The letter outlines the role of CAHs as safety net providers for rural communities and as hubs around which local systems of care are organized.
Read the RoundTable's Letter to the Editor in the Concord Monitor, published on September 20.
8th Annual Rural Oral Health Conference Hits a Nerve
Conference Chair Dr. Peggy Smith chatting with keynote speaker Dr. Bob Russell
This year's conference on September 10 in Westford, MA brought together more than 120 participants, eager to hear about the impact on rural oral health in today's changing health care climate. As Dr. Bob Russell implied in his challenging keynote speech, we can't continue to go along as we've always done. "Dental must become part of the national health transformation and action plan....and must be included in ALL aspects of the Affordable Care Act." Dr. Russell heads the highly successful Iowa I-Smile program.
Dr. Russell outlined many obstacles now in the way of achieving oral health access--all well known to the audience. But despite roadblocks such as resistance to new workforce models, loopholes in the ACA that leave gaps in dental coverage, decrease in states and federal public program spending, and a host of other challenges, he remains optimistic that we are moving in the right direction. Regardless of what happens with the ACA, there is forward momentum.
What needs to happen? He says, "Changes within licensure, flexible deployment, greater use of all available workforce, and a payment systems that recognizes the entire oral health team including primary care and non-traditional providers must become part of the mix to improve rural oral health access."
Laurie Norris, JD, now a Senior Policy Advisor for the Centers for Medicare and Medicaid, reviewed ways in which CMS and the states are now moving forward together. She is known widely for her efforts in calling national attention to the link between untreated dental caries and serious illness and death. Responding to Dr. Norris, a panel of oral health directors from the New England states described what is happening in their states.
As in years past, a large contingent of dental hygiene students from Boston University Goldman School of Dental Medicine, Mt. Ida College, and Tunxis Community College (CT) attended the conference along with faculty members.
Afternoon sessions focused on a range of topics: recruitment of oral health professionals, successful school oral health programs, water fluoridation campaigns, and the "culture of poverty," among others. Read the speakers' presentations here.
University of New England Dental School Opens with 64 Students
UNE Dental School
The School, located in Portland, ME, welcomed its inaugural class on August 28, 2013. Classes are being held in the new Oral Health Center on Stevens Avenue; a formal dedication will take place on Oct 2,2013. The class includes 24 students from Maine, five from New Hampshire, and four from Vermont, with the other students representing 16 states and Canada.
College of Dental Medicine Dean James Koelbl said the focus on the fourth year will be on"extensive clinical experience in a distributed, community-based clinical learning environment across northern New England."
Once the College is fully operational, faculty and students will provide approximately 12,000-15,000 patient visits per year in the Oral Health Center, with an additional 20,000-25,000 visits per year provided in the community-based network.
New Hampshire Wins Oral Health Grant from CDC
In more good news on the oral health front, New Hampshire was one of 21 recipients awarded a "State Oral Disease Prevention Program" grant from the Centers for Disease Control (CDC).
Aim of the grant program is to assist state health departments with improving the oral health of their residents, in particular those children and adults who are most at risk for oral health diseases.
In announcing the grant, Dr. Jose Montero, Director of Public Health at the NH Department of Health and Human Services, had this to say:
"The health field has learned much more recently about the connection between oral health and overall health.This grant will allow us to build infrastructure and capacity to assess the places in the State where the dental workforce is insufficient, to monitor and evaluate fluoridation efforts, and to develop a plan that addresses barriers to achieving good oral health for all New Hampshire residents."
New Hampshire is receiving $230,000 in the first year of the grant. The grants are renewable for up to five years.
RoundTable member Nancy Martin is DHHS Oral Health Program Manager.
$300,000 Grant for Mental Health, other Health Care Services for Maine's Rural Veterans
Matthew Chandler, RoundTable Board member, and Director, Rural Health and Primary Care, Maine CDC, Maine DHHS, received the good news on September 12:
Maine has been awarded a $300,000 grant to improve the quality of mental health and other critical healthcare services for veterans living in rural areas. Montana and Alaska are also receiving the same award, designed to enhance crisis intervention services through telehealth technologies. These services will enable health providers to coordinate care wirelessly and electronically across long distances to detect and treat post-traumatic stress disorders (PTSD), traumatic brain injury, and other injuries for rural veterans.
The grants, funded by HHS' Health Resources and Services Administration, are part of an ongoing collaboration between HHS and the Department of Veterans Affairs (VA) to implement a 21st century information infrastructure for rural health. The programs are designed to build on existing networks of care among health care entities such as critical access hospitals, home health agencies, community mental health clinics and other providers of mental health services.
The Maine Department of Health and Human Services has three basic objectives for the funding:
In the next issue of the newsletter we will have more detail on how Matt Chandler and his team plan to move forward with this key initiative that offers so much promise to rural veterans and their health care providers.
- Use the statewide health information exchange (HIE) to improve care coordination for veterans seen by both the VA and private providers;
- Provide coordinated and collaborative support to VA providers for implementing HIE connection, and;
- Make statewide HIE records available to veterans who are accessing their medical records information.
Medical Students Wary of Careers in Primary Care
Aerial view of the Biddeford CampusStudents at the The University of New England School of Osteopathic Medicine UNECOM) say they would love to do primary care in a rural area - but debt is weighing them down.
Read the story in the Concord Monitor. A reporter interviewed seven UNECOM students who are spending their third year of medical school at Lakes Region General Hospital, Laconia, NH., to hear their thoughts on a career in primary care. Several said they were attracted but the specter of huge loans upon graduation may influence their choice of practice areas.
The University offers these statistics about its College of Osteopathic Medicine (UNECOM) graduates:
- More than 60% of its graduates practice in primary care disciplines.
- In Maine, 10% of practicing physicians are UNECOM graduates;
- 25% of UNECOM graduates practicing in Maine serve in rural areas.
- In New England, 17% of UNECOMN graduates are practicing in medically underserved areas.
Carsey Institute Finds NH Child Poverty Increased in 2011-2012
New Hampshire experienced the largest increase in child poverty of any state in the country from 2011 to 2012, according to a new study from the Carsey Institute. From being one of the country's best states, NH has slumped.
After having the lowest child poverty in the nation for more than a decade, New Hampshire no longer holds this distinction, with a 2012 child poverty rate of 15.6 percent, an increase of 3.6 percentage points from 2011 when the child poverty rate was 12 percent. This represents a more than 30 percent increase in just one year and more than a 75 percent increase between 2007 and 2012.
"These new estimates suggest that child poverty plateaued in the aftermath of the Great Recession but has not yet begun to fall as we enter the fourth year of 'recovery.' While modest improvements are evident in some places, increases in others raise concerns about the well-being of America's children," the Carsey researchers said.
Read the Report here.
NOSORH Offers Rural-Focused Grant Writing Workshop, Starting Oct. 3
October 1 is the registration deadline for the 3rd Grant Writing Institute sponsored by the National Organization of State Offices of Rural Health (NOSORH), designed to grow leaders with a specialty in rural health grant writing. NOSORH says, "It's not just Grant Writing 101 - it's Grant Writing for rural people and places. It's a class for beginners, it's all taught virtually, and at the end of the course those who complete their grant portfolio assignments earn a certificate of completion for Rural Health Grant Writing Specialist."
Kassie Clarke, of Grant Expectations and formerly in the Oregon Office of Rural Health is the lead faculty for the nine-session Institute.
For full details and online registration, click here.
Nevada Health Plan for Uninsured - Can we learn from other states?
Kaiser Health News reported recently on an unusual Nevada nonprofit that helps connect 12,000 uninsured residents to doctors and hospitals who are willing to accept a lower-cost, negotiated fee for their services. The Access to Healthcare Network is a medical discount plan that helps uninsured residents with low and moderate incomes get care from 2,000 providers around the state offering a wide variety of medical services. In addition to the provider charges, members also pay $35 a month to support Access to Healthcare's coordinators who help them understand their options and what they are responsible for.
One in five people in Nevada is uninsured, Kaiser says.
Read more about the Nevada plan.
When it comes to Health Care, there are Two Americas
This graphic from The Commonwealth Fund shows that we live in one of the highest performing areas on the country, in regard to overall health care system performance.
Where you live DOES make a difference, writes Dr. David Blumenthal in his Commonwealth Fund Blog post on the Two Americas.
The New England Rural Health RoundTable newsletter is edited by Dot Bergin and published monthly. Please send news of your organization to her at:
The RoundTable's Executive Director is Julie Arel. You may contact her by US mail, email. or phone:
NERHRT, P.O. Box 72, Starksboro, VT 05487