May, 2013

Iowa Dental Director to Keynote 8th Annual
Rural Oral Health Conference

"Rural Oral Health in a Changing Health Care Environment"
Keynote: Bob Russell, DDS, MPH (invited)
Public Health Dental Director Bureau Chief
Iowa Department of Public Health

Tuesday, September 10, 2013
Westford Regency Inn and Conference Center
Westford, MA 

Workshops include:

• Funding for Safety Net Clinics
• Quality Improvement in the Dental Office
• Integrating Oral Health in the Healthcare Home
• Fluorides and Fluoridation
• and the State Dental Director's Forum

New This Year! Rural Health Poster Session.
This is a wonderful opportunity to showcase your organization's trail blazing activities. Deadline for submitting posters is August 12, 2013

Please submit your entries to:
Lora Wise
Northern New England Geriatric Education Center
Lebanon, NH 03766
603-653-3477
lora.g.wise@dartmouth.edu
(Please contact Lora for specific mailing directions.)

Vermont Dentists, FQHC Representatives Meet to Discuss Oral Health for All

As RoundTable members have advocated for years, "oral health and public health are one and the same."

In mid-April, Vermont dentists and representatives from the state's Federally Qualified Health Centers (FQHCs) gathered in Stowe to develop practical strategies to improve the oral health of Vermonters. The meeting was co-sponsored by the Vermont State Dental Society and Bi-State Primary Care Association with support from the DentaQuest Foundation and the University of Vermont College of Medicine's Office of Primary Care and Area Health Education Center. Some 55 participants attended. Among the issues discussed:

• Role of private practitioners and FQHCs in addressing the oral health care needs of the underserved.
  
  
• Strategies that FQHCs employ in order to make care accessible and to improve the overall health of patients they serve.  
  
  
• FQHCs are required to offer a sliding fee discount for patients whose income is less than 100% of the Federal Poverty Level.
  
  
• Many FQHCs also provide transportation to help patients get to appointments or may offer services through a mobile unit or out in the community where patients congregate
  
  
• All FQHCs provide care coordination for their patients with other health and social service providers in the community.  

David Averill, D.D.S, President of Vermont State Dental Society, noted that approximately 80% of the patients on Medicaid in Vermont who receive dental services are seen by dentists in private practice.

Averill: Path forward to oral health

On April 28, Dr. David Averill wrote an op-ed piece in the Vermont Digger in which he affirmed the belief that good oral health is part of being healthy and everyone deserves access to dental care. As a native Vermonter, a longtime dentist practicing in Burlington, and as president of the Vermont  State Dental Society, Dr. Averill outlined some of the barriers of access to care that he sees. He wrote, "On the frontlines, dentists see firsthand the complex and intertwined oral health care barriers Vermonters face, among them: 

• Non-existent, insufficient or minimal dental health insurance coverage;
  
  
• A separation between oral health and overall health management both in policy and individual wel-lbeing practices;
  
  
• Costly out-of-pocket expenses;
  
  
• Stagnant and inadequate Medicaid reimbursement rates;
  
  
• Rural geography makes transportation to and from dental practices difficult and time consuming;

Dr. Averill said the state's dentists championed a comprehensive oral health bill that called for expanded dental education in the classroom and expanded loan repayment and loan forgiveness programs.

Honors for Mid-State Health Center

Mid-State Health Center, Plymouth, NH., has been named Business of the Year by the Grafton Country Business Council. No wonder our incoming RoundTable President Sharon Beaty is beaming in the photo above! Mid-State, an FQHC "look-alike," is one of four participants in the North Country Accountable Care Organization (North Country ACO).

Grafton is the second largest of New Hampshire's ten counties, covering 1,747 square miles in the west-central part of the state. A recent study by Plymouth State University found that education and health services is the largest super sector in the county, making up more than 30% of the total county jobs and is growing rapidly.

$100,000 Grant for NH Oral Health Coalition

The New Hampshire Oral Health Coalition, in conjunction with its fiscal sponsor the New Hampshire Public Health Association, has received a $100,000 grant from the DentaQuest Foundation, Boston, MA, under the Foundation's Oral Health 2014 Initiative.

The Initiative, aimed at eliminating barriers to good oral health, serves to strengthen in-state oral health leaders to better serve at the community, state and national levels. The NH project focuses on convening oral health stakeholders from throughout the state to cross-educate on community programs while identifying supporting infrastructure for public health dental hygienist placements within underserved areas and populations.

Gail T. Brown is Policy Director and Hope Saltmarsh is Policy Chair.

CMS Announces Second Round of Innovation Awards

This second round of Health Care Innovation Awards differs from the first round in that CMS is specifically seeking innovations in four areas:  

• rapidly reducing costs for patients with Medicare and Medicaid in outpatient hospital and other settings;
• improving care for populations with specialized needs;
• testing improved financial and clinical models for specific types of providers, including specialists; and
• linking clinical care delivery to preventive and population health.  Like the first round, these awards will emphasize results and ensure program integrity.

CMS will accept letters of intent to apply beginning June 1 until June 28, 2013 3pm EDT. Applications will be accepted beginning June 14 until August 15, 2013 3pm EDT.

At a May 17 Webinar, one caller asked CMS officials if there would be opportunity for rural providers; another caller asked about participation by Critical Access Hospitals and the answer to both questioners was "yes." 
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Awards will be announced in January 2014, with the project expected to begin in April 2014, to extend for a three year period. For details, see the CMS fact sheet.

Farm Bill Limping Toward Passage....Perhaps?

It appears that Farm Bill 2013 may be passed by Congress, soon. Thus far, the House Agriculture Committee has voted (May 15) to approve a $940 billion farm bill. On May 14, the Senate Agriculture Committee, chaired by Rep. Debbie Stabinow (D-MI) passed its own version, which means that Congress may finally get to work on a new five-year bill this summer.

What's the biggest single item in the Farm Bill and the one most hotly contested today?  It is the Supplemental Nutrition Assistance Program (SNAP), commonly known as food stamps, which provides nutritional assistance to low income families and individuals. SNAP accounted for nearly 70 percent of spending in the 2008 legislation, the last time it was signed into law.The House bill cuts projected spending in farm and nutrition programs by nearly $40 billion over the next 10 years. Just over half, $20.5 million, would come from cuts to SNAP, over the 10 year period.  The Senate voted to cut spending by $23 billion, with $4.1 billion of the cuts coming from the food stamp program.

A handful of House Democrats have vowed to oppose the legislation until some of the SNAP funding is restored. Rep. Jim McGovern (D-MA) said "The $20.5 billion cut in SNAP is a poison pill. It means that we shouldn't be supporting the farm bill."

Rep. Peter Welch (D-VT) said, "This is a good bill for Vermont's agriculture sector which is vital to the economic health of our state. While good for our farmers, it will do serious harm in its current form to those who rely on federal nutrition programs. I intend to work hard when this bill is debated by the full House of Representatives to preserve Vermont's priorities, including the availability of nutritious food for families in need."

There are other elements in the Farm Bill that are of interest to RoundTable members. The bill contains funding for various rural development projects as well as price supports to farmers.   

Stay tuned! 

Massachusetts Wins Award

left to right: Joan Hatem-Roy, Elder Services of the Merrimack Valley, Lawrence, MA; Jennifer Raymond, Hebrew Senior Life; Molly Butler, MA State Office of Rural Health, and Michele Boutaugh, Administration of Aging/Administration on Community Living

Molly Butler, MA State Office of Rural Health, participated in a recent conference focused on how states are working with the Stanford Chronic Disease Self Management Education (CDSME) programs. She accepted the award for Massachusetts as the state with the "Highest Retention Rates for Completers."

In Massachusetts, part of the Administration of Aging/Administration on Community Living (ACL) funding pays for DPH support for CDSME program coordination and development of CDSME activities in rural areas of Western and Southeastern Massachusetts. MDPH Office of Rural Health is instrumental in implementing programs in areas of low population density, often underserved,rural areas of the state by recruiting leaders, providing training, helping develop the Southeastern Massachusetts Collaborative and to expanding the Western Massachusetts Collaborative.The grant, which began in September 2012, runs for three years.

May is Older Americans Month

Please take note of this upcoming conference, sponsored by a number of MA agencies. Focus is on preventing and responding to substance abuse and related problems in older adults.

Wednesday, June 5 2013
8:15 AM - 4 PM
College of the Holy Cross
Hogan Campus Center
Worcester, MA
508-793-2564

News Around the States...

Maine

Bangor Beacon Community has received a three-year federal grant for $12.72 million from the Office of the National Coordinator for Health Information Technology. The Beacon Community Program funds 17 pioneering communities across the country that are using health IT as a foundation for bringing together doctors, hospitals, local health program administrators, and patients to achieve measurable improvements in health care quality, safety, efficiency, and population health. The Maine Beacon Community is using health IT to reduce emergency department visits and hospital admissions and readmissions. To see interesting profiles of patients with chronic diseases who are being helped by IT-enabled care management, check out Bangor Beacon's website.

New Pediatric Ambulance Goes Into Service
Maine Medical Center has an oversized and especially equipped new pediatric ambulance ready to transport sick babies from other hospitals to Maine Medical or even into Boston, if necessary. The ambulance was paid for entirely by donations. Read the story in the Portland Press Herald.

Massachusetts

Martha's Vineyard Community Services Names New Director
Juliette Fay is the new executive director of Martha's Vineyard Community Services (MVCS), the principal human services agency on the island. She began her new job on April 1, succeeding Julia Burgess who retired after seven years in the post. Fay has had more than 40 years' experience in human services, in a variety of positions. She has a bachelor's degree in philosophy from Boston College and a master's in public administration from Harvard University.

MVCS serves more than 6,000 people each year, including year-round residents and seasonal visitors, and is the Island's third largest employer, delivering a wide range of programs and services. They include behavioral health and substance abuse treatment, early childhood programs, childcare services and education, domestic violence rape counseling services, as well as disability services for people living with disabilities and their families. Read more about MVCS.

And also on the Vineyard, Island Schools teach school kids how to enjoy locally grown food.  Read the story in the Vineyard Gazette.

Vermont

On May 16 Governor Peter Shumlin named Paul Dupre as Commissioner of Mental Health Services. Dupre has served since 1978 as director of Washington County Mental Health Services Inc. and is said to be a strong supporter of the administration's decentralized approach to rebuilding the mental health system.

Elizabeth Cote has rejoined the University of Vermont Office of Primary Care and AHEC program as Director. She's also editor of "Primarily Vermont," which focused on the state's two Accountable Care Organizations in its Spring issue. Cote was formerly Executive Director, Vermont State Dental Society. 

We welcome news of your organization and its members. Please send your news to: Dot Bergin, Editor: nerhrt@gmail.com or 781-275-7071.

The New England Rural Health RoundTable newsletter is published monthly. Current issues are available in HTML format, with links to additional information. Previous issues are available in printer-friendly Adobe Acrobat format.

For more information about becoming a member of the RoundTable, please contact Julie Arel, Executive Director.