Support Surges for Buckling up in Pickup Trucks

Good news!  In a strong showing of support to change the state’s seat belt law to include pickup trucks, the Senate Transportation Committee on Tuesday, January 20, voted to report out Senate Bill 40 by a vote of 7 to 1.  The bill will now move to the full Senate for consideration and a floor vote.

Several Senators were undecided or no votes going into the hearing, but they were swayed by the contacts made by Coalition members before the hearing and the great testimony we had in support of SB 40.  I am attaching a copy of the ISBC press release highlighting our win and the testimony presented.  Please feel free to share it with members of your organization.

Please take a moment and write a thank you to the seven Senators that voted SB # 40 out of Committee.  They were:

                            SENATOR                             E-MAIL ADDRESS

        Senator Allen Paul                      S27@IN.gov

        Senator Connie Sipes                 csipes@nafck12.in.us

        Senator Tom Wyss                     S15@IN.gov

        Senator Bud (Charles) Meeks      S14@IN.gov

        Senator Robert Meeks                S13@IN.gov

        Senator Allie Craycraft                S26@IN.gov

        Senator Joseph Zakas                S11@IN.gov

Next Steps:

We need your help to secure the next three wins to make SB 40 law.  Please help in the following ways:

         Contact your local Senators with letters, phone calls and e-mails - remember to use the vote smart website to find out who your legislators are

         Write a letter to the editor in support of Senate Bill 40 – remember, sample letters can be viewed at our website: www.clarian.org/isbc; but we encourage you to personalize it from your viewpoint

         Contact your local government and secure a resolution in support of Senate Bill #40

         Ask your family, friends, neighbors and co-workers to contact their Senators and express their support for the bill

         Watch for opinion surveys in your local media on this issue and be sure to participate in them

SB 40 will likely go to the full Senate next week, possibly January 29.  That means the time to take action is NOW.  This is the next big step.

If it passes successfully out of the full Senate, it will then he heard by a committee in the House of Representatives and then go to the full House.  Reports from the House member contacts that have been made have been positive, so we really want to see the bill make it out of the Senate.

    How does a town of 759 people miles from nowhere in eastern Oregon land a full-time, 24 hours 7 days a week health clinic with not one, but two physician assistants, a medical technician, and a circuit-riding doctor?

How does a community of 2,968 in the plains of Iowa come up with the money to renovate its hospital?

How about one of 6,097 in the pines of Arkansas? How does it build an entirely new hospital and recruit enough doctors to fill it?

How? I’ll tell you.

A few months ago, I and photographer Brent Miller began crisscrossing the country to capture stories of innovative rural health care for an upcoming book by the National Rural Health Association. Along the way, we saw some pretty amazing things.

We met women in Montana isolated by geography and chronic illness connected together via Internet support groups that more than one said “had saved her life.” We made rounds with lay health workers in Appalachian Kentucky as they stopped in on clients to make sure they had their medicines, help them get doctors appointments, and even get the roof fixed. We watched third-year medical students—most from the city--get hands-on experience taking care of rural patients who otherwise would have little care and in the process—hopefully—begin a path toward becoming rural doctors. At these and every other stop, we heard heartbreaking stories of need and heartwarming stories of people responding to those needs.

From those stories, several key ingredients in rural development—whether it be getting health care, creating jobs, or improving schools--emerged. It takes passion. It takes partners. And it takes locally grown solutions. Finally, and perhaps most importantly, it takes a certain attitude to bring it all together.

Indeed, without that attitude, all the passion, all the partnerships, and all the solutions won’t amount to a hill of beans. What is the attitude? In Marquette, Michigan, where the community has built an incredible network of volunteering doctors and dentists to give free care to the region’s poor and uninsured, they have a Finnish word for it: sisu. You see it on bumper stickers. You sense it when they tell their story.

Since my Finnish is a bit rusty, I’ll just call it gumption—that can-do, must-do notion that says if it is to be, it is up to me (us, actually). Don’t take no for an answer; make it happen.

And make it happen, they have.

In Condon, Oregon, and surrounding Gilliam County, citizens (don’t just call them “taxpayers”) levied a property tax on themselves to raise funds with which to run the health clinic. They then went out and hired two physician’s assistants, knowing that one would likely burn out if left to handle everything himself.

In Clarion, Iowa, private citizens donated the $2.3 million needed to update and upgrade the local hospital. On top of that, they pitched in to help get a clinic for victims of domestic and sexual abuse—many of whom are Mexican immigrants working in the mega hog and chicken operations dotting the fields around town.

In Crossett, Arkansas, and surrounding Ashley County, citizens voted a one-cent sales tax to build a brand new hospital to replace the old wood-frame structure that had served for decades, but could serve no more. And like Condon, they, too, went out and recruited help—hiring a handful of doctors to come in and staff the new facility.

In none of these or any of the places we visited was there a hint of the quixotic. Were the plans grand? Yes. Did they meet some opposition? Undoubtedly. Were they tilting at windmills? Hardly. They were and are making real differences in the lives of the people, in the lives of their communities. It just took some gumption.

Copyright 2004, Thomas D. Rowley, RUPRI Fellow

As a result of these changes, payments to the 863 critical access hospitals that play a crucial role in the delivery of rural health care are expected to increase by $900 million over the next ten years.

“I am pleased that Congress has worked with the Administration to bolster services to people with Medicare living in rural areas,” said Health and Human Services Secretary Tommy Thompson. We believe the rural provisions in the new Medicare law will have a major positive impact on the delivery of health care to rural beneficiaries.”

Critical access hospitals are limited-service hospitals located in rural areas that receive cost-based reimbursement. To be designated a critical access hospital, a facility must, among other requirements: (1) be located in a county or equivalent unit of a local government in a rural area; (2) be located more than a 35-mile drive from a hospital or another health care facility; or (3) be certified by the State as being a necessary provider of health care services to residents in the area.

Under policies in effect prior to the new Medicare law, these hospitals could not have more than 15 beds for acute care. As a result of the new law, as implemented by the policies announced today, a critical access hospital can have up to 25 beds designated as either acute care beds or swing beds ‑ beds that may at times be used for acute care, and at other times for post-acute care.

In addition to increasing the permissible number of beds, the new policies put into effect a provision of Medicare law that increases the payment for both inpatient and outpatient services rendered by critical access hospitals from 100 percent to 101 percent of reasonable costs.

Billing for Outpatient Dental Services - MMA Legislation - Section 950
    As of February 8, 2004, for outpatient dental services that are not covered by Medicare, dentists do not need to submit a claim to Medicare and receive a denial if the beneficiary has group secondary or supplemental coverage.  Read more on this change at http://www.cms.hhs.gov/medlearn/matters and click on Article #SE0402.

Power Wheelchair Brochure
    A brochure describing Medicare coverage of power wheelchairs and other
power-operated vehicles is now available at
http://www.cms.hhs.gov/medlearn/PowerWheelchair_120503.pdf .

Attention:  All Federal Grant and/or Cooperative Agreement Applicants

     OMB has issued new regulations requiring that all non-profits applying for federal funding in the form of grants or cooperative agreements must have a DUNS number.  The attached references provide additional details on this new procedure.

    All organizations that wish to apply for or renew federal grant and/or cooperative agreement awards on or after October 1, 2003, must provide a Dun & Bradstreet (D&B) Data Universal Numbering System (DUNS) number with each application.  This new requirement was recently issued as a final OMB policy and published in the Federal Register on June 27, 2003.  The DUNS number is used for tracking purposes, as OMB has come to the conclusion that there is a need for improved statistical reporting of Federal grants and cooperative agreements.  Applicants for these grants can receive a number from Dun & Bradstreet by calling the toll-free DUNS Number request line at 1-866-705-5711.  Applicants may also apply online at http://www.dnb.com/us/duns_update/.  The process of issuing a DUNS number can take up to 30 days with the online option, so the phone process is recommended.  Both electronic and paper applications must include a valid DUNS number, and applications are not considered complete without one.  Individuals applying for federal grants separate from their business are exempt from the DUNS requirement.  The specifics on the numbering system can be found at www.grants.gov.  Appropriate agencies were notified of this policy through OMB's proposal published in the Federal Register on October 30, 2002, an OMB memorandum to department heads on July 15, 2003, and a final notice in the Federal Register on June 27, 2003.  These documents can be found at www.whitehouse.gov/omb/grants.

Annual Rural Health Conference June 9 to 11, 2004, at French Lick

    The Program for the 7^th Annual Rural Health Conference is shaping up to be one of the best yet.  Keynote Speakers confirmed for the program include Larry Gamm, Ph.D., speaking about Rural Healthy People 2010, and Connie Curran, Ed. D., RN speaking on Addressing the Shortage of Health Professionals in Rural America.

     In keeping with our theme, Visions for Healthier Generations, breakout session tracks  will focus on such topics as Adult Clinical Medicine, Child and Adolescent Health, Access, Innovative Strategies, and Administrative and Management Issues.

You can help make this Conference the best ever by:

         Put June 9 to 11, 2004, on your calendar

        Become a sponsor or help recruit a sponsor  (call IRHA at 812/238-4936 for sponsorship form) – see www.indianaruralhealth.org for sponsorship form

        Exhibit or recruit new exhibitors (call for information) - see www.indianaruralhealth.org for exhibit form

        Nominate someone for an award – see www.indianaruralhealth.org for awards nomination form

        Encourage a student to submit a poster for the poster contest – see www.indianaruralhealth.org for poster submission form

        Begin now to solicit door prizes and silent auction items

        Tell your friends and colleagues about the Conference

    This year the Rural Health Conference will be in the Hoosier A, B, and C Ballroom, which will certainly give us more space.  We will have more space for exhibits in the Hoosier D Ballroom.  Put the Conference on your calendar and spread the word! 

    The 2^nd Annual Indiana Rural Health Public Policy Forum, held last Thursday at the Westin in Indianapolis, turned out to be another HUGE SUCCESS for IRHA.  The Westin facilities this year allowed us to spread out and not feel quite so crowded.  From the singing of the National Anthem by Miss Indiana, Bryn Lawton Chapman (if you missed her, you have another chance to meet this very talented young lady at Conference in June), to the wrap up of the day’s highpoints by Forum Chairman Spencer Grover, the day went well.

    Federal Office of Rural Health Director Dr. Marcia Brand was the first Keynote Speaker, focusing on the status of the various rural health initiatives of the Department and HHS Secretary Thompson.  Chuck Fluharty challenged the audience to become proactive in advocating for rural America—his call for a new AARP—the American Association of Rural People was a call to action for all of us interested in the quality of life—including health—in Rural America.  An outstanding group of advocates spoke about current legislative initiatives to impact rural health in Indiana.  Bobby King, CEO of Hancock Memorial Hospital joined Karla Sneegas in the final presentation on efforts to reduce smoking.  His hospital is a model for all healthcare providers to practice what we preach when it comes to Tobacco.  Allison Wharry from IHHA gave an update on the possible legislative approaches to health planning—without predicting what may happen in this session—a short session, which makes it difficult to address major state issues.  Dr. Joe O’Neil of Riley Hospital made all of us aware of the terrible statistics about traffic fatalities in rural Indiana (see the update on seatbelt legislation). David Roos provided information on efforts to cover children and their families for health care.   Dr. Greg Wilson updated the Forum attendees on the major health initiatives of the state.  (I continue to marvel at the leadership in addressing Indiana’s public health issues that come from our State Health Commissioner, particularly in a time of declining funding.)

     Thanks to IRHA Administrative Assistant Paula Johnson and Education Coordinator Tina Elliott (who returned from surgery just in time for the Forum) for all of their attention to the details that made for a great day! 

     Meeting Notice:  The next Critical Access Hospital Benchmarking Task Force Meeting will be held on Thursday, February 12, 2004, at 10:00 a.m. at the Indiana Farm Bureau Building in Indianapolis.  Information will be forwarded to members on February 2.

     Wanted:  A good used autoclave.  Please contact the IRHA office if you have one available for an IRHA member.  Thank you.