News from the National Rural Health Association

On Monday, April 29, NRHA Vice President of Program Services, Amy Elizondo, participated in the White House Forum on Military Credentialing and Licensing.  NRHA was invited to take part in the Advanced Medical Occupations Roundtable as part of the forum.

The forum stemmed from First Lady Michelle Obama’s and Dr. Jill Biden’s Joining Forces campaign they started two years ago in support of veterans and military families. The First Lady welcomed participants as this particular forum focused on improving veterans’ transition to civilian health careers. Dr. Mary Wakefield, administrator for the Health Resources and Services Administration, moderated the discussion, which also included opening remarks from Health and Human Services Secretary Kathleen Sebelius.

The discussion focused on three key areas: 1) adapting civilian education to build on military training and experience, 2) improving strategies for veterans and 3) streamlining licensure for veterans.  

As roughly 31 percent of the enrolled veterans who served in Iraq and Afghanistan are returning to their rural communities according the Veterans Health Affairs Office of Rural Health, NRHA is looking to collaborate with military and other health organization partners to help translate veterans’ health training skills to assist with workforce issues in rural areas. 

NRHA contributed to the discussion by offering the opportunity to collaborate and working toward meeting the needs of returning veterans while simultaneously helping meet the needs of rural America. Follow up steps were established, and NRHA will provide updates. For more information on the issue, visit The Fast Track to Employment: Streamlining Credentialing and Licensing for Service Members, Veterans, and their Spouses and attend NRHA’s 36^th Annual Rural Health Conference next week in Louisville, Ky., which will feature sessions on both rural health workforce issues and innovative projects to advance veterans health.

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At a Senate Appropriations Subcommittee hearing on the President’s budget currently underway, several Senators expressed concern over proposed cuts to Critical Access Hospitals (CAHs).  The President’s budget proposes to alter the CAH program in two ways.  First, facilities designated by their states as “necessary providers” that are located less than ten miles from another facility would lose their status, regardless of community need, the type of facility less than ten miles from them,  or the reason the state’s governor designated them as necessary providers.  Second, the budget calls for reducing reimbursement for all CAHs from 101% of “reasonable costs” to 100% of reasonable costs.

At the hearing, Secretary Sebelius was questioned about this reduction by Senators Jerry Moran (R-KS), Mark Pryor (D-AR), Thad Cochran (R-MS), and John Boozman (R-AR).  Senator Moran raised many critical questions about the current fiscal challenges at many CAHs and the effect such cuts would have on the rural health safety net.  Senator Moran quoted the National Rural Health Association in his exchange with the Secretary and called on the Administration to reconsider this recommendation.

The Subcommittee will soon post a recap of the hearing and video of the testimony on their website.

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Seventy-seven members of Congress sent a “Dear Colleague” letter to the Appropriations Subcommittee on Labor, HHS, Education, and Related Agencies in support of $280 million for HRSA’s Title VII health professions programs in Fiscal Year (FY) 2014. The letter outlines how important these programs are for health care workforce development and education.

Representatives Diana DeGette (D-CO) and Mike Burgess (R-TX) cosponsored the letter and NRHA applauds them for leading the effort to sustain these programs that provide critical support to the rural health care safety net.

A copy of the final letter is available here.

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At a Senate Finance Committee hearing on the President’s budget request for federal fiscal year 2014 yesterday, Senator Pat Roberts (R-KS) asked Secretary Sebelius about the repeated calls from the administration to strip some facilities of their Critical Access Hospital (CAH) status and lower reimbursement rates for all CAH facilities. Specifically, the budget calls for decreasing payments to CAHs from 101% of reasonable costs to 100% of reasonable costs. Furthermore, the President proposes to eliminate CAH status for facilities 10 miles away, or less, from another facility.  Secretary Sebelius said that she “shared (the Senator’s) concerns about the importance of Critical Access Hospitals” and promised to follow-up with the Senator’s office about his concerns with the cuts.

NRHA applauds Senator Roberts for his continued work to protect and strengthen the Critical Access Hospital system.

For a full copy of the President’s budget, click here. To watch the Senate hearing and Senator Roberts’ question, click here.

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The Washington Post recently reported that cancer clinics are beginning to turn away Medicare patients, blaming the sequester budget cuts. The reduced funding, which took effect for Medicare on April 1, makes it impossible to administer expensive chemotherapy drugs while staying afloat financially.

According to the Huffington Post, some cancer patients enrolled in clinical trials in rural areas will have to travel thousands of miles to continue treatment because of the across-the-board cuts.

The director of the last private cancer clinic in  Kalispell, Mont. says these funding cuts from sequestration have made it too expensive for many to continue chemotherapy there, and patients may have to travel to Washington, D.C. or Boston to continue their care.

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