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NCHN eNews
November 22, 2011
Happy Thanksgiving from NCHN
Dear NCHN Members and Friends,

This Thanksgiving, we celebrate you and all that you do to support each other and to improve health care in the communities you serve. We are thankful for your involvement in NCHN and we are thankful to have the opportunity to support you. As always, we welcome your feedback and ideas. Let us know what we can do to support you better or more.

Finally, check out details on the Health Care Innovation Challenge under Funding.

Happy Thanksgiving!
NCHN Board and Staff

Let us know what's going on with your network
If you have information you would like to share, or have any feedback, please email us.








Upcoming NCHN Calls & Events

NCHN Offices Closed for Thanksgiving
Thursday and Friday, November 24 & 25

2012 Annual Conference Planning Committee
Monday, December 5 @ 2:00 PM ET

Coffee/Tea Chats with Dr. Mary Kay Chess
Wednesday, December 7 @ 11:00 AM

NCHN Transformer Leadership Learning Community Session
Friday, December 9 @ 11:00 AM ET

NCHN Quarterly Membership Call
Business Plans for Networks
Monday, December 12 @ 2:00 PM ET

Program Development Committee Call
Tuesday, December 13 @ 1:00 PM ET

Executive Coaching Team Training Session
Wednesday, December 14 @ 11:00 AM ET




Thanksgiving Calamity


It was an odd holiday, yessiree... The Sewtnof siblings planned a potluck Thanksgiving dinner at one of their houses, however, none could cook well. Each planned to make two items. Four of them had dramas causing them to be late. All in all, it was the start of a rough holiday and everyone was in a sour mood, but once they discovered what their meal would be, they giggled at life's irony and got over themselves.



Quarterly Membership Call: Business Plans for Networks

The Program Development Committee is organizing the next Quarterly Membership Call, which will be on Monday, December 12, 2011 at 2:00 PM ET. 

Committee members thank those of you that took the time to complete the 2011 NCHN Quarterly Membership Call Survey and have been using your input to plan the calls.  The next most requested item from the survey that they will be addressing is “Business Plans for Health Networks” of which 76% of the respondents to the survey indicated “high” in terms of a topic that was of most interest to you.  The other item from the survey that the Committee is also attempting to address was the request to have more members involved in the calls and the sharing of information between NCHN members.

In preparation for this call, the Program Development Committee is requesting examples/samples of Business Plans that you have developed for your network.  We are looking for Business Plans in two areas, a standard Business Plan for the operation of your network; and a targeted Business Plan for the implementation of a new product or service for your network.  We would like to collect as many different examples as possible and will be utilizing the examples in a new “Tool Chest for Network Planning.”  The Business Plan will be the first planning tool the Committee will focus on the December Quarterly Membership Call. The Committee plans are to expand the Tool Chest over the upcoming months to include examples of Strategic Plans, Marketing Plans, Communication Plans, and other types of planning documents that networks have found useful in the management and operation of their networks. 

So, we need your help – please share your Business Plan – if you want to delete sensitive or private information from the plan that is fine.  We are looking for examples of formats, tracking systems, etc. of how networks use Business Plan tools. 

If you have any questions, please let Rebecca know.  And please submit your examples ASAP.


Featured Member: Oregon Rural Health Quality Network

The ORHQN was formed in 2005 via a HRSA Health Network Planning Grant to establish a peer review network for Oregon’s 25 CAHs.  Subsequently, the ORHQN expanded into clinical, operational, and financial benchmarking as well as serving as the primary training source for the TeamSTEPPs team communication and Just Culture programs.  Additionally, the ORHQN facilitates a number of clinical and operational “Round Tables” to leverage the collective wisdom and best practices of those in the network.
» Visit ORHQN's website

Are you in the NCHN Member Directory? Submit a description and photo for your primary contact. Email Christy with submissions or updates. You may also revise or submit your Member Profile on the NCHN website.




RWHC Eye on Health Newsletter

Rural Wisconsin Health Cooperative
Review & Commentary on Health Policy Issues for a Rural Perspective – December 1st, 2011

Health Workforce Forecast Model Launched
The “Wisconsin Registered Nurse Supply and Demand Forecasts: Results Report 2010-2035” produced
by the Office of Economic Advisors, Wisconsin Department of Workforce Development (DWD) shows
what can be done with DWD’s powerfully expanded health workforce forecasting model.

Catalyzed by the availability of the 2010 RN Renewal License Survey data, DWD enhanced an existing forecasting model. Hopefully the same tool, appropriately adjusted, will soon also be applied to data acquired from the recent relicensure of physicians.


ED Opening at North Country Health Consortium

Application deadline: November 23, 2011

The Northern NH Area Health Education Center/North Country Health Consortium is seeking a highly experienced leader to become its Executive Director. The ideal candidate will have an appropriate Masters Degree in public health, health systems administration, or similar.

AHEC/NCHC is a workforce education development center and vertical network of not for profit organizations. The Executive Director will lead innovative collaboration to improve health access to a regional population in the rural White Mountains of Northern New Hampshire.

Highly qualified candidates should submit letters of interest and curriculum vitae to the Chair of the Search Committee, Edward D Shanshala II, by email at Ed.Shanshala@ACHS-Inc.Org or by mail to 25 Mount Eustis Road, Littleton, New Hampshire 03561.




National Rural Health Day Recap
What did others do to celebrate?

  • NOSORH held a series of webinars focused on rural health. Webinars included presentations by Dr. Mary Wakefield (HRSA), Carolyn Sheridan (AgriSafe), Tom Morris (HRSA-ORHP), Kristine Sande (RAC), Rebecca Davis (NCHN, of course), Mary Beth Skupien (VHA-Office of Rural Health), Natalie Gonzalez (3RNet), Sue Sheridan (Consumers Advancing Patient Safety), and Dennis Wagner (Partnership for Patients Initiative, HHS).
  • NRHA’s 2011 president Kris Sparks spoke on the “Power of Rural” at an event hosted by the Pennsylvania Office of Rural Health in observance of National Rural Health Day. NRHA hosted the Helmsley Foundation’s health information technology policy meeting inWashington, D.C. CEO Alan Morgan discussed rural health innovations and goals during the Tennessee Rural Health Conference. And NRHA continued to advocate for rural health on Capitol Hill. Read NRHA's announcement
  • US Department of Veterans Affairs Office of Rural Health Celebrates National Rural Health Day: "Currently, 3.3 million rural Veterans are enrolled in the VA system, which represents 41% of the total enrolled Veteran population. "

NRHA asks what you think about the new Occupy Healthcare movement
from NRHA's facebook

Here's what organizers are saying:

  • Close to 50 million people are without insurance.
  • Over 60% of bankruptcies are a result of of medical bills.
  • "If we allow the current trends to continue, the price of family health insurance may surpass the average family income by 2025."
  • "The fundamental flaw in our system, the one that can’t be solved by any mere reform, is that in the U.S. health care system it is more profitable to treat sick patients than it is to promote healthy living and prevent illness."
    (Source: The fatal flaw in American healthcare,, November 3, 2011)


RWHC Leadership Series 2011-2012
Rural Wisconsin Health Cooperative is a NCHN Member Partner & Network Member

RWHC is pleased to offer this innovative leadership development series for both new and experienced healthcare managers.  Along with the workshops, the leadership topics are available for On-Site Training.  RWHC offers a range of Organizational Development Services. The series will begin in June 2011 and is open to both RWHC members and non-members.

Click on the link below to view the Workshop Schedule. Workshops are held in Wisconsin.
On-Site Training Now Available!  Contact Jo Anne Preston at 608.644.3261 or for individual consultation regarding on-site training.




Achieving Compliance with the Joint Commission’s Staffing Effectiveness Requirements
Offered by Concerro

November 29, 2011 @ 1:00 PM ET

Does your hospital have adequate staffing? Join Concerro for a complimentary staffing management webcast as the Joint Commission discusses how to ensure your facility is staffed effectively to provide quality patient care.

Attendees will learn valuable information on updated regulations around staffing effectiveness and how to identify whether or not your hospital has adequate staffing.
During this webcast you will learn how to:

  • Describe the Joint Commission’s staffing effectiveness approach
  • Identify one strategy to use in your organization’s effectiveness compliance activities
  • Apply updates to regulations to comply with what surveyors are looking for


SNHPA Webinar: 340B Compliance in an Era of Increased Oversight

November 29, 2011 @ 1:00 PM EST

The 340B program is facing unprecedented scrutiny from federal regulators and policymakers. In its first-ever study on the 340B program, the Government Accountability Office (GAO) found that the Health Resources and Services Administration (HRSA) needs to improve its oversight of the program, including in the areas of preventing diversion and tightening up eligibility criteria for private non-profit hospitals. Three influential members of Congress have, in response to the GAO study, asked HRSA for a detailed accounting of its oversight of the program. A growing number of 340B hospitals have reported receiving letters from drug manufacturers raising questions about whether their 340B drugs are being properly used and requesting additional information from the hospitals. HRSA has also announced that it will begin recertifying the eligibility of all covered entities, including hospitals, to ensure that entries in the 340B database are both accurate and up to date. Taken together, these developments signal that the 340B program is entering a new era of increased oversight. Both industry and covered entity stakeholders believe that audits by HRSA are inevitable and could begin as early as next year. Drug companies are also discussing conducting audits.

Safety Net Hospitals for Pharmaceutical Access (SNHPA) will host a webinar on Tuesday, November 29 from 1:00-2:30 PM (Eastern) focused on the changing 340B compliance landscape. Besides updating attendees on recent compliance-related developments, the webinar will provide practical guidance on how hospitals enrolled in the 340B program can effectively respond to new oversight actions, including audits.

Who Should Attend: In-house counsel, pharmacy directors, 340B pharmacy managers, CFOs, and government relations staff.


NRHA Webinar: Trends in Rural Health Care

Trends in Rural Health Care: "Developing Centers of Excellence"
Webinar: Thursday, December 1 @ 1:00 PM CST
Register now: Space is limited!

Join us for an Educational Webinar on December 1st sponsored by Gold Corporate Partner American Board of Physician Specialties.

We will be discussing the following objectives in rural health care.

• Review the major universal challenges facing our healthcare system today
• Understand basic intent and plan for proposed healthcare reform to meet those challenges
• Review specific challenges for Rural Emergency Medicine and current solutions
• Review the major trends in Rural Primary Care and specific examples of solution implementation
• Understand the top priorities necessary to become Centers of Excellence in Rural Health


The Affordable Care Act: An update from the National Advisory Committee on Rural Health and Human Services

Friday, December 2 @ 2:00 PM CT

The National Advisory Committee on Rural Health and Human Services has devoted its work this year to the effects of the Affordable Care Act (ACA) on rural areas. The Committee's 2011 Report to the Secretary (pdf), released in March, included a section on Rural Implications of Accountable Care Organizations and Payment Bundling.

The committee has published 5 white papers on the ACA covering topics that include Rural Implications of Key Primary Care Provisions; the Maternal, Infant and Early Childhood Home Visitation Program; and Rural Policy Implications for Health Insurance Exchanges. Committee Chair Ronnie Musgrove will be joined on this call by several members to discuss committee recommendations to the Secretary of the Department of Health and Human Services.

Committee Chair Ronnie Musgrove, along with several other NACRHHS members


Health Outcomes Among Children and Families Living in Rural Communities

Conference: December 1 - 2, 2011
Bethesda, MD

This trans-agency conference brings together a panel of community members and experts from NIH Institutes and Centers, federal agencies, and organizations to identify gaps in research that address emerging differences between health outcomes for children and families living in rural communities compared to those in urban areas.

Access to care and services remains a critical issue for improving the health of individuals who live in rural and underserved areas. A growing body of evidence supports the concept that a rural place of residence is associated with poor health outcomes and risky health behaviors. Further, multiple reports (e.g., Rural Healthy People 2010) have documented several unmet health needs of children living in rural communities. These children are reportedly less physically active and have higher rates of tobacco use, overweight/obesity, and dental caries than their urban counterparts. Further, differences in health behavior and outcomes can be exacerbated by poverty and low educational attainment within families living in rural areas.




Super Committee Deliberations Likely to End

November 21, 2011 (Rural Health Voices) - Various media reports indicate that the Joint Select Committee on Deficit Reduction will conclude their work this afternoon without a final agreement.  The Committee was tasked with finding $1.2-$1.5 trillion in savings over the next ten years.  Various proposals included cuts and modifications to the rural health care safety net.  Some proposals even called from eliminating Critical Access Hospital, Sole Community Hospital and Medicare Dependent Hospital designations.  NRHA has maintained contact with various Capitol Hill offices throughout this process and has met with staff members from many Super Committee offices to make sure these proposals were not adopted.  For more information on the conclusion of Super Committee work click here or here.

Continue to monitor NRHA's blog for information relating to the ongoing deficit reduction negotiations and all pending announcements.  Please contact NRHA government affairs at (202) 639-0550 with any questions.

Health Leaders Prepare For Round Two Of Cuts
by Marilyn Werber Serafini and Mary Agnes Carey, KHN Staff Writers

November 20, 2011 (Kaiser Health News) - Regardless of whether Congress' super committee meets its deadline for finding ways to reduce the federal deficit, budget and policy experts are braced for Washington soon to face the painful task of finding more savings - and they anticipate that health spending will be at the top of the list. 

Some health care leaders are already laying the groundwork to redirect the debate, to insure that effort doesn’t just shift spending from one part of the health care system to another.


More from Kaiser Health News (Re: Deficit Reduction Super Committee)
Interest Group Wish List: A Window Into The Challenge For The Super Committee (Nov. 14, 2011)
Viewpoints: Waiting For the Super Committee; TV Coverage Of Supreme Court's Health Law Session (Nov. 18, 2011)
Despite Deep Opposition To Health Law, Ga. Contemplates Exchange (Nov. 21, 2011)
If There's No Deficit Reduction Deal, What Happens Next? (Nov. 21, 2011)

Final HPSA Negotiated Rulemaking Report
HRSA email, Nov. 15, 2011

The HPSA/MUA Negotiated Rulemaking Committee’s Final Report was posted on their website:

The Committee deliberated for 14 months, including 36 days of meetings and numerous sub-Committee meetings and conference calls to review and assess considerable data analyses and research. In this effort, the Committee received extensive technical assistance from a HRSA contractor, John Snow Inc., (a firm specializing in research, technical data analysis and evaluation) and from HRSA staff. Additionally, Committee members contributed research and their own analyses to help inform the Committee process.

Although the Committee did not reach a full consensus, 90 percent of voting members endorsed this Report (final vote in favor of endorsement: 21 to 2; five members were absent.).

The Committee urges the Secretary to implement those sections/recommendations for which consensus was reached by the Committee. Further, the Committee urges the Secretary to seriously consider the other recommendations, all of which were overwhelmingly endorsed by the Committee.


'We Don't Have to Die...'
by Bill Bishop

November 17, 2011 (The Daily Yonder) - Seven out of ten rural young people in one survey said they had never been asked how they would make their communities better. That's a big mistake. Adults need to ask.

For the past five years, the Rural Policy Research Institute has sponsored surveys of high school and middle school students in 39 rural communities in Nebraska, Missouri and Kansas. The results showed that “rural communities have persistently, if unintentionally, overlooked involving youth in the shaping of their own futures.”

More than 7 out of 10 young people surveyed said that no adult had ever asked them how to improve things in their towns. Still, 6 out of 10 said they would return if they were presented with the right opportunity. About half, in fact, said they had an interest in owning their own businesses.


Over 100,000 primary care providers sign up to adopt electronic health records through their Regional Extension Centers

November 17, 2011 (HHSNews Release) - The HHS Office for the National Coordinator for Health Information Technology announced today that more than 100,000 primary care providers are adopting certified Electronic Health Records (EHRs) to help improve their quality of care and ultimately lower health care costs. This commitment by more than one-third of all primary care providers nationwide to work with their Regional Extension Center (REC) to participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs as a way to transition from paper records to certified EHRs, representing a major step toward broader and more meaningful use of health IT.


Low-Cost Broadband and Computers for Students and Families
by Josh Gottheimer and Jordan Usdan, Chairman's Office

November 7, 2011 (The FCC | Blog) - Yesterday, at a public school in Washington, DC, joined by cable and technology executives and nonprofit leaders, FCC Chairman Genachowski announced an unprecedented effort to help close the digital divide, bringing low-cost broadband and computers to millions of low-income Americans.

Right now nearly one-third of the country – 100 million Americans – doesn’t have high-speed Internet at home.  Compare that to Singapore and Korea, where broadband adoption rates top 90 percent.  Minorities and low-income Americans are the hardest hit by this divide.  Research shows that cost, relevance, and digital literacy are the primary reasons many people aren’t connecting. Whether we're talking about jobs, education, or health care, in this day and age, getting online is a necessity, not a convenience.


How will adopting electronic health records (EHR) improve providers’ business goals?

Adopting electronic health records (EHR) will help health care providers build a sustainable medical practice. The next generation of health care professionals will expect and demand that their own medical facility have a state-of-the-art information system.

Becoming a meaningful user of electronic health records will allow providers who are building their practices to recruit and retain talented young clinicians. Electronic health records will also help improve the safety and quality of health care for your patients. The meaningful use of electronic health records will help health care providers and hospitals offer higher quality and safer care.  

» MORE Q&A from



Health Care Innovation Challenge
The Center for Medicare and Medicaid Innovation

LOI Due: December 19, 2011
Application Due: January 27, 2012
Anticipated Award Date: March 30, 2012

The Health Care Innovation Challenge will award up $1 billion in grants to applicants who will implement the most compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and CHIP, particularly those with the highest health care needs.

The objectives of this initiative are to:

  • Engage a broad set of innovation partners to identify and test new care delivery and payment models that originate in the field and that produce better care, better health, and reduced cost through improvement for identified target populations.
  • Identify new models of workforce development and deployment and related training and education that support new models either directly or through new infrastructure activities.
  • Support innovators who can rapidly deploy care improvement models (within six months of award) through new ventures or expansion of existing efforts to new populations of patients, in conjunction (where possible) with other public and private sector partners.

Awards will range from approximately $1 million to $30 million for a three-year period.  Applications are open to providers, payers, local government, public-private partnerships and multi-payer collaboratives.  Each grantee project will be monitored for measurable improvements in quality of care and savings generated.

The Health Care Innovation Challenge will encourage applicants to include new models of workforce development and deployment that efficiently support their service delivery model proposal.  Enhanced infrastructure to support more cost effective system-wide function is also a critical component of health care system transformation, and applicants are encouraged to include this as an element of their proposals.



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