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"We need to make changes, now who can help us?"
For any community, acknowledging that improvement is needed is the, often difficult, first step in the process of improving healthcare access or services. The second step--finding agencies and experts who can promptly provide knowledgeable and affordable assistance--can be equally challenging!
This section of the Toolbox provides a first look at available resources. The agencies listed here, which also reappear in other sections, have been chosen on the basis of their over-arching missions to address rural health care issues, their experience in community network building and their user friendliness. And, unless stated otherwise, they provide free information and referrals, so this section does not include organizations that require a fee for membership.
By design,
this list of Federal, State and regional resources
is a limited one, but it is meant to function as a
springboard to other, more specific, resources as
referred to in each Toolbox section. Appropriate foundations,
professional associations, academic institutions,
and other national and state organizations and consultants
are listed within each topic section. For an overview
of significant resources, see Toolbox Section:
Internet Resources--An Overview.
A couple
of guidelines: patience and persistence are required
when contacting governmental, especially Federal,
agencies. Frequently, they seem overly structured
but simultaneously under-organized in their interagency
communications' systems. They also tend to suffer
from a lack of staffing continuity, due partially
to managerial ebb and flow from political appointee
turnover following national elections.
In seeking information, or ordering publications, misinformation, shipping delays and out-of-print notices are often the rule rather than the exception. The key to success seems to be to continue investigating until the proper source, i.e., the right department and the right person within that department, is contacted directly.
Then, Federal agencies can be very helpful indeed, especially in providing policy papers, regulatory guidelines, national data and an overall vision of needed progress.
State agencies are an important link in the information gathering process, as they tend to be easier to access, and timelier in their responses, such as returning phone calls, than their Federal counterparts. State agencies are likely to be efficient in providing state-specific data, licensure requirements, leadership training and tips on coalition building with other state-sponsored and/or private programs.
For more immediate answers, contact regional or local service centers, which compensate for a seemingly chronic lack of available resources with personalized responses to queries, deft referrals and practical strategies based on a working knowledge of their service area(s).
Understanding the advantages and limitations of the aid these basic health care information resources can offer, and how their functions overlap (or not) at local, state and national levels is a sound starting point for any community health improvement process. |
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Suggestions on where to begin:
Federal
- The U.S. Department of Health and
Human Services' division of Health
Resources and Services Administration
(HRSA): Within HRSA, find the
Bureau of Primary Health Care (BPHC),
the Bureau of Health Professions (BHP),
the HIV/AIDS Bureau, the Maternal and
Child Health Bureau, the Office of Minority
Health (OMH) and the Office of Rural
Health Policy (ORHP), among others.
HRSA maintains both a national office
and regional field offices.
HRSA also provides grant opportunities, online previews of grants and grant information and technical assistance workshops.
HRSA, national office, 5600 Fishers Lane, Rockville, MD 20857; (301) 443-2086; or 1-888-Ask HRSA; Website at: http://www.ask.hrsa.gov/; Funding information is listed online at http://www.hrsa.gov/grants/default.htm
Also helpful: The U.S. Department of Health and Human Services Information Center and Hotline online at http://www.hhs.gov/about/referlst.html
Note: Number for information on all Federal agencies is the Federal Information Center at: 1-800-688-9889. If desired topic/department is not listed on voice menu, follow instructions to reach an operator.
As part of HRSA, the Office of Rural Health Policy (ORHP) promotes better health care service in rural America through its information clearinghouse, and expertise in financing, research and policy. ORHP funds five research centers located across the nation, for policy-related research and analysis of rural health issues. These include the Cecil G. Sheps Center for Health Service Research at the University of North Carolina at Chapel Hill, Project HOPE Walsh Center and the University of Minnesota Rural Health Research Center, among others.
Federal Office of Rural Health Policy, 5600 Fishers Lane, Room 9A-55, Rockville, MD 20857; Phone (301) 443-0835; Fax (301) 443-2803; website: http://www.ruralhealth.hrsa.gov/
- The Rural Information Center
(RIC): This service is a project
of the United States Department of Agriculture
and National Agricultural Library (NAL).
Website: http://www.nal.usda.gov/ric/
The RIC health resources home page
is a fertile reference for anyone interested
in understanding rural health issues.
It is rich in useful
links to national rural health agencies,
organizations, grants and resources.
Go to: http://www.nal.usda.gov/ric/ruralres/health.htm
- The Rural Assistance Center
(RAC): This website is excellent
for staying updated on rural assistance
funding opportunities and health policies
affecting rural areas and concerns.
http://www.raconline.org/
It
is a cooperative effort of HRSA, the
University of North Dakota Center for
Rural Health http://www.med.und.nodak.edu/depts/rural/
and
the Rural Policy Research Institute
(RUPRI) http://www.rupri.org/
- Centers for Medicare &
Medicaid Services (CMS) [formerly
known as the Health Care Financing Administration
(HCFA)] is the Federal agency that administers
Medicare, Medicaid, the Health Insurance
Portability and Accountability Act of
1996 (HIPAA) and the State Children's
Health Insurance Program (SCHIP). CMS
offers a number of ongoing workgroups
and updated learning resources, as well
as many quality-focused activities for
providers, and information for professional,
government and consumer audiences. CMS
also maintains oversight and certification
of nursing homes. Website is http://cms.hhs.gov
- Other Federal Programs A brief, but meaty, overview of Selected Federal Programs Designed to Meet Rural Health Needs can be found at: http://www.gmu.edu/departments/chpre/ruralhealth/
briefspublications.html (To access, click the printable file, as listed by title, above.)
It is the work of George Mason University's
Capital Area Rural Health Roundtable,
part of GMU's Center for Health Policy
Research & Ethics, also found online
at http://www.gmu.edu/departments/chpre/ruralhealth/
The Roundtable provides policy briefs,
publishes forum topics, sends updates
to its member listserv and maintains
a comprehensive directory of over 600
Roundtable members and organizations.
State
- The Office of Rural Community
Affairs (ORCA) is the Texas
state office of rural health (formerly
the Center for Rural Health Initiatives)
as well as the state agency "dedicated
solely to serving rural Texas"
in business and economic development,
housing, water and sewer infrastructure,
etc. Located in Austin, it provides
"one-stop shopping" with recruitment
and retention scholarship and loan programs
designed to attract primary health care
professionals to rural Texas and keep
them there. It also co-sponsors technical
assistance workshops and guides hospitals
in achieving Critical Access Hospital
(CAH) designation.
Additionally, ORCA sponsors workshops on rural health grant opportunities, publishes the Rural Health Reporter quarterly and serves as an information clearinghouse.
Office of Rural Community Affairs
1700 N. Congress Ave., Ste. 220
PO Box 12877
Austin, TX 78711
Phone: (512) 936-6701
Fax: (512) 936-6776
http://www.orca.state.tx.us/
- The Department of State Health
Services (The Texas Department
of Health became part of the Department
of State Health Services on September
1, 2004. For more information, visit
www.dshs.state.tx.us.)This
state department monitors, regulates
or facilitates a vast array of public
health issues in the state, from A (abstinence
education) to Z (zoonosis control).
Though its home office is located in
Austin, DSHS keeps in touch with health
concerns across Texas through 11 public
health regions, 17 regional offices
and the Texas Center for Infectious
Diseases in San Antonio.
Texas' DSHS participates with local
health departments through various programs
and contracts, provides information
on professional licensure and certification,
conducts newborn screenings, sponsors
innovation grants, oversees health facility
licensing and compliance, publishes
a monthly Funding Watch newsletter
listing grant opportunities and promotes
cultural competency through its Office
of Minority Health. Healthcare workforce
information is available through the
Health Professions Resource Center,
online at: http://www.dshs.state.tx.us/chs/default.shtm
For researchers, DSHS is a gold
mine of data, as it is the keeper of
Texas' vital statistics. DSHS collects
and summarizes the status of health
factors by region and by county and
Texas health data queries may be customized
to fit search criteria. For specific
health data online, see http://soupfin.tdh.state.tx.us/
DSHS's Bureau of State Health Data
Policy Analysis in Austin provides up-to-date
lists, by Texas county or partial county,
of Federally designated Health Professional
Shortage Areas (HPSAs) and Medically
Underserved Areas (MUAs), important
in assessing an area's health care needs
and critical in qualifying for many
Federal and state grant programs. This
bureau also supplies Health Professions
Resource Center (HPRC) tables on the
statewide supply of Physicians, Physician
Assistants, Nurses, Dentists and some
34 other health professions over the
past years through the year 2000. The
HPRC website is http://www.dshs.state.tx.us/chs/default.shtm
DSHS publishes the latest statewide public
health news, with many resources
available
for review online at http://www.dshs.state.tx.us. The department also facilitates
the Texas State Strategic Health Partnership.
- Texas' Department of State
Health Services, 1100 West
49 th St., Austin, TX 78756-3199;
Phone (512) 458-7111; website: http://www.dshs.state.tx.us
- Other State Agencies: Dozens of other state agencies and organizations, both those directly linked to public health concerns and those that are not, can offer assistance. Many provide helpful services as a part of membership status. Each Toolbox section lists resources appropriate to its topic.
- Contacting your Legislator(s): Communicating with elected officials regarding community health care issues is often considered either a first or a last resort, but truthfully, can work effectively both ways. One online source for researching who represents whom and appropriate contact information at the state level is The Texas Legislature Online at: http://www.capitol.state.tx.us/ (searchable by county). For Federal listings, go to http://www.senate.gov/ or http://www.house.gov/writerep/
Local
- Area Health Education Center(s), or AHEC(s) are grant-funded and/or non-profit regional service centers which work at all stages of the health professional pipeline to improve community access to primary health care, especially in underserved and rural areas. Funding for AHECs was originally authorized by Congress in 1971, and AHECs now operate in most U.S. states. They respond to the needs of their region by promoting health career information to students and helping maintain and advocate community-based clinical training sites for health professions students. They support programs to recruit and retain health professionals for underserved populations and foster and facilitate the utilization of distance learning.
AHECs are also involved in community health systems support and education. Their mission is to build bridges between local entities, partnering with educational and religious institutions, healthcare providers and professionals, service organizations and state and government agencies to address unmet health needs in their communities.
For listing of AHECs by state, go to http://www.nationalahec.org/main/index.asp and click Locate link.
Area Health Education Centers are located in the Eastern third of Texas (the East Texas AHEC region, with program office in Galveston), the Rio Grande area (the South Texas AHEC region, with program office in San Antonio) and in West Texas (the West Texas Area AHEC region, with program office in Lubbock).
- East Texas AHEC, Galveston, TX; Phone (409) 772-7884;
- South Texas AHEC, San Antonio, TX; Phone (210) 567-7820;
- West Texas AHEC, Lubbock, TX; Phone (806) 743-1338
- Health Education Training
Centers (HETCs) operate similarly
to AHECs, and often work cooperatively
with joint AHEC-HETC programs. In Texas,
the Health Education Training Centers
Alliance of Texas (HETCAT), headquartered
in San Antonio, states as its mission:
"to improve the supply, distribution,
quality and efficiency of personnel
providing health services to Hispanic
and other populations with serious unmet
health needs, particularly along the
Texas-Mexico border."
In Texas, both AHECs and HETCATs can provide practical insights into local and regional health workforce issues and experience in forging networking links to other agencies, as well as offering services and programs that support community health systems development.
- SC-HETCAT — San
Antonio, TX; Phone (210) 567-7800
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