Health Resources and Services Administration Office of Regional Operations Update

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1 Health Resources and Services Administration Office of Regional Operations Update State Offices of Rural Health Regional Partnership Meeting Region D Austin, Texas May 19-20, 2015 Hal Zawacki U.S. Department of Health and Human Services Health Resources and Services Administration Office of Regional Operations, Region IX

2 Healthy Communities, Healthy People

3 HRSA - America s Health Care Safety Net Mission To improve health and achieve health equity through access to quality services, a skilled health workforce and innovative programs. Improve Access to Quality Health Care and Services Strengthen the Health Workforce Build Healthy Communities Improve Health Equity Jim Macrae HRSA Acting Administrator

4 The Programs HRSA Delivers Community Health Centers National Health Service Corps Workforce Training for Primary Care, Mental and Behavioral Health, Public Health, Medicine, Dentistry, Nursing, and Geriatrics Workforce Diversity Children s Hospital GME Practitioner Databanks Maternal and Child Health Healthy Start Poison Control Ryan White HIV/AIDS Mental/Behavioral Health and Primary Care Integration Rural Health Policy & Programs Telehealth Health Care for the Homeless Migrant Health Centers Vaccine Injury Compensation Black Lung Clinics Program 340B Drug Pricing Organ Donation & Transplantation And more

5 HRSA National Activities Nearly 22 million patients are served in 1,300 HRSAfunded health centers and 9,200 health care delivery sites Over 500,000 people living with HIV/AIDS receive services through more than 900 HRSA-funded Ryan White Clinics. Two-thirds are members of minority groups. 34 million women, infants, children, and adolescents benefit from HRSA s maternal and child health programs. 9,200 National Health Service Corps clinicians are working in underserved areas in exchange for loan repayment or scholarships.

6 HRSA Regional Offices Foster and coordinate regional collaborations that help: increase access to quality health care; improve health equity; and ensure optimal health for all. Provide an essential feedback loop between the Agency and regional stakeholders for implementation of HRSA programs and provisions of the Affordable Care Act.

7 Regional Office Locations

8 HRSA Regional Offices Headquarters Regional Administrators Regional Administrator (VI): Princess Jackson Regional Administrator (IX): John Moroney Regional Offices Operating Components: Office of Regional Operations (ORO) Work to improve health care systems and America s health care safety net, increase access to quality care, reduce disparities, and advance public health. Serves as a point of contact for questions about HRSA. Bureau of Health Workforce (BHW) Bureau of Primary Health Care (BPHC) Maternal and Child Health (MCHB) Office of Federal Assistance Management (OFAM)

9 Regional Federal Partners U.S. Department of Health and Human Services Office of Intergovernmental and External Affairs (IEA) Regional Director (VI): Marjorie McColl Petty Regional Director (IX): Melissa Stafford Jones Office of Public Health & Science (VI); Office of the Assistant Secretary for Health (IX) Administration for Children and Families Administration for Community Living Centers for Medicare & Medicaid Services Indian Health Service Substance Abuse and Mental Health Services Administration Housing and Urban Development Environmental Protection Agency

10 Office of Regional Operations (ORO) ORO Core Functions External Affairs and Outreach Foster greater alignment and collaboration between HRSA programs and other public and private programs working in communities to pursue common goals and integrated systems of care. Strategic Stakeholder Partnerships Generate collaborative efforts between state health care leaders and HRSA improve public health and health care systems. Regional Surveillance Conduct surveillance and analysis of regional / state health care environmental trends and recommends ways to improve policies and programs. Regional Management Provides leadership on HRSA's mission, goals, priorities and initiatives in regions, states and territories. Technical Assistance Provide technical assistance to HRSA grantees.

11 Strategic Stakeholder Partnerships The face of HRSA at various meetings, conferences, events, etc. Educate and share information with the American people and stakeholders about HRSA s programs and resources. Connect and work collaboratively with: HRSA s state-level grantees (PCA, PCO, AHEC, SORH) HRSA s Bureaus and Offices Various state-level officials (e.g. governors, state health officers, etc.) Public and private sector organizations Tribal partners

12 ORO FY 2015 Essential Topics Affordable Care Act Outreach and Enrollment Rural Health Tribal Affairs Behavioral Health Region Specific Topics: Primary Care and Public Health Integration HIV / AIDS Maternal and Child Health Native Hawaiians / Pacific islanders Transgender Persons Homelessness Veterans

13 Affordable Care Act Outreach and Enrollment

14 Rural Coverage in the Health Insurance Marketplace Nearly 20% of Americans live in rural areas. Disproportionately older/larger Medicare population. More prevalence of chronic disease. Greater proportion lack coverage than urban areas.* Lower income levels.* In states that are expanding Medicaid, rural residents more likely to be eligible for the coverage expansion. Consumer Assistance roles include Navigators, Certified Application Counselors, Health Center O&E Counselors, Agents and Brokers. *source: The Uninsured: An Analysis by Income and Geography, Barker AR, Londeree JK, McBride TD, Kemper LM, Mueller K, RUPRI Center for Rural Health Policy Analysis, Rural Policy Brief, June

15 Recommendations from the National Advisory Committee on Rural Health and Human Services* 1. Build on Initial Lessons Learned to Target Subsequent Outreach & Enrollment Efforts 2. Clarify that O & E efforts qualify under the IRS Form 990 Community Benefit 3. Leverage Existing Community Infrastructure to Reach Rural Communities 4. Enhance the Ease of Use of the Health Insurance Marketplace Web Site * National Advisory Committee on Rural Health and Human Services: Rural Implications of the Affordable Care Act: Outreach, Education, Enrollment; January 2014 Policy Brief

16 Ideal Ways to Target Rural America at the Local Level Through Radio Through Local newspapers With flyers through bill statements (e.g. cable, electric, and water bills) and bank deposit slips By leveraging family members as messengers Visit town-hall meetings and community dinners Visit state fairs and rodeos Use school-based campaigns Coordinate with faith-based communities Training retirees as O & E volunteers Coordinate with Chambers of Commerce, Rotary Clubs, Lions Clubs, VFW s, Girl Scouts, Boy Scouts, and other civic groups Work with the USDA Cooperative Extension Service * National Advisory Committee on Rural Health and Human Services: Rural Implications of the Affordable Care Act: Outreach, Education, Enrollment; January 2014 Policy Brief

17 Investing in the Health Care Workforce

18 HRSA s Interest in Workforce Development Workforce touches the work across all HRSA activities and programs. The evolution of efforts have mirrored changes and needs in the national health care system. National workforce needs are greater than ever with the growth/aging of the population and increases in the insured population.

19 Bureau of Health Workforce (BHW) Helping America to build a health care workforce prepared and eager to improve the public health by expanding access to quality health services and working to achieve health equity. Created in May 2014, integrating HRSA workforce programs previously housed in two bureaus: Health Professions and Clinician Recruitment and Service. Challenges: The U.S. faces shortages of primary care physicians, dentists, nurses, public health and other health professionals. The Nation s health care workforce does not currently reflect the diversity of the population that it serves. The aging of the population is a significant trend that requires retooling the health workforce to deal with geriatric issues. Integrating Behavioral Health and Oral Health into Primary Care

20 Acceptance of New Patients by Office-based Physicians Medicaid Acceptance Accepting New Patients with: Private insurance National 84.7% Significantly >: AR, OK Significantly <: None Medicare National 83.7% Significantly >: None Significantly <: None Medicaid National % Signif. >: OK, NV, AR, NM Signif.<: LA, CA Acceptance of New Patients With Public and Private Insurance by Office-based Physicians: United States, U.S. Department of Health & Human Services, Centers for Disease Control & Prevention, National Center for Health Statistics, NCHS Data Brief, Publication No. 195, March 2015.

21 Scholarship, Loan and Loan Repayment Programs for Health Professionals National Health Service Corps Loan Repayment Program for primary care medical, dental, and mental and behavioral health clinicians; National Health Service Corps Scholarship Program for primary care medical and dental providers-in-training; NURSE Corps Scholarship and Loan Repayment programs for registered nurses and RN students; Faculty Loan Repayment Program for health professions faculty from disadvantaged backgrounds; Scholarship and Loan Programs for health professions schools, which make scholarships and low-interest loans available to students from disadvantaged backgrounds.

22 Workforce Training Programs Expanded under the ACA Health workforce grant programs support primary care training programs in underserved areas. Health Professions Training Grants address current shortages & diversity of clinicians and faculty. Graduate Medical Education - Teaching Health Centers train medical and dental residents in community-based ambulatory patient care settings. Primary Care Residency Expansion Advanced Nursing Education program Physician Assistant training program ACA provided $230 million to train an additional 1,700 primary care providers; 500 primary care physicians, 600 primary care advanced practice nurses, 600 Physician Assistants.

23 Contact Information Joseph Walker HRSA Office of Regional Operations Dallas Regional Division (VI) Hal Zawacki HRSA Office of Regional Operations San Francisco Regional Division (IX)

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