Federal Advocacy

GME Funding -

Federal Incentives

Title VII

Earl Kemp ekemp@usd.edu , Gar Elison, Bob Maudlin, Jim Jessen, Greg Anderson anderson.gregory@mayo.edu

Research - Jim Ballard jaball@email.uky.edu

Curricula - Greg Anderson

Admissions Project - Jim Boulger, anderson.gregory@mayo.edu

Coordinators - Tara Wagner, Carrol Christman, Jamie Anderson jta@med.unr.edu

Program Director GME Funds

Dr. Pugno:

urges interaction between the NRHA and the AAFP section on Rural Health -- staff person to staff person
personal interactions more effective in the long haul than "official channels"
personal contact with staffers of legislators also most likely to have an impact.
Medicaid issues may become as big an issue nationally as Medicare. Academy has been little cautions about raising some of the regional Medicaid problems for fear of loosing favorable status in other regions.

Dr. Kahn:

Everyone seems to agree that one problem is the absence of any unified national policy… HCFA has intentionally left their guidelines on interpretation of the rules a bit lax, but this is causing them some difficulty as well. An approach which seeks to be constructive and collaborative with them certainly is most likely to succeed.

· Sees very little likelihood of any major changes in regulations at the national level in the near future without legislative action -- especially in the direction of reduced regulation/reqirements

· Negotiations with regional officers more likely to be successful. Such meetings should be held with representatives of the involved region. Norm says he and/or Parry and/or Rick Kellerman would be glad to meet with the regional representatives the day or so prior to the meeting with the regional HCFA reps to strategize, but emphasized that the presence of outsiders in the actual meeting raises all kinds of red flags to the HCFA people. This would imply multiple meetings throughout the country.

This information may not be quite what we had hoped. However, Norm seems quite willing to work with us in our efforts.

Earl

State priorities for RME

I just e-mailed Earl this morning to see if the group can use my one day

(July 18) availability.

We are expecting our North Carolina Federal delegates to make a trip to

Eastern Rural North Carolina the first week of August. What I suggested to

our ECU Deans as rural health care policy advocacy issues for our region

are:

1. Continued and improved critical access hospital and critical

access primary care funding,

2. Focus of VII toward rural education

3. Funding of Rural Fellowships (4th year) through GME funding

mechanism (similar to Geriatric Fellowship) as incentive for tertiary

hospital

4. Continued/expanded community health center funding

5. Funding of distance learning

6. Prioritizing funding and support of rural outcomes research

7. Consideration of direct teaching grants for rural faculty to

compensate for time from away from making a living.

This is an excellent list. It does presume that admissions are taken care of. Are you comfortable with selections and the way your school takes feedback from graduate outcomes (rural and underserved locations and preparation for challenging locations such as CHC and rural)? Often we can be clever and mention outcomes connections to get by those who would not like us with a simple rural focus. Once we get them to agree to connect outcomes to selections, then we just need to be there to do more than cognitive evals. We need to make sure we do ongoing procedural and behavioral and leadership - things the service and rural oriented kids do well.