Rural and Border Health: Duel Challenges for the Health Care Workforce

1. Rural and Border Health: Duel Challenges for the Health Care Workforce Marcia K. Brand, Ph.D. Office of Rural Health Policy Health Resources and Services Administration

2. Background • About the Office of Rural Health Policy (ORHP) • HRSA’s border health activities: a new responsibility for the Office of Rural Health Policy (ORHP)

3. Rural Health and Border Health as “Policy Arenas” • Rural health – a health policy focus since the early mid-l980s, addressing challenges unique to providing health services to underserved rural and frontier areas • Border health – a health policy focus since early interest in community and migrant health, coming into greater awareness (NAFTA, globalization) • Similarities and differences in policy concerns

4. Rural and Border Health: Shared Challenges • Workforce • Infrastructure and community development • Provider viability and reimbursement • Geographic barriers • Health conditions reflect poverty and poor living conditions

5. Rural and Border Health: Shared Opportunities • Context: extraordinary commitment at the Federal, State and local to address these challenges

6. Rural and Border Health: Opportunities at the Federal Level • HHS interest in rural health – Task Force, National Advisory Committee • HHS interest in border health – Office of Global Health Affairs, HRSA collaboration • The provisions of the Medicare Modernization Act (MMA) • Health center initiative

7. Rural and Border Health: Other Opportunities • Providing information: Rural Assistance Center www.raconline.org • Providing technical assistance: • Program of All Inclusive Care for the Elderly (PACE) • Rural Health Clinics • Small hospital performance improvement • 340 B program • EMS

8. Rural and Border Health: Other Opportunities (cont.) • Recruiting providers: • Rural Recruitment and Retention Network (http:www.3rnet.org) • A focus on community colleges • Targeting resources: Rural urban commuting areas (RUCAS) • Supporting research: Mujer Y Corazon: Community Health Workers and their Organizations

9. Rural and Border Health: Other Opportunities (cont.) • Testing new service delivery models: Frontier extended stay clinics • Working with frontier communities: Frontier Center • Seasonal changes in population • Using distance technology

10. What do you need to make it easier to provide quality health care in border communities? • Technical assistance • Resources • Research • Other?

11. For additional information contact Marcia K. Brand, Ph.D. Director, Office of Rural Health Policy HRSA 301-443-4619 mbrand@hrsa.gov