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

Marcia K. Brand, Ph.D.Marcia K. Brand, Ph.D.

Office of Rural Health PolicyOffice of Rural Health Policy

Health Resources and Services AdministrationHealth Resources and Services Administration

BackgroundBackground

About the Office of Rural Health About the Office of Rural Health Policy (ORHP)Policy (ORHP)

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

Rural Health and Rural Health and Border Health as Border Health as “Policy Arenas”“Policy Arenas” Rural health – a health policy focus since Rural health – a health policy focus since

the early mid-l980s, addressing the early mid-l980s, addressing challenges unique to providing health challenges unique to providing health services to underserved rural and frontier services to underserved rural and frontier areas areas

Border health – a health policy focus Border health – a health policy focus since early interest in community and since early interest in community and migrant health, coming into greater migrant health, coming into greater awareness (NAFTA, globalization)awareness (NAFTA, globalization)

Similarities and differences in policy Similarities and differences in policy concernsconcerns

Rural and Border Rural and Border Health: Shared Health: Shared ChallengesChallenges WorkforceWorkforce Infrastructure and community Infrastructure and community

developmentdevelopment Provider viability and Provider viability and

reimbursementreimbursement Geographic barriers Geographic barriers Health conditions reflect poverty Health conditions reflect poverty

and poor living conditionsand poor living conditions

Rural and Border Rural and Border Health: Shared Health: Shared OpportunitiesOpportunities Context: extraordinary Context: extraordinary

commitment at the Federal, State commitment at the Federal, State and local to address these and local to address these challengeschallenges

Rural and Border Health: Rural and Border Health: Opportunities at the Opportunities at the Federal Level Federal Level HHS interest in rural health – Task HHS interest in rural health – Task

Force, National Advisory Force, National Advisory CommitteeCommittee

HHS interest in border health – HHS interest in border health – Office of Global Health Affairs, Office of Global Health Affairs, HRSA collaborationHRSA collaboration

The provisions of the Medicare The provisions of the Medicare Modernization Act (MMA)Modernization Act (MMA)

Health center initiative Health center initiative

Rural and Border Rural and Border Health: Other Health: Other OpportunitiesOpportunities Providing information: Rural Assistance Providing information: Rural Assistance

Center Center www.raconline.orgwww.raconline.org Providing technical assistance:Providing technical assistance:

– Program of All Inclusive Care for the Program of All Inclusive Care for the Elderly (PACE)Elderly (PACE)

– Rural Health ClinicsRural Health Clinics– Small hospital performance improvementSmall hospital performance improvement– 340 B program340 B program– EMSEMS

Rural and Border Health: Rural and Border Health: Other Opportunities Other Opportunities (cont.)(cont.) Recruiting providers: Recruiting providers:

– Rural Recruitment and Retention Network Rural Recruitment and Retention Network (http:www.3rnet.org)(http:www.3rnet.org)

– A focus on community collegesA focus on community colleges Targeting resources: Rural urban Targeting resources: Rural urban

commuting areas (RUCAS)commuting areas (RUCAS) Supporting research: Mujer Y Corazon: Supporting research: Mujer Y Corazon:

Community Health Workers and their Community Health Workers and their Organizations Organizations

Rural and Border Health: Rural and Border Health: Other Opportunities Other Opportunities (cont.)(cont.) Testing new service delivery Testing new service delivery

models: Frontier extended stay models: Frontier extended stay clinicsclinics

Working with frontier Working with frontier communities: Frontier Centercommunities: Frontier Center– Seasonal changes in populationSeasonal changes in population– Using distance technologyUsing distance technology

What do you need to make it easier What do you need to make it easier to provide quality health care in to provide quality health care in border communities?border communities?

Technical assistanceTechnical assistance ResourcesResources ResearchResearch Other?Other?

For additional For additional information contactinformation contact

Marcia K. Brand, Ph.D.Marcia K. Brand, Ph.D.

Director, Office of Rural Health PolicyDirector, Office of Rural Health Policy

HRSAHRSA

301-443-4619 301-443-4619

mbrand@hrsa.govmbrand@hrsa.gov