January 3, 2014 Letter on Policy Briefs

The Honorable Kathleen Sebelius, Secretary
U.S. Department of Health and Human Services
200 Independence Ave, SW
Washington, D.C. 20201

Dear Secretary Sebelius,

The National Advisory Committee on Rural Health and Human Services is pleased to provide you with a policy brief and a promising practices case study which are the results of our meeting in Bozeman, Montana in September.  These products discuss the following:

  • Policy Brief: The Rural Implications of the Affordable Care Act Outreach, Education, and Enrollment
  • Case Study: The Intersection of Rural Poverty and Federal Human Services Programs

As you may recall from our letter dated September 23, 2013, the Committee remains concerned that a significant portion of rural America may not be able to reap the benefits of the Affordable Care Act’s coverage expansion without more successful outreach, education and enrollment efforts in rural communities.  In preparing this policy brief, the Committee met with a range of health providers, insurance representatives, and stakeholders at a community health center in Livingston, Montana, and a critical access hospital, in Harlowton, Montana.  Gaining input from the field informed the recommendations we offer to you.  These include evaluating year-one enrollment efforts by geographic location and using that data as a  baseline to drive subsequent efforts; promoting outreach, education, and enrollment as a way for non-profit hospitals to meet their Community Health Needs Assessment Community Benefit reporting; and directing the CMS Advisory Panel on Outreach and Education to include rural considerations in the future.

At this meeting, the Committee also continued its examination of the intersection of rural poverty with federal human services programs, a subject that we began to explore at the April Meeting in Montrose County, Colorado.  In Colorado, we visited the Montrose County Department of Health and Human Services, and in Gallatin County, Montana, we visited a Community Action Agency.  During both site visits, the Human Services Subcommittee explored the role of anchor organizations in creating a unified safety net for low-income families in rural America.

The Committee identified promising practices that successful anchor organizations have used to make sure low-income residents have access to a wide range of human services programs.  The Committee hopes that this case study will both inform federal human services policy and provide a blueprint for state and local human services practitioners looking to strengthen their local human services safety nets.

Our next meeting, in Omaha, Nebraska, will be held from April 28-30, 2014, where we will focus on premium pricing and plan structure for the newly rural insured.  We would welcome having you or your designee join us there as we continue to review Human Services in rural areas as well as the ACA’s impact on rural Americans.

As always, please let us know if we can assist you in any way.


The Honorable Ronnie Musgrove

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