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Department of Health and Human Services
The National Advisory Committee on Rural Health and Human Services
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Letter to the Secretary: March 2-4, 2003, Washington, D.C.

April 4, 2003

The Honorable Tommy G. Thompson
Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201

Dear Secretary Thompson,

The National Advisory Committee on Rural Health and Human Services met in Washington, D.C. from March 2-4, 2003. During this time, we successfully completed our work on a report examining quality health care in rural America and outlining the Committee's recommendations for addressing the issue. We also devoted time to the important issue of the Allied Health Workforce in rural areas by finalizing a white paper on that subject. In addition, the three-day meeting included presentations from key federal and private sector staff on oral health, mental health and aging and the particular needs that rural Americans face in these areas.

Over the past year, the Committee's primary focus has been on quality health care in rural areas. Although we have addressed this issue in the past as part of broader rural health issues, this is the first time we have examined it in detail. The report we prepared is attached for your review. Quality of health care in rural areas is of great concern to the Committee and I would like to highlight some of the recommendations that grew out of our year's work:

  • The Secretary of the Department of Health and Human Services should work with the Office of Management and Budget to increase funding to Quality Improvement Organizations in order to help providers prepare for public reporting in hospital, home health and individual ambulatory provider settings.

  • The Secretary should work with the Congress to fund the new Small Health Care Provider Quality Improvement Program authorized in the Safety Net Bill of 2002.

  • The Secretary should support re-authorization of the Medicare Rural Hospital Flexibility Grant program.

  • The Secretary should increase funding for state survey and certification to create uniformity and promote quality improvement.

While our main report for this year addresses quality, the issue of the rural allied health workforce also arose as an area of great concern to our members and the rural communities we represent. Due to the urgent need to address the workforce crisis facing rural communities, rather than wait to complete a formal report, we crafted a white paper to bring the issue to your attention. The attached report serves as a broad introduction to training, recruitment and research that are required to improve the quality and quantity of allied health professionals serving rural America.

Over the course of our three-day meeting, we heard presentations on the specific needs of rural communities related to oral health, mental health and aging. Representatives from the Substance Abuse and Mental Health Services Administration, the Administration on Aging, the Office of Rural Health Policy and the National Association of Rural Health Clinics provided pertinent background information on their current efforts to serve rural America's health needs. In all three arenas of health care the need for more providers and the importance of providing care within home communities was stressed. During the next year, we will examine ways to meet the needs of the rural elderly and strategies for improving access to oral health services in rural communities. The Committee is also interested in finding ways to foster the integration of primary care and mental health services.

The Committee's next meeting will take place from June 8-10, 2003 in San Antonio and Uvalde, TX. We are looking forward to this meeting, as it will be the first opportunity for us to meet with our new members representing diverse areas of human services delivery. Health care and human services delivery systems are closely tied together across the country, but especially in rural areas. The inclusion of five of our human services colleagues will expand our focus and will truly augment our ability to improve the health status of all rural Americans.

As always, we thank you for your ongoing support of America's rural citizens and of the National Rural Advisory Committee.