CSRHA Begins 2006 Advocating for Rural Health Priorities and Needs

Members of the California State Rural Health Association (CSRHA) Advocacy Committee were pleased to have an opportunity to listen to its rural members and hear from Legislators and representatives from state government during its 2005 annual rural health conference. During a special Rural Caucus Forum, Assemblymember Mike Villines, Senator Dave Cox and Assemblymember Dave Cogdill joined rural health advocates to discuss a variety of issues related to the delivery of healthcare in rural communities. Below is a recap of the issues addressed:

  • Inappropriate timeframe for Medi-Cal certification and provider numbers for specialists through the Department of Health Services. This issue is coupled with an increasing need for specialists to serve under-insured and uninsured rural residents;
  • Implementation of the Mental Health Services Act (Proposition 63) and the Committee’s lack of good policies to ensure improved mental health services to rural patients by working with rural safety net provider organizations;
  • Children have limited access to healthcare for drug and alcohol services if they are Medi-Cal eligible because of the inability of providers to contract with health plans;
  • California Children’s Services (CCS) policies and practices are not user-friendly to rural providers;
  • District hospitals are in jeopardy of loosing their AB 915 supplemental funds due to Medi-Cal Redesign and the recent federal waiver agreements;
  • Impact of the changes to County Medical Services Program (CMSP) reimbursement policies for behavior health services to indigent adults in rural counties;
  • The elimination of the Public Health Services program which provides public health nurses to 11 rural counties in California;
  • The need for fair reimbursement for Medi-Cal by having the State of California participate in the Critical Access Hospital program;
  • Astronomical profit margins among insurance companies contracting with rural and other health providers through managed care financial models;
  • Need for infrastructure investment to ensure broadband exists for rural California which is designed to solve multiple issues, including: emergency services, access to specialty care, public safety, improved economic development and the creation of small business opportunities for rural communities;
Changing and offering flexibility for the licensing status for healthcare facilities to better serve their communities, when a traditional hospitals and clinic structure is not required.


As a result of these discussions and from additional surveys from rural advocates, the CSRHA Advocacy Committee has established its advocacy plans for the current year. The following items have become part of CSRHA’s advocacy activity and efforts for 2006:

1. Promote the Rural Advocacy Framework adopted by CSRHA Board of Directors in December 2005. See the attached document.

2. Advocate strong support for the National Rural Health Association’s (NRHA) Federal Advocacy Agenda and Priorities. See attached document.

3. Development of CSRHA Rural Advocacy Priorities for 2006. These include:

  • Increase funds for rural workforce grant and incentive programs through a Rural Workforce Taskforce designed to develop opportunities for improving the recruitment and retention of healthcare workers to rural shortage areas. The first task is to collect and analyze data from existing rural workforce incentive and grant programs administered by the State of California and to learn about their funding status and effectiveness. (Administrative Advocacy, Convening Role)
  • Improve the Critical Access Hospital (CAH) program through advocating for the State of California’s participation of Medi-Cal. Require Medi-Cal to reimburse CAH providers on an allowable cost basis for all services. (Budget Advocacy)
  • Develop a position and recommendation to improve the prison healthcare crisis through a Prison Healthcare Taskforce. See attached document. Coordinate with the Rural Caucus, the California Department of Corrections and CSRHA members through ongoing meetings to ensure rural California is considered during any changes. (Administrative Advocacy, Convening Role, Policy Position Development)
  • Expand broadband to all of rural California and promote the expansion of telemedicine and e-health through increased funding at the state and federal level. Provide support to the Rural Caucus, the California Telemedicine and eHealth Center (CTEC) and other technology organizations with similar missions and goals through advocacy. (Budget Advocacy, Convening Role, Policy Position Development)

4. Testimony and advocacy to the California Rural Health Policy Council (CRHPC)for 2006. Click here for a complete draft of the testimony. Of the items addressed, CSRHA developed five positions to communicate with the CRHPC. These include:

  • Request the CRHPC to write a letter of support to the appropriations Congressional leadership recommending rural health federal funding levels equivalent to previous federal budget levels.
  • Request for the State Office of Rural Health (SORH), coordinated by the RHPC to provide analysis and data through Economic Impact Reports for each rural county on healthcare services delivery.
  • Request an evaluation of funding and effectiveness of existing workforce programs designed to recruit healthcare workers to shortage areas.
  • Request any proposal for managed care to rural areas to include protection of patient access to quality health care services and ensures the financial stability of safety net providers in rural California’s communities. CSRHA strongly urge the Governor to consider the rural community’s role in planning and implementation.
  • Request the RHPC hire the position of executive director and release the most recent annual report required by legislation to be delivered to the State Legislature and the Rural Caucus.

If you are interested in joining the CSRHA Advocacy Committee, please let us know. The Advocacy Committee will be seeking new members beginning in March 2006. A current list of members is attached here.

The CSRHA Advocacy Committee meets regularly on the last Monday of each month to evaluate its effectiveness and to guide the organizational strategy. If you have additional questions or would like to discuss an issue for the advocacy committee to consider, please contact Lauri Medeiros, CSRHA Executive Director at lmedeiros@csrha.org.

Article Posted 01/31/06