RURAL HEALTH
 

Report reveals mental health needs in rural hospital EDs (3/27/09)

Ten emergency departments (ED) in rural community hospitals that do not have in-patient psychiatric services collected data between January 1-December 31, 2008 to better understand who needed in-patient psychiatric care in rural communities. The survey conducted by the Foundation for Healthy Communities found that there were 525 patients who presented in the ED with a primary diagnosis of mental health or substance abuse who required an in-patient admission for treatment of their problem(s).

Among the detailed findings, more than half (57%) of the patients reported a severe mental health problem such as bipolar disorder or schizophrenia. General mental health problems like anxiety or panic disorder accounted for 29% of the patients. Ten percent had substance abuse as the primary diagnosis. Fewer than half of the patients presenting in the emergency department in a mental health crisis (46%) had private health insurance or Medicare coverage.

The survey also tracked how long patients in need of a psychiatric admission were in the ED. More than a quarter of the patients were in the emergency department for 6-12 hours and 5% spent more than 12 hours there.

Community hospitals in Colebrook, Woodsville, Berlin, North Conway, Littleton, Lancaster, New London, Claremont, Wolfeboro and Peterborough participated in the study. Read the full report HERE.

Foundation releases report on in-patient behavioral health services in NH (7/5/07)

The Foundation for Healthy Communities has released a report which identifies and documents key components of the different approaches 12 rural hospitals in New Hampshire use to address the needs of patients who arrive in their Emergency Departments with mental illness. The survey was done on behalf of the Rural Health Coalition, a group representing all of the rural Critical Access Hospitals in the state.
"HELP NEEDED: Emergency Mental Health Care in New Hampshire’s Rural Hospitals" found: the number of patients presenting with mental illness as their primary diagnosis in the ED increased 15% between 2003 to 2005, and that there is considerable variation in how emergency mental health care is provided to people within the hospital services areas and related mental health regions in the state.
While there is variation among the 12 hospitals in how they try to provide emergency mental health care, there are cross-cutting concerns common in most of the communities. These include: lack of in-patient resources in rural areas; few community treatment resources for low income persons; lack of clarity regarding the involuntary emergency admission (IEA) process; inadequate number of mental health professionals located in rural areas; transportation to treatment problems; and few follow-up services for substance abusers who undergo detoxification.

Foundation releases economic report (5/22/06)

In New Hampshire’s first-ever documented data on the economic influence of rural hospitals, “The Economic Impact of Rural Hospitals on New Hampshire’s Rural Health Service Areas”, released by the Foundation for Healthy Communities and the NH Rural Health Coalition, shows that hospitals in rural communities are vital to the workforce. Often they are their respective community’s largest employer, if not in size, then in payroll. Together, New Hampshire’s rural hospitals employ more than 6,300 people with a combined payroll of nearly $245 million.
A town that has a hospital is also likely to have physician practices, a nursing home, pharmacies, dentists and other health-related professions, which, as the report shows, add another 12,000 people to the overall health sector workforce in those areas and $457 million more in payroll and benefits. Hospitals’ economic effect on employment is especially evident in the state’s more rural counties. The Foundation’s report states that hospital employees in Berlin, Colebrook and Lancaster account for 8.25% of the total workforce in Coos County. Total health sector employment brings that number up to
nearly 18%.
The report clearly shows that a prosperous health sector, with rural hospitals leading the way in their communities, contributes extensively to overall economic health. Although the study is a snapshot of just one year, analysts say it is representative of most years in the health care industry. The availability of health services in the rural areas of New Hampshire is a primary determinant of whether or not those areas experience growth or continue to succeed.
Hospital employment and income data was provided by the rural hospitals for fiscal year 2003. Population data comes from the 2000 U.S. Census. Funding for the report was provided by the U.S. Department of Health and Human Services through a grant from the New Hampshire Department of Health and Human Services, Office of Rural Health.

New London Hospital first in the nation to receive federal award (8/25/05)

New London Hospital is the first hospital in the country to receive an award from the Loan/Grant Program of the USDA Rural Development Office to improve medical services in the area. At a ceremony on August 24, USDA Rural Development Rural Utilities Service Administrator Curtis Anderson and State Director Jolinda LaClair presented a $2.6 million loan and a $268,000 grant to the hospital for implementating a telemedicine system, designed to advance patient service, quality and safety.

New London Hospital will use the funds to purchase and install a software system that integrates patient information among the hospital, physician practices, school-based health clinic, outpatient services and nursing home. The system will provide access to patient information to all clinical staff and healthcare providers.

The importance of technology and electronic medical records has been recognized by top hospitals as critical tools to improve quality and safety. Hospital CEO Bruce Kings says the hospital plays an important role in the overall health of the area it serves, and he hopes the success the loan/grant program can serve as a model for others to follow in similar rural development projects.

Littleton Regional Hospital has received a grant to sponsor a Critical Care Emergency Medical Transport Program (CCEMTP) for paramedics in the Littleton, Woodsville and Lancaster area. This grant is provided through the Foundation For Healthy Communities and the NH DHHS Bureau of Rural Health and Primary Care, under the Rural Collaborative for Health Improvement Project (CHIP).

CCEMTP is designed to help paramedics and nurses to serve with competence and confidence in meeting the needs of the critical care patients undergoing inter-facility transports. The program will assist the clinician in developing the necessary skills and knowledge to manage the critical patient during high-risk transfer.

CCEMTP will begin April 30, 2005 and run until June 11, 2005, and will be held at the Judd Gregg Public Safety Academy and Littleton Regional Hospital.

For more information on the course curriculum or requests for student applications please contact Kurt Lucas at (603) 444-9205. Due to the class size, registrations to the program will be limited to paramedics meeting registration qualifications and priority need.

The Foundation for Healthy Communities has developed advisories for Critical Access Hospitals on Conditions of Participation and Appendix W

Rural CHIP grants awarded (7/7/04)

The Foundation awarded $199,000 to six Critical Access Hospitals (CAH) in new funding through the Rural Collaborative Health Improvement Project. Grants were provided in two categories: network development and Emergency Medical Services (EMS) Systems Development activities. Most of the network development activities will address oral health needs in rural areas. The EMS grants will address training and new opportunities for coordination. The CAH grant recipients are: Alice Peck Day Memorial Hospital in Lebanon; Cottage Hospital in Woodsville; Littleton Regional Hospital; New London Hospital; Upper Connecticut Valley Hospital in Colebrook; and Weeks Medical Center in Lancaster. The Foundation administers the Rural CHIP for the NH Department of Health and Human Services. It is funded by the Medicare Rural Hospital Flexibility Grant Program.

DHHS Announces Release of Rural Health Report

The New Hampshire Department of Health and Human Services (DHHS), Division of Public Health Services Wednesday released the New Hampshire Rural Health Report. While the Morgan Quitno Press' annual state health rankings rated New Hampshire as the healthiest state in the nation in 2000, and has consistently ranked the State in the top 5 nationwide from 1997 to 2002 based on a series of prominent health status indicators, the residents of rural areas experience unique challenges.

Among the findings of the report are that:

• Approximately 440,000 people, or 37% of New Hampshire residents, live in rural areas, and rural areas make up 84% of the land mass of the State
  
• There is a 32% higher rate of unemployment in rural areas (4.5% compared with 3.3% in non-rural areas)
  
• Rural residents are 32% more likely to be 65 years of age or older and thus more likely to require medical services
  
• Rural residents under 65 years of age are 48% more likely to be uninsured
  
• Rural residents between the ages of 21 and 65 years of age are 13% more likely to have a disability
  
• Rural residents wait on average 77% longer for an ambulance to arrive during an emergency than residents of non-rural areas.
  

Rural Health Coalition

The principal purposes for which the Rural Health Coalition was created are: 

To establish a planning entity supporting the development and implementation of rural health policy in New Hampshire

To favorably affect the health status of all residents served in rural environments of New Hampshire through promotion of rural health issues

To meet the challenges of an ever changing health care environment by assuring rural New Hampshire residents access to care from essential community providers through rural community care networks operating on a cooperative basis within the meaning of Section 1381 of the Internal Revenue Code of 1986.

For more information about the Rural Health Coalition, contact Chairperson Harry Dorman at dormanh@alicepeckday.org or Paula Minnehan at pminnehan@nhha.org.