In This Issue

IRHA Board of Directors

Contact Us

Cheryl Clarke, President IRHA

“Failure to plan is planning to fail.”

As this quote from an unknown author illustrates, without thoughtful planning, an organization is not likely to meet its goals.  As IRHA approaches 2008, it is time to review our organization’s goals and plan how we can collectively further our mission.  
As IRHA is a grass-roots organization, its membership is at the heart of its success.  Please consider the following as part of your plan to support the IRHA in 2008.
  1.    Join:  If you are currently a member, renew your IRHA membership for 2008.  A joint membership opportunity is also available in 2008 for NRHA and IRHA memberships.   If you are not a member, please consider joining the IRHA.
  2.    Grow:  Please ask at least one colleague to join the IRHA.  Nothing is more persuasive than a personal request.  If you would like a brochure to hand out with a request, contact LeAnn Ely at lely@assoc-mgmt.com.
  3.    Gather:  Mark your calendars now for the 2008 IRHA Chautauqua to be held on September 18, 2008, in Ankeny.  Attendance at this conference grew by 20% this year.  Gather with your colleagues to learn creative solutions to providing quality health care in rural areas.
  4.    Volunteer:  Consider volunteering for an IRHA board position or a committee appointment.  
  5.    Speak:  Share your insights regarding rural health with all who will listen.  Iowans are particularly poised to bring light to rural health issues as numerous presidential candidates visit our state.  State legislators and policymakers, local officials, business leaders, and other stakeholders also need to understand the importance of protecting the rural health infrastructure.
  6.    Share:  Timely information to benefit all members can be shared quickly with the IRHA membership via email.  Forward such information to any board member for distribution.

The IRHA Board looks forward to an exciting and challenge year in 2008.  Please join us in implementing these plans for success.

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Thank You Cece!
Jack Cameron

Cece, thank you for leading the IRHA team and most especially thank you for helping to strengthen our health as an organization.  Here is my personal highlights reel of your Presidency.

There is a saying in the non- profit world “no money, no mission.”  Some of us remember a time a few years ago when we had no money, only the determination to pay our bills, tighten our belts and count every penny. Our dynamic duo, Jodi and Larry, helped us through the crisis years. Then, at the start of Cece’s term, a miracle happened. Working with NRHA, Cece and LeAnn ‘found’ a long lost check. Hallelujah!  Today, IRHA has a solid foundation on which to build.
 
Membership is the lifeblood of volunteer associations like IRHA.  Nationally, associations lose 10% of their members on average every year. With a lot of hard work Cece, Larry and the board did better than average. Moreover, the NRHA IRHA joint membership campaign Cece set in motion is still in progress. Add to this a Wellmark Foundation Capacity Building grant to develop IRHA membership strategy Cece submitted came “very, very, very, very close” to winning and may yet find a sponsor. Voluntary associations, including IRHA, need a sustainable membership business model.

In associations where directors and officers have short terms and high turnover; institutional memory and continuity of operations need to be addressed. Cece understood this and took LeAnn with her to the NRHA national conference. Future directors and officers now have LeAnn as a local resource.

Having great partners and doing world class work helps to solidify credibility. Cece really, really, really, really stretched to help Bill Applegate, who worked so diligently to find sponsors, succeed in delivering the Iowa Rural Health Survey. I used four ‘reallys’ because it took four IRHA Presidents (Mary, Janan, Jack and Cece) to complete this project. Kudos!  Read Ann Salzer’s gem of a report to see what hard work can accomplish

Once again thank you Cece for helping IRHA become a healthier organization with greater mission potential.

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IRHA Joins PFCD
The Partnership to Fight Chronic Disease is a national, bipartisan coalition of health care stakeholders committed to fighting chronic disease and serving as an umbrella organization to integrate and promote the best of existing chronic disease prevention and management programs from across the country. The United States cannot effectively address escalating health care costs without addressing the problem of chronic disease.  Seven of every 10 Americans die each year of a chronic disease.  
The Iowa co-chairs for PFCD are Tom Vilsack and Terry Branstad. IRHA has joined with business, labor, faith and health organizations in Iowa to focus attention on chronic diseases which cost Iowans $7.6 billion annually. More information at http://www.fightchronicdisease.org/crisis/index.cfm

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Is Perception Reality? Statewide Study Reveals Iowans' Attitudes About Health Care

(Des Moines, IA) – In the first statewide survey to examine the health perceptions of Iowans, researchers found that 85% of Iowans feel good about their health. Iowans also feel their access to health care is satisfactory, with 93% agreeing that travel time to see a physician is “reasonable.”

While the survey highlights the overall positive outlook of Iowans and their acceptance of personal responsibility, the results contradict conventional wisdom that there are access problems in the state. The survey begs the question, “is perception reality?” when it comes to access to health care in the state of Iowa.

The study also found no real difference in perceptions of access between those who live in rural* and non-rural areas. “This study indicates that statewide there appears to be no systemic perception of inadequate access to health care services, though important pockets of problems deserving of attention may exist to some degree.” says Ann Selzer, president of Selzer & Co., the Des Moines based firm that conducted the research.

Additional Strengths
•    16 % of Iowans say their health is improving over what it was last year while only 9% say it is getting worse.
•    More than nine in ten Iowans have health insurance and 79% say their coverage is good.
•    Most Iowans, 94%, have a regular place they visit for health care, a medical home – and they feel the travel distance to that place is “reasonable.”

Opportunities for Improvement
•    The vast majority of those with improving health, 85%, also agree that more exercise and better nutrition lead to improved health.
•    Iowans are interested in prevention – and 88% agree that they could reduce everyone’s health care costs by changing their own health behaviors.
•    Only one in four Iowans say they comply with what their primary care provider recommends all the time.
•    The majority of Iowans have, at one time or another, chosen to manage their health care costs by not seeing a health provider when they were sick, not filling prescriptions or not scheduling follow-up medical tests.

Despite the fact that 85% of Iowans are reporting good health, there is still much room for improvement. The survey also shows that 36% are also suffering from a chronic condition such as high blood pressure, diabetes, arthritis or heart disease. This provides an opportunity for improving the health of those residents suffering (but not necessarily complaining about) chronic conditions. The findings of this study prove Iowans are receptive to prevention methods, take personal responsibility for their health care and actively seek health care.

The study, sponsored by The Iowa Rural Health Association, Iowa Farm Bureau, Partnership for Better Health, Iowa Health System and Des Moines University, was conducted by Selzer & Co. The telephone study involved 1,000 Iowans and was conducted in July 2007.

*Rural: There is no standard definition of the term “rural.”  The U.S. Census defines it as any area that is not urban. For the purposes of the study, Selzer & Co. has defined “rural” as participants who meet one of the two following criteria: living on a farm and working as a farmer or living in a small town or in the country at least 50 miles from a major city in Iowa or its suburbs.

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Chautauqua In Pictures
    

Bill Northey

"I know most of the people in this room. Cheryll Jones and Mary Weaver…" -Patty Judge

"Here are IDPH’s Priorities…" -Tom Newton

"Protection from Zoonotic Diseases involves Agriculture and Public Health working together." - Mark Shearer and Ann Garvey

Cheryl Clark, Mary Weaver and Ray Kuthy

This is a survey of PERCEPTIONS in rural and non-rural Iowa Bill Applegate and Ann Selzer

    
    

Rural:(definition, humorous) Where the number of large animal bites exceeds the sexually transmitted disease rate for that geographic area Raymond A. Kuthy

Cece Arnold presenting the 2007 Jerry Karbeling Award to Kathy Williams

Lunch Lee Friel and Ray Kuthy

Rural populations, which tend to be older, need Medication Knowledge services Bernard Sorofman

 

Doreen Chamberline and Cece Arnold

We have developed a new toolkit for depression Joan Blundall

Rapporteur(definition): One who is designated to give a report, as at a meeting Russss Currier

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New Directors in Words
Elections to the Board of Directors were held at the IRHA annual meeting in Des Moines. Here are bio sketches of your new directors:
David Fries – Iowa Prescription Drug Corp (President-Elect)
David J. Fries serves as Executive Director for the Iowa Prescription Drug Corp. a not for profit organization. The corporation established a program called Iowa Priority which is designed to improve the quality of life and reduce the cost of prescription medications for Medicare eligible Iowans. The program has approximately 68,000 members and has provided discounts at the point of purchase since January 1, 2002. The corporation was also granted approval for a Medicare Discount Drug Card beginning June 1, 2004.   For 29 years he was with the Iowa Department of Public of Health and retired on January 31, 2002 serving 12 years as the Deputy Director and the Deputy Director of Operations.  David headed the Chautauqua committee.   

William K. Appelgate, PhD – Des Moines University (Director)
Vice President for Planning & Technology for Des Moines University. He concurrently serves as the Executive Director of the Iowa Chronic Care Consortium, a collaborative statewide effort among health care providers, private employers, state government and health plans to deploy chronic care strategies and demonstrations to
Iowans. The Consortium has also led the Iowa Medicaid program launch of a Comprehensive Wellness Assessment program that brings innovative health prevention strategies to 370,000 Iowans in that program.
Bill conceived and successfully lead the Iowa Rural Health Survey project.

Joan Blundall, MS, HCA – The Higher Plain, Inc. (Director)
Joan Blundall is the Director of Community Based Initiatives: The Higher Plain, Inc. She has a strong commitment to increasing health literacy in the area of depression and other mental health issues. In her thirty years in the mental health field, Ms. Blundall has published many articles and chapters of text books on issues of mental health, rural service provision, and health care financing. Her work has been featured by the print and television media. She represents Iowans on the Consumer Advocate Panel and the Bureau of Rural Health and Primary Care as a gubernatorial appointee. Ms. Blundall has helped organizations expand community and volunteer networks in rural areas during the farm crisis and following natural disasters. She has been called to Washington D.C. regarding needs of the underserved. She submitted a report to the Governor of Iowa on the financial condition of Community Mental Health Centers. Ms. Blundall consults with communities on fund-raising, strategic planning, operations management, HIPPA regulations, network development, and resource acquisition.

James Gill, MD, PhD – Jackson County Public Hospital (Treasurer)
Dr. Gill is a physician, emergency department coverage for Jackson County Public Hospital, Maquoketa, Iowa through EPA. He served as a Zoonotic Disease Specialist and Lead investigator for research of 1) avian influenza and 2) vector-borne diseases that primarily include tick-borne diseases at the University Hygienic Laboratory in Iowa City. Jim discovered several novel pathogens here in Iowa.

Denise M. Hill, JD, Attorney - Whitfield and Eddy Law Firm/Des Moines University (Director)
Denise M. Hill joined the Whitfield and Eddy law firm in the fall of 2006 where she is in general practice including: health law, employment law, estate planning and administrative law. She is also a mediator trained by the American Health Lawyers Association and the International Academy of Alternative Dispute Resolution and a registered lobbyist. Prior to joining Whitfield and Eddy, she practiced at the Davis Brown law firm; she was an attorney and manager of public and regulatory affairs at the Iowa Medical Society; and at the Iowa Department of Personnel, she was a labor relations attorney. She is a practitioner scholar member of the faculty at Des Moines University, teaching courses on health law and ethics. She is the vice president of the Iowa Society of Health Care Attorneys. She graduated with honors from Drake Law School and received her master's in public administration from the Drake School of Business and Public Administration.
Julie Scadden – Iowa EMS Association (Director)
Julie started as a volunteer for Schaller Ambulance in 1992. She completed the EMT-I and then the Paramedic Specialist programs. She completed her Paramedic training at Western Iowa Tech in Sioux City. She now works part-time for the Sac County Ambulance Service. Julie is very active in EMS serving on the Iowa Scope of Practice Committee & several other committees on both the state and regional level. She maintains her Paramedic certification along with PHTLS Instructor, ACLS Instructor, AMLS Instructor, AHA Regional Faculty, & PEPP Coordinator. She is also a member of the DMAT-B team and spent time in Florida in 2004 for hurricane relief for the State of Iowa EMAC team. Julie is the mother of 4 children, volunteering her spare time serving on a citizen's advisory group for the Schaller-Crestland Schools and Football Cheerleading coach until this past year. Julie continues to be a volunteer paramedic on the Schaller Ambulance squad, serving currently as the secretary on their board.
DeeAnn Wedemeyer-Oleson, PharmD -  Guthrie County Hospital (Director)
DeeAnn Wedemeyer-Oleson, of Guthrie Center, Iowa, graduated from Drake in 1999 and is director of pharmacy at Guthrie County Hospital. She has previously received the Innovative Pharmacy Practice and Distinguished Young Pharmacists Award from Iowa Pharmacy Association. In addition, she serves as a consultant for the Iowa Foundation for Medical Care and writes a column for Pharmacy Practice News, a nationally distributed hospital pharmacy publication.

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Kathy Williams Receives Jerry Karbeling Award

Jerry Karbeling was a member of the Iowa Rural Health Association and served on the Board for 5 years.  He served as President of the Association in 2002-2003. At the time of his death in 2005, Jerry was the Senior Vice President for Public Affairs and Corporate Development for the Iowa Pharmacy Association, a practicing community pharmacist, and owner of Big Creek Pharmacy in Polk City. He was a healthcare activist, an adjunct professor, and served on the City Council of Polk City.

The Iowa Rural Health Association recognizes Jerry’s legacy and retains the memory of his contributions by awarding the Jerry Karbeling Award. Past recipients include Cheryll Jones and Mary Weaver.
This year IRHA honors Kathy Williams with our 2007 Jerry Karbeling Award.  
Doreen Chamberlin, IDPH Bureau of Health Care Access Chief and Kathy’s boss, described Kathy as a shy, quite, soft spoken person of few words. Just like Jerry Karbeling…not. The Kathy we know and appreciate is ever broadcasting the latest news and information relevant to rural health. Need proof, I have 39 e-mails in my inbox from Kathy. Moreover, Kathy actually helped found IRHA, served on the board and truly exemplifies the heart, soul and spirit of Jerry Karbeling. Thanks Kathy for all the great work you do.

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Affordable Health Care Commission Making Great Progress 
Ro Foege

As co-chair, I am happy to report great progress of The Legislative Interim Commission on Affordable Health Care Plans for Small Businesses and Families.  This bi-partisan group includes legislators, medical providers, small business and insurance representatives, and consumers.
 
The overall objective of any health care reform in Iowa is to create a "health care" system that focuses on helping consumers stay healthy.  Today, Republicans and Democrats alike recognize that what we have is a "sick care" system that responds primarily when one becomes sick.
 
States are now taking the lead in proposing changes to our system because Washington, D.C. has failed in providing health care security to all.  In poll after poll, health care is the number one domestic issue Americans are concerned about.  Americans and Iowans want the system fixed, and I believe that Iowa can deliver.
 
The Commission has been meeting monthly and has adopted a set of eight principles to guide their work as they develop recommendations to be presented to the 2008 General Assembly:
1.    Coverage and care should be universal or near universal.
2.    Coverage should be affordable and take into account all health care costs.
3.    Everyone should have a medical home.
4.    Health care should be accessible.
5.    Financing should be a shared responsibility.
6.    Reforms should drive quality improvements and contain costs.
7.    Reforms should do no harm.
8.    Reforms must be sustainable and doable.
Former Governors Release Report
In addition to the monthly Commission meetings, three large public hearings have been held across the state, co-chaired by former Governors Tom Vilsack and Terry Branstad.  At these public forums, citizens were given the opportunity to express their concerns and make suggestions.  On October 10, Governors Vilsack and Brandstad reported their findings to the Commission.  Based on their findings, the former Governors recommended that Iowa take steps towards a universal health insurance program by imposing health coverage, similar to Iowa laws requiring liability insurance coverage for car owners.  In addition, they stressed the importance of strong collaboration and compromise among the various stakeholders to make the required structural changes needed to improve the current delivery system.
 
What's Next?
The Commission has three more scheduled meetings:
•    October 17 in Sioux City
•    November 14 in Dubuque
•    December 19 in Des Moines
Commission members are charged with developing recommendations to be presented to the Iowa Legislature for consideration in the 2008 session.  
 
It has been an honor and pleasure to work side-by-side with my fellow legislators as well as dozens and dozens of passionate, committed professionals on the commission.  I look forward to fulfilling my role in finding the best possible solutions to one of the most important issues facing Iowans today.
 
For additional information about the Health Care Commission, please go to:
http://www.legis.state.ia.us/aspx/Committees/Committee.aspx?id=208

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New Interactive Map Tracks Comprehensive State Initiatives on Covering the Uninsured

With the number of the uninsured continuing to grow, states have taken the lead in developing proposals to reform the health care system with the goal of increasing the number of people with health coverage and making coverage more affordable. Kaiser has created a new online interactive map and related summaries of plans to track which states have enacted or are planning comprehensive health initiatives .
Uninsured Primer and Fact Sheet Updated with 2006 Data  
The Foundation's Kaiser Commission on Medicaid and the Uninsured (KCMU) has updated two of its key publications that provide basic information on health coverage in America and the uninsured policy problem.  The Uninsured: A Primer reviews the basic profile of the uninsured population, how they receive care, and what the options are for increasing coverage.  It includes many charts and tables of data.  The Uninsured and Their Access to Care fact sheet describes the characteristics of the uninsured population, the difference health insurance makes, and why there is a large uninsured population.

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Dr. Clancy Advice Columns Launched on AHRQ Website
Kevin Murray
I'm pleased to announce that today we are officially launching a new series of advice columns written by Dr. Clancy and posted on the AHRQ Web Site.  The columns are designed to help consumers navigate the health care system and make decisions about their health care.
 
The bi-weekly columns, which will appear on AHRQ's Consumer & Patients Web site (www.ahrq.gov/consumer), build on AHRQ’s ongoing work to help consumers make informed decisions and seek services that are appropriate for them and their families.
 
To read Dr. Clancy's first column, "Recognizing High-Quality Health Care," go to http://www.ahrq.gov/consumer/cc.htm.  Like the other columns that will follow, it draws on existing information produced by AHRQ in publication, brochure, or pod cast formats.  
 
We will be marketing these columns to other health care Web sites, magazines, and companies to use for their employees and customers.
 

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National Rural Behavioral Health Webinar Series: 2007-2008
November 1, 2007 from 1–2:30pm E.T.
Creating State-Community Partnerships for Social-Emotional Well-being in Rural America:  States and rural communities use a variety of strategies to support the social and emotional well-being of all children and to support comprehensive services and supports for those children with behavioral health challenges and their families. This Webinar will help participants become familiar with several key federal grant programs to improve children’s mental and behavioral health including: CMHS Systems of Care, Safe Schools/Healthy Students, Circles of Care, National Child Traumatic Stress, Statewide Family Networks, and Suicide Prevention. Presenters will discuss the benefits of not only building strong partnerships between state-level and community partners, but also enhancing linkages across federal grantee programs for community mental/behavioral health. The Webinar will also provide opportunities for participants to explore current efforts and how challenges can be addressed to build a strong and effective voice for rural individuals in their communities and states.   The Federal Intra-agency Rural Behavioral Health Workgroup is sponsoring this Webinar, in collaboration with the National Center for Mental Health Promotion and Youth Violence Prevention, the National Technical Assistance Center for Children's Mental Health at Georgetown University as well as the Technical Assistance Partnership.
What is a Webinar?
Webinars use the Internet to provide information to groups of people anywhere in the world, and allow participants to comment or pose questions to the presenter(s).
When you register, you will receive information on how to log in. By logging in to the host Web site, participants can listen to the presentation by using their computer's sound system, watch the accompanying PowerPoint on their computer, and type in their questions or comments in a chat bar.
Viewing Requirements

Joining this event is easy and free!  All you need is access to a phone and an internet connection. Register today at: https://tapartnership.on.raindance.com/confmgr/.

If you are a first-time registrant, we recommend that you use the following guidelines for creating a username and password:
 Username: firstname.lastname. For example, John Smith's username would be john.smith
 Password: lastname.yearofbirth. For example, if Jane Smith were born in 1960, her password would be smith1960
Questions

If you have questions or concerns, contact Tiara Etheridge by e-mail at tetheridge@air.org or by phone at (202) 403-5932.  You can also take a look at “TA Partnership Webinar Frequently-Asked Questions,” located online at http://www.tapartnership.org/learningopp/webinarshowto.asp.  

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Changing Face of Agriculture: Alternative Agriculture, Biofuels and Food Safety

Eileen Fisher
The  “Changing Face of Agriculture: Alternative Agriculture, Biofuels, and Food Safety” conference will be held November 15-16, 2007 at the Embassy Suites in the Old Market of Omaha, Nebraska.  The conference will feature speakers on: Everything But… Alternative Agriculture in the Midwest,  Biofuels: An EPA Perspective, and What the USDA Does to Guarantee Food Safety and Food Security for Meat & Poultry.   Lunchtime keynote Fadi Fathallah, PhD Associate Professor, Department of Biological & Agricultural Engineering, University of California, Davis, CA will speak about Ergonomic Interventions in California’s  Labor Intensive Agriculture.
 
Registration is $175 for the 2-day conference which includes a tour of E3 Biofuels plant, Mead Cattle Company, and Soaring Wings Vineyard or $110 for Thursday only. Farmers are encouraged to attend the conference at a special rate of $25 per day.  For more information, call 319-335-4224 or visit http://www.public-health.uiowa.edu/icash/  or register online at http://www.unmc.edu/dept/rhen/index.cfm?CONREF=77  The conference is hosted Iowa's Center for Agricultural Safety and Health and the North American Agromedicine Consortium (NAAC).  
 Iowa’s Center for Agricultural Safety and Health (I-CASH) and the North American Agromedicine Consortium (NAAC) are co-sponsoring the “Changing Face of Agriculture: Alternative Agriculture, Biofuels, and Food Safety”  November 15-16, 2007 at the Embassy Suites in the Old Market of Omaha, Nebraska.

Each subject area will be covered by the following plenary presentations:
o    Everything But…: Alternative Agriculture in the Midwest by Matthew Russell, State Food Policy Project Coordinator, Drake University Agricultural Law Center and Iowa Network for Community Agriculture, Des Moines, IA  
o    Biofuels: An EPA Perspective by Sally Shaver, MS  Associate Counselor for Agricultural Policy, Office of Air and Radiations, U.S. Environmental Protection Agency, Research Triangle Park, NC
o    What the USDA Does to Guarantee Food Safety and Food Security for Meat & Poultry by Richard Raymond, MD  , Under-Secretary for Food Safety, Food Safety and Inspection Service, US Department of Agriculture, Washington, DC

Additional presentation by:
o    Ergonomic Interventions in California Labor Intensive Agriculture,  Fadi Fathallah, PhD Associate Professor, Department of Biological & Agricultural Engineering, University of California, Davis, CA

The conference will include a 4 hour breakout session on each of the three focus areas: Alternative Agriculture, Biofuels, and Food Safety.  
Farmers are encouraged to attend the conference.  A special rate of $25 per day of the conference is available.  
For more information, contact Eileen Fisher at 319-335-4224 or visit http://www.unmc.edu/dept/rhen/index.cfm?CONREF=77.  Online registration is available online through the University of Nebraska Medical Center http://www.unmc.edu/dept/rhen/index.cfm?conref=78.