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Welcome! 

The National Association of Rural Health Clinics (NARHC) is the only national organization dedicated exclusively to improving the delivery of quality, cost-effective health care in rural under served areas through the Rural Health Clinics (RHC) Program. NARHC works with Congress, federal agencies, and rural health allies to promote, expand, and protect the RHC Program. Through the association, NARHC members become actively engaged in the legislative and regulatory process. Please view this Web Site as an information resource for and about the Rural Health Clinics program. We have tried to provide you with valuable up-to-date information on issues affecting rural health clinics and the communities they serve. In addition, there are useful links to other sites that we have found valuable.


It's Cost Report Time! Do you need assistance?

Check out our Consultants and Vendors page to see who can assist you.


Is It Time For Your Clinic To Be Certified/Recertified?

AAAASF has developed a program of inspection and accreditation to help improve the quality of patient care in rural health clinics. For nearly 30 years, AAAASF has inspected and accredited an array of surgery facilities using a nationally recognized set of standards that are considered the Gold Standard in the industry. We are expanding this concept to RHCs to establish a peer to peer accreditation program that mirrors our past efforts. Visit www.rhcaccreditation.org for more information.

PO Box 9500

Gurnee, IL 60031 

866-603-2067

www.rhcaccreditation.org  


Membership Drive:

NARHC Memberships run from January 1st through December 31st annually.  If you are not a member, click here for the membership form.

Want to save money on your 2009 NARHC Membership dues? Click here for a Membership Recruitment Program form for all of the details.

Want to know more about benefits of being a member? Click on the "About Us" page for all of the details.


Looking for Information regarding upcoming conferences? 

Click on the Events tab and scroll down to the appropriate conference. To view the agenda, click on On-Line Registration and Payment and once this screen opens, click on flyer/brochure.


July 1, 2009

To:  RHC Community and Friends

From:  Bill Finerfrock

Re:  Broadband Internet Grants

Earlier today, the Rural Utility Service announced the availability of $4.7 BILLION in grants and loans to bring broadband internet access to unserved or underserved rural communities.  This money is for infrastructure development.  One of the goals of this initiative is to "provide broadband access, education, awareness, training, equipment, and support to community anchor institutions (e.g., schools, libraries, medical facilities)".

For purposes of this initiative, a "rural area" is defined as:

any area, as confirmed by the latest decennial census of the Bureau of the Census, which is not located within: 1. a city, town, or incorporated area that has a population of greater than 20,000 inhabitants; or 2. an urbanized area contiguous and adjacent to a city or town that has a population of greater than 50,000 inhabitants.  The funding instruments will be grants, loans, and loan/grant combinations.

The following entities are eligible to apply for assistance:
 
1. States, local governments, or any agency, subdivision, instrumentality, or political    
     subdivision thereof
2. A non-profit foundation, a non-profit corporation, a non-profit institution, or a non-
     profit association
3. Other non-profit entities
4. For-profit corporations
5. Limited liability companies; and
6. Cooperative or mutual organizations
 
 
Here is a link to the announcement.  You are encouraged to share this with others in your community, particularly local government officials to determine whether you might qualify for a grant or loan.

http://broadbandusa.sc.egov.usda.gov/files/BB%20NOFA%20FINAL%20with%20disclaimer_1.pdf


Updated News

FOR IMMEDIATE RELEASE
May 1, 2009

FDA Warns Consumers to Stop Using Hydroxycut Products
Dietary Supplements Linked to One Death; Pose Risk of Liver Injury

The U.S. Food and Drug Administration is warning consumers to immediately stop using Hydroxycut products by Iovate Health Sciences Inc., of Oakville, Ontario and distributed by Iovate Health Sciences USA Inc. of Blasdell, N.Y. Some Hydroxycut products are associated with a number of serious liver injuries. Iovate has agreed to recall Hydroxycut products from the market.

The FDA has received 23 reports of serious health problems ranging from jaundice and elevated liver enzymes, an indicator of potential liver injury, to liver damage requiring liver transplant. One death due to liver failure has been reported to the FDA. Other health problems reported include seizures; cardiovascular disorders; and rhabdomyolysis, a type of muscle damage that can lead to other serious health problems such as kidney failure.

Liver injury, although rare, was reported by patients at the doses of Hydroxycut recommended on the bottle. Symptoms of liver injury include jaundice (yellowing of the skin or whites of the eyes) and brown urine. Other symptoms include nausea, vomiting, light-colored stools, excessive fatigue, weakness, stomach or abdominal pain, itching, and loss of appetite.
 
“The FDA urges consumers to discontinue use of Hydroxycut products in order to avoid any undue risk. Adverse events are rare, but exist. Consumers should consult a physician or other health care professional if they are experiencing symptoms possibly associated with these products,” said Linda Katz, M.D., interim chief medical officer of the FDA’s Center for Food Safety and Applied Nutrition.
 
Hydroxycut products are dietary supplements that are marketed for weight-loss, as fat burners, as energy-enhancers, as low carb diet aids, and for water loss under the Iovate and MuscleTech brand names.  The list of products being recalled by Iovate currently includes:

Hydroxycut Regular Rapid Release Caplets
Hydroxycut Caffeine-Free Rapid Release Caplets
Hydroxycut Hardcore Liquid Caplets
Hydroxycut Max Liquid Caplets
Hydroxycut Regular Drink Packets
Hydroxycut Caffeine-Free Drink Packets
Hydroxycut Hardcore Drink Packets (Ignition Stix)
Hydroxycut Max Drink Packets
Hydroxycut Liquid Shots
Hydroxycut Hardcore RTDs (Ready-to-Drink)
Hydroxycut Max Aqua Shed
Hydroxycut 24
Hydroxycut Carb Control
Hydroxycut Natural

Although the FDA has not received reports of serious liver-related adverse reactions for all Hydroxycut products, Iovate has agreed to recall all the products listed above. Hydroxycut Cleanse and Hoodia products are not affected by the recall. Consumers who have any of the products involved in the recall are advised to stop using them and to return them to the place of purchase. The agency has not yet determined which ingredients, dosages, or other health-related factors may be associated with risks related to these Hydroxycut products. The products contain a variety of ingredients and herbal extracts.

Health care professionals and consumers are encouraged to report serious adverse events (side effects) or product quality problems with the use of these products to the FDA's MedWatch Adverse Event Reporting program online, by regular mail, fax or phone.

–Online:  www.fda.gov/MedWatch/report.htm
–Regular Mail: Use FDA postage paid form 3500 found at:  
www.fda.gov/MedWatch/getforms.htm and mail to MedWatch,
5600 Fishers Lane, Rockville, MD 20852-9787
–Fax: 800-FDA-0178
–Phone: 800-FDA-1088

The FDA continues to investigate the potential relationship between Hydroxycut dietary supplements and liver injury or other potentially serious side effects.

For more information:

Hydroxycut Products

Dietary Supplements -- Overview

FDA 101: Dietary Supplements

NIH Office of Dietary Supplements

Media Inquiries:
Susan Cruzan, 301-796-4540

Consumer Inquiries:
888-INFO-FDA

April 27, 2009
To:  RHC Community and Friends
From:  Bill Finerfrock
Re:  Swine Flu Information
 
As you may have read, several cases of swine flu have been diagnosed in the United States and more in other parts of the world. As a consequence of this “outbreak” the Centers for Disease Control and Prevention (CDC) has issued guidance for health professionals. Below is a link to the CDC website and the guidance on how health professionals should deal with this situation.
 
 
If you have questions, I encourage you to either contact your local health department or the CDC directly.

January 30, 2009

To: RHC Community and Friends
From: Bill Finerfrock
Re: Legislative Alert
 
I am writing to let you know about some pending legislation that could affect the RHC community and to seek your assistance.
 
As you know, Congress is presently debating the economic stimulus package, formally known as H.R. 1, the American Recovery and Reinvestment Act of 2009 (ARRA). Included in this legislation are provisions to give financial incentives to providers that adopt and use an electronic health record (EHR) system. These incentives would begin in 2011. 
 
At the same time, the legislation directs federal agencies to establish new EHR certification standards as well as a single, uniform standard for EHR systems that will allow different systems to “talk” with one another. This is often referred to as “interoperability standards”. These standards would have to be in force prior to 2011 ensuring that when a provider purchased and used a certified EHR, it would be able to communicate with other certified systems. 
 
As part of the incentive program, language was included in the legislation providing specific incentives through either the Medicare or Medicaid programs for providers that are “meaningful users” of a certified EHR. For traditional physician offices and hospitals, the incentives are linked to their Medicare payments. However, for RHCs the incentive would be linked to the percentage of Medicaid patients seen in the RHC setting. Specifically, if 30% or more of an RHCs patients were Medicaid recipients, the clinic would be eligible for the incentive payments. If an RHC failed to have the volume of Medicaid, then they would not be eligible for the payments. 
 
NARHC believes that most RHCs will be eligible for an EHR incentive payment either directly through this Medicaid initiative OR because they are part of a hospital that will be eligible for a separate incentive program exclusively for hospitals. 
 
We also believe that approximately 15% of RHCs will be unable to qualify for an incentive payment because they are either not part of a hospital (provider-based) or they have an insufficient number of Medicaid patients to reach the 30% threshold. 
 
Therefore, we have asked Congress to modify the EHR incentive program to provide a mechanism by which RHCs with insufficient Medicaid volume can qualify for the bonus payments based upon their Medicare volume. 
 
I am writing to ask you to contact your representatives in Washington (House and Senate) to urge them to support this modification. Attached is a sample letter you can send to them if you need some assistance in crafting your message. 
 
In addition to the sample letter, I am providing you with a link to the Congressional web page where you can find your elected officials and their e-mail addresses.
 
 If you click on the HOUSE link below and then enter your state AND your zip code where requested, you will be immediately directed your Representative in Congress.
 
 
If you click on the SENATE link below and then enter your state, you will be given the contact information for your Senators.
 
 
Even if you are a provider-based RHC or you are a clinic with a high enough Medicaid population to qualify, I’m asking that you write your representative to make sure that ALL RHCs have the ability to access the federal money being made available for EHR adoption and use.
 
Your consideration of this request is appreciated.
 
Click here for a copy of the sample letter

January 21, 2009

To:  RHC Community and Friends

From:  Bill Finerfrock

Re:  RHC Rule Update

Yesterday, as one of his first official acts, President Obama  notified all agencies that they were to cease work on all pending regulatory changes until the new Administration has an opportunity to review the work.  This was not unexpected and follows a tradition going back to the Reagan Administration.  As a result of this announcement, no further work on the RHC rule will take place in CMS until it has been reviewed by Obama Administration officials. 

It is not clear how long this review process will take.  I expect, however, it will take several months to complete the review.  It should be noted that it will take several more weeks before the new CMS Administrator is in place, as well as those political appointees below the Administrator level.  It is conceivable that the review of Medicare/Medicaid rules will not commence until those political appointees are in place. 

NARHC will seek meetings with those officials reviewing the proposed changes in the RHC regulations to express our views on the strengths and weaknesses of those proposed changes. 

Earlier today, CMS responded to the Congressional and organizational requests for a 60 day extension of the proposed rule comment period by saying NO. Consequently ALL comments in response to the RHC proposed rule must be submitted by 5:00 pm (EASTERN) tomorrow, August 26th.

If there is any good news in all of this, it is that several of the Senators who requested the extension are extremely upset with CMS's refusal to grant this reasonable request. We are in the process of working with these offices to develop a strategy to prevent the unnecessary and inappropriate closure of Rural Health Clinics.

In the meantime, I want to urge everyone to submit comments on the proposed changes. If we have any hope of getting CMS to make the changes necessary to prevent the inappropriate closure of RHCs, then it is imperative that you write.

NARHC Draft Comments

Attached is a copy of the draft comments NARHC intends to submit prior to the August 26th deadline. It is possible that some changes will be made. It is being reviewed for content and it is also being reviewed for typographical and grammatical errors.  (Click here for draft comments)

You are encouraged to review these comments and where you think appropriate, submit comments similar to those incorporated in the NARHC document. I would ask that when submitting comments, be as specific and heartfelt as possible. Explain the situation in your community and most importantly, what these proposed changes may mean for access to health care in your community.

Realistically we don't expect CMS to accept everything we've recommended but if we don't ask, it can't happen. Some of these proposals go a bit farther than some might like but again, if you don't push the extremes, you can't change the middle ground either.

Your feedback (with what little time we have) would be appreciated.

RHC Proposed Rule Comment Period - August 25, 2008
AAAASF

Bill Finerfrock, Executive Director, NARHC

RHC Proposed Rule Released - June 26, 2008

The Centers for Medicare and Medicaid Services (CMS) today released for public comment the long awaited proposed changes to the Rural Health Clinic rules and regulations. To view the summer (5 pages) or complete proposed rule (103 pages), click on the Legislative Tab.

The Health Resources and Services Administration (HRSA) announced today that they are withdrawing the proposed changes in the methodology used to designate health professional shortage areas and medically underserved areas/populations. HRSA acknowledged in the withdrawal notice that a number of significant issues were raised by those who submitted comments and as a result, they recognize the need to go back to the drawing board. To read the full announcement from Bill Finerfrock, NARHC, Executive Director, click on the Legislative Tab.


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listserve page.

To post a question on listserve, send an email to narhc-news@orbit.sparklist.com.


Click here for RHC Fact Sheet

 

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