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National Conference of State Legislatures
Rural Health Brief
THE STATE LEGISLATIVE AGENDA FOR RURAL HEALTH:
SYNOPSIS OF A MEETING SPONSORED BY
THE FEDERAL OFFICE OF RURAL HEALTH POLICY AND THE ROBERT WOOD JOHNSON FOUNDATION
August 2001

For More Information:
Tim Henderson, NCSL @ 202/624-3573
Marcia Brand, Federal Office of Rural Health Policy @ 301/443-0835 

On June 22, 2001, NCSL convened a one-day national meeting of state lawmakers and rural health officials in Boise, Idaho to debate and discuss a range of health policy topics of importance to state governments (see attached agenda). Fifty participants representing 20 states and American Samoa worked to reach a common understanding of the importance of various rural health policy issues and identify possible next steps for participation and activity in the state policymaking process.

The meeting convened with a series of NCSL-facilitated panel and small group discussions among participants structured to maximize audience participation and allow ample time for general discussion. Lawmakers in attendance debated several issues of common concern pertaining to state rural health policy and reached the following conclusions:

1. States generally lack a comprehensive or "umbrella" policy or program for rural health as well as a centralized known location for receipt and distribution of rural health information. This is viewed in part to be due to the presence of pervasive categorical programs and funding streams and a shortage of informed and experienced state policymakers;
2. There is a need for greater coordination and integration of services and programs in many rural areas to sustain or improve the access-to-care infrastructure. The Critical Access Hospital (CAH) Program and the opportunities the program presents for states and localities to encourage greater service integration in rural communities are viewed as positive developments. CAH programs in Nebraska and Oklahoma offer early success stories;
3. Supportive and innovative partnerships between the federal and state governments are key to the development of effective rural health policies and programs;
4. Developing support for using tobacco settlement funds to finance rural health programs and services is an ongoing challenge. A recent agreement in Nebraska to spend these funds to improve the state's public health system appears promising;
5. State Medicaid programs should institute more innovative means to pay for various health services in rural areas.
6. The use of telecommunications to provide health care in rural areas remains an attractive strategy, particularly in frontier communities;
7. Ensuring prescription drug coverage in rural areas is a major challenge for states. Current initiatives in Pennsylvania and Maine provide important role models;
8. The problems of financing and establishing effective delivery of oral health services to impoverished rural communities in most states is overwhelming. Multiple approaches taken recently in Washington and Texas are vital first steps to addressing the problem.

There was a consensus among attendees for NCSL to convene further forums for state officials to deliberate ways and means for enhancing state rural health policy.

National Conference of State Legislatures

Office of Rural Health Policy, U.S. Health Resources and Services Administration
and
The Robert Wood Johnson Foundation