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Rural Health

The Challenge

Senator Murray addresses the challenges of rural healthcare at a roundtable in Wenatchee.
Senator Murray addresses the challenges of rural healthcare at a roundtable in Wenatchee.

Senator Murray appreciates the vital role played by Washington’s rural hospitals. As a member of the relevant committees (Budget; Appropriations; and the Health, Education, Labor & Pensions Committee), Senator Murray is a key player in supporting rural healthcare.

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Legislation to Help Rural Hospitals

Supports the Full Market Basket Increase

Senator Murray has worked to provide relief from the Balanced Budget Act. In 1999, she cosponsored the Balanced Budget Relief Act. In 2000, she helped draft and worked to secure passage of the Medicare Benefits Improvements and Protection Act. Both bills corrected inequities for Critical Access Hospitals and Medicare DSH hospitals. This year, Senator Murray continues to support the Full Market Basket Increase for hospitals, including rural hospitals.

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Supports the Health Care Access and Rural Equity Act (H-CARE)

Senator Murray is an original cosponsor of this bill, which was introduced in April 2003. Supported by the National Rural Health Association, the H-CARE Act:

Addresses Medicare Disparities by:

  • Establishing a Low-Volume Adjustment Payment for Small, Rural Hospitals
  • Equalizing Medicare Disproportionate Share (DSH) Payments, which are used to cover the costs of treating the uninsured
  • Closing the Gap Between Urban and Rural “Standardized Payment” Levels
  • Improving the Wage Index Calculation, which accounts for hospitals’ labor costs
  • Ensuring Rural Hospitals are Reimbursed Fairly for Outpatient Services
  • Protecting Rural Hospitals’ Access to Independent Lab Services

Provides Resources to Meet Crucial Rural Health Care Needs

  • Capital Infrastructure Improvement Loan Program

Builds on the Successes of the Critical Access Hospital (CAH) Program with:

  • Improved Payments for Ambulance Services provided to CAHs
  • Increased Flexibility for CAHs to Allocate the use of Acute and Swing-Beds
  • New Incentives to Ensure 24-hour Access to Emergency On-Call Providers
  • New Measures to Assure CAHs will Receive Timely Medicare Reimbursement

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Supports the Rural Health Training Incentive Act (S.1868)

All across the nation, rural areas are experiencing a shortage of primary care physicians and health practitioners. In order to address this festering problem, we must recruit students from rural communities into the health professions and give medical students access to training in rural areas. Research has demonstrated that 45 percent of family practice residents who spend two months in a rural setting and 75 percent of residents who train in for two years or more in a rural setting go on to a rural community.

Senator Murray joined several of her colleagues in introducing the Rural Health Training Incentive Act, which will award a grant to the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) joint medical school to strengthen and expand existing programs that encourage more health professionals to practice in rural areas.

Specifically, the grant will be used to:

  • develop new mechanisms for recruiting and mentoring rural youth with respect to all health professions,

  • strengthen and stabilize the system of training for the family physicians needed in rural areas,

  • and expand the network of rural training tracks throughout WWAMI

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Supports the Nurses Reinvestment Act (S.AMDT 136 to H.J. Res. 2)

Senator Murray has been a strong supporter of addressing America’s nursing shortage. Despite the overwhelming shortage of nurses throughout America, our country’s nursing schools turned away more than 5,200 qualified applicants due in part to a shortage of nursing faculty. During consideration of the Fiscal Year 2003 Omnibus Appropriations bill, she cosponsored an amendment that successfully increased funding for Nurse Reinvestment Act programs by $15 million, to bring total funding to $113.5 million for Fiscal Year 2003.

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Fighting for A Budget that Protects Rural Hospitals

The current Administration has proposed eliminating or under-funding several health programs that serve rural communities. Senator Murray, as a member of the Senate Labor, Health & Human Services and Education Appropriations Subcommittee, is working to restore funding for these critical programs.

Save the Community Access Program (CAP)

CAP grantees help communities coordinate care for the uninsured and hard-to-insure. Last year, Senator Murray successfully restored funding needed for CAP to continue providing care, despite the Administration’s attempt to eliminate the CAP program. Once again, Murray is fighting against the Administration’s plans to eliminate the CAP program.

Invest in the Telehealth Program

This program provides direct assistance to rural providers to offset the cost of telemedicine. In Fiscal Year 2003, the Administration proposed cutting funding to $5.6 million, however, Murray was successful in obtaining $27 million. Once again, the Administration is severely under-funding crucial telehealth programs by proposing only $4 million. Senator Murray believes this is largely inadequate and is fighting to obtain $44 million in FY 2005 funding for this important health program.

Save the Rural Health Research Grant Program

This grant program provides funding to help rural communities and providers find the most effective ways to provide care to rural patients. Despite severe financial restrictions, Senator Murray was able to allocate close to $9 million in Fiscal Year 2004, a great improvement over the Administration’s meager request for under $6 million.

Save the Medicare Rural Hospital Flexibility Program

This program provides funding to help rural hospitals meet reimbursement challenges, and is especially helpful for traditionally underserved areas in Washington state. Despite the instrumental role that this program has played in improving quality healthcare in rural areas, the Administration eliminated funding for Rural Health Flexibility Grants in its Fiscal Year 2005 budget.

According to the National Rural Health Association, the Administration’s proposed cuts to programs in the Health Resources and Services Administration are “the largest reductions to rural programs in more than 10 years.” Fortunately, Murray introduced an amendment to the budget that successfully restored funding for this crucial program to Fiscal Year 2004 levels.

Increase Funding for the National Health Service Corps

This program extends opportunities for health care providers in Health Care Shortage Areas. Senator Murray is now working to increase funding in Fiscal Year 2005 to $205 million, an increase of more than $30 million. This increase will help medically under-served communities recruit and retain health care providers to serve in their community.

Full Funding for the Health Professions Act, Title VII and Title VIII

These programs offer support to individuals who seek an education in various health professions, and have proven effective in producing an increased number of health care professionals serving in underserved areas. Without this funding, many families in Washington state would not receive essential primary care services.

Despite their importance, the Administration has proposed $158 million for all Title VII and Title VIII Health Professions programs – a 64 percent reduction! At a time when our country is experiencing severe shortages in nursing, primary care, pharmacy, public health, and other health professions that are leaving many without access to care, Senator Murray is fighting to increase funding for these important programs to ensure the involvement of future generations of nurses and health care professionals.



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