CSRHA Celebrates Successful Federal Advocacy Trip
by Desiree Rose and Laurel Mildred, MSW

Administrative visits highlights
Senate & Congressional visits highlights

CSRHA and its delegation of 12 rural and mental health advocates visited Washington D.C to raise awareness and disseminate information on the health issues affecting California’s rural populations as part of the National Rural Health Association’s (NRHA) Rural Health Policy Institute on January 27th-29th, 2009. The delegation split in teams and visited with several administrative officials within the Healthcare Resources and Services Administration (HRSA), as well as nine of California’s Senate and Congressional representatives. CSRHA shared its federal advocacy platform and emphasized urgent issues involved with FMAP funding, HIT and eHealth Services, mental health and workforce development. 

ADMINISTRATIVE VISITS HIGHLIGHTS:
Part of the CSRHA contingent attended the early session of the NRHA Conference in order to meet and honor California Representative Pete Stark (D-Fremont), Chair of the House Ways and Means Subcommittee on Health, who was given an award for his work on behalf of rural communities.  Concurrently, Judith Shaplin, CEO of Mountain Health & Community Services, and Chair of CSRHA’s Advocacy Committee arranged a meeting with Tom Morris, Associate Administrator for Office of Rural Health Policy within HRSA.

Mr. Morris shared information on Workforce Investment Act funding proposed in the federal stimulus bill and disclosed that HRSA is considering a new initiative to fund mental health strategies for the upcoming 3-year grant cycle. He indicated that he will be visiting California in the near future and expressed a desire to collaborate with CSRHA to help coordinate site visits to some rural healthcare facilities so he can learn and see first-hand the unique and innovative work our members our doing, as well as to discuss ongoinng barriers. Stay tuned for details regarding Mr. Morris’s upcoming visit!

Later that day, part of the CSRHA delegation made the trip to Rockville, Maryland to conduct administrative visits with other officials from HRSA. The group met first with Dena Puskin, Director of the Office for the Advancement of Telehealth and Johanna Barraza Cannon, Director of the HRSA Office of Health Information Technology.  The advocates covered a range of rural telehealth issues and information on the potential for California to maintain its leadership in the area of health information technology, tele-health, and the broad utilization of technology to link rural communities.  
Next, the delegation enjoyed an engaging meeting with Rick Smith, HRSA Associate Administrator for Clinician Recruitment and Services.  Mr. Smith discussed the expansion of the dollars allocated to the National Health Services Core (NHSC) in the stimulus package and the need for encouraging applicants. Mr. Smith stressed that the funding level of this program is best maintained through an increase in the number of applicants not by the utilization of vacancy rate data or personnel to population data. The group discussed ways to increase the number of applicants, as well as, opportunities to include more mental health service providers in the NHSC.  

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SENATE AND CONGRESSIONAL VISITS HIGHLIGHTS:
The next day, CSRHA’s delegation met with representatives from two Senate Offices and seven Congressional offices, including: Representative Patrick Kennedy (Rhode Island) Chair, Healthcare Caucus; Senator Diane Feinstein;Senator Barbara Boxer; Representative Jerry Lewis; Representative Grace Napolitano; Representative Wally Herger; Representative Mary Bono Mack; Representative Bob Filner; and Representative Mike Thompson. These are the highlights of each meeting:

Representative Patrick Kennedy (D-Rhode Island) and Senior Legislative Assistant Laurel Havas expressed ongoing support for mental health advocacy issues, concern about veteran's issues and interest in federal workforce development recommendations.  Kennedy had to rush off to cast his vote on the stimulus bill, but let us know that he is planning to sponsor a Mental Health Patients' Bill of Rights this year.

Kristin Wikelius, Legislative Assistant to Senator Diane Feinstein discussed California aspects of the federal stimulus bill, including the formulas that will determine the state's share of funding.  She advised us that opportunities for policy reform will take a backseat to the complexity of getting the stimulus bill passed.  She noted however that Congress plans to take up health care reform very quickly afterwards, perhaps as early as March, and she urged us to ensure that the rural voice is heard during the debate.

Carina Armenta, Legislative Assistant to Senator Barbara Boxer, expressed a desire for California-specific data to use in federal policy making.  She discussed a range of policy issues including veteran’s mental health, workforce development and rural health facility issues, and advised that particular activism and care needs to be given to make the case for rural California issues at the federal policy level, because these issues are often the domain of rural states such as Montana.

Jennifer Wickre, Legislative Assistant to Representative Jerry Lewis (R-San Bernardino), held a wide-ranging discussion on issues of assessing rural clinic needs in San Bernardino County. The group encouraged the Office to work closely with CSRHA in obtaining information on rural health issues or setting up forums for input on critical issues related to pending federal legislation, emerging community needs, or facilitation statewide or regional forums on topics the office which to explore in order to better influence federal policy.   

Elizabeth Ziegler, Legislative Assistant to Representative Grace Napolitano (D-Norwalk), expressed interest in continuing to advocate for mental health care for all Californians.  The Office has special interest in the Department of Mental Health Office of Suicide prevention. There was also dialogue concerning a bill that was being drafted for in-school mental health services and the group provided the Office feedback on the issue or requiring providers to be certified or licensed. Lastly, the Office was concerned about Mental Health Service Act dollars being used to help balance the State’s growing deficit.  The group agreed to send media, informational notices, and/or any communication related to these funds to the Office.   

Taryn Nader, Legislative Assistant to Representative Mary Mack Bono (R-Palm Springs) expressed interest in veteran's mental health and said that Representative Bono is concerned with substance abuse and will be looking on opportunities to raise awareness on this issue in this session.

Jay Sulzmann, Senior Policy Advisor to Representative Wally Herger (R-Chico) was knowledgeable about rural health facilities issues and engaged the rural health advocates in discussion about the policy issues around Federally Qualified Health Care facilities and Rural Health Clinics.

At the end of the day, Judith Shaplin set off for an individual meeting with her district Congressman, Representative Bob Filner (R-San Diego) for a discussion of veteran's affairs, as well as issues unique to Federally Qualified Health Centers.

Representative Mike Thompson (D-St. Helena) and CSRHA’s delegation discussed a wide range of rural health topics, and Thompson expressed his ongoing strong support of California’s rural healthcare sector. He encouraged CSRHA to continue to stay in touch him and his district offices, and happily posed in a photo with the group!

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A SPECIAL THANKS TO THE 2009 FEDERAL ADVOCACY DELEGATION MEMBERS
The trip would not have been a success without their participation!

• Tom Bachman, Community Development - Mountains Community Hospital Lake Arrowhead
• Peter Castle, JD, Associate Director - California Association of Social Rehabilitation Agencies
• Rick DeGette - Alameda County Behavioral Health Services Agency
• Harry Jasper, Administrator - Southern Humboldt Community Healthcare District
• Brian Keefer, Program Manager - California Mental Health Planning Council
• Shannon Means, Program Coordinator – California State Rural Health Association
• Laurel Mildred, MSW, Policy Consultant
• Gail Nickerson, Director, Clinic Services - Adventist Health, Roseville CA
• Desiree Rose, Executive Director - California State Rural Health Association
• Adrianne Shilton, Program Director, Workforce Education and Training - California Mental Health Directors Association
• Judith Shaplin, CEO – Mountain Health & Community Services
• Maia Schneider, Director of Community & Government Relations - Tahoe Forest Health System

CSRHA hopes to return to Washington to continue their efforts in September of 2009. 
If you are interested in joining CSRHA for follow up visits to Washington D.C., please contact Desiree Rose, CSRHA Executive Director at drose@csrha.org, or 916.453.0780.

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Article posted on 4/9/09