Exhibitor Setup

7:30a 

Registration Open

8:00-9:00a  

Buffet Breakfast with the Exhibitors

9:00-9:15a 

Welcome and Opening Remarks

Speaker: Earl Ferguson, M.D., PhD, CSRHA President

9:15a-10:15a

Health Care Reform:  The Rural Advantage
Keynote Speaker:
Paul D. Moore, D.Ph.
Senior Health Policy Advisor
U.S. Department of Health and Human Services
Health Resources and Services Administration
Office of Rural Health Policy

The Affordable Care Act gives rural Americans greater control over their  health care.  In addition, rural health care providers will benefit from a variety of provisions in the law that recognize the unique needs and challenges of rural communities and importance of rural providers in assuring access to healthcare in rural areas.  This presentation will provide an opportunity to learn more about the Health Resources and Services Administration regarding:

• The Programs delivered and people served;
• Their role in the implementation of health reform around such issues as increasing access to primary care services, healthcare workforce, and broadening access to 340B drug discounts;
• The Office of Rural Health Policy’s role in supporting rural health programs and rural health infrastructure.

10:15-10:45a 

Break in Trade Show

10:45a-12noon

Legislative Town Hall Meeting  (Legislators TBA)

12:00-1:00p 

Buffet Lunch with the Exhibitors

1:00-2:00p

State and DHCS 1115 Waiver Update

Ms. Willburn will present new statistics and data related to rural health and our healthcare delivery system.

During this last year Bobbie Wunsch with Pacific Health Consulting Group has provided consultation and support for California’s efforts to design the 1115 Waiver to the federal Centers for Medicare and Medicaid Services (CMS). California’s section 1115 Medicaid waiver addresses enrolling seniors and people with disabilities who are on Medi-Cal into Medi-Cal managed care plans or alternative county organized systems of care; enroll uninsured low-income adults into an expanded number of county coverage initiatives and pilot projects to improve the California Children’s Services program. An overview of the status and next steps regarding the 1115 waiver and next steps regarding implementation at the ground level in rural California will be presented.

Speakers: Sandra Willburn, Chief, CA Office of Primary and Rural Health Care, DHCS, Bobbie Wunsch, Pacific Health Consulting Group; Dean Germano, CEO, Shasta Community Health Center;  Lee Kemper, Director, County Medical Services Program  

2:00-3:00p

eHealth Update

Hear the leaders of California's initiatives and programs to support the adoption and meaningful use of electronic health records give a brief overview of their programs, followed by a question and answer period. This panel will provide attendees with an opportunity to learn more about how to get Medi-Cal Incentive payments, subsidized Health Information Exchange, technical support programs and rural broadband.

Speakers: Speranza Avram, Executive Director, California Health Information Partnership and Services Organization (CalHIPSO); Eric Brown, Executive Director, California Telehealth Network; Jonah Frohlich, Deputy Secretary of Health Information Technology, California Health and Human Service Agency; Carladenise Edwards, Executive Director, Cal eConnect; and, Larry L. Dickey, MD, MPH, Medical Director, Office of Health Information Technology, California Department of Health Care Services

3:00-4:30p

Rural Health Policy Council Meeting

The purpose of California Rural Health Policy Council’s public meetings are to provide public access to California’s top rural health policymakers in a roundtable setting conducive to discussing rural health challenges and issues.

Panelists: Lesley Cummings, Executive Director, Managed Risk Medical Insurance Board; David Maxwell-Jolly, PhD, Director, Department of Health Care Services; Stanley A. Bajorin, Chief Deputy Director, (representing Dr. Stephen W. Mayberg), Department of Mental Health; Steven Tharratt, MD., Director, Emergency Medical Services Authority; Janine LaMar, Deputy Director/Chief Counsel,(representing Dr. Renée Zito) Department of Alcohol and Drug Programs, Office of Legal Services

4:30-6:30p

President’s Reception and Trade Show

• Silent Auction Opening
• Rural Photo Contest
• Hors d’oeuvres and refreshments

Registration Open

8:00-9:00a  

Buffet Breakfast with the Exhibitors

9:00-9:45a 

NRHA Federal Update

Speaker: Danny Fernandez, Government Affairs and Policy Manager, National Rural Health Association

10:00-11:15a

Concurrent Sessions A

1) Advancing Preventative Health in Rural California: Oral Health, Premature Birth, Nutrition & Obesity, and Infectious Disease Prevention

There is a great deal of disparity in the incidence of preventable health conditions in rural California. This panel will explore four of these health issue areas, where prevention can have a major impact not only on the health of rural Californians, but also on the health care resources available in rural California. The four health issues focused on in this panel are: oral health, infectious diseases, premature birth, and obesity. The panel will provide an overview of each of the four health issue areas, including changes in resources and examples of best practices or successful programs and/or campaigns to address these health issues. They will also provide information about whether or not federal healthcare reform, workforce, health information technology, and changes in health insurance coverage, such as Medi-Cal waivers will impact these preventative health care issue areas. Participants in this preventative health focused breakout session will be able to take back to their communities’ knowledge about how to address and increase prevention efforts involving these four issue areas.

Speakers: Francisco Ramos-Gomez, DDS, MS, MPH, Professor, Section of Pediatric Dentistry, UCLA School of Dentistry; Dean Blumberg, M.D., UC Davis Medical School; Harold Goldstein, Dr.Ph,  Executive Director, California Center for Public Health Advocacy; Robert Kahle, M.D., MSJ, Medical Director, Women’s and Children’s Services, Mercy Healthcare Sacramento & Secretary Treasurer California Association of Neonatologists (CAN) & Chair, CA Premature Infant Health Coalition

2) ) Rural Mental Health Challenges, Resources and Successful Models of Practice

Mental health care is a complicated and important component of our rural health care system. Shortages in our rural based mental health workforce and inadequate funding have been a serious problem in rural California for some time. This workshop will explore major changes in how mental health is provided, how care is organized, and how it is supported in California emphasizing rural communities and counties. Panelists will also discuss the impact federal health care reform, 1115 waiver, health information technology and other landscape changing issues are having on small county mental health systems of care. The goals of the panel are to provide participants with best practice and successful model information that can be translated back to their communities and mental health programs, and a better understanding where policy, resources and the field generally is going.

Speakers: Harriet Markell, Director, CA Council of Community Mental Health Agencies; Stephanie Oprendek, Sr. Associate, CA Institute for Mental Health; Don Kingdon, PhD., Director, CA Mental Health Directors Association

3) Cal-SEARCH: A Case Study of Building the Rural Healthcare Workforce for the 21st Century

Safety Net providers have long faced challenges in recruiting and retaining a dedicated, culturally competent health care workforce.  This has been particularly problematic for community clinics and health centers (CCHCs).  The implementation of health care reform which will bring hundreds of thousands of newly-insured patients will exacerbate this challenge.  Rural communities are especially challenged.  Cal-SEARCH is an innovative program sponsored by the Statewide Office of Health Planning and Development, the California Primary Care Association and the California Area Health Education Center program.  Health care provider students (medical, dental, nurse practitioner and physician assistant) participate in 4 to 6 week clinical rotations in a CCHC, and conduct a community project to address a health need specific to the community served by the health center.

The first year of the Cal-SEARCH program has just concluded, and we will share data about the participants and lessons learned.  Particular emphasis will be given to experiences in rural placements.  Attendees will learn how they can participate in the program and discuss other methods for recruiting and retaining health care workers in their communities.

Speakers: Jim Perkins, Deputy Director of Programs, California Primary Care Association; John Blossom, MD, Director, California Area Health Education Center Program; and, Angela Minniefield, MPA, Deputy Director, Health Care Reform Implementation, Office of Statewide Health Planning and Development

4) Electronic Health Records: Rural Hospital-Led Community Project & Vendor Selection and Contracting

Mr. Freitas will discuss the advantages of a community-EHR project to a rural hospital.  Through the experience of the Greater Sierra Health Information Organization’s project, sponsored by Sierra Nevada Memorial Hospital, the successes and challenges will be presented.  As a rural California hospital facing challenges of physician recruitment, strained relationships with providers and increased competition for ancillary services, the environment for this project was not unique.

Dr. Salamone will discuss how to participate in EHR vendor demonstrations through Q & A and use cases. In addition, she will show participants how to use the eHealth Initiative Master Quotation Guide, and other contracting tools.

The purpose of the eHealth Initiative Master Quotation Guide© (“Guide”) is to assist small- to medium-sized medical practices in comparing the costs of electronic health record (EHR) vendors. It is intended to help physicians, clinicians, practice administrators and other decision makers compare quotations and bids from vendors for EHR software, implementation and training services as well as support and maintenance.

Speakers: Mark Freitas, Director of Business and Information Technology, Sierra Nevada Memorial Hospital; and, Kimberly Harris-Salamone, PhD., Vice President of Health Information Technology, Health Services Advisory Group

11:15-11:45a

Final Break in Trade Show

11:45a

Exhibitor Break Down

11:45a-1:00p

Rural Champions Awards Luncheon

1:00p-2:15p

Concurrent Sessions B

1)  An Innovative Program for Improving Children’s Oral Health in Lake County

This oral health project was initially developed through a partnership between Lake County Office of Education, Healthy Start; Lake County Public Health; and First 5 Lake. The main goal of the project is to improve children’s oral health, targeting low income families in this rural, non-fluoridated county.  The project addresses the limited access to oral health care for children in this rural county due to lack of transportation options, pediatric dentists and dentists accepting MediCal. In addition, the project addresses the large amount of treatment that children need to resolve their oral health issues when neglected, and limited understanding that parents had around their child's oral health care and nutritional needs. This innovative partnership has created a continuum of dental care from screening in schools, to nutrition and oral health care education for parents and children, to treatment and follow-up at the dentist, and ultimately, to changing dental habits in the family.

Speakers: Cathy Ferron, Principal Consultant, Ferron and Associates; Marta Fuller, RN, Coordinator, Children’s Dental Disease Prevention Program, Lake County Health Services; and, Joan Reynolds, Healthy Start Director, Lake County Office of Education

2) Rural Telehealth: Success, Failures & Enhancing Development

Telehealth program implementation can be achieved quicker and more efficiently when a structured process is applied. Christine Martin and Kurt Hahn, with their combined experience of over 13 years in the telehealth arena, will address various trials and tribulations of the successes and failures in the adoption process experienced by both the California Telemedicine and eHealth Center (CTEC) and North Sonoma County Healthcare District. NSCHD first partnered with UCDMC then turned to Dr. James Gude and his group of Intensivist to support a reopened ICU. Currently the District additionally uses telemedicine support from the California Pacific Med Center in its Stroke center, as well as a variety of resources in Healdsburg District Hospital's emergency department.

CTEC, California’s Regional Telehealth Resource Center, and EMQ FamiliesFirst, one of the state’s largest private non-profit family centered treatment programs, partnered to apply a structured implementation methodology to implement telemedicine child psychiatry services at a rural patient clinic and an urban provider site. This presentation will discuss: 1) The value added by using a structured process, 2) The elements of a structured process and 3) An organizational experience with the use of these activities and tools. It will also include a look into the future and an anticipated dependence on telemedicine and the importance it will play to the successes of clinics and hospitals.

Speakers: Christine Martin, Executive Director, California Telehealth and eHealth Center; and, Kurt Hahn, North Sonoma County Healthcare District

3) Communities Working Together to Become Culturally Competent

Together panelists will address the various health needs of California’s rural minority residents: transgender, African American, Latino and Native American. Panelists will reference 2 community outreach projects.

1) “Project HEALTH: Harnessing Education, Advocacy, and Leadership in Transgender Healthcare,” San Francisco’s Lyon-Martin Health Services, the Transgender Law Center and Equality California have formed an innovative collaboration to build a comprehensive program that aims to expand access to healthcare for transgender individuals.

2) “Reach Out” project funded by CA MRMIB/ Anthem Blue Cross is designed to help rural Lake County provider clinics cross barriers to target minority underserved populations with health prevention information and access to health care and insurance. 

The panelists will address the assessment tools, training strategies, retention methods, community responsiveness, and clinical experience that are unique to providers serving minority communities. In addition, discussion will occur about the challenges facing minorities, and how to utilize the findings of this model to assess the replication in your community. 

Speakers: Kristina Wertz, Legal Director, Transgender Law Center, Daniel Gould, Health Network Coordinator, Equality California; Annie Barnes, Executive Director, Sunrise Special Services Foundation, Inc.; and, Latino Health Representative

4) Utilizing Grassroots Outreach and Partnerships to Increase Access to Quality Healthcare in Rural Communities

Panelists will describe best practice strategies on how grassroots outreach and local partnerships can increase access to quality healthcare in rural communities.

The California State University (CSU), Chico School of Nursing took on the challenge of developing a state of the art clinical simulation center by creating a public-private partnership that has become a model for rural clinical simulation. The isolation in rural areas often excludes health-care providers from high-tech training.  However the same rural setting fosters partnerships that can provide opportunity for rural practitioners. Presenters will provide insight into ways that human patient simulation can be used to provide training for critical events, develop multidisciplinary team skills and improve medical emergency team (MET) performance.

The California Health Collaborative has administered the Cancer Detection Program: Every Woman Counts, a statewide safety net program that offers comprehensive breast and cervical cancer screening services to underserved women, in the 16 most northern counties of California since 1994.  While carrying out their contracted scope of work, the CDP: EWC program staff has identified numerous gaps in the program as evidenced by the needs of women who contact them for help or complaints. One ongoing need has been that of community based comprehensive patient navigation services for recipients with abnormal screening results and/or breast or cervical cancer diagnoses. In addition, a significant barrier that has recently arisen is access to diagnostics for the medically underserved with abnormal breast cancer screening results.  The presentation will focus on the collaborative process and resulting innovative programs,  CHC CDAP and CECaNN, spearheaded by California Health Collaborative to overcome the barriers and meet the healthcare needs of residents in rural communities.

Speakers: Becky Damazo, RN, MSN, California State University, Chico; and, Barbara Clifford, Program Manager, California Health Collaborative

2:30p-5:30p

Rural eHealth Summit

The Rural eHealth Summit will provide practical, real world information to assist rural health providers with implementing health information technology applications in their clinical practice. In addition to providing attendees with an opportunity to learn about best practices, the Summit will also provide attendees an opportunity to share their experiences and questions regarding Health IT challenges, needs, priorities and solutions.

1. Summit Overview and Opening Remarks (30 minutes)
   
   This session will focus on real-world experiences with EHR adoption. It will begin with an overview of where rural providers are today in terms of EHR adoption, and the unique challenges they face, from a rural hospital, community clinic and rural health clinic perspective.
   
   Speaker: Lynn Barr, CSRHA HIT Director
   
   
2. Best Practices Panel (45 minutes)
   
   Health IT leaders will discuss the unique challenges and triumphs of implementing EHRs in the rural hospital, community clinic and rural health environments. Each of the speakers represent organizations that have successfully implemented EHRs. After each speaker presents their EHR adoption model, the audience will be encouraged to ask questions to learn whether the best practices presented may be appropriate for their environment.
   
   Panelists: Darcie Antle, Director, Ukiah Valley Rural Health Center; Mark Freitas, Director of Business and Information Technology, Sierra Nevada Memorial Hospital; and, Charles Kitzman, Chief Information Office, Shasta Community Health Center
   
   
3. Table Breakouts (60 minutes)
   
   Attendees will divide into  EHR Table Breakout for rural hospitals, rural health clinics and rural community clinics. Attendees are encouraged to attend the breakout for their organizational type, where they can have roundtable discussions with their peers and share their concerns, issues and solutions, led by highly knowledgeable HIT leaders in their sector.  
   
   Moderators: Pam Lane, Vice President of Health Informatics, California Hospital Association; Andie Martinez,  Senior Policy Analyst For Special Populations, California Primary Care Association; and Gail Nickerson, Director, Clinic Services, Adventist Health
   
   
4. Reactionary Panel and Next Steps (45 minutes)
   
   Panelists will discuss the lessons learned from the afternoon. Panelists will summarize the strengths, concerns and attitudes of their breakout participants, and discuss what types of additional assistance may be required to get to meaningful use. Model programs will be highlighted and policy implications will be discussed.
   
   Panelists: Pam Lane, Vice President of Health Informatics, California Hospital Association; Andie Martinez,  Senior Policy Analyst For Special Populations, California Primary Care Association; and Gail Nickerson, Director, Clinic Services, Adventist Health

Rural Workforce Summit

The purpose of the Rural Workforce Summit is to identify current workforce needs, priorities, challenges and solutions. The issues of existing rural workforce disparities, as well as impact of eHealth and Meaningful Use, federal health care reform and state budget impacts on health care workforce will be addressed. Participants will work directly with workforce experts and their peers to engage not just in dialogue, but action planning that can be applied at the local and state level, including policy and program institutions focused on health care workforce development.

1. Summit Overview and Opening Remarks (15 minutes)
   
   This presentation will provide a “big picture” up to date overview of the new federal, state and foundation health workforce resources, policies, and programs on the landscape. The speaker will also identify major players and key organizations who are leading the way on health workforce issues in California.
   
   Speaker: Steve Barrow, CSRHA Policy Director
   
   
2. Summit Opening Panel of Experts (60 minutes)
   
   Panelists will provide updates and thought provoking challenges on three levels of workforce issues: 1) Providing an economic development and investment perspective; 2) Offering an overview of the education and training opportunities and promising new directions in workforce education, and; 3) Providing a front-line human resource viewpoint on healthcare recruitment and retention
   
   Panelists will also touch on the workforce side of federal health care reform implementation, ARRA, health information technology, and other new opportunities on the landscape.
   
   Panelists: Barbara Halsey, Director, California Workforce Investment Board;  Linda Zorn, Director, Regional Health Occupations Resource Centers, Butte College; Dave Jones, CEO, Mountain Valleys Health Centers, Board of Director CSRHA & Chair CSRHA’s Workforce Advisory Committee; and Tamarra Harris, Director of Human Resources, Trinity Hospital
   
   Moderator: José Millan, Vice Chancellor, Economic Development and Workforce Preparation, Chancellor’s Office California Community Colleges
   
   
3. Table Breakouts and Reaction Plans (120 minutes)
   
   After the Opening Panel discussion, participants self select breakout workgroups where they will focus on a variety of workforce issues. The breakout issues will be selected prior to the Summit through a survey of the registrants to the Workforce Summit and our workforce policy experts.
   
   Each table breakout will:
   
   a) Clarify the specifics of the workforce issue(s) assigned to their table
   
   b) Identify the challenges, opportunities and action steps needed to move California forward on the issue(s), including identifying the lead organization and lead person(s) on the issue
   
   c) Identify what needs to be accomplished in the next year or two and identify who will do what in the next six months to keep the issue moving forward
   
   d) Reporting out - At the end of the Breakout Worktable Session a representative from each group will report to the whole plenary the highlights of the work accomplished at the work session and recommendations for action
   
   e) Reaction Panel - A panel of workforce experts will provide reactions, commentary and lead discussions on the Breakout Session recommendations and suggested next steps
   
   
   Panelists: Barbara Halsey, Director, California Workforce Investment Board; Angela Minniefield, MPA, Deputy Director, OSHPD, Healthcare Workforce Development; and Kevin Barnett, MCP, Dr.PH Senior Investigator, Public Health Institute & Co-Director California Health Workforce Alliance
   
   Moderator: Steve Barrow, CSRHA Policy Director

CSRHA Board of Directors Meeting (open to the public)

1:00-3:00p

CSRHA Advocacy Committee Meeting