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Obama's Proposed Budget is a Mixed Bag for Rural Health

Cheryl Clark, February 2, 2010

There are other rural health segments that are being level-funded. Rural telehealth, which received a $4 million boost last year to $12 million, would remain the same, as would spending on rural hospital flexibility grants ($41 million), rural health policy development ($10 million), black lung disease clinics ($7 million), and research on diseases caused by radiation ($2 million).

In other portions of the budget, there is $5 million in grants to states to help federally qualified health centers and rural health clinics transition to a prospective payment system for the Children's Health Insurance Program.

Martin Kramer, a spokesman for the Health Resources and Services Administration, says outreach grantees can be small rural hospitals, nonprofit organizations or community health centers, and can receive grants to "try out their ideas to meet the goals."

Kramer adds that the money does not have to be focused solely on recruiting physicians, but can also be used to recruit other providers in rural areas, such as nurses, emergency medical technicians, oral health or mental health providers.

Additionally, the budget would increase spending for inspections in a way that is sure to affect rural clinics. Currently, survey and certification frequency for federal reimbursement is scheduled every 11.5 years, but the frequency would be cut in half, to every six years.

Other types of facilities would also have more frequent certification reviews and surveys: non-accredited hospitals would go from every five years to every three years. End-stage renal disease facilities, now reviewed every 4.6 years, would be surveyed every three years. And ambulatory surgical centers, along with hospices, outpatient physical therapy, outpatient rehabilitation, portable X-rays, and ambulatory surgical centers would go from surveys every 11.5 years to every six years.

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