Thursday, April 15, 2010

Adding the Executive Branch to the Portfolio

I have enjoyed the opportunity to serve on the National Advisory Committee on Rural Health and Human Services for the past two years. The committee advises the Secretary of Health and Human Services, currently Kathleen Sebelius, regarding rural health and human services issues. Physicians, nurse practitioners, academics, policy folks, retired bureaucrats, association types, and a couple hospital administrators among others serve on the committee. It is staffed by the Office of Rural Health Policy…a truly amazing group of folks. We meet three times per year – once in Washington, D.C. The other two meetings are field trips to rural America. We develop a two to three topic report annually for the Secretary on issues we believe are important to rural communities. We also write comment letters and white papers on issues of interest when time is of the essence.

When I was asked to serve on this committee, I thought it might be an interesting opportunity to get involved in the executive branch of government. Most of my work in the past has been on the legislative side of things. It has been interesting getting a better understanding of the depth and breadth of our government. I am continuously amazed how truly gigantic it really is.

The most recent meeting was in D.C. in late February. At the time, we thought we would be focused on healthcare reform as a done deal and what impact the new legislation would have on the rural areas of our country. We talked instead about bundled payments and accountability of care organizations, regulatory issues that affect rural health and human services issues, and stimulus funding for implementation of the electronic health record. We also spent time discussing the epidemic of childhood obesity, especially as it relates to rural America.

One of the highlights of this meeting was a discussion with Mary Wakefield, director of the Health Resources and Services Administration. What a ball of fire she is. And coming from North Dakota, she is someone who can really relate to the rural nature of our committee.

When I am in D.C., I try to make it to Capitol Hill. I met with staffers in both Senator Harkin and Grassley’s office as well as the health aide in Congressman Boswell’s office. I am always impressed with how bright and committed these folks are to doing the work to keep their bosses in the know on important issues facing their constituents. I’m preparing to head to Washington next week for more meetings with our elected officials.

I’m looking forward to thanking our leaders for their efforts to fix our Medicare “tweener” hospital challenges. After several years of advocating for “tweener” hospitals, we have some legislation that improves the inequitable Medicare payment levels for middle-sized rural hospitals like GRMC. So many of us fought for this change and I want to acknowledge the Iowa Congressional delegation for their efforts to make sure this was written into the bill and just as importantly stayed in the bill as it was written into law.

I digress…back to my committee work. It is easy sometimes to lose heart, given how slowly some things in government move. Yet, when one is able to influence the process by making sure we are telling the story of how legislation and regulation impact the people we are dedicated to serving, it can be rewarding. I remind myself that I am a member of a “special interest group,” that is, someone who advocates for the special interests of the patients and families we are privileged to serve. I believe government works best when “we, the people” get involved.

This is going to be a particularly interesting year for our committee, given the changes coming in the delivery of healthcare and human services, but also because the committee is coming to Iowa in September on one of its field trips. I can’t wait to show off our state to the rest of the committee.

(By the way…Jesse Jackson was on my plane ride home from DC to Chicago…you never know who you might run into. I didn’t get a chance to talk with him…he was riding up front!)

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

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