Texas Syndromic Surveillance (TxS2) system – important deadline January 27

January 11th, 2017

We are moving along in implementing the Texas Syndromic Surveillance (TxS2) system. Our current timeline has us starting pilot in March, followed by the rest of the state in April.

We were recently informed of an important deadline regarding registering for syndromic surveillance. Our contracting office is preparing to make significant changes over the summer so we must have vendor information forms for all facilities that want to connect to TxS2 and all LHDs that want to view data in TxS2 by January 27, 2017. The vendor information form sets up the facility/LHD as a vendor with DSHS for the purpose of executing the Memorandum of Understanding (MOU) for data sharing. MOUs will be going out via DocuSign, so it is very important that names and email addresses for both the signatory and contact are correct. Any facility that wants to submit or view data in TxS2 will need to submit the vendor information form. Any LHD that wants to view data in TxS2 will need to submit the vendor information form.

Please note that registration will not close after January 27. We can still process vendor forms submitted after this date, but the MOUs will not be sent out until after September 1, 2017. We must have a fully executed MOU before we can connect facilities to TxS2 and allow access for facilities and LHDs to view data.

In addition, this project supports the federal Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs for the meaningful use of certified EHR technology to improve patient care. Consistent with federal guidelines regarding Stage 3 Meaningful Use, on June 30, 2016, DSHS declared readiness to receive data meeting the messaging requirements specified in the 2014 or 2015 Edition CEHRT and PHIN Messaging Guide for Syndromic Surveillance, Release 2.0 for data submitting January 1, 2017.

Registration for the TxS2 System opened May 5, 2016, for hospitals with emergency departments, free-standing emergency centers, and urgent care centers to register their intent to submit data to TxS2. We are currently only accepting registrations from these Data Providers. DSHS will not be connecting other Data Providers to TxS2 in 2017. DSHS did not operate a statewide surveillance system in 2013, 2014, or 2015. Eligible Professionals who practice in one of the above-listed locations may also be registered when the facility is registered.

Registering your intent to submit data to TxS2 is one way of meeting the “Active engagement” requirements under the Meaningful Use programs, and facilities will receive registration status updates throughout the process and a registration confirmation message when all the steps in the registration process are complete.

If you have any questions, please feel free to email us at syndromic.surveillance@dshs.state.tx.us or call (512) 776-2679. You may also visit our TxS2 website at http://www.dshs.texas.gov/txs2/ and our syndromic surveillance and meaningful use website at http://www.dshs.texas.gov/mu/syndromic.aspx.

 

Happy National Rural Health Day from TORCH!

November 19th, 2015

Texas is one of the most urban and most rural states in the country. Rural Texas, for that matter is comprised of over 3.2 million residents spread over a geographic area the size of France! Our organization has been blessed for the last 25 years to be the principal voice and advocate for the rural and community hospitals all across our great state. Along with our partners at the Texas Association of Rural Health Clinics and the Northwest Texas Hospital Association, we want to wish all of the many rural healthcare leaders, providers and stakeholders an enjoyable #NationalRuralHealthDay 2015. This is the one day a year that we callout the contributions that are made every day to improve the health of rural Americans by these dedicated professionals.

In a time of great change, we often look to those on the cutting edge for direction. However, when it comes to rural areas, we often lead from the bottom up; drawing from what it is that we do best: caring for our fellow man, holding firm to our values and traditions and routinely employing a genuine ‘can do’ spirit. While the healthcare marketplace is shifting, we feel rural hospitals and providers are poised to lead the way and to succeed in the future delivery system. TORCH is channeling that energy into new programs around population health. We hope that rural providers will want to learn more about these opportunities and to get in on the ground floor of this evolutionary effort to strengthen rural healthcare in Texas for the long term.

U.S. Census data show that the 2,000 or so rural and nonurban hospitals that serve the rural population treat a patient base that is generally older, sicker, and less affluent than their urban counterparts. By focusing on the health of the population in the years ahead, we feel we can preserve what’s best about rural healthcare facilities, while at the same time bringing improved quality of life to rural people and communities. Not only that, but with the recent spate of hospital closures, preserving healthcare in rural communities means preserving jobs and economic stability in these areas as well. The food, fuel and fiber that Americans depend on comes largely from rural areas. In order to meet the needs of our growing country, we must have a healthy and dependable rural workforce.

So what’s the big takeaway from all this talk about the future of access to care and rural economic viability? Well, please take a moment today to remember and thank those people you know who make it their life’s pursuit to provide life-saving healthcare services to our family and friends in rural areas. Then on the other 364 days of the year, be sure to do whatever you can to shop local for your own healthcare needs, to promote the creation of sound healthcare policy that recognizes the unique needs and issues of rural healthcare providers and to urge your elected officials to support legislation that will help save rural hospitals and support rural communities. If you’ll do that, we promise that you will have helped to move rural healthcare forward in the year ahead.

For those of you with a penchant for social media, let’s all do our part to get #NationalRuralHealthDay ‘trending’ this year. Use this hashtag as a rallying cry on November 19th and be sure to share with all of your connections, friends and followers why you feel rural healthcare is such an important part of the fabric of life for all Americans. Many other resources can be found at http://celebratepowerofrural.org/.

Lastly, please be sure and send us pictures and stories from your own rural healthcare celebrations. You will find us on both Facebook and Twitter by searching for ‘torchnet’, so please join us and we hope that you have a fantastic #NationalRuralHealthDay, everyone. Go Rural!

Rob Thomas Named the 2015 Gordon Russell Merit Award Recipient

April 22nd, 2015

Each year, the Texas Organization of Rural & Community Hospitals honors a rural hospital administrator who embodies the spirit of superior service to their local community. This award exists to recognize outstanding achievement by rural and community hospital administrators for their leadership and dedication to the profession. Gordon Russell, the award’s namesake, was the administrator of Hi-Plains Hospital for more than 40 years and a former mayor of Hale Center, Texas.

Since 1992, Rob Thomas has served as the CEO/ Administrator of Columbus Community Hospital, Columbus, Texas. Fellow rural hospital administrators from around the state selected Thomas for this honor. Thomas has overall management responsibilities for the Columbus Community Hospital, which includes the 40-bed non-profit acute care hospital, the two Rural Health Clinics and a Foundation. The Hospital services include a six-bed LDRP OB Unit, an active Surgery Department and 20 Active Staff Physicians. During his tenure as CEO, Thomas has expanded the hospital’s services with a new OB, ER and expansion of the Surgery Department in 2004. Also, a new Professional Building opened in 2009, including an outpatient PT Department with hydrotherapy, Orthopedic Suite, a nine physician Rural Health Clinic and an Education Center. In 2012, the Hospital was expanded to include the Sleep Study Suites, Nursing Outpatient Services, Respiratory Department, Health Information, Business Office and Administration offices, and a new MRI Suite, and expanded Lobby and Registration areas.

A native of Canada, Thomas earned a Bachelor’s Degree at Gordon College in Boston, MA. After moving to Texas in 1979, Thomas attended the University of Houston and studied accounting and became a Certified Public Accountant in 1985. He is active in the Columbus Rotary Club, Past President of the Columbus Chamber of Commerce, Advisory Board of the Champion Valley Boys and Girls and a member of Sts. Peter and Paul Catholic Church. He also has served as President of the South East Texas Hospital Systems, a member of the Texas Organization of Rural & Community Hospitals Board and currently serving as Vice-Chair of the TORCH Foundation.

Rob Thomas is married to Rachel, an ED Physician, and they have two married children and are proud grandparents of a one year old. We applaud the selection of Rob Thomas for this prestigious recognition. We hope that he will continue to provide leadership and direction to TORCH and rural hospitals for years to come. Congratulations to Rob for receiving this award!

Quorum Report: Against Backdrop of Proposed Tax Cuts; Rural Hospital Closures Accelerate

March 13th, 2015

Reimbursement rate cuts from 2011 were never restored; rural hospitals have some of the highest rates of uninsured

Rural hospitals are closing at such an alarming rate in Texas that hospital administrators are beginning to fear wide swaths of the state may be left without the benefit of trauma care and some areas may have no hospital within 100 miles.

Rural and community health care providers are calling it, ironically, a death by a thousand cuts, including the budget cuts of 2011. Jack Endres, the administrator of East Texas Medical Center – Jacksonville, has seen three hospitals in his own chain go under since late last year: Clarksville, Mount Vernon and Gilmer.

“Keeping these hospitals open is no longer sustainable,” Endres said. “It’s not like it’s done. We’re only accelerating.”

East Texas Medical Center Regional Healthcare System was once a system of 15 hospitals, including 3 in Tyler. Along with the three hospitals that closed at the end of 2014, the chain’s hospitals in Crockett, Fairfield and Trinity have given notice.

“I think we’re going to see a large number of small rural hospitals close this year and next year,” Endres said. “A large number of the rurals are going to go under unless we can get relief from the cuts in reimbursements that the state and federal government have imposed on us. It’s no longer sustainable.”

The era of cost shifting is over, Endres said. There are no more costs to cut. For hospitals in the rural and community network – known as the Texas Organization of Rural and Community Hospitals – the news out of Austin isn’t good. These hospitals, which cover 85 percent of the state’s geography, also carry the burden of some the state’s highest rates of uninsured patients.

The state’s average rate of uninsured residents is 26 percent. The percentage in rural areas can sometimes run as high as 50 percent. Of the 15 Texas counties with the highest uninsured rates, 14 are located in rural areas.

The talk is all tax relief in Austin, even though the cuts to reimbursements made in the 2011 budget have yet to be restored to the state’s hospitals, Endres said. Endres’ own chain contains the region’s single Level 1 Trauma Center in East Texas, in Tyler. The chain considers the trauma center its social and moral obligation, but keeping specialists of all types on call around the clock is a costly burden.

“We’re not being paid enough to keep it open,” Endres said. “It doesn’t pay for itself.”

This is not just a Texas problem. One analyst’s projection puts another 283 hospitals on the brink of closure. But Texas dominates, if only for its vastness. Statistics show 45 hospitals have closed across the country since 2010. A quarter of those are located in Texas, with the trend increasing its pace.

The only solution would be a major reversal in reimbursement rates or a significant increase in insurance coverage. That looks unlikely. Endres predicts health care may dwindle to a limited number of hospitals in rural areas, supported by tertiary facilities that can offer a limited range of services.

Edith Gonzalez died in late 2013. The toddler choked on a grape, but when her family rushed her to Shelby Regional Medical Center in Center, the doors were locked and the parking lot was empty. Endres says that trend won’t be reversed. Without access to medical care, some outcomes can be predicted.

“People will die,” Endres said.

By Kimberly Reeves March 6, 2015 10:07 AM

 

RCMH Advises TORCH-Member Hospitals on Controlled Substances Registration

August 6th, 2014

In years past, DPS would send renewal notification to facilities 90 days before the expiration of a controlled substances registration.  That is no longer being done.  It is now a facility’s responsibility to submit a renewal to DPS at least 45 days prior to the expiration of the registration. As a cost-savings measure, DPS is now only sending a generic postcard to facilities that tells them to go to the controlled substances website to download a renewal application.  Because the postcards are sent out en masse on a quarterly basis to facilities whose registrations will be expiring within the next quarter, it is possible that a facility may not receive the postcard as early as they previously had and could actually receive the notice about the time that their registration is set to expire.  All facilities should calendar at least 6 weeks prior to their controlled substances registration to submit a renewal to DPS.  If the application is not submitted timely, there is a $50 late fee – even if a facility is usually exempt from the normal $25 registration fee. Please be cautious and do not be caught off-guard and have your controlled substances registration expire because you did not receive the usual 90-day notification.

Texas Rural Hospitals Standing By To Serve Our Veterans

May 29th, 2014

News media accounts of the Veterans Administration healthcare situation are disheartening and it appears that a great disservice has been done to some of our veterans who have served their country.  In light of the evolving situation, Texas rural hospitals and clinics are more than willing to step up and provide top quality health care to these veterans on a local basis if Congress will let them. The rural factor is especially important because a disproportionate number of veterans are from rural areas. In the case of Texas and across the country, 15% of the population lives in rural areas, however, 40% of the veterans are from rural areas.

The unfolding VA hospital drama brings to light another issue. For the most part, the Veterans Administration forces veterans to travel past their local physicians and hospitals, sometimes driving hundreds of miles to a VA facility. While the VA is sometimes willing to contract with local hospitals for limited services, those contracts are complicated and convoluted, and payments offered to the hospitals are far too low.  Some services are not available locally, but when they are, don’t we have a duty to our veterans to try and make their lives a little easier?

We think Congress should give thought to a system where veterans can see the doctor or hospital of their choice (within reason, of course) and the VA act more like an insurance company – paying providers directly like it does for military retirees. Why continue to carry on with a duplicative health care system that pushes a great inconvenience on to our veterans, especially those living in remote rural areas.

The hospital in Childress cites an excellent example where veterans in this northwest Texas community must drive past their hospital to Amarillo (250 miles roundtrip) for a CT Scan. While the VA does pay for their mileage, there is no factor for time and inconvenience. Besides, waiting to get a CT done at an approved VA facility is probably longer and the service more costly, than in Childress. So why not just let Childress perform the scan and pay them for the work? Keeping such services local is better for the patient and the facility. It’s a win-win.

Perhaps the VA facilities should primarily serve the veterans in their immediate vicinity where there is a higher concentration of patients.  Or we might consider an alternative coverage model that leverages programs that have proven to be more efficient and effective, like Medicare.  Congress could act on either option, but we must do something to ensure rural veterans have access to healthcare that is safe, timely and closer to home.  We owe them that much.

One thing is certain, Texas rural hospitals are ready to do our part, if and when Congress needs us to.

David Pearson, President and CEO

Texas Organization of Rural & Community Hospitals

(Contact info: P.O. Box 203878, Austin, TX 78720, dpearson@torchnet.org, 512.873.0045)

Increasing Value in Health Care from a Rural Perspective

April 15th, 2014

Are you hearing more about the need to increase value in health care, but wondering how to approach it from a rural perspective?

The RUPRI Rural Health Center and Stratis Health have developed the Rural Health Value website, sponsored by the Federal Office of Rural Health Policy (ORHP). At the website, you’ll find a variety of resources to help rural providers, communities, and other key stakeholders transition to a value-based health care delivery system. Two resource examples you can find at www.RuralHealthValue.org include:

  • A 10-minute video describes The Value Transformation of Rural Health Care. This conversational video (and the accompanying discussion guide) introduces the value transformation in rural health care, discusses how rural health care is rapidly changing, and suggests strategies to navigate the changing health care environment. Health care leaders can use this video and discussion guide during staff, board, and community meetings to inform audiences and inspire conversation.
  • A presentation discusses The Merger Frenzy. During health care organization affiliation discussions, the local health care system should be considered as a community treasure. Joseph Lupica, a national health care affiliation expert, embraces the Rural Health Value “stop and think” step during health care organization planning. Review Mr. Lupica’s interview and presentation for insights about the health care affiliation process.

In addition to these two resources, www.RuralHealthValue.org provides access to more than 50 original documents and links on topics critical to those interested in rural health care. Other Rural Health Value resources include:

Please explore www.RuralHealthValue.org to find the resources you need to help your rural health care organization or community move successfully into a value-based future. Also, be sure to click on Share Your Rural Innovation. We welcome your ideas. Also, please forward this email to others interested in rural health care value.

It’s Time for DSH Audits in Texas

March 26th, 2014

Texas Health and Human Services Commission recently sent letters to Texas hospitals informing them that they have initiated an audit of the DSH program for fiscal year 2011 in accordance with the federal regulations regarding disproportionate share hospital (DSH) payments issued by CMS on December 19, 2008 (See Federal Register Vol. 73, No. 245, December 19, 2008, rules and regulations). HHSC has contracted with Myers and Stauffer LC, a certified public accounting firm, to perform the mandated audits.

The regulation mandates auditing and reporting requirements for DSH payments under state Medicaid programs. The certified audit report, along with other required data elements, must be submitted by the Medicaid program to CMS by December 31, 2014. Texas’ DSH year corresponds with the federal fiscal year; therefore, the DSH year under audit covers the time period from October 1, 2010 through September 30, 2011. If your hospital received Medicaid DSH payments during this time period, it is subject to the DSH program audit and must identify its actual Medicaid and uninsured costs incurred during the DSH year in question. To fulfill the other reporting requirements, several additional data elements will need to be reported by your hospital.

It is important to the Texas Medicaid program that all hospitals that received DSH payments during these time periods provide the information needed in order to complete the required federal audit. Once your completed surveys (and other required documents) are received by Myers and Stauffer, HHSC will contact you to address any questions they may have and to schedule a detailed examination of your survey responses if considered necessary. Per 1 TAC 355.8065(o)(1)(D) “A hospital that fails to provide requested information or to otherwise comply with the independent certified audit requirements may be subject to a withholding of Medicaid disproportionate share payments or other appropriate sanctions.”

Webinars with Myers and Stauffer have been scheduled to assist hospitals in the completion of the survey. The webinar will discuss the CMS requirements, known issues in data collection and review, and provide a detailed description of the survey document including answering any questions hospitals might have. The webinar is intended for the hospital personnel that will be responsible for actual completion of the survey and will run two to three hours in length. Each webinar will be limited to 100 call-in lines. After the first 100 callers have joined the conference the website and phone lines will be locked and you will be asked to participate in a webinar scheduled at a later date.

There are four scheduled opportunities to participate; three live webinars and one in-person seminar at the Texas Hospital Association. All four of these events will cover the same material. Participation in more than one session will not be necessary. The sessions will take place on Thursday, March 27 at 1:30 pm, Wednesday, April 2 at 9:00 am, Friday, April 4 at 9:00 am and in-person at THA on Wednesday, April 9 at 9:00am. To register, go to https://webinar.mslc.com/?meeting=5849964. The webinar telephone is 888-506-9354 and the participant code is 9793484.

We would encourage you to participate in one of these sessions if necessary. However, if your hospital cannot attend, a link to the presentation materials (including frequently asked questions (FAQs) and responses) will be made available following the conclusion of the webinars.

Small Rural Hospital Improvement Program (SHIP) Grants DUE MARCH 6

February 19th, 2014

The Texas Department of Agriculture (TDA) announces the availability of the Federal Fiscal Year (FY) 2014 Small Rural Hospital Improvement Grant Program (SHIP).  The purpose of SHIP is to help small rural hospitals of 49 beds or less, and do any or all of the following: 1) enable the purchase of equipment and/or training to help hospitals attain value-based purchasing provision in the Patient Protection and Affordable Care Act (ACA), 2) aid small rural hospitals in joining or becoming accountable care organizations, or create shared savings programs per the ACA, and 3) enable small rural hospitals to purchase health information technology, equipment and/or training to comply with meaningful use, ICD-10 standards, and payment bundling.  APPLICATIONS DUE MARCH 6, 2014

Eligibility

Though the State Office of Rural Health (SORH) within the Texas Department of Agriculture (TDA) will be the official grantee of record, and act as a fiscal intermediary for all hospitals within Texas, SHIP funds are geared towards assisting small rural hospitals that are essential access points for Medicare and Medicaid beneficiaries. Eligible small rural hospitals are non-federal, short-term general acute care facilities that are located in a rural area, including faith-based hospitals. For the purpose of this program:

1.       “Small hospital” is defined as 49 available beds or less, as reported on the hospital’s most recently filed Medicare Cost Report,

2.       “Rural” is defined as either located outside of a Metropolitan Statistical Area (MSA) or located within a rural census tract of a MSA, as determined under the Goldsmith Modification or the Rural Urban Commuting Areas (RUCAs), and,

3.       Eligible SHIP hospitals may be for-profit or not-for-profit. Tribally operated hospitals under Titles I and V of P.L. 93-638 are eligible to the extent that such hospitals meet the above criteria.

The 2014 SHIP RFA and Application is attached to this email or can be found here: http://www.texasagriculture.gov/GrantsServices/SHIP.aspx

Healthcare Access San Antonio Partners with Holon Solutions and TORCH

February 14th, 2014

Healthcare Access San Antonio (HASA), the Texas Organization of Rural & Community Hospitals (TORCH) and Holon Solutions have joined together to help make connecting to the region-wide health information exchange (HIE) affordable for rural health providers. The HIE initiative with TORCH and Holon Solutions will connect area hospitals, clinics, physician offices and other providers in the 22 counties in South Texas included in HASA’s service area.

HASA is the entity authorized by the State of Texas to develop the HIE for Bexar and 21 surrounding counties. It is one of 12 such exchanges in the State.

Low doctor-patient ratios and the historically high cost of HIE software have made it more difficult for rural health providers than their urban counterparts to share health information with other providers. And while the ultimate success of an HIE depends on making rural HIE solutions available to as many health providers as is possible, past attempts to address their specific needs have proven to be cost prohibitive due to the initial capital expenditure required as well as the funding needed to pay for additional IT staff. Read the full press release by clicking here.