Evaluation of the grant program for rural health care transition : seventh semi-annual progress report

252 Pages·1993·7.2 MB·English

by  Giggie, Marisa

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DocumentTitle Evaluationofthe GrantProgramforRural Health CareTransition: Seventh Semi-annualProgress
Report
Author MarisaGiggie, CharlesNagatoshi, Ju DocumentDate 28-Jan-93
DocumentDescription: Reportto Congress - ProgressReport
ProjectSpecifics
SRNumber 91-124
ProjectNumber 500-91-0075
ProjectTitle Rural HealthCareTransitionGrants - Evaluationofthe FY 1991 Awards
Awardee MathematicaPolicyResearch, Inc.
ProjectOfficer Mazumdar, Sid
Principle Investigator
FundingLevel 1189459
StartDate 9/30/1991
EndDate 5/31/1996
ProjectDescription:
1 sgalloway 04-Jun-02 4
Initiated (CIVIS): Date: Accepted (IQ): Date:
j
Released (IQ): Date: Received (Sub): Date:
! Finished (Sub): Date: QC'd (IQ): Date:
J
I
Returned (IQ): Date: pproved (CMS): Date:
j
1 1
version 1.0

Contract No.: 500-87-0028-12, 500-91-0075
MPR Reference No.: 7871, 8028
Baltimore,MD 21244
EVALUATION OF THE GRANT PROGRAM FOR
RURAL HEALTH CARE TRANSITION
SEVENTH SEMI-ANNUAL PROGRESS REPORT
January 28, 1993
Authors:
Marisa Giggie
Charles Nagatoshi
Judith Wooldridge
Programmers:
Katherine Condon
Jenny Minier
Submitted to: Submitted by:
Health Care Financing Administration Mathematica Policy Research, Inc.
6340 Security Boulevard P.O. Box 2393
Oak Meadows Building, Room 2302 Princeton, NJ 08543-2393
MD
Bahimore, 21207 [phone]
Project Officer: Project Directors:
Siddhartha Mazumdar Valerie Cheh
Judith Wooldridge

CONTENTS
Chapter Page
EXECUTIVE SUMMARY
xi
INTRODUCTION
I ^ 1
A. LEGISLATIVE HISTORY AND PURPOSE OF
THE GRANT PROGRAM
1
THE NUMBER AND DISTRIBUTION OF
B.
GRANTEES
3
STATUS OF GRANTEES
C. 6
L 1989 Grantees 6
2. 1990 Grantees 8
3. 1991 Grantees 8
4. 1992 Grantees 11
CHANGES AMONG GRANTEES AFTER
II 1990 1
YEAR
13
A. CHANGES IN MANAGEMENT DURING THE
FIRST YEAR
13
B. CHANGES IN HEALTH CARE PERSONNEL
AFTER YEAR
1 16
1. Physicizms 16
2. Nurses 18
3. Other Licensed or Certified Allied Health Professional Staff ... 20
C. CHANGES IN SERVICES AFTER 1 YEAR 21
CLOSURES
D. 23
III SELF-REPORTED PROGRESS OF 1990 GRANTEES - 27
PROGRESS OF GRANTEES
A. 1990 28
1. Activities Completed 28
2. Service Implementation 30
PROBLEMS ENCOUNTERED
B. 37
PROJECT MODIFICATIONS
C. 38
GRANT EXPENDITURES
D. 39
iii

CONTENTS (amiimied)
Chapter Page
IV PROGRESS OF 1991 GRANTEES AFTER 9 MONTHS 43
CHARACTERISTICS AT AWARD
A. 43
1. Ownership and Management 43
2. Beds, Occupancy Rates, and Services 46
3. Staffing 49
4. Finances 53
B. ACTIVITIES COMPLETED 56
PROBLEMS ENCOUNTERED
C. 58
PROJECT MODIFICATIONS
D. 59
GRANT EXPENDITURES
E. 60
EFFECTS OF PHYSICIAN LOSSES AND
F.
ADMINISTRATIVE CHANGES ON THE GRANT
PROGRESS AND FINANCIAL STATUS OF THE
GRANTEES
1991 62
1. Effects of Physician Losses 62
2. Effects of Administrative Changes 64
V 1992 GRANT SOLICITATION PROCESS AND
APPLICANT CHARACTERISTICS 67
A SOLICITING AND SCORING THE APPLICATIONS
AND SELECTING GRANTEES 67
GEOGRAPHIC DISTRIBUTION OF THE
B.
APPLICANTS 69
COUNTY CHARACTERISTICS OF APPLICANTS
C.
AND GRANTEES
73
1. Social and Economic Characteristics 73
2. Access,to Facilities 76
3. Health Professional Shonages 78
FEDERAL AND EXTERNAL FUNDING AND
D.
LOCAL COOPERATION
80
Federal Funding Amounts 80
1.
2. External Funding 81
iv