[Congressional Record (Bound Edition), Volume 159 (2013), Part 12]
[Senate]
[Pages 17859-17860]
[From the U.S. Government Publishing Office, www.gpo.gov]




                       NATIONAL RURAL HEALTH DAY

  Mr. DURBIN. Mr. President, today is National Rural Health Day. More 
than 59 million Americans--nearly one in five--call rural communities 
their home, including more than 9 million Medicare beneficiaries. These 
small towns, farming communities, and frontier areas depend on rural 
hospitals for their health care needs. And their needs are as unique as 
the communities they live in.
  Rural areas are sparsely populated and are disproportionately older. 
More families in rural communities tend to live with less income than 
their urban counterparts, and patients tend to be physically isolated, 
which can substantially increase travel costs associated with medical 
care. These needs are not easily addressed by a one-size-fits-all 
approach. Rural providers must rely on providing affordable primary 
care and a system that values prevention, wellness and, above all, care 
coordination.
  In Illinois, there are 102 counties, 83 of which are rural. Of these 
83 rural counties in Illinois, 81 are designated as primary care 
shortage areas, which affects nearly 2 million Illinoisans. To 
incentivize providers to work in underserved areas, States rely on the 
National Health Service Corps--NHSC--Loan Repayment program, the NHSC 
Scholars program, and the State Loan Repayment program. These programs 
have been a mainstay of rural recruitment. This year, through the 
coordination of loan repayment programs, an estimated 231,000 patients 
in rural Illinois were able to access care. These programs provide 
recruitment tools for facilities in rural parts of the State.
  Recruiting primary care professionals to rural communities is 
challenging. Many programs, including these recruitment programs, 
require more funding.
  New approaches are needed to increase the workforce in rural America. 
For instance, the Federal Government and States should look at 
licensure and new payment models that would allow allied professionals, 
including advanced practice nurses and physician assistants living in 
these communities, to help meet the growing demand for primary health 
care services.
  Fortunately for Illinois, our network of critical access hospitals, 
rural health clinics, and federally qualified health centers work with 
their limited resources to provide exceptional care in rural 
communities. Critical access hospitals provide local access to 
healthcare for more than one million people in Illinois in areas that 
are medically underserved and have too few primary care professionals.
  More needs to be done to help rural communities improve access to 
primary medical care. About 10 percent of physicians practice in rural 
America despite the fact that nearly one-fourth of the population lives 
in these areas.
  This is a fact that Cody Holst and his wife know all too well. Cody 
is a Hancock County cattleman who lives in Carthage, IL. Last year, 
Cody's wife Erin was rushed to the emergency department at Memorial 
Hospital. Erin was expecting but was only 32 weeks along in her 
pregnancy. Doctors told Cody that typically they would recommended she 
be flown to Peoria, IL, approximately 100 miles away. But in this case 
they did not have that much time. Erin would need an emergency C-
Section. Any delay in this operation would jeopardize Erin's pregnancy 
and

[[Page 17860]]

her life. Fortunately, the operation was successful and led to the 
healthy birth of Reese Holst. If Memorial Hospital was not in the 
community and Cody had to travel any further, his wife and child may 
not be here today.
  This is just one of the many examples of what critical access 
hospitals are able to do for families in these communities. Critical 
access hospitals make sure Americans in small communities, such as Cody 
and his family, still have access to high quality health care.
  The Affordable Care Act begins to address some of these urgent issues 
facing the Nation's health care system, such as lack of access to 
health insurance coverage. Nearly 8 million rural Americans under the 
age of 65 will have insurance under the law. More Americans will gain 
access to private health insurance and Medicaid, increasing the demand 
for care by rural hospitals and providers. Many of the provisions in 
the law are aimed at solving this very challenge. For example, the 
Affordable Care Act dedicates funding to evaluate current payment 
systems, particularly the Medical Home Model of care that incentivizes 
care coordination.
  As the demand for primary care providers increases, the Affordable 
Care Act aims to extend the role of nurse practitioners in primary care 
settings and provides $15 million for ten nurse-managed clinics that 
train nurses and provide primary health care services in medically 
underserved communities. The law also includes more than $200 million 
to training primary care doctors, nurses, and physician assistants and 
expanded the National Health Service Corps program by $1.5 billion. The 
Affordable Care Act has provided a great foundation to solving these 
problems, but more needs to be done.
  Today, on National Rural Health Day, I urge my colleagues to join me 
in recognizing the unique healthcare needs and opportunities that exist 
in rural communities and work together to solve the issues these 
communities face.

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