CNN talk show host Larry King set aside his microphone and became a health care activist May 1, bringing the Larry King Cardiac Foundation to GW Hospital for a panel discussion and screening event.

King was in Washington to moderate a panel discussion covering a broad range of Public Health topics including diabetes, metabolic syndrome, the Presidential candidate’s health care proposals and the future of the nation’s health care system.

“Metabolic syndrome is not a clinical diagnosis per se, but it’s a cluster of factors that would give a doctor a clue that you may be headed for heart disease,” explained Elizabeth G. Nabel, MD, director, National Heart, Lung, and Blood Institute, National Institutes of Health. Some of these factors could potentially include elevated blood sugar, high blood pressure and abdominal obesity. The American Heart Association estimates that metabolic syndrome will soon become the primary risk factor for cardiovascular disease in the United States, ahead of smoking.

Panelists also addressed rise in obesity among Americans and its impact on health care. “It’s given rise to the epidemic of diabetes,” said Richard Kahn, PhD, chief scientific and medical officer, American Diabetes Association “It plays a role with the development of cancers, and it certainly plays a huge role in the development of many of the other risk factors that are components of the so called metabolic syndrome.”

With about 47 million Americans living without health insurance, panelists addressed health care finance reform. “It’s getting harder and harder to fix. Premiums and health care costs go up much faster than wages and our ability to afford it,” said Larry Levitt, vice president of communications for The Henry J. Kaiser Family Foundation. Panelists agreed that access to health care is essential and that the great disparities within our country, in terms of accessible, quality health care, need to be reduced.

James R. Mault, MD, director, Microsoft Health Solutions Group, used the forum to emphasize the need to make personal medical records electronically available to every American. The panel concluded with the concern for the future of health care in terms of the baby-boomer impact, as well as future generations. 

Richard Becker, MD, GW Hospital CEO, hosted the discussion and moderated a question and answer session. Following the panel discussion, free cardiovascular health screenings were offered at the Foggy Bottom courtyard, where individuals received an evaluation of their cardiovascular health status. Throughout the day two individuals were taken to the Emergency Room. 

GW Hospital has provided cardiovascular procedures for more than 115 patients in partnership with the Larry King Cardiac Foundation. Cardiac Surgeon, Frederick Lough, MD, missed the festivities as he was operating on a Larry King Cardiac Foundation patient.

To download a copy of the report, please visit: http://www.gwumc.edu/sphhs/departments/healthpolicy/chsrp/new_publications.cfm

In April of 2008, we issued a research brief[1] which analyzed the impact on various federal programs of a February 29, 2008 Notice of Proposed Rulemaking (NPRM) regarding the designation of Medically Underserved Populations and Health Professional Shortage Areas.[2] Among its findings, the report estimated that resources for one-third of community health center sites would be jeopardized by this rule change because they could not attain a sufficiently high priority status, even under the newly-proposed, higher-scoring Tier 2 methodology.[3] On May 1, 2008, we issued a revision in response to an April 21, 2008 clarification notice from the Health Resources and Services Administration (HRSA).

Since that time, in informal communication with state Primary Care Offices HRSA has further clarified a statement contained in its April 21^st notice[4] to assert that health center grantees can retain their tiered-based designation status at the grantee level if any single grantee site is located in a medically underserved area. Assuming for the moment that – despite the provisions of the February 29^th NPRM – HRSA did, in fact, intend this “any site” policy to apply at the health center grantee level, we joined with the Robert Graham Center to re-examine the impact of the rule at the grantee level, using the tiered methodology published in the NPRM[5] and linking each grantee to all its sites.

Our latest analysis shows that 31 percent of health center grantees would still not qualify for Tier 2 designation, even if ‘any site’ can confer MUA status.  At present, about 18 percent of grantees with one or more sites in a MUA/P designated area would no longer meet Tier 2 qualifications under the proposed rules, even with the assumption that ‘any site’ counts. An additional 13 percent of health center grantees do not have any sites located in a MUA/P designated area and thus would still not qualify under the Tier 2 methodology. Interestingly, health centers with fewer sites are less likely to be designated under the ‘any site’ assumption and are disadvantaged under this approach -- we found that 54 percent of solo-site grantees may lose their designation, compared to just 15 percent of those with 11 or more sites.

Our latest analysis – as with the previous analyses contained in our April 11^th report – was based on the methodology developed by HRSA as it was published on February 29, 2008, and which had used the status of health center sites to estimate level of eligibility as Tier 2 facilities.[6] In our April 11^th report, we updated the analysis using more recent data from 2005[7], since the HRSA analysis had employed data from 1999. Thus, while HRSA’s use of 1999-based data in the February 29^th NPRM[8] show that only about eight percent of health center sites would not qualify for designation under the Tier 2 scoring method, our analysis using 2005 data and the same HRSA-published methodology concluded that one-third of health center sites would not qualify.[9] Hence, in contrast to HRSA’s claim that only 16 of 1,001 grantees are in jeopardy of losing their current designation status,[10] we estimate that, in fact, more than 300 health center grantees would need an alternative pathway to reach tier-based designation.

These results are subject to change since the proposed methodology gives leeway to use local data for designations, in lieu of national data as we have used (and as HRSA used), and the NPRM indicates that service areas could be modified. These would change the impact, but we have no way of modeling the effects of such changes. Moreover, our analysis does not take into account the newly-proposed ‘Safety Net Facility’ designation, since there is substantial confusion over the qualifying requirements and over what benefit such a designation would confer on the recipient.[11]

Our grantee level estimates suggest that, in light of the policy unknowns in the proposed rule and the ongoing confusion over how the agency intends to apply its methodology, withdrawal of the proposed rule would appear to be the soundest policy course.

[6] 73 FR 11256 and 11273. 

Week of April 25

WASHINGTON — The George Washington University Medical Center, GW Medical Faculty Associates and the GW Hospital will be offering free assessment of stroke risk to the general public on Friday, May 9th starting at 7 am until 1 pm. The stroke unit at GW, who have Primary Stroke Center Certification from the American Stroke Association and the Joint Commission, will assess the risk of stroke using a combination of family history, a brief individual health questionnaire, blood pressure, pulse and carotid (neck) artery blood flow evaluation.

WASHINGTON - The George Washington UniversityCancer Institute Gala, supported by principal benefactors Dr. and Mrs. Cyrus Katzen and Dr. and Mrs. Bernard Katzen, took place this evening at the National Building Museum. Proceeds from the Gala will provide funds for critical cancer programs in the DC area. GW President Steven Knapp joined Provost and Vice President for Health Affairs, John F. Williams as hosts of the event, while Diane Robinson Knapp and Kimberly D. Russo, associate administrator at GW Hospital, served as the Gala co-chairs.

One of the highlights of the evening was an awards ceremony that recognized five honorees whose lives and work have had an impact on the community and the world. This year’s Gala honorees were: 

WASHINGTON – The GW Cancer Institute received a $500,000 grant from the Avon Foundation that will support breast cancer outreach, education and screening services in the DC community. GW Cancer Institute Executive Director, Steven Patierno, PhD, accepted a check on May 4, as part of the Avon Walk DC Closing Ceremony.

The Foundation’s support for breast cancer services is critical because it will address the fact that DC has nearly the highest breast cancer mortality rate in the country. Actress Reese Witherspoon, honorary chair of the Avon Foundation, presented the check to Patierno and six other area organizations designated to receive funding from the Avon Foundation. This is the largest grant the Avon Foundation has awarded to GW.

The Avon grant will enable GW to deploy the GW Mammovan, a mobile mammography unit, equipped with state-of-the-art digital mammography technology, to medically underserved areas of the District, including Anacostia, a quadrant of our city that currently has no mammographic facilities. The GW Mammovan will reach women who have very little access to mammography, outreach and breast cancer education. The Avon Foundation’s executive director for Breast Cancer Crusade, Marc Hurlbert, PhD, attended the Fifth Annual Cancer Gala on Saturday, May 3, at the National Building Museum to announce that the grant had been awarded.

“We are pleased to be a recipient of this grant from the Avon Foundation. It will enable GW to provide a critical service to those in our city, who are in need. It is our hope that we can help to lower the breast cancer mortality rate in our city and deliver services that will detect breast cancer at an earlier stage, in women who live in our own backyard,” said John F. Williams, MD, EdD, MPH, Provost and Vice President for Health Affairs, GW Medical Center.

The Avon grant will also support the work of the GW Cancer Institute to create a network of business and faith-based community partnerships that will facilitate culturally competent outreach specialists to work with members of the community to provide educational materials and patient navigation. Additionally, it will enable the establishment of an Avon Imaging Fellowship that will provide training and experience for a Radiology/ Mammography Fellow in community-based medicine.

About the GW Medical Center/ GW Cancer Institute

As the GW Medical Center works to cement its position among leading academic health centers, excellence in cancer research is one of three signature multidisciplinary programs leading this strategic mission. Cutting-edge research aims to improve the health and well-being of our local, national and international communities. Within the next decade, cancer research at GW will prove to be a defining characteristic of the Medical Center and an integral part of its clinical and educational programs.

About The George Washington University Medical Center

On May 1, 2008, researchers in the Department of Health Policy at the George Washington University School of Public Health and Health Services issued an update of its earlier report titled "Analysis of the Proposed rule on Designation of Medically Underserved Populations and Health Professional Shortage Areas."  That earlier report, prepared by the Geiger Gibson/RCHN Community Health Foundation, analyzed proposed regulations issued by the U.S. Department of Health and Human Services (HHS) that would modify the way in which areas are designated as being medically underserved or health professional shortage areas; designations which safety net and other providers depend on to qualify for federal funding, physician subsidies and placement, and health-related investments.

On April 21, 2008, HHS issued a notice that extended the comment period on these regulations to May 29, 2008, as well as made certain clarifications to the regulations and requested comments on additional topics. Our May 1 revision discusses the April 21 notice and corrects and clarifies some earlier technical calculations.

The revised documents can be found at:
http://www.gwumc.edu/sphhs/departments/healthpolicy/chsrp/new_publications.cfm

and
http://www.gwumc.edu/sphhs/departments/healthpolicy/chsrp/safetynet_publications.cfm

**

GW Medical Student Honored by President in White House Ceremony; Rose Garden Ceremony Honors Physicians for Peace Volunteers’ Work to Build Global Health Systems

• Dr. Eid Mustafa, Wichita Falls, Texas, for his work in the West Bank
• Amy Fiedler, The George Washington University Medical Center, for her work in Eritrea
• Emily Tinsley, BSN, RN, Charlottesville, Va., for her work in Central America
• Dr. Ogo Emejuru, Norfolk, Va., for his work in Nigeria
• Caroline Ramwell, MSN, RN,PNP, University of Virginia, for her work in Sri Lanka and Central America
• Dr. Juan Montero, Chesapeake, Va., for his work in the Philippines

Physicians for Peace was founded in 1989 to mobilize medical volunteers and healthcare educators to help build medical systems in developing and third world countries. The organization has conducted medical missions in 50 countries.

“Volunteers are the very lifeblood of our organization,” noted Physicians for Peace President and CEO, Brig. Gen. Ron Sconyers, (USAF, Ret.).  “These professionals give selflessly of their time and their talent to help those in need in some of the most desperate conditions in the world.  That the President has recognized the invaluable contributions of our volunteers is a real testimony to their work as America’s medical diplomats in the developing world.”    

The George Washington University Department of Nursing Educationwas recently honored by the United States Distance Learning Association (USDLA) with the world's most prestigious distance learning award presented for excellence in distance learning.

St Louis, MO (April 23, 2008) -- The United States Distance Learning Association (USDLA) yesterday presented its 2008 International Distance Learning Award to The George Washington University Department of Nursing Education’s National Nurse Emergency Preparedness Initiative (NNEPI)in conjunction with the 2008 National Conference in St. Louis, Missouri. Since 1987, USDLA has been the world's premier distance learning association. The USDLA International Awards program honored outstanding individuals and organizations for excellence in the field distance learning, education and training.

These prestigious International Awards are presented annually to organizations and individuals engaged in the development and delivery of distance learning programs. Included in the recognition ceremony were awards for 21st Century Best Practice, Best Practice for Distance Learning Programming, Excellence in Distance Learning Teaching, Outstanding Leadership by an Individual, Hall of Fame and Eagle Awards.

"As a premier organization for the entire distance learning profession, we are honoring The George Washington University Department of Nursing Education as a leader in the industry," said Dr. John G. Flores, CEO of USDLA. "The National Nurse Emergency Preparedness Initiative project team at The George Washington University Department of Nursing Education has raised the bar of excellence and we are truly honored by The George Washington University’s contributions to the distance learning industry."

The USDLA Awards were created to acknowledge major accomplishments in distance learning and to highlight those distance learning instructors, programs, and professionals who have achieved and demonstrated extraordinary results through the use of online, videoconferencing, satellite and blended learning delivery technologies. In addition, winners will be recognized in an edition of USDLA’s Distance Learning Today quarterly supplement.  Distance Learning Today appears in USA TODAY's top-tier markets for distance learning - major commuter hubs, convention centers and hotels.  It is read by 3.5 million goal-oriented, affluent professionals who recognize the value of distance learning, education and training. The section will also be featured on the USDLA website, which averages 2.6 million hits per month.

“The George Washington University Department of Nursing Education produced Nurses on the Front Line: Preparing for and Responding to Emergencies and Disasters to address a critical gap in the nation’s emergency preparedness,” said Jean E. Johnson, PhD, FAAN, Project Director of The National Nurse Emergency Preparedness Initiative. “We are deeply appreciative of the contributions our colleagues in the field of nursing made to this endeavor, particular the expert review panels assembled by The National Organization of Nurse Practitioner Faculties and The American Association of Colleges of Nurses.”

 “When we received U.S. Department of Homeland Security funding to develop the NNEPI course, we set out to create a course that integrates rich media content and engaging interactive experiences to arm nurses with the knowledge, skills and abilities they need to think critically and respond effectively in unpredictable emergency situations,” said Ellen M. Dawson, PhD, ANP, Chair of The Department of Nursing Education and Co-Director of The National Nurse Emergency Preparedness. “We feel confident that we achieved that goal and we are honored to be recognized by The U.S. Distance Learning Association for our contributions to the field.”

Mr. Reggie Smith III, USDLA board member and chair of the awards committee, noted that, “We look forward to seeing how The George Washington University Department of Nursing Education will inspire the 2009 award entries as they are recognized in Distance Learning Today to 3.5 million readers and via their participation in National Distance Learning Week (http://www.ndlw.org ), November 10-14, 2008.”

About The George Washington University Department of Nursing Education
The George Washington University Department of Nursing Education was established in 2004 and is an integral part of The George Washington University Medical Center. The George Washington University Medical Center is an internationally recognized interdisciplinary academic health center that has consistently provided high quality medical care in the Washington, DC metropolitan area for 176 years. The George Washington University Department of Nursing Education launched the first Doctor of Nursing Practice program in the nation’s capital and offers eight graduate-level programs in the clinical, research and leadership fields. The Department of Nursing Education is accredited through the Commission on Collegiate Nursing Education. For more information about GW’s nursing programs, click on “Nursing” at http://www.gwumc.edu/healthsci/.

About United States Distance Learning Association (USDLA)
The United States Distance Learning Association (USDLA) is a non-profit association formed in 1987 and is located in Boston, Massachusetts. USDLA promotes the development and application of distance learning for education and training and serves the needs of the distance learning community by providing advocacy, information, networking and opportunity. Distance learning and training constituencies served include pre-k-12 education, higher and continuing education, home schooling as well as business, corporate, military, government and telehealth markets. The USDLA trademarked logo is the recognized worldwide symbol of dedicated professionals committed to the distance learning industry. http://www.usdla.org

# # #

Contact: Jean E. Johnson, PhD, FAAN, Senior Associate Dean for Health Sciences Programs and Project Director for The National Nurse Emergency Preparedness Initiative
E-mail: hspjej@gwumc.edu
Phone: 202-994-3725The NNEPI online course is available at http://learning.nnepi.org

WASHINGTON — Responses to eValue8^TM, an annual survey of American health plans conducted by the National Business Coalition on Health (NBCH), indicate that 58 percent of the 150 plans surveyed will pay for substance use screening and brief intervention services (SBI). These services are defined by medical billing codes recently approved by the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS). In addition, The Office of Personnel Management (OPM) recently announced that the 5.6 million employees with Federal health insurance will also be covered for SBI services.

The George Washington University Medical Center is an internationally recognized interdisciplinary academic health center that has consistently provided high-quality medical care in the Washington, DC metropolitan area for 176 years. The Medical Center comprises the School of Medicine and Health Sciences, the 11^th oldest medical school in the country; the School of Public Health and Health Services, the only such school in the nation’s capital; GW Hospital, jointly owned and operated by a partnership between The George Washington University and a subsidiary of Universal Health Services, Inc.; and the GW Medical Faculty Associates, an independent faculty practice plan. For more information on GWUMC, visit  HYPERLINK http://www.gwumc.edu www.gwumc.edu

WASHINGTON (April 14, 2008) — A proposed federal rule could disrupt health center funding and jeopardize health care for millions of poor and underserved populations across the nation. A new study from The George Washington University Medical Center’s School of Public Health and Health Services (SPHHS) provides the first up-to-date estimates of the effects of the new regulations and their impact on safety net providers and vulnerable populations. The study is the second in a continuing series of health policy research briefs prepared by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative.

The GW policy brief, “Analysis of the Proposed Rule on Designation of Medically Underserved Populations and Health Professional Shortage Areas,” examines a proposed rule issued on February 29, 2008, which creates a new method to designate Health Professional Shortage Areas and Medically Underserved Areas or Populations. These designations are used by the federal government to prioritize the distribution of federal and state funds to communities nationwide, with vulnerable populations with high health care needs.

At present, all health center sites that provide the full range of primary care services are counted as being in medically underserved areas and their communities are targeted for priority funding. The new rule would create a three-tier designation system: “Tier 1,” “Tier 2,” and “Safety Net Facility.” Under the proposed system: 

• Almost one-third of health centers would fail to meet either “Tier 1” or “Tier 2” status and therefore would lose priority funding. Instead, they would be designated as “safety net facilities,” the lowest priority level, and thus could potentially lose eligibility for additional federal funding to meet community and patient need.  

• The proposed rules would disproportionately affect urban areas and states in the northeast and northwest. In 15 states, more than half of existing health centers would fall into “safety net facility” status and would thus be in jeopardy.