Maine Rural Health Research Center

Completed Projects

Access to Mental Health Services and Family Burden of Rural Children with Significant Mental Health Problems
The needs of rural children with SED and the burden these needs place on their families are intertwined and may place these rural children and their families at "double jeopardy" of having their mental health and other needs go unmet. Using the National Survey of Children with Special Health Care Needs (NS-CSHCN) and information on community characteristics from the Area Resource File (ARF) we will examine the factors associated with whether children and their families have their needs meet across the rural continuum.
Funder: Office of Rural Health Policy (ORHP)
Topics: Children, Mental health

Analysis of 2004-2005 State Flex Grant Plans
This project will analyze state Flex grant applications and related budget and work plan revisions focusing on state activities in the core Flex program areas of networks, quality improvement, and EMS.
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Emergency medical services (EMS), Networking and collaboration, Quality

Availability, Characteristics, and Role of Detoxification Services in Rural Areas
This project will produce a comprehensive description of the distribution and characteristics of detoxification (detox) services across rural areas including a discussion of access issues, the role of detox services within local systems of care, barriers to the delivery of detox services by rural providers, and policy and regulatory incentives needed to encourage the development of rural detox services. Products will include a working paper and related journal articles addressing these topics.
Funder: Office of Rural Health Policy (ORHP)
Topic: Substance abuse

Chronic Illness and the Rural Informal Safety Net: The Case of Diabetes
Funder: Office of Rural Health Policy (ORHP)
Topics: Chronic diseases and conditions, Health insurance and the uninsured

Community Impact Assessment
This project will evaluate the impact of the Flex program on local communities. Activities will focus on identifying the ways in which the program could have a measurable effect, as well as the ways in which Flex program coordinators intended to affect community health. A briefing paper that integrates information on scope of services, networking, and quality will be produced. Additionally, case studies will be conducted in six CAH communities.
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Networking and collaboration

Consequences of Rural Uninsurance
This study will assess whether uninsured rural residents have different levels of access to care than their urban counterparts, and the factors associated with any differences (including sub-analyses for individuals with identified chronic conditions). In doing so, it will provide policymakers with critical information for improving rural health systems.
Funder: Office of Rural Health Policy (ORHP)
Topic: Health insurance and the uninsured

Database for Rural Health Research in Progress
This searchable database of current rural health services research and policy analysis includes all ORHP-funded studies as well as research funded by other federal agencies, major private foundations and other sources.
Funder: Office of Rural Health Policy (ORHP)
Topic: Health policy

Development of State Flex Program Logic Models and Related Toolkit
Funder: Office of Rural Health Policy (ORHP)
Topic: Critical Access Hospitals and Rural Hospital Flexibility Program

Effects of Scope of Service and Reimbursement on Access to Mental Health Services in Rural Areas
Funder: Office of Rural Health Policy (ORHP)
Topics: Health services, Health services, Mental health

Expanding Rural Health Insurance Coverage: How Do Insurance Reform Strategies Stack Up?
This purpose of this study is to inform policymakers about the current state of health insurance coverage in rural America, and to assess how specific reform strategies may differentially affect rural residents. Using a combination of analytic strategies, we will provide policymakers and rural health advocates with the necessary tools to develop reform strategies that meet the needs of rural residents.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health insurance and the uninsured, Health policy

Financial Impact of Mental Health Services on Rural Individuals and Families
This project will use the Medical Expenditure Panel Survey (MEPS) to examine the financial burden that rural residents face in seeking mental health services, compared to urban residents. Implications of financial burden for access to needed mental health services for rural residents will be assessed.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health care financing, Health insurance and the uninsured, Mental health

Health Insurance Coverage and Access to Health Services for the Rural Near Elderly
Funder: Office of Rural Health Policy (ORHP)
Topics: Aging, Health insurance and the uninsured, Health services

Health Insurance Dynamics of Uninsured Rural Families
To better understand the dynamics of insurance coverage among rural and urban families, this study will use the Medical Expenditure Panel Survey (MEPS) to compare family health insurance coverage among non-elderly rural and urban families.
Funder: Office of Rural Health Policy (ORHP)
Topic: Health insurance and the uninsured

Health Reform�Rapid Response
This project will include several projects as requested by ORHP and DHHS as those agencies prepare for national health reform. Responses are primarily in the areas of health insurance and behavioral health.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health care financing, Health policy, Health services, Mental health

Impact of Employment Transitions on Health Insurance Coverage of Rural Residents
This project aims to examine rural-urban differences in the proportion of employed adults with private health insurance who experience an employment transition (defined as a change in jobs or hours worked, or no job) and the impact of that change on health insurance status.
Funder: Office of Rural Health Policy (ORHP)
Topic: Health insurance and the uninsured

Impact of Mental and Emotional Stress on Rural Employment Patterns
This study will use the National Longitudinal Survey of Youth to investigate how mental health symptoms affect employment patterns, and the extent to which these effects differ by rural and urban residence.
Funder: Office of Rural Health Policy (ORHP)
Topic: Mental health

Locally Managed Behavioral Health Organizations: How Do They Affect The Capacity of Medicaid Managed Behavioral Health Programs to Serve Rural Populations?
Funder: Office of Rural Health Policy (ORHP)
Topics: Medicaid and S-CHIP, Mental health, Networking and collaboration

Measuring Rural Underinisurance
Funder: Office of Rural Health Policy (ORHP)
Topic: Health insurance and the uninsured

Measuring the Community Benefits and Impact of Critical Access Hospitals
This project will develop, test, and implement a set of community benefits and impact indicators for Critical Access Hospitals (CAHs). These indicators will assist CAHs, policymakers, and rural stakeholders to understand the impact of CAHs on their communities and local health care delivery systems.
Funder: Office of Rural Health Policy (ORHP)
Topic: Critical Access Hospitals and Rural Hospital Flexibility Program

Mental Health Encounters in Critical Access Hospital Emergency Rooms: A National Survey
This project will survey Emergency Room (ER) managers in a nationally representative sample of Critical Access Hospitals (CAHs) to determine the proportion of ER encounters involving mental health pathology, types of mental health problems most commonly seen in these encounters, and resources available to CAHs to address the problems encountered.
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Emergency medical services (EMS), Mental health

Mental Health Services in Rural Jails
This project will investigate how rural jails manage the mental health and substance abuse problems of their inmates. Through analysis of the National Survey of Jails and semi-structured interviews with state-level and county-level/local officials, barriers to providing such services will be assessed and promising practices will be documented.
Funder: Office of Rural Health Policy (ORHP)
Topic: Mental health

National Rural Hospital Flexibility Program Tracking Project: Tracking State Policy and Program Development
Funder: Office of Rural Health Policy (ORHP)
Topic: Critical Access Hospitals and Rural Hospital Flexibility Program

National Study of Rural Health Clinics
Funder: Office of Rural Health Policy (ORHP)
Topics: Health services, Rural Health Clinics (RHCs)

National Study of Substance Abuse Prevalence and Treatment Services in Rural Areas
This project will research the prevalence of the abuse of legal and illegal substances across rural populations and geographic areas, including the extent to which rural individuals are receiving treatment for their substance abuse and barriers to the receipt of treatment.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health disparities, Health services, Rural statistics and demographics, Substance abuse

Patterns of Individual Health Plan Coverage Among Rural Residents
Funder: Office of Rural Health Policy (ORHP)
Topics: Health insurance and the uninsured, Rural statistics and demographics

Provision of Specialty Mental Health Services by Rural Health Clinics
This project will document the extent to which Rural Health Clinics (RHCs) are employing mental health staff nationally, understand why more RHCs are not employing specialty mental health staff, and analyze the barriers to and opportunities for the delivery of mental health services by RHCs. The results will identify opportunities and interventions to encourage RHCs to offer this important service.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health services, Mental health, Rural Health Clinics (RHCs), Substance abuse

Role of Advanced Practice Registered Nurses in Addressing Mental Health Workforce Shortages
Funder: Office of Rural Health Policy (ORHP)
Topics: Mental health, Nurses, Workforce

Role of Community Mental Health Centers as Rural Safety Net Providers
Funder: Office of Rural Health Policy (ORHP)
Topics: Federally Qualified Health Centers (FQHCs), Mental health

Role of Inpatient Psychiatric Units in Small Rural Hospitals and Rural Mental Health Systems
This is a descriptive, exploratory study which will investigate the role of the small rural hospital IPU from the perspectives of both the rural hospital, in terms of scope of services and revenue enhancement, and the regional mental health system, meeting the needs of outpatient mental health and primary care providers, law enforcement, and human services.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health services, Hospitals and clinics, Mental health

Rural Hospital Flexibility Performance Monitoring Project- Grant Years 2003-2008
Under contract with the federal Office of Rural Health Policy, the Rural Health Research Centers at the Universities of Minnesota, North Carolina, and Southern Maine are cooperatively conducting a performance monitoring project for the Medicare Rural Hospital Flexibility Program (Flex Program). The monitoring project will assess the impact of the Flex Program on rural hospitals and communities and the role of states in achieving overall program objectives, including improving access to and the quality of health care services; improving the financial performance of Critical Access Hospitals; and engaging rural communities in health care system development.
Funder: Office of Rural Health Policy (ORHP)
Topic: Critical Access Hospitals and Rural Hospital Flexibility Program

Rural-Urban Differences in Access to Children's Mental Health Services
This study uses data from the Urban Institute's National Survey of America's Families to examine and compare the use of mental health services by rural and urban children, age 6 to 17, relative to their need for mental health care, family income, and insurance status.
Funder: Office of Rural Health Policy (ORHP)
Topics: Children, Health services, Mental health

Safety Net Activities of Independent Rural Health Clinics
This national study will investigate and describe the safety net role of independent Rural Health Clinics (RHC). It will further examine the market effect of Federally Qualified Health Centers (FQHC) on the safety net role of independent RHCs at the county level.
Funder: Office of Rural Health Policy (ORHP)
Topics: Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs)

Special Study of EMS Issues
This study will focus on state, community, and hospital level initiatives designed to build the infrastructure to support EMS service capacity and encourage the integration of these services into the rural healthcare infrastructure in the areas of quality improvement, financing, staffing, medical control, and networking and integration.
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Emergency medical services (EMS), Networking and collaboration

State Flex Program Quality Improvement Activities
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality

Urban and Rural Differences in Utilization Patterns, Risk Factors and Expenditures of the Dually Eligible Elderly and Non-Elderly Persons with Disabilities
Funder: Office of Rural Health Policy (ORHP)
Topics: Aging, Disabilities, Medicaid and S-CHIP, Medicare

Using Program Logic Models to Monitor the Performance of State Flex Programs
This project will use a program logic model approach to track state program activities and develop tools that allow states to systematically monitor and manage their accomplishments in the context of Flex Program goals.
Funder: Office of Rural Health Policy (ORHP)
Topic: Critical Access Hospitals and Rural Hospital Flexibility Program

Topics Centers Researchers Other Resources Search		Maine Rural Health Research Center Completed Projects Access to Mental Health Services and Family Burden of Rural Children with Significant Mental Health Problems The needs of rural children with SED and the burden these needs place on their families are intertwined and may place these rural children and their families at "double jeopardy" of having their mental health and other needs go unmet. Using the National Survey of Children with Special Health Care Needs (NS-CSHCN) and information on community characteristics from the Area Resource File (ARF) we will examine the factors associated with whether children and their families have their needs meet across the rural continuum. Funder: Office of Rural Health Policy (ORHP) Topics: Children, Mental health Analysis of 2004-2005 State Flex Grant Plans This project will analyze state Flex grant applications and related budget and work plan revisions focusing on state activities in the core Flex program areas of networks, quality improvement, and EMS. Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Emergency medical services (EMS), Networking and collaboration, Quality Availability, Characteristics, and Role of Detoxification Services in Rural Areas This project will produce a comprehensive description of the distribution and characteristics of detoxification (detox) services across rural areas including a discussion of access issues, the role of detox services within local systems of care, barriers to the delivery of detox services by rural providers, and policy and regulatory incentives needed to encourage the development of rural detox services. Products will include a working paper and related journal articles addressing these topics. Funder: Office of Rural Health Policy (ORHP) Topic: Substance abuse Chronic Illness and the Rural Informal Safety Net: The Case of Diabetes Funder: Office of Rural Health Policy (ORHP) Topics: Chronic diseases and conditions, Health insurance and the uninsured Community Impact Assessment This project will evaluate the impact of the Flex program on local communities. Activities will focus on identifying the ways in which the program could have a measurable effect, as well as the ways in which Flex program coordinators intended to affect community health. A briefing paper that integrates information on scope of services, networking, and quality will be produced. Additionally, case studies will be conducted in six CAH communities. Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Networking and collaboration Consequences of Rural Uninsurance This study will assess whether uninsured rural residents have different levels of access to care than their urban counterparts, and the factors associated with any differences (including sub-analyses for individuals with identified chronic conditions). In doing so, it will provide policymakers with critical information for improving rural health systems. Funder: Office of Rural Health Policy (ORHP) Topic: Health insurance and the uninsured Database for Rural Health Research in Progress This searchable database of current rural health services research and policy analysis includes all ORHP-funded studies as well as research funded by other federal agencies, major private foundations and other sources. Funder: Office of Rural Health Policy (ORHP) Topic: Health policy Development of State Flex Program Logic Models and Related Toolkit Funder: Office of Rural Health Policy (ORHP) Topic: Critical Access Hospitals and Rural Hospital Flexibility Program Effects of Scope of Service and Reimbursement on Access to Mental Health Services in Rural Areas Funder: Office of Rural Health Policy (ORHP) Topics: Health services, Health services, Mental health Expanding Rural Health Insurance Coverage: How Do Insurance Reform Strategies Stack Up? This purpose of this study is to inform policymakers about the current state of health insurance coverage in rural America, and to assess how specific reform strategies may differentially affect rural residents. Using a combination of analytic strategies, we will provide policymakers and rural health advocates with the necessary tools to develop reform strategies that meet the needs of rural residents. Funder: Office of Rural Health Policy (ORHP) Topics: Health insurance and the uninsured, Health policy Financial Impact of Mental Health Services on Rural Individuals and Families This project will use the Medical Expenditure Panel Survey (MEPS) to examine the financial burden that rural residents face in seeking mental health services, compared to urban residents. Implications of financial burden for access to needed mental health services for rural residents will be assessed. Funder: Office of Rural Health Policy (ORHP) Topics: Health care financing, Health insurance and the uninsured, Mental health Health Insurance Coverage and Access to Health Services for the Rural Near Elderly Funder: Office of Rural Health Policy (ORHP) Topics: Aging, Health insurance and the uninsured, Health services Health Insurance Dynamics of Uninsured Rural Families To better understand the dynamics of insurance coverage among rural and urban families, this study will use the Medical Expenditure Panel Survey (MEPS) to compare family health insurance coverage among non-elderly rural and urban families. Funder: Office of Rural Health Policy (ORHP) Topic: Health insurance and the uninsured Health Reform�Rapid Response This project will include several projects as requested by ORHP and DHHS as those agencies prepare for national health reform. Responses are primarily in the areas of health insurance and behavioral health. Funder: Office of Rural Health Policy (ORHP) Topics: Health care financing, Health policy, Health services, Mental health Impact of Employment Transitions on Health Insurance Coverage of Rural Residents This project aims to examine rural-urban differences in the proportion of employed adults with private health insurance who experience an employment transition (defined as a change in jobs or hours worked, or no job) and the impact of that change on health insurance status. Funder: Office of Rural Health Policy (ORHP) Topic: Health insurance and the uninsured Impact of Mental and Emotional Stress on Rural Employment Patterns This study will use the National Longitudinal Survey of Youth to investigate how mental health symptoms affect employment patterns, and the extent to which these effects differ by rural and urban residence. Funder: Office of Rural Health Policy (ORHP) Topic: Mental health Locally Managed Behavioral Health Organizations: How Do They Affect The Capacity of Medicaid Managed Behavioral Health Programs to Serve Rural Populations? Funder: Office of Rural Health Policy (ORHP) Topics: Medicaid and S-CHIP, Mental health, Networking and collaboration Measuring Rural Underinisurance Funder: Office of Rural Health Policy (ORHP) Topic: Health insurance and the uninsured Measuring the Community Benefits and Impact of Critical Access Hospitals This project will develop, test, and implement a set of community benefits and impact indicators for Critical Access Hospitals (CAHs). These indicators will assist CAHs, policymakers, and rural stakeholders to understand the impact of CAHs on their communities and local health care delivery systems. Funder: Office of Rural Health Policy (ORHP) Topic: Critical Access Hospitals and Rural Hospital Flexibility Program Mental Health Encounters in Critical Access Hospital Emergency Rooms: A National Survey This project will survey Emergency Room (ER) managers in a nationally representative sample of Critical Access Hospitals (CAHs) to determine the proportion of ER encounters involving mental health pathology, types of mental health problems most commonly seen in these encounters, and resources available to CAHs to address the problems encountered. Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Emergency medical services (EMS), Mental health Mental Health Services in Rural Jails This project will investigate how rural jails manage the mental health and substance abuse problems of their inmates. Through analysis of the National Survey of Jails and semi-structured interviews with state-level and county-level/local officials, barriers to providing such services will be assessed and promising practices will be documented. Funder: Office of Rural Health Policy (ORHP) Topic: Mental health National Rural Hospital Flexibility Program Tracking Project: Tracking State Policy and Program Development Funder: Office of Rural Health Policy (ORHP) Topic: Critical Access Hospitals and Rural Hospital Flexibility Program National Study of Rural Health Clinics Funder: Office of Rural Health Policy (ORHP) Topics: Health services, Rural Health Clinics (RHCs) National Study of Substance Abuse Prevalence and Treatment Services in Rural Areas This project will research the prevalence of the abuse of legal and illegal substances across rural populations and geographic areas, including the extent to which rural individuals are receiving treatment for their substance abuse and barriers to the receipt of treatment. Funder: Office of Rural Health Policy (ORHP) Topics: Health disparities, Health services, Rural statistics and demographics, Substance abuse Patterns of Individual Health Plan Coverage Among Rural Residents Funder: Office of Rural Health Policy (ORHP) Topics: Health insurance and the uninsured, Rural statistics and demographics Provision of Specialty Mental Health Services by Rural Health Clinics This project will document the extent to which Rural Health Clinics (RHCs) are employing mental health staff nationally, understand why more RHCs are not employing specialty mental health staff, and analyze the barriers to and opportunities for the delivery of mental health services by RHCs. The results will identify opportunities and interventions to encourage RHCs to offer this important service. Funder: Office of Rural Health Policy (ORHP) Topics: Health services, Mental health, Rural Health Clinics (RHCs), Substance abuse Role of Advanced Practice Registered Nurses in Addressing Mental Health Workforce Shortages Funder: Office of Rural Health Policy (ORHP) Topics: Mental health, Nurses, Workforce Role of Community Mental Health Centers as Rural Safety Net Providers Funder: Office of Rural Health Policy (ORHP) Topics: Federally Qualified Health Centers (FQHCs), Mental health Role of Inpatient Psychiatric Units in Small Rural Hospitals and Rural Mental Health Systems This is a descriptive, exploratory study which will investigate the role of the small rural hospital IPU from the perspectives of both the rural hospital, in terms of scope of services and revenue enhancement, and the regional mental health system, meeting the needs of outpatient mental health and primary care providers, law enforcement, and human services. Funder: Office of Rural Health Policy (ORHP) Topics: Health services, Hospitals and clinics, Mental health Rural Hospital Flexibility Performance Monitoring Project- Grant Years 2003-2008 Under contract with the federal Office of Rural Health Policy, the Rural Health Research Centers at the Universities of Minnesota, North Carolina, and Southern Maine are cooperatively conducting a performance monitoring project for the Medicare Rural Hospital Flexibility Program (Flex Program). The monitoring project will assess the impact of the Flex Program on rural hospitals and communities and the role of states in achieving overall program objectives, including improving access to and the quality of health care services; improving the financial performance of Critical Access Hospitals; and engaging rural communities in health care system development. Funder: Office of Rural Health Policy (ORHP) Topic: Critical Access Hospitals and Rural Hospital Flexibility Program Rural-Urban Differences in Access to Children's Mental Health Services This study uses data from the Urban Institute's National Survey of America's Families to examine and compare the use of mental health services by rural and urban children, age 6 to 17, relative to their need for mental health care, family income, and insurance status. Funder: Office of Rural Health Policy (ORHP) Topics: Children, Health services, Mental health Safety Net Activities of Independent Rural Health Clinics This national study will investigate and describe the safety net role of independent Rural Health Clinics (RHC). It will further examine the market effect of Federally Qualified Health Centers (FQHC) on the safety net role of independent RHCs at the county level. Funder: Office of Rural Health Policy (ORHP) Topics: Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs) Special Study of EMS Issues This study will focus on state, community, and hospital level initiatives designed to build the infrastructure to support EMS service capacity and encourage the integration of these services into the rural healthcare infrastructure in the areas of quality improvement, financing, staffing, medical control, and networking and integration. Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Emergency medical services (EMS), Networking and collaboration State Flex Program Quality Improvement Activities Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality Urban and Rural Differences in Utilization Patterns, Risk Factors and Expenditures of the Dually Eligible Elderly and Non-Elderly Persons with Disabilities Funder: Office of Rural Health Policy (ORHP) Topics: Aging, Disabilities, Medicaid and S-CHIP, Medicare Using Program Logic Models to Monitor the Performance of State Flex Programs This project will use a program logic model approach to track state program activities and develop tools that allow states to systematically monitor and manage their accomplishments in the context of Flex Program goals. Funder: Office of Rural Health Policy (ORHP) Topic: Critical Access Hospitals and Rural Hospital Flexibility Program