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Policy I: Rural Health Care Clay Layne HCS / 455 July 24, 2011 James McKenzie Rural Health Care Rural health tends to be overshadowed by larger urban communities. The health care providers and patients in rural communities are faced by obstacles that are different from urban areas. Rural communities in America are challenged with unique factors of disparities that are not found in urban areas (National Rural Health Association, 2011). Some factors are education, economics, cultural, social, and lack of support from legislators. In the rural America community there are less than 10 percent of physicians practicing (National Rural Health Association, 2011). Residents in this type of community are less likely to have health care and prescription drug coverage by their employer (National Rural Health Association, 2011). Rural residents income tend to be very low than working middle class. Many of these residents rely heavily on government assistance and food stamps (National Rural Health Association, 2011). Health care providers that accepts medicare are paid much less than their urban counterparts. There also have been increases to the death rate due to the distance involved. For example the time and distance of a car crash, the call for help and the arrival of the EMS in a rural area is critical.  The National Rural Health Association was formed in 1980 to help develop awareness and new policy to help improve rural health (National Rural Health Association, 2011). The National Rural Health Association (NRHA) defines rural based on the purpose of the program that are needed, used, and reference to programmatic designations (National Rural Health Association, 2011). The program targets rural providers, rural residents and rural communities for the reason to be guided to selecting the criteria of programmatic designations which each one have its own statistical validity (National Rural Health Association, 2011).The National Rural Health Association believes that these criteria will help to ensure a designation is appropriate for a specific program while limited the unrelated programs (National Rural Health Association, 2011).  The NRHA supports the following policy recommendation. Recognition of professional of quality of life in the working environment should be supported by the employers and supported organization (National Rural Health Association, 2011). Employers should try to normalize workers job function that can cause psychological issues (National Rural Health Association, 2011). The believes to provide workers with information and tool needed to work that congress and the state governments should help fund and create the program (National Rural Health Association, 2011). For example the NRHA believes the rural areas should have access to the proper trained dental health professionals relative to demographics and the size of the community. NRHA researchers found in Alaska that 25 % of the tribal programs were vacant or  30 % for dentist turnover annually (National Rural Health Association, 2011). There are an average of 2.5 more oral disease in Alaska Native children than the United States (National Rural Health Association, 2011). The geography increases the cost of the dental care and many villages are challenged with economic condition, which result in negative support of a full time dentist (National Rural Health Association, 2011). Therefore, the NRHA support and endorses the provision of dental health care, oral aid, and therapist in communities of this magnitude (National Rural Health Association, 2011). The first stage is the Formulation stage the development of acceptable and effective course of action for addressing what has been elected on the policy agenda (Anderson, 2011). Acceptable formulation defines the proposed action that is likely to be elected by legitimate decision makers, usually through a bargaining process that is political feasible (Anderson, 2011). Effective formulation defines as the proposed policy is as efficient, implemental, and valid solution to the current issue (Anderson, 2011). Policy analyst look for effective alternatives if the proposed policy seen to be ineffective.  Therefore, effective formulation is viewed as the analytical phase and the acceptable formulation is viewed as political phase (Anderson, 2011). The roles of both should complement each other but the elected or appointed officials have the final choices. The stages can be framed to defined issues, drafting policy, setting goals, and objectives and policy organizing and development (Anderson, 2011). The rural health research policy should be formulated around the issues and information to the current policy. This information can be collected from current and past documents, the human resources and development pattern, logistical aspect of the program, implementation process, and research program (Anderson, 2011). A focal group is also needed to help manage and organize the policy formulation (National Rural Health Association, 2011). The ideal group is of a health or medical background that is administratively strong and politically influential (National Rural Health Association, 2011). The next stage is the Legislative Stage. The legislative is defined as an ideal first, pass on to a representative that sponsors the bill, then sign by the committee and place on the calendar to debate and vote on (United States House of Representatives, 2011). If majority votes the same process takes place in the Senate, if  approved and majority votes then it is pass to the government to sin or veto within 10 days (United States House of Representatives, 2011).  It contains many topics that arranges from Universal Services Fund to Access Standards for policy recommendation. The organization finds this as a great resource for policymakers and advocates comprehending the multitude of opportunities and issues facing rural health care (National Rural Health Association, 2011). Yearly the Government Affairs Committee approves the legislative and regulatory agenda (National Rural Health Association, 2011). The Government Affairs Committee evaluates the members input by weighing them all, scope out opportunities in the future year, formulating policy around the rural health environment (National Rural Health Association, 2011). Policy that are elected by the decision makers are adopted by the Rural Health Congress, by supporting the background and the policy by producing a series of documents and statements (National Rural Health Association, 2011). Overall the input and goals reflects the values and mission the NRHA and members set forth and support.  The Implementation stage is the next process. This is a tool that helps manage for specific policy measures, or multiple measures created to help agencies monitor and manage the process of implementing the policy (Management Study Guide, 2011). This process is intended to be flexible due the degree of urgency, sensitivity and innovation that is associated with the specific policy measures (Management Study Guide, 2011). The NRHA is now annual establishment of the rural health policy institute (National Rural Health Association, 2011). This helps provides members a forum to learn how the process and policy works. It also gives them visibility on the stages it takes for bill to form and the communication that is involved. In 1997 the NRHA help create the Flex program along with the National Organization of State Offices of Rural Health (NOSORH) (National Rural Health Association, 2011). Rural communities in America are challenged with unique factors of disparities that are not found in urban areas. Some factors are education, economics, cultural, social, and lack of support from legislators. In the rural America community there are less than 10 % of physicians practicing. The National Rural Health Association was formed to help develop awareness and new policy to help improve rural health (National Rural Health Association, 2011). The program targets rural providers, rural residents and rural communities for the reason to be guided to selecting the criteria of programmatic designations which each one have its own statistical validity (National Rural Health Association, 2011). The rural health research policy should be formulated around the issues and information to the current policy. The stages can be framed to defined issues, drafting policy, setting goals and objectives and policy organizing and development. The NRHA legislation agenda is to develop annually from direct input from the members enrolled (National Rural Health Association, 2011). It is information gathered and collected from members and rural health advocates that would like to see change on issues that impact rural health. In spite of many challenges rural health has faces NHRA is an organization that has implement many policy to improve the rural communities’ health (National Rural Health Association, 2011). Reference Anderson, J. (2011) Public Policymaking Sixth Ed. Chapter 3. Retrieved from; acade mic.udayton.edu/grantneeley/Morality%20Policy Management Study Guide (2011) Strategy Implementation - Meaning and Steps in Implementing a Strategy. Retrieved from; http:// www.managementstudyguide.com/strategy-implementation.htm National Rural Health Association (2011) Government Affairs, Defining Rural Health Care. Retrieved from; http://www.ruralhealthweb.org/ United States House of Representatives (2011) The Legislative Process. Retrieved from; http://www.house.gov/content/learn/legislative_process/