Congressional changes in the law to permit reimbursement of physician extenders under Medicare seem closer as national television publicizes the program. (Author)

The article describes North Carolina's precedent setting Office of Rural Health Services, its background and design, and its significant role in the development of primary health care clinics such as that in Balsom Grove which is staffed by a family nurse practitioner and enjoying wide community support. (SB)

Wayne Myers, director of the Office of Rural Health Policy, discusses Appalachian rural health and access to health care. The health manpower shortage in Central Appalachia still exists but is less severe than 10 years ago. The needs of underserved areas could be address by training local people in the community and through telemedicine and…

A number of Appalachian initiatives aim to recruit rural doctors. West Virginia's three medical schools require all students to spend time working in rural clinics, where they develop an understanding of and connections to rural communities. In two rural Tennessee counties, East Tennessee State University maintains teaching medical practices…

Caring Start is a mobile-clinic program that provides prenatal care, well-baby clinics, childhood immunizations, counseling services, and contraceptives to rural poor families in northwest Pennsylvania. Before the mobile clinic, many rural women (mostly teenagers) went without prenatal health care due to lack of transportation. (LP)

The National Cancer Institute created the Appalachia Leadership Initiative on Cancer, composed of four similar projects that focus on increasing screening for cervical and breast cancer among low-income, older women. The program relies on community coalitions that develop innovative grass roots methods to spread the message about the importance of…

Supports renewed funding of the Appalachian Regional Commission's (ARC) "finish-up health plan" and "highway finish-up program." Discusses at length the need for primary care services, prevention of infant mortality, and the lack of physicians in Appalachia, and how the ARC plans can affect these needs. (LC)

Describes a rural West Virginia health-care center as a successful model program for integration between the clinic and community. Describes center facilities, funding sources, community cooperation, and cooperative residency program with regional medical school. Discusses implications for other medical-education programs. Describes differences…