Site Visit to Utah and Nevada — Essential Community Health Services on the Frontier

From the opening dinner to the closing summary, this site visit explored the delivery and financing of essential community services for vulnerable populations in the frontier West. A sequel to the Forum\u27s March 30-31, 1998, urban-centered site visit to Philadelphia, Providing Community-Based Primary Care: Nursing Centers, CHCs, and Other Initiatives, the visit spanned 493 miles. It included overview presentations, bus briefings, facility tours, telehealth demonstrations, panel discussions, and wrap-up reviews. Topics included the Utah health marketplace, the demands of emergency preparedness, the development of a patchwork of services along a continuum ranging from preventive care to tertiary referrals and follow-up, and various models of care (the nursing center, hospital or health system, community health center, migrant health service center, rural health clinic, and other examples). The visit also focused on special topics: private-public partnerships developed by a large health system to address safety- net issues, targeted services for Native Americans and for farm workers, and health workforce concerns