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Announcements from the Federal Office of Rural Health Policy

February 2, 2018

What’s New

NEMJ: The Challenging Quest to Improve Rural Health CareThe New England Journal of Medicine has a new article (subscription required) in its current edition that reviews the history of federal policy for rural health and examines current challenges that include widening disparities in life expectancy, sustainability of rural hospitals, tackling the opioid epidemic and the shortage of rural health workforce.

Teen Attitudes Toward Alcohol and Drug Use.  Last week was National Drug and Alcohol Facts Week, an annual observance promoted by the National Institute on Drug Abuse (NIDA) to foster a science-based understanding among teenagers of drugs, alcohol and addiction.  Since 1975, a NIDA-funded survey called Monitoring the Future has asked teens aged 12 to 17 about their attitude and behavior toward substance use.  The most recent survey showed that opioid misuse is at historic lows for teens but that vaping and marijuana use are more popular.  The findings on teen opioid use is similar to an October report from the Centers for Disease Control and Prevention that showed a decline in past-month drug use among teenagers in rural areas.

Funding Opportunities

Addressing Violence Against Women in Rural Areas – February 15 [DEADLINE EXTENDED].  The U.S. Department of Justice (DOJ) will make 45 awards of up to $750,000 each to support projects in rural jurisdictions that address and prevent sexual assault, domestic violence, dating violence and stalking.  Eligible applicants include city, county and state governments, Native American tribal governments, nonprofits and public institutions of higher education.   The original January 31 deadline for applications has been extended to February 15.

RWJF Change Leadership Programs – February 21 & March 14. The Robert Wood Johnson Foundation supports clinical and health policy leadership to lead change across disciplines and sectors.  RWJF seeks scholars and leaders from underrepresented populations and backgrounds each year.  Themes for the Interdisciplinary Research Leaders Program for 2018 focus on better health care delivery for rural America.

NURSE Corps Loan Repayment Program – March 8.  Eligible nurses working full time in a Critical Shortage Facility may receive up to 85% repayment of their unpaid nursing education debt in exchange for a two-year commitment to stay and practice in rural and other underserved areas.  The first of two technical assistance calls for interested applicants will take place on Thursday, February 8 at 2:00 pm ET.  See link for more details.

Indian Health Service Scholarship Program – March 28.  The IHS offers scholarships to qualified American Indian and Alaska Native candidates enrolled in undergraduate or graduate degree programs for health professions.  The scholarships provide financial aid that covers tuition, fees, and living expenses in exchange for a two-year service commitment within an Indian health program.

Rural Health  Research

Taking Stock: Policy Opportunities for Advancing Rural Health.  This paper from the Rural Policy Research Institute covers seven topic areas that have implications for rural people and the rural health care delivery system:  Medicare, Medicaid and CHIP, insurance coverage and affordability, quality, health care finance and system transformation, workforce and population health.

Policy Updates

Questions about Rural Health Policy Updates? Write to ruralpolicy@hrsa.gov

Comments Requested: HIT Trusted Exchange Framework Draft – February 20.  The Office of the National Coordinator for Health Information Technology (ONC) is seeking public input on a draft version of the Trusted Exchange Framework.  This document proposes policies, procedures, and technical standards needed to establish interoperability, one of the hurdles toward broader use of telehealth and Electronic Health Records in rural areas.  The goal is an electronic system that allows both input and access of health information from different sources in a secure way.

New Evaluation Results on the State Innovation Models (SIM) Initiative.  The CMS Innovation Center recently released evaluation results for the SIM Initiative Round Two Model Test Awards.  Participating states – Colorado,  Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington – were awarded over $622 million to implement health policy and regulatory innovations tailored to the needs of their state’s residents.   The SIM Initiative has created federal-state partnerships with states, territories, and the District of Columbia to design and test strategies that meet the goals of higher quality/lower cost health care delivery.  The Innovation Center received considerable input from rural stakeholders to help shape the initiative.

Request for Nominations: Advisory Panel on Hospital Outpatient Payment. CMS is accepting nominations on a continuous basis for two vacancies on the Advisory Panel on Medicare Hospital Outpatient Payment (HOP). The Panel may include urban and rural representatives of hospitals, hospital systems, or other Medicare outpatient providers and advises the Secretary of Health & Human Services and the Administrator of the CMS on Medicare outpatient payment systems.  The Panel also includes representatives of Critical Access Hospitals who advise on the level of supervision of hospital outpatient services.  Please submit nominations  electronically to APCPanel@cms.hhs.gov.

Medicare EHR Incentive Program Payment Adjustment Fact Sheet for CAHs. This fact sheet provides the payment reductions for Critical Access Hospitals (CAHs) that do not meet the meaningful use of Certified Electronic Health Record Technology (CEHRT) requirements. Beginning in FY2016, CAHs that don’t meet the requirements, or qualify for a hardship exemption, will be reimbursed 100.33% of reasonable costs.  For each subsequent year, reimbursements will be reduced to 100% of reasonable costs.

Resources, Learning Events and Technical Assistance

Cardiovascular Disease in Women and Minorities – [TODAY] Thursday, February 1 at 12:30 pm ET. As a kick-off for American Heart Month, HRSA’s Office of Regional Operations will host this 90 minute webinar to distinguish care patterns and patient outcomes across various populations.  Cardiovascular disease is one of several chronic conditions impacting quality of life, mortality and healthcare costs in rural areas.

Rural Transportation Toolkit – Monday, February 12 at 1:00 pm ET.  The Rural Health Information Hub and the NORC Walsh Center for Rural Health Analysis will present best-practice models and resources for improving access to transportation, overcoming barriers, and improving transportation safety in rural communities.

Updated Information on Hepatitis C Infection – Wednesday, February 14 at 2:00 pm ET.  Last year, the Centers for Disease Control and Prevention announced that new hepatitis C virus (HCV) infections have nearly tripled in recent years, and attribute the increase to the rise in injection drug use.  Because HCV has few symptoms, nearly half of people living with the virus don’t know about it and the majority of new infections go undiagnosed. In rural areas lacking access to primary care, the impact of the opioid epidemic is compounded by needle-born infectious disease.  This hour-long webinar will review the basics of hepatitis C virus infection and drug therapy management in primary care settings.

Resource of the Week

Nationwide Poison Control Centers.  Last week, a high alert was issued in response to a spike in the number of poisonings from laundry detergent pods.  More than 80 incidents of teenagers intentionally ingesting detergent were reported in January alone.  If swallowed, highly concentrated toxins in the laundry pods can lead to vomiting, difficulty breathing, lost consciousness and seizures.  The Health Resources and Services Administration (HRSA) provides funding for the nation’s 55 poison centers.  Each can be reached through the same Poison Help Line number (posted in the link above), and anyone who calls can receive free, professional treatment advice 24-hours a day.  Emergency response is a challenge in rural areas; last year, the Centers for Disease Control and Prevention identified non-drug poisonings as one of the leading causes of higher rates of unintentional injury and death in rural areas.

Approaching Deadlines

PCORI  Engagement Awards – February 1
Comments Requested: FCC Rural Health Care Funding – February 2
Medicaid and CHIP Payment and Access Commission (MACPAC) Nominations – February 5
Comments Requested: Revised Head Start Quality Measures – February 6
Comments Requested: Quality Measures Under Consideration – February 9
Comments Requested: USDA Child Nutrition Programs – February 12
Understanding Vaccination Coverage in Rural Areas – February 13
Addressing Violence Against Women in Rural Areas – February 15
Environmental Problem-Solving for Underserved Communities – February 16
Comments Requested: HIT Trusted Exchange Framework Draft – February 20
Tribal Practices for Wellness in Indian Country – February 20
Comments Requested: Addressing Needs in Rural Schools – February 20
Campus Suicide Prevention – February 20
RWJF Change Leadership Programs – February 21 & March 14
SAMSHA Treatment Drug Courts – February 21
Rural Health Network Development Planning Program – February 23
Medicare Rural Hospital Flexibility Program EvaluationFebruary 23
Nurse Anesthetist Traineeship Program – February 28
Rural PREP Microresearch – March 1 (depending on funds)
Comments Requested:  Labor Redefines Employer Health Plans – March 6
NURSE Corps Loan Repayment Program – March 8
New Medicare Episode Payment Model – March 12
Rural Health Clinic Policy and Assessment Program – March 16
Comments Requested: FDA Opioid Prescribing Guidelines – March 16
Indian Health Service Scholarship Program – March 28
Guaranteed Loans for Rural Rental Housing – Ongoing through 2021
Drinking Water and Waste Disposal for Rural and Native Alaskan Villages – Ongoing
HIT Strategies for Patient-Reported Outcome Measures – Ongoing
HIT to Improve Health Care Quality and Outcomes – Ongoing
Community Facilities Program –  Ongoing
Summer Food Service Program – Ongoing

 

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