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Announcements from the Federal Office of Rural Health Policy

June 23, 2014

Hot Off the Presses

  1. Local Foods, Local Places is a program supported by EPA, the U.S. Department of Agriculture (USDA), the U.S. Department of Transportation (DOT), the Appalachian Regional Commission (ARC), and the Delta Regional Authority (DRA) to help create more livable places by promoting local foods. From June 9 to July 15, 2014,communities are invited to apply for assistance from Local Foods, Local Places, which will provide direct technical support to selected communities to help them develop and implement action plans promoting local food and downtown revitalization. Special consideration will be given to communities that are in the early stages of developing or restoring local food enterprises and creating economically vibrant communities. Selected communities in Appalachia and the Delta region will be eligible to receive financial assistance to help them implement those plans.Local Foods, Local Places builds on the ARC-EPA-USDA Livable Communities in Appalachia partnership, which works to promote economic development, preserve rural lands, and increase access to locally grown food in Appalachian towns and rural communities. Communities anywhere in the United States are eligible to apply. Visit the website for more eligibility information and details on how to apply.
  2. The Housing Preservation Grant (HPG) program is a grant program administered by the Rural Housing Service which provides organizations grant funds to assist low- and very low-income homeowners in repairing and rehabilitating their homes in rural areas. In addition, the HPG program assists rental property owners and cooperative housing complexes in rural areas in repairing and rehabilitating their units if they agree to make such units available to low- and very low-income persons. If submitting a paper pre-application, the closing deadline for receipt of all applications is 5:00 p.m., local time for each Rural Development State Office on July 28, 2014. For more information on application requirements and eligibility criteria, see the Federal Register Notice.

Rural Research Highlights

  1. Trends in Hospital Network Participation and System Affiliation, 2007-2012
    Network participation and system affiliation represent two viable ways for hospitals to build and/or access necessary capacities to engage in the transformation to an integrated, patient-centered, pay-for-value model of care delivery. This policy brief tracks trends in network participation and system affiliation among U.S. general community hospitals from 2007 to 2012. Network participation increased in larger hospitals, non-government not-for-profit hospitals, and metropolitan hospitals. System affiliation generally increased in hospitals of all sizes and types. However, there are notably higher percentages of system affiliation among midsized and large hospitals, investor-owned hospitals, and metropolitan hospitals compared to their counterparts.
  2. Safety Net Clinics Serving the Elderly in Rural Areas: Rural Health Clinic Patients Compared to Federally Qualified Health Center Patients
    This policy brief by the NC Rural Health Research Program uses data extracted from 2009 Medicare outpatient provider claims to look at the location of clinics, the number of beneficiaries served, and the number of and cost per claim for each type of rural safety net clinic. We further examined characteristics of Medicare beneficiaries comparing their age, the health problems for which they sought care, and the distance they travelled to obtain care. Because Rural Health Centers (RHCs) and Federally Qualified Health Centers (FQHCs) are similar in mission but may be different in practice, understanding their respective Medicare patient profiles is important. This findings brief is the third and final in a series on RHCs which draws on a large, national dataset that includes claims data on the approximately 90% of RHCs that billed Medicare in 2009.More recent rural research can be found on

Webinars, Events, and Other Technical Assistance

  1. The Advisory Panel on Hospital Outpatient Payment will be meeting August 25-26. CMS permits hospitals to participate by providing information on appropriate levels of supervision. Registration to attend this meeting in person will open June 30 and close August 1 although presentations and comments must be emailed to by July 25. The Panel will make recommendations to CMS about the appropriate supervision level (General, Extended Duration, or Direct) for outpatient therapeutic procedures presented for consideration. At this meeting the panel will deliberate chemotherapy and complex drug delivery among other topics. For more information on the HOP Panel Summer Meeting, see the Federal Register Notice and the HOP Panel website.
  2. HRSA invites you to join the next Health Information and Quality Webinar on Friday, June 20, 2014 from 2PM – 3PM ET on the topic of health IT tools for veterans. Veterans have access to a variety of health information technology tools that empower them to be  active participants in their healthcare. The Veterans Health Administration (VA) is America’s largest integrated health care system with over 1,700 sites of care, serving 8.76 million Veterans each year. Under the U.S. Census Bureau definition of rural utilized by the Veterans Administration (VA), 3.2 million (36%) of Veterans who receive care through the VA live in rural America.  The VA has created a web-based tool called “My HealtheVet” which is a suite of online tools for Veterans to access their health information  electronically. When used collaboratively with the health care team, these tools can be used to: increase process efficiency, help patients become more engaged and active, enhance communication, increase patient and provider satisfaction, and lead to improved health outcomes.HRSA provides funding for community-based programs, which are programs that are funded at the local and community level. Listeners will be able to learn through this webinar how a rural provider was and former ORHP Rural Health Outreach grantee was able to successfully link electronic patient information with the VA to enhance care coordination. Community Health IT, a non-profit entity and HRSA grantee in Gainesville, Florida designed to improve the health of their local communities through activated health information exchange (HIE), has created a web-based tool called “My HealthStory”. This tool enables Veterans to share their health information from the VA health system to their civilian doctors and hospitals.Presenters for this webinar will provide an overview of both My HealtheVet and My HealthStory and highlight examples of how their programs are currently being used to support safety net providers and Veterans.Participants can register at

Other Useful Information and Resources

  1. As noted in a prior announcement, the comment period for the Medicare Inpatient Prospective Payment System 2015 payment update is open for public comment with comments being accepted through June 30th.  Several provisions of the rule have, or may have, a rural impact.  Specifically, the proposed rule:
  •  Implements revised labor market areas based on OMB-updated metropolitan statistical areas (MSAs) using 2010 Census data.
  • Modifies a policy adopted in last year’s IPPS final rule regarding the CAH 96-hour payment condition.
  • Requests comments on what would be a reasonable timeline for adopting Worksheet S-10 as the new data source for determining the amount of uncompensated care provided by hospitals for determining Medicare DSH payment.
  • Those interested in more information about the potential implications of the Worksheet S-10 for rural hospitals can refer to a recently released study from the University of North Carolina, Provision of Uncompensated Care by Rural Hospitals: A Preliminary Look at Medicare Cost Report Worksheet S-10.
  1.  The Centers for Disease Control and Prevention (CDC) has completed a new Chronic Fatigue Syndrome (CFS) web page focused on the pediatric population with links to informational factsheets for parents, educators and healthcare providers, respectively:  CFS is a disabling illness of unknown cause and origin.  The management of CFS may require input from a variety of healthcare professionals (e.g. medical doctors, rehabilitation specialists, mental health professionals, and physical or exercise therapists), which may be more difficult for rural residents to access.
  2. Click here for the latest issue of MLN Connects, a weekly newsletter that gives provider news and updates that may affect how rural providers are impacted by CMS rollouts. Previous issues and a link to subscribe to MLN Connects are available in the archive.

Funding Opportunities

  1. The Centers for Disease Control and Prevention (CDC) has announced the availability of six new funding opportunities to advance the nation’s chronic disease prevention and health promotion efforts.  The opportunities address one or more of the leading risk factors for the major causes of death and disability in the United States: tobacco use, poor nutrition, and physical inactivity.  Some of the opportunities also address key health system improvements and community supports to help Americans manage their chronic conditions such as high blood pressure and pre-diabetes.  These opportunities are relevant to rural areas because there tend to be higher rates of diabetes and other chronic diseases among rural populations.
    For more information, please visit:
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