Announcements from the Federal Office of Rural Health Policy

June 15, 2017

What’s New

Combating Drug Addiction – TODAY, Thursday, June 15 at 2:30 pm ET. The White House and the Office of National Drug Control Policy (ONDCP) will hold the first meeting of the President’s Commission on Combating Drug Addiction and the Opioid Crisis.  The meeting will be streamed online for live public viewing on the White House website.  Anyone wishing to submit comments or questions for the Commission may send an email to commission@ondcp.eop.gov, with notice that written comments, including name and contact information of the submitter, may be posted publicly on the ONDCP website. The Centers for Disease Control and Prevention have tracked a significant increase in opioid-related overdose across the country, with higher rates in rural areas.

Funding Opportunities

Faculty Loan Repayment Program (FLRP) – June 29.  Health professionals who are U.S. citizens from a disadvantaged background may be eligible to receive payment assistance for their educational loans in exchange for a two-year commitment on the faculty of a health professions school.  FLRP supports the next generation of the health workforce by recruiting degreed professionals to pursue faculty roles in their respective health care fields.  Health care workforce with cultural understanding of the patients they serve is particularly important in rural areas, where it’s more difficult to recruit and retain professionals.

CPC+ Expands to 4 New (Mostly Rural) Regions – July 13. CMS announced the Round 2 regions selected for the Comprehensive Primary Care Plus (CPC+) model: Louisiana, Nebraska, North Dakota, and the Greater Buffalo Region of New York.  The CPC+ model is an advanced primary care medical home model that offers an innovative payment structure, including a monthly care management fee, to support primary care practices to improve quality, access, and efficiency.  Physician practices in these regions can apply for 2018 participation via on online portal.

Repair or Rehab Housing for Low-income Rural Residents – July 17. State and local governments, nonprofit organizations, and federally recognized tribes are invited to submit pre-applications for the USDA Rural Housing Service Housing Preservation Grant program, which provides funds to repair and rehabilitate homes and rental properties for low-income rural residents (income at 80% or less of area median income). Many rural communities continue to face substandard housing conditions which contribute to poorer health outcomes. Complete pre-applications should be submitted to your local USDA Rural Development state office.

Expanding Medication Assisted Treatment – July 31.  Seventeen states with the highest rates of admissions for treatment of opioid use disorder are eligible to apply for funding that will expand or enhance access to medication assisted treatment.  The Substance Abuse and Mental Health Services Administration (SAMHSA) will make five awards of $2 million per year for up to three years.  See eligible states in Appendix E of the grant program guidance.  Last month, the Rural Health Research Centers released a report showing 60% of rural counties have no physicians with a waiver required to prescribe buprenorphine for opioid use disorder.

First Responders – July 31.  States, tribal organizations and local government entities are eligible to apply for funding of up to $41.3 million over four years for an anticipated 30 grantees.  SAMHSA will enter into cooperative agreement with successful applicants to train and provide resources to first responders on carrying and administering a drug or device approved by the FDA for emergency treatment of opioid overdose. First responders are vital to the outcome of an overdose, yet many rural emergency services lack the resources to respond as quickly and effectively.

Rural Health  Research

For more rural health research and to receive updates on new reports, visit the Rural Health Research Gateway.

Health Services Delivery and Policy Options For Rural Communities After Hospital Closure.  Hospital closures can affect the infrastructure of essential rural primary care, possibly creating access issues for residents.  This policy brief from the Rural Policy Research Institute describes opportunities for rural communities to develop a high performance rural health system after a hospital closure, including three case studies that describe real-world transitions from centering on inpatient hospital-based care to new models of delivery in rural places.  It outlines currently available health services delivery options under existing Federal and State laws and policy options under consideration in response to hospital closures in rural communities.

Policy Updates

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

Comments Requested: Developing Measures for Telehealth – June 30.  The National Quality Forum has posted a draft document aiming to develop a telehealth framework for ensuring that clinical measures are applied to telehealth encounters.  The project, contracted to NQF by the Centers for Medicare & Medicaid Services and sponsored by the Federal Office of Rural Health Policy, is intended to identify existing and potential metrics for care delivered via telehealth, and develop a framework with guiding principles for future telehealth measurement.  NQF invites comments on the body of the report as well as suggestions on measurement concepts.  For questions, contact the NQF project team at telehealth@qualityforum.org.

Comments Requested:  HUD Healthy Homes survey – July 3. The Department of Housing and Urban Development (HUD) administers the American Healthy Homes Survey, a nationally representative survey of key environmental contaminants in the nation’s housing, including lead, mold, pesticides, and for the first time, formaldehyde. The Centers for Disease Control and Prevention find that rural areas generally experience lower levels of airborne formaldehyde, a potential carcinogen, but face other infrastructural deficits that jeopardize housing conditions. In response to HUD’s invitation, commenters may suggest ways to enhance the quality, utility, and clarity of the information collected for the survey in relation to housing in rural communities.

Comments Requested: Improving the ACA Insurance Market – July 12.  CMS has published a request for information seeking recommendations from the public on how to create a more flexible, streamlined approach to the regulatory structure of the individual and small group health insurance markets.  As rural consumers face fewer plan choices and issuers are leaving the Marketplace, CMS would like feedback on how it could change existing regulations or guidance to put patients first, promote greater consumer choice, enhance affordability, and return more control over healthcare to the states. Rural stakeholders may be able to provide feedback explaining challenges particular to rural areas.

Resources, Learning Events and Technical Assistance

Advancing Triple Aim at a Critical Access Hospital – TODAY, Thursday, June 15 at 3:00 pm ET.  Lessons learned about managing financial pressures, building revenue and increasing local services will be shared by rural hospital administrators at this webinar hosted by the National Rural Health Association (NRHA).  The event is the first in NRHA’s 2017 Rural Health Care Transformation webinar series.

Implementing Telebehavioral Health – TODAY, Thursday, June 15, 3:00 – 4:30 pm ET.  Attendees at this 90-minute webinar held by the SAMHSA-HRSA Center for Integrated Solutions will learn about the key elements and specific steps necessary to implement telebehavioral health in primary care practice settings to address the needs of individuals living with mental illness and substance use disorders.  Transportation is a health disparity for rural residents and telehealth is seen as one way to reach patients in remote areas.

Peer-Led Self-Management – Monday, June 19, 3:00 – 4:30 pm ET.  HRSA-SAMSHA Integrated solutions will also host this online session on peer-led interventions as a method for increasing self-management of chronic physical and behavioral health conditions.  Attendees will learn about a Health Center program serving homeless individuals where previously homeless peer staff are key to building trust and engagement with clients.  Peer-led therapies are an effective model for long-term support of rural patients with chronic conditions.

Building Collaborative Communities – Thursday, June 20, 2:00 pm ET. The Connecting Kids to Coverage campaign and the National League of Cities are hosting an hour-long webinar highlighting ways local organizations can create partnerships with city governments to expand Medicaid and CHIP outreach and enrollment efforts.  The Mississippi Health Collaborative, a state with mostly rural counties, will share their experiences building sustainable access to coverage for vulnerable and hard-to-reach citizens.

Training Series for Health Care Providers on Prescribing Opioids – Ongoing. The CDC has an eight-part online training series to help health care providers apply CDC’s prescribing recommendations in their clinical settings through interactive patient scenarios, videos, knowledge checks, tips, and resources. Rural practitioners report their concern about the potential for opioid abuse, but at the same time report insufficient training in prescribing opioids. For this reason, the CDC created the 2016  Guideline for Prescribing Opioids for Chronic Pain and associated training. Topics in the series include communicating with patients, treating chronic pain without opioids, and prescribing decision making.

Resource of the Week

Free Medication Assisted Treatment Training – Ongoing Weekly.  The Providers Clinical Support System offers free waiver training for prescribing medication for opioid use disorder (OUD).  The training is an 8-hour course, provided half-and-half in four-hour windows, required to obtain a Drug Enforcement Agency Drug Addiction Treatment Act waiver to prescribe buprenorphine, one of three medications approved by the FDA for the treatment of OUD.  Earlier this year, research showed that most rural counties had no waivered providers.

Approaching Deadlines

Comments Requested: CAH Accreditation – June 18
Data Requested: Non-Drug Treatment for Chronic Pain – June 19
NIDA Funding To Expand Treatment For Opioid Abuse – June 20
Post-Secondary Success for Rural Vets – June 21|
Comments Requested: Hospice Payment Rates and Policy – June 26
Comments Requested: Skilled Nursing Facility (SNF) Payment Rates –  June 26
Comments Requested: Inpatient Rehabilitation Facility (IRF) payment rates –June 27
Faculty Loan Repayment Program (FLRP) – June 29
Rural Health and Safety Education – June 30
Comments Requested: Developing Measures for Telehealth – June 30
Rural Health Experts Wanted – July 3
Building Communities of Recovery – July 3
Comments Requested:  HUD Healthy Homes survey – July 3
Comments requested: Universal Education for Opioid Prescribers – July 10
Comments Requested: Improving the ACA Insurance Market – July 12
Comments Requested: Improving the ACA Insurance Market – July 12
CPC+ Expands to 4 New (Mostly Rural) Regions – July 13
Transitional Living Program/Maternity Group Homes – July 14
Delta Health Care Service Grant Program – July 17
Repair or Rehab Housing for Low-income Rural Residents – July 17
USDA Rural Telemedicine Development – July 17
Suicide Prevention – July 18
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