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Category Archives: Current Affairs

Announcements from the Federal Office of Rural Health Policy

October 5, 2017

Suicide Rates for Rural Counties Consistently Higher Than Urban Counties

In the latest edition of its Morbidity and Mortality Weekly Report (MMWR) Rural Health Series, researchers at the Centers for Disease Control and Prevention (CDC) examined suicide trends between 2001 – 2015.  Suicide is one of the top ten leading causes of death in the United States, and suicide occurs at a much higher rate in rural areas than urban.  While this is a documented rural-urban disparity, the new CDC report examines the annual changes in the rates of suicide by a number of additional variables including sex, race/ethnicity, age group, and mechanism of death.

A few key findings across all urbanization levels during the study time period include:

  • Suicide rates for males were four to five times higher than for females
  • Non-Hispanic whites and non-Hispanic American Indian/Alaska Natives had the highest suicide rates
  • Higher suicide rates were observed among persons aged 35-64 years
  • Firearms were the most often used mechanism of death, with rates in rural counties almost double those in large and medium/small metropolitan counties

“The trends in suicide rates by sex, race, ethnicity, age, and mechanism that we see in the general population are magnified in rural areas,” said James A. Mercy, Ph.D., director of CDC’s Division of Violence Prevention.  “This report underscores the need for suicide prevention strategies that are tailored specifically for these communities.”

CDC recently released a technical package of strategies representing the best available evidence to prevent or reduce public health problems like violence.  The package includes examples of programs that can be customized to fit the cultural needs of different communities.

Additional forthcoming work on disparities in suicide rates in rural areas includes:

  • The National Advisory Committee on Rural Health and Human Services has identified suicide as an important rural disparity to address, and will be issuing a policy brief with recommendations to the Secretary of HHS later this year;
  • A HRSA commentary on suicide trends in rural America will be authored in the coming weeks;
  • CDC findings on suicide and other injury-related topics will be highlighted during National Rural Health Day activities the week of November 13th.

Rural Health Information Hub

October 4, 2017

View the Rural Health Information Hub updates.

Announcements from the Federal Office of Rural Health Policy

October 4, 2017

What’s New

Comments Requested: Strategic Plan for HHS – October 27. Every four years, the U.S. Department of Health and Human Services (HHS) updates its strategic plan, which describes the objectives and strategies the Department will employ to enhance the health and well-being of Americans. The draft strategic plan for 2018-2022 highlights five goals, two of which include objectives that specifically improve rural health: reducing provider shortages (objective 1.4) and leveraging telehealth to improving access to mental health and substance use disorder services (objective 2.3). HHS seeks comments on the plan. Interested commenters may consider topics addressed by the National Advisory Committee on Rural Health and Human Services or other areas where HHS can explicitly target improvements in rural health and human services.

USDA Childhood Obesity Study. The U.S. Department of Health and Human Services (HHS) named reducing childhood obesity one of three clinical priorities, and several HHS agencies have taken the lead on funding, guidance and standards.  The Economic Research Service at the U.S. Department of Agriculture (USDA) studies economic and policy issues in rural America and finds that obese children tend to live in a disadvantaged household with limited or no access within a 15-mile radius to supermarkets that carry healthful foods (p. 12). This finding suggests improving access to nearby grocery stores may help reduce rates of rural childhood obesity. The HHS Administration for Children & Families Healthy Food Financing Initiative helps bring grocery stores to underserved rural and urban communities. Rural health care providers may also consider additional strategies and efforts to help increase access to healthful foods in their communities.

Assessment for Preventing Medical Errors – December 15.  The Institute for Safe Medication Practices (ISMP) launched a medication safety self-assessment that may help rural providers in both inpatient and outpatient settings assess and compare their performance to health providers with similar populations as a way to reduce adverse drug events related to high-alert medications. This tool is funded via a contract with the Food and Drug Administration (FDA), and “focuses on best practices for eleven medication categories,” including insulin, opioids, and chemotherapy. Information submitted by providers to ISMP will be anonymous. Adverse drug events (ADEs) include medication errors and allergic reactions and overdoses, and can be a challenge to identify in small rural hospitals where there is limited pharmacist support.

Funding Opportunities

USDA Delta Health Care Services Program – October 10. The U.S. Department of Agriculture (USDA) Delta Health Care Services (DHCS) Program provides financial assistance to address continuing unmet health needs in the Delta region. USDA extended the application deadline for 2018 funding from July 24 to October 10. Further, USDA clarified that all members of applicant consortia must have a physical address or headquarters located in one of the eight states served by the Delta Regional Authority. Applicants may revise and resubmit applications by the new deadline. ALERT: DHCS may be an opportunity to extend the impact of organizations in the FORHP Delta States Rural Development Network Grant Program, which supports rural communities in the eight Delta states implement preventive or clinical services for chronic diseases.

Improve Tribal Road Safety – December 11. The U.S. Department of Transportation Federal Highway Administration requests grant applications for Tribal Transportation Safety Funds for projects to prevent and reduce serious injuries and deaths in transportation-related crashes on tribal lands. Eligible projects can develop transportation safety plans; assess, improve, or analyze crash reporting data; or complete infrastructure improvements. On average, two American Indians die every day in motor vehicle crashes, predominantly in large, rural states. Staff responsible for roadway safety can find tools to improve safety on rural and tribal roads and guidance for effective tribal crash reporting. Health care providers serving rural and tribal communities can help by implementing proven prevention strategies to help reduce transit injuries and deaths.

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Community Health Worker ECHO Starts November 7th

October 3, 2017

Community Health Worker ECHO

Join Community Health Workers to increase your ability to effectively and efficiently empower individuals to manage their health.  Get expert Community Health Worker (CHW) knowledge in a virtual learning network with University of Missouri and Community Health Worker leaders and specialists throughout the state.

Learn about best practices and evidence-based care, including:

  • Working with diverse populations
  • Knowledge of community-based services and resources
  • Patient navigation
  • Building strong rapport with clients
  • Communicating effectively with clients and healthcare providers

Why Community Health Worker ECHO?

Project ECHO is a guided practice model that revolutionizes medical education and increases workforce capacity to provide best-practice specialty care and reduce health disparities. Community Health Workers work in a variety of areas of practice to meet the needs of the communities they serve. This Community Health Worker ECHO creates space for CHWs to share their experiences with one another in order to better prepare them for the challenges they face while supporting their communities’ ever-changing needs.

When will the Community Health Worker ECHO be held?

It will begin on November 7th and will be held on the 1st and 3rd Tuesdays of each month from 2:00 to 3:00 p.m. for the next 8 months.

Registration is now open!  To register visit the link below:
http://medicine2.missouri.edu/show-me-echo/register/

Rural Health Research & Policy Centers

September 28, 2017

View the Research Alert

Rural Health Information Hub

September 27, 2017

View the Rural Health Information Hub updates.

Announcements from the Federal Office of Rural Health Policy

September 27, 2017

What’s New

Roadmap to Behavioral Health.  A consumer guide that connects individuals to resources for disaster distress, suicide prevention, veterans crisis and recovery from substance use disorder was created by the Centers for Medicare & Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA).  The guide provides simple explanations of feelings and behaviors that may need attention, a check list for getting help and treatment, and tips for managing long-term behavioral health care.  According to SAMSHA data from 2015, more than 18% of residents in non-metropolitan counties had some sort of mental illness in the previous year, which amounts to more than 6 million people.

CMS Reveals New Medicare Cards. CMS redesigned Medicare cards to include a unique, randomly assigned number in place of one’s Social Security number. Medicare beneficiaries can expect to receive their new card in the mail beginning in April 2018 and all cards must be replaced by April 2019. CMS will provide 21 months for health care providers and Medicare beneficiaries to transition to the new cards during which they can use either their current SSN-based Medicare number or their new Medicare number. Congress required new Medicare cards to prevent fraud and combat identity theft in the elder population. Rural hospitals can help by protecting facilities against malicious software attacks.

Effective Post-ER Suicide Prevention. Suicide is the tenth leading cause of death in the U.S. and varies by geography. Rural communities have higher rates of suicide than urban areas and the disparity has widened over time. Recent research supported by the National Institute of Mental Health showed that sending caring postcards or letters each month to at-risk patients following an emergency visit reduced suicide attempts and deaths and slightly reduced health care costs. Universal screening of ER patients for suicide risk could substantially increase the public health benefits of the post-ER postcard intervention and other prevention efforts. Additional resources on suicide prevention can help rural hospitals and other providers improve mental health care in their communities.

Funding Opportunities

For CAHs: Pediatric Readiness Quality Improvement – October 13.  The Emergency Medical Services for Children Program at HRSA requests applications from Critical Access Hospitals (CAHs) to participate in this initiative.  Participating hospitals will receive mentoring from the Pediatric Readiness Quality Collaborative (PRQC); physicians can earn Maintenance of Certification Part IV credit and nurses can receive Continuing Nursing Education credit. The PRQC will focus on pediatric patient safety, patient assessments, inter-facility transfer guidelines, and disaster preparedness. Using a train-the-trainer model, teams will be supported through targeted quality improvement education, the provision of tools and resources to support local efforts, and sharing of best practices.  The deadline to submit a letter of interest has been extended to October 13, 2017. More information about the Pediatric Readiness Quality Improvement Collaborative is at https://emscimprovement.center/collaboratives/PRQuality-collaborative/  Additional questions can be directed to qeca@texaschildrens.org.

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