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Announcements from the Federal Office of Rural Health Policy

May 10, 2018

What’s New

CMS Announces Rural Health Strategy.  On Tuesday, the Centers for Medicare & Medicaid Services (CMS) announced the agency’s first strategy aimed directly at rural populations, with five objectives for health equity.  Among these, empowering patients to make decisions about their health care is one that CMS has endorsed for all beneficiaries.  But others, such as advancing telehealth and viewing CMS policy through a rural lens, acknowledge a more significant challenge specific to rural areas.

Funding Opportunities

Community Building for Rural and Native Americans, Letters of Interest – May 29.  Rural community development corporations and Tribal housing authorities are among those eligible to apply for funding from Enterprise Community Partners, a national nonprofit for affordable housing.  The application is a two-step process: Letters of Interest (LOI) must be submitted by May 29 and will be evaluated to select applicants who may submit a full proposal due on August 6. For more information, register to attend the Rural and Native American LOI Webinar – Thursday, May 10 (TODAY) at 2:00 pm ET.

DOJ Funding for Drug Courts – June 5.  The U.S. Department of Justice (DOJ) will make approximately 40 grants with an award ceiling of $2 million to develop and improve adult drug courts with evidence-based treatment for substance use disorder and other practices proven to reduce obstacles to recovery. Eligible applicants include city, county and state governments, and Native American tribal governments.  Opioid Use Disorder has had a proportionally larger impact on rural areas, but abuse of alcohol and other substances has also contributed to low education attainment, poverty and high risk behaviors.

NURSE Corps Scholarship Program – June 14. Students enrolled – or accepted for enrollment – in a professional degree program at an accredited school of nursing in the U.S. are eligible to apply for tuition, related costs and a monthly stipend in exchange for work at a facility in rural and medically-underserved areas upon graduation.

Director Training for Rural Residency Programs – June 15.  The National Institute for Program Director Development (NIPDD) helps physician faculty and directors of rural residency programs. This funding from the Rural Training Track (RTT) Collaborative provides full scholarship for the $5,500 tuition fee.  Those accepted for an NIPDD fellowship will engage with and learn from seasoned program directors, family medicine educators and other family medicine leaders about effective rural residency training.

Tribal Behavioral Health Grant Program – June 22. The Substance Abuse and Mental Health Services Administration (SAMHSA) will award up to 30 grants to fund promising community-based approaches that reduce suicide and substance use, address trauma, and promote the mental health and resiliency of American Indian/Alaska Native (AI/AN) youth. AI/AN tribes, tribal organizations, and consortia of tribes and tribal organizations are eligible to apply for this five-year grant program.

Policy Updates

Visit the FORHP Policy page to see all recent updates and send questions to ruralpolicy@hrsa.gov

Comments Requested: EMS Agenda 2050 – May 31.  The project team for the Emergency Medical Services (EMS) Agenda 2050 created a draft document envisioning the future of this essential component of the rural health care safety net, and request comment from healthcare and public health professionals to finalize it.

Comments Requested: Policy Updates for Skilled Nursing Facilities – June 26.  CMS displayed its proposed rule for fiscal year (FY) 2019 updating payment rates and rules for Skilled Nursing Facilities (SNFs) and non-Critical Access Hospital (CAH) swing beds. The rule includes an overall proposed payment rate increase of 2.4 percent, with rural SNFs and non-CAH swing beds experiencing this payment rate increase as 2.5 percent. CMS has also proposed replacing the current case-mix system with a new system called the Patient Driven Payment Model (PDPM) to be implemented by October 2019, which is projected to increase payments to small and rural SNFs and non-CAH swing beds. The proposed rule also includes changes to the SNF quality reporting program, changes to the SNF value-based purchasing program, and a request for information regarding electronic health information and interoperability.

Comments Requested: Policy Updates for Rehabilitation Facilities – June 26.  CMS displayed its proposed rule for fiscal year (FY) 2019 updating payment rates and rules for Inpatient Rehabilitation Facilities (IRFs). In addition to a payment rate increase of 0.9 percent ($75 million) compared to last year, the proposed rule solicits comments about removing the face-to-face requirement for rehabilitation physician visits, expanding the use of nurse practitioners and physician assistants in meeting the IRF coverage requirements.  The proposal would update the IRF quality reporting program, including adding a new quality measure removal factor and removing two measures from the measure set. Several IRF-Patient Assessment Instrument items have also been proposed for removal, and there is a request for information in the rule related to electronic health information and interoperability.

Comments Requested: Policy Updates to Psychiatric Facilities – June 26.  CMS displayed its proposed rule for fiscal year (FY) 2019 updating payment rates and rules for Inpatient Psychiatric Facilities (IPF). The rule includes an overall proposed increase in the payment rate by 1.25 percent, or $50 million for FY 2019. CMS has proposed to continue to apply the 17 percent payment adjustment for IPFs located in rural areas, which has been in place since 2004.The rule also updates the IPF quality reporting program by proposing the removal of eight (8) measures beginning with the FY 2020 payment determination. Additionally, the proposed rule includes technical changes to some of the IPF regulations and a request for information related to electronic health information exchange and interoperability.

Comments Requested: Policy Updates to Medicare Hospice – June 26.  CMS displayed its proposed rule for fiscal year (FY) 2019 updating payment rates and rules for hospices.  The rule includes an overall proposed payment increase of 1.8 percent ($340 million). CMS also proposed changes to the regulation text allowing physician’s assistants to be recognized by Medicare as an attending physician in addition to physicians and nurse practitioners. The rule also includes a request for information related to electronic health information exchange and interoperability, and proposed changes to the quality reporting program that include removal of routine individual public reporting of 7 hospice item set measures and instead displaying them as a composite.

Resources, Learning Events and Technical Assistance

State Coverage Initiatives Affecting Rural Communities – Monday, May 14 at 3:00 pm ET.  This hour-long webinar hosted by  the National Organization of State Offices of Rural Health is the first in a four-part series reviewing state-level changes to insurance coverage through Medicaid and state marketplaces.  Subsequent webinars in the series will take place at 3:00 pm ET on Tuesday, Wednesday, and Thursday, May 15-17.

Treating Pregnant Women with Opioid Use Disorder – Wednesday, May 16 at 1:00 pm ET.  The Health Resources and Services Administration (HRSA) will host this one-hour webinar to review guidance for optimal maintenance of pregnant and parenting women with opioid use disorder.  Available resources will be discussed, including the Substance Use Warmline, which provides free and confidential clinician-to-clinician telephone consultation for substance use evaluation and management.  In addition to rising rates of opioid use, research has shown that opioids are now the most common reason for seeking treatment for illicit substances during pregnancy.

Opioids in Indian Country – Wednesday, May 16 at 2:30 p.m. ET. Building off of its two previous webinars, SAMHSA’s Tribal Training and Technical Assistance Center will host an upcoming webinar that will provide additional available treatment resources and highlight recovery efforts among tribal communities in Minnesota and Michigan.

Addressing Workforce Shortages in Rural Areas – Wednesday, May 16 at 3:00 pm ET.  The U.S. Department of Labor will host this one-hour webinar to share free resources for expanding apprenticeship programs – across sectors including health care, information technology and manufacturing – at the local level.

California Telehealth Resource Center (TRC) Regional Conference – May 16-18. Topics covered at this conference in San Diego, CA include: federal and state telehealth policy, mobile health, school-based telehealth, project ECHO for pain management and opioid addiction treatment, telehealth and EHR integration, and direct-to-consumer strategies. Clinician champions, coordinators, C-suite leadership, and IT professionals will among the 300 attendees at this regional conference hosted by the California TRC, one of twelve HRSA-funded Telehealth Resource Centers throughout the country.

Northeast Telehealth Resource Center (TRC) Regional Conference – June 5-6.  Another HRSA-funded TRC is hosting a two-day conference in Portland, Maine features regional and national telehealth leaders and seventeen breakout sessions on topics including strategies for planning and sustaining telehealth programs, telehealth for FQHCs, models for serving vulnerable populations through telehealth, a hands-on technology lab with the National Telehealth Technology Assessment Resource Center, and more.

National Rural Institute on Alcohol and Drug Abuse – June 10-14.  Registration is now open for this annual conference in Menomonie, Wisconsin.  The four-day agenda includes keynote presentations and meeting sessions on substance abuse treatment from a rural perspective.

Approaching Deadlines

National Health Service Corps Scholarships – May 10
USDA Community Connect Grants – May 14
CDC Funding for Opioid Overdose Prevention Research – May 15
Nominations for the U.S. Preventive Services Task Force (USPSTF) – May 15
Improve Rural Youth Literacy – May 18
Letters of Intent for Preventing Rural Teen Pregnancy – May 21
Comments Requested: Services for Abuse of Vulnerable Adults – May 21
Comments Requested: CMS Proposal Reducing State Medicaid Reporting Burden – May 22
USDA Rural Health and Safety Education Grants – May 24
Grants for Family Planning – May 24
Comments Requested: Direct Provider Contracting in Medicare and Medicaid – May 25
AHRQ Research Demonstration and Dissemination Grant – May 26
Community Building for Rural and Native Americans, Letters of Interest – May 29
HCOP Funding for Health Professions Schools – May 29
Nominations: Advisory Committee on HIV, Viral Hepatitis and STD Prevention – May 30
Comments Requested: EMS Agenda 2050 – May 31
Save the Date: Rural Cancer Control Research Meeting – May 30-31
Funding for Patient-Involved Research – June 1
Wellness and Resilience for AI/AN Children – June 4
Grants for Distance Learning and Telemedicine Programs – June 4
DOJ Funding for Drug Courts – June 5
CDC Funding for Diabetes, Heart Disease, and Stroke – June 11
NURSE Corps Scholarship Program – June 14
Director Training for Rural Residency Programs – June 15
Resources for Tribal Self Governance Planning – June 17
Resources for Tribal Self Governance Negotiation – June 17
State Initiative for Child Abuse and Neglect – June 18
Tribal Behavioral Health Grant Program – June 22
CDC Health Promotion Research Centers – June 25
Comments Requested: CMS Updates Payment and Policy for Hospitals – June 25
Comments Requested: Policy Updates to Medicare Hospice – June 26
Comments Requested: Policy Updates to Psychiatric Facilities – June 26
Comments Requested: Policy Updates for Rehabilitation Facilities – June 26
Comments Requested: Policy Updates for Skilled Nursing Facilities – June 26
Preventing Rural Teen Pregnancy – June 29
CMS Annual Call for Medicare EHR Incentive Program Measures  – June 29
Rural Health Care Telecommunications Program – June 29
Comments Requested: HRSA Burden Reduction – July 2
Invest in Rural Transportation – July 19
Guaranteed Loans for Rural Rental Housing – Ongoing through 2021
Telecommunications Infrastructure Loans – Ongoing
Funding for Rural Water and Waste Disposal Projects –  Ongoing
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