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Federal Office of Rural Health Policy Announcement

April 18, 2019

What’s New

Increasing Number of Grandparents Raising Grandchildren.  An analysis from the U.S. Census Bureau shows that, in 2016, there were over 7.2 million grandparents nationwide living with grandchildren under the age of 18.  Reports from media outlets and nonprofit organizations suggested that a recent rise in these arrangements is due in part to the opioid crisis.  To get an accurate and better understanding of what is happening, the Census Bureau examined data from its American Community Survey and data on opioid prescribing from the Centers for Disease Control and Prevention (CDC).  Previous research focused on the national or state level, but levels of opioid prescriptions vary widely within states, and county level data allow for a more localized analysis.  Data analysis showed a rural-urban divide in grandparents caring for grandchildren that is similar to the higher rates of overdose deaths in rural areas.  In 2016, 32 percent of grandparents were responsible for grandchildren in urban areas, compared to 46 percent of grandparents in rural areas.  The Census Bureau created an overview of their analysis, with methods, maps and data.  See frequently asked questions answered by the Administration for Children and Families on this topic and the Funding Opportunities section below for related resources.

Call for Manuscripts: Clinical and Translational Science to Improve Rural Health. Publishers of the Journal of Clinical and Translational Science have issued a call for papers for a special rural-themed edition. They are particularly interested in innovative studies with the intention of improving health care delivery and outcomes among underserved rural populations.

Funding Opportunities

Rural Communities Opioid Response Program-Medication-Assisted Treatment Expansion – Coming Soon.  As part of its Rural Community Opioid Response Program (RCORP), the Health Resources and Services Administration (HRSA) will invest approximately $8 million to establish and/or expand medication-assisted treatment in high-risk rural communities.  Rural Health Clinics, Critical Access Hospitals, Health Center Look-Alikes, and tribal organizations are among the eligible applicants. While applicants do not need to be previous or current RCORP award recipients, all applicants must be located, and all services must be provided, in HRSA-designated rural areas.

FAQs for Rural Communities Opioid Response Program-Implementation Funding.  The deadline for applications for the Rural Communities Opioid Response Program-Implementation is May 6.  The Health Resources and Services Administration has provided answers to frequently asked questions on eligibility and application requirements.  Additionally, you can view a recording of the technical assistance webinar for applicants. For questions beyond those in the link above, email ruralopioidresponse@hrsa.gov.

County Health Rankings Research Grants – April 26. The County Health Rankings and Roadmaps program is seeking proposals from qualified researchers to strengthen and enhance the impact of the County Health Rankings.  Up to $385,000 will be available for a year-long project period.  This call for proposals focuses on two research categories to strengthen their Rankings model:  1) refinement of current methodology, including testing alternative methods for small sample sizes; and 2) exploration of novel data sources/measures for inclusion, for example, factoring Family and Social Support.

ACF Community Economic Development (CED) Projects – June 3.  The Administration for Children and Families (ACF) will award $13 million to Community Development Corporations for projects that enhance job creation and business development for low-income communities in areas with a demonstrated need.  Bonus points will be awarded to projects that will create jobs in rural communities with high rates of poverty, unemployment, or substance abuse.

DOJ Comprehensive Opioid Abuse Site-based Program – June 5. The Department of Justice (DOJ) will make 150 awards of up to $500,000 each to support first responders, crime victims, and alternatives to incarceration for individuals with opioid use disorder. Effective responses must address the needs of the individual who is abusing drugs, as well as children or loved ones who may be experiencing trauma, violence, and victimization. A specific category of rural and tribal communities has been identified as a priority for this funding.

USDA Rural Health and Safety Education Grants – June 10.  The U.S. Department of Agriculture (USDA) will invest $2.9 million for up to 10 awards to Land Grant Colleges and Universities for programs that provide health and nutrition education to rural communities.

Brookdale Foundation Relatives as Parents Program – June 12.  The Brookdale Foundation opened its annual request for proposals from state agencies and local nonprofits for services to relatives caring for children outside of the foster system. Recipients will receive up to $15,000 seed money and must establish a collaborative network with other support systems such as family services, child care, aging, education, legal, health care, mental health, and transportation services. Public state agencies that receive the grant must match the funds 100 percent in cash or in-kind.  Many of the services considered important for positive child welfare outcomes are limited in rural communities, and there are reports that the opioid crisis is overwhelming foster care in several states.  Last year, the Agency for Children and Families issued a brief exploring special considerations for rural practice, including caseworker skills and availability, confidentiality and ethical practice, and the importance of cultural competency.

HRSA Medical Student Education Program – June 14.  The Health Resources and Services Administration (HRSA) will give priority to medical schools in states with a shortage of primary care providers for this investment of more than $23 million.  The program is designed to prepare and encourage medical students training in the most underserved states to choose residencies and careers in primary care that serve tribal communities, rural communities, and/or medically underserved communities after they graduate.

Rural Health  Research

Dying Too Soon: Disparities in Death By Rurality, Race, and Ethnicity.  A recently released brief by the Rural Health Research Gateway finds rural counties had higher rates of premature death (defined as years of potential life lost before age 75) than urban counties.  Researchers analyzed data from the 2017 County Health Rankings, and found that counties with a majority of residents identifying as non-Hispanic Black or American Indian/Alaska Native had significantly higher rates of premature death.

Policy Updates

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

CMS releases Care Coordination Toolkit and series of ACO Case Studies. The Centers for Medicare & Medicaid Services (CMS) has released a public Accountable Care Organization (ACO) Care Coordination Toolkit highlighting innovative strategies that ACOs and End-Stage Renal Disease Care (ESRD) Seamless Care Organizations (ESCOs) use to collaborate with beneficiaries, clinicians, and post-acute care partners to ensure high-quality, effective care is provided at the right time and in the right setting. CMS has also released seven case studies to describe innovative initiatives from ACOs and ESRD ESCOs on a variety of topics including engaging beneficiaries, coordinating care in rural settings, and promoting health literacy. Each case study includes detailed results and lessons learned.

SIM Initiative Evaluation: Model Test Year Five Annual Report. In December 2018, the Center for Medicare & Medicaid Innovation released its fifth annual report on Round 1 of the CMS State Innovation Models (SIM) Initiative, which tests the ability of the governments in six states (Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont) to move providers to value-based payment. A number of these states had activities involving rural providers, including RHCs, FQHCs, and CAHs. As a key finding, states used SIM awards to provide resources to providers to enable provider participation in Medicaid alternative payment models. While most state-led models supported through SIM did not realize Medicaid savings, many results were promising considering the limited provider incentives. A 2017 guide from Rural Health Value highlights the rural focus within select SIM awards from Rounds 1 and 2.

Learning Events and Technical Assistance

Enhancing Tribal and State Government Relationships – Thursday, April 18 at 3:00 pm ET.  The National Indian Health Board will host this one-hour web event featuring both tribal and state health department officials.  Speakers will discuss ways to meet, exchange resources, and build trust to collaborate on an effective response to emerging public health crises.

Using HIT for Opioid Use Disorder Treatment – Thursday, April 18 at 3:00 pm ET.  The Health Information Technology, Evaluation, and Quality Center (HITEQ) will host this 90-minute webinar on promising and innovative practices for the use of health information technologies (HIT) to enhance opioid use disorder (OUD) treatment. The discussion will focus on how various health information technology practices and tools, including electronic health records and prescription drug monitoring programs, can be used to enhance OUD services and specifically medication assisted treatment (MAT).

Opioid Treatment in Rural Health Clinics – Wednesday, April 24 at 2:00 pm ET. The National Association of Rural Health Clinics will be hosting a technical assistance webinar for Rural Health Clinics (RHCs) on opioid treatment in the RHC setting as a follow up to a webinar their webinar on the same subject in August 2018. Archived webinars from the Rural Health Clinic Technical Assistance Series can be found on the Rural Health Information Hub.

Great Plains Telehealth Resource Conference – April 28-30.  Registration is still open for the 2019 annual conference held in Bloomington, Minnesota by the Great Plains Telehealth Resource and Assistance Center (gpTRAC).   The two-day event will feature a variety of exhibitors and presenters covering topics such as telehealth in substance use treatment programs and developing a curriculum for nurse training programs.  The gpTRAC is one of 12 regional and two national Telehealth Resource Centers supported by the Office for the Advancement of Telehealth in HRSA’s Federal Office of Rural Health Policy.

The Changing Burden of Diabetes in Rural and Urban U.S. – Monday, April 29 at 12:00 pm ET.  Though diabetes is one of the leading causes of the death in the U.S., research suggests that the burden of disease varies considerably between residents in rural and urban settings. This hour-long webinar hosted by the Rural Health Research Gateway will provide an in-depth look at how the burden of diabetes has changed over time.

Assistance for Applicants to RMOMS Funding – Tuesday, April 30 at 2:00 pm ET.  The Health Resources and Services Administration (HRSA) will hold a webinar to assist applicants to the  Rural Maternity and Obstetrics Management Strategies (RMOMS) Program.  This new grant program will be an investment of $1.8 million in three health networks to test models that improve obstetrics services in rural areas.  Call-in number: 888-603-9810; participant code:  9971486.  For more information, email RMOMS@hrsa.gov.

Resource of the Week

Rural Flood Relief Resources.  The Center for Rural Affairs provides a listing of organizations offering relief and assistance for rural communities. The compilation includes information and resources for mental health and wellness services for residents recovering from floods in Iowa and Nebraska.

Approaching Deadlines

SAMSHA Grants for Children with Serious Emotional Disturbances – April 19

SAMHSA Grants Linking Actions for Unmet Needs in Children’s Health – April 19

HRSA Small Health Care Provider Quality Improvement Grant Program – April 22

SAMHSA: Substance Use Disorder Treatment for Minorities at High Risk for HIV/AIDS – April 22

NIH Summer Research Education Experience Program – April 23

Comprehensive Cancer Control Mentorship Program – April 26

County Health Rankings Research Grants – April 26

Mary Kay Foundation Domestic Violence Shelter Grants – April 30

CDC Overdose Data Collection – May 2

Comments Requested: CMS Proposed Updates to Interoperability & Patient Access to Health Data – May 3

Comments Requested: ONC Proposal for Interoperability of Health IT – May 3

Rural Communities Opioid Response Program-Implementation (RCORP-Implementation)  – May 6

RCORP-Evaluation Funding Opportunity – May 6

HRSA Maternal Opioid Misuse Model – May 6

SAMHSA Grants for First Responders to Opioid Overdose – May 6

HRSA: Graduate Psychology Education Program – May 7

HRSA Opioid Workforce Expansion Program – May 7

DOJ Opioid Affected Youth Initiative – May 7

DOJ:  Building Capacity for Tribal Researchers – May 13

DOJ: Tribal Justice Technical Assistance – May 14

NIH Intervention Research to Improve Native American Health – May 14

CDC Grants for Health and Wellness in Indian Country – May 15

USDA Traditional Distance Learning and Telemedicine Grant Program – May 15

National Health Service Corps Scholarship Program – May 16

NIH: Researching Interventions to Heart and Lung Disease Risk – May 17

HRSA: Enhancing Oral Health Infrastructure in Health Centers – May 21

HRSA: Rural Maternity and Obstetrics Management Strategies – May 24

USDA Higher Education Multicultural Scholars Program – May 24

USDA Higher Education Challenge Grants Program – May 29

HHS: YES Initiative for Minority and Disadvantaged Youth – May 31

Capacity Building for Patient-Centered Outcomes Research – May 31

USAC Telecommunications Program for Rural Health Care – May 31

USDA Rural Broadband Loan and Grant Program – May 31

ACF Community Economic Development (CED) Projects – June 3

DOJ Comprehensive Opioid Abuse Site-based Program – June 5

USDA Rural Community Development Initiative – June 5

Community Development Financial Institution Program – June 6

Native American Community Development Financial Assistance – June 6

SAMHSA Rural Opioid Technical Assistance Grants – June 7

Environmental Workforce Development and Job Training – June 10

USDA Community Facilities Technical Assistance and Training Grant – June 10

USDA Rural Health and Safety Education Grants – June 10

Brookdale Foundation Relatives as Parents Program – June 12

Research for Smoking Cessation in Disadvantaged Populations – June 13

HRSA Medical Student Education Program – June 14

Indian Health Service Loan Repayment Program – Ongoing through August 2019

NIH: Research for Disparities Among Minority/Underserved Children – Cycles thru May 2020

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

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