Federal Office of Rural Health Policy Announcements

November 15, 2018

What’s New

Today is National Rural Health DayThe Federal Office of Rural Health Policy (FORHP) joins the National Organization of State Offices of Rural Health (NOSORH), along with state and local organizations across the country, in recognizing the challenges of delivering health care in rural communities, as well as the many creative ways these hurdles are overcome.  FORHP activities this year include online events with federal partners at the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS).  In addition, a Twitter Chat hosted by @HRSAgov will have an open Q&A on the benefits and barriers to implementing telehealth in rural areas.

Funding Opportunities

Rural Veterans Health Access Program Letter of intent November 30. The Federal Office of Rural Health Policy is collaborating with the Veterans Rural Health Resource Centers to improve access to care for rural veterans through Critical Access Hospitals, other rural health providers and the Veterans Affairs system.  Eligible applicants are state organizations participating in the Medicare Rural Hospital Flexibility Program.  Three awardees will receive $300,000 per year for efforts toward meeting one or more of three objectives for the program: 1) coordinating care for veterans among primary care and specialist health providers in a geographic region; 2) increasing access to mental health and/or substance use disorder services; and 3) increasing access to crisis intervention services and the detection of post-traumatic stress disorder, traumatic brain injury, and other signature injuries of veterans.  The application deadline is February 12, 2019.

Policy Updates

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

Scope of Practice Policies for Clinicians by State.  The National Conference of State Legislatures provides this interactive map to educate state policymakers about scope of practice issues for behavioral health providers, nurse practitioners, oral health providers and physician assistants.  The site features an in-depth look at three professions that are essential for recovery from opioid misuse: peer support specialists, licensed professional counselors, as well as nurse practitioners and physician assistants who can prescribe buprenorphine-containing products. While more than 60% of rural counties lack a physician with a waiver to prescribe buprenorphine, rural communities tend to have more providers like these, who require fewer years of education and training.

CMS Releases 2017 Quality Payment Program Results. The Centers for Medicare & Medicaid Services (CMS) recently released performance information from the first year of the Quality Payment Program (QPP). Results show rural practices performed well in the QPP’s Merit-based Incentive Payment System (MIPS). Overall, 93 percent of rural practices earned positive payment adjustments, including 65 percent who earned additional adjustments for exceptional performance. CMS continues to offer options to help rural and small practices participate in the QPP, including no-cost, customized technical assistance and the opportunity to participate in MIPS through the virtual group option.

Comments Requested:  Proposals for Medicaid and CHIP Managed Care Regulations – January 14.  In response to stakeholder feedback, CMS proposes to revise and streamline the final rule on Medicaid and Children’s Health Insurance Program (CHIP) managed care published in 2016.  Of interest to rural stakeholders and State Offices of Rural Health are proposals to allow states flexibility in establishing network adequacy standards, to change requirements for quality reporting systems, and to revise requirements for the dissemination of information to enrollees.

Medicaid Guidance for Expanding Behavioral Health.  CMS issued a letter to State Medicaid Directors outlining opportunities to design innovative service delivery systems for Adults with a Serious Mental Illness or Children with a Serious Emotional Disturbance using strategies already available under current authority and strategies available through 1115 demonstration waivers.  For example, improving access to mental health services in schools could include partnerships with Federally Qualified Health Centers (FQHCs) and Rural Health Clinics or reimbursement of school-based providers through managed care plans.  Medicaid is an important source of health insurance in rural areas covering almost one-quarter of non-elderly rural individuals.

Resources, Learning Events and Technical Assistance

Combating the Opioid Crisis: Addressing Stigma – Thursday, November 15 at 9:00 am ET.  In this hour-long webinar, experts from the New York State Department of Health and the Peer Network of New York will provide an overview of how stigma negatively affects people who use drugs and review strategies for reducing it.  Earlier this year, a report commissioned by the Appalachian Regional Commission identified stigma as one of the key barriers to addressing the crisis in rural areas.

AgriSafe Celebrates the Power of Rural Nurses – Thursday, November 15 at 1:00 pm ET.  In observance of National Rural Health Day, the AgriSafe Network hosts this 90-minute webinar on its distance learning Nurse Scholar Program and ways rural nurses can increase their knowledge and improve their ability to identify and prevent symptoms of agriculture related illnesses.

NIH on Native American Therapeutic Traditions – Monday, November 19 at 10:30 am ET.  In celebration of Native American Heritage Month, the National Institutes of Health (NIH) will host an hour-long discussion of American Indian therapeutic traditions and modern health treatments.  Guest speaker Dr. Joseph Gone is a citizen of the Gros Ventre tribal nation in rural Montana; he is also a clinical-community psychologist and Professor of both Anthropology and Global Health and Social Medicine at Harvard University.

Understanding Agricultural Respiratory Hazards – Monday, November 19 at 1:00 pm ET.  In this 90-minute webinar, the AgriSafe Network will review major respiratory hazards in agricultural workplaces, the illnesses caused by exposure, and evidence-based resources for rural clinicians and patients.

NRHA on the All of Us Research Program – Tuesday, November 27 at 2:00 pm ET.  The All of Us Research Program is a long-term initiative conducted by the National Institutes of Health that aims to enroll one million or more participants who will share information about their family health histories, lifestyles, and personal medical histories. The goal is to help improve researchers’ baseline understanding of what it means to be healthy and sick, ultimately to develop more precise and effective methods to keep people healthy and treat those who get sick. In this one-hour webinar, the National Rural Health Association (NRHA) will share information about the effort and provide context on how and why rural communities can participate.  Read more about the program on NRHA’s blog.

Supporting Emotional Wellness in Frontier Areas – Tuesday, November 27 at 3:00 pm ET.  The Northwest Center for Public Health Practice hosts this one-hour webinar to explain how one rural Montana health department adopted an emergency response framework to better support emotional health in their community. Mental healthcare needs are not met in many rural communities across the country because adequate services are not present.

Rural Virtual Job Fair – Wednesday, November 28 at 6:45 pm ET.  HRSA’s Bureau of Health Workforce will host a Rural Focused Virtual Job Fair a free, interactive event held online to allow primary care providers a chance to talk about their sites approved for the National Health Service Corps or NURSE Corps.  Recruiters will discuss their organization’s benefits, their clinical environments (including approaches to integrated care), the populations they serve, and the rewards of providing care in their rural communities.

Approaching Deadlines

Comments Requested: Impact of Socioeconomic Status on Medicare Programs – November 16

Instructor Training Grants for Physical Activity Programs – November 19

Comments Requested: Reducing Regulations for Healthcare Providers – November 19

MCHB Challenge: Addressing Opioid Use in Pregnant Women – November 19

USDA Delta Health Care Services Grant Program – November 26

MCHB Challenge:  Remote Pregnancy Monitoring – November 27

Nurse Faculty Loan Program – November 28

Responding to Opioid Use Disorder in Tribal Communities – November 29

Rural Veterans Health Access Program Letter of intent November 30

Grants for Early Head Start Child Care in Low-Income Communities – November 30

Head Start Child Care in Migrant and Seasonal Communities – November 30

Head Start Child Care for American Indian/Alaska Native Communities – November 30

CDC Cooperative Agreement for Public Health Crisis Response – November 30

Rural Health Network Development Planning Program – November 30

Farm to School Grant Program – December 4

Health Disparities Research with Tribal Epidemiology Centers – December 4

AHRQ Dissemination of Research for Unhealthy Alcohol Use – Letter of Intent December 5

EPA Design Competition for People, Prosperity and the Planet – December 11

Research to Address Opioid Crisis (Clinical Trial Required) – December 11

Research to Address Opioid Crisis (Clinical Trial Not Allowed) – December 11

NBCC Minority Fellowship for Addictions Counselors – December 15

NBCC Minority Fellowship for Mental Health Counselors – December 15

Comments Requested: Telehealth for Substance Use Disorder Treatment – December 31

AHRQ Dissemination of Research for Unhealthy Alcohol Use – January 4

Advanced Nursing Education Workforce (ANEW) – January 8

Rural Veterans Health Access Program – February 12

Grants for Patient-Centered Outcomes Research Institute (PCORI) – February 12

Rural Primary Care SBIRT for Maternal Opioid Use – March 29

Indian Health Service Loan Repayment Program – Ongoing through August 2019

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