Announcements from the Federal Office of Rural Health Policy

January 18, 2018

What’s New

Two New Policy Briefs from the National Advisory CommitteeThe National Advisory Committee on Rural Health & Human Services is a citizens’ panel of nationally-recognized rural health experts that provides recommendations on rural issues to the Secretary of the Department of Health and Human Services twice each year.  The latest policy briefs were written by the committee after a meeting last fall in Boise, Idaho, where the group focused on the impact of suicide in rural America and enhancing the Rural Health Clinics program to adapt to a value-focused health care environment.  Also, a new website for the rural health advisory committee provides a look back more than two decades into the past with recommendations for health policy issues such as provider payment reform, workforce development, and telehealth implementation.  Beginning in 2003, the committee expanded its focus to include human services and started addressing such issues as homelessness, intimate partner violence and social determinants of health.

CDC Updates Numbers on Opioid Overdose.  The Centers for Disease Control and Prevention (CDC) collected mortality data from the National Vital Statistics System and found that there were more than 63,600 drug overdose deaths in the United States in 2016.  The age-adjusted rate of death was 21 percent higher than it was just one year before.  The highest rates of death were among adults aged 35-44, the age range that also had the greatest percentage increase in overdose death rate, 29 percent higher than in 2015.  Last year, the CDC determined that the drug overdose rate in rural areas is higher than in urban areas.

2020 Census Expected to be a Challenge for Rural Areas. Rural areas and particularly minority populations that live in them are typically considered Hard to Count (HTC) for Census data collection every decade.  But researchers at the University of New Hampshire Carsey School of Public Policy predict that the 2020 Census will present an even greater challenge for the population count that’s used to determine federal spending, community planning for schools and hospitals and site selection for new business, among other uses for the data. Seventy-nine percent of HTC counties are in rural areas, where counts are typically conducted via mail and door-to-door canvasing.  Plans for the 2020 Census call for a majority of residents to receive communication that will urge a response via the internet, for which broadband access adds a special challenge for rural areas.

Funding Opportunities

Rural Health Clinic Policy and Assessment Program – March 16.  HRSA’s Federal Office of Rural Health Policy seeks applications for the Rural Health Clinic Policy and Clinical Assessment Program. Eligible applicants include public, private and non-profit organizations,  tribes and tribal organizations, faith-based and community-based organizations. One (1) entity will be awarded up to $100,000 per year for three years to provide expert technical assistance to rural health clinics (RHCs).  The purpose of this program is to identify key policy, regulatory and clinical challenges facing RHCs and identify possible solutions, while also informing them and other rural stakeholders about key RHC issues and changes that could affect care delivery in these locations.  On Wednesday, January 31, 2018 from 2:00 – 3:00 pm ET, FORHP will host a technical assistance webinar to go over the application for the program.  For dial-in number and further information, contact Wakina Scott:

Policy Updates

Questions about Rural Health Policy Updates? Write to

Medicaid and CHIP Payment and Access Commission (MACPAC) Nominations – February 5.  The Government Accountability Office (GAO) is accepting nominations for MACPAC commissioners for appointments that will be effective May 1, 2018.  MACPAC is a non-partisan legislative branch agency that makes recommendations to Congress, the Secretary of Health & Human Services, and the states on issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP).  Nominees can come from diverse regions across the country, including rural, and represent a wide range of perspectives such as enrollees, researchers, and providers.  Letters of nomination and resumes should be submitted no later than February 5, 2018 to

Comments Requested: Quality Measures Under Consideration – February 9. CMS is seeking public feedback on Measures Under Consideration (MUC) for certain Medicare quality programs.  The list of MUCs (beginning on page 12 in the link) are quality and efficiency measures currently or soon-to-be in use for programs frequently mentioned in FORHP’s policy updates, such as the Merit-based Incentive Payment System and the Medicare Shared Savings Program. A full list of applicable programs begins on page 6.  Submissions or recommendations for a new specialty measure set and/or revisions to the current 2018 specialty measure sets should be sent to the PIMMS Quality Measures Support mailbox at

New Guidance to Promote Work and Community Engagement Among Medicaid Beneficiaries. CMS has issued guidance for states interested in Medicaid demonstrations that create incentives for able-bodied, working-age Medicaid beneficiaries to participate in work and community engagement activities, such as skills training, education, job search, volunteering or caregiving.  The CMS letter to state Medicaid directors describes considerations for states interested in these demonstrations, such as reasonable modifications for individuals with substance use disorders, and supports for beneficiaries in localities lacking transportation and/or facing economic stress.  Rural providers and stakeholders can find updated information on with guidance for states on how reform strategies should align with the core objective of serving the health and wellness of vulnerable and low-income individuals and families.

Updated Policy Manual for RHCs and FQHCs. The 2018 update of Chapter 13 of the Medicare Benefit Policy Manual – Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) services – provides information on requirements and payment policies for RHCs and FQHCs, as authorized by Section 1861(aa) of the Social Security Act. This chapter now includes payment policy for Care Management Services in RHCs and FQHCs as finalized in the Calendar Year (CY) 2018 Physician Fee Schedule Final Rule. All other revisions serve to clarify existing policy.

Resources, Learning Events and Technical Assistance

Webinar on Rural Hospital Closures – Thursday, January 18 at 1:00 pm ET.  From January 2005 through early November 2017, 124 rural hospitals closed in the U.S., with rural communities losing services in higher proportion than urban communities. Join experts from the Federal Office of Rural Health Policy, the Episcopal Health Foundation, A&M Rural & Community Health Institute and the University of North Carolina Chapel Hill as they discuss the factors that contributed to rural hospital distress.

Strategies to Combat Opioid Use in Rural Communities – Thursday, January 18 at 2:00 pm ET.  This one-hour webinar hosted by the FORHP-funded Rural Health Research Gateway will  discuss cost-effective, evidence-based prevention, treatment, and recovery programs that have been successfully implemented in rural communities. It will conclude by describing community organizing strategies to engage a wide range of local stakeholders to reduce the burden of opioid use.

National Drug and Alcohol Facts Week – January 22-28.  This week-long event is aimed at raising teenagers’ awareness and knowledge of facts about drug and alcohol. Launched in 2010 by scientists at the National Institute on Drug Abuse (NIDA), the annual observance relies on locally-planned school and community events that present scientific facts about drug and alcohol use, what causes addiction, and evidence-based strategies for helping friends or family.  NIDA provides an online guide for planning and promoting events, as well as free booklets and other resources for teens.  Recent research has shown that roughly 10% of rural teens meet criteria for alcohol use disorder, and that rural areas have a higher rate of drug overdose deaths.

Impact of Opioid Epidemic on Rural Maternity – Wednesday, January 24 at 11:00 am ET.  Experts in maternal-fetal medicine will provide the latest data on the effects of opioid use in late pregnancy and the risk of malformations, adverse neurological development, and neonatal abstinence syndrome on fetuses exposed to opioids in-utero, as well as the effects of opioid exposure on the breastfed infant.  The issue is critical for maternal and child health in rural areas, where researchers have found a significant increase in newborns diagnosed with neonatal abstinence syndrome.

Rural Health Network Development Planning Program – Wednesday, January 24 at 2:00 pm ET.  Up to 20 rural public and nonprofit entities forming a consortium of three or more organizations will be awarded total funding of $2 million to assist in the planning and development of an integrated health care network at the local level.  By emphasizing the role of networks, the program creates a platform for medical care providers, social service providers, and community organizations to coalesce key elements of a rural health care delivery system for the purpose of improving local capacity and coordination of care.  Apply through by Friday, February 23, 2018. Interested applicants can join this webinar to learn more about the program and application process. For more information (including dial-in # for the webinar) please contact Sara Afayee at

AgriSafe: Protecting Farmer’s Hearing – Thursday, January 25 at 1:00 pm ET.  During this one-hour webinar hosted by the AgriSafe Network, participants will learn about Noise-Induced-Hearing-Loss symptoms among agricultural workers and educational activities to promote hearing conservation.

FDA Opioid Policy Steering Committee Meeting – Tuesday, January 30 at 8:30 am ET.  The Food and Drug Administration (FDA) established the Opioid Policy Steering Committee (OPSC) to explore and develop strategies to combat the opioid crisis.  OPSC will hold a public meeting to collect stakeholder input on new approaches FDA might adopt to promote the safe use of opioid painkillers and reduce overprescribing that may contribute to new addiction.  New ideas may benefit rural communities where CDC research shows rates of prescription opioid misuse and overdose death are highest.  Comments on the proposed strategy for prescribing will be accepted through March 16.

Resource of the Week

Updates to CMS Medicare Diabetes Prevention Program. New resources added to the site include an MDPP Supplier Roadmap with a step-by-step guide for participation, key facts and helpful resources for MDPP enrollment, and an overview of the distinct but complementary roles of CMS and the Centers for Disease Control in preventing the onset of type 2 diabetes among Medicare beneficiaries.

Approaching Deadlines

Comments Requested: Promoting Healthcare Choice/Competition – January 25
Preventive Medicine Residency Program – January 26
Comments Requested: Rules for School Lunches – January 29
Training Nurses for Primary Care – January 29
Grants to Address Local Drug Crises – January 29
Comments Requested: DOL Updates Senior Employment Program – January 30
Training and Enhancement – Primary Care Physicians and PAs – January 30
ASTHO Community Health Worker Learning Community – January 31
ASTHO Telehealth Learning Community – January 31
Addressing Violence Against Women in Rural Areas – January 31
PCORI  Engagement Awards – February 1
Comments Requested: FCC Rural Health Care Funding – February 2
Medicaid and CHIP Payment and Access Commission (MACPAC) Nominations – February 5
Comments Requested: Revised Head Start Quality Measures – February 6
Comments Requested: Quality Measures Under Consideration – February 9
Comments Requested: USDA Child Nutrition Programs – February 12
Understanding Vaccination Coverage in Rural Areas – February 13
Environmental Problem-Solving for Underserved Communities – February 16
Tribal Practices for Wellness in Indian Country – February 20
Comments Requested: Addressing Needs in Rural Schools – February 20
Campus Suicide Prevention – February 20
SAMSHA Treatment Drug Courts – February 21
Rural Health Network Development Planning Program – February 23
Medicare Rural Hospital Flexibility Program EvaluationFebruary 23
Nurse Anesthetist Traineeship Program – February 28
Rural PREP Microresearch – March 1 (depending on funds)
Comments Requested:  Labor Redefines Employer Health Plans – March 6
Rural Health Clinic Policy and Assessment Program – March 16
Comments Requested: FDA Opioid Prescribing Guidelines – March 16
Guaranteed Loans for Rural Rental Housing – Ongoing through 2021
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