What’s New
CDC Rural Health Series Webinar – Wednesday, May 3, 2017 at 12:00 pm ET. There will be a free webinar on the CDC’s report examining factors impacting mental and behavioral health for rural children. Mental, behavioral, and developmental disorders (MBDDs) begin in early childhood and often affect lifelong health and well-being. Persons who live in rural areas report more health-related disparities than those in urban areas, including poorer health, more health risk behaviors, and less access to health resources. The webinar will begin with researchers examining the factors impacting mental and behavioral health for rural children. This will be followed up with a discussion about the experience of one community’s response to this growing issue. Time will be available for a Q&A with the presenters. Connection details will be emailed to you immediately upon registration. A recording will be available after the event.
April is National Minority Health Month. The Rural Health Information Hub (RHIHub) features a number programs underway in rural communities to support minority health in their library of Rural Health Models & Innovations. RHIHub also lists 36 funding programs and other opportunities currently accepting applications to address topics relevant to rural minority health. Last month, the CMS Office of Minority Health joined with FORHP to launched a campaign to improve chronic disease management, a health disparity impacting minority and rural populations disproportionately.
Economic Data in the Appalachian Region. The Appalachian Regional Commission uses data from the Census Bureau’s American Community Survey to provide state and county-level information on population, age, race and ethnicity, housing occupancy, education, labor force, employment, income, health insurance coverage, disability, and veteran status, for the 13 Appalachian states. The report includes breakdowns by five levels of urban to rural county types.
2017 Million Hearts® Hypertension Control Challenge. Are you a clinician, practice, or health system with exceptional rates of hypertension control? If so, you could be recognized as Million Hearts® Hypertension Control Champions! According to the CDC Morbidity and Mortality Weekly Report, 42.6% of heart disease deaths in rural were potentially premature deaths compared to 27.8% in urban areas. The Centers for Disease Control and Prevention (CDC) is announcing the 2017 Million Hearts® Hypertension Control Challenge to improve understanding of successful implementation strategies by motivating clinical practices to strengthen their high blood pressure control efforts.
Funding Opportunities
Behavioral Health Workforce Education and Training – June 12. HRSA’s Bureau of Health Workforce will make 150 awards totaling $44 million to develop and expand the behavioral health workforce in underserved areas including rural with persistent recruitment and retention issues. Accredited institutions of higher education must show (a) training in prevention and clinical interventions for behavioral health disorder; (b) strategies for incorporating families and community partnerships; (c) curricula enhancement and interprofessional training for students/interns, faculty, and field placement supervisors; and (d) career development in behavioral health for paraprofessionals and peer support specialists.
NIDA Funding To Expand Treatment For Opioid Abuse – June 20. The National Institute on Drug Abuse (NIDA) will provide up to $200,000 to organizations testing approaches for expanding medication-assisted treatment (MAT) for opioid use disorder. Both the Centers for Disease Control and Prevention (CDC) and County Health Rankings & Roadmaps have recently documented that rural communities have higher age-adjusted rates of death and premature death, based in part on higher rates of drug overdoses. Among the listed organizations eligible to apply are state, county, and city or township governments; federally recognized tribal governments and organizations; colleges and universities; and nonprofit agencies.
Rural Health Research
Closure of Hospital Obstetric Services Disproportionately Affects Less-Populated Rural Counties Access to obstetric care in rural communities is critical to ensuring good maternal and child health outcomes. Although over 28 million reproductive-age women live in rural U.S. counties, 43% of rural counties in the U.S. had no hospital-based obstetric services in 2002. Media coverage and reports since then have indicated that the number of rural hospitals providing obstetric care has been decreasing; however, the national scope of these access problems has not been quantified. A recent project by the University of Minnesota Rural Health Research Center has resulted in two policy briefs which examine the closure of hospital-based obstetric services in rural areas from 2004 to 2014: one takes a national perspective, while a second brief documents state-level variability on the same topic.
Policy Updates
Questions about Rural Health Policy Updates? Write to ruralpolicy@hrsa.gov
2018 Marketplace Stabilization Rule Finalized— CMS finalized policy changes for the Health Insurance Marketplace 2018 benefit year to help lower premiums, stabilize the market place, and increase choices such as in rural areas with only one insurer. Key changes that may impact rural providers, stakeholders, and State Offices of Rural Health include a shortened open enrollment period for the 2018 benefit year, increased variation in the actuarial values for plan levels, the Essential Community Provider standard lowered to 20%; and shifting network adequacy plan reviews to States.
Resources, Learning Events and Technical Assistance
Training Series for Health Care Providers on Prescribing Opioids – Ongoing. The CDC has launched an online training series regarding the recommendations in the clinical setting through interactive patient scenarios, videos, knowledge checks, tips, and resources. Rural practitioners report their concern about the potential for opioid abuse, but at the same time report insufficient training in prescribing opioids. In response to those concerns, the CDC created the 2016 Guideline for Prescribing Opioids for Chronic Pain and associated training. The first training Addressing the Opioid Epidemic: Recommendations from CDC is available now. Future topics include: communicating with patients, treating chronic pain without opioids, and prescribing decision making.
CMS Safety-Net Providers Open Door Forum – Wednesday April 19, from 2:00-3:pm ET. The Centers for Medicare & Medicaid Services (CMS) hosted a call to provide updates on CMS policies relevant to safety-net providers, including rural health clinics and federally-qualified health centers. Topics for this call included the Social Security Number Removal Initiative, the Accountable Health Communities Model, and the Chronic Care Management Toolkit. The SSNRI is intended to reduce the prevalence of medical identity theft, providers will have to update systems by December 31, 2019. AHC model will address the unmet health-related social needs, such as food insecurity and inadequate or unstable housing, that may increase the risk of developing chronic conditions, reduce an individual’s ability to manage these conditions, increase health care costs, and lead to avoidable health care utilization. Rural providers and communities can benefit from leveraging non-health related resources which can impact overall health access and outcomes. The CCM Toolkit provides detailed billing and coding information for optimization of reimbursements. CMS data show that two thirds of people on Medicare have two or more chronic conditions, with rural populations experiencing more limitations due to those chronic conditions than urban populations. Please Note: An audio recording of this call can be accessed by dialing 1-855-859-2056 and entering the Conference ID 57715647, beginning 2 hours after the call has ended, the recording expires after 2 business days. CMS Open Door Forums are now available through Podcast.
QIO Special Session – Thursday, April 20, 1:30 – 4:00 pm ET. CMS will host a special session to gather information from all stakeholders, including rural providers such as Critical Access Hospitals and Rural Health Clinics, to inform the priorities and aims of the next phase of the Quality Improvement Program (QIO). This is the largest federal program dedicated to improving health and healthcare quality at the local level for Medicare beneficiaries. Registration has closed, however slides will be made available the morning of the event, CMS will continue to solicit feedback and input on the QIO’s 12th Scope of Work. For questions about the event, please contact Monique Ndenecho at Monique.Ndenecho@cms.hhs.gov.
Physician Compare: Achieving Benchmarks – Tuesday, April 25 at 11:00 am ET. CMS will host two webinars to discuss the Achievable Benchmark of Care (ABCTM) for their Physician Compare reporting system. The benchmark is based on the Physician Quality Reporting System (PQRS), which many rural providers already participate in. The webinars will provide an opportunity for providers to help CMS make final decisions on Physician Compare reporting for eligible clinicians, including benchmarks for reaching a 5-star rating. Webinars are scheduled for the following times (both sessions will be the same): The second session will be held Thursday, April 27 at 3:00 pm ET.
Respiratory Disease in Farmers – Wednesday, April 26th at 1:00 pm ET. The AgriSafe Network will host this hour-long webinar with a general overview of allergic and non-allergic respiratory diseases including asthma, chronic obstructive pulmonary disease, hypersensitivity pneumonia, and organic dust toxic syndrome. The program is designed for health care professionals working in rural or agricultural environments where these diseases are commonplace. Viewers of this webinar will be able to recognize the similarities and differences in the presentation, diagnostic approach, and treatment modalities available.
Requirements for Emergency Preparedness – April 27 at 2:30 pm ET. CMS will host a webinar reviewing requirements for providers and suppliers under the Emergency Preparedness Rule to enable health care providers to respond to every emergency (pandemic, hurricanes, fires, chemical spills, etc.) in a timely collaborative, organized, and effective manner. All providers affected by the rule, including Rural Health Clinics, Federally Qualified Health Centers, and Critical Access Hospitals, are encouraged to learn more about requirements that must be met by November 15, 2017.
Medication Assisted Treatment Training – ongoing weekly. The Substance Abuse and Mental Health Services Administration funded program, Providers Clinical Support System, offers free waiver training for prescribing medication for opioid use disorder (OUD). The training is an 8-hour course, provided in two four-hour windows, required to obtain a Drug Enforcement Agency Drug Addiction Treatment Act waiver to prescribe buprenorphine, one of three medications approved by the FDA for the treatment of OUD. Research from WWAMI Rural Health Research Center states that 82.5% of rural counties do not have a single physician who has obtained a waiver to prescribe buprenorphine.
The Journal of Rural Health published a commentary in response to the CDC MMWR Rural Health Series report titled Health-Related Behaviors by Urban-Rural County Classification. The authors commented on the CDC MMWR focus on rural health, and urge researchers to continue work that leads to a better understanding of the demographic, cultural, and economic context of America’s rural communities and the ways that these forces shape health status and needs.
Approaching Deadlines
Comment: New bundled payment programs delayed – April 19
AmeriCorps State and National Grants – April 19
AmeriCorps Indian Tribes Grants – April 19
AHRQ Telehealth Information Request – April 24
Ideas Requested: Medicare Advantage and Part D Plan – April 24
Grants for the Benefit of Homeless Individuals – April 25
NHSC Scholarships – April 27
Nutrition Education on Indian Reservations – May 1
Regional Telehealth Resource Center Program – May 2
National Telehealth Resource Center Program – May 2
Next Generation ACO – May 4
Youth Farm Safety Education – May 10
NURSE Corps Scholarship Program – May 11
Chronic Disease Management for Older Adults – May 12
Primary/Behavioral Health Care Integration – May 17
Improving Rural Economies – May 26
Community Facilities Program – Ongoing
Summer Food Service Program – Ongoing