Announcements from the Federal Office of Rural Health Policy

July 6, 2017

Funding Opportunities

Look Beneath the Surface (LBS) Anti-Trafficking Program – July 19.  The Administration for Children and Families will make nine awards of up to $200,000 each for regional programs that identify and refer victims of severe forms of human trafficking as defined by the Trafficking Victims Protection Act of 2000. Victim identification activities under the LBS Program include direct outreach to victims, anti-trafficking training and outreach to local professionals and organizations or entities that may encounter victims of trafficking.  The National Human Trafficking Hotline says it reported 7,752 cases of human trafficking in 2016.  Isolation makes rural areas targeted locations for both sex and labor trafficking due to limited resources for monitoring and enforcement.

Community Economic Development Projects – July 24.  Private and non-profit Community Development Corporations (CDCs) are eligible to apply for this funding from the Administration for Children and Families (ACF) to develop innovative projects that enhance job creation and business development for low-income individuals.  An expected 22 awards of up to $800,000 each will be made for programs that actively recruit individuals with low incomes to fill positions created by ACF’s Community Economic Development activities, to help those individuals successfully hold those jobs and to ensure that the businesses and jobs created remain viable for at least one year after the end of the grant period.  The USDA’s Economic Research Service tracks rural employment and economic trends and shows a consistent lag behind metropolitan areas.

Developing Future Victim Specialists for Indian Country – August 9.  The Department of Justice will form cooperative agreements funded with $450,000 each for institutions of higher education and/or organizations serving tribal governments to begin building a pipeline of victim service professionals that will serve American Indian /Alaska Native victims in locations that are often remote and where positions are often hard to fill.  This program will work to identify students in relevant disciplines (e.g., sociology, social work, psychology, etc.) to serve in victim service positions either at the Department of the Interior’s Bureau of Indian Affairs or in tribally-based victim service programs. Eligible applicants will include tribal colleges and universities (individually or as a consortium), non-tribal colleges and universities that are located close to American Indian/Alaska Native communities, or any other organization with connections to both tribes and educational institutions that educate students pursuing degrees in fields relevant to victim services.

Policy Updates

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Comments Requested: Updates to the Medicare Quality Payment Program – August 21.  The Centers for Medicare & Medicaid Services (CMS) released for public comment a proposed rule for the second year of the Medicare Quality Payment Program (QPP). This proposed rule outlines the policy updates CMS intends to apply to the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs) under the QPP beginning in 2018. Proposals of interest to rural stakeholders include exempting additional clinicians from MIPS by increasing the low-volume threshold for small practices, adding a bonus to the MIPS score for small practices and another for complex patients, allowing FQHCs and RHCs that voluntarily report to opt-out of sharing their data on Physician Compare, clarifying policies for participation in MIPS virtual groups, modifying the MIPS scoring criteria and payment adjustment, proposing policies for “topped-out” quality measures, updating Advanced APM scoring and risk standards, and giving more detail about how CMS will implement the All-Payer Combination Option for Advanced APM participation. You can submit comments at, by mail, or by hand/courier no later than 5 p.m. EDT on August 21, 2017 to assure consideration.  See Events section below for details on a listening session about these changes hosted by CMS on Wednesday, July 5th.

New Quality Payment Program (QPP) Website for Rural Clinicians.  CMS launched a new section on the QPP website dedicated to clinicians working in small or rural practices as well as those in underserved areas. This webpage serves as a single point of reference to get Technical Assistance about the Merit-based Incentive Payment System (MIPS) and to review the flexibilities to help reduce the burden on small practices for participation and reporting. More features and information will be added over time.

Comments Requested: Updates to Policy for End-Stage Renal Disease – August 28. The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule to update 2018 Medicare payment rates and polices for dialysis facilities via the End-Stage Renal Disease ESRD (ERSD) Prospective Payment System. If finalized, the rule would take effect on October 1, 2017 and provide an overall payment rate increase from CMS of $80 million, implement policies for coverage and payment for dialysis services furnished to individuals with acute kidney injury (AKI) by dialysis facilities, and update the ESRD Quality Incentive Program (QIP). CMS indicates that most rural dialysis facilities will experience a 0.6% payment increase, however 132 rural hospital-based dialysis facilities will experience an estimated 0.7% decrease in payments. Additionally, in payment year 2021, some of the changes to the ESRD QIP will result in estimated payment reductions for 325 rural facilities (-0.19%). The proposal includes a Request for Information (RFI) to encourage continued feedback on improvements to the Medicare program including ideas for regulatory, sub-regulatory, policy, practice and procedural changes.

Resources, Learning Events and Technical Assistance

CMS Listening Session: Proposed Rule for Quality Payment Program – Wednesday, July 5 from 2:00 to 3:30 pm ET. CMS is hosting a listening session for Part B Fee-For-Service clinicians and practice managers, state and national associations representing healthcare providers, and other stakeholders to learn about proposed policy for the Quality Payment Program. Participants are encouraged to review the proposed rule prior to the listening session.  See more details about what the changes will mean for rural providers in the Policy Updates section above.

Application Assistance: Rural Health Opioid Grant Program – Thursday, July 6 at 2:00 pm ET.  The National Organization of State Offices of Rural Health (NOSORH) will host this one-hour webinar to discuss key strategies for applying to the Rural Health Opioid Program.  The session supplements technical assistance for applicants that will be provided in a call from the Federal Office of Rural Health Policy on July 13th.  (Watch this space next week for more details.)  Attendees to NOSORH’s Thursday, July 6th  program will learn to 1) answer 10 key questions before making the decision to apply, 2) describe steps and strategies for writing a successful application, and 3) identify resources to support the grant application effort.

Save the Date and Register for 3RNet’s Annual Conference – September 12-14.  The National Rural Recruitment and Retention Network (3RNet) will hold its annual conference in Scottsdale, AZ. 3RNet members represent over 5,000 communities across the U.S. that actively recruit physicians and other health care providers to work in rural areas.  Attendees will benefit from workshops and a speaker line up sharing insight on rural recruitment challenges, resources and tools.

Training Series for Health Care Providers on Prescribing Opioids – Ongoing. The CDC has an eight-part online training series to help health care providers apply CDC’s prescribing recommendations in their clinical settings 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. For this reason, the CDC created the 2016  Guideline for Prescribing Opioids for Chronic Pain and associated training. Topics in the series include communicating with patients, treating chronic pain without opioids, and prescribing decision making.

Approaching Deadlines

Comments Requested: Universal Education for Opioid Prescribers – July 10
Comments Requested: Improving the ACA Insurance Market – July 12
CPC+ Expands to 4 New (Mostly Rural) Regions – July 13
Transitional Living Program/Maternity Group Homes – July 14
Delta Health Care Service Grant Program – July 17
Delta Region Community Health Systems – July 17
Repair or Rehab Housing for Low-income Rural Residents – July 17
USDA Rural Telemedicine Development – July 17
Suicide Prevention – July 18
Look Beneath the Surface (LBS) Anti-Trafficking Program – July 19
Rural Health Opioid Program – July 21
Community Facilities Technical Assistance Grant – July 24
Community Economic Development Projects – July 24
Rural Community Development Initiative – July 25
Grants for Socially-Disadvantaged Groups – July 25
Training Rural Teachers – July 28
Expanding Medication Assisted Treatment – July 31
First Responders to Opioid Overdose – July 31
Empowered Communities/Healthier Nation – July 31
Comments Requested: Interoperability Standards – July 31
Improved Nutrition Services for Elders – August 7
Support for Veteran and Minority Farmers and Ranchers – August 7
Funding for Children Affected by Substance Abuse – August 9
Developing Future Victim Specialists for Indian Country – August 9
Comments Requested: Payment Changes for Medicare Clinicians – August 21
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