What’s New
Hurricane Response: CMS Waivers and Exceptions for Facilities. To prevent gaps in access to care for beneficiaries, the Centers for Medicare & Medicaid Services (CMS) has issued several waivers to reporting requirements in areas affected by Hurricanes Harvey and Irma. Details, including the types of facilities and state-specific documents can be found with other resources on the CMS Emergency Response and Recovery Page.
More Data on How Geography Impacts Health Outcomes. On Friday, the Centers for Disease Control and Prevention (CDC) released the latest in their MMWR Rural Health Series, examining rural and metropolitan areas and finding factors that make a difference in health outcomes. For the September 8th report, researchers looked at rates of testing for the genetic mutation that increases risk for breast and ovarian cancer and how much that testing led to preventive care. They found that, from 2009-2014, the rates for testing more than doubled in metropolitan areas and tripled in rural, but overall rates of testing still lagged in rural areas. The study also wanted to know what women did once BRCA gene mutations were discovered. The percentage who went on to get a mastectomy was similar in metropolitan and rural areas. Rates of preventive action with magnetic resonance imaging (MRI) and mammogram screenings was lower in rural areas but increased as awareness of the BRCA gene and demand for testing grew.
Funding Opportunities
Health Care Transit Design Challenge – October 5. Building on successful projects funded in the 2015 Ride to Wellness Initiative, the Federal Transit Administration (FTA) seeks new applications for the 2017 Health Care Access Design Challenge. Seven communities will win up to $30,000 and direct FTA-funded technical assistance to plan and design transportation solutions that improve access to health care. Health care providers in rural communities often separated from patients by great distances can lead transportation improvements to increase access to care and influence broader health outcomes.
Revitalize Rural Rental Housing – December 1. The U.S. Department of Agriculture (USDA) offers loans and grants to finance affordable rental housing for lower-income, elderly, and disabled households in rural communities. Research shows that housing problems contribute to poorer health, particularly in rural areas facing disproportionate poverty and housing problems. The Multifamily Preservation and Revitalization (MPR) demonstration will fund existing multifamily rental housing projects to extend their affordable use for low- and moderate-income residents and avoid tenant displacement due to rising rents. Pre-applications requesting only debt deferral must be received by 5 PM ET on September 28. Pre-applicants may be interested in additional funding and learning opportunities for housing improvement.
NIH Research for Obesity Prevention – May 7. National Institutes of Health (NIH) seeks proposals for the study of effective ways to prevent or treat adult and childhood obesity, one of three clinical priorities for the U.S. Department of Health and Human Services. Reducing obesity in rural communities where rates exceed national averages will require resources to improve community prevention strategies and make healthy eating and physical activity the easiest choice for residents.
Policy Updates
Questions about Rural Health Policy Updates? Write to ruralpolicy@hrsa.gov
Nominations Needed: Federal Pain Management Task Force – September 27. CMS replaced 3 pain management survey questions in the Hospital Inpatient Quality Reporting Program with 3 questions on communication about pain, effective October 1. The Pain Management Best Practices Inter-Agency Task Force will advise on best practices for pain management and prescribing pain medications. Members of the task force will include representatives of rural and underserved areas. Disproportionate burdens fall on these communities but existing strategies to manage chronic pain and prevent prescription drug misuse often do not address their unique needs. Email nomination materials to PainTaskForce@hhs.gov.
Comments Requested: Cervical Cancer Screening – October 9. The U.S. Preventive Services Task Force (USPSTF) is a national panel of medical experts who make recommendations about preventive services in clinical settings. On September 12th, the USPSTF issued their draft recommendation for cervical screening and ask for public review and feedback. Earlier this year, a report from the Centers for Disease Control and Prevention identified data showing higher rates of death from certain cancers, including cervical, in rural areas.
Resources, Learning Events and Technical Assistance
Behavioral Health Workforce Conference – Wednesday, September 13, 11:00 am-5:00 pm. The Health Resources and Services Administration’s Bureau of Health Workforce will host this free virtual conference that will interest practitioners, students or trainees interested in behavioral health workforce education and training. One of the four tracks at the conference (Track 1) will cover training models to reach rural and medically underserved populations.
Rural Hospitals for Organ Donation – Wednesday, September 13 at 2:00 pm ET. The Division of Transplantation at HRSA will host this hour-long webinar kick-off of their Hospital Campaign for Organ Donation. More than 1,000 hospitals, including 265 small/rural hospitals, participated in last year’s campaign and earned recognition from the Federal government for their efforts to educate staff, patients, visitors, and community members about organ, eye, and tissue donation. The new campaign starts October 1. To get information on how to dial in to the webinar, send an email to Genna@akoyaonline.com.
Culturally Appropriate Behavioral Health – Wednesday, September 13 at 3:00 pm ET. This 90-minute webinar from the SAMHSA-HRSA Center for Integrated Health Solutions address a range of concerns for cultural and linguistic competency and review specific tools and resources behavioral health care that is culturally appropriate. According to the Housing Assistance Council, the 2010 Census reported Hispanics as the largest minority group in rural areas at 9.3% of the rural population, surpassing African Americans at 8.2%. Native Americans were at less than 2%, but more than half of all Native Americans live in rural or small town areas.
Farm Health Flood Threats – Thursday, September 14 from 1:00 – 2:15 pm ET. Disaster recovery can be as dangerous as the disaster itself, especially if no disaster preparedness plan was implemented. This is particularly true on farms and ranches where inherent farm hazards such as machinery and equipment, livestock, and agriculture chemicals are displaced and co-mingled, putting emergency response personnel, farm workers and family members in danger. Floods can also heighten the risk of health threats such as mold, tetanus bacteria, contaminated well water, heat illness and high stress. This one-hour webinar hosted by the AgriSafe Network will highlight basic precautions to prevent possible diseases and injuries during and after flooding.
Evaluating Nutrition Programs for Older Adults – Thursday, September 14 at 3:00 pm ET. The Administration for Community Living (ACL) recently released the first of two reports evaluating nutrition services programs that provide access to nutritious meals, facilitate social contact, and support family caregivers to meet the health and social needs of older adults. According to the USDA’s Economic Research Service, 15% of rural households are considered food insecure, and remote locations present a challenge for programs delivering food to seniors.
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.
Resource of the Week
Rural Emergency Preparedness and Response. This topic guide at the Rural Health Information Hub outlines the challenges to emergency response to disaster in rural areas. In addition to trying to reach residents and businesses in remote locations, emergency responders much also manage with limited resources and communication barriers. RHIHub offers a number of resources to help plan and manage for disaster and references other agencies at the federal and state levels that can help. To learn more about health and safety hazards that come with flooding on farms and ranches, see the AgriSafe webinar in the events section above.
Approaching Deadlines
Behavioral Health Integration for Native Americans – September 16
Comments Requested: 340B Drug Pricing Program – September 20
Comments Requested: Verifying CAHs Meet Medicare Requirements – September 29
USDA Loans for Rural Broadband – September 30
Health Care Transit Design Challenge – October 5
Comments Requested: Cervical Cancer Screening – October 9
Research to Reduce Tobacco Use – October 11
Comments Requested: CMS Cancels Cardiac Bundles – October 16
\Comments Requested: CMS Revises Joint Replacement Bundles – October Students to Service (S2S) Loan Repayment Program – October 19
Comments Requested: USDA Summer Meals Program – October 23
Address Suicide Research Gaps in Rural Communities – November 2
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