Federal Office of Rural Health Policy Announcements

January 7, 2021

COVID-19 Taking Heavy Toll on Farmers’ Mental Health. The American Farm Bureau released a report showing that two in three farmers surveyed say that the pandemic has impacted their mental health. Farmers and farmworkers were 10% more likely than rural adults as a whole to have experienced feeling nervous, anxious or on edge during the pandemic (65% vs. 55%). Two-thirds of rural adults ages 18-44 say they are personally experiencing more mental health challenges than they were a year ago.

CDC Recommended Strategies for Initial COVID-19 Vaccination. The Centers for Disease Control and Prevention (CDC) produced a guide intended to assist state, tribal, local, or territorial immunization programs with planning for the first three phases of vaccination: Phase 1a, which includes healthcare personnel and residents of long-term care facilities; Phase 1b, frontline essential workers and individuals aged 75 years and older; and Phase 1c, other essential workers, persons 65-74 years of age, and individuals 16-64 years of age with underlying medical conditions.

Share Your Thoughts and Opinions on Health – Respond by January 11. The Health Resources and Services Administration (HRSA) is seeking English-speaking individuals to participate in upcoming virtual discussions about health from any of the following groups: 1) parents or guardians of children ages 6 months to 3½ years; 2) people with HIV; 3) people living in rural areas; 4) HRSA health center patients; 5) adults ages 45 years and older. Patient feedback will help HRSA create easy to understand health materials for everyone. We’ll hold 90-minute Zoom sessions in January, March, and May. Participants will receive monetary payment. If you or someone you know who may be interested, please have them email Heidi Palacios or call (972) 503-3100 x407.

AHRQ Hospital Utilization Trends. The Agency for Healthcare Research and Quality (AHRQ) provides a series of data files on monthly hospital utilization. The tables include state-by-state data on hospitalizations due to COVID-19, influenza, and other respiratory conditions; normal newborns and deliveries; non-elective stays admitted through emergency departments; and elective inpatient stays. 

National Rural Health Day Events Archive. Where available, webinar recordings, PowerPoint slides, and transcripts for 2020 National Rural Health Day programming can now be accessed on the National Rural Health Day website. All links are free and accessible to the public. Event topics range from telehealth and COVID-19 testing to social determinants of health and substance use disorder. Participating organizations included the Department of Health and Human Service entities Centers for Disease Prevention and Control, Centers for Medicare and Medicaid Services, Health Resources and Services Administration, National Institutes of Health (NIH), the National Advisory Committee on Rural Health and Human Services, the National Association of Rural Health Clinics, and the National Organization of State Offices of Rural Health.

Federal Office of Rural Health Policy Announcements

December 17, 2020

HHS Report: Strengthening the Entry-Level Health Care Workforce. The U.S. Department of Health & Human Services (HHS) commissioned an in-depth look at the challenges and opportunities for this segment of the health care workforce that includes community health workers, behavioral health peer support, and home health aides. Forecasting a shortage across professions, the report identifies entry-level positions as one option for expanding community-level capacity while also increasing employment opportunities.

CMS:  Rural-Urban Disparities in Health Care in Medicare. The Centers for Medicare & Medicaid Services (CMS) uses two sources of information in this summary of the quality of care received by Medicare beneficiaries. The first source is the Consumer Assessment of Healthcare Providers and Systems (CAHPS) and its survey on health care experiences (e.g., ease of getting needed care, how well providers communicate, etc.). The second is the Healthcare Effectiveness Data and Information Set (HEDIS) with information collected from medical records and administrative data on the technical quality of care for a variety of medical issues, including diabetes, cardiovascular disease, and chronic lung disease. 

Federal Office of Rural Health Policy Announcements

December 10, 2020

CDC Recommendation for Allocating COVID-19 Vaccine. In its Morbidity and Mortality Weekly Report, the Centers for Disease Control and Prevention (CDC) provide guidance for federal, state, and local jurisdictions. 

HRSA Funds Additional RHCs to Expand COVID-19 Testing. On December 7, the Health Resources and Services Administration (HRSA) disbursed $9.3 million to support COVID-19 testing at Rural Health Clinics (RHCs). HRSA used updated data from the Centers for Medicare & Medicaid Services to identify 188 previously unsupported RHCs and calculate more than $49,000 per site for the December 2020 payment. The terms and conditions for recipients of this round of funding remain the same as those for RHCs previously funded in May 2020. Recently posted Frequently Asked Questions about the program provide more details. 

GAO: Urgent Actions Needed for Federal Response to Pandemic. The Government Accountability Office (GAO) is an independent, nonpartisan agency that examines how taxpayer dollars are spent and reports to Congress with information to help the government work more efficiently. In a report released last week, the GAO listed a number of findings about challenges across the nation and made 11 specific recommendations for improving the federal response. 

HHS National Plan to Improve Maternal Health. The U.S. Department of Health & Human Services (HHS) announced an action plan with three specific targets: 1) reduce maternal mortality in the U.S. by  50 percent, 2) reduce low-risk cesarean deliveries by 25 percent, and 3) achieve blood pressure control in 80 percent of women of reproductive age with hypertension. In its announcement HHS highlighted recent maternal health activities, including winners of a competition launched earlier this year by the Agency for Healthcare Research and Quality, the Cross-Sectional Innovation to Improve Rural Postpartum Mental Health Challenge.      

GHPC Report: Promoting Access to Maternal Care for Women with SUD in Rural Communities. The Georgia Health Policy Center (GHPC) reviews the challenges in rural areas to caring for women with mental health challenges and substance use disorder (SUD). Among the state- and federal-level innovations currently improving access to care is the HRSA/FORHP-supported Rural Maternity and Obstetrics Management Strategies (RMOMS) program initiated last year. 

HHS Request for Information: Novel Technologies for Chronic Disease Management in Aging Underserved Populations – December 22. The U.S. Department of Health & Human Services (HHS) seeks innovative technology solutions to chronic disease management for aging populations in underserved areas.

Federal Office of Rural Health Policy Announcements

December 3, 2020

Updated Provider Relief Funds FAQs. In support of the national response to COVID-19, the Department of Health and Human Services (HHS) is distributing $175 billion from the Coronavirus Aid, Relief, and Economic Security (CARES) Act Provider Relief Fund (PRF) to hospitals and healthcare providers. The PRF Frequently Asked Questions (FAQs) provide guidance to recipients regarding terms and conditions, attestation, reporting and auditing requirements, and the general and targeted distributions. On November 18, new questions were added under the headings Use of Funds and Miscellaneous.

Indian Health Service (IHS) Pandemic Vaccine Plan. The plan details how the IHS health care system will prepare for and operationalize a vaccine when it becomes available. It also provides important guidance for all IHS federal tribal health programs and urban Indian organizations that choose to receive COVID-19 vaccine coordinated through IHS.

HHS Request for Information on Redundant, Overlapping, or Inconsistent Regulations – December 21. On November 27, the U.S. Department of Health & Human Services (HHS) issued a Request for Information (RFI) seeking input from the public to improve existing regulations, and eliminate unnecessary or duplicative regulations, through future exercise of rulemaking authority. As this RFI seeks input on regulations issued by any HHS office or agency, those responding may consider addressing regulatory issues of particular interest to rural health.

HHS Request for Information on Best Practices in Response to COVID-19 – December 24. There are a number of innovative programs, policies, and best practices that prevent and mitigate the consequences of COVID–19 in urban and rural areas, while also preserving access to healthcare services for non-COVID-19 medical conditions. The Department of Health and Human Services (HHS) requests information on these innovative approaches and best practices in health care for both COVID-19 and non-COVID-19 conditions to inform and improve HHS priorities and programs. 

Comments Requested: Paperwork Reduction for the FCC – December 24. As part of its Measuring Broadband America Program, the Federal Communications Commission (FCC) seeks input from the public on the types of information that should be collected to determine the speed and performance of broadband connections. Specifically, the FCC would like to receive comments on how they might “further reduce the information collection burden for small business concerns with fewer than 25 employees.” Currently, there are software-based tools and online tools that can test consumers’ broadband connections. However, these tools track speeds experienced by consumers, rather than speeds delivered directly to a consumer by an internet service provider. The Measuring Broadband America Program will focus on the broadband performance delivered. 

Federal Office of Rural Health Policy Announcements

November 19, 2020

New Information on RMOMS Program. A pilot federal grant program introduced in the 2019, Rural Maternal and Obstetric Management Strategies (RMOMS) will run until August 2023 to improve maternal care in rural communities. New information added to the website lists the three rural networks funded last year and provides more detailed information about the grantees and their activities.

CARES Act Supports Online Resource for Professional Licensure. The website for the Multi-Discipline Licensure Resource Project was created to support pandemic response through the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the FORHP-supported Licensure Portability Program. Created by the Association of State and Provincial Psychology Boards, the site provides up-to-date information on emergency regulation and licensing in each state for psychologists, occupational therapists, physical assistants, and social workers. 

Emergency Call for Volunteer Health Care Professionals. The Massachusetts General Hospital (MGH) Rural Medicine Program seeks emergency volunteers for Indian Health Service sites within the Great Plains Area. According to the Centers for Disease Control and Prevention, American Indian and Alaska Native persons appear to be disproportionately affected by the COVID-19 pandemic, and insufficient public health resources may contribute to the disparity. Qualifying volunteers are physicians, nurse practitioners, physician assistants, nurses, and respiratory therapists who are currently licensed in any of the 50 US states. MGH anticipates that travel expenses will be eligible for reimbursement. Please direct questions to rosebuddoctors@gmail.com.

Federal Office of Rural Health Policy Updates

November 12, 2020

HRSA Celebrates National Rural Health Day. HRSA will recognize National Rural Health Day started 10 years ago by the National Organization of State Offices of Rural Health. A series of events, all available to the public online, is meant to bring your attention to the great things happening in rural communities to improve quality and access to health care.  The full schedule of events held by federal and local partners can be found in the headline link. Look for more detail in links marked NRHD in the Events section below, and please make note of the sessions on Thursday, November 19, including a kick-off from HRSA administrator Tom Engels at 10:00 am and a talk from three FORHP grantees about COVID-19 efforts.   

HHS Launches KidneyX COVID-19 Kidney Care Challenge. The U.S. Department of Health & Human Services announced a new project to address the higher risk of severe illness from COVID-19 for people with kidney disease. With encouragement to communities that face health disparities,  the Challenge invites new solutions from entities or individuals that can reduce the impact of pandemic without requiring significant time, expertise, money, or other resources from the patient. 

Federal Office of Rural Health Policy Announcements

November 5, 2020

HRSA Celebrates National Rural Health Day. The Health Resources and Services Administration (HRSA) will recognize the annual event with online activities on Thursday, November 19. HRSA Administrator Tom Engels will kick off the day, along with a welcome from Jeff Colyer, Chair of the National Advisory Committee on Rural Health and Human Services. HRSA will host a variety of events throughout the week which are open to the public, including a virtual rural job fair and webinars focused on the rural response to COVID-19, social determinants of health, and telehealth.

USDA: The Meatpacking Industry During COVID-19. The Economic Research Service at the U.S. Department of Agriculture (USDA) provides data on rural counties where meatpacking is the primary employer, and where confirmed cases are higher than in other rural areas. 

States Turn to Telehealth During the Pandemic. With funding support from the Health Resources and Services Administration, the National Conference of State Legislatures provides details of more than 79 bills changing telehealth policies in 36 states, the District of Columbia and Puerto Rico.

ONC Interim Final Rule on Pandemic-Related Health IT. The Office of the National Coordinator for Health Information Technology (ONC) is accepting comments on an Interim Final Rule, effective on December 4, pertaining to Information Blocking and the ONC Health IT Certification Program that were outlined in the ONC Cures Act Final Rule released in March 2020.

Federal Office of Rural Health Policy Announcements

October 29, 2020

Open Enrollment for the Health Insurance Marketplace Begins November 1. The six-week period during which consumers may enroll in a health insurance plan using the Federal Health Insurance Marketplace begins on Sunday, November 1, and ends on Tuesday, December 15.  Those without an employer-based plan may visit HealthCare.gov and CuidadodeSalud.gov to shop for plans that will begin coverage on January 1, 2021. Fourteen states and the District of Columbia have their own state-based websites for enrollment in individual/family or small business health coverage, or both. Some consumers may qualify for Medicaid coverage or a lower cost Marketplace plan depending on their state of residence and household size.

Expanded Provider Relief Fund Eligibility and Updated Reporting Requirements. The U.S. Department of Health and Human Services (HHS) expanded the types of providers that are eligible for Phase 3 Provider Relief Funds (PRF) to include residential treatment facilities, physician assistants, and advanced practice nursing providers, among others. Providers may submit applications until November 6.  HHS also updated the reporting requirements and auditing instructions in response to stakeholder feedback.  This new guidance now allows providers to apply PRF payments against all lost revenues without limitation.

COVID-19 Hospital Data Coverage Report – Updated Weekly. The U.S. Department of Health and Human Services (HHS) is providing weekly updates to the data set tracking whether hospitals, including rural and Critical Access Hospitals (CAHs), are completing their COVID-19 data reporting. As specified in recent guidance, hospitals and CAHs must report daily to the federal government, or to their state if they receive a written release from the state, a set of required data elements. Failure to do so will result in a series of enforcement actions over several weeks that could result in termination of the Medicare provider agreement. 

CRS: Medicaid Telehealth Policies in Response to COVID-19. The Congressional Research Service (CRS) provides objective policy and legal analysis to committees and members of the U.S. House and Senate. For this report, researchers examined how states have increased the number of services, provider types, and other telehealth options under Medicaid. 

Request for Information: Maternal and Child Health Bureau Strategic Plan – Respond by December 18. The Maternal and Child Health Bureau (MCHB) at the Health Resources and Services Administration supports research and federal grant programs that ensure the health and well-being of mothers, children, and families. The bureau seeks feedback from the public about future plans for their work, including how MCHB can support efforts to eliminate disparities based on race, income, disability, and geography. 

New Telehealth Platform to Mobilize Health Care Workforce During COVID-19. ProviderBridge.org was created by the Federation of State Medical Boards through the CARES Act and the FORHP-supported Licensure Portability Program. The site provides up-to-date information on emergency regulation and licensing by state as well as a provider portal to connect volunteer health care professionals to state agencies and health care entities. 

Federal Office of Rural Health Policy Announcements

October 22, 2020

HHS Awards Nearly $500 Million to Workforce Programs. Last week, the U.S. Department of Health & Human Services announced a new round of funding to recruit and support primary care professionals and students for the National Health Service Corps, Nurse Corps, and other programs building the health workforce. Through these efforts, more than 16,000 clinicians provide care to 17 million patients in underserved areas nationwide.

Medicare Open Enrollment Has Begun. Medicare beneficiaries can review health and drug plans for 2021 and make changes between now and December 7. The online system helps beneficiaries compare pricing and benefits between Original Medicare (Parts A and B), Medicare prescription drug plans (Part D), Medicare Advantage plans (Part C), and individually-purchased Medicare Supplement Insurance (Medigap) policies. Free, personalized counseling on Medicare options is available through the nonprofit State Health Insurance Assistance Program, or calling 1-800-MEDICARE (1-800-633-4227). Free materials are also available to support rural providers, among others, with outreach activities.

New Data on Local Use of Rural Hospitals. This new data brief from Centers for Medicare & Medicaid Services explores the extent to which rural Medicare beneficiaries bypass their nearest rural hospital and which hospital services rural Medicare beneficiaries most often seek locally and at distant hospitals. Traveling to a distant hospital for services rather than using the local rural hospital, aka ‘rural bypass’, can increase financial pressure on rural providers, especially Tribal hospitals and Critical Access Hospitals. 

Report on U.S. Coal Industry. The U.S. Energy Information Administration recently released the Annual Coal Report, which includes information on the number of mines, their productive capacity, prices, employment, and consumption. Highlights for 2019 include a decrease in the production, productive capacity, and average number of employees at U.S. coal mines, as well as a decrease in U.S. coal consumption. The Federal Office of Rural Health Policy manages the Black Lung Clinics Program that provides predominantly rural miners with access to educational, screening, medical, and benefits counseling services with the goal to reduce morbidity and mortality associated with occupationally-related coal mine dust lung diseases.

Federal Office of Rural Health Policy Updates

October 15, 2020

HRSA Releases 2019-2020 Report on Health Equity. The Health Resources and Services Administration (HRSA) released a report on health equity across the United States. According to the Centers for Disease Control and Prevention, health equity is achieved when no one is disadvantaged from achieving their full health potential because of social position or other socially determined circumstances. 

CDC: Motor Vehicle Traffic Death Rates Among Adolescents and Young Adults Aged 15–24. A new data brief from the CDC reports that motor vehicle traffic (MVT) deaths generally declined between 2000 and 2018, but rates were about twice as high in rural than urban areas for both males and females.

CDC: Increase in Drug Overdose Deaths Involving Cocaine. In a separate brief, the CDC reports that, between 2009 and 2018, the rate of overdose deaths involving cocaine rose significantly across all age groups, gender identities, and racial/ethnic categories. The overdose death rate in 2018 involving cocaine with concurrent use of opioids was triple the rate of those without any concurrent opioid use. Among all regions of the country—Northeast, Midwest, South, and West—rates were significantly lower in rural counties than in urban counties; however, the rate in Northeastern rural counties was about triple the rates of Midwestern, Southern, and Western rural counties.