Date: May 26, 2022

Preparing for Medicaid/CHIP Unwinding. In March 2020, the Centers for Medicare & Medicaid Services (CMS) temporarily waived certain eligibility requirements for Medicaid and the Children’s Health Insurance Program (CHIP) to help people keep their health coverage during the pandemic. However, with the public health emergency ending, states will soon be required to restart eligibility reviews for this public health insurance covering more than 83 million beneficiaries of Medicaid and the Children’s Health Insurance Plan. Nearly a quarter of individuals under age 65 who live in rural areas are covered by Medicaid. When the eligibility waivers end, some estimates count up to 15 million people will lose their coverage through a process called “unwinding.” To help states prepare for the change, CMS will host a monthly learning series from May through October of this year. The Communications Toolkit, linked in the headline above, has information to help beneficiaries understand the steps to renew their coverage.

White House and HRSA on Test-to-Treat for COVID-19 –  Wednesday, June 1 at 2:00 pm ET. The Health Resources and Services Administration (HRSA) invites you to join a webinar to share the White House’s call to action around Test-to-Treat as a strategy to mitigate the impact of COVID-19. The webinar will feature HRSA Administrator Carole Johnson and White House COVID-19 Coordinator Dr. Ashish Jha as well as a moderated panel exploring safety-net provider perspectives.  If you prefer to join by phone: 833-568-8864; Webinar ID: 161 896 3980.

The Implications of Long COVID for Rural Communities. Researchers from the Center for Rural Health Research at East Tennessee State University report that higher rates of infection and lagging vaccinations mean that the lingering effects, now called long COVID, are likely to have a disproportionate effect on rural communities. While symptoms and severity of long COVID can range from mild to severe, the potential impact on mental health, social function, and the ability to keep working can be substantial. Watch a presentation from the Centers for Disease Control and Prevention on evaluating and supporting patients with cognitive symptoms following COVID.

Updated Chartbook Focuses on Rural Border Health. With facts and figures about health status, behavioral risk factors, mortality, and access to care, the resource aims to inform rural health policy for four states – Arizona, California, New Mexico, and Texas – along the U.S. southern border. The chartbook is a collaboration between the Federal Office of Rural Health Policy (FORHP)-supported Rural & Minority Health Research Center and the National Rural Health Association.

Answer the call: 988 Lifeline Suicide & Crisis Network Jobs. On July 16, 2022, the National Suicide Prevention Lifeline (1-800-273-8255) will transition to an easy-to-remember, 3-digit number (988). To strengthen and expand the existing network of over 200 locally operated and funded crisis centers across the country, the Lifeline suicide & crisis network is looking to bring on new volunteers and paid employees to receive training to answer calls, chats, and texts from people in crisis. Since 1999, suicide rates in rural areas have been consistently higher than those in metropolitan areas.

Updated Guidance on COVID-19 Booster Shots. Last week, the Centers for Disease Control & Prevention (CDC) recommended a booster shot of the Pfizer-BioNTech COVID-19 vaccine for children ages 5-11 who completed their primary vaccination more than five months ago. The booster shot is 10 micrograms, the same dosage as the primary series for this age group. The CDC also strengthened its recommendation that those 12 and older who are immunocompromised and those 50 and older should receive a second booster dose at least four months after their first. Visit COVID.gov to find nearby locations for masks, testing, vaccines, and treatment. 

CMS Advancing Rural Maternal Health Equity. The Office of Minority Health at the Centers for Medicare & Medicaid Services (CMS) provides a high-level summary of its Rural Maternal Health Initiative implemented between June 2019 and November 2021. The effort comes from the CMS Rural Health initiative, established in 2016 to meet the needs specific to these areas.

Heat-Related Illness: Know the Signs. As temperatures rise, the newly formed federal Office of Climate Change and Health Equity is tracking areas of the country expected to experience a high number of extremely hot days over the next few months. The health impacts of a heat wave like the one that hit states in the Northwest last summer, go beyond dehydration and heat stroke to include: increased hospitalizations for heart disease, worsening asthma and chronic obstructive pulmonary disease (COPD), and even an increase in violence, crime, and suicide. Last month, the U.S. Department of Health & Human Services awarded $385 million to help households lower cooling and heating costs. Learn more online about the Low Income Home Energy Assistance Program.

Ongoing: HRSA Payment Program for RHC Buprenorphine-Trained Providers. In June 2021, HRSA launched an effort to improve access to substance use disorder treatment by paying for providers who are waivered to prescribe buprenorphine, a medication used to treat opioid use disorder. Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained to obtain the waiver necessary to prescribe buprenorphine after January 1, 2019. Approximately $1.2 million in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted. Send questions to DATA2000WaiverPayments@hrsa.gov. There is ongoing availability of a free online course for waiver eligibility training from the American Osteopathic Academy of Addiction Medicine and the Providers Clinical Support System.

Date: May 19, 2022

New Federal Funding to Increase Internet Access. On Friday, the U.S. Department of Commerce announced Internet for All, a $65 billion investment included in the Infrastructure Investment and Jobs Act – also known as the Bipartisan Infrastructure Law – that passed last November. The federal National Telecommunications and Information Administration, an agency within Commerce, has opened the application window for several programs that will support efforts in states and U.S. territories to close the digital gap in areas with little or no high-speed internet. This is a particular issue in rural communities given long-standing gaps relative to urban areas. A separate program, the Affordable Connectivity Program, helps low-income households pay for monthly internet service and provides discounts for laptops, tablets, and desktop computers. For more information about these opportunities as they arise, sign up for the newsletter from the Office for the Advancement of Telehealth at HRSA.

DOT Previews the Reconnecting Communities Pilot Program. The Bipartisan Infrastructure Law also provides up to $1 billion over the next five years for transportation infrastructure that facilitates mobility, access, and economic development. Rural areas face considerable challenges with transportation which creates ongoing barriers getting to and from needed health care services. For facilities eligible to apply for the funding – state, local, and tribal governments, as well as public and nonprofit planning organizations – the federal Department of Transportation (DOT) will hold a one-hour webinar TODAY at 1:30 pm ET to provide a preview.

Questions Answered About New Sites for the NHSC – Deadline Extended to June 7. The Health Resources and Services Administration (HRSA) will hold a two-hour Q&A session for facilities applying to become an approved site for the National Health Service Corps (NHSC). Approved sites gain the ability to recruit and retain qualified clinicians in medical, dental, and behavioral health professions; post vacancies to HRSA’s national Health Workforce Connector; and participate in HRSA Virtual Job Fairs to connect with job-seeking primary care trainees and practicing clinicians. Today’s Q&A session for applicants starts at 11:30 am ET. Critical Access Hospitals and Rural Health Clinics are encouraged to apply to become a service site. Last month’s webinar for rural providers is archived at the Rural Health Information Hub. Additional funding from the American Rescue Plan has created more opportunities for rural clinicians to receive loan repayment from the NHSC but, to qualify, a clinician has to be working at an eligible NHSC site.

Latest Data Show Growth and Widened Disparities in Firearm Death Rates. Last week, the Centers for Disease Control and Prevention released new data showing death by firearm is a growing public health problem. From 2019 to 2020, the firearm homicide rate increased about 35 percent to the highest rate recorded in more than 25 years. The firearm suicide rate, higher than that for firearm homicide, remained level but data showed highest rates for males, older adults, and non-Hispanic White and American Indian or Alaska Native persons. 

HRSA Launches Crisis Hotline for Expecting and New Mothers. Professional counselors are staffing the line around the clock, offering mental health support in English or Spanish.  Research from the Centers for Disease Control & Prevention shows that about 1 in 8 women experience symptoms of postpartum depression that may be missed or misunderstood by family. The National Maternal Mental Health Hotline is funded by HRSA through the agency’s Maternal and Child Health Bureau (MCHB). In response to the nationwide shortage of baby formula, MCHB issued guidance for families and providers, with additional information from the Food and Drug Administration and the U.S. Department of Agriculture.

Feedback Requested to Improve the Organ Procurement and Transplantation Network – Deadline extended to May 23. Last month, HRSA released a Request for Information seeking input on ways to strengthen the program that ensures availability and access to donor organs for patients with end-stage organ failure. Research shows social determinants of health create disparities in access to organ transplantation, particularly for racial and ethnic minorities, groups with lower socioeconomic status, and patients in rural areas.

HRSA Celebrates National Nurses Month. HRSA is commemorating National Nurses Month by highlighting the significant contributions of our country’s nurses. HRSA currently has more than 7,700 National Health Service Corps (NHSC) and 500 Nurse Corps participants serving at rural sites and schools across the country. About 39 percent of all NHSC nurses serve in a rural community throughout the nation. In AY 2020-2021, the Advanced Nursing Education Nurse Practitioner Residency programs trained 368 post graduate, licensed and certified Nurse Practitioners, the majority of whom trained in primary care (99 percent), medically underserved (99 percent), and rural (44 percent) settings. Join HRSA in recognizing that ‘Nurses Make a Difference’ by following along on Facebook, Twitter, LinkedIn, YouTube and Instagram.

Ongoing: HRSA Payment Program for RHC Buprenorphine-Trained Providers. In June 2021, HRSA launched an effort to improve access to substance use disorder treatment by paying for providers who are waivered to prescribe buprenorphine, a medication used to treat opioid use disorder. Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained to obtain the waiver necessary to prescribe buprenorphine after January 1, 2019. Approximately $1.2 million in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted. Send questions to DATA2000WaiverPayments@hrsa.gov. There is ongoing availability of a free online course for waiver eligibility training from the American Osteopathic Academy of Addiction Medicine and the Providers Clinical Support System.

Date: May 5, 2022

Apply to Provide Technical Assistance for Rural Health Workforce Training by June 8. In response to pandemic-related workforce shortages, the Health Resources and Services Administration (HRSA) will make one award to strengthen training and certification programs in the following support roles for health care in rural areas: community health workers, health IT and/or telehealth technical support, community para-medicine and case management staff, and respiratory therapists. Eligible applicants are public and private, nonprofit entities that can assist networks formed by HRSA’s Rural Public Health Workforce Network Training Program.   

County Health Rankings for 2022. The annual ranking of health for nearly every county in the nation takes a closer look at four specific social determinants that impact health outcomes: living wage, gender pay gap, childcare cost burden, and school funding adequacy.  References to rural areas throughout the report highlight major geographic disparities before and after the pandemic.

COGME Reports on Strengthening Rural Health Workforce.  The Council on Graduate Medical Education, COGME, provides ongoing assessment of physician workforce trends and makes recommendations to federal policymakers. In this new report, COGME focuses on gaps in rural health care and makes six recommendations for federal policy and investment, including programs such as the National Health Service Corps, Rural Residency Planning and Development, and other training programs funded by HRSA.   

Evaluating the Million Hearts Model. In 2017, the Centers for Medicare & Medicaid Services (CMS) launched the Million Hearts Cardiovascular Disease Risk Reduction Model. Designed by the CMS Innovation Center to test if health care costs could be lowered by prevention, the program called on participants to reduce the incidence of first-time heart attacks and strokes among Medicare beneficiaries.  A little more than a third (36 percent) of the original participants – primary care and specialty practices, health centers, and hospitals – were rural providers. While this report only evaluates the first four years of a five-year program, results show improved preventive care for cardiovascular disease. 

HRSA News Round-Up for April. In case you missed it, HRSA announced investments to: support community-based doulas; strengthen home visiting supports for parents, infants, and children; expand investments in state responses to the maternal mortality crisis; launch the largest investment ever made in Community Health Worker training; and build new data tools to reduce health disparities through health centers.

Ongoing: HRSA Payment Program for RHC Buprenorphine-Trained Providers. In June 2021, HRSA launched an effort to improve access to substance use disorder treatment by paying for providers who are waivered to prescribe buprenorphine, a medication used to treat opioid use disorder. Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained to obtain the waiver necessary to prescribe buprenorphine after January 1, 2019. Approximately $1.2 million in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted. Send questions to DATA2000WaiverPayments@hrsa.gov. There is ongoing availability of a free online course for waiver eligibility training from the American Osteopathic Academy of Addiction Medicine and the Providers Clinical Support System.

Date: April 28, 2022

SAMHSA Certified Behavioral Health Clinics – Planning, Development, and Implementation Grants – May 17.  The Substance Abuse and Mental Health Services Administration (SAMHSA) will make 156 grants, each for $1 million to establish new Certified Behavioral Health Clinic programs. Eligible applicants are community-based nonprofit organizations; local governments; and facilities operated by a tribe, tribal organization, or under the authority of the Indian Health Service. A separate program, SAMHSA Certified Behavioral Health Clinics – Improvement and Advancement – May 17, for existing Certified Community Behavioral Health Clinic (CCBHC) that meet certification criteria.  SAMHSA expects that applicants will include a focus on groups facing health disparities.  In rural areas, these disparities are driven by accessibility, availability, affordability, and acceptability.

CMS Focus on Health Equity. The Centers for Medicare & Medicaid Services (CMS) has a new, proactive plan to bring more equitable health outcomes to people in underserved and disadvantaged communities. The CMS Framework for Health Equity calls for improved data collection, more culturally appropriate services, and broader access to health-related social services for those who receive care paid for by the nation’s largest health insurer. This public health insurance covers nearly 64 million enrolled in Medicare and more than 83 million beneficiaries of Medicaid and the Children’s Health Insurance Plan. Health equity goals for the 2022 Strategic Plan include incentivizing other insurers to enter single-issuer rural counties in the individual market.  CMS will host a Health Equity Symposium today at 1:00 pm to provide more details on the health equity plan. 

Comments Requested: New Questions for Census Survey – May 18. In April 2020, the U.S. Census Bureau launched a new project to inform on a range of topics experienced by households during the COVID-19 pandemic. New questions for the Household Pulse Survey are being formulated, for example, changing the focus of one vaccination question from reasons for not receiving the vaccine to reasons for not receiving a vaccine booster dose. The Department of Commerce invites the general public and other Federal agencies to comment on proposed and continuing information collections.

Ongoing: HRSA Payment Program for RHC Buprenorphine-Trained Providers. In June 2021, the Health Resources and Services Administration (HRSA) launched an effort to improve access to substance use disorder treatment by paying for providers who are waivered to prescribe buprenorphine, a medication used to treat opioid use disorder. Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained to obtain the waiver necessary to prescribe buprenorphine after January 1, 2019.  Approximately $1.2 million in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted. Send questions to DATA2000WaiverPayments@hrsa.gov. There is ongoing availability of a free online course for waiver eligibility training from the American Osteopathic Academy of Addiction Medicine and the Providers Clinical Support System.

Date: April 21, 2022

Apply for New Community Health Worker Training Program – Deadline June 11. On Friday, the U.S. Department of Health & Human Services announced availability of $226.5 million for a new program building the pipeline of public health workers at the community level. The multiyear effort will support training and apprenticeship programs for the critical role of trusted messenger connecting people to care and support. Administered through the Health Resources and Services Administration’s (HRSA) Bureau of Health Workforce, the program will train as many as 13,000 community health workers who will address needs in rural and underserved communities. These roles, providing culturally competent and individualized services, are critical in rural areas where health services are limited. 

USDA Launches Effort to Fund Economic Development in Rural Communities. On Wednesday, the U.S. Department of Agriculture announced a new collaboration between federal agencies and local leaders and residents. The Rural Partners Network is a whole-of-government approach that includes 16 federal agencies and regional commissions to help rural communities access government resources and funding. At launch, selected communities in Georgia, Kentucky, Mississippi, New Mexico, and certain Tribes within Arizona will participate to share local concerns and ensure rural communities have a voice in policymaking. 

HRSA to Host First National Telehealth Conference. Over the course of two days (May 16-17), public and private sector leaders will discuss best practices and lessons learned during the COVID-19 pandemic. Topics include the role of telehealth in underserved communities, achieving health equity through improved broadband connectivity, and telehealth as a model for integrating behavioral health care during the pandemic and beyond. 

HHS Renews Public Health Emergency. On April 12, the U.S. Department of Health & Human Services (HHS) extended the current Public Health Emergency (PHE) declaration for another 90 days. The most recent continuation of the PHE was set to expire on April 16, 2022. The extension of the PHE means the continuation of flexibilities for health care providers, such as the Coronavirus Waivers issued by the Centers for Medicare & Medicaid Services.

HHS Distributing $1.75 Billion in Provider Relief Fund Payments. Last week, the U.S. Department of Health & Human Services announced payments, distributed through the Health Resources and Services Administration’s (HRSA), to 3,680 providers across the country. Since November 2021, HRSA has distributed approximately $13.5 billion from the fund to offset costs related to COVID-19. 

Funds Awarded to Strengthen the Maternal, Infant, and Early Childhood Home Visiting Program. Also last week, the Health Resources and Services Administration’s (HRSA) announced $16 million in awards administered by its Maternal and Child Health Bureau to support pregnant people and parents with young children.

Study on Video-Enabled Tablets for Rural Veterans’ Mental Health Care. In an open-access article on the JAMA Network, researchers describe their findings when 471,791 rural U.S. veterans with a history of mental health care use received video-enabled tablets to access services. The study included rural veterans identified by the U.S. Department of Veteran Affairs (VA) as a high-risk for suicide, and compared monthly mental health service utilization for patients who received VA tablets during COVID-19 with patients who were not issued tablets over 10 months before and after tablet shipment.

Ongoing: HRSA Payment Program for RHC Buprenorphine-Trained Providers. In June 2021, the Health Resources and Services Administration’s (HRSA) launched an effort to improve access to substance use disorder treatment by paying for providers who are waivered to prescribe buprenorphine, a medication used to treat opioid use disorder. Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained to obtain the waiver necessary to prescribe buprenorphine after January 1, 2019.  Approximately $1.2 million in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted. Send questions to DATA2000WaiverPayments@hrsa.gov. There is ongoing availability of a free online course for waiver eligibility training from the American Osteopathic Academy of Addiction Medicine and the Providers Clinical Support System.

Date: April 14, 2022

Preview New Opportunity for Delta Workforce Training Program. Next Thursday, April 21, join the Federal Office of Rural Health Policy for a preview of a Notice of Funding Opportunity (NOFO) that will be released soon. The Delta Region Rural Health Workforce Training Program will train future and current health professionals in critical administrative support professions, preparing them for high-quality jobs in the rural counties and parishes of the federal Delta Regional Authority. Jobs supported by this funding include medical coding and billing, insurance claims processing, health information management, clinical documentation, business operations for healthcare organizations, and supply chain and materials management. The hour-long call will take place on Zoom at 2:00 pm ET. The program coordinator will highlight key changes to the NOFO that make it easier for interested applicants to apply.

Rural Playbook for the Bipartisan Infrastructure Law. The new legislation promises billions of dollars for high-speed internet, improvements to roads and bridges, clean drinking water, and modernized wastewater systems. The playbook is intended to help communities understand the available funding set aside for rural areas and how to apply for these federal dollars.

Successful Federal Efforts to Address SDOH. Social determinants of health (SDOH) include factors such as housing, food and nutrition, transportation, social mobility, and environmental conditions as having significant impact on health outcomes. In this series of policy briefs, the U.S. Department of Health & Human Services describes the Department’s strategic approach to SDOH and provides successful examples of current federal programs. 

The Persistence of Poverty in Rural America. The Housing Assistance Council (HAC) is a national nonprofit focused on improving conditions in the poorest rural places. In this policy brief, HAC identifies 377 persistent poverty counties in the United States – those classified by the Census Bureau as having poverty rates of 20 percent or more for three consecutive decades.  Approximately 81 percent of these counties are outside of metropolitan areas.

Earth Day Brings Federal Focus to Climate Change. Over three days next week, the newly formed federal Office of Climate Change and Health Equity will host experts speaking about the impact that climate change has on health and well-being. Each hour-long event will take place at noon on Tuesday, Wednesday, and Thursday, April 19-21. See the link to learn details about speakers and the topics that will be covered, and contact GoGreen@hhs.gov with questions.

Ongoing: HRSA Payment Program for RHC Buprenorphine-Trained Providers. In June 2021, the Health Resources and Services Administration (HRSA) launched an effort to improve access to substance use disorder treatment by paying for providers who are waivered to prescribe buprenorphine, a medication used to treat opioid use disorder. Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained to obtain the waiver necessary to prescribe buprenorphine after January 1, 2019.  Approximately $1.2 million in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted. Send questions to DATA2000WaiverPayments@hrsa.gov. There is ongoing availability of a free online course for waiver eligibility training from the American Osteopathic Academy of Addiction Medicine and the Providers Clinical Support System.