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.

Federal Office of Rural Health Policy Announcement

October 8, 2020

HRSA’s National Survey of Children’s Health. Each year the Maternal and Child Health Bureau at the Health Resources and Services Administration (HRSA) collects information from parents and caregivers on the physical, emotional, and behavioral health of children ages 0-17 years old in the United States. The survey is meant to be a tool with reliable data for researchers and policymakers on a wide range of factors that can influence children’s health – from the prevalence and impact of special health care needs, to adverse childhood experiences and mental and behavioral health. HRSA also released a new brief on Rural/Urban Differences in Children’s Health using the combined data of the 2017-2018 surveys.

HHS Announces Phase 3 of Provider Relief Funds. The U.S. Department of Health and Human Services (HHS) has allocated $20 billion for a Phase 3 CARES Act Provider Relief Funds (PRF) distribution. Behavioral health care providers and new providers that began practicing in the first quarter of 2020 may submit applications for payment between October 5 and November 6. Providers who previously received, rejected, or accepted a General Distribution PRF payment of two percent of annual revenue from patient care may also apply for this round of funding.

FCC Extends Purchasing Deadline for COVID-19 Telehealth Program. The Federal Communications Commission’s Wireline Competition Bureau has extended the deadline for recipients of COVID-19 Telehealth Program funding to purchase eligible telehealth devices and implement services to December 31. 

CDC: Rates of Alcohol Induced Deaths Among Adults in Urban and Rural Areas. A new data brief from the Centers for Disease Control and Prevention (CDC) reports that, among adults aged 25 and older, deaths caused by alcohol were stable from 2000 to 2006, but then increased 43 percent between 2006 and 2018. During that same time, death rates increased for men and women at all levels of urbanization. For women in rural areas, the death rate was among the lowest in 2000; by 2018, rates for women in noncore areas had more than doubled.

Sleeve Up to Fight Flu. The Centers for Disease Control and Prevention (CDC) has a new social media campaign, “#SleeveUp to #FightFlu.” encouraging everyone aged 6 months and older to get the flu vaccine. Widespread vaccination will help reduce the strain on health care systems responding to the COVID-19 pandemic. The CDC’s preliminary estimates for the 2019-2020 flu season include up to 740,000 hospitalizations and up to 62,000 deaths. 

RWJF: National Trends and Demographics in Suicide Deaths. The Robert Wood Johnson Foundation’s (RWJF) State Health Access Data Assistance Center (SHADAC) reports on the trend of increasing suicide rates in the United States. Data details compare rates by age, race, gender, and urbanization from the years 2000 to 2018;  a companion brief includes state-level trends.

Federal Office of Rural Health Policy Announcements

October 1, 2020

New Research on Child Health. A new report from the Federal Interagency Forum on Child and Family Statistics compares 41 indicators of well-being in children by the type of community they live in. (These are metropolitan, nonmetropolitan, micropolitan, or rural, according to the Office of Management and Budget.) The brief finds that infant mortality rates were highest in rural counties (6.8 per 1,000). During the same time, the mortality rate for Hispanic and American Indian or Alaska Native, non-Hispanic infants was also higher for those living in rural counties than those living in micropolitan and metropolitan counties. Separately, the Centers for Disease Control and Prevention released Mental Health Treatment Among Children Aged 5-17 years, 2019, finding that as the level of urbanization decreased, the percentage of children who had taken medication for their mental health increased.

GAO: Federal Efforts on COVID-19 Could Be Strengthened. The U.S. Government Accountability Office (GAO) reviews data collection, equipment and testing supplies, and economic payouts, among other issues related to the pandemic and makes 16 recommendations to address them. 

The Impact of Coronavirus on Households Across America. This is the third in a series of reports based on surveys conducted by NPR, the Harvard T.H. Chan School of Public Health, and the Robert Wood Johnson Foundation. With a significant section on rural households, the report finds that many challenges cascading from the pandemic are due to long-standing inequities. 

COVID-19 Resources

Federal Office of Rural Health Policy FAQs for COVID-19. A set of Frequently Asked Questions (FAQs) from our grantees and stakeholders, updated regularly. 

COVID-19 FAQs and Funding for HRSA Programs. Find all funding and frequently asked questions for programs administered by the Health Resources and Services Administration (HRSA).

CDC COVID-19 Updates. The Centers for Disease Control and Prevention (CDC) provides daily updates and guidance, including a section specific to rural health care, and a Toolkit for Tribal Communities. New this week: the Changing Age Distribution of the COVID-19 Pandemic in the Morbidity and Mortality Weekly Report.

CMS Coronavirus Stakeholder Calls. The Centers for Medicare & Medicaid Services (CMS) hosts recurring online sessions to share information related to COVID-19. These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

HHS Coronavirus Data Hub. The U.S. Department of Health & Human Services (HHS) launched a website in July with data on the COVID-19 response at federal, state, and local levels. The hub includes estimated and reported hospital capacity by state, with numbers updated daily.

GHPC’s Collection of Rural Health Strategies for COVID-19. With support from the Federal Office of Rural Health Policy (FORHP), the Georgia Health Policy Center (GHPC) provides reports, guidance, and innovative strategies gleaned from their technical assistance and peer learning sessions with FORHP grantees.

Confirmed COVID-19 Cases, Metropolitan and Nonmetropolitan Counties. The RUPRI Center for Rural Health Policy Analysis provides up-to-date data and maps on rural and urban confirmed cases throughout the United States. An animated map shows the progression of cases beginning January 21.

Rural Response to Coronavirus Disease 2019. The Rural Health Information Hub posted a guide to help you learn about activities underway to address COVID-19. The online resource now includes Rural Healthcare Surge Readiness, a tool with resources for healthcare systems preparing for and responding to a COVID-19 surge in their communities.

SAMHSA Training and Technical Assistance Related to COVID-19. The Substance Abuse and Mental Health Services Administration (SAMHSA) created this list of resources, tools, and trainings. 

Federal Office of Rural Health Policy Announcements – New Funding Opportunity

September 30, 2020

The Health Resources and Services Administration’s Federal Office of Rural Health Policy has released the Notice of Funding Opportunity (NOFO) for the Rural Health Care Services Outreach Program (Outreach) (HRSA-21-027).  HRSA plans to award 60 grants to rural communities as part of this funding opportunity.

Review the NOFO at: https://www.grants.gov/web/grants/view-opportunity.html?oppId=326599  

The Outreach Program administered by HRSA’s FORHP focuses on expanding the delivery of health care services to include new and enhanced services exclusively in rural communities. Applicants are required to deliver health care services through a consortium of at least three health care provider organizations, use an evidence-based or promising practice model to inform their approach, and demonstrate health outcomes and sustainability by the end of the four-year performance period.

In addition to funding Outreach programs through the regular Outreach track, in FY 21, FORHP will also afford applicants a unique opportunity to take part in a national effort that targets rural health disparities through a second track called the “Healthy Rural Hometown Initiative.” This initiative was created through the HHS Rural Task Force and driven by findings from report published by the Centers of Disease Control and Prevention (CDC) in 2019 that noted that the number of preventable death from the five leading cause of death in rural areas was higher than those in urban areas. Unfortunately, these findings echo earlier CDC research on the rural disparities in avoidable or excess death in 2017.

The Healthy Rural Hometown Initiative (HRHI) is an effort that seeks to address the underlying factors that are driving growing rural health disparities related to the five leading causes of avoidable death (heart disease, cancer, unintentional injury/substance use, chronic lower respiratory disease, and stroke). The goal of the HRHI track is to demonstrate the collective impact of projects that better manage conditions, address risk factors and focus on prevention that relate to the leading causes of death in rural communities. This track should be a good fit for applicants who want to identify and bridge the gap between the social determinants of health and other systemic issues that contribute to achieving health equity with regards to excess death in rural communities. Furthermore, this is a rural-specific and community-based approach to addressing these disparities and represents a new and more targeted strategy given the enduring health gaps between rural and urban populations.

Of the successful 60 award recipients, HRSA aims to award approximately 45 to regular Outreach track applicants and at least 15 to HRHI applicants for a ceiling amount of up to $200,000 (Regular Outreach) or $250,000 (HRHI) total cost (includes both direct and indirect, facilities and administrative costs) per year (and final numbers will be subject to how applicants score). 

The HRHI is part of an ongoing multi-year effort by FORHP to highlight how rural community health efforts can improve health at the local level. We are encouraging rural health stakeholders to join us in this broader effort while also taking on the challenge of addressing these long-standing rural health disparities related to the five leading causes of death. 

NOTE: The eligibility criteria for this program has changed and now includes all domestic public and private, nonprofit and for-profit entities with demonstrated experience serving, or the capacity to serve, rural underserved populations. Urban-based organizations applying as the lead applicant should ensure there is a high degree of rural control in the project. The applicant organization must represent a network that includes at least three or more health care provider organizations and, at least 66% (or two-thirds) of consortium members must be located in a HRSA-designated rural area.

Please review the guidance in its entirety for more information about eligibility criteria and specific program requirements. Visit www.grants.gov to review the Outreach NOFO and apply. Learn about the Outreach Program.

A webinar for applicants is scheduled on Tuesday October 13, from 3-4:30 p.m., EST. A recording will be made available for those who cannot attend.

For more information about this funding opportunity, contact the Program Coordinator, Alexa Ofori, at RuralOutreachProgram@hrsa.gov.  

Federal Office of Rural Health Policy Announcements

September 24, 2020

Tool for Rural Grant Eligibility Updated. The Health Resources Services Administration (HRSA) Rural Health Grants Eligibility Analyzer tool has been updated to include the Office of Management and Budget (OMB) revised delineations for metropolitan, micropolitan, and combined statistical areas.

Comments Requested:  Modifications to the Definition of Rural for FORHP Grants – October 23.  The Federal Office of Rural Health Policy (FORHP) proposed modifications to the definition of ‘rural’ used to designate areas to be eligible for its rural health grants. The proposed definitions are based on a data-driven methodology that will allow community organizations serving rural populations within metro areas to be able to apply for grants as well as allow more of the rural populations within metro areas to access services provided using grant funds.

CDC: Urban-Rural Differences in Suicide Rates, 2000-2018. The Centers for Disease Control and Prevention (CDC) used data from the National Vital Statistics System to find that suicide rates increased overall for urban and rural areas for the years studied, with the pace of increase greater for rural suicide rates. The CDC’s National Center for Health Statistics has released their findings from a survey on Mental Health Treatment Among Adults in 2019. Results show that overall, as the level of urbanization decreased, the percentage of adults who had taken medication for their mental health increased, and the percentage who had received counseling or therapy decreased. 

SAMHSA: National Survey on Drug Use and Health. In its annual report, the Substance Abuse and Mental Health Services Administration (SAMHSA) presents data on the use of illicit drugs, alcohol, and tobacco, as well as trends in mental health and access to treatment. Statistics cover a range of demographic and geographic characteristics, including comparison of urban and rural. 

Census Report on Income and Poverty in the United States, 2019. The report from the U.S. Census Bureau presents data based on information collected every month in the Current Population Survey (CPS). Findings show a median household income of $68,703 in 2019, with a 1.3 percent decline in the official poverty rate. 

New Report on Post-Acute Care in Rural America.  The National Rural Health Resource Center released findings from their May 2020 Virtual Summit, which focused on the issues, challenges, and strategies related to the integration of acute and post-acute care in rural areas. The report covers the current state of rural post-acute care, including the impact of COVID-19, and explores strategies and tactics to address key issues, such as payment, workforce, and community care coordination.