November 18, 2021

HRSA Celebrates National Rural Health Day. The public is invited to join the Health Resources and Services Administration (HRSA) online TODAY, November 18 at 11:30 am ET for a feature HRSA presentation. Acting HRSA Administration Diane Espinosa will welcome speakers from several HHS agencies and the Domestic White House Policy Council who will present on federal strategies to prioritize health equity and eliminate disparities in health access, policy, and practice. Then later at a virtual presentation at 3:00 pm ET, Federal Office of Rural Health Policy grantees will share best practices from their projects that consider social determinants of health to improve health outcomes.

November is National COPD Awareness Month. The education and awareness program Learn More, Breathe Better provides resources for patients, caregivers, and health professionals for better understanding of Chronic Obstructive Pulmonary Disease, also known as COPD. The Centers for Disease Control and Prevention has found that more than 57 percent of deaths from chronic lower respiratory disease in the most rural counties were potentially preventable, compared with 13 percent in the most urban counties. On Friday, November 19 at 9:00 pm ET, musician Lyle Lovett and Ted Koppel will host a virtual event featuring performances and interviews from Lovett, Rodney Crowell, and Steve Earle. The group wants to raise awareness of the added risk that COVID-19 brings to those with COPD. 

Community Toolkit for Addressing Health Misinformation. The new resource asks for participation from individuals, teachers, school administrators, librarians, faith leaders, and health care professionals to understand, identify, and stop the spread of misinformation. Earlier this year, the U.S. Surgeon General Dr. Vivek Murthy issued an advisory, calling misinformation an urgent threat to public health. The toolkit includes common types of misinformation and a checklist to help evaluate the accuracy of health-related content. 

Facilities Selected for Rural Provider Transition Project. The project selected five facilities to participate in the second year of the Federal Office of Rural Health Policy’s (FORHP) Rural Healthcare Provider Transition Project: Sierra Vista Hospital in New Mexico, Dahl Memorial Health Care in Montana, Golden Valley Memorial Healthcare in Missouri, Coteau des Prairies Health Care System in South Dakota, and Electra Hospital District in Texas. Participants will receive targeted technical assistance provided by the National Rural Health Resource Center to help transition to value-based care and population health management. 

CDC: Sepsis-related Death Rates Higher in Rural Areas. Sepsis is an extreme response to infection, triggering a life-threatening chain reaction throughout the body. For this report, the Centers for Disease Control and Prevention (CDC) found that, in 2019, there were 201,092 deaths involving sepsis, with three-fourths of those deaths occurring among persons aged 65 and older.  Within that age range, death rates were highest among non-Hispanic black adults (377.4 per 100,000), followed by non-Hispanic white (275.7), and Hispanic (246.4). Sepsis-related death rates were higher in rural areas (307.3 per 100,000) compared with urban areas (271.3).

Ongoing: HRSA Payment Program for RHC Buprenorphine-Trained Providers. In June of this year, 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 $1.5 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: November 12, 2021

COVID-19 Health Equity Task Force Brings Public Health Focus to Rural Areas. On Wednesday, the White House announced a $785 million investment to respond to inequities in underserved communities that were exacerbated by the pandemic. The funding is based on recommendations from the Task Force that was created in January of this year to make specific recommendations for bolstering public health in rural areas and communities of color. The Task Force included rural representation in Tim Putnam, a former rural hospital administrator from Indiana who chaired the Healthcare Access and Quality Subcommittee. 

HRSA Celebrates National Rural Health Day. The public is invited to join the Health Resources and Services Administration (HRSA) online on Thursday, November 18 at 11:30 am ET. Speakers and panelists from several agencies will share what HRSA has learned from the efforts at the federal level and from collaboration with state- and community-level partners. Health equity is a priority focus, and Federal Office of Rural Health Policy (FORHP) grantees will share best practices from their projects that consider social determinants of health to improve health outcomes.

Wisconsin Project to Prevent Overdose Death Sees Results. The primary goal of the Prescription Drug/Opioid Overdose-Related Deaths Prevention Project – PDO for short – was to reduce the number of deaths and adverse events by 10 percent in three high-risk counties. Two counties targeted for the program are mostly metropolitan, one is rural. The report describes policy challenges to distributing Naloxone, a medicine that rapidly reverses an opioid overdose, through local public health agencies and the ways that officials were able to work through them. Although reducing stigma about addiction was not a stated goal of the PDO project, it was the first step in training as many people as possible to recognize an overdose and take action.

CDC: Infant Mortality Rates for Metropolitan and Nonmetropolitan Counties. The Centers for Disease Control and Prevention (CDC) report data showing that, in 2019, the infant mortality rate was highest for non-Hispanic Black mothers in both urban (10.60 infant deaths per 1,000 live births) and rural (10.85). Second highest was infant deaths for American-Indian or Alaska Native mothers; in urban areas, the rate was 5.95 infant deaths per 1,000 live births and in rural, the number was 9.78. 

How CAHs Address Social Needs in their Communities. Critical Access Hospital (CAH) is a designation given to eligible rural hospitals by the Centers for Medicare & Medicaid Services.  This policy brief summarizes CAH initiatives addressing social needs – access to education, food security, stable housing, employment, and interpersonal violence – that significantly impact health outcomes and health care costs. 

Ongoing: HRSA Payment Program for RHC Buprenorphine-Trained Providers. In June of this year, 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 $1.5 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: November 4, 2021

CDC Recommends Pediatric COVID Vaccine. On Tuesday, the Centers for Disease Control and Prevention (CDC) expanded their recommendations for the Pfizer-BioNTech vaccine to include about 28 million children aged 5-11 years. The CDC reports that, during a six-week period in late June to mid-August, COVID-19 hospitalizations among children and adolescents increased fivefold. November 5 at 2:00 pm ET, join HRSA for a Town Hall meeting to get the latest information on this announcement. 

New Funding Available for the Rural Health Network Development Planning Program applications due January 28. The Health Resources and Services Administration will be making approximately 20 awards of $100,000 each for a one-year period of performance to promote the development of integrated health care networks in order to (i) achieve efficiencies; (ii) expand access to, coordinate, and improve the quality of basic health care services; and (iii) strengthen the rural health care system as a whole. Eligible applicants are domestic public and private, nonprofit and for-profit entities that can deliver services in HRSA-designated rural area, particularly for populations that have historically been underserved and have poorer health outcomes. The applicant organization must represent a network that includes at least three or more health care provider organizations. HRSA’s Federal Office of Rural Health Policy will hold an hour-long webinar for applicants on Wednesday November 17^th  at 3:00 pm ET. (Meeting ID: 161 864 4747; Participant Code: 81822150) A recording will be made available for those who cannot attend. 

CDC Listening Sessions Provide Strategies for COVID Vaccine Outreach. The Centers for Disease Control and Prevention (CDC) is sharing what their Vaccine Task Force has learned about reaching people with limited access to vaccines. Successful community-level actions were reported during jurisdictional listening sessions conducted earlier this year. These reported activities use existing systems – case managers, community organizations, pharmacies, residential facilities, etc. – to take action steps for scheduling appointments, arranging transportation, and sharing reliable information through trusted networks. These lessons learned may be particularly useful in rural areas where vaccination rates are lower.

CMS Expands Telehealth for Behavioral Health. This week, the Centers for Medicare & Medicaid Services (CMS) updated telehealth policies for 2022 to expand behavioral health services, including treatment of substance use disorders through Opioid Treatment Programs. The policy updates allow patients to receive these services in their homes. CMS is also allowing reimbursement for audio-only services for certain patients, beneficial to rural patients with limited access to high-speed broadband. In addition, for the first time outside of the COVID-19 public health emergency, Medicare will pay for mental health visits furnished by Rural Health Clinics and Federally Qualified Health Centers through digital and audio telecommunications. For specifics on the policy updates, CMS has published a fact sheet on the Calendar Year 2022 Physician Fee Schedule Final Rule.

New CMS Policy Promotes Growth in the Medicare Diabetes Prevention Program. The Centers for Medicare & Medicaid Services (CMS) also announced updated policies to improve the Medicare Diabetes Prevention Program (MDPP) Expanded Model, created to help prevent Medicare beneficiaries with prediabetes from developing type 2 diabetes. As part of this update, CMS is reducing barriers to participation in rural communities, where the rate of potentially avoidable death from diabetes is higher than in urban areas. This includes waiving the Medicare enrollment fee for all organizations that apply to enroll as an MDPP supplier on or after January 1, 2022, shortening the MDPP services period to one year instead of two years, and restructuring payments so MDPP suppliers receive larger payments for participants who reach milestones for attendance. For specifics on the policy updates, CMS has published a fact sheet on the MDPP Expanded Model updates in the Calendar Year 2022 Medicare Physician Fee Schedule Final Rule.

Rural Hospital Mergers Shown to Reduce Services, but Improve Care Quality. Two studies funded by the Agency for Healthcare Research and Quality provide mixed news on the impact of mergers. The article published in Health Affairs, linked above, found that merged rural hospitals were more likely to eliminate maternal/neonatal and surgical services to stay in business. A second study published in JAMA Network Open found greater reduction in inpatient deaths for several common conditions such as heart failure, acute stroke, and pneumonia at merged rural hospitals. Researchers conclude in this study that mergers result in lower death rates, however more research is needed to assess the impact of mergers on the health care of rural communities.  

Unintentional Injury Death Twice as High for Rural Children (pdf). Unintentional injuries are the leading cause of death among children aged 0-17 years and the overall rate for rural children is nearly twice as high as for children living in urban areas (12.4 per 100,000 versus 6.3). The data brief from the National Center for Health Statistics reports that rates were highest for children under one year in both urban (29.3) and rural areas (48.8), and identifies suffocation as the leading cause for that age group. 

Partnership of CDFIs Document Their Rural Efforts. The Partners for Rural Transformation (PRT) is a coalition led by six Community Development Financial Institutions (CDFIs) committed to transforming rural areas of persistent poverty in the Mississippi Delta, Appalachia, Native American communities, the deep south, the Rio Grande Valley, and farming regions in the rural West. With support from the Robert Wood Johnson Foundation, the PRT commissioned this report from the Urban Institute to capture their efforts to expand public and private funding and address community needs. 

HRSA Celebrates National Rural Health Day. The public is invited to join the Health Resources and Services Administration (HRSA) online on Thursday, November 18, at 11:00 am ET. Speakers and panelists from several agencies will share what has been learned from the efforts at the federal level and from collaboration with state- and community-level partners. Health equity is a priority focus and Federal Office of Rural Health Policy (FORHP) grantees will share best practices from their projects that consider social determinants of health to improve health outcomes.

Ongoing: HRSA Payment Program for RHC Buprenorphine-Trained Providers. In June of this year, 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 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 $1.5 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: November 2, 2021

Apply Now!  Rural Health Network Development Planning Funding Opportunity

The Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy (FORHP) has announced a funding opportunity that supports the planning and development of integrated health care networks seeking to expand access and improve quality of care in rural communities. HRSA plans to award 20 grants to rural communities as part of this funding opportunity.

Review the funding opportunity to learn more about eligibility & apply:

• Rural Health Network Development Planning Program

FORHP will hold a technical assistance webinar via Zoom for applicants on Wednesday, November 17, 2021 from 3-4 p.m. ET. A recording will be available for those who cannot attend. (Meeting ID: 161 864 4747; Participant Code: 81822150)

Successful award recipients of the Rural Health Network Planning Program will receive up to $100,000 for a one-year period to conduct planning activities that support at least one of the following:

• Achieve efficiencies. Focus on identifying ways to achieve better system efficiencies and improve regional and/or local rural health care services through collaboration, access to additional services, and quality improvement.
• Expand access to, coordinate, and improve the quality of basic health care services. Focus on ways to build capacity and a network infrastructure that enables entities to coordinate care and increase access to care for rural communities both locally and regionally.
• Strengthen the rural health care system as a whole. Focus on ways to enhance community and partner relationships to promote involvement and participation in network planning activities aiming to strengthen the rural health care system.

The eligibility criteria for this program 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.

Tribes and tribal organizations under the same tribal governance must still meet the consortium criteria of three or more entities, but are only required to have a single Employer Identification Number (EIN) located in a HRSA-designated rural area to be eligible. Applicant organizations that share the same EIN as its parent organization, or organizations with the same network who are proposing different projects, are eligible to apply by requesting an exception request.

In FY 2021, HRSA awarded over $1.9 million for Rural Health Network Development Planning Program (Network Planning) grants to assist in the development of an integrated health care network, specifically network participants who do not have a history of formal collaborative efforts. Current FY 21 Network Planning grant recipients may not apply for this funding opportunity if they have previously received a Network Planning grant for the same or similar project unless the entity is proposing to expand the scope of the project or the area that will be served through the project.

Please note that 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 network members must be located in a HRSA-designated rural area.

To learn more about the Network Planning Program click here.  For more information about this funding opportunity, contact the Program Coordinator Nkem Osian at nosian@hrsa.gov. 

Date: October 28, 2021

New Federal Strategy for Overdose Prevention. The U.S. Department of Health & Human Services announced a new focus prioritizing four objectives: primary prevention, harm reduction, evidence-based treatment, and recovery support. Earlier this year, the Centers for Disease Control and Prevention determined that the rate of rural overdose deaths from 1999 to 2019 rose from 4.0 to 19.6 per 100,000 people. In 2019, rates in rural counties were higher than in urban counties in California, Connecticut, North Carolina, Vermont, and Virginia. 

Open Enrollment for Health Insurance Begins November 1. Plans and pricing are already available for preview and consumers may use the Federal Health Insurance Marketplace or one of 18 state-based websites. This year the Centers for Medicare & Medicaid Services took steps to increase the number of Marketplace-registered agents and assisters – especially in underserved communities – to help consumers review options and to  understand their benefits and rights. The boosted effort is the result of a series of research briefs on health insurance access for underserved populations, including racial/ethnic minorities and those living in rural areas. 

New Funding and Resources for State Medicaid Agencies. The Centers for Medicare & Medicaid Services launched a new “one stop shop” for home and community-based services. State-level stakeholders can learn about innovative models for care delivered to Medicaid beneficiaries outside of an institution, such as in their own home. These services, which can be particularly challenging in rural areas, include personal hygiene, nutrition, home health, and transportation. Funding from the American Rescue Plan provides qualifying states with a temporary 10 percentage point increase for certain expenditures for home and community-based services.

HHS Announces New Plan for Health Workforce. The U.S. Department of Health & Human Services (HHS) released a new strategy for expanding supply, ensuring equitable distribution, and improving the quality of the nation’s health workforce. The plan is one of the requirements of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, and will be implemented by the Health Resources and Services Administration and several other operating divisions of HHS.

CDC Seeking Public Input on Work-Related Stress for Health Workers – Comment by November 26. The Centers for Disease Control and Prevention (CDC) seeks information on best practices and promising practices for the positive mental health and well-being of health workers. The feedback will be used to inform interventions under development by the CDC’s National Institute for Occupational Safety and Health. The request includes feedback about first responders and emergency services personnel experiencing higher levels of stress during the pandemic.  

Case Study: Barriers to Hub and Spoke Model for OUD Treatment. Originating in Vermont, the Hub and Spoke model provides a point of care at each stage of recovery from opioid use disorder (OUD), from the intense beginning to long-term treatment. This case study examines what happened in Montana, designated as a Frontier and Remote state by the federal government. Earlier this year, the HRSA-supported Center on Rural Addiction at the University of Vermont conducted a baseline needs assessment (pdf) in that state of rural and non-rural practitioners during two separate one-month periods in 2020. Both rural and non-rural practitioners named stigma and patient time/transportation as top barriers to treatment. A majority of rural providers also named medication diversion as a top concern. 

Place-Based Patterns in Youth Suicide Rates. An analysis of public-use data from the Centers for Disease Control and Prevention revealed rural-specific trends in suicide for Americans aged 10 to 24 over the last 20 years. The study from the American Communities Project and the Center on Rural Innovation found that rural communities have seen some of the highest rates in the age group. Two of the geography types studied, Hispanic Centers and the African American South, had lower rates than the national average. However, rates for Native American communities were far above all others, in some cases more than double other types. 

Reaching Farm Communities for Vaccine Confidence. The AgriSafe Network is a nonprofit organization that provides information and training on injury and disease related to agriculture. Their health professionals and educators created a social media toolkit that aims to provide clear messages about COVID-19 vaccination for agriculture, forestry, and fishing workers.

Ongoing: HRSA Payment Program for RHC Buprenorphine-Trained Providers. In June of 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 (RHC) 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 $1.5 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: October 14, 2021

JAMA: Birth Volume and Geographic Distribution of U.S. Obstetric Hospitals, 2010 – 2018. In an open-access article from the Journal of the American Medical Association (JAMA), researchers report that, among more than 34 million hospital births in the U.S., 37.4 percent of the hospitals were low volume. Among low-volume hospitals, 18.9 percent were isolated and 58.4 percent of these were rural.

New Plan and Policy Statement for Climate Impacts on Health. Last week, the Department of Health and Human Services (HHS) revealed its roadmap for assuring that all parts of the Department address the effects that climate change can have on health and well-being. The plan is in response to an Executive Order for a whole-of-government approach to confronting the crisis that includes extreme weather, rising temperatures and sea levels, and increases in levels of carbon dioxide.

New Spanish Language App Helps Latinos With Health Care. A report from the Department of Health and Human Services (HHS) shows that insurance coverage and access to care improved significantly for Latinos between 2013 and 2016, but they still have among the highest uninsured rate of any racial or ethnic group within the U.S. To build on progress, HHS launched a Spanish version of its QuestionBuilder app, which can help Latino patients prepare for their in-person or telehealth appointments. The Agency for Healthcare Research and Quality built the app to help users improve their interaction with clinicians, providing questions they might want to ask with links to helpful resources. The 2020 Census reports that Hispanics are the second most prevalent racial or ethnic group in rural America, comprising 10.4 percent of the rural population. 

Rural Doulas Supporting Maternal and Infant Health. The latest feature article in The Rural Monitor spotlights a New Mexico doula program that reaches American Indian, Hispanic, and other populations who lack nearby labor/delivery units, a Minnesota program helping moms experiencing incarceration, and a North Dakota program training postpartum doulas to care for families impacted by opioid use disorder and other substance use.

Date: October 7, 2021

HRSA Payment Program for Buprenorphine-Trained Clinicians. In June of this year, the Health Resources and Services Administration (HRSA) launched an effort to improve access to substance use disorder treatment by paying for clinicians who are cleared to prescribe buprenorphine, a medication used to treat opioid use disorder. Rural Health Clinics still have the opportunity to apply for a $3,000 payment for each clinician who trained to obtain the waiver necessary to prescribe buprenorphine after January 1, 2019. Approximately $1.5 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.

CDC Seeking Public Input on Work-Related Stress for Health Workers – Comment by November 26. The Centers for Disease Control and Prevention seeks information on best practices and promising practices for the positive mental health and well-being of health workers. The feedback will be used to inform interventions under development by the Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational Safety and Health. 

CDC’s COVIDVaxView: A Data Dashboard. The Centers for Disease Control and Prevention (CDC) launched an interactive tool for exploring data on COVID-19 vaccination coverage, uptake, and intention by a variety of different factors, including urban, suburban, and rural location. The data supplement the CDC’s COVID Data Tracker. 

GAO on FCC Efforts to Map Broadband Scarcity. In 2020, the Federal Communications Commission (FCC) was tasked with collecting data on the availability of broadband services across the U.S.  For this report, the Government Accountability Office (GAO) interviewed stakeholders at the state and local levels to find challenges for the FCC, which include conflicting and missing data. 

Date: September 30, 2021

New COVID-19 Provider Funding Application Portal Open through October 26.  As of September 29, health care providers can apply for $25.5 billion in provider relief funds. The package includes $8.5 billion in American Rescue Plan (ARP) resources for those who serve rural patients covered by Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP) and $17 billion for Provider Relief Fund (PRF) Phase 4 for a broad range of providers experiencing changes in operating revenues and expenses. Providers may apply for both programs with a single application, and applications must be completed and submitted by October 26 at 11:59 p.m. ET.  HRSA will host four technical assistance webinars for applicants starting on Thursday, Sept 30. 

CDC: State of Vaccination Confidence. (pdf) This is the 15^th report from the Centers for Disease Control and Prevention (CDC) on how Americans think and feel about COVID-19 vaccination. Following the September 9th announcement of an action plan to boost vaccination rates, news reports and social media conversations varied widely: one poll found that the Food and Drug Administration (FDA) approval increased vaccine confidence, while some local news outlets and surveys reported no change in the number of people getting vaccinated. The Centers for Disease Control and Prevention (CDC) report was issued on September 13, almost two weeks before the FDA amended their emergency use authorization for the Pfizer-BioNTech COVID-19 vaccine to allow a single booster dose for certain persons at high risk for contracting the virus.

CDC: Trends in Death Rates, 1999-2019. The Centers for Disease Control and Prevention (CDC) report that death rates for both men and women over the ten-year period were higher in rural areas than urban, and the differences widened over the period. The greatest differences between rural and urban were deaths due to heart disease (189.1 per 100,000 compared with 156.3), cancer (164.1 compared with 142.8), and chronic lower respiratory disease (52.5 compared with 35.4).

Comments Requested: Measuring Quality in Rural Telehealth – Respond by October 8. For more than five years, the National Quality Forum (NQF) has worked with staff and other partners of the Federal Office of Rural Health Policy to develop a rural-specific framework for measuring the performance of healthcare via telehealth. The NQF requests comment from the public on their draft framework (pdf) that covers five domains: 1) access to care and technology; 2) costs, business models, and logistics; 3) experience; 4) effectiveness; and 5) equity that calls for rural-specific measurement of quality.

HHS Inspector General Reports on Use of Crisis Teams by Indian Health Service During Pandemic. The Office of Inspector General (OIG) at the U.S. Department of Health & Human Services (HHS) reviews more than 100 federal programs in an effort to fight waste, fraud, and abuse. This report examines the first five deployments of Critical Care Response Teams to American Indian and Alaska Native communities from June through September 2020.

DEA Alert on increase in Deadly Drugs.  The Drug Enforcement Administration (DEA) issued a rare public safety warning about fake prescription pills containing fentanyl and methamphetamine. DEA laboratory testing reveals a dramatic rise in the number of pills containing at least two milligrams of fentanyl, which is considered a lethal dose. The Centers for Disease Control and Prevention (CDC) reports that, in 2019, drug deaths involving psychostimulants such as methamphetamine were higher in rural counties; the most recent provisional count of deaths across the U.S. shows a 30 percent year-over-year increase in overdose deaths.

Kaiser Family Foundation on Housing and Internet Access. The national nonprofit for health policy used the Census Bureau’s American Community Survey to examine housing adequacy, affordability, and internet access for those enrolled in Medicaid, the federal/state program for health care that covers nearly one in four (24%) nonelderly individuals in rural areas.

Date: September 23, 2021

HHS and USDA Launch Resource Guide for Child Care in Rural Areas. The U.S Departments of Agriculture (USDA) and Health & Human Services (HHS) released a new federal guide to strengthen and expand child care facilities in rural communities. The USDA-RD HHS-ACF Joint Facilities Resource Guide (pdf) includes best practices, innovative approaches, success stories and a list of federal resources available.  The Administration of Children and Families (ACF) is the HHS agency administering federal programs for child care; Rural Development (RD) at the USDA focuses on improving the economy and quality of life in rural America. 

Open Enrollment for Healthcare.gov Extended. Usually, the annual period for buying or changing health insurance plans for the next calendar year begins in November and runs until December 15. Starting this year, the federal government is extending the open enrollment period to January 15 for states that use Healthcare.gov, the federal website for health insurance. State Marketplaces not using the federal eligibility and enrollment platform (Healthcare.gov) can decide their own end date, provided that it is no earlier than December 15. The Centers for Medicare & Medicaid Services made this and other changes to the Health Insurance Marketplace in the final rule for Benefits and Payment Parameters (pdf), further detailed in the Policy Updates section below. It is estimated that 65 percent of uninsured rural adults could have access to a health plan with a $0 premium on Healthcare.gov. 

HRSA Releases New Projections for the Health Workforce. According to data collected by the National Center for Health Workforce Analysis (NCHWA), the supply of primary care physicians in the U.S. will see a shortage by the year 2030; a surplus of nurse practitioners and physician assistants is projected for the same time span. The forecast shows the largest shortages in Nevada, Mississippi, Oklahoma, and Arizona. The NCHWA is part of the Bureau of Health Workforce (BHW) at the Health Resources and Services Administration. Last week, BHW announced funding for a new federal program to increase the number of physician assistants in rural areas. Accredited training programs that can demonstrate a high rate of rural placement for graduates may apply for the HRSA Physician Assistant Rural Training Program through December 9. 

CDC: Overdose Deaths Up by a Third. The Centers for Disease Control and Prevention (CDC) released the latest data on reported deaths due to overdose within the 50 states and the District of Columbia. While final counts are not yet complete, 90,133 deaths occurred between February 2020 and February 2021, an increase of more than 30 percent over the previous year.

ONC: Challenges to Interoperability. The ability to exchange electronic health data between facilities, known as interoperability, is essential to the long-term goals of the Office of the National Coordinator for Health IT (ONC). This report examines the challenges for acute care hospitals – including rural hospitals and Critical Access Hospitals – exchanging electronic health information with public health agencies. The report uses data collected in 2019 and identifies ongoing barriers that may have been exacerbated by the pandemic. 

RAND Weighs in on Vaccine Hesitancy. The RAND Corporation is a non-partisan, nonprofit organization that researches and analyzes public policy. Their recommendations promote the World Health Organization’s “three Cs” model: 1) boosting confidence in the safety and effectiveness of vaccines, 2) combating complacency about the pandemic, and 3) increasing the convenience of getting vaccinated. Earlier this year, the Centers for Disease Control and Prevention cited data showing lower COVID-19 vaccination coverage in rural areas.

Household Food Security in the U.S. Last Year. The Economic Research Service (ERS) at the U.S. Department of Agriculture released its annual report on access to adequate food for households in the U.S.  The survey data collected in December 2020 showed an estimated 89.5 percent of households had food access throughout the year, a number not significantly different from the same survey taken at the end of 2019. The prevalence of very low food security for rural areas, 4.5 percent, was slightly higher than the national average of 3.9 percent.