Join RTTC’s Virtual Launch Week: RISE for Rural Telementoring

On October 25-29, join the national Rural Telementoring Training Center (RTTC) for the virtual launch of Resources, Information, Support, and Education – RISE for Rural Telementoring.

This week celebrates the release of an array of tools and resources to support the implementation and evaluation of telementoring for rural health care. Over the course of five days, the RTTC will host multiple virtual events to highlight the theme of Emerging Voices in Rural Telementoring, including a photography competition, micro-lectures from leaders in telementoring, and stories from community members and rural health workers. 

All events are virtual and free to attend. 

Register here

Visit the RTTC website: www.ruraltelementoring.org

October 22, 2021

CMS NEWS: CMS Launches Webpage to Share Innovative State Actions to Expand Medicaid Home and Community-based Services

The Centers for Medicare & Medicaid Services (CMS) launched a new “one-stop shop” for state Medicaid agencies and stakeholders on Medicaid.gov to advance transparency and innovation for home and community-based services. Home and community-based services allow people enrolled in Medicaid to receive services and supports in a preferred setting outside of an institution, such as in their own home. Through this new webpage, state Medicaid agencies and stakeholders can access information about states’ plans to enhance, expand, and strengthen home and community-based services across the country using new Medicaid funding made available by the American Rescue Plan Act of 2021 (ARP).

Additionally, CMS is approving a new Medicaid section 1115 demonstration in Alabama, entitled the “Community Waiver Program,” to operate concurrently with a home and community-based services 1915(c) waiver. This new opportunity in the state’s Medicaid program will increase access to home and community-based services, and allow the state to meet the needs of additional individuals who prefer to get long-term care services and supports in their home or community rather than an institutional setting.

“One-stop Shop” for Plans to Enhance, Expand, & Strengthen Home and Community-based Services 

To encourage states to expand home and community-based services and strengthen their programs, the Biden-Harris Administration implemented a funding increase established by the ARP. The ARP provided states with a temporary 10 percentage point increase in federal Medicaid funding for certain Medicaid home and community-based services from April 1, 2021 through March 31, 2022, if they meet certain requirements. As the COVID-19 pandemic continues, the additional federal funding made available under the ARP allows those enrolled in Medicaid who need long-term services and supports to receive the assistance required to reside in the setting of their choice.

“The Biden-Harris Administration recognizes the value and dignity that come with access to home and community-based services,” said the Department of Health and Human Services (HHS) Secretary Xavier Becerra. “Thanks to the American Rescue Plan, we can support states working to expand access to home and community-based services for Medicaid beneficiaries. With the launch of this new online hub, we’re making it easy for states to exchange ideas on how best to care for their residents.”

“The ability to access health care at home or in the community is essential for many low-income families, older adults, and individuals with disabilities who rely on Medicaid services — especially during this unprecedented public health emergency,” said CMS Administrator Chiquita Brooks-LaSure. “Thanks to the American Rescue Plan, CMS is providing state Medicaid agencies with the tools and funding needed to expand this important care. We welcome the opportunity to work with states to expand home and community-based services to meet the needs of their communities.”

The announcement issued reinforces CMS’s commitment to assist states in response to the public health emergency. State administrators and stakeholders are encouraged to visit Medicaid.gov to view states’ programs and activities to identify innovative approaches that can support home and community-based services and improve capacity building and infrastructure in their area by drawing inspiration from other states.

For example, some states are delivering vaccines to people with disabilities and older adults through mobile COVID-19 vaccination programs. Other states are focusing on the potential of home and community-based services to help people with Medicaid coverage receive care outside a skilled nursing facility after a hospitalization, when aligned with the beneficiary’s goals. Other activities may include expanding and implementing new, community-based behavioral health crisis response services, ensuring that a qualified provider with training quickly and properly responds to mental health and substance use-related crisis situations. Many states are also providing recruitment and retention bonuses and increasing pay for direct support professionals, as well as implementing new training programs and other strategies to strengthen the direct support workforce. These actions allow Medicaid enrollees to receive care in the comfort of their own home or in a preferred community setting.

To view the home and community-based services webpage with states’ ARP section 9817 spending plans and narratives, letters issued to states on their spending plans and narratives, and other important information related to the implementation of ARP section 9817, please visit https://www.medicaid.gov/medicaid/home-community-based-services/guidance/strengthening-and-investing-home-and-community-based-services-for-medicaid-beneficiaries-american-rescue-plan-act-of-2021-section-9817-spending-plans-and-narratives/index.html.

For additional information on ARP funding for home and community-based services, see the guidance that CMS issued to states via a State Medicaid Director Letter in May of this year.

New Demonstration for Home and Community-based Services in Alabama

The Biden-Harris Administration is proud to help states that have long been at work to advance home and community-based services. Separate from the new website launched today, CMS has approved Alabama’s earlier application for a section 1115 demonstration, entitled “Community Waiver Program.” The 1115 demonstration will operate concurrently with a home and community-based services 1915(c) waiver in Alabama, a new opportunity in the state’s Medicaid program to meet the needs of additional individuals who prefer to get long-term care services and supports in their home or community rather than an institutional setting. Together, Alabama’s 1115 demonstration and 1915(c) waiver will increase access to home and community-based services for many Alabamans who are currently on a waiting list.

The state will now be able to redesign its home and community-based services delivery system to address concerns, such as long waiting lists, high use of residential services and out-of-home placements, and low integrated community employment rates among its residents. CMS will also provide the authority needed for Alabama to create a new program that supports individuals with intellectual disabilities who choose to work, live with family, or live independently.

“It is important we find ways to collaborate to help Alabamians in need, particularly those with intellectual disabilities. My Administration is pleased to offer the Community Waiver Program, which focuses on serving individuals with intellectual disabilities before they are in crisis,” said Alabama Governor Kay Ivey. “The partnership between the Alabama Department of Mental Health and the Alabama Medicaid Agency will help integrate these individuals in the community, giving them a better chance to develop skills to work and live independently.”

To view Alabama’s section 1115 demonstration approval and the new 1915(c) waiver, visit: https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/101016.

COVID-19: Moderna & Jansen (J&J) Booster Shots

Effective October 20, 2021, FDA amended the emergency use authorizations for the Moderna and Jansen (Johnson & Johnson) COVID-19 vaccines to allow for use of a single booster dose for certain populations.

Get the most current list of billing codes, payment allowances and effective dates.

More Information:
CMS News Alert
COVID-19 provider toolkit including:

• Payment rates for administering vaccines
• How to bill correctly

Date: October 14, 2021

HHS Announces Availability of $100 Million for State Loan Repayment Programs to Support Primary Health Care Workforce in Underserved Communities

October 14 – The U.S. Department of Health and Human Services (HHS) is announcing the availability of $100 million in American Rescue Plan (ARP) funding for state-run programs that support, recruit, and retain primary care clinicians who live and work in underserved communities. This funding represents a five-fold increase to the Health Resources and Services Administration’s (HRSA) State Loan Repayment Program (SLRP), and helps improve health equity by ensuring that clinicians working in high-need communities remain in them.

HRSA’s Bureau of Health Workforce is accepting applications for these grants from all 50 states, Washington D.C., and U.S. territories. HRSA estimates that it will make up to 50 awards of up to $1 million per year, over the program’s four-year project period.

Read the release.

Provider Relief Funding

HRSA is now accepting applications for $25.5 billion in Provider Relief Fund (PRF) Phase 4 and American Rescue Plan (ARP) Rural payments. 

Application Due Date: Tuesday, October 26, 11:59 p.m. ET.

Rural Communities Opioid Response Program-Implementation

Federal Office of Rural Health Policy (FORHP) is accepting applications for the Rural Communities Opioid Response Program – Implementation. FORHP plans to make awards of approximately 50 grants – of up to $1 million each – to enhance substance and opioid use disorder prevention, treatment, and recovery service delivery in rural communities. 

Application Due Date: Thursday, January 13, 2022, 11:59 p.m. ET.

Public Consultation on the Draft HHS Strategic Plan FY 2022-2026

The Department of Health and Human Services (HHS) is seeking public comment on its draft Strategic Plan for fiscal years 2022-2026 that articulates how the Department will achieve its mission through five strategic goals. You can comment by email, fax, or mail through Sunday, November 7.  

• E-mail: HHSPlan@hhs.gov, please include the Objective Number in the subject line of your email.
• Fax: (202) 690-5882

Mail: U.S. Department of Health and Human Services
Office of the Assistant Secretary for Planning and Evaluation, Strategic Planning Team
Attn: Strategic Plan Comments
200 Independence Avenue, SW, Room 434E
Washington, DC 20201

New! Find a Health Center Video

This week HRSA released a new video, “Find a Health Center,” to increase awareness about health centers and help potential patients locate a health center near them.

Help by sharing the video on your social media pages and with your colleagues!

National Domestic Violence Awareness Month

October is National Domestic Violence Awareness Month. Domestic violence and health care are closely linked. According to a survey of contacts with the National Domestic Violence Hotline, 53% of respondents reported that an abusive partner has also controlled and/or restricted access to healthcare.

Office of Women’s Health and Bureau of Primary Health Care are working with the Administration of Children and Families and the National Domestic Violence Hotline to address these intersections.

Learn about other HRSA intimate partner violence work or view last year’s webinar, Sheltering in Place, Intimate Partner Violence, and the Healthcare Response.

National Bullying Prevention Month

October is National Bullying Prevention month. To bring awareness to this issue, which affects 1 in 5 high school students, HRSA participated in the HHS effort to highlight the role health care providers can play in identifying and addressing bullying. In a new public service announcement (PSA), Dr. Rachel Levine, the U.S. Assistant Secretary of Health, calls on health care providers to address and combat bullying in their communities.

Bullying can result in long-term mental and physical health problems. Helping providers intervene early and effectively is critical. Please share the PSA with relevant providers, including pediatricians, nurses, mental health professionals, and social workers.

DATA 2000 Waiver Training Payments Still Available for Rural Health Clinics

HRSA continues to accept applications for payment from Rural Health Clinics (RHCs) employing buprenorphine-waivered providers under the Drug Addiction Treatment Act of 2000 (DATA 2000) Waiver Training Payment Program. 

The program gives RHCs the opportunity to apply for a $3,000 payment for each eligible employed provider who attained a DATA 2000 waiver on or 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.

HRSA is collaborating with the Substance Abuse and Mental Health Services Administration (SAMHSA) to process these applications. For more information, the program provides a video and FAQs.

Date: October 21, 2021

Click to view NRHA Today.

Date: October 19, 2021

The Flex Monitoring Team has released a new policy brief, The Association Between System Affiliation and Financial Performance in Critical Access Hospitals.

There is growing evidence to suggest that affiliation with a health system may have important implications for rural hospitals. However, most studies have not investigated the effects of system affiliation on CAHs, specifically, and it is important for hospitals and state Flex programs to anticipate the consequences and potential impact of system affiliation. The purpose of this study is to examine the association between system affiliation and the financial indicators included in the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS).

Data on system affiliation in 2018 were drawn from the Medicare Cost Reports in the Healthcare Cost Reporting Information System (HCRIS) and from the American Hospital Association (AHA) Annual Survey. Data on hospital financial performance, size, ownership, and operation of long-term care or rural health clinics in 2018 came from HCRIS. The final sample included 1,360 CAHs, 582 of which were identified as being affiliated with a health system and 778 of which were identified as not being affiliated.

Consistent with previous studies of rural hospitals generally, results from this analysis showed that system affiliation is significantly associated with CAH financial performance. On average, system affiliation was associated with stronger financial performance.

View Policy Brief