Announcements from the Federal Office of Rural Health Policy

August 2, 2018

Funding Opportunities

ACF Funds Improving Rural Child Welfare – August 13. The Administration for Children and Families (ACF) will award up to $1.9 million for three years to help communities meet the broad range of needs for families involved with both substance misuse treatment and the child welfare system. Recent research from the Office of the Assistance Secretary for Planning and Evaluation (ASPE) shows that a higher rate of overdose deaths significantly increased the odds that children enter the foster care system in rural areas. Eligible applicants are regional partnerships including the state child welfare agency and at least one other local organization, such as community health service providers, schools, or others providing services to children and families. The Rural Services Integration toolkit can help rural providers implement evidence-based and promising programs to link patients and families to needed health and human services.

Rural Health Research

Addressing Commuting as a Public Health Issue: Strategies Should Differ by Rurality. Car commuting is a known risk factor for poor health, by contributing to sedentary behavior and air pollution. Prevention efforts to reduce car commuting—especially long, solo commutes—are important to improving public health. This brief from the University of Minnesota Rural Health Research Center estimates the rate of solo car commuting and long (greater than 30 minutes) solo car commutes by rurality and urban adjacency and identifies differences in socio-demographic factors that relate to commuting behavior by geographic location.

Gender Differences in Social Isolation and Social Support among Rural Residents. In this newly released policy brief, researchers at the University of Minnesota Rural Health Research Center looked at nationally-representative data on social habits of older Americans to learn more about social isolation and its impact on health outcomes in rural communities.

Independently Owned Pharmacy Closures in Rural America, 2003-2018. Over the last 16 years, 1,231 independently owned rural pharmacies (16.1%) in the United States have closed. The most drastic decline occurred in the immediate period following the implementation of Medicare Part D – between 2007 and 2009. This decline has continued through 2018, although at a slower rate. Six hundred and thirty rural communities that had at least one retail (independent, chain, or franchise) pharmacy in March 2003 had no retail pharmacy in March 2018.

Insurance and Access to Care in Urban and Rural Areas, 2014-2015. In this brief from the Agency for Healthcare Research and Quality researchers found that, while rural residents were more likely to have public insurance, there were few differences in the percentage reporting unmet need for medical care, dental care, or prescription drugs across the rural-urban continuum.

Policy Updates

Visit the FORHP Policy page to see all recent updates and send questions to ruralpolicy@hrsa.gov

CMS Proposes Medicare Outpatient Payment and Policy Changes – September 24. CMS seeks comments on its annual rule proposing payment and policy changes for Medicare outpatient services. Changes in the rule are estimated to reduce payments with equal impact to urban and rural hospitals overall. Proposals relevant to rural providers include paying for off-campus clinic visits at the physician rate rather than the hospital rate, reducing payments to non-excepted off-campus provider-based departments for drugs acquired through the 340B Drug Discount Program, and removing measures from the Hospital Outpatient Quality Reporting Program. The rule includes several requests for information (RFI) including providers sharing information with patients about charges and out-of-pocket costs and using Medicare and Medicaid conditions of participation to advance progress toward interoperability. Comments on the proposed rule are due by September 24.

Resources, Learning Events and Technical Assistance

Suicide Prevention in Rural Populations – Tuesday, August 7 at 1:00 pm. The SAMHSA-HRSA Center for Integrated Health Solutions is a national training and technical assistance center that promotes the development of integrated primary and behavioral health services. This hour-long webinar is an interactive roundtable discussion on suicide screening and prevention tools and the management of suicide risk, with a special focus on rural populations.

Tribal Grant Learning Series: Preparing a Budget for Your Proposal – Wednesday, August 8 at 1:00 pm ET. Session #5 in this webinar series on the grant application process will help tribal organizations gain a better understanding of the basic elements of federal grant budgets and learn how to develop budgets for their project work plan that cover allowable costs.

Responding to Emerging Agricultural Health Threats – Wednesday, August 8 at 11:00 am ET. The National Libraries of Medicine hosts this hour-long session on new occupational health threats in agriculture. Natalie Roy, Executive Director of AgriSafe Network will discuss the systematic approach rural health stakeholders must take to respond to extreme weather events, opioid misuse and elevated suicide rates in farming communities.

HRSA Telehealth Learning: Pediatric Obesity – Wednesday, August 8 at 2:00 pm ET. Session #3 in HRSA’s Telehealth Learning Series features experts from the University of Kansas Medical Center who have developed treatment recommendations for pediatric obesity. During this webinar, you will hear about the prevalence of pediatric obesity and the use of telehealth for its treatment. Last month, the Journal of the American Medical Association published a study showing the prevalence of severe obesity for rural children aged 2-19 is nearly twice that of their urban counterparts.

CIHS Roundtable: Integrated Care for Rural Populations – Tuesday, August 14 at 3:00 pm. The SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) is a national training and technical assistance center that promotes the development of integrated primary and behavioral health services. This hour-long webinar for HRSA-funded safety net providers is an interactive, roundtable session providing direct access to experts in the field for questions and consultations. Integrating behavioral health into primary care is one way to better address mental health and substance use issues, particularly in rural areas short on mental/behavioral health workforce.