Federal Office of Rural Health Policy Announcement

March 21, 2019

What’s New

Ongoing Work on Rural Health Issues at the CDC.  In the latest edition of The Rural Monitor, Senior Policy Analyst Diane Hall answers questions about the work on rural health at the Centers for Disease Control and Prevention (CDC). What started as a series in 2017 for their Morbidity and Mortality Weekly Report (MMWR) has continued with ongoing work with representation from each of the CDC’s centers ensuring that rural communities are included in funding opportunities and projects.  The MMWR series oriented the public and policymakers to the rural specifics on topics such as drug overdose deaths, leading causes of death, suicide trends, and cancer incidence and deaths.

2019 County Health Rankings.  Released on Tuesday of this week, the 2019 ranking of health for nearly every county in the nation reminds us that health outcomes are heavily influenced by where we live.  This year’s analysis focuses specifically on homes and the way they shape the health of individuals, families and communities.  Among the key findings is evidence showing that severe housing cost burden has decreased in large urban areas since the end of the real estate crisis that ended in 2010.  In that same period of time, however, nearly half of all rural counties experienced an increase in severe housing costs.

CDC: Tracking Transmission of HIV.   On Monday, the Centers for Disease Control and Prevention (CDC) released their latest report on rates of HIV transmission in the United States.  Data for sexual and needle-sharing behaviors were obtained from National HIV Behavioral Surveillance, a system of research on behaviors of three populations at increased risk for HIV: 1) gay, bisexual and other men who have sex with men; 2) persons who inject drugs; and 3) heterosexuals at increased risk of infection.  These data for behavioral factors in 2016 were compared to data for newly diagnosed cases from the National HIV Surveillance System.  The analysis found that, of the 38,700 new infections diagnosed in 2016, approximately 80% of new HIV transmissions were from persons who did not know they had HIV infection, or who had received diagnosis but were not receiving care.  The report concludes that decreasing the rate of transmission relies on increasing the rate of testing and treating those who are HIV-positive with newer drugs proven to be effective at suppressing the virus.  Last year, the CDC identified 220 mostly rural counties experiencing or at-risk of significant increases of infection.  See the Approaching Deadlines section below for current funding opportunities related to the effort of reducing HIV transmission.

Funding Opportunities

CDC Overdose Data Collection – May 2. The Centers for Disease Control and Prevention (CDC) will make 78 awards to state and local governments for a three-year funding opportunity.  A total investment of $945 million will be available to help local partners collect timely data on prescribing, and on nonfatal and fatal drug overdoses.  The purpose is to help the CDC understand the scope, direction, and contours of the epidemic and then use data to inform and target their prevention and response efforts.

HRSA Opioid Workforce Expansion Program – May 7.  The Health Resources and Services Administration (HRSA) will make 29 awards for a total investment of $39 million to train behavioral health professionals with a focus on prevention, treatment, and recovery services for substance use disorders.  Eligible applicants are accredited institutions of higher education or behavioral health professional training programs.

CDC Grants for Health and Wellness in Indian Country – May 15. The Centers for Disease Control and Prevention (CDC) will invest $20 million for 30 awards.  Native American tribal organizations and federally-recognized governments are eligible to compete for multi-year projects with long-term goals of reducing rates of death and disability from tobacco use, diabetes, heart disease and stroke, and reducing the prevalence of obesity.

Policy Updates

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

No Policy Updates this week.

Resources, Learning Events and Technical Assistance

Webinar for RHCs on the AgriSafe Nurse Scholar Program – Wednesday, March 27 at 2pm EDT. As part of its Rural Health Clinic (RHC) Technical Assistance series, the National Association of Rural Health Clinics (NARHC) will host a webinar featuring a speaker from AgriSafe’s Nurse Scholar program. The AgriSafe Nurse Scholar program is a distance learning opportunity available to rural nurses providing agriculture specific healthcare training on the spectrum of risks for farmers and agricultural workers.

A Health Equity Approach to Obesity Efforts – Monday, April 1 at 8:30 am ET.  This day-long workshop hosted by the National Academies will explore health equity issues for demographic groups with above-average obesity risk and discuss prevention and treatment efforts.  Last year, the Centers for Disease Control and Prevention released findings that obesity prevalence was significantly higher among adults living in rural counties.

AgriSafe: Safety Sensitivity of Opioid Use in High-Hazard Industries – Monday, April 1 at 3:00 pm ET.  Safety-sensitive work is typically classified as operating motor vehicles, modes of transportation, other heavy machinery, or tasks requiring high levels of cognitive function or judgement. Because farm duties frequently demand the use of heavy machinery, the concurrent use of narcotics can be dangerous. This 75-minute webinar hosted by the AgriSafe Network will educate healthcare providers on how to assess occupational agricultural risks and corresponding patient guidance for those who are taking opioid medications.

AgriSafe: Assessment of Opioid Misuse Risk Among Farmers – Tuesday, April 2 at 1:00 pm ET.  Prescription opioids are often the first-line therapy to treat chronic and acute pain among farmers. Prescribing opioids to farmer populations that may not seek regular treatment or have access to alternative therapies increases the risk for potential opioid misuse. Properly assessing for these characteristics among other abuse or addiction risk factors, is critical in providing treatment that is both appropriate and effective. This hour-long training module will provide insight on misuse risk factors among farmers to better inform healthcare providers on warning signs in this specific cohort.

ICYMI:  Addressing the Burden of COPD in Rural America –  Webinar Recording Available.  In case you missed it, check out a recording of the webinar on Chronic Obstructive Pulmonary Disease (COPD) hosted by the Rural Health Information Hub and the National Advisory Committee on Rural Health and Human Services.  The webinar highlighted the prevalence and outcomes of COPD in rural America, recent NACRHHS policy recommendation, and what it’s like to live with the disease.

Resources of the Week

It’s National Poison Prevention Week.  Each year during the third week of March, the American Association of Poison Control Centers raises awareness to poison prevention and the resources that are available around the clock every day of the year.  Poisonings remain among the top three leading causes of unintentional fatal injury. These poisonings are overwhelmingly related to drug overdose; but additional risk in rural areas comes from fumes and vapors that occur in industrial, manufacturing and agricultural occupations.

Profiles Spotlight Innovations in Rural Health Care Delivery and Finance. The Rural Health Value team has recently published two new profiles highlighting real-world innovative approaches that rural providers are taking to improve care and lower costs. The most recent profile showcases the work of Health Care Collaborative (HCC) of Rural Missouri, which has built and sustained a network of more than 55 member organizations to meet both health care and social service needs in the community. The other profile describes how Community Care Partnership of Maine, a collaboration of nine federally qualified health centers (FQHCs) and three community hospital systems, uses predictive analytics to identify patients with the highest risk and plan interventions to support care management.

Approaching Deadlines

Increasing Access to HIV Primary Health Care Services – March 22

Comments Requested:  Physician-focused Payment Model for Rural Emergencies – March 22

HRSA Rural Residency Planning and Development Program – March 25

SAMHSA: Expanding Capacity for Substance Use Disorder – March 25

Rural Health and Economic Development Analysis – March 27

NURSE Corps Loan Repayment Program – March 28

Comments Requested: Changes to Hospital Star Ratings – March 29

Indian Health Service Scholarships – March 29

Medicare Rural Hospital Flexibility Program – March 29

SAMHSA: Underage Substance Use in Tribal Communities – March 29

Rural Primary Care SBIRT for Maternal Opioid Use – March 29

National Indian Health Board Health Policy Fellowships – March 30

ACL Alzheimer’s Disease Programs Initiative – April 1

NIH: Small Business Innovations for Health Disparities – April 1

Comments Requested: Draft Report on Best Practices for Pain Management – April 1

Medicare Rural Hospital Flexibility – EMS Supplement – April 5

CDC Immunization and Vaccine Programs for Children – April 8

CDC Research Grants to Identify Effective Strategies for Opioid Overdose Prevention – April 8

ARC Funding for Economic Revitalization in Appalachia – April 10

DOJ Training and Technical Assistance for Violence Against Women – April 11

DOJ Grants to Tribal Governments for Special Domestic Violence Criminal Jurisdiction Solicitation – April 11.

OMH Hepatitis B Demonstration Grant Program – April 13

CDC: Collecting Information for the National Violent Death Reporting System – April 15

Full-Service Community Schools Program – April 15

NIH Grants to Translate Research Into Clinical Practice – April 15

USDA Distance Learning and Telemedicine Grants – Opioid – April 15

Nurse Anesthetist Traineeship Program – April 15

CDC Violent Death Reporting System – April 15

USDA Community Connect Grant Program – April 15

Strengthening Care for HIV and Opioid Use Disorder – April 16

SAMSHA Grants for Children with Serious Emotional Disturbances – April 19

SAMHSA Grants Linking Actions for Unmet Needs in Children’s Health – April 19

HRSA Small Health Care Provider Quality Improvement Grant Program – April 22

SAMHSA: Substance Use Disorder Treatment for Minorities at High Risk for HIV/AIDS – April 22

NIH Summer Research Education Experience Program – April 23

Mary Kay Foundation Domestic Violence Shelter Grants – April 30

CDC Overdose Data Collection – May 2

Comments Requested: CMS Proposed Updates to Interoperability & Patient Access to Health Data – May 3

Comments Requested: ONC Proposal for Interoperability of Health IT – May 3

Rural Communities Opioid Response Program-Implementation (RCORP-Implementation)  – May 6

RCORP-Evaluation Funding Opportunity – May 6

HRSA Maternal Opioid Misuse Model – May 6

SAMHSA Grants for First Responders to Opioid Overdose – May 6

HRSA Opioid Workforce Expansion Program – May 7

DOJ Opioid Affected Youth Initiative – May 7

NIH Intervention Research to Improve Native American Health – May 14

CDC Grants for Health and Wellness in Indian Country – May 15

USDA Traditional Distance Learning and Telemedicine Grant Program – May 15

Capacity Building for Patient-Centered Outcomes Research – May 31

USAC Telecommunications Program for Rural Health Care – May 31

USDA Rural Broadband Loan and Grant Program – May 31

Research for Smoking Cessation in Disadvantaged Populations – June 13

Indian Health Service Loan Repayment Program – Ongoing through August 2019

NIH: Research for Disparities Among Minority/Underserved Children – Cycles thru May 2020

Guaranteed Loans for Rural Rental Housing – Ongoing through 2021

Telecommunications Infrastructure Loans – Ongoing

Funding for Rural Water and Waste Disposal Projects –  Ongoing

Drinking Water and Waste Disposal for Rural and Native Alaskan Villages – Ongoing

HIT Strategies for Patient-Reported Outcome Measures – Ongoing

HIT to Improve Health Care Quality and Outcomes – Ongoing

Community Facilities Program –  Ongoing

Summer Food Service Program – Ongoing