Federal Office of Rural Health Policy Announcements

November 29, 2018

What’s New

USDA Report on Rural Individuals’ Telehealth Practices. The Economic Research Service at the U.S. Department of Agriculture used detailed household data to analyze three basic telehealth activities as practiced by consumers age 15 or older: 1) online health research; 2) online health maintenance (communication with health providers, including communicating with medical practitioners, maintaining records, and paying bills); and 3) online health monitoring via devices that exchange data remotely with medical personnel. The research found that rural residents were less likely than urban to engage in these telehealth activities, and the report breaks down the findings by income, education and other demographic factors.

Suicide Surveillance Strategies for American Indian and Alaska Native Communities. The Suicide Prevention Resource Center (SPRC) is a federally-supported organization working to advance the National Strategy for Suicide Prevention. This November 2018 report from the SPRC summarizes their findings on suicide prevention research, in an effort “to better understand how American Indian and Alaska Native (AI/AN) communities can gather information about suicide—in ways that are feasible and culturally appropriate.” The report acknowledges the difficulty of collecting data around the sensitive topic of suicide, and also that “each tribe is different and has its own unique culture, so what works in one community might not work in another.” Their findings and recommended strategies are meant to form a foundation for suicide surveillance in tribal communities, but the report stresses that local adaptation is critical to success. Earlier this year, the Centers for Disease Control and Prevention issued research indicating that an estimated 70 percent of AI/AN who died by suicide lived in rural areas and more than a third of suicide deaths occurred among young people, ages 10-24 years. See the Funding Opportunities section below for notices related to this topic.

World AIDS Day is December 1. Established in 1988, World AIDS Day serves as a reminder of the ongoing effort to treat and prevent HIV/AIDS and a recognition of successes, including recent evidence from the Centers of Disease Control and Prevention (CDC) that those who get treatment can live a healthy life. Last year, the CDC reported that in the South and the Midwest, more than 20% of new HIV diagnoses were in suburban and rural areas. The Rural Health Information Hub has articles, program models, toolkits and other resources for addressing HIV in rural communities. At HRSA, recent data from the Ryan White HIV/AIDS program shows that 85% of rural patients receiving treatment were virally suppressed.

Funding Opportunities

Rural Economic Development Loan and Grant Program – December 31. The U.S. Department of Agriculture (USDA) provides zero-interest loans to local utility organizations that are passed through to local businesses for projects that will create and retain employment in rural areas. Projects may include business incubators and start-up ventures, workforce training, business expansion and facilities and equipment for medical care.

Tribal Behavioral Health Grant Program – January 4. The Substance Abuse and Mental Health Services Administration (SAMHSA) will make 51 awards of up to $250,000 each to prevent and reduce suicidal behavior and substance use among AI/AN youth through the age of 24 years. Successful applicants will be federally recognized American Indian and Alaska Native (AI/AN) tribes and tribal organizations that can demonstrate an ability to develop and implement services to prevent suicide and reduce the impact of mental and substance use disorders and trauma. AI/AN community members should be involved in all grant activities, including planning, program implementation, and evaluation. At a minimum, community members should include youth, family members, tribal leaders, and spiritual advisors.

Physician Assistant Program for Primary Care Enhancement – January 14. HRSA’s Bureau of Health Workforce will make seven awards totaling $2 million in funding to increase the number of primary care physician assistants (PA), particularly in rural and underserved settings. Eligible applicants must be accredited and academically-affiliated PA training programs. Domestic faith-based and community-based organizations, tribes and tribal organizations may apply for these funds, if otherwise eligible.

Funding for Geriatrics Career Development – January 15. HRSA’s Bureau of Health Workforce (BHW) will invest $2 million to make 26 awards to accredited schools of allopathic medicine, osteopathic medicine, nursing, social work, psychology, dentistry, pharmacy, or allied health. The purpose of the funding is to support the career development of individual junior faculty in geriatrics. BHW is also accepting applications for the Geriatrics Workforce Enhancement Program – February 6, that will develop partnerships between academia, primary care, and community-based organizations to educate and train a workforce to provide value-based care for older adults. The 2010 Census found that nearly 20 percent of Americans aged 65 and older lived in rural areas, and populations of older adults increase by rurality.

Environmental Public Health Internship Program – January 18. The National Environmental Health Association will support 19 undergraduate and 6 graduate students for ten-week internships in environmental health during the summer of 2019. Interns will gain a firsthand perspective on the day-to-day responsibilities of environmental health professionals and receive a stipend of $400-600 per week to cover lodging, food, and incidental expenses. Rural populations are exposed to environmental risks from agricultural, mining, and other sources, but research has shown that the environmental health workforce in rural areas is underdeveloped.

Tribal College Extension Special Emphasis – February 1. The National Institute of Food and Agriculture (NIFA) will invest $1.1 million in projects that build healthy communities through youth, agricultural, and economic development. Eligible applicants are Tribal Land Grant Colleges, established in 1994 to provide educational opportunities, conduct research, and serve needs of tribal communities. Previous projects funded through this program have addressed substance use disorder, workforce training, and stewardship of local lands.

Rural Health Innovation and Transformation Technical Assistance – February 22. HRSA’s Federal Office of Rural Health Policy seeks to fund one applicant at up to $500,000 per year for three years to provide technical assistance to rural stakeholders and the public through the Rural Health Innovation and Transformation Technical Assistance (RHIT-TA) program. The purpose of this TA is to help rural health stakeholders understand and engage in the value-based care landscape. Eligible applicants include domestic public, private, and nonprofit organizations.

Policy Updates

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

Rural Community Hospital Demonstration Report to Congress. In October, the CMS Innovation Center published the Report to Congress on the progress of the Rural Community Hospital Demonstration, which began in 2005 per the Medicare Modernization Act of 2003 and has been re-authorized twice since. The demonstration examines the effect of an alternative payment methodology for inpatient hospital services in small rural community hospitals with fewer than 51 beds that are not eligible to be Critical Access Hospitals. Over a 12-year period, 33 hospitals participated at some point, and the demonstration increased payments on a per hospital, per year basis by 41 percent during fiscal year (FY) 2005-2009 and 42 percent during FY 2011-2013.

Comments Requested: Proposed Drug Pricing Changes for Medicare Advantage (MA) and Part D Plans – January 25. CMS solicits public comments on potential Medicare policies intended to lower costs for beneficiaries and to provide MA and Part D plans with tools to lower the cost of prescription drugs. Proposals include requiring Part D Explanation of Benefit statements to list drug pricing information, restricting Part D plans from prohibiting or penalizing a pharmacy from disclosing a lower cash price to an enrollee, and redefining the negotiated price paid to pharmacies. Rural pharmacies report that payments from Part D plans are a major concern that affect their financial viability.

Resources, Learning Events and Technical Assistance

CDC Guidance for Hepatitis A Outbreaks – Thursday, November 29 at 2:00 pm ET. During this hour-long webinar, experts from the Centers for Disease Control and Prevention (CDC) will discuss vaccination to stop hepatitis A outbreaks and current CDC recommendations for the hepatitis A vaccine. Hepatitis A is a highly contagious, vaccine-preventable, viral disease spread via a fecal-oral route or by exposure to contaminated food or water. Hepatitis A rates have declined substantially in the United States since the introduction of the hepatitis A vaccine in 1996. However, since early 2017, CDC has observed an increase in the number of community-wide hepatitis A outbreaks in multiple states and recommends vaccination for persons who report drug use or are at high risk for drug use, men who have sex with men, and persons experiencing homelessness. Read the CDC’s June 2018 public health alert on Hepatitis A outbreak.

Enrollment Tutorial: Diabetes Prevention Program – Wednesday, December 12 at 11:00 am ET. Diabetes affects more than 25 percent of Americans aged 65 or older and, according to the Centers for Disease Control and Prevention (CDC), is about 17 percent more prevalent in rural areas. The Medicare Diabetes Prevention Plan (MDPP) Expanded Model is lifestyle change curriculum approved by the CDC that teaches beneficiaries how to manage their diabetes. This hour-long webinar hosted by the CMS will provide a tutorial on how to enroll Medicare beneficiaries into the program.

Insights on Rural Health Insurance Market Challenges – Wednesday, December 12 at 2:00 pm ET. According to the U.S. Census Bureau, populations in rural areas are more dependent on public health insurance programs (e.g. Medicare and/or Medicaid) for health insurance coverage than those living in urban areas. Additionally, those living in rural areas have a slightly higher uninsured rate than those living in urban areas. In this hour-long webinar, experts from the National Advisory Committee on Rural Health and Human Services will discuss its August 2018 policy brief, Rural Health Insurance Market Challenges.