Federal Office of Rural Health Policy Announcements

February 14, 2019

What’s New

White House Launches High Speed Broadband Initiative.  On Wednesday, the White House announced a new effort to increase broadband access, particularly in rural areas where coverage and speeds are insufficient to accommodate needs for health care, education and commerce.  With input from a range of federal agencies, including the U.S. Departments of Agriculture, Commerce, Health and Human Services and Interior as well the Federal Communications Commission, the American Broadband Initiative Milestones Report offers recommendations grouped into three categories: streamlining federal permitting processes to speed broadband deployment, leveraging federal assets to lower the cost of broadband build-outs, and maximizing the impact of federal funding.  See the Funding Opportunities section below for announcements related to broadband access and telecommunications specific to rural areas.

Advancing Tobacco Prevention and Control in Rural America. The National Network of Public Health Institutes (NNPHI), in conjunction with the Maine Public Health Institute and the National Association of Chronic Disease Directors (NACDD), announced the release of a new report highlighting the significant toll tobacco has on rural communities.  The report – which includes 15 recommendations for advancing rural tobacco control initiatives and suggestions for future research – explores rates and patterns of commercial tobacco use across rural, aspects of the rural context that may affect tobacco control efforts, and current rural tobacco control activities. According to the Centers for Disease Control and Prevention, cigarette smoking disproportionately affects the health of people with lower socioeconomic status, with people living in deprived, rural areas experiencing rates of lung cancer that are 18-20 percent higher than people living in urban areas.

AHA Report on Challenges to Rural Access to Care.  The American Hospital Association (AHA) report takes a comprehensive look at persistent challenges to health care in rural communities, an examination that includes hospital closures, the opioid crisis, social determinants of health, lack of behavioral health and workforce shortages.  While it acknowledges a role and responsibility for better policy at every level, the report focuses on federal policies and investments in light of their nationwide impact and reach.

Funding Opportunities

Increasing Access to Healthy Foods Innovation Grants – March 6. The National Recreation and Park Association will fund 15 grantees for up to $35,000 each to implement one of three innovation strategies in their community:  1) starting or expanding farmers markets; 2) starting or planning meal programs for youth and seniors; and 3) addressing transportation and infrastructure barriers in rural, suburban or urban communities.  According to the Economic Research Service at the U.S. Department of Agriculture, food insecurity is strongly associated with chronic disease and poor health.

Native Youth and Culture Fund – March 12.  The First Nations Development Institute will make 20 awards of up to $19,500 each for native-controlled nonprofit and community organizations that will develop projects incorporating culture and tradition to address social and health issues, such as drug and alcohol abuse, teen pregnancy, and mental health.  The projects must focus on one or more of four priorities: 1) preserving and strengthening cultural beliefs and values; 2) engaging both youth and elders in traditional practices; 3) increasing youth leadership through education and mentoring; 4) reviving or preserving tribal language, arts, history or other culturally relevant areas.

HRSA Rural Residency Planning and Development Program –Extended to March 25.The purpose of this grant program is to develop new rural residency programs or Rural Training Tracks (RTT) in family medicine, internal medicine, and psychiatry to support expansion of the physician workforce in rural areas. The new rural residency programs are intended to be sustainable through separate public or private funding beyond the three-year grant period of performance.  This program is a collaboration between the Federal Office of Rural Health Policy and the Bureau of Health Workforce at the Health Resources and Services Administration (HRSA).  The original deadline of March 4 has been extended to March 25.

ACL Alzheimer’s Disease Programs Initiative – April 1.  The Administration for Community Living (ACL) will make 22 awards of up to $1 million each for development and expansion of dementia-capable home and community-based service systems in states and communities.  Eligible applicants are housing authorities, public and private institutions of higher learning and state and local governments, including federally recognized tribal organizations.  The Centers for Disease Control and Prevention estimates that by 2030, one in five Americans, 72.7 million people, will be aged 65 or older; this number is projected to reach 83.7 million by 2050. Previous research from the Alzheimer’s Association has shown that three socioeconomic factors – low income, low education attainment, and having lived in a rural area as a child – are associated with greater risk of developing Alzheimer’s and other dementias.

CDC Immunization and Vaccine Programs for Children – April 8.  More than $377 million will go toward 64 awards for programs that prevent disease, disability and death through immunization.  Through cooperative agreement with the Centers for Disease Control and Prevention (CDC), city, state and territorial governments will use federal funds and resources to develop, implement, promote and assess immunization-related activities with the goal of achieving and sustaining high immunization coverage.  The CDC released data last year showing that rural youth are less likely to be vaccinated against serious illness than those in urban areas, a status that echoes research on the subject over the last 25 years.

Nurse Anesthetist Traineeship Program – April 15.  HRSA’s Bureau of Health Workforce will invest $2.25 million for 80 awards to accredited schools of nursing, nursing centers, academic health centers, state or local governments, and other public or private nonprofit entities. The purpose of the Nurse Anesthetist Traineeship Program is to increase the number of Certified Registered Nurse Anesthetists (CRNAs) providing care, especially to rural and underserved populations.  Nurse Anesthetists are on the front lines of the opioid epidemic, especially in rural areas, where they are often the sole provider of anesthesia services.  As part of their training, these individuals learn about multi-modal pain management and opioid addiction and treatment, which are a key part of helping communities address the crisis.

Capacity Building for Patient-Centered Outcomes Research – May 31. The Patient-Centered Outcomes Research Institute (PCORI) will award $20.5 million for projects that encourage meaningful engagement of patients and other healthcare stakeholders in the research process.  PCORI views this broader engagement as involving patients, caregivers and providers participants in the research process – from topic selection through design and conduct of research to dissemination of results.  Eligible applicants include any public, private, non-profit or for-profit organization or any unit of local, state or federal government.  Past research projects have uncovered gaps in understanding and lessons learned from rural patient engagement in health-related research.

USAC Telecommunications Program for Rural Health Care – May 31.  The Universal Service Administrative Company (USAC) is an independent, not-for-profit corporation designated by the Federal Communications Commission to administer federal funds for broadband connectivity in areas that lack it.  Through its Rural Health Care Telecommunications Program, USAC provides assistance to healthcare providers for eligible expenses related to broadband connectivity based on the urban-rural price difference in an area.  Public and nonprofit healthcare providers located within rural areas designated by USAC are eligible.

USDA Rural Broadband Loan and Grant Program – May 31.  The U.S. Department of Agriculture (USDA) will make grants and loans of up to $25 million to fund broadband service through its Rural eConnectivity program (ReConnect).  Eligible applicants are public and private non-profit organizations, for-profit corporations and limited liability companies, as well as state, local and tribal governments that can provide service in rural areas where at least 90% of the households do not have sufficient broadband access, defined as 10 megabits per second (Mbps) downstream and 1 Mbps upstream. Three types of award will be made depending on the best fit for the applicant’s business model, service area, and financial plan: 1) one-hundred percent grant with a 25 percent match requirement; 2) fifty percent grant/fifty percent loan with interest rate set at the time funds are advanced; 3) one-hundred percent loan with an interest rate fixed at two percent.

Policy Updates

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

Comments Requested: Proposed Updates to Interoperability & Patient Access to Health Data – Early April. On February 11, the Centers for Medicare & Medicaid Services (CMS) proposed policy changes supporting its MyHealthEData initiative to improve patient access and advance electronic data exchange and care coordination throughout the healthcare system. The proposed rule solicits comments on policies that would affect hospitals, including critical access hospitals (CAHs). This includes policies on public reporting and prevention of information blocking and requiring Medicare-participating hospitals, psychiatric hospitals, and CAHs to send electronic notifications when a patient is admitted, discharged or transferred. In addition to the policy proposals, CMS is releasing two related Requests for Information (RFIs). CMS will accept comments on the major provisions in this proposed rule and the RFIs (CMS-9115-P) until early April (exact date will be updated upon posting at the Federal Register).

Learning Events and Technical Assistance

AgriSafe Strategies for Heat-Related Illness – Tuesday, February 19 at 4:30 pm ET.  The AgriSafe Network will hold this one-hour webinar to review warning signs of heat-related illnesses encountered by agricultural workers, and provide resources that can be shared in rural communities.

Telehealth Training Modules for the Health Workforce – Wednesday, February 20 at 2:00 pm ET.  Programs in HRSA’s Bureau of Health Workforce provide financial support to institutions and individuals training in primary and behavioral health care.  The goal of the Workforce Grand Rounds webinar series is to improve health professions training, particularly in rural and underserved communities. This 90-minute webinar will identify telehealth strategies and models for hard-to-reach populations in both rural and urban communities.

Q&A Session for New Health Center Applicants – Wednesday, February 20 at 3:00 pm ET.  To assist applicants for New Access Points for Health Centers – March 12,  HRSA’s Bureau of Primary Health Care will hold an hour-long Q&A session about the application process.  Public, private, and nonprofit entities including tribes, tribal organizations, faith-based organizations, and community-based organizations may apply. New Access Points – also known as NAPs – are new, full-time, permanent service delivery sites providing comprehensive primary health care services to underserved populations.

AgriSafe: Opioid Use in High-Hazard Industries – Tuesday, February 26 at 1:00 pm ET.  This hour-long webinar training educates healthcare providers on how to assess occupational agricultural risks and corresponding patient guidance for those who are taking opioid medications.

Rural Philanthropy Toolkit – Tuesday, February 26 at 1:00 pm ET.  The Rural Health Information Hub will host this one-hour webinar on a toolkit to help rural organizations create and maintain partnerships with philanthropies. The toolkit provides steps and resources for connecting with philanthropic organizations and examples of emerging strategies in rural communities.

Save the Dates: Virtual Job Fairs for SUD Clinicians and Employers – through March 7.  HRSA’s Bureau of Health Workforce will hold a series of virtual job fairs to match employers and clinicians treating substance use disorder (SUD).  Virtual job fairs are free, interactive events held online allowing sites approved by the National Health Service Corps and/or NURSE Corps a chance to discuss their site, the populations they serve, and currently available positions.  Clinicians and trainees in medical, nursing, dental, and mental/behavioral health can learn about hundreds of opportunities in rural and medically underserved communities.

Approaching Deadlines

USDA Healthy Food Financing Initiative – February 14

Rural Sexual Assault, Domestic Violence and Stalking Program – February 14

Environmental Justice Small Grants Program – February 15

NIH/NIDA: Mobile Technologies for Substance-Use Treatment – Letters of Intent February 19

Comments Requested: Proposed Changes to the 2020 Health Insurance Marketplace – February 19

Comments Requested: Accrediting Organizations Conflict of Interest and Consulting Services in Medicare – February 19

Comments Requested: Proposed Changes to the Medicare Advantage Risk Adjustment Model – February 19

Nominations:  Medicaid and CHIP Payment and Access Commission (MACPAC) – February 20

NHSC Loan Repayment Program – February 21

NHSC Loan Repayment Program for Substance Use Disorder Workforce – February 21

Youth Health Equity Fellowship – February 22

Rural Health Innovation and Transformation Technical Assistance – February 22

Public Safety and Victim Services in Tribal Communities – February 26

Comments Requested:  Proposed Updates to the Medicare Advantage (MA) and Part D Programs – March 1

NIH: Small Business Innovations for Health Disparities – Letters of Intent March 1

NIH Researching HIT for Health Disparities – March 4

Advanced Nursing Education Nurse Practitioner Residency Program – March 4

Increasing Access to Healthy Foods Innovation Grants – March 6

DOJ Grants for Children Experiencing Domestic Violence – March 6

Nominations:  Medicare Payment Advisory Commission (MedPAC) – March 8

AMAF Community Health Grants for Diabetes/Hypertension – March 8

Veteran Nurses in Primary Care Training Program – March 8

Pediatric Mental Health Care Access Program – March 11

Licensure Portability Program for Telehealth – March 11

Native Youth and Culture Fund – March 12

New Access Points for Health Centers – March 12

RWJF Interdisciplinary Research Leaders – March 13

NIH/NIDA: Mobile Technologies for Substance-Use Treatment  – March 19

Increasing Access to HIV Primary Health Care Services – 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

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

Comments Requested: Proposed Updates to Interoperability & Patient Access to Health Data – Early April

ACL Alzheimer’s Disease Programs Initiative – April 1

NIH: Small Business Innovations for Health Disparities – April 1

Medicare Rural Hospital Flexibility – EMS Supplement – April 5

CDC Immunization and Vaccine Programs for Children – April 8

Nurse Anesthetist Traineeship Program – April 15

CDC Violent Death Reporting System – April 15

Strengthening Care for HIV and Opioid Use Disorder – April 16

Mary Kay Foundation Domestic Violence Shelter Grants – April 30

HRSA Maternal Opioid Misuse Model – May 6

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