July 26, 2018
Identifying Bright Spots in Appalachian Health: Statistical Analysis. This week, the Appalachian Regional Commission (ARC) released a new study on health indicators in each of the Appalachian Region’s 420 counties. Researchers first identified 19 county-level outcome measures that capture the overall health of a community, including infant mortality rate, cancer mortality rate and prevalence of obesity, diabetes, and depression. They then identified 29 county-level drivers that affect health, including social determinants, health behaviors, and access to health care services. From this data they found 42 “Bright Spot” counties, each defying predictions for health with better-than-expected outcomes. The report includes case studies on ten of these bright spots and data files for all 420 counties.
HRSA Recognizes Success of Rural Quality Improvement Projects. This week, FORHP’s parent agency, the Health Resources and Services Administration (HRSA) recognized 13 organizations for their work in improving chronic disease health outcomes and advancing the quality and delivery of rural health care. Through FORHP’s Small Health Care Quality Improvement Program, these organizations have invested resources into quality improvement projects across rural America that have improved patient health outcomes through activities such as care coordination, telehealth and patient education.
Infectious Disease and the Opioid Crisis. The HHS Office of the Assistant Secretary for Health’s Office of HIV/AIDS and Infectious Disease Policy and the HHS Office on Women’s Health recently sponsored a workshop at the National Academies of Sciences, Engineering and Medicine (NAS) to explore the infectious disease consequences of the opioid crisis and consider opportunities to better integrate effective responses. Section 3 of the NAS report, beginning on page 53, takes an in-depth look at opportunities and barriers to treatment in rural areas and can serve as a strategic action and planning resource for communities.
Support for Rural Financial Institutions – August 20. The U.S. Department of Treasury Community Development Financial Institutions (CDFI) Fund will provide grants through its Capital Magnet Fund to finance affordable housing and community revitalization efforts that benefit low-income people and communities. Community facilities that have been funded under the program include health clinics, senior housing, wellness centers, and oral health facilities. Nearly 30% of CDFIs primarily serve rural communities where poverty rates are higher and partners for economic development are fewer.
Technical Assistance Cooperative Agreement for Rural Residency Development – August 22. The Federal Office of Rural Health Policy (FORHP) will provide up to $2,400,000 over a three-year project period to support one technical assistance (TA) center to assist the creation of new, sustainable rural residency programs through the Rural Residency Planning and Development — Technical Assistance (RRPD-TA) Cooperative Agreement funding opportunity. The primary purpose of this cooperative agreement is establishment of a rural residency planning and development TA center to support HRSA grantees awarded a future grant to support development of sustainable rural residencies: the Rural Residency Planning and Development (RRPD) program, which will be awarded in FY 2019. Residency programs supported by the RRPD-TA will be allopathic and osteopathic physician residency training programs in family medicine, internal medicine, and psychiatry specialties that provide at least 50% of training in rural communities. Applicants are strongly encouraged to establish a consortium to ensure the fulfilment of the full range of activities outlined in the announcement. The applicant organization will serve as the applicant of record and coordinate all cooperative agreement activities and must be national in scope. A technical assistance webinar for applicants will be held Thursday, August 2, 2018 from 2:00 to 3:30 PM ET. For further details on how to access this webinar, please see page (ii) in the Notice of Funding Opportunity.
Rural Health Research
ASPE Shows Opioid Crisis Increases Need for Child Welfare Services. Recent research conducted by the U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation (ASPE) finds a link between substance misuse and children served by child welfare programs. A 10% increase in overdose deaths or drug-related hospitalizations was associated with an increase in children entering foster care by 4.4% and 2.9%, respectively. Even when accounting for overdose deaths, ASPE finds that living in rural areas increased the likelihood of children entering foster care by 11% compared to urban areas. Rural hospitals have an important role to play in preventing and addressing opioid and other substance misuse problems that could also include supporting local child welfare services by, for example, helping to identify and recruit foster parents.
MedPAC 2018 data book highlights Medicare spending for services provided in rural and urban areas. The Medicare Payment Advisory Commission (MedPAC) Data Book provides information on national health care and Medicare spending as well as Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care in the Medicare program, and hospital closures. Among the key findings: about 91 percent of rural hospitals were paid through the Critical Access Hospital, Rural Referral Center, or Sole Community Hospital provisions or the Medicare Dependent Hospital program in 2016. Collectively, these four types of hospitals accounted for 90 percent of all rural Medicare discharges.
Visit the FORHP Policy page to see all recent updates and send questions to firstname.lastname@example.org
No policy updates to report this week.
Resources, Learning Events and Technical Assistance
Community-Based Indicators for HIV Programs – Tuesday, July 31 at 10:00 am ET. MEASURE Evaluation is a nonprofit organization that uses data and community-level information to help governments better understand what’s needed and what works for HIV prevention and care among low-income populations. This hour-long webinar will focus on a new online collection of community-based indicators for HIV programs that can help measure if the beneficiaries of community programs are being assessed and tested, are receiving needed services, and if people living with HIV are adhering to treatment. See the What’s New section above for news on the link between infectious disease and the opioid crisis, particularly for rural areas.
Caring for Diverse and Communication-Vulnerable Patients – Tuesday, July 31 at 12:00 pm ET. The ECRI Institute is a non-profit organization of health scientists using research to improve patient care. This hour-long webinar, hosted by ECRI on HRSA’s behalf, will address communication challenges and strategies clinicians and organizations can implement to improve the quality of care for patients with communication vulnerability related to low health literacy, language barriers and cultural factors. As reported by the Economic Research Service at USDA, more minorities are living in rural areas and Culturally and Linguistically Appropriate Services Standards are a key part of achieving health equity.
Outreach and Enrollment Strategies for Rural Communities – Tuesday, July 31, at 1:00 pm ET. This Connecting Kids to Coverage National Campaign webinar will share proven strategies and best practices for reaching eligible families in rural communities from representatives from national and local partner organizations who specialize in rural health outreach and enrollment. Families living in rural communities are disproportionately uninsured compared to those from urban and suburban areas across the country. Access slides and recordings from previous National Campaign webinars here. Is your organization enrolling children and teens living in rural areas in Medicaid and CHIP? The Connecting Kids to Coverage National Campaign is collecting stories of organizations enrolling rural children and teens in Medicaid and CHIP for a future Campaign Notes eNewsletter. Send information about your organization via email to ConnectingKids@cms.hhs.gov.
Addressing Oral Health Through Primary/Behavioral Integration – Tuesday, July 31 at 3:00 pm ET. The SAMHSA-HRSA Center for Integrated Health Solutions will host a special roundtable discussion for integrated primary and behavioral health providers to learn best practices and strategies in aiding patients through identifying and addressing barriers to oral health care.
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.
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.
Resource of the Week
New Innovation Profile on Community Care Integration. Rural Health Value (RHV) has developed a series of innovation profiles describing potentially replicable innovations in rural health care that show promise in improving health, improving care, and lowering costs. This week, RHV published its latest profile on Southern Prairie, a 12-county collaboration in rural southwestern Minnesota that facilitates the integration of health care services and community supports across the region through accountable care approaches. RHV is funded through a cooperative agreement with FORHP to analyze rural implications of changes in the organization, finance, and delivery of health care services and will assist rural communities and providers transition to a high performance rural health system. For the full series of innovation profiles and more, visit: https://cph.uiowa.edu/ruralhealthvalue/.
Call for Grant Reviewers – Immediate and Ongoing
Strengthening STD Prevention – July 31
DOT Grants for Buses and Bus Facilities – August 6
Injury Control Research Centers – August 6
Rural Housing Preservation Grants – August 9
Pediatric Mental Health Care Access Program – August 13
SAMHSA State Opioid Response Grants – August 13
Support for Rural Financial Institutions – August 20
SAMSHA Tribal Opioid Response Grants – August 20
Farm Labor Housing Direct Loans and Grants – August 27
Department of Labor YouthBuild Program – September 18
Rural Cancer Research – September 19
Guaranteed Loans for Rural Rental Housing – Ongoing through 2021
Telecommunications Infrastructure Loans – Ongoing
Community Facilities Program – Ongoing
Summer Food Service Program – Ongoing
The Announcements from the Federal Office of Rural Health Policy are distributed weekly. To subscribe, sign up for Rural Health Updates at HRSA.gov.