Federal Office of Rural Health Policy Announcements

August 9, 2018

What’s New

MCHB Grand Challenges.  HRSA’s Maternal and Child Health Bureau (MCHB) is holding four competitions that will award a total of $1.5 million for low-cost, scalable, innovative solutions that improve the health of mothers and children.  The first of these challenges launched in late July and supports the promotion of healthy eating practices to prevent childhood obesity.  Subsequent challenges will launch in the fall and address children with special health care needs, remote pregnancy monitoring, and preventing opioid misuse in pregnant women and new moms.  MCHB just released state fact sheets for one its well-known programs, Maternal, Infant, and Early Childhood Home Visiting (MIECHV). Of the 888 U.S. counties served by the MIECHV program in 2017, fifty percent were rural.

Seeking Nominations for Rural Health Champions in WV – September 3.  West Virginia Rural Health Awards will be awarded to individuals or organizations deserving of recognition for their rural health efforts in West Virginia.  The awards will be presented at the 26th Annual West Virginia Rural Health Conference on October 17-19, 2018 in Pipestem, WV. The conference provides best practices in rural health, innovation, leadership, and clinical techniques. To promote rural health immersion, health students and community members are encouraged to apply for a conference scholarship. Students and faculty will present their rural health research during a poster and oral presentation. Continuing education has been approved for physicians, attorneys, nurses, pharmacists, dentists, social workers, gerontologists, and community health educators.

Funding Opportunities

DEADLINE EXTENDED: Substance Use Funding for NHSC Sites – August 14.  Approved sites for the National Health Service Corps (NHSC) may be eligible for future awards through the NHSC Loan Repayment Program to improve access to quality opioid and substance use disorder treatment in rural and underserved areas.  NHSC sites that provide general substance use disorder treatment, Medication Assisted Treatment, and/or an opioid treatment program are eligible to submit documentation through their Customer Service Portal account to opt-in and take advantage of this opportunity.  The original deadline of July 17 has been extended to August 14.

Rural Health Research

Different Populations Served by the Medicare Home Health Benefit: Comparison of Post-Acute Versus Community-Entry Home Health in Rural Areas. Medicare beneficiaries may be admitted to home health following an inpatient stay (post-acute) or directly from the community (community-entry). An analysis of Medicare data for rural, fee-for-service Medicare beneficiaries who utilized home health from 2011 to 2013 found significantly higher rates of community-entry among beneficiaries who were older, female, non-white, living alone, and dually eligible for Medicare and Medicaid, and who had lower clinical severity, lower functional status, more cognitive impairment, and a higher need for caregiver assistance for supervision and safety. Wide variation by state also exists in rates of community-entry home health for rural beneficiaries. Results suggest two different populations are being served by the Medicare home health benefit, which supports differentiation between community-entry and post-acute episodes in payment policy reform.

Pediatric Readiness in Critical Access Hospital Emergency Departments.  Experts in HRSA’s Federal Office of Rural Health Policy and Maternal and Child Health Bureau joined data analysts at the University of Utah to examine the challenges to emergency care, policies and procedures for pediatric care in Critical Access Hospitals.

Policy Updates

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

Comments Requested: FCC Telehealth Pilot Program – September 10.  The Federal Communications Commission (FCC) recently took steps to explore the creation of an experimental “Connected Care Pilot Program” to promote the use of broadband-enabled telehealth services delivered directly to low income rural consumers. For the next 30 days, they seek public input (Notice of Inquiry) on their planning for the program and what it should cover, including whether they should work with HHS or other federal agencies.  Within 30 days following September 10, the FCC will reply to the comments received.  Comments can be filed electronically using the Commission’s Electronic Comment Filing System.

CMS Finalizes Medicare Inpatient Hospital Rule for FY2019CMS updated the Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) for the 2019 fiscal year, which begins October 1, 2018.  In addition to announcing payment rates for the upcoming year, this rule overhauls some key provisions of the Medicare and Medicaid Promoting Operability Program, updates guidelines for hospitals to post their standard charges online, removes 18 measures from CMS quality programs, and de-duplicates another 25 quality measures.  The rule also covers updates to the Frontier Community Health Integration Project (FCHIP) Demonstration and the Rural Community Hospital Demonstration.  A CMS Fact Sheet is available here.  

CMS Finalizes Short-Term Limited-Duration Insurance Plan Rule. The Internal Revenue Service, Department of Labor, and Department of Health & Human Services recently published a joint rule finalizing the definition of short-term, limited-duration (STLD) health insurance, effective October 2, 2018.  This type of coverage is exempt from the definition of individual health insurance coverage under the Patient Protection and Affordable Care Act (PPACA) and is not subject to the PPACA provisions that apply to the individual market.  Prior to this rule, STLD plans could provide coverage for 3 months or less.  This rule requires that STLD plans contain language that helps consumers understand the coverage they are getting, that the plan lasts for less than 12 months from the date issued, and that it may be renewed for up to 36 months. States can adopt a definition with a shorter initial contract term and/or a shorter duration of a policy, and can require additional information be part of the consumer notice.  State Offices of Rural Health and other rural stakeholders can monitor the availability of these plans locally in the fall when the rule takes effect. 

Resources, Learning Events and Technical Assistance

CMS Blue Button 2.0 Developer Conference – Monday, August 13 at 1:00 pm.  The Centers for Medicare and Medicaid Services (CMS) will host the first-ever Blue Button 2.0 Conference in Washington, DC at the General Services Administration Headquarters. The conference will help further the work of the MyHealthEData initiative, and provide an opportunity for networking among developers to learn, build software, and share insights on how Medicare claims data can be leveraged to improve health outcomes.

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.

Resource of the Week

Neighborhood Navigator for Social Services.  This tool created by the American Academy of Family Physicians (AAFP) allows users to enter a zip code and find free or reduced cost services to address social determinants of health.  The Neighborhood Navigator was created to help AAFP member physicians assist their patients at the point of care, but is available to anyone seeking food, job training, transportation services and more.

Approaching Deadlines

Call for Grant Reviewers – Immediate and Ongoing

Rural Housing Preservation Grants – August 9

Technical Assistance Agreement for Rural Opioid Response Program – August 10

ACF Funds Improving Rural Child Welfare – August 13

Pediatric Mental Health Care Access Program – August 13

SAMHSA State Opioid Response Grants – August 13

DEADLINE EXTENDED: Substance Use Funding for NHSC Sites – August 14

Coordinating Research for Rural Opioid HIV Initiative – August 15

Support for Rural Financial Institutions – August 20

SAMSHA Tribal Opioid Response Grants – August 20

Technical Assistance Cooperative Agreement for Rural Residency Development – August 22

Provide Feedback on Reducing Regulatory Burden for Care Coordination – August 24

Farm Labor Housing Direct Loans and Grants – August 27

Comments Requested: Updates to CMS Home Health Payments and Policy – August 31

Seeking Nominations for Rural Health Champions in WV – September 3

Comments Requested: New Medicare Advantage Demonstration September 4

Comments Requested: FCC Telehealth Pilot Program – September 10

Comments Requested: CMS Updates Medicare Clinician Payments and Policy – September 10

Department of Labor YouthBuild Program – September 18

Rural Cancer Research – September 19

MCHB Challenge: Preventing Childhood Obesity – September 24

CMS Proposes Medicare Outpatient Payment and Policy Changes – September 24

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