Federal Office of Rural Health Policy Announcements

December 6, 2018

What’s New

New Data on Suicide Mortality from the CDC. Using data from the National Vital Statistics System (NVSS), the Centers for Disease Control and Prevention (CDC) recently released a report on rates of suicide in the United States from 1999 to 2017. The data brief ranks suicide as the second leading cause of death for people aged 10-34 and the fourth leading cause for ages 35-54. For the most recent year studied, the age-adjusted suicide rate for the most rural counties was nearly twice (1.8 times) the rate for the most urban counties. In a separate data brief from the CDC, the NVSS showed there were 70,237 drug overdose deaths in 2017. The surveillance system found that, among persons aged 15 and over, adults aged 25-54 had higher rates than other age groups. West Virginia, Ohio and Pennsylvania were the three states with the highest observed age-adjusted overdose death rates in 2017; the four states with the lowest rates were Texas, North Dakota, South Dakota and Nebraska.

New Federal Report: Reforming America’s Healthcare System through Choice and Competition. The Department of Health and Human Services (HHS) in collaboration with the Departments of the Treasury and Labor and the Federal Trade Commission collaborated to develop this report, which identifies challenges to and recommendations for improving the health care system. It describes the influence of state and federal laws, regulations, guidance, and polices on choice and competition in health care markets and identifies actions that states or the Federal Government could take to develop a better functioning health care market. Rural relevant issues addressed include scope of practice, workforce mobility, and telehealth.

Funding Opportunities

AmeriCorps VISTA Seeking Proposals for Community Projects – January 14. The Corporation for National and Community Service (CNCS) is a federal agency that provides grants and resources for civic engagement and service through two signature volunteer programs, Senior Corps and AmeriCorps. Rural communities, Indian country and areas of concentrated poverty are among the priority populations for AmeriCorps VISTA, a federal anti-poverty program that provides short-term support for organizations developing long-term solutions. Projects must be developed in accordance with four core principles: 1) an anti-poverty focus, 2) community empowerment, 3) sustainable solutions, and 4) capacity building.

Funding for Integrating Behavioral Health and Primary Care – January 28. HRSA’s Bureau of Health Workforce will make ten awards for total funding of $4 million to accredited schools of allopathic or osteopathic medicine, physician assistant training programs, or accredited public or nonprofit private hospitals. The program has a special emphasis on treatment of opioid use disorder and will support innovative training programs that integrate behavioral health into primary care, particularly in rural and underserved settings. Faith-based and community-based organizations, tribes and tribal organizations may apply for these funds, if otherwise eligible. As of December 4, 2018, HRSA had designated a total of 2,705 Mental Health Professional Shortage Areas (pdf). It’s estimated that 1,881 practitioners would be needed to remove these designations.

Support for Enrollment of Children in Medicaid and CHIP – January 28. The Centers for Medicare & Medicaid Services (CMS) will enter into cooperative agreements with awards up to $1.5 million to support outreach strategies that increase enrollment and retention of uninsured children in Medicaid and the Children’s Health Insurance Program (CHIP). Eligible entities include states with an approved child health plan, local governments, Indian tribes or tribal consortiums, Indian Health Service providers, federal health safety net organizations, public or nonprofit private organizations, eligible faith-based organizations, and elementary or secondary schools. Letters of intent are due January 4. Children with Medicaid in both urban and rural areas are more likely to use health services than those that are uninsured.

Environmental Cleanup Through Brownfields Grants – January 31. The U.S. Environmental Protection Agency (EPA) provides grants and technical assistance for cleanup and redevelopment of land deemed environmentally hazardous through its Brownfields Program. The program has made a difference in rural and Tribal communities by helping to transform designated brownfield sites into medical facilities or multi-use town centers, or returning private land to public use and enjoyment. For 2019, the EPA is accepting applications for three brownfield grants, all due on January 31: 1) Brownfields Assessment Grants will support developing inventories of brownfields by assessing and prioritizing sites. 2) Brownfields Cleanup Grants provide funding for cleanup activities at sites contaminated by hazardous substances, pollutants and/or petroleum. 3) Brownfields Multipurpose Grants provide funding to research, plan and develop strategies for areas affected by one or more brownfield sites.

Rural Residency Planning and Development Program – March 4. A collaboration between HRSA’s Bureau of Health Workforce and the Federal Office of Rural Health Policy, this program will help expand the health workforce in rural areas by developing new physician residency programs in family medicine, internal medicine, and psychiatry. An estimated 28 awards will be made for residency programs at hospitals, medical schools and community-based-ambulatory settings in rural areas. Consortia of urban and rural partnerships also may be eligible. Awardees will receive technical assistance from the Rural Residency Planning and Development – Technical Assistance Center, which was awarded via cooperative agreement in September 2018.

Rural Health Research

The Rural Hospital and Health System Affiliation Landscape – A Brief Review. Rural hospitals that join health systems may find it challenging to balance local decision-making control and the requirements of larger, better-funded regional health systems. This policy paper from the RUPRI Center for Rural Health Policy Analysis examines rural hospital motivations for joining health systems and examines different affiliation structures.

Recent Journal Articles Publishing Rural Health Research. Several articles written by the HRSA/FORHP-supported Rural Health Research Centers were recently published in peer-reviewed journals. Among these are Patterns of Telehealth Use Among Rural Medicaid Beneficiaries and Overcoming Barriers to Prescribing Buprenorphine for the Treatment of Opioid Use Disorder. While some journal articles offer free access, others may require a subscription or affiliation with a subscribing library.

Policy Updates

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

Comments Requested: Reducing Burden Relating to Use of Health IT and EHRs – January 28. Per the requirements of the 21^st Century Cures Act of 2016, the U.S. Department of Health and Human Services seeks comment on a draft plan of action to reduce regulatory and administrative burden relating to the use of health IT and Electronic Health Records (EHRs). The goals outlined intend to reduce the effort and time to record information in EHRs during care delivery; reduce the effort and time required to meet regulatory reporting requirements; and improve the functionality of EHRs. Stakeholders reported at listening sessions that small and rural hospitals face the highest hurdles in electronic reporting, as they are most resource-challenged. The proposed action plan seeks to minimize those burdens.

Resources, Learning Events and Technical Assistance

Learning Opportunities for Agricultural Health and Safety – December 11-13. Upcoming from the AgriSafe Network: Prevention of Zoonotic Diseases describes how many emerging infectious diseases come from interaction between humans and animals; Respiratory Protection Adapted to Agriculture explains diverse respiratory hazards and key components of an effective protection program; Prevention of Grain Dust Explosions identifies health hazards in the grain industry. Note that all times listed are Central Standard Time.

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), and 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 Centers for Medicare & Medicaid Services 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.