Federal Office of Rural Health Policy Announcements

July 19, 2018

What’s New

Integrating Infectious Disease Prevention and Treatment into the Opioid Response. The U.S. Department of Health & Human Services (HHS) is making infectious disease prevention part of its opioid response effort. Some communities hardest hit by the opioid crisis, a disproportionate number of them rural, have also seen associated increases in hepatitis B and C and other infections, such as endocarditis, septic arthritis and abscesses, driven by increases in the numbers of people who inject opioids. The National Institutes of Health is seeking public comment until July 20th on an integrated approach to the crisis.

Raising Awareness of Human Trafficking. The Administration for Children and Families is providing free materials in English and Spanish to raise awareness of human trafficking at the community level. The National Human Trafficking Hotline reported more than 26,000 calls from all 50 states, DC and U.S. territories in 2017. More than two-thirds of confirmed cases are forced labor and nearly 20 percent are sexually exploited. According to the National Human Trafficking Resource Center, rural areas have several economic risk factors for human trafficking, including persistent rates of poverty, decreasing workforce participation rates and high demand for low-skilled manual labor. To request a free sample pack of these new materials, grantees and interested stakeholders should send their name and mailing address to Flavia.Keenan-Guerra@acf.hhs.gov.

Geographic Differences in Obesity for Children, Adolescents. A recent study published in the Journal of the American Medical Association (JAMA) finds significant geographic difference in obesity for children and adolescents aged 2-19. According to the study conducted by the Centers for Disease Control and Prevention, differences in obesity by urbanization levels were not significant but the prevalence of severe obesity in non–metropolitan statistical areas (MSAs) was 9.4 percent, nearly double that of large MSAs at 5.1 percent.

Funding Opportunities

Pediatric Mental Health Care Access Program – August 13. Native American Tribal governments and organizations, which are mostly rural, as well as state governments are eligible to apply for 20 awards of up to $445,000 each. The program supports statewide or regional pediatric mental health care access programs via telehealth.

Rural Health Research

Adverse Childhood Experiences in Rural Areas of the United States. Adverse childhood experiences (ACEs) are childhood abuses and household disruptions experienced before the age of 18 that include exposure to mental illness, substance abuse, imprisonment, separation or divorce, adult violence, physical abuse, and sexual abuse. This newly published study examines whether exposure to ACEs in rural areas is associated with adult activity limitations, self‐reported general poor health status, chronic diseases, and poor mental health. The study was conducted by researchers in the Federal Office of Rural Health Policy and the Office of Health Equity at the Health Resources and Services Administration.

Policy Updates

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

Comments Requested: CMS Updates Medicare Clinician Payments and Policy – September 10. On July 12, CMS displayed its proposed rule for calendar year (CY) 2019 updates to Medicare payment rates and rules for clinicians, including rural clinicians. Proposed updates under this rule apply to the Physician Fee Schedule (PFS) and the Quality Payment Program (QPP). Major updates under the PFS that are applicable to rural providers include (1) streamlining Evaluation and Management (E&M) payment and reducing clinician burden and (2) adding new payment opportunities for communication technology-based services for Rural Health Clinics and Federally Qualified Health Centers. Rural providers should also note QPP policy proposals such as (1) expanding the definition of MIPS eligible clinicians to include new clinician types (physical therapists, occupational therapists, clinical social workers, and clinical psychologists); (2) adding a third element to the low-volume threshold determination and giving eligible clinicians who meet one or two elements of the low-volume threshold to voluntarily participate in MIPS; and (3) overhauling the MIPS “Promoting Interoperability” performance category to support greater EHR interoperability and patient access to their health information. Additionally, CMS is seeking comment through Requests for Information on promoting interoperability and electronic healthcare information exchange and price transparency.

AHRQ Seeks Nominations to National Advisory Council – August 8. The Agency for Healthcare Research and Quality (AHRQ) is seeking nominations for seven new members of its National Advisory Council. The panel, which includes representatives from the private health care sector including, health plans, providers, purchasers, consumers and researchers, advises the agency director and the Secretary of HHS on AHRQ activities and priorities for a national health services research agenda. Among other attributes, nominees should be distinguished in the conduct of health care research and demonstration projects, the fields of health care quality research or health care improvement and the practice of medicine. This is an opportunity for rural providers and researchers to contribute to the work and research priorities of AHRQ.

Resources, Learning Events and Technical Assistance

Impact of the Opioid Epidemic on Rural Youth – Thursday, July 19 at 3:00 pm ET. This 90-minute webinar from the Rural Behavioral Health Webinar Series will focus on how schools and communities are responding to children and youth.

Partnerships for Advancing Tribal Health (PATH) – Tuesday, July 24 at 8:30 am ET. Opioids are taking a toll on tribal communities and there is a call for a more comprehensive response for these populations. PATH provides a national forum for tribal and federal officials (SAMHSA, CDC, CMS, IHS, NIH, and OMH) to advance a collaborative approach.

Sustainability Planning for Integrating Behavioral Health – Wednesday, July 25 at 2:00 pm ET. 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 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.

Rural Health Clinics (RHCs) Technical Assistance Webinar – Wednesday July 25 at 2:00 pm ET. CMS representatives will discuss updates for RHCs related to care management and communication-based technology services proposed in the CY 2019 Physician Fee Schedule.

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.