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November 30, 2023
What's New
New Opportunity: CMS Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model – Apply by March 18. The Centers for Medicare & Medicaid Services (CMS) seeks eight states to participate in a new model program designed to improve population health while curbing costs. Eligible applicants are state Medicaid agencies, state public health agencies, state insurance agencies, or other entities with the authority and capacity to enter into an agreement with the federal government. As with all CMS Innovation Models, selected states will receive tools and resources to help move the entire healthcare system toward value-based care, with improved outcomes for all participants in that system – patients first, but also providers, and the public and private insurers that pay providers. The AHEAD Model will have a focus on engaging rural and safety net hospitals and primary care providers, including Critical Access Hospitals, Rural Emergency Hospitals, and Rural Health Clinics. See Resources of the Week below to learn more about rural-specific aspects of the program.
Learn About Funding and Opportunities from HHS Catalytic Program for the Climate – TODAY, November 30 at 12:00 pm ET Eastern. The Office of Climate Change and Health Equity (OCCHE) was established in 2021 to address the impact of climate change on the health of people living in the United States and territories. The office will coordinate efforts across 12 operating divisions in the U.S. Department of Health & Human Services (HHS); from the beginning, it identified rural areas as uniquely vulnerable, with safety net health organizations serving people greatly affected by storms, heat waves, and wildfires. Today’s online information session gives focus to a “catalytic program” that OCCHE will launch in early 2024 – providing funding, tax credits, grants and other supports made available by the Inflation Reduction Act. The opportunities are meant for health care organizations, especially safety net providers, to improve energy efficiency, infrastructure resilience, and more. Register to attend the program kick-off happening today at noon Eastern. If you can’t make it, check the page in the headline link for a recording later today or tomorrow.
CDC Research: Geographic Variation in Health Insurance Coverage. A new report from the National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC) examines how health insurance coverage varies by age, state, region, and urbanization level. Using data from the 2022 National Health Interview Survey, researchers found that the percentage of uninsured adults aged 18-64 was about 14 percent for those living in both nonmetropolitan counties and large central metropolitan counties. Within the same age range, the percentage of adults with public insurance (i.e., Medicaid, CHIP, Medicare, military plans, and other government-sponsored health plans at the state level) was highest in nonmetropolitan counties, at 30 percent. This new information corresponds with historical data showing higher rates of uninsurance in rural areas and a higher rate of enrollment in public sources of coverage.
HHS Establishes Secretary’s Advisory Committee on Long COVID. The U.S. Department of Health and Human Services (HHS) made the announcement last week and invites nominations to bring perspectives from outside the government to help inform federal action. Committee activities will focus on health equity, needing a diverse membership of persons with multidisciplinary expertise – clinical, medical, public health, behavioral health, human services, employment, data science, and research – as well as those with Long COVID experience. Researchers and even insurers have already considered that long COVID could be “a mass disabling event” affecting economic productivity. A more recent study suggests a higher prevalence among nonmetropolitan adults. As of December 2022, data from the Centers for Disease Control and Prevention show that the top five states for self-reported symptoms are mostly rural: Montana, Wyoming, Mississippi, Kentucky, and Alaska.
Trends in the Prevalence of Chronic Obstructive Pulmonary Disease. A review of data from the Behavioral Risk Factor Surveillance System showed the prevalence of COPD has remained stable overall, but with disparities based on rural residence. Specifically, between the years 2011 and 2021, prevalence increased for adults 75 years and older, for those living in rural areas, and for those who smoked. Researchers suggest the COPD National Action Plan provides a comprehensive framework for COPD prevention, treatment, and management strategies. These can be tailored to address risk factors specific to various populations. In rural areas, for example, there are higher rates of smoking, history of asthma, and exposure to lung irritants, but limited access to pulmonologists. The Rural Health Information Hub recently updated the Rural Chronic Obstructive Pulmonary Disease Toolkit, with models for effective COPD programs, issues to consider when implementing, and resources for funding and sustainability.
Ongoing: Updates to Requirements for Buprenorphine Prescribing. As announced by the Substance Abuse and Mental Health Services Administration in January 2023, clinicians no longer need a federal waiver to prescribe buprenorphine for treatment of opioid use disorder. Clinicians are still required to register with the federal Drug Enforcement Agency (DEA) to prescribe controlled medications. On June 27, the DEA began to require that registration applicants – both new and renewing – affirm they have completed a new, one-time, eight-hour training. Exceptions for the new training requirement are practitioners who are board certified in addiction medicine or addiction psychiatry, and those who graduated from a medical, dental, physician assistant, or advanced practice nursing school in the U.S. within five years of June 27, 2023. Watch this 11-minute video that explains the changes. Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained between January 1, 2019 and December 29, 2022 (when Congress eliminated the waiver requirement). Approximately $889,000 in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted. Send questions to DATA2000WaiverPayments@hrsa.gov.
COVID-19 Resources
Learning About Long COVID & Fatiguing Illness – Thursday, December 14 at 3:00 pm Eastern. The Centers for Disease Control and Prevention fund this monthly webinar-style ECHO learning session to rapidly disseminate Post-COVID Conditions (PCC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) findings and emerging best practices. The series offers didactic presentations by subject matter experts, examples of emerging best practices and models of care, and a facilitated Q&A. This program is intended primarily for providers who care for patients with PCC and ME/CFS but is open to all healthcare professionals and all Long COVID and ME/CFS patient-lived experience experts interested in learning more about the treatment of Long COVID and ME/CFS.
HHS/DoD National Emergency Tele-Critical Care Network. A joint program of the U.S. Department of Health & Human Services (HHS) and the U.S. Department of Defense (DoD) is available at no cost to hospitals caring for COVID-19 patients. Teams of critical care clinicians - critical care physicians, nurses, respiratory therapists, and other specialized clinical experts – are available to deliver virtual care through telemedicine platforms, such as an app on a mobile device. Hear from participating clinicians, and email to learn more and sign up.
Mobilizing Health Care Workforce via Telehealth. ProviderBridge.org was created through the CARES Act by the Federation of State Medical Boards and HRSA’s Office for the Advancement of Telehealth. The site provides up-to-date information on emergency regulation and licensing by state as well as a provider portal to connect volunteer health care professionals to state agencies and health care entities.
Online Resource for Licensure of Occupational Therapists, Physical Therapists, Psychologists, and Social Workers. The site provides up-to-date information on emergency regulation and licensing in each state.
Funding and Opportunities
National Center for Healthy Housing Mini-Grants for Rural Lead Poisoning Prevention – December 8. The national nonprofit provides funding and technical assistance to build capacity and advance evidence-based efforts to prevent childhood lead poisoning in rural communities.
Frontline Indigenous Partnership Ohiyesa Premedical Program – January 31. A year-long educational program designed to engage and support Native American tribal and/or community college students interested in pursuing a health care career, with a program focused on the physician pathway. The program includes quarterly virtual group meetings, individual meetings with faculty sponsors and mentors, and a three-week summer program on-site at the Brigham and Women's Hospital in Boston.
Department of Labor YouthBuild Grants – February 1. The federal grants go to organizations providing pre-apprenticeship services that support education, occupational skills training, and employment services for at-risk youth, ages 16 to 24, while performing meaningful work and service to their communities. The YouthBuild program model contains wrap-around services such as mentoring, trauma-informed care, personal counseling, transportation support, and employment. Applications from rural, urban, and Native American organizations are encouraged. Each of 75 grantees will receive up to $1.5 million. Last year’s YouthBuild grantees included 15 projects in rural areas.
HRSA Regional AIDS Education and Training Centers – February 5. HRSA’s HIV/AIDS Bureau provides funding to operate an AIDS education and training center program for primary health care clinicians to counsel, diagnose, treat, and medically manage people with HIV disease. Applicants should demonstrate a plan to market and provide services for health care professionals in community-based organizations, local health departments, Federally Qualified Health Centers, interprofessional health care teams serving minority, rural, and underserved populations.
USDA Hispanic-Serving Institutions Education Grants Program – February 6. The U.S. Department of Agriculture (USDA) provides grants to support higher education programs that attract, retain, and graduate outstanding students capable of enhancing the nation’s food, agriculture, natural resources, and human sciences (FANH) professional and scientific workforce. An estimated 22 awards, each up to $1.2 million, will go to institutions with a minimum of 25 percent undergraduate full-time enrollment.
Policy Updates
Send questions to ruralpolicy@hrsa.gov.
Application Assistance for Rural Residency Funding – Apply by February 12. Learn more about what’s needed to apply for the newest funding opportunity for establishing rural residencies, the Rural Residency Planning and Development Program (RRPD). The FORHP-supported RRPD provides start-up funding for new residency programs to address physician workforce shortages in family medicine, internal medicine, psychiatry, general surgery, preventive medicine, or obstetrics and gynecology. Eligible applicants are rural hospitals and graduate medical education consortiums that may include universities, Historically Black Colleges and Universities, and/or Tribal organizations. A maximum of 15 awardees will receive up to $750,000 for a three-year grant period to develop new and sustainable programs approved by the Accreditation Council for Graduate Medical Education, especially programs specifically designed for underserved areas and populations. Research has shown that physicians from a rural background and those trained in rural settings are more likely to continue practicing in rural areas after completing their residencies.
CMS Final Rules Overview - Impacts for RHCs – Monday, December 11 at 2:00 pm Eastern. Recent final rules from the Centers for Medicare & Medicaid Services (CMS) include payment and policy changes that are important to CMS-designated Rural Health Clinics (RHCs). During this webinar, policy experts will provide an overview of changes to the Medicare Physician Fee Schedule and the Medicare Hospital Outpatient Prospective Payment System that will go into effect on January 1, 2024. Among many, these changes include:
- expanded services covered under the Healthcare Common Procedure Coding System (HCPCS) code G0511 (chronic care management and behavioral health care provided by RHCs);
- an extension of payment for telehealth services until December 31, 2024;
- the addition of marriage and family therapists and mental health counselors as provider types billable for substance use treatment;
- the establishment of intensive outpatient programs for substance use treatment.
Additional time will be provided for Q&A. Advance registration is required.
Proposed Updates: Health Insurance Marketplaces and Insurers for 2025 – Comment by January 8. The Centers for Medicare & Medicaid Services propose new standards for health insurance plans on State and Federal Marketplaces, as well as new requirements for agents, brokers, web-brokers, direct enrollment entities, and other assisters that help Marketplace consumers. Proposals include requiring state Marketplaces to develop standards for time and distance to receive care that are at least as stringent as those under the Federally facilitated Marketplace plans; allowing states to add routine dental services as an essential health benefit; easing consumers’ transition to new coverage under special enrollment periods; and establishing standards for Marketplace call centers to have live representatives available during hours of operation. The number of issuers offering plans in rural areas has increased in recent years making Marketplace plans an important source of health insurance coverage for those living in rural areas.
Medicare Finalizes Rule on Nursing Home Ownership Disclosure. Published on November 15, the final rule for Nursing Home Ownership Disclosure requires nursing homes enrolled in Medicare or Medicaid – upon initial enrollment or when revalidating – to disclose additional information regarding their owners, operator, management, and entities that lease or sub-lease property to nursing homes. The rule also finalizes definitions of private equity company and real estate investment trust for Medicare provider enrollment purposes and makes these disclosures public.
Learning Events and Technical Assistance
MCHB Reports on New Maternal/Child Health Research – Tuesday, December 5 at 1:00 pm Eastern. HRSA’s Maternal and Child Health Bureau (MCHB) will delve into findings from the latest National Survey of Children’s Health in this hour-long session.
The Maternal, Infant, and Early Childhood Home Visiting Program in Rural Areas – Monday, December 11 at 1:00 pm Eastern. The Rural Health Information Hub hosts an hour-long look at recent recommendations from the National Advisory Committee on Rural Health & Human Services. The session will present findings from the Committee’s work, including participation from HRSA’s Maternal and Child Health Bureau, and include a discussion of the resulting policy brief.
UVM Center on Rural Addiction: PTSD Treatment in Individuals with OUD – Wednesday, December 13 at 12:00 pm Eastern. This hour-long presentation will discuss effective treatment for post-traumatic stress disorder (PTSD) in individuals with co-occurring opioid use disorder (OUD). The University of Vermont Center on Rural Addiction is one of three FORHP-supported Rural Centers of Excellence on Substance Use Disorders.
Resources of the Week
New CMS Initiatives Added to Catalog for Rural Providers. Updates from the Rural Health Value team includes summaries for the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model (see What’s New section above) and the Guiding an Improved Dementia Experience (GUIDE) Model, announced last week with applications due on January 30. The Rural Health Value team is funded by the Federal Office of Rural Health Policy.
Telehealth Policy Resource Center Fact Sheet for 2024 Physician Fee Schedule. The fact sheet covers telehealth services made eligible by the Centers for Medicare & Medicaid Services in the 2024 Physician Fee Schedule. These are services that can be delivered by telehealth, remote monitoring services, physician supervision, diabetes self-management training, and more. The Center for Connected Health Policy is supported by HRSA’s Office for the Advancement of Telehealth.
Approaching Deadlines
CDC Rape Prevention and Education – November 30
CMS Making Care Primary Model – November 30
HUD Fair Housing Initiatives Program – November 30
Advisory Committee Seeks Input on Rural Participation in Alternative Payment Models – Comment Period Extended to December 1
CDC Rigorous Evaluation of Policy-Level Interventions to Prevent Overdose – December 1
Commonwealth Fund/Harvard Fellowship in Minority Health Policy – December 1
HRSA National Health Service Corps Students to Service Loan Repayment Program – December 7
National Center for Healthy Housing Mini-Grants for Rural Lead Poisoning Prevention – December 8
HRSA Healthy Start: Eliminating Disparities in Perinatal Health – December 15
DOJ/CDC Reaching Rural: Collaborative Solutions for Substance Misuse – December 15
ACL Small Business Innovation Research Program – December 18
NIH Research Centers in Minority Institutions – December 18
National Board for Certified Counselors Foundation Rural Scholarships – December 31
USDA Rural Economic Development Loan and Grant Program – December 31
Comments Requested: Disincentives for Health Care Providers that Commit Information Blocking – Comment by January 2
Comments Request: No Surprises Act Federal Independent Dispute Resolution Operations for FY 2024 – Comment by January 2
USDA Technical Assistance/Training for Rural Water and Waste Disposal Systems – January 2
AmeriCorps State and National Grants – January 4
Proposed Update: Medicare Advantage and Prescription Drug Plans – Comment by January 5
CDC Community Health Worker Services for HIV in Rural Communities – January 5
NARHC Bill Finerfrock Health Policy Fellowship – January 5
Proposed Updates: Health Insurance Marketplaces and Insurers for 2025 – Comment by January 8
NIDA Seeking Telemedicine/Remote-Based Platforms for SUD Treatment – January 8
Request for Information: Upcoming ICD-11 – Comment by January 12
NTIA Tribal Broadband Connectivity Program – January 23
Udall Foundation Native American Congressional Internship – January 24
Rural Health Network Development Planning Program – January 26
HHS Environmental Justice Community Innovator Challenge, Phase 1 – January 30
EPA Small Communities, Big Challenges Competition – January 31
Frontline Indigenous Partnership Ohiyesa Premedical Program – January 31
Department of Labor YouthBuild Grants – February 1
HHS Innovation Challenge: Preventing Human Trafficking/Women and Girls – February 1
HRSA Nurse Faculty Loan Program – February 5
HRSA Regional AIDS Education and Training Centers – February 5
RWJF Summer Health Professions Education Program – February 5
USDA Hispanic-Serving Institutions Education Grants Program – February 6
HRSA Rural Residency Planning and Development Program – February 12
CMS Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model – March 18
Ongoing Opportunities
HRSA Needs Rural Reviewers for Grant Applications
Economic Development Administration Public Works/Economic Assistance Program (CARES Act Funding)
Extended Public Comment Period for FCC’s COVID-19 Telehealth Program
FCC Affordable Connectivity Program for Broadband Service
National Indian Health Board Vaccination Event Funding – Ongoing while funds last
SAMHSA 988 Suicide and Crisis Lifeline Volunteer and Job Opportunities
USDA Disaster Repair Grants for Rural Community Facilities – Ongoing while funds last
USDA Water Infrastructure Grants for 2022 Disaster Areas – Ongoing while funds last
ACF Low Income Home Energy Assistance Program
ACF Rural Community Development Program for Rural Water Systems
Addiction Policy Forum: Sites for Anti-Stigma Pilot
AgriSafe Mental Health Training for Agricultural Producers & Families
American Association of Birth Centers (AABC) Foundation - Accreditation Grants
American Heart Association Rural Health Care Outcomes Accelerator
American Indian Public Health Resource Center Technical Assistance
AmeriCorps American Connection Corps for Broadband in Rural Areas
Appalachian Community Fund Technical Assistance Grants
Appalachian Regional Commission J-1 Visa Waivers for Doctors
ASA Rural Access to Anesthesia Care Scholarship
CDC Direct Assistance to State, Tribal, Local, and Territorial Health Agencies
CDC Training Pediatric Medical Providers to Recognize ACEs
CORH Targeted Technical Assistance for Rural Hospitals Program
Delta Region Community Health Systems Development Program
Delta Regional Authority Community Infrastructure Fund
Delta Doctors J-1 Visa Waiver Program
Department of Commerce: Economic Development Assistance Programs
DRA Technical Assistance for Delta Region Community Health Systems Development
EPA Drinking Water State Revolving Fund
EPA Water Infrastructure and Innovation Act Program
FEMA/SAMHSA Post-Disaster Crisis Counseling Assistance and Training Program
GSA Federal Surplus Property Available for Public Use
GPHC & RWJF: Rapid Cycle Research and Evaluation Grants for Cross-Sector Alignment
HRSA/SAMHSA Medications for Opioid Use Disorder Training and Mentoring
HRSA Seeking Nominations for Migrant Health Advisory
HRSA Technical Assistance for Look-Alike Initial Designation for the Health Center Program
Housing Assistance Council: Housing Loans for Low-Income Rural Communities
HUD Distressed Cities and Persistent Poverty Technical Assistance Program
HUD Hospital Mortgage Insurance Program
IHS Tribal Forensic Healthcare Training
IHS/DOD Medical Supplies and Equipment for Tribes (Project TRANSAM)
NARHC Certified Rural Health Clinic Professional Course
National Health Resource Center on Domestic Violence Technical Assistance
National Indian Health Board Vaccination Event Funding
National Indigenous Women's Resource Center Technical Assistance for Domestic Violence Programs
Native Americans into Medicine
Host Sites for National Environmental Public Health Internship
NIH Addressing the Impact of Structural Racism and Discrimination – Various dates until October 2025
NIH Native American Research Centers for Health – Various dates until July 2026
NIH Project Talk Initiative Host Site Applications
NIH Research to Improve Native American Health – October 2024
NIH Researching Mental Health Practices in Low-Resource Settings – September 2024
NIH Researching Social, Behavioral, and Economic Impact of COVID-19 in Underserved/Vulnerable Populations – September 2024
NIH Researching the Role of Work in Health Disparities – Various dates until September 2024
NIH Special Interest Research – Pandemic Impact on Vulnerable Children and Youth – May 2024
NIH Researching Barriers to Care for HIV-Associated Comorbidities – May 2025
NIH Research to Address Vaccine Hesitancy in Health Disparity Populations – June 2026
NIH Research to Understand Disparities in Maternal Morbidity and Mortality – Various dates until October 2026
Nominations for Federal Advisory Commission on HIV, Viral Hepatitis, and Sexually Transmitted Diseases
NRHA Chief Nursing Officer Certification Program for Rural Hospitals
Oweesta Native CDFI Loan Funds and Technical Assistance
Primary Care Development Corporation Community Investment Loans
Rural Community Assistance Corporation Community Facility Loans for Western States and Pacific Islands
Rural Community Assistance Corporation Environmental Infrastructure Loans for Western States
Rural Graduate Medical Education Planning and Development
RTT Collaborative: Rural Training Track Directors University
RWJF Investigator-Initiated Research to Build a Culture of Health
RWJF Pioneering Ideas Brief Proposals
SAMHSA Crisis Counseling Assistance and Training Program for Communities Post-Disaster
SAMHSA Training to Provide Medication Assisted Treatment
SBA Guaranteed Loans for Small Business
Southeast Rural Community Assistance Loans
Tribal Grant Writing Training
Treasury Department Opportunity Zone Economic Development Program
United South and Eastern Tribes, Inc Tribal Health Program Support
USDA Community Facilities Program
USDA Community Food Projects Technical Assistance
USDA Drinking Water and Waste Disposal for Rural and Native Alaskan Villages
USDA Economic Impact Initiative Grants
USDA Emergency Community Water Assistance Grants
USDA Healthy Food Financing Initiative Technical Assistance
USDA Intermediary Relending Program
USDA Multifamily Housing Loan Guarantees
USDA National School Lunch Afterschool Snack Program
USDA Rural Business Development Grants
USDA Rural Business Investment Program
USDA Rural Energy Savings Program
USDA SEARCH – Special Evaluation Assistance for Rural Communities and Households (for Water/Waste Projects)
USDA Summer Food Program
USDA Technical Assistance for Healthy Food Financing Initiative
USDA Telecommunications Infrastructure Loans and Loan Guarantees
USDA Funding for Rural Water and Waste Disposal Projects
USDA Water and Waste Disposal Grants to Alleviate Health Risks on Tribal Lands and Colonias
USDOT Rural Opportunities to Use Transportation for Economic Success (R.O.U.T.E.S)
Veterans Affairs Health Professional Scholarship Program
Veterans Affairs Virtual Living Room - Using Technology to Address the Critical Healthcare Needs of Veterans in Rural Areas
Western Region Public Health Training Center – Future Leaders Program
WWAMI Area Health Education Center Scholars Program
3RNET Recruitment and Retention Assistance
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