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December 7, 2023
What's New
Town Hall for CDC Rural Public Health Strategic Plan – Wednesday, December 13 at 3:00 pm Eastern. The Centers for Disease Control and Prevention (CDC) seeks to advance rural public health using the best science and solutions. Feedback on the draft CDC Rural Public Health Strategy will be incorporated into the agency’s public health programs with the guidance of the relatively new CDC Office of Rural Health.
CMS Announces New Residency Slots for Underserved Communities. This is the second round of new Medicare funding for residency positions to train physicians in highest need areas, prioritized by Health Professional Shortage Area scores. The Centers for Medicare & Medicaid Services (CMS) awarded the first round last winter, kicking off a five-year process legislated by the Consolidated Appropriations Act, 2021 to distribute 200 new residency slots each year. This week, researchers at the FORHP-supported program that helps hospitals plan and develop rural residencies released analysis of the 99 hospitals that were awarded in this round to determine rural location of physician placements – whether sites were rural as defined by CMS or by FORHP – and the time they are required to train in these locations. They found only three programs training their residents for 50 percent of the time or greater in a CMS or FORHP rurally located area. Next month, the FORHP-supported RuralGME.org will be joined by CMS representatives to co-host a webinar to help rural hospitals understand how to apply for round three, expected to open in January.
Report Highlights Rural-Urban Disparities in Medicare. Research funded by the Centers for Medicare & Medicaid Services evaluated the rural-urban comparisons in quality of health care in the Medicare program, and how quality and outcome varies by race and ethnicity. The analysis found that, overall, people with Medicare living in rural areas had results that were below the national average for the Consumer Assessment of Healthcare Provider and Systems (CAHPS) survey scores for about 20 percent of all clinical care measures examined with rural residents. These scores were consistently below the national average on measures of behavioral health. The analysis also displayed noteworthy variation in racial and ethnic differences when looking separately within rural and urban areas. For example, CAHPS scores for Hispanic people with Medicare living in rural areas were generally below the national average for all people with Medicare living in rural areas, while scores for Hispanic people with Medicare living in urban areas were generally like the national average for all people with Medicare living in urban areas. These patterns applied to people with both Medicare Advantage and Medicare fee-for-service coverage.
HHS Releases Healthcare Cybersecurity Strategy. The U.S. Department of Health and Human Services (HHS) released a concept paper outlining the Department’s cybersecurity strategy for the health care sector. Cyber incidents in health care are on the rise and have led to extended care disruptions, patient diversions to other facilities, and delayed medical procedures, all putting patient safety at risk. Although FORHP-funded research from the University of Minnesota identified lower rates of ransomware attacks in rural areas, many rural hospitals are less equipped to handle these attacks due to a shortage of IT personnel in rural areas and smaller budgets for cybersecurity infrastructure. The Administration for Strategic Preparedness and Response’s website offers tools and resources for healthcare facilities, including small facilities and low-resource hospitals, to protect themselves from cyber attacks.
HRSA Updates Data Tool for NHSC Students and Trainees. The dashboard created and managed by the Bureau of Health Workforce at HRSA shows the pipeline of clinicians in training through its Nurse Corps Scholarship and National Health Service Corps (NHSC) Scholarship and Student to Service Programs. Users can download data and/or view state-by-state information on an interactive map showing clinicians and trainees by NHSC program, discipline, and more.
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
**New: COVID-19 Home Tests Available. Every home in the U.S. is again eligible to receive four (4) free at-home tests ordered at www.covid.gov. Delivery is free through the U.S. Postal Service.
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 Coronavirus Aid, Relief, and Economic Security (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
CMS Making Care Primary Model – extended to December 14. Back in September, the Centers for Medicare & Medicaid Services (CMS) opened the application window for a new model from the CMS Innovation Center. While CMS-designated Rural Health Clinics are not eligible, other rural primary care providers (including Federally Qualified Health Centers) may seek to participate in the ten-year program that will provide resources to strengthen coordination between primary care clinicians, specialists, and other providers to address health needs and health-related social needs such as housing and nutrition. Beginning July 1, 2024, CMS is working with State Medicaid Agencies in eight states: Colorado, North Carolina, New Jersey, New Mexico, New York, Minnesota, Massachusetts, and Washington. To be eligible to apply, an organization must bill for services for a minimum of 125 Medicare beneficiaries and deliver more than half of their services in a participating state. The original application deadline of November 30 has been extended to December 14.
DOJ/CDC Reaching Rural: Collaborative Solutions for Substance Misuse – December 15. The U.S. Department of Justice (DOJ) and the Centers for Disease Control and Prevention (CDC) provide a one-year training and technical assistance initiative to address substance use in rural communities. Selected participants will form the second cohort in this collaboration between the DOJ, the CDC, and the State Justice Institute. The inaugural class of 67 Reaching Rural fellows was launched in December 2022.
Alzheimer’s Association Supporting Research in Health Disparities, Policy, and Ethics – Letters of Intent January 9. The national nonprofit organization identifies rural populations as an area of focus for its funding to increase understanding and to address diversity, equity, and inclusion in Alzheimer’s disease and related dementia research. A letter of intent by January 9 is required of applicants to the program.
EPA Training/Technical Assistance for Safe Drinking Water in Small Public Water Systems – February 2. The U.S. Environmental Protection Agency (EPA) technical assistance to help communities identify water infrastructure needs and plan for improvements. Total funding for the program is more than $30 million for organizations that work side-by-side with publicly managed water systems in small and rural communities.
Policy Updates
Send questions to ruralpolicy@hrsa.gov.
Medicare Physician Fee Schedule Final Rule Summary: Calendar Year 2024. This newsletter from the Medicare Learning Network provides information for staff involved in billing for services covered by the Medicare Physician Fee Schedule under policies that will take effect on January 1, 2024.
CMS Hosts Skilled Nursing Facilities and Long-Term Care Open Door Forum – Thursday, December 7 from at 2:00 pm Eastern. Advance registration is required for this regularly scheduled Open Door Forum held by the Centers for Medicare & Medicaid Services (CMS) to address the concerns and issues affecting the nursing home industry, including those for Medicare Skilled Nursing Facilities and Medicaid Nursing Facilities. The hour-long session will be a Zoom webinar with an option to dial-in.
Overview of New Medicare Rules Affecting RHCs – Monday, December 11 at 2:00 pm Eastern. The National Association of Rural Health Clinics will host the free, FORHP-supported webinar with details about 2024 regulatory updates for RHCs and will provide additional time for Q&A. Among changes that will affect Rural Health Clinics (RHCs) certified by the Centers for Medicare & Medicaid Services: inclusion of Remote Physiologic Monitoring and Remote Therapeutic Monitoring; an extension of payment for telehealth services until the end of 2024; the addition of marriage and family therapists and mental health counselors as billable provider types; and the establishment of an Intensive Outpatient Program. Advance registration is required.
Learning Events and Technical Assistance
How PACE Can Meet Needs for Dually Eligible in Rural Areas – December 7, at 2:00 pm Eastern. A national nonprofit working to improve health care delivery will host an hour-long webinar to explain the Program of All-Inclusive Care for the Elderly (PACE) and how it meets the needs of the twenty percent of dually eligible beneficiaries who live in rural areas, where access to integrated Medicare and Medicaid programs are limited. It will feature perspectives from a rural PACE provider and a state that is seeking to offer PACE statewide. Advanced registration required.
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.
Integrating Quality Measures into Opioid Stewardship Programs – Tuesday, December 12 at 1:00 pm Eastern. The National Rural Health Resource Center is a FORHP-supported nonprofit that will share lessons learned from an opioid stewardship program that was successfully replicated across thirteen Minnesota rural health care organizations over the past six years.
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
Toolkit for Communicating About Medicaid and CHIP Renewal. Created for physicians, pediatricians, and other health professionals, the toolkit contains messaging for patients and families who have been disenrolled from Medicaid or the Children’s Health Insurance Program (CHIP), two forms of public health insurance coverage that play a critical role in rural areas. Among the ready-to-use materials are messages for on-hold phone recordings, e-newsletters and patient portals, and Frequently Asked Questions from patients. CMS estimates that more than 27 million people are due for renewal in Medicaid or CHIP. As of August 2023, more than 7 million people were disenrolled, while more than 13 million had their enrollment renewed.
At-A-Glance: CDC Office of Rural Health: The Centers for Disease Control and Prevention (CDC) released an information sheet. The document describes the role of rural public health, rural health disparities, and strategies the CDC’s Office of Rural Health is developing to address inequities in rural health.
3RNet Training for Rural Recruitment. A recording of the hour-long session for health care employers in rural areas that took place on December 5th. The training includes how to share jobs on social media and how to use 3RNet Plus Tools to feature jobs and track candidates. Watch this space for additional trainings from 3RNet scheduled for January and March.
Approaching Deadlines
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
CMS Making Care Primary Model – Extended to December 14
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
Alzheimer’s Association Supporting Research in Health Disparities, Policy, and Ethics – Letters of Intent January 9
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
EPA Training/Technical Assistance for Safe Drinking Water in Small Public Water Systems – February 2
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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