June 6, 2019 What's New AHA Rural Report Podcast Series. The American Hospital Association (AHA) has a podcast built around their recently published "Rural Report: Challenges Facing Rural Communities and the Roadmap to Ensure Local Access and High-quality, Affordable Care." The first episode, 14 minutes in duration, features experts discussing current approaches to mental and behavioral health. Meeting Summary - HHS and HRSA Rural Summit. Earlier this year, HHS and HRSA convened a forum of rural health care stakeholders to discuss challenges rural communities face in providing and accessing health care and how HRSA and HHS can address these challenges in the course of program and policy development. The summary from this discussion is now available online at the Federal Office of Rural Health Policy's Rural Health Resource Guide. The Impact of Food Assistance on County-Level Employment. The Economic Research Service (ERS) at the U.S. Department of Agriculture (USDA) recently released a study on the economic impact of the Supplemental Nutrition Assistance Program, also known as SNAP. According to their research, consumers' use of SNAP benefits had a greater impact in rural areas during national economic downturn, creating additional jobs in those counties. The ERS conducts research and analysis on a broad range of economic and policy topics related to agriculture and rural areas. Identifying High-Need Rural Counties for Health Resource Planning. Analyses of location selection by health care providers in the U.S. are often retrospective, mapping the results of previous decisions. Examples include studies of the location choices of new physicians, freestanding emergency departments, and diabetes self-management educations programs. These studies have generally documented that providers prefer to locate in well-resourced, urban areas, rather than areas with higher rates of illness and/or lower-income populations. Using federal data, researchers at the Rural & Minority Health Research Center at the University of South Carolina developed a relatively simple technique to measure the level of potential health care need at the local level. In a separate report on planning for primary care in high-need areas, the same researchers demonstrate a process for identifying counties with limited access to Rural Health Clinics and Federally Qualified Health Centers, featuring maps and statistics that show distribution of safety net providers in rural counties. Funding and Opportunities IHS Tribal Management Grant Program – July 1. The Indian Health Service (IHS) provides grants to assist federally recognized tribes and tribal organizations in assuming all or part of existing IHS programs, services, functions, and activities. Funds may also be used to obtain technical assistance for program planning and evaluation, including development of management systems for contract management; and for planning, designing, monitoring, and evaluating federal programs serving tribes. DOT Public Transportation on Indian Reservations – July 9. The U.S. Department of Transportation (DOT) will make 35 awards for total funding of $5 million to support planning, capital, and, in limited circumstances, operating assistance for tribal public transit services. Eligible applicants are federally recognized Indian tribes or Alaska Native villages, groups, or communities as identified by the U.S. Department of Interior (DOI), Bureau of Indian Affairs (BIA) that are located in rural areas with a population of 50,000 or less. Seeking Host Applicants for Citizens' Institute on Rural Design – July 22. Rural and tribal communities with populations of 50,000 or less are eligible to apply to participate in local design workshops to address specific community challenges. Up to three communities will be selected to form a Learning Cohort for training in design, planning, community engagement, and facilitation techniques. Examples of potential design challenges include improving access to locally-produced food, creating heritage tourism industry, developing outdoor recreation, and designing quality affordable housing. HUD Hospital Mortgage Insurance Program – Ongoing. The U.S. Department of Housing and Urban Development (HUD) provides mortgage insurance for acute care hospital facilities ranging from large teaching institutions to small, rural Critical Access Hospitals. The program helps hospitals access affordable financing for capital projects that may include remodeling, expansion, modernization, equipment, refinancing, and acquisition. Applications are accepted on an ongoing basis. Policy Updates Visit the FORHP Policy page to see all recent updates and send questions to ruralpolicy@hrsa.gov. New Opportunity to Apply to be a Medicare Shared Savings Program ACO—Notice of Intent June 28. For provider groups interested in becoming a Medicare Shared Savings Program Accountable Care Organization (ACO) in 2020, CMS will accept Notices of Intent Apply (NOIA) between June 11 and June 28, 2019. An NOIA is required in order to submit an application, which will be due by July 29. The ACO Program was restructured for 2019 and offers rural providers a path to take on financial risk for shared savings and losses. Email questions to SSPACO_Applications@cms.hhs.gov. CMS Publishes PACE Final Rule- The Centers for Medicare & Medicaid Services (CMS) finalized a rule updating and modernizing the Programs of All-Inclusive Care for the Elderly (PACE), which provides comprehensive medical and social services to certain frail, elderly individuals (many of whom are "dually eligible" for both Medicare and Medicaid) who qualify for nursing home care but can still live safely in the community. This rule strengthens protections for PACE participants, provides administrative flexibility for PACE organizations, and reduces administrative burden for clinicians. RHI Hub provides examples of PACE programs in rural areas as well as toolkits on how to get started. CMS Beyond the Policy Podcast: New Episode on Value-Based Care. The episode features a discussion on the direction of the CMS Innovation Center with the CMS Administrator, Seema Verma and the CMS Innovation Center Director, Adam Boehler, that was moderated by Tom Corry, the CMS Director of the Office of Communications. This includes a mention of new models for rural health care. Learning Events and Technical Assistance The Future of Nursing 2020-2030 – Friday, June 7 at 9:30 am ET. The National Academy of Medicine will hold the first in a series of town hall events to get feedback from the public for its Committee on the Future of Nursing 2020-2030. The four-hour event will take place in Chicago and is viewable online. In rural areas, there are more registered nurses (RNs) than any other type of clinician except clinical aides, but nearly one million of rural RNs are older than 50 and will reach retirement age in the next decade. Emergency Triage, Treat, and Transport (ET3) Model RFA Webinar – Tuesday, June 11 at 2:00 pm ET. This upcoming webinar hosted by the Center for Medicare and Medicaid Innovation will provide an overview of the ET3 Model Request for Applications (RFA) which was released for review on May 22. The ET3 Model is a voluntary five-year payment model that provides greater flexibility for ambulance care teams to implement alternate models of emergency medical services (e.g., transport to alternative destinations) that appropriately address the needs of Medicare beneficiaries. Register for the webinar today to learn more about eligibility requirements, especially for rural ambulance providers and suppliers, and for an opportunity to ask questions during the Q&A session. Join the Conversation on Maternal Health Care in Rural Communities – Wednesday, June 12 at 8:30 am ET. This interactive event hosted by CMS, HRSA, the National Rural Health Association, and others will provide an overview of the state of maternal healthcare in rural communities, with a focus on access to maternal health services before, during, and after pregnancy. Learn about promising practices and help identify areas of opportunity to improve access to maternal health services and achieve health equity within rural communities. The event will be held in Washington, DC, and virtual attendance will be available via webcast. MAT 2.0: Evidence-Based Practices in SUD Treatment – Wednesday, June 12 at 2:00 pm ET. Experts from the HRSA-supported University of California San Francisco Clinician Consultation Center's Substance Use Warmline will share evidence-based practices and resources on medication assisted treatment (MAT) for patients with substance use disorder (SUD). They will discuss the MAT model from assessment and induction to management and monitoring, provide case-based examples, and answer provider questions about patient considerations during a 30-minute question and answer session. (Note: This webinar was previously scheduled for Friday, May 10.) Using the Law and Policy to Promote Health Equity – Thursday, June 13 at 1:00 pm ET. In this one-hour webinar hosted by the Office of Disease Prevention and Health Promotion, experts from public and nonprofit organizations will take a comprehensive look at legal and policy strategies that can address health inequities. Northeast Telehealth Resource Center Regional Conference – June 17-18 in Portland, ME. This two-day conference in Portland, Maine features a keynote presentation by Chris Gibbons, MD, MPH - Chief Health Innovation Adviser, FCC and the Future for Digital Health, a special panel on Federal and Regional Telehealth Policy Perspectives, and other key topics from national and regional telehealth leaders. There are more than fifteen breakout sessions on a wide variety of areas including: strategies for planning and sustaining telehealth programs, telehealth use cases across various environments, models for serving vulnerable populations through telehealth, and more. This year's event also includes a Pre-Conference Telebehavioral Health Workshop: "A Provider's Guide to TeleMental Health: Key Concepts and Use Cases", and two hands-on technology labs with the National Telehealth Technology Assessment Resource Center. NHSC Rural Community LRP Application Assistance – Thursday, June 18 at 1:00 pm ET. Applicants to the National Health Service Corps (NHSC) Rural Community Loan Repayment Program (LRP) can get information about the process during this 90-minute webinar. Dial-in 800-857-1286; Passcode 4667956. National Rural Institute on Alcohol and Drug Abuse – June 23-27 in Menomie, WI. Registration is open for this unique annual conference for rural alcohol and drug abuse professionals, federal agency representatives and nationally-known experts. Key resource professionals from throughout the U.S. will present intensive study tracks and special topics on current innovative and emerging topics. National Opioid Leadership Summit – Tuesday, June 25 in Sacramento, CA. Join the Public Health Institute, U.S. Surgeon General Jerome Adams and colleagues from across the country on June 25, 2019 in Sacramento to learn about, share and collaborate on real solutions to the opioid crisis that bridge the criminal justice, health care, and public health sectors. Resource of the Week New Tool Helps Calculate the Cost of Lead Exposure. Created by Altarum with support from the Robert Wood Johnson Foundation, the Value of Lead Prevention tool allows state and local leaders and the public to easily calculate the cost of lead exposure in their state. It also computes the economic benefits of specific policies and programs, from replacing lead drinking water service lines to eradicating lead paint hazards in older homes. While there is not much research on the prevalence of lead exposure in rural areas, at least one recent study notes findings suggesting that rural populations are at as great a risk of elevated blood lead levels as are urban populations. Lead is most dangerous to children, especially those under age six, potentially causing damage to virtually every body system. Lead poisoning has no distinctive clinical symptoms, but even low levels can result in decreased intelligence, impaired neurobehavioral development, and decreased stature and growth. The Centers for Disease Control and Prevention (CDC) monitors lead exposure, and provides information for parents and policymakers. Approaching Deadlines Community Development Financial Institution Program – June 6 Native American Community Development Financial Assistance – June 6 SAMHSA Rural Opioid Technical Assistance Grants – June 7 Environmental Workforce Development and Job Training – June 10 Rural Communities Opioid Response Program-Medication-Assisted Treatment Expansion (RCORP-MAT Expansion)– June 10 RCORP - Rural Centers of Excellence on Substance Use Disorders – June 10 USDA Community Facilities Technical Assistance and Training Grant – June 10 USDA Rural Health and Safety Education Grants – June 10 DOJ School Violence Technology and Threat Assessment – June 11 Brookdale Foundation Relatives as Parents Program – June 12 CDC Grants for Health and Wellness in Indian Country – June 12 Research for Smoking Cessation in Disadvantaged Populations – June 13 CDC Emergency Department Surveillance of Non-fatal Suicide Outcomes – June 14 HRSA Medical Student Education Program – June 14 NIH Research to Address Opioid Epidemic and Minority Health Disparities – June 14 Comments Requested: Clarification of Ligature Risk Interpretive Guidance – June 17 Comments Requested: Proposed Changes to Payment and Policy for Inpatient Psychiatric Facilities – June 17 Comments Requested: Proposed Payment and Policy Changes for Medicare Inpatient Rehabilitation Facilities – June 17 Comments Requested: Trusted Exchange Framework for Electronic Health Information – June 17 Comments Requested: Proposed Update to Hospice Payment Rate – June 18 Comments Requested: Proposed Payment and Policy Changes for Medicare Skilled Nursing Facilities – June 18 USDA Local Food Promotion Program – June 18 Comments Requested: Proposed Updates for FY2020 Medicare Inpatient and Long-term Care Hospital Payments – June 24 New Opportunity to Apply to be a Medicare Shared Savings Program ACO—Notice of Intent June 28 Proposals Requested: Medicare Measures for Promoting Interoperability – June 28 Hardship Exclusion for Medicare Interoperability – July 1 HUD Comprehensive Housing Counseling Grant Program – July 1 IHS Tribal Management Grant Program – July 1 Comments Requested: CMS Issues Draft Guidance on Hospital Co-location – July 2 Request for Information: State Waivers for Health Insurance – July 2 Contractor Sought for RWJF Rural Leadership Pathways Learning Initiative – July 8 USDA Rural Housing Preservation Grant – July 8 DOT Public Transportation on Indian Reservations – July 9 Federal Investment in Rural Transportation – July 15 DOL Workforce Opportunity for Appalachian and Delta Regions – July 15 NHSC Rural Community Loan Repayment Program – July 18 Seeking Host Applicants for Citizens' Institute on Rural Design – July 22 CDC National Harm Reduction Syringe Services Program Monitoring and Evaluation – July 26 AHA Rural Hospital Leadership Team Award – August 30 Indian Health Service Loan Repayment Program – Ongoing through August 2019 NIH: Research for Disparities Among Minority/Underserved Children – Cycles thru May 2020 Guaranteed Loans for Rural Rental Housing – Ongoing through 2021 HUD Hospital Mortgage Insurance Program – Ongoing RWJF Investigator-Initiated Research to Build a Culture of Health – Ongoing 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 | 
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