September 12, 2019 What's New New Models for Obstetrics Care in Rural Communities. On Tuesday, the U.S. Department of Health & Human Services (HHS) announced $9 million in awards to launch the Rural Maternity and Obstetrics Management Strategy (RMOMS) program. Recipients from three states – Missouri, New Mexico, and Texas – will receive up to $600,000 in a planning year and up to $800,000 in three implementation years to pilot, test, and develop models that improve access to and continuity of maternal obstetrics care in rural communities. Separately, the Centers for Medicare & Medicaid Services, a division of HHS, released an issue brief on the scope of challenges to maternal care in rural areas of the country with a call for more collaboration at national, state, and community levels. HRSA/FORHP Awards to Support Rural Emergency Medical Services. The Medicare Rural Hospital Flexibility Program (Flex) is one of several in the hospital-focused programs of the Federal Office of Rural Health Policy (FORHP) at the Health Resources and Services Administration (HRSA). The Flex Program also targets rural Emergency Medical Services (EMS) and, in a new initiative, will fund projects to support the implementation of demonstration projects of sustainable EMS models and quality metrics for rural EMS agencies. Last week, supplements of up to $250,000 each year for three years were awarded to the state Flex programs in South Carolina, Florida, Ohio, North Dakota, Washington, Arizona and New Mexico. Suicide Rates Still Rising, Especially in Rural. On Friday, the Journal of the American Medical Association (JAMA) released a new report on county-level suicide rates, specifically comparing trends and contributing factors that varied between urban and rural areas. The study included all individuals aged 25 to 64 years who died by suicide between January 1, 1999 and December 31, 2016. Results showed that 77 percent of the decedents were male and that suicide rates were higher and increased more rapidly in rural than in large metropolitan counties. New Census Report Finds Increases in Uninsured – This week the U.S. Census Bureau released its 2018 estimates of health insurance coverage finding a statistically significant increase from 2017 in the percent of people without health insurance. In metropolitan areas, the percent of people uninsured increased from 7.9% in 2017 to 8.4% in 2018. In non-metropolitan areas, the percent uninsured increased from 8.1% to 9.1% over the same time frame. Funding Opportunities PCORI Research Grants - Improving Healthcare Systems – Letters of Intent, October 1. The Patient-Centered Outcomes Research Institute (PCORI) will make grants to study alternative features of healthcare systems that have the greatest potential for sustained impact and replication. Priority research areas include patients' access to care, professional decision-making on the basis of patients' personal values, and the efficiency of healthcare delivery. Populations of interest include residents of rural areas, racial and ethnic minority groups, low-income groups, and individuals with low health literacy. Any public or private research organization is eligible to apply for awards of up to $3 million for a three-year project. Whole Kids Foundation School Garden Grant Program – October 15. All public K-12 schools, or any non-profit organization working with them, are eligible for a $2000 grant to support a new or existing education garden. Private schools with 501c3 nonprofit status are also eligible and previous grantees may apply for new funding. Many of the program's success stories include rural schools and organizations and provide ideas for new applicants. USDA Small Business Innovation Research, Phase I – October 23. The U.S. Department of Agriculture (USDA) will make an estimated 90 awards of up to $106,000 each to fund research on new technologies that address problems affecting people, institutions, and communities in rural America. Small businesses with fewer than 500 employees are eligible to apply. Rural health related research priorities include, but are not limited to: water and air quality; expanding broadband access, virtual health applications, and communication technologies; and programs and products that increase consumption of healthy foods. Policy Updates Visit the FORHP Policy page to see all recent updates and send questions to ruralpolicy@hrsa.gov. Comments Requested: PTAC Proposal on Remote Specialist Care – October 1. The Physician-Focused Payment Model Technical Advisory Committee (PTAC) requests public comment on a proposal for a new payment model that would create either Regional Referral Centers (RRCs) or a single National Referral Center (NRC) to provide remote specialists and experts for most health issues. The specialists would support field providers such as visiting nurses, community providers, PCPs, or hospital doctors and would serve any geographic location. Comments can be emailed to PTAC@hhs.gov with the subject line "Public Comment – [name of document]." Resources, Learning Events and Technical Assistance Rural Health and the Law: Public Health Approaches/Potential Legal Solutions – Thursday, September 12 at 2:00 pm ET. This three-part series by the American Health Lawyers Association and the Centers for Disease Control and Prevention will examine the growing disparity between rural and urban health outcomes. Participants in all three programs will come away with an understanding of the drivers of this disparity, and learn about innovations in public health and healthcare to address them. Legal and policy solutions will be discussed including the use of telemedicine, medical-legal partnerships, rural accountable care organizations, and county-based care integration models. The monthly series will begin in September and end in November. Overview of the Rural Health Information Hub – Thursday, September 12 at 3:00 pm ET. The HRSA/FORHP-supported Southwest Telehealth Resource Center will provide an overview of the tools and services available at the Rural Health Information Hub, an online clearinghouse of news, information, and resources. VA Video Connect for Mental Health – Monday, September 16 at 3:00 pm ET. The U.S. Department of Veterans Affairs (VA) uses its VA Video Connect program to make medical visits more convenient for veterans, especially those in rural areas, with limited access to VA facilities. This one-hour webinar will explain a new implementation strategy for mental health access. AgriSafe Webinars for Farm Safety Week – September 16 – 20. The AgriSafe Network will hold daily webinars during National Farm Safety Week covering health and safety topics for agricultural workers and families such as pregnancy risks, ergonomic safety, opioid use, safeguards for children, and current research on agricultural health. NACCHO Rural Health Section's Third Quarterly Call – Wednesday, September 18 at 2:00 pm ET. The Rural Health Section of the National Association of County and City Health Officials (NACCHO) will hold an online meet and greet for all rural health department officers, partners, and interested persons from around the country. The hour-long session will provide an overview of NACCHO's recent assessment of local health department work to prevent and control healthcare-associated infections and combat antimicrobial resistance. Pharmacopeia Chapter Updates Impacting Hospitals – Tuesday, September 24 at 2:00 pm. This one-hour webinar supported by our office and the National Rural Health Association will cover new standards impacting all hospitals with pharmacies: United States Pharmacopeia (USP) Chapter 797, providing standards for preparing compounded sterile medications, and Chapter 800, providing standards for safe handling of hazardous drugs to minimize the risk of exposure to healthcare personnel, patients, and the environment, were released on June 1, 2019 and will become enforceable on December 1, 2019. HRSA Telehealth Learning Series - Tuesday, September 24 at 3:00 pm ET. Join the Health Resources and Services Administration (HRSA) for this 60-minute webinar that will highlight the work of the HRSA/FORHP-supported Telehealth Centers of Excellence. Speakers from the Medical University of South Carolina and University of Mississippi Medical Center will review their core telehealth programs to include tele-ICU, tele-stroke, school based telehealth, tele-emergency, and diabetes remote patient monitoring. They will also discuss how to develop tiered quality of care metrics and apply population health research approaches to telehealth outcome measures. For more information, contact Nancy Rios at NRios@hrsa.gov. Save the Date: 3RNet 2019 Annual Conference – September 24-26 in Wichita, KS. The National Rural Recruitment and Retention Network (3RNet) is a nonprofit organization that matches health care professionals to employers in rural and underserved areas. Attendees of this annual two-day conference will network with 3RNet members and other stakeholders, learn strategies for rural recruitment and retention, and gain insight from experienced leaders in health professions staffing. Last year, 3RNet made more than 2,500 clinician placements in rural, frontier, and underserved urban communities. Approaching Deadlines Comments Requested: Methods for Assuring Access to Covered Medicaid Services-Rescission – September 13 Small Rural Hospital Transition Project – Letters of Intent September 15 Comments Requested: Specialty Care Models to Improve Quality of Care and Reduce Expenditures – September 16 Senior Corps Retired and Senior Volunteer Program (RSVP) – September 25 Comments Requested: Medicare Physician Fee Schedule Proposed Policy, Payment, and Quality Provisions for CY 2020 – September 27 Comments Requested: Proposed Updates to Medicare Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment System – September 27 Comments Requested: ESRD and DMEPOS CY 2020 Proposed Rule – September 27 EPA Assistance for Local Foods, Local Places – September 30 USDA Rural Broadband Access Loan and Loan Guarantee Program – September 30 Become a Sponsoring Agency for AmeriCorps VISTA Program – October 1 Comments Requested: PTAC Proposal on Remote Specialist Care – October 1 PCORI Research Grants - Improving Healthcare Systems – Letters of Intent October 1 Comments Requested: Rural Access to Health Care Services – October 9 Whole Kids Foundation School Garden Grant Program – October 15 USDA Small Business Innovation Research, Phase I – October 23 Comments Requested: Proposed Changes to Confidentiality of Substance Use Disorder Patient Records – October 25 Radiation Exposure Screening and Education Program – October 28 Grants for Transportation of Veterans in Highly Rural Areas – October 31 USDA Rural Energy for America Program (REAP) – October 31 Rural Health Network Development Program – November 25 HRSA Rural Health Network Development Planning Program – November 29 Bloomberg Public Health Fellows – December 1 Delta States Rural Development Grant Program - December 6 Partnership to Promote Local Efforts To Reduce Environmental Exposure – December 15 NIH: Research for Disparities Among Minority/Underserved Children – Cycles thru May 2020 Guaranteed Loans for Rural Rental Housing – Ongoing through 2021 SBA Guaranteed Loans for Small Business – Ongoing Drinking Water State Revolving Fund – Ongoing Seeking Nominations: National Advisory Committee on Migrant Health – Ongoing 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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