October 10, 2019 What's New NIHCM: Population Shifts Impacting Rural Health. As urbanization increases, an older, sicker and poorer population remains in rural America. New infographics from the National Institute for Health Care Management (NIHCM) Foundation depict the population shifts driving these changes, the corresponding health care challenges, and promising tools to improve rural health. In rural areas, 18.4 percent of the population is over 65 years of age compared to 14.5 percent in urban areas, and rates of obesity, diabetes and smoking are higher. See the Resource of the Week below for a new toolkit supporting older adults in rural areas. October is Domestic Violence Awareness Month. In 2017, the Health Resources and Services Administration (HRSA) launched its Strategy to Address Intimate Partner Violence, with targets and projects that involve each of the agency's bureaus and offices. This month, HRSA's Office of Women's Health released the first progress report for that initiative, describing its achievements between 2017 and 2018. Victims in rural areas may be reluctant to report intimate partner violent abuse, and unaddressed abuse has an impact that goes beyond the individual and into communities. See the Events section below for two webinars in October to increase awareness of domestic violence. Comments Requested: The 2020 National Vaccine Plan – October 24. The U.S. Department of Health & Human Services is seeking input from the public on a 10-year national strategy for addressing vaccine-preventable diseases. The plan will update all aspects of vaccine research and development, supply, financing, distribution, and safety, and address causes of an increased reluctance to vaccinate that led to recent outbreaks of pertussis, hepatitis B and measles. Last year, the Centers for Disease Control and Prevention released research showing a lower rate of vaccination for rural teenagers and made recommendations for making it a routine part of clinical care. Funding Opportunities Reducing Harm in High Intensity Drug Trafficking Areas – November 1. Through a grant from the Office of National Drug Control Policy, the University of Baltimore will fund and study community-based efforts to reduce opioid overdose in High Intensity Drug Trafficking Areas (HIDTAs). Eligibility requires a letter of support from a regional HIDTA and extends to state and local public entities, Native American tribal governments and organizations, nonprofits, and faith-based organizations. Projects must be evidence-based, include both implementation and evaluation, and support partnership of law enforcement with public health agencies. MAT-LINK: Researching Outcomes for Maternal OUD – November 15. Funding preference may be given to applicants that can show geographic and population diversity for this project supported by the Public Health Informatics Institute. The MATernaL and Infant NetworK to Understand Outcomes Associated with Treatment for Opioid Use Disorder during Pregnancy (MAT-LINK) seeks proposals from clinical sites that have the ability to integrate or link maternal and newborn data and the authority to access and share these data with the Centers for Disease Control and Prevention. A webinar for interested applicants will be held today, October 10, at 1:00 pm. See the headline link above for details. PCORI: Community Convening for Patient-Centered Research – November 15. The Patient-Centered Outcomes Research Institute (PCORI) will make awards of up to $100,000 for research that convenes patients, clinicians, researchers and other stakeholders. Public, private and nonprofit organizations should select a central focus or theme that unifies stakeholders such as geography, a particular health condition, or hard-to-reach populations, including veterans, LGBTQ and rural residents. Letters of Inquiry are due Friday, November 15 at 5:00 pm ET. Policy Updates Visit the FORHP Policy page to see all recent updates and send questions to ruralpolicy@hrsa.gov. Comments Requested: Proposed Reforms to Physician Self-Referral and Anti-Kickback Laws – December 31. Yesterday, the Department of Health and Human Services released proposed reforms to two separate, but related, rules that interpret the Physician Self-Referral Law (or the Stark Law) and the Federal Anti-Kickback Statute. The Stark Law protects patients from unnecessary services and referrals that benefit a provider's self-interest while the Anti-Kickback Statute provides criminal penalties for soliciting or receiving reward from the referral of services under Medicare and Medicaid. As part of the Department's Regulatory Sprint to Coordinated Care, the proposed changes are designed to promote coordinated care and support the transition to value-based arrangements while continuing to protect against fraud and abuse. The Stark Law rule proposes to allow physicians to enter into value-based arrangement with a variety of providers in order to promote innovative care, and the Anti-Kickback rule proposes reform to the safe harbors for telehealth and local transportation as well as value-based arrangements. Rural Health Value highlights how rural providers and communities have been working towards innovative and coordinated care and the barriers they have encountered. Learning Events and Technical Assistance Public Health and Transportation Webinar Series: Part One - Collaborating Together for Community Health – Thursday, October 10 at 2:00 pm ET. A Federal Transit Administration (FTA) grantee, the National Center or Mobility Management (NCMM), will host a series of webinars on collaborations between transportation – a barrier to health care access in rural areas – and public health. This webinar is the result of new collaborations between the Department of Transportation and CDC's Health Impact in 5 Years initiative. Part one will focus on how public health and transportation professionals can work together to support community health and well-being. This webinar will provide an opportunity for mobility management and transportation practitioners to hear from public health professionals on potential areas for collaboration between the two sectors, and discuss ideas for developing, implementing, and evaluating initiatives to improve community health. HRSA Virtual Job Fair – Wednesday, October 16 at 6:45 pm ET. The Health Resources and Services Administration (HRSA) will hold a three-hour virtual job fair to connect job-seeking medical, nursing, dental, and mental/behavioral health clinicians and trainees with hundreds of opportunities at health care facilities, most in medically-underserved areas of the country. Interested job seekers register here. The Effects of Overexposure to Stories of Trauma – Wednesday, October 23 at 1:00 pm ET. This webinar from the Migrant Clinicians Network provides an overview of stress and injury affecting the behavioral health of those who witness trauma. Kaethe Weingarten, PhD will discuss the role of clinicians, social workers, and other witnesses and helpers, describing coping strategies for both providers and clients. Recovery and Medication Assisted Treatment – Thursday, October 24 at 1:00 pm ET. The Psychiatry & Behavioral Health Learning Network will introduce Medication Assisted Treatment (MAT) and the role of federally-approved medications to treat opioid use disorders. Experts will discuss how MAT fits into substance abuse treatment and recovery, identify the benefits and drawbacks of MAT, and address associated stigma. Recognizing Domestic Violence and Human Trafficking – Friday, October 25 at 1:00 pm ET. In a one-hour webinar, the National Center for Health in Public Housing will point out signs of domestic violence and human trafficking that can be identified by clinicians and staff in health settings. HRSA Webinar: Domestic Violence Awareness Month – Thursday, October 31 at 1:00 pm ET. Experts from the Health Resources and Services Administration (HRSA) will discuss state-level efforts to address intimate partner violence and provide strategies for implementing trauma-informed care during this 90-minute webinar. HRSA Webinar: Screening for Food Insecurity – Thursday, October 31 at 1:00 pm ET. The Office of Regional Operations at the Health Resources and Services Administration (HRSA) will host a one-hour webinar to help identify patients experiencing food insecurity and connect them to resources. In rural areas, access to nutritious food is often limited by financial and transportation constraints. Resource of the Week Toolkit: State Strategies to Support Older Adults Aging in Place in Rural Areas. This toolkit from the National Academy for State Health Policy highlights state initiatives to help older rural adults age in place by increasing services that help people remain in their homes, expanding and professionalizing the caregiver workforce, and making delivery system reforms within Medicaid programs. According to research referenced in the toolkit, more than 85 percent of older adults prefer to remain in their own homes and communities, and serving older adults in their homes is usually less expensive than housing people in facilities. This resource was funded by the Geriatrics Program in the Bureau of Health Workforce at the Health Resources and Services Administration. Approaching Deadlines Whole Kids Foundation School Garden Grant Program – October 15 Small Rural Hospital Transition Project – October 16 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 National Health Service Corps Students to Service Loan Repayment Program – October 31 USDA Rural Energy for America Program (REAP) – October 31 Reducing Harm in High Intensity Drug Trafficking Areas – November 1 Comments Requested: Rural Eligibility for FORHP Funding – November 2 Robert Wood Johnson Health Policy Fellowship – November 6 EPA Technical Assistance for Small Public Water Systems – November 14 MAT-LINK: Researching Outcomes for Maternal OUD – November 15 PCORI: Community Convening for Patient-Centered Research – November 15 EPA Student Design Competition for People, Prosperity and the Planet – November 19 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 Community Food Projects Technical Assistance – Ongoing 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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