November 4, 2021 What's New CDC Recommends Pediatric COVID Vaccine. On Tuesday, the Centers for Disease Control and Prevention (CDC) expanded their recommendations for the Pfizer-BioNTech vaccine to include about 28 million children aged 5-11 years. The CDC reports that, during a six-week period in late June to mid-August, COVID-19 hospitalizations among children and adolescents increased fivefold. Tomorrow, November 5 at 2:00 pm ET, join HRSA for a Town Hall meeting to get the latest information on this announcement. New Funding Available for the Rural Health Network Development Planning Program applications due January 28. The Health Resources and Services Administration will be making approximately 20 awards of $100,000 each for a one-year period of performance to promote the development of integrated health care networks in order to (i) achieve efficiencies; (ii) expand access to, coordinate, and improve the quality of basic health care services; and (iii) strengthen the rural health care system as a whole. Eligible applicants are domestic public and private, nonprofit and for-profit entities that can deliver services in HRSA-designated rural area, particularly for populations that have historically been underserved and have poorer health outcomes. The applicant organization must represent a network that includes at least three or more health care provider organizations. HRSA's Federal Office of Rural Health Policy will hold an hour-long webinar for applicants on Wednesday November 17th at 3:00 pm ET. (Meeting ID: 161 864 4747; Participant Code: 81822150) A recording will be made available for those who cannot attend. CDC Listening Sessions Provide Strategies for COVID Vaccine Outreach. The Centers for Disease Control and Prevention (CDC) is sharing what their Vaccine Task Force has learned about reaching people with limited access to vaccines. Successful community-level actions were reported during jurisdictional listening sessions conducted earlier this year. These reported activities use existing systems – case managers, community organizations, pharmacies, residential facilities, etc. – to take action steps for scheduling appointments, arranging transportation, and sharing reliable information through trusted networks. These lessons learned may be particularly useful in rural areas where vaccination rates are lower. CMS Expands Telehealth for Behavioral Health. This week, the Centers for Medicare & Medicaid Services (CMS) updated telehealth policies for 2022 to expand behavioral health services, including treatment of substance use disorders through Opioid Treatment Programs. The policy updates allow patients to receive these services in their homes. CMS is also allowing reimbursement for audio-only services for certain patients, beneficial to rural patients with limited access to high-speed broadband. In addition, for the first time outside of the COVID-19 public health emergency, Medicare will pay for mental health visits furnished by Rural Health Clinics and Federally Qualified Health Centers through digital and audio telecommunications. For specifics on the policy updates, CMS has published a fact sheet on the Calendar Year 2022 Physician Fee Schedule Final Rule. New CMS Policy Promotes Growth in the Medicare Diabetes Prevention Program. CMS also announced updated policies to improve the Medicare Diabetes Prevention Program (MDPP) Expanded Model, created to help prevent Medicare beneficiaries with prediabetes from developing type 2 diabetes. As part of this update, CMS is reducing barriers to participation in rural communities, where the rate of potentially avoidable death from diabetes is higher than in urban areas. This includes waiving the Medicare enrollment fee for all organizations that apply to enroll as an MDPP supplier on or after January 1, 2022, shortening the MDPP services period to one year instead of two years, and restructuring payments so MDPP suppliers receive larger payments for participants who reach milestones for attendance. For specifics on the policy updates, CMS has published a fact sheet on the MDPP Expanded Model updates in the Calendar Year 2022 Medicare Physician Fee Schedule Final Rule. Rural Hospital Mergers Shown to Reduce Services, but Improve Care Quality. Two studies funded by the Agency for Healthcare Research and Quality provide mixed news on the impact of mergers. The article published in Health Affairs, linked above, found that merged rural hospitals were more likely to eliminate maternal/neonatal and surgical services to stay in business. A second study published in JAMA Network Open found greater reduction in inpatient deaths for several common conditions such as heart failure, acute stroke, and pneumonia at merged rural hospitals. Researchers conclude in this study that mergers result in lower death rates, however more research is needed to assess the impact of mergers on the health care of rural communities. Unintentional Injury Death Twice as High for Rural Children (pdf). Unintentional injuries are the leading cause of death among children aged 0-17 years and the overall rate for rural children is nearly twice as high as for children living in urban areas (12.4 per 100,000 versus 6.3). The data brief from the National Center for Health Statistics reports that rates were highest for children under one year in both urban (29.3) and rural areas (48.8), and identifies suffocation as the leading cause for that age group. Partnership of CDFIs Document Their Rural Efforts. The Partners for Rural Transformation (PRT) is a coalition led by six Community Development Financial Institutions (CDFIs) committed to transforming rural areas of persistent poverty in the Mississippi Delta, Appalachia, Native American communities, the deep south, the Rio Grande Valley, and farming regions in the rural West. With support from the Robert Wood Johnson Foundation, the PRT commissioned this report from the Urban Institute to capture their efforts to expand public and private funding and address community needs. HRSA Celebrates National Rural Health Day. The public is invited to join us online on Thursday, November 18 at 11:00 am ET. Speakers and panelists from several agencies will share what we've learned from our efforts at the federal level and from collaboration with state- and community-level partners. Health equity is a priority focus and Federal Office of Rural Health Policy (FORHP) grantees will share best practices from their projects that consider social determinants of health to improve health outcomes. Ongoing: HRSA Payment Program for RHC Buprenorphine-Trained Providers. In June of this year, the Health Resources and Services Administration (HRSA) launched an effort to improve access to substance use disorder treatment by paying for providers who are waivered to prescribe buprenorphine, a medication used to treat opioid use disorder. Rural Health Clinics still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained to obtain the waiver necessary to prescribe buprenorphine after January 1, 2019. Approximately $1.5 million 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. There is ongoing availability of a free online course for waiver eligibility training from the American Osteopathic Academy of Addiction Medicine and the Providers Clinical Support System. COVID-19 Resources Round 1 Provider Relief Fund Reporting – Grace Period for Submitting Until November 30. Provider Relief Fund (PRF) recipients who received funds prior to June 30, 2020, should have completed reports by September 30. Resources on the Reporting and Auditing web page will help PRF recipients comply with reporting. Last month, HHS announced a grace period to support those facing natural disasters and the Delta variant surge. While the September 30 deadline for reporting has not changed, recoupment or other enforcement actions will not be initiated during the grace period, lasting October 1 – November 30, 2021. NARHC Assistance with Federal Programs for COVID-19 Testing, Vaccine Distribution, and Provider Relief Fund. The National Association of Rural Health Clinics (NARHC) includes a review of the application process for the new round of Provider Relief Funding in its collection of technical assistance webinars for all COVID-related programs designated for Rural Health Clinics. Federal Office of Rural Health Policy Resources for COVID-19. A set of Frequently Asked Questions (FAQs) from our grantees and stakeholders. Rural Health Clinic Vaccine Distribution (RHCVD) Program. Under the program, Medicare-certified RHCs will receive direct COVID-19 vaccines in addition to their normal jurisdictions' weekly allocation. Contact RHCVaxDistribution@hrsa.gov for more information. Online Resource for Licensure of Health Professionals. As telehealth usage increased during the pandemic, FORHP funded new work with the Association of State and Provincial Psychology Boards to reduce the burden of multi-state licensure. The site provides up-to-date information on emergency regulation and licensing in each state for psychologists, occupational therapists, physical therapists assistants, and social workers. HRSA COVID-19 Coverage Assistance Fund. The Health Resources and Services Administration (HRSA) will provide claims reimbursement at the national Medicare rate for eligible health care providers administering vaccines to underinsured individuals. HHS Facts About COVID Care for the Uninsured. The U.S. Department of Health & Human Services (HHS) helps uninsured individuals find no-cost COVID-19 testing, treatment, and vaccines. The HRSA Uninsured Program provides claims reimbursement to health care providers generally at Medicare rates for testing, treating, and administering vaccines to uninsured individuals, including undocumented immigrants. There are at-a-glance fact sheets for providers and for patients in English and Spanish. CDC COVID-19 Updates. The Centers for Disease Control and Prevention (CDC) provides daily updates and guidance, including a section specific to rural health care, COVID-19 Vaccination Trainings for new and experienced providers, and Tips for Talking with Patients about COVID-19 Vaccination. New: Updated list of all available vaccines and their ingredients. 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 and struggling with access to enough critical care physicians, nurses, respiratory therapists, and other specialized clinical experts. Teams of critical care clinicians 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 by the Federation of State Medical Boards through the CARES Act and the FORHP-supported Licensure Portability Program. 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. FCC Emergency Broadband Benefit Program. The Federal Communications Commission (FCC) created this temporary program to help eligible individuals and households afford internet service during the pandemic. Eligible households can enroll through an approved broadband service provider or by visiting GetEmergencyBroadband.org. The program will end when the fund runs out of money, or six months after the U.S. Department of Health & Human Services declares an end to the COVID-19 health emergency, whichever is sooner. New: Reaching Farm Communities for Vaccine Confidence. The AgriSafe Network is a nonprofit organization that provides information and training on injury and disease related to agriculture. Their health professionals and educators created a social media toolkit that aims to provide clear messages about COVID-19 vaccination for agriculture, forestry, and fishing workers. Funding and Opportunities Just Transition Fund: Grants/Technical Assistance for Coal Communities Applying for Federal Funding – November 15. The nonprofit grant-maker, Just Transition Fund, provides assistance to communities transitioning away from coal-based economies. Grants of up to $25,000 are available to support successful application to federal funding specific to coal communities from the Economic Development Administration. The EDA is accepting proposals from frontline coal communities in the following priority states: Arizona, Colorado, Illinois, Indiana, Kentucky, Minnesota, Missouri, Montana, New Mexico, North Carolina, Ohio, Pennsylvania, Texas, Virginia, West Virginia, and Wyoming. National Health Service Corps Loan Repayment Programs – December 16. Three programs will award more applicants this year with an historic $800 million in funding from the American Rescue Plan. Loan repayment programs play a critical role in supporting clinicians in rural communities, with more than 30 percent of the funds going to rural applicants. The NHSC Loan Repayment Program awards up to $50,000 in exchange for a two-year commitment to provide primary medical, dental or mental/behavioral health care at approved sites in high-need, underserved areas. The NHSC Substance Use Disorder Workforce Loan Repayment Program provides up to $75,000 in exchange for a three-year commitment to health care professionals who provide substance use disorder treatment services. Providers in rural communities may apply to the NHSC Rural Community Loan Repayment Program, which awards up to $100,000 for three years of service. HRSA Access to HIV Services for Women and Children – January 28. The Health Resources and Services Administration (HRSA) expects to make 114 awards with a total investment of $75 million to expand family-centered care for low-income women, infants, children, and youth with HIV. Eligible applicants are existing grantees of the Ryan White HIV/AIDS Program Part D and new community-based organizations that can provide services in areas where current projects are ending. (See Appendix B in Related Documents, Notice of Funding Opportunity.) The amount for this round of funding has been increased to address areas, primarily rural, with limited resources. Primary Care Development Corporation Community Investment Loans – Ongoing. Primary Care Development Corporation is a Community Development Financial Institution that provides loans, training, resources, and business development services for healthcare providers in under-resourced communities. Types of financing include loans for provider recruitment and retention, and bridge financing to complete projects. Rural Health Research Research in this section is provided by the HRSA/FORHP-supported Rural Health Research Gateway. Sign up to receive alerts when new publications become available. Rural Healthy People 2030 Survey. The Southwest Rural Health Research Center at Texas A&M University wants to hear from individuals who live or work in rural communities for a 20-minute survey on the most important Healthy People 2030 objectives for rural health. The project is supported by the Federal Office of Rural Health Policy through its Rural Health Research Centers program. Policy Updates Send questions to ruralpolicy@hrsa.gov. CMS Updates 2022 Physician Payment Policies under Medicare. This week, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates on policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, on or after January 1, 2022. The Calendar Year (CY) 2022 PFS Final Rule includes updates to rural health clinic (RHC) and federally qualified health center (FQHC) policies, implementation of a new policy that allows physician assistants to bill Medicare directly, updates to the Medicare Diabetes Prevention Program, and provisions on telehealth. CMS Updates 2022 Hospital Outpatient Payment Policies under Medicare. CMS finalized Medicare payment rates for hospital outpatient and Ambulatory Surgical Center (ASC) services. In addition to updating the payment rates, the Calendar Year (CY) 2022 Hospital Outpatient Prospective Payment System (OPPS) and ASC Payment System Final Rule includes policies such as price transparency, payment for 340B acquired drugs, and payment for non-opioid pain management drugs and biologicals. CMS Issues Home Health Final Rule for 2022. CMS issued the Calendar Year (CY) 2022 Home Health Prospective Payment System Final Rule, including the nationwide expansion of the Home Health Value-Based Purchasing Model. The final rule updates CY 2022 Medicare home health payment rates and the wage index for home health agencies (HHAs). CMS estimates that Medicare payments to HHAs in CY 2022 would increase in the aggregate by $570 million (3.2 percent), which reflects the an estimated 0.1 percent decrease in payments due to the changes in the rural add-on percentages for CY 2022 CMS Issues ESRD Final Rule for 2022. This week, CMS issued a final rule that updates payment rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to beneficiaries on or after January 1, 2022. The ESRD PPS provides a bundled, per-treatment payment to ESRD facilities. There are also facility-level adjustments for ESRD facilities that have a low patient volume, for facilities in rural areas, and for the wage index. Extension for Hospitals to Submit 2021 Quality Measures. CMS extended two important deadlines for quality measure reporting from February 28 to March 31, 2022. The affected programs are: 1) the electronic clinical quality measure (eCQM) data submission for the calendar year 2021 reporting period, and 2) the Medicare Promoting Interoperability Program attestation for eligible hospitals and Critical Access Hospitals. Learning Events and Technical Assistance HRSA Town Hall on Pediatric COVID Vaccine in Underserved Communities – Friday, November 5 at 2:00 pm ET. Speakers will share the latest information about COVID-19 vaccination for children ages 5-11. This includes ways to build vaccine confidence among parents and support shared decision-making between providers and families. A CDC representative will also provide an overview of the pediatric vaccine rollout plan. This event is co-hosted by HRSA's Bureau of Primary Health Care and the Maternal and Child Health Bureau. SEARCH 2021: The National Telehealth Research Symposium – November 8-10. Registration is open for the annual event that supports health researchers, academicians, and visionaries in telehealth with a virtual venue to share findings and foster research partnerships. This year's agenda includes keynotes and panel presentations designed to promote federal research resources and priorities, and will feature discussions pertaining to health disparities and development of digital health research programs within academic medical centers. Over 50 experienced and graduate researchers will present their work and share innovative studies. Rural Family Physicians: Training, Distribution, Scope of Practice – Tuesday, November 9 at 1:00 pm ET. The FORHP-supported Rural Health Research Gateway will host an hour-long presentation on what is considered the most prevalent physician specialty in rural America. Understanding Rural Health Challenges and Building Successful Partnerships to Achieve Vaccine Confidence - Tuesday, November 9 at 3:00 pm ET. The hour-long webinar hosted by the Association of Immunization Managers (AIM) will provide perspectives from immunization coalition and program leaders about how they have partnered to boost vaccine confidence, perspectives on challenges and strategies in rural communities for overcoming access and vaccine hesitancy issues, and best practices for creating successful partnerships to build vaccine confidence. Speakers include Karen Sharpnick of Get Immunized Idaho, Sarah Leeds, Immunization Manager at the Idaho Department of Health and Welfare, and Dr. Yabo Beysolow, REACH national subject matter expert and pediatrician. Emergency Preparedness for Maternal and Child Health – Wednesday, November 10 at 2:00 pm ET. HRSA will host community leaders and advocates for a discussion about their experiences during recent wildfires. Weather-related disasters that also include tornadoes, hurricanes, and floods are expected to become more frequent and severe as a result of climate change, with more challenges to preparedness and response in rural areas. The HHS Maternal-Child Health (MCH) Emergency Planning toolkit includes considerations for rural populations and highlights promising practices. HRSA Advancing Health Equity Among Hispanic Population – Wednesday, November 17 at 1:00 pm ET. The first of a four-part webinar series on the factors that contribute to health disparities for Hispanic populations will focus on breaking down social barriers during the pandemic. Federal Efforts to Achieve Health Equity in Rural Communities – Thursday, November 18 at 11:30 am ET. HRSA is working towards eliminating disparities in health access, policy, and practice and its determinants for rural populations across the nation. As part of HRSA's observance of National Rural Health Day, this panel discussion will highlight federal engagement in rural health, sharing strategies, activities and resources related to the Administration's priority of health equity. Panelists from the White House Domestic Policy Council, CMS Office of Minority Health, and Indian Health Service (IHS) will join FORHP for this discussion. AgriSafe Update on COVID Vaccines and Boosters – Thursday, November 18 at 1:00 pm ET. The hour-long session is intended for agricultural communities. Dr. Lisa Morici will share trusted data on how the vaccines have been developed, and the safety and efficacy determined by clinical trials. She will provide updates on booster doses, and on vaccines for children. Addressing Health Disparities in Rural Communities: FORHP Grantee Highlights – Thursday, November 18 at 3:00 pm ET. Across the nation, recipients of FORHP grants are finding ways to use their grant funding to create equitable access to health care in their communities. During this panel discussion, hear from current FORHP grantees as they share their work and best practices in their projects focused on health equity. This presentation is part of HRSA's observance of National Rural Health Day. Resources of the Week New Toolkit for MOUD in Rural Communities. A new resource from the Rural Health Information Hub aims to help rural communities and organizations develop, implement, evaluate and sustain Medication for Opioid Use Disorder (MOUD) programs. MOUD programs, sometimes called Medication-Assisted Therapy, are the gold-standard for treating OUD, but they're harder to find in rural areas, often do not enough qualified prescribers, or because of community worries that drug treatment centers might attract more crime. Toolkit Supporting Treatment of OUD with Homelessness. Includes guidance and resources that take a whole-person approach to care for people experiencing opioid use disorder (OUD) with homelessness. The toolkit is the work of experts at the Homeless and Housing Resource Center, with support from the federal Substance Abuse and Mental Health Services Administration. Approaching Deadlines National Health Service Corps Students to Service Loan Repayment Program – November 4 HHS Seeks Public Input on Four-Year Strategic Plan – November 7 AmeriCorps State and National Public Health AmeriCorps – November 8 Robert Wood Johnson Health Policy Fellows – Letters of Intent November 12 Just Transition Fund: Grants/Technical Assistance for Coal Communities Applying for Federal Funding – November 15 RWJF Researching COVID-19 Socioeconomic Recovery/Children's Health – Letters of Intent November 17 CDC Seeking Public Input on Work-Related Stress for Health Workers – November 26 Comments Requested: Criteria for Determining Maternity Care Health Professional Target Areas – November 26 End of Grace Period for Round 1 Provider Relief Fund Reporting – November 30 Department of Commerce Pilot Program: Connecting Minority Communities – December 1 EPA Brownfields Assessment Grants – December 1 EPA Brownfields Cleanup Grants – December 1 EPA Technical Assistance for Small Public Water Systems – December 3 Comments Requested: Requirements Related to Surprise Billing – December 6 HRSA Physician Assistant Rural Training Program – December 9 HRSA Graduate Psychology Education Program – December 9 HRSA New Geographic Service Areas for HIV/AIDS Early Intervention – December 10 RADx-UP Mini-Grant Program for COVID-19 Testing Initiatives – December 10 HRSA Primary Care HIV Prevention in Health Centers – December 14 National Health Service Corps Loan Repayment Programs – December 16 HRSA Rural Residency Planning and Development (RRPD) Program – December 20 Department of Labor Stand Down Grants for Veterans Services – December 31 COVID-19 Extension for Medicare Graduate Medical Education (GME) Affiliation Agreement – January 1 HRSA Family-to-Family Health Information Centers (F2F HICs) – January 5 NIH Research for AI/AN End-of-Life Care – January 8 USDA Farm to School Grants – January 10 HRSA Nurse Faculty Loan Program – January 13 HRSA Rural Communities Opioid Response Program - Implementation – January 13 NIH Researching Behavioral Risk Factors for Cancer in Rural Populations – January 18 HRSA Delta Region Rural Health Workforce Training Program – January 25 HRSA Rural Health Network Development Planning Program – January 28 Ongoing Opportunities CFPB Rental Assistance Finder HHS/DoD National Emergency Tele-Critical Care Network Extended Public Comment Period for FCC's COVID-19 Telehealth Program FCC Emergency Broadband for Individuals and Households FEMA COVID-19 Funeral Assistance HRSA Payment Program for Buprenorphine-Trained Clinicians – Until Funds Run Out AgriSafe Nurse Scholar Program – March 2022 AHRQ Health Services Research Demonstration and Dissemination Grants – September 2022 AHRQ Research to Improve Patient Transitions through HIT – December 2022 American Indian Public Health Resource Center Technical Assistance 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 Delta Region Community Health Systems Development Program Department of Commerce American Rescue Plan Funding for Indigenous Communities – September 2022 Department of Commerce: Economic Development Assistance Programs Department of Labor Dislocated Worker Grants DRA Technical Assistance for Delta Region Community Health Systems Development EPA Drinking Water State Revolving Fund FEMA/SAMHSA Crisis Counseling Assistance and Training Program (CCP) GPHC & RWJF: Rapid Cycle Research and Evaluation Grants for Cross-Sector Alignment HRSA Technical Assistance for Look-Alike Initial Designation for the Health Center Program Housing Assistance Council: Housing Loans for Low-Income Rural Communities 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 NIH Project Talk Initiative Host Site Applications NIH Dissemination and Implementation Research in Health – May 2022 NIH Practice-Based Research for Primary Care Suicide Prevention – June 2022 NIH Research – Alcohol and Other Substance Use – Various Dates Through August 2022 NIH Research: Intervening with Cancer Caregivers to Improve Patient Outcomes – September 8, 2022 NIH Research on Minority Health/Health Disparities – September 8, 2022 NIH Research on Palliative Care in Home/Community Settings – September 8, 2022 NIH Intervention Research to Improve Native American Health – Various Dates Until September 2023 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 Nominations for Federal Advisory Commission on HIV, Viral Hepatitis, and Sexually Transmitted Diseases Nominations for National Advisory Committee on Migrant Health Primary Care Development Corporation Community Investment Loans Rural Graduate Medical Education Planning and Development RWJF Investigator-Initiated Research to Build a Culture of Health RWJF Pioneering Ideas Brief Proposals SBA Guaranteed Loans for Small Business Southeast Rural Community Assistance Loans Tribal Grant Writing Training 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 Guaranteed Loans for Rural Rental Housing – through 2021 USDA Healthy Food Financing Initiative Technical Assistance USDA Intermediary Relending 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 USDA Funding for Rural Water and Waste Disposal Projects USDOT Rural Opportunities to Use Transportation for Economic Success (R.O.U.T.E.S) | 
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