February 2, 2022 What's New Special Enrollment Period for Consumers Losing Medicaid or CHIP Coverage. Last Friday, our office sent out information about an anticipated loss of health care coverage for millions of public health beneficiaries as the Public Health Emergency (PHE) for COVID-19 comes to a close. On that same day, the Centers for Medicare & Medicaid Services (CMS) announced a Special Enrollment Period for qualified beneficiaries of Medicaid and the Children's Health Insurance Program (CHIP). Between March 31, 2023 and July 31, 2024, CMS will allow Marketplace-eligible consumers to submit a new application or update an existing application through HealthCare.gov. A recently released study, conducted pre-pandemic, showed that nearly two-thirds of disenrolled beneficiaries had a period of uninsurance. Health care providers and other community-based organizations can assist with outreach to individuals and families who may lose coverage. To help you better understand what states can do, the nonprofit State Health & Value Strategies provides two resources for state Medicaid agencies, state-based marketplaces, labor departments, and employers. The first is an issue brief discussing strategies for helping people understand and navigate their coverage options. A companion brief describes the importance of a Medicaid disenrollment survey to monitor coverage changes (p. 4) associated with the unwinding of continuous enrollment. FCC Makes Changes to Its Program for Rural Health. Last week, the Federal Communications Commission (FCC) announced efforts to make it easier for rural health care providers to access funding for high-speed broadband connections and telecommunications services. Four new proposals for the FCC's Rural Health Care Program are intended to make it easier for providers to receive support, reduce delays in funding commitments, and improve overall efficiency of the program. Public response to FCC proposals in February 2022 brought about the current changes that include the way service rates are determined and invoiced. The Second Further Notice of Proposed Rulemaking announced on January 26 includes fine tuning rules for determining rural and urban rates, and making it easier for health care providers to receive funding as soon as they become eligible. Approaching Deadline for Rural HIV and Aging Challenge – Extended to February 14. The Administration for Community Living will award $500,000 in cash prizes for innovative and effective pilot solutions that address the needs of people in rural communities who are aging with HIV. Some potential solutions may be: enhancing the capacity of community-based organizations; increasing engagement/reducing isolation for long-term survivors; or addressing social determinants of health such as transportation or access to physical activities. Up to 10 winners may be selected to each receive a prize of up to $15,000. Because these are prize competitions, there are no reporting requirements, deliverables, or other restrictions associated with federal grants. The participants selected to receive a prize for Phase 1, Design of Concept, may compete for Phase 2, Development of Solution. Guidelines for Pregnant People with HIV. This week, a federal panel of experts issued new guidelines for people with HIV who are pregnant, have recently given birth, or are trying to conceive. Thanks to antiretroviral medications and other viral suppression strategies, parent-to-child transmission of HIV is less than 1 percent in the United States. The updated recommendations include new information about the use of antiretroviral drugs before and during pregnancy, guidance for pregnant people who have not achieved viral suppression, and infant feeding options. The Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV also co-authored sections published in the Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. Updates to these guidelines are anticipated in April 2023. GAO: What's Needed to Fund Tribal Broadband? The U.S. Government Accountability Office (GAO) reports on two federal programs that could extend reliable, affordable broadband to 200,000 households, and recommends that the agency that administers them improve how it measures what reliable and affordable mean. Ongoing: HRSA Payment Program for RHC Buprenorphine-Trained Providers. As announced by the Substance Abuse and Mental Health Services Administration in January 2023, clinicians no longer need DATA 2000 Waiver training to prescribe buprenorphine; however, the payment program to defray earlier training costs is still active. Launched in June 2021, the initiative pays for providers who previously received a waiver to prescribe buprenorphine, a medication used to treat opioid use disorder. Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who previously trained to obtain the waiver necessary to prescribe buprenorphine after January 1, 2019. Approximately $900,000 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 Rural Health Clinic Vaccine Distribution (RHCVD) Program. Under the program, Medicare-certified Rural Health Clinics (RHCs) receive direct COVID-19 vaccines in addition to their normal jurisdictions' weekly allocation. Webinar recordings explaining RHC vaccine programs are available on the National Association of Rural Health Clinics website. *New: As a reminder, the Pfizer-BioNTech COVID-19 bivalent vaccine for people 12 years of age and older is available to order through the RHCVD program in both single and multi-dose vials. The single-dose option responds to widespread requests to allow greater flexibility for RHCs that may not have the demand or capacity to store multi-dose vials. Contact RHCVaxDistribution@hrsa.gov for more information. Provider Relief Fund (PRF) Reporting Portal – Report by March 31 for RP4. The PRF Reporting Portal is open from January 1, 2023 to March 31, 2023 for Reporting Period 4 (RP4). Providers who received one or more PRF (General or Targeted) and/or American Rescue Plan Rural payments exceeding $10,000, in the aggregate, from July 1, 2021 to December 31, 2021, must report on their use of funds during RP4. Resources are available to assist providers with completing their reports. For a quick glance at all PRF reporting-related resources, visit the PRF Reporting Resources Page. **NEW: Phase 4 and ARP Rural Payment Reconsiderations Deadline: Providers who believe their Phase 4 and/or ARP Rural payment was calculated incorrectly have an opportunity to submit a payment reconsideration request by February 21, 2023 at 11:59 p.m. ET. All providers have had at least 45 days from the date of their Phase 4 and/or ARP Rural payment determination notification to submit a reconsideration request. The February 21 deadline reflects the final opportunity to submit a request. For more information visit the Payment Reconsideration webpage. Updated Guidance on COVID-19 Vaccines. In December, the Centers for Disease Control and Prevention recommended updated (bivalent) COVID-19 vaccines for children down to 6 months of age. This expands earlier guidance announced in October. Current recommendation is that people aged 6 months and older receive one updated (bivalent) dose if it has been at least 2 months since their last COVID-19 vaccine dose, whether that was: - Their final primary series dose, or
- An original monovalent dose
People who have gotten more than one original (monovalent) dose are also recommended to get an updated (bivalent) dose. In September, the U.S. Department of Health & Human Services announced that people with public, private, or no insurance coverage can get COVID-19 vaccines at no cost, for as long as the federal government continues purchasing and distributing them. To find nearby locations for vaccines, masks, testing, and treatment, visit COVID.gov. 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 by the Federation of State Medical Boards through the CARES Act and the FORHP-supported Licensure Portability Grant 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. 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. Federal Office of Rural Health Policy Resources for COVID-19. A set of Frequently Asked Questions (FAQs) from our grantees and stakeholders. 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 Become a Host Site for the CDC Public Health Associate Program – February 28. The Centers for Disease Control and Prevention (CDC) seeks host sites – including those that serve rural communities; state, tribal, local, and territorial public health agencies; community-based organizations; and academic institutions. Selected sites will host a CDC-funded Public Health Associate (apply by February 3) who will get hands-on experience as a foundation for their careers in public health. NIH Research Centers in Minority Institutions – March 1. The National Institutes of Health (NIH) makes grants to institutions with a commitment to educating underrepresented students. Research grantees must offer doctorate degrees in the health professions or in a health-related science and/or provide clinical services to medically underserved communities. SAMHSA Adult Offender Re-Entry Program – March 6. The Substance Abuse and Mental Health Services Administration (SAMHSA) will make approximately 33 awards, each up to $400,000 per year. Grants are intended to expand substance use disorder treatment and related recovery and re-entry services for individuals returning to their community from incarceration. SAMHSA State Pilot Program - Treating Pregnant/Postpartum Women – March 27. The Substance Abuse and Mental Health Services Administration (SAMHSA) aims to enhance services for pregnant/postpartum individuals experiencing substance use disorder, with an emphasis on diagnoses for opioid use disorders. Eligible applicants are Single State Agencies for Substance Abuse. CDC State Physical Activity and Nutrition Program – March 28. The Centers for Disease Control and Prevention (CDC) will make 17 awards of up to $1.3 million each for evidence-based nutrition and physical activity strategies that address health disparities related to poor nutrition, physical inactivity, and/or obesity. No more than one applicant per state will receive funding for a 5-year project period. Last week, the CDC released data showing a low proportion of U.S. adults met physical activity guidelines, with the lowest prevalence among adults living in the most rural counties. HUD Community Compass Technical Assistance for Federal Housing Programs – March 28. The U.S. Department of Housing and Urban Development (HUD) will invest more than $80 million for 45 grantees. Community Compass is designed to help HUD's customers navigate complex community development challenges by equipping them with the knowledge, capacity, and systems to implement HUD programs successfully. Through this funding, HUD will also address the technical assistance needs of priorities that include: the Violence Against Women Act's 2022 Reauthorization, racial and gender equity, transit-oriented development, housing supply, re-entry housing for persons exiting jails and prisons, and mental health. Eligible applicants include state and local governments, public housing authorities, small and disadvantaged businesses, and institutions of higher education. Eligibility also includes Tribal entities under the Native American Housing Assistance and Self Determination Act. ACL Rehabilitation Research/Training Center on Disability in Rural Communities – March 31. The Administration for Community Living (ACL) will commit total funding of $875,000 to one grantee for well-designed research, training, and technical assistance to improve services for people with disabilities in rural communities. CDC Drug Free Communities Support Program – April 11. The Centers for Disease Control and Prevention (CDC) will make 100 awards to community-based coalitions that have not previously received a grant under this program that has two goals: 1) establish and strengthen coalitions working to prevent and reduce substance use among youth aged 18 and younger; and 2) over time, reduce substance use among adults by addressing community factors that increase the risk of substance use. AHRQ Small Research Projects to Advance the Science of Primary Care – June 16. The Agency for Healthcare Research and Quality (AHRQ) considers rural populations a priority for small research projects that advance the role of primary care. Specific areas of research include: coordination of care; person-centered delivery that addresses social determinants of health; recruitment and retention of primary care workforce; and the impact of financing models on quality. 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. Community Socio-Demographics and Rural Hospital Survival Analysis. Among the key findings in this study from the Center for Economic Analysis of Rural Health: among rural hospitals at risk of financial distress, closures disproportionately took place in communities with specific sociodemographic characteristics: lower incomes, lower percentage of college graduates, larger populations, lower percentages of White population, higher percentages of Black population, higher child poverty, higher unemployment rates, higher uninsurance rates for those younger than 65, higher percentage of adults reporting fair or poor health, higher obesity levels, and higher rates of smoking. Changes in Service Offerings Post-System Affiliation in Rural Hospitals. Among the findings in this policy brief from the RUPRI Center for Rural Health Analysis: gains in services occurred more frequently in hospitals that left health care systems, while the majority of service losses occurred in hospitals that joined systems. Policy Updates Send questions to ruralpolicy@hrsa.gov. OMB Proposes Updates to Race and Ethnicity Standards – Comment by April 12. Last week, the Office of Management and Budget (OMB) published a notice and request for comments on their effort to improve the quality and usefulness of Federal race and ethnicity data. The topics for evaluation include: 1) whether the guidance for collecting and reporting race and ethnicity data can be improved, 2) how to best address detailed race and ethnicity groups; and 3) the wording of questions and instructions for respondents. The working group is also seeking participants for their virtual, bi-monthly listening sessions to hear directly from members of the public. According to one study analyzing the latest Census data, rural population declined between 2010 and 2020 to just 14 percent of the U.S. total. At the same time, racial and ethnic diversity in rural areas increased overall, with Hispanics representing 9 percent of the rural population, followed by non-Hispanic Black people, representing 7.7 percent. Nearly one-third of all rural children (32.5 percent) come from racial or ethnic minority populations, compared to 28.1 percent in 2010. Rural Hospitals Make Gains in Interoperability. According to a new report, interoperability – the ability of health care providers to exchange electronic health information – continues to improve among hospitals. As of 2021, 88 percent of hospitals engaged in sending and obtaining patient health information electronically. The rate of availability of outside information at the point of care grew over 20 percent in 2021 reaching 62 percent nationwide. For rural and small hospitals the rate grew by more than 26 percent, reaching a rate of 48 percent. Additionally, usage of information received electronically from outside sources by rural and small hospitals increased at twice the rate of hospitals nationally (over 40% vs. over 20%) between 2017 and 2021. The report concludes these less-resourced hospitals are still not on par with their counterparts, indicating the need to continue addressing challenges with having full access to electronic information from external sources. Rural Provider Participation in Accountable Care Relationships. The Centers for Medicare & Medicaid Services (CMS) released information on three Medicare accountable care initiatives in which groups of providers collaborate to improve care. For 2023, the Medicare Shared Savings Program will have 456 accountable care organizations (ACOs), including 2,240 Rural Health Clinics (RHCs) and 467 Critical Access Hospitals (CAHs). The ACO Realizing Equity, Access, and Community Health (ACO REACH) model will have 132 ACOs with 78 RHCs and 15 CAHs. The Kidney Care Choices Model will have 130 entities with more than 8,000 providers participating, including newly expanded areas in North Dakota and South Dakota. Learning Events and Technical Assistance Advancing Health Equity Among Hispanic/Latino Populations – Tuesday, February 7 at 1:00 pm ET. HRSA's Office of Intergovernmental and External Affairs holds the first in a four-part series about the factors that contribute to health disparities, and successful models for health equity among Hispanic/Latino populations. The session will be broadcast in Spanish, with live language interpretation to English. For more information about the session, please contact Lauren DeVol at LDeVol@hrsa.gov or Veronica Roa at VRoa@hrsa.gov. Learning About Long COVID & Fatiguing Illness – Thursday, February 9 at 3:00 pm ET. 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. Annual Rx and Illicit Drug Summit – April 10-13. Federal policymakers from the Substance Abuse and Mental Health Services Administration and the National Institute on Drug Abuse are among those sharing their expertise at this annual conference on substance use disorder. The summit takes place over four days in Atlanta, Georgia. Discounted registration fees are available until March 3rd. Resources of the Week Orientation to Rural Emergency Hospital Conversion and Technical Assistance. Here, you'll find a recording and presentation slides from the January 18 webinar that gives an overview of the new Rural Emergency Hospital designation, policy and regulatory requirements, and an introduction to technical assistance provided by the Rural Health Redesign Center. An Approach to Integrating Behavioral Health in Rural Primary Care Practices. This resource highlights the role of a behavioral health care manager (BHCM) to screen and monitor patients, coordinate care with other healthcare providers, track treatment response, and recommend patient medications. The University of Rochester is one of three Centers of Excellence for the federal Rural Communities Opioid Response Program (RCORP). Internet For All Map. The interactive map shows 56 states and territories that have received grants from the federal Broadband Equity, Access, and Deployment Program. More than $42 billion has been committed to infrastructure planning and deployment nationwide. Click each state or territory on the map to learn the details of current internet availability, amount of funding, and contact information for the state/territory Broadband Office. Approaching Deadlines American Psychiatric Association Diversity Leadership Fellowship – February 3 CDC Public Health Associate Program – February 3 SAMHSA Minority Fellowship – February 3 Request for Information: Updating the Healthy Start Initiative – February 3 Department of Labor Youthbuild Grants – February 7 HRSA Funding for Rural Health Innovation and Transformation Technical Assistance Provider – February 7 CDC/NIHB Strengthening Tribal Public Health Systems – February 8 HRSA Nurse Anesthetist Traineeship Program – February 10 HRSA Maternal and Child Health Secondary Data Analysis Research – February 13 Comments Requested: Medicare Advantage, Medicare Part D Updates – February 13 Comments Requested: Proposed Updates to Expand Access to Opioid Use Disorder Treatment – February 14 EPA Grants Supporting Technical Assistance for Brownfields Communities – February 14 ACL Rural HIV and Aging Challenge – Extended to February 14 CDC Researching Strategies to Prevent Firearm-Related Violence – February 16 HRSA Funding One Provider: Rural Quality Improvement Technical Assistance – February 17 HRSA Ryan White HIV/AIDS Program Part C Capacity Development Program – February 17 NOSORH Rural Health Grant Writing Institute – February 17 CDC Research Grants to Inform Firearm-Related Violence Prevention Strategies – February 20 Appalachian Regional Commission INSPIRE SUD Recovery to Work – Letters of Intent Required by February 21 HRSA Nurse Corps Loan Repayment Program – February 23 Become a Host Site for the CDC Public Health Associate Program – February 28 USDA Rural Business Development Grants – February 28 NIH Research Centers in Minority Institutions – March 1 National Center for Rural Health Professions Summer Preceptorships – March 5 SAMHSA Adult Offender Re-Entry Program – March 6 SAMHSA Expanding SUD Capacity in Adult and Family Drug Treatment Courts – March 6 USDA Emergency Food Assistance Program – Reach and Resiliency – March 6 CDC Advancing Health Equity for Priority Populations with or at Risk for Diabetes – March 7 HRSA Funding One Provider: Targeted Technical Assistance for Rural Hospitals – March 7 SAMHSA Expanding MAT for Prescription Drug and Opioid Addiction – March 7 HRSA Rural Communities Opioid Response - Neonatal Abstinence Syndrome – March 8 Department of Transportation Planning for Areas of Persistent Poverty Program – March 10 Comments Requested: Proposed Updates for Interoperability – March 13 CDC High Obesity Program – March 21 HRSA Integrated Substance Use Disorder Training Program – March 21 SAMHSA Linking Actions for Unmet Needs in Children's Health – March 21 Treasury Department: Community Development Financial Institutions Capital Magnet Fund – March 21 Delta States Rural Development Network Grant Program – March 22 SAMHSA State Pilot Program - Treating Pregnant/Postpartum Women – March 27 CDC State Physical Activity and Nutrition Program – March 28 HUD Community Compass Technical Assistance for Federal Housing Programs – March 28 ACL Rehabilitation Research/Training Center on Disability in Rural Communities – March 31 Administration for Native Americans – Social/Economic Development Strategies – March 31 Medicare Graduate Medical Education (GME) Residency Positions Available – March 31 FCC Rural Health Care Telecommunications Program – April 1 CDC Drug Free Communities Support Program – April 11 Comments Requested: OMB Updates to Race and Ethnicity Standards – April 12 AHRQ Small Research Projects to Advance the Science of Primary Care – June 16 UMMC Caregiver University for Alzheimer's Support – Quarterly Deadlines Until October 10 Ongoing Opportunities CDC Monkeypox Vaccine Equity Pilot Program CFPB Rental Assistance Finder Extended Public Comment Period for FCC's COVID-19 Telehealth Program FCC Affordable Connectivity Program for Broadband Service FEMA COVID-19 Funeral Assistance HRSA Payment Program for Buprenorphine-Trained Clinicians – Until Funds Run Out SAMHSA 988 Suicide and Crisis Lifeline Volunteer and Job Opportunities USDA Emergency Rural Health Care Grants (Track One only) – September 2023 or until funds run out ACF Low Income Home Energy Assistance Program ACF Rural Community Development Program for Rural Water Systems AgriSafe Mental Health Training for Agricultural Producers & Families AgriSafe Nurse Scholar Program – March 2023 AHRQ Health Services Research Demonstration and Dissemination Grants – October 2023 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 Appalachian Regional Commission J-1 Visa Waivers for Doctors ASA Rural Access to Anesthesia Care Scholarship Burroughs Wellcome Fund Seed Grants for Climate Change and Health – Quarterly through August 2023 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 Delta Doctors J-1 Visa Waiver Program 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 EPA Water Infrastructure and Innovation Program FEMA/SAMHSA Post-Disaster Crisis Counseling Assistance and Training Program GPHC & RWJF: Rapid Cycle Research and Evaluation Grants for Cross-Sector Alignment 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 Native Americans into Medicine Host Sites for National Environmental Public Health Internship NIH Project Talk Initiative Host Site Applications NIH Research to Improve Native American Health – Various Dates Until September 2023 NIH Practice-Based Research for Primary Care Suicide Prevention – February 2023 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 Nominations for Federal Advisory Commission on HIV, Viral Hepatitis, and Sexually Transmitted Diseases 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 RWJF Investigator-Initiated Research to Build a Culture of Health RWJF Pioneering Ideas Brief Proposals 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 Multifamily Housing Loan Guarantees 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 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) WWAMI Area Health Education Center Scholars Program | 
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