March 2, 2023 What's New New Recommendations on Rural Child Care. The National Advisory Committee on Rural Health and Human Services has a new policy brief examining the challenges in rural areas. The brief focuses on the long-standing difficulties and its importance for the well-being and economic stability of rural families. The pandemic brought greater attention to these challenges, along with historic levels of funding to childcare providers through COVID-19 supplemental appropriations to ensure continued availability of care. Apply for NHSC Loan Repayment – Deadline April 25. HRSA's Bureau of Health Workforce announced the next opportunity for three loan repayment programs from the National Health Service Corps (NHSC). Of more than 20,000 NHSC members serving across the country, about one in three works in a rural area. In exchange for commitment to serve at an NHSC- approved facility, practicing clinicians providing primary medical, dental, or behavioral health care services may qualify for loan repayment up to $50,000 with an NHSC Loan Repayment Program award, up to $75,000 for the NHSC Substance Use Disorder Workforce Loan Repayment Program, and up to $100,000 for the NHSC Rural Community Loan Repayment Program. The rural NHSC program is in coordination with FORHP's rural opioid programming providing evidence-based substance use disorder treatment. USDA Advances Equity. In February of last year, the U.S. Department of Agriculture (USDA) launched an effort focused on removing barriers to federal programs within the agency's mission. The announcement named historical discrimination – racial, and also geographic, social, and economic – it intends to address with a newly formed Equity Commission. In the year before, USDA made a Request for Information from the public and held five public listening sessions, asking for feedback on customer experience with USDA programs. The response pointed to a history of discrimination, barriers to funding and land, and loss of trust with Indian Tribes among several other findings that have become priorities for the equity initiative. Earlier this week, the Equity Commission released its first set of recommendations. These and information about other efforts can be found at www.usda.gov/equity. Understanding Firearm Deaths by State. RAND Corporation, an independent research organization, examined state-level mortality data to compare state-by-state and national-level rates of death. An interactive map that sorts by gender, race (Black, White, and Hispanic), urban/non-urban, and age shows that 29 of 50 states have an annual rate of death higher than the national average. The data originated with the Centers for Disease Control and Prevention, which last year announced historically high rates of firearm homicide nationwide and the highest rates of firearm suicide in rural areas. RAND reports that suicide deaths drive the overall death rate higher in nonurban areas. A second interactive map shows how adding or removing firearm laws could affect death rates in each state. Greater Hardship for Rural Hospitals in States that Haven't Expanded Medicaid. A new analysis from the national nonprofit Kaiser Family Foundation reports slimmer operating margins for rural hospitals (2.2 percent versus 3.9 percent in states with Medicaid expansion) for the period from July 2021 through June 2022. Moreover, the report says these margins would have dropped to 1.2 percent in expansion states and -0.7 percent in non-expansion states if not for federal COVID-19 relief funds. ERS on County-Level Data Sets. The Economic Research Service (ERS) at the U.S. Department of Agriculture released updates to its data on socioeconomic indicators such as poverty rates, population change, unemployment rates, and education levels. ERS State Fact Sheets, which show numbers comparing rural and urban, were also updated to add estimates on educational attainment. HRSA Needs Rural Reviewers for Grant Applications. The Health Resources and Services Administration (HRSA) relies on grant reviewers to select the best programs from a competitive group of applicants. Over the coming months, the Federal Office of Rural Health Policy will be competing a number of programs, including among other things: substance use disorders and opioid use disorder, rural workforce, and rural hospitals. Having reviewers with expertise in rural health greatly benefits the review process and is also an opportunity to learn about the review process itself. Reviews are typically held remotely over a period of a few days and reviewers who participate and complete their assigned duties receive an honorarium. Registration is easy and does not commit you to serving as a reviewer. Please consider lending your expertise to these important initiatives. 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. **New and Ongoing: The University of Vermont Center on Rural Addiction, a HRSA Rural Center of Excellence on Substance Use Disorders, offers an incentive to help defray previous training costs of $750 to each qualifying provider who obtained a DATA-Waiver. To qualify, providers must be practicing in a HRSA-designated rural county in Vermont, Maine, New Hampshire, or Northern New York. To apply for the $750 payment, providers should contact cora@uvm.edu. 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. 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. Funding and Opportunities CDC Assessing Coalition Capacity for Rape Prevention/Education – March 14. The Centers for Disease Control and Prevention (CDC) will make 63 awards with total investment of $7 million to CDC-approved state sexual assault coalitions. The one-year project requires funding recipients to assess their capacity by identifying communities with a high burden of sexual violence, and to assess existing partnerships to determine gaps and inequities in sexual violence prevention efforts. HRSA Advanced Nursing Education Workforce Program – April 7. HRSA's Bureau of Health Workforce will make 53 awards, each about $650,000, for innovative academic-practice partnerships that prepare advanced practice registered nursing students to practice primary care in rural and underserved settings. Grantees will also be expected to facilitate employment in rural and underserved settings for program participants following graduation. DOJ Rural Domestic/Dating Violence, Sexual Assault, and Stalking Program – April 11. The U.S. Department of Justice (DOJ) will make 55 awards, each up to $950,000, to enhance the safety of victims and support projects uniquely designed to address these crimes in rural areas. Recent data indicate prevalence of intimate partner violence (IPV) might be similar in rural and urban populations, but hospitalizations related to IPV are greater in rural areas, suggesting difficulty accessing preventive services to intervene before violence escalates. NIH Strategies for Managing SUD in Primary Care and Ambulatory Settings – April 14. The National Institutes of Health (NIH) will provide funding to develop and test strategies to improve the capacity of primary care and ambulatory care settings to provide evidence-based, patient-centered care for people who misuse opioids and other substances. Priority populations include inner city, rural, low income, minority, women, children, and elderly, among others. Indian Health Service Zero Suicide Initiative Coordinating Center – April 17. A cooperative agreement will be awarded to one organization to provide technical assistance to grantees of the Zero Suicide Initiative. Last year, the Centers for Disease Control and Prevention released data showing that, between 2015 and 2020, there was a 20 percent increase in suicide deaths among American Indian/Alaska Natives compared with an increase of less than 1 percent for the overall U.S. population during that timeframe. HHS Evidence-Based Teen Pregnancy Prevention – April 18. The U.S. Department of Health & Human Services (HHS) will make 70 awards, each between $350,000 and $2 million, to implement teen pregnancy prevention programs that have been proven effective through rigorous evaluation. Funding will be used to serve communities with greatest needs and significant barriers. Eligible applicants include state, local, and Tribal governments and organizations; public and private nonprofits; small businesses; school districts and institutions of higher education. A newly-released chartbook on rural population health shows higher rates of birth for rural adolescents aged 15-19 compared with urban teens. CDC National Cardiovascular Health Program – April 25. The Centers for Disease Control and Prevention (CDC) will make 51 awards, each between $850,00 and $2 million, to state governments to continue efforts in underserved communities with limited access to information about cardiovascular health. A separate, forecasted opportunity is expected to be made for local health departments. Recent data show consistently higher mortality rates for cardiovascular disease in rural areas; the highest mortality was found among Black men in all regions. ACF Tribal Maternal, Infant, and Early Childhood Home Visiting Program – Development and Implementation Grants – May 1. The Administration for Children and Families (ACF) will make 16 awards, each ranging from $250,000 to $1 million per year, to develop and implement home visiting services in Tribal communities. Among a range of activities, grantees of will assess community need and readiness, develop capacity and infrastructure, and evaluate the program's effectiveness at the local level. Economic Development Administration Public Works/Economic Assistance Program – Ongoing. As part of federal funding for COVID-19 economic relief (CARES Act) the U.S. Department of Commerce expects to make 3,000 awards to state, local, and Tribal governments; public and private non-profits; and institutions of higher learning to support construction, technical assistance, and revolving loan funds in distressed communities. Policy Updates Send questions to ruralpolicy@hrsa.gov. New Information on COVID-19 Waivers and Flexibilities. Earlier this week, the Centers for Medicare & Medicaid Services released a fact sheet with updates to policy on vaccines, testing, and treatments; telehealth services; continuing flexibilities for health care professionals; and expanded hospital capacity through care in a patient's home. Last week, the agency provided updates specific to Rural Health Clinics and Critical Access Hospitals, describing the Medicare and Medicaid waivers and flexibilities that have been terminated, made permanent, or that will end with the public health emergency (PHE) on May 11, 2023. DEA Announces Proposed Rules for Permanent Telemedicine Flexibilities – Comment by March 31. Last week, the Drug Enforcement Administration (DEA) announced proposed rules for the prescribing of controlled medications via telemedicine beyond the end of the COVID-19 public health emergency. One rule addresses the expansion of induction of buprenorphine via telemedicine encounter while the other covers telemedicine prescribing of controlled substances when the practitioner and the patient have not had a prior in-person medical evaluation. While opioid use disorders occur at similar rates in both rural and urban areas, medication assisted treatment (MAT) prescribers have been disproportionately located in urban areas. Updated RHC and FQHC Medicare Benefit Policy Manual – On January 26, the Centers for Medicare & Medicaid Services (CMS) revised Chapter 13 of the Medicare Benefit Policy Manual to include payment policy for Rural Health Clinics and Federally Qualified Health Centers as finalized in the CY 2022 and CY 2023 Physician Fee Schedule Final Rules. Key updates can be found in the CMS Medicare Learning Network (MLN) Connects newsletter. Learning Events and Technical Assistance National Health Service Corps Loan Repayment Programs for Tribal Communities – Thursday, March 2 at 2:00 pm ET. At this hour-long session hosted by the National Indian Health Board and the Association of American Indian Physicians, learn how to apply to HRSA's National Health Service Corps Loan Repayment Program. RHCs and Medicare Shared Savings Program – What You Need to Know to Consider Joining – Tuesday, March 7 at 3:00 pm ET. Rural Health Clinic (RHC) participation in the Medicare Shared Savings Program (MSSP) has grown significantly. During this free webinar hosted by the National Association of Rural Health Clinics, the Centers for Medicare & Medicaid Services, and Rural Health Value will share an overview of the program, highlight opportunities for RHCs, review changes to the MSSP for 2024, and provide time for Q&A. Advanced registration is required. Learning About Long COVID & Fatiguing Illness – Thursday, March 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. Register for Rural Suicide Prevention Workshops – March 21, May 23, and July 25. This comprehensive training for service providers in rural communities includes special focus on youth, substance use, and Indigenous communities. The interactive workshop features video demonstrations, active discussion groups, and access to the latest research on best practices. Attendees will get free, ongoing support – including online discussion forums and monthly Q&A video calls – for one year after the workshop. This opportunity is provided by the University of Rochester Recovery Center of Excellence (COE), one of three COEs in FORHP's rural opioid programming. 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 3. Resource of the Week How One New Mexico County is Taking a Community-Wide Approach to Treating Alcohol and Substance Use Disorders. A new article in The Rural Monitor describes this community's understanding of Native culture to take an effective, holistic approach to recovery. Approaching Deadlines SAMHSA Sober Truth on Preventing Underage Drinking – March 3 UVM CORA Northern New England Naloxone Vending Machine Program – March 3 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 – Reach/Resiliency in Tribal/Rural Areas – 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 Assessing Coalition Capacity for Rape Prevention/Education – March 14 SAMHSA First Responders – Comprehensive Addiction and Recovery Act – March 14 Mayo Clinic Native American Pathways Summer Program – March 15 RWJF Health Policy Research Scholars – March 15 National Indian Health Board Outstanding Service Awards – March 16 DOJ Second Chance Act Pay for Success Initiative – March 21 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: Community Development Financial Institutions Capital Magnet Fund – March 21 Delta States Rural Development Network Grant Program – March 22 NIH Addressing the Impact of Structural Racism and Discrimination – March 24 NIH Innovations for Improving Minority Health/Eliminating Health Disparities – March 24 SAMHSA National Child Traumatic Stress Initiative – Community Treatment/Service Centers – March 27 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 RWJF Culture of Health Prize – March 29 ACL Rehabilitation Research/Training Center on Disability in Rural Communities – March 31 Administration for Native Americans – Social/Economic Development Strategies – March 31 DEA Proposed Rules for Permanent Telemedicine Flexibilities – March 31 Medicare Graduate Medical Education (GME) Residency Positions Available – March 31 National Association of Emergency Medical Technicians Diversity Scholarships – March 31 FCC Rural Health Care Telecommunications Program – April 1 HRSA HIV/AIDS Intervention Services – New Geographic Areas – April 3 Institute of Museum and Library Sciences Grants for Native American Libraries – April 3 HRSA Advanced Nursing Education Workforce Program – April 7 EPA Environmental Justice Collaborative Problem-Solving – April 10 CDC Drug Free Communities Support Program – April 11 CDC Racial and Ethnic Approaches to Community Health (REACH) – April 11 DOJ Rural Domestic/Dating Violence, Sexual Assault, and Stalking Program – April 11 HRSA Advanced Nursing Education Nurse Practitioner Residency and Fellowship Program – April 11 Comments Requested: OMB Updates to Race and Ethnicity Standards – April 12 DOT Bus and Bus Facilities Infrastructure Program – April 13 Denali Commission Grants for Alaska Communities – April 14 EPA Environmental Justice Government-to-Government Program – April 14 NIH Strategies for Managing SUD in Primary Care and Ambulatory Settings – April 14 Indian Health Service Zero Suicide Initiative Coordinating Center – April 17 HHS Advancing Equity Through Teen Pregnancy Prevention – April 18 CDC National Cardiovascular Health Program – April 25 DOJ Violence Against Women Grants to Indian/Tribal Governments – April 25 HRSA National Health Service Corp Loan Repayment Programs – April 25 ACF Tribal Maternal, Infant, and Early Childhood Home Visiting Program – Development and Implementation Grants – May 1 ACF Community Economic Development Projects – May 8 AHRQ Small Research Projects to Advance the Science of Primary Care – June 16 Berkley Rural Public Health Master's Program – August 13 UMMC Caregiver University for Alzheimer's Support – Quarterly Deadlines Until October 10 Ongoing Opportunities CFPB Rental Assistance Finder Economic Development Administration Public Works/Economic Assistance Program (CARES Act Funding) 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 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 Addressing the Impact of Structural Racism and Discrimination – Various Dates Until October 2025 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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