April 13, 2023 What's New SAMHSA Warns About New Illicit Drug Threat. This week, the Substance Abuse and Mental Health Services Administration (SAMHSA) alerted the public to the noticeable rise of xylazine, a non-opioid agent increasingly found in combination with opioids such as fentanyl. Known by its street name, "tranq" or "tranq dope," the drug is approved only for veterinary use; in humans, the powerful sedative, analgesic, and muscle relaxant can depress breathing, blood pressure, heart rate, and body temperature to critical levels. The overdose antidote naloxone does not reverse its effects. Additionally, people who inject drugs containing xylazine can develop severe skin wounds that easily become infected and, if left untreated, may lead to amputation. Expanding Rural Food Options Through EBT: A Case Study. A program in rural Tennessee experimented by supplying local food producers with knowledge and training about how to accept payment provided by the Supplemental Nutrition Assistance Program (SNAP). After a workshop informing farmers about the benefits of accepting SNAP, the program provided hands-on support for navigating the application process for Electronic Benefit Transfer (EBT), the system by which low-income consumers who receive SNAP benefits can purchase food at local farmers' markets. See Funding section below for a new opportunity, USDA's Farmers Market Promotion Program. How One Appalachian Program Approaches OUD Recovery. Researchers evaluate The Kentucky Access to Recovery Program (KATR), which provides services to individuals recovering from opioid use in several counties in Eastern Kentucky, and conclude KATR demonstrates a potentially effective strategy for increasing health-related social services in rural areas. Rural Broadband Access and Telehealth Use During the Pandemic. Researchers compared county-level data broadband capacity with telehealth use among Medicare Fee-for-Service beneficiaries from January through September 2020. The association between broadband access and telehealth utilization and the decreased telehealth utilization in rural areas highlight the importance of broadband access for healthcare access and the need to continue investing in broadband infrastructure to promote equitable healthcare access across populations. Atlas of Rural and Small-Town America. The Economic Research Service at the U.S. Department of Agriculture updated its statistics on several socioeconomic factors: people, jobs, rural-urban county classifications, income, and veterans. 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 COVID-19 Distribution Programs - Vaccines, Testing Supplies, Therapeutics. As a reminder, CMS-certified Rural Health Clinics (RHCs) can receive COVID-19 vaccines, testing supplies, and COVID-19 antivirals directly from HRSA. Please reference the linked websites for additional information and enrollment instructions. Technical assistance resources for these programs are available through the National Association of Rural Health Clinics. Note: The Pfizer-BioNTech COVID-19 bivalent vaccine for people 12 years of age and older is available to order through RHC Vaccine Distribution 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. 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. Funding and Opportunities DOJ Rural Domestic/Dating Violence, Sexual Assault, and Stalking Program – EXTENDED to April 14. 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. The original deadline has been extended to tomorrow. USDA Farmers Market Promotion – May 2. The U.S. Department of Agriculture (USDA) will invest more than $15 million in 300 awards to increase access to locally produced food through direct producer-to-consumer markets. CDC Overdose Data to Action in States – May 8. The Centers for Disease Control and Prevention (CDC) expect to make 51 awards to track fatal and nonfatal overdoses and emerging threats. The funding that will go to state health departments, including the District of Columbia, is parallel to a similar effort that will fund 40 local health departments, CDC Limiting Overdose through Collaborative Actions in Localities – May 8. SAMHSA Implementation Research in Community Behavioral Health Clinics – May 8. The Substance Abuse and Mental Health Services Administration (SAMHSA) is collaborating with the National Institutes of Health to launch an initiative that aims to sustain and improve the knowledge/evidence base in behavioral health. This initiative will create partnerships between researchers and Certified Community Behavioral Health Clinics (CCBHCs) that have expressed interest in the collaboration. Investigators interested in pursuing this research opportunity with CCBHCs are invited to register for a short webinar on April 19, from 1-2 PM to learn more about this initiative and explore the database in depth. SAMHSA Cooperative Agreement for the Hispanic/Latino Behavioral Health Center of Excellence – May 23. The Substance Abuse and Mental Health Services Administration (SAMHSA) make one award to one public or private nonprofit entity that will develop and disseminate culturally informed, evidence-based behavioral health information. The Center of Excellence will also provide training and technical assistance on best practices in mental health promotion, prevention, and treatment for substance use disorders. SAMHSA American Indian/Alaska Native Behavioral Health Center of Excellence – May 26. The Substance Abuse and Mental Health Services Administration (SAMHSA) will make one awards of up to $1.5 million to disseminate culturally informed, evidence-based behavioral health information and provide technical assistance and training. USDA Summer Food Service Program – Ongoing. The U.S. Department of Agriculture (USDA) offers funding on a per-meal basis to organizations providing meals to lower-income children when they do not have access to school lunch or breakfast. Contact your USDA State agency to determine eligibility, application requirements, and deadlines. Policy Updates Send questions to ruralpolicy@hrsa.gov. CMS Releases Proposed Hospice Payment Rate Update for FY 2024 – Comments Due May 30. On March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare hospice payments and the aggregate cap amount for fiscal year (FY) 2024. The proposed rule would include a 5-percent cap on wage index decreases and require hospice certifying physicians to be Medicare-enrolled or to have validly opted-out as a prerequisite for payment for the hospice period of care in question. Also, this rule includes information on hospice utilization trends and solicits comments regarding information related to the provision of higher levels of hospice care. Comments Requested on Proposed Medicare Inpatient Rehabilitation Facility Payment Rates – due June 2. On April 3, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update Medicare payment policies and rates for Inpatient Rehabilitation Facilities (IRF) for fiscal year (FY) 2024. The proposed rule would also update reporting requirements for the IRF Quality Reporting Program. Comments Requested on Proposed Medicare Inpatient Psychiatric Payment Rates – due June 5. On April 4, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update Medicare payment policies and rates for the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year (FY) 2024. The proposed rule includes updates to the inpatient psychiatric payment rates and a request for information to about future payment changes and data collection for inpatient psychiatric services. CMS Releases Proposed Skilled Nursing Facility Prospective Payment System for FY 2024 – Comments due June 5. On April 4, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY) 2024. In addition to the rate updates, the proposed rule includes proposals for the SNF Quality Reporting Program (QRP) and the SNF Value-Based Purchasing (VBP) Program for FY 2024 and future years. Also, effective with services furnished on or after January 1, 2024, CMS proposes to add marriage and family therapists and mental health counselors to the list of practitioners whose services are excluded from the consolidated billing provision and is seeking comments identifying HCPCS codes that might meet the criteria for exclusion from SNF consolidated billing. Comments Requested on Proposed Medicare Hospital Payment and REH Updates – due June 9. On April 10, 2023, CMS issued proposed changes to Medicare's inpatient prospective payments made to acute care and long-term care hospitals. Specifically, CMS proposes a 2.8% increase to hospitals that successfully participate in the Inpatient Quality Reporting program and are meaningful electronic health record (EHR) users. They also propose to continue policies that support low wage index hospitals, many of which are rural, and to include data for hospitals that reclassify from urban to rural (42 CFR §412.103) in other wage index calculations. There is a proposal to adjust payments when homelessness is indicated and a Request for Information on the unique challenges faced by safety-net hospitals and the patients they serve. Finally, CMS has proposed to allow Rural Emergency Hospitals (REH), a Medicare new provider type, to serve as training sites for Medicare Graduate Medical Education (GME) payment purposes, and they provided proposed regulations on what information must be submitted to CMS when a hospital applies to become an REH. Learning Events and Technical Assistance Learning About Long COVID & Fatiguing Illness – Thursday, April 13 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. Preparing for Extreme Heat, Rural Health, and Climate Change – Tuesday, April 18 at 1:00 pm ET. Panelists from HRSA's Bureau of Primary Health Care (BPHC), the Centers for Disease Control and Prevention, and other organizations will discuss these challenges and review resources. HRSA on National Donate Life Month – Tuesday, April 18 at 1:00 pm ET. HRSA's Office of Intergovernmental and External Affairs in Regions 1, 5, and 7 in collaboration with HRSA Health Systems Bureau, Division of Transplantation, invite you to a webinar in observance of National Donate Life Month. During this session speakers will discuss healthy living and disease prevention, highlight the need for minority organ donors, and share personal experiences with organ donation. Participants will also learn about HRSA programs and resources available to Hispanic/Latino communities and organizations serving this population. Please note, this panel session is being offered entirely in Spanish with live English interpretation. NACRHHS Updates: PACE and Childcare Need in Rural Areas – Tuesday, April 18 at 2:00 pm ET. Members of the National Advisory Committee on Rural Health and Human Services (NACRHHS) recently explored two topics of importance to rural areas. The first was the use of the Programs of All Inclusive Care for the Elderly (PACE) in rural areas. The second was childcare need and availability in rural areas. Please join us for a webinar that will highlight the rural context related to these to topics, and a discussion of the policy brief and recommendations submitted to the Secretary of the U.S. Department of Health & Human Services. Mobile Health Innovations for Domestic Violence/Human Trafficking Survivors – Wednesday, April 19 at 1:00 pm ET. Experts will explore collaborations among primary care and behavioral health to increase access to care via mobile health. Strategies for Mental/Health Wellness in Older Adults – Wednesday, April 19 at 2:00 pm ET. Some issues related to healthy aging in rural areas will be covered in this session hosted by the Mental Health Technology Transfer Center Network. HRSA Virtual Job Fair – Wednesday, April 19 at 6:00 pm ET. HRSA's Bureau Health Workforce hosts this free, online event over 3.5 hours to connect primary care clinicians and trainees with health care facilities that have job openings. To register, complete a clinician profile on the Health Workforce Connector. HRSA Health Equity: Better Health Through Better Understanding – April 25 at 1:00 pm ET. HRSA's Office of Health Equity hosts this hour-long event in recognition of National Minority Health Month. Speakers will highlight the importance of improving health outcomes for racial and ethnic minority communities through culturally and linguistically appropriate healthcare, information, and resources. Save the Date: AHA Rural Health Summit for Southwest Region – Friday, May 12, Dallas, TX. The American Heart Association (AHA) may provide scholarship for those who need financial assistance to attend this conference of rural health leaders from Arkansas, Colorado, New Mexico, Oklahoma, Texas, and Wyoming. Register for Rural Suicide Prevention Workshops – 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. Resources of the Week House Appropriations Hearing: Addressing Challenges in Rural America. A recording of the nearly three-hour focus on rural in the House Committee on Appropriations. Testimony and discussion include access to health care, labor/workforce development, and education. How Community Health Workers Are Impacting Rural Communities. The report from the Association of State and Territorial Health Officials describes ways in which communities can use funding to build community health worker programs. Telehealth Technology Showcase. The series of videos from the National Telehealth Technology Assessment Resource Center covers questions related to: Remote Patient Monitoring, Direct to Consumer, Emergency Medical Services and School Based telehealth. Approaching Deadlines DOT Bus and Bus Facilities Infrastructure Program – April 13 DOJ Rural Domestic/Dating Violence, Sexual Assault, and Stalking Program – EXTENDED to April 14 Comments Requested: Disclosure of Ownership for Nursing Facilities – April 14 Denali Commission Grants for Alaska Communities – April 14 DOE Energy Improvement in Rural/ Remote Areas – April 14 Department of Labor Seeks Feedback About Mental Health in the Workplace – April 14 EPA Environmental Justice Government-to-Government Program – April 14 NIH Strategies for Managing SUD in Primary Care and Ambulatory Settings – April14 Indian Health Service Zero Suicide Initiative Coordinating Center – April 17 HHS Advancing Equity Through Teen Pregnancy Prevention – April 18 DOJ Supporting Vulnerable/At-Risk Youth Transitioning Out of Foster Care – April 19 DOJ Expanding Access to Sexual Assault Forensic Examinations – April 20 Citizen's Institute on Rural Design: Request for Applicants – April 21 FCC Publishes Request for Comment on Proposed Changes to the Universal Service Rural Health Program – April 24 CDC National Cardiovascular Health Program – April 25 DOJ Violence Against Women Grants to Indian/Tribal Governments – April 25 HRSA National Health Service Corps Loan Repayment Programs – April 25 SAMHSA American Indian/Alaska Native Behavioral Health Center of Excellence – May 26 HRSA National Health Service Corps Scholarship Program – April 27 HRSA Nurse Education, Practice, Quality and Retention – Pathway to Registered Nurse Program – April 27 DOJ/JBS International Building Capacity for Children Impacted by Drug Crisis – April 28 HUD Section 4 Capacity Building Grants: Rural and Tribal Communities – April 28 NIH RAD-xUP CDCC Community Collaboration Mini-Grant Program – April 28 SAMHSA Historically Black Colleges and Universities Center for Excellence – April 28 USDA Rural Health and Safety Education Grants – April 28 American Association of Colleges of Osteopathic Medicine Health Policy Fellowship – April 30 ACF Tribal Maternal, Infant, and Early Childhood Home Visiting Program – Development and Implementation Grants – May 1 DOJ Tribal Sexual Assault Services Program – May 1 HRSA Nurse Faculty Loan Program – May 1 NIH Evaluating Pandemic Era Food/Housing Policies on Disparity Populations – May 1 SAMHSA Mental Health Awareness Training Grants – May 1 SAMHSA Rural Emergency Medical Services Training – May 1 USDA Farmers Market Promotion – May 2 DOJ Mentoring for Youth Affected by Opioid and Other Drug Misuse – May 4 HRSA Nurse Corps Scholarship Program – May 4 SAMHSA Developing Infrastructure for Mental Health of Children/Families in AI/AN Communities – May 5 ACF Community Economic Development Projects – May 8 CDC Overdose Data to Action: Limiting Overdose in Localities – May 8 CDC Overdose Data to Action in States – May 8 SAMHSA Cooperative Agreements to Implement Zero Suicide – May 8 SAMHSA Implementation Research in Community Behavioral Health Clinics – May 8 SAMHSA Minority Fellowship Program – May 9 HRSA Rural Communities Opioid Response Program – Child and Adolescent Behavioral Health – May 12 HRSA Rural Health Care Coordination Program – May 15 SAMSHA National Strategy for Suicide Prevention – May 15 SAMHSA Tribal Behavioral Health Program – May 15 Department of Justice Tribal Researcher Capacity Building Grants – May 16 USDA Produce Prescription Program (Gus Schumacher Nutrition Incentive Program) – May 16 NIH Research to Improve Native American Health – May 17 HRSA Delta Health Systems Implementation Program – May 18 ACF Child Care Dissertation Grants – May 19 VA Staff Sergeant Fox Suicide Prevention Grants – May 19 ACL Funding One Rehabilitation Research Center for Minority Entities – May 22 SAMHSA Cooperative Agreement for the Hispanic/Latino Behavioral Health Center of Excellence – May 23 HRSA Health Careers Opportunity Program – May 24 AHRQ Safety Program for Telemedicine – May 25 Comments Requested: CMS Proposed Hospice Payment Rate Update for FY 2024 – May 30 Comments Requested on Proposed Medicare Inpatient Rehabilitation Facility Payment Rates – June 2 Comments Requested on Proposed Medicare Inpatient Psychiatric Payment Rates – June 5 Comments Requested: CMS Releases Proposed Skilled Nursing Facility Prospective Payment System for FY 2024 – June 5 Comments Requested on Proposed Medicare Hospital Payment and REH Updates – June 9 AHRQ Small Research Projects to Advance the Science of Primary Care – June 16 USDA Rural Utilities Service Community Connect Grant Program – June 20 Berkley Rural Public Health Master's Program – August 13 UMMC Caregiver University for Alzheimer's Support – Quarterly deadlines October 10 Ongoing Opportunities HRSA Needs Rural Reviewers for Grant Applications 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 NIH Researching Barriers to Care for HIV-Associated Comorbidities – May 2025 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) Veterans Affairs Health Professional Scholarship Program WWAMI Area Health Education Center Scholars Program | 
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