| Read this in your browser December 12, 2024 What's New Obstetric Care Access at Rural Hospitals in the United States. In the United States, access to maternity care in rural counties continues to decline. Last week, JAMA Network published a research article from the FORHP-funded University of Minnesota Rural Health Research Center showing that rural counties with no hospital-based obstetric services increased from 54 percent of rural counties in 2014 to almost 59 percent in 2022. The study authors discussed their findings in a recent Gateway webinar - Access to Maternity Care in Rural U.S. Communities. The presentation described disparities in maternal health outcomes for rural populations, the growing scarcity of obstetric care, and the far-reaching consequences of obstetric unit closures. Introduction to the Rural Hospital Stabilization Program – Wednesday, December 18 at 3:00 pm Eastern. The Federal Office of Rural Health Policy (FORHP) is pleased to support the Rural Hospital Stabilization Program (RHSP), a new initiative designed to assist rural hospitals in improving their financial stability and meeting community health care needs. Administered by FORHP through a grant to the National Rural Health Resource Center, this program offers no-cost assistance to rural hospitals to enhance or expand health care services such as pulmonary rehabilitation, outpatient behavioral health services, and primary care, ensuring care remains accessible close to home. To learn more about RHSP, join the introductory webinar next week. VA Proposes Expanded Access to Telehealth for Rural Veterans – Comment by January 13. The U.S. Department of Veterans Affairs (VA) announced its intention to eliminate copayments for all VA telehealth services and establish a telehealth grant program to fund designated VA telehealth access points in non-VA facilities, with a focus on rural and medically underserved communities, where approximately 4.4 million veterans reside. VA officially published the proposed Telehealth Grant Program rulemaking in the VA Federal Register on November 13. The Federal Register 60-day public comment period will remain open through January 13. NIDA Seeks People with Lived Experience for New Working Group – Respond by January 10. The National Institute on Drug Abuse (NIDA) is seeking people with lived or living experience (PWLLE) with drug use to participate in a working group to the National Advisory Council on Drug Abuse. The working group will advise on how to better engage PWLLE with drug use in NIDA-funded research. The working group will also help create standards to guide researchers in engaging this population. This is an opportunity to ensure that the rural voice of PWLLE is represented in substance use disorder research. Pharmacy-Based Preventive Services for Opioid Use Disorder: A Survey of U.S. Pharmacists. Using online survey data from 1,146 pharmacists, researchers examine their perceptions about drug use, drug screening, interventions, and the commitment and readiness to address opioid use disorder and drug use disorder in their patients. The research includes breakdowns of pharmacist demographics as well as rurality of pharmacy locations. Pharmacists who were White, practiced at a rural location, worked at a chain pharmacy, had not received opioid-related training in the past year, or practiced screening patients for opioid use had elevated odds of perceiving concerns about opioid use problems in their practice settings. Having practiced pharmacy services for less time, and having received training for OUD-related preventive services within the last year, were associated with increased levels of commitment/readiness for providing care to patients with drug use problems. National Telehealth Resource Centers Reports on AI in Rural Health. The HRSA-supported National Consortium of Telehealth Resource Centers provides an overview of artificial intelligence (AI), applications of AI, and how AI can be used in health care. Application Assistance: HRSA Rural Veterans Health Access Program – Monday, December 15 at 1:00 pm Eastern. FORHP will hold a technical assistance webinar to assist with applications for three state-level cooperative agreements expanding services for veterans in rural areas, first announced last week. Funding and Opportunities NARHC Bill Finerfrock Health Policy Fellowship – January 6. The National Association of Rural Health Clinics (NARHC) offers a four-week fellowship in Alexandria, Virginia for mid-career professionals to learn leadership skills for becoming grassroots advocates and champions for rural health. Selected fellows will receive lodging, travel expenses, and an $8,000 stipend. Patient-Centered Outcomes Research Institute (PCORI) Funding: Improving Mental and Behavioral Health – Letters of Intent January 14. PCORI provides funding for patient-centered comparative clinical effectiveness research projects that focus on improving mental and behavioral health. Studies should compare system, community, and individual level interventions that improve mental and behavioral health conditions. The nonprofit organization has a dedicated focus on rural health with several ongoing projects. Letters of intent are required by January 14. SAMHSA/American Psychological Association - Psychology Minority Fellowship Programs – January 15. The Substance Abuse and Mental Health Services Administration (SAMHSA) and the national trade association for psychology offer fellowship programs to prepare psychology masters students, doctoral students, and postdoctoral trainees for careers in behavioral health focused on serving communities of color, including Native American communities. According to the results of the 2020 Census, nearly 14 million rural residents identify as Black, Hispanic or Latino, Native, Asian, or multiracial. RWJF Summer Health Professions Education Program – February 5. The Robert Wood Johnson Foundation provides a free summer enrichment program designed to improve access to information and resources for college students interested in the health professions. Each year, RWJF seeks eligible students include those from populations that have been historically marginalized, including rural. Patient-Centered Outcomes Research Institute (PCORI) Funding: Broad Pragmatic Studies – Letters of Intent February 6. PCORI provides funding for patient-centered comparative clinical effectiveness research in the areas of addressing disparities; assessment of prevention, diagnosis, and treatment options; communication and dissemination research; and improving healthcare systems. The nonprofit organization has a dedicated focus on rural health with several ongoing projects. A separate opportunity, PCORI Maternal Morbidity and Mortality Topical Studies also requires Letters of Intent by February 6. HRSA Scholarships for Disadvantaged Students Program – February 19. HRSA's Bureau of Health Workforce will award an estimated $51.47 million to approximately 85 grantees over a period of five years through this opportunity. The funding goes to accredited school programs in certain disciplines that make scholarships available to students from disadvantaged backgrounds. HRSA Nurse Faculty Loan Program – February 24. HRSA's Bureau of Health Workforce seeks to increase the number of qualified nursing faculty through low interest loans for individuals studying to be nurse faculty and loan cancellation for those who then go on to work as faculty. Successful applicants must establish, operate, and maintain a student loan program. Eligibility includes: state, local, and tribal governments; independent school districts; public and private institutions of higher learning; nonprofits and for-profit organizations other than small businesses. HRSA will invest $25.6 million for an expected 80 awards over a one-year period of performance beginning July 1, 2025. Policy Updates Send questions to ruralpolicy@hrsa.gov. New study on Medicare Graduate Medical Education (GME) payments for Sole Community Hospitals (SCH) and Medicare Dependent Hospitals (MDH) – Researchers from the HRSA-funded Rural Residency Planning and Development Technical Assistance Center studied the effects of specific hospital classifications on Medicare GME payments. In this simulation study, the authors found that that median opportunity cost per resident was around $70,000 and $65,000 for SCHs and MDHs, respectively. This study demonstrates the significant financial barriers that SCHs and MDHs face in participating in GME program, under the current reimbursement method. The paper concludes that policy adjustments addressing the barrier may incentivize rural facilities to launch or participate in GME, which may help lessen the geographic maldistribution of physicians. Updated Rural Emergency Hospital (REH) Fact Sheet with 2025 Payments. The Centers for Medicare & Medicaid Services (CMS) updated their Fact Sheet on Rural Emergency Hospitals (REHs) to include new information on Indian Health Service REHs and 2025 payment information. Congress created REHs to preserve access to emergency and outpatient services in rural areas. FORHP funds the Rural Health Redesign Center to provide 1:1 technical assistance to help hospitals and communities make informed decisions about converting to this model of care. Advanced Primary Care Management Services: Get Information about Billing Medicare. Last week, the Centers for Medicare & Medicaid Services (CMS) released information on billing Medicare for Advanced Primary Care Management (APCM). ACPM services combine elements of several existing care management and communication technology-based services you may have already been billing for patients. Starting January 1, 2025, providers may use a new payment bundle that reflects the essential elements of advanced primary care. CMS Calendar Year 2025 Medicare Physician Fee Schedule Final Rule Summary. The Centers for Medicare & Medicaid Services (CMS) published a Medicare Learning Network (MLN) summary for Calendar Year 2025 Medicare Physician Fee Schedule final rule. Specifically, this MLN provides updates on changes that apply to services provided in 2025 including, telehealth, caregiver training, therapy, cardiovascular risk assessment and management, evaluation and management, behavioral health, Advanced Primary Care Management, global surgery payment, and dental and oral health. 2025 Physician Fee Schedule Webinar: Registration Required – Thursday, January 30 at 2:00 pm Eastern. Subject matter experts from the Centers for Medicare & Medicaid Services will present highlights of policy updates from the Calendar Year 2025 Medicare Physician Fee Schedule final rule in a webinar produced by the Rural Health Information Hub. Covered topics will include: general care management, Advanced Primary Care Management, telehealth, policy updates for Rural Health Clinics and Federally Qualified Health Centers, behavioral health, dental services, and more. The webinar is free, and you must register to attend. Learning Events and Technical Assistance USICH: How Health Systems and Hospitals Can Help Solve Homelessness – Thursday, December 12 at 12:30 pm Eastern. The United States Interagency Council on Homelessness (USICH) is a federal agency with the sole mission of preventing and ending homelessness in America. During this one-hour webinar, they will discuss their recent federal guidance for hospitals and health systems, with effective strategies relevant for all health professionals, including public health departments and researchers. According to USICH, nearly 20 percent of the people experiencing homelessness in the U.S. live in rural areas, and rural areas have higher rates of unsheltered homelessness than big cities or suburbs. Developing a Behavioral Health Paraprofessional Training Program – Thursday, December 17 at 12:00 pm Eastern. HRSA's Bureau of Health Workforce will hold a two-hour session via Zoom, hosted by its National Workforce Collaborative. Attendees will see presentations from HRSA's Behavioral Health Workforce Education and Training (BHWET) programs and learn promising practices for successful paraprofessional programs. Resource of the Week A Toolkit for Developing Local Multisector Plans for Aging in Rural Areas. The SCAN Foundation offers 10 steps for developing a master plan for aging with rural focus, covering leadership development, community engagement, implementation planning, evaluation, and sustainability. Highlights rural-specific challenges for aging in rural communities. COVID-19 Resources Learn About Long COVID & Fatiguing Illness – Thursday, December 12 at 3:00 pm Eastern. The Centers for Disease Control and Prevention funds this monthly webinar-style Project ECHO (Extension for Community Healthcare Outcomes) learning session to rapidly disseminate findings about Post-COVID Conditions (PCC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). The series offers 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 health care 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. *New: a short course on Long COVID in Children and Adolescents opened on November 14 and runs until February 25, 2025. Mobilizing Health Care Workforce via Telehealth. ProviderBridge.org was created through the Coronavirus Aid, Relief, and Economic Security (CARES) Act by the Federation of State Medical Boards and HRSA's Office for the Advancement of Telehealth. 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. Approaching Deadlines AHRQ State-Based Healthcare Extension Cooperatives – December 12 Call for Nominations to the CMS Health Equity Advisory Committee – December 12 Administration for Community Living State Health Insurance Assistance Program (SHIP) Grants – December 13 Administration for Community Living Small Business Innovation Research – December 16 COSSUP Reaching Rural: Advancing Collaborative Solutions for Substance Use and Misuse – December 16 USDA Rural Multifamily Preservation and Revitalization Program – Email Intent to Apply by December 16 NOSORH Rural Health Grant Writing Institute: Beyond the Basics – December 18 Delta Regional Authority Workforce Grant Program – December 20 FEMA Assistance to Firefighters Grants – December 20 CMS Enhancing Coverage of Preventive Services Under the Affordable Care Act – Comment by December 27 CMS Seeks Feedback on Quality Measures for Medicare Hospitals, including REHs – Comment by December 30 USDA Intermediary Relending Program for Rural Economic Development – December 31 USDA Rural Energy for America Program (REAP): Grants and Loans for Energy Systems/Improvements – December 31 NARHC Bill Finerfrock Health Policy Fellowship – January 6 ASPPH/USDA Rural Health Fellowship – January 9 NIDA Seeks People with Lived Experience for New Working Group – Respond by January 10 VA Proposes Expanded Access to Telehealth for Rural Veterans – Comment by January 13 Patient-Centered Outcomes Research Institute (PCORI) Funding: Improving Mental and Behavioral Health – Letters of Intent January 14 SAMHSA/American Psychological Association - Psychology Minority Fellowship Programs – January 15 NHTSA Road to Zero Community Traffic Safety Grants – January 17 HRSA Behavioral Health Workforce Education and Training Program for Professionals – January 21 HRSA Graduate Psychology Education Program – January 21 CMS Proposed Changes to Medicare Part C and D – Comment by January 27 HRSA Centers of Excellence in Maternal and Child Health Education, Science, and Practice – January 27 OIG Updating Antikickback Safe Harbor Provisions – Comment by January 27 HRSA Rural Veterans Health Access Program – February 5 RWJF Summer Health Professions Education Program – February 5 Patient-Centered Outcomes Research Institute (PCORI) Funding: Broad Pragmatic Studies – Letters of Intent February 6 PCORI Maternal Morbidity and Mortality Topical Studies – Letters of Intent February 6 HRSA Scholarships for Disadvantaged Students Program (funding goes to schools, not individuals) – February 19 HRSA Nurse Faculty Loan Program – February 24 U.S. Department of Energy Demonstration Funding for Energy Improvement in Rural/Remote Areas – Letters of Intent February 27 Ongoing Opportunities Bold indicates HRSA- and/or FORHP-funded opportunities. ACF Low Income Home Energy Assistance Program ACF Rural Community Development Program for Rural Water Systems Addiction Policy Forum: Sites for Anti-Stigma Pilot AgriSafe Mental Health Training for Agricultural Producers & Families 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 AmeriCorps American Connection Corps for Broadband in Rural Areas Appalachian Community Fund Technical Assistance Grants Appalachian Regional Commission J-1 Visa Waivers for Doctors Association of American Indian Physicians Tribal Grant Writing Training ASA Rural Access to Anesthesia Care Scholarship California Department of Health Care Access – Small and Rural Hospital Relief Program CDC Direct Assistance to State, Tribal, Local, and Territorial Health Agencies CDC Training Pediatric Medical Providers to Recognize ACEs CMS Medicaid and CHIP Renewal and Transition Resources for Partners Communities Unlimited, Inc: Water and Wastewater Loans for Rural Systems Cybersecurity & Infrastructure Security Agency – Technical Assistance for Rural EMS Communications Delta Region Community Health Systems Development Program Delta Regional Authority Community Infrastructure Fund Delta Doctors J-1 Visa Waiver Program Department of Commerce: Economic Development Assistance Programs DRA Technical Assistance for Delta Region Community Health Systems Development EPA Drinking Water State Revolving Fund EPA Water Infrastructure and Innovation Act Program FEMA/SAMHSA Post-Disaster Crisis Counseling Assistance and Training Program GSA Federal Surplus Property Available for Public Use GPHC & RWJF: Rapid Cycle Research and Evaluation Grants for Cross-Sector Alignment HRSA Needs Rural Reviewers for Grant Applications HRSA/SAMHSA Medications for Opioid Use Disorder Training and Mentoring 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 Forensic Nursing Consultation Program and Training IHS/DOD Medical Supplies and Equipment for Tribes (Project TRANSAM) Licensure Portability: the Multi-Discipline Licensure Resource Project NARHC Certified Rural Health Clinic Professional Course National Health Resource Center on Domestic Violence Technical Assistance National Indian Health Board Tribal Environmental Justice Technical Assistance Center National Indian Health Board Tribal Environmental Impact Network Call for Technical Assistance Providers National Indian Health Board Vaccination Event Funding National Indigenous Women's Resource Center Technical Assistance for Domestic Violence Programs HRSA National Rural Health Resource Center: Rural Hospital Stabilization Program 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 Researching Firearm Injury and Mortality Prevention – February 2026 NIH Research to Address Vaccine Hesitancy in Health Disparity Populations – June 2026 NIH Planning Grants for Native American Research Centers for Health (NARCH) – various dates until July 2026 NIH Research to Understand Disparities in Maternal Morbidity and Mortality – Various dates until October 2026 NIH Data Informed, Place-Based Community-Engaged Research to Advance Health Equity – January 2027 NIH/UVA Seeking Rural Individuals to Participate in Weight Loss Study (iREACH) – until 2027 NIH Project Talk Initiative Host Site Applications NOSORH Rural Primary Care Institute Nominations for Federal Advisory Commission on HIV, Viral Hepatitis, and Sexually Transmitted Diseases NRHA Chief Nursing Officer Certification Program for Rural Hospitals Opportunity Finance Network/Partners for the Common Good – Economic Justice Partnership Fund 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 RCORP Rural Center of Excellence on SUD Prevention: Developing a Rural Community Approach to Overcoming Stigma Rural Graduate Medical Education Planning and Development Rural Grocery Transition Specialist Program RTT Collaborative: Rural Training Track Directors University RWJF Investigator-Initiated Research to Build a Culture of Health RWJF Pioneering Ideas Brief Proposals SAMHSA Crisis Counseling Assistance and Training Program for Communities Post-Disaster SAMHSA Training to Provide Medication Assisted Treatment SAMHSA 988 Suicide and Crisis Lifeline Volunteer and Job Opportunities Small Business Administration Guaranteed Loans for Small Business Small Business Administration Certified Development Company (504) Loan Program: Rural Initiative Pilot Program Southeast Rural Community Development Loans Targeted Technical Assistance for Rural Hospitals Program Treasury Department Opportunity Zone Economic Development Program United South and Eastern Tribes, Inc Tribal Health Program Support USDA Circuit Rider Program – Technical Assistance for Rural Water Systems 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 Intermediary Relending Program – Ongoing with deadlines every quarter USDA Multifamily Housing Loan Guarantees USDA National School Lunch Afterschool Snack Program USDA/NRHA Rural Hospital Technical Assistance 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 Veterans Affairs Virtual Living Room - Using Technology to Address the Critical Healthcare Needs of Veterans in Rural Areas Western Region Public Health Training Center – Future Leaders Program WWAMI Area Health Education Center Scholars Program 3RNET Recruitment and Retention 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