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RHIhub This Week - November 21, 2018

Twitter Chat

photo of hospital Access to Healthcare in Rural Communities
In case you missed it: the RHIhub hosted a #RuralHealthChat with @NOSORH last week on National Rural Health Day to celebrate the #PowerofRural. Read the tweets in order and catch up on what you missed!

 New in Our Online Library

Recent News

CDC: Agency Forms Undergoing Paperwork Reduction Act Review
Nov 20, 2018 -- The Centers for Disease Control and Prevention is seeking public comment on an information collection seeking information from rural providers on challenges they face in diagnosing, treating, and managing traumatic brain injury (TBI), and to determine where gaps in services in rural communities can be addressed to improve TBI outcomes. Comments are due within 30 days of this notice.
Source: Federal Register

HHS: Regulatory Agenda
Nov 16, 2018 -- Semiannual regulatory agenda from the Department of Health and Human Services (HHS) outlining the rulemaking activities HHS expects to undertake in the foreseeable future. Includes abstracts for prospective HHS rules that are expected to have major economic impacts on a substantial number of small entities.
Source: Federal Register

Labor Pains: The OB-GYN Shortage
Nov 16, 2018 -- Discusses several programs that are working to address OB-GYN shortages across the United States. They range from telemedicine options to rural OB-GYN residency tracks.
Source: AAMCNews

Frail Older Adults Not Getting the In-Home Health Care They Need
Nov 15, 2018 -- Highlights a recent study which found disparities between the need for home-based medical care and what is actually provided, between male and female patients, and between patients of different races. Specifically discusses access barriers to home health care in rural areas. The study found that rural residents were 78% less likely to receive home-based care than residents in the most metropolitan counties.
Source: Home Health Care News

CMS May Allow Hospitals to Pay for Housing Through Medicaid
Nov 14, 2018 -- U.S. Department of Health and Human Services (HHS) Secretary Alex Azar said in a speech that Medicaid may soon allow hospitals and health systems to directly pay for housing, healthy food, and more to improve the overall health of enrollees. Azar expressed that including social determinants of health in overall health considerations could allow the U.S. to spend less on healthcare while improving health. (May require subscription to view article.)
Source: Modern Healthcare

News Highlighting National Rural Health Day

Funding & Opportunities

CMS Health Equity Award
An honorary award to recognize an organization that demonstrates a commitment to health equity by reducing disparities among the CMS beneficiaries they serve, particularly among racial and ethnic minorities, individuals with disabilities, sexual and gender minorities, and those living in rural areas.
Geographic coverage: Nationwide
Application Deadline: Dec 7, 2018
Sponsors: Centers for Medicare and Medicaid Services, CMS Office of Minority Health

Rural Economic Development Loan and Grant Program (REDL and REDG)
Loans and grants to assist in the economic development of rural areas, including funds for healthcare facilities and equipment, telecommunications networks, and job creation projects.
Geographic coverage: Nationwide
Application Deadline: Dec 31, 2018
Sponsors: U.S. Department of Agriculture, USDA Rural Development

National Environmental Public Health Internship Program Application for Host Sites
Opportunities for local, state, and tribal health departments to host environmental health student interns.
Geographic coverage: Nationwide
Application Deadline: Jan 11, 2019
Sponsor: National Environmental Health Association

Geriatrics Academic Career Award Program
Funding to support the career development of junior faculty in geriatrics at accredited schools of allopathic medicine, osteopathic medicine, nursing, social work, psychology, dentistry, pharmacy, and allied health. The overall goals of the program are to develop the necessary skills to lead healthcare transformation in a variety of settings, including rural and/or medically underserved settings, to be age-friendly and to provide training in clinical geriatrics, including the training of interprofessional teams of healthcare professionals to provide healthcare for older adults.
Geographic coverage: Nationwide
Application Deadline: Jan 15, 2019
Sponsors: Bureau of Health Workforce, Health Resources and Services Administration, U.S. Department of Health and Human Services

Rural Communities Opioid Response Program - Planning
Planning grants designed to strengthen the capacity of multi-sector consortia to address prevention, treatment, and recovery from substance use disorder, including opioid use disorder in rural counties identified to be at the highest risk. The overall goal of the program is to reduce the morbidity and mortality associated with opioid overdoses in high-risk rural communities.
Geographic coverage: Nationwide
Application Deadline: Jan 15, 2019
Sponsors: Federal Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services

National Environmental Public Health Internship Program Application for Students
Ten-week summer internship opportunity for students from accredited environmental health academic programs.
Geographic coverage: Nationwide
Application Deadline: Jan 18, 2019
Sponsor: National Environmental Health Association

Tribal College Extension Special Emphasis Grants
Grants for tribal extension pilot projects that address National Institute of Food and Agriculture critical areas of reduction of childhood and adolescent obesity, improved food safety, increased food security, development of sustainable energy, and adaptation of agriculture and natural resources to global climate change.
Geographic coverage: Nationwide
Application Deadline: Feb 1, 2019
Sponsors: National Institute of Food and Agriculture, U.S. Department of Agriculture

Flex Rural Veterans Health Access Program
Grants for current Medicare Rural Hospital Flexibility Program award recipients in states with certified Critical Access Hospitals to work with providers and other partners to improve access to needed healthcare services and to improve the coordination of care for veterans living in rural areas.
Geographic coverage: Nationwide
Letter of Intent (Optional): Nov 30, 2018
Application Deadline: Feb 12, 2019
Sponsors: Federal Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services

Environmental Justice Small Grants Program
Grants to support community-driven projects designed to engage, educate, and empower communities to better understand local environmental and public health issues and develop strategies for addressing those issues, building consensus in the community, and setting community priorities.
Geographic coverage: Nationwide
Application Deadline: Feb 15, 2019
Sponsor: U.S. Environmental Protection Agency

Rural Broadband Access Loan and Loan Guarantee Program
Loans and loan guarantees to provide funds for the construction, improvement, or acquisition of facilities and equipment needed to provide broadband service in eligible rural areas.
Geographic coverage: Nationwide
Application Deadline: Sep 30, 2019
Sponsors: U.S. Department of Agriculture, USDA Rural Utilities Service

New Resources

American Indians and Alaska Natives Must Be Included in Research on Adverse Childhood Experiences
Highlights a report on adverse childhood experiences (ACEs) in tribal populations. Presents data on poverty, substance abuse, and age, among other factors, of American Indian and Alaska Native populations across the nation.
Sponsoring organization: Child Trends
Date: 11/2018

Are Marketplace Premiums Higher in Rural than in Urban Areas?
Examines monthly health insurance premium differences among 499 rural and urban premium rating regions for the Affordable Care Act (ACA) compliant nongroup marketplaces in the U.S. Includes state-by-state data for average monthly premium costs in rural and urban areas during 2016 and 2017.
Additional links: Full Report
Sponsoring organizations: Robert Wood Johnson Foundation, Urban Institute
Date: 11/2018

Case Study: How Alaska Addresses Its Health Care Workforce Challenges
Reviews how state agencies and organizations in Alaska have collaborated to address health workforce shortages, particularly in rural areas of the state. Highlights the state's apprenticeship program, workforce coalition, use of Medicaid to pay nontraditional healthcare workers, and more.
Sponsoring organization: National Academy for State Health Policy
Date: 11/2018

Changes to the Merit-based Incentive Payment System Pertinent to Small and Rural Practices, 2018
Describes the importance of legislative changes to the Merit-based Incentive Payment System that occurred as part of the Bipartisan Budget Act of 2018. Includes an appendix comparing the original framework for the system with changes for 2018/2019.
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Date: 11/2018

County by County Plan Year 2019 Insurer Participation in Health Insurance Exchanges
County-level map of the United States showing the number of health insurance carriers that will participate in the Health Insurance Exchanges during 2019.
Sponsoring organization: Centers for Medicare and Medicaid Services
Date: 09/2018

Federal Student Loan Forgiveness and Loan Repayment Programs
Provides an overview of federal student loan forgiveness and repayment programs, including those administered by the Health Resources and Services Administration. Addresses program components, effects, cost, and issues for Congress to consider.
Sponsoring organization: Congressional Research Service
Date: 11/2018

The Future of Health Services Research: Advancing Health Systems Research and Practice in the United States
Focuses on the importance of health services research to guide decision-making. Addresses the history of the field, future priorities, major funders, its impact on improving healthcare systems and access to care, and needs related to data infrastructure. Includes data on projects supported by the Federal Office of Rural Health Policy, a few rural health research examples, and priorities related to rural.
Sponsoring organization: National Academy of Medicine
Date: 2018

The Health and Economic Concerns of Rural Americans
Presentation features a discussion on the role social and economic disparities play in the health of people in rural communities. Highlights the effect the opioid crisis has had in rural areas and discusses ways communities can use local resources to combat opioid abuse.
Sponsoring organization: The Forum, Harvard T.H. Chan School of Public Health
Date: 11/2018

Information on Medicare Telehealth
Report to Congress, mandated by the 21st Century Cures Act, examines how Medicare patients are using telehealth, particularly in rural areas, with breakdowns by race/ethnicity, age group, and primary diagnoses including mental health issues. Includes an analysis of Medicare claims data regarding high volume services that could be delivered through telehealth, an overview of telehealth models funded by the Center for Medicare and Medicaid Innovation, and state-level breakdowns of Medicare telehealth data. Discusses who may benefit from telehealth expansion and barriers to expansion.
Sponsoring organization: Centers for Medicare and Medicaid Services
Date: 11/2018

Mobile Mammography Participation Among Medically Underserved Women: A Systematic Review
Describes the effect of mobile programs in promoting mammographic screening participation among medically underserved women. Examines 4 studies conducted in rural areas and 3 studies conducted in both urban and rural areas, through articles published from 2010-2018.
Author(s): Suzanne Vang, Laurie R. Margolies, Lina Jandorf
Location: Preventing Chronic Disease, 15
Date: 11/2018

Ohio Addiction Policy Inventory and Scorecard: Overdose Reversal and Other Forms of Harm Reduction
Describes changes in Ohio addiction policies related to overdose reversal and harm reduction. Examines the evidence supporting the policy changes and how they will address the needs of Ohio residents. Identifies existing gaps in policy and potential opportunities for improvement. Discusses barriers rural counties face, such as limited access to harm reduction services or healthcare specialists for treatment.
Additional links: Detailed Inventory Tables, Detailed Policy Scorecard, Executive summary
Sponsoring organization: Health Policy Institute of Ohio
Date: 11/2018

QuickStats: Birth Rates by Urbanization Level and Age Group of Mother — National Vital Statistics System, United States, 2017
Line chart showing birth rates for rural and urban mothers by age for 5-year age ranges starting at age 15-19 and ending at age 40-44.
Sponsoring organization: Centers for Disease Control and Prevention
Location: MMWR (Morbidity and Mortality Weekly Report), 67(45), 1281
Date: 11/2018

Rural Health Research Recap: Rural Communities: Age, Income, and Health Status
Summary of key findings from the Federal Office of Rural Health Policy funded Rural Health Research Centers' most recent research on the demographics and health status of rural residents. Features statistics comparing mortality and incidence of various health conditions in rural and urban areas, and poverty rates in the South, West, Midwest, and Northeast United States. Provides links to each of the referenced source documents.
Sponsoring organization: Rural Health Research Gateway
Date: 11/2018

Rural Residents with Higher Educational Attainment Were More Likely to Engage in Telehealth Activities
Bar chart showing use of telehealth for health monitoring, health maintenance, and health research by education level for rural residents.
Sponsoring organization: USDA Economic Research Service
Date: 11/2018

Rural-Urban Disparities in Health Care in Medicare
Examines rural/urban differences in Medicare quality, including breakdowns by race and ethnicity. Focuses on patient experience and clinical care measures, including screening for and management of health conditions and medication-related issues.
Additional links: FAQs, Technical Appendix
Sponsoring organization: Centers for Medicare and Medicaid Services
Date: 11/2018

Suicide Rates by Major Occupational Group — 17 States, 2012 and 2015
Examines suicide deaths by occupational group for men and women aged 16-64 years from the 17 states participating in both the 2012 and 2015 National Violent Death Reporting System. Includes information on suicide rates among male farmers, ranchers, and other agricultural managers and among male agricultural workers.
Sponsoring organization: Centers for Disease Control and Prevention
Location: MMWR (Morbidity and Mortality Weekly Report), 67(45), 1253-1260
Date: 11/2018

Tribal Broadband: FCC Should Undertake Efforts to Better Promote Tribal Access to Spectrum
Examines wireless broadband access for tribal entities, barriers to obtaining spectrum licensing for tribes, and steps taken by the Federal Communications Commission (FCC) to support tribal access. Provides recommendations for the FCC to improve broadband wireless internet access in rural tribal areas.
Additional links: Full Report
Sponsoring organization: Government Accountability Office
Date: 11/2018

Washington County Memorial Hospital Improving Patient Experience
Highlights a Critical Access Hospital (CAH) in Potosi, Missouri that participated in the Small Rural Hospital Transition (SRHT) project. Improvements focused on quality reporting, patient communication, patient rounding, and more.
Sponsoring organization: National Rural Health Resource Center
Date: 11/2018

Open Calls for Contributions

Call for Abstracts: 2019 36th Annual AcademyHealth Research Meeting
Deadline: Jan 8, 2019
Event Dates: Jun 2 - 4, 2019
Washington, DC
Conference Website

Upcoming Events

Tribal and Very Small Systems
Time: 1:00 - 2:30 p.m. Central
U.S. Environmental Protection Agency
ANTHC Alaska Tribal Conference on Environmental Management
Alaska Native Tribal Health Consortium
Anchorage, AK
Oregon’s 100% FMAP Savings and Reinvestment Program
Time: 1:30 - 3:00 p.m. Mountain
Arizona Advisory Council on Indian Health Care, Arizona Center for Rural Health
Substance Use Disorder and the 2019 Physician Fee Schedule: An Intersection
Time: 12:00 - 1:00 p.m. Eastern
Indiana Rural Health Association
812.478.3919 Ext. 235
Advisory Committee on Infant Mortality Meeting
Also available by webinar
Health Resources and Services Administration
Rockville, MD
Ways to Organize Cross-Jurisdictional Sharing: The Role of Third Parties
Time: 12:00 - 1:00 p.m. Central
Center for Sharing Public Health Services
Unlocking Potential: Engaging Young People in Community Change
Time: 2:00 p.m. Central
County Health Rankings & Roadmaps
Health in All Policies: Evaluation Strategies
Time: 2:00 - 3:00 p.m. Eastern
National Association of County and City Health Officials
Long-Term Services and Supports: Cherokee Elder Care’s PACE Program
Time: 1:00 - 2:00 p.m. Central
Centers for Medicare and Medicaid Services
Opioid Safety - Patient and Family Perspectives
Time: 11:00 a.m. - 12:00 p.m. Mountain
Montana Hospital Association
Prevention of Grain Dust Explosions
Time: 12:00 - 1:00 p.m. Central
AgriSafe Network
Train the Trainer: Hazard Mapping in the Ag Classroom
Time: 3:30 - 4:30 p.m. Central
AgriSafe Network
Measuring Access to Care in VHA: Novel Metrics and Future Possibilities
Time: 11:00 a.m. - 12:00 p.m. Central
U.S. Department of Veterans Affairs
Nevada Broadband Workshop 2019
National Telecommunications and Information Administration
Carson City, NV

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Please send an email telling how RHIhub has impacted you to Your stories may be used in testimony, budget documents and presentations concerning the Rural Health Information Hub.