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RHIhub This Week - April 3, 2019

New in the Rural Monitor

St. George ambulance Making Informed Decisions about Rural EMS
by Tami Lichtenberg
In rural America, many community members do not understand the skill level, training, and availability of the people who answer their 911 calls. The Informed Self-Determination Process helped the community of St. George, Maine learn about their EMS system and created consensus about what EMS would look like in their town.

Update RHIhub Topic Guide

telehealth patient and doctor Telehealth Use in Rural Healthcare
This topic guide has received extensive updates. Includes information on funding programs, the financial impact of telehealth, challenges related to telehealth services, telehealth’s role in healthcare access, and more!

Models and Innovations

Families Plus logo Families Plus Comprehensive Health and Mentoring for Underserved Youth
In rural Delta County, Colorado, behavioral health services were successfully integrated into physical health services for underserved children accessing a primary care clinic.
Garret Regional Medical Center logo Garrett County Regional Cancer Patient Navigator Program
A community consortium used grant-funding to expand cancer treatment services for residents in a 3-state, 8-county region in Appalachia.

 New in Our Online Library

Recent News

CMS Finalizes Medicare Advantage and Part D Payment and Policy Updates to Maximize Competition and Coverage
Apr 1, 2019 -- The Centers for Medicare and Medicaid Services (CMS) announces updates to Medicare Advantage and Part D plans offering more choices and supplemental benefits. Some actions target the opioid crisis and some benefits target social determinants of health, such as providing transportation for grocery shopping to increase access to healthy food.
Source: Centers for Medicare and Medicaid Services

Opioid Treatment Grew With W.Va. Expanded Medicaid
Apr 1, 2019 -- A new study published in Health Affairs found that increased Medicaid coverage in West Virginia correlated with an increase in diagnosis and treatment for opioid use disorder. West Virginia had the highest rate of deaths related to drug overdoses in the U.S. in 2017.
Source: U.S. News and World Report

Public Safety and Homeland Security Bureau Seeks Comment On Improving the Wireless Resiliency Cooperative Framework
Apr 1, 2019 -- The Federal Communications Commission (FCC) is seeking input on its Wireless Resiliency Cooperative Framework, which is intended to improve communications during disasters. They are particularly interested in feedback from people who used the Framework during the 2017 and 2018 Atlantic hurricane seasons.
Source: Federal Communications Commission

Klobuchar, Collins, Rosen Introduce Bipartisan Legislation to Increase Number of Doctors in Rural and Other Medically Underserved Areas
Mar 29, 2019 -- Legislation reintroduced to the U.S. Senate would extend the Conrad State 30 Program, encouraging international physicians to practice in rural and underserved areas after completing their residencies in the U.S. The program is currently slated to expire later this year; the Conrad State 30 & Physician Access Act would extend it to 2021.
Source: Office of Senator Amy Klobuchar

PBS Film on Rural Healthcare Crisis Set to Air April 8, 2019
Mar 29, 2019 -- The Independent Television Service (ITVS) announces the premiere of The Providers on April 8, 2019. The documentary will highlight the physician shortage in rural America and the opioid epidemic. The film underscores the power of the patient-provider relationship by following the journeys of three safety-net healthcare providers and their patients in rural New Mexico.
Source: Independent Television Service (ITVS)

UA Division of Agriculture to Address Mental Health, Suicide in Rural Communities
Mar 29, 2019 -- The University of Arkansas System Division of Agriculture offers a Farm Stress program aimed at improving farmer mental health and will be offering Mental Health First Aid training for county and state staff to help them identify and respond to mental health issues and reduce suicide in the agricultural community.
Source: The Pine Bluff Commercial

VA Secretary Seeks $1 Billion for Veteran Telehealth Services
Mar 29, 2019 -- The Department of Veterans Affairs (VA) is using telehealth to connect Veterans to care, particularly in rural areas, and requested a 10.5% budget increase as part of a 5-year plan to expand access using telehealth and app-based video visits.
Source: mHealthIntelligence

North Dakota Doesn't Have Enough Psychiatrists. Telemedicine Is Helping to Fix That
Mar 28, 2019 -- Telemedicine is helping North Dakota recruit psychiatrists to provide services in rural areas of the state, no matter their location of residence. The medical school is training psychiatry residents to use the technology and its use in the state is spreading - almost 25% of the state's psychiatrists have delivered a telemental health visit.
Source: STAT

Rural Crisis Response: How to Lend a Hand in a Way That Helps
Mar 28, 2019 -- Shares lessons learned from coordinating a rural Wisconsin community's response to a 2007 tornado and the recent roof collapse of Wolf River's fire station.
Source: Daily Yonder

Funding & Opportunities

Oral Health Services Expansion Grants
Awards funding to Section 330 Health Center grantees to enhance or expand oral health services.
Geographic coverage: Nationwide
Application Deadline: Apr 22, 2019
Sponsors: Bureau of Primary Health Care, Health Resources and Services Administration


Reentry Projects - Adults and Young Adults
Grants for evidence-based, evidence-informed interventions, and promising practices shown to achieve successful employment outcomes for justice-involved individuals released from prison or jail or who are currently under supervision. Projects must serve high-crime, high-poverty communities, and a balance of rural and urban projects will be funded.
Geographic coverage: Nationwide
Application Deadline: Apr 25, 2019
Sponsors: Employment and Training Administration, U.S. Department of Labor


Hillman Emergent Innovation: Serious Illness and End of Life Program
Grants for early stage or untested interventions that address health challenges faced by vulnerable populations including the economically disadvantaged, racial and ethnic minorities, LGBTQ people, people experiencing homelessness, rural populations, and other groups that encounter barriers to accessing services.
Geographic coverage: Nationwide
Letter of Intent (Required): Apr 29, 2019
Application Deadline: Jul 22, 2019
Sponsor: Rita and Alex Hillman Foundation


Grants to Tribal Domestic Violence and Sexual Assault Coalitions Program
Grants for the development and operation of nonprofit, nongovernmental tribal domestic violence and sexual assault coalitions.
Geographic coverage: Nationwide
Application Deadline: May 9, 2019
Sponsors: Office on Violence Against Women, U.S. Department of Justice


Health Center Expanded Services: Integrated Behavioral Health Services Supplemental Funding
Supplemental funding to existing Health Center Program operational grant award recipients to increase access to high quality integrated behavioral health services, including prevention or treatment of mental health conditions and/or substance use disorders, including opioid use disorder.
Geographic coverage: Nationwide
Application Deadline: May 13, 2019
Sponsors: Health Resources and Services Administration, U.S. Department of Health and Human Services


Household Water Well System Grants
Grants for qualified nonprofit organizations and tribes to create a revolving loan fund to increase access to clean, reliable water for households in eligible rural areas.
Geographic coverage: Nationwide
Application Deadline: May 27, 2019
Sponsors: U.S. Department of Agriculture, USDA Rural Utilities Service


Water and Waste Disposal Revolving Loan Funds
Grants to help nonprofit organizations establish revolving loan funds that will finance water and wastewater projects in rural communities.
Geographic coverage: Nationwide and U.S. territories
Application Deadline: May 27, 2019
Sponsors: U.S. Department of Agriculture, USDA Rural Utilities Service


Youth Engagement in Sports: Collaboration to Improve Adolescent Physical Activity and Nutrition (YES Initiative)
Grants to develop and implement sports fitness programs based on successful evidenced-based strategies of youth engagement for racial/ethnic minority and/or socioeconomically disadvantaged 6th, 7th, and/or 8th graders, particularly those who reside in communities where no or few youth sports programs exist. The YES Initiative intends to identify characteristics of effective collaborations that improve physical activity and nutrition through increased participation in sports.
Geographic coverage: Nationwide
Application Deadline: May 31, 2019
Sponsors: Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services


Rural Community Development Initiative (RCDI)
Funding to help nonprofit housing and community development intermediary organizations support housing, community facilities, and community and economic development projects in rural areas. Priority will be given to applications that address USDA's goal to reduce the morbidity and mortality associated with Substance Use Disorder (including opioid misuse) in high-risk rural communities.
Geographic coverage: Nationwide
Application Deadline: Jun 5, 2019
Sponsors: U.S. Department of Agriculture, USDA Rural Development


Community Facilities Technical Assistance and Training Grant
Grants to intermediary organizations to provide technical assistance and training for rural organizations and agencies to identify and plan for community facility needs that exist in their area, and once those needs have been identified, locating public and private resources to finance those identified needs. Priority will be given to applications that address USDA's goal to reduce the morbidity and mortality associated with Substance Use Disorder (including opioid misuse) in high-risk rural communities.
Geographic coverage: Nationwide
Application Deadline: Jun 10, 2019
Sponsors: U.S. Department of Agriculture, USDA Rural Development

New Resources

2017 National and State Healthcare-Associated Infections Progress Report
Examines progress on reducing health-care associated infection rates for 6 types of infections in 4 types of hospitals using data from the National Healthcare Safety Network. Compares observed versus expected infection rates using 2015 baseline data with standardized infection ratios (SIR) and use of ventilators, urinary catheters, and central lines using standardized utilization ratios (SURs). Includes national and state data tables on SIR and SUR for Critical Access Hospitals.
Sponsoring organization: Centers for Disease Control and Prevention
Date: 03/2019


2017 Quality Payment Program Reporting Experience
Reports on clinician experience participating in the first year of the Quality Payment Program, which provides clinicians with quality-related payment adjustments through either the Merit-based Incentive Payment System (MIPS) or the Advanced Alternative Payment Models (APMs). Includes discussions related to program design for rural practices, data on eligibility and participation for small and rural practice clinicians, and their payment adjustment scores.
Additional links: Appendix
Sponsoring organization: Centers for Medicare and Medicaid Services
Date: 03/2019


Addressing Low Case-Volume in Healthcare Performance Measurement of Rural Providers: Recommendations from the MAP Rural Health Technical Expert Panel
Final report recommending how to measure healthcare performance in low case-volume situations, such as rural providers. Reviews existing and proposed low-volume healthcare quality measures, how measures are calculated, data use, and data analysis techniques. Focuses on Centers for Medicare and Medicaid Services (CMS) quality programs reporting requirements.
Sponsoring organization: National Quality Forum MAP Rural Health Workgroup
Date: 03/2019


Community Health Center Financing: The Role of Medicaid and Section 330 Grant Funding Explained
Describes the two main sources of funds, Medicaid and Section 330 grant funding, that enable community health centers to provide healthcare services for underserved rural and urban populations in the U.S. Discusses Medicaid's special payment rules for community health centers, the role of Section 330 funding, and the expansion of community health centers due to funding increases.
Sponsoring organization: Kaiser Family Foundation
Date: 03/2019


Disabilities in the U.S. Farm Population
Reports summary information on disability rates among farmers and farmworkers between 2008 and 2016. Includes some state-specific information.
Sponsoring organization: USDA Economic Research Service
Location: Amber Waves
Date: 04/2019


Facility-Based Ambulatory Care Provided to Rural Medicare Beneficiaries in 2014
Chartbook describing claims, costs, and common diagnoses in facility-based ambulatory care provided to rural Medicare patients. Features statistics in various categories with breakdowns by Federally Qualified Health Centers in rural and urban areas, Rural Health Clinics, Critical Access Hospitals, and Prospective Payment Systems in rural and urban areas.
Sponsoring organization: North Carolina Rural Health Research Program
Date: 03/2019


FH Healthcare Indicators and FH Medical Price Index 2019: An Annual View of Place of Service Trends and Medical Pricing
White paper exploring changes in healthcare utilization, demographic and geographic factors, diagnoses, costs, and procedures. Features statistics including usage of retail clinics and telehealth from 2012-2017, and urgent care, ambulatory surgery centers, and emergency rooms from 2008-2017, with breakdowns by urban and rural locations.
Sponsoring organization: FAIR Health
Date: 04/2019


LTC Focus (Long-term Care: Facts on Care in the US)
Mapping tool presents long-term care data by a number of indicators nationally or on a state-by-state basis. Features data on facility characteristics, state policies, and resident characteristics, among other factors.
Sponsoring organization: Brown School of Public Health

National Hospital Ambulatory Medical Care Survey: 2016 Emergency Department Summary Tables
Provides data on ambulatory care emergency department (ED) hospital visits. Table 1 provides metropolitan/nonmetropolitan ED visit data based on hospital location, Table 2 includes metro/nonmetro ED visit data by location of patient residence, and Table 14 has metro/nonmetro injury visit data based on hospital location.
Sponsoring organization: National Center for Health Statistics
Date: 03/2019


Promising Practice: Community Cafes in Alaska Give People a Say in Their Health Care
Provides an overview of the first community cafe sponsored by the Petersburg Medical Center (PMC) in Petersburg, Alaska and facilitated by the Alaska State Office of Rural Health (AK-SORH). Covers the thought process behind the AK-SORH's idea to facilitate community cafes across the state. Describes the goals of community cafes: to educate and receive feedback on a topic chosen by the community, and learn more about the community's health needs.
Sponsoring organization: National Organization of State Offices of Rural Health
Date: 04/2019


Recommendations to the Indian Health Service on American Indian/Alaska Native Pregnant Women and Women of Childbearing Age with Opioid Use Disorder
Report details recommendations from the American College of Obstetricians and Gynecologists to the Indian Health Service on best practices for treating pregnant American Indian and Alaska Native women with opioid use disorder (OUD). Discusses screening for OUD, medication-assisted treatment (MAT), and care integration, among other factors.
Sponsoring organization: The American College of Obstetricians and Gynecologists

Relationship Between Adherence to Antihypertensive Medication Regimen and Out-of-Pocket Costs Among People Aged 35 to 64 With Employer-Sponsored Health Insurance
Assesses the proportion of people taking antihypertensive medicine, the rates of adherence to these regimens, and the costs. Features demographic statistics with breakdowns by urban or rural location.
Author(s): Madeleine M. Baker-Goering, Kakoli Roy, David H. Howard
Location: Preventing Chronic Disease, 16
Date: 03/2019


Rural Surgery Call Coverage: Innovative Locoregional Solutions Can Fill the Gap
Features rural locum tenens systems as possible templates to help provide call coverage for rural surgeons. Highlights a successful pilot Canadian Rural Locum Tenens Project and a collaboration with a surgical group in Ohio that helped provide surgical coverage for area rural hospitals.
Author(s): Stephen Hiscock, Michael Sarap
Location: Bulletin of the American College of Surgeons, 104(4), 52-54
Date: 04/2019


Student Homelessness Growing Fastest in Rural America
Examines trends in homelessness among rural students, which may contribute to disparities in health and academic outcomes. Explores challenges in identifying and supporting homeless families, funding in rural schools, and obstacles facing homeless rural students. Features statistics including percent change in number of homeless students from school years 2013-2014 to 2016-2017 in select states, with breakdowns by rural or nonrural locations.
Sponsoring organization: Institute for Children, Poverty & Homelessness
Date: 02/2019


Tracking Federal Funding to Combat the Opioid Crisis
Features a report tracking the federally funded programs aimed at addressing the opioid crisis for the fiscal years 2017-2018. Highlights examples in five states where it compares total money spent by department on opioid treatment and reduction, as well as the number of opioid related deaths.
Sponsoring organization: Bipartisan Policy Center
Date: 03/2019


Vietnam-Era Veterans Represent the Largest Share of All Rural Veterans
Bar chart showing the rural and urban veteran population by service period, based on 2017 American Community Survey data.
Sponsoring organization: USDA Economic Research Service
Date: 03/2019

Open Calls for Contributions

Call for Presentations: 2020 Annual EMS Today Conference
Deadline: Apr 25, 2019
EMS Today
Event Dates: Mar 4 - 6, 2020
Tampa, FL
Conference Website

Call for Proposals: 2019 22nd Annual New England Rural Health Conference
Deadline: Apr 30, 2019
New England Rural Health Association
Event Dates: Nov 6 - 7, 2019
Newry, ME
Conference Website

Request for Proposals: 2019 27th Annual West Virginia Rural Health Conference
Deadline: May 1, 2019
West Virginia Rural Health Association
Event Dates: Oct 9 - 11, 2019
Huntington, WV
Conference Website

Call for Abstracts: 2019 Annual National Association of Community Health Centers Financial, Operations Management/IT Conference
Deadline: May 13, 2019
National Association of Community Health Centers
Event Dates: Oct 24 - 25, 2019
Chicago, IL
Conference Website

Call for Abstracts: 2019 Annual Nevada Public Health Association Conference
Deadline: Jun 14, 2019
Nevada Public Health Association
Event Dates: Sep 24 - 25, 2019
Reno, NV
Conference Website

Upcoming Events

Apr
4
Indian Health STD Surveillance Report
Time: 2:00 - 3:00 p.m. Central
Indian Health Service
Apr
4
Million Hearts® in Municipalities Learning Collaborative: Physical Activity and Smoking Cessation Strategies to Improve Cardiovascular Health
Time: 2:00 - 3:00 p.m. Central
Centers for Disease Control and Prevention, National Association of County and City Health Officials
Apr
5
Medicaid Managed Care Organization (MCO) Training Sessions for CAH and Rural Hospitals, Part 1 of 3
Time: 11:00 a.m. - 12:00 p.m. Central
Illinois American Association of Healthcare Administrative Management (IL AAHAM), Illinois Association of Medicaid Health Plans (IAMHP), Illinois Critical Access Hospital Network
815.875.2999
Apr
9
2019 Kentucky Harm Reduction Summit
Kentucky AIDS Education Training Center (AETC), KY Department for Public Health, University of Kentucky Harm Reduction Initiative (KIRP)
Covington, KY
Apr
10
Engaging with Tribal Communities in Responding to STDs: An Update on the Indian Health Service’s STD Surveillance Report and How Health Departments Can Collaborate with Tribal Organizations
Time: 2:00 - 3:00 p.m. Central
Association of State and Territorial Health Officials, National Association of County and City Health Officials, National Coalition of STD Directors
llacy@ncsddc.org
Apr
11
Health Center FTCA Program CY2020 Deeming
Time: 2:00 p.m. Eastern
Health Resources and Services Administration
Apr
11-12
Substance Use Disorder Tools and Programs
Northwest Regional Primary Care Association
Boise, ID
206.783.3004
info@nwrpca.org
Apr
12
Medicaid Managed Care Organization (MCO) Training Sessions for CAH and Rural Hospitals, Part 2 of 3
Time: 10:00 - 11:00 a.m. Central
Illinois American Association of Healthcare Administrative Management (IL AAHAM), Illinois Association of Medicaid Health Plans (IAMHP), Illinois Critical Access Hospital Network
815.875.2999
Apr
12
Oral Health Infrastructure Toolkit
Time: 11:00 a.m. - 12:00 p.m. Central
Health Resources and Services Administration, National Network for Oral Health Access
Apr
16
CMS 1st Annual National Care Transitions Awareness Summit and Grand Rounds
CMS Care Transitions Affinity Group
Baltimore, MD
CareTransitionsAffinityGroup@cms.hhs.gov
Apr
16
Upper Midwest Telehealth Resource Center - Virtual Office Hours
Time: 12:30 - 1:30 p.m. Eastern
Upper Midwest Telehealth Resource Center
855.283.3734 Ext. 238
info@umtrc.org
Apr
18
Enhancing Relationships between Tribal and State Governments
Time: 3:00 - 4:00 p.m. Eastern
National Indian Health Board
Apr
18
Understanding Access on the Ground: The Experience of Veterans, Providers, and Staff
Time: 2:00 - 3:00 p.m. Central
U.S. Department of Veterans Affairs
Apr
18
Using Health Information Technology to Enhance Opioid Use Disorder Treatment
Time: 3:00 - 4:30 p.m. Eastern
Health Information Technology, Evaluation, and Quality Center (HITEQ)
Apr
18
Using the Community Commons New Assessment & Collections
Time: 1:00 - 2:00 p.m. Central
Community Commons
Apr
24
2019 ICAHN Professional Education Services, Succeeding in the Changing Culture of Healthcare, Part 1 of 3
Time: 11:00 a.m. - 12:00 p.m. Central
Illinois Critical Access Hospital Network
217.223.0452
Apr
26
Medicaid Managed Care Organization (MCO) Training Sessions for CAH and Rural Hospitals, Part 3 of 3
Time: 10:00 - 11:00 a.m. Central
Conference theme: Care Coordination and Escalation
Illinois Critical Access Hospital Network
815.875.2999
Apr
26
Upper Midwest Telehealth Resource Center - Virtual Office Hours
Time: 12:30 - 1:30 p.m. Eastern
Upper Midwest Telehealth Resource Center
855.283.3734 Ext. 238
info@umtrc.org
May
7
2019 24th NRHA Health Equity Conference
National Rural Health Association
Atlanta, GA
816.756.3140 ext.12
siress@NRHArural.org
May
7
2019 Rural Medical Education Conference
National Rural Health Association
Atlanta, GA
816.756.3140 ext.12
siress@NRHArural.org
May
7-10
2019 42nd Annual NRHA Rural Health Conference
National Rural Health Association
Atlanta, GA
816.756.3140 ext.12
siress@NRHArural.org
RHIhub staff will be presenting and exhibiting
May
7-10
2019 4th Rural Hospital Innovation Summit
National Rural Health Association
Atlanta, GA
816.756.3140 ext.12
siress@NRHArural.org
May
14
The Opioid Hydra: Understanding Mortality Epidemics and Syndemics Across the Rural-Urban Continuum
Time: 12:00 - 1:00 p.m. Central
National Network of Libraries of Medicine
319.335.4997
derek-d-johnson@uiowa.edu
May
14-15
2019 Annual Louisiana Rural Hospital Coalition Conference
Louisiana Rural Hospital Coalition
Baton Rouge, LA
May
20
Northeast Kansas Grants 101 Workshop
Health Resources and Services Administration, Kansas Department of Health and Environment, Kansas State University
Manhattan, KS
HRSAORORegion7@hrsa.gov
May
29-30
2019 Annual Oklahoma Rural Health Conference
Oklahoma Office of Rural Health, Rural Health Association of Oklahoma
Norman, OK
580.213.3177
agseigars@nwosu.edu
May
29-31
2019 Oregon Conference on Opioids & Other Drugs, Pain, and Addiction Treatment
Oregon Public Health Association
Bend, OR
503.244.5211
elizabethw@linesforlife.org
May-Jun
31-1
2019 27th Annual Health Provider Retreat
National Rural Recruitment & Retention Network, New Mexico Department of Health, New Mexico Health Resources, Inc.
Santa Ana Pueblo, NM
505.260.0993
nmhealth@nmhr.org
Jun
1
ANEW Way Forward: Innovations in Interprofessional Training Using Integrated Behavioral Models in Primary Care
National Center for Integrated Behavioral Health, University of Pennsylvania, School of Nursing
Philadelphia, PA
anewsymposiumevents@nursing.upenn.edu

Tell Us How RHIhub Has Impacted You

The Rural Health Information Hub is seeking your comments on how our services have helped you in your efforts to improve healthcare and population health in rural communities. Have the RHIhub services helped you to stay informed, get a grant, find the proper federal agency contact or other expert, or otherwise changed your life?

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