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RHIhub This Week - May 15, 2019

New in the Rural Monitor

Meg Moynihan at silo Preventing Farmer Suicides through Helplines and Farm Visits
by Allee Mead
Difficult economic conditions have caused many farmers to experience high levels of stress and a sense of hopelessness about saving their business and way of life. The Minnesota Farm & Rural Helpline and NY FarmNet are working to improve farmers’ mental health and prevent suicides.

Upcoming Webinar

Improving Oral Health Care Services in Rural America from the National Advisory Committee on Rural Health and Human Services
Adequate access to oral health services in rural areas is a persistent challenge, with approximately 34 million Americans living in rural areas designated as Dental Health Professional Shortage Areas.

Join us on Tuesday, May 21 at 12:00 p.m. Central as we hear oral health policy recommendations from the National Advisory Committee on Rural Health and Human Services' (NACRHHS).

 New in Our Online Library

Recent News

HHS: Establishment of the Interdepartmental Substance Use Disorders Coordinating Committee and Solicitation of Nominations for Committee Members
May 15, 2019 -- The U.S. Department of Health and Human Services is establishing an Interdepartmental Substance Use Disorders Coordinating Committee to identify areas for improved coordination across Federal agencies and with state and local efforts on substance abuse, as directed by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. HHS is seeking nominations for the committee, including at least one member with research or clinical mental health experience working with medically underserved populations. Nominations are due June 14, 2019.
Source: Federal Register

AHRQ: Agency Information Collection Activities: Proposed Collection; Comment Request
May 14, 2019 -- Request for information from the Agency for Healthcare Research and Quality (AHRQ) regarding potential revisions to the Consumer Assessment of Healthcare Providers and Systems Health Plan Survey (CAHPS), which addresses access to healthcare services among other areas. AHRQ would like feedback on current uses of the survey, what should stay the same, what should be added, and more. Comments are due June 13, 2019.
Source: Federal Register

Dealing With Hospital Closure, Pioneer Kansas Town Asks: What Comes Next?
May 14, 2019 -- Fort Scott's 132-year-old hospital closed, leaving many without jobs and the rural community with higher rates of chronic disease and preterm births without their hospital. For now, the emergency department, outpatient clinic, and physical therapy service remain, but their future is also uncertain.
Source: Kaiser Health News

The Medicare Promoting Interoperability Program Hardship Exception Application for Eligible Hospitals and Critical Access Hospitals is Now Available
May 14, 2019 -- The Centers for Medicaid and Medicare Services (CMS) is now accepting hardship exception applications for the meaningful electronic health record (EHR) use requirements from eligible hospitals and Critical Access Hospitals (CAHs). Without the exemption, hospitals must show that they meet the Promoting Interoperability Program EHR requirements.
Source: Centers for Medicare and Medicaid Services

VA: Veterans Care Agreements
May 14, 2019 -- Interim final rule from the Department of Veterans Affairs (VA) establishing the parameters of agreements for furnishing services to veterans outside of VA facilities, including in rural areas. It also allows payment rates for highly rural areas to exceed the limits set for other areas. The rule goes into effect May 14, 2019.
Source: Federal Register

HRSA Awards $24 Million to 120 Rural Organizations for Opioid Response
May 13, 2019 -- The Health Resources and Services Administration (HRSA) awarded $24 million to recipients in 40 states for the Rural Communities Opioid Response Program (RCORP) planning grants. The grants will support needs assessments, partnerships, and plans for substance use disorder prevention, treatment, and recovery efforts, including for opioid use disorder.
Source: Health Resources and Services Administration

Maryland's All-Payer Model Shows Limited Effects for Rural Hospitals
May 13, 2019 -- Rural hospitals in Maryland had fewer outpatient visits after implementation of Maryland's global budget program, but otherwise showed no change, according to a newly published research study. Viewpoints vary on what is working well or could be improved for Maryland's all-payer model.
Source: Healthcare Dive

‘Who’s Going to Take Care of These People?’
May 11, 2019 -- Fairfax Community Hospital in rural Oklahoma faces imminent closure after its outside ownership group declared bankruptcy. Its employees continue working for free, knowing how essential the hospital's services are to the community, hoping the community can regain control of the hospital or another management group can keep it running. (May require subscription to view full article.)
Source: Washington Post

Congress Mulls Pilot Program to Treat COPD Patients Via Telehealth
May 10, 2019 -- A proposed bill would create a 3-year pilot enabling respiratory therapists to provide care to Medicare beneficiaries with chronic obstructive pulmonary disease (COPD) using telehealth. The Better Respiration through Expanded Access to Tele-Health (BREATHE) Act is based on research showing that video-based care for COPD patients can reduce readmissions. COPD is particularly prevalent in rural areas.
Source: mHealthIntelligence

Health Resources and Services Administration’s National Health Service Corps New Site Application Cycle
May 9, 2019 -- The Health Resources and Services Administration's cycle for the 2019 National Health Service Corp New Site Application is open and has expanded eligibility to include facilities that provide general substance use disorder treatment, medication assisted treatment, and/or opioid treatment services. Applications are due by May 30, 2019.
Source: HRSA Bureau of Health Workforce

The Rural Philanthropic Analysis Project 2017-2019
May 9, 2019 -- Summarizes the work and findings of the Rural Philanthropic Analysis Project (RPAP) team. Addresses the rural philanthropic landscape, examples of rural philanthropic strategies, effective cultural and tactical elements, and recommendations for regional and national funders.
Source: Campbell University Blog

Putting our Rethinking Rural Health Strategy into Action
May 8, 2019 -- Blog post from the Centers for Medicare and Medicaid Services (CMS) Administrator about initiatives CMS has undertaken to advance rural health. Focuses on the CMS Rural Health Strategy, which seeks to reduce unintended CMS policy impacts on rural healthcare and strengthen rural health.
Source: Centers for Medicare and Medicaid Services

Funding & Opportunities

Forward Promise: Partnering with Systems to Disrupt Dehumanization
Grants to support the planning, implementation, and evaluation of partnership efforts between community-based organizations and youth-serving systems to address the root causes of health disparities and expand and promote the health and well-being of boys and young men of color.
Geographic coverage: Nationwide and U.S. Territories
Application Deadline: Jun 6, 2019
Sponsor: Robert Wood Johnson Foundation


Bus and Bus Facilities Infrastructure Program
Grants to assist in the financing of buses and bus facilities capital projects, including replacing, rehabilitating, purchasing, or leasing buses or related equipment, and rehabilitating, purchasing, constructing, or leasing bus-related facilities. A minimum of 10% of the total program funding will be awarded to projects located in rural areas.
Geographic coverage: Nationwide
Application Deadline: Jun 21, 2019
Sponsors: Federal Transit Administration, U.S. Department of Transportation


Sexual Risk Avoidance Education Program
Funding for projects to educate youth on how to voluntarily refrain from non-marital sexual activity and prevent other youth risk behaviors.
Geographic coverage: Nationwide and U.S. territories
Application Deadline: Jul 1, 2019
Sponsors: Administration for Children and Families, U.S. Department of Health and Human Services


Transitional Living Program
Grants to implement, enhance, and/or support effective strategies for successful transition to sustainable living for runaway and homeless youth ages 16 to under 22 and/or pregnant and parenting youth ages 16 to under 22 and their dependent children.
Geographic coverage: Nationwide
Application Deadline: Jul 1, 2019
Sponsors: Administration for Children and Families, U.S. Department of Health and Human Services


Public Transportation on Indian Reservations: Tribal Transit Program
Funding to support planning, capital, and operating assistance for tribal public transit services. Among other things, this funding supports partnerships working to expand access to health, medical, and social service providers.
Geographic coverage: Nationwide
Application Deadline: Jul 9, 2019
Sponsors: Federal Transit Administration, U.S. Department of Transportation


Dissemination and Implementation Research in Health (R01, R03, and R21)
Funding for research that seeks to identify, develop, test, evaluate, and/or refine strategies to disseminate and implement evidence-based practices into public health, clinical practice, and community settings. This program is featured in the Division of Cancer Control and Population Sciences Selected List of Funding Opportunities Relevant to Rural Cancer Control.
Geographic coverage: Nationwide and U.S. territories
Application Deadline: May 7, 2022
Sponsors: National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services


Strengthening the Tribal Response to Violence Against Native Women
Training, technical assistance, and resources designed to help individual tribal governments and tribal communities strengthen the response to effectively address sexual assault, domestic violence, dating violence, and stalking.
Geographic coverage: Nationwide
Applications accepted on an ongoing basis
Sponsor: Tribal Law and Policy Institute

New Resources

Case Study: New Mexico
Reports the results of a field study focused on rural New Mexico documenting how philanthropy and community can support rural vitality. Part of the Rural Philanthropic Analysis series.
Sponsoring organization: Campbell University Office of Rural Philanthropic Analysis
Date: 05/2019


CDC Telebriefing: Pregnancy-Related Deaths Happen Before, During, and Up to a Year after Delivery
Press briefing discussing the recently released Vital Signs: Pregnancy-Related Deaths, United States, 2011–2015, and Strategies for Prevention, 13 States, 2013–2017. Includes a question and answer session with: Ann Schuchat, the Principle Deputy Director of the Centers for Disease Control and Prevention (CDC); Wanda Barfield, the director of CDC's Division of Reproductive Health and Assistant Surgeon General in the U.S. Public Health Service; and Emily Peterson, a medical officer in the Division of Reproductive Health and lead of CDC’s Pregnancy Mortality Surveillance System (PMSS). Includes discussion on maternal mortality disparities among different racial/ethnic groups and in rural areas.
Additional links: Audio Recording
Sponsoring organization: Centers for Disease Control and Prevention
Date: 05/2019


Comparing Buprenorphine-Prescribing Physicians Across Nonmetropolitan and Metropolitan Areas in the United States
Highlights a study comparing buprenorphine prescribing rates between metro and nonmetro areas. Looks at physician treatment practices, characteristics, and practice location.
Author(s): Lewei (Allison) Lin, Hannah K. Knudsen
Location: Annals of Family Medicine, 17(3), 212-220
Date: 2019


Family Physicians' Contributions to Rural Emergency Care and Urban Urgent Care
Presents a study on the role of family physicians play in rural versus urban emergency departments. Compares rates in urban, large rural, small rural, and frontier facilities.
Author(s): Lars E. Peterson, James C. Puffer, Urooj Nasim, Stephen Petterson, Warren P. Newton
Location: Journal of the American Board of Family Medicine, 32(3), 295-296
Date: 05/2019


Implementing the 21st Century Cures Act: Making Electronic Health Information Available to Patients and Providers, Part II
Provides a recording of a hearing from the U.S. Senate Committee on Health, Education, Labor and Pensions on implementation of the 21st Century Cures Act, which is intended to improve interoperability of electronic health records. Addresses requirements that would impact healthcare facilities, including rural hospitals and Critical Access Hospitals. Includes testimony from the Office of the National Coordinator of Health Information Technology and the Center for Medicare and Medicaid Services Center for Clinical Standards and Quality.
Additional links: Kate Goodrich Testimony
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
Date: 05/2019


Medicare Physician Payment Reform After Two Years: Examining MACRA Implementation and the Road Ahead
Provides a recording of a U.S. Senate Committee on Finance hearing on physician payment reforms under the Medicare Access and CHIP Reauthorization Act (MACRA). Features testimonies about what is working well and challenges faced, including provisions and challenges for small and rural practices. Contains testimonies from the American Medical Association, American Academy of Family Physicians, American College of Surgeons, American Medical Group Association, and Brookings Institution.
Additional links: American Medical Association Testimony, John Cullen Testimony, Scott Hines Testimony
Sponsoring organization: Senate Committee on Finance
Date: 05/2019


National Ambulatory Medical Care Survey: 2016 National Summary Tables
Provides data on outpatient visits to physician offices, with information on physician practice, patient, and visit characteristics. Tables 1, 13, 19, and 30 include data by metropolitan status for metro and nonmetro areas.
Sponsoring organization: National Center for Health Statistics
Date: 05/2019


Opioids in Appalachia: The Role of Counties in Reversing a Regional Epidemic
Details the state of the opioid epidemic in Appalachia and presents recommendations to help county leaders respond to the opioid crisis. Features individual county case studies highlighting the challenges and strategies in addressing the opioid crisis.
Additional links: Executive Summary
Sponsoring organization: National Association of Counties
Date: 05/2019


Opportunities to Advance Complex Care in Rural and Frontier Areas
Examines obstacles rural and frontier healthcare organizations face in providing complex care based on interviews with experts around the U.S. Focuses on rural social determinants of health, workforce shortages, and rural community relationships. Includes examples of models related to community collaboration, care coordination, social determinants of health, the health workforce, technology, and payment.
Sponsoring organization: Center for Health Care Strategies
Date: 05/2019


Oversight Hearing on "The President's FY2020 Budget Request for Indian Programs"
Provides a recording of a U.S. Senate Committee on Indian Affairs hearing on the President's Fiscal Year (FY) 2020 budget request for Indian programs, including the Indian Health Service. Includes testimony from the Bureau of Indian Affairs, Indian Health Service, National Congress of American Indians, and the National Indian Health Board.
Additional links: Chris Buchanan Testimony, Jefferson Keel Testimony, National Indian Health Board Testimony
Sponsoring organization: Senate Committee on Indian Affairs
Date: 05/2019


Poverty, Urban-Rural Classification and Term Infant Mortality: A Population-Based Multilevel Analysis
Determines the association between county poverty and rurality with term infant mortality by analyzing 2013 birth-infant death data from the National Center for Health Statistics. Includes county poverty statistics by rural and urban residence, maternal characteristics, and health and obstetric characteristics.
Author(s): Yousra A. Mohamoud, Russell S. Kirby, Deborah B. Ehrenthal
Location: BMC Pregnancy & Childbirth, 19, 40
Date: 2019


Primary Care Physician Characteristics Associated with Low Value Care Spending
Highlights study on the relationship between low value care (LVC) and the characteristics of primary care physicians. Looks at physicians' patient panel size, specialty, and region, among other characteristics.
Author(s): Tyler W. Barreto, Yoonkyung Chung, Peter Wingrove, et al.
Location: Journal of the American Board of Family Medicine, 32(2), 218-225
Date: 03/2019


Rural Communities Opioid Response Program
Details the multi-year initiative to overcome barriers to access of prevention, treatment, and recovery for substance use disorder (SUD). Features a national, county-level map highlighting where funding has been allocated to rural communities for SUD programs.
Sponsoring organization: Health Resources and Services Administration

Rural/Urban and Regional Variation in the 2019 CMS Hospital Wage Index
Findings brief describing the geographic variation in the 2019 Centers for Medicare and Medicaid Services (CMS) hospital wage index by rural and urban definitions. Includes data comparisons for rural and urban definitions by Census region, frontier and remote (FAR) codes, and state.
Sponsoring organization: North Carolina Rural Health Research Program
Date: 05/2019


The Special Diabetes Program for Indians: Estimates of Medicare Savings
Examines the potential Medicare savings due to the Special Diabetes Program for Indians (SDPI) efforts in providing diabetes prevention and treatment services to American Indians and Alaska Natives. Focuses on diabetes prevalence and end-stage renal disease related to diabetes. Appendix II includes additional information about the Special Diabetes Program for Indians.
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
Date: 05/2019


Statement of Chairman Ajit Pai, Federal Communications Commission: Hearing on the FCC's Fiscal Year 2020 Budget Request
Offers a statement from the Federal Communications Commission (FCC) Chairman on the 2020 FCC budget at a hearing before the U.S. Senate Committee on Appropriations Subcomittee on Financial Services and General Government. Addresses federal investments in rural broadband and the rural healthcare program, the impact of those investments, and future plans.
Sponsoring organizations: Federal Communications Commission, Senate Committee on Appropriations
Date: 05/2019


An Update on the President’s Commission on Combating Drug Addiction and the Opioid Crisis: One Year Later
Report details a one year update to the President's Commission on Combating Drug Addiction and the Opioid Crisis. Highlights the commission's accomplishments and examines its initial objectives. Includes rural references throughout.
Sponsoring organization: The White House
Date: 05/2019

Open Calls for Contributions

Call for Proposals: 2019 Wisconsin Healthcare Workforce Summit
Deadline: Jun 1, 2019
Wisconsin Council on Medical Education and Workforce
Event Dates: Sep 24, 2019
Oshkosh, WI
Conference Website

Call for Presentations: 2019 12th Annual Rural Youth Substance Abuse Prevention Conference
Deadline: Jun 3, 2019
Coalition for Healthy Youth
Event Dates: Aug 7 - 9, 2019
Lancaster, SC
Conference Website

Call for Abstracts: 2019 3rd Annual National Native Health Research Training Conference
Deadline: Aug 1, 2019
Indian Health Service
Event Dates: Sep 23 - 25, 2019
Temecula, CA
Conference Website

Upcoming Events

May
16
CMS Quality Payment Program: MIPS Group Participation Overview in 2019 (Year 3)
Time: 1:00 - 2:00 p.m. Eastern
Centers for Medicare and Medicaid Services
CMSQualityTeam@ketchum.com
May
21
Improving Oral Health Care Services in Rural America from the National Advisory Committee on Rural Health and Human Services
Time: 12:00 - 1:00 p.m. Central
National Advisory Committee on Rural Health and Human Services, Rural Health Information Hub
webinars@ruralhealthinfo.org
May
21
RWJF Life in Rural America Symposium
Also available by livestream
Robert Wood Johnson Foundation
Charleston, WV
May
21
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
21-22
Collaborating to Combat a Crisis Symposium
Big Country Area Health Education Center, Prevention Resource Center
Abilene, TX
jjones@abirecovery.org
May
22
Long-Term Services and Supports: Changing Tribal Demographics in Post-Acute Care
Time: 1:00 - 2:00 p.m. Central
Centers for Medicare and Medicaid Services
ltssinfo@kauffmaninc.com
May
30
Effectiveness of Opioids for Chronic Pain - the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) Trial in Context
Time: 12:00 - 1:00 p.m. Central
U.S. Department of Veterans Affairs
Jun
3-5
Native HOPE 3-Day Training Conference
Native HOPE
Albuquerque, NM
505.897.7968
maha@nativeprideus.org
Jun
12-13
2019 3rd Annual South Dakota Rural Health Leaders Conference
South Dakota Association of Healthcare Organizations, South Dakota Healthcare Financial Management Association, South Dakota Office of Rural Health
Sioux Falls, SD
605.361.2281
info@sdaho.org
Jun
20
Upper Midwest Telehealth Resource Center - Telebehavioral Health
Time: 12:00 - 1:00 p.m. Eastern
Upper Midwest Telehealth Resource Center
855.283.3734 Ext. 238
info@umtrc.org
Jun
23-26
2019 WSHA Rural Hospital Leadership Conference
Washington State Hospital Association
Chelan, WA
206.216.2519
ashleyb@wsha.org
Jun
24
2019 Opioid Crisis Next Door: It's Everybody's Business
Illinois Critical Access Hospital Network
Springfield, IL
kfauble@icahn.org
Jun
24
Risk Management 101
Rural Wisconsin Health Cooperative, Wisconsin Office of Rural Health
Sauk City, WI
JWagner@rwhc.com
Jun
27
Targeted Rural Health Education?
Time: 1:00 - 2:00 p.m. Eastern
Rural PREP
206.616.0235
rprep@uw.edu
Jul
9
Agricultural Health and Safety Course for Medical and Safety Professionals - Session C - Special Topics
Available online beginning July 9, 2019
Ag Health & Safety Alliance, AgriSafe Network, Nebraska, Central States Center for Agricultural Safety and Health, Great Plains Center for Agricultural Health, University of Nebraska Medical Center
402.552.3394
ellen.duysen@unmc.edu
Jul
9
Telehealth 101: The Easy Basics of Telehealth and Telemedicine
Time: 12:00 - 1:00 p.m. Central
South Central Telehealth Resource Center
info@learntelehealth.org
Jul
9-10
2019 Annual NRHA State Rural Health Association (SRHA) Leadership Conference
National Rural Health Association
Denver, CO
lhudson@nrharural.org
Jul
9-10
Agricultural Health and Safety Course for Medical and Safety Professionals - Session A - Agricultural Health
Ag Health & Safety Alliance, AgriSafe Network, Nebraska, Central States Center for Agricultural Safety and Health, Great Plains Center for Agricultural Health, University of Nebraska Medical Center
Omaha, NE
402.552.3394
ellen.duysen@unmc.edu
Jul
9-11
2019 Annual NACCHO Conference
National Association of County and City Health Officials
Orlando, FL
202.507.4245
nacchoannualreg@naccho.org
Jul
10-11
2019 Flex Program Reverse Site Visit
Federal Office of Rural Health Policy, National Rural Health Resource Center
Washington, DC
218.216.7028
nclement@ruralcenter.org
Jul
11-12
Agricultural Health and Safety Course for Medical and Safety Professionals - Session B - Agricultural Safety and Prevention
Ag Health & Safety Alliance, AgriSafe Network, Nebraska, Central States Center for Agricultural Safety and Health, Great Plains Center for Agricultural Health, University of Nebraska Medical Center
Omaha, NE
402.552.3394
ellen.duysen@unmc.edu
Jul
12
Introduction to the UDS Mapper
Time: 1:00 - 2:00 p.m. Central
American Academy of Family Physicians, Health Resources and Services Administration

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.