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RHIhub This Week - July 10, 2019

New in the Rural Monitor

Woman standing alone looking out a window Social Isolation and Loneliness: Insights from Rural Clinical Providers and Other Experts
by Kay Miller Temple, MD
As more healthcare delivery efforts include social risk assessments, the impact of the social determinants of health is better understood. Rural clinicians, researchers, and other experts share perspectives on social isolation and loneliness.

Models and Innovations

PHN logo West Virginia's Partners In Health Network Regional Collaborative Services
A West Virginia nonprofit membership organization offers credentialing services and a secure web-based case management data collection tool.

 New in Our Online Library
 Information from around the web

Recent News

HHS Announces Quality Summit to Streamline and Improve Quality Programs Across Government
Jul 9, 2019 -- The U.S. Department of Health and Human Services (HHS) has announced the formation of a Quality Summit, which will bring together industry stakeholders and government leaders to discuss how current programs can be adapted to deliver a value-based care model to improve outcomes for patients and access to care. The goal, as described in the Quality Summit fact sheet, will be to improve reporting on data and quality measures, in keeping with President Trump's Executive Order on price and quality transparency in healthcare. Nominations for participation in the Summit will be accepted via email until July 21, 2019.
Source: U.S. Department of Health and Human Services

New AAFP Initiative Addresses Rural Health Care Crisis
Jul 9, 2019 -- The American Academy of Family Physicians (AAFP) is launching an Academy-wide strategic initiative to improve healthcare in rural areas. The goals are to influence policy and payment issues, address educational needs for physicians, support recruitment of physicians to rural areas, and help family physicians improve rural health disparities.
Source: American Academy of Family Physicians

VA: Notice of Request for Information on Information and Documentation Required for Clean Claims for Care and Services
Jul 9, 2019 -- Request from the Department of Veterans Affairs (VA) for input regarding what information and documentation VA should require non-federal healthcare entities and providers to submit with certain claims for payment for hospital care, medical services, or extended care services. Comments are due August 8, 2019.
Source: Federal Register

Amid an Urgent Public Health Crisis, a Bid to Find Better Ways to Curb Opioid Abuse
Jul 8, 2019 -- A Michigan collaborative comprising public and private funders, state government, and an insurance company has received a $5 million series of grants to remove barriers to effective treatment for opioid use disorder. The initiative will encourage adoption of medication-assisted treatment, prioritizing rural areas, and will emphasize care that puts patients first.
Source: Inside Philanthropy

Caring for the Most Vulnerable Victims of the Opioid Crisis: Newborns
Jul 8, 2019 -- As more women face opioid addictions, rural hospitals such as Alice Hyde Medical Center are seeing an increase in Neonatal Abstinence Syndrome (NAS) births. Many of those births have additional complications, as the hospitals try to help both mother and child.
Source: VTDigger

With Rural Health Care Stretched Thin, More Patients Turn To Telehealth
Jul 7, 2019 -- Nearly a quarter of rural Americans have used some kind of telehealth service, as shown by a new poll on rural life and health. Barriers still remain though, including broadband access and insurance regulations.
Source: National Public Radio

Small and Rural or Large and Urban—Health Systems' Size Influences Decisionmaking
Jul 6, 2019 -- Discussion with 3 chief financial officers regarding the impact of hospital size on decisions regarding consolidation, price transparency, outsourcing, risk-based contracts, and cost accounting. Includes CFOs from 2 rural hospitals. (Subscription may be required to view article.)
Source: Modern Healthcare

Exchange Programs Think Beyond Urban vs. Rural
Jul 5, 2019 -- Rural-Urban Exchange Programs are being used to create productive dialogue and relationships between those in rural and urban locations of states across the country who are all working to build healthy sustainable communities.
Source: Stateline, Pew Charitable Trusts

Audiology Telehealth: Helping Rural Veterans Access Hearing Evaluations
Jul 3, 2019 -- A new Department of Veterans Affairs pilot program is using audiology store and forward telehealth technology to provide access to hearing tests for rural veterans.
Source: U.S. Department of Veterans Affairs

Funding & Opportunities

Farm Labor Housing Direct Loans and Grants
Low interest loans and need-based grants to develop affordable housing for year-round, migrant, or seasonal domestic farm laborers.
Geographic coverage: Nationwide
Application Deadline: Aug 30, 2019
Sponsors: U.S. Department of Agriculture, USDA Rural Development, USDA Rural Housing Service

3RNet Recruitment and Retention Assistance
Helps health professionals find jobs in rural and underserved areas and assists employers in recruiting and retaining health professionals in rural and underserved areas.
Geographic coverage: Nationwide and U.S. Territories
Applications accepted on an ongoing basis
Sponsor: National Rural Recruitment & Retention Network

SBA 7(a) Guaranteed Loans
Loan guarantees to financial institutions that provide loans to small businesses (including small healthcare practices) for working capital, equipment purchase, real estate purchase, building construction/renovation, business acquisition, and debt refinancing.
Geographic coverage: Nationwide
Applications accepted on an ongoing basis
Sponsor: Small Business Administration

SBA Certified Development Company (504) Loan Program
Provides small businesses with long-term, fixed-rate financing for major fixed assets, such as land and buildings. 504 Loans are potential options for healthcare practitioners who want to build a new office or expand or renovate an existing medical building.
Geographic coverage: Nationwide
Applications accepted on an ongoing basis
Sponsor: Small Business Administration

Telecommunications Infrastructure Loans and Loan Guarantees
Loans and loan guarantees for the construction, maintenance, improvement, and expansion of telephone service and broadband in rural areas.
Geographic coverage: Nationwide
Applications accepted on an ongoing basis
Sponsors: U.S. Department of Agriculture, USDA Rural Utilities Service

USDA Community Facilities Direct Loan and Grant Program
Direct USDA loans and/or grants to construct, enlarge, or improve essential community facilities for healthcare, public safety, education, and public services in rural areas.
Geographic coverage: Nationwide
Applications accepted on an ongoing basis
Sponsors: U.S. Department of Agriculture, USDA Rural Development

Water and Waste Disposal Loan and Grant Program
Funding for clean and reliable drinking water systems, sanitary sewage disposal, sanitary solid waste disposal, and storm water drainage to households and businesses in eligible rural areas.
Geographic coverage: Nationwide
Applications accepted on an ongoing basis
Sponsors: U.S. Department of Agriculture, USDA Rural Development

Water and Waste Disposal Loan Guarantees
A loan guarantee program that helps private lenders provide affordable financing to qualified borrowers to improve access to clean, reliable water and waste disposal systems for households and businesses in rural areas.
Geographic coverage: Nationwide
Applications accepted on an ongoing basis
Sponsors: U.S. Department of Agriculture, USDA Rural Development

Zero Suicide Academy
A 2-day training for senior leaders of healthcare and behavioral healthcare organizations that seek to dramatically reduce suicides among patients in their care.
Geographic coverage: Nationwide
Applications accepted on an ongoing basis
Sponsors: Education Development Center, Inc., National Action Alliance for Suicide Prevention

New Resources

3 Questions to Integrate Substance Use Disorder Services into Primary Care
Fact sheet providing examples of tools and potential mentoring opportunities for providing substance use disorder treatment services in rural areas.
Sponsoring organization: National Organization of State Offices of Rural Health
Date: 06/2019

At the Front Lines in Tennessee: Rural Clinic Offers Trauma-Informed Treatment for Substance Use Disorder
Describes the work of a rural Tennessee physician who uses medication-assisted treatment, cognitive behavioral therapy, and group therapy sessions to treat patients struggling with substance use disorder. Explores the connection between adverse childhood experiences and substance abuse, and stigma associated with seeking treatment.
Sponsoring organization: Center for Health Care Strategies
Date: 06/2019

Factors Determining Patients' Choice Between Mobile Health and Telemedicine: Predictive Analytics Assessment
Results of a study to examine factors influencing the choice of communication medium for receiving healthcare, through analysis of mobile health versus telemedicine visits with a virtual urgent clinic. Features statistics including demographics of virtual urgent clinic users, with breakdowns by urban and rural settings.
Author(s): Saif Khairat, Songzi Liu, Tanzila Zaman, Barbara Edson, Robert Gianforcaro
Location: JMIR Mhealth Uhealth, 7(6)
Date: 06/2019

Guidance to States and School Systems on Addressing Mental Health and Substance Use Issues in Schools
Report provides guidance to school systems and state governments about mental health and substance use in schools. Highlights examples of methods to identify and address mental health issues and substance use in schools. Discusses state-level Medicaid funding for behavioral health.
Sponsoring organizations: Centers for Medicare and Medicaid Services, Substance Abuse and Mental Health Services Administration
Date: 07/2019

Infectious Diseases Society of America Position Statement on Telehealth and Telemedicine as Applied to the Practice of Infectious Diseases
Position statement to educate members of the Infectious Diseases Society of America on telehealth and to promote use of this technology in clinical care, research, and education. Explores the potential to increase access to subspecialist care in rural areas, and describes reimbursement policies of private insurers, Medicare, and Medicaid, for telehealth services provided to patients in rural areas. Also describes HIPAA requirements for telehealth interactions and protected health information.
Author(s): Jeremy D. Young, Rima Abdel-Massih, Thomas Herchline, et al.
Location: Clinical Infectious Diseases, 68(9), 1437-1443
Date: 05/2019

Location of Medication-Assisted Treatment for Opioid Addiction: In Brief
Examines the location of providers who offer medication-assisted treatment (MAT) for opioid use disorder based on the location of providers with Drug Addiction Treatment Act (DATA) waivers and federally certified opioid treatment programs. Includes maps showing the location of both by county. Addresses the number of rural counties with no providers and policy options for rural access to MAT.
Sponsoring organization: Congressional Research Service
Date: 06/2019

On the Path to Health Equity: Building Capacity to Measure Health Outcomes in Community Development
Report details the role of social determinants of health in perpetuating health inequities in communities. Highlights strategies for communities to address these inequities in both rural and urban areas.
Sponsoring organizations: Enterprise Community Partners, NeighborWorks America
Date: 2019

The Oral Health of American Indian and Alaska Native Children Aged 1-5 Years: Results of the 2018-19 IHS Oral Health Survey
Details the results of a survey on the oral health of American Indian and Alaska Native children ages 1-5. Compares rates to other groups and with rates from 2010 and 2014. Discusses the potential negative health effects of poor oral health during childhood.
Sponsoring organization: Indian Health Service
Date: 04/2019

Planning, Conducting and Leveraging Primary Care Office Needs Assessments
Issue brief highlighting components unique to primary care offices (PCOs) and offering resources on promising practices. Intended to build knowledge regarding PCO needs assessment.
Sponsoring organization: National Organization of State Offices of Rural Health
Location: NOSORH Issue Brief, 1(3)
Date: 07/2019

Resource Guide: Promising Programs in Native American Communities
Highlights promising programs for tribal communities in Montana. Features programs to support mental health and suicide prevention, substance abuse, social determinants of health, and diabetes prevention, among other issues.
Sponsoring organization: Montana Healthcare Foundation
Date: 05/2019

The Role of Hospitals in Population Health: Findings from National Conversations, Statewide Survey and Local Perspectives
Reviews the literature on population health and the role of hospitals and health systems in advancing population health. Discusses efforts by hospitals to address population health at a national level based on interviews with key informants, and in Kansas based on an online survey and discussions with hospitals. Offers recommendations for organizations interested in engaging with population health efforts.
Additional links: Executive Summary
Sponsoring organization: Kansas Health Institute
Date: 06/2019

Rural Success: Dahl Memorial Healthcare Association, MT
Highlights a frontier Critical Access Hospital in Ekalaka, Montana, with a focus on their quality improvement efforts. Covers their plans for a new building, updated electronic health records system, antibiotic stewardship efforts, and training to improve Emergency Department Transfer Communication (EDTC).
Sponsoring organization: Stratis Health
Location: MBQIP Monthly, 1-2
Date: 07/2019

Team-Based Clinic Redesign of Opioid Medication Management in Primary Care: Effect on Opioid Prescribing
Study examines an opioid medication management redesign in 20 rural primary care clinics. Looks at daily opioid usage rates of long-term opioid therapy patients before and after the redesign.
Author(s): Michael L. Parchman, Robert B. Penfold, Brooke Ike, et al.
Location: Annals of Family Medicine, 17(4), 319-325
Date: 07/2019

Open Calls for Contributions

Call for Topics: Connections 2020 - 9th Biannual Conference
Deadline: Sep 16, 2019
Healthcare Georgia Foundation
Event Dates: Mar 30 - 31, 2020
Conference Website

Upcoming Events

Bureau of EMS & Trauma System's EMS Resiliency, Wellness & Safety Summit
Arizona Department of Health Services
Kingman, AZ
Hepatitis B and the Opioid Epidemic: Opportunities to Increase Adult Vaccination
Time: 12:00 p.m. Pacific
Association of Asian Pacific Community Health Organizations
Preparing Rural Nurses to Care for Sexual Assault Victims
Time: 12:00 - 1:00 p.m. Eastern
Indiana Rural Health Association
Primary Care and Behavioral Health Integration: Building Workforce Capacities
Time: 3:00 - 4:30 p.m. Eastern
Call-in: 877.917.4906
Passcode: 9450742
Health Resources and Services Administration
Rural Reach: A Strategic Approach to Reaching the Rural Poor
Time: 12:00 - 1:00 p.m. Eastern
Indiana Rural Health Association
The Balancing Act: Maximizing Quality Care and Profitability in a Rural Therapy Department
Time: 10:00 - 11:00 a.m. Mountain
Idaho Hospital Association
Using Social Media for Recruitment
Time: 12:00 - 1:00 p.m. Eastern
Indiana Rural Health Association
From Classroom to Community: A Case Study on Chronic Disease Management
Time: 12:00 - 1:00 p.m. Eastern
Indiana Rural Health Association
812.478.3919 Ext. 235
2019 12th Annual Missouri Rural Health Conference
Missouri Hospital Association, Missouri Office of Rural Health and Primary Care, Missouri Primary Care Association, Missouri Rural Health Association
Camdenton, MO
2019 17th Annual Mid-South Critical Access Hospital Conference
Alabama Hospital Association, Alabama Office of Primary Care and Rural Health, Arkansas Department of Health, Arkansas Hospital Association, Kentucky Hospital Association, Kentucky Hospital Research and Education Foundation, Kentucky State Office of Rural Health, Louisiana Department of Health, Louisiana Hospital Association, Mississippi Hospital Association, Mississippi Office of Rural Health, Tennessee Department of Health, Tennessee Hospital Association
Nashville, TN
2019 23rd Annual Tribal Leaders Summit & Trade Show
United Tribes Technical College
Bismarck, ND
2019 59th Annual Nevada Hospital Association Meeting
Nevada Hospital Association
Incline Village, NV
2019 74th Annual Wyoming Hospital Association Meeting and LeadingAge Wyoming Annual Meeting and Convention
Wyoming Hospital Association
Cheyenne, WY
2019 Region E SORH Regional Partnership Meeting
Federal Office of Rural Health Policy, National Organization of State Offices of Rural Health
Portland, OR
888.391.7258 Ext. 102
2019 42nd Annual Pennsylvania EMS Conference
Pennsylvania Department of Health, Pennsylvania Emergency Health Services Council
Manheim, PA
2019 Annual Kansas Hospital Association Convention and Trade Show
Kansas Hospital Association
Wichita, KS
2019 Annual Hawaii Health Workforce Summit
Hawaii and Pacific Basin Area Health Education Centers, Hawaii State Department of Health, University of Hawaii Manoa, John A. Burns School of Medicine
Honolulu, HI
2019 Community Paramedicine/Mobile Integrated Health Conference
Atrium Health
Charleston, SC
Arizona Telemedicine Program - Developing a Telemedicine Program (Phoenix)
Arizona Telemedicine Program
Phoenix, AZ
Arizona Telemedicine Program - Developing a Telemedicine Program (Tucson)
Arizona Telemedicine Program
Tucson, AZ
Introduction to the UDS Mapper
Time: 1:00 - 2:00 p.m. Central
American Academy of Family Physicians, Health Resources and Services Administration
Rural Veteran Suicide Prevention
Time: 3:00 - 4:00 p.m. Eastern
U.S. Department of Veterans Affairs

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