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RHIhub This Week - March 18, 2020

New RHIhub Issue Guide

Covid-19 Rural Response to Coronavirus Disease 2019 (COVID-19)
RHIhub This Week emails will continue to feature the latest information and resources on coronavirus disease 2019 (COVID-19). See our COVID-19 guide for ongoing coverage of information and activities underway to address COVID-19, including federal and state resources to help communities and healthcare facilities respond to this issue.

Upcoming Webinar

Linking Research to Rural Communities with the NIH National Center for Advancing Translational Sciences
Join us Tuesday, March 31 at noon Central as our featured speakers Kay Miller Temple, Michael Kurilla, and Laura James discuss the NIH National Center for Advancing Translational Sciences (NCATS) and their efforts to include rural populations in research, as featured in an October 2019 Rural Monitor article.

 New in Our Online Library
 Information from around the web

Recent News

News about COVID-19

CDC Webinar: Update for Rural Partners, Stakeholders, and Communities on the Coronavirus Disease 2019 (COVID-19) Response
Mar 17, 2020 -- The Centers for Disease Control and Prevention (CDC) announced a webinar to update rural stakeholders on the coronavirus disease 2019 (COVID-19). The call will be held Monday, March 23, 2020.
Source: Centers for Disease Control and Prevention

CMS Sends Guidance to Programs of All-Inclusive Care for the Elderly (PACE) Organizations
Mar 17, 2020 -- The Centers for Medicare and Medicaid Services (CMS) issued guidance to all Programs of All-Inclusive Care for the Elderly (PACE) Organizations in response to the 2019 novel coronavirus (COVID-19) pandemic. PACE is a Medicare and Medicaid program that serves older adults that often have serious medical conditions. The guidance offers actionable information with respect to infection control among these populations.
Source: Centers for Medicare and Medicaid Services

Coronavirus Threatens Strained Rural Health Care System
Mar 17, 2020 -- Features a rural county in Texas whose severely ill residents must travel at least 90 miles for care. Describes the numerous challenges rural areas face should they encounter a coronavirus outbreak and includes information on how states are combating the spread of the virus.
Source: Pew Charitable Trusts

OCR Announces Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency
Mar 17, 2020 -- The Office for Civil Rights (OCR) at the U.S Department of Health and Human Services (HHS) announced it will waive potential penalties for HIPAA violations against healthcare providers that utilize communication platforms, i.e. Skype, for telehealth services during the COVID-19 outbreak. Includes further guidance for healthcare providers on responsibly offering telehealth to patients.
Source: U.S. Department of Health and Human Services

President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak
Mar 17, 2020 -- The Centers for Medicare and Medicaid Services (CMS) announced it will temporarily pay clinicians to provide telehealth services for Medicare beneficiaries across the country. Describes how Medicare beneficiaries can now receive various telehealth services from any healthcare facility or their home to help reduce the risk of COVID-19 transmission.
Source: Centers for Medicare and Medicaid Services

EOP: Making General Use Respirators Available
Mar 16, 2020 -- Notice from the Executive Office of the President, stating that, due to the anticipated shortage of personal respirator devices, the U.S. Secretary of Health and Human Services shall take appropriate and necessary steps to facilitate the emergency use of general use respirators by healthcare personnel to help prevent the spread of COVID-19.
Source: Federal Register

Rural Hospitals Brace for Coronavirus
Mar 16, 2020 -- Features a 15-bed, rural hospital in Idaho and discusses how the novel coronavirus disease could overwhelm their facility. Hospital staff visit local businesses and schools to inform on prevention measures.
Source: NPR

'We'll Improvise': A Resource-Starved Rural Hospital Steels Itself for Coronavirus's Arrival
Mar 14, 2020 -- Features a hospital in rural Washington that is bracing itself for the arrival of the novel coronavirus disease. With already limited resources, the hospital struggles to find supplies as hospital vendors ration equipment. (May require a subscription to view full article).
Source: The Washington Post

CMS Takes Action Nationwide to Aggressively Respond to Coronavirus National Emergency
Mar 13, 2020 -- The Centers for Medicare and Medicaid Services (CMS) announced they will be taking actions to follow the President's declaration of a national emergency through the Stafford Act due to COVID-19. Details administrative actions regarding waivers and flexibilities for healthcare facilities, provider enrollment flexibilities, relief for State Medicaid Agencies, and suspension of enforcement activities.
Source: Centers for Medicare and Medicaid Services

Coronavirus Challenges County Public Health Departments
Mar 13, 2020 -- Discusses measures public health departments are taking to respond to the novel coronavirus outbreak in their counties, including limiting public gatherings, school cancellations, and setting up testing sites. Describes how public health officials need to tailor plans to their communities.
Source: National Association of Counties

Trump Declares COVID-19 Emergency, Asks Hospitals to Activate Emergency Plans
Mar 13, 2020 -- President Donald Trump declared the COVID-19 outbreak a national emergency and asked hospitals to activate emergency preparedness measures. Highlights that the HHS secretary has authority to waive several hospital requirements, including limits on number of beds and length of stay in Critical Access Hospitals, state provider license restrictions, telemedicine requirements. (May require a subscription to view full article).
Source: Modern Healthcare

CDC to Award Over $560 Million to State & Local Jurisdictions in Support of COVID-19 Response
Mar 11, 2020 -- The Department of Health and Human Services (HHS) announced that the Centers for Disease Control and Prevention (CDC) is distributing funding to state and local jurisdictions to support the nation's response to the coronavirus disease 2019 (COVID-19). The $560 million in funds will allow public health leaders to implement strategies to contain the spread of the virus.
Source: U.S. Department of Health and Human Services

News about other topics

AHRQ: Agency Information Collection Activities: Proposed Collection; Request
Mar 18, 2020 -- Request for information from the Agency for Healthcare Research and Quality (AHRQ) regarding innovative approaches to managing opioid medications for chronic pain in older adults. AHRQ will use the information for planning purposes and does not intend to comment on responses. Submissions are due by April 25, 2020.
Source: Federal Register

Six RVs to Help Rural Colorado's Opioid Addiction Are Coming to a Parking Lot near You
Mar 16, 2020 -- Highlights a traveling RV program that provides medication-assisted treatment to those addicted to opioids across rural Colorado. Each RV has a nurse, an addiction counselor, and a peer coach, as well as telehealth services to connect patients with a doctor who can write prescriptions.
Source: The Colorado Sun

The Startling Inequality Gap That Emerges After Age 65
Mar 12, 2020 -- Summarizes an analysis that found seniors living in urban areas are surviving longer than seniors in rural areas. Discusses how access to medical treatments, community culture, and tobacco use can contribute to these health disparities.
Source: Kaiser Health News

Funding & Opportunities

AARP Community Challenge
Grants for projects that work to improve livability for all residents of a community.
Geographic coverage: Nationwide
Application Deadline: Apr 1, 2020
Sponsor: AARP

Accelerating Innovative Mobility (AIM) Challenge Grants
Grants for the development, implementation and adoption of innovative technologies, practices, and service models to improve mobility and enhance the rider experience, with a focus on innovative service delivery models, creative financing, partnerships, and integrated payment solutions. Rural communities are a program priority.
Geographic coverage: Nationwide
Application Deadline: Apr 17, 2020
Sponsor: Federal Transit Administration

Juvenile Justice and Mental Health Collaboration Program
Grants to support juvenile justice and mental health agency partnerships as they develop and implement coordinated programs that reduce crime and recidivism associated with youth mental illness and/or co-occurring disorders. Rural communities are a program priority.
Geographic coverage: Nationwide
Application Deadline: May 4, 2020
Sponsors: Bureau of Justice Assistance, U.S. Department of Justice

Second Chance Act Community-Based Reentry Program
Grants to provide reentry services and programs to reduce recidivism and combat violence by facilitating the successful reintegration of individuals returning from incarceration. Rural communities are a program priority.
Geographic coverage: Nationwide
Application Deadline: May 4, 2020
Sponsors: Bureau of Justice Assistance, U.S. Department of Justice

Direct Services for Victims of Human Trafficking
Grants to develop, expand, or strengthen victim service programs for victims of human trafficking. Rural communities are a priority.
Geographic coverage: Nationwide and U.S. territories
Application Deadline: May 18, 2020
Sponsors: Office for Victims of Crime, U.S. Department of Justice

The Gus Schumacher Nutrition Incentive Program
Supports projects that will increase the purchase of fruit and vegetables among low-income consumers who participate in the Supplemental Nutrition Assistance Program by providing incentives at the point of purchase.
Geographic coverage: Nationwide
Application Deadline: May 18, 2020
Sponsors: National Institute of Food and Agriculture, U.S. Department of Agriculture

AgriSafe Nurse Scholar Program
A distance learning opportunity available to rural nurses designed to increase knowledge base in prevention, identification, and assessment of diseases related to agricultural work exposures. A 50% nonprofit registration rate is available for nurses working for nonprofit organizations, Rural Health Clinics, Federally Qualified Health Centers, government agencies, and educational institutions.
Geographic coverage: Nationwide
Application Deadline: Nov 13, 2020
Sponsor: AgriSafe Network

New Resources

COVID-19 resources

COVID-19 Emergency Declaration Health Care Providers Fact Sheet
Lists 1135 waivers available from CMS to help healthcare providers respond to COVID-19, with information for specific facility types including skilled nursing facilities, Critical Access Hospitals, and home health agencies.
Sponsoring organization: Centers for Medicare and Medicaid Services
Date: 03/2020

COVID-19 Healthcare Planning Checklist
Resource to help state, local, tribal, and territorial governments prepare for and respond to COVID-19. Identifies specific activities jurisdictions can undertake, including activities addressing safety and infection control, EMS, and hospital and healthcare delivery.
Sponsoring organization: Office of the Assistant Secretary for Preparedness and Response
Date: 03/2020

The EMS Compact
Information on the agreement enabling emergency medical service (EMS) personnel licensed in Compact member states to cross state borders to practice and work in other Compact states without getting an EMS license in the remote state. Describes ways in which this agreement may enhance communities' responses to COVID-19 when local resources are reduced. Includes a map showing locations of EMS Compact states and contact information for each member state's Compact Commissioner.
Sponsoring organization: Interstate Commission for EMS Personnel Practice

Health Industry Cybersecurity: Management Checklist for Teleworking Surge During the COVID-19 Response
A guide for healthcare enterprise management on how to address important factors related to teleworking during a public emergency. Includes action items related to information technology and cybersecurity, legal and privacy considerations, and communication.
Sponsoring organization: Healthcare and Public Health Sector Coordinating Council
Date: 03/2020

HHS OIG Policy Statement on Practitioners That Reduce, Waive Amounts Owed by Beneficiaries for Telehealth Services During the COVID-19 Outbreak
Discusses OIG policy that gives healthcare providers the ability to waive or reduce costs for telehealth services owed by individuals covered by Federal healthcare programs in order to address COVID-19 concerns. Describes the impact of this policy on Medicare beneficiaries and providers.
Sponsoring organization: Office of Inspector General (HHS)
Date: 03/2020

Medicaid State Plan Fee-for-Service Payments for Services Delivered Via Telehealth
Explains state policy options for paying Medicaid providers that use telehealth to deliver services, with the goal of increasing access to care in response to the COVID-19 pandemic.
Sponsoring organization: Centers for Medicare and Medicaid Services
Date: 03/2020

Medicare Telehealth Frequently Asked Questions (FAQs) - March 17, 2020
Information on Medicare payment for telehealth services related to the COVID-19 public health emergency. Addresses services that can provided and variety of related issues.
Sponsoring organization: Centers for Medicare and Medicaid Services
Date: 03/2020

Medicare Telemedicine Health Care Provider Fact Sheet
Explains Medicare coverage and payment of virtual services, which are being broadened in response to COVID-19 so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility. Includes information on Medicare telehealth visits, virtual check-ins, and E-visits. Also briefly discusses HIPAA.
Sponsoring organization: Centers for Medicare and Medicaid Services
Date: 03/2020

Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency
Discusses the enforcement discretion that the HHS Office of Civil Rights (OCR) will use during to the COVID-19 nationwide public health emergency related to Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements. Explains that OCR will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered healthcare providers in connection with the good faith provision of telehealth during the public health emergency. Identifies applications that can be used and those that should not be used.
Sponsoring organizations: HHS Office for Civil Rights, U.S. Department of Health and Human Services
Date: 03/2020

Prepare for Coronavirus (COVID-19)
Clinical management, patient education, and preparedness resources to help family physicians respond to COVID-19. Includes updates on payment and telehealth.
Sponsoring organization: American Academy of Family Physicians

State COVID-19 Response Resources
A list of state government pages focused on response to COVID-19, with information on state guidance, resources for healthcare providers in the state, and state monitoring.
Sponsoring organization: Rural Health Information Hub

Telehealth Coverage Policies in the Time of COVID-19 to Date
Summary of telehealth services that are covered by various public and private payers related to COVID-19. Will be updated with new information and new policies as the situation develops.
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
Date: 03/2020

Virtually Perfect? Telemedicine for Covid-19
Perspective article that discusses the role telehealth could play in responding to COVID-19. Discusses telemedicine approaches related to surge control and triage, patient isolation, eICU, community paramedicine, and more.
Author(s): Judd E. Hollander, Brendan G. Carr
Location: New England Journal of Medicine
Date: 03/2020

Other resources

2019 Transportation Trends Mental Health and Transportation
Report explores the role transportation plays in providing access to mental healthcare. Highlights a number of programs in both rural and urban communities, as well as resources pertaining to transportation to support mental health.
Sponsoring organization: National Aging and Disability Transportation Center
Date: 03/2020

2020 NACo Legislative Conference: Rural Grants 101: How County Officials Can Tap Into USDA Programs
Audio recording of National Association of Counties (NACo) panel discussion presented on March 2, 2020 in Washington, DC, describing ways in which counties can access USDA funding programs. Topics include rural electric cooperatives, rural telecommunications, and rural water and wastewater systems. Transcript available by clicking the dots above the Subscribe tab, then selecting Open Transcript.
Sponsoring organization: National Association of Counties
Date: 03/2020

Association of Neighborhood Measures of Social Determinants of Health With Breast, Cervical, and Colorectal Cancer Screening Rates in the US Midwest
Results of a study examining how area-level social determinants of health and rurality were associated with cancer screening practices in 75 Mayo Clinic and Mayo Clinic Health System practices in Minnesota, Iowa, and Wisconsin in 2016-2017. Features statistics on factors associated with 3 types of cancer screenings, with breakdowns by urban, rural, and highly rural areas.
Author(s): Shaheen S. Kurani, Rozalina G. McCoy, Michelle A. Lampman, et al.
Location: JAMA Network Open, 3(3)
Date: 03/2020

The Exchange Feature Issue: Preparing for and Responding to Wildfires and Planned Outages
Newsletter issue focusing on lessons learned by medical facilities and communities in Colorado and California during the wildfires of 2017 and 2019. Covers information useful for rural hospital emergency managers and administration, including mass sheltering, hospital evacuation, managing stress and compassion fatigue among workers, and community recovery.
Sponsoring organization: Office of the Assistant Secretary for Preparedness and Response
Location: Issue 10
Date: 03/2020

Exploring Opportunities to Leverage Pharmacists in Rural Areas to Promote Administration of Human Papillomavirus Vaccine
Describes the role of rural pharmacists in promoting and administering the human papillomavirus (HPV) vaccine using information gathered from interviews of 11 pharmacists at independently owned pharmacies in Iowa. Identifies factors facilitating the administration and accessibility of the vaccine, and reports on personal barriers regarding safety, lack of information, and staff capacity.
Author(s): Grace Ryan, Eliza Daly, Natoshia Askelson, et al.
Location: Preventing Chronic Disease, 17
Date: 03/2020

Hospital Compare Quality Measure Results for CAHs, 2018
Describes the rates at which Critical Access Hospitals (CAHs) reported quality improvement measures in 2018. Reports state rankings based on reporting rates. Includes national CAH performance results of selected inpatient and outpatient quality measures. Contains links to state-specific reports.
Sponsoring organization: Flex Monitoring Team
Date: 03/2020

MedPAC Report to the Congress: Medicare Payment Policy, 2020
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation.
Sponsoring organization: Medicare Payment Advisory Commission
Date: 03/2020

Prevalence of Tobacco Use Among Rural-Dwelling Individuals Who Inject Drugs
Research letter describing a study assessing the prevalence of smoking through a multi-site survey of people who inject drugs, conducted during 2018-2019 in rural Wisconsin. Features statistics on participant characteristics.
Author(s): Wajiha Z. Akhtar, Marlon P. Mundt, Ruth Koepke, et al.
Location: JAMA Network Open, 3(3)
Date: 03/2020

Report to Congress on Medicaid and CHIP, March 2020
Reports on three aspects of Medicaid: improving the structure of Disproportionate Share Hospital (DSH) payments, state reporting on the quality of care for individuals covered by Medicaid or the State Children's Health Insurance Program (CHIP), and the timeliness and quality of Medicaid demonstration evaluations. Chapter 1 examines the relationship between DSH allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the amounts and sources of hospitals' uncompensated care costs. Table 1-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
Date: 03/2020

Vital Signs: Colorectal Cancer Screening Test Use — United States, 2018
Reports on colorectal cancer screening among adults 50-75 years of age. Includes data by location of patient residence for metropolitan and nonmetro areas, with breakdowns by age group for 50-64 and 65-75 years of age.
Sponsoring organization: Centers for Disease Control and Prevention
Location: MMWR (Morbidity and Mortality Weekly Report), 69(10), 253-259
Date: 03/2020

Open Calls for Contributions

Call for Presentations: 2020 24th Annual Tribal Leaders Summit & Trade Show
Deadline: May 31, 2020
United Tribes Technical College
Event Dates: Sep 8 - 10, 2020
Bismarck, ND
Conference Website

Upcoming Events

Controlled Substances Prescription Monitoring Program (CSPMP), Statutes, Electronic Prescriptions for Controlled Substances (EPCS), and Resources for You
Time: 12:00 - 1:00 p.m. Mountain
Arizona Telemedicine Program, Southwest Telehealth Resource Center, U of Arizona College of Public Health
Coronavirus and Preventing the Spread of Infection
Time: 1:00 - 2:00 p.m. Central
The Compliance Team
Coronavirus Disease 2019 (COVID-19) Update to Tribal and Urban Indian Organization Leaders
Time: 3:30 - 4:30 p.m. Eastern
Call-in: 800.857.5577
Passcode: 6703929
Participant Passcode: ihs123
Indian Health Service
COVID-19 in Rural Areas – Addressing Social Determinants of Health in a Pandemic
Time: 12:30 p.m. - 1:30 p.m. Central
Caravan Health
COVID-19 Listening Session: HRSA Regions 1, 2, 3, and 5
Time: 1:00 - 2:00 p.m. Central
National Network for Oral Health Access
Telehealth and COVID-19
Time: 11:00 a.m. Pacific
Great Plains Telehealth Resource and Assistance Center, National Consortium of Telehealth Resource Centers
COVID-19 Listening Session: HRSA Regions 4, 6, and 7
Time: 11:00 a.m. - 12:00 p.m. Central
National Network for Oral Health Access
COVID-19: Primary Care Strategies to Support Alternative Care Delivery Methods
Time: 10:00 a.m. - 11:00 a.m. Pacific
Caravan Health
Mid-Atlantic Telehealth Resource Center - Virtual Office Hours
Time: 12:00 - 1:00 p.m. Eastern
Call-in: 1.646.558.8656
Meeting ID: 401 473 325
Mid-Atlantic Telehealth Resource Center
Update for Rural Partners, Stakeholders, and Communities on the Coronavirus Disease 2019 (COVID-19) Response
Time: 1:00 - 2:00 p.m. Eastern
Centers for Disease Control and Prevention
HRSA-NETRC Telehealth Webinar Series: Part 2 of 3 - TeleDentistry to Expand Dental Access in the Northeast
Time: 10:00 - 11:00 a.m. Eastern
Health Resources and Services Administration, Northeast Telehealth Resource Center
Long-Term Services and Supports: Money Follows the Person – Tribal Initiative, Part 2
Time: 1:00 - 2:00 p.m. Central
Centers for Medicare and Medicaid Services
Migratory and Seasonal Agricultural Worker Identification, Classification, and Reporting
Time: 1:30 - 2:30 p.m. Central
National Center for Farmworker Health
Connecting with Asian American and Pacific Islander (AAPI) Families: The Impact of AAPI Cultures and Traditions when Caring for Someone with Alzheimer's
Time: 2:00 - 3:00 p.m. Eastern
Administration for Community Living
US Preventive Services Task Force Final PrEP Recommendations and PrEP Implementation Guidelines and Resources from Fenway Health
Time: 2:00 - 3:00 p.m. Central
Health Resources and Services Administration
Addressing Youth Substance Use at the County Level Through Policy and Practice
Time: 2:00 - 3:00 p.m. Central
National Association of Counties
How to Complete the 2020 Region VIII Health Center Salary, Benefits, Turnover, and Vacancy Survey Tool
Time: 12:00 - 1:00 p.m. Mountain
Community Health Association of Mountain/Plains States
Ground Ambulance Cost Data Collection Workshop
Kentucky Ambulance Providers Association, Kentucky State Office of Rural Health
Bardstown, KY
The Childhood Trauma—Addiction—Incarceration Pipeline: A National Public Health Crisis Compounded in Rural Areas
Time: 3:00 - 4:00 p.m. Eastern
North Central Regional Center for Rural Development
2020 Annual MPHA Public Health Nursing Conference
Michigan Public Health Association
Lansing, MI
CAH Swing Bed Requirements
Time: 9:00 - 11:00 a.m. Central
Georgia Hospital Association, Mississippi Hospital Association
Rural Opioid Symposium - Corydon
Indiana Rural Health Association
Corydon, IN
KHA Small Rural and CAH Forum
Kentucky Hospital Association
Louisville, KY
Texas Rural Hospital Symposium
Texas Rural Health Association, West Texas Area Health Education Center
Abilene, TX
Presidential Task Force on Missing and Murdered American Indians and Alaska Natives - Grand Traverse Band of Ottawa and Chippewa Tribal Listening Session - Michigan
U.S. Department of Justice
Acme Township, MI
Telehealth 101: The Easy Basics of Telehealth and Telemedicine
Time: 12:00 - 1:00 p.m. Central
South Central Telehealth Resource Center
2020 11th Annual State of California Trauma Summit - CANCELED
California Emergency Medical Services Authority
San Diego, CA
2020 8th Annual California Telehealth Resource Center Telehealth Summit - CANCELED
California Telehealth Resource Center
Olympic Valley, CA
2020 6th Annual Idaho Healthcare Summit
Employers' Health Coalition of Idaho, Idaho State University, Kasiska Division of Health Sciences, Saint Alphonsus
Boise, ID
Lunch & Learn: Pain Population Management: The Non-MAT Prescription
Time: 12:00 - 1:00 p.m. Eastern
Indiana Rural Health Association
MARHC 2020 Spring Billing Conference - Liberty
Missouri Association of Rural Health Clinics
Liberty, MO
2020 23rd Annual Michigan Rural Health Conference
Michigan Center for Rural Health
Grand Rapids, MI
2020 Annual Utah Hospital Association Membership Meeting
Utah Hospital Association
Saint George, UT
2020 Triannual Membership Meeting
Association for Utah Community Health
West Valley City, Utah
Respirator Fit Testing Training
Time: 11:00 a.m. - 1:00 p.m. Central
University of North Dakota Center for Rural Health
2020 Improving Veterans Care Conference
Sioux Falls Veterans Administration Health Care Administration, Yankton Rural Area Health Education Center
Sioux Falls, SD

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