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RHIhub This Week - April 28, 2021

New in the Rural Monitor

closeup of a wireless router Broadband in Rural America: Faster Speeds for Home and Healthcare
Fast, reliable broadband is essential for people to access telehealth and patient portals as well as work and study from home, but rural and tribal areas fall behind urban and suburban areas in terms of broadband deployment and speed. Organizations in Alabama, Colorado, and Kentucky share how broadband affects their work and their patients' care.

Updated RHIhub Topic Guide

Abbeville County Community Paramedic Program Community Paramedicine
Our recently updated topic guide provides Frequently Asked Questions, resources, funding opportunities, and model programs related to rural community paramedicine and its potential challenges.

Models and Innovations

San Luis Valley mobile health unit Mobile Health Units for Opioid Use Disorder Treatment
Mobile health units travel to 32 Colorado counties and provide care, including medication-assisted treatment, telehealth sessions, and counseling, to people with opioid use disorder.

 New in Our Online Library
 Information from around the web

Recent News

HHS Announces $1 Billion from American Rescue Plan for Construction and Renovation Projects at Health Centers
Apr 27, 2021 -- The U.S. Department of Health and Human Services (HHS) announced the availability of $1 billion to support COVID-19 related capital needs and construction and renovation projects for Health Resources and Services Administration (HRSA) Health Center Program funded health centers. Nearly 1,400 health centers are eligible for the funding provided by the American Rescue Plan. Applications are due June 24, 2021.
Source: U.S. Department of Health and Human Services

HHS Releases New Buprenorphine Practice Guidelines, Expanding Access to Treatment for Opioid Use Disorder
Apr 27, 2021 -- The U.S. Department of Health and Human Services (HHS) released new practice guidelines that exempt eligible healthcare providers from federal certification and training requirements to obtain a waiver to treat up to 30 patients with buprenorphine. These actions aim to increase access to treatment for opioid use disorder during the COVID-19 pandemic.
Source: U.S. Department of Health and Human Services

Regional Population Loss 'Metastasizes' in the Last Decade
Apr 27, 2021 -- Analyzes population changes in the United States, finding that more than half of all U.S. counties lost population in the last decade, while two-thirds of rural counties experienced population loss. Includes interactive maps of rural/urban population loss and gain between 1970-2019 and 2010-2020. Identifies counties with biggest losses and gains for each time period.
Source: The Daily Yonder

A First-time Rural Public Health Leader Meets the Pandemic Head-on
Apr 26, 2021 -- Features a public health director of a rural county in Colorado who began her job directly before the COVID-19 pandemic hit. Describes how she led the department in its COVID-19 response efforts with support from the local Board of Commissioners and retired public health veterans.
Source: National Association of Counties

Outpacing the U.S., Hard-Hit Navajo Nation Has Vaccinated More Than Half of Adults
Apr 26, 2021 -- Highlights the Navajo Nation, which once had one of the highest per-capita COVID-19 infection rates in the country and has now vaccinated more than half of its adult population. Discusses how Navajo Nation is taking steps to ease public health measures while continuing to be cautious and keep infection rates down.
Source: NPR

Rural Ambulance Crews Have Run Out of Money and Volunteers
Apr 26, 2021 -- Rural ambulance crews are struggling during the COVID-19 pandemic due to lack of funding, volunteer shortages, and low call volumes. Examines the situation in Wyoming, where 10 localities are in danger of losing ambulance services. Explains how struggling ambulance services are accepting takeovers from hospitals and healthcare systems to stay afloat. (May require a subscription to view full article.)
Source: New York Times

Only One Vaccine Is OK for Older Teens. It's Also the Hardest to Manage in Rural America.
Apr 23, 2021 -- Out of the three approved COVID-19 vaccines, Pfizer-BioNTech is the only one currently approved for those aged 16-17 years. Discusses the difficulty of vaccinating that age group in rural communities, identifying limited supply, far distances to travel, and rural vaccine hesitancy as barriers.
Source: Kaiser Health News

Biden Administration Reaches Out to Rural Americans to Get Vaccinated
Apr 22, 2021 -- Discusses the Biden Administrations' COVID-19 Community Corps, which is made up of hundreds of local and national groups to encourage communities to get COVID-19 vaccines. Describes the need for trusted voices to reach rural communities and address vaccine-related concerns. Highlights rural efforts across the country to increase vaccine distribution.
Source: NPR

Radically Rural: Reimagining Rural Healthcare Post-Pandemic
Apr 22, 2021 -- Discusses how telehealth utilization has increased in both rural and urban areas during the COVID-19 pandemic due to waivers put in place by the federal government. Addresses barriers to care in rural communities including lack of broadband access and provider shortages. Highlights federal COVID relief efforts and other initiatives to support rural healthcare.
Source: The Daily Yonder

Federal Register

Public Inspection: CMS: Medicare Program: Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2022 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Proposed Changes to Medicaid Provider Enrollment; and Proposed Changes to the Medicare Shared Savings Program
Apr 28, 2021 -- Pre-publication notice of proposed rule from the Centers for Medicare and Medicaid Services (CMS) regarding changes to the hospital inpatient prospective payment system (IPPS) for operating and capital-related costs of acute care hospitals for fiscal year 2022. Includes details of changes impacting Critical Access Hospital (CAH), Medicare graduate medical education for teaching hospitals, inpatient hospital services provided by long-term care hospitals, quality reporting programs, as well as changes related to the COVID-19 pandemic, among other things. Comments are due by June 28, 2021.
Source: Federal Register

Public Inspection: CMS: Medicare Program: Modification of Limitations on Redesignation by the Medicare Geographic Classification Review Board
Apr 28, 2021 -- Pre-publication notice of interim final rule with comment period from the Centers for Medicare and Medicaid Services (CMS) amending regulations to allow hospitals with a rural redesignation under the Social Security Act to reclassify through the Medicare Geographic Classification Review Board (MGCRB) using the rural reclassified area as the geographic area in which the hospital is located. These changes align CMS policy with the decision in Bates County Memorial Hospital v. Azar, effective with reclassifications beginning with fiscal year (FY) 2023. This interim final rule is effective May 10, 2021. Comments are due by June 28, 2021.
Source: Federal Register

CMS: Medicare Program; Durable Medical Equipment Fee Schedule Adjustments To Resume the Transitional 50/50 Blended Rates To Provide Relief in Rural Areas and Non-Contiguous Areas; Extension of Timeline for Final Rule Publication
Apr 26, 2021 -- The Centers for Medicare and Medicaid Services announces the continuation of the May 11, 2018 interim final rule. The provisions adopted in the interim final rule will continue until May 11, 2022. The timeline for publication of the final rule is also extended until May 11, 2022.
Source: Federal Register

HRSA: Agency Information Collection Activities: Proposed Collection: Public Comment Request Information Collection Request Title: Health Center Program: COVID-19 Data Collection Tools, OMB No. 0906-0062-Revision
Apr 23, 2021 -- The Health Resources and Services Administration (HRSA) is seeking comment on forms related to the Health Center COVID-19 Vaccine Program. HRSA uses the data collected to optimize COVID-19 testing and vaccination; track health center capacity and the impact of COVID-19 on operations, patients, and staff; and better understand training and technical assistance, funding, and other health center resource needs. Comments are due by June 22, 2021.
Source: Federal Register

Funding & Opportunities

Firehouse Subs First Responder Grants
Grants for life-saving equipment, prevention education, and disaster relief for first responders and public safety organizations. The Foundation recognizes the needs of rural and volunteer departments throughout the country and will consider their applications despite not being within 60 miles of a Firehouse Subs restaurant.
Geographic coverage: Nationwide
Application Deadline: May 12, 2021
Sponsor: Firehouse Subs Public Safety Foundation


I Strengthen My Nation: American Indian/Alaska Native Youth Projects to Stand Against Substance Misuse
A challenge program that will award funding to youth-led community and art projects to enhance resilience against substance misuse in American Indian and Alaska Native communities.
Geographic coverage: Nationwide
Application Deadline: Jul 7, 2021
Sponsors: National Institute on Drug Abuse, National Institutes of Health, U.S. Department of Health and Human Services


Veterans Housing Rehabilitation and Modification Pilot Program
Grants to rehabilitate and modify the primary residence of veterans who are low-income and living with disabilities, with a focus on helping them regain and/or maintain their independence to alleviate critical health, life, and safety issues. Applicants from rural and other geographic areas that lack reliable internet access may request a waiver from the electronic submission requirement through HUD's Office of Rural Housing and Economic Development.
Geographic coverage: Nationwide
Application Deadline: Jul 30, 2021
Sponsor: U.S. Department of Housing and Urban Development


Foster G. McGaw Prize for Excellence in Community Service
Monetary awards that honor health delivery organizations that have demonstrated exceptional commitment to community service.
Geographic coverage: Nationwide
Application Deadline: Jul 31, 2021
Sponsor: American Hospital Association


Long-Term Effects of Disasters on Health Care Systems Serving Health Disparity Populations (R01- Clinical Trial Optional)
Grants for research focused on understanding the long-term effects of natural and/or human-made disasters on healthcare systems serving health disparity populations. Health disparity populations include, but are not limited to, American Indians, Alaska Natives, and underserved rural populations.
Geographic coverage: Nationwide and U.S. territories
Application Deadline: Sep 7, 2023
Sponsors: National Cancer Institute, National Institute on Aging, National Institute on Drug Abuse, National Institute on Minority Health and Health Disparities, National Institutes of Health, U.S. Department of Health and Human Services

New Resources

American Rescue Plan Act of 2021 (P.L. 117-2): Private Health Insurance, Medicaid, CHIP, and Medicare Provisions
Provides an overview of the provisions of the American Rescue Plan Act of 2021 that relate to private health insurance, Medicaid, the State Children's Health Insurance Program (CHIP), and Medicare. Includes information on provisions specific to rural providers.
Sponsoring organization: Congressional Research Service
Date: 04/2021


An Analysis of Suicide Risk Factors among Farmers in the Midwestern United States
Study examining psychological, social, and contextual risk factors for suicide among farmers. Draws data from 600 surveys of agricultural producers in Kansas, Michigan, Missouri, and South Dakota. Discusses rates of depression, anxiety, farming-specific stressors, social support, and coping strategies.
Author(s): Andrea Bjornestad, Courtney Cuthbertson, Jessie Hendricks
Location: International Journal of Environmental Research and Public Health, 18(7), 3563
Date: 03/2021


CCHP Policy Finder
Database of telehealth laws and regulations with state-by-state information, information related to COVID-19 telehealth policy changes, Medicaid and Medicare information, and other payer and professional requirements. Offers maps comparing policies in each state.
Additional links: Policy Trend Maps
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center

Computer and Internet Use in the United States: 2018
Provides data on computer and Internet use by household characteristics, including location in a rural or urban area, for the nation and by region. Includes information on owning a desktop or laptop computer, owning a smartphone, owning a tablet, having an Internet subscription, and having broadband access.
Sponsoring organization: U.S. Census Bureau
Date: 04/2021


Critical Access Hospital Response to COVID-19
Webinar recording summarizing results of a survey of Critical Access Hospital (CAH) executives in eight states regarding the hospitals' ability to respond to the COVID-19 pandemic from February-August 2020. Covers survey findings related to CAH finance, federal waivers and regulatory flexibilities, capacity for treatment, workforce, and partnerships. Discusses opportunities for future research on COVID-19 response and preparedness for future disasters and public health emergencies.
Additional links: Presentation Slides
Sponsoring organization: Flex Monitoring Team
Date: 04/2021


Demographics and Disability Status of Adults Living Alone in Rural Areas
Policy brief examining differences in age and disability status of people who live alone in rural and urban areas. Describes health impacts of living alone and explores American Community Survey (ACS) data from 2014-2018 to represent demographic characteristics and prevalence of disabilities for rural and urban adults living alone.
Sponsoring organization: University of Minnesota Rural Health Research Center
Date: 04/2021


Home Care and Hospice During COVID: A Rural Perspective
Interview with leaders from CHI Health at Home, a home health and hospice care provider serving rural Minnesota and North Dakota. Describes how the COVID-19 pandemic impacted operations and patient care, including the increased role of technology, as well as the benefits of federal waivers.
Sponsoring organization: Office of the Assistant Secretary for Preparedness and Response
Date: 2021


Influenza and Pertussis Vaccination Rates Among Pregnant Women in Rural and Urban Areas
Analyzes patterns of prenatal vaccination among pregnant women from 2012-2018, using data from the Pregnancy Risk Assessment Monitoring System. Features demographics and statistics on influenza and pertussis vaccine uptake prior to and during pregnancy, with breakdowns by urban and rural location.
Sponsoring organization: Southwest Rural Health Research Center
Date: 04/2021


Lyme Disease in the U.S.: Where is Risk Highest?
Examines the ten-year trend for incidence of Lyme disease in the U.S. Features county-level maps showing total Lyme disease cases and average Lyme disease incidence rates from 2008-2018.
Sponsoring organization: Lerner Center for Public Health Promotion
Date: 04/2021


Making It Plain: Rural Hospitals and the Healthcare Delivery System
Recording of an April 21, 2021, town hall discussing COVID-19 epidemiological trends, compliance with public health guidance, and vaccine rates in rural communities. Explores barriers and solutions regarding vaccine administration and acceptance in rural areas, and describes federal plans to promote vaccine acceptance in rural communities. Features speakers from the Black Coalition Against COVID-19 (BCAC), the American Hospital Association, and the White House COVID-19 response team, among others.
Sponsoring organization: BlackDoctor.org
Date: 04/2021


Population Health in Rural America in 2020: Proceedings of a Workshop
Presents the proceedings of the Population Health in Rural America 2020 workshop. Chapters examine rural demographics and social determinants of health, rural health and data challenges, rural and tribal healthcare, community health needs assessment, and rural health policy.
Additional links: Read Online
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
Date: 2021


Provisional Death Counts for Coronavirus Disease 2019 (COVID-19): Health Disparities
Provides provisional COVID-19 death counts based on death certificate data received and coded by the National Center for Health Statistics. Includes weekly death rate data for metropolitan and nonmetropolitan counties.
Sponsoring organization: Centers for Disease Control and Prevention
Date: 04/2021


Rural-Urban Disparities in Cancer
Provides data and maps reflecting cancer incidence and mortality, comparing rural, nonmetro urban, and metro counties. Explores urban and rural disparities regarding cancer type, access to healthcare for rural residents, risk factors for cancer incidence, and preventative care.
Sponsoring organization: National Cancer Institute

Seat Belt Use in 2020 - Overall Results
Details seat belt usage data from 2019-2020. Breaks down data by occupant group, such as drivers versus passengers, levels of traffic, type of vehicle, and rural versus urban location, among other measures.
Sponsoring organization: National Highway Traffic Safety Administration
Date: 02/2021


State Health Disparities Research in Rural America: Gaps and Future Directions in an Era of COVID-19
Discusses research methods and partnerships to address rural health disparities. Highlights recommendations from a national workshop on rural health disparities, including community participation in rural health research, innovative research design, interventions that are relevant to rural challenges, and cultural competence in rural research.
Author(s): Lisa Cacari Stone, Mary C. Roary, Augusto Diana, Patricia A. Grady
Location: The Journal of Rural Health
Date: 04/2021


State Telehealth Laws and Reimbursement Policies Report, Spring 2021
Bi-annual summary report on telehealth policies as of February 2021. Covers Medicaid reimbursement, private payer laws, and professional regulation.
Additional links: Executive Summary, Infographic, Summary Chart
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
Date: 04/2021


Trends in Singleton Preterm Birth by Rural Status in the U.S., 2012-2018
Policy brief showing variations in preterm birth by demographics, payment method, and participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) during pregnancy. Features statistics with breakdowns by 5 levels of population density.
Sponsoring organization: Southwest Rural Health Research Center
Date: 04/2021

Open Calls for Contributions

Call for Proposals: 2021 Annual Arizona Health Equity Conference
Arizona Department of Health Services
Event Dates: Oct 14, 2021
Conference Website

Presentation and Abstract Submission: 2021 Annual Oklahoma Primary Care Association Conference
Deadline: May 7, 2021
Oklahoma Primary Care Association
Event Dates: Sep 30 - Oct 1, 2021
Oklahoma City, OK
Conference Website

Call for Proposals: 2021 Ohio Rural Health Conference
Deadline: May 31, 2021
Ohio Rural Health Association, Ohio State Office of Rural Health, Ohio University, Appalachian Rural Health Institute, Ohio University, Department of Social and Public Health
Event Dates: Aug 11 - 13, 2021
Conference Website

Call for Abstracts: 2021 Annual NASEMSO Meeting
Deadline: Oct 1, 2021
National Association of State EMS Officials
Event Dates: Nov 14 - 18, 2021
Reno, NV
Conference Website

Upcoming Events

Apr
28
A Conversation on Applying Restorative Justice to Elder Abuse
California Elder Justice Coalition
May
4
COVID-19 Vaccines: Building Confidence & Explaining Efficacy
Time: 2:00 - 3:00 p.m. Central
Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
May
4
Implementing High-Quality Primary Care: Report Release Webinar
Time: 1:00 p.m. Eastern
National Academies of Sciences, Engineering, and Medicine
May
6
HRSA Midwest Region (Regions 5 & 7) Community Member Listening Session
Time: 1:00 p.m. Eastern
Health Resources and Services Administration
May
11
How to Leverage Telehealth Strategies for Substance Use Brief Intervention
Time: 3:00 - 4:00 p.m. Eastern
National Council for Behavioral Health, SBIRT Oregon
May
12
HANYS Recovery and Preparedness Webinar Series: Drivers and Strategies for Overcoming COVID-19 Vaccine Hesitancy
Time: 3:00 - 4:00 p.m. Eastern
Healthcare Association of New York State
518.431.7867
learning@hanys.org
May
12
UMTRC Webinar: Ohio Telehealth Billing & Reimbursement Webinar for Maternal Health
Time: 12:00 - 1:00 p.m. Eastern
Upper Midwest Telehealth Resource Center
bsanders@indianarha.org
May
13
Midwest Diabetes Conference - Remote Patient Monitoring
Time: 10:00 - 11:30 a.m. Eastern
Community Care Network of Kansas, Illinois Primary Health Care Association, Indiana Primary Health Care Association, Michigan Primary Care Association, Midwest Clinicians' Network, Minnesota Association of Community Health Centers, Missouri Primary Care Association, Ohio Association of Community Health Centers, Wisconsin Primary Health Care Association
nhall@indianapca.org
May
14
UMTRC Virtual Telehealth Workshop - May
Time: 9:00 a.m. - 4:30 p.m.
Upper Midwest Telehealth Resource Center
bsanders@indianarha.org
May
18
Demystifying the Immigration Process for Maine's Physician Recruiters
Time: 11:00 a.m. - 12:00 p.m. Eastern
Maine Office of Rural Health and Primary Care
May
18
Healthcare Immigration Strategies: Part 1
Time: 3:00 - 5:00 p.m.
New Mexico Health Resources, Inc.
May
18-20
2021 Region B SORH Regional Partnership Meeting
Federal Office of Rural Health Policy, National Organization of State Offices of Rural Health
May
19-20
2021 Texas Rural Health Association Conference
Also available by webinar
Texas Rural Health Association
Abilene, TX
325.672.0495
kcheek@bcahec.org
May
20
Midwest Diabetes Conference - Patient Engagement
Time: 10:00 - 11:30 a.m. Eastern
Community Care Network of Kansas, Illinois Primary Health Care Association, Indiana Primary Health Care Association, Michigan Primary Care Association, Midwest Clinicians' Network, Minnesota Association of Community Health Centers, Missouri Primary Care Association, Ohio Association of Community Health Centers, Wisconsin Primary Health Care Association
nhall@indianapca.org
May
20
NCTRC Webinar - Mistakes, Myths and Misconceptions Your Telehealth Diabetes Program Need To Avoid to be Successful!
Time: 11:00 a.m. Pacific
Upper Midwest Telehealth Resource Center
bsanders@indianarha.org
May
20-21
2021 3rd Annual Native American and Rural Emergency Medicine Conference
Native American Emergency Medicine Consortium
May
20-27
Seeking Funding for Your Infrastructure Project?
Time: 9:00 a.m. - 3:00 p.m., May 20 & May 27
California Financing Coordinating Committee (CFCC)
916.447.9832 ext. 1429
registration@rcac.org
May
21
2021 8th Annual Mississippi Rural Health Association Rural Health Clinic Conference
Mississippi Rural Health Association
May
21
Oral Health Summit
Time: 9:00 a.m. - 3:30 p.m. Eastern
Appalachia Funders Network
kathryn@ruralsupportpartners.com
May
25
Healthcare Immigration Strategies: Part 2
New Mexico Health Resources, Inc.
May
25-28
National Advisory Council on Migrant Health (NACMH) Meeting
Time: 1:00 - 5:00 p.m. daily, Eastern
National Advisory Council on Migrant Health
301.594.4300
epaul@hrsa.gov
May
27
Midwest Diabetes Conference - Medication Therapy Management
Time: 10:00 - 11:30 a.m. Eastern
Community Care Network of Kansas, Illinois Primary Health Care Association, Indiana Primary Health Care Association, Michigan Primary Care Association, Midwest Clinicians' Network, Minnesota Association of Community Health Centers, Missouri Primary Care Association, Ohio Association of Community Health Centers, Wisconsin Primary Health Care Association
nhall@indianapca.org
Jun
3
Ag Worker Health 102: Supporting Agricultural Worker Health
Time: 1:00 p.m. Central
National Center for Farmworker Health
Jun
3
Midwest Diabetes Conference - Diabetes and Oral Health
Time: 10:00 - 11:30 a.m. Eastern
Community Care Network of Kansas, Illinois Primary Health Care Association, Indiana Primary Health Care Association, Michigan Primary Care Association, Midwest Clinicians' Network, Minnesota Association of Community Health Centers, Missouri Primary Care Association, Ohio Association of Community Health Centers, Wisconsin Primary Health Care Association
nhall@indianapca.org

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.