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RHIhub This Week - October 6, 2021

New in the Rural Monitor

Doula meeting with a pregnant woman Doulas Provide Support for Maternal and Infant Health in Rural Communities
Three programs across rural America demonstrate how doulas improve birth outcomes by providing prenatal, labor, and postpartum support. A New Mexico program reaches American Indian, Hispanic, and other populations who lack nearby labor/delivery units; a Minnesota program works with moms experiencing incarceration; and a North Dakota program is training postpartum doulas who will care for families impacted by opioid use disorder and other substance use.

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 Information from around the web

Recent News

At a Rural ICU, COVID-19's Summer Surge Put Telehealth to the Test
Oct 5, 2021 -- Describes the development of a telehealth intensive care unit (ICU) that treats critical COVID-19 patients at Whitfield Regional Hospital, a small Alabama rural hospital facing closure. Discusses the financial and staffing challenges facing Whitfield and other rural Alabama hospitals and the process of developing telehealth capacity, as well as future plans to develop a full tele-ICU to connect rural patients to physicians in the state's metro hospitals.
Source: STAT

Rural Hospitals that Joined Chains Were More Likely to Stop Maternal and Neonatal Services, Limit Mental-Health Access
Oct 5, 2021 -- Describes a study of 172 rural hospitals that merged with larger health systems from 2009-2016, comparing them to 549 independent hospitals and finding that the number of acquired hospitals that offered any maternal or neonatal services decreased. Also notes that merged hospitals were less likely to offer surgical services and mental health services.
Source: The Rural Blog

Rate of New Vaccinations Falls by 20%
Oct 4, 2021 -- Reports on rural COVID-19 vaccination rates as of September 30, noting a 20% decrease in new rural vaccinations and nearly a 1/3 decrease in metropolitan counties. Notes that 42.1% of the rural population and 54% of the metro population were fully vaccinated as of September 30. Offers a map with county-level data, charts tracking vaccination rates over time, and state-by-state rural and metro comparisons.
Source: The Daily Yonder

NIHB is Seeking Comments on the PHICCS II Tool and Process
Oct 1, 2021 -- Announces a comment period to improve the National Indian Health Board's Public Health in Indian Country Capacity Scan (PHICCS II), including information on opportunities to comment and contact information.
Source: National Indian Health Board

Become an Associate for the Public Health Associate Program (PHAP)!
Sep 30, 2021 -- Announces an experiential learning opportunity for early-career public health professionals through the Public Health Associate Program (PHAP). Provides information on the academic and work requirements for the associate program and application information.
Source: Centers for Disease Control and Prevention

Covid Is Killing Rural Americans at Twice the Rate of Urbanites
Sep 30, 2021 -- Reports on rural disparities in COVID-19 mortality, finding that in September 2021, rural death rates were double those of urban areas. Discusses the impacts of health disparities and workforce shortages on rural COVID-19 challenges, as well as the burden to rural hospitals and issues with transferring patients to larger hospitals for specialized care.
Source: Kaiser Health News

Federal Register

HRSA: Meeting of the National Advisory Committee on Rural Health and Human Services
Oct 5, 2021 -- The Health Resources and Services Administration will hold a virtual public meeting of the National Advisory Committee on Rural Health and Human Services (NACRHHS) on October 25-27, 2021. The agenda will include discussions on Behavioral Health and Primary Care Integration in Rural America and recommendations to the Secretary of Health and Human Services on the Rural Emergency Hospital designation. Pre-registration is required by October 24, 2021. Written statements and request to make oral comments should be submitted to Steven Hirsch at least 3 business days prior to the meeting.
Source: Federal Register

HHS: Center for Indigenous Innovation and Health Equity Tribal Advisory Committee; Solicitation of Nominations for Delegates
Oct 1, 2021 -- Notice from the Department of Health and Human Services (HHS) Office of Minority Health (OMH) establishing and seeking nominations for a Center for Indigenous Innovation and Health Equity Tribal Advisory Committee (CIIHE TAC) to support research, education, service, and policy development advancing Indigenous solutions that ultimately address health disparities in American Indian/Alaska Native (AI/AN) and Native Hawaiian and Pacific Islander (NHPI) populations. CIIHE TAC will consist of 16 delegate positions: One from each of the 12 geographic areas served by the Indian Health Service and four National At-Large Member positions. Delegates must be elected tribal officials from a federally recognized tribe acting in their official capacity as elected officials of their tribe or individuals designated by an elected tribal official. Nominations are due by October 29, 2021.
Source: Federal Register

Funding & Opportunities

Engaging the Arts to Build Vaccine Confidence
Funding for community-based arts and culture organizations interested in improving vaccine confidence and acceptance through their chosen art form(s). While the target population is the general American public, applicants are encouraged to highlight their strategies for reaching young adults, rural communities, and populations disproportionately impacted by COVID.
Geographic coverage: Nationwide
Application Deadline: Oct 14, 2021
Sponsors: CDC Foundation, Centers for Disease Control and Prevention

Academy of General Dentistry Foundation Grant Program
Grant support for nonprofit community-based outreach programs that provide free oral cancer screenings and education to the public, especially underserved communities, that lack access to oral healthcare due to geographic and/or economic hardship.
Geographic coverage: Nationwide
Application Deadline: Nov 1, 2021
Sponsor: Academy of General Dentistry

Combating Opioid Overdose Through Community-Level Intervention
Grants for evidence-based or promising community-level approaches that aim to reduce opioid-involved overdose, overdose involving stimulants, or poly-drug overdose in regions of the United States with the highest rates of fatal and non-fatal overdoses.
Geographic coverage: Nationwide and U.S. territories
Application Deadline: Nov 1, 2021
Sponsor: University of Baltimore Center for Drug Policy and Enforcement

Advancing Disaster Education Initiatives in Rural America
Grants for the development of innovative educational resources and Extension initiatives to address the preparation for, response to, and recovery from hazards and disasters in rural communities.
Geographic coverage: Nationwide
Application Deadline: Nov 12, 2021
Sponsor: Extension Disaster Education Network (EDEN)

Health Services Research on Minority Health and Health Disparities (R01 Clinical Trial Optional)
Grants to encourage innovative exploratory and developmental health services research to improve minority health and/or reduce health disparities at the healthcare system-level, as well as within clinical settings.
Geographic coverage: Nationwide
Application Deadline: Nov 17, 2021
Sponsors: National Institute on Alcohol Abuse and Alcoholism, 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

Ryan White HIV/AIDS Program Part C Early Intervention Services Program: New Geographic Service Areas
Funding to provide, on an ongoing outpatient basis, high quality early intervention services and comprehensive primary care services for individuals with HIV infection in new geographic service areas.
Geographic coverage: Nationwide
Application Deadline: Dec 10, 2021
Sponsors: Health Resources and Services Administration, HRSA HIV/AIDS Bureau, U.S. Department of Health and Human Services

USDA Community Facilities Guaranteed Loan Program
Loans from eligible private lenders, guaranteed by USDA, to help build essential community facilities in rural areas.
Geographic coverage: Nationwide
Applications accepted on an ongoing basis
Sponsors: U.S. Department of Agriculture, USDA Rural Development

New Resources

Applying for Phase 4 of the PRF & the ARP Rural Distribution
Provides an overview of Provider Relief Fund (PRF) Phase 4 general distribution and American Rescue Plan (ARP) rural distribution, as well as the application process for these opportunities. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript, Webinar Q&A Follow-Up
Sponsoring organization: National Association of Rural Health Clinics
Date: 09/2021

COVID-19 Cases and Vaccination Rates
Data brief examining the relationship between vaccination rates, COVID-19 one-week incidence, and metropolitan or nonmetropolitan location, using data on confirmed COVID-19 cases from August 29, 2021 – September 4, 2021 and vaccination data as of August 15, 2021. Features statistics on total case rates and vaccination percentages, with breakdowns by census regions, select states, and metropolitan or nonmetropolitan location.
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Date: 09/2021

COVID-19 Working Paper: Meatpacking Working Conditions and the Spread of COVID-19
Report details the working conditions of meatpacking plants and how they affected the spread of COVID-19 during the first months of the pandemic. Compares manufacturing jobs in rural versus total counties and highlights specific rural counties where meatpacking plants were infected. Discusses occupational characteristics that may have contributed to the spread.
Sponsoring organization: USDA Economic Research Service
Date: 09/2021

Critical Access Hospital Telehealth Guide
Provides practical guidance on implementing and sustaining telehealth in Critical Access Hospitals, to optimize healthcare delivery, expand access, and enhance care coordination. Focuses on Medicare outpatient telehealth services and includes information on Medicaid coverage and remote services that may not strictly be considered telehealth.
Sponsoring organizations: National Rural Health Resource Center, Northwest Regional Telehealth Resource Center
Date: 08/2021

Delivery of Healthcare In Rural America
Presentation slides discussing rural healthcare delivery in the United States and challenges to creating high-performing rural healthcare systems such as the COVID-19 pandemic, caring for high-risk populations, behavioral health needs, access issues, and more. Includes recommendations from the Bipartisan Policy Center Rural Health task force on developing current and long-term financial stability for hospitals and other healthcare providers, infrastructure supports, and more to address rural population health.
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Date: 09/2021

Disparities in COVID-19 Vaccination Status, Intent, and Perceived Access for Noninstitutionalized Adults, by Disability Status — National Immunization Survey Adult COVID Module, United States, May 30–June 26, 2021
Examines COVID-19 vaccination status and intent and perceived vaccine access among adults by disability status. Includes data on vaccination by disability status for those in metropolitan compared to nonmetro areas.
Sponsoring organization: Centers for Disease Control and Prevention
Location: MMWR (Morbidity and Mortality Weekly Report), 70(39), 1365-1371
Date: 10/2021

Federal Data for Conducting Patient-Centered Outcomes Research on Economic Outcomes
Examines 29 federal and federally-funded healthcare data sources relevant to patient-centered outcomes research (PCOR) on economic outcomes to find gaps to aid future data collection efforts. Exhibit 2 reports on the overall characteristics for the 29 data sources by data source steward, how the data is collected, aggregation level, observation length, how often the data is collected, observable social determinants of health (SDOH) measures, and observable factors related to health equity, which includes rural-urban status. Exhibit A-2 outlines each characteristic mentioned above for all 29 data sources included in the analysis.
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
Date: 09/2021

Grantee Sourcebook: Rural HIV/AIDS Planning Program, 2020-2021
Detailed descriptions of 7 Rural HIV/AIDS Planning Program grant projects funded in fiscal year 2020. Reports on each grantee's key Ending the HIV Epidemic (EHE) strategies, secondary focus areas, target populations served, network development and planning activities, initial outcomes of their planning work, and sustainability strategies of the HIV/AIDS rural health networks and HIV-related programming beyond the planning year. Grantee profiles identify the geographic areas served, network partners, and primary contact person.
Sponsoring organization: Federal Office of Rural Health Policy
Date: 09/2021

Healthy People 2020: An End of Decade Snapshot
Provides an overview of the Healthy People 2020 initiatives 985 measurable objectives for the past decade. Figures 7 and 10 provide information and data on the end of decade, or final, status for measurable objectives by population subgroup, including sex, race and ethnicity, educational attainment, family income, disability status, and rural status.
Sponsoring organization: Office of the Assistant Secretary for Health
Date: 09/2021

Impact of USDA's Supplemental Nutrition Assistance Program (SNAP) on Rural and Urban Economies in the Aftermath of the Great Recession
Reports on the effects of Supplemental Nutrition Assistance Program (SNAP) benefit spending on employment, output, and household incomes between 2009-2014. Describes the different impacts of SNAP benefit outlays on urban and rural economies.
Additional links: Report Summary
Sponsoring organization: USDA Economic Research Service
Date: 10/2021

Introducing Clinical Pharmacy Specialists into Interprofessional Primary Care Teams
Examines the integration of clinical pharmacy specialists as part of the interprofessional primary care team and in the Clinical Pharmacy Specialist Rural Veteran Access (CRVA) initiative to determine impacts on healthcare access for rural patients.
Author(s): Megan B. McCullough, Anna Zogas, Chris Gillespie, et al.
Location: Medicine (Baltimore), 100(38), e26689
Date: 09/2021

Medicare Advantage Enrollment Update 2021
Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) and other prepaid enrollment plans by metropolitan and nonmetropolitan location, from 2009-2021.
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Date: 09/2021

Medicare: Provider Performance and Experiences Under the Merit-Based Incentive Payment System
Examines Centers for Medicare and Medicaid Services (CMS) data on Merit-Based Incentive Payment System (MIPS) performance category scores, final scores, and payment adjustments from performance years 2017 through 2019. Summarizes interviews with 11 stakeholder groups and identifies strengths and challenges of the MIPS program. Presents data on MIPS performance scores and related payment adjustments by practice size, geographic location, method of participation, and specialty.
Additional links: Full Report
Sponsoring organization: Government Accountability Office
Date: 10/2021

Restoring Access to Maternity Care in Rural America
Examines regional partnerships to build rural access to maternity care through hub-and-spoke models of education and support from urban healthcare organizations to rural maternity providers, investments in telehealth, and remote monitoring systems. Discusses barriers to maternity care access in rural areas and highlights local examples of maternal health provider networks, investments in the rural maternity workforce, and policy implications of developing rural maternity care.
Sponsoring organization: Commonwealth Fund
Date: 09/2021

Rural Carve-out Funding
Policy brief discussing rural health funding inequities and the potential to target federal funding to rural and underserved communities to improve community-level health behaviors, workforce, technology, and financial resources. Offers policy recommendations to improve the equitable distribution of federal funding and promote best practices.
Sponsoring organization: National Rural Health Association
Date: 09/2021

Rural Transportation Issues: Research Roadmap
Report details the form and function of the transportation systems serving rural areas. Discusses gaps in service for all forms of rural transportation, including EMS and non-emergency medical transportation.
Additional links: Read Online
Sponsoring organizations: National Academies of Sciences, Engineering, and Medicine, National Cooperative Highway Research Program
Date: 2021

State Cross-Agency Collaboration During the COVID-19 Pandemic Response
Examines cross-agency approaches to COVID-19 response efforts in Illinois, Indiana, and Rhode Island. Identifies key themes, lessons, and best practices for other states to consider when preparing for future public health emergencies. Highlights efforts to serve rural populations.
Sponsoring organization: National Academy for State Health Policy
Date: 10/2021

Successes and Challenges to Network Sustainability: Perspectives of 2019-2020 Rural Health Network Development Planning Grantees
Policy brief using interview data from 18 grantees from the 2019-2020 cohort, to assess successes and challenges related to funding and sustaining network planning efforts. Also describes general barriers and facilitators of success during the grant year.
Sponsoring organization: University of Minnesota Rural Health Research Center
Date: 10/2021

Open Calls for Contributions

Call for Presentations: 2022 Annual North Dakota Mind Matters Conference
Deadline: Nov 29, 2021
North Dakota Brain Injury Network
Event Dates: Mar 24 - 25, 2022
Fargo, ND
Conference Website

Upcoming Events

Cultural Connections for Better Health: LGBTQ Voices
Time: 4:00 - 5 p.m. Central
Kansas Office of Primary Care & Rural Health
Ground Ambulance Data Collection System: Labor Section Overview
Time: 2:00 p.m. Eastern
Centers for Medicare and Medicaid Services
State of Telehealth: Removing Barriers to Access and Improving Patient Outcomes
Time: 10:00 a.m. Eastern
U.S. Senate Subcommittee on Communications, Media, and Broadband
Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Staffing Considerations, Workforce Impacts, and Future Trends
Time: 11:00 a.m. - 1:15 p.m. Central
Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
Emergency Connectivity Fund Program Office Hours for Tribal Applicants
Time: 3:00 - 4:00 p.m. Central
Universal Service Administrative Company
Q&A Ground Ambulance Data Collection System
Time: 2:00 p.m. Eastern
Centers for Medicare and Medicaid Services
2021 Annual NOSORH Meeting
National Organization of State Offices of Rural Health
COVID-19 and Influenza: What to Expect This Flu Season
Time: 4:00 p.m. Eastern
National Indian Health Board
InROC Webinar 2 - Adolescent Addiction Access Program
Time: 1:00 - 2:00 p.m. Eastern
Indiana Rural Health Association
What Does It Take to Transform Persistent Rural Poverty into Opportunity?
Time: 2:30 p.m. Eastern
Urban Institute
NCTRC Webinar - Ransomware in Health
Time: 11:00 a.m. Pacific
National Consortium of Telehealth Resource Centers, Southwest Telehealth Resource Center
Drumming up Interest for Public Health in Indian Country Capacity Scan (PHICCS) II
Time: 3:00 p.m. Eastern
National Indian Health Board
Transportation Diversity, Equity and Inclusion Lunch & Learn: Tribal Transit
Time: 12:30 p.m. Eastern
National Aging and Disability Transportation Center
CoE Office Hour: Resources & Tools for Advancing Rural Health Equity
Time: 2:00 p.m. Eastern
Center of Excellence for Integrated Health Solutions, National Council for Mental Wellbeing
AzCRH Webinar: Overdose Recognition & Naloxone Administration
Time: 12:00 - 1:00 p.m. Arizona
Arizona Center for Rural Health
National Advisory Committee on Rural Health and Human Services Meeting
Health Resources and Services Administration, National Advisory Committee on Rural Health and Human Services
RTTC's Virtual Launch Week: RISE for Rural Telementoring
Rural Telementoring Training Center
Center for Indigenous Innovation and Health Equity (CIIHE) Post-RTC Listening Session
Time: 1:00 p.m. Eastern
U.S. Department of Health and Human Services Office of Minority Health
Nation-to-Nation Dialogue on the COVID-19 Response in Indian Country
Time: 2:00 - 4:00 p.m. Eastern
U.S. Department of Health and Human Services
CMS Special Open Door Forum: Repetitive, Scheduled Non-Emergent Ambulance Transport Prior Authorization Model National Expansion
Time: 2:00 - 3:30 p.m. Eastern
Call-in: 1.888.455.1397
Passcode: 8604468
Centers for Medicare and Medicaid Services
Measure Applications Partnership (MAP) Rural Health Advisory Group: Orientation Web Meeting
Time: 1:00 - 3:00 p.m. Eastern
National Quality Forum MAP Rural Health Workgroup
2021 Annual New England Rural Health Conference
New England Rural Health Association
Newry, ME
2021 Annual Idaho CAH-RHC-Free Medical Clinic Conference
Idaho Bureau of Rural Health and Primary Care
2021 Annual Midwest Rural Agricultural Safety & Health (MRASH) Conference
Great Plains Center for Agricultural Health, Heartland Center for Occupational Health & Safety, Iowa's Center for Agricultural Safety and Health
2021 Annual National PACE Association Conference
Live sessions run Nov. 8-19, 2021. Self-paced event runs through Feb. 7, 2022.
National PACE Association
2021 9th Annual Telehealth Summit of South Carolina
Palmetto Care Connections
2021 National Conference on EMS
New Jersey Office of Emergency Medical Services
Atlantic City, NJ

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