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Rural Health Information Hub

RHIhub This Week - May 24, 2023

New in the Rural Monitor

Man yawning while driving a car When It's Not Enough: Sleep's Impact on Rural America's Health and Safety
Pivoting from a universal question, "How'd you sleep?" clinical sleep experts, a federal public health agency representative, and Nebraska Extension discussed sleep's impact on rural health and public safety.

Upcoming Webinar

Emergency Preparedness and Response Efforts in Critical Access Hospitals
Join us June 6, 2023, at 12:00 p.m. Central for an RHIhub webinar with speakers from Critical Access Hospitals in Colorado and Michigan discussing their experiences of responding to and recovering from disasters and emergencies.

 New in Our Online Library
 Information from around the web

Recent News

Domestic Violence Shelters Move Out of Hiding
May 24, 2023 -- The long-held standard for domestic violence shelters has been to keep residents in hiding at undisclosed addresses, but domestic violence shelter directors have said keeping their locations secret has gotten more complicated, and the practice can isolate residents. A Bozeman, Montana nonprofit recently finished construction of a campus minutes off a main road leading into town, and similar changes are percolating across the nation.
Source: KFF Health News

Rural Hospitals Struggle With Staffing Shortage, and Not Just Doctors
May 23, 2023 -- Executives from Dartmouth Heath, MaineHealth, and The University of Vermont Health Network participated in a panel discussion about rural hospitals and their difficulties. Challenges include workforce shortages, hospital closures, housing costs, and the need for creative scheduling.
Source: Chief Healthcare Executive

A Striking Gap Between Deaths of Black and White Babies Plagues the South
May 22, 2023 -- Describes challenges faced by women seeking maternity care in rural South Carolina counties. Infant death rates in South Carolina are higher than the national average, and a report published by the South Carolina Department of Health and Environmental Control shows the rate for non-Hispanic Black babies is growing worse. The death rate among infants born to Black mothers in the state increased by nearly 40% from 2017 to 2021.
Source: KFF Health News

Organizations Team Up to Improve Cancer Care in Rural Appalachia
May 22, 2023 -- The Appalachian Community Cancer Alliance has launched a lung cancer screening initiative to improve cancer care in rural Appalachia. Through partnerships with local advocates in communities at risk, the initiative will focus on developing and implementing new patient-centric approaches to promote the importance of and raise awareness about lung cancer screening in rural Appalachia.
Source: The ASCO Post

8 Questions About Proposed Changes to Rural Floor Wage Index
May 19, 2023 -- The Centers for Medicare and Medicaid Services (CMS) is proposing a policy change for the rural floor wage index in 2024 that could have profound financial effects on urban and rural hospitals. Under this proposal CMS would treat hospitals with rural classifications the same as geographically rural hospitals when calculating the wage index.
Source: HealthLeaders

Collins, Cortez-Masto Lead Bipartisan Bill Protecting Rural Ambulance Services
May 19, 2023 -- Senators Susan Collins of Maine and Catherine Cortez-Masto of Nevada introduced legislation to ensure all communities, regardless of population, have access to adequate emergency medical services. The Protecting Access to Ground Ambulance Medical Services Act allows ambulance providers to be properly reimbursed by Medicare for the costs of providing emergency services, while also ensuring that existing EMT services, particularly in rural locations, remain operational, with sufficient staff and supplies.
Source: Office of Senator Susan Collins

HHS Announces Over $65 Million to Address the Maternal Health Crisis and Invest in New Approaches to Care
May 19, 2023 -- The Department of Health and Human Services has awarded over $65 million in funds to implement innovative approaches to improve maternal health outcomes and reduce disparities for patients at highest risk. This will help ensure healthier pregnancy and postpartum outcomes and address health disparities among women of color and women in rural and medically underserved areas.
Source: U.S. Department of Health and Human Services

America's Rural Hospitals Are in the Red
May 17, 2023 -- Describes challenges faced by St. Luke's Health – Memorial San Augustine, a rural, one-story hospital in East Texas. The hospital recently eliminated inpatient services as part of its conversion from Critical Access Hospital status to Rural Emergency Hospital.
Source: Marketplace

Manchin, Ernst, Shaheen, Moran Reintroduce Bipartisan Bill to Make Rural, Underserved Telehealth Flexibilities Permanent
May 17, 2023 -- U.S. Senators Joe Manchin, Joni Ernst, Jeanne Shaheen, and Jerry Moran reintroduced the Protecting Rural Telehealth Access Act. This legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024.
Source: Office of Senator Joe Manchin

Funding & Opportunities

Medicare Shared Savings Program Advance Investment Payments
The Medicare Shared Savings Program offers providers and suppliers an opportunity to create an Accountable Care Organization that is held accountable for the quality, cost, and experience of care of an assigned Medicare fee-for-service beneficiary population through different payment models. A new payment option in 2023 is the Advance Investment Payments designed to encourage healthcare providers in rural and underserved areas to join together to form an Accountable Care Organizations.
Geographic coverage: Nationwide
Application Deadline: Jun 15, 2023
Sponsor: Centers for Medicare and Medicaid Services

Delta Health Care Services Grant Program
Grants to address unmet health needs in the Delta Region through cooperation among healthcare professionals, institutions of higher education, research institutions, and other entities.
Geographic coverage: Alabama, Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri, Tennessee
Application Deadline: Jul 3, 2023
Sponsors: U.S. Department of Agriculture, USDA Rural Development

Nurse Education, Practice, Quality and Retention Simulation Education Training Program
Funding to enhance nursing education and strengthen the nursing workforce through experiential learning opportunities, including the use of simulation-based technology. Funding should expand the capacity of nurses to advance the health of patients, families, and communities in rural or medically underserved areas.
Geographic coverage: Nationwide
Application Deadline: Jul 3, 2023
Sponsors: Health Resources and Services Administration, U.S. Department of Health and Human Services

Native Voices Rising Grants
General operating support grants designed to strengthen Native-led organizations that are improving the lives of their community members.
Geographic coverage: Nationwide
Application Deadline: Jul 7, 2023
Sponsors: Common Counsel Foundation, Native Americans in Philanthropy

Healthy Start Initiative - Enhanced
Grants to improve health outcomes before, during, and after pregnancy and reduce the racial/ethnic differences in rates of infant death and adverse perinatal outcomes. The program priority is diverse communities and populations, such as non-Hispanic Black, American Indian/Alaska Native, and rural areas that are experiencing the greatest disparities in maternal and infant health outcomes.
Geographic coverage: Nationwide
Application Deadline: Jul 17, 2023
Sponsors: Health Resources and Services Administration, Maternal and Child Health Bureau, U.S. Department of Health and Human Services

Native Community Development Financial Institution Relending Demonstration Program
Loans for Native Community Development Financial Institutions to use for relending to increase homeownership opportunities for Native American tribes, Alaska Native communities, and Native Hawaiian communities in rural areas.
Geographic coverage: Nationwide
Application Deadline: Jul 17, 2023
Sponsors: U.S. Department of Agriculture, USDA Rural Development, USDA Rural Housing Service

Brookwood-Sago Mine Safety Grants
Grants for education and training programs to help identify, avoid, and prevent unsafe working conditions in and around mines. Special emphasis is given to programs and materials that target workers at smaller mines, including training miners and employers about new MSHA standards, high-risk activities, or hazards identified by MSHA.
Geographic coverage: Nationwide and U.S. territories
Application Deadline: Jul 21, 2023
Sponsors: Mine Safety and Health Administration, U.S. Department of Labor

Grants for Transportation of Veterans in Highly Rural Areas
Grants for new organizations to assist veterans with transportation in highly rural areas. Applicants should provide transportation services to VA medical centers and assist with transportation services in connection with the provision of VA medical care to these veterans.
Geographic coverage: Nationwide and U.S. territories
Application Deadline: Jul 30, 2023
Sponsor: U.S. Department of Veterans Affairs

John and Polly Sparks First Responder Grant for Rural First Responders Mental Health Interventions
Grants for evidence-based research and intervention in providing mental health training dissemination to first responders in rural areas.
Geographic coverage: Nationwide
Application Deadline: Oct 15, 2023
Sponsor: American Psychological Foundation

EPA Water and Wastewater Technical Assistance (TA)
Technical assistance to build community capacity, resolve compliance challenges, and address water infrastructure needs in large and small water systems in rural, tribal, urban, and suburban communities across the country. The overall goals of the TA program are: (1) more communities with applications for federal funding, (2) quality water infrastructure, and (3) reliable water services.
Geographic coverage: Nationwide and U.S. Territories
Applications accepted on an ongoing basis
Sponsor: U.S. Environmental Protection Agency

Honor the Earth Building Resilience in Indigenous Communities Grants
Grants for Native organizations working to enhance the safety, health, and resilience of Indigenous communities' through culturally based projects focused on energy efficiency, renewable energy, and creating food security using traditional knowledge and methods.
Geographic coverage: Nationwide
Applications accepted on an ongoing basis
Sponsor: Honor the Earth

Rural Program Directors University
A training, networking, and peer learning community for program, associate program, and site directors of rural residency programs, training tracks, and pathways.
Geographic coverage: Nationwide
Applications accepted on an ongoing basis
Sponsor: RTT Collaborative

Virtual Living Room - Using Technology to Address the Critical Healthcare Needs of Veterans in Rural Areas
A grant program that combines rural technology, U.S. Department of Veterans Affairs resources, and local support to provide solutions to improve healthcare access for veterans in rural areas.
Geographic coverage: Nationwide
Applications accepted on an ongoing basis
Sponsors: Foundation for Rural Service, NTCA: The Rural Broadband Association, U.S. Department of Veterans Affairs

New Resources

2023 MIPS Eligibility Decision Tree
Presents information to determine if providers are eligible to participate in the Merit-Based Incentive Payment System (MIPS) in the 2023 Performance Year. Includes information on the low-volume threshold criteria.
Sponsoring organization: Centers for Medicare and Medicaid Services
Date: 05/2023

Accountable Health Communities (AHC) Model Evaluation: Second Evaluation Report
Provides an overview of the Accountable Health Communities (ACH) Model, which tests whether identifying and addressing core health-related social needs (HRSNs) of community-dwelling beneficiaries improves health outcomes, reduces healthcare costs, and reduces unnecessary healthcare utilization. Explores the context in which the AHC Model was implemented and the model's impacts on Medicaid, FFS Medicare, and Medicare Advantage beneficiaries. Presents information on participating organizations that had rural areas within their geographic target areas (GTAs) and compares outcomes among urban and rural participants.
Additional links: Findings at a Glance
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
Date: 05/2023

Addressing Food Insecurity in Rural Tennessee
A podcast that discusses local hospitals in rural Hardeman County, Tennessee that collaborated to improve access to healthy food for citizens who were experiencing food insecurity and a lack of transportation to grocery stores. Includes information on a community health needs assessment, data exploration, obesity rates, use of grant funds to address health and wellness, and more.
Sponsoring organization: American Hospital Association
Date: 05/2023

Adult Asthma Prevalence and Trend Analysis by Urban–Rural Status Across Sociodemographic Characteristics—United States, 2012-20
Examines 2020 asthma prevalence and 2012-2020 annual asthma trends by large central metro, large fringe metro, medium metro, small metro, micropolitan, and noncore location. Utilizes Behavioral Risk Factor Surveillance System (BRFSS) data to analyze geographic distribution of asthma conditions, which is further broken down by sex, age, race/ethnicity, educational attainment, insurance status, and income.
Author(s): Xiaoting Qin, Cynthia A. Pate, Hatice S. Zahran
Location: Journal of Allergy and Clinical Immunology: Global, 2(2), 100085
Date: 05/2023

America's Health Rankings Senior Report 2023
Provides a national and state-by-state overview of population health for older adults across 52 measures using data from 22 unique data sources. Covers social and economic factors, physical environment, clinical care, behaviors, and health outcomes. Highlights health disparities, including rural-urban disparities, across five categories of health. Includes state-by-state summaries and county-level maps for risk of social isolation by state.
Additional links: County-Level Maps for Risk of Social Isolation
Sponsoring organization: United Health Foundation
Date: 2023

The Association Between Social Functioning and Health Literacy Among Rural Southeastern African Americans with Hypertension
Analyzes how the relationship between social support and health literacy may mitigate health outcomes in African American populations in rural Southeastern USA. Utilizes data from the Southeastern Collaboration to Improve Blood Pressure Control trial to examine social isolation and health literacy in 1,221 individuals, with data further broken down by age, sex, education, income, cognition impairments, marriage status, and study site.
Author(s): Iliana Gutierrez, Joanna Bryan, Elizabeth Baquero, Monika M. Safford
Location: Health Promotion International, 38
Date: 05/2023

Association of Rural Living With COPD-Related Hospitalizations and Deaths in Us Veterans
Highlights a study aiming to identify the cause of higher COPD rates in rural areas. Utilizes VA data to draw conclusions about incidence and access to treatment for COPD for rural veterans. Breaks down data by age, comorbidities, and rurality, among other factors.
Author(s): Spyridon Fortis, Yubo Gao, Arianne K. Baldomero, et al.
Location: Scientific Reports, 13, 7887
Date: 05/2023

Behavioral Health Conditions Reach Crisis Levels: Counties Urge Stronger Intergovernmental Partnerships and Outcomes
Features a number of counties throughout the nation and details their behavioral health needs and access challenges. Presents each county as a case study. Describes the policy priorities for each county and the barriers to access. Several of the featured counties are rural.
Additional links: Executive Summary
Sponsoring organization: National Association of Counties
Date: 05/2023

Closing the Opportunity Gap for Young Children
Discusses the factors that cause inequities and limited access to resources for young children, such as poverty, food insecurity, abuse and violence, lack of social and emotional safety, inadequate healthcare and schooling, and more. Discusses policy and practices aimed at reducing opportunity gaps, with a focus on historically disadvantaged populations, including those in rural areas.
Additional links: Read Online
Sponsoring organization: National Academies of Sciences, Engineering, and Medicine
Date: 2023

Disparities in Diabetes Care: Differences Between Rural and Urban Patients Within a Large Health System
Examines rural versus urban residence and the related impact on a patient's quality of diabetes care. Analyzes 2019 data of 45,279 patients with diabetes in a large healthcare system, comparing rural versus urban outcomes of 5 diabetes care metrics. Discusses health disparities in diabetes care based on geography.
Author(s): Randy Foss, Karen Fischer, Michelle A. Lampman, et al.
Location: The Annals of Family Medicine, 21(3), 234-239
Date: 05/2023

Effect of the Communities That Care Prevention System on Adolescent Handgun Carrying: A Cluster-Randomized Clinical Trial
Analyzes the impact of Communities That Care (CTC), a community-based behavioral health intervention system, in reducing adolescent handgun carrying in rural areas. Examines survey data from 4,407 youth from 2003 to 2011 living in various rural communities and states in grades 5 through 12 and their likelihood to carry handguns.
Author(s): Ali Rowhani-Rahbar, Sabrina Oesterle, Emma L. Gause, et al.
Location: JAMA Network Open, 6(4)
Date: 04/2023

Evidence-Based, Whole-Person Care for Pregnant People Who Have Opioid Use Disorder
Report presents care recommendations for treatment of opioid use disorder during pregnancy. Discusses the risks of opioid use during and after pregnancy and explores factors to consider when treating pregnant people. Highlights barriers for rural patients.
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Date: 05/2023

Health Inclusive Poverty Measure Estimates in the United States: 2014 to 2021
Reports on the Health Inclusive Poverty Measure (HIPM), which expands the Supplemental Poverty Measure (SPM) by including health insurance values. Tables 3 and 6 include data on poverty rates for the HIPM and SPM for those inside and outside metro areas in 2021.
Sponsoring organization: U.S. Census Bureau
Date: 05/2023

Improving Health Care Access in Rural Communities: Obstacles and Opportunities
Presents the U.S. Senate Committee on Finance, Subcommittee on Health Care hearing on improving access to high-quality, affordable healthcare in rural communities. Discusses workforce issues, education pipeline, transportation, broadband, school-based health centers, payment models and value-based care, and rural friendly policies. Features testimonies from representatives of Frances Mahon Deaconess Hospital, Choptank Community Health System, Essentia Health, and the Sheps Center For Health Services Research.
Additional links: Testimony by David Herman, Testimony by Erin Aune, Testimony by Mark Holmes, Testimony by Sara Rich
Sponsoring organization: Senate Committee on Finance, Subcommittee on Health Care
Date: 05/2023

Medicaid Coverage in Metro and Small Town/Rural Counties, 2020-2021
Presents county-level data for children and non-elderly adults insured by Medicaid in 2020-2021.
Sponsoring organization: Georgetown University Health Policy Institute
Date: 05/2023

Pandemic Era Telehealth Innovations in the Mental Health and Substance Use Treatment Fields: Practice-Informed Findings and Recommendations
Report highlights some takeaways from the expansion of telebehavioral health during the COVID-19 pandemic. Discusses the ways behavioral health providers adapted telehealth to their practices and the effect that had on access, outcomes, and care utilization, among other factors. Details the effect telebehavioral health had on expanding access to rural areas.
Sponsoring organization: National Council for Mental Wellbeing
Date: 05/2023

RHC Billing 101 Webinar
Recording of a May 22, 2023, webinar providing an overview of traditional Medicare billing guidelines for Rural Health Clinics. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Sponsoring organization: National Association of Rural Health Clinics
Date: 05/2023

Rural Healthy People 2030: Common Challenges, Rural Nuances
Policy brief reporting the findings of Rural Healthy People 2030, a companion piece to the Healthy People 2030 initiative with a focus on health priorities of rural populations. Features statistics including the top 20 Rural Healthy People priorities with breakdowns by census region, Medicaid expansion status, gender, age, race, and field of employment.
Sponsoring organization: Southwest Rural Health Research Center
Date: 05/2023

Understanding the U.S. Behavioral Health Workforce Shortage
Discusses the shortage of behavioral health professionals across the country and highlights some of the contributing factors. Breaks down factors affecting licensed providers, clinical supporters, community care workers, and frontline workers. Makes recommendations for policymakers and includes considerations for rural areas.
Sponsoring organization: Commonwealth Fund
Date: 05/2023

Open Calls for Contributions

Call for Proposals: 2023 Annual Maryland Rural Health Conference
Deadline: Jun 23, 2023
Maryland Rural Health Association
Event Dates: Oct 22 - 24, 2023
Ocean City, MD
Conference Website

Call for Abstracts: 2023 Annual Appalachian Translational Research Network (ATRN) Summit
Deadline: Jun 30, 2023
Appalachian Translational Research Network
Event Dates: Oct 5 - 6, 2023
Morgantown, WV
Conference Website

Upcoming Events

Scaling Safe Food Delivery During & Post COVID-19
Time: 3:00 p.m. Central
National Indian Health Board
Don't Let the Germs Get Under Your Skin: Preventing Infections in Rural Hospitals
Illinois Health and Hospital Association
Springfield, IL
CMS ITU Training: Great Plains Area Virtual Trainings
Sessions available June 5 - June 14
Centers for Medicare and Medicaid Services
Emergency Preparedness and Response Efforts in Critical Access Hospitals
Time: 12:00 p.m Central
Rural Health Information Hub
Physician-Focused Payment Model Technical Advisory Committee (PTAC) Meeting
HHS Office of the Assistant Secretary for Planning and Evaluation
2023 Montana Frontier Healthcare Conference
HIMSS Montana Chapter, Montana Health Network
Billings, MT
2023 Annual South Dakota Rural Health Leaders Conference
South Dakota Association of Healthcare Organizations
Fort Pierre, SD
2023 IHA Small & Rural Hospitals Annual Meeting
Illinois Health and Hospital Association
Springfield, IL
2023 AHA Leadership Summit
American Hospital Association
Seattle, WA
2023 48th Annual USAging Conference & Tradeshow
Salt Lake City, UT
503.244.4294 Ext. 1003
2023 Annual CADCA's Mid-Year Training Institute
Community Anti-Drug Coalitions of America
Dallas, TX
Being an Ally in Indian Country
Time: 9:00 a.m. - 4:00 p.m. Pacific
Native Wellness Institute
Agricultural Health and Safety Course for Medical and Safety Professionals
Ag Health & Safety Alliance, AgriSafe Network, Nebraska, Central States Center for Agricultural Safety and Health, Great Plains Center for Agricultural Health, University of Nebraska Medical Center
Omaha, NE
Community Care Coordination: How to Effectively Identify, Engage and Sustain Community Partners
Time: 2:00 p.m. Central
National Rural Health Resource Center
Tribal Care Coordination Dashboard Project: Coeur Adolescent Support Team (CAST) Referrals
Time: 10:00 a.m. Mountain
Robert Wood Johnson Foundation, Systems for Action
2023 Rural Michigan Opioid and Substance Use Disorder Summit
Michigan Center for Rural Health
Gaylord, MI
2023 Annual NACo Conference
National Association of Counties
Austin, TX
2023 Annual Association of Clinicians for the Underserved Conference
Association of Clinicians for the Underserved
Washington, DC

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Please send an email telling how RHIhub has impacted you to Your stories may be used in testimony, budget documents and presentations concerning the Rural Health Information Hub.