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Rural Health Information Hub

RHIhub This Week - September 6, 2023

New in the Rural Monitor

silhouette of a man in a jail cell 'Planting Seeds of Change': In Rural Counties, Expanding Jail-Based Mental Health Services is a Community Effort
by Gretel Kauffman
In rural communities, where funding is often limited and mental health resources may be scarce, ensuring incarcerated people have access to needed care can be a challenge.

Exploring Rural Health Podcast

Rural Recovery Housing, featuring Ernie Fletcher and Erica Walker
Check out our latest episode with discussion about recovery housing in rural communities. Features Governor Ernie Fletcher, co-founder and Chief Medical Officer of the Fletcher Group, and Erica Walker, Outreach and Engagement Specialist for the Fletcher Group.

 New in Our Online Library
 Information from around the web

Recent News

Bolstering the Health Workforce Starts With Good Data, Strong Incentives
Sep 6, 2023 -- Summarizes a discussion on rural healthcare workforce recruitment and retention at the 2023 National Conference of State Legislatures Legislative Summit. Notes that good data helps policymakers understand where the need is greatest so that resources can be prioritized for those places. Describes incentives used across the country including loan repayment programs, interstate compacts, virtual networking, and more.
Source: National Conference of State Legislatures

Even in the Most Depressed County in America, Stigma Around Mental Illness Persists
Sep 6, 2023 -- Discusses depression rates in Logan County, West Virginia. A recent report found that 32% of the county's residents have been diagnosed with depression which is the highest rate in the country. Also notes that the counties with the highest rates for depression tend to be found in Appalachia. Describes the mental healthcare options in the county and how stigma contributes to low use.
Source: KFF Health News, USA Today

2nd Round of Wildfire-Prevention Funding Will Have Tools to Help Rural Applicants
Sep 5, 2023 -- Following analysis of the first round recipients of the Community Wildfire Defense Grant, the U.S. Forest Service has developed new tools to allow lower resourced communities a better chance at success in the second round of funding. The lower resourced communities are often rural the analysis found. Notes challenges for rural communities in securing grants are usually less administrative capacity and less access to matching funds.
Source: The Daily Yonder

CMS Announces Transformative Model to Give States Incentives and Flexibilities to Redesign Health Care Delivery, Improve Equitable Access to Care
Sep 5, 2023 -- Announcement from the Centers for Medicare & Medicaid Services (CMS) of the States Advancing All-Payer Health Equity Approaches and Development Model (AHEAD Model), a model built on lessons learned from the Maryland Total Cost of Care Model, the Vermont All-Payer ACO Model, and the Pennsylvania Rural Health Model. 8 states will receive up to $12 million to redesign healthcare delivery with a focus on investment in primary care, providing hospitals with a prospective payment stream, improving care coordination, and increasing referrals for community resources. The first funding opportunity will be released in the fall of 2023 with a second coming in the spring of 2024.
Source: Centers for Medicare & Medicaid Services

Rural Arkansas Hospitals Weigh Trading Inpatient Care for New Federal Funds
Sep 5, 2023 -- A hospital in rural Arkansas has become the state's first Rural Emergency Hospital (REH). Describes the distribution of hospitals in Arkansas and discusses the financial instability of rurally located facilities. Describes payment systems for various facility types and the impact that has on a hospital's decision-making when considering converting to an REH.
Source: Arkansas Advocate

Biden Harris Administration Invests More Than $80 Million to Help Rural Communities Respond to Fentanyl and Other Opioid Overdose Risks
Aug 31, 2023 -- Announcement of over $80 million in funding across 39 states through the Rural Communities Opioid Response Program (RCORP) for response to the opioid and fentanyl crisis. Funded programs address issues such as access to medication to treat opioid use disorder, overdose prevention, mental health, neonatal exposure, and disseminating best practices in treatment and prevention.
Source: Health Resources & Services Administration

Federal Register

CMS: Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting
Sep 6, 2023 -- Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) that would establish minimum staffing standards for long-term care facilities. This rule also proposes to require states to report the percentage of Medicaid payments for certain Medicaid-covered institutional services that are spent on compensation for direct care workers and support staff. Comments are due by November 6, 2023.
Source: Federal Register

CMS: Medicare Program: Hospital Outpatient Prospective Payment System: Remedy for the 340B-Acquired Drug Payment Policy for Calendar Years 2018-2022; Extension of Comment Period
Sep 5, 2023 -- Notice from the Centers for Medicare & Medicaid Services (CMS) extending the comment period for the July 11, 2023, proposed rule titled "Medicare Program; Hospital Outpatient Prospective Payment System: Remedy for the 340B-Acquired Drug Payment Policy for Calendar Years 2018-2022." Comments are now due September 11, 2023.
Source: Federal Register

Funding & Opportunities

Rural Economic Development Loan and Grant Program (REDL and REDG)
Loans and grants to assist in the economic development of rural areas, including funds for healthcare facilities and equipment, telecommunications networks, and job creation projects.
Geographic coverage: Nationwide
Application Deadline: Sep 30, 2023
Sponsors: U.S. Department of Agriculture, USDA Rural Development

Health Center CEO Leadership Institute
A 6 month educational program for health center CEOs to learn with and from peers and sharpen health center-specific leadership skills.
Geographic coverage: Nationwide
Application Deadline: Oct 16, 2023
Sponsor: National Association of Community Health Centers

Service Area Competition Funding for Health Center Program (Areas Served with a Project Period Start Date of June 1, 2024)
Funding to provide comprehensive primary healthcare services to an underserved area or population. Areas with a June 1, 2024 project period start date are eligible to apply.
Geographic coverage: Nationwide and U.S. territories
Application Deadline: Oct 30, 2023
Sponsors: Bureau of Primary Health Care, Health Resources and Services Administration, U.S. Department of Health and Human Services

Community Wildfire Defense Grants
Grants for at-risk local communities and tribes to plan for and mitigate the risk created by wildfires. Priority is given to projects located in areas identified as having a high or very high wildfire hazard potential; that benefit low-income communities; and/or serve communities impacted by a severe disaster within the previous 10 years.
Geographic coverage: Nationwide and U.S. territories
Application Deadline: Oct 31, 2023
Sponsors: Forest Service, U.S. Department of Agriculture

Drinking Water System Infrastructure Resilience and Sustainability Program
Funding for projects in small and disadvantaged communities that are designed to increase natural hazard resilience in drinking water systems.
Geographic coverage: Nationwide
Application Deadline: Nov 6, 2023
Sponsor: U.S. Environmental Protection Agency

NIH Extramural Loan Repayment Program
Loan repayment assistance for researchers that are not employed by the NIH. Loan repayment awards are based on an applicant's potential to build and sustain a research career, not to support specific research.
Geographic coverage: Nationwide and U.S. territories
Application Deadline: Nov 16, 2023
Sponsors: National Institute on Minority Health and Health Disparities, National Institutes of Health, U.S. Department of Health and Human Services

New Resources

Caring for Rural Communities in the Geriatric ED
Webinar recording discussing care for older patients in rural emergency departments. Includes information on rural specific challenges and innovative rural programs. Transcript available within the video playback.
Additional links: Chat Notes, Slide Deck
Sponsoring organization: The Geriatric Emergency Department Collaborative
Date: 08/2023

Emergency Department Interventions for Opioid Use Disorder: Overview of the Landscape, Key Components, and Analysis of Five Case Studies
Provides an overview of the evidence base for emergency department (ED)-based programs to address and treat opioid use disorders (OUD). Describes factors that motivated the development of these programs, how they are structured and financed, and barriers and facilitators to ED-based OUD treatment. Features case studies of five ED-based programs, including Marshall Medical Center in rural California.
Sponsoring organizations: Brandeis University, HHS Office of the Assistant Secretary for Planning and Evaluation
Date: 08/2023

Health Disparities in Central Nervous System Disorders: Driving Transformative Change: Proceedings of a Workshop–in Brief
Highlights the proceedings of a workshop on strategies to reduce health disparities relating to central nervous system (CNS) disorders. Explores CNS health disparities in rural and low-income communities and among racial and ethnic minority groups, such as American Indian and Alaska Native tribal nations. Discusses the roles academia, industry, and the government have in creating a diverse neuroscience workforce to advance community partnerships and collaborations.
Additional links: Read Online
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
Date: 2023

Impact of Higher Payments for Rural Home Health Episodes on Rehospitalizations
Examines the impact of home health rural add-on payments on beneficiary outcomes, specifically on rehospitalizations. Uses Medicare data from 2007 to 2014 to compare rehospitalizations between rural and urban post-acute home health episodes before and after the implementation of the add-on payments in 2010. Discusses the implications of the findings on home health payment policy.
Author(s): Lacey Loomer, Momotazur Rahman, Tracy M. Mroz, Pedro L. Gozalo, Vincent Mor
Location: Journal of Rural Health, 39(3), 604-610
Date: 06/2023

Improving Maternal and Infant Services in Rural Iowa
Podcast episode discussing how St. Anthony Regional Hospital in Carroll, Iowa, responded to decreasing access to maternal health care in rural Iowa. Discusses the hospital's Center for Excellence pilot program that aims to expand access to obstetric services and improve maternal and infant health outcomes.
Sponsoring organization: American Hospital Association
Date: 09/2023

Mental Health Matters: Policy Framework on Workforce Mental Health
Policy framework designed to support the development of workforce mental health policies. Discusses nondiscrimination, workplace supports, rural communities, workforce shortages and more.
Sponsoring organization: National Conference of State Legislatures
Date: 08/2023

Missing Components of Receptor Status Among Women With Invasive Breast Cancer
Examines factors related to the testing of receptors that aid in accurate prognosis and treatment of patients with invasive breast cancer. Analyzes patient data of 321,913 women for missing components of receptor status (MCRS) according to patient and clinical characteristics, such as age at diagnosis, race, insurance status, rural versus urban residence, and more.
Author(s): Julie A. Stephens, James L. Fisher, Robert Wesolowski, Electra D. Paskett
Location: JAMA Network Open, 6(8)
Date: 08/2023

National Advisory Council on the National Health Service Corps (NACNHSC) Meeting Minutes, June 27–28, 2023
Minutes from the June 27-28, 2023 meeting, including presentations on a family medicine residency program at the Northern Navajo Medical Center in Shiprock, New Mexico, the Choptank Community Health System community-based program in Maryland, managing patients with complex conditions, empowering clinicians for resiliency and transformative care, reports from Bureau of Health Workforce council meetings, and National Health Service Corps updates.
Additional links: Agenda, Choptank Community Health System Community-Based Program, Shiprock-UNM Family Medicine Residency
Sponsoring organization: National Advisory Council on the National Health Service Corps
Date: 06/2023

National Rural Health Day 2023 Key Messages & Data Points
Provides messages and data points regarding issues such as healthcare infrastructure, hospitals, and clinics; the strengths of the rural healthcare workforce; demographics of rural communities related to population, income, food insecurity, and healthcare shortages; and the services provided by the State Offices of Rural Health (SORHs).
Sponsoring organization: National Organization of State Offices of Rural Health
Date: 08/2023

Nonfatal and Fatal Falls Among Adults Aged ≥65 Years — United States, 2020–2021
Reports on older adults who reported falling, as well as unintentional fall-related death rates among older adults. Includes data for metropolitan, micropolitan, and noncore areas.
Sponsoring organization: Centers for Disease Control and Prevention
Location: MMWR (Morbidity and Mortality Weekly Report), 72(35), 938-943
Date: 08/2023

Pediatric Hospitalizations at Rural and Urban Teaching and Nonteaching Hospitals in the US, 2009-2019
Describes changes in the number and proportion of pediatric hospitalizations and costs at urban teaching, urban nonteaching, and rural hospitals versus freestanding children's hospitals from 2009-2019. Estimates the number and proportion of hospitals providing inpatient pediatric care and characterizes changes in clinical complexity. Features statistics including sociodemographic, clinical, and hospital characteristics of pediatric hospitalizations, with breakdowns by urban and rural location.
Author(s): JoAnna K. Leyenaar, Seneca D. Freyleue, Mary Arakelyan, David C. Goodman, A. James O'Malley
Location: JAMA Network Open, 6(9)
Date: 09/2023

Quality Time: Sharing PIE – Improving Swing Bed Quality
Podcast episode discussing how two Critical Access Hospital (CAH) quality improvement leaders in Mississippi and Nevada used proactive approaches to improve their swing bed programs. Describes efforts in reducing healthcare-associated infections with pneumonia and improving the documentation and coordination of swing bed patients.
Sponsoring organization: Stratis Health
Date: 09/2023

Rural Disaster Behavioral Health: A Guide for Outreach Workers and Crisis Counselors
Provides recommendations to behavioral health professionals who are working with rural populations following a disaster. Offers an overview of rural populations in the United States, behavioral health impacts of disasters, strategies to effectively assist in a rural context, and disaster response recommendations and resources.
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Date: 08/2023

Rural Emergency Hospitals: Legislative and Regulatory Considerations for States
Provides an overview of the Rural Emergency Hospital designation, including licensure and federal requirements for the designation that states must consider before pursuing legislation for REH licensure. Presents a table comparing how 14 states addressed these considerations. Offers legislation to assist states that want to pursue the model.
Additional links: Guide to Legislative and Regulatory Considerations for States
Sponsoring organization: National Academy for State Health Policy
Date: 08/2023

SAMHSA Strategic Plan 2023-2026
Details the Substance Abuse and Mental Health Services Administration's framework and funding priorities for 2023-2026. Discusses priorities such as strengthening the behavioral health workforce, suicide prevention, and behavioral health integration, among other issues. Highlights behavioral health equity measures that address rural communities.
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Date: 08/2023

Sociodemographic Differences in COVID-19 Pandemic Experiences Among Families in the United States
Examines challenges experienced by individuals during the COVID-19 pandemic according to sociodemographic differences. Analyzes survey data focused on children and caregivers and their experiences with infection and testing, healthcare, school, access to food, child care and work, financial concerns, and more. Data is broken down by demographic variables such as caregiver education, age of children, and rural versus urban location.
Author(s): Kaja Z. LeWinn, Leonardo Trasande, Andrew Law, et al.
Location: JAMA Network Open, 6(8)
Date: 08/2023

Use of Medication for Opioid Use Disorder Among Adults With Past-Year Opioid Use Disorder in the US, 2021
Evaluated 47,291 adults using the 2021 National Survey on Drug Use and Health to determine whether rates of medication for opioid use disorder (MOUD) use changed following implementation of COVID-19 pandemic policies intended to increase availability. Discusses gender, age, race and ethnicity, telehealth, and metro versus nonmetro residence.
Author(s): Christopher M. Jones, Beth Han, Grant T. Baldwin, Emily B. Einstein, Wilson M. Compton
Location: JAMA Network Open, 6(8)
Date: 08/2023

Year Three Evaluation Report: Evaluation of the EMS Supplemental Funding Grants
Provides an overview of the eight Flex Program Emergency Medical Services (EMS) Supplemental funding grant recipients, including a summary of the project goals, partners, and outcome measures. Details each grantee's project accomplishments, lessons learned, and sustainability strategies.
Sponsoring organization: Flex Monitoring Team
Date: 09/2023

Open Calls for Contributions

Call for Presentations: 2024 34th Annual National Leadership Forum & SAMHSA's 20th Prevention Day
Deadline: Sep 18, 2023
Community Anti-Drug Coalitions of America
Event Dates: Jan 29 - Mar 1, 2024
National Harbor, MD
Conference Website

Upcoming Events

American Indian/Alaska Native Communities Defining Their Own Principles of Recovery
Time: 2:00 p.m. Eastern
Federal Office of Rural Health Policy, Substance Abuse and Mental Health Services Administration
Coming Face to Face With Suicide in American Farming
Time: 2:30 - 4:00 p.m. Eastern
National Institute of Mental Health
2023 50th Annual NARMH Conference
National Association for Rural Mental Health
Pittsburgh, PA
2023 Annual NOSORH Meeting
National Organization of State Offices of Rural Health
Traverse City, MI
The Global Rural Nursing Exchange Network (GRNEN) Presents: Psychologically Traumatic Experiences of Rural Registered Nurses Who Live and Work in the Same Community
Time: 3:30 - 4:30 p.m. Central
University of Texas at Arlington Center for Rural Health and Nursing
State Plans for Continuing Key Medicaid Home and Community-Based Flexibilities Implemented During the Public Health Emergency
Time: 1:00 p.m. Central
National Academy for State Health Policy
2023 2nd Annual Texas Rural Health Conference
University of Texas at Arlington Center for Rural Health and Nursing
Arlington, TX
2023 Annual Colorado Rural Health Conference
Colorado Rural Health Center
Aurora, CO
2023 Illinois Rural Health Summit: Exploring Gender Health Equity Through Policy
Southern Illinois University School of Law, Southern Illinois University School of Medicine
Springfield, IL
2023 27th Annual Florida Rural Health Association Educational Summit
Florida Rural Health Association
Tampa, FL
2023 40th Annual Oregon Rural Health Conference
Oregon Office of Rural Health
Sunriver, OR
31st Annual California Fall Health Professional Shortage Area (HPSA) Designation Workshop
California Department of Health Care Access and Information, California Primary Care Office, California State Office of Rural Health
Seaside, CA
AgriStress Response Network - Mental Health Innovations Exchange
Time: 10:00 - 11:00 a.m. Central
Sessions available monthly through 2023
AgriSafe Network

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