FORHP Announcements – April 1

April 1, 2021

What’s New

American Rescue Plan Includes $6 Billion for CHCsThe sweeping, nationwide plan to recover from the pandemic will invest more than $6 billion in underserved and rural areas through Community Health Centers (CHCs). More than 91 percent of health center patients are individuals or families living at or below 200 percent of the Federal Poverty Guidelines, and more than 60 percent are racial or ethnic minorities.

Volunteer to Administer COVID-19 Vaccines.  The U.S. Department of Health & Human Services has expanded its definition of persons authorized to give the vaccine.  These include, among others, current and retired traditional and non-traditional health care professionals, and students in health care programs.

HHS: Special Enrollment Period for Health Coverage EXTENDEDLast week, the U.S. Department of Health & Human Services (HHS) announced that the special enrollment period for qualified individuals and families to purchase health insurance in states served by the HealthCare.gov platform has been extended to August 15.  Some states run their own health insurance enrollment websites and may or may not make a similar offer.  Enter your zip code to find local help. 

CHART Model’s ACO Track RFA Delayed to Spring 2022.  This week, the Centers for Medicare & Medicaid Services (CMS) announced that the release of the Community Health Access and Rural Transformation (CHART) Model Accountable Care Organization (ACO) Transformation Track Request for Applications (RFA) is delayed until spring 2022. The CHART Model aims to help rural communities transform their health care delivery systems. This delay applies only to the ACO Transformation Track.  Applications for the CHART Community Transformation Track are due by May 11, 2021.

HHS Reports on Risk of COVID-19 Infections in Fee-For-Service Medicare.  The U.S. Department of Health & Human Services points to several factors raising the risk of infections, hospitalization, and deaths. These risks vary across the country, with some geographic areas having higher concentrations of at-risk beneficiaries. This issue brief provides information on risk scores at the national, state, and county level, and includes a database of risk scores by county.

COMING SOON: Emergency Broadband Benefit ProgramThe Federal Communications Commission (FCC) Emergency Broadband Benefit (EBB) will make $3.2 billion available to qualifying households to lower the cost of high-speed internet service, providing discounts on internet service bills and an opportunity for a computer or tablet. The EBB program is similar to the Lifeline program with expanded eligibility, vendors, and subsidies.  We encourage you to develop a plan now to support patients to apply promptly after the application period is announced by the end of April; funds are expected to go quickly.

Funding and Opportunities

DOJ Services for Victims of Human Trafficking – Extended to April 16.  The U.S. Department of Justice (DOJ) will make 27 awards of up to $800,000 each, for direct services to victims of human trafficking.  Eligible applicants include state, local, and tribal governments, public housing authorities, and nonprofit organizations, with priority given to rural areas. A separate but related funding notice, DOJ Housing Assistance Grants for Victims of Human Trafficking – Extended to April 16, will invest $15 million in 25 awards for programs that provide transitional housing and financial assistance.

Pre-Admissions Workshops for AI/AN Students in Health Professions Training/Schools – April 23.  The National Center for American Indian Health Professions helps American Indian and Alaska Natives (AI/AN) prepare for application to medical school or other advanced health professions program.  Selected students must be current high school seniors (18 years or older), current community college or undergraduate students, or recent college graduates.

Loan Repayment and Scholarship Programs for the NHSC – May 6.  National Health Service Corps (NHSC) programs received an increase of $800 million in funding as part of the American Rescue Plan for pandemic relief (see What’s New above). This additional funding will support the largest number of NHSC clinicians in the program’s history. There is one application for working health professionals to apply to the NHSC Loan Repayment Program, the NHSC Substance Use Disorder Workforce Loan Repayment Program, and the NHSC Rural Community Loan Repayment Program.  The NHSC Scholarship Program, which is for eligible medical, dental and nursing students in any year of training, provides up to four years of scholar support.   Applications for all programs are due on May 6.

SAMHSA Overdose Treatments for Use by First Responders – May 17.  The Substance Abuse and Mental Health Services Administration (SAMHSA) will make up to 20 awards with total funding of $7.9 million to help first responders administer a drug or device for emergency reversal of opioid overdose.  Eligible applicants include state, local, and tribal governments and tribal organizations.

Rural Health Research

Research in this section is provided by the HRSA/FORHP-supported Rural Health Research Gateway.  Sign up to receive alerts when new publications become available. 

Post-acute Care Trajectories for Rural Medicare Beneficiaries: Planned versus Actual Hospital Discharges to Skilled Nursing Facilities and Home Health Agencies. Post-acute care services are designed to help patients transition from hospitalization in acute care facilities to their homes. Skilled nursing facilities and home health agencies provide the majority of post-acute care services to Medicare beneficiaries. This study from the WWAMI Rural Health Research Center used Medicare administrative data for rural, fee-for-service Medicare beneficiaries to describe post-acute care trajectories following acute hospitalization and examine differences between planned discharge disposition from the hospital and actual post-acute care received.

Policy Updates

Visit the FORHP Policy page to see all recent updates and send questions to ruralpolicy@hrsa.gov.

CMS Guidance to Resume Hospital Survey ActivitiesAs of March 23, 2021, the Centers for Medicare & Medicaid Services (CMS) is lifting the suspension on hospital survey activities, which was put in place due to the public health emergency.  Non-immediate jeopardy complaints received during the suspension period will be investigated within 45 days of the memo’s release.  Hospitals with surveys that ended after January 20, 2021 will have 10 days from the memo’s release to develop plans of correction, unless an extension is requested.

Updated Guidance on Emergency Preparedness RequirementsOn March 26, the Centers for Medicare & Medicaid Services (CMS) released guidance interpreting the emergency preparedness requirements in the Burden Reduction Final Rule of 2019, which applies to all providers and suppliers.  In response to the public health emergency, the guidance also provides best practices, lessons learned, and planning considerations for emerging infectious diseases.

Learning Events and Technical Assistance

HRSA Building COVID-19 Vaccine Trust for Patients – Wednesday, April 7 at 1:00 pm ET. The Bureau of Health Workforce at the Health Resources and Services Administration (HRSA) invites clinicians, grantees, students, and the public at large to the Clinical Leaders Forum webinar: Building COVID-19 Vaccine Trust for Community Health Center Patients.

ASTHO Tackling Inequities in Digital Care Webinar – Monday, April 12 at 2:00 pm ET.  The Association of State and Territorial Health Officials (ASTHO) will hold a 90-minute webinar to present innovations that improve digital equity and potentially lower disparities.

NHLBI: Disease Management Tools for the Underserved – Wednesday, April 14 at 10:00 am.  The National Heart, Lung, and Blood Institute (NHLBI) is hosting a two-day virtual workshop to discuss barriers to—and opportunities for—improving heart, lung, blood, and sleep health in underserved communities. Participants will discuss how to tailor health monitoring devices and tools that diagnose patients in underserved, low-resource, and remote communities.

NTIA Series on Broadband Grant Programs – Wednesday, April 14 at 2:30 pm ET.  The National Telecommunications and Information Administration (NTIA), part of the U.S. Department of Commerce, will hold a series of webinars in connection with three new broadband grant programs authorized and funded by the Consolidated Appropriations Act, 2021: The Broadband Infrastructure Program, the Tribal Broadband Connectivity Program, and the Connecting Minority Communities Program. The webinars, taking place April – July, are designed to help applicants prepare high quality grant applications.

HRSA: Expanding Rural OUD Treatment via Telehealth – Thursday, April 15 at 12:00 pm ET.  The Health Resources and Services Administration (HRSA) will hold a one-hour session to highlight innovative telehealth for treatment of opioid use disorder (OUD) in rural areas.

Rural Community Health Workers for COVID-19 – Thursday, April 15 at 1:00 pm ET.  The National Rural Health Association (NRHA), in partnership with the Federal Office of Rural Health Policy (FORHP), will host an hour-long webinar featuring Dr. John Brooks, Medical Epidemiologist from the Centers for Disease Control and Prevention. See more about rural Community Health Workers below under Resources of the Week.

Resource of the Week

Opioid and Substance Use Strategies for CAHs. The HRSA/FORHP-funded Flex Monitoring Team has released their archived webinar on opioid and substance use in rural communities.  The webinar took place in February to accompany a policy brief published last year.  The webinar discusses why Critical Access Hospitals (CAHs) should address these issues, provides a framework to support them in this work, and provides examples of activities CAHs are participating in.

Approaching Deadlines

DOJ Violence Against Women Grants to Indian Tribal Governments – April 7

HRSA Behavioral Workforce Education and Training Program for Paraprofessionals – April 12

HRSA Grants for RCORP – Psychostimulant Support – April 12

CMS Community Health Access and Rural Transformation Model (CHART) – Letters of Intent (Optional) April 13

DOJ Second Chance Act Community-Based Reentry Program – April 13

DOJ Research and Evaluation on Violence Against Women – Extended to April 13  (from March 16)

NIH Community COPD Awareness – April 14

Information Requested: NIH Improving the Mental Health of Rural People – April 15

DOJ Housing Assistance Grants for Victims of Human Trafficking – Extended to April 16 (from March 1) 

DOJ Services for Victims of Human Trafficking – Extended to April 16 (from March 2)  

SAMHSA SBIRT Program for Substance Use Disorder – April 19

HHS Advancing Health Literacy to Enhance Equitable Community Responses to COVID-19 – April 20

Pre-Admissions Workshops for AI/AN Students in Health Professions Training/Schools – April 23

CDC Childhood Lead Poisoning Prevention and Surveillance – April 25

DOJ Tribal-Researcher Capacity Building Grants – April 26

DOL Grants for State Apprenticeship Programs – April 26

DOL Young Adult Reentry Partnership – April 26

SAMHSA: MAT for Prescription Drug and Opioid Addiction – April 27

USDA Rural Health and Safety Education Grants – April 29

CMS Primary Care First Model Cohort 2 – April 30

Delta Region Innovative Readiness Training Medical Missions – Letters of Intent April 30

NIH Firearm Injury/Mortality Prevention Research – April 30

CDC Preventing Violence Affecting Young Lives – May 1

John Hopkins Center for American Indian Health Scholarship – May 1

CDC National Initiative to Address COVID-19 Health Disparities – May 3

NIH Small Business Innovations for Improving Minority Health – May 3

HUD Older Adults Home Modification Grants – May 4

NHSC Loan Repayment Program – May 6

NHSC Rural Community Loan Repayment Program – May 6

NHSC Scholarship Program – May 6

NHSC Substance Use Disorder Workforce Loan Repayment Program – May 6

Nurse Corps Scholarship Program – May 6

NIH Research for End-of-Life and Palliative Care Health Literacy – May 7

EPA Environmental Justice Collaborative Problem-Solving – May 7

Treasury Department Emergency Capital Investment Program – May 7

ACL Alzheimer’s Disease Program Grants to States and Communities – Extended to May 10 (from April 26)

CDC Drug Free Communities – May 10

CMS Community Health Access and Rural Transformation Model (CHART) – Extended to May 11 (from March 16)

Enhancement Grants for Native American Library Services – May 11

EPA Technical Assistance for Wastewater Treatment – May 17

SAMHSA Overdose Treatment for Use by First Responders – May 17

Comments Requested:  Proposed Changes to the Census Bureau Definition of Urban – May 20

CMS Minority Research Grant Program – June 11

USDA Summer Food Service Program – June 15

Special Enrollment Period for Health Coverage – Extended to August 15 (from May 15)

Ongoing Opportunities

Extended Public Comment Period for FCC’s COVID-19 Telehealth Program

AHRQ Research to Improve Patient Transitions through HITDecember 2022

American Indian Public Health Resource Center Technical Assistance

ASA Rural Access to Anesthesia Care Scholarship

CDC Direct Assistance to State, Tribal, Local, and Territorial Health Agencies

CDC Training Pediatric Medical Providers to Recognize ACEs

Delta Region Community Health Systems Development Program

Department of Commerce: Economic Development Assistance Programs

Department of Labor Dislocated Worker Grants

Department of Labor Stand Down Grants for Veterans Services – through December 2021

DRA Technical Assistance for Delta Region Community Health Systems Development

EPA Drinking Water State Revolving Fund

FCC COVID-19 Telehealth Program – Public Comments Requested

GPHC & RWJF: Rapid Cycle Research and Evaluation Grants for Cross-Sector Alignment

Housing Assistance Council: Housing Loans for Low-Income Rural Communities

HUD Hospital Mortgage Insurance Program

IHS Tribal Forensic Healthcare Training

IHS/DOD Medical Supplies and Equipment for Tribes (Project TRANSAM)

NARHC Certified Rural Health Clinic Professional Course

NIH Practice-Based Research for Mental Health Interventions in Pediatric Primary Care SettingsJuly 1, 2021 (Letters of Intent June 1)

NIH Research to Improve Health Care Quality and Outcomes Through HIT – July 17, 2021

NIH Research for AI/AN End-of-Life CareJanuary 8, 2022

NIH Dissemination and Implementation Research in HealthMay 2022

NIH Research – Alcohol and Other Substance Use – Various Dates Through August 2022

NIH Research on Minority Health/Health DisparitiesSeptember 8, 2022

NIH Research on Palliative Care in Home/Community Settings – September 8, 2022

NIH Intervention Research to Improve Native American Health – Various Dates Until September 2023

Nominations for Federal Advisory Commission on HIV, Viral Hepatitis, and Sexually Transmitted Diseases

Nominations for National Advisory Committee on Migrant Health

Opportunity Zones for Economic Development

Primary Care Development Corporation Community Investment Loans

Rural Graduate Medical Education Planning and Development

RWJF Investigator-Initiated Research to Build a Culture of Health

RWJF Pioneering Ideas Brief Proposals

SBA Guaranteed Loans for Small Business

Southeast Rural Community Assistance Loans

Tribal Grant Writing Training

USDA Community Facilities Program

USDA Community Food Projects Technical Assistance

USDA Drinking Water and Waste Disposal for Rural and Native Alaskan Villages

USDA Economic Impact Initiative Grants

USDA Emergency Community Water Assistance Grants

USDA Guaranteed Loans for Rural Rental Housing – through 2021

USDA Intermediary Relending Program

USDA Rural Business Development Grants

USDA Rural Business Investment Program

USDA Rural Energy Savings Program

USDA Summer Food Program

USDA Technical Assistance for Healthy Food Financing Initiative

USDA Telecommunications Infrastructure Loans

USDA Funding for Rural Water and Waste Disposal Projects

USDOT Rural Opportunities to Use Transportation for Economic Success (R.O.U.T.E.S)

The Announcements from the Federal Office of Rural Health Policy are distributed weekly. To subscribe, sign up for Rural Health Updates at HRSA.gov.

The vClinician: Mom and Babies Opioid User Disorder App

JBS International is a proud Phase 1 and Phase 2 winner of the Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau Grand Challenge: Addressing Opioid Use Disorder in Pregnant Women and New Moms. Their response to HRSA’s Challenge provides a mobile decision-support application (i.e., vClinician: M&B OUD [Moms and Babies Opioid Use Disorder]) or “virtual clinical guide” to health care providers and educators in diverse medical settings.

You are invited to utilize this app where content focuses on one the following:

To download this free mobile app, go to the App Store (for iPhones) and Google Play Store (for Android phones) and search for vClinician: M&B OUD. For more information, please download vClinician: M&B OUD App Guide in the link.

COVID-19: Nursing Home Reporting, Updated Telehealth Video, Pharmacies & Other

CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS)

Special Edition – Friday, May 8, 2020

New Guidance Available on Requirements for Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes

Nursing homes are now required to report the first week of COVID-19 data to the Centers for Disease Control and Prevention (CDC) beginning May 8 but no later than May 17. For the first time, all 15,000 nursing homes will be reporting this data directly to the CDC through its reporting tool. This reporting requirement is the first action of its kind in the agency’s history. On April 19, CMS announced the agency would be requiring facilities to report COVID-19 information to the CDC and to families. Within three weeks of that announcement, on April 30, CMS issued an Interim Final Rule with Comment Period with the new regulatory requirements. As nursing homes report this data to the CDC, we will be taking swift action and publicly posting this information so all Americans have access to accurate and timely information on COVID-19 in nursing homes.

CMS has a longstanding requirement for nursing homes to report cases of communicable diseases, such as COVID-19, to the appropriate state or local health department. This new requirement not only helps health departments intervene when needed but serves to provide awareness to the public (e.g., families) and surveillance for public health agencies and the CDC. The importance of ongoing transparency and information sharing has proven to be one of the keys to the battle against this pandemic. Building upon the successes of the Trump Administration prior to COVID-19, CMS has strongly supported transparency, such as the work done over the past several years to improve public access and understanding of nursing home inspection reports and expand the information available to consumers on Nursing Home Compare. The agency remains committed to greater transparency and plans to publicly release new data by the end of May. CMS will never stop working to give patients, residents, and families the clearest and most accurate information possible.

Guidance and Frequently Asked Questions

Telehealth Video: Medicare Coverage and Payment of Virtual Services

This updated video provides answers to common questions about the expanded Medicare telehealth services benefit under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act.

Medicare Pharmacies and Other Suppliers May Temporarily Enroll as Independent Clinical Diagnostic Laboratories to Help Address COVID-19 Testing MLN Matters® Article

A new MLN Matters Special Edition Article SE20017 on Medicare Pharmacies and Other Suppliers May Temporarily Enroll as Independent Clinical Diagnostic Laboratories to Help Address COVID-19 Testing is available. Learn how to temporarily enroll to be an additional laboratory resource to meet the urgent need to increase COVID-19 testing capability.

COVID-19: IRF Flexibilities During the PHE

CMS is exercising regulatory flexibilities for Inpatient Rehabilitation Facilities (IRFs) during the COVID-19 Public Health Emergency (PHE) to waive the 60 percent rule.

We are also waiving IRF coverage and classification requirements if all of these criteria are satisfied:

  • Patient is admitted to a freestanding IRF to alleviate acute care hospital bed capacity issues
  • IRF is located in an area that is in Phase 1 or has not entered Phase 1; see Guidelines for Opening Up America Again

Add the following letters at the end of your unique hospital patient identification number (the number that identifies the patient’s medical record in the IRF) to identify patients eligible for each waiver:

  • D- 60 percent rule
  • DS- Coverage and classification requirements
  • DDS- Both 60 percent rule and coverage and classification requirements

For More Information:

COVID-19: IRF Interdisciplinary Team Meetings During the Pandemic

CMS expects Inpatient Rehabilitation Facilities (IRFs) to hold in-person weekly interdisciplinary team meetings to discuss Medicare Part A fee-for-service patients. During the public health emergency, it may be safest to conduct meetings electronically. We will accept all appropriate forms of social distancing precautions.

N95 and PPE Decontamination by the National Guard

National Guard protocol for collecting and decontaminating N95 masks and PPE  Residential treatment programs can coordinate pick-up and return with the County Local Emergency Management Agency (EMA). 

Programs  can coordinate pick-up and return with the County Local Emergency Management Agency (EMA) – here is a link to the phone numbers for each county agency.

New Marshall ECHO Clinics to Focus on Treatment of Endocrinology and Cardiology Issues in West Virginia

 

Marshall University has launched a new program to help primary care providers treat conditions associated with endocrinology and cardiology issues.

ECHO Clinics, in partnership with Project ECHO (Extension for Community Healthcare Outcomes) will be held the first Tuesday of each month at 12 p.m. with alternating endocrinology and cardiology sessions.

Project ECHO uses a telehealth model to bridge the gap in health care for rural and underserved communities.

Contact Jennifer Plymale at plymale@marshall.edu to learn more or if you are interested in participating in ECHO clinics.

Participation in teleECHO clinics is free. Participants who join teleECHO clinics receive free Continuing Medical Education credits for the total time spent participating, including didactics and patient-case presentations.

What is Project ECHO?

The ECHO model is not ‘traditional telemedicine’ where the specialist assumes care of the patient, but instead a guided practice model where the primary care provider retains responsibility for managing the patient.

During a teleECHO clinic, using video technology, primary care providers in multiple locations present patient cases to a multidisciplinary team of specialists to determine treatment. These specialists serve as mentors, training community providers to provide care in clinical areas that were previously outside their expertise.

Over time the primary care providers operate with increased independence as their skills and self-efficacy grow. A teleECHO clinic is, essentially, virtual grand rounds. Primary care providers from multiple locations connect at regularly scheduled times with a team of specialists using low cost, multi-point videoconferencing.

During teleECHO clinics providers present patient cases to specialist expert teams who mentor the providers to manage patients with common, complex conditions. These case based discussions are supplemented with short didactic presentations to improve content knowledge and share evidence based best practices.

Geriatrics ECHO

Elderly patients are a unique and growing population in Central Appalachia and can benefit tremendously from advanced treatment techniques.

Marshall Health’s Geriatrics ECHO will provide education and support to rural and suburban providers on the challenges faced by these important patients.

Shirley Neitch, MD, FACP, AGSF, Chief of Marshall’s Section of Geriatrics, will provide didactic instruction on emerging issues in geriatrics care and lead discussions on sample case studies provided by real clinics.

The initial ECHOs will focus on responsible benzodiazepine administration and deprescribing and future events will explore other areas of geriatric care, including dementia.

Geriatric ECHOs will be held via videoconference on the third Tuesday of each month starting Feb. 19.

For more information or to register your organization to participate, contact J.T. Schneider at 304-691-8982 or schneider7@marshall.edu.