An Update on the Federal Overdose Prevention Strategy. FORHP’s Rural Communities Opioid Response Program figures prominently among ongoing federal grant programs that are part of the strategy that is now entering its third year. The effort involves every one of the 12 operating divisions of the U.S. Department of Health & Human Services and, in 2023 alone, featured groundbreaking changes to policy that include:
- Eliminated the Drug Enforcement Agency waiver for prescribing medications for opioid use disorder (MOUD) and made temporary rules for prescribing via telemedicine permanent; (See more details about SAMHSA policy changes for MOUD in the next item.)
- Increased Medicare payment rates for opioid treatment programs (OTPs), including services provided by mobile units;
- Expanded the clinical workforce that may bill Medicare by including marriage and family therapists, licensed professional counselors, and others to provide behavioral health services;
- Established Medicare payment for Intensive Outpatient Program services, which can be furnished in hospital outpatient departments, Community Mental Health Centers, Federally Qualified Health Centers, Rural Health Clinics, and OTPs.
The latest initiative in the overdose prevention strategy was announced earlier this week. The Substance Abuse and Mental Health Services Administration will invest more than $20 million to advance health information technology in behavioral health care and practice settings.
SAMHSA Finalizes Rule on Medications for the Treatment of Opioid Use Disorder. On January 31, the Substance Abuse and Mental Health Services Administration (SAMHSA) published final revisions to federal regulations surrounding opioid use disorder treatment standards, including accreditation and certification standards for opioid treatment programs (OTP). The final rule addresses several longstanding barriers to broader use of medications to treat opioid use disorder. Among other changes, the revised policy formalizes various methadone treatment protocols at OTPs that were put in place during the pandemic, and expands access to take-home methadone. The finalized rule also adds to the workforce and their capabilities, expanding the definition of OTP practitioner to include Nurse Practitioners and Physician Assistants, among other types of clinician, and allowing for MOUD prescribing via telehealth. The effective date of this final rule is April 2, 2024 and the compliance date is October 2, 2024.
The Economic Effects of Rural Hospital Closures. Researchers at the North Carolina Rural Health Research Program report on changes to annual income, population size, unemployment, and size of the labor force in nonmetro counties that experienced a hospital closure between 2001 and 2018.
AHRQ Needs Public Input: Severe Maternal Morbidity Measurement – Comment by March 4. The Agency for Healthcare Research and Quality (AHRQ) needs assistance with data on state-level rates of severe maternal morbidity, that help inform HRSA’s Maternal and Child Health Bureau Title V Block Grant. Among the questions AHRQ has for stakeholders representing consumers – including but not limited to state and local health departments, accountable care organizations, and providers such as Critical Access Hospitals and Rural Health Clinics – is what quantitative data would you need to make maternal health service improvements. The comment period closes on March 4th and comments should be sent to askahrq@ahrq.hhs.gov. Recently, the Government Accountability Office cited several factors that pose additional risks and challenges for pregnant women in rural areas.
New Medicaid Model for Treatment of Rare Diseases. The Centers for Medicare & Medicaid Services (CMS) announced the Cell and Gene Therapy (CGT) Access Model, an initiative that aims to improve the lives of people with Medicaid living with rare and severe diseases by increasing access to potentially transformative treatments. Initially the model will focus on increasing access to gene therapy treatment for sickle cell disease, a genetic blood disorder that disproportionately impacts Black Americans. CGT is a multi-year payment model with state Medicaid agencies and pharmaceutical companies acting as participants, with optional grant funding available for states to provide an increased level of support for patients receiving gene therapy. CMS expects to release a Request for Application (RFA) to manufacturers in early spring 2024 and an RFA and Notice of Funding Opportunity (NOFO) to states in summer 2024.
NIH: Higher Mortality Rates for Patients on Respiratory Support in Rural Care. The National Institutes of Health (NIH) published a study finding rural patients receiving ventilator life support in intermediate care units had significantly higher death rates than patients in the same type of unit at urban hospitals. Data was collected from 2010 to 2019 on 2.75 million hospitalizations of Medicare patients who were on respiratory support at rural and urban hospitals across the country.
Ongoing: Updates to Requirements for Buprenorphine Prescribing. As announced by the Substance Abuse and Mental Health Services Administration in January 2023, clinicians no longer need a federal waiver to prescribe buprenorphine for treatment of opioid use disorder. Clinicians are still required to register with the federal Drug Enforcement Agency (DEA) to prescribe controlled medications. On June 27, the DEA began to require that registration applicants – both new and renewing – affirm they have completed a new, one-time, eight-hour training. Exceptions for the new training requirement are practitioners who are board certified in addiction medicine or addiction psychiatry, and those who graduated from a medical, dental, physician assistant, or advanced practice nursing school in the U.S. within five years of June 27, 2023. Watch this 11-minute video that explains the changes. Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained between January 1, 2019 and December 29, 2022 (when Congress eliminated the waiver requirement). Approximately $889,000 in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted. Send questions to DATA2000WaiverPayments@hrsa.gov.
**New: CDC’s COVIDVaxView Dashboard. The Centers for Disease Control and Prevention (CDC) continues to share weekly COVID-19 vaccination data using a variety of data sources. A new resource, COVIDVaxView Interactive, goes deeper with a look at variations in vaccine confidence by demographics and geography.
Provider Relief Fund Reporting Period 6. The Provider Relief Fund (PRF) Reporting Portal opened January 1 and will remain open until March 31, 2024 at 11:59 p.m. ET. Providers who received one or more PRF (General or Targeted) and/or American Rescue Plan Rural payments exceeding $10,000, in the aggregate, from July 1 to December 31, 2022 must report on their use of funds during Reporting Period 6 to comply with PRF Reporting Requirements. More information and resources can be found on the PRF Reporting webpage.
Learn About Long COVID & Fatiguing Illness – Thursday, February 8 at 3:00 pm Eastern. The Centers for Disease Control and Prevention fund this monthly webinar-style ECHO learning session to rapidly disseminate findings about Post-COVID Conditions (PCC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). The series offers presentations by subject matter experts, examples of emerging best practices and models of care, and a facilitated Q&A. This program is intended primarily for providers who care for patients with PCC and ME/CFS but is open to all healthcare professionals and all Long COVID and ME/CFS patient-lived experience experts interested in learning more about the treatment of Long COVID and ME/CFS.
COVID-19 Home Tests Available. Every home in the U.S. is again eligible to receive four (4) free at-home tests ordered at www.covid.gov. Delivery is free through the U.S. Postal Service.
Home Test to Treat is a new program funded by the National Institutes of Health focused on providing COVID-19 care and treatment for adults who are at greater risk of being affected by COVID-19. Adults who do not currently have COVID-19 or flu may enroll and receive free tests if they are uninsured or are enrolled in Medicare, Medicaid, the Veterans Affairs health care system, or the Indian Health Services. Individuals who are currently positive for COVID-19 can enroll to receive telehealth services for COVID-19 and treatment (if prescribed) at no cost. Enrollees may also be invited to participate in a completely optional research component of the program. Informational flyers are available in English and Spanish.
Mobilizing Health Care Workforce via Telehealth. ProviderBridge.org was created through the Coronavirus Aid, Relief, and Economic Security (CARES) Act by the Federation of State Medical Boards and HRSA’s Office for the Advancement of Telehealth. The site provides up-to-date information on emergency regulation and licensing by state as well as a provider portal to connect volunteer health care professionals to state agencies and health care entities.
Online Resource for Licensure of Occupational Therapists, Physical Therapists, Psychologists, and Social Workers. The site provides up-to-date information on emergency regulation and licensing in each state.
HRSA Nurse Faculty Loan Program – Deadline extended to February 12. HRSA’s Bureau of Health Workforce provides funding to accredited schools of nursing to provide student loans to students enrolled in advanced nursing degree programs who are committed to becoming nurse faculty. In exchange for up to four years of full-time nurse faculty employment in an accredited school of nursing, the program authorizes cancellation of up to 85 percent of the original student loan amount. The program also encourages Advance Practice Registered Nurses to serve as full-time preceptors within an academic-practice partnership framework. The original deadline was February 5.
ARC Appalachia READY Local Governments Training – February 29. The federal Appalachian Regional Commission (ARC) will assist local governments within its jurisdiction across 13 states. Participants will receive nine weeks of virtual training – at no cost – to better identify, secure, manage, and implement federally funded projects. Governments serving distressed areas and census tracts, priority communities identified by the Interagency Working Group on Coal and Power Plant Communities, members of the federal Rural Partners Network, and historically underserved and marginalized populations are encouraged to apply.
CDC Strengthening Public Health Systems Through National Partnerships – April 1. The Centers for Disease Control and Prevention (CDC) will support organizations that work with governmental public health in a five-year program to provide capacity-building assistance and ultimately strengthen the nation’s public health infrastructure. A total investment of $62 million will go an estimated 45 awards.
HRSA Advanced Nursing Education – Sexual Assault Examiners Program – April 2. HRSA’s Bureau of Health Workforce makes grants to accredited schools of nursing at public and private institutions of higher education. The purpose is to increase the supply, distribution, and quality of nurses caring for survivors of sexual assault and domestic violence. Last month, the Rural Health Information Hub updated its topic guide on violence and abuse in rural areas, citing research on the need for Sexual Assault Nurse Examiners.
Department of Veterans Affairs Staff Sergeant Fox Suicide Prevention Grants – April 26. The VA will support community-based organizations providing suicide prevention services to eligible veterans and their families. Priority is given to rural communities, tribal lands, medically underserved areas, and U.S. Territories. Total funding of more than $52 million will go to an estimated 80 awards.
NIH Researching Barriers to Care and Risk of HIV-Associated Comorbidities Among Vulnerable Population Groups – June 28. The National Institutes of Health include seven states with a substantial HIV burden in rural areas in this Notice of Special Interest for research. The original deadline of May 8, 2025 has been moved up.
Send questions to ruralpolicy@hrsa.gov.
CMS Webinar: AHEAD Model Hospital Global Budgets – February 14 at 3:00 pm Eastern. In this hour-long webinar, the Centers for Medicare & Medicaid Services (CMS) will provide an overview of the hospital global budget methodology for the new States Advancing All-Payer Health Equity and Development (AHEAD) Model and answer audience questions. AHEAD is a state total-cost-of-care model, and global budgets are a key feature to control the growth of health care costs and improve care. A hospital global budget pays a pre-determined, fixed annual budget for hospital inpatient and outpatient facility services, rather than paying a fee for each service provided. This webinar will describe the method CMS will use to calculate the Medicare hospital payment amount for the AHEAD model as well as operational considerations for hospitals. States interested in participating in the model should submit their applications by Monday, March 18, 2024, at 3:00 p.m. ET (for Cohorts 1 and 2) & Monday, August 12, 2024, at 3:00 p.m. ET (Cohort 3). To get notified about model events and resources, sign up for email updates about the AHEAD Model on the CMS website.
CMS Seeking Public Input on Updates to Medicare Advantage and Part D Prescription Drug Coverage – Comment by March 1. The Centers for Medicare & Medicaid Services (CMS) is required to update Medicare Advantage (MA) payment rates and other policies for calendar year 2025. The full Advance Notice may be viewed on the CMS website by selecting “2025 Advance Notice.” For Medicare Advantage, CMS proposes to continue phasing in previously finalized adjustments to plan pay rates as well as make new adjustments for MA plans in Puerto Rico. They also request input on future quality measures. For the Part D Prescription Drug program, CMS invites comment on draft guidance implementing parts of the Inflation Reduction Act of 2022 (IRA) that take effect in 2025. Specifically, the IRA creates a newly defined standard Part D benefit design; lowers the annual out-of-pocket threshold; establishes the Manufacturer Discount Program, under which manufacturers provide discounts on applicable drugs in the initial coverage phase and catastrophic phase of the defined standard drug benefit; and changes the liability of enrollees, sponsors, manufacturers, and CMS. In recent years, non-metro areas have seen slightly higher growth in the number of MA plans and enrollment than metropolitan counties.
Rural Provider Participation in Medicare ACOs Grows. In 2024, two Medicare ACO initiatives will have increased participation by rural providers: the Shared Savings Program (SSP), the permanent ACO program, and the ACO REACH Model, which intends to improve access to and care for underserved populations, including those in rural areas. Accountable care organizations (ACOs) are groups of doctors, hospitals, and other health care professionals that work together to give patients high-quality, coordinated service and health care, improve health outcomes, and manage costs. This year, both SSP and ACO REACH will have over 25 percent more participation from Federally Qualified Health Centers, Rural Health Clinics, and Critical Access Hospitals than in 2023. The increase in SSP is due, in part, to recent changes in the program intended to encourage participation among providers from rural and underserved areas. Even though the transition from volume-based payment (i.e., fee-for-service with no connection to value) to value-based payment has been slower in rural America than in urban areas, increased rural provider participation in these initiatives furthers the CMS goal for all beneficiaries with traditional Medicare to be in a care relationship with accountability for quality and total cost of care by 2030.
CMS Rural Health Open Door Forum – Thursday, February 29 at 2:00 pm Eastern. The Rural Health Open Door Forum addresses Rural Health Clinic, Critical Access Hospital, and Federally Qualified Health Center issues as well other topics relevant to rural providers. Agenda coming soon.
CDC Recruiting Rural Host Sites for Public Health Associates Program – Thursday, February 8 at 1:00 pm Eastern. The Centers for Disease Control and Prevention (CDC) will hold an information session specifically for rural sites applying to host CDC public health associates in 2024.
Rural Mental Health Solutions Roundtable – Thursday, February 8 at 11:30 am Eastern. The Western Community Assessment Network (WeCAN) welcomes participation from rural communities outside the organizations three focus states – Idaho, Montana, and Wyoming – for a three-hour event that will include the Rural Health Liaison from the U.S. Department of Agriculture (USDA), and from Rural Minds, a national nonprofit.
Rural Emergency Hospital Education and Fireside Chat with an REH CEO – Thursday, February 8 at 2:00 pm Eastern. The FORHP-supported Rural Health Redesign Center will give an overview of the new provider-type designation that allows hospitals at risk of closure to remain in operation with Emergency Department services, observation care, and a limited number of outpatient services.
AgriSafe: Addressing Substance Use and Aging in Agricultural Communities – Thursday, February 22 at 1:00 pm Eastern. The AgriSafe Network examines the factors that contribute to substance use among older adults in the agricultural sector.
Cervical Cancer Learning Series for Safety-Net Settings. HRSA’s Office of Women’s Health invites you to participate in CERV-Net: A Cervical Cancer ECHO Learning Series for Safety-Net Settings. CERV-Net is a free, virtual, collaborative learning series that prepares and empowers safety-net providers to engage partners, patients, and communities to ultimately improve cervical cancer care across the cancer continuum. The series consists of 11 sessions on Thursdays from 9:00-10:00 a.m. (ET) covering cervical cancer prevention, screening, management, and quality improvement activities. Continuing medical education credits are available at no cost to physicians, nurse practitioners, nurses, and physician assistants. If interested, please complete the interest form by Tuesday, February 13, 2024. For more details, please contact CERVNet@norc.org. The Centers for Disease Control and Prevention cite lack of access to screening as a reason for higher prevalence of cervical cancer in rural areas. Download resources from OWH’s page for the Federal Cervical Cancer Care Collaborative.
Department of Justice Mentor Site Initiative for Jail-Based Medication-Assisted Treatment – February 9
HRSA Nurse Faculty Loan Program – Deadline extended to February 12
HRSA Rural Residency Planning and Development Program – February 12
Department of Treasury Community Development Financial Institutions – February 15
USDA Sustainable Community Projects for Children, Youth, and Families At-Risk – February 15
ARC Investments Supporting Partnerships in Recovery Ecosystems (INSPIRE) Grants for the Appalachian Region – Letters of Intent February 16
NOSORH Rural Health Grant Writing Institute – February 16
HHS Assistance for Tribal Self-Governance Negotiation – February 19
USDA Rural Utilities Service – Community Connect Grants – February 20
HRSA School-Administered Loans for Public Schools – February 21
SAMHSA Strategic Prevention Partnerships for Communities – February 21
SAMHSA Strategic Prevention Framework/Partnerships for States – February 21
CMS’ Proposed Rule Addresses Appeals Rights for Certain Changes in Patient Status – Comment by February 22
Input to CMS on Burden of Information Collection Requirements – Comment by February 26
HRSA Geriatric Workforce Enhancement Program – February 26
SAMHSA FentAlert Challenge: Empowering Youth for Safe Choices – February 26
HRSA Continuation Contracts for National Health Service Corps Loans – February 27
Indian Health Service Scholarship Programs – February 28
USDA Produce Prescription Program – February 28
USDA Rural Business Development Grants – February 28
ARC Appalachia READY Local Governments Training – February 29
Become a Host Site for the CDC Public Health Associate Program – February 29
Institute of Museum and Library Sciences Native American Library Services Basic Grants – March 1
AHRQ Needs Public Input on Severe Maternal Morbidity Measurement – Comment by March 4
HRSA Nurse Corps Loan Repayment Program – March 7
Robert Wood Johnson Foundation Health Policy Research Scholarships – March 7
USDA Rural Health and Safety Education Competitive Grants – March 14
FTA Seeks Proposals for Mobility, Access, and Transportation Insecurity (MATI) Program – Express interest by March 15
HRSA Physician Assistant Rural Training in Behavioral Health – March 15
CMS Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model – March 18
SAMHSA Rural Emergency Medical Services Training – March 20
NIHB/CDC Strengthening Tribal Public Health Systems – March 21
Department of Commerce Tribal Broadband Connectivity Program – March 22
HRSA Behavioral Health Integration Evidence Based Telehealth Network Program – March 22
CMS Accepting Applications for New Physician Residency Slots – March 31
HRSA Provider Relief Reporting Period 6 – March 31
USDA Rural Energy for America Program (REAP) – March 31
CDC Strengthening Public Health Systems Through National Partnerships – April 1
SAMHSA Grants to Expand SUD Capacity in Treatment Drug Courts – April 1
HRSA Advanced Nursing Education – Sexual Assault Examiners Program – April 2
HRSA State Maternal Health Innovation – April 2
HRSA Medicare Rural Hospital Flexibility Program – April 16
HRSA Medicare Rural Hospital Flexibility Program – Supplement Funding for Rural Emergency Services – April 25
Department of Veterans Affairs Staff Sergeant Fox Suicide Prevention Grants – April 26
CMS Request for Information on Medicare Advantage Data – Comment by May 29
AHRQ Safety Program for Telemedicine: Improving Antibiotic Use – June 2024
HRSA Needs Rural Reviewers for Grant Applications
Resources for Medicaid/CHIP Renewals
Economic Development Administration Public Works/Economic Assistance Program (CARES Act Funding)
Extended Public Comment Period for FCC’s COVID-19 Telehealth Program
FCC Affordable Connectivity Program for Broadband Service
National Indian Health Board Vaccination Event Funding – Ongoing while funds last
SAMHSA 988 Suicide and Crisis Lifeline Volunteer and Job Opportunities
USDA Disaster Repair Grants for Rural Community Facilities – Ongoing while funds last
USDA Water Infrastructure Grants for 2022 Disaster Areas – Ongoing while funds last
ACF Low Income Home Energy Assistance Program
ACF Rural Community Development Program for Rural Water Systems
Addiction Policy Forum: Sites for Anti-Stigma Pilot
AgriSafe Mental Health Training for Agricultural Producers & Families
American Association of Birth Centers (AABC) Foundation – Accreditation Grants
American Heart Association Rural Health Care Outcomes Accelerator
American Indian Public Health Resource Center Technical Assistance
AmeriCorps American Connection Corps for Broadband in Rural Areas
Appalachian Community Fund Technical Assistance Grants
Appalachian Regional Commission J-1 Visa Waivers for Doctors
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
CORH Targeted Technical Assistance for Rural Hospitals Program
Delta Region Community Health Systems Development Program
Delta Regional Authority Community Infrastructure Fund
Delta Doctors J-1 Visa Waiver Program
Department of Commerce: Economic Development Assistance Programs
DRA Technical Assistance for Delta Region Community Health Systems Development
EPA Drinking Water State Revolving Fund
EPA Water Infrastructure and Innovation Act Program
FEMA/SAMHSA Post-Disaster Crisis Counseling Assistance and Training Program
GSA Federal Surplus Property Available for Public Use
GPHC & RWJF: Rapid Cycle Research and Evaluation Grants for Cross-Sector Alignment
HRSA/SAMHSA Medications for Opioid Use Disorder Training and Mentoring
HRSA Seeking Nominations for Migrant Health Advisory
HRSA Technical Assistance for Look-Alike Initial Designation for the Health Center Program
Housing Assistance Council: Housing Loans for Low-Income Rural Communities
HUD Distressed Cities and Persistent Poverty Technical Assistance Program
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
National Health Resource Center on Domestic Violence Technical Assistance
National Indian Health Board Vaccination Event Funding
National Indigenous Women’s Resource Center Technical Assistance for Domestic Violence Programs
Native Americans into Medicine
Host Sites for National Environmental Public Health Internship
NIH Special Interest Research – Pandemic Impact on Vulnerable Children and Youth – May 2024
NIH Research to Improve Native American Health – October 2024
NIH Researching Mental Health Practices in Low-Resource Settings – September 2024
NIH Researching Social, Behavioral, and Economic Impact of COVID-19 in Underserved/Vulnerable Populations – September 2024
NIH Researching the Role of Work in Health Disparities – Various dates until September 2024
NIH Addressing the Impact of Structural Racism and Discrimination – Various dates until October 2025
NIH Researching Firearm Injury and Mortality Prevention – February 2026
NIH Research to Address Vaccine Hesitancy in Health Disparity Populations – June 2026
NIH Planning Grants for Native American Research Centers for Health (NARCH) – various dates until July 2026
NIH Research to Understand Disparities in Maternal Morbidity and Mortality – Various dates until October 2026
NIH Data Informed, Place-Based Community-Engaged Research to Advance Health Equity – January 2027
NIH/UVA Seeking Rural Individuals to Participate in Weight Loss Study (iREACH) – until 2027
NIH Project Talk Initiative Host Site Applications
NRHA Chief Nursing Officer Certification Program for Rural Hospitals
Oweesta Native CDFI Loan Funds and Technical Assistance
Primary Care Development Corporation Community Investment Loans
Rural Community Assistance Corporation Environmental Infrastructure Loans for Western States
Rural Graduate Medical Education Planning and Development
Rural Grocery Transition Specialist Program
RTT Collaborative: Rural Training Track Directors University
RWJF Investigator-Initiated Research to Build a Culture of Health
RWJF Pioneering Ideas Brief Proposals
SAMHSA Crisis Counseling Assistance and Training Program for Communities Post-Disaster
SAMHSA Training to Provide Medication Assisted Treatment
SBA Guaranteed Loans for Small Business
Southeast Rural Community Assistance Loans
Treasury Department Opportunity Zone Economic Development Program
United South and Eastern Tribes, Inc Tribal Health Program Support
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 Healthy Food Financing Initiative Technical Assistance
USDA Intermediary Relending Program
USDA Multifamily Housing Loan Guarantees
USDA National School Lunch Afterschool Snack Program
USDA/NRHA Rural Hospital Technical Assistance
USDA Rural Business Development Grants
USDA Rural Business Investment Program
USDA Rural Energy Savings Program
USDA Technical Assistance for Healthy Food Financing Initiative
USDA Telecommunications Infrastructure Loans and Loan Guarantees
USDA Funding for Rural Water and Waste Disposal Projects
USDA Water and Waste Disposal Grants to Alleviate Health Risks on Tribal Lands and Colonias
USDOT Rural Opportunities to Use Transportation for Economic Success (R.O.U.T.E.S)
Veterans Affairs Health Professional Scholarship Program
Western Region Public Health Training Center – Future Leaders Program