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Hello Everyone!
We hope you are having a good spring season! It's been a typical spring up in here in Duluth, Minnesota--a few warm days, some rainy weeks, and one epic blizzard.
Thank you to all who made the journey up to Duluth this past week for our Flex Workshop. As a first timer to the workshop, it was fun to meet others new to Flex as well, and also to hear from those who have been around for a while.
I hope you enjoy this month's edition of Rural Route. We appreciate you taking the time to read it.
Thank
s,
Andy Naslund
Program Coordinator
Technical Assistance and Services Center (TASC)
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Welcome to Alyssa Kennett, SORH Director in Wyoming, and Lela Shepard, SORH Director in Florida.
We bid a fond farewell to Iona Thraen from Utah and Scott Ekblad from Oregon, who are both leaving their Flex positions in April. We wish them both well!
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FORHP Updates
Updates include:
- Reminder that FORHP will be accepting MBQIP waiver requests for Fiscal Year (FY) 2019 until Friday, May 17, 2019 for potentially ineligible Critical Access Hospitals (CAHs).
- Reminder that the current Flex grants end on August 31, 2019, and you will need to request a no-cost extension if you will have unspent Flex funds by August
- See Mike McNeely's April letter regarding the expectations for the Hospital State Division and how they should spend award funds in the award year.
CAH Regulatory Update
Updates include:
- Medicare Advantage (MA) and Prescription Drug Program payment and policy
- Policy and technical changes to MA
- Medicare Prescription Drug Benefit
- Programs of All-Inclusive Care for the Elderly (PACE)
- Medicaid fee-for-service and managed care
- HRSA requests health center service areas feedback
- Enhancements to CMS Mapping Medicare Disparities (MMD) Tool
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Thank you to everyone who was able to attend the Flex Workshop in Duluth. It was great
getting to know everyone. Back row from left to right: Renee Clark (North Carolina), Nathan Morse (Maine), Lisa Lewis (West Virgina), Teresa Leatherman (Missouri), Colton Gordon (Utah), Lisa Garza (Kentucky), Alyssa Kennett (Wyoming). Front row from left to right: Megan Hartwig (Iowa), Crystal Begay (New Mexico), Stephanie Moore (West Virginia),
Jill Bullock (Arizona), Tricia Franklin (Alaska)
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2019 Flex Program Reverse Site Visit
We are pleased to announce that the 2019 Flex Program Reverse Site Visit (RSV) will be held July 10-11, 2019 at the
Washington Marriot Wardman Park in Washington, DC. This in-person Flex grantee meeting is supported by the Federal Office of Rural Health Policy (FORHP).
The purpose of the Flex Program RSV is to highlight the latest information and issues in the Medicare Rural Hospital Flexibility (Flex) Program, as well as offer states an opportunity to share experiences, lessons learned and successes in a collaborative learning environment.
Online registration for the Flex Program RSV will open soon. A draft agenda for the event is currently under development. Information regarding lodging and room rates will be forthcoming and further information will be provided as it is made available.
Please note that the deadline to make hotel reservations at the group rate is Monday, June 10, 2019. Don't hesitate to contact us if you have any questions.
The Reverse Site Visit is targeted to the 45 states that participate in the Medicare Rural Hospital Flexibility (Flex) Program. The intended audience for the Flex Program RSV is State Office of Rural Health Directors, Flex Coordinators/other key Flex personnel (two per state), the Flex Monitoring Team (FMT), Stratis Health's Rural Quality Improvement Technical Assistance (RQITA) team, Technical Assistance and Services Center (TASC) staff and Advisory Committee, and FORHP staff.
If you would like to have more than two attendees, please contact your project officer at FORHP for approval.
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The Health Resources and Service Administration's (HRSA) Federal Office of Rural Health Policy (FORHP) released a Notice of Funding Opportunity (NOFO) on April 25 for the Rural Communities Opioid Response Program-Rural Centers of Excellence on Substance Use Disorders (RCORP-RCOE). HRSA will provide three cooperative agreements totaling about $20 million to establish three Rural Centers of Excellence.
Each Center will adopt one of the following three Focus Areas:
- Focus Area 1: Innovative and effective treatment interventions for substance use disorders (SUD), particularly opioid use disorder (OUD), in rural communities;
- Focus Area 2: Best practices in recovery housing programs for SUD, particularly OUD, intervention among low-income, high-risk individuals in rural communities; and
- Focus Area 3: Addressing synthetic opioid-related overdose mortality in rural communities in the Delta and/or Appalachian regions.
Selected RCORP-RCOE applicants will receive up to $6.7 million each for a three-year period of performance to identify, translate, disseminate, and provide technical assistance to implement evidence-based programs and promising practices related to treatment for and prevention of SUD in rural communities, with a focus on the current opioid crisis.
Eligible applicants include domestic public or private, non-profit or for-profit entities, including, but not limited to,
- Public or private institutions of higher education;
- State, county, or city or township governments;
- Faith-based and community-based organizations; and
- Federally recognized American Indian tribes, tribal organizations, and tribal governments.
See pages 7-8 of the NOFO for more information on eligibility requirements.
Applicant organizations may be located in an urban or rural area but all RCORP-RCOE program activities must exclusively serve populations residing in HRSA-designated rural areas, whether across multiple states, within one or more regions, or throughout the nation. See the HRSA Rural Health Grants Eligibility Analyzer to identify HRSA-designated rural areas.
FORHP will host a technical assistance webinar for applicants on Tuesday, May 7, 2019, from 1:00 to 2:30 p.m. EDT. FORHP will also provide a recording for those who cannot attend. Please see page iii in the NOFO for details to log in to the webinar and access the webinar playback. You may also contact [email protected] for questions on this program.
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HRSA's FORHP also a Notice of Funding Opportunity (NOFO) last week for the Rural Communities Opioid Response Program-Medication-Assisted Treatment Expansion (RCORP-MAT Expansion). HRSA plans to invest approximately $8 million in rural communities as part of this funding opportunity.
Successful RCORP-MAT Expansion award recipients will receive up to $725,000 for a three-year period of performance to establish or expand medication-assisted treatment (MAT) in eligible hospitals, health clinics, or tribal organizations located in high-risk rural communities.
Eligible applicants include domestic public or private, non-profit or for-profit:
- Rural Health Clinics, as defined by Social Security Act Section 1861(aa) and 42 CFR Parts 405 and 491;
- Critical Access Hospitals, as defined by Section 1820 (e) of the Social Security Act and 42 CFR 485 subpart F;
- Health Center Look-Alikes, defined as entities that meet all Health Center Program statutory, regulatory, and policy requirements but do not receive funding under section 330 of the Public Health Service Act, as amended (see https://bphc.hrsa.gov for more information);
- Other small rural hospitals with 49 available staffed beds or less, as reported on the hospitals' most recently filed Medicare Cost Reports; or
- Tribes or tribal organizations (excluding health centers that receive Health Center Program federal award funding).
All applicants must be located, and all services must be provided, in HRSA-designated rural areas (as defined by the
Rural Health Grants Eligibility Analyzer). Applicants do not need to be RCORP-Planning award recipients to apply for this funding opportunity. Applicants may apply for RCORP-MAT Expansion funding if they have applied for
RCORP-Implementation funding, but they must detail in their applications how they will avoid duplication of effort and services if awarded both grants. Award recipients are strongly encouraged to leverage workforce recruitment and retention programs like the
National Health Service Corps (NHSC)
Before applying for RCORP-MAT Expansion on grants.gov, applicants must register in
grants.gov
,
SAM, and
DUNS. These registration processes can take up to a month to complete.
FORHP will hold a webinar for applicants on
Thursday, May 16, 2019 from 12:00-1:30 p.m., ET. A recording will be made available for those who cannot attend. Please reference page ii in the NOFO for the dial-in and playback information for the webinar. You can also contact
[email protected] for questions pertaining to the NOFO.
To learn more about how HRSA is addressing the opioid epidemic, visit
https://www.hrsa.gov/opioids.
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Newsflash
Boulder City Hospital (BCH) is recognized for its use of Project ECHO in advancing the quality of their antibiotic stewardship program (ASP). The ASP program, established in 2013, became stronger when they began participating in Project ECHO to gain education through didactic presentations. Project ECHO participation also allows them to present cases and receive feedback from infectious disease specialists, a provider type that is not typically available in rural hospitals
Pictured left to right:
Peggy Caspar, BCH Board President; Laima Etchegoyhen, Flex Program Coordinator, University of Nevada, Reno School of Medicine; Arleen Sheeler, Risk Manager, BCH; Jessica Murray, Quality Management and Infection Control, BCH; Stephanie West, Pharmacy Manager, BCH; and Thomas Maher, CEO
, BCH.
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Rural Chronic Obstructive Pulmonary Disease (COPD) Podcast Series: Episode #1 Out Now!
The
National Rural Health Resource Center (The Center) has partnered with Dr. Bill Auxier of
Rural Health Leadership Radio
to produce a six-part podcast series about Rural Chronic Obstructive Pulmonary Disease (COPD) and its prevalence in rural America.
This series from The Center provides information about COPD, how
rural
providers are meeting the needs of their communities, and the importance of billing and coding appropriately while ensuring quality of care is being addressed.
Each podcast features a guest with expert knowledge in COPD and rural health.
- Grace Anne Dorney Koppel is President of the Dorney Koppel Foundation, the immediate former President and a current board member of the COPD Foundation, and chair of the Advocacy and Public Policy Committee for the COPD Foundation. Grace Anne is also a patient of COPD, diagnosed in 2001.
- Grace Anne explains COPD's prevalence, its symptoms, the stigma surrounding the disease, her personal experiences with COPD, the challenges of COPD treatment in rural communities, her work with the Dorney Koppel Foundation, and the path to success with COPD
Coming very soon:
E
pisode 2
featuring Paul Moore
- Paul Moore is a Senior Health Policy Advisory for the Federal Office of Rural Health Policy (FORHP) and Executive Secretary for the National Advisory Committee for Rural Health and Human Services.
The 2018 FY COPD Supplemental Project
The goal of the COPD Supplemental Project is to address rural disparities in COPD services and to provide resources and technical assistance to rural hospitals and provider-based clinics in order to address these
disparities
. The COPD Supplemental Project will result in the creation of a manual, a podcast series, dissemination of an assessment, and three webinars.
The components of the COPD Supplemental Project will address the following topics: the importance of addressing COPD services in rural America, the current landscape in rural, payment, workforce needs, clinical treatment, and technology. Please contact Caleb Siem at
[email protected] with any questions.
In April, TASC also hosted a
COPD Prevalence and Impact Webinar
to help Flex programs discover the scope and scale of COPD matters in rural America, understand the personal impact of COPD, learn about national initiatives and FORHP efforst, and hear examples of state-level efforts underway with COPD. Speakers included Kristi Martinsen, Director, Hospital State Division, FORHP; Grace Anne Dorney Koppel, Dorney Koppel Foundation; and Lannette Johnston, MS, BSN, RN, CHC, Quality Improvement Coordinator with the Pennsylvania Office of Rural Health.
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The 2018 FY EMS Supplemental Project
EMS
The goal of the EMS Supplemental Project is to better position state-wide and community-level EMS agencies to move toward value-based care. The EMS Supplemental Project will result in the creation of three manuals and an online assessment for EMS providers to determine their readiness for value-based payment systems in rural communities. A small group meeting was held in March with rural EMS experts from around the country to develop key strategies to support the transition of rural EMS services to value models and a summary will be disseminated in May. In addition, there will be an RSV pre-event learning session held in Washington, D.C. on July 9, 2019 for Flex Programs to share progress, challenges, successes, and lessons learned. Please contact Nicole Clement at
[email protected] with any questions.
Save the Date - May 15 TASC 90 webinar on EMS
Please join us for the May TASC 90 Webinar focusing on EMS on May 15 at 2:00 p.m. CST. A calendar appointment will be emailed soon to all state Flex Programs which will include speaker information and learning objectives.
This webinar is for state Flex Programs.
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Updated for 2019: State Flex Profiles Now Available
Thank you to everyone that completed the annual update of the State Flex Profiles, maintained by the Technical Assistance and Services Center (TASC) in coordination with the Federal Office of Rural Health Policy (FORHP). We are pleased to announce that 41 of 45 Flex states updated the information on their profile. The State Flex Profiles can be found on the TASC website at:
https://www.ruralcenter.org/tasc/flexprofile
State Flex Profiles showcase the beneficial activities occurring at the state-level to support the critical access hospitals (CAHs) and their communities around the country. No two states have the same exact approaches and the profiles are updated annually as an opportunity for states to share their excellent work and to learn from one another. The profiles include information on the work occurring in the five Flex Program areas as well as successes, best practices, and innovations. Use the State Flex Profiles to identify approaches to similar rural health issues, identify best practice opportunities, and access contact information for individuals at the state-level who are supporting Flex Program activities.
What to do if your state profile is
missing or you want to update content
States that did not submit updated profile content will only have contact information and links to RHIhub and Flex Monitoring Team information about their state displaying on their State Flex Profile. Should a state wish to update their profile, it can be done by completing the State Flex Profile questionnaire at
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MBQIP Updates
Updated Resources
Please send your MBQIP questions to the TASC email address
. TASC will ensure your question reaches the appropriate person.
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Webinars, Recordings & Events
Save the Dates
May 15, 2019 | 2:00 p.m. Central Time
June 3, 2019 | 2:00 p.m.
July 9, 2019 | Washington, D.C.
July 10-11, 2019 | Washington, D.C.
August 5, 2019 | 2:00 p.m. Central Time
August 14, 2019 | 2:00 p.m. Central Time
Webinar Playbacks
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New and Updated Resources
A full list of resources is available in the
TASC resource library
Many more resou
rces can be found on the
TASC website
by searching for key words in the search field.
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New Flex Monitoring Team Research
A full list of research can be found on the Flex Monitoring Team website.
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Rural Interview with CDC
The Centers for Disease Control and Prevention (CDC) is focusing on rural health. Take some time to
read the RHIhub interview with CDC on their work with rural, and the need for storytelling and data collection.
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The most recent interviews are on the topics of agriculture and mental health, various aspects of rural health, PAs and NPs in CAHs, and HIV, immunization, and billing.
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