FORHP UpdateState Offices of Rural Health Regional Partnership Meeting

September 4-5, 2019

Sarah YoungPublic Health Analyst Federal Office of Rural Health Policy (FORHP)

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12https://www.ruralcenter.org/taschttps://www.ruralcenter.org/tasc

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https://www.ruralcenter.org/resource-library/population-health-portal

https://www.ruralcenter.org/resource-library/population-health-portal

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www.flexmonitoring.org/cahmpas

16https://www.ruralcenter.org/rhi/srht

17https://www.ruralcenter.org/drchsdhttps://www.ruralcenter.org/drchsd

18http://www.optimizingruralhealth.org/http://www.optimizingruralhealth.org/

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https://www.hrsa.gov/ruralhealth/ruralhospitals/regionmap.html

https://www.hrsa.gov/ruralhealth/ruralhospitals/regionmap.html

Office for the Advancement of Telehealth

Programs• Telehealth Resource Centers

• Telehealth Centers of Excellence• Telehealth Research Center• Licensure Portability Program

• School-Based Telehealth Network Grant Program • Substance Abuse Treatment Network Grant Program• Evidence Based - Telebehavioral Health Network Program

2019 Focus:• Increasing access to behavioral health services.• Contributing to the telehealth evidence base.• Providing guidance to health care providers

starting or expanding telehealth services. • Increasing telehealth use through-out HRSA.

Office for the Advancement of TelehealthTelehealth Resource Centers (TRCs)

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24TRC Telehealth Guides & Fact Sheets

Community-Based Division Programs

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• Direct Services - Outreach- Quality- Delta- Black Lung- Radiation Exposure

Screening Education Program (RESEP)

- Pilot programs

• Non-Direct Services (Capacity-building)

- Network Planning- Network Development- Pilot programs

Common Themes Across CBD Programs

Partnerships• Legislation:

consortium eligibility

Sustainability• Legislation: “a

plan for sustaining the project after Federal support has ended”

Outcomes•Legislation:• “description of how the local community or region to be served will experience increased access to quality health care services across the continuum of care as a result of the activities carries out by the entity.” (Quality)•“…to promote rural health care services…” (Outreach)

Allows for Innovation•Legislation: “Expanding…the delivery of healthcare services to include new and enhanced…” (Outreach)•“expand access to coordinate and improve health care services” (Network)

Community-Based Division Priorities

Collaboration• Engagement of non-

traditional partners• Partnership with other

HRSA grantees and programs

• Engagement of SORHs and CBD grantees

Evidence-based/Data• Establishing what really

works for rural

Innovation• Innovative ways to show

impact• New approach for the

Outreach Program

Information Dissemination• Community Health

Gateway• FORHP Grants In Motion• FORHP Weekly

announcements

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Program FY 2020 FY 2021 FY 2022

Rural Health Network Development Planning (Network Planning)

Funding applications available in Summer 2019.

Awards in Summer 2020.

Funding applications available in Fall 2020.

Awards in Summer 2021.

Funding applications available in Fall 2021.

Awards in Summer 2022.

Small Healthcare Provider Quality Program (Quality)

Funding applications available in Winter 2021.

Awards in Summer 2022.

Rural Health Care Services Outreach Program (Outreach)

Funding applications available in Winter 2020.

Awards in Summer 2021.

Rural Health Network Development Program(Network Development)

Funding applications available Fall 2019.

Awards in Summer 2020.

Delta States Rural Development Network Grant Program (Delta)

Funding applications available Fall 2019.

Awards in Summer 2020.

Black Lung Clinics Program and Centers of Excellence (BLCP)

Funding applications available Winter 2019.

Awards in Summer 2020.

Radiation Exposure Screening and Education Program (RESEP)

Funding applications available Fall 2019.

Awards in Summer 2020.

Community-Based Division Upcoming Funding Opportunities

Rural Community Opioid Response Program (RCORP) Initiative

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RCORP-Planning RCORP-Implementation RCORP-MAT Expansion

Goal

To strengthen the capacity of multi-sector consortiums to address opioid use disorder prevention, treatment, and recovery.

To strengthen and expand SUD/OUD prevention, treatment, and recovery service delivery.

To enhance access to medication-assisted treatment within small rural clinic and hospital settings.

Period of performance 1 year 3 years 3 years

Award amount Up to $200K Up to $1 million Up to $725K

# Awards 95 (FY18); 120 (projected-FY19)

75 (projected-FY19); 34 (projected-FY20) 11 (projected-FY19)

EligibilityDomestic public or private, non-profit or for-profit, entities. Additional

applicant and consortium specifications as described in NOFO. All services must exclusively target rural areas.

RCORP Initiative

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RCORP-Technical Assistance RCORP-Evaluation RCORP-Centers of

Excellence

Goal

To assist rural consortiums with addressing opioid use disorder prevention, treatment, and recovery service and workforce needs.

To evaluate the impact of RCORP initiatives through data collection and analysis, and to develop evaluation tools and resources for rural communities.

To support the dissemination of best practices related to the treatment for and prevention of SUDs within rural communities, with a focus on the current opioid crisis, and the development of methods to address future SUD epidemics.

Period of performance 4 years 4 years 3 years

Award amount $6 million per year $3 million per year $6.7 million

Award recipient JBS International 1 award--TBA Up to 3 awards--TBA

FY 2018 FY 2019 FY 2020 FY 2021 FY2022

95 Planning awards (1 year)

120 Planning awards (1 year)

1 Technical Assistance cooperative agreement (4 years)

75 Implementation awards (3 years)

1 Evaluation cooperative agreement (4 years)

FY18- FY19

FY18 – FY21

FY19-FY20

FY19 – FY21

34 Implementation awards (3 years)FY 20 – FY22

FY19 – FY21 11 MAT Expansion awards (3 years)

FY2023 FY2024

FY19 – FY21 3 Centers of Excellence cooperative agreements (3 years)

FY19-FY22

FY20 – FY22

Projected RCORP Timeline

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FY18 RCORP Planning Cohort

Source: JBS International

• 95 award recipients located across the country.

• Focus on prevention, treatment, and/or recovery.

• Activities include formalizing consortium; conducting needs assessments; developing workforce and service delivery plans; and planning for sustainability.

• Grant will position consortia to operationalize their plans and move towards service delivery.

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Early Results from FY18 RCORP-Planning

• Executed MOU/s with partner organizations92%

• Expanded consortium membership• Increased the number of disciplines

represented in consortium~1 in 5

• Held face-to-face meetings with consortium members79%Source: JBS International

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• Importance of collaboration and stakeholder engagement • Approach every county differently • The key technical assistance needs grantees have had so far are

around:• Data collection and analysis• Developing needs assessments• Developing Memorandum of Understanding (MOU) with partners• Identifying evidence-based practices

Early Lessons Learned from FY18 RCORP-Planning

• Regulation, Legislation, & Policy Review

• Policy-focused Health Research

• Information for Rural Stakeholders

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Rural Health Policy and Research

FORHP Policy Email: If you have any questions related to policy updates, please contact us at RuralPolicy@hrsa.gov.

• Proposed Updates to Medicare Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment System (comment by September 27)

• The proposals on price transparency are highlighted with CMS proposing that all hospitals, including rural PPS hospitals and critical access hospitals (CAHs) make pricing information publicly available. Proposals also include reducing payment differences between certain sites of services, using the inpatient wage index values to address wage index disparities, and changing the generally applicable minimum required level of supervision from direct supervision to general supervision for hospital outpatient therapeutic services furnished by all hospitals and CAHs.

• Medicare Physician Fee Schedule Proposed Policy, Payment, and Quality Provisions for CY 2020 Proposed Rule (comment by September 27)

• The proposals on price transparency are highlighted with CMS proposing that all hospitals, including rural PPS hospitals and critical access hospitals (CAHs) make pricing information publicly available. Proposals also include reducing payment differences between certain sites of services, using the inpatient wage index values to address wage index disparities, and changing the generally applicable minimum required level of supervision from direct supervision to general supervision for hospital outpatient therapeutic services furnished by all hospitals and CAHs.

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Rural-Relevant 2020 Policy Updates(Outpatient and Ambulatory Care)

• Rural Access to Health Care Services – Comment by October 9• The Health Resources and Services Administration (HRSA) seeks

information from the public about measuring access to health care in rural communities. This Request for Information (RFI) supports the ongoing work of the HHS Rural Health Task Force that is seeking to identify the needs of rural communities, how to meet those needs, and what HHS policy changes can address those needs.

• Questions for public comment specific to rural communities include:• What are the core health care services needed?• What types and numbers of health care professionals are needed?• What factors are important to identify core health services?• How should access to health care services be measured?

• https://www.hrsa.gov/rural-health/rfi-rural-health-care-access

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Rural-Relevant 2020 Policy Updates

Additional Policy Resources

Federal Office of Rural Health Policy –https://www.hrsa.gov/rural-health/policy/index.html

Rural Health Value – https://ruralhealthvalue.public-health.uiowa.edu/

Center for Connected Health Policy –https://www.cchpca.org/

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For over 30 years, the Rural Health Research Centers have been conducting policy relevant research on healthcare in rural areas and providing a voice for rural

communities in the policy process.

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Rural Research

The Rural Health Research Gateway provides easy and timely access to research conducted by the Rural Health Research Centers.

https://www.ruralhealthresearch.org/

Contact Information

Sarah YoungFlex Program Coordinator, Hospital State Division

Federal Office of Rural Health Policy (FORHP)Health Resources and Services Administration (HRSA)Email: SYoung2@hrsa.govPhone: 301-443-5905

Web: www.hrsa.gov/ruralhealth/

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