Policy Update

i Dec 6th No Comments by

Last month, State Rural Health Associations were invited to join the NOSORH Policy Committee. The committee heard about the election results, an FORHP regulatory update and a preview of the work of the Policy and Program Monitoring Team. For more information or to join the Policy committee, please contact Matt Strycker.

The following update was provided by Hall Render, NOSORH Policy Liaison:

Democrats Set to Control Key Health Committees in Next Session of Congress
The Democratic takeover of the House of Representatives following the recent midterm elections will significantly change the political landscape for healthcare issues when lawmakers return for the 116th Session of Congress next year. Overall, the election results will mean divided government and a return to the era when little is accomplished legislatively. Lawmakers are expected to go from one “fiscal cliff” to another as they struggle to pass funding bills that will keep the government open.

The main focus of House Democrats is expected to be oversight of the Trump administration’s implementation of health policies but could extend to the idea of “Medicare-for-all” or other programs that would move the country towards universal health care.

Shoring up the Affordable Care Act (“ACA”), drug pricing and surprise medical bills are also anticipated to be some of the major healthcare issues tackled during the new Congress. After Republicans’ unsuccessful efforts to repeal and replace the ACA, House Democrats will be looking to pass legislation bolstering the ACA’s insurance markets and cementing the law’s provisions on pre-existing conditions. They will also look to fixing the cost-sharing reimbursement issue, which saw some bipartisan support in the Senate last year and could be one of the few pieces of legislation that makes it to the president’s desk. By contrast, the Senate, which will remain under Republican control, is expected to focus more broadly on health care.

Both parties are in alignment as to the necessity of lowering drug pricing. House Democrats will try to reign in pharma by making drug pricing one of their top issues. Incoming House Energy and Commerce Health Subcommittee Chairman Anna Eshoo (D-CA) said she wants to hold hearings before developing her prescription drug policy priorities. Meanwhile, Energy and Commerce leadership staff have signaled that 340B drug pricing program reform will no longer be a high priority for the committee. In addition, House Democrats are expected to conduct oversight of issues such as Medicaid work requirements and the Justice Department’s decision to back anti-ACA lawsuits.

At the committee level, Rep. Richard Neal (D-MA) will become the chairman of the full House Ways and Means Committee, which is expected to add at least four new Democratic members. On the Ways and Means Health Subcommittee, Chairman Peter Roskam (R-IL) and Health Subcommittee member Erik Paulsen (R-MN) both lost their races for reelection. With the retirement of Reps. Sam Johnson (R-TX), Lynn Jenkins (R-KS) and Diane Black (R-TN), Republicans will see very large changes in their membership on this subcommittee. Since Republicans currently hold an 11-7 majority on the subcommittee, these losses and retirements should mean no Republican will be removed from the subcommittee and one will be added. As for who will take the gavel as the subcommittee’s next chairman, Rep. Lloyd Doggett (D-TX) is currently expected to get the nod over Rep. Mike Thompson (D-CA) because he has more overall seniority in Congress.

At the House Energy and Commerce Committee, Rep. Frank Pallone (D-NJ) will become the full committee chairman and Rep. Greg Walden (R-OR) will become the Ranking Minority Member. Pallone has a reputation for “doing deals” across the aisle, which could make additional opioid funding a possibility. The change in control of the House means Rep. Michael Burgess (R-TX) will become the Energy and Commerce Health Subcommittee’s Ranking Minority Member once Rep. Eshoo takes the gavel. In addition to drug pricing, Eshoo’s agenda is expected to include coverage of pre-existing conditions and investment in biomedical research and development.

On the Senate side, drug pricing and additional opioid legislation could make some progress, but little else is expected to happen on the healthcare front. Senate Republicans, such as Bill Cassidy (R-LA), will continue to push for 340B reform, but any 340B legislation that passes the Senate should die in the Democratically controlled House. At the committee level, the Health Education Labor and Pensions Committee will see no loss in its membership. Sen. Lamar Alexander (R-TN) will remain chairman and Sen. Patty Murray (D-WA) will remain the Ranking Member.

At the Senate Finance Committee, Sen. Chuck Grassley (R-IA) is expected to become the next chairman. Sen. Grassley says he wants to work “on improving the affordability, quality and accessibility of health care, including in rural America.” Sen. Ron Wyden (D-OR) will remain the committee’s Ranking Member. Losses by Sen. Claire McCaskill (D-MO) and Sen. Dean Heller (R-NV) open one seat on the Democratic side of the committee aisle and one on the Republican, which are expected to be filled before lawmakers return for the 116th Session of Congress in January.

Congress Unlikely to Make Progress on Health Care Bills Before Year-End
As government funding battles overtake Capitol Hill, it appears Congress will not use the lame duck to resolve outstanding healthcare issues. While the desire to steer clear of health are fights is something different from prior years, outgoing House Ways and Means Committee Chairman Kevin Brady (R-TX) said this week that healthcare legislation will not be a priority during what’s left of the lame duck session.

Furthermore, Democratic control of the House of Representatives that comes in January has caused many Democratic lawmakers to push their healthcare priorities into the New Year. However, some policy changes could still surface as additions to a year-end spending package that must be passed before December 7 in order to avoid a partial government shutdown.

Luckily for a majority of healthcare programs, funding for most agencies within the Department of Health and Human Services (HHS) was included in a giant spending package Congress passed in September. Those that remain to be funded include the FDA, which receives its funding through a separate bill and user fees. A House Republican tax bill was released on November 26, but it did not address any of the Affordable Care Act’s taxes, such as the medical device tax and the “Cadillac” tax on health plans.

CMS to Expand Medicaid Covered Mental Health Treatment
On November 14, CMS announced that states can soon begin applying for waivers to expand treatment capacity for serious mental health issues. HHS Secretary Alex Azar highlighted the effectiveness of waivers for substance abuse treatment citing Virginia as an example. Virginia received approval for a waiver in 2016 and subsequently saw a 39 percent decrease in opioid-related emergency room visits.

Waivers will allow states to lift the “IMD exclusion.” The IMD exclusion prohibits the use of federal Medicaid funds to pay for substance use disorder treatment for patients age 21-64 at inpatient mental health treatment facilities that have more than 16 beds. It also prohibits Medicaid beneficiaries who are receiving treatment at IMDs from receiving additional Medicaid-covered care elsewhere. Many experts state the IMD exclusion is a large hindrance to treatment for low income people.

Health-Related Bills Introduced This Month
Sen. Orrin Hatch (R-UT) introduced S.3693 to amend Title XVIII of the Social Security Act to provide for the treatment of certain cancer hospitals.

Sen. Todd Young (R-IN) introduced S.3685 to amend the Public Health Service Act to expand the authority of the Secretary of Health and Human Services to permit nurses to practice in healthcare facilities with critical shortages of nurses through programs for loan repayment and scholarships for nurses.

Sen. Jeff Merkley (D-OR) introduced S. 3680 to require the Secretary of Health and Human Services to establish references prices for prescription drugs for purposes of federal health programs.

Rep. Erik Paulsen (R-MN) introduced H.R. 7177 to amend Title III of the Public Health Service Act and Titles XI and XVIII of the Social Security Act to accelerate the adoption of value-based payment and delivery arrangements among health care stakeholders intended to coordinate care, improve patient outcomes, share accountability or lower costs.

Sen. Bill Cassidy (R-LA) introduced S. 3619 to amend Title XVIII of the Social Security Act to restructure the payment adjustment for non-emergency ESRD ambulance transports under the Medicare program.

Rep. Erik Paulsen (R-MN) introduced H.R. 7122 to amend Title III of the Public Health Service Act and Titles XI and XVIII of the Social Security Act to accelerate the adoption of value-based payment and delivery arrangements among healthcare stakeholders intended to coordinate care, improve patient outcomes, share accountability or lower costs.

Sen. Rand Paul (R-KY) introduced S. 3610, known as the Medicare Patient Empowerment Act of 2018, to amend Title XVIII of the Social Security Act to establish a Medicare payment option for patients and eligible professionals to freely contract, without penalty, for Medicare fee-for-service items and services while allowing Medicare beneficiaries to use their Medicare benefits.


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National Rural Health Day a Nationwide Success

i Dec 6th No Comments by

 

National Rural Health Day (NRHD) was celebrated on November 15, 2018, with a record number of nationwide events held by State Offices of Rural Health, rural communities, providers and stakeholders. Activities this year included Walk with a Doc walks, Twitter chats, and a call to action to use the #PowerofRural on social media to create a coast-to-coast conversation on rural health. The #PowerofRural generated over 7 million impressions and over 2,200 tweets on November 15, surpassing 2017’s impressions by over 3 million!

NRHD received broader national attention and reached new audiences with many new partners engaged this year. Teryl Eisinger, NOSORH Executive Director, was interviewed on Cerner’s The Value of National Rural Health Day podcast, and she wrote a blog post, The Power of Rural to Improve Health, that was featured on the HHS Office of Disease Prevention and Health Promotion’s Prevention Policy Matters blog. In addition, Karen Madden, Director of the Charles D. Cook Office of Rural Health, and Dr. David Sabgir, Founder & CEO of Walk with a Doc, joined Eisinger for a Rural Matters podcast on the topic of NRHD and the Power of Rural.

Now in its fourth year, the 2018 Community Stars e-book was published on NRHD with inspirational stories of individuals and organizations who truly embody the Power of Rural. Over 100 nominations were received with 29 different states represented. Thanks to all who took the time to submit a nomination to formally recognize the work of the many unsung heroes of rural health!

There were many opportunities to participate in NRHD, including three live NOSORH webinars on rural health hot topics: A Conversation on Rural EMS, Policy and the Power of Rural, and Rural Networks: Making a Difference in the Opioid Epidemic. The presentations and recordings can be found here on the NOSORH website. A Telehealth Twitter Chat was hosted by HRSA and an Access to Healthcare in Rural Communities Twitter Chat was co-hosted by NOSORH and RHIhub. In addition, NOSORH partnered with Walk with a Doc to encourage rural communities to host a special NRHD Walk with a Doc, resulting in 17 walks held across 12 different states!

As always, NRHD wouldn’t be successful without support from all 50 State Offices of Rural Health and partners across the nation! Along with countless events promoted by national partners, many State Offices participated in NRHD activities, including obtaining Governor’s proclamations, visiting rural providers and partners, holding contests, producing videos, distributing press releases, hosting rural health conferences, presenting special awards, and much more.

Be sure to mark your calendar for Thursday, November 21, and join the Power of Rural movement throughout 2019!

For more information on NRHD, contact Ashley Muninger, NOSORH Communications & Development Coordinator.


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NRHD 2018 Schedule of Events

i Nov 15th No Comments by

NOSORH Webinar- Policy and the Power of Rural from
11:00-11:30 am ET
This conversation will focus on the current and future work of rural health policy, how rural citizens can communicate with policymakers and their communities to make an impact on rural health, and the impact of a changing Congress. Click  here to join the webinar.

RHI Hub Twitter Chat on Access
12:00-1:00 pm ET
Join the RHIhub and NOSORH on National Rural Health Day to discuss access to health care in rural areas and the impact of a lack of access for rural people. Discussion will also focus on specific barriers to access, solutions to those barriers, and celebrating rural communities that have tackled this problem in meaningful ways. Everyone is welcome to follow along and jump in with comments, questions, and any information on Rural Access to Healthcare that they would like to share. Use the hashtag #RuralHealthChat to join. Click for more information

FORHP Webinar on HIN Network with CMS
1:00-2:00 pm ET
The Centers for Medicare & Medicaid Services will host a webinar to highlight examples of Hospital Improvement Innovation Network (HIIN) projects that address access to care and harm reduction in critical access and rural hospitals. Click here to join the webinar: CMS Hospital Improvement Innovation Network (HIIN) Efforts in Rural Health

HRSA Telehealth Twitter Chat
2:00-3:00 pm ET
The Health Resources and Services Administration (HRSA) is hosting a National Rural Health Day Twitter chat on the role of Telehealth. The chat will focus on how the use of telehealth can help health care and accessibility in rural areas across the nation. Join by using the hashtag #TalkTelehealth!

NOSORH Webinar- Rural Networks: Making a Difference in the Opioid Epidemic
3:00-3:30pm ET
During this conversation participants will learn how small rural networks are collaborating and innovating with their communities to address the opioid crisis in rural New York. Click here to join the webinar.

NOSORH Webinar- A Conversation on Rural EMS
4:00-4:30pm ET
This conversation will focus on the current state of rural EMS and how leaders are educating and bringing innovation to their states. Click here to join the webinar.

For more National Rural Health Day events, please visit www.powerofrural.org!

Community Stars 2018

i Nov 15th No Comments by

Those who dedicate their life’s work to rural health are extraordinary people whose contributions are deserving of recognition.  To honor our nation’s rural health leaders the National Organization of State Offices of Rural Health (NOSORH) is proud to present “Community Stars,” a collection of touching and impactful stories that embody the true Power of Rural.

Community Stars is an electronic publication that is released on National Rural Health Day each year.  Those featured in the book were nominated by a member of their State Office of Rural Health (SORH), a community member, or peer.  Each Community Star profile is a shining example of their generosity, service, and dedication to the people who call rural America home. We thank all those who nominated a Community Star and we’re eager to have you meet them as we celebrate National Rural Health Day and the Power of Rural!

Thank you to everyone who helped shine a spotlight on those making a difference in rural health by nominating an outstanding Community Star! We are pleased to announce the 2018 Community Stars! Read their stories by clicking below

Publish at Calaméo or browse the library.

September 2018

i Oct 16th No Comments by

Timothy Lopez
Director
New Mexico Office of Rural Health

What I’m currently reading: “Between The World And Me” by T a-Nehisi Coats.

Favorite thing about working at a SORH: The amazing colleagues and partners

What I’m working on right now: Working on completing the New Mexico health plan

Best advice I ever received: To live each day to the fullest and to spread joy and happiness.

If I weren’t doing this, I would be… A chef in my own restaurant.

3 great things about rural health in New Mexico: Amazing healthcare providers, dedicated leadership and staff.

Last place I traveled to: Philadelphia

People would be surprised if they knew: I was a roadie for concerts in the 90’s

Who inspires you? My mother

My Top 3 Goals for 2018:
Get a knee replacement
Continue to work in the Office of Rural Health
Increase the number of healthcare providers in rural New Mexico

July 2018

i Oct 16th No Comments by

Alisa Druzba
Director
New Hampshire Rural Health and Primary Care

What I’m currently reading: A Gentleman in Moscow by Amor Towles

Last place I traveled to: Oregon! I was there from June 24 through July 5, and we did a road trip that showed us many beautiful places in Oregon. And this time I didn’t make my husband take side trips to look at little hospitals and clinics 🙂

Favorite thing about working at a SORH: The passion and dedication of our internal partners and our external stakeholders, and the ability of the communities to use their own strengths.

Who inspires you: My national colleagues. I always feel recommitted to the work after seeing them at conferences.

People would be surprised if they knew: I get really nervous before doing a speech.

If I weren’t doing this, I would…Post retirement I want to volunteer at national parks and wander the trails answering questions.

Favorite quote: “It’s a lucky man or woman gets up in the morning, puts both feet on the floor, knows what they’re about to do, and thinks it still matters.” – Joe Biden

Sponsor with NOSORH and Be Recognized!

i Sep 28th No Comments by

NOSORH invites you to explore a sponsorship level that meets your needs and to join us in showcasing your organization at the NOSORH Annual Meeting in beautiful Cheyenne, Wyoming on October 17-18, 2018.

With your support, you’ll become a valued partner in National Rural Health Day on November 15, 2018, shine in the social media spotlight, and gain recognition through the activities developed to promote the positive messages of #powerofrural throughout the year. We’re planning special tools and ideas to bring more attention to the work of our sponsors on National Rural Health Day and beyond.

If you’ve not yet explored the many opportunities and benefits of partnering with NOSORH, it’s not too late! We encourage you to review the 2018 Sponsor Prospectus.

The sponsor registration deadline is October 5, 2018. Sponsor logos are also needed by that date to guarantee inclusion in meeting material.

Your support and partnership help build the capacity of State Offices of Rural Health! We thank you in advance for your consideration and hope to see you in Cheyenne!


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Nationwide Events Planned for National Rural Health Day

i Sep 28th No Comments by

National Rural Health Day (NRHD) is next month! Help us shine a spotlight on the positive aspects of rural health and communities across the nation! NOSORH is holding a 30-minute webinar with national partners on Oct 3 at 3:00 pm ET to learn more about how to engage in the Power of Rural. All current and potential NRHD partners are invited to attend! Register here.

State Offices of Rural Health are invited to attend the webinar “NRHD Resources for SORH” on Thursday, October 4 at 1:00-1:30 pm ET to learn about National Rural Health Day resources available to SORH, including the NRHD Toolkit for SORH. Participants are also encouraged to share their plans. Register here.

Here are some ways to join the Power of Rural movement:

  • Start by visiting org! This website is the headquarters for all things NRHD, including toolkits, resources, upcoming events, and more!
  • For Partners- National associations, agencies and non-profits are invited to partner with NOSORH to grow the Power of Rural movement. Please be sure to take the Pledge to Partner to get updates and recognize your efforts in rural America.
  • Corporate partners and non-profits are invited to be recognized for their support at the NOSORH Annual Meeting. A special session is planned to help grow the reach of your rural work. Sponsors will also be highlighted on National Rural Health Day. Click here to view the 2018 Sponsor Prospectus
  • For SORH – The NRHD Starter Toolkit for SORH, developed specifically for SORH, contains comprehensive toolkits as well as stand-alone educational and promotional items (coloring books, social media posts, postcards, etc.) to support this year’s NRHD efforts.
  • For communities and other rural stakeholders – Check out the FREE NRHD Community Engagement Toolkit for resources designed especially for community stakeholders who serve the health needs of rural communities, including hospitals, clinics, first responders, and others. It features customizable posters, flyers, social media graphics, media release templates, and much more! These NRHD tools will enhance outreach efforts to schools, churches, local media outlets, and community businesses.
  • It only takes a few steps to start a positive movement! NOSORH is once again partnering with Walk with a Doc for a fun and easy way to engage rural communities in better health on NRHD and beyond. Invite rural hospitals, health clinics, etc. in your state to host a free community walk on NRHD and start a local chapter! Click here to learn how.
  • We need YOU to make a difference! Take the Pledge to Partner to get the latest updates and help bring collective focus to specific healthcare issues facing rural communities across the United States.
  • Follow NOSORH on Facebook and Twitter and help us expand our NRHD reach by liking, sharing, and retweeting posts! Click here for free NRHD social media graphics. Don’t forget to use the #powerofrural in every post and encourage your partners to do the same.
  • Stay tuned for more information on this year’s lineup of live, 30-minute webinars that will be featured throughout the day on NRHD.
  • Are you planning an event on NRHD? Do you have a unique idea you’d like to share? Share your plans at org and we’ll feature your event on the website!

Whether you’ve already made plans or are just starting to think about it, there are plenty of ways to get involved in celebrating the #PowerofRural!

Contact Ashley Muninger for more information.


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How Rural Health Clinics Work with State Offices of Rural Health

i Sep 28th No Comments by

How Rural Health Clinics Work with State Offices of Rural Health- Sept 2018

Committee Clips

i Sep 4th No Comments by

NOSORH committees are great focal points for engaging in many NOSORH initiatives.  Descriptions of all committees and contact information can be found on the NOSORH website.

Educational Exchange- The committee met on August 20th at their new time of 3:00pm ET. The group focused their efforts on the best way to work with SORH on completing the SORH Proficiencies self-assessment tool. Be sure to check the NOSORH calendar for upcoming webinars supported by the committee. Our next meeting will be held on September 17th at the new time of 3:00pm ET.

RHC Committee- During the August meeting, the RHC Committee examined the CMS proposed rule for the Physician Fee Schedule specific to Rural Health Clinics with presentations provided by Wakina Scott of FORHP and Nathan Baugh of NARHC. An overview of the Patient Centered Medical Home (PCMH) Facilitator Training provided in partnership of the Louisiana State Office of Rural Health and The Compliance Team (TCT). Tracie Ingram, LA SORH, and Kate Hill, TCT, presented the recap to the committee. TCT is the newest CMS endorsed PCMH Accreditation Body. Finally, the RHC Committee will host the Chronic Care Management for Rural Provider webinar with a Medicare focus presented by Captain Corinne Axelrod of CMSon Wednesday, September 19at 2 PM ET.

Communications- The committee has been working on new resources for NRHD and is excited to be announcing the slate of NRHD webinars in the coming weeks.

Policy Committee – The August meeting of the Policy Committee included updates on the efforts for SORH reauthoriziation. Hall Render is strategizing with leadership to push for a vote on the House version of the SORH reauthorization bill (HR 5641). The committee heard an update from FORHP including information on CY 2019 Proposed Rule for Hospital Outpatient Prospective Payment System.

Policy Program Monitoring Team- The August meeting included a review of recent State health coverage initiatives and PPACA related court cases. The team also discussed and formulated points for responding to CMS Request for Information on the Stark Law. The team plans to review comments on telemedicine reimbursement and AC0 definitions this month.


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