Primary Care Office Needs Assessments

State and territorial Primary Care Offices (PCOs) must complete a unique community-based health needs assessment as a component of their funding from the Health Resources and Services Administration (HRSA) Bureau of Health Workforce (BHW), within the Department of Health and Human Services (DHHS). PCOs receive direct guidance from BHW that identifies differences between a traditional PCO needs assessment and a community-based health needs assessment.

This issue brief is intended to build foundational knowledge regarding the PCO needs assessment, highlight the components that are unique to PCOs, and offer resources on promising practices identified through publicly available needs assessments and public health organizations.

Issue Brief: Planning Conducting and Leveraging PCO Needs Assessments

June 2019

i Jun 20th No Comments by

Matt McCullough
Utah State Office of Rural Health
NOSORH Member since 2016

Favorite thing about working at a SORH: My favorite thing about working at a SORH is the statewide impact we can have and the many amazing people we get to work with throughout Utah.

What I’m working on right now: New interactive maps and public data sets to add to the Data Portal on our new website, as well as SHIP consortium projects, a strategic plan document and balanced scorecard measures, hiring new staff and putting on our 8th annual Rural Hospital Administrators Summit.

If I weren’t doing this, I would be…kayaking with my wife and kids or out doing landscape photography.

3 great things about rural health in my state: (1) Amazing people who care deeply about the work that they do (2) No hospital closures and few hospitals in financial distress (3) The Rural 9 network of independent rural hospitals that is having great success!

What I’m currently reading: Good to Great by Jim Collins

Last place I traveled to: Lake Powell, Utah

Favorite quote: “There are two primary choices in life; to accept conditions as they exist, or accept the responsibility for changing them.”

RHIhub Spotlight

i Jun 4th No Comments by

The RHIhub launched a new evidence-based Rural Telehealth Toolkit. Developed in collaboration with the NORC Walsh Center for Rural Health Analysis, this toolkit is designed to help rural organizations that are looking to start a telehealth program to address health issues in their communities.

The webinar Introducing the Telehealth Toolkit will be held on June 5th. Tune in to learn more about the toolkit and hear from some successful programs about their lessons learned. Featured speakers include:

  • Luciana Rocha, MPH, Principal Research Analyst at the NORC Walsh Center for Rural Health Analysis
  • Susan Maley, MPH, PhD, managed the Rural Veterans Health Access Program from 2014 to 2018
  • David Scott, MPH, PhD, RPh, Professor of Pharmacy Practice at the School of Pharmacy, NDSU College of Health Professions
  • Danielle Louder, Program Director for the Northeast Telehealth Resource Center (NETRC)

The Rural Monitor featured three new articles:

There are three new Models and Innovations now available:

  • Minnesota Farm & Rural Helpline – The Minnesota Farm & Rural Helpline is a free, confidential helpline available 24/7 for farmers and farm families to connect with counselors, help with daily living (like childcare or food assistance), and financial/legal advice.
  • Health Advocacy Summit – HAS provides free one-day conferences for young adults with chronic or rare conditions to access health and educational resources and build a community of peers and advocates.
  • My Virtual Clinic School-based Telehealth Program – An Indiana rural health association, four Rural Health Clinics, and several rural school districts collaborate to expand healthcare access to schools.

Chronic obstructive pulmonary disease, or COPD, is a progressive disease of the lungs that causes shortness of breath. With a high prevalence rate in rural America, it is also considered a preventable cause of death. Learn more about COPD and the efforts needed to impact the disease in our new video, The Challenges of Chronic Disease in Rural Areas: Chronic Obstructive Pulmonary Disease (COPD).

Finally, on May 21st, RHIhub hosted a webinar with the National Advisory Committee on Rural Health and Human Services on improving oral health care services in rural America. Speakers highlighted some of the current barriers to oral health care and reviewed the recommendations from the committee to the Secretary of the Department of Health and Human Services. The recording, slides, and transcript are available on the website.

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Committee Clips

i Jun 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.

Board of Directors – The Board of Directors met twice in the month of May: during the NRHA meeting and on May 23.  They revised the Policy for Board responsibilities during NRHA and endorsed a new plan for the 2019 Community Stars effort. Maner Costerian reported on the annual federal audit and provided a clean report- “as good as you can get”. The Board formally commended Donna Pfaendtner, Administrator, for her exceptional work on the financial responsibilities of the organization. In addition, a policy for a new mentoring program for SORH Directors was approved. The Board also reviewed and approved draft comments for response to the CMS Request for Information regarding Geographic Population Based Payment model.

Communications- The Communications Committee met to provide input on the revamped Community Stars 2019 process, brainstormed possible presenters/topics for the NRHD webinar and reviewed their purpose statement to be sure it reflects the work they do. The June meeting has been moved to June 12 at 2:00 pm ET.

Development- The Development Committee continues to support Partnership Development and other sponsorship activities. The committee is reviewing its purpose statement and continues to discuss strategies to increase membership engagement. If anyone has potential partner and/or sponsor suggestions, please contact Graham Adams ( or Kylie Nissen (, co-chairs of the committee.

Executive Committee – The Executive Committee considered amendments and additions to the Board policies on the use of Executive Sessions, a policy on Diversity and whether the current policy on the CEO compensation and performance are needed. Recommendations to the Board that there is no need for a policy on executive session, the CEO performance review policy is sufficient and that the board should plan to study models for diversity policies in the future. The Committee will work with the CEO to review bylaw changes, which will allow for needed changes to NOSORH governance.

Educational Exchange The EE Committee met in May to review the future focus of the committee and revise the committee purpose statement; Chris has sent out draft language to all members, please submit feedback as soon as possible. The committee also reviewed the first draft of the Communicating SORH Value rubric. The committee will continue the discussion on the future focus and review the first draft of the Workforce rubric at the June 17th meeting.

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TruServe Update

i Jun 4th No Comments by

NOSORH recently hosted a TruServe Roundtable Discussion, to listen to the recording, please click here.

Reminder – Add the new SORH PIMS measures to TruServe! The webinar “Updated SORH Performance Reporting: PIMS Measures and TruServe Collection” was held on May 29. Click here for the webinar recording and materials. If you haven’t already, contact Mark to discuss getting the new SORH measures into your TruServe system.

Next training is:

Wednesday, June 26th at 2:00 pm Eastern.

Webinar link:

Dial into: 1-415-655-0002, passcode 921 776 408#

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Policy Update

i Jun 4th No Comments by

Appropriations Process Rolls Along

On May 9, the House Appropriations Committee passed by a vote of 30-23 the annual Labor-HHS spending bill for the upcoming fiscal year. The full-committee passage came two weeks after the House Labor-HHS Appropriations Subcommittee introduced their fiscal year (FY) 2020 spending bill.

As passed by the committee, the bill provides $12,500,000 for the State Offices of Rural Health, a $2.5-million-dollar increase over FY 2019 funding. Also included in the spending bill is $59 million for Medicare Rural Hospital Flexibility Grants and $19,942,000 for the Small Rural Hospital Implementation Grant Program.  The next step for the Labor-HHS bill is before the full House of Representatives, which hopes to pass the bill no later than June 27.

The Senate Appropriations Committee has yet to introduce any of their spending bills for FY 20. Senate Appropriations Chairman Richard Shelby (R-AL) has indicated the Senate’s desire to pass a disaster relief bill before embarking on the annual appropriations bills. The Senate and House bills are expected to significantly differ with the House bill having controversial policy riders included in the committee-passed bill.

Funding for FY 2020 expires in 123 days on September 30, 2019.

HELP Committee Leaders Release Draft Bill Targeting Health Care Priorities

Senate Health, Education, Labor, and Pensions (HELP) committee leaders Sen. Lamar Alexander (R-TN) and Sen. Patty Murray (D-WA) released a wide-ranging draft bill addressing health care issues such as surprise medical billing, prescription drug costs, and urgent public health concerns. The proposal is separated into five main sections: approaches to tackling balance or “surprise” medical billing, reducing prescription drug costs, increasing transparency in health care, bolstering public health, and improving the exchange of health IT. According to Sen. Alexander, legislation combining these proposals with ones from the Senate Finance Committee will be marked up this summer with the goal of having it reach the President’s desk by July.

For surprise medical bills, patients would be tasked with paying bills as if they are receiving in-network care when they are unexpectedly treated out-of-network in an emergency situation or at an in-network facility.

The proposal includes several measures addressing public health concerns, including combating vaccine misinformation and maternal mortality. To increase transparency in the health care system, the draft proposes to require plans to maintain updated provider directories. Plans and providers would also be required to give patients estimates of their expected out-of-pocket costs within 48 hours of a request. The draft also contains many drug pricing provisions, such as speeding low-cost generic drugs to market.

The committee is requesting comments on the discussion draft. Comments must be submitted to by 5 PM on Wednesday, June 5, to be considered. A section-by-section summary can be found here.

Rural Health Bill Introduced this Month

Senators Brian Schatz (D-HI) and Lisa Murkowski (R-AK) introduced the Expanding Capacity for Health Outcomes Act of 2019 (ECHO Act). The bill is intended to increase access to health care services in rural areas by expanding the use of technology-based collaborative learning and capacity building models.  The bill builds on findings of the 2016 ECHO Act that was signed into law and required HHS to examine ECHO models and report to Congress.

The ECHO model is an innovative medical education program that uses interactive videoconferencing to link specialist teams with primary care providers in rural areas. The bill, S. 1618, would create a program to provide grants and technical assistance to further develop and evaluate the ECHO model and similar models.

Reps. Mark Green (R-TN) and Bennie Thompson (D-MS) introduced H.R. 2990 to amend title XVIII of the Social Security Act to permit States to designate without any mileage limitations facilities that are located in rural areas as critical access hospitals. The bill would repeal the “35-mile rule” that currently bars hospitals from pursuing a Critical Access Hospital (CAH) designation.

Currently, a rural hospital must be at least 35 miles away from another hospital to receive the CAH designation.  If passed, the bill would allow states to designate a facility a CAH if it meets the other requirements: (1) the hospital must have 25 or fewer inpatient beds; (2) must provide 24/7 emergency care services; and (3) the average length of stay for acute care patients must be 96 hours or less.

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SORH Regional Meetings Underway this Month

i Jun 4th No Comments by

This month will see Region D and Region A meetings hosted in Hawaii and Massachusetts. NOSORH looks forward to seeing everyone there! Meeting resources can be found here on the NOSORH website after each meeting. There is still time to register for Regions B, C, and E. More information on each of those meetings is below:

Region B:

Augusta, Georgia
August 27 – 29, 2019
DoubleTree by Hilton
2651 Perimeter Parkway
Augusta, Georgia 30909

800-222-TREE (8733) or 706-855-8100. The federal rate is $102 per night. The total rate including taxes is $122.28.
Please use code “NOS” to get the rate. Online reservations click here. Reservation deadline: August 5, 2019

Meeting Registration: click here
Draft Agenda: click here

There will be a free optional meeting centered on issues related to the Centers for Disease Control and Prevention taking place on August 27 from 9:00 am – 12:00 pm. You will have the option to register for it when you register for the regional meeting.


Region C:

Kansas City, Missouri
July 30 – 31, 2019
Sheraton Kansas City Hotel at Crown Center
2345 McGee Street
Kansas City, Missouri 64108

Reservation: 866-932-6214

The federal rate is $125 per night. The total rate including taxes is $149.39. Please use code: “NOSORH Region Meeting” to get the rate. Click here for the online reservation system. Reservation deadline: July 8, 2019

Meeting Registration: click here
Draft Agenda: click here

There will be a free optional meeting hosted by the HRSA Office of Regional Operations Regions V and VII. It will take place on July 29 from 1:00pm – 5:00pm. You will have the option to register for it when you register for the regional meeting.


Region E:

Portland, Oregon
September 4-5, 2019
Embassy Suites – Downtown
319 SW Pine Street
Portland, OR 97204

Reservation:800-HILTONS (800-445-8667)

The federal rate is $184 per night. The total rate including taxes is $212.15.  Please use code: “NOS” to get the rate. Online reservations click here. Reservation deadline: August 13, 2019

Online Registration: click here
Draft Agenda: click here

There will be a free optional meeting focusing on issues related to workforce. It will take place on September 6 from 9:00 am – 12:00 pm.

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RHC Committee Releases Revamped Education Module and RHC Technical Assistance Survey

i Jun 4th No Comments by

The NOSORH RHC Committee recently revised and released Module #1 – An Introduction to the Rural Health Clinic Program. This educational resource is an overview of the Rural Health Clinic Program and related requirements. The Committee will continue updating each module in the series of educational resources found on the RHC Resources page of the NOSORH website. Stay tuned for a webinar in late July to reintroduce both Module #1 and Module #2.

Finally, it’s that time again- RHC Technical Assistance Survey time!! The purpose of this survey is to gain an understanding of the technical assistance needs your SORH may have for assisting primary care providers in your state and to help shape the work of the RHC Committee. The results of the survey will be compiled and shared. Please complete the survey by June 17, 2019. Your participation is greatly appreciated!

Thank you to the RHC Committee and partner members for providing your time and expertise to these valuable resources.

If you have interest in learning more or engaging with the RHC Committee, please reach out to Crystal Barter (, Committee Chairperson or Tammy Norville (

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Webinar: Updated SORH Performance Reporting: PIMS Measures and TruServe Collection (5/29/2019)

i May 31st No Comments by

Webinar Recording

Webinar Slides

Webinar Resource

Peer-Driven Resources

The core of NOSORH is to build the capacity of State Offices of Rural Health and rural stakeholders. To accomplish this, NOSORH provides a number of peer-driven and leadership development resources to assist your office. NOSORH’s mentoring program is rooted in the philosophy of former SORH director and life-long rural health advocate, Jim Bernstein. Jim developed the first SORH in North Carolina, served as president of the National Rural Health Association, and was a model mentor in cultivating the next generation of rural health leaders. NOSORH continues Jim’s legacy as a master of change, working within existing policy frameworks to build sustainable programs that address longstanding problems.

Through support from the Federal Office of Rural Health Policy, NOSORH is able to offer a peer-to-peer mentoring program, an educational exchange scholarship program, and a Rural Health Leadership Institute.

NOSORH Mentoring Program

The NOSORH Mentoring Program is an opportunity for new SORH Directors to participate in a mentoring experience with veteran SORH leaders from across the country. The experience is intended to last approximately six (6) months, engaging the mentor and mentee in identifying and achieving professional development goals. As a component of this, mentees are required to attend the New SORH Orientation with FORHP and attend a “NOSORH 101” webinar with NOSORH staff.

Mentors will work collaboratively with their assigned mentee to acclimate them to the SORH Proficiencies framework, identify strategic goals for the mentoring experience, and offer support as appropriate.

For more frequently asked questions on the Mentoring program, check out the program FAQ guide.

Educational Exchange Scholarship

All NOSORH members are eligible to request travel scholarships to meet with another SORH and learn about a topic of importance to that member’s SORH. Scholarships support travel that enable a NOSORH member to link with a mentor or peer at another SORH who will help that member:

  • develop or enhance his or her expertise and leadership skills
  • adopt a promising practice, and/or
  • improve their program management or strategic planning/implementation effectiveness.

More information on the Educational Exchange Scholarship program can be found in the Program Overview.

Completed applications for the Educational Exchange Scholarships should be submitted to Chris Salyers at

For questions or more information, contact:

Chris Salyers, NOSORH Education and Services Director, at: or (734) 881-9551