Committee Clips

i Apr 3rd 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.

JCREC-  The Joint committee met, and many federal agency updates were given, along with the Policy Page that NRHA is working on, NASEMSO supporting the National Rural EMS & Care Conference, and an update from Tom Perkins, Virginia Office of EMS, on their ongoing partnership with rural.

Board – The NOSORH Board met last month to follow up on strategic planning efforts. A task force has been assigned to review committee structure and governance and a “futures” effort lead by Graham Adams (SC) will provide insight on positioning SORH for the future. Additionally, the Board acted to allow NOSORH employees to donate Paid Time Off to other employees. The Board also heard about a funding lines increase and plans to grow SORH engagement with the CDC. Board minutes of past meetings are posted here.

Executive– The Executive Committee met in March to plan the March Board agenda, follow up on strategic planning efforts and to follow up on a NOSORH employee family leave policy.

Flex – The Flex Committee reviewed the Funding Extension Progress Report guidance released last month with a focus on provider-based RHC work and EMS services. The group discussed several approaches to meet the newly clarified requirements such as including operational support services to clinics such as coding and billing education. Additionally, the group is developing a list of potential updates for the Flex Program.

RHC- The RHC Committee continues to focus on technical assistance offered to Rural Health Clinics across the nation as well as topics pertinent to SORH work. Currently, the committee is investigating rural Home Health designations and discussing Chronic Care Management coding and potential billing impact. The NOSORH RHC Institute had its Kickoff on March 18th in San Antonio as a precursor to the NARHC Spring Conference. The RHC Institute runs through July.

Policy Program Monitoring Team – The PPMT will meet twice this month, Tuesday April 10th and April 25th. The group will discuss proposed short-term limited duration health plans and work to continue planning a series of webinars which will help SORH and their partners with a framework for understanding potential state health care coverage initiatives. The initiatives discussed will include those affecting Medicaid programs and the Affordable Care Act (ACA) marketplace.

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Rural EMS Sponsorship and Exhibitor Opportunities

i Apr 3rd No Comments by

Support the work of the Joint Committee on Rural Emergency Care by sponsoring the National Rural EMS & Care Conference in Tucson, AZ, on April 24-25. The conference offers an opportunity for sponsors and exhibitors to meet with local, regional and national EMS stakeholders, and to be recognized for their support. Three levels of support are being offered for the conference:

Prime Sponsor-$5,000
Select Sponsor- $2,500
Conference Exhibitor-$1,000

Please click here for the 2018 Sponsor Prospectus to register as a sponsor and for more information regarding each level of sponsorship.

Click here to view the full conference agenda.

The conference will be held at the Westward Look Wyndham Grand Resort, 245 E. Ina Road, Tucson, AZ. To book a room, please call (800) 722-2500 and reference the “National Rural EMS & Care Conference 2018” to get the $91 + tax room rate. You may also book online by clicking here.

For more information about the conference, please visit:

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RHIhub Spotlight

i Mar 30th No Comments by

The RHIhub is excited to announce the launch of Daily & Weekly Custom Alerts! Now you can sign up for email alerts related to specific states and topics, choose how often you get them, and even which types of resources interest you most, so that you’re always up to date on the information that you need.

Two new articles have been published in the Rural Monitor:

Two Topic Guides have been updated:

  • Critical Access Hospitals (CAHs) – includes extensive information on CAHs, including reimbursement, eligibility, funding, legislation, and more.
  • Rural Public Health Agencies – new FAQs on challenges and opportunities, workforce, and how rural providers and public health workers can collaborate on population health, accreditation, including research related to costs and barriers in rural areas, and public health infrastructure and governance.

A webinar was recently held with the National Advisory Committee on Rural Health and Human Services, NACRHHS Policy Brief on Modernizing the Rural Health Clinic Act Provisions, with speakers from the Federal Office of Rural Health Policy, the Idaho Department of Health and Welfare, and the Maine Rural Health Research Center. A recording is available online.

Another webinar with NACRHHS is coming up on April 24, 2018 at 1:00 pm Central: NACRHHS Policy Brief on Understanding the Impact of Suicide in Rural America

New Models and Innovations:

  • ARCare Aging Well Outreach Network – ARcare Aging Well Outreach Network, run by an FQHC, provides falls assessments, exercise opportunities, medication management, and other services to older patients in rural Arkansas. From May 2015 to December 2017, the network served 584 patients through 1,296 medical encounters.
  • The Sapling Center – The Sapling Center in rural eastern Kentucky provides those 14 to 25 years old with free services like counseling, life skills training, volunteer opportunities, and fun activities.
  • New Horizons Substance Use Recovery Network – Opioid use disorder is treated within Michigan’s FQHCs by integrating primary care, behavioral health, and MAT-waivered providers.

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Take the TruServe Survey

i Mar 30th No Comments by

Have an idea to make TruServe better? Please take a few minutes to share your opinions on this brief survey:

Join fellow SORH staff from across the country to learn more about maximizing the utility of TruServe at the next TruServe training on Tuesday, April 24th at 2:00pm ET. These monthly training sessions work to answer questions for existing users and provide a broad overview of TruServe for anyone using the system.

Webinar link:

Dial-in: 1 (415) 655-0002
Passcode: 921 776 408 #

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Policy Update

i Mar 30th No Comments by

The following update was provided for our members by Hall Render, NOSORH Legislative Liaison:

State Office of Rural Health Bill Nears Finish Line in Senate

During the week of March 19, Senate leadership hotlined (fast-tracked without debate) the State Offices of Rural Health Reauthorization Act of 2018 (S. 2278) through the Senate. Without any of the 100 members objecting, the SORH bill is now set to pass the Senate.

The Senate parliamentary procedure came weeks after the Senate Health, Labor, Education and Pensions (HELP) Committee voted to advance the bill out of committee. The bill advanced after an amendment was agreed to which increases the authorization of appropriations level to $12,500,000 for each of the fiscal years 2018 through 2022. The bill passed the committee unanimously.

Major Spending Bill Passes Congress

On March 23, President Trump signed a major $1.3 trillion spending bill into law, which keeps the government funded through September 30, 2018. The bill passed the House 256-167 and the Senate 65-32. In both bodies, the measure received the support of a majority of members from each party. In the Senate, unanimous consent was needed from all senators to waive procedural rules and set up votes before Friday’s midnight deadline.

The bill includes a total of $78 billion ($10 billion above FY 2017) for the Department of Health and Human Services. Within the HHS funding, the Centers for Medicare & Medicaid Services (“CMS”) received $4 billion in funding for administrative expenses, the Health Resources and Services Administration received $7 billion and the Substance Abuse and Mental Health Administration received $5 billion. The legislation includes nearly $4 billion in resources to combat the opioid crisis through investing in treatment, prevention and law enforcement efforts. More than $2.3 billion in funding is provided for mental health programs and other training.

Rural communities will see a $135 million increase in healthcare program funding, including $100 million for drug addiction treatment and prevention. In addition, Congress appropriated $10 million annually for the State Offices of Rural Health and $49.6 million for rural hospital flexibility grants.

Two provisions that were not included in the bill are stabilization of the ACA’s health insurance markets and providing coverage for patients with high medical costs. The first measure, known as the Alexander-Murray provision, would have reinstated government subsidies paid to health insurers. The second would have provided funding to help states set up high-risk insurance pools to provide coverage for people with high medical costs. Though the ACA stabilization proposal had already been negotiated on a bipartisan basis, Republicans wanted to include language that would ban federal funds from being used for abortions, which Democrats said was a non-starter.

House Energy and Commerce Committee Reviews Solutions to Combat the Opioid Crisis

On the week of March 19, the House Energy and Commerce Health Subcommittee wrapped up a two-day hearing examining 25 bipartisan bills addressing the opioid crisis. The legislation focused on prevention and public health solutions. Energy and Commerce Chairman Greg Walden (R-OR) stated “The unprecedented plague of opioid addiction and substance use disorder in our country requires an unprecedented response.” Legislation reviewed included Jessie’s Law, introduced by Reps. Tim Walberg (R-MI) and Debbie Dingell (D-MI), which would help ensure doctors have access to a consenting patient’s prior history of addiction in order to make fully informed care and treatment decisions.

The Poison Center Network Enhancement Act of 2018 (H.R. 5329), authored by Reps. Susan Brooks (R-IN) and Eliot Engel (D-NY), was discussed to reauthorize the important network of centers within the National Poison Data System that offer free, confidential, expert medical advice 24 hours a day, seven days a week. Oftentimes these programs serve as the primary resource for poisoning information and help reduce emergency room visits. Lawmakers also spent a lot of time debating legislation known as the Overdose Prevention and Patient Safety Act (H.R. 3545) introduced by Reps. Markwayne Mullin (R-OK) and Earl Blumenauer (D-OR). That measure would modernize substance use disorder treatment records to permit records to be shared in accordance with the Health Insurance Portability and Accountability Act for the purposes of treatment. It would also increase penalties in the event of disclosure, add breach notification requirements and provide discrimination prohibitions.

Senate Committee Hearing Assesses 340B Program

On March 15, the Senate HELP Committee held a hearing to examine the 340B drug discount program as some stakeholders have urged lawmakers to scale back its reach. HELP Committee Chairman Lamar Alexander (R-TN) said the purpose of the hearing was to learn more about the program and “how it might be improved so that hospitals and clinics can continue to provide low-income patients with help to afford their health care.” Chairman Alexander said to expect the committee to hold another 340B hearing soon, likely featuring a representative from the Health Resources & Services Administration (“HRSA”), which oversees the program.

The hearing showed a clear dividing line between Senate Democrats and Republicans on the 340B program, with Democrats advocating that savings from the program are desperately needed for the poorest populations and Republicans stating the program is being abused and needs to be reformed. Sen. Bill Cassidy (R-LA) introduced legislation for expansive changes to the 340B program, such as implementing a two-year moratorium on certain new 340B hospitals and outpatient departments and adding new reporting requirements for hospitals. By contrast, Sen. Patty Murray (D-WA) admitted that calls for transparency and accountability are appropriate, but the 28.5 percent cut CMS made last year for certain 340B drugs was “unnecessary” and fails to address skyrocketing drug costs.

House Ways and Means Committee Holds MACRA Hearing

On the week of March 19, the House Ways and Means Health Subcommittee held a hearing on implementing the Medicare Access and CHIP Reauthorization Act (“MACRA”) of 2015, which featured witnesses from CMS. Demetrios Kouzoukas, Principal Deputy Administrator and Director of the Center for Medicare, testified that the full promise of MACRA has not been realized as too few physicians and clinicians are participating in alternative payment models, and far too many clinicians find the law’s reporting requirements too burdensome. He laid out a plan to move forward on four areas of emphasis: “giving consumers greater control over health information through interoperable and accessible health information technology; encouraging transparency from payers and providers; using experimental models in Medicare and Medicaid to help patients drive value and quality throughout the entire system; and removing government burdens that impede this transformation.”

Providers and industry stakeholders have urged Congress to improve fairness and reduce burdens under the program. In the hearing, Kouzoukas urged stakeholders to work with CMS to increase innovation and submit promising ideas to the Innovation Center.

Health Care Price Transparency Working Group Created By Senators

A bipartisan group of senators are launching a working group to tackle the high price of health care. They are seeking feedback from patients, providers and insurers to help craft legislation to make health care pricing more transparent. Led by Sen. Bill Cassidy (R-LA), the group includes Sens. Todd Young (R-IN), Chuck Grassley (R-IA), Michael Bennet (D-CO), Tom Carper (D-DE) and Claire McCaskill (D-MO). The group is seeking data on what information consumers currently have about prices and out-of-pocket costs, who should ultimately be responsible for providing information to consumers and how to ensure transparency requirements don’t place unnecessary burdens on health care stakeholders.

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Design and Dissemination Studios: Researcher and Student Opportunity, Stakeholders Welcome!

i Mar 30th No Comments by

NOSORH and the Collaborative for Rural Primary care, Research, Education and Practice (Rural PREP) are looking for researchers to participate in research Design and Dissemination Studios (DDS) to be held in conjunction with two SORH Regional Meetings. Researchers who address topics on rural primary care health profession education OR students in a rural primary care education or training program are sought. Research projects that are proposed, in progress or published are of interest for the DDS. Travel stipends are available. Support for researchers to prepare to participate in this innovative activity to inform research is provided.

The DDS is an innovative strategy of the Rural PREP project led by Dr. Randall Longenecker, Associate Director, Communities of Practice Lead, Ohio University, and Dr. Davis Patterson, Project Director, University of Washington School of Medicine. Rural PREP is a national project whose mission is to improve and sustain rural health through community engagement and research in primary care health professions education. The DDS are events in which communities participate in the design of research and then help interpret and disseminate the results. The process makes research more community-centered, culturally relevant, and accessible to those who will most benefit from the findings. To learn more about DSS click here.

Stakeholders from across the nation are invited to participate in the sessions held in conjunction with SORH regional meetings on June 12th from 9:00-11:30am in Charlottesville, VA; and on June 25th from 2:00-4:30pm in Little Rock, AR.  Travel support is available for stakeholders in the amount of $500.

Stakeholder Registration Information:

RPREP Registration: click here

Registration deadlines: Region A- Charlottesville, VA – May 14, 2018; Region D – Little Rock, AR – June 5, 2018

For more information contact Matt Strycker. 

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NOSORH Partners with LilyPad – Practice Operations National Database (POND)

i Mar 30th No Comments by

NOSORH is working with LilyPad on their Practice Operations National Database (POND) product to support clinics to report and benchmark data. To date, 12 states have enrolled in POND, with 95 clinics reporting data on 336 providers, including physicians and advanced practitioners. Listening sessions will be planned with State Offices of Rural Health and POND users to learn more about the opportunities for improving and reporting on the impact of the work of clinics.

POND is a web-based data collection, reporting and benchmarking application for rural providers including rural health clinics, community health centers, health system satellite practices, and independent physician or advanced level provider practices to collect financial, operational, productivity and compensation factors with five Quality measures added in March 2018. Learn more about POND

As you prepare the Flex Funding Extension Progress Report that is due in EHB on May 9, 2018, this tool may assist in addressing the clarified requirement around work with provider-based rural health clinics.

For additional resources, questions or further assistance, please contact Tammy Norville at or (919) 689-5110.

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ASTHO Support Helps Facilitate Stronger NOSORH, PCO National Committee Partnership

i Mar 30th No Comments by


Over the last several months, the collaboration between the National Organization of State Offices of Rural Health (NOSORH) and the Association of State and Territorial Health Officials (ASTHO) has enabled a blossoming relationship between NOSORH and the PCO National Committee. NOSORH has been supporting the PCO National Committee with meeting logistics, surveys, and regular check-ins. Beth Kolf, NOSORH Project Coordinator, has been the lead working directly with the PCO National Committee chair and co-chair, Dianne Roberts (IL) and Tom Rauner (NE).

“When we first started this work with the PCO National Committee, I didn’t know much about the work of a PCO,” said Kolf. “I feel like working with them has helped me to better understand the work and needs of PCOs and see how that matches up with the work being done by the SORH. Not to mention, they are such a nice group, and I really enjoy working with them!”

At the most recent meeting of the PCO National Committee, results of a Technical Assistance survey were discussed that looked at the self-reported need for education and technical assistance. The most common requests were on the Shortage Designation Management System (SDMS), followed by Needs Assessment Best Practices and the HRSA DataWarehouse. NOSORH will be working alongside the Center for Health Workforce Studies and ASTHO to deliver education for PCOs through webinars and other effective learning formats.

In addition to the work focused on the PCO National Committee, Kolf manages the logistics for the PCO Mentoring program. All participants have been selected, including seven mentees and five mentors across the country. They will attend an in-person meeting at the ASTHO offices on April 17th and 18th to help develop specific objectives for the mentoring experience and provide a broad overview of the PCO program and its partners. Afterwards, mentors and mentees will receive travel support from ASTHO to make a site visit during the summer months and complete an evaluation of their time in the program.

In the upcoming months, a couple of resources will be made available through the partnership between NOSORH and ASTHO that will target SORH, PCO, and State and Territorial Health Officials. One report will look at the relationship between education and job skills training with health outcomes, and a brief on best practices for completing a PCO Needs Assessment will also be disseminated.

“The partnership with ASTHO continues to be enable NOSORH to assist our membership in new and important ways,” said Chris Salyers, Education and Services Director at NOSORH. “We are thankful for such a strong partnership with ASTHO. The chance to work closely with the PCO National Committee has been something we’ve wanted to do for a long time, and ASTHO helped us accomplish that goal.”

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Updates to SORH Regional Meetings

i Mar 30th No Comments by


State Offices of Rural Health, mark your calendars with these dates and locations for the upcoming SORH Regional Meetings.

Region A will be meeting in Charlottesville, Virginia on June 12-14 at the Omni Charlottesville.

Call (800) 843-6664 to make your reservation at the Omni Charlottesville. Please ask for the “SORH Region A Partnership Meeting” rate of $128/night plus 12.3% sales tax, bringing the total per night to $143.74. Reservation deadline: May 18, 2018

Online Registration (No registration fee. Registration Deadline: May 14, 2018)

Draft Agenda

Pre-meeting Rural PREP Design and Dissemination Studio on June 12:
On the morning of June 12th, Rural Primary care, Research, Education, and Practice (Rural PREP) will join NOSORH to conduct a Design and Dissemination Studio (DDS). The DDS is an innovative strategy where communities participate in the design of research and then help interpret and disseminate the results. The process makes research more community-centered, culturally relevant, and accessible to those who will most benefit from the findings. Researchers who address topics on rural primary care health profession education OR students in a rural primary care education or training program are sought. SORH from all regions are invited to attend. To learn more about DSS click here.


Region B will be held in Pensacola, Florida on September 5-7 at the Holiday Inn Pensacola Beach.

If you’d like to make your reservations early, contact the hotel at (850) 932-5331. The room rate is $106/night plus tax. Please reference the group code “NOS” when making reservation.


Region C will be held in Minneapolis, Minnesota on August 14-15 at the Radisson Blu Mall of America.

NEW: The HRSA Office of Regional Operations will be holding a half day, pre-conference meeting on the afternoon of Monday, August 13. All SORH are invited to attend. More information to follow.

If you’d like to make your hotel reservations early, contact the hotel at 1-800-333-3333. The room rate is $149/night plus tax. Please reference “NOSORH Region C Partnership Meeting” when making your reservation. Reservations must be made by Monday, July 30.


Region D will be held in Little Rock, Arkansas on June 26-27 at the Doubletree by Hilton Little Rock.

Please call (501) 372-4371 to make your reservation and ask for the “CDTHLT” rate of $96/night plus 14.4% sales tax bringing the total per night to $110.40 or to register online click here. Reservation deadline: June 5, 2018

Rural PREP Pre-meeting Design and Dissemination Studio on June 25:
On the afternoon of June 25th, Rural Primary care, Research, Education, and Practice (Rural PREP) will join NOSORH to conduct a Design and Dissemination Studio (DDS). The DDS is an innovative strategy where communities participate in the design of research and then help interpret and disseminate the results. The process makes research more community-centered, culturally relevant, and accessible to those who will most benefit from the findings. Researchers who address topics on rural primary care health profession education OR students in a rural primary care education or training program are sought. SORH from all regions are invited to attend. To learn more about DSS click here.


Region E will take place on August 28-29 in Salt Lake City, Utah at the Salt Lake Plaza Hotel Temple Square.

If you’d like to make your reservations early, contact the hotel at (801) 521-0130. The room rate is $124/night. Please reference “SORH Region E Partnership Meeting” when making your reservation.


If you have any questions about any of these meetings, please contact Matt Strycker at or Trevor Brown at

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Ambulance Payment Reform, Grant Writing Workshop, Different Approaches to Community Paramedicine and More at the National Rural EMS & Care Conference

i Mar 30th No Comments by

You don’t want to miss the wide variety of rural EMS topics offered in Tucson later this month! Dr. Chelsea White’s session, Different Approaches to Rural Community Paramedicine Projects: Tribal and Frontier Success Stories, is just one of the topics expected to engage local, regional and national EMS stakeholders gathering at the National Rural EMS & Care Conference. Dr. White is an emergency physician in the Department of Emergency Medicine at the University of New Mexico (UNM), where he also serves as Director of the UNM Center for Rural and Tribal EMS, as well as the Director of UNM EMS Fellowship. Learn from Dr. White about Community Paramedicine in isolated, frontier Native American reservations. Tribal EMS agencies face many of the problems common to rural and frontier agencies. Language, traditions, culture, views on health care, and forms of government vary widely from tribe to tribe, posing challenges to inter-tribal and off reservation collaboration. And since federally recognized tribes are classified as sovereign “domestic dependent nations”, state offices of EMS, boards of pharmacy, and other regulatory bodies have little to no jurisdiction over most tribal EMS agencies, affecting consistency and causing further isolation.

It’s not too late to register and join a nationwide group of rural EMS stakeholders for two full days of rural-relevant content from national experts and plenty of networking time. Arrive early and attend a half-day “EMS Grant Writing 101 Workshop” to learn how to write and submit a complete grant proposal, understand rural relevant data important to EMS and identify funding opportunities.

Click here to view the full conference agenda.

Click here to register for the Conference and the Grant Writing 101 Workshop.

The conference will be held at the Westward Look Wyndham Grand Resort, 245 E. Ina Road, Tucson, AZ. To book a room, please call (800) 722-2500 and reference the “National Rural EMS & Care Conference 2018” to get the $91 + tax room rate. You may also book online here.

Please share this registration information with all partners, providers, or other interested parties. Also, please include in any newsletters or other distributions you may have.

If you have any questions, please contact Matt Strycker at or Trevor Brown at

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