Fiscal Year 2020 Appropriations Become Law
During the final legislative week of December 2019, Congress passed and the President signed into law, the Fiscal Year (FY) 2020 HHS Appropriations bill. Congress appropriated the State Offices of Rural Health (SORH) Grant Program $12,500,000 for Fiscal Year 2020. The amount is an increase of $2.5 million for the SORH line over FY 19. The $12,500,000 for SORH was authorized to be appropriated through the State Offices of Rural Health Reauthorization Act of 2018 which was signed into law.
Also included in the spending bill was $53,609,000 for Medicare Rural Hospital Flexibility Program and $19,942,000 for the Small Rural Hospital Improvement Program (SHIP) for FY 2020. Congress funded both programs at the same amount in FY 2019. Also included in the Health Resources and Services Administration rural health account was $110,000,000 in funding for the Rural Communities Opioids Response Program.
At a broader level, the spending deal extended a number of health programs through May 22, 2020. This May deadline is intended to create pressure for a Memorial day deal for health care items such as prescription drug pricing and surprise billing and potentially rural health care, with surprise billing being the most likely to pass.
Rural Health Bill Introduced
Senator Dick Durbin (D-IL) and Rep. Adam Kinzinger (R-IL) introduced legislation to re-open the Critical Access Hospital necessary provider program. The Rural Hospital Closure Relief Act (S. 3103/H.R. 5481) would allow the HHS Secretary to waive the current requirement that CAHs be located at least 35 miles from another hospital as long as they meet specific criteria, including: (1) being located in a rural area: (2) demonstrating two consecutive years of financial loses; and (3) serving a patient population with a high percentage of Medicare recipients, a population with a high percentage of individuals below 150% of the federal poverty level, or being located in a federally-designated health professional shortage are.
The legislation could potentially be included in the Senate Finance Committee’s expected rural health package that may be introduced later this year.
House Committee Meets on Rural Health Measures
On January 8, the House Energy and Commerce Committee held a hearing to discuss the advancement of a number of health care-related bills. Among the legislative measures considered by the committee were:
The bills could be considered by the full House in the coming weeks and months.
While working with State Offices of Rural Health (SORH), NOSORH discovered an unmet need for more in-depth technical assistance (TA) to build SORH capacity as well as provide an extension of the SORH to rural providers. This led to the development of the Tiered Technical Assistance Program– a set of innovative services, TA strategies, and resources to help SORH engage rural primary care providers.
The fundamental focus of NOSORH’s work is to maximize the capacity of SORH. This new program is planned to bridge, supplement, strengthen and grow existing SORH efforts, partnerships and resources, at the request of the SORH. It is not meant to replace currently offered TA or compete with other TA providers or established relationships. This service set is designed to provide support services for unmet need(s) to SORH and the communities they serve while strengthening the SORH TA infrastructure. The program has been informed by the work of the leaders and partners of NOSORH’s Primary Care Committee (formerly known as the Rural Health Clinic Committee).
All TA services are provided and/or coordinated by Tammy Norville, NOSORH Technical Assistance Director. Tammy maintains Registered Medical Manager, Registered Medical Biller, Registered Medical Coder, Certified Professional Coder, and Certified Professional Coder – Instructor certifications. Tammy directly served rural communities during her almost 15-year tenure at the North Carolina SORH. The cornerstone of her experience is operational efficiency in various healthcare settings, allowing flexibility and innovative approaches to project management and challenge resolution.
For more information or to register for the program, please contact Tammy Norville (firstname.lastname@example.org).
Favorite thing about working at a SORH: My favorite thing about working at a SORH is the strong spirit of camaraderie with my internal and external partners! I know that at any given time, I can reach out to my friends in other states for their advice or guidance. It really is like a little family.
Best advice I ever received: Be kind…not only to others but also to yourself.
What I’m working on right now: In addition to the normal SORH activities, I am busy working on a population health initiative related to cultural competency and Public Health Reaccreditation.
My favorite quote: My favorite quote is by Maya Angelou, “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”
Last place I traveled to: In October, we cruised to the Bahamas and the Turks and Caicos. I have always loved to travel. My favorite places so far include Dubai, United Arab Emirates, Thailand, the Philippines, and Spain.
Who inspires me? My dad has always been such an inspiration to me. He came from a very poor family of 8 in West Virginia. He instilled in me the value of a wonderful education, hard work and determination. My rural roots run deep.
If I weren’t doing this, I would be…traveling and writing a blog. Maybe one day…
The National Network of Public Health Institutes (NNPHI) Evidence to Action Evaluation Group (E2A) is working with NOSORH to gather collaborators who can offer insight concerning the experiences of older adults in rural areas relating to mobility and falls prevention. E2A will lead exploratory facilitation efforts along with the Public Health Institute. E2A specifically requests that collaborators with a strong community presence participate, as they would also like to receive feedback via an online community survey. The requested involvement includes participation in one telephone interview or focus group lasting 45-60 minutes. This will most likely take place in January/February 2020.
The E2A team is in its fourth year of leading evidence-informed falls prevention evaluations in collaboration with the Centers for Disease Control and Prevention (CDC). The CDC-funded efforts led by E2A have involved evaluation design, instrument development, and data analysis aligned with the CDC STEADI (Stopping Elderly Accidents, Deaths, and Injuries) Initiative, a comprehensive approach to falls prevention among older adults.
Mobilizing more than 40-member public health institutes with over $1.5 billion in annual funding – as well as ten university-based regional training centers, and 40 affiliates – NNPHI leverages more than 8,000 subject-matter experts with organizational partners across the nation to improve the public’s health. NNPHI supports national public health system initiatives and strengthens public health institutes to promote multi-sector activities resulting in measurable improvements of public health structures, systems, and outcomes.
Your insight for this falls prevention and mobility effort will help inform resources for older adults nationwide. If you are interested in learning more and getting involved, please contact Nicole Lordi at email@example.com by December 29, 2019. Thanks for your dedication to falls prevention.
Passage of Stopgap Shutdowns Potential Midnight Shutdown
On November 21, President Trump signed a continuing resolution bill funding the government through December 20, 2019. This stopgap measure provided Congress four additional weeks to reach an agreement on a Fiscal Year 2020 spending bill. The continuing resolution (H.R. 3055) cleared the Senate and was signed into law just hours before the midnight deadline.
The funding bill contains funding extensions for many health care programs, such as community health centers and teaching health centers that operate graduate medical education programs, and extends the community mental health services demonstration program. It also delays again the nearly $4 billion in Medicaid Disproportionate Share Hospital (DSH) cuts.
Congress now has less than two weeks to pass an omnibus spending bill for FY ’20 or pass another CR. Senate leaders are predicting an additional CR will be needed through February or March of 2020. Throughout 2019, the National Organization of State Offices of Rural Health (NOSORH) has called on the Senate to increase the funding for the State Offices of Rural Health (SORH) grant program. Please contact NOSORH if you are interested in reaching out to your Senators.
Congress Mulls Rural Health Package Before Year-End
With just weeks remaining in 2019, NOSORH has been meeting with House and Senate staff on a possible year-end rural health package. The long-awaited package of rural health legislation would come out of the Senate Finance and House Ways and Means Committees.
On the House side, the Ways and Means Committee released a Request for Information in November to interested rural stakeholders. NOSORH submitted extensive comments to the committee and is working with the Co-chairs of the Ways and Means Rural Health Taskforce on next steps. The chairs of the task force are Reps. Terri Sewell (D-AL), Jodey Arrington (R-TX), Danny Davis (D-IL), and Brad Wenstrup (R-OH).
Senate Rural Health Caucus Introduces Bill
On November 20, the Co-chairs of the Senate Rural Health Caucus, Senator John Barrasso (R-WY) and Tina Smith (D-MN), introduced the Strengthening Our Rural Health Workforce Act of 2019. The bill, S. 2902, seeks to establish a new National Rural Health Care Workforce Commission. The Commission would develop both short and long-term goals to improve the rural health workforce and help coordinate work to achieve these goals across federal agencies and at the national and state levels. The legislation would also award grants for States to translate the new Rural Health Workforce recommendations into reality. A summary of the bill can be found here. The bill has been referred to the Senate HELP Committee.
Congress Celebrates National Rural Health Day
On November 21, Rep. Abby Finkenauer (D-IA) introduced H. Res. 719, a resolution in support of National Rural Health Day. The resolution expresses that Congress supports the goals and ideals of National Rural Health Day, celebrates rural health care providers and rural Americans and commits to advancing legislation to improve health care in rural America. The resolution had the bipartisan support of 12 other House members. Approximately 40 members of Congress and various other congressional committees tweeted their support of NRHD on November 21.
Favorite thing about working at a SORH: I love working with our rural members and our staff. I love the challenge of offering so many different resources from quality, education, grant assistance, resources, EMS, workforce and policy. When we are able to help one person I know we are helping many in the community. No other job is more rewarding than to help someone.
Best advice I ever received: The best advice I ever received was you can only control what you say and do. This advice has served me well over the years to not become too frustrated when things don’t go according to plan. For example, I have been working with rural hospitals to report quality data since 2006 and we still don’t have them all, but we continue to work with them and I believe we’ll get them all reporting!
What I’m currently reading: The Library of Light and Shadow – I love to switch off reading from a personal book to a work-related book. Next on my list is Good Leaders Ask Great Questions.
People would be surprised if they knew: that I’ve been to Disney World/Land over 50 times…I’ve lost count. By the way, I’ve never lived in California or Florida. This all started when I was a kid and we’d go several times a year because my parents loved it and that tradition carried on to me and now to my daughter. We love the haunted mansion ride, Space Mountain, Winnie the Pooh, and even Small World. In fact, we are going to Disney World this year; we have to check out the new Star Wars park.
Last place I traveled to: France to celebrate our 25th wedding anniversary. It was amazing!!! We made it to the top of the Eiffel Tower, and that’s no small feat since I’m afraid of heights. We stood in buildings built in 40 AD and drank the best wine I’ve ever tasted.
Who inspires you? Michelle Obama inspires me. Through hard work and dedication and commitment to family and self, she has achieved so many things in life. I try every day to have