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).
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.
Early November in Washington state is a beauty to behold. Tammy Norville, NOSORH Technical Assistance Director, had the opportunity to partner with the Washington State Office of Rural Health to provide a half-day interdisciplinary team education session grounded in palliative care services. The live session was on location in Dayton, Washington, and simulcast to Critical Access Hospitals (CAH) and other partners around the state.
The session was a journey through the revenue cycle and explored options to ensure the sustainability of palliative care services in an environment with no straightforward payment structure while continuing to transition to value. A lunch session with the host organization and an onsite visit with one CAH rounded out the visit.
The top three takeaways from the experience:
Thank you to the Washington SORH team of Pat Justis, Lindy Vincent, and Kassie Clarke, who coordinated the event and was an outstanding tour guide.
If you have an interest in this or other technical assistance projects, please contact Tammy Norville (firstname.lastname@example.org), Technical Assistance Director.
Congratulations to the 2019 NOSORH Award recipients! Awardees were honored at a ceremony during the NOSORH Annual Meeting in Albuquerque, New Mexico, on October 17.
A special thank you to the NOSORH Awards Committee, co-chaired by Margaret Brockman (NE) and Cathleen McElligott (MA)! We appreciate all who took the time to submit a nomination!
SORH Award of Excellence
Arizona Center for Rural Health
“In addition to improving access to quality health care services, this SORH is deeply focused on social justice and health equity. They demonstrate a true dedication to reducing the health disparities of the deeply disenfranchised and impoverished families and individuals in their bi-cultural and bi-national communities. They have also been working with state and local health and social services organizations to address such important and timely topics as the opioid epidemic, human trafficking, adverse childhood experiences, women’s health, innovative telemedicine use, border health issues, American Indian access to care, and behavior change for social good.”
Emerging Leader Award:
Kathryn Miller, Wisconsin Office of Rural Health
“While Kathryn is not new to her position as a Flex Coordinator, and her coworkers have always seen her excellent work up close, in the last few years she has emerged on both a state and national level as someone others recognize and look to for leadership. As a leader, she is collaborative: she’s quick to help someone with questions, and lend her assistance on a project. She’s strategic: she keeps a real-time tally of invoices and payments on two federal grants for over 60 hospitals, so she knows which projects are withering and can reach out to add extra support, or see eventual failures coming and take action. And she’s able to flow with changes: as the Flex program has shifted to a primary focus on quality, added layers of measurement and evaluation, and as our purchasing department rolls out new requirements and documentation monthly, she rises to the continuing changes and keeps everything moving forward and the quality high.”
The James D. Bernstein Mentoring Award:
Roslyn Council, New Jersey Office of Rural Health
“Roslyn’s calming presence and warm nature drew me in – her knowledge, support of the region, and expertise have been invaluable to me. Over the past year, she has taken me under her wing and showed me how to be a regional representative. Roslyn has been so supportive, from answering questions or reaching out to check in. Her ability to listen, observe, and understand the needs of those around her is incredible and it makes her capacity to mentor so effective. I am certain there are many of us who have benefited from her work in public health over the years.”
The Distinguished Andrew W. Nichols Rural Health Advocate Award and the Legislator of the Year Award will be announced at a later date.
The National Organization of State Offices of Rural Health (NOSORH), its Federal, state, nonprofit, and other partners, invite all those who live, work, visit or return to their roots in rural America to thank rural health professionals and celebrate the Power of Rural on November 21, 2019. The “key messages” for National Rural Health Day include: 1.) Rural America is fueling an innovative rural health infrastructure; 2.) Rural America is a great place for mission-minded health professionals to provide individualized care; and 3.) Rural America offers a beautiful and challenging landscape, requiring unique approaches.
It’s not too late to get involved with National Rural Health Day (NRHD) activities! Visit the PowerofRural.org website for the latest news and events happening throughout the country.
Below are some fun, easy ways to “plug in” to the Power of Rural this month:
Spotlight the #PowerofRural on Social Media
Follow NOSORH on Facebook/Twitter and use the #PowerofRural in every post (and encourage others to do the same)! Download social media graphics from the toolkits. Click here to put a National Rural Health Day frame on your Facebook Profile Pic!
Join our Thunderclap
Help us amplify the #PowerofRural by joining the nationwide NRHD Thunderclap! Tweet the #PowerofRural at 11:21 am (in your timezone) on 11.21.19!
NOSORH/RHIhub Twitter Chat on Funding
RHIhub and NOSORH are co-hosting a NRHD Twitter Chat “Access to Funding for Rural Health Projects”. Join the discussion at 1:00 pm ET on November 21 by using the hashtag #RuralHealthChat!
NEW-“Key Messages and Data Points” Publication
NOSORH is excited to offer a brand new “Key Messages & Data Points” electronic publication for National Rural Health Day! The document features rural-relevant data under 3 National Rural Health Day key messages. Click here to view and download.
The Providers film screening
This year’s National Rural Health Day will feature a special two-week screening (November 7-21) of the award-winning documentary, The Providers. The film is set against the backdrop of the physician shortage and opioid epidemic in rural America and follows three healthcare providers and their patients. Encourage your clinics, hospitals, office, etc to host a screening of the film as a way to celebrate NRHD! Click here to register.
Live web event featuring The Providers
A live NRHD web event titled “The Art of Telling Your Power of Rural Story”, will be held on November 21 at 2:00 pm ET. Join this insightful discussion with Anna Moot-Levin, one of the film’s producers, and featured provider, Matt Probst, PA-C, from El Centro Family Health. Together, they will offer participants a window into the world of making the film and discuss the importance of storytelling to inspire more collaboration and innovation that leads to positive change, improves rural health outcomes and perceptions, and more. Registrants of the film screening and web event will be given a “Providers Discussion Guide” as a framework for having meaningful conversations about the film’s central themes. Additionally, registered participants can pose questions in advance of the web event. Click here to register.
Community Stars – Now taking pre-orders for hardcopy book!
Stay tuned for the release of the 2019 Community Stars e-book on November 21! This year’s publication will feature the inspiring stories of “Stars” from 44 different states who are making a big impact on rural health! Also, for the first time, the Community Stars book will be available in electronic and hardcopy format! Pre-order your hardcopy book today!
NRHD Toolkits available for free resources!
The PowerofRural website has easy-to-use online toolkits with resources designed for community stakeholders, including hospitals, clinics, first responders, and others who serve the health needs of rural communities. Toolkits includes logos, display advertising, social media, public service announcement and media release templates, and much more! We encourage you to share these tools widely with your partners. You can even make the tools your own by adding your logo and URL.
Rural Health Clinical Congress- Free CME Event for Rural Providers- Nov 23
In partnership with NOSORH, RME Collaborative is proud to offer the 2019 Rural Health Clinical Congress (RHCC)! The RHCC is designed to take the distance out of learning, providing high-level, practical education for rural healthcare professionals through a virtual learning environment. This free, multi-topic CME/CE event is specifically for primary care clinicians and registered nurses who care for patients in rural and underserved areas. The RHCC will take place on Saturday, November 23, and feature a comprehensive curriculum covering clinical, practice management, and patient-centric topics, including diabetes, heart failure, asthma, teledermatology, and dyslipidemia. The program will be delivered by rural and clinical experts through an interactive, engaging virtual platform. Click here to learn more and register for this unique continuing education event!
Walk with a Doc on 11.21.19
Invite rural hospitals, health clinics, and communities in your state to host a free Walk with a Doc event on NRHD. Walk with a Doc is a fun and easy way to engage communities in better health while celebrating the Power of Rural!
Nationwide Activities to Note
Organizations and agencies from around the country are hosting their own National Rural Health Day Events, including the Federal Office of Rural Health Policy! Be sure to check out their schedule of events and make plans to participate!
The Chartis Center for Rural Health will announce the 2019 Performance Leadership Awards on NRHD. Based on the results of the Hospital Strength INDEX from iVantage Health Analytics, the 2019 Performance Leadership Awards reflect top quartile performance among all rural hospitals in the United States in either Quality, Outcomes or Patient Perspective. The Chartis Center for Rural Health will be reaching out to SORH this week with a link to this year’s award winners and marketing resources.
Share Your Plans!
We want to hear from you! Are you planning an event on NRHD? Do you have a unique idea you’d like to share with us? During the weeks leading up to NRHD 2019, your event will be shown on the Power of Rural website. Click here to submit your plans.