New England Rural Health Association
October Newsletter
Organization News
Hello NERHA members & friends, 

I hope the fall is finding you well. Typically the association would be feverishly working on last-minute details for our in-person conference. Instead, we are developing ways to stay connected and engaged with all of you during this time by creating monthly webinars, virtual round table discussions,  and a virtual conference series filled with our keynote speakers and federal panelist.  I know it is not the same, but COVID has forced us to get creative. It has made us challenge who we are and what we have to offer in a positive way. We promise to bring you innovative and interesting presentations and discussions and we hope you will join us!

I know the first week of November will be a hectic time with elections and we want to encourage you to take an active role in protecting rural health. We know that empowered voices build healthy communities. Please use your voice to get out and vote. Put together your safe voting plan: See if you can vote early in your state to avoid crowds, see if you can request an absentee ballot to vote by mail, or if you must vote in person on election day, make sure you know where your polling location is, come prepared with hand sanitizer, and wear a mask. Below in our “Advocate and Take Action” section, you will find resources on registering to vote, checking your status, and rural health issues. 

Once that civic duty is completed, participate in our keynote presentation with speaker Tanya Lord on November 5th. Tanya’s theme will fit perfectly for the week by helping us all to better understand our differences and how to come together. We assure you this will be an open and engaging experience for the audience to help develop personal and professional humility as it relates to caring for patients and families. 

Moving into winter, we have further discussions planned on innovations to stay connected and prevent isolation especially with the New England winter, flu season, and continued COVID-19 situation. In January, we are excited to hear from Dr. Renée Joskow, CAPT, U.S. Public Health Service who is the team lead for the Rural Healthcare Surge Readiness COVID-19 Healthcare Resilience Task Force. Dr. Joskow will share resources, recommendations, and regional data. 

Throughout all of this, our goal is to keep you connected… to us and to each other. This can be especially difficult for a rural and regional association, but we are committed to our members and creating a positive experience. Please do not hesitate to reach out if you have any ideas, suggestions, or needs. 

Be well and stay safe,


Ann Marie Day
Executive Director

President's Corner

This month I have been thinking about how COVID has impacted us for the better, as well as the worse. It started when I was venting to my wife last week about how Zoom has increased the number of meetings I have, and how virtual meeting platforms have made meetings more difficult. But then I was talking to friends over the weekend about how I’d been Zooming practically nonstop all week, and the first thing I said was how stimulating I found it. Apparently my left and right brain are in disagreement. And then I thought of Robinson Crusoe. 

I have recently been re-reading Daniel Defoe’s classic about the mariner cast away on a deserted island. Now that guy was rural! Talk about social isolation! You may remember one of the overarching themes is that, no matter how bad things look, they could be worse. Look for the silver lining. Be thankful for small favors, etc. At his most despondent, Robin even made a list of pluses and minuses about his situation. “Bad—I’m stuck all alone on an island. No bread. Wild animals. Good—I’m alive! I’m in the tropics! I look good in goat skins!” (I’m paraphrasing.)

Even allowing for the political incorrectness of Defoe’s tale (although I can’t blame someone writing 300 years ago for not predicting our current social mores), his lesson made me think how I had unwittingly found a bright side of COVID. Do I feel Zoomed to death? Sure. But if not for virtual meetings, I would be stuck on my own island, going stir crazy from social isolation. Instead, I have the privilege of seeing a host of people from all over, every day. I like them. We thumbs up. We laugh. We work. Of course there’s all the stress associated with any meeting, but on balance I am truly grateful for the opportunity to see and interact with all these folks. Thank you, COVID.

This made me think more broadly about the two sides of the COVID ledger. In the spirit of Robinson Crusoe, I offer my thoughts about the ups and downs of a few aspects of a pandemic:

Virtual meetings: 

  • Bad—Too many. People don’t interact. I don’t look good on camera. Rural “broadband” makes me freeze-frame with my mouth open and my eyes closed.
  • Good—Lots of stimulation! We’re still working! Meetings are shorter! Telecommuting!
Telehealth:
  • Bad—Inconsistent payment parity. Variable patient acceptance. Not great for chronic conditions.
  • Good—We’re still providing services! We’re still working! Behavioral health no-shows a thing of the past! Fun new technology!

Face Masks:

  • Bad—People look like bad guys. Hot. Elastic blowout.

  • Good—I can talk to myself and people don’t see my lips move! I can stick my tongue out at rude people and not get punched! Unsightly nose hair a thing of the past!

You see where I’m heading with this. Even during a pandemic, we can find the up side, or at least the lighter side, of each issue. And I suspect we’re all going to need that kind of relief this winter. 

My prescription for the COVID blues: Come up with your own lists! Find the positive! Laugh! Love your island!

My very best,

Andy

Member Spotlight

If you’d like to be considered for a member spotlight, please let us know!
Save The Date!

 

Event Description

This presentation will provide participants with a background to understanding whole-person care. Her presentation will focus on understanding how biases impact the ability to engage in partnerships of care. She will discuss the concepts to reduce stigmatizing behavior toward patients, families and co-workers and engage the audience in developing personal and professional humility as it relates to learning about and caring for patients and families.

Registration

Member Exclusive Event! If you aren’t yet a member, consider joining for as little as $50 for an individual membership to participate in our exciting events. 

Find out more and register here!
 



Sponsor the Events!

Click here to visit our website and see how you can sponsor the virtual event series and work together with us to broaden your reach.

 
Sleeve Up to Fight Flu
This season, the Centers for Disease Control and Prevention (CDC) is encouraging everyone to roll their sleeve up for the annual influenza vaccine. By continuing to wear a mask, washing hands often, and getting a flu vaccine we can help stop the spread of flu viruses and the virus that causes COVID-19 this fall and winter season. Additionally, HHS is asking everyone to get vaccinated against the flu by this Halloween and say Boo to the Flu!According to the CDC:
  • Everyone aged 6 months and older needs a flu vaccine.
  • The flu can cause serious complications such as pneumonia.
  • Getting a flu vaccine lowers your chances of being hospitalized from the flu.
  • Getting a flu vaccine can help save medical resources this fall and winter.
Join the CDC in raising awareness about the importance of getting vaccinated by using the hashtag #SleeveUp to #FightFlu on social media and by sharing resources and graphics.
Resources

Introducing the Social Determinants of Health in Rural Communities Toolkit

Webinar recording presents the Social Determinants of Health in Rural Communities Toolkit. Discusses strategies, models, and lessons learned for addressing social determinants of health in rural communities. Features presentations from representatives of NORC Walsh Center for Rural Health Analysis, CASA of Oregon, and the Community Outreach and Patient Empowerment Program.

Additional links: Audio Recording, PowerPoint Handout

ABClatino Media Network Provides COVID -19 Health Information in Spanish

Early this year, ABClatino turned most of their attention to the Coronavirus pandemic in order to provide the Latino community in Northeast Dutchess with timely information and resources, including eight special newsletters.

With funds from the Foundation for Community Health and the Berkshire Taconic Community Foundation, ABClatino has created a special digital & multimedia library with important information about Covid-19 in Spanish.

HRSA’s Health Professions Education and Training (HP-ET) Initiative will use the Readiness to Train Assessment Tool (RTAT™)

Developed by Community Health Center (CHC), Inc., to help health centers assess and improve their readiness to engage in health professions training programs. CHC, Inc., is a HRSA-funded National Training and Technical Assistance Partner (NTTAP).

The HRSA HP-ET Initiative will enhance health centers’ capabilities to recruit, develop, and retain their workforce by exposing health and allied health professions students, trainees, and residents to education and training programs conducted at health centers. Primary Care Associations (PCAs) will use the results of the RTAT™ to expand targeted workforce training and TA capabilities by working with health centers in their respective states on focused strategic workforce plan activities intended to increase health center capacity with recruitment efforts.

Your PCA should have provided the link to the RTAT™. Contact your PCA with any questions.

Features a recording of a panel discussion on innovative strategies for financing rural health. Discusses challenges in rural communities, such as health disparities, limited broadband access, hospital closures, and more. Mentions the effect of the COVID-19 pandemic on rural health.

Operationalizing an Implementation Framework to Disseminate a Care Coordination Program for Rural Veterans

Features a study on a framework for assessment prior to the implementation of a care coordination program in Veterans Affairs (VA) facilities. Details a nurse-led care coordination program and highlights the methods for assessing the local context of the program before implementation.

Merit-Based Incentive Payment System (MIPS): Participating in the Improvement Activities Performance Category in the 2020 Performance Year

Provides details on how to participate in the performance improvement part of the Merit-based Incentive Payment System (MIPS), one of two payment options under the Medicare Quality Payment Program. Identifies differences for small practices and clinicians located in a rural or Health Professional Shortage Area.

Recent News

Despite Low Numbers, Leaders Concerned about COVID's Impact on Indigenous Communities

Sep 20, 2020 - Provides an overview of COVID-19 cases among Native Americans living in Vermont and discusses the limitations of state data collection for Native American case reporting. Highlights economic and health factors that make tribal populations vulnerable during the pandemic.
 



St. Joseph Heathcare, Good Shepherd Food Bank host drive-through produce pick-up

BANGOR, Maine (WABI) - Hundreds of local families have healthy food to eat this week thanks to a drive-through event on Tuesday in Bangor. Saint Joseph Healthcare partnered with Good Shepherd Food Bank to make the produce pick up possible. Cars began trickling in at 10:00 a.m. and volunteers loaded up boxes all day until the last one was gone. In all they distributed about 500 healthy meal kits.
 



New and Expanded Challenges Facing Vulnerable Populations in New Hampshire

The COVID-19 crisis has had widespread impacts on life in New Hampshire, but the negative effects have been most severe on people who were already the most vulnerable. Read more from New Hampshire Fiscal Policy Institute
 


 


Red-Zone Report: More than Half of Rural Counties Hit Red-Zone Level

Oct 6, 2020 -- Analyzes new COVID-19 infections, describes that an additional 68 rural counties are on the White House red-zone list, meaning more than half of all rural counties are currently in the red zone. Includes an interactive map of all U.S. counties' infection rates between September 27 - October 3, 2020, as well as trends observed in the data.

 

Getting Health Care Was Already Tough in Rural Areas. The Pandemic Has Made It Worse

Oct 7, 2020 -- Provides an overview of a nationwide poll that reported one in every four households have been unable to get medical care during the COVID-19 pandemic, widening the disparities that already exist in rural communities. Describes that in rural areas, some obstacles to healthcare include high rates of uninsured residents, small healthcare workforce, and an increase of hospital closures.
 



Taking a Look at Farmer Stress

Oct 8, 2020 -- Addresses the rising stress levels in farmers and ranchers due to a string of events that have hurt profit margins. Discusses efforts to increase mental health awareness and reduce stigma in farming communities, includes information on the Rural Response Hotline dedicated to support Nebraskan farmers.

Advocate and Take Action

One, two, THREE weeks to VOTE! Have you created your Voting Plan? Have you tripled your vote? 


Congress and the Administration are at a stalemate and health centers' funding is in jeopardy. No election has meant more to our future than this November’s. We must ensure Community Health Centers are represented at the polls – and by doing so, secure our funding. We must make our voices heard this election.

  • If you haven’t registered to vote, check here.

  • Click here to check your voter registration status.

  • To access health center tailored materials to help mobilize others in your community, click here.

This November is about more than presidential elections. There are many issues on the ballot that will affect Community Health Centers and our patients.

It is important for health center advocates to consider these issues when casting your vote:
 

1. Federal policies and funding

  • The House and Senate have only passed short-term funding for Community Health Centers leaving these essential small businesses with the inability to plan for the long-term. With COVID-19 cases rising again and increased numbers of unemployed and uninsured people, Community Health Centers need long-term, stable funding.

  • The Supreme Court will soon hear arguments on Texas v. Azar which challenge the constitutionality of the Affordable Care Act. Remember...Medicaid expansion, which has increased the number of people for whom health centers can provide care, as well as other important policies, could be struck down.

  • The future of our 340B program is at risk and, without action, how will we secure the funding shortfall if the 340B savings are taken away from us?

2. State Medicaid

  • Half of all health center patients use Medicaid. When states cut Medicaid, during economic downturns, it has a direct impact on our patients and our health centers’ ability to deliver care. State policymakers must protect state Medicaid programs from cuts and work to expand access to care during this pandemic. Medicaid is the first and last resort for primary care, vaccinations, wellness visits, maternal health and dental services for many of our neighbors.

3. State and Local Leaders who Protect FQHCs

  • Additional health center-related issues that are decided by state and local leaders, include:

    • Protecting health center payment provisions that keep our doors open;

    • Improved access to telehealth services for health center patients; and,

    • Preserving and enforcing the many provisions of the Affordable Care Act that ensure access to quality, affordable health care.

Keep these issues in mind as we all continue to fight for long-term stable funding of health centers and health equity for our communities.
 



Comments Requested: Proposed DATA 2000 Training Payment Application – December 7.  HRSA will soon be able to reimburse Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) for the average training costs of eligible physicians and practitioners to obtain Drug Addiction Treatment Act of 2000 (DATA 2000) waivers. These waivers allow eligible physicians to treat opioid dependency in settings other than opioid treatment programs (OTPs).  FQHCs and RHCs are encouraged to provide comments on whether the proposed application collects necessary and useful information, if HRSA accurately estimated the burden of completing the application, and how the application could be improved.
 



Interested in Policy? - Join our “Health Policy Happy Hour” committee meetings the 3rd Tuesday of the month from 5-6pm. Please email admin@newenglandrha.org to get added to the invite.
Funding & Opportunities
Take the Next Step in your Career with the NHSC Students to Service Loan Repayment Program

The 2021 Application Program and Guidance for the National Health Service Corps Students to Service Loan Repayment Program (NHSC S2S LRP) is now open and includes new nursing disciplines. In response to health workforce needs for quality primary and maternity care, the FY21 program includes Nurse Practitioners (NPs) and Certified Nurse Midwives (CNMs).

The application cycle closes on November 5 at 7:30 p.m. ET.
 



National Assessment of Rural FQHCs: Roles and Opportunities Related to Rural Hospital Closures

Health centers that serve rural communities face a number of interlocking challenges, including determining how to respond when a local hospital faces financial vulnerability or closure. To better understand the health center experience with rural hospital closures, Capital Link, a HRSA-funded NTTAP, is conducting a national assessment of Federally Qualified Health Centers (FQHCs) in rural communities. They hope to identify and share successful strategies health centers have used to respond to this challenge.

If you are a FQHC serving rural communities, please share your experience by completing this short assessment by Friday, October 16. Capital Link will summarize and share the results. Individual responses will not be disclosed without prior approval.
 



NRHA Grant Partnership Offers Rural Pediatric Telehealth Stipends

Oct 5, 2020 -- The National Rural Health Association (NRHA) partnered with the American Academy of Pediatrics and HRSA's Maternal Child Health Bureau to provide technical assistance for the Supporting Providers and Families to Access Telehealth and Distant Care Services for Pediatric Care project. The stipend program will offer $5,000 to community-based practices that serve rural areas and are new to telehealth implementation.
 



FEMA Opens $600 Million Grant Application Process

New Building Resilience Infrastructure and Communities Grant for $500 Million Included.

The two grant programs, the Flood Mitigation Assistance grant and the Building Resilient Infrastructure and Communities grant, or BRIC, will provide funds to states, local communities, tribes and territories for eligible mitigation activities. These programs allow for funding to be used on projects that will reduce future disaster losses and strengthen our nation’s ability to build a culture of preparedness.
 



CARES Act Provider Relief Fund


New Phase of Provider Relief Fund Opens for Applications

 Providers are encouraged to apply for the latest round of Provider Relief Fund (PRF) support. Applications will be considered regardless of whether your organization was previously eligible for, applied for, received, accepted, or rejected prior PRF payments. For this newest phase, funding will be allocated to providers based on assessed financial losses and changes in operating expenses caused by COVID-19.  For more information about the Phase 3-General Distribution, please visit the Provider Relief Fund webpage.
 

Apply here through November 6

Register for the webcast on October 15 at 3 p.m. ET to learn more.
 



NIH Research to Improve Health Disparities

The National Institutes of Health (NIH) will support research projects from public and private higher learning institutions, nonprofit organizations, Indian/Native American tribal governments, and state and local governments.  Research will explore innovative health services for disparity populations that include racial/ethnic minorities, socioeconomically disadvantaged populations, and underserved rural populations.
 



Applications are Open for our Next FREE Learning Collaborative on the Fundamentals of Comprehensive Care!

What is a Learning Collaborative? 

The Comprehensive Care Learning Collaborative is a 4-month participatory learning experience offered by the National Health Center Training and Technical Assistance Partners (NTTAP), funded by the Health Resources and Services Administration, and hosted by Community Health Center, Inc. (CHC) in Middletown, CT. The Collaborative is designed to provide Federally Qualified Health Centers (FQHCs) that are beginning or restarting their move to high performance team-based comprehensive primary care with knowledge about the basic principles and best practices of care and the strategies to plan for implementation.  The Collaborative will consist of four videoconference learning sessions with primary care teams from across the country.  The action periods between sessions will include assignments and deliverables, and calls between health center coaches and CHC mentor coaches to facilitate the uptake of the intervention.

The learning collaborative begins mid-November and is FREE for health centers to join.

APPLY HERE

Applications are open until November 16th.
 


New Hampshire J-1 Visa Waiver Program

Offers a J-1 Visa waiver to foreign physicians who commit to serving for 3 years in an underserved area of New Hampshire, allowing them to remain in the United States.

Sponsors: New Hampshire Department of Health and Human Services, New Hampshire Rural Health and Primary Care Section
 



NNLM HIV/AIDS Coordination Center (NACC) Funding Opportunity!

The NNLM HIV/AIDS Coordination Center (NACC) is pleased to announce the availability of funding for short-term outreach projects that focus on bringing HIV/AIDS health information resources to consumers. Awarded projects will start on November 9, 2020 and run through April 30, 2021. The maximum funding per award is $16,593.50.
The application due date is October 30, 2020.

Community-based organizations (CBOs), community health centers, public libraries, and other organizations working with people living with HIV are encouraged to apply. Projects must include some aspect of broaden access to and awareness of HIV/AIDS health information resources throughout the United States. This can be achieved through educational programming, training programs, and the use of technology.

Organizations applying for this award must be NNLM members. Membership is free. Please refer to the RFP for detailed information about NNLM membership, the online application process, and information required for the project proposal and budget. (https://nnlm.gov/nacc/funding). Applications must be submitted through the NNLM online application system.

Please feel free to contact Penny Glassman at penny.glassman@umassmed.edu if you have questions about the award, your application, the submission process, or the deadline. We are happy to review any drafts or answer questions related to your project or application.
 



Rural Health Care Services Outreach Program

HRSA has released the Notice of Funding Opportunity (NOFO) for the Rural Health Care Services Outreach Program (Outreach) (HRSA-21-027). HRSA plans to award 60 grants to rural communities as part of this funding opportunity. Read more, including about a TA session for applicants scheduled for Tuesday, October 13.
 



Rural Health Network Development Planning

HRSA released the NOFO for the Rural Health Network Development Planning Program (Network Planning) (HRSA-21-021). HRSA plans to award 20 grants to rural communities as part of this funding opportunity. Read more, including about a TA session for applicants scheduled for Wednesday, October 7.

If you are considering applying or need help, please let us know. We would be happy to be a partner on your efforts or provide letters of support.
Upcoming Events

NERHA & NYSARH Webinar: The Health Care Workforce: Trends, Issues, and Resources

Thursday, October 15th, 2020  from  1:00pm - 2:00pm - Register Here



New England Rural Health CFO Virtual Roundtable Discussion

When: Thursday, October 15th, at 4:00PM (ET). Register here (after registering, please look for a Confirmation email and survey from First American Healthcare Finance)


FQHC CFO Discussion

When: Thursday, October 22nd at 4:00PM (ET). Register here (after registering, please look for a Confirmation email and survey from First American Healthcare Finance)
 



HITEQ Highlights: Telehealth Considerations and Strategies for Special and Vulnerable Populations

Thursday, October 15 from 2:00-3:00 p.m. ET - Register here

Hosted by the HITEQ Center in collaboration with the National Center for Equitable Care for Elders, the National Center for Farmworker Health, and the Corporation for Supportive Housing (all HRSA-funded NTTAPs)
 



 Roundtable Discussion for Health Centers: Ensuring Diverse and Inclusive COVID-19 Clinical Trials through Health Center Engagement in the ACTIV-2 Clinical Trial

Thursday, October 15 from 5:00-6:00 p.m. ET - Register here


NIH funds the ACTIV-2 Study to evaluate medications to improve the symptoms of COVID-19. If you have adult patients diagnosed with COVID-19, consider encouraging them to join this clinical trial.

Learn more about how you can engage patients at an upcoming webinar specifically for health centers. Leadership from Rise Above COVID (directing the ACTIV-2 Study, part of Operation Warp Speed) will lead a roundtable discussion, including a Q&A, for health centers that want to learn more about this study and ways to get involved in the effort to find a cure.
 



Register for Ready Seniors Virtual Workshop 10/21

Wednesday, October 21, 2020 from 10 AM - 3:30 PM ET

Increasingly, older adults with complex health issues live alone in the community, far from their relatives and caregivers. An older adult may depend upon community service providers for basic necessities and psychosocial support prior to a disastrous event. However, the need for these critical services increases when services are disrupted or the senior is impacted during a major disaster.

FEMA Region II and the Administration for Community Living have partnered to address this disparity through a workshop aimed at preparing Area Agencies on Aging and other organizations that provide critical support services to senior citizens in their communities.
 


 

Rural Assembly Everywhere

October 26th @ 1:30 - Learn More and Register

Kathleen Sebelius to Appear as Keynote Speaker at Rural Assembly Everywhere - 

Check out the full schedule at a glance on our website (details subject to change). And stay tuned for more announcements coming soon. Registration is now open for Rural Assembly Everywhere. Be one of the first to claim your FREE spot and join us October 26 to 30 for a great line-up of keynote speakers, breakouts, and happy hours.
 



Provider Recruitment and Retention Training for Health Centers: Addressing Issues with Staffing, Recruiting, and Retention in the Face of a Pandemic

Tuesday, October 27th, Time: 3:00 - 4:30 p.m. ET

Join the webinar the day of the session

Call-in: 888.323.9689

Passcode: 7945934

Health Resources and Services Administration
 



CREST'S 13th Annual Northern New England Rural Emergency Services and Trauma Symposium

November 19th, Time: 8:00 a.m. - 2:15 p.m. Eastern

Dartmouth-Hitchcock's Center for Rural Emergency Services and Trauma

603.653.1234

clpd.support@hitchcock.org

Join US
Interested in becoming a new member or need to renew your membership? Join the New England Rural Health Association now to take advantage of networking opportunities including our regional conference, members only networking events, and educational sessions.
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