New England Rural Health Association
September Newsletter
Organization News
Hello everyone,

I had wanted to discuss the topic of recovery this month in recognition of September being National Recovery Month. In addition, a recent passing in the Maine recovery community deeply touched my heart. Jesse Harvey was a passionate advocate and supporter for everyone’s individual recovery journey. He was a member of Young People in Recovery and founded recovery houses across the state. I knew Jesse through previous work at my community’s health center where he spoke during a community opioid forum. There was not a dry eye in the building that evening, and Jesse’s story helped to create understanding and commitment to provide treatment and resources for those struggling with a substance use disorder. Wherever he went, Jesse touched peoples’ hearts and opened their eyes to harm reduction. He will always be remembered for the impact he had and the lives he helped save. My deepest condolences to his family, friends, and loved ones.

It should not take the loss of life to compel us to do better, but this is what sadly often ignites the flame of change. Now more than ever with social isolation, increased stress and anxiety, and the financial impacts of the pandemic, we need to ensure people do not lose connection to their recovery community, supports, and peers. There are amazing prevention, treatment, and recovery programs all across New England, but the work is never done.  I wanted to be sure to share a couple resources for those seeking treatment or support during this difficult time. Keep fighting the fight and thank you to all of those working in this critical area. 

CDC Alcohol and Substance Use Resources during COVID-19

NAMI COVID-19 Resource and Information Guide
 

Be well and stay safe,

Ann Marie Day

Executive Director

President's Corner

THIS… is… JEOPARDY!

Alex: OK, we’re down to our last category in Double Jeopardy: Federal Programs. 

Contestant 1: I’ll take Federal Programs for 200, Alex.

Alex: This federal program provides low-cost medications to millions of Americans and significant savings to safety-net providers such as rural hospitals, critical access hospitals, and community health centers.

Contestant 2: What is the ACA?

Alex: Sorry.

Contestant 3: What is 340B?

Alex: Good. Go!

Contestant 3: Programs for 400, please.

Alex: This federal program started as a 1992 compromise among lawmakers to temporarily fix  unintended consequences of another CMS program. The stated intent was “to stretch scarce Federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.” But over the years it has grown into a multi-billion dollar program, become a mainstay of healthcare provider budgets and spun off multi-million dollar consulting companies to untangle the regulations.

Contestant 1: What is the Office of Pharmacy Affairs?

Alex: Let’s ask our judges… Sorry, we can’t accept that.

Contestant 3: What is 340B?

Alex: Yes!

Contestant 3: Programs for 600, Alex.

Alex: This federal program has become the darling of liberals who tout it as a shining example of increasing health access for the poor, and the bane of conservatives and big pharma who see it as another ballooning entitlement program. If recent House and Senate hearings are any indication, lawmakers have pretty much split on party lines in boosting or bashing it.

Contestant 1: What is 340B?

Alex: Right!

Contestant 1: Federal Programs for 800, Alex.

Alex: This federal program has become a funding source that struggling healthcare providers have grown to depend on to keep the doors open and lights on. Proponents bless it for helping patients and the providers they depend on. Detractors deride it as a gravy train of income for hospitals and a contributor to the high cost of healthcare.

Contestant 2: What is 340B?

Alex: Yes! Quick on that signaling device. Go!

Contestant 2: Programs for 1,000, Alex.

Alex: The Daily Double! You are ahead by $40,000. How much will you wager?

Contestant 2: Let’s make it a true Daily Double, Alex.

Alex: Hello! This federal program has increasingly been circumvented by pharmaceutical companies and pharmacy benefits management companies who are refusing to comply with its rules. The Health Resources & Services Administration, the original program administrator, has stated they do not have the statutory authority to intervene and enforce the rules.

Contestant 2: What is SNAP?

Alex: No, you loser! Anyone?

Contestant 1: What is 340B? 

Alex: Of course! And now, on to Final Jeopardy. Today’s category: Looming Threats to Healthcare. Make your wagers. Now, a word from our sponsor…

Andy: Healthcare policy wonks will claim that I have oversimplified a complex issue. Perhaps. But wonkish complexity makes most folks’ eyes glaze, and my goal is to playfully expose a kernel of important truth. All that anyone with an interest in preserving our rural healthcare providers needs to know is just this: 340B is absolutely vital to many hospitals’ and health centers’ survival. No exaggeration. The loss of a few percent of our 340B income would force more than a few to close their doors for good. Is 340B a cumbersome, outdated, bloated program? Yes. But it should be thoughtfully replaced, not dismantled. Cutting even part of the benefits without creating a durable replacement is a recipe for disaster. You probably have seen calls to advocate for 340B, and you’ll see many more in days to come. Please take them seriously. Without 340B, it really could be Final Jeopardy for many of our rural providers.

My very best,

Andy

Member Spotlight

MaryAnn Seebeck, MS, RN

Director: Human Services

Town of New Shoreham

Block Island, Rhode Island

Can you please tell us a little about yourself and your work in rural health?

I became a Registered Nurse in 1985, and worked the majority of my career in the field of Women’s Health.  I was fortunate to have been offered so many opportunities in this career, to learn and to teach, and to experience many different cultures.  In 2013, I chose to pursue an advanced degree.  Those studies required a deep look into the healthcare delivery system in this country and required me to find a place to do a project for a community or an organization.  I chose to do my work on the tiny, remote community of Block Island.  Here, there are roughly 1,000 year-round residents, of whom well more than half are over the age of 65. I had many mentors during this work, including some amazing retired Nurse Practitioners, and of course, the AMAZING Mary Donnelly (https://youtu.be/SUxu02GPAqg)  I began working with the Senior Advisory Committee members on building a program for aging in place here on Block Island.  Through these endeavors I have met some of the most amazing seniors –the degree of heartiness and good health and resiliency of most of the Island seniors is like no other place.  This program is ongoing.  About 3 years ago, I was appointed as the Town’s Director of Human Services.  This is an ever-changing and evolving role.  I am always seeking ways to bring programs and services to the Island that are available on the mainland, but that are not available to Block Island residents simply because of geographical location.

 

What does it mean to be a member of the New England Rural Health Association?

I have been a member of the NERHA since 2017.  It has been a fantastic way to network with other health professionals to share best practices.  It is an amazing opportunity to meet with groups and individuals who have the ability to influence rural health care policy.  I look forward to attending the annual conferences and learning about what others in the field are doing in their communities, and to the presentations of work, since so many of the presentations and work being done is pertinent for Block Island.

 

What does rural health mean to you?

“Health” means many things to me.  The ability to access needed services, the ability to feel safe in your body, mind, home, neighborhood, the ability to safely and effectively manage your own and/or your loved ones chronic health conditions- all of these factors contribute to “health”.  When you live in a very remote place that is only accessible by air or sea, the ability to access services becomes critical.  It is my hope to be able to enhance the system of community support that exists currently, to implement safe and effective action to enable folks who wish to age in place in their homes on Block Island to do so safely and in the most supportive environment possible.

 

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

September is National Recovery Month
This is an observance held every September to educate Americans that substance use treatment and mental health services can enable those with mental and substance use disorders to live healthy and rewarding lives. Now in its 31st year, Recovery Month celebrates the gains made by those living in recovery.
Congratulations! 2021 NRHA president and NERHA member John Gale wins Calico Leadership Award

NRHA member John Gale, Maine Rural Health Research Center senior research associate and director of policy engagement and Flex Monitoring Team co-principle investigator, was recently awarded the Calico Leadership Award at the 2020 Flex Program Reverse Site Visit. The Calico Leadership Award is presented annually by the Technical Assistance and Services Center, a program of the National Rural Health Resource Center, to an outstanding rural health leader. Gale has focused his academic work on the role of key rural providers, including rural health clinics and critical access hospitals. Your chance to learn more from Gale on topics including building a better rural health clinic, mental health and substance abuse models, and rebuilding the foundations of rural health after COVID is at NRHA’s 18th Rural Health Clinic Conference and 19th Critical Access Hospital Conference hosted virtually for the first time Sept. 22-25. See how much you’ll save while accessing all event content live and on demand for a year.
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

Registration will become available soon! Please be sure you are signed up as a member and on our mailing list so that you will be notified as soon as it is open.
 



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.

 
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

PEPPER Resource
Click Here for Doc. Download

 
The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is a Microsoft Excel workbook that summarizes provider-specific Medicare claims data statistics for areas that have been identified as prone to improper Medicare payments due to billing, coding and/or admission necessity issues. These areas are identified by the Centers for Medicare & Medicaid Services.

Visit https://pepper.cbrpepper.org/ for more information on PEPPER, including sample reports, user’s guides, recorded training sessions and national-level comparative data. View the PEPPER distribution schedule and information on how to get your organization’s PEPPER.

If you have questions, visit our Help Desk to request assistance with PEPPER.
 
 
Engaging Communities to Preserve Access to Emergency Medical Services in Rural Maine
This paper goes to the heart of assuring EMS response in emergencies: that EMS capabilities in a given community are understood by the community, that they are the type and level desired, and that they are adequately paid for by those who depend upon them.

New Resource: Discharge Planning During the COVID-19 Pandemic


HHS' Assistant Secretary for Preparedness and Response recently published Discharge Planning and Care Coordination during the COVID-19 Pandemic, a resource developed in partnership with ACL and the Centers for Medicare & Medicaid Services. This tool is designed to support nurses, social workers, case managers, and others conducting discharge planning for adults with disabilities after COVID-19 treatment.

Buyback Program of Unused Prescription Opioids in US Rural Communities, 2017–2018

Describes a buyback intervention that was designed to encourage rural, ambulatory surgery patients to return unused prescription opioids to a U.S. Department of Veterans Affairs (VA) hospital. Provides data on patient characteristics as well as percent of opioids prescribed and returned during 2017 and 2018. Includes implications for public health.

NVRH Recruits with Rural Lifestyle

Aug 31, 2020 - Details how the Northeastern Vermont Regional Hospital, a Critical Access Hospital (CAH) in Vermont, recruits healthcare providers. Describes ongoing efforts to provide a supportive work environment such as flexible scheduling, an on-staff counselor, and  peer groups.

Rural Community Paramedicine Toolkit

This toolkit presents practical strategies that can help rural communities build successful community paramedicine programs. In particular, it focuses on existing programs that have successfully provided rural community paramedicine services. It also offers guidance for implementation, evaluation, dissemination, and sustainability.

Recent News

In Rural Vermont, Food Relief Program Is Eyed as Model

Sep 8, 2020 -- Describes Vermont Everyone Eats!, a food relief initiative that distributes federal CARES Act funds through a grant that pays restaurants to prepare meals for those in need in response to the COVID-19 pandemic, including residents living in rural communities. The grant requires restaurants to source 10 percent of the food they use to prepare meals for the program from local farms.
 


 

Research Report: States with Broadband Funding Program Have Better Access

Sep 1, 2020 -- Discusses an analysis of three statewide broadband policies: availability of state-level funding, existence of a state-level broadband office or task force with full-time employees, and restrictions on municipal/cooperative broadband provision. Compares the effects of these policies on broadband availability in rural areas to the overall availability within the state.
 


 

Telehealth in Vermont: COVID-19 Response and Recovery

Provides an overview of telehealth services and regulations in Vermont prior to, and in response to, the COVID-19 public health emergency. Includes resources on billing and reimbursement, licensure, patient consent, telehealth platforms and technology, sample workflows and implementation toolkits, case studies, and planning for the future.
 



Community-Level Factors Associated With Racial And Ethnic Disparities In COVID-19 Rates In Massachusetts

This past spring, Massachusetts had one of the highest incidence rates of COVID-19 cases in the US. Early reports suggested that Black and Latino residents were disproportionately affected. However, evidence on whether specific demographic, economic, and occupational factors were associated with a higher risk for COVID-19 among minority communities remains sparse. José Figueroa and coauthors examined the association between community-level factors and COVID-19 case rates across 351 cities and towns in Massachusetts between January 1 and May 6, 2020. Read More >
 

New Covid-19 Cases Are on the Rise Again in Rural Counties

Rural areas now account for a disproportionately large share of new infections and deaths.
 
Advocate and Take Action

Deadline Approaching: Your Input Needed!

The New England Rural Health Association will be submitting comments. If there are any comments/thoughts you’d like to share with us to include, please send to us. 

HRSA recently published two Requests for Information (RFI). We will collect feedback on the areas of consideration outlined in the RFIs, as well as more general feedback or suggestions, through Friday, September 18.

  • Health Professional Shortage Area (HPSA) Scoring Criteria RFI:
    HRSA seeks public input and feedback to inform policy considerations related to changes to HPSA scoring criteria and on possible additions or alternative approaches to HPSA scoring, as well as to solicit additional ideas and suggestions.
     

  • Maternity Care Health Professional Target Area Criteria RFI:
    HRSA seeks public input and feedback to inform policy considerations related to the establishment of criteria for Maternity Care Health Professional Target Areas and to solicit additional ideas and suggestions related to the RFI’s topic areas.

Recent threats to the 340B Program 

In response to ongoing attacks by pharmaceutical manufacturers against the 340B Drug Pricing Program, 340B Health has begun circulating a letter to send to Department of Health and Human Services (HHS) Secretary Alex Azar that explains the importance of the 340B Drug Pricing Program. Thus far, over 900 hospitals have signed onto this letter. If you would like to add your hospital to the letter, please follow the instructions within this link. For questions regarding this letter, please contact Kathryn Dibitetto, Vice President of Government Relations at 340B Health.

On Capitol Hill, Representatives David McKinley (R-WV) and Diana Degette (D-CO) are circulating a letter to Secretary Azar that calls on him to use his statutory authority to address the actions of these pharmaceutical manufacturers and require them to comply with the law. NRHA is contacting offices in the House to urge representatives to sign this important letter. We strongly encourage you to also contact your House lawmakers today to ask them to support this bipartisan letter.

As a reminder, all health centers should be aware of two critical resources: 340B Response Toolkit and an Advisory RE: Mandatory Terms of Use Data Submission.
 

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.
 



Employment Opportunity - The New Hampshire Public Health Association (NHPHA), Executive Director 

The New Hampshire Public Health Association (NHPHA), a membership organization dedicated to strengthening New Hampshire’s public health system, is seeking a self-directed, positive, and committed Executive Director to be the key management leader of the Association. Please see the job listing for further information. 
 



The Health Resources and Services Administration's (HRSA) Federal Office of Rural Health Policy (FORHP) has released the Notice of Funding Opportunity (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. Review the funding opportunity Here

 



Maine Care for the Underserved Pathways AHEC Scholars Program

A multidisciplinary certificate and honors distinction program for health professions students in Maine that offers opportunities for hands-on training, experience in rural and underserved communities, and networking with other students and professionals.
 



Massachusetts General Hospital Fellowship Program in Rural Health Leadership

A full-time fellowship for early-career clinicians who have an interest in partnering with rural communities to improve health.

Application Deadline: Sep 30, 2020
 


 

Health Care Transportation Access "Ready-to-Launch" Implementation Grants

Grants to support communities that are ready to take concrete steps toward implementing transportation solutions to address healthcare access.

Application Deadline: Oct 1, 2020
 


A Unique Training at Yale University, School of Nursing

Are you a nurse practitioner (NP) or NP Student in your last year with a passion for remote or rural practice?

Are you interested in receiving more training in advanced procedures and skills, not often taught in primary care programs? We are piloting a unique, simulation-based training program based on input from an expert panel, to teach new, remote NPs advanced, or extended skills, using simulation technology. We are surveying confidence before and after the training.

Please join us for a free, 2-day training program, held in the simulation lab at Yale University, wherein you will be able to learn from content experts, and practice such skills as:
 

• Airway management and intubation

• X-ray interpretation

• EKG interpretation

• Splinting and fracture stabilization

• Chest decompression with needle thoracostomy

• Suturing

• Dental blocks

• Ocular emergencies

 

If you are interested in participating in this intervention, free of charge, with CME available, in the Fall semester of 2020, Email:

Benjamin.Woodard@yale.edu or Suzanne.Cashman@umassmed.edu
Upcoming Events

Stay Tuned For More NERHA Virtual Event Updates Coming Soon!
 


Community Health Worker (CHW) - Virtual Conference Series: Celebrate and Educate!

Virtual Sessions held from September 15 - October 14, 2020. Register Here
 



Advancing the Response to COVID-19: Sharing Promising Programs and Practices for Racial and Ethnic Minority Communities virtual symposium hosted by the U.S. Department of Health and Human Services (HHS) Office of Minority Health. The virtual symposium will highlight state, tribal, territorial and community-based efforts addressing COVID-19 among racial and ethnic minority and American Indian and Alaska Native communities.

Thursday Sept. 17, 2020 from 12-6pm ET  - Register Here
 



National Association of Community Health Centers Webinar: Health Center Leadership Webinar Series 2 of 4: Excelling in Your Role as a Health Center Leader - Communicate Like a Leader

Date: Thursday September 17th Time: 2:00 - 3:00 p.m. Eastern -  Register Here
 



 Building the Nation’s Peer Recovery Support Services Infrastructure

Monday, September 21 2:00-3:30 p.m. ET

Register by Friday, September 18
 



WEBINAR: The Opioid-related Syndemic in Rural Northern New England: Findings from the DISCERNNE Study

This presentation will discuss the risk and resource environment surrounding the syndemic of opioid use disorder, HCV and overdose in rural communities in the northern New England, and opportunities to prevent Scott County-like HIV outbreaks.

September 22, 2020, 1:00 – 2:00 pm - Register Here 

 


 

IPRO QIN -QIO Webinar: Implementing Telehealth During COVID-19

A Patient's Post-Acute Care Experience: How telehealth made a critical difference in a patient's care during the pandemic - hear from the patient and her physician

September 22 from 1 - 3pm EDT - Register Here 

 



County Health Rankings & Roadmaps: Spotlight on Rural: Local Efforts at the Intersection of Health and Housing

September 22, 2020 Time: 3:00 - 4:00 p.m. Easter - Register Here
 


 

Webinar: Launch of the Readiness to Train Assessment Tool (RTAT™)

Developed to assess organizational readiness to implement Health Professions Training (HPT) programs in health centers across the country.

September 23, 2020 at 3:00 PM-4:30 PM ET - Register Here

 


 

Introducing the Rural Community Paramedicine Toolkit

Thursday, September 24th at 12:00 p.m. Central - Register Here

Featured speakers, Sarah Hodge, Jared Smith, Matt Walker, Dennis Russell, and Daphne Russell, discuss the Rural Community Paramedicine Toolkit and describe strategies to establish and sustain related rural programs.  
 


 

V4A 2020 4th Annual Conference: Reframing Aging September 25th, 2020

Friday, September 25, 2020 - Click here for more information
 



Webinar: Community-Based Strategies for Suicide Prevention Among Older Adults

Monday, September 28, 2020 2:00-3:30 PM ET - Webinar Registration

In recognition of Suicide Prevention Awareness Month, join NCOA for a discussion of community-based strategies to support older adults in managing mental health. This webinar will discuss the prevalence of suicide among older adults as well as the unique risk factors present for an aging population both before and during the COVID-19 pandemic

 


 

Telehealth for HIV Care: A Follow-Up Discussion - Tuesday, September 29, 2020 from 2:00 PM – 3:00pm PM ET Register here                 

Free Webinar -A collaboration between HRSA Office of Regional Operations Regions 1, 4, 7 and the Northeast Telehealth Resource Center.   

 



BPC Webinar: Tracking Federal Funding to Fight America's Opioid Epidemic

Wednesday, September 30, 2020 from 12-1:15 p.m. ET  Register here 

 



Webinar: How to Win Back Every Single Patient Keynote

When: Sep 30, 2020 2:00 PM ET - Register Here
 



Identifying the Enabling Services Workforce for Social Determinants of Health Screening and Documentation

Wednesday, September 30 from 2:00-3:00 p.m. ET Register here

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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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