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Rural Health Briefing, Vol. 3, No. 1 March 1, 2002
Update: Rural Hospital Flexibility Program
a. National Progress - Medicare Ambulance Fees
State Action
Status of Arizona Critical Access Hospital Designations
Status of Critical Access Hospital Designation Applications
Status of State Medicaid Funding for Critical Access Hospitals
Arizona News
College of Public Health - Rural Leadership Roles
ADHS Bioterrorism Preparedness Plan
ADHS - Dental Trailer Loan Program
Rural Health Conference Program
Border Health Information Conference
Other
National News
Medicare Ambulance Fee Schedule – Final Rules
USDA Elimination of J-1 Visa Waivers
HHS Federal Poverty Guidelines for 2002
Bioterrorism and Preparedness
AHRQ - Training of Clinicians
CDC - Supplemental Funds for Public Health Preparedness and Response for Bioterrorism
CDC Smallpox Outbreak Response Plan and Guidelines
AHA - Rural Hospital Disaster Readiness
UAB Bioterrorism CE
AHRQ Quality Indicators
Healthy Communities Access Coalition Action Alert – Community Access Program Funding
Kaiser Study: Public Service Advertising
Kaiser Studies on Medicaid Prescription Drug Coverage
4. How to Contact Your Representatives
Congressional Delegation
State Legislators
5. Grant Opportunities
Reminder – Rev. PS398 Grant Application Packet
Reminder - New HRSA Grants App. Center
Reminder - Reminder: Rural Health Outreach/
Network Grants
Rural Information Center Health Services (RICHS) Grants Online
Selected Grant Opportunities Technology Opportunities Program (TOP)
Excellence in Partnerships for Community Outreach, Research on Health Disparities and Training
Reducing Oral Health Disparities
Health Risk Reduction: Community-Based Strategies
Health Services Research on Rural Health
Mental Health in Rural Areas Research
Self-Management of Chronic Diseases
Telehealth Interventions to Improve Clinical Nursing Care
Community Facilities Loans
Technical Skills Training Program
6. Conferences Relevant to Rural Health
Congress on Childhood Emergencies
World Rural Health Conference
National Rural Health Association Annual Conference
National Conference on Health Education and Health Promotion
Annual Meeting of Rural Sociological Society
Annual Conference, National Association for Rural Mental Health
7. Other
Rural Issues: Traumatic Brain Injury
Universal Service: Rural Health Care
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1. Rural Hospital Flexibility Program
National Action - Medicare Ambulance Fees
On February 23, the Centers for Medicare & Medicaid Services (CMS) announced a final regulation creating a fee schedule for both beneficiaries and Medicare to pay for ambulance services (see national news section, below). The final regulation, mandated by Congress in the Balanced Budget Act of 1997 (BBA), is available in the February 27 issue of the Federal Register. As a result of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA), Critical Access Hospitals (or entities owned and operated by a Critical Access Hospital) are exempted from the fee schedule, if there is no other ambulance provider or supplier within 35 miles. These entities will continue to be paid according to "reasonable costs."
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b. State Action
(1) Status of Arizona Critical Access Hospital Designations: Three rural hospitals in Arizona have now received new provider numbers as critical access hospitals – Wickenburg Regional Medical Center, Benson Hospital, and Northern Cochise Community Hospital (Willcox). CMS has approved retroactive billing for cost-based Medicare reimbursement for these hospitals: November 1, 2001 for Wickenburg; January 1, 2002 for Benson; and February 1, 2002 for Willcox. Two additional Critical Access Hospital designation applications are pending for Southeast Arizona Medical Center (Douglas) and Page Memorial Hospital.
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(2) Status of Critical Access Hospital Designation Applications: A financial feasibility study was recently completed for Sage Memorial Hospital (Ganado). Another hospital, Parker Regional Medical Center, has submitted a request for a financial feasibility study. The Indian Health Service recently notified Arizona Flex Program staff that three IHS facilities are expected to submit Critical Access Hospital designation applications in the fall, Hopi Health Care Center (Polacca), Parker IHS, and San Carlos IHS. A community meeting was recently held in Springerville to discuss the status of White Mountain Regional Medical Center. Another community meeting is scheduled in Holbrook on March 19 to present the results of a community health needs assessment, and discuss the prospects of converting Petrified Forest Medical Center into a critical access hospital.
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(3) Status of Enhanced Medicaid Reimbursement for Critical Access Hospitals: In the December special session, the AHCCCS budget for 2002 was cut by about one-half percent. In deciding how to revise the budget, the agency determined that Medicaid payments for patients are entitlements that could not be cut. The agency looked to optional funding programs to make budget cuts. Because the special funding for Critical Access Hospitals ($1.7 million appropriated last year) is discretionary funding, the agency reduced that line item to $300,000 through July 2002. Agency representatives note that although the Medicaid funding may be very significant to individual rural hospitals, the proportion of the total Medicaid pool for these rural hospitals, based on a five-year history of utilization, is less than on-half of one percent of total AHCCCS funds.
AHCCCS has approved an internal procedure for distribution of enhanced Medicaid reimbursement to rural hospitals that become critical access hospitals. Distribution will occur monthly (when the current special session ends, if no further budget cuts are made). AHCCCS will consider the CMS effective date of Critical Access Hospital designation for Medicare reimbursement to be the same effective date for Medicaid reimbursement.
AHCCCS will pay the hospitals their regular Medicaid billing costs. The $300,000 is a pool for special funding in excess of the usual Medicaid rate. The allocation of special funding to be distributed is based on a formula: the pool will be divided monthly by the number of eligible hospitals and the number of months of eligibility. Based on this formula, Wickenburg will be eligible for 9 months of special funding; Benson will be eligible for 7 months. The other hospitals will be eligible for the number of months that accrue from the effective dates of their Critical Access Hospital designations. The monthly pool will then be divided by utilization based the amount of AHCCCS dollars paid for inpatient and outpatient services for each eligible hospital. Laboratory and other services will not be included.
Continuation of the funding in 2003 is uncertain. Concerned legislators approved the $1.7 million appropriation for the state’s Critical Access Hospitals, but with the state’s current fiscal crisis, these funds were reduced. Rural leaders concerned about the future of Arizona’s fragile rural hospitals should contact their state legislators if they want to see the funding continued.
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2. Arizona News
a. College of Public Health - Rural Leadership Roles: The new dean of the Arizona College of Public Health, Marie Swanson, recently announced appointment of several rural health advocates to leadership positions in the state’s College of Public Health.
Jill Guernsey de Zapien of the Rural Health Office, will serve as the college’s Associate Dean for Community Programs. Ms. De Zapien is a long-time advocate of health care programs in rural and border communities, including the recruitment and training of "promotoras" to bridge the cultural gap between residents of underserved communities and the health care system.
Alison Hughes, Acting Director of the Rural Health Office since the death of Dr. Andrew Nichols in April 2001, was appointed the permanent Director of the RHO. Two RHO staff members will serve as Associate Directors: Howard Eng, Associate Director for Education and Research, and Lynda Bergsma, Associate Director for Service.
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b. ADHS - Emergency Preparedness and Trauma Care: The Bureau of Emergency Medical Services of the Arizona Department of Health Services is currently revising the State Trauma Plan, including provisions related to the role of hospitals in rural areas. In addition, ADHS has formed an advisory committee to assist in the development of a statewide bioterrorism preparedness plan, to be supported with approximately $18.6 million in special funds allocated by HHS for Arizona. Designated funding for hospitals will be based on the plan, which the state must submit to HRSA by April 15.
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c. ADHS Dental Trailer Loan Program: The ADHS Office of Oral Health is accepting applications for its dental trailer loan program. This program is designed to assist communities in delivering dental care to underserved populations while establishing a permanent dental delivery program. A 10 x 40 foot trailer equipped with two dental operatories and an x-ray unit will be leased, for a nominal fee, to the recipient. Applicants must be non-profit or community-based and must demonstrate a viable plan for a permanent dental facility or program to replace the trailer within five years. Applications must be submitted by April 15, 2002. For more information, contact Jo Merendino, Office of Oral Health, (602) 542-1866 or merendj@hs.state.az.us.
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d. Rural Health Conference Program: This year’s annual Rural Health Conference is scheduled for July 22-24 at the new Hilton Resort in Sedona. The conference theme is "Strengthening Our Public Health Infrastructure." Invited keynote address presenter is Marie Swanson, PhD, Dean, Arizona College of Public Health. Val Schott, President of the National Rural Health Association will be the plenary luncheon speaker on the first day of the conference; the invited plenary luncheon speaker for the second day of the conference is Jay Glasser, PhD, University of Texas School of Public Health and President-Elect of the American Public Health Association. Plenary sessions will include: a panel discussion of "Rural Public Health in Arizona", "Models that Work," "Bioterrorism Preparedness," "Rural Health Policy Issues in Arizona," and "College of Public Health Rural/Border Initiatives." Concurrent sessions will include "From Violence to Viagra - The Impact of the Media on Public Health;" Bioterrorism and Disaster Preparedness Information Resources;" "Rural Health Issues;" Field Trip to a Water Plant; "Environmental Health;" "Communicable Disease;" and "The New AHSC AHEC Initiatives.
e. Border Health Information Conference: The fourth annual Border Health: Information for Action Conference is scheduled to be held at the Rio Rico Resort September 26-27, 2002. Conference planners have issued a call for abstracts in April 2002 on conference themes: Adolescent and Children; Environmental Health; Gender & Health; and Community Health. Binational organizers of the conference include: in Arizona – the Arizona Department of Health Services, the Border Health Foundation, the University of Arizona, the Arizona College of Public Health, and the Arizona Health Sciences Center Office of Minority Affairs; in Sonora – Servicos de Salud de Sonora, El Colegio de Sonora, Associacion Sonorense de Salud Reproductiva, A.C., Mexfam, La Red Fronteriza de Salud y Ambiente, A.C. For further information, contact Mary Contreras, College of Public Health, (520) 318-7270, Ext. 10 or ContrerM@u.arizona.edu.
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3. National News
a. Medicare Ambulance Fee Schedule – Final Rules
The newly published final rule for ambulance fee schedules provides a pre-established fee for each different service provided in seven categories of ground ambulance services and two categories of air ambulance services. Ambulance providers will not be allowed to charge beneficiaries more than their deductible and 20 percent of Medicare’s fee for the service. The final regulation contains a number of changes made in response to public comments, including:
(1) Implementation beginning on April 1, 2002 (rather than January 1, 2001), phased in over a 5-year period (rather than a 4-year period);
(2) Changes in assumptions allowing increases in payments (such as the amount of "low billing" – when providers bill less than the Medicare approved amount – that will continue to occur after the fee schedule begins;
(3) Phase-in of policy under which Medicare will pay a basic life support rate for services furnished at the BLS level even when an advanced life support vehicle is used.
The new ambulance payment system was produced under a negotiated rulemaking process that included affected industry, professional, and governmental groups. The negotiating committee that developed the fee schedule expressed particular concern about ambulance access for beneficiaries in rural areas. While the new plan includes several bonuses for rural providers, CMS will continue to consider alternative approaches to ensure adequate payment for isolated, essential, low-volume, rural ambulance suppliers as experience under the fee schedule becomes available.
The new fee schedule establishes a base rate payment plus separate mileage payment based on specified relative value units for each level of ambulance service; higher payments for services qualifying as an "emergency response;" adjustments to recognize difference in relative practice costs among geographic areas; and the higher transportation costs that may be incurred by ambulance suppliers in rural areas with low population density.
The rule implements BIPA increased payment for rural ambulance mileage greater than 17 miles and up to 50 miles by at least one-half of the additional payment per mile established under the fee schedule for the first 17 miles of a rural transport, for services provided before January 1, 2004.
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b. USDA Elimination of J-1 Visa Waiver Program
News alerts received today, March 1, from the National Rural Recruitment and Retention Network(3RNet) and the National Organization of State Offices of Rural Health (NOSORH) report that the U.S. Department of Agriculture ‘s J-1 Visa Waiver program has been discontinued effective February 27, 2002. All pending applications are being returned. Questions should be directed to Maria Bynum in the USDA Office of Communications, (202) 720 5192; maria.bynum@usda.gov
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c. HHS Federal Poverty Guidelines for 2002
The U.S. Department of Health and Human Services published new federal poverty guidelines for 2002 in the February 14 issue of the Federal Register.
Annual Federal Poverty Guidelines - 2002
Size of Family 48 Contiguous States & DC
1 $ 8,860
2 $11,940
3 $15,020
4 $18,100
5 $21,180
6 $24,260
7 $27,340
8 $30,420
For each additional person, add $3,080.
Monthly Federal Poverty Guidelines - 2002
Size of Family 48 Contiguous States & DC
1 $ 738
2 $ 995
3 $1,252
4 $1,508
5 $1,765
6 $2,022
7 $2,278
8 $2,535
For each additional person, add $257.
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d. Bioterrorism and Preparedness
(1) AHRQ - Training of Clinicians: As part of its Evidence-Based Practice Program, the Agency for Healthcare Research and Quality has published guidelines for Training of Clinicians for Public Health Events Relevant to Bioterrorism Preparedness, Evidence Report/Technology Assessment: Number 51. A summary of the report is available online: http://www.ahrq.gov/clinic/evrptfiles.htm@bioter.
The full evidence report, prepared by Johns Hopkins University, is available (free) by calling the AHRQ Publications Clearinghouse at 1-800-358-9295.
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(2) CDC Supplemental Funds for Public Health Preparedness and Response for Bioterrorism: The Centers for Disease Control and Prevention (CDC) has announced the availability of fiscal year 2002 funds for the cooperative agreement program to upgrade state and local public health jurisdictions’ preparedness for and response to bioterrorism, other outbreaks of infectious disease, and other public health threats and emergencies. Guidelines for these supplemental funds are available on the CDC Public Health Emergency Preparedness & Response website: http://www.bt.cdc.gov/
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(3) CDC Smallpox Outbreak Response Plan and Guidelines: The CDC plan for coordinating CDC, state, and local public health activities in the event of a smallpox outbreak, as part of a bioterrorism attack, are also available on the CDC National Immunization Program website: http://www.cdc.gov/nip/smallpox. The website provides guidelines for health care providers in evaluating patients for smallpox, as well as training opportunities.
(4) American Hospital Association Update: Rural Hospital Disaster Readiness: In November 2001, the American Hospital Association’s Small or Rural Hospital Section published a "Rural Hospital Disaster Readiness" paper that includes a bibliography of Bioterrorism Readiness Tools and guidelines for rural hospitals. The paper is available online: http://www.aha.org/memberrelations/updatenewsletter.asp
(5) UAB Bioterrorism CE: The University of Alabama at Birmingham’s Center for Disaster Preparedness (Department of Emergency Medical Services) and Center for Outcomes and Effectiveness Research and Education has developed resource information and continuing education modules related to rare infections and potential bioterrorist agents. The project is funded by the Agency for Healthcare Research and Quality, and is available online: http://www.bioterrorism.uab.edu.
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e. AHRQ Quality Indicators
The Agency for Healthcare Research and Quality has developed a new set of quality indicators organized into three "modules," each of which measures quality associated with processes of care that occurred in an outpatient or an inpatient setting. All three modules rely solely on hospital inpatient administrative data. The new indicators represent a refinement and further development of quality indicators developed in the early 1990s as part of the Healthcare Cost and Utilization (HCUP) project.
The Prevention Quality Indicators are a set of measures that can be used with hospital inpatient discharge data to identify "ambulatory care-sensitive conditions." These are conditions for which good outpatient care can potentially prevent the need for hospitalization or for which early intervention can prevent complications or more serious disease.
Even though these indicators are based on hospital inpatient data, they provide insight into the quality of the health care system outside the hospital setting. For example, patients with diabetes may be hospitalized for diabetic complications if their conditions are not adequately monitored or if they do not receive the patient education needed for appropriate self-management.
The Prevention QIs consist of 16 ambulatory care sensitive conditions which are measured as rates of admission to the hospital: (1) bacterial pneumonia; (2) dehydration; (3) pediatric gastroenteritis; (4) urinary tract infection; (5) perforated appendix; (6) low birth weight; (7) angina without procedure; (8) congestive heart failure; (9) hypertension; (10) adult asthma; (11) pediatric asthma; (12) chronic obstructive pulmonary disease; (13) diabetes short-term complication; (14) diabetes long-term complication; (15) uncontrolled diabetes; (16) lower-extremity amputation among patients with diabetes.
The new Prevention QI module can be downloaded from the AHRQ website: http://www.ahrq.gov/qual/qiix.htm.
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f. Healthy Communities Access Coalition Action Alert – Community Access Program Funding
On February 26, the Healthy Communities Access Coalition (HCAC) issued an Action Alert to recruit congressional co-sponsors for H.R. 3450, which provides for re-authorization of health care safety net programs, including the Consolidated Health Centers Program and the National Health Service Corps, as well as establishing the Community Access Program as a demonstration program in federal law.
When Congress adjourned last year, H.R. 3450 had only 43 cosponsors; it currently has 87 co-sponsors, but only a majority of the House (218) can ensure passage. Passage of H.R. 3450 is critical for immediate authorization of the CAP. Rep. Ed Pastor is the only member of the Arizona congressional delegation currently co-sponsoring this legislation. Contact your representative for support.
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g. Kaiser Study: Public Service Advertising
The Kaiser Family Foundation recently released a new national study on public service advertising that finds broadcast and cable television networks donate an average of 15 seconds an hour to air public service ads (PSAs), representing just under one-half of one percent (0.4%) of all air time. By comparison, 25 percent of air time is filled with paid advertising and promotions. A significant portion of donated air time (43%) is during the late night hours between midnight and 6 am.; nine percent is in prime time. Network-sponsored campaigns featuring their own stars, calling them PSA-style promos, account for 25% of all donated PSAs on the major broadcast networks.
Although broadcasters granted the use of the public airwaves are legally required to "serve the public interest," there is no mandate that PSAs be a part of this public interest requirement.
Some public education campaigns are buying ad time rather than relying solely on donated air time to get their messages heard. The study found that one in three (36%) TV spots that have public service messages are paid for. A companion survey of public service directors at local TV stations indicated one in three (35%) would be more likely to donate air time to a group that also buys ads.
More than one in three (37%) PSAs that receive donated air time address a child-related topic, such as children’s health care, parenting, education, or mentoring. One out of every four donated PSAs (27%) is on a health-related topic.
Copies of the study are available from the Kaiser Family Foundation website: http://www.kff.org/content/2002/20020221a or by calling its publication request line at 1-800-656-4533.
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h. Kaiser Studies on Medicaid Prescription Drug Coverage
The Kaiser Commission on Medicaid and the Uninsured recently released three publications that outline the relevant issues about
Medicaid and prescription drugs today.
-- "Medicaid: Purchasing Prescription Drugs" explains how Medicaid purchases outpatient drugs and outlines the policy tools available to states to limit the rate of growth in spending on prescription drugs http://www.kff.org/content/2002/4025/4025.pdf
-- "Medicaid Outpatient Prescription Drug Benefits: Findings from a National Survey and Selected Case Study Highlights" is a report summarizing a survey of 43 states and the District of Columbia on their prescription drug benefit and the financing of the benefit as of mid-2000. State level information includes who is eligible and how utilization and cost is controlled through coverage and payment policies http://www.kff.org/content/2002/2225/2225.pdf .
-- "Outpatient Prescription Drug Benefits Under Medicaid: Detailed Case Studies" reports on case studies of Indiana, Massachusetts, Montana, North Carolina, Oregon, and Pennsylvania. The states were chosen for their diverse characteristics in order to illustrate the issues and challenges for delivering prescription drugs to the elderly and disabled via Medicaid, managed care, and pharmaceutical assistance
programs http://www.kff.org/content/2002/4003/4003.pdf .
For more information, call 202/347-5270.
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4. How to Contact Your Representatives
a. Arizona Congressional Delegation: Links to Representatives are available at http://www.house.gov. Links to Senators are available at http://www.senate.gov.
b. Arizona State Legislators: Available through the Arizona Legislative Information System (ALIS): Call 1-800-352-8404
http://www.azleg.state.az.us/
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Grant Opportunities
a. Reminder – Revised PS398 Grant Application Packet: If you will use the PS398 grant application this year, you need to be aware that it was revised as of 5/2001 and as of 1/10/02, the NIH will no longer accept applications on the old form. The 5/01 version is not being ent out in a hard copy format any more. It is only available at this link: http://grants.nih.gov/grants/funding/phs398/phs/398.html.
b. Reminder – HRSA’s New Grants Application Center
New Address ( Effective December 1, 2001)
HRSA Grants Application Center
Attention: Grants Management Officer
901 Russell Avenue, Suite 450
Gaithersburg, MD 20879
c. Reminder – Rural Health Outreach/Network Grants
APPLICATIONS AVAILABLE: JUNE 2002
DUE DATE: SEPTEMBER 13, 2002 - OUTREACH
DUE DATE: SEPTEMBER 20, 2002 - NETWORK
Please contact the HRSA Grant Application Center (HRSA GAC) at 1-877-477-2123, FAX 1-877-477-2234 or E-mail HRSAGAC
@hrsa.gov immediately and ask to be placed on the mailing list to receive the Rural Health Outreach or Network Development official application kits as soon as they are available. For the OUTREACH GRANT cite the reference number 93.912A For the NETWORK DEVELOPMENT GRANT cite the reference number 93.912B. The most up-to-date ORHP information is posted on Office of Rural Health Policy web site at: www.ruralhealth.hrsa.gov/
For information regarding funding for the Outreach and Network grants go to: www.ruralhealth.hrsa.gov/funding.htm#providers
Although most of the application materials are posted on the web, you must still call HRSA GAC at 1-877-477-2123 to receive the official application packet. For additional information contact Lilly Smetana at lsmetana@hrsa.gov or by calling 301-443-6884.
d. Rural Information Center Health Service - Grants
Information about grant opportunities with deadlines between March-July 2002 are available through the Federal Office of Rural Health Policy’s Rural Information Center Health Service. Grants Relevant to Rural Health webpage is: http://www.nal.usda.gov/ric/richs/grants.htm
Some grant opportunities of interest for rural health issues include the following:
(1) TITLE: Technology Opportunities Program (TOPS)
AGENCY: National Telecommunications and Information Administration (NTIA), U.S. Department of Commerce
SCOPE: To provide underserved communities with opportunities to explore the possibilities that emerging digital network technologies offer to solve critical challenges in such areas as lifelong learning, community and economic development, government and public services, safety, health, culture, and the arts.
DEADLINES: March 21, 2002
CONTACT: Stephen J. Downs, Director, 1401 Constitution Avenue, NW, NCHB, Room 4092, Washington DC 20230; Phone 202-482-2048; fax: 202-501-5136; email: TOP@ntia.doc.gov. Website: http://www.ntia.doc.gov/top/grants/documents/notice2002.html.
Forms: http://www.ntia.doc.gov/otiahome/top/grants/documents/guidlines2001.html.
(2) TITLE: Excellence in Partnerships for Community Outreach, Research on Health Disparities and Training (Centers of Excellence) (NIH Guide, February 8. 2002)
AGENCY: National Center on Minority Health and Health Disparities (NCMHD)
SCOPE: The National Center on Minority Health and Health Disparities (NCMHD) announces the availability of support for a new program that is intended to promote minority health research as well as support the Department of Health and Human Services initiative to address and ultimately eliminate health disparities.
DEADLINES: April 24 for letters of intent; May 24 for applications
CONTACT: For program information: Dr. Jean L. Flagg-Newton, Deputy Director, NCMHD 6707 Democracy Blvd., Suite 800, MSC 5465, Bethesda, Maryland 20892-5465, (301) 402-1366. (301) 480-4049 (fax), Email: Flaggnej@od.nih.gov. For grants information: Ms. Usha Ganti, Acting Grants Management
Officer, NCMHD, 6707 Democracy Blvd., Suite 800, MSC 5465, Bethesda, MD 20892-5465, (301) 402-1366, (301) 480-4049 (fax), Email: GantiU@od.nih.gov http://grants.nih.gov/grants/guide/rfa-files/RFA-MD-02-001.html.
(3) TITLE: Reducing Oral Health Disparities
AGENCY: National Institute of Dental and Craniofacial Research, National Center on Minority Health and Health Disparities, and the National Institute of Nursing Research, NIH
SCOPE: Pilot research focusing on the determinants, prevention/
reduction, or impacts of oral health disparities in populations currently under-represented (includes low-income rural population, special needs population, and all race/ethnic population). RFA issued concurrently with two other RFAs ("Planning Grants for Research to Prevent or Reduce Oral Health Disparities" (DE-02-005) and "Research Infrastructure and Capacity Building for Minority Dental Institutions to Reduce Oral Health Disparities (DE-02-003).
DEADLINES: April 18, 2002
CONTACT: For inquiries regarding programmatic issues, Dr. Ruth Nowjack-Taymer, Program Director, 45 Center Drive, Room 3AN-44D, Bethesda, MD 20892-6401; Phone: (301) 594-5394; Fax: 301-480-8254 Email: Ruth.Nowjack-Raymer@nih.gov; Jean Flagg-Newton, Deputy Director, 6707 Democracy Blvd., Suite 800, MSC 5465, Bethesda, MD 20892-5465; (301) 402-1366; flagnej@od.nih.gov or jf41v@nih.gov/ Janice Phillips, Program Director, National Institute of Nursing Research, Build 45, Room 3AN12, Bethesda, MD 20892-6300; 301-594-6152; Fax 301-480-8260; email Janice.Phillips@nih.gov. Website: http://grants.nih.gov/grants/guide/rfa-files/RFA-DE-02-004.html.
(4) TITLE: Health Risk Reduction: Community-Based Strategies (NIH Guide April 5, 1996, PA-96-037)
AGENCY: National Institute of Nursing Research (NINR)
SCOPE: To support research on the clinical application of intervention strategies designed to reduce health risks at the community level. NINR is particularly interested in community-
based strategies targeting health problems of rural residents and of underserved minority groups. Eligible applicants include domestic and foreign, for-profit and non-profit organizations, public and private.
DEADLINES: June 1, October 1.
CONTACT: Applications: Grants Information Office, NIH Office of Extramural Outreach and Information Resources, (301) 435-0714. Programmatic Information:
NINR, Division of Extramural Programs, (301) 594-6906.
(5) TITLE: Health Services Research On Rural Health, (NIH Guide May 1, 1992, PA-92-71)
AGENCY: Agency for Health Care Policy and Research (AHCPR)
SCOPE: Grants will be awarded to non-profit institutions to support the development of new research in the areas of delivery, organization, and financing of rural health services. Key areas of research include: access, health professions, emergency care delivery systems, rural hospitals, alternative delivery systems, provision of primary health care, technology, special populations, health promotion and disease prevention, and special populations including elderly, rural poor, people with HIV/AIDS, and the homeless.
DEADLINES: June 1, October 1.
CONTACT: NIH Office of Grants Information, Division of Research Grants, (301) 435-0714.
(6) TITLE: Mental Health in Rural Areas Research Grant
AGENCY: National Institute of Mental Health (NIH)
SCOPE: Research on mental health problems and risks associated with rural and frontier communities to undertake studies that will (1) improve our understanding of barriers that place limits on the provision of care in these areas; and (2) provide information that will improve the organization, financing, delivery, quality, effectiveness, and outcomes of care for persons with mental disorders living in these diverse communities.
DEADLINES: June 1, 2002, October 1, 2002.
CONTACT: Anthony Pollitt, PhD, Office of Rural Mental Health Research, 6001 Executive Boulevard, Room 7130, MSC 96317, Bethesda, MD 20892-9631; Phone (301) 443-4525; fax (301) 443-4045. http://grants.nih.gov/grants/guide/pa-files/PA-00-082.html
(7) TITLE: Self-Management of Chronic Diseases
AGENCY: Office of Extramural Research (NIH), National Institute of Nursing Research, National Heart, Lung, and Blood Institute, the National Institute on Aging, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Mental Health, and the National Institute of Neurological Disorders and Stroke).
SCOPE: Investigate the applicability of effective self-management interventions to a broad spectrum of multiple chronic diseases across the life-course. Chronic disease is defined as illnesses that are prolonged, are rarely cured completely, and require self-management behaviors by affected individuals and/or their caretakers.
DEADLINES: June 1, 2002, October 1, 2002
CONTACT: Extramural Outreach and Information Resources Office, Office of Extramural Research, 6701 Rockledge Drive, MSC 7910, Room 6207, Bethesda, MD 20892-7910. Phone (301) 435-0714; Fax 301-480-8443. Email: grantsinfo@nih.gov
Website: http://grants.nih.gov/grants/guide/pa-files/PA-00-109.html.
(8) TITLE: Telehealth Interventions to Improve Clinical Nursing Care (NIH RECORD, Sept. 22, 2000, PA-00-138)
AGENCY: National Institute of Nursing Research (NINR); National Library of Medicine (NLM)
SCOPE: The goal of this Program Announcement is to stimulate clinical research on innovative nursing telehealth interventions, particularly their use among a wide variety of clinical situations, diverse patient populations, and different clinical settings.
DEADLINE: Ongoing.
CONTACT: Applications: (301) 435-0714. Programmatic Information: Carole Hudgings, NINR, (301) 594-5976; Milton Corn, NLM, (301) 496-4621.
(9) TITLE: Community Facilities Loans
AGENCY: Rural Development Administration, USDA
SCOPE: To construct, enlarge, extend, or otherwise improve community facilities providing essential services to rural residents. Facilities include fire and rescue services, transportation, health facilities, schools, municipal buildings, industrial park sites, access ways and utility extensions. There are direct loans and guaranteed
loan programs. Some types of facilities that have used these loans include: hospitals, assisted living units for the elderly, nursing homes, mental health clinics, drug treatment centers, and physician/dental clinics.
DEADLINE: Ongoing.
CONTACT: Applications are available from USDA Rural Development (formerly FmHA) State Offices, which can be located at: http://www.rurdev.usda.gov.
(10) TITLE: H-1B Technical Skills Training Grant Program (Federal Register, April 13, 2001)
AGENCY: Employment and Training Administration, Department of Labor
SCOPE: Local Workforce Investment Boards are eligible to apply for this skills training program that provides a long term solution to domestic skill shortages in high skill and high technology occupations. Funds may be used for technical skills training for employed and unemployed American workers. Training must focus on occupations that are experiencing skills shortages in the domestic job market. [Special note: This program has been used to address nursing workforce needs.]
DEADLINE: ongoing.
CONTACT: Programmatic Information: Fax questions to Le Phan, (202) 693-2879 (notice ID # SGA/DFA 01-105). Additional information: http://www.doleta.gov/h-1b.
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6. Conferences Relevant to Rural Health
a. Third National Congress on Childhood Emergencies
April 15-17
HRSA's Maternal and Child Health Bureau and National Highway Traffic Safety Administration
Dallas, TX
For more information, contact:
Emergency Medical Services for Children
Children's National Medical Center
111 Michigan Avenue, NW
Washington, DC 20010-2970
(202) 884-4927
b. World Rural Health Conference
April 30-May 3
World Organization for Family Doctors
Melbourne, Australia
For more information, contact:
The Meeting Planners Pty Ltd
91-97 Islington Street, Collingwood VIC 3066
Ph: 61 3 9417 0888 Fax: 61 3 9417 0899
ruralhealth@meetingplanners.com.au (email)
c. National Rural Health Association (NRHA) Annual Conference
May 15-18
Kansas City, MO
For more information, contact:
National Rural Health Association (NRHA)
One West Armour Blvd.; # 203
Kansas City, MO 64111
(816) 756-3140; Fax: (816)756-3144
mail@NRHArural.org (email)
http://www.NRHArural.org/pagefile/eo.html
d. National Conference on Health Education and Health Promotion
" Strengthening America Through Health Education and Health Promoting Alliances"
June 5-7
CDC and ASTDHPPHE
New Orleans, LA
For more information, contact:
Professional and Scientific Associates
(800) 772-8232 ext. 220
HEHP2002@psava.com (email)
e. Annual Meeting Rural Sociological Society
"The Community Effect in Rural Places"
August 14-18
Chicago, IL
* For more information, contact:
Rural Sociological Society
211 Mumford Hall,
University of Missouri
Columbia, MO 65211-6200.
(573) 882-9065
(573) 882-3958 (fax)
ruralsoc@missouri.edu (email)
http://www.RuralSociology.org/annual-meeting/2002/index.html
f. National Association for Rural Mental Health's Annual Conference
"Riding the Winds of Change: Alternatives for the Journey"
August 26-29
Santa Fe, NM
For more information, contact:
NARMH
3700 W. Division Street
Suite 105
St. Cloud, MN
(320) 202-1820
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7. Other
a. Rural Issues: Traumatic Brain Injury
The Research and Training Center on Rural Rehabilitation Services at the University of Montana forwarded to us a January 2002 article about traumatic brain injury and its implications for rural residents. The research shows that the states with the highest rates of traumatic brain injury-related fatalities all have large rural populations. The typical causes of traumatic brain injury include vehicular crashes, a mortality factor more common in rural areas than in urban areas, falls, acts of violence, and sports injuries, with alcohol being associated with half of all TBIs and substance abuse a being a significant risk factor for TBI. The highest incidence of TBI is among persons aged 15-24 and those aged 75 and older.
The article notes that it appears that residents of rural and remote U.S. counties may be at greater risk than urban residents both for incurring traumatic brain injuries and of dying from traumatic brain injuries. Rural TBI survivors and their families also experience unique problems in transitioning from rehabilitation hospital to home and in accessing services and supports: (1) rural people are less likely to be insured than their urban counterparts; (2) the combination of inadequate rural public transportation and the lack of access to professionals with expertise in TBI rehabilitation may impede a rural TBI survivor’s ability to become functionally independent. For further information, see the full text at: http://ruralinstitute.umt.edu/rtcrural/RuDis/TBIfacts.htm
b. Universal Service: Rural Health Care
Rural areas in Arizona that are eligible for universal service discounts for telecommunications are listed on the Universal Service Administrative Company Rural Health Care website: http://www.rhc.universalservice.org/
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