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The Office of Rural Health Policy (ORHP) will fund a cooperative agreement to support a Rural Assistance Center (RAC). The RAC is a gateway to information on rural health for residents in rural areas of the United States and for all others interested in the issue. Through daily interactions and responding to inquiries and concerns, the RAC will be able to ensure that ORHP and the Department of Health and Human Services are informed of developing and ongoing grass-roots issues in the rural U.S. The role of ORHP as the Department of Health and Human Service¿s focal point for rural information allows its staff to identify key regulatory and statutory issues. The staff of ORHP will work collaboratively with the RAC to prioritize key issues and develop information resources to share with callers and web users. It is also expected that RAC staff will produce publications to respond to emerging issues. ORHP and Department staff will review RAC proposals for publications to ensure that critical issues are appropriately identified. When publications are prepared for release, ORHP and Department staff will review them for accuracy and completeness. The awardee must be able to identify and facilitate access to information from a wide range of sources that deal with aspects of rural health care. ORHP will also coordinate information sharing between the RAC and the Rural Health Research Centers, the Rural Recruitment and Retention Network, State Offices of Rural Health, and other projects that are funded by the Office. RAC staff will work with ORHP to develop strategies for dissemination of key research findings and for providing synthesis of key research findings. The applicant should be familiar with providers of Technical Assistance (TA) for rural health care providers funded by ORHP and be able to make referrals, avoid duplication of services, and ensure that rural residents are directed to appropriate resources for their information needs. The awardee will provide

This announcement solicits applications for the Rural Health Care Coordination Network Partnership Program (Care Coordination Program). The purpose of the Rural Health Care Coordination Network Partnership Program is to support the development of formal, mature rural health networks that focus on care coordination activities for the following chronic conditions: diabetes, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD). Care coordination in the primary care practice involves deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient¿s care to achieve safer and more effective care. Rural Americans are unhealthier, with higher rates of chronic illnesses, such as diabetes, CHF, and COPD and have higher rates of high-risk behaviors such as smoking, physical inactivity, and poor nutrition.[1],[2],[3],[4] These high-risk behaviors cause many of the illnesses, suffering and deaths due to chronic diseases and conditions.[5] The increasing prevalence of chronic diseases and the high cost of health care in the U.S. bring treatment of the ¿whole¿ person to the forefront, especially as there are often psychosocial (psychological and social) issues related to chronic diseases; for example, there is a link between diabetes and depression. In addition, more mental health problems are seen in the primary care setting than other health care settings; thus, integrating behavioral health care into primary care helps address both the physical and psychosocial aspects of health and wellness. Reviews and reports from the Agency for Healthcare Quality and Research (AHRQ) have shown a positive impact from integrating a team approach to care for a variety of disease conditions.[6] Health care coordination for people living with chronic conditions is vital to providing high quality care, especially in rural areas where access to health care is an issue. The main goal of care coordi

This notice announces the opportunity to apply for funding under the National Rural Health Policy, Community, and Collaboration Program. The purpose of this program is to identify, engage, educate, and collaborate with rural stakeholders on national rural health policy issues and promising practices in an effort to improve the health of people living in rural communities nationwide. Program objectives include: (1) Identifying and educating rural stakeholders about national policy issues and promising practices for rural health. (2) Maintaining projects that will help support engagement of rural communities in a broad range of activities. (3) Facilitating partnerships and collaborations at the local, regional, state, and national levels to improve the exchange of information and promising practices that support rural health. (4) Identifying and promoting broader collaborative federal efforts to support, promote, and address unique rural health issues. A successful program will continue to build upon the federally funded resources that currently exist, leverage the broad network of rural health organizations and individual subject matter experts, and provide a mechanism for the Federal Office of Rural Health Policy (FORHP) to engage with public rural health stakeholders beyond Health Resources and Services Administration (HRSA) funded award recipients and current partners to add value, information, and support to rural communities.

This announcement solicits application for  the State Offices of Rural Health Coordination and Development Program (SORHCDP). The purpose of the SORHCDP is to enhance the rural health infrastructure in each State by continuing to develop and provide leadership development and technical assistance activities to State Offices of Rural Health (SORHs) and their partners to better coordinate and improve rural health services. The goals of the SORHCDP are to help SORHs: ·       Assist in the coordination of rural health care through the education and development of State level rural health leadership; and ·       Facilitate partnerships and collaboration at the local, regional, State, and national levels to improve the exchange of information and best practices that support rural health. The cooperative agreement assists SORHs to increase their performance in key areas and become more efficient and effective. The cooperative agreement will involve an ongoing partnership with the Federal Office of Rural Health Policy (FORHP) staff in the final development and implementation of the submitted work plan.

This notice announces the opportunity to apply for funding under the Rural Health Innovation and Transformation Technical Assistance (RHIT-TA) program. The purpose of this program is to provide technical assistance (TA) to rural stakeholders and the public to help them understand and engage in the value-based care landscape in the context of rural health care. In an effort to control health care costs and improve the quality of care, public and private payers have increasingly implemented initiatives to encourage value-based care. Value-based care programs reward health care providers for the quality of care through the realignment of financial incentives towards value over volume. Because of the unique economic factors affecting rural providers, the implementation and effects of value-based care initiatives may look different in rural, low-volume settings. For example, low patient volumes, along with low margins, in rural settings can make it more difficult to absorb the financial risks associated with value-based care. Start-up costs for value-based care may seem prohibitive for some, while small volumes may make it more difficult to measure value and may increase the risk of skewed outcomes. At the same time, value-based care initiatives are evolving towards risk-based models, and there is a need to help stakeholders and the public understand how these changes affect rural health care. Therefore, a major goal of this funding opportunity is to support the ability of rural providers to participate and succeed in current and emerging payment and delivery system models designed to provide value-based care. Value-based care is one of the four priorities of the United States Department of Health and Human Services (HHS).

The purpose of this program is to support integrated rural health care networks that have combined the functions of the entities participating in the network, including skilled and experienced staff and a high functioning network board, in order to address the health care needs of the targeted rural community. Recipients will combine the functions of the entities participating in the network to address the following legislative aims: (i) achieve efficiencies; (ii) expand access, coordinate, and improve the quality of essential health care services; and (iii) strengthen the rural health care system as a whole. The RHND Program encourages innovative solutions to local health care needs identified by local communities and supports rural communities in preparing for changes within the health care environment. Furthermore, the program creates an opportunity for rural health networks to collaboratively address the key priorities of the U.S. Department of Health and Human Services (HHS): mental health, substance use disorder, and value-based care. The overarching goals for the RHND Program are to: * Improve access and quality of health care in rural areas through sustainable health care programs created as a result of network collaboration; * Prepare rural health networks for the transition to value-based payment and population health management; * Demonstrate improved health outcomes and community impact; * Promote the sustainability of rural health networks through the creation of diverse products and services; * Utilize and/or adapt an evidence-based or promising practice model(s) in the delivery of health care services.

This notice announces the opportunity to apply for funding under the Rural Health Care Services Outreach Program (Outreach Program). The Outreach Program is a community-based grant program aimed towards promoting rural health care services by enhancing health care delivery to rural underserved populations in the local community or region. Through consortia of local health care and social service providers, communities can develop innovative approaches to challenges related to the specific health needs in rural areas that expand clinical and service capacity in rural communities. The overarching goals for the Outreach Program are to: * Expand the delivery of health care services to include new and enhanced services exclusively in rural communities; * Deliver health care services through a strong consortium, in which every consortium member organization is actively involved and engaged in the planning and delivery of services; * Utilize community engagement and evidence-based or innovative, evidence informed model(s) in the delivery of health care services; and * Improve population health, and demonstrate health outcomes and sustainability In addition to funding Outreach programs through the Regular Outreach track, in FY 21, FORHP will also afford applicants a unique opportunity to take part in a national effort that targets rural health disparities through a second track called the "Healthy Rural Hometown Initiative."

This notice announces the opportunity to apply for funding under the Rural Communities Opioid Response Program - Rural Centers of Excellence on Substance Use Disorders (RCORP-RCOE). RCORP-RCOE is part of the RCORP initiative, which is a multiyear effort to reduce the morbidity and mortality of substance use disorder (SUD), including opioid use disorder (OUD), in rural communities at the highest risk for these conditions. RCORP-RCOE will provide up to three years of funding to support three Rural Centers of Excellence (Centers) on SUD. The purpose of RCORP-RCOE is to support the identification, translation, dissemination, and implementation of evidence-based programs and best practices "related to the treatment for and prevention of substance use disorders within rural communities, with a focus on the current opioid crisis and developing methods to address future substance use disorder epidemics."1 The Centers will engage in research to identify "science-based prevention, treatment, and other risk reduction interventions, including community-based approaches that may be replicable in other rural communities and associated professional training."2 After identifying rural-relevant interventions, the Centers will serve as a resource for "scientific and technical assistance to county and state health departments and other entities as identified seeking guidance on how to address the substance use disorder challenges in their community."

The purpose of this FOA is to fund a single interdisciplinary Coordinating Center to formalize and centralize support of the rural opioid initiative administered by NIDA and co-funded by CDC, SAMHSA, and ARC. This initiative was funded under RFA-DA-17-014 and RFA-DA-17-023 The Coordinating Center will provide scientific, technical, regulatory, ethical, and logistical support of data comparability, new data collection, and data integration; developing integrated rural opioid initiative datasets; assisting grantees with acquisition and analysis of local administrative and/or research datasets that enable evaluation of their implementation activities or augment their community assessments; conducting requested analyses that relate to the integrated rural opioid initiative datasets; developing and executing a rural opioid initiative publication and dissemination plan; and providing logistical support for in-person meetings, conference calls, and webinars that include the rural opioid initiative grantees and funders. The Coordinating Center will be represented on the rural opioid initiative executive steering committee, along with the funders and rural opioid initiative grantees.

This announcement solicits applications for the Rural Health Network Development (RHND) Program.  The purpose of this program is to support mature, integrated rural health care networks that have combined the functions of the entities participating in the network in order to address the health care needs of the targeted rural community.  Awardees will combine the functions of the entities participating in the network to address the following statutory charges:  (i) achieve efficiencies; (ii) expand access, coordinate, and improve the quality of essential health care services; and (iii) strengthen the rural health care system as a whole.

This announcement solicits applications for the Rural Health Network Development (RHND) Program.  The purpose of this program is to support mature, integrated rural health care networks that have combined the functions of the entities participating in the network in order to address the health care needs of the targeted rural community.  Awardees will combine the functions of the entities participating in the network to address the following statutory charges:  (i) achieve efficiencies; (ii) expand access, coordinate, and improve the quality of essential health care services; and (iii) strengthen the rural health care system as a whole.

This announcement solicits applications for the Rural Health Network Development Planning Grant Program (¿Network Planning¿).   The purpose of the Network Planning program is to assist in the development of an integrated healthcare network, if the network participants do not have a history of formal collaborative efforts.  Health care networks can be an effective strategy to help smaller rural health care providers and health care service organizations align resources and strategies, achieve economies of scale and efficiency, and address challenges more effectively as a group than as single providers.  The Network Planning program promotes the planning and development of healthcare networks in order to: (i) achieve efficiencies; (ii) expand access to, coordinate, and improve the quality of essential health care services; and (iii) strengthen the rural health care system as a whole.  The health care system is undergoing a significant amount of change and this can be particularly challenging for small rural providers.  The goals of the Network Planning program represent ways to help rural providers better serve their communities given changes taking place in health care, as providers move from focusing on the volume of services to focusing on the value of services.  This program brings together key parts of a rural health care delivery system, particularly those entities that may not have collaborated in the past under a formal relationship, to work together to establish and improve local capacity and coordination of care.  Furthermore, this program supports one year of planning with the primary goal of helping networks create a foundation for their infrastructure and focusing member efforts to address important regional or local community health needs.

This RFA encourages research to promote a greater understanding of the challenges faced by rural population groups, for the development (or adoption/adaptation) of evidence-based interventions that can reduce health risks faced by rural Americans. Both prevention and treatment interventions are needed to address rural health issues. Prevention strategies should address and measure reductions in risk factors and enhancement of protective factors, while treatment approaches would seek to measure and address amelioration of health in individuals living with existing conditions. To accomplish these goals, the research community will be encouraged to use a wide range of culturally appropriate methodological approaches that can enhance access to and acceptability of interventions in rural settings, such as telehealth and community-based prevention research, where appropriate. It is our hope that research supported under this RFA will contribute to our knowledge of the sustainability of health promotion and disease prevention strategies in rural settings.    

The primary purpose of this cooperative agreement is the establishment of a rural residency planning and development TA center to support HRSA's anticipated Rural Residency Planning and Development (RRPD) program, planned to start in FY 2019. The RRPD-TA awardee will identify and work with potential RRPD applicants to share resources and conduct preparatory work in anticipation of supporting the RRPD awardees. Contingent on the availability of resources, the secondary purpose of this cooperative agreement is to provide TA to other entities that a) would have been eligible for the RRPD program but did not apply, and b) were not selected for a RRPD program award. This cooperative agreement and the RRPD grant program are complementary and seek to expand the number of rural residency training programs and subsequently increase the number of physicians choosing to practice in rural areas.

DLT grants are designed to provide access to education, training, and health care resources for rural Americans. The DLT Program is authorized by 7 U.S.C. 950aaa and provides financial assistance to encourage and improve telemedicine and distance learning services in rural areas through the use of telecommunications, computer networks, and related advanced technologies that students, teachers, medical professionals, and rural residents can use. The regulation for the DLT Program can be found at 7 CFR part 1734 Subpart B. The grants, which are awarded through a competitive process, may be used to fund telecommunications-enabled information, audio and video equipment, transmission facilities, and related advanced technologies which extend educational and medical applications into rural areas. Grants are intended to benefit end users in rural areas, who are often not in the same location as the source of the educational or health care service.

This announcement solicits applications for the Rural Opioid Overdose Reversal (ROOR) Grant Program. The purpose of the ROOR program is to reduce the incidences of morbidity and mortality related to opioid overdoses in rural communities through the purchase and placement of emergency devices used to rapidly reverse the effects of opioid overdoses and the training of licensed healthcare professionals and emergency responders on the use of opioid devices. Community partnerships are an important component of this program and can be comprised of local emergency responders as well as other local non-profit and for-profit entities involved in the prevention and treatment of opioid overdoses. In addition, care coordination is essential to efforts in reducing incidences of morbidity and mortality related to opioid overdoses. As a result, this funding opportunity announcement is seeking innovative approaches that involve broad community partnerships which may include referral of individuals to appropriate substance abuse treatment centers where care coordination and communication is facilitated by a team of qualified health care providers. The ROOR goals are to: 1) Purchase naloxone and opioid overdose reversal devices and increase the availability in rural areas through strategic placement; 2) Train licensed healthcare professionals and others using the devices to recognize the signs of opioid overdose, administer naloxone, administer basic cardiopulmonary life support, report results, and provide appropriate transport to a hospital or clinic for continued care after administration; 3) Refer those with a drug dependency to appropriate substance abuse treatment centers where care coordination is provided by a team of providers; and Demonstrate improved and measurable health outcomes, including but not limited to, reducing opioid overdose morbidity and mortality in rural areas.

This funding opportunity is to fund a demonstration project addressing rural medical communications. The 2014 National Emergency Communications Plan (NECP) recognizes this evolving landscape with the involvement of new stakeholders and changes in technologies and policies impacting emergency communications Response agencies are becoming more connected to each other, requiring that need to communicate and share information during emergencies, such as public health, medical, and transportation agencies, critical infrastructure sectors, and the public. Emergency responders are not always trained for the types of incidents they encounter but can share valuable information and provide situational awareness during response and recovery efforts. Specifically, medical providers require communications systems and procedures to transmit patient information and coordinate an influx of patients following large-scale disasters. As the whole community increases its engagement during emergencies and as technology advances, the need for medical communications and trained personnel increases to ensure coordinated and effective response. To implement the 2014 NECP, OEC needs to improve its understanding of communications among emergency responders and medical personnel, especially in rural communities. To examine rural emergency medical communications, OEC is reestablishing the Rural Emergency Medical Communications Demonstration Project (REMCDP). The intent of REMCDP is to work with a public health or medical facility to examine communications barriers and identify solutions that enhance existing emergency communications infrastructure.

· The purpose of this cooperative agreement is to evaluate the impact of Rural Community Opioid Response Program (RCORP) initiatives which currently include the RCORP-Planning, RCORP-Implementation, and RCORP-Technical Assistance (RCORP-TA) activities, and to develop valuable RCORP-based evaluation tools and resources for use in rural communities and to inform future rural health initiatives. Working with all RCORP award recipients, the RCORP-Evaluation anticipated activities include collecting and analyzing award recipient-reported data, defining and implementing impact indicators to assess the effectiveness of TA and award recipient activities, working with the RCORP-TA provider to identify RCORP best practices, using RCORP findings to identify research needs, and making recommendations to enhance RCORP activities and inform future rural health initiatives.

This notice announces the opportunity to apply for funding under the Rural Health Network Development Planning Program ("Network Planning"). Health care networks can be an effective strategy to help smaller rural health care providers and health care service organizations align resources and strategies, achieve economies of scale and efficiencies, and address challenges more effectively as a group than as single providers. For example, a critical access hospital, a community health center, and a public health department may collaborate to form a network around a shared purpose. Other examples of health care providers could be: hospitals, public health agencies, home health providers, mental health centers, substance abuse service providers, rural health clinics, primary care providers, oral health providers, social service agencies, health profession schools, local school districts, emergency services providers, community and migrant health centers, federally-qualified health centers, tribal health programs, churches, faith-based organizations, and civic organizations that are/will be providing health care. The goals of the Network Planning program are centered around approaches that will aid providers in better serving their communities given the changes taking place in health care, as providers transition from focusing on the volume of services to focusing on the value of services. The intent is that rural health networks will expand access to care, increase the use of health information technology, explore alternative health care delivery models, and continue to achieve quality health care across the continuum of care from prevention and wellness to acute and long-term care.

The purpose of this Funding Opportunity Announcement (FOA) is to reduce the burden of cancer and improve the quality of cancer care in rural areas among low-income and/or underserved populations. The FOA encourages two types of applications: 1) observational research that includes pilot testing of intervention to understand and address predictors of cancer care/treatment and outcomes in rural low-income and/or underserved populations; or 2) intervention research to address known predictors of cancer care/treatment and outcomes in rural low-income and/or underserved populations. Specifically, the focus for observational studies (with pilot testing) is understanding and addressing the predictive and/or mediating role of social determinants of health, barriers to care, and treatment; and the focus for interventional research is on addressing quality of care related to cancer diagnosis, treatment and/or survivorship. Most existing cancer control interventions are not ready for direct implementation and dissemination in low-income rural areas, so proposals should seek to develop, adapt, and/or implement, and test interventions.

This notice announces the opportunity to apply for funding under the National Rural Health Information Clearinghouse Program. The purpose of this program is to serve as a national clearinghouse for information on rural health to support access to healthcare and improve population health in rural communities. A successful program will continue to build upon the federally funded resources that currently exist and serve as a primary resource for information, opportunities, and tools related to rural health.