Rural Health and Primary Care
What's New and Featured Resources
The next listening session will be held at Millinocket Regional Hospital in Millinocket on Monday, February 3rd at 6:00pm.
The Maine Department of Health and Human Services is working to make health care better in rural parts of the state and wants to hear from people living in Millinocket and surrounding communities. Please come and share your thoughts about what is most important to you when you think about health care.
Certification Program for Primary Care Tax Credit
Applications for the Primary Care Access Tax Credit Certification Program (Tax Year 2019) are now available. Eligible candidates are encouraged to apply. Awards are made on a first come, first served basis to eligible candidates who submit complete applications with all necessary supporting documentation. Please follow the instructions carefully.
Please note that applications must be sent by U.S.P.S. mail and must be postmarked during the time-limited submission period of January 15, 2020 through February 18, 2020. Submissions with a postmark before January 15, 2020 or after February 18, 2020 will not be accepted. Please also note that this application is for new applicants only. Applications will be mailed to individuals seeking continued eligibility.
Certification Program for Dental Care Tax Credit
Applications for the Dental Care Access Tax Credit Certification Program (Tax Year 2019) are now available. Eligible candidates are encouraged to apply. Awards are made on a first come, first served basis to eligible candidates who submit complete applications with all necessary supporting documentation. Please follow the instructions carefully.
Please note that applications must be sent by U.S.P.S. mail and must be postmarked during the time-limited submission period of January 15, 2020 through February 18, 2020. Submissions with a postmark before January 15, 2020 or after February 18, 2020 will not be accepted. Please also note that this application is for new applicants only.
HRSA Scholarships for Disadvantaged Students
The Health Resources and Services Administration (HRSA) will make approximately 79 awards from a total investment of $48.2 million. The program funds eligible academic institutions that train health profession students. The institutions then make scholarships available to students from disadvantaged backgrounds who have financial need. Eligible applicants are accredited schools of allopathic and osteopathic medicine, dentistry, nursing, pharmacy, podiatric medicine, optometry, veterinary medicine, public health, chiropractic, and allied health; schools offering a graduate program in behavioral and mental health practice; and programs for physician assistant training. Students should contact their financial aid office to find out if their school participates.
Other announcements from the Office of Rural Health Policy: Week of January 9, 2020 (PDF)
Webinar: How to Win the Tyranny of Small Number: Coalitions, Collaborations and Networks
The Center for Optimizing Rural Health (CORH) is hosting an upcoming webinar on January 14th at 12:00 PM CST. This one hour webinar will discuss how payors view rural, low volume providers and identify barriers and solutions for rural providers in the current value based climate. Speaker Shannon Calhoun will also explore collaborations, coalitions and networks as a way to engage in better payor relations and negotiations. There will be designated time at the end of the presentation for Q&A. Mrs. Calhoun is a distinguished healthcare executive with 24 years of experience in the industry. Mrs. Calhoun has spent the last five years in network and business development in value-based healthcare transformation and alternative payment models with an emphasis on Practice Transformation and Collaborative Accountable Care Organizations. Much of Shannon's work focuses on programs that better position providers for healthcare payment and delivery reform with the goal of creating sustainable solutions for both the network and the network's healthcare members.
Applying for the National Health Service Corps Substance Use Disorder Workforce Loan Repayment Program or the Rural Community Loan Repayment Program? Get Your DATA 2000 Waiver
One of the tools to combat the opioid crisis is increasing the number of clinicians who are eligible to provide medication-assisted treatment (MAT) services. The Substance Abuse and Mental Health Services Administration (SAMHSA) provides free MAT training and resources, via the Providers Clinical Support System (PCSS)1, for eligible clinicians. After completing MAT training, eligible clinicians can request DATA 2000 waivers to treat opioid dependency with approved buprenorphine products.
Applicants for the NHSC SUD Loan Repayment Program or the Rural Community Loan Repayment Program may receive priority if they have DATA 2000 waivers.
Overview of Behavioral Health in Rural America.
For a deeper examination of behavioral health in rural areas, the Rural Policy Research Institute provides an overview of mental health conditions and contributing factors, and proposes policy options to address them.
Other announcements from the Office of Rural Health Policy: Week of December 19, 2019 (PDF)
Learning Opportunities to Address Special Populations
Tools and Strategies to Assist Providers Working with Farmers will be held Monday, December 16th at 1:00pm.
Experts will Experts will share tools and strategies to address the mental health needs of farmers, ranchers, and agricultural workers. The webinar is hosted by the Mental Health Technology Transfer Center Network, with support from the Substance Abuse and Mental Health Services Administration.
Supportive Services for Older Rural Adults will be held Tuesday, December 17th at 1:00pm.
In this hour-long webinar hosted by the Rural Health Information Hub, national experts will discuss work by the National Advisory Committee on Rural Health and Human Services to expand policy and programs for older adults.
- Tools and Strategies to Assist Providers Working with Farmers
- Supportive Services for Older Rural Adults
Other announcements from the Office of Rural Health Policy: Week of December 12, 2019 (PDF)
Value Based Care in Rural Hospitals: Managing Time and Resources to Improve Quality of Patient Outcomes to be held on Wednesday, December 18th from 3:00-4:00pm.
Value-based care is a shift in the health care environment that has the potential to benefit everyone in health care from patients and providers to payers and even suppliers. For starters, it can help lower costs, raise patient satisfaction, and make your health care organization more efficient. In this session, attendees will learn more about tools available to help bring their organization closer to the value-based care model, and why these tools should be used in rural hospitals.
Preventing Hepatic Encephalopathy in Patients With Cirrhosis to be held on Tuesday, January 7th at 7:30pm
This session will explore complexities of managing hepatic encephalopathy through case-based discussion. Learn about the pathophysiologic processes and neurologic manifestations of the various stages of HE due to cirrhotic liver disease. Attendees will also learn how to monitor and effectively manage patients at risk for recurrent HE and review the mechanisms of actions, administration, effectiveness, and adverse events of oral therapies that can be used to maintain serum ammonia concentrations at safe levels in patients with a history of HE.
Federal New Markets Tax Credit Subsidy to be held on Thursday, January 9th 3:00-4:00pm
Health care and urgent care borrowers whose facilities, equipment and operations are located in economically distressed rural communities are excellent candidates for the federal new markets tax credit subsidy. This subsidy is in the form of either (a) a forgiven loan with approximate interest-only payments during the 7-year compliance period (which is forgiven at the end of such period), or (b) a loan with below-market interest-only payments during the 7-year period which matures up to 40 years (which can be well beyond any secured asset's useful life).
Learn the intent of the Program; why health care and urgent care borrowers are good candidates; the economic benefits; legal and underwriting requirements; whether the borrower qualifies for the forgiven loan or the non-forgiven loan; the steps to obtain such financing; how the financing technically works; and the unwind of the financing at the end of the 7-year compliance period.
Driving Financial Sustainability and Population Health in Rural Health to be held on Tuesday January 14th from 3:00-4:00pm
We are raising the standard of what it means to be rural health care organization by using analytics to drive financial stainability and population health in rural communities. This session will present a data-driven strategy that is proven effective in supporting rural health care organizations transform with health care’s modern and value-based initiatives. Because rural health care is resource limited, the level of success increasingly depends on the ability to streamline performance management. This presentation will focus on the strategies used to improve financial and clinical outcomes through analytics and a performance improvement methodology.
- Value Based Care in Rural Hospitals: Managing Time and Resources to Improve Quality of Patient Outcomes
- Preventing Hepatic Encephalopathy in Patients With Cirrhosis
- Federal New Markets Tax Credit Subsidy
- Driving Financial Sustainability and Population Health in Rural Health
National Rural Health Day
Thank you to all who came to the Rural Health and Primary Care Program's NRHD event at the Hall of Flags to thank all the providers, administrators and support personnel who have committed themselves to providing care to the rural and underserved residents of Maine, celebrate the successes and bring attention to the work that still needs to be done. A big thank you also goes out to Commissioner Lambrew for speaking and congratulations go out again to our awardees:Kris Doody, RN, CEO; The Maine AHEC Network and Teresa Alley, RDH.
Today is not too early to be thinking about what you can do to celebrate National Rural Health Day 2020.
J-1 Visa Waiver Program
Also known as the Conrad State 30 Program, the J-1 Visa Waiver Program helps address shortages of qualified doctors in rural areas. In exchange for a waiver of certain visa restrictions, including the two-year foreign residency requirement, international medical graduates agree to complete their medical training in the United States and practice primary care for at least three years at an eligible site.
All slots are currently filled. The next application cycle will begin on October 1, 2020.
Note to attorneys and future applicants: Updates to the J-1 Visa Waiver application process are likely to be enacted within the next year. Please check for new rules prior to preparing and submitting applications for the 2020 application cycle.
Public Health and Transportation Webinar Series Part One: Collaborating Together for Community Health
Part one of our public health and transportation webinar series will focus on how public health and transportation professionals can work together to support community health and well-being. This webinar will provide an opportunity for mobility management and transportation practitioners to hear from public health professionals on potential areas for collaboration between the two sectors, and discuss ideas for developing, implementing, and evaluating initiatives to improve community health.
- Webinar registration
- Other announcements from the Office of Rural Health Policy: Week of September 26, 2019 (PDF)
Free Educational Opportunity: 3RNet's 2019 Academy
As National Health Service Corps slots and State Loan Repayment Programs become more competitive, it is more important than ever to learn new strategies to recruit providers and then keep the providers that we have already incentivized to remain.
3RNet's 2019 webinar series, Recruiting for Retention Hierarchy: Building the Foundation, will examine the recruiting process - everything from planning and preparation to sourcing to closing the deal. Without a well defined recruitment process, employers will be hard pressed to succeed in recruitment efforts.
The Maine Rural Health and Primary Care Program is offering this educational opportunity to all working in Maine's rural and underserved facilities at no cost. Register Now!
The Shortage Designation Modernization Project and Auto HPSA Update
The Shortage Designation Project is a Health Resources and Services Administration (HRSA) initiative to modernize current shortage designation processes while maintaining transparency, accountability, and parity. The project is currently in Phase 2, which includes updates to all auto-HPSA facilities of the following types:
- Federally Qualified Health Centers
- Federally Qualified Health Center Look-Alikes
- Tribally-Run Clinics
- Urban Indian Organizations
- Dual-Funded Tribal Health
- Federally-Run Indian Health Service Clinics
- Rural Health Clinics meeting NHSC site requirements
The impact analysis portion of the project is now complete and the portal is ready for use. The Maine Primary Care Office is in the process of analyzing data and initiating supplemental data rescores. Should HRSA accept the documentation that will be submitted, all 47 organizations should receive an additional two points for their mental health designation due to alcohol and substance misuse and approximately 75 percent of organizations should receive an additional point for their dental health designation due to lack of fluoridation. Nearest Sources of Care are currently under review.
Detailed information regarding the project can still be found at the Shortage Modernization Project Website. Please contact the office should you have any questions.
Networking/Learning Opportunity: Mobility Management Peer Learning Network
Join other transportation stakeholders on the third Tuesday of every other month from 12-1 to learn about mobility management from your peers. Each learning session will cover either a different aspect of mobility management or a different way mobility management is applied in Maine.
Funding Opportunity: Teaching Health Center Graduate Medical Education Program
The Health Resources and Services Administration is accepting applications for the fiscal year 2020 teaching Health Center Graduate Medical Education Program. The program provides funding to support the training of residents ina new or expanded primary care residency training program in rural and underserved communities. Eligible applicants are community-based ambulatory patient care centers that sponsors the training of an accredited primary care residency program. The application cycle closes on August 30, 2019.
Now Available: Sentinel Events Newsletter
The latest newsletter prepared by the Sentinel Events Team of the Division of Licensing and Certification is now available. Errors in electronic health records, diagnostic overshadowing and medical malpractice are topics that are examined in this issue.
Save the Date: The Maine Committee on Trauma Annual Conference
The MCOT Annual Conference will be held on November 6, 2019 at the Samoset Resort in Rockport, Maine. This Conference is a shared endeavor of the Trauma Programs at Central Maine Medical Center, Northern Light Eastern Maine Medical Center and Maine Medical Center, in collaboration with Atlantic Partners EMS. The conference is designed for Physicians, Physician Assistants, Nurse Practitioners, Nurses, EMS Providers, and other clinicians. The educational focus is on current issues and trends in trauma and critical care.
Registration and conference details to follow.
National Health Service Corps (NHSC) Rural Community Loan Repayment Program (LRP) is open through July 18, 2019
A new National Health Service Corps Program, the Rural Community Loan Repayment Program, will expand and improve access to quality opioid and substance use disorder (SUD) treatment in our rural, underserved areas nationwide. Health care clinicians qualified to provide SUD treatment may be eligible for this loan repayment in return for service at an NHSC-approved SUD treatment facility.
Congratulations to Redington-Fairview General Hospital and Wabanaki Health and Wellness
Redington-Fairview General Hospital and Wabanaki Health and Wellness have recently received grants from the Health Resources and Services Administration to implement and sustain SUD/OUD prevention, treatment, and recovery services in rural communities.
For more information:
Other announcements from the Office of Rural Health Policy: Week of May 16, 2019 (PDF)
Certification Program for Primary Care Tax Credit
The Department of Health and Human Services has awarded the tax credit certification to eligible primary care professionals for tax year 2018. Certificates were awarded in accordance with 10-144 Chapter 298 – Rules Governing the Certification Program for Primary Care Tax Credit (effective date: May 19, 2016).
This serves as notice to unsuccessful applicants. No other notice will be sent. Unsuccessful applicants may reapply in a subsequent tax year.
The submission period for tax year 2019 will open next January. Applications will be made available on this website at that time.
Rural Medical Access Program
The application period is now closed for the Rural Medical Access Program (RMAP). RMAP provides financial incentives, in the form of reimbursement of insurance premiums, to ensure the availability of doctors who provide prenatal care and deliver babies in rural and underserved communities. Eligibility is determined by the The RHPCP in collaboration with the State Bureau of Insurance. The next application cycle will open in March 2020.
Attention: NHSC sites
Is your facility a National Health Service Corps site? If so, the primary care office division of the Rural Health and Primary Care Program would like to remind you that, in return for recruitment/retention resources and assistance, facilities must continually meet Program requirements. In addition, unless auto-approved, facilities must complete recertification applications once every three years. Program information and requirements are all outlined in the most recent NHSC Site Reference Guide (PDF). You may wish to pay particular attention to some areas of concern from some recent reviews:
- Have you updated your nondiscrimination statement to include all protected categories? Not sure? Check out the poster (PDF).
- Is your sliding fee schedule out-of-date? The 2019 guidelines are available.
- Does your sliding fee policy have conditions beyond proof of family income and family size? Eligibility cannot include other factors such as assets, insurance status, participation in the Health Insurance Marketplace, citizenship, population type, etc. See page 16 of the Guide (PDF) and page 3 of the Information Package (PDF).
Please contact the Rural Health and Primary Care Program should you have any questions.
New Resource from RHIhub: Human Services to Support Rural Health
A new topic guide launched last month at the Rural Health Information Hub provides a comprehensive look at social determinants of health and the role that factors such as food assistance, job training, and safe housing play on the overall health of rural communities. The guide uses data from the U.S. Department of Agriculture’s Economic Research Service and other federal data sources to scope social and economic well-being in rural areas, reviews federal assistance programs, and answers a list of frequently asked questions about integrating social services with health care.
Other announcements from the Office of Rural Health Policy: Week of April 4, 2019 (PDF)
New Data on Suicide Mortality and Drug Overdose Deaths
Using data from the National Vital Statistics System (NVSS), the Centers for Disease Control and Prevention (CDC) recently released a report on rates of suicide in the United States from 1999 to 2017. The data brief ranks suicide as the second leading cause of death for people aged 10-34 and the fourth leading cause for ages 35-54. For the most recent year studied, the age-adjusted suicide rate for the most rural counties was nearly twice (1.8 times) the rate for the most urban counties.
In a separate data brief from the CDC, the NVSS showed there were 70,237 drug overdose deaths in 2017. Maine was one of 20 states having a drug overdose death rate higher than the national rate (21.7 per 100,000).
- Suicide Mortality in the United States, 1999–2017
- Drug Overdose Deaths in the United States, 1999–2017
Other announcements from the Federal Office of Rural Health Policy: Week of December 6, 2018 (PDF)
Evidence-based Toolkits for Rural Community Health
These step-by-step guideson subjects including care coordination, health promotion and community health workers, provide resources and examples drawn from evidence-based and promising programs for rural communities. The toolkits glean information from HRSA/FORHP-funded grant programs to showcase what works and why and are made available by NORC Walsh Center for Rural Health Analysis and the University of Minnesota Rural Health Research Center in collaboration with the Rural Health Information Hub.
Other announcements from the Federal Office of Rural Health Policy: Week of June 28, 2018 (PDF)
Are you an employer in a rural area looking for a health care provider? Are you a health care professional looking for an opportunity in Maine?
3Rnetis a national network that matches health care professionals with employers in rural areas. Register today! It is a free resource for both health care professionals and health care facilities located in rural Maine.
Promoting access to quality health care for Mainers living in rural and underserved areas.
- Increase resources and reduce costs for health care statewide with a focus on rural areas;
- Facilitate communication among stakeholders on rural health issues;
- Increase access to primary, mental and dental health care services for underserved populations;
- Reduce geographic, financial, transportation and other barriers that prevent access to health care services.