ORH wants to acknowledge the difficult situation that many of our rural communities are facing with fires burning across the state. We thank our first responders, clinicians and facility staff for their hard work during these past six months. Starting with COVID-19 and now dealing with fires causing destruction to our communities, your hard work and dedication is an inspiration to all of us and will help rural Oregon come through these challenges.

November 2020 is Oregon Rural Health Month

November is Oregon Rural Health Month! Governor Kate Brown has proclaimed November Oregon Rural Health Month to celebrate Oregon’s rural hospitals, clinics and providers.  It also recognizes the extraordinary work they have done to meet the challenges of the COVID-19 pandemic. Read the full proclamation here.

National Rural Health Day is November 19

To help you celebrate Rural Health Month and National Rural Health Day, get the free Community Engagement Toolkit from NOSORH including downloadable, customizable tools, such as posters, coloring books, postcards, graphics, and more available here. Or contact the ORH and let us help you come up with some great ideas!

ORH Conference Registration is Now Open

Registration is live for the 37^th Annual Oregon Rural Health Conference and the 2020 Rural Health Clinic Workshop. New this year, both events are entirely virtual!

Conference sessions are spread out in short blocks of time over six days, with topics covering the latest solutions for health care systems from facing the problems presented by COVID-19 to the challenges of delivering effective health care in the rural environment. Thanks to our loyal partners, AllCare Health and the Oregon Rural Health Association, who are supporting this educational event, there is no cost for the RHC Workshop or the conference this year. Please note that there is a $30 charge for those seeking CE credits.

Accreditation: Oregon Health & Science University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit:  OHSU School of Medicine designates each live activity for the number of AMA PRA Category 1 Credits™ listed below. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

RHC Workshop: Live activity, 6.0 AMA PRA Category 1 Credits™

37^th Annual Rural Health Conference: Live activity, 14.5 AMA PRA Category 1 Credits™

2020 Forum on Aging in Rural Oregon Continues Online

More sessions coming in September and October!

In response to COVID-19, ORH revamped the originally scheduled Forum on Aging in Rural Oregon. Since April we have partnered with outstanding organizations and speakers to provide virtual learning opportunities on timely rural aging content, including:

• Assistive technology
• Hospice and long-term care during COVID-19
• De-escalation approaches
• Finding meaning and purpose during these unusual times
• Elder financial exploitation and scams

If you would like to receive upcoming Forum on Aging in Rural Oregon announcements, please contact Rose Locklear. The slides and recordings from previously aired online sessions can be found on the Forum webpage.

Upcoming Geriatric Opioid Conference

Registration is now open for the Addressing Geriatric Opioid Prescribing and Opioid Misuse – Prevent Opioid-Related Harms in Older Adults in Rural Oregon Conference, which will be held October 22, 2020 from 8:30 am to 5:00 pm on Zoom.

Course highlights include:

• Discuss the fundamentals of opioid use disorder (screening, diagnosis, and treatment)
• Address non-opioid alternatives to pain treatment (increasing the use of evidence-based practices for acute and chronic pain)
• Learn the most up-to-date information highlighting improper opioid prescribing in older adults

This conference is American Academy of Family Physicians CME approved.

For questions of additional information, please email jpalmer@pacificu.edu.

Recruitment for Retention Education Opportunity

ORH is offering an education opportunity to Oregon practice sites. Join us October 6, 2020 for the kick off for the 2020 3RNet Academy webinar series. This year’s theme is Recruiting for Retention Hierarchy: Strategically Market Using Candidate Motivations!

For more information on the upcoming Recruiting for Retention Academy, contact Stacee Reed, Program Manager for Recruitment & Retention.

Oregon Practice Opportunities Promoted at National AAFP Residency Conference

Stacee Reed, ORH Program Manager for Recruitment Services, promoted rural Oregon practice opportunities at the 2020 American Academy of Family Physicians (AAFP) National Conference for Family Medicine Residents & Medical Students. 

This year’s all virtual AAFP Conference brought together family medicine residents and medical students to attend workshops, procedural skills courses, and access residency programs from across the country. ORH worked in partnership with 3RNet, the national nonprofit linking health professionals with practice opportunities in rural and underserved communities. The team encouraged medical students to attend Oregon-based residency programs, and Oregon family medicine residents to stay and work in rural Oregon.

Oregon Health Care Provider Loan Repayment Application Cycle Closes Soon

Oregon Health Care Provider Incentive Loan Repayment offers licensed health care providers, as well as pre-licensed mental health providers, an opportunity to apply to receive tax-free funds to repay qualifying educational loan debt. The current provider application cycle closes at 5:00 pm on October 29, 2020. Eligible providers are highly encouraged to apply as early in the cycle as possible to allow time for information requests about their application.

Eligible providers who are unable to submit a completed application before the October 29 deadline may apply in the next program application cycle, which opens October 30, 2020 and closes on January 28, 2021. For more information, including qualification requirements, FAQs, and applications visit the program’s webpage.

New Application Cycle of the Oregon Partnership State Loan Repayment Program is Open

The 2020-2021 Oregon Partnership State Loan Repayment Program (SLRP) provider application cycle has begun. Unlike most loan repayment programs, SLRP’s provider application process is not competitive. As long as SLRP funds are available, an eligible provider who meets all program requirements, submits a complete application, and works at a SLRP qualifying practice site will receive an award. An awardee’s practice site must provide 50% of the award amount, plus a 10% administrative fee.

If an awardee is funded at an amount that is fiscally unfeasible for their practice site to participate, the awardee and practice site may negotiate an award amount that would allow the practice site to participate. For more information on, including provider and site applications, please visit the program’s webpage.

Rural Medical Practitioners Insurance Subsidy Program

Annual affidavits for eligibility within the Rural Medical Practitioners Insurance Subsidy Program for all of 2021 will be accepted between October 1 and December 31, 2020. Affidavits submitted prior to October 1 are applied towards 4^th quarter 2020. Affidavits submitted after December 31 are applied towards 2^nd quarter 2021.

Emails will be sent to all participating practitioner’s email address on file reminding them to renew for 2021 prior to the end-of-year deadline.

Rural Volunteer Emergency Medical Service Provider Tax Credit

Tax year 2021 applications and renewal forms for the Rural Volunteer Emergency Medical Service Provider Tax Credit will be posted to the ORH website the first week in December.

Emails will be sent to all participating EMS Provider’s email address on file reminding them to renew for tax year 2021.

Oregon Rural Practitioner Tax Credit

Tax year 2021 applications and renewal forms for the Oregon Rural Practitioner Tax Credit will be mailed to all participating practitioner’s home addresses the first week in January.

Emails will be sent to all participating practitioner’s email address on file reminding them to renew for tax year 2021.

Workplace Safety for Rural Hospitals

Patient-assist injuries are a significant and costly occupational health problem for health care organizations. Hospital staff often overexert themselves during patient transfers (Dressner, 2018) leading to much higher rates of injury (48.1 and 180.5 per 10,000 workers) compared to all other occupations (32.2 per 10,000) (Bureau of Labor Statistics, 2016). These injuries cost health care organizations $15,860 per workers’ compensation claim (Dressner, 2017) and between $37,700 and $58,400 for each turnover replacement (Nursing Solutions Incorporated, 2019).

When health care workers face a safety risk at work, they frequently reach out to co-workers before supervisors (Lawton & Parker, 2002; MacPhee & Scott, 2002) (Pravikoff, Tanner, & Pierce, 2005). For these reasons, safety programs typically recommend having champions or frontline workers who impact safety through peer feedback and role modeling safety, as well as advocating safety at various levels of an organization (Soo, Berta, & Baker, 2010). The safety champions study is designed to help organizations address patient-assist injuries in a cost-effective manner for workers and patients as well as to sustain annual improvements by providing professional development opportunities to your most influential staff.

The safety champion study identifies the most influential frontline workers through Social Network Analysis (SNA), a statistical technique that detects which workers are perceived by their peers as safety savvy. Detected workers are invited to complete leadership and quality improvement training workshops. And perhaps more importantly, the program encourages hospital leaders to meet with champions on a regular basis to collaborate for quality improvement plans and actions.

Preliminary research indicates that SNA can identify workers who indeed are most likely to use safety equipment during patient transfers and best prepared to teach others. The pilot study—Safety Champions—conducted at a Critical Access Hospital in Oregon more than doubled equipment use and decreased the annual injury rate by 75% during a time that hospital patient volume and complexity increased substantially.

Researchers are looking to expand this successful program across Oregon Critical Access Hospitals to include patient outcomes. If you are interested in learning more about this opportunity to support and participate in safety champions research, please contact Dr. David Hurtado, Sc.D., and download the study recruitment flier.

SHIP (Small Rural Hospital Improvement Program) COVID-19 Awards Underway

All 32 of Oregon’s SHIP-eligible hospitals received SHIP COVID awards in the amount of $84,317. Funding for this supplementary SHIP award was provided from the Coronavirus Aid, Relief, and Economic Security (CARES) Act, and is intended to provide support for expenditures to plan, prepare and respond to the coronavirus pandemic.

All awards have been obligated and are 95% paid. A first quarterly report was submitted to HRSA July 31, with approximately 55% of the total funds having been spent. Oregon awardees reported the following allocation of their expended funds:

Maintaining Hospital Operations: 50%

Funds allocated to this category include expenditures to:

• Support permanent and contracted personnel salaries in response to COVID-19 impacts.
• Provide paid leave for exposed or vulnerable hospital staff.
• Develop new and/or update existing patient registries to inform workflows that will support continuity of services to patients whose access has been limited by COVID-19 response.
• Purchase equipment to enhance electronic tracking, data exchange, reporting and billing.

COVID Safety: 35%

Expenses allocated to this category include:

• Purchase of supplies for respiratory hygiene and cough etiquette.
• Purchase of personal protective equipment (PPE).
• Purchase and installation of visual alerts and signage, and temporary space reconfigurations and barriers.

This category also includes work to review, update, and/or implement emergency operations plans and infection control, including staff training and workflow updates.

COVID Response: 15%

This allocation category includes expenditures such as:

• Support of COVID-19 testing and laboratory costs, including purchasing COVID-19 tests, specimen handling and collection, storage, and processing equipment.
• Purchase of equipment— such as ventilators and respiratory equipment—to treat patients impacted by COVID-19.
• Enhancement of telehealth infrastructure to perform triage, care and follow-up via telehealth—including patients in their homes, community settings and public housing, and patients with unstable or no housing.
• Creation of enhanced workflows, health information exchange capacity, and data exchange to support communications with public health partners, centralized assessment locations, and other health care providers.

The SHIP COVID project period lasts through September 30, 2021, though it is anticipated that Oregon awardees will fully expend all awards by the close of 2020.

Please email Rebecca Dobert, Program Manager, or call (971) 271-0481 for any and all SHIP questions.

2020 Helping EMS in Rural Oregon (HERO) Agency Training Grants Awarded

ORH is pleased to announce the award of the 2020 Helping EMS in Rural Oregon (HERO) grants.

HERO awards provide training resources, supplies and materials to rural and frontier EMS agencies. These often all-volunteer agencies face many challenges:

 “In the last five years, the number of volunteers within our service area declined 34% and the call volume increased by 62%.”

“We recently had to replace obsolete heart monitors…this took two budget cycles to complete and put a severe drain on our EMS budget.”

“Our training budget was removed due to the COVID-19 crisis.”

A generous donation from the Board of the former Port Orford Community Ambulance service was made to fund this valued program. The gift provided $2,500 awards to support four rural and/or frontier agencies:

1. Falls City Volunteer Fire Department;
2. Idanha-Detroit Rural Fire Protection District;
3. Pilot Rock Fire Department; and
4. Sherman County EMS.

ORH was also able to provide additional funding to HERO applicants with funds that were redirected from work that was rescheduled due to COVID-19.

Partial awards were made to:

1. Blue Mountain Hospital District EMS;
2. Mist-Birkenfeld Rural Fire Protection District;
3. Siuslaw Valley Fire and Rescue; and
4. Sweet Home Fire and Ambulance District.

The 2020 awards will support a wide variety of projects, including:

• Advanced Cardiac and Pre-Hospital Trauma Life Support training;
• Emergency Medical Responder and Emergency Medical Technician-Advanced instruction and materials for volunteers; and
• Provision of Personal Protective Equipment (PPE), trauma supplies and Stop the Bleed training kits for crews.

The support will provide these resources for responders from Columbia, Grant, Lane, Linn, Marion, Morrow, Polk, Sherman and Umatilla Counties.

More information about the HERO program and how to make a donation, is available on the ORH website or by contacting Program Manager Rebecca Dobert I 971-271-0481.

ORH Awards Scholarships In Lieu of 2020 Rural Health Clinic Listening Tour

Earlier this year, ORH began planning and outreach for the 2020 Rural Health Clinic (RHC) Listening Tour. Amid COVID-19, these efforts were put on hold and then redirected. In lieu of visits to RHCs this summer, ORH has awarded several scholarships for continuing education and professional development to support clinics. Below is a list of the scholarships awardees. We hope to see you for next year’s in-person RHC Listening Tour! Please contact Rose Locklear with questions about the 2021 RHC Listening Tour.

Evergreen Family Medicine was awarded a partial scholarship to attend the American Association of Professional Coders (AAPC).

Warner Mountain Medical Clinic received a partial scholarship to attend Oregon State University’s Community Health Worker Course.

The following RHCs will attend the National Association of Rural Health Clinic’s Fall Institute:

• Family Health Associates
• Madras Medical Group
• Orchid Health
• Providence Seaside
• Woodburn Pediatric Clinic

The following RHCs are attending the National Association of Rural Health Clinics Certified RHC Professional Course:

• CHI St. Anthony
• Columbia Memorial
• Evergreen Family Medicine
• Lake Health
• Malheur Memorial
• Morrow County Health District (Irrigon Medical & Ione Community)
• Orchid Health
• Providence Seaside
• Samaritan Medical Group-Newport, Depoe Bay, Toledo, Waldport
• Snake River Pediatrics
• Salem Health Medical Clinic—Woodburn

ORH Releases the 2020 Areas of Unmet Health Care Need (AUHCN) in Oregon Report

The Areas of Unmet Health Care Need report is published annually by the Oregon Office of Rural Health to measure the medically underserved in rural areas. This report has been used:

• As part of a risk assessment formula for rural hospitals to receive cost-based Medicaid reimbursement (SB 607, passed in 1991; HB 3650, passed in 2011—the 2017 designations are available here);
• As part of the determination of "medically underserved" geographic areas for the Oregon Governor’s Health Care Shortage Area Designation; and
• As part of the scoring process for Oregon health care provider incentive programs.

How this report can be helpful to you:  As a health care organization in Oregon, you can use this report to quantify how well the communities you work with are able to access physical, mental and oral primary health care.

The report provides a total unmet need score for each primary service care area in Oregon. You can compare an area's score to other service areas as well as to overall scores for the state, all urban, all rural and all frontier areas. 

If a score is low, you can identify why by looking at which of the nine variables are negatively impacting the service area. For example, are community members unable to access mental health care because there are no mental health care providers in the area? Or is a significant percentage of the population between 138% and 200% of the Federal Poverty Level and therefore unable to afford insurance because they do not make the cut to receive Medicaid but are also unlikely to be able to afford to buy their own insurance?

We hope you will find this helpful as you prioritize technical and funding assistance. If you have any questions on the report or how it can be used, please contact Emerson Ong or Sarah Andersen.

Knight Cancer Institute Special Call Funding Cycle Now Open

The OHSU Knight Cancer Institute Community Partnership Program is pleased to announce that a Special Call funding cycle is now open. Applications will be accepted for projects that aim to address the most pressing COVID-19-related needs of Oregon communities in three priority areas:

• Impacts of COVID-19 and its intersection with cancer, such as impacts on cancer prevention, screening, and/or survivorship (including treatment);
• Impacts of COVID-19 in relation to social determinants of health, including factors that: 1) may lead to an increased risk of COVID-19 infection and/or severe COVID-19 related illness, or 2) impact access to COVID-19 testing and/or follow-up care; and
• Impacts of COVID-19 on populations and communities that can be disproportionately affected such as certain racial/ethnic groups (e.g. Black/African American, Latinx, Native American, Pacific Islander, other), refugees, immigrants, disabled, and/or rural communities.

The request for proposals is now available. Full proposals are due at noon on September 14, 2020 and funding notifications will be issued in October.

In addition to funds, grantees gain access to technical assistance and networking opportunities to enhance project success. 

For questions about the program or application process, email the Community Partnership Program team or call 503-418-8077.

HRSA Rural Health Network Development Planning Program NOFO

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). 

This program assists in the development of an integrated health care network, specifically with network participants who do not have a history of formal collaborative efforts. The goals of the program are to achieve efficiencies; to expand access to, coordinate, and improve the quality of essential health care services; and to strengthen the rural health care system as a whole.

The Network Planning Program offers rural health care providers the opportunity to better address community needs and respond to challenges such as supporting providers in the transition from volume-based to value-based care. The intent is for rural health networks to 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.

The eligibility criteria for this program has been reauthorized to include all domestic public and private, nonprofit and for-profit entities with demonstrated experience serving, or the capacity to serve, rural underserved populations. Urban-based organizations applying as the lead applicant should ensure there is a high degree of rural control in the project. The applicant organization must represent a network that includes at least three or more health care provider organizations and, at least 66% of network members must be located in a HRSA-designated rural area.

In FY20, HRSA made 20 awards in 16 states and in FY21, HRSA anticipates making approximately 20 awards. Technical assistance to grantees is provided by CRL Consulting, a recipient of the Network Planning—Technical Assistance Cooperative Agreement.

Interested applicants may attend a live webinar on October 7, 2020 at 12:00 pm PST.

For questions on Network Planning, please email Jillian Causey or call 301-443-1493.

USDA Implements Immediate Measures to Help Rural Communities Affected by COVID-19

USDA Rural Development has taken a number of immediate actions to help rural residents, businesses and communities affected by the COVID-19 outbreak. Rural Development will keep customers, partners and stakeholders continuously updated as more actions are taken to better serve rural America. 

Read the full stakeholder announcement here.

New COVID-19 Federal Rural Resource Guide Available

Through its new COVID-19 Federal Rural Resource Guide, USDA provides information on Federal programs that can assist rural communities, organizations, and individuals impacted by the COVID-19 pandemic.

This one-stop-shop of Federal programs is a first-of-its-kind resource for rural leaders looking for funding and partnership opportunities to help address the pandemic.

New COVID-19 Reporting and Testing Requirements for Nursing Homes and Other Providers

The Centers for Medicare & Medicaid Services (CMS) announced sweeping regulatory changes that require nursing homes to test staff and offer testing to residents for COVID-19. Laboratories and nursing homes using point-of-care testing devices will be required to report diagnostic test results as required by the Coronavirus Aid, Relief, and Economic Security Act (CARES Act).

For the latest information on the changes, view the CMS announcement.

Congratulations Adventist Health Tillamook!

Northwest Medical Foundation of Tillamook, known locally as Adventist Health Tillamook, has been awarded a $1 million rural communities opioid response program-implementation (RCORP-I) grant from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services. This award will support work over the next three years to address substance use disorder in Tillamook County and implement key strategies identified by the RCORP Tillamook consortium and planning workgroup.

Copies of the needs assessment, as well as the strategic and workforce plans for Tillamook County opioid and substance use response are available to the public here. The new funding will support implementation of strategies that meet needs identified through this work, such as:

• Developing countywide best practices for prescription guidelines to address pain, transitional plans for high-use community members, education and alternatives for pain management.
• Increasing knowledge on opioid basics and overdose prevention.
• Increasing the number of prevention, treatment and recovery providers implementing evidence-based practices in the county.

Catch-Up To Get Ahead Campaign to Promote Childhood Immunizations

In a new campaign, HRSA is urging health centers and health care providers to “catch-up to get ahead” on childhood immunizations. The COVID-19 pandemic has led to alarming declines in well-child visits and routine immunization rates. This raises the risk for outbreaks and further strain on our nation’s health care system.

To increase childhood immunization rates, HHS is coordinating the “Catch-Up to Get Ahead” effort. Your health center can promote the importance of childhood immunizations by using social media messages and graphics from the Catch-Up to Get Ahead Toolkit.

EMSC Distributes Statewide Pediatric Restraint Systems

In 2019, when the Oregon Health Authority Emergency Medical Services (OHA EMS) program surveyed EMS transport agencies, many rural and frontier agencies were in need of appropriately sized pediatric restraint systems in their ambulances. Oregon Administrative Rule 333-255-0072(2)(r) requires ground ambulances to carry “appropriately-sized child restraint system(s) that, at a minimum, covers a weight range of between 10 and 99 pounds.”

In 2020, the Oregon Emergency Medical Services for Children Program received a $22,000 grant from the Oregon Department of Transportation to provide pediatric restraint systems to Oregon rural and frontier EMS ground transport agencies. In July, 38 agencies were awarded a total of 93 Ferno Pedi-Mate Plus pediatric restraint systems, which were shipped directly to recipients along with additional educational resources.

Many thanks to the OHA EMS programs and their continuing work to support resources for Oregon’s rural and frontier agencies!

For questions about this or other OHA EMSC programs, please contact Rachel Ford, MPH, Emergency Medical Services for Children Program Coordinator at 971-673-0564.

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