2021 Legislative Priorities Highlights & Wrap Up
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Tag: Department of Health and Human Services (HHS)
Notice on Ground Ambulance and Patient Billing Advisory Committee
The Centers for Medicare and Medicaid Services (CMS) has filed for publication in the Federal Register the Solicitation of Nominations Notice for the Ground Ambulance and Patient Billing (GAPB) Advisory Committee. The Notice is scheduled to be included in the Federal Register for tomorrow, Tuesday, November 23.
The Congress created the GAPB Advisory Committee as part of The No Surprises Act enacted last year and currently being implemented by the Departments of Health and Human Services, Labor and the Treasury. The American Ambulance Association, International Association of Fire Chiefs, International Association of Fire Fighters, National Association of Emergency Medical Technicians, and the National Volunteer Fire Council successfully advocated that the Congress take into consideration the unique characteristics of ground ambulance services when determining balance billing policy for our services. The Congress excluded ground ambulance services from the provisions of The No Surprises Act and created the GAPB Advisory Committee to address balance billing.
The AAA has identified candidates, including AAA President Baird, who we will be supporting for inclusion on the Advisory Committee who we believe are well-positioned to represent the AAA membership. Once formed, the Advisory Committee has 180 days in which to report its recommendations to the Congress. The directive of the Committee is to review options to “improve the disclosure of charges and fees for ground ambulance services, better inform consumers of insurance options for such services, and protect consumers from balance billing.” We will be keeping the AAA membership continually informed of the actions and deliberations of the GAPB Advisory Committee.
Should you have any questions regarding the GAPB Advisory Committee, please contact AAA Senior Vice President of Government Affairs Tristan North. He can be reached at tnorth@ambulance.org.
PRF Reporting Grace Period Ending November 30
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It’s Time for EMS to Apply for HHS Provider Relief Fund Tranche 4!
Recorded October 8, 2021 | Free to All | Speaker: Asbel Montes
The deadline for Provider Relief Fund (PRF) applications is 11:59 PM October 26, 2021. If your EMS agency has not yet applied for funds, the American Ambulance Association strongly encourages you to do so! We are happy to answer member questions, just email hello@ambulance.org. Remember, Amber cost data collection software (www.emsamber.com) access is included with your AAA membership and has a PRF module to help you with your application. If you are an AAA member and need help accessing Amber, email shilker@ambulance.org. HRSA is also hosting a technical assistance webinar for PRF applications on October 13, 2021.
Tranche 4 Application—TIN Validation Error
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OCR Issues Guidance on HIPAA, COVID-19 Vaccinations, and the Workplace
Today, the U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) issued guidance to help the public understand when the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule applies to disclosures and requests for information about whether a person has received a COVID-19 vaccine.
In the guidance, OCR reminds the public that the HIPAA Privacy Rule does not apply to employers or employment records. The HIPAA Privacy Rule only applies to HIPAA covered entities (health plans, health care clearinghouses, and health care providers that conduct standard electronic transactions), and, in some cases, to their business associates. The HIPAA Privacy Rule applies to most EMS providers but only as it relates to it’s patient’s Protect Health Information (PHI).
Today’s guidance addresses common workplace scenarios and answers questions about whether and how the HIPAA Privacy Rule applies. The Privacy Rule does not apply when an individual:
- Is asked about their vaccination status by a school, employer, store, restaurant, entertainment venue, or another individual.
- Asks another individual, their doctor, or a service provider whether they are vaccinated.
- Asks a company, such as a home health agency, whether its workforce members are vaccinated.
Generally, the Privacy Rule does not regulate what information can be requested from employees as part of the terms and conditions of employment that an employer may impose on its workforce
The Privacy Rule does not prohibit a covered entity or business associate from requiring or requesting each workforce member to:
- Provide documentation of their COVID-19 or flu vaccination to their current or prospective employer.
- Sign a HIPAA authorization for a covered health care provider to disclose the workforce member’s COVID-19 or other vaccination record to their employer.
- Wear a mask–while in the employer’s facility, on the employer’s property, or in the normal course of performing their duties at another location.
- Disclose whether they have received a COVID-19 vaccine in response to queries from current or prospective patients.
OCR stated that they are issuing this guidance to help consumers, businesses, and health care entities understand when HIPAA applies to disclosures about COVID-19 vaccination status and to ensure that they have the information they need to make informed decisions about protecting themselves and others from COVID-19.
More details about the latest guidance on HIPAA, COVID-19 Vaccinations, and the Workplace may be found at https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/hipaa-covid-19-vaccination-workplace/index.html. If you have questions regarding what information you may or may not share relative to COVID-19 vaccinations, please contact the AAA for assistance.
Application Open: COVID-19 Provider Relief Funding
From HHS on September 29, 2021
The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced a new application cycle for $25.5 billion in COVID-19 provider funding. Applicants will be able to apply for both Provider Relief Fund (PRF) Phase 4 and American Rescue Plan (ARP) Rural payments during the application process. PRF Phase 4 is open to a broad range of providers with changes in operating revenues and expenses. ARP Rural is open to providers who serve rural patients covered by Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP).
See a detailed list of eligible provider types here.
The application is open now and will close on October 26, 2021 at 11:59 p.m. ET. Providers who have previously created an account in the Provider Relief Fund Application and Attestation Portal and have not logged in for more than 90 days will need to first reset their password before starting a new application. In order to streamline the application process and minimize administrative burdens, providers will apply for both programs in a single application.
HHS recently hosted a briefing session to provide information about these upcoming funding opportunities – view the video here. HRSA will also host webinar sessions featuring guidance on how to navigate the application portal. Register now using the links below.
- Thursday, September 30 from 3:00 – 4:00 p.m. ET
- Tuesday, October 5 from 3:00 – 4:00 p.m. ET
- Two additional webinars the weeks of October 11th and 18th (dates, times, and registration forthcoming)
Real time technical assistance is available by calling the Provider Support Line at (866) 569-3522, for TTY dial 711. Hours of operation are 8 a.m. to 10 p.m. CT, Monday through Friday.
HHS PRF Tranche 4 | Important Funding Opportunity for EMS Providers
Speaker: Scott Moore, Esq. | Share on Facebook
This funding opportunity will distribute $25.5 billion in additional Phase 4 General Distribution for EMS agencies and American Rescue Plan (ARP) payments for qualified rural providers who furnish services to Medicaid/CHIP and Medicare beneficiaries. It is critical for all #EMS providers to apply for this funding opportunity regardless of previous funding allocations. We have learned that many EMS providers did not apply for the Tranche 3 funding opportunity because they did not believe that they would be eligible to receive funds under the announced funding formula. Due to the limited number of applicants in Tranche 3, HRSA modified the formula and many who failed to apply would have received funds. We are recommending that all EMS agencies apply to receive the funding that they desperately need. The deadline for applying is 11:59 p.m. on October 26, 2021. There is no penalty for applying.
HHS Provides More Details on Phase 4 and Rural Provider Relief Fund Distribution
As previously reported by the AAA, the Department of Health and Human Services (HHS) has announced that it will open on September 29, Phase 4 of the Provider Relief Fund (PRF) to allocate $17 billion dollars for COVID-19 relief. In addition, it will provide $8.5 billion specifically for rural providers. On September 15, HHS held a stakeholder call on the PRF in which the agency provided more details on the distribution.
The application process will remain open for 4 weeks. Providers will be able to use the funding through December 31, 2022. The Administration’s goal is to release the rural funds before Thanksgiving and the Phase four funds by mid-December 2021. The agency indicated it has additional funding it is holding back to reimburse for the uncompensated care fund for which providers and suppliers can still apply.
The AAA has been advocating relentlessly for the Administration to open a fourth phase of funding and support rural providers and suppliers. As described below, these phases of funding will rely upon data from Medicare, Medicaid, and the State Children’s Health Insurance Program (CHIP). It is important that all AAA members who qualify not only submit applications, but also make sure that you have appropriately submitted claims to these programs, including when allowed, claims under the ground ambulance treatment in place waiver. We strongly recommend that all AAA members apply for funding.
Phase 4 Funding
The Phase 4 PRF methodology and application will primarily follow the same rules set forth for Phase 3. It will apply for Q2 2020 through Q1 2021. The funding will be available for the same broad set of providers and suppliers that were eligible under Phase 3.
Phase 4 will have two components. The Acting Administrator of HRSA has explained that 75 percent of the funding for Phase 4 will be determined based on a provider’s lost revenues and expenses that the provider submits through the application process. HRSA will calculate the amount awarded based on the number of applications received. However, it will establish a base for all providers and then adjust that base up for medium and small providers who have lower volumes over which to spread their costs. The determination of provider size will be based on patient revenues.
The second component of Phase 4 funding will allocate 25 percent for bonus payments to providers serving Medicare, Medicaid, and CHIP patients. The final amounts awarded will be determined based on the volume of services provided to these patient populations.
The Acting Administrator also noted that once again providers who have higher values compared to their peer group will be flagged and may have the amount they receive capped or may not receive any funding. There will be a reconsideration process for these providers as well.
Rural Funding
In addition to Phase 4, HRSA will provide rural-specific relief to providers and suppliers serving rural patients. The determination of whether a provider qualifies will be based on the patient’s location, not that of the providers. HRSA will use Medicare, Medicaid, and CHIP data to calculate the payment, so the application process will be simplified and providers required to submit less information. The amounts will be determine based on the number of patients served and the number of applicants.
Additional Relief
The Acting Administrator also indicated that HRSA will provide a 60-day grace period for those providers who received funds already and are required to report if they cannot meet the current reporting deadline. She also noted that HRSA is establishing a reconsideration process for Phase 3 as well. Details will be available on the HRSA website.
Additional Information
HRSA will be posting information on its website. It will also host two webinars on September 30 and October 5 to provide more information about how providers can apply to these programs.
HHS: Availability of Add’l $25.5 Billion in COVID-19 Provider Funding
HHS Announces the Availability of $25.5 Billion in COVID-19 Provider Funding
This morning the Department of Health and Human Services (HHS) announced that it will be making $25.5 billion in new funding available for healthcare providers affected by the COVID-19 pandemic. The funding, available through the Health Resources and Services Administration (HRSA) will include $8.5 billion in American Rescue Plan Act (ARPA) resources for providers who serve rural Medicaid, Children’s Health Insurance Program (CHIP), or Medicare patients, and an additional $17 billion for Provider Relief Fund (PRF) Phase 4 for a broad range of providers who can document revenue loss and expenses associated with the pandemic.
Getting additional financial relief for ground ambulance service providers who are still struggling from the lost revenue and increased expenditures resulting from being on the frontlines of responding to the pandemic has been a top priority for the AAA. The AAA along with the International Association of Fire Chiefs, International Association of Firefighters, National Associations of EMTs and National Volunteer Fire Association have continually pressed HHS to release the remaining funds. We strongly encourage all AAA members to submit an application regardless of whether you have applied for previous rounds of funding.
Consistent with the requirements included in the Coronavirus Response and Relief Supplemental Appropriations Act of 2020, PRF Phase 4 payments will be based on providers’ lost revenues and expenditures between July 1, 2020, and March 31, 2021 (Q3 – Q4 2020 and Q1 2021). The PRF Phase 4 will reimburse smaller providers, who tend to operate on thin margins and often serve vulnerable or isolated communities, for their lost revenues and COVID-19 expenses at a higher rate compared to larger providers. PRF Phase 4 will also include bonus payments for providers who serve Medicaid, CHIP, and/or Medicare patients, who tend to be lower- income and have greater and more complex medical needs. HRSA will price these bonus payments at the generally higher Medicare rates to ensure equity for those serving low-income children, pregnant women, people with disabilities, and seniors.
Consistent with the focus of the ARPA, HRSA will make ARPA rural payments to providers based on the amount of Medicaid, CHIP, and/or Medicare services they provide to patients who live in rural areas as defined by the HHS Federal Office of Rural Health Policy. As rural providers serve a disproportionate number of Medicaid and CHIP patients who often have disproportionately greater and more complex medical needs, many rural communities have been hit particularly hard by the pandemic. Accordingly, ARP rural payments will also generally be based on Medicare reimbursement rates.
In the announcement, HHS stated that it would “expedite and streamline” the application process and minimize administrative burdens, providers will apply for both programs in a single application. HRSA will use existing Medicaid, CHIP and Medicare claims data in calculating payments. The application portal will open on September 29, 2021. HHS has stated that to ensure that these provider relief funds are used for patient care, PRF recipients will be required to notify the HHS Secretary of any merger with, or acquisition of, another health care provider during the period in which they can use the payments. They have stated that providers who report a merger or acquisition may be more likely to be audited to confirm their funds were used for coronavirus-related costs.
To promote transparency in the PRF program, HHS also released detailed information about the methodology utilized to calculate PRF Phase 3 payments. Providers who believe their PRF Phase 3 payment was not calculated correctly according to this methodology will now have an opportunity to request a reconsideration. HHS announced that additional details on the PRF Phase 3 reconsideration process will be released at a later date.
In addition, many of you attended the PRF Reporting Q&A AAA webinar yesterday with Asbel Montes, Brian Werfel, and Scott Moore. HHS has acknowledged the challenges facing many providers across the country due to recent natural disasters and the Delta variant, HHS announced a final 60-day grace period to help providers come into compliance with their PRF Reporting requirements if they fail to meet the deadline on September 30, 2021. While the deadlines to use funds and the Reporting Time Period will not change, HHS will not initiate collection activities or similar enforcement actions for non-compliant providers during this grace period.
Members can access more information about eligibility requirements, the documents and information providers will need to complete their application, and the application process for PRF Phase 4 and ARP Rural payments by visiting the HRSA website.
The combined application for American Rescue Plan rural funding and Provider Relief Fund Phase 4 will open on September 29, 2021. Like we have done with the previous rounds of HHS funding, we encourage all ambulance service providers to submit an application for this Phase 4 funding. If you have questions regarding this or any COVID-19 related questions, please contact hello@ambulance.org.
HHS/ASPR Project ECHO COVID-19 Clinical Rounds
From HHS/ASPR – Project ECHO COVID Clinical Rounds
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Provider Relief Fund Reporting Requirement Deadline is Approaching
The American Ambulance Association wants to remind our members that the deadline to submit your initial report on your use of HHS Provider Relief Funds is fast approaching. Any ambulance provider or supplier that received more than $10,000 in aggregate funds from the first two rounds of General Distribution funding will need to submit a report on their use of such funds by September 30, 2021. This initial report will detail the expenditure of PRF funds through June 30, 2021.
Relevant Background
On March 27, 2020, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). As part of that Act, Congress allocated $100 billion to the creation of a “CARES Act Provider Relief Fund,” which will be used to support hospitals and other healthcare providers on the front lines of the nation’s coronavirus response. An additional $75 billion was allocated as part of the Paycheck Protection Program and Health Care Enhancement Act, with subsequent legislation adding further amounts to this fund. In total, the Provider Relief Fund (PRF) will distribute $178 billion to health care providers and suppliers to fund healthcare-related expenses or to offset lost revenue attributable to COVID-10.
To date, HHS has distributed approximately $148.4 billion through three rounds of General Distribution funds ($92.5 billion) and multiple smaller Targeted Distributions. A portion of the PRF is also being used to reimburse health care providers for the costs of testing, treating, and vaccinating the uninsured.
Summary of Final Reporting Requirements
On June 11, 2021, HHS issued its final PRF Reporting Requirements. Under these new guidelines, health care providers will be required to report for any “Payment Received Period” in which they received one or more PRF payments that, in the aggregate, exceed $10,000. Providers meeting this threshold for any Payment Received Period will report on their use of such funds during the corresponding “Reporting Time Period.”
The following table sets forth the applicable Payment Received Periods and corresponding Reporting Time Periods. The table also sets forth the deadline to use funds received within each Payment Receiving Period.
| Period | Payment Received Period | Deadline for use of Funds | Reporting Time Period |
| 1 | April 10, 2020 – June 30, 2020 | June 30, 2021 | July 1, 2021 – September 30, 2021 |
| 2 | July 1, 2020 – December 31, 2020 | December 31, 2021 | January 1, 2022 – March 31, 2022 |
| 3 | January 1, 2021 – June 30, 2021 | June 30, 2022 | July 1, 2022 – September 30, 2022 |
| 4 | July 1, 2021 – December 31, 2021 | December 31, 2022 | January 1, 2023 – March 31, 2023 |
PRF payments received in the first two rounds of General Distribution funding will fall within the first reporting period. PRF payments received in the third round of General Distribution funding will fall within either the second or third reporting periods, depending on when the funds were actually received.
As a result, ambulance providers and suppliers that received more than $10,000 in the aggregate from the first two rounds of General Distribution funding will need to submit an initial report during the 90-day period starting on July 1, 2021. This initial report will detail all expenditures of PRF funds through June 30, 2021.
Ambulance providers and suppliers that received between $10,001 and $499,999 in aggregated PRF funds during each Payment Received Period are required to report on their use of such funds in two categories: (1) General and Administrative Expenses and (2) Health Care Related Expenses. Ambulance providers and suppliers that received $500,000 or more in aggregated PRF funds during each Payment Received Period will be required to submit more detailed information for each of these general categories.
Specific Instructions Related to Reporting of Lost Revenues
The American Ambulance Association has received numerous questions from members regarding the appropriate methodology to report lost revenues attributable to the coronavirus. Specifically, many members have inquired as to the appropriate methodology for calculating their lost revenues.
HHS has indicated that health care providers must report their lost revenues using one of three methodologies:
- The difference between actual patient care revenues;
- The difference between budgeted patient care revenues and actual patient care revenues; or
- An alternative methodology selected by the provider for estimating lost revenues.
Based on HHS guidance, it appears that the default methodology is to measure the difference between actual patient care revenues for each calendar quarter during the applicable period. The provider will also be asked to further break down patient care revenues by applicable payer. In basic terms, the first methodology will compare: (i) your actual calendar year 2019 patient care revenues to (ii) your actual calendar year 2020 patient care revenues. The A.A.A. suggests that all members start by conducting this basic revenue analysis. To the extent your lost revenues in 2020 equal or exceed (in combination with your increased expenses, if any) the total PRF funds received during the first Payment Received Period, no additional revenue analysis is required.
In some instances, you may find that your actual revenue losses for calendar year 2020 do not fully offset the PRF funds received during the First Payment Received Period. In that event, it may be beneficial to conduct a separate revenue analysis using the budgeted vs. actual methodology. Note: you are only eligible to use this methodology to the extent you had a formal budget approved prior to March 27, 2020.
This methodology is likely to be beneficial to ambulance providers or suppliers that, pre-pandemic, were projecting significant revenue growth in calendar year 2020. For example, consider the case of a hypothetical “ABC Ambulance Service, Inc.” ABC Ambulance had $1 million in patient care revenues in calendar year 2019. However, in November 2019, the company signed an agreement to be the preferred provider of a major hospital system in its service area. As a result, the company was projecting significant revenue growth in calendar year 2020. Specifically, when it created its 2020 budget in December 2019, it projected that its patient care revenues would rise to $1.5 million in 2020.
When the pandemic hit in mid-March 2020, the company saw a significant slowdown in its transport volume. Like many ambulance providers, it saw its transport volume rebound somewhat in the 3rd and 4th quarters of 2020. As a result, it ended the year with $1.2 million in patient care revenues.
A revenue analysis using the default methodology would show an increase in revenues, i.e., its revenues increased by $200,000 over 2019. However, its 2020 actual revenues were $300,000 less than it projected in its 2020 budget. Using this second methodology, the company would be able to claim $300,000 in lost revenues to offset against its PRF funds.
Please note that any ambulance provider or supplier using this second methodology will be required to submit additional documentation with its initial PRF report. Specifically, you will be required to submit a copy of the 2020 budget relied upon to show the lost revenue, together with an attestation from its CEO, CFO, or other authorized official attesting to the fact that this budget was formally established prior to March 27, 2020.
HHS will also permit ambulance providers or suppliers to utilize an alternative methodology created by the entity for calculating their lost revenues. However, to utilize an alternative methodology, the provider or supplier will be required to submit additional documentation explaining not only the methodology, but also the justification for why this methodology was reasonable. HHS has indicated that providers or suppliers electing to use an alternative methodology will face an increased risk of audit. As a good rule of thumb, the use of an alternative methodology is likely to limited to situations where the EMS agency’s business is extremely seasonal, or where there was some major change in their operations during the 2020 calendar year (e.g., a partial sale of the company, a large acquisition, etc.).
Further Information Related to PRF Reporting
HHS updated its instructions for how ambulance providers and suppliers should complete their PRF Reporting obligations. These updated instructions start on Page 4 of the Revised Reporting Requirements.
HHS also recently updated its Frequently Asked Questions (FAQs) associated with the PRF Reporting Program.
HHS | $103mm for Healthcare Workforce Resiliency and to Address Burnout
FOR IMMEDIATE RELEASE
Contact: HHS Press Office
202-690-6343
media@hhs.gov
202-690-6343
media@hhs.gov
HHS Announces $103 Million from American Rescue Plan to Strengthen Resiliency and Address Burnout in the Health Workforce
Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced the availability of an estimated $103 million in American Rescue Plan funding over a three-year period to reduce burnout and promote mental health among the health workforce. These investments, which take into particular consideration the needs of rural and medically underserved communities, will help health care organizations establish a culture of wellness among the health and public safety workforce and will support training efforts that build resiliency for those at the beginning of their health careers.
“The Biden-Harris Administration is committed to ensuring our frontline health care workers have access to the services they need to limit and prevent burnout, fatigue and stress during the COVID-19 pandemic and beyond,” said HHS Secretary Xavier Becerra. “It is essential that we provide behavioral health resources for our health care providers – from paraprofessionals to public safety officers – so that they can continue to deliver quality care to our most vulnerable communities.”
Health care providers face many challenges and stresses due to high patient volumes, long work hours and workplace demands. These challenges were amplified by the COVID-19 pandemic, and have had a disproportionate impact on communities of color and in rural communities. The programs announced today will support the implementation of evidence-informed strategies to help organizations and providers respond to stressful situations, endure hardships, avoid burnout and foster healthy workplace environments that promote mental health and resiliency.
“This funding will help advance HRSA’s mission of developing a health care workforce capable of meeting the critical needs of underserved populations,” said Acting HRSA Administrator Diana Espinosa. “These programs will help to combat occupational stress and depression among our health care workers as they continue their heroic work to defeat the pandemic.”
There are three funding opportunities that are now accepting applications:
- Promoting Resilience and Mental Health Among Health Professional Workforce – Approximately 10 awards will be made totaling approximately $29 million over three years to health care organizations to support members of their workforce. This includes establishing, enhancing, or expanding evidence-informed programs or protocols to adopt, promote and implement an organizational culture of wellness that includes resilience and mental health among their employees.
- Health and Public Safety Workforce Resiliency Training Program – Approximately 30 awards will be made totaling approximately $68 million over three years for educational institutions and other appropriate state, local, Tribal, public or private nonprofit entities training those early in their health careers. This includes providing evidence-informed planning, development and training in health profession activities in order to reduce burnout, suicide and promote resiliency among the workforce.
- Health and Public Safety Workforce Resiliency Technical Assistance Center – One award will be made for approximately $6 million over three years to provide tailored training and technical assistance to HRSA’s workforce resiliency programs.
To apply for the Provider Resiliency Workforce Training Notice of Funding Opportunities, visit Grants.gov. Applications are due August 30, 2021.
Learn more about HRSA’s funding opportunities.
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CMS Addresses Substance Use, Mental Health Crisis Care for Those with Medicaid
CMS Addresses Substance Use, Mental Health Crisis Care for Those with Medicaid
$15 Million Funding Opportunity for State Planning Grants to Bolster Mobile Crisis Intervention Services
The Centers for Medicare & Medicaid Services (CMS) announced a funding opportunity made possible by the American Rescue Plan (ARP) to help states strengthen system capacity to provide community-based mobile crisis intervention services for those with Medicaid. The $15 million funding opportunity is available to state Medicaid agencies for planning grants to support developing these programs.
This funding opportunity provides financial resources for state Medicaid agencies to assess community needs and develop programs to bring crisis intervention services directly to individuals experiencing a mental health or substance use related crisis outside a hospital or facility setting. These services may include screening and assessment, stabilization and de-escalation, and coordination of referrals after the initial treatment.
“Investing in crisis intervention services ensures Americans experiencing a mental health or substance use disorder crisis get the care and treatment they need,” said Secretary Becerra. “These grants will help states build these critical services to help communities send a responder who is trained and ready to assist people in crisis.”
“It is vital that we can meet people where they are, especially when those individuals are in crisis,” said CMS Administrator Chiquita Brooks-LaSure. “This funding will help state Medicaid agencies plan innovative ways to provide and better mobilize these essential intervention services to their communities.”
The planning grants provide funding to develop, prepare for, and implement qualifying community-based mobile crisis intervention services under the Medicaid program. Grant funds can be used to support states’ assessments of their current services, strengthen capacity and information systems, ensure that services can be accessed 24 hours a day/365 days a year, provide behavioral health care training for multi-disciplinary teams, or to seek technical assistance to develop State Plan Amendment (SPAs), demonstration applications, and waiver program requests under the Medicaid program.
Letters of Intent to apply from states and territories are due July 23, 2021. Final applications must be submitted by August 13, 2021, 3:00 pm ET. The period of performance for this grant will be from September 30, 2021, through September 29, 2022. The Notice of Funding Opportunity (NOFO) provides additional details regarding eligibility and program requirements, as well as key deadline and application submission information.
To view the NOFO, visit Grants.gov and search for the announcement by CFDA# 93.639.
HHS ASPR Project ECHO COVID-19 Clinical Rounds
HHS Office of the Assistant Secretary for Preparedness and Response
- Peer to Peer Sharing : HHS ASPR, Project ECHO, and the National Emerging Special Pathogens Training and Education Centers (NETEC) together support the COVID-19 Clinical Rounds, peer to peer real-time knowledge sharing sessions among front line clinicians on challenges and successes encountered treating COVID-19.
- Audience of Multidisciplinary Clinicians: Physicians, nurses, and EMS clinicians participate in the Rounds, which continue to focus on critical care, emergency departments, and EMS.
- Format of Sessions: Each Clinical Rounds session includes brief presentations from experienced expert clinicians complemented by discussion among expert panelists in response to Q&A from participants.
- Sharing of Experience, Not Official Guidance: Rounds are intended to be the sharing of clinical experience rather than formal recommendations or guidance.
- Evolving Clinical Round Topics: Topics of Clinical Rounds evolve to address the dynamic COVID-19 medical response.
- Continuing Medical Education (CME) Credit: Participants can fill out a short survey and receive 1 hour of Continuing Medical Education credit instantly for each session.
HHS Issues Revised Notice of Provider Relief Fund Reporting Requirements
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HHS Revises Provider Relief Fund Reporting Requirements
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HRSA | Federal Office of Rural Health Policy Update
HRSA | Federal Office of Rural Health Policy Update | May 13, 2021
What’s New
CDC and USDA Team Up for Vaccine Education Effort. The Centers for Disease Control and Prevention (CDC) is providing $9.95 million in funding to the U.S. Department of Agriculture’s USDA) National Institute of Food and Agriculture (NIFA) to improve vaccine confidence in rural areas. NIFA will work with local partners through the Land Grant University System and its Cooperative Extension System, a nationwide educational network that provides non-formal higher education and learning to farming communities.
HRSA COVID-19 Coverage Assistance Fund. The Health Resources and Services Administration (HRSA) will provide claims reimbursement at the national Medicare rate for eligible health care providers administering vaccines to underinsured individuals. This may be particularly helpful in rural communities given higher rates of uninsured and underinsured.
HHS/DoD National Emergency Tele-Critical Care Network. A joint program of the U.S. Department of Health & Human Services (HHS) and the U.S. Department of Defense (DoD) is available at no cost to hospitals caring for COVID-19 patients and struggling with access to enough critical care physicians, nurses, respiratory therapists and other specialized clinical experts. Teams of critical care clinicians are available to deliver virtual care through lightweight telemedicine platforms, such as an app on a mobile device. Hear from participating clinicians and email to learn more and sign up.
HHS Coordinates New Effort to Vaccinate Migratory/Seasonal Workers in Agriculture. The U.S. Department of Health & Human Services (HHS) is working with several divisions, including the Food and Drug Administration and the Health Resources and Services Administration to boost vaccination rates in a workforce often at heightened risk of COVID-19 infection.
RAND/RWJF Report: COVID-19 and the Experiences of Populations at Greater Risk. The RAND Corporation joined with the Robert Wood Johnson Foundation (RWJF) to examine the way people view health issues. Researchers asked people in the United States about their experiences related to the pandemic, and their views on issues such as freedom, racism, and the role of government.
COVID-19 Resources
New: FCC Emergency Broadband Benefit Program. The Federal Communications Commission (FCC) created this temporary program to help eligible individuals and households afford internet service during the pandemic. Eligible households can enroll through an approved broadband service provider or by visiting GetEmergencyBroadband
We Can Do This: COVID-19 Public Education Campaign. The U.S. Department of Health & Human Services announced a national effort to help community partners promote COVID-19 vaccine confidence. The campaign includes educational materials targeted to specific audiences and seeks volunteers for the COVID-19 Community Corps. New: The Rural Communities Toolkit provides resources for building vaccine confidence.
Volunteer to Administer COVID-19 Vaccines. The U.S. Department of Health & Human Services has expanded its definition of persons authorized to give the vaccine. These include, among others, current and retired traditional and non-traditional health care professionals, and students in health care programs.
HHS Facts About COVID Care for the Uninsured. The U.S. Department of Health & Human Services (HHS) helps uninsured individuals find no-cost COVID-19 testing, treatment and vaccines. The HRSA Uninsured Program provides claims reimbursement to health care providers generally at Medicare rates for testing, treating, and administering vaccines to uninsured individuals, including undocumented immigrants. There are at-a-glance fact sheets for providers and for patients in English and Spanish.
Federal Office of Rural Health Policy FAQs for COVID-19. A set of Frequently Asked Questions (FAQs) from our grantees and stakeholders. New: Resources for Rural Health Clinics.
COVID-19 FAQs and Funding for HRSA Programs. Find COVID-19-related funding and frequently asked questions for programs administered by the Health Resources and Services Administration (HRSA).
CARES Act Provider Relief Fund Frequently Asked Questions. Includes information on terms and conditions, attestation, reporting and auditing requirements, general and targeted distributions, and how to report capital equipment purchases.
CDC COVID-19 Updates. The Centers for Disease Control and Prevention (CDC) provides daily updates and guidance, including a section specific to rural health care, a vaccine locator by state, and COVID-19 Vaccination Trainings for new and experienced providers. New: Updated Frequently Asked Questions about COVID-19 vaccination, including new guidance for use in adolescents 12 and older.
CMS Coronavirus Partner Resources. The Centers for Medicare & Medicaid Services (CMS) provides information for providers, health plans, state Medicaid programs, and Children’s Health Insurance Programs and holds regular stakeholder calls to provide updates.
HHS Coronavirus Data Hub. The U.S. Department of Health & Human Services (HHS) website includes estimated and reported hospital capacity by state, with numbers updated daily.
NIH Community Engagement Alliance Against COVID-19 Disparities. The National Institutes of Health (NIH) created a collection of online resources with information for communities hit hardest by the pandemic, such as African Americans, Hispanics/Latinos, and American Indian/Alaska Natives.
COVID-19 Data from the U.S. Census Bureau. The site provides access to demographic and economic data, including state and local data on at-risk populations, poverty, health insurance coverage, and employment.
ATTC Network COVID-19 Resources for Addictions Treatment. The Addiction Technology Transfer Center (ATTC) Network was established in 1993 by the Substance Abuse and Mental Health Services Administration. The online catalog of COVID-related resources includes regularly-updated guidance and trainings for professionals in the field.
GHPC’s Collection of Rural Health Strategies for COVID-19. The FORHP-supported Georgia Health Policy Center (GHPC) provides reports, guidance, and innovative strategies gleaned from their technical assistance and peer learning sessions with FORHP grantees. New: The Impact of Rural Residence on COVID-19 Disparities.
Confirmed COVID-19 Cases, Metropolitan and Nonmetropolitan Counties. The RUPRI Center for Rural Health Policy Analysis provides up-to-date data on rural and urban confirmed cases throughout the United States. An animated map shows the progression of cases beginning March 26, 2020 to the present.
Rural Response to Coronavirus Disease 2019. The Rural Health Information Hub has a compendium of rural-specific activities and guidelines, including Rural Healthcare Surge Readiness, a tool with resources for responding to a local surge in cases.
SAMHSA Training and Technical Assistance Related to COVID-19. The Substance Abuse and Mental Health Services Administration (SAMHSA) created this list of resources, tools, and trainings for behavioral health and recovery providers.
Mobilizing Health Care Workforce via Telehealth. ProviderBridge.org was created by the Federation of State Medical Boards through the CARES Act and the FORHP-supported Licensure Portability Program. The site provides up-to-date information on emergency regulation and licensing by state as well as a provider portal to connect volunteer health care professionals to state agencies and health care entities.
Online Resource for Licensure of Health Professionals. Created by the Association of State and Provincial Psychology Boards, the site provides up-to-date information on emergency regulation and licensing in each state for psychologists, occupational therapists, physical therapists assistants, and social workers.
Funding and Opportunities
Nurse Corps Scholarship Program – extended to May 26. The Nurse Corps Scholarship Program provides financial support to students enrolled in nursing degree programs in exchange for a commitment to serve in high-need areas across the country. This year, Nurse Corps has additional funding for qualified nursing students that includes tuition, fees, other reasonable educational costs, and a monthly living stipend.
DOJ National Tribal Clearinghouse on Sexual Assault – June 3. The U.S. Department of Justice (DOJ) will make one award for $980,000 to an organization that can provide nationwide training and technical assistance for response to sexual assault crimes and services for victims in American Indian/Alaska Native communities.
DOJ Comprehensive Opioid, Stimulant, and Substance Abuse Site-Based Program – June 7. The U.S. Department of Justice (DOJ) will make 110 awards with total funding of $163 million to support state, local, tribal, and territorial response to use of illicit substances. A subcategory of the program will award up to $600,000 each for projects in rural areas, small counties, and tribal areas with a population of fewer than 100,000 for a federally recognized tribe.
HRSA Rural Northern Border Region Planning Program – June 14. The Health Resources and Services Administration’s (HRSA) will make approximately four awards of up to $190,000 each to support health care needs in underserved rural communities of the Northern Border Regional Commission (NBRC) service area.
DOJ Second Chance Act Youth Offender Reentry Program – June 15. The U.S. Department of Justice (DOJ) will make 13 awards of up to $750,000 each to support youth returning to their communities from correctional facilities. The program encourages collaboration between state agencies, local government, and community- and faith-based organizations. Separately, the DOJ will make approximately 15 awards of up to $750,000 each for the Juvenile Drug Treatment Court Program – June 15.
USDA Local Food Promotion Program – June 21. The U.S. Department of Agriculture (USDA) will make grants of up to $200,000 each for planning grants, and up to $750,000 for implementation grants. Grant recipients will create or expand projects that increase the availability of locally produced food.
DOJ Strategies to Support Children Exposed to Violence – June 22. The U.S. Department of Justice (DOJ) estimates eight awards with total investment of $7 million to support community-level strategies for children exposed to violence. Priority consideration will be given to applications promoting civil rights, building trust between law enforcement and the community, and that are intended to benefit high poverty areas.
HUD Housing Opportunities for Persons with AIDS – July 6. The U.S. Department of Housing and Urban Development (HUD) will make 18 awards of up to $2.25 million each for community projects that provide housing for people with HIV/AIDS in underserved areas. Rural populations are among those of interest for ensuring health equity. Also known as Housing as an Intervention to Fight AIDS, the program aims to create housing and service models that can be replicated in other similar localities.
Rural Health Research
Research in this section is provided by the HRSA/FORHP-supported Rural Health Research Gateway. Sign up to receive alerts when new publications become available.
Medicare-Paid Naloxone: Trends in Nonmetropolitan and Metropolitan Areas. Previous research has found that Medicare paid for an increasing share of naloxone prescriptions from 2016 to 2018 and pays for 1/3 of all naloxone dispensed from retail pharmacies as of 2018. This brief from the Rural and Underserved Health Research Center examines trends in Medicare-paid naloxone dispensing rates in nonmetropolitan versus metropolitan areas from 2014 to 2018.
Policy Updates
Visit the FORHP Policy page to see all recent updates and send questions to ruralpolicy@hrsa.gov.
Request for Information on Advancing Equity and Support for Underserved Communities – Comments due July 6. The Office of Management and Budget (OMB) seeks input from a broad array of stakeholders in the public, private, advocacy, not-for-profit, and philanthropic sectors, including State, local, Tribal, and territorial areas, on available methods, approaches, and tools that the Government can use to promote equity and support underserved communities.
Increased Medicare payment for COVID-19 monoclonal antibody infusions. The Centers and Medicare & Medicaid Service (CMS) announced last week an increase in the national average payment rate for administering monoclonal antibody treatments for COVID-19 from $310 to $450 for most health care settings. Additionally, they have established a higher national payment rate of $750 for monoclonal antibody treatments administered in a beneficiary’s home, including the beneficiary’s permanent residence or temporary lodging. CMS is updating its COVID-19 toolkits for providers, states, and insurers to reflect this change.
Medicare Guidance on Interoperability Rule Requirements for Hospitals. This interpretive guidance from the Centers for Medicare & Medicaid Services (CMS) outlines the Conditions of Participation (CoPs) requiring hospitals, psychiatric hospitals, and Critical Access Hospitals (CAHs) to send electronic patient event notifications of a patient’s admission, discharge, and/or transfer to another healthcare facility or to another community provider or practitioner, which are effective as of May 1, 2021. These CoPs were finalized in the May 2020 Interoperability and Patient Access Final Rule and are addressed in the recently released Interoperability Final Rule FAQs.
Medicare Waiver for Ambulance Treatment in Place. This Fact Sheet describes the circumstances in which ground ambulance services may be reimbursed by Medicare for treatment provided in place because a patient was not able to be transported to a destination permitted under Medicare regulations due to community-wide emergency medical service (EMS) protocols due to the COVID-19 PHE. This waiver is retroactively effective to March 1, 2020.
Learning Events and Technical Assistance
ONDCP Workshop for SUD: Rural Faith-Based Leaders – Thursday, May 13 at 1:00 pm ET. The Office of National Drug Control Policy (ONDCP) will hold a second session (90 minutes) in its series for faith leaders in rural areas. The workshops are meant to increase understanding of substance use disorder (SUD) and provide guidance on connecting faith to prevention, treatment, and recovery. If you would like to attend, please RSVP to Betty-Ann Bryce, Special Advisor for Rural Affairs at MBX.ONDCP.RuralAffairs@ondcp.
MATRC: Answering Questions About Telehealth and Telemental Health – Friday, May 14 at 12:00 pm ET. The Mid-Atlantic Telehealth Resource Center (MATRC) holds a live, two-hour event to answer questions about the basics. The MATRC is one of 14 FORHP-Supported Telehealth Resource Centers. This is a recurring session taking place every other Friday from 12:00 to 2:00 pm ET.
HRSA Telehealth Series: Learn About Licensure Compacts – Monday, May 17 at 12:30 pm ET. Experts from the National Center for Interstate Compacts will discuss agreements for doctors, nurses, psychologists and other clinicians to see patients across state lines via telehealth.
SBIRT for SUD Native American Communities – Tuesday, May 18 at 11:00 am ET. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a process to quickly assess substance use disorder (SUD) in a person and move them toward more extensive treatment. This hour-long session is hosted by the National American Indian & Alaska Native Prevention Technology Transfer Center.
AgriSafe: Zoonotic Disease and Pregnancy – Wednesday, May 19 at 1:00 pm ET. The AgriSafe Network will hold a one-hour session to explain the risk that diseases transmitted between farm animals and humans pose to pregnant women.
Overcoming Mental Health Stigma in Rural Communities – Wednesday, May 19 at 2:00 pm ET. The Mental Health Technology Transfer Center Network will host a one-hour workshop to discuss what influences negative attitudes toward mental health and techniques to overcome various forms of stigma.
Assessment of Opioid Misuse Risk Among Farmers in the Clinical Setting – Friday, May 21 at 1:00 pm ET. The AgriSafe Network will host an hour-long webinar to provide insight on misuse risk factors and warning signs among farmers.
SAMHSA Connecting Prevention Specialists to Native Communities – Friday, May 21 at 1:00 pm ET. The Tribal Training and Technical Assistance Center at the Substance Abuse and Mental Health Services Administration (SAMHSA) holds virtual trainings to cover topics such as crisis response, youth engagement, and sexual assault awareness. Trainings will take place on the third Friday of each month.
Resource of the Week
Successful COVID-19 Messaging in Rural Communities. In this 30-minute video, the state leadership in West Virginia present insight from their research and vaccine outreach campaign.
Approaching Deadlines
CDC Childhood Lead Poisoning Prevention and Surveillance – extended to May 14 (from April 25)
Park and Recreation Mentorship Grants for Rural Youth Impacted by Opioids – May 15
ARC Investments Supporting Partnerships/Recovery Ecosystems – Letters of Intent May 17
CDC Drug Free Communities – extended to May 17 (from May 10)
Cross-Jurisdictional Sharing in Public Health: Small Grants Program – May 17
EPA Technical Assistance for Wastewater Treatment – May 17
SAMHSA Overdose Treatment for Use by First Responders – May 17
HRSA Expanding Community-Based Workforce for COVID-19 Vaccine Outreach – May 18
Comments Requested: Proposed Changes to the Census Bureau Definition of Urban – May 20
CMS Primary Care First Model Cohort 2 – extended to May 21 (from April 30)
CDC Community Health Workers for COVID Response – May 24
New Sites for National Health Service Corps (NHSC) – May 25
Native American Agriculture Fund Grants for Youth – May 25
Nurse Corps Scholarship Program – extended to May 26
AAA Letter to HHS Secretary on the Provider Relief Fund
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ASPR TRACIE Newsletter April 2021
From HHS ASPR TRACIE Healthcare Emergency Preparedness Information Gateway
This issue of The Express highlights the following new/updated resources:
Please continue to access our Novel Coronavirus Resources Page, the National Institutes of Health Coronavirus Disease 2019 (COVID-19) Treatment Guidelines, and CDC’s Coronavirus webpage, and reach out if you need technical assistance (TA). |
| New: COVID-19 and the Changing Healthcare Delivery Landscape (Speaker Series) |
| Paul Biddinger, MD, FACEP, Medical Director, Emergency Preparedness, Mass General Brigham; Mark Jarrett, MD, MBA, MS, Chief Quality Officer, SVP & Deputy Chief Medical Officer, Northwell Health; and Meghan Treber, MS, ICF TRACIE Program Director, HHS ASPR highlight the impact of COVID-19 on healthcare delivery (e.g., supply chain, patients delaying emergency care, the delay of elective procedures, and financial impacts to the healthcare system) in this brief recording. Access the rest of the Healthcare Operations during the COVID-19 Pandemic speaker series for more information. |
| Updated: Healthcare Delivery Impacts Tip Sheet and Summary Document |
| This updated tip sheet describes the short- and long-term effects of COVID-19 related community mitigation measures on the healthcare system, including morbidity and mortality from chronic health conditions and lack of access. The accompanying summary document can help healthcare system planners prepare to mitigate these potential healthcare delivery impacts. |
| New: Acute Care Delivery at Home Tip Sheet |
| Some healthcare providers and systems have been providing hospital-level care in patient’s homes for years; others have implemented acute care delivery at home models in response to overcrowding at hospitals due to COVID-19. This tip sheet provides an overview of characteristics of various types of acute care delivery at home programs to help healthcare providers better understand this care model. |
| Issue 12: COVID-19 and Healthcare Professional Stress and Resilience |
| The articles in Issue 12 of The Exchange focus on three categories: understanding acute and chronic stressors in the healthcare worker population, identifying at-risk employees, and promising practices in building resilience. Be on the lookout for Issue 13, which will focus on the significant contributions made by supportive care providers and healthcare engineering representatives during the COVID-19 pandemic. |
| Mind Over Matter: Strategies to Help Combat the Coronavirus Blues |
| This document (created by the COVID-19 Schools Task Force, FEMA Region VII, and HHS Region 7) summarizes the contents of the Mind Over Matter Resource Guide, which can be used to support messaging for college and university campus communities to help combat COVID-19 fatigue and promote general wellness, both during and after the pandemic. |
| UCSD Health Medical Cyber Disaster Preparedness Study |
| The University of California San Diego (UCSD) is interested in better understanding how cybersecurity and cyber attacks impact our hospital systems and how we can better prepare in the future. This brief survey will provide a basic understanding of where we stand nationally on healthcare cyber preparedness. Your responses will be kept confidential and all data will be deidentified and reported in FEMA regions. The survey should take approximately five minutes to complete. You will receive no compensation for your participation and participation in this research is voluntary. The principal investigator of this study can be contacted at:
Dr. Christian Dameff, MD University of California San Diego Department of Emergency Medicine 200 W. Arbor Dr. #8676 San Diego, CA 92103
COVID-19 Clinical Rounds Peer-to-Peer Virtual Communities of Practice are a collaborative effort between ASPR, the National Emerging Special Pathogen Training and Education Center (NETEC), and Project ECHO. These interactive virtual learning sessions aim to create a peer-to-peer learning network where clinicians from the U.S. and abroad who have experience treating patients with COVID-19 share their challenges and successes; a generous amount of time for participant Q & A is also provided. These webinar topics are covered every week:
Access previous webinars and special topic sessions and sign up today to receive information on upcoming events. |