National Governors Association Center for Best Practices Request for Applications Rural Health Learning Collaborative

Transcription

1 Natinal Gvernrs Assciatin Center fr Best Practices Request fr Applicatins Rural Health Learning Cllabrative IMPORTANT INFORMATION Purpse: T prvide technical assistance t states interested in develping and implementing initiatives t increase access t high quality and csteffective health care in rural areas. RFA Release Date: Mnday, February 13, 2017 Optinal Bidders Calls: Wednesday, February 22, 1:00 p.m. ET Passcde: Tuesday, February 28, 3:00 p.m. ET Passcde: Applicatins Due: Friday, March 10, 5:00 p.m. ET Selectin Annuncement: Week f March 20, 2017 Prject Perid: March 2017 March 2018 Eligibility: NGA Cntact(s): States, cmmnwealths, and territries ( states ) Lauren Blck, Prgram Directr lblck@nga.rg r PURPOSE The Rural Health Learning Cllabrative is an pprtunity fr gvernrs senir staff and ther state fficials t receive technical assistance t identify and implement strategies regarding access t high quality and cst-effective health care in rural America. BACKGROUND Challenges facing rural America, particularly regarding access t high quality health care, are f primary cncern t gvernrs thrughut the cuntry. Rural cmmunities face a significant set f barriers including prer health and well-being, limited access t care, lwer incmes, diminishing ppulatins, higher rates f uninsured individuals, and aging ppulatins. Increasing numbers f hspital clsures and prvider shrtages cmpund the challenges facing rural America and ultimately cntribute t pr health and unstable rural ecnmies. Gvernrs are seeking t identify shrt- and lng-term slutins t imprve the health and well-being f rural cmmunities. 1

2 Recent trends pint t a widening gap between the health status f rural Americans and their urban cunterparts. Over time, rates f chrnic diseases and mrtality have declined acrss America. Hwever, these imprvements have been much slwer in rural areas, and in sme cases rates f chrnic diseases have been rising. 1 Lack f access t evidence-based and cst-effective health care has had a significant impact n the health utcmes f rural ppulatins. This is true acrss the cntinuum f care frm primary t tertiary. Fr example, since 2010, rural cmmunities have seen a significant increase in hspital clsures. 2 Lw patient vlumes cupled with fee-fr-service payment mdels, result in negative perating margins fr many rural hspitals. 3 Furthermre, a heavy reliance n public payers results in payments fr services that d nt always cver csts. The absence f hspitals and adequate primary care within r near rural cmmunities severely limits access t health care services. Hspital clsures als may result in negative cnsequences fr lcal cmmunities where the hspital was a majr emplyer, resulting in jb lss and declining new investment in the lcal ecnmy. 4 In general, wrkfrce shrtages are a majr issue fr rural America with mre than three quarters f the cuntry s rural cunties experiencing health care wrkfrce shrtages. 5 Rural cmmunities struggle t recruit and retain health care prviders, prmpting residents t seek care utside f the cmmunity. 6 Furthermre, the remaining health care wrkfrce is strained t prvide necessary services and may face cnsiderable burnut leading t additinal departures. This additinal burden n an already strained system adds t existing challenges fr residents in accessing high quality primary care, behaviral health, and ral health care. Behaviral health prviders in particular are disprprtinately scarce in rural areas. 7 States have lng been explring strategies t maintain access t critical services thrugh certain health care wrkfrce strategies (e.g., maximizing primary care, telehealth, faith r lay wrkfrce as extenders, creating hme-grwn health wrkfrce pipeline, etc.). Sustainable plicy slutins rely n data; nt just t estimate shrtages, but t creatively address the health wrkfrce needs that match the mdern health systems. Having the right data t cnduct a needs assessment t determine shrtages and develp multidisciplinary, lcally-meaningful slutins is an nging issue fr states fficials, including State Offices f Primary Care. This is especially critical fr rural cmmunities where ne prvider (primary care, psychiatrists, etc.) may practice in multiple cunties r wrk with prviders ther than physicians. Multiple states have implemented successful data cllectin and analysis strategies frm which thers may learn. 1 Frstensn, S. (2017, January 13). The Death Rate Between Rural and Urban America is Getting Wider. Vx Media. Retrieved January 17, 2017, frm Rural Hspital Clsures: January 2010 Present Sheps Center. (n.d.). Retrieved January 17, 2017, frm 3 Hlmes, G. M., Pink, G. H., & Kaufman, B. G. (2016, June). Predicting Financial Distress and Clsure in Rural Hspitals. The Jurnal f Rural Health. Retrieved January 17, Eilrich, F. C., Deksen, G. A., & St. Clair, C. F. (2015, July). The Ecnmic Impact f Recent Hspital Clsures n Rural Cmmunities. Natinal Center fr Rural Health Wrks. Retrieve January 17, 2017, frm HspitalClsure-August-2015.pdf 5 Gdwin, K., & Tbler, L. (2016, August). Imprving Rural Health: State Plicy Optins. Natinal Cnference f State Legislatures. Retrieved January 17, 2017, frm 6 ilrich, F. C., Deksen, G. A., & St. Clair, C. F. (2007, January). The Ecnmic Impact f Recent Hspital Primary Care Physician and the Ptential Health Dllars Lst t Out-migrating Health Services. Natinal Center fr Rural Health Wrks. Retrieve January 23, 2017, frm

3 DESCRIPTION OF THE LEARNING COLLABORATIVE In this learning cllabrative state applicants may chse t fcus n a variety f plicy issues impacting the health f their rural ppulatins. Examples f such plicy issues include, but are nt limited t: Rural hspital clsures and strategies t retain critical services alng the cntinuum f care Behaviral health in rural areas Health care wrkfrce shrtages Health care wrkfrce data and analytics Scpe f practice and emerging prfessins Rural health care systems as a driver f ecnmic develpment Preparing fr ptential new federal legislatin and/r regulatins and their impact n rural health Telehealth and telemedicine Oral health in rural areas Emergency medical transprtatin issues Thrugh this initiative, states will explre the underlying issues impacting their cmmunities and wrk twards strategies t ensure new r cntinued access t care. Participating states will gain a firsthand understanding f innvative, evidence-based/prmising plicies, prgrams, and practices thrugh a variety f activities including ne r mre f the fllwing: Learning Labs: The NGA Center will bring 3-5 states tgether t tackle a specific plicy issue with key experts. If there is an innvatr state that has prduced prmising r evidence-based results in the issue area, the NGA Center will bring learning states t the innvatr state t learn abut their apprach. States will develp a strategic actin plan t articulate specific strategies and actin items t address the desired plicy changes. Multi-state Cnvening: Leaders frm multiple states will cnvene with natinal experts t discuss specific plicy issues impacting rural America. The fcus f this meeting culd be reginal r tpic based depending n the interest f participating states. Individualized State TA and In-state Retreats: The NGA Center will meet with state leaders, key stakehlders, and ther state representatives (as applicable) t tackle specific individual state challenges (e.g. identifying strategies t use data t assess existing wrkfrce capacity, engaging with rural hspitals t identify sustainability challenges and slutins, r implementing telehealth strategies). Telecnference Calls: The NGA Center will bring tgether states and natinal experts via telecnference t address specific plicy questins, learn abut initiatives in ther states, and t discuss emerging issues in rural health plicy. The NGA Center fr Best Practices (the Center) is cmmitted t prviding high quality technical assistance t meet the needs f states lking t imprve health care in rural cmmunities thrugh evidence-based slutins. This prject is made pssible thrugh a grant frm the Health Resurces and Services Administratin. 3

4 TIMELINE The fllwing is an verview f key prject dates. RFA Release Date Mnday, February 13, 2017 Optinal Bidders Calls Wednesday, February 22, 1:00 p.m. ET Passcde: Tuesday, February 28, 3:00 p.m. ET Passcde: Applicatins Due Friday, March 10, 5:00 p.m. ET Selectin Annuncement Week f March 20, 2017 Date Annuncing First Learning Week f March 20, 2017 Cllabrative Opprtunity Prject Perid March 2017 March 2018 REQUIRED APPLICATION CONTENT All states may apply t participate in the learning cllabrative. T apply, states must submit the fllwing materials. Letter frm the Gvernr. The letter must include the state s interest in and desired utcme related t the technical assistance pprtunity. The letter shuld indicate wh the gvernr is designating as the team leader. This individual will serve as the main pint f cntact between the NGA Center and the state. Brief Narrative. The narrative shuld nt exceed fur (4) pages (11-pint fnt, single-spaced) and shuld include the fllwing elements: Descriptin f current challenges. Applicants shuld prvide a brief descriptin f current challenges that exist as the state plans fr and wrks n addressing access t high quality and cst-effective health care in rural areas. (20 pints) Descriptin f current wrk. Applicants shuld prvide a brief descriptin f hw state departments and agencies are currently wrking t address access t health care in rural areas, including specific gals, implementatin steps, and benchmarks f prgress. This descriptin shuld identify existing state effrts, prgrams, and any technical assistance the state is receiving frm the NGA Center r ther rganizatins related t this issue. (20 pints) Descriptin f preliminary gals and expected utcmes. Applicants shuld prvide an verview f the state s gals, expected utcmes, and hw success will be measured fr this learning pprtunity. Applicants als shuld describe hw they envisin using this technical assistance pprtunity t meet brader state gals, and include a descriptin f existing capacity r infrastructure t supprt initiatives that may be pursued thrugh this learning cllabrative. The descriptin shuld include the plicy issues that the team wishes t fcus n (which may extend beynd the list prvided abve) and the preferred frmats f technical assistance (e.g. multi-state cnvenings, in-state retreats, r crss-state sharing f best practices). (35 pints) 4

5 Learning cllabrative team. Prvide a brief statement describing the cre team and team leader that will participate in the learning cllabrative, including the reasn fr each member and agency s participatin. If individuals wh are instrumental t implementing the state s actin plan are nt included in the team, describe hw these individuals will be included in this wrk. Prvide the names, titles, and cntact infrmatin f the team leader and all team members. State applicatins must include the name and cntact infrmatin f an administrative staff persn wh is cnnected t the team lead and can help schedule cnference calls and facilitate ther team lgistics. We encurage states t include representatives frm the gvernr s ffice in the learning cllabrative team. Examples f individuals that the state may cnsider n their team include individuals in the fllwing rles: Gvernr s ffice representative Representative frm the State Office f Rural Health Representative frm the State Primary Care Office Representative frm the State Area Health Educatin Center Health secretary r ther state health fficial Medicaid directr State health care wrkfrce data expert Representative frm the State Wrkfrce Investment Bard State teams shuld include five t six members. (25 pints) SUBMISSION INFORMATION All applicatins must be received by 5:00 p.m. ET n Friday, March 10, Applicatins must be submitted by the gvernr s ffice. Please cmbine all applicatin materials int a single PDF dcument and it t Lauren Blck at lblck@nga.rg. Fllwing submissin, applicants will receive a cnfirmatin frm the NGA Center verifying receipt f yur applicatin. Once accepted int the learning cllabrative, states will nt be required t reapply fr any additinal technical assistance pprtunities related t this rural health learning cllabrative. The NGA Center will wrk with the individually selected states t determine the cmbinatin f activities that will best meet the needs f the states. Questins may be directed t Lauren Blck (lblck@nga.rg; ). This request fr applicatin (RFA) is nt binding n the NGA Center fr Best Practices, nr des it cnstitute a cntractual ffer. Withut limiting the freging, the NGA Center reserves the right, in its sle discretin, t reject any r all applicatins; t mdify, supplement, r cancel the RFA; t waive any deviatin frm the RFA; t negtiate regarding any prpsal; and t negtiate final terms and cnditins that may differ frm thse stated in the RFA. Under n circumstances shall NGA be liable fr any csts incurred by any persn in cnnectin with the preparatin and submissin f a respnse t this RFA. 5