The Branch
A monthly update for NOSORH members and partners
June 2020
NOSORH Annual Meeting Going Virtual!
NOSORH and the Annual Meeting Planning Committee recently made the decision that the 2020 NOSORH Annual Meeting will be going virtual on September 29-30! NOSORH is excited to work with the Planning Committee to deliver a robust agenda and exciting new opportunities for our members, partners and other stakeholders. As information about the virtual conference becomes available, NOSORH will be alerting you. If you have any questions, please contact Matt Strycker at stryckerm@nosorh.org.
Navigating COVID-19 Regulations & Guidance
You may have noticed a slower, steady stream of new and revised COVID-related guidance being released over the last week or two and not the massive influx experienced early on. Wading through all of this guidance can be overwhelming. How do you know what to dig into and what to scan?

The NOSORH COVID-19 Resources page is a one-stop shop for navigating the guidance and other regulatory updates. Two items of note are the press release reminding Providers Must Act by June 3, 2020 to Receive Additional Relief Fund General Distribution Payment and the addition of the Interim Final Rule for the Paycheck Protection Program. These two items contain information that may be vital to the sustainability of rural providers – primary care as well as hospital. When possible, ensure information shared with rural providers is from a vetted, reputable source providing guidance and requirements from the agency having oversight of those particular funds.

Continue to keep an eye on the NOSORH COVID-19 Resources and the SORH COVID-19 Responses pages to stay up-to-date on best practices, guidance and requirements as they become available.
Support NOSORH with New Partner Opportunities!
Check out NOSORH’s 2020 Partnership Invitation and help put the focus on rural health in 2020! When you partner with NOSORH, you’re helping us to work with state and community stakeholders to improve health in America’s rural communities. There are various levels of partnership and no matter what level you select, know that your investments will make a difference. Although the NOSORH Annual Meeting is going virtual this year, we are still planning on plenty of opportunities to virtually network with members and other stakeholders during the meeting, on National Rural Health Day, and throughout the year – stay tuned for more details!
Save the Date! National Rural Health Day 2020
Join NOSORH in celebrating the 10 th annual National Rural Health Day on November 19, 2020! Be sure to visit the National Rural Health Day headquarters at www.powerofrural.org for resources, toolkits and more (as they become available)! Also, be thinking of some rural rock stars to nominate for the 2020 book of Community Stars! This annual book is released on NRHD and features the inspirational people, organizations and communities making a BIG difference in rural health. Please help us find a shining star from all 50 states. Nominations will open on June 15.
Coming Soon: RHC Technical Assistance Education Module
The revised and refreshed RHC Technical Assistance Education Series Module #3 – Helping SORH Make TA Decisions is coming this month to the RHC Resource page on the NOSORH website! The module is geared toward directors and team members interested in the development and implementation of technical assistance (TA) for rural primary care providers, including Rural Health Clinics. The goal is to enhance understanding and application of the core principles of TA. In addition, the module helps SORH determine their capacity to provide TA and outlines benefits/opportunities for providing TA services. The current precarious economic situation in many rural communities makes now a compelling time to start this TA work designed to enhance rural primary care and RHC service sustainability in rural areas. Keep an eye on your email for the roll-out of the refreshed module about mid-month and plan to join us for the “Resource Roundup” webinar for official relaunch in late July! In the meantime, reach out to Tammy Norville ( tammyn@nosorh.org ) with questions or for additional information.
Rural Health Policy Update
On May 15, the House passed H.R. 6800, the Health and Economic Recovery Omnibus Emergency Solutions Act. The massive $3 trillion Coronavirus Relief bill is not going to be considered by the Senate, but does represent a starting point in the next virus-relief package. A few of the bill highlights include: an additional $100 billion to the Public Health and Social Services Emergency Fund; reduce the interest rate in Medicare Advanced Payment loans for all hospitals; include hazard pay for frontline healthcare workers; and a requirement for the promulgation of emergency OSHA standards for healthcare workers. Notably absent from the bill was a liability protection measure which Senate Republicans have said is a “red-line” for their support. The Senate will begin putting Read More
Rural Hospital Assistance Program Now Accepting Applications
T he Center for Optimizing Rural Health (CORH) will open their application portal for the Rural Hospital Assistance Program from June 1 - July 31, 2020. CORH offers technical assistance to 30 rural hospitals each year to help address economic challenges, understand community needs and resources and find ways to ensure hospitals and communities can keep needed care locally. The application is open to all rural and CAH hospitals in the US. Access the application here   or check out their Twitter page for updates. Selected hospitals will be notified in August 2020 with technical assistance provided from September 2020- August 2021.To learn more, please visit their website or email info@optimizingruralhealth.org.
Depression, Alcohol and Farm Stress: Addressing Co-Occurring Disorders
As summer arrives, it is important to recognize the stress experienced among agricultural communities navigating farming and ranching in a year of tariffs, unprecedented weather, and a global health pandemic. Although agricultural communities face unique stressors, finding resources to provide mental health support for this community can be difficult. The Mountain Plains Mental Health Technology Transfer Center (MHTTC) has compiled farm stress and mental health resources to help mental health providers, rural communities, and primary care providers address these areas. The resources are rural and agriculture specific, allowing professionals to not only learn best practices for support, but to truly understand cultural and industry factors that play large roles in farmer mental health.

The Mountain Plains MHTTC guide Depression, Alcohol and Farm Stress: Addressing Co-Occurring Disorders in Rural America, walks through specific resources utilized in screening for common co-occurring disorders that affect farmers, farmworkers, and farm families. It uses a case scenario to discuss frequent barriers in identifying these disorders and highlights the unique stressors and needs of rural agricultural communities.

Be sure to join MHTTC, the Suicide Prevention Resource Center, and NOSORH on June 2 at 3:00 pm ET for the webinar:   Rural Primary Care Tools and Resources for Managing Suicidal Ideation During COVID-19 . This webinar will provide rural primary care providers with tools to address concerns about a possible increase in deaths by suicide during the COVID-19 pandemic.
The Mountain Plains MHTTC is funded by the Substance Abuse and Mental Health Services Administration, and produces many resources and trainings related to Rural Mental Health . For other related farm stress resources, visit their Farm Stress and Mental Health website
NOSORH Promising Practice
Getting More Nurses Working in Rural Montana
by Beth Blevins

In Montana, 52 of 56 counties are classified as medically underserved and ten counties have no physician. This is why nurses play such an important role there, and why the Montana Office of Rural Health/Area Health Education Center (MORH/AHEC) is working to get more nurses in rural, underserved communities.

“Montana is different than other states because of our extreme frontier nature, so nurse practitioners (DNPs) have a full scope of practice here,” said Kristin Juliar, MORH/AHEC Director. “In many communities, they may be the sole primary care practice, and physician supervision is some distance away.”

Using a grow-your-own approach, MORH has joined with the Montana State University College of Nursing, where it is housed, to get more nurses trained and working in rural areas. Read More
Past Promising Practice articles can be found here on the NOSORH website

June
2
(3:00 ET)
Webinar-  Rural Primary Care Tools & Resources for Managing Suicidal Ideation During COVID-19
Concerns about a possible increase in deaths by suicide and serving people with suicidal ideation during the pandemic are the source of increased distress among rural providers. This webinar provides tools for rural primary care providers to address these concerns. Click here to register  
June
24
(2:00 ET)
TruServe Monthly Training

September
29-30
Virtual NOSORH Annual Meeting

November
19
National Rural Health Day

F eatured Resources
Resources for Rural Community Health Needs Assessments and Community Health Improvement Plans
We often hear our rural health partners discuss community health needs assessments (CHNA) and community health improvement plans (CHIP), but are we all talking about the same thing? With support from FORHP, NOSORH developed a fact sheet examining rural CHNAs and CHIPs . It explores the nuances of the terms for rural health stakeholders, as part of the broader community health improvement process. Highlighting the differences between non-profit hospital reporting of financial benefits and an accredited health department CHIP – a communication barrier for many – and offering useful tools and resources to learn more, the fact sheet can encourage meaningful discussions at the community level.
NOSORH Manual: Using Data to Define Rural Populations
Understanding the data points that characterize rural communities ensures State Offices of Rural Health have a solid base for providing technical assistance and targeting resources to areas of highest need. The Using Data to Define Rural Populations manual assists SORH and other rural health stakeholders in identifying the steps to developing an initial dataset for defining rural populations in their state.
#PowerofRural