ORHP Overview

 

The Office of Rural Health Policy (ORHP) coordinates activities related to rural health care within the U.S. Department of Health and Human Services. While located within the Health Resources and Services Administration (HRSA), the Office has a department-wide responsibility to analyze the impact of policy on rural communities. The Office’s policy role is created by Section 711 of the Social Security Act, which charges the Office with advising the Secretary on rural health issues. In that role, the Office examines issues such as the effects of Medicare and Medicaid on rural citizens’ access to health care, specifically on the viability of rural hospitals, and the availability of rural physicians and other health professionals.

 

ORHP serves as both a policy and programmatic resource for rural communities. In FY 2007, ORHP administered 16 grant programs with a focus on capacity building at the community and State levels.

 

The Office’s grant programs provide funding at both the community and State levels to support improved rural health care delivery. The Office’s hospital-State programs provide grants to the States to support State-wide activities via the 50 State Offices of Rural Health (SORH) and to work with rural hospitals across the Nation. Through its community-based programs, the Office supports projects that improve access to high quality health care services, encourage network development among rural health care providers, enhance delivery of emergency medical services and place and train people on the use of automatic external defibrillators. The Office also oversees the Black Lung Clinics grant program and the Radiation Exposure Screening and Education grant program. While these programs are not solely focused on rural health issues, many of the populations affected reside in rural areas.

 

In addition, the Office is also charged with two agency-wide coordinating functions: HRSA’s border health activities and the Agency’s intergovernmental affairs activities. Much of the 2,100-mile U.S.-Mexico border is rural and the urban regions face health care delivery challenges similar to rural areas, such as limited health workforce capacity and fragile infrastructure. Coordination of the agency’s intergovernmental affairs activities resides with ORHP due to the office’s interaction with many programs across the agency.

Authorizing Legislation:

Black Lung
Section 427(a), Public Law 91-173 of the Federal Coal Mine Health and Safety Act of 1977 as amended by section 5(6), Public Law 92-303 of the Black Lung Benefits Act of 1972 and amended by section 9, Public Law 95-239 of the Black Lung Benefits Reform Act of 1977.

Delta Health Initiative Grant Program
Section 1820(j) of the Social Security Act 42 U.S.C. 1395

Delta States Rural Development Network Grant Program
Section 330A of the Public Health Service Act 42 U.S.C. 254c

Frontier Extended Stay Clinics Demonstration
Section 301 and 330A of the Public Health Service Act 42 U.S.C. 241 and 254c.

Medicare Rural Hospital Flexibility Grant Program
Section 1820(j) of the Social Security Act 42 U.S.C. 1395

Network Development Grant Program
Section 330A of the Public Health Service Act 42 U.S.C. 254c

Network Development Planning Grant Program
Section 330A of the Public Health Service Act 42 U.S.C. 254c

Policy Oriented Rural Health Services Research Program
Section 711 of the Social Security Act 42 U.S.C. 912

Public Access to Defibrillation Demonstration Projects
Section 313 of the Public Health Service Act 42 U.S.C. 245 as amended by section 159(c), P.L. 107-188 of the Public Heath Security and Bioterrorism Preparedness and Response Act of 2002.

Radiation Exposure, Screening and Education Program
Section 417C of the Public Health Service Act as amended by section 4, Public Law 106-245 of the Radiation Exposure Compensation Act Amendments of 2000.

Rural Access to Emergency Devices Grant Program
P.L. 106-505, Title IV – Cardiac Arrest Survival Act, Subtitle B, section 413 of the Public Health Improvement Act 42 U.S.C. 254c.

Rural Health Outreach Grant Program
Section 330A of the Public Health Service Act 42 U.S.C.

Rural Health Research Centers Program
Section 711 of the Social Security Act 42 U.S.C. 912

Small Health Care Provider Quality Improvement Grant Program
Section 330A of the Public Health Service Act 42 U.S.C. 254c

Small Rural Hospital Improvement Grant Program
Section 1820(g)(3) of the Social Security Act 42 U.S.C. as amended by section 4201(a), P.L. 105-33 of the Balanced Budget Act and section 405(f), P.L. 108-173 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003.

State Offices of Rural Health Grant Program
Section 338J of the Public Health Service Act 42 U.S.C. 254r as amended by section 301, P.L. 105-392.

 

FY 2007 Overview

 

The Office had a variety of noteworthy programmatic and policy accomplishments in FY 2007 which addressed the Office’s key priority areas for the year: health information technology (HIT), quality improvement, and performance measurement. Some examples of the Office’s activities include funding a new HIT grant program, hosting the third bi-annual All-Programs Meeting, and creating an electronic performance improvement and measurement system (PIMS).

 

Flex Critical Access Hospital (CAH) HIT Network Grant

Through the new Flex Critical Access Hospital (CAH) HIT Network grant program, the Office awarded approximately $25 million to 16 State Offices of Rural Health. This program supports the development of Flex CAH-HIT Network pilot programs to promote and implement HIT and electronic health records in CAHs and the providers with which they work.

 

ORHP All-Programs Meeting

In August, over 800 ORHP community-based and State grantees attended the Office’s All-Programs Meeting in Washington D.C., where they exchanged ideas with HRSA partners and learned from fellow grantees about best practices being implemented across rural America. The meeting highlighted various rural health issues, such as the changing demographics of rural, workforce, rural health policy, quality improvement, HIT, mental health, and veterans affairs. In addition to the All-Programs Meeting, a commemorative twentieth anniversary roundtable session was held in August, where past and current directors and deputy directors shared highlights from their years of service.

 

Performance Improvement and Measurement System (PIMS)

To enhance the Office’s ability to report and track the progress of its programs, ORHP identified performance measures for all of its programs over the past year and is working with the HRSA Office of Information Technology to develop the performance improvement and measurement system (PIMS). This system will be compatible with the Electronic Handbook, which is currently used by grantees to submit their non-competing continuation guidance. The PIMS system is expected to be operational by FY 2009 and will help quantify the impact of ORHP funding on quality of services, access to health care and improvement of health outcomes.

 

 

ORHP Budget

 

Chart 1 – Budget Summary for Programs, FY 2006 and FY 2007 (amounts in thousands)

 

 

Note: Individual line items may include funding for more than one grant program. For example, the Rural Health Outreach line item includes funding for the Rural Health Care Services Outreach, Rural Network Development, Network Planning, Small Health Care Provider Quality Improvement, Frontier Extended Stay, and Delta Network grant programs. The Medicare Rural Hospital Flexibility Grant line includes funding for the Flex, Small Hospital Improvement, and Delta Health Initiative grant programs. The policy line item includes funding for the Rural Health Research Center grant program, as well as all of the Office’s policy activities. Also, the Flex Line for FY 2007 includes $25 million above the base to fund the Critical Access Hospital Health Information Technology Network Grant Program.

 

Chart 2 – Total number of ORHP Grants and Amounts by State, FY 2007

 

Total number of Grants awarded: 399

Total amount Funding provided: $111,952,162

 

 

State	# Grants Awarded	FY 2006 Funding		State	# Grants Awarded	FY 2006 Funding		State	# Grants Awarded	FY 2006 Funding
AK	8	1,602,065		LA	14	4,288,849		OH	8	2,028,011
AL	12	3,310,117		MA	5	984,191		OK	7	1,273,805
AR	9	2,472,161		MD	5	999,854		OR	6	1,354,576
AZ	9	1,530,635		ME	6	1,690,510		PA	10	1,751,016
CA	7	1,792,809		MI	18	4,509,305		RI	1	141,600
CO	6	2,164,816		MN	10	4,264,345		SC	9	3,524,792
CT	2	298,500		MO	9	2,300,538		SD	8	1,736,014
DE	3	451,415		MS	9	2,585,738		TN	8	3,556,620
FL	7	1,214,459		MT	12	2,393,988		TX	13	4,145,940
GA	13	2,544,901