U.S. Department of Health and Human Services 

Health Resources and Services Administration 

Office of Rural Health Policy 

2007 Annual Report 

1 
     

       

       

       

       

   

   

     

Table of Contents
 

ORHP OVERVIEW ......................................................................................................................................................3
 

FY 2007 OVERVIEW...................................................................................................................................................4
 

POLICY ACTIVITIES..................................................................................................................................................6
 

KEY REGULATORY REVIEW AND POLICY ACTIVITIES .............................................................................................6
 

Rural Medicare Payment..................................................................................................................................6
 

Rural Health Care Quality ................................................................................................................................7
 

Health and Human Services (HHS) Rural Task Force ................................................................................7
 

National Advisory Committee on Rural Health and Human Services (NACRHHS) ................................7
 

POLICY RELATED PROJECTS AND PARTNERSHIPS ...................................................................................................8
 

340B Technical Assistance..............................................................................................................................8
 

CAH Capital Replacement Manual.................................................................................................................8
 

Center for Rural Health Works (RHWks) .......................................................................................................8
 

Delta Regional Authority/ Appalachian Regional Authority Pharmacy Assist Demonstration ...............8
 

National Association of Counties (NACo)......................................................................................................9
 

National Conference of State Legislatures (NCSL)......................................................................................9
 

National Organization of State Offices of Rural Health (NOSORH) ..........................................................9
 

National Rural Health Association (NRHA) ...................................................................................................9
 

National Rural Recruitment and Retention Network ..................................................................................10
 

Rapid Response to Requests for Rural Data Analysis ..............................................................................10
 

Rural Assistance Center.................................................................................................................................10
 

Rural Health Clinic Technical Assistance Series........................................................................................11
 

Rural Health Research Center Gateway .....................................................................................................11
 

Rural Hospital Performance Improvement Project.....................................................................................11
 

Rural Policy Analysis Cooperative Agreement ...........................................................................................12
 

Technical Assistance and Services Center .................................................................................................12
 

GRANT PROGRAMS ................................................................................................................................................13
 

RESEARCH AND POLICY GRANT PROGRAMS.........................................................................................................13
 

Frontier Extended Stay Clinic Program (FESC) .........................................................................................14
 

Rural Health Research Centers Program (Research Centers) ................................................................15
 

Targeted Rural Health Research Grant (TRHR).........................................................................................16
 

HOSPITAL STATE TEAM GRANT PROGRAMS .........................................................................................................17
 

Critical Access Hospital Health Information Technology Network Grant Program (CAHHIT) .............18
 

Medicare Rural Hospital Flexibility Grant Program (Flex) .........................................................................19
 

Small Rural Hospital Improvement Grant Program (SHIP).......................................................................20
 

State Offices of Rural Health Grant Program (SORH)...............................................................................21
 

COMMUNITY‐BASED GRANT PROGRAMS..............................................................................................................22
 

Black Lung Clinics Program (BLCP).............................................................................................................23
 

Delta Health Initiative (DHI) ...........................................................................................................................24
 

Delta States Rural Development Network Grant Program (Delta)...........................................................25
 

Radiation Exposure Screening and Education Program (RESEP)..........................................................26
 

Rural Health Care Services Outreach Grant Program (Outreach) ..........................................................27
 

Rural Health Network Development Grant Program..................................................................................28
 

Rural Health Network Development Planning Grant Program (Network Planning) ..............................29
 

Rural Access to Emergency Devices (RAED) ............................................................................................30
 

Small Health Care Provider Quality Improvement Grant Program (Rural Quality)................................31
 

OTHER HRSA INITIATIVES ADMINISTERED BY ORHP...................................................................................32
 

BORDER HEALTH.....................................................................................................................................................33
 

INTERGOVERNMENTAL AFFAIRS (IGA).................................................................................................................34
 

APPENDIX A: ORHP STAFF..................................................................................................................................35
 

2 
 

 

 

 

 

 

 

 

 

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 hospitalState 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. 

3 
 

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. 

4 
                             

ORHP Budget 

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

Rural Health Programs 

FY 2006 Final 

Appropriation 

FY 2007 Final 

Appropriation 

RuralHealthOutreach38,88538,885

RuralHealthResearch8,7378,737

MedicareRuralHospitalFlexibility63,53863,538

RuralandCommunityAccesstoEmergency

Devices

1,4851,487

RuralEMSTrainingandAssistance

EquipmentProgram

00

StateOfficesofRuralHealth8,1418,141

DenaliCommission39,28339,283

Radiation,Screening,Exposureand

EducationProgram

1,9171,919

BlackLung5,8915,891

Total$167,877$167,881

Note:Individuallineitemsmayincludefundingformorethanonegrantprogram.Forexample,theRuralHealthOutreachlineitemincludesfundingfor

theRuralHealthCareServicesOutreach,RuralNetworkDevelopment,NetworkPlanning,SmallHealthCareProviderQualityImprovement,Frontier

ExtendedStay,andDeltaNetworkgrantprograms.TheMedicareRuralHospitalFlexibilityGrantlineincludesfundingfortheFlex,SmallHospital

Improvement,andDeltaHealthInitiativegrantprograms.ThepolicylineitemincludesfundingfortheRuralHealthResearchCentergrantprogram,as

wellasalloftheOffice’spolicyactivities.Also,theFlexLineforFY2007includes$25millionabovethebasetofundtheCriticalAccessHospital

HealthInformationTechnologyNetworkGrantProgram.

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 

AK 8 1,602,065 

AL 12 3,310,117 

AR 9 2,472,161 

AZ 9 1,530,635 

CA 7 1,792,809 

CO 6 2,164,816 

CT 2 298,500 

DE 3 451,415 

FL 7 1,214,459 

GA 13 2,544,901 

HI 4 2,294,450 

IA 9 2,075,227 

ID 5 1,020,735 

IL 9 4,214,928 

IN 9 3,231,429 

KS 6 1,793,275 

KY 10 2,824,139 

State # Grants 

Awarded 

FY 2006 

Funding 

LA 14 4,288,849 

MA 5 984,191 

MD 5 999,854 

ME 6 1,690,510 

MI 18 4,509,305 

MN 10 4,264,345 

MO 9 2,300,538 

MS 9 2,585,738 

MT 12 2,393,988 

NC 8 1,889,875 

ND 8 2,825,353 

NE 13 4,180,281 

NH 8 1,387,426 

NJ 2 248,294 

NM 11 2,404,608 

NV 7 1,273,805 

NY 9 1,435,195 

State # Grants 

Awarded 

FY 2006 

Funding 

OH 8 2,028,011 

OK 7 1,273,805 

OR 6 1,354,576 

PA 10 1,751,016 

RI 1 141,600 

SC 9 3,524,792 

SD 8 1,736,014 

TN 8 3,556,620 

TX 13 4,145,940 

UT 6 1,370,214 

VA 10 3,354,980 

VT 4 982,853 

WA 9 3,650,520 

WI 8 3,374,829 

WV 5 2,287,554 

WY 5 1,023,091 

5 
           

 

Policy Activities 

Key Regulatory Review and Policy Activities

In its policy role, the Office focuses on issues related to access to care for residents of rural areas. 

Because many of the policy levers at the Federal level are related to the Medicare program, Medicare 

policy review and analysis comprise much of the Office’s policy work. However, significant time and 

attention are also devoted to other policy areas including Medicaid, the State Children’s Health Insurance 

Program (SCHIP), workforce, quality, and health information technology (HIT). The Office advises the 

Secretary on the effects of current policies and proposed statutory, regulatory, administrative, and 

budgetary changes in previously mentioned areas. 

o	 The specific Medicare regulations that come through ORHP for review vary somewhat from year 

to year. However, the major Medicare payment system regulations generally come through for 

review during both the proposed rule-making and final rule-making cycles. Recently, regulations 

relating to the Medicare Advantage, Medicare Drug Benefit, and various quality reporting 

programs also have been reviewed for comment. 

o	 Medicaid and SCHIP are State-based programs. Therefore, much of the discretion for these 

programs is left to the States. However, ORHP does participate in the departmental review of 

Medicaid and SCHIP waiver proposals to assure that the interests of rural Medicaid beneficiaries 

are considered. 

o	 The Office role in workforce policy encompasses a wide variety of issues including Medicare 

Graduate Medical Education, J1-Visa Waivers, the National Health Service Corps, and Title VII 

programs that provide support to rural providers. 

o	 Rural Health quality issues are relatively new, yet important activity to the Office. ORHP 

participates in review and analysis of rural provider participation in quality measurement and 

reporting activities and value-based purchasing programs. 

Rural Medicare Payment 

During Fiscal Year 2007, the policy staff in ORHP reviewed approximately 150 draft Federal regulations 

and policies to determine how they might affect rural providers and the individuals they serve. Of these 

regulations, 26 included provisions ORHP staff felt had the potential to adversely affect rural providers or 

for which staff felt additional language should be added to provide adequate protections for rural 

providers. 

ORHP often identifies issues of particular concern to rural providers during its review of the Medicare 

payment system regulations. 

o	 The FY 2008 Inpatient Prospective Payment System (IPPS) regulations implemented a new 

payment classification for IPPS diagnosis-related groups (DRGs) called the Medicare Severity, or 

MS-DRGs, which better accounts for the severity of each patient’s condition. ORHP analyzed the 

impact of these changes on rural providers and will continue to monitor their impact as they are 

implemented in the coming years. 

o	 The CY 2008, Outpatient Prospective Payment System (OPPS) regulations offered the continued 

opportunity to provide assistance to CMS in developing a payment add-on for certain rural 

hospitals. Additionally in this regulation, ORHP worked with CMS to develop reasonable 

standards for changes to Critical Access Hospital conditions of participation pertaining to 

requirements for co-location and off-campus provider-based facilities. 

6 
 

 

 

 

o	 During 2007, the Office continued to work with CMS on the CAH necessary provider facility 

relocation Interpretive Guidelines to encourage CMS to establish reasonable flexibility for CAHs 

as they proceed through the relocation process. Data provided by ORHP regarding CAH 

services, staffing, and geographic location assisted in CMS publishing revised guidance in 

September 2007. 

o	 In 2007, ORHP identified small rural independent pharmacies as a key policy area to monitor. 

Recent policy changes impacting these providers include the implementation of Medicare Part D, 

as well as Medicaid program payment changes. ORHP has concern about the long-term viability 

of these providers and what their closure could mean for access to pharmaceutical services in 

remote areas. 

Rural Health Care Quality 

In 2007, the Quality Improvement Organizations (QIOs) continued their work with CAHs and small rural 

hospitals in order to improve quality and patient safety as part of the requirement under the CMS 8th 

Scope of Work (SOW). The CMS 8th SOW was the first time QIOs were required to engage CAHs. In 

2007, CAHs continued to increase their participation in reporting quality measures to the Hospital 

Compare Web site operated by CMS. By the end of FY 2007, approximately 80 percent of CAHs were 

reporting on at least one measure, which is over a 20 percent increase in participation from 2006. This is 

significant since CAHs participate in the program on a voluntary basis compared to hospitals paid under 

the Medicare Inpatient Prospective Payment System (IPPS) who are required to participate in order to 

receive a full payment update. 

Also in 2007, the National Quality Forum approved five emergency department acute myocardial 

infarction (AMI) transfer measures, often referred to as the Rural Emergency Department Transfer 

measures as they have particular relevance to the activities of rural hospitals. These measures have 

been incorporated in the Outpatient Prospective Payment System (OPPS) new quality reporting program 

which hospitals will begin reporting on in 2008. 

Throughout 2007, ORHP worked with CMS to develop a Medicare Hospital Value-Based Purchasing 

(VBP) plan that is inclusive of rural facilities. CMS’s VBP plan prepared in a Report to Congress 

developed a proposal that links payment more directly to the quality of care provided (i.e., pay-forperformance) under the Medicare program for hospitals beginning with FY 2009. 

Health and Human Services (HHS) Rural Task Force 

ORHP continues to coordinate the HHS Secretary’s Rural Task Force. The HHS Rural Task Force, 

established in 2001, is comprised of representatives from each Agency and Office of the Secretary Staff 

Divisions. The Task Force continues to conduct department-wide quarterly meetings to encourage 

collaboration and partnership among HHS agencies on topics that affect rural communities. In 2007, a 

range of issues were presented, including: 

1) Overview of the Medicare Advantage in rural America; 

2) Overview of the National Advisory Committee on Rural Health & Human Services; 

3) Human Services: A Look Inside the Administration on Children and Families (ACF); 

4) Value-Driven Healthcare. 

National Advisory Committee on Rural Health and Human Services (NACRHHS) 

In 2007, ORHP continues to act as primary staff for the National Advisory Committee on Rural Health and 

Human Services. NACRHHS is a 21-member citizen’s panel of nationally recognized rural health experts 

that provides recommendations on rural issues to the Secretary of the Department of Health and Human 

Services. Each year, the Committee produces a report for the Secretary on key health and human 

service issues affecting rural communities with recommendations on the selected issues. 

The three topics that the 2007 Report to the Secretary: Rural Health and Human Services focused on 

were Medicare Advantage, Substance Abuse, and Head Start in rural areas. The year 2007 marked the 

twentieth anniversary of the Office of Rural Health Policy. Accordingly, the 2008 Report will examine the 

past twenty years of rural health and human services, provide information on major structural changes, 

and analyze emergent trends. 

7 
       

 

 

Policy Related Projects and Partnerships

One of the unique aspects of the Office of Rural Health Policy is its entrepreneurial nature. Since its 

inception, the Office has put an emphasis on working with key partners and organizations to develop 

projects to address long-standing rural health problems. The Office uses a portion of its funding in the 

Policy/Research line to support these activities. The emphasis of these special projects is either to 

highlight an issue or work with key rural partners to develop services or resources that fill an identified 

need. 

Some of these “special projects” are focused on the needs of all rural communities, such as the need for 

general information on rural health. Others may focus only on a specific issue such as the recruitment 

and retention of health workforce or the role of economic development in health care. Still, other activities 

focus on a particular type of health care providers. In each case, however, the projects and initiatives 

supported by the Office meet an identified rural health care need. 

340B Technical Assistance 

As a result of a change in the law in 2003, approximately 350 rural hospitals qualified to participate in the 

340B Drug Pricing Program. To assist these facilities in signing up for the program, the ORHP provided 

supplemental funding to the HRSA Pharmacy Services Support Center (PSSC) in FY 2007 to assist rural 

hospitals in understanding and applying for participation in the 340B discount drug purchasing program. 

The PSSC is a resource established in 2002 to assist HRSA grantees and eligible health care sites to 

optimize the value of the 340B Program and provide clinically and cost effective pharmacy services that 

improve medication use and advance patient care. The PSSC operates under a contract between the 

American Pharmacists Association (APhA) and the Office of Pharmacy Affairs (OPA), in the HRSA 

Healthcare Systems Bureau. To date, over 180 rural hospitals are participating in the 340B program as a 

result of this assistance. 

CAH Capital Replacement Manual 

Cost based reimbursement, and the Flex Grant Program to States (administered by the Office), have 

allowed CAHs to improve their financial performance. Some are now considering replacing their facility, 

many of which were built in the 1950s. Such replacement has shown to dramatically increase admissions 

and outpatient visits; as well as allow improvements in staff recruitment, clinical performance and quality 

of care. Increasing market share also adds significantly to the local economy. To date, few lenders 

(Federal and private), architects and builders have had any experience with CAHs - which creates a real 

obstacle for rural hospital CEOs and Boards. To help them get started on the right path, a “Manual for 

CAH Replacement” is being developed. This manual will contain step-by-step guidance, simple tools and 

successful strategies for obtaining capital and building a replacement CAH. 

Center for Rural Health Works (RHWks) 

This long-standing effort of the Office examines the important link between economic development and 

health care in rural communities. The health sector is often one of the top employers in a rural economy, 

a role and relationship that often is not fully understood. The Center for Rural Health Works (RHWks) is 

an ongoing program that works to strengthen local systems of health. As the national focal point, it 

provides technical assistance, tools and training to help States measure the economic impact of the 

health-care sector on local, regional and State economies. It also develops feasibility studies for new 

health care services. During FY 2007, RHWks activities included conducting two regional workshops, 

responding to more than 300 requests for technical assistance, redesigning their Web site and developing 

four new applications for measuring the economic impact of health care on local communities. They 

shared the results of their studies and activities at numerous regional and national conferences. 

Delta Regional Authority/ Appalachian Regional Authority Pharmacy Assist Demonstration 

The ORHP has also partnered with the Appalachian Regional Commission (ARC) for a two-year pilot 

program to increase access to affordable medications by improving the management of patient 

assistance program (PAPs) at clinics located within the ARC and Delta Regional Authority (DRA). As a 

result of joint ARC/DRA PAP workshop meetings, enhancements to PAP programs have been identified 

and are being implemented at clinics in Kentucky, Ohio, Mississippi, and Missouri. 

8 
National Association of Counties (NACo) 

The National Association of Counties (NACo) has established a partnership with the Center for Rural 

Health Works (RHWks) to help county elected officials take the lead in conducting a comprehensive 

community engagement process to improve health care and economic development. The purpose of this 

project is to help rural communities recognize that improving their health care system has a direct and 

positive impact on local economic growth. This was a new initiative for FY 2005 and continues in FY 

2007. During this year, the NACo and RHWks provided on-site technical assistance to three rural 

counties. This project produced three county-level reports on economic impact, community need, a 

health services directory, and useable data/information. The reports were provided to each county and 

placed on the NACo Web site. NACo also disseminated information about this project through workshops 

at its Western Regional and Annual Conferences and through articles in NACo’s publication “County 

News.” 

National Conference of State Legislatures (NCSL) 

ORHP continues to work with the National Conference of State Legislatures (NCSL) to hold an annual 

meeting for rural legislators focusing on new and emerging issues. The annual meeting attracts 30-50 

elected State officials who live and serve rural communities. In 2007, the meeting focused on the 

challenges facing rural emergency medical services and trauma care providers. 

National Organization of State Offices of Rural Health (NOSORH) 

The State Office of Rural Health (SORH) program continued to be enhanced in 2007 by a cooperative 

agreement with the National Organization of State Offices of Rural Health (NOSORH), which was 

designed to build and sustain rural health infrastructure in each State. Under the agreement, NOSORH 

coordinates the planning and logistics for five regional grantee meetings, a new SORH director orientation 

meeting and the annual grantee meeting. In addition, the peer-to-peer mentoring program has been 

strengthened and improved, EMS and GIS mapping sessions were held and five partnership / 

collaboration projects were funded. 

National Rural Health Association (NRHA) 

In 2007, ORHP collaborated with the National Rural Health Association (NRHA) to identify, analyze, and 

address rural health needs. Activities include identification and promotion of best practices for rural 

health care providers, promotion of rural quality initiatives and provision of resources to communities 

including skill building and leadership development. Other activities include promotion of best practices 

via teleconference or webinar series, treatment of agriculture-related disease and injury via access to 

AgriSafe Network Resources, and provision of technical assistance to and strengthen State-based 

entities such as State Offices of Rural Health (SORHs) and State Rural Health Associations (SRHAs). In 

addition, the NRHA was able to collect information about the effects of implementation of Medicare and 

Medicaid reforms on rural health access to services, providers, pharmacists and systems of care. 

Specific and key accomplishments through NRHA activities in 2007 are very diverse. Site visits were 

conducted in six States (Georgia, Michigan, Mississippi, South Dakota, Vermont, and West Virginia) to 

identify models that work for improving rural health care quality. As result of this work, a manual entitled, 

“What Makes Rural Health Care Work” was developed based on the compilation of information obtained 

from the various site visits. The NRHA also supported the development of an outline and first chapter of 

a rural public health textbook highlighting topics of importance in rural communities. Additionally, NRHA 

provided of a total of thirty-six State Rural Health Associations or States which received technical 

assistance grants in the amount of $9,500. The NRHA also trained AgriSafe providers using a model 

which integrates behavioral health within AgriSafe services. Finally, NRHA hosted two policy meetings 

key policy issues pertaining to Medicare payment titled “Improving Options for Medicare Beneficiaries” 

and “Emerging Issues in Rural Pharmacy”. 

9 
 

 

 

National Rural Recruitment and Retention Network 

The National Rural Recruitment and Retention Network (3RNet) works to increase the number of 

providers practicing in rural America. The project consists of 48 State-based, not-for-profit organizations 

that encourage and assist physicians and other health professionals in locating practices in underserved 

rural communities. Members include State Offices of Rural Health, Primary Care Offices, Primary Care 

Associations, Area Health Education Centers, and other not-for-profit entities. The 3RNet coordinates 

workshops, training, and presentations for those interested in recruiting and keeping providers in rural 

communities. 

During FY 2007, 3RNet helped States improve their retention and recruitment activities especially for 

primary care physicians, RNs, dentists, pharmacists, and mental health professionals. Members placed 

750 medical professionals. This included 220 family practice physicians, 65 internal medicine physicians, 

50 pediatricians, 100 dentists, 80 nurse practitioners, and 80 physician assistants. 3RNet also 

maintained a toll-free phone line to assist providers interested in serving rural America. Due to the 

recruitment and retention help from 3RNet, the cost savings to rural communities is substantial. 

Research from the 3RNet shows that physician recruitment costs often cost up to $28,000 and nonphysician recruitment costs generally run up to 30 percent of the first year’s salary. In FY 2007, it is 

estimated that the 750 placements through 3RNet will result in up to $9 million in saved recruiting costs 

for rural communities. 

Rapid Response to Requests for Rural Data Analysis 

In 2007, ORHP funded the Rapid Response to Requests for Rural Data Analysis to support quick turn 

around to assist with policy making. Due to the nature of rural policy analysis and formulation, policy 

makers often require information that is available only through specialized analysis of databases of 

information. In order to acquire the information from the data sets needed to identify trends, problems 

and progress in rural health care financing and access to care in rural areas, ORHP funds a consortium of 

research institutions that have access to the required data storage capacity, personnel, and computer 

resources to provide the information. Topics analyzed for policy makers in 2007 include rural Veteran 

services, Rural Health Clinic geographic locations and shortage designation status, Value Based 

Purchasing in rural hospitals, Medicare Advantage and CAHs, and the experience of rural independent 

pharmacies with Medicare Part D. 

Rural Assistance Center 

The Rural Assistance Center (RAC) staff helps rural residents seeking information to navigate the wide 

range of health policy and social services information available online, in the research literature, and 

within the Federal and State bureaucracies. With many different possible funding streams available for 

use by rural communities, RAC identifies those that best meet the needs of rural communities and directs 

users to those that best suit them. RAC staff provides free customized assistance such as performing 

database searches on rural health and services topics and funding resources, referring users to 

organizations or individuals for additional information, furnishing selected publications, and posting a wide 

variety of timely information on the Internet (funding resources, conference announcements, 

bibliographies, directories, and full-text documents). The RAC identifies and collects sources of 

information and research from a myriad of federal and non-federal sources; archives and provides easy 

access to that information; disseminates information and promotes the use of services available through 

RAC; and makes information actionable for rural stakeholders. During 2007, RAC responded to over 900 

individual requests for information and assistance. 

The RAC Web site is the most comprehensive source of information on rural health and human services 

on the Internet. RAC’s extensive web site and electronic mailing lists are used to distribute information to 

a large number of rural health and human services resources such as news, documents, tools, funding 

opportunities, and events to a broad rural audience. RAC’s Web site averages over 60,000 visits per 

month, while RAC’s e-mail listservs have over 12,000 combined subscribers. 

10 
Rural Health Clinic Technical Assistance Series 

More than 3,000 Rural Health Clinics (RHCs) nationwide are served by the Rural Health Clinic Technical 

Assistance (RHC TA) services funded by ORHP. As safety-net providers, RHCs play a key role in 

maintaining access to care for rural underserved populations, yet they face unique operational and 

administrative challenges in providing such care. The RHC TA Series is designed to assist RHCs in 

meeting those challenges by providing access to relevant and timely information. TA is provided through 

a combination of educational conference calls, as well as the use of a listserv, both of which are available 

free of charge to all RHCS and their staff. The RHC TA Web site posts written transcripts, speaker 

presentations, and audio transcripts of each call. The utilization of these methods allows ORHP to 

provide crucial TA to RHCs in an efficient and cost-effective manner. 

In FY 2007, the RHC TA Conference Call series provided RHCs nationwide with seven conference calls 

on RHC-specific issues. The topics were determined approximately one month before each call by an 

advisory group of RHC experts. Topics addressed in these calls included RHC regulation updates, NPI 

requirements, Medicare Advantage reimbursement, access to capital, shortage designations, and various 

documentation requirements. The calls attracted an average of 230 participants per call. A recent 

estimate shows that these conference calls save RHCs an average of $900 per call compared to the cost 

of traveling staff to similar events held offsite. In the aggregate for FY 2007, this results in a savings of 

over $200,000 per call for the participating RHCs. In addition, it should be noted that the RHCs are 

allowed to take the cost of the educational programs as allowable cost on their cost report. By getting this 

information for free, clinics can use the $900 they save for the actual delivery of care to patients. 

Rural Health Research Center Gateway 

The Rural Health Research Gateway (Research Gateway) Web site was developed and went live in 

February 2007 to improve the dissemination of information and publications of the Rural Health Research 

Centers (Research Centers). The Research Gateway is a user-friendly Web site for many tasks. Users 

can access information about the Research Centers, including contacts and area of expertise. Searches 

can be conducted for summaries of research projects, both those underway and completed. The user 

can carry out searches several ways, by topic, researcher, Research Center, funding organization, and 

date. Users can also find and print Policy Briefs, Analytic Reports, Fact Sheets, and other publications 

resulting from the work of the Research Centers. The Research Gateway links to the Web sites of the 

Research Centers so the user can print a copy of the publications of interest. 

The Research Gateway currently includes all projects and their related publications from the Research 

Centers from 2006 and later. Projects and publications from 2003-05 are being added as resources 

permit. 

Rural Hospital Performance Improvement Project 

The Rural Hospital Performance Improvement (RHPI) Project is a comprehensive and ongoing technical 

assistance to rural hospitals in the Mississippi Delta Region, defined by the Delta Regional Authority 

(DRA), for the purpose of improving financial, operation, and clinical performance. The RHPI Project 

coordinates the delivery of on-site technical assistance services. A range of performance improvement 

services are offered that respond to specific hospital performance needs. RHPI has developed 

performance improvement sustainability strategies at the State, regional (network) and local (internal 

hospital) levels. Primary players in these activities include the State Offices of Rural Health (SORH), the 

State Hospital Associations, and the State Quality Improvement Organizations (QIOs). 

In 2007, RHPI completed seventy consultations, which included: five performance improvement 

assessments, 57 targeted consultations, and eight Balanced Scorecard (one specific type of healthcare 

management system) implementations. Follow-up performance improvement assessments of nine 

hospitals and employee feedback surveys of eleven hospitals were completed. Many conferences and 

workshops were held, including two “Balanced Scorecard” workshops, four Partnership Committee calls 

and one regional conference with 100 participants from the eligible hospitals, consultants, and State 

partners. RHPI also initiated a quality improvement project that focused on AMI presenting in ERs. In 

November of 2007, a program evaluation was completed entitled The Relationship between Financial 

Status and Quality of Care in Rural Hospitals in the Delta. 

11 
Rural Policy Analysis Cooperative Agreement 

In FY 2007, ORHP funded the Rural Policy Analysis Cooperative Agreement to support research and 

analysis on key policy issues affecting rural communities. The 2007 funding supported several activities 

including work with rural community colleges on health workforce development, the Rural Policy 

Research Institute Rural Health Panel, and the Rural Hospital Issues Group. The RUPRI Rural Health 

Panel provides science-based, objective policy analysis to Federal policymakers. Panel members come 

from a variety of academic disciplines and create documents that reflect the consensus judgment of all 

panelists. The Rural Hospitals Issues Group, a panel of small rural hospital administrators and rural 

hospital finance experts from across the country, discuss issues such as the MMA, Medicare Advantage, 

and other policy issues affecting small rural hospitals. 

Technical Assistance and Services Center 

The Technical Assistance Services Center (TASC) provides assistance and information to Rural Hospital 

Flexibility Program (Flex Program) grantees on Medicare reimbursement policies, Federal regulations, 

hospital operations, and other issues that may arise. The staff of ORHP works closely with TASC to 

prioritize key issues and develop information resources to share with Flex grantees. 

The Flex Program grantees frequently need assistance with detailed information on Medicare 

reimbursement policies, Federal regulations, hospital operations, and other issues that may arise. 

TASC has supported the 45 participating State Flex Programs through the following activities: assistance 

in converting over 1,200 perspective payment hospitals to Critical Access Hospital (CAH) status; 

integration of emergency medical services into the rural medical delivery systems with more than 12 EMS 

educational sessions and three manuals for Flex Program and hospital leaders; building rural hospital 

networks to exchange information, provide economies of scale, obtain collective volume, and increase 

cost efficiency and overall effectiveness—TASC provides resources to hundreds of networks created 

throughout the country, and provides educational sessions; and, improving quality and performance 

improvement in rural hospitals and has coordinated three national rural quality forums and staff has 

presented at over 50 State quality and performance improvement events. 

12 
         

 

 

 

 

Grant Programs 

Research and Policy Grant Programs

In FY 2007, ORHP administered three grant programs within the Policy Research Team. The grant 

programs are: 1) the Frontier Extend Stay Clinic Demonstration program; 2) the Rural Health Research 

Centers; and 3) the Targeted Rural Health Research grant programs. There were 10 grants awarded in 

these three programs with a total budget of almost 4.3 million dollars. In addition to the above grants, 

Policy Research Team members manage numerous cooperative agreements and contracts that support 

research and analysis of key policy issues affecting rural communities. These activities work to educate 

and inform rural decision makers and policy leaders at the local, State, and Federal level. 

The management of the grants is done with a workforce composed of seven team members. In addition 

to their responsibilities, most members of the team also serve as policy analysts in reviewing of Medicare, 

Medicaid, and other regulations. Their familiarity with the development of current policy and the work 

done by the grantees allow team members to serve as a base of knowledge and expertise for rural health 

care policy decision making. 

Policy Research Team Members: 

Carrie Cochran, Team Lead 

Heather Dimeris Tom Morris 

Nancy Egbert Erica Molliver 

Michelle Goodman Joan Van Nostrand 

Truman Fellows: Judy Herbstman and Nina Meigs 

13 
 

 

 

 

 

 

Frontier Extended Stay Clinic Program (FESC) 

PROGRAM COORDINATOR: Carrie Cochran, MPA At a Glance Email: ccochran@hrsa.gov 

Phone: (301) 443-4701 Grants Awarded: 

 2005: 1 continuing award 

AUTHORIZING LEGISLATION: Title III, Section 330A of the  2006: 1 continuing award 

Public Health Services Act, 42 U.S.C. 254c.  2007: 1 continuing award 

Amount Awarded: Up to $1.5 million PROGRAM OVERVIEW: per year per grantee The purpose of the FESC cooperative agreement  2005: $1.5 million demonstration program is to examine the effectiveness and  2006: $1.5 million appropriateness of a new type of provider, the Frontier  2007: $1.5 million Extended Stay Clinic, in providing health care services in 

certain remote clinic sites. The FESC is designed to address Project Period: 4 years the needs of patients who are unable to be transferred to an 

acute care facility because of adverse weather conditions, or Next Competitive Grant 

who need monitoring and observation for a limited period of Application:

time.  Year: 2011 

 Anticipated # Grants: 1 

FY 2007 program activities include, but are not limited to:  Anticipated Grant Amount: Up

• Implementation and testing of FESC protocols; to $1.5 million per year 

• Evaluation of program and financial activities; 

• Providing technical assistance to CMS FESC Demonstration and participating organizations; 

• Developing or continuing Health Information Technology (HIT) and quality initiatives; and 

• Exploring the FESC model in the lower 48 States including the relationship with CAHs. 

In remote, frontier areas of the country, weather and distance can prevent patients who experience 

severe injury or illness from obtaining immediate transport to an acute care hospital. For residents in 

some of those communities, providers offer observation services traditionally associated with acute care 

inpatient hospitals until the patient can be transferred or is no longer in need of transport. However, 

extended stay services are not currently reimbursed by Medicare, Medicaid, or other third-party payers. 

The Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) authorized CMS to 

conduct a demonstration program in which FESCs would be treated as Medicare providers. In a separate 

recognition of the extended care services provided by some frontier clinics, an additional demonstration 

program to be administered by ORHP was established by the Consolidated Appropriations Act of 2004. 

KEY PROGRAM ACCOMPLISHMENTS: 

In 2007, ORHP continued the work started in 2004 by providing funding to the Alaska FESC Consortium 

for the participation of five clinic sites in frontier Alaska and Washington. Preliminary results of the second 

year of data collection indicate that the five clinics recorded 1,785 extended stays (two hours or greater 

duration). The mean length of encounter was 5.64 hours with only 9 percent of the stays were over 12 

hours; 38 percent of the extended stays resulted in being discharged home, without further referral; 53 

percent resulted in emergency transfer to a higher level of care. 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm
 

14 
 

 

 

 

 

 

 

 

Rural Health Research Centers Program (Research Centers) 

PROGRAM COORDINATOR: Joan F. Van Nostrand, DPA At a Glance Email: jvan_nostrand@hrsa.gov 

 Phone: (301) 443-0613 # Grants Awarded: 

 2005: 8 continuing awards 

A  2006: 8 continuing awards UTHORIZING LEGISLATION: Section 711 of the Social  2007: 8 continuing awards Security Act 

Amount Awarded: Up to $550,000 PROGRAM OVERVIEW: per year per grantee The purpose of the Rural Health Research Centers  2005: $4.4 million Program (Research Centers) is to help policy makers better  2006: $4 million understand the problems that rural communities face in  2007: $4 million assuring access to health care and strengthening health of 

their residents. The goals of the Research Centers are to Project Period: 4 years

conduct and disseminate policy-relevant research on health 

care and health of residents in rural areas. Next Competitive Grant 

Application:

The Research Centers engage in activities to understand  Year: 2008 

the ways in which the health of rural Americans can be  Anticipated # Grants: Up to 6

improved, analyze the implications of national and State  Anticipated Grant Amount: Up

policy options, and communicate research results to policy- to $660,000 per year per grantee 

makers and others who may take action based on research (up to $3,960,000 combined) 

results. The research conducted by the Centers provides 

important data and findings to the office’s policy staff which they bring to bear in their annual review of 

key Departmental regulations. The Research Centers bring to the forefront the health care challenges 

facing rural America. 

The Research Centers Program, initiated in 1987, is the only Federal program dedicated entirely to 

producing policy-relevant research on health care and health in rural areas. Each Research Center has 

its own identity (although it may be part of a larger organization), Web site, and core staff. Research 

Centers often are located in universities across the United States. Staff includes a disciplinary mix of 

health services research, epidemiology, public health, geography, medicine, and nursing. Over the fouryear award cycle, each Research Center develops a portfolio of three research projects per year in 

conjunction with input from the office and other experts. With its overarching emphasis on research about 

access to health care, the Research Centers Program addresses HHS, HRSA, and ORHP goals. 

KEY PROGRAM ACCOMPLISHMENTS: 

In 2007, the 8 Research Centers conducted 24 research projects and wrote 30 policy briefs and research 

reports. They also authored 17 articles which were published in 2007 in peer-reviewed journals, and 

another 13 articles were accepted for publication and are in-press. To strengthen dissemination of 

research results of the Research Centers, the Gateway to Rural Health Research was launched in 2007. 

The Gateway is a Web site which allows “one stop shopping” about the eight Research Centers. The 

Gateway provides easy access to the Centers’ publications and authors, as well as to summaries of 

research in progress or completed. All Research Centers have Web sites which highlight their rural 

research results and in 2007, there were over 161,000 visits to these sites. Research Center staff 

presented research findings to 185 policy, provider, payer, and academic audiences. They also 

responded to over 400 requests for information concerning rural issues from various national and State 

policy makers. 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm
 

15 
 

 

 

 

 

 

 

 

 

Targeted Rural Health Research Grant (TRHR) 

PROGRAM COORDINATOR: Erica Molliver, M.H.S. At a Glance Email: Emolliver@hrsa.gov 

Phone: (301) 443-1520 # Grants Awarded: 

 2005: 4 new awards 

AUTHORIZING L  2006: 3 new awards EGISLATION: Section 711 of the Social 

Security Act  2007: 2 new awards 

Amount Awarded: Up to $150,000 PROGRAM OVERVIEW: per grantee The Targeted Rural Health Research Grant Program  2005: $590,574 

(TRHR) provides funding for policy-oriented rural health  2006: $449,923 

care services research projects which address critical  2007: $300,000 

issues facing rural communities in their quest to secure 

affordable, high quality health services. The program is Project Period: 1 year 

unique in its dual mission of both enhancing policymakers’ 

knowledge of rural health, and expanding the pool of Next Competitive Grant 

Application:

Grantee’s research findings help to inform the Office as  Year: 2008 

well as National, State, and local decision makers about  Anticipated # Grants: Up to 5 

current rural health care services issues. In order to ensure 

experienced rural health care services researchers. 

 Anticipated Grant Amount: Up 

policy relevancy at the national level, grantees must to $150,000 per grantee (up to 

address one of a selected number of topics, and all aspects $750,000 combined) 

of the research must be national in scope. For 2007, grant 

recipients conducted policy-relevant research on issues of national significance in the area of rural health 

services as they relate to the following topic areas: Rural Health Clinics, Public Health Workforce, Oral 

Health, HIT Implementation, and Emergency Medical Services (EMS). 

This program originated in 2003 as a single year grant program entitled Policy-Oriented Rural Health 

Services Research Grant Program. The name was revised in 2005 to the One-Year Rural Health 

Research Grant Program. In 2007 however, it became apparent that the 12-month timeframe was 

unrealistic considering the nature of the work being done and the inherent challenges involved. 

Applicants for the 2007 funding cycle were therefore notified that under expanded authority, grantees 

would have the ability to extend their project period without the need to formally request for prior approval 

of a no-cost extension. In order to reflect this change, the grant name was changed to the Targeted Rural 

Health Research Grant Program. Beginning with the Fiscal Year 2008 competitive funding cycle, project 

and budget periods will be 18 months, as opposed to 12 months. 

KEY PROGRAM ACCOMPLISHMENTS: 

Grantees’ research findings have been instrumental in bridging the gaps between policy and program 

needs, and have complemented the larger scale projects conducted by the eight ORHP-funded Rural 

Health Research Centers. FY 2007 grantees generated research findings in the following areas: 

•	 “Preventive Care: Supports and Barriers to Best Practices for a National Sample of Rural 

Medicare Beneficiaries” 

•	 “Diabetes and Obesity: Is There a Rural-Urban Difference in the Burden?" 

•	 "Descriptive Analysis of the Health Status of a National Asbestos-Related Cohort" 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm
 

16 
         

 

Hospital State Team Grant Programs
 

In FY 2007, ORHP administered four grant programs within the Hospital State Team (HST). The grant 

programs are: 1) the Critical Access Hospital Health Information Technology (CAH HIT) Network; 2) 

Medicare Rural Hospital Flexibility (Flex); 3) Small Rural Hospital Improvement Program (SHIP); and 4) 

the State Offices of Rural Health (SORH). The CAH HIT program is a new 18 month, $25 million 

competitive program in which 16 awards were made. 

There were 157 grants awarded in these 4 programs with a budget of almost $69 million dollars. In 

addition to the above grants, HST members manage numerous cooperative agreements and contracts 

that support States with technical assistance, recruitment of health care providers, assistance in attaining 

funds to build replacement facilities and numerous other activities that support States and rural health 

care providers. 

The management of the grants is done with a workforce composed of 12 project officers with 4 individuals 

serving as program coordinators. In addition to their grant responsibilities, most of the team also serves 

as Regional Liaisons to the States in five regions. This enables the staff to build relationships with the 

State partners and keep abreast of State and regional specific rural health issues through regional calls 

and meetings. Collectively, the HST serves as a base of knowledge and expertise on State and regional 

rural health issues. 

Hospital State Team Members: 

Nancy Egbert, Team Lead 

Anthony Achampong Steve Hirsch 

George Brown Michael McNeely 

Karen Beckham Jeanene Meyers 

Jennifer Chang Keith Midberry 

Jerry Coopey Kathryn Umali 

Michelle Goodman 

17 
 

 

 

 

 

Critical Access Hospital Health Information Technology 

Network Grant Program (CAHHIT) 

PROGRAM COORDINATOR: George Brown, MPH At a Glance Email: gbrown@hrsa.gov 

Phone: (301) 443-0835 # Grants Awarded: 

 2005: N/A

 2006: N/A AUTHORIZING LEGISLATION: Section 1820 (g) 3 of the Social  2007: 16 new awards Security Act 

Amount Awarded: Up to $1.6M per PROGRAM OVERVIEW: grantee The Rural Hospital Flexibility Program’s Critical Access Hospital  2005: N/A

Health Information Technology Network Grant Program (Flex  2006: N/A

CAH-HIT Network) was a one-time only award that the Office of  2007: $24 M 

Rural Health Policy offered in FY 2007. The purpose of this 18-

month, patient-centered pilot program is to provide funds to Project Period: 18 months 

support the development of HIT in rural communities through the 

16 States that received the CAH-HIT Network grant. The purpose Next Competitive Grant Application: of the grant is to develop networks and implement HIT across the  Year: TBD 

continuum of care, which will lead to improved care coordination  Anticipated # Grants: TBD 

and health outcomes for rural residents. In addition, HRSA’s  Anticipated Grant Amount: TBD 

experience has shown that it is cost effective to utilize networks of 

health care providers to develop HIT systems; therefore, the 

following types of HIT may be used by the CAH-HIT Network 

grantees: 

• Practice management systems; 

• Disease registry systems; 

• Care management systems; 

• Clinical messaging systems; 

• Personal health record systems; 

• Electronic health record systems; and 

• Health information exchanges. 

The CAH-HIT Network grantees have included various organizations in their networks, such as public 

health departments, community-based clinics, faith-based organizations, and other HRSA grantees. 

These networks will use quality improvement programs along with HIT to track five performance outcome 

measures, two of which will be diabetes control and health disease risk reduction. 

The CAH-HIT Network program is a one-time funding opportunity; however, it is being administered as a 

pilot program from which lessons can be learned on HIT network implementation in rural areas. A 

thorough evaluation is underway that will offer lessons learned to the rural community. 

KEY PROGRAM ACCOMPLISHMENTS: 

At the conclusion of the project, it is expected that the grantees will have each developed a more 

comprehensive management of medical information and its secure exchange between health care 

consumers and providers. It is anticipated that the expanded use of HIT will: 

• Improve health care quality; 

• Prevent/reduce medical errors; 

• Increase administrative efficiencies; and 

• Expand access to affordable care. 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm
 

18 
 

 

 

Medicare Rural Hospital Flexibility Grant Program (Flex) 

PROGRAM COORDINATOR: Steven Hirsch, MSLS At a Glance Email: shirsch@hrsa.gov 

Phone: (301) 443-7322 # Grants Awarded: 

 2005: 45 continuing awards 

 2006: 45 continuing awards AUTHORIZING LEGISLATION: Section 1820(j) of the Social  2007: 45 new awards 

Security Act (42 U.S.C. 1395) 

Amount Awarded: Up to $650,000 per 

year per grantee, with an average grant of PROGRAM OVERVIEW: $490,000 The Rural Hospital Flexibility Program (Flex) provides  2005: $22.2 million funding to State governments to stabilize rural hospital  2006: $22.2 million 

finance, integrate emergency medical services (EMS) into  2007: $22 million 

the health care system, and improve the quality of care. The 

Flex program supports a variety of activities, including Project Period: 3 years 

conversion of small rural hospitals to Critical Access Hospital Next Competitive Grant Application: (CAH) status; CAH status allows hospitals the benefit of  Year: 2010 receiving cost-based reimbursement from Medicare for  Anticipated # Grants: 45 inpatient, outpatient, and swing bed services. Only States  Anticipated Grant Amount: Up to with CAHs or potential CAHs are eligible for the Flex $650,000 per year per grantee, with 

program. an average grant of $490,000 

Flex funding to the States also encourages the development of collaborative systems of care in rural 

areas, including the CAHs, EMS providers, clinics, and other providers of necessary health care services. 

The Flex program requires States to develop rural health plans, and funds the States to support and 

implement community-level outreach and technical assistance. The goals of the Flex program are to: 

1. Designate CAHs in the State 

2. Develop and implement rural health networks 

3. Support existing CAHs and eligible hospitals 

4. Improve and integrate EMS services 

5. Improve quality of care 

Although focused on small, rural hospitals, the Flex program operates on the National, State, community, 

and facility levels and covers a broad range of health service issues. Since the program’s inception in 

1999, its focus has shifted from CAH conversions toward its broader goals related to EMS and quality and 

performance management. States have increasingly used their Flex resources for EMS activities, 

including training programs, needs assessments, and network building. Performance improvement has 

also been a significant program goal for CAHs, EMS providers and other health care providers involved in 

the Flex program. Efforts have included using a balanced scorecard approach, development of 

relationships with State Quality Improvement Organizations, development of quality improvement-related 

networks, and participation in national quality improvement and reporting efforts. 

KEY PROGRAM ACCOMPLISHMENTS: 

Since the Flex program’s inception, more than 1,200 hospitals have converted to CAH status. Most of 

these hospitals have shown improvement in their financial status and have offered new, needed services 

to their communities. More than 80 percent of CAHs report engaging in activities to improve the quality of 

care provided to patients. Over half of CAHs report data to CMS’s Hospital Compare Web site even 

though they receive no financial advantage for doing so. Over two years of reporting, CAHs have shown 

significant increases in the percent of patients receiving recommended care for most quality measures. 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm
 

19 
 

 

 

Small Rural Hospital Improvement Grant Program (SHIP) 

PROGRAM COORDINATOR: Jennifer L. Chang, MPH 

Email: jchang@hrsa.gov 

Phone: (301) 443-0736 

AUTHORIZING LEGISLATION: Section 1820(g)(3) of the 

Social Security Act, 42 U.S.C. 1395i-4 

PROGRAM OVERVIEW: 

The Small Rural Hospital Improvement Grant Program 

(SHIP) is available to assist small rural hospitals that are 

essential access points for Medicare and Medicaid 

beneficiaries. Each State Office of Rural Health (SORH) 

coordinates participation of the small rural hospitals within 

its State. For example, $14.5 million was awarded across 

46 States in FY 2007, which the SORHs then disbursed 

across 1,622 eligible hospitals within these 46 States. Each 

hospital received approximately $8,930. 

The purpose of the SHIP program is to help small rural 

hospitals do any or all of the following: 

1. Pay for costs related to the implementation of the
 

Medicare Prospective Payment System (PPS) 

2. Comply with provisions of the Health Information Portability and Accountability Act (HIPAA) of 1996 

3. Reduce medical errors and support quality improvement (QI) 

Unlike many grant programs, the SHIP program allows funds to purchase equipment and software for 

regulatory compliance and improvements that can be cost-prohibitive for small hospitals. The goal of the 

program is to allow small rural hospitals to purchase equipment and materials, information technology, 

training and education, technical assistance, consultants or assessments within the areas of PPS 

implementation, HIPAA compliance and QI. Examples of allowable activities include: 1) purchase of 

billing and coding software and charge-master review for PPS implementation; 2) purchase of security 

applications and workspace modifications to increase security and privacy for HIPAA compliance, and 3) 

purchase of electronic health record systems and providing staff training and educational materials in QI. 

First authorized by the Balanced Budget Refinement Act of 1999 of the Social Security Act, the original 

purpose of the SHIP program was to help small rural hospitals meet PPS requirements. Funding was first 

provided by the Labor/HHS Appropriations Act for FY 2002, along with an expanded program purpose to 

include assistance for HIPAA compliance and QI. The SHIP program addresses HHS, HRSA, and ORHP 

goals related to HIPAA and improving the quality, safety, cost, and value of health care services. 

KEY PROGRAM ACCOMPLISHMENTS: 

To maximize purchasing power through economies of scale, eligible hospital grantees are encouraged to 

form consortiums in order to pool grant funds for the purchase of services. For the most recent reporting 

year, a reported $2.4 million was invested in consortiums; this comprises 16 percent of FY 2006 funds. In 

the most recent award cycle (FY 2007), 31 more hospitals were funded than in the previous year. 

At a Glance 

# Grants Awarded: 

 2005: 47 new awards 

 2006: 47 continuing awards 

 2007: 46 continuing awards 

Amount Awarded: Up to $1,200,000 per 

year per State grantee

 2005: $ 14.8 million 

 2006: $ 14.5 million 

 2007: $ 14.5 million 

Project Period: 5 years, starting with FY 

2008 grants (previously, project period 

was 3 years) 

Next Competitive Grant Application:

 Year: 2008 

 Anticipated # Grants: Up to 47 

 Anticipated Grant Amount: 

Average of $315,400 per year per 

State grantee, up to $14.5 million, 

combined 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm
 

20 
 

 

 

 

 

 

 

State Offices of Rural Health Grant Program (SORH) 

PROGRAM COORDINATOR: Keith J. Midberry, MHSA At a Glance Email: kmidberry@hrsa.gov 

Phone: (301) 443-2669 # Grants Awarded: 

	 2005: 50 continuing awards 

	 2006: 50 continuing awards AUTHORIZING LEGISLATION: Public Health Service Act,  2007: 50 continuing awards Section 338J; 42 U.S.C. 254r Amount Awarded: Up to $150,000 per 

year per grantee PROGRAM OVERVIEW:  2005: $7.4 million 

The purpose of the State Offices of Rural Health Grant  2006: $7.2 million 

(SORH) Program is to strengthen rural health care delivery  2007: $7.2 million 

systems by creating a focal point for rural health within each Project Period: 5 years State. The program provides an institutional framework that Next Competitive Continuation Grant links rural communities with State and Federal resources to Application: help develop long-term solutions to rural health problems. 	 Year: 2008 

 Anticipated # Grants: 50 

The three core functions of the SORH program are to:  Anticipated Grant Amount: Up to

1. Serve as a clearinghouse of information and innovative	 $150,000 per year per grantee
 

approaches to rural health services delivery 

2. Coordinate State activities related to rural health in order to avoid duplication of efforts and resources 

3. Identify Federal, State, and nongovernmental programs about rural health and provide TA to public 

and nonprofit private entities on participation within them. 

Additionally, the SORH program encourages strengthening State, local, and Federal partnerships in rural 

health, and promotes rural recruitment and retention of a competent health care workforce. Funds cannot 

be used for direct delivery of health care services, purchase of real property or equipment (vehicles, 

medical, communications), or to conduct any activity regarding a Certificate of Need. 

The SORH program was developed in 1991 as a Federal-State partnership. It features a single grantee 

from each State, and requires a State match of $3 for each $1 of Federal funding. Over the past 16 

years, this program has leveraged in excess of $200 million in State matching funds. Currently, 36 Offices 

are located in State health departments, 11 in academic settings, and 3 in non-profit organizations. 

KEY PROGRAM ACCOMPLISHMENTS: 

A SORH Performance Measurement workgroup was formed to revise and update the SORH Government 

Performance and Results Act (GPRA) measures. ORHP is seeking approval of the measures from the 

Office of Management and Budget (OMB). The new measures will be used collectively to produce more 

detailed yearly reports about the SORH program. The workgroup also created comprehensive definitions 

for the terms technical assistance (TA) and client. 

Beginning with the budget period July 1, 2008 - June 30, 2009, SORHs will: 

1) Report the total number of technical assistance (TA) encounters provided directly to clients within their 

State by SORH 

2) Provide several specific examples of different types of TA provided. 

3) Report the total number of clients within the State that received TA directly from SORH. 

4) Provide several specific examples of different types of clients that received TA. 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm
 

21 
   

 

 

 

Community‐Based Grant Programs
 

In FY 2007, ORHP administered nine community-based grant programs through its Community-Based 

Team (CBT), made up of 14 project officers. The programs are: the Black Lung Clinics Program; Delta 

Health Initiative; Delta States Rural Development Network Grant Program; Radiation Exposure Screening 

and Education Program; Rural Health Outreach Grant Program; Network Development Grant Program; 

Network Development Planning Grant Program; Rural Access to Emergency Devices (RAED) Grant 

Program; and the Small Health Care Provider Quality Improvement (SHCPQI) Grant Program. Each 

community-based grant program administered by the CBT have differences, but each is predicated upon 

on a defined underserved population, a commitment to change and a set of linked objectives designed to 

build on local assets while addressing the improvement of health status for rural residents. This year, 

232 grants and a combined program budget of over $39 million was awarded for community-based 

programs. 

Project officers in the CBT manage grants based on the primary issue area addressed in the application, 

instead of focusing solely on one program or one geographic area. This ensures that all project officers 

understand the CBT programs and develop an area of expertise for the team and the Office. Below are 

the primary issue areas addressed through the Community Based programs: 

•	 Access to care 

• Cardiovascular health 

• Case management 

• Chronic disease 

• Diabetes 

•	 Emergency management services and 

trauma care 

•	 Health information technology 

•	 Maternal and child health 

•	 Mental health and substance abuse 

• Nutrition 

• Obesity 

• Oral health 

• Pharmacy 

• Quality 

•	 Recruitment and retention 

• “Safety net” collaboration 

•	 School-based health centers 

• Transportation 

• Uninsured 

• Women’s health 

Community-Based Team Members: 

Sherilyn Pruitt, Team Lead 

Julia Bryan Lilly Smetana 

Eileen Holloran Lakisha Smith 

Vanessa Hooker Sonja Carter Taylor 

Kristi Martinsen Shelia Tibbs 

Nisha Patel Kathryn Umali 

Elizabeth Rezai-zadeh Shelia Warren 

Jacob Rueda 

22 
 

 

Black Lung Clinics Program (BLCP) 

PROGRAM COORDINATOR: Kristin Martinsen, MPM 

Email: kmartinsen@hrsa.gov 

Phone: (301) 594-4438 

AUTHORIZING LEGISLATION: Black Lung Benefits Reform 

Act of 1977, Section 427(a), and 42 CFR Part 55a 

PROGRAM OVERVIEW: 

The purpose of the Black Lung Clinics Program (BLCP) is to 

seek out and provide services to miners (active and inactive) 

with the intention of minimizing the effects of respiratory 

impairment or improving the health status of miners or coal 

miners exposed to coal dust as a result of employment and 

to increase coordination with other services and benefits 

programs to meet the health-related needs of this population. 

Grantees have varied models of service delivery. BLCP 

services may be provided either directly or through formal 

At a Glance 

# Grants Awarded: 

 2005: 3 new, 12 continuing awards 

 2006: 15 continuing awards 

 2007: 15 new awards 

Amount Awarded: 

 2005: $5.8 million 

 2006: $5.7 million 

 2007: $5.65 million 

Project Period: 3 years (with possibility of 

competitive continuation) 

Next Competitive Grant Application:

 Year: 2010 

 Anticipated # Grants: Up to 15

 Anticipated Grant Amount: Varies 

by grantee 

arrangements with appropriate health care providers. Current clinics include Federally Qualified Health 

Centers, hospitals, State health departments, mobile vans, and stand alone clinics. 

Programs meet the health care needs of the population through services that include: 

1. Outreach 

2. Primary care (including screening, diagnosis and treatment) 

3. Patient and family education and counseling (including anti-smoking education) 

4. Patient care and coordination (including individual patient care plans for all patients and referrals as 

indicated) 

5. Pulmonary rehabilitation 

In 1972, Congress amended the Federal Coal Mine Health and Safety Act of 1969 to establish a program 

of grants and contracts to fund clinics to treat coal miners with respiratory diseases. The “Black Lung 

Benefits Reform Act of 1977" (Public Law 95-239), signed March 1, 1978, was intended by Congress to 

ensure the continued expansion of the program initiated under the 1969 law. A Federal Register (50 FR 

7913) on February 27, 1985, clarified the authority of HHS’s Secretary to support clinics to evaluate and 

treat coal miners with respiratory impairments, with administrative jurisdiction delegated to HRSA’s 

Bureau of Primary Health Care. In FY 2006, the program was moved to the Office of Rural Health Policy 

to better serve the needs of its constituents, most of whom are located in rural areas. 

The program addresses the HHS strategic plan goal of increasing health care service availability and 

accessibility and improving health care quality, as well as the HRSA goals of improving access to health 

care and improving health outcomes. 

KEY PROGRAM ACCOMPLISHMENTS: 

The program added a long term health outcome measure around improving pulmonary function and 

began a study to determine the location of miners to best target resources. Between 2003 and 2006, 

there was a 5.6 percent increase in the number of active and retired miners seen each year in the clinics. 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm 

23 
 

 

 

 

Delta Health Initiative (DHI) 

PROGRAM COORDINATOR: Kathryn Umali, MPH At a Glance Email: kumali@hrsa.gov 

Phone: (301) 443-7444 # Grants Awarded: 

	 2005: N/A

	 2006: 1 new award AUTHORIZING LEGISLATION: Public Law 109-149, 	 2007: 1 continuing award Departments of Labor, Health and Human Services, and 

Education, and Related Agencies Appropriations Act, 2006 Amount Awarded: 

 2005: N/A PROGRAM OVERVIEW:  2006: $24.75 million 

The purpose of the Delta Health Initiative Cooperative  2007: N/A

Agreement Program is to provide funding to an alliance 

addressing longstanding unmet rural health needs (access Project Period: 5 years 

to health care, health education, research, job training, and Next Competitive Grant Application: capital improvements) of the Mississippi Delta. The goal of 	 Year: 2011 the DHI is to improve the health status of the people living 	 Anticipated # Grants: Up to 1 in the rural Mississippi Delta. 	 Anticipated Grant Amount: Up to 

$24,750,000 per year per grantee In response to the notable poor health status of the 

Mississippi Delta Region, HRSA’s Office of Rural Health 

Policy funded a five-year cooperative agreement in the 

amount of $24,750,000 in FY 2006. 

With this funding, the grantee worked with nine other partners on projects concerning: 

• chronic disease management, 

• health education, 

• intervention, 

• wellness promotion, 

• access to health care services, 

• health information technology, 

• workforce training, 

• care coordination and 

• construction of public health related facilities. 

The partners proposed 27 projects and have worked on communication and coordination systems among 

themselves. Three of these projects entailed construction of public health related facilities. 

By addressing the rural health needs of the people living in the Mississippi Delta through the program’s 

27 projects, DHI supports multiple HHS, HRSA, and ORHP goals and objectives, including improving the 

safety, quality, and access to health care. 

KEY PROGRAM ACCOMPLISHMENTS: 

Since its initial funding in 2006, DHI has enhanced numerous health outcomes in improving the health of 

the people living in the Mississippi Delta. Of the three construction projects, one is completely finished 

and the rest are progressing accordingly. Furthermore, the program has fostered better collaboration 

between the partners through the grantee’s efforts in improving its organizational and infrastructure 

capacity. The DHI has conducted 156 community-based events/classes to promote well-being, held 86 

professional education/training seminars, trained or educated 1,035 health professionals, and 17,018 

Delta residents, conducted 1,553 screenings/patient interviews, accounted for 5,435 patient-encounters 

for medical services, held 61 community-based health career recruitment events, and recruited 195 

school counselors and county personnel to promote health career programs. 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm
 

24 
 

 

 

Delta States Rural Development Network Grant Program 

(Delta) 

PROGRAM COORDINATOR: Lakisha M. Smith, MPH At a Glance 

Email: lsmith2@hrsa.gov 

Phone: (301) 443-0837 # Grants Awarded: 

 2005: 8 continuing awards 

 2006: 8 continuing awards AUTHORIZING LEGISLATION: Public Health Service Act,  2007: 12 new awards Section 330A (e) (42 U.S.C. 254c) 

Amount Awarded: Award range PROGRAM OVERVIEW: $400,000 - $1,000,000 per grantee The purpose of the Delta States Rural Development Network  2005: $5.1 million Grant Program (Delta) is to fund organizations located in the  2006: $5.1 million eight Delta States (Alabama, Arkansas, Illinois, Kentucky,  2007: $5.1 million Louisiana, Mississippi, Missouri, and Tennessee) which 

address unmet local health care needs and prevalent health Project Period: 3 years disparities through the development of new and innovative 

project activities in rural Delta communities. The Delta program Next Competitive Grant Application: supports projects that strengthen community organizations’  Year: 2010 ability to develop and implement projects to address local  Anticipated # Grants: Up to 12 health care needs.  Anticipated Grant Amount: 

In accordance with ORHP’s goal to improve the health and between $300,000 - $430,000 per 

wellness of people living in rural communities, the Delta grant grantee. 

program fosters the development of new collaborative efforts 

amongst a variety of rural providers within the Delta Region to address health problems that could not be 

solved by single entities working alone. In the current grant cycle, grantees are expected to propose 

multi-county projects that address the following key focus areas: 

1.) delivery of preventative or clinical health services surrounding chronic disease, 

2.) increase access to prescription drugs for the medically indigent, and/or 

3.) practice management technical assistance services. 

Grantees may also focus grant activities around the following other priority health areas: oral health 

improvement, school-based health services, mental health, and/or teenage pregnancy prevention efforts. 

The Delta Grant Program was first competed in FY 2001 when the Senate Appropriations Committee 

allocated $6.8 million towards addressing health care needs in the Mississippi Delta. In FY 2007, the 

Delta grant sought to define specific targeted focus areas for grantees to concentrate their project 

activities. This change will prove to serve as a better fit for performance measurement activities within 

ORHP. More applicants were also funded to bring about greater impact and service delivery capacity in 

the Delta region than in previous grant cycles. 

KEY PROGRAM ACCOMPLISHMENTS: 

The Delta grant program had success in providing needed health services to rural communities within the 

Delta region. There have been marked achievements particularly in oral health care, chronic disease 

management and school based health services. Many projects continue to date as a result of initial 

funding provided by the Delta Grant program. By the end of year three of the most recent three-year 

funding cycle, 93 percent of Delta counties and parishes were involved in network supporting programs or 

services, versus 87 percent in the previous year. The outcome is that the Delta grant surpassed its target 

of reaching 331,100 people, or 7 percent of the population by serving an actual amount of 395,000 people 

within the region, or 8.4 percent of the Delta population. The program reached approximately 82,000 

more people in year three than reported in year two. 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm 

25 
 

 

 

Radiation Exposure Screening and Education Program 

(RESEP) 

PROGRAM COORDINATOR: Vanessa Hooker 

Email: vhooker@hrsa.gov At a Glance 

Phone: (301) 594-5105 # Grants Awarded: 

 2005: 1 new / 6 continuing awards 

AUTHORIZING LEGISLATION: Public Health Service Act  2006: 7 continuing awards 

Section 417C; 42 USC 285(a)-9  2007: 7 continuing awards 

PROGRAM OVERVIEW: Amount Awarded: 

The purpose of the Radiation Exposure Screening and  2005: $1.958 million 

Education Program (RESEP) is to support appropriate  2006: $1.917 million 

healthcare organizations to improve the knowledge base and  2007: $1.917 million 

health status of persons adversely affected by the mining, 

milling, or transporting of uranium and the testing of nuclear Project Period: 3 years 

weapons for the Nation’s weapons arsenal. 

Next Competitive Grant Application:

The major objectives of the programs are to:  Year: 2008 

1) Screen individuals for cancer and other radiogenic  Anticipated # Grants: 7-10 

 diseases;  Anticipated Grant Amount: Up to 

2) Provide referrals for medical treatment of individuals $300,000 per year per grantee 

 screened; 

3) Develop and disseminate public information and 

 education programs for the detection, prevention, and treatment of radiogenic cancers and 

 diseases; and 

4) Facilitate documentation of claims for the Radiation Exposure Compensation Act (RECA) 

program. 

Currently, there are seven health organizations in five southwestern States (Arizona, Colorado, Nevada, 

New Mexico and Utah) participating in the RESEP Program. These organizations are comprised of one 

medical center, one research hospital, one Indian Health Service facility, two community health centers, 

and two universities. In FY 2007, non-competing continuation grants were awarded to these 

organizations for a total of $1,917,000. 

KEY PROGRAM ACCOMPLISHMENTS: 

Annual and long-term performance measures were established for the program in the 2006 Performance 

Assessment Rating Tool (PART) evaluation. These measures are updated in PARTweb bi-annually. The 

program is currently working on a national outreach activity to identify eligible individuals no longer 

residing in the local affected areas. The RESEP grantees currently collect local outreach information, but 

there is no program-wide data collection system. This annual measure will seek to implement a 

streamlined process of data collection. 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm
 

26 
 

 

Rural Health Care Services Outreach Grant Program 

(Outreach) 

PROGRAM COORDINATOR: Nisha Patel, MA, CHES 

Email: npatel@hrsa.gov At a Glance 

Phone: (301) 443-6894 # Grants Awarded: 

 2005: 30 new / 71 continuing 

AUTHORIZING LEGISLATION: Section 330A (e) of the Public  2006: 65 new / 43 continuing 

Health Service Act 42 U.S.C 254c (E).  2007: 27 new / 95 continuing 

PROGRAM OVERVIEW: Amount Awarded: Up to $150,000 in 

The purpose of the Outreach program is to promote rural health Year 1, $125,000 in Year 2 and 

care services outreach by expanding the delivery of health care $100,000 in Year 3 per grantee 

services to include new and enhanced services in rural areas.  2005: $18.8 million 

The Outreach program supports projects that demonstrate  2006: $17.9 million 

creative or effective models of outreach and service delivery in  2007: $17.6 million 

rural communities. Applicants may propose projects to address 

the needs of a wide range of population groups including, but Project Period: 3 years 

not limited to, low-income populations, the elderly, pregnant 

women, infants, adolescents, rural minority populations and Next Competitive Grant Application:

rural populations with special health care needs. All projects  Year: 2009 

should be responsive to any unique cultural, social, religious,  Anticipated # Grants: Up to 90 

and linguistic needs of the target population.  Anticipated Grant Amount: Up to 

$150,000 in Year 1, $125,000 in 

The goal of the Outreach grant program is to improve the health Year 2 and $100,000 in Year 3 

status and outcome in rural areas by providing diverse health per grantee services on a variety of health topics to the community. The 

services may include: health education and promotion; health 

screenings; health fairs; and training and education to providers, among other activities. Grantees may 

focus on health topics that include primary health care, dental care, mental health services, home health 

care, emergency care, health promotion and education programs, outpatient day care, and other services 

not requiring in-patient care. 

KEY PROGRAM ACCOMPLISHMENTS: 

The Outreach grant program has success in providing needed health services to rural communities. The 

program has helped to bring rural communities together to work towards a common goal, which is to 

improve the health and well-being of rural populations. Although the Outreach program is a three-year 

grant, many of the programs have continued success beyond the project period and Federal funding. 

The grantees are encouraged to develop creative sustainability and evaluation plans that allow their 

program to be expanded and enhanced. Since the program’s inception in FY 1991, to-date funding has 

been provided to 683 grantees in 48 States and 3 Territories. 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm
 

27 
 

 

 

 

 

 

Rural Health Network Development Grant Program 

(Network Development) 

PROGRAM COORDINATOR: Sherilyn Z. Pruitt, MPH At a Glance Email: spruitt@hrsa.gov 

Phone: (301) 594-0819 # Grants Awarded: 

 2005: 10 new / 27 continuing 

AUTHORIZING LEGISLATION: Section 330A(f) of the Public  2006: 23 new / 15 continuing 

Health Service Act, as amended  2007: 5 new / 33 continuing 

P Amount Awarded: Up to $180,000 per ROGRAM OVERVIEW: 

year per grantee (3 year award) The purpose of the Rural Health Network Development Grant  2005: $7 million Program is to expand access to, coordinate and improve the  2006: $6.7 million quality of essential health care services, and enhance the  2007: $6.5 million delivery of health care in rural areas. These grants support 

rural providers who work in formal networks, alliances, Project Period: 3 years 

coalitions or partnerships to integrate administrative, clinical, 

technological, and financial functions. Funds provided Next Competitive Grant Application:

through this program are not used for direct delivery of  Year: 2008 

 Anticipated # Grants: Up to 30 services. The ultimate goal is to strengthen the rural health  Anticipated Grant Amount: Up to care delivery system by 1) improving the viability of the $180,000 per year per grantee (up individual providers in the network, and/or 2) improving the to $540,000, combined) delivery of care to people served by the network. Networks 

must consist of at least three separately owned entities, and 

each must sign a memorandum of agreement or similar document. Upon completion of the grant 

program, a network should have completed a thorough strategic planning process, business planning 

process, be able to clearly articulate the benefits of the network to its network partners/members and to 

the community it serves, and have a sound strategy in place for sustaining its operations. 

Some anticipated outcomes of supporting the development of rural health networks include: 

•	 achieving economies of scale and cost efficiencies of certain administrative functions; 

•	 increasing the financial viability of the network; enhancing workforce recruitment and retention; 

•	 sharing staff and expertise across network members; enhancing the continuum of care; 

•	 providing services to the under- and uninsured; improving access to capital and technologies; 

•	 ensuring continuous quality improvement of the care provided by network members; and 

•	 enhancing the ability of network members to respond positively to rapid and fundamental 

 changes in the health care environment. 

The Network Development Grant Program was started in 1997 with 34 grantees and $6.1 million. Todate, the program has awarded almost $75 million to support 159 Network Development grants. 

The Network Development program supports HRSA goals of improving access and quality of health care, 

improving health outcomes, and improving public health and health care systems. The Program also 

supports HHS goals to improve the safety, quality, affordability and accessibility of health care; and to 

promote the economic and social well-being of individuals, families and communities. 

KEY PROGRAM ACCOMPLISHMENTS: 

In addition to the technical assistance that is provided to all first and second year Network Development 

grantees, all grantees were invited to participate in free quarterly conference calls arranged by the 

National cooperative of Health Networks, a national association of health network executives and 

strategic health partners. Additionally, grantees with a focus on Health Information Technology (HIT) 

participated in the HRSA-sponsored HIT meeting, attended by over 500 HRSA grantees. 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm
 

28 
 

 

 

 

 

 

Rural Health Network Development Planning Grant Program 

(Network Planning) 

PROGRAM COORDINATOR: Eileen Holloran At a Glance Email: eholloran@hrsa.gov 

Phone: (301) 443-7529 # Grants Awarded: 

 2005: 19 new awards 

 2006: 12 new awards AUTHORIZING LEGISLATION: Public Law 107-251m 116  2007: 10 new awards 

Stat. 1621, Section 330A(f) of the Public Health Service Act, 

42 U.S.C. 254c. The Catalog of Federal Domestic Amount Awarded: Up to $85,000 per 

Assistance Number is 93.912. year per grantee

 2005: $1.6 million 

 2006: $1.2 million PROGRAM OVERVIEW: The legislative purpose of the Rural  2007: $841,391 Health Network Development Planning Grant Program 

(Network Planning) program is to expand access to, Project Period: 1 year coordinate and improve the quality of essential health care 

services and enhance the delivery of health care, in rural Next Competitive Grant Application:

areas. The program provides one-year grants to rural  Year: FY 2008 

entities to plan, develop, and operationalize a formal health  Anticipated # Grants: Up to 12

 Anticipated Grant Amount: Up to care network, and is only for formative networks that do not $85,000 per year per grantee. yet have a formalized structure. Grant funds typically are Estimated total funds available to used to acquire staff, contract with technical experts, and award: $960,000 purchase resources to 'build' the network (funds cannot be 

used for direct delivery of health care services). Successful grantees often apply for the three-year 

Network Development implementation grant to continue the work they started under the Network 

Planning grant. 

Network Planning grantees use the planning grant to lay the foundation of a rural health network by: 

1. Identifying potential collaborating network partners in the community/region; 

2. Convening potential collaborating network partners; 

3. Conducting planning activities; and 

4. Begin carrying out network activities, including activities to promote the network’s sustainability. 

By helping rural providers develop formal integrated health care networks, the Network Planning program 

supports multiple HHS, HRSA, and ORHP goals and objectives, including improving the health care 

system, access to care, the continuity and quality of care, and the financial viability of health care 

providers in underserved areas. 

Network Planning Grants were first awarded in 2004. The maximum award in FY 2004 was $100,000. In 

FY 2005, the maximum award was lowered to $85,000. 

KEY PROGRAM ACCOMPLISHMENTS: 

A Grantee Meeting held in April 2007 fostered new collaborations and sharing of best practices among 

grantees, and one successful grantee was asked to present their best practices at the National Rural 

Health Association’s Annual Meeting. In addition, multiple former grantees are continuing their network 

development work through the three-year Network Development implementation grant. Of the five new 

Network Development grantees in FY 2007, one was a former Network Planning grantee; also six current 

and one former Network Planning grantees have applied for the FY 2008 Network Development grant. 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm
 

29 
 

 

 

Rural Access to Emergency Devices (RAED) 

PROGRAM COORDINATOR: Eileen Holloran At a Glance Email: eholloran@hrsa.gov 

Phone: (301) 443-7529 # Grants Awarded: 

 2005: 48 continuing awards 

AUTHORIZING LEGISLATION: Public Health Improvement Act  2006: 4 new awards 

Title IV, Subtitle B, 42 U.S.C. 254c note, Public Law 106-505  2007: 4 continuing/ 9 new awards 

PROGRAM OVERVIEW: Amount Awarded: 

The purpose of the Rural Access to Emergency Devices  2005: $7.4 million 

(RAED) Grant Program is to provide funding to rural community  2006: $309,408 

partnerships to purchase automated external defibrillators  2007: $1.2 million 

(AEDs) that have been approved, or cleared for marketing by  2008: No funds available 

the Food and Drug Administration; and provide defibrillator and 

basic life support training in AED usage through the American Project Period: 3 years 

Heart Association, the American Red Cross, or other nationallyrecognized training courses. Next Competitive Grant Application:

 Year: 2009 

A community partnership is composed of local emergency  Anticipated # Grants: 7-10 

response entities such as community training facilities, local  Anticipated Grant Amount: Up to 

emergency responders, fire and rescue departments, police, $120,000 per year per grantee 

community hospitals, and local non-profit entities and for-profit 

entities. 

In the past, AEDs have been placed in colleges, universities, community centers, local businesses, law 

enforcement and ambulance vehicles, fire trucks, 911 dispatch centers, and offices. The grant creates 

opportunities to educate the public on AEDs via advertisements, news media, schools, churches, 

shopping malls, restaurants, home owner associations, businesses, local government bodies, security 

firms, etc. 

The 13 current RAED grantees are located in 12 States across the nation: Alaska, Arizona, Delaware, 

Florida, Iowa, Illinois, Louisiana, New Jersey, Nevada, Pennsylvania, Texas, and Utah. 

KEY PROGRAM ACCOMPLISHMENTS: 

Approximately 275 AEDs were placed and approximately 650 lay persons and first responders were 

trained in their utilization in 2006. In 2007, the numbers of placements and trainings increased in size 

and diversity of audience. The RAED Program has increased public awareness, the number of AEDs 

available and the number of persons, first responders, and lay persons trained in using an AED in the 

event of sudden cardiac arrest. 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm
 

30 
 

 

 

 

 

Small Health Care Provider Quality Improvement Grant 

Program (Rural Quality) 

PROGRAM COORDINATOR: Elizabeth Rezai-zadeh, MPH At a Glance Email: erezai@hrsa.gov 

Phone: (301) 443-4107 # Grants Awarded: 

	 2005: N/A

 2006: 15 new awards 

AUTHORIZING LEGISLATION: Section 330A(g), Title III of  2007: 15 continuing awards 

the Public Health Service Act 

Amount Awarded: Up to $50,000 per 

year per grantee PROGRAM OVERVIEW: 	 2005: N/A The Rural Quality Grant Program (Rural Quality) is available 	 2006: $ 737,757 to support rural public, rural non-profit, or other providers of  2007: $ 680,202 

healthcare services, such as critical access hospitals or rural 

health clinics. The purpose of the program is to improve Project Period: 2 years

patient care and chronic disease outcomes by assisting rural 

primary care providers with the implementation of quality Next Competitive Grant Application:

improvement strategies, with a focus on quality improvement  Year: 2008 

 Anticipated # Grants: Up to 60 for chronic disease management. 	 Anticipated Grant Amount: Up to 

$75,000 per year per grantee (up to The goal of the Rural Quality program is to improve health $4.5m, combined) outcomes through enhanced chronic disease management in 

rural primary care settings by: 

1. Implementing and using an electronic patient registry system; 

2. Tracking and reporting specific health indicators by using nationally-accepted performance 

measures; 

3. Assessing the need for and implementing additional quality improvement activities; and 

4. Participating in technical assistance through monthly conference calls and peer-learning 

workshops with fellow Rural Quality grantees, facilitated by a quality improvement specialist. 

The Rural Quality program was sponsored by ORHP for the first time in Federal fiscal year (FY) 2006 as 

a two-year grant program. The grantees’ focus was on diabetes in the first learning year and 

cardiovascular disease (CVD) in the second learning year. 

The Institute of Medicine’s (IOM) reports, “To Err is Human” and “Crossing the Quality Chasm”, highlight 

the urgency of improving the quality of health care in the United States. As identified by the IOM reports, 

patient care should be safe, timely, effective, efficient, patient-centered, and equitable (STEEPE). The 

IOM report, “Quality Through Collaboration: The Future of Rural Health,” released in November 2004, 

identified that rural health care organizations can be leaders in quality improvement. 

While many quality improvement initiatives focus on in-patient hospital care, quality improvement is also 

needed in the primary care setting to decrease morbidity and mortality and foster cost-effective care. 

Timely disease prevention and management in the primary care setting can improve patient health and 

decrease costly emergency room visits and hospital admissions that often follow deferred primary care. 

The Rural Quality program addresses this need for quality primary care in the rural setting. 

KEY PROGRAM ACCOMPLISHMENTS: 

Since the inception of the Rural Quality program in FY 2006, over 2,000 diabetic patients have been 

served by the 15 grantee organizations. Among patients with measured HbA1c lab values, the annual 

average HbA1c was 7.1 (slightly above the goal of <7.0). This average was maintained as new patients 

were added throughout the year to the patient registry. 

For additional information on program background, eligibility, and other requirements, please contact the 

Program Coordinator listed above, or refer to http://ruralhealth.hrsa.gov/funding/GrantPrograms.htm 

31 
 

Other HRSA Initiatives Administered by ORHP
 

The Office manages two agency-wide HRSA activities: border health and intergovernmental affairs (IGA). 

Border Health 

ORHP is charged with managing border health 

activities for the Agency, as much of the 2,100-

mile U.S.-Mexico border is rural. Among the 

urban regions along the border, they face similar 

healthcare delivery challenges as rural areas, 

such as limited health workforce capacity and a 

fragile infrastructure. The Office coordinates 

these activities through its Division of Border 

Health in Dallas, Texas. 

Border Team Members: 

Frank Cantu, Team Lead 

Margarita Figueroa-Gonzalez 

Michelle Goodman 

Michelle Mellen 

Elizabeth Rezai-zadeh 

Lilia Salazar 

Erma Woodard 

IGA Team Members: 

Tom, Morris, Team Lead 

Karen Beckham 

Kathryn Umali 

Administrative Team 

ORHP is staffed by an Administrative Team 

responsible for office functions such as phone 

reception, travel processing, and day-to-day 

office operation. Staff on this team is also 

responsible for budget development, contracts, 

grants, and inter-agency agreement processing, 

and human resources. 

Office of Intergovernmental Affairs (IGA) 

Office serves as the primary coordinator of all IGA 

activities for HRSA. This includes serving as HRSA’s 

primary liaison to the U.S. Department of Health and 

Human Services’ Office of Intergovernmental Affairs. 

In addition, ORHP is the single point of contact for 

HRSA on all external activities, such as State and 

local governmental affiars, stakeholder association 

and interest group activities, and all internal activities, 

such as cooperative agreements and activities related 

to HRSA’s Offices and Bureaus. 

Administrative Team Members: 

Heather Dimeris, Team Lead 

Mary Collier 

Michele Pray-Gibson 

Amal Thomas 

April Ward 

32 
 

 

 

Border Health
 

PROGRAM COORDINATORS: Frank Cantu Elizabeth Rezai-zadeh Michelle Goodman 

FCantu@hrsa.gov erezai@hrsa.gov MGoodman@hrsa.gov

 Phone:(214) 767-8068 Phone:(301) 443-4107 Phone:(301) 443-7440 

PROGRAM OVERVIEW: 

On September 2004, the Office of Rural Health Policy (ORHP) assumed responsibility for coordinating 

border health activities across the agency. Activities within Border Health are supported through 

cooperative agreements, inter-agency agreements, and/or contracts. The purpose of the Division of 

Border Health is to: 

•	 Provide leadership and direction to coordinate the Agency’s assets in border regions; 

•	 Assures that the Agency’s engagement with regions of the border is strategic, performancebased, build partnerships and alliances, and maximizes utilization of Agency assets; 

•	 Assures agency-wide coordination by establishing border health program policies and procedures 

including tracking mechanisms. 

KEY PROGRAM ACCOMPLISHMENTS: 

The inter-agency agreement with the Environmental Protection Agency represents on innovative part of 

Border Health activities. One Border Environmental Health Coordination Program Cooperative 

Agreement award was made to Texas A & M University to test the effectiveness of environmental health 

education and training by promatoras (lay community health workers) in reducing pesticide exposure and 

illness in residents of border colonias. 

Over the past three years (FYs 2005-2007), ORHP has supported two annual events; the U.S.-Mexico 

Border Health Association Meeting, and the Pan-American Health Organization’s Immunizations in the 

Americas Weeks. The purpose of the former was to further educate clinicians and community workers 

about HRSA programs and the progress toward achieving U.S.-Mexico Border 2010 Health Objectives. 

The purpose of the Pan-American Health Organization’s event is to further educate clinicians and 

community workers in the appropriate use of vaccines and to facilitate the vaccination of children and 

adults in local clinics and community health centers along the US-Mexico border. 

In FYs 2006 and 2007, ORHP organized an expert meeting, Improving Knowledge Transfer among 

Health Researchers and Decisionmakers at the Border in Dallas, TX on June 26, 2007. The purpose of 

this meeting was to identify ways to improve the translation and dissemination of border health research 

produced in the United States so as to maximize its use by decisionmakers in health policy and practice. 

This invitational meeting brought together representatives from government agencies and foundations 

that fund research, leading researchers and university officials, health policymakers, program 

administrators, and health care providers to examine their experience and discuss ways to improve the 

flow of knowledge among stakeholders at the border. A report of this meeting is posted on the ORHP 

Web site at: http://ruralhealth.hrsa.gov/border/dallasmeeting.htm. Follow-up activities are being planned 

in FY 2008. 

33 
     

 

 

Intergovernmental Affairs (IGA)
 

PROGRAM COORDINATORS: Kathryn Umali, MPH, CHES 

Email: kumali@hrsa.gov 

Phone: (301) 443-7444 

Karen Beckham, MA 

Email: kbeckham@hrsa.gov 

Phone: (301) 443-0502 

PROGRAM OVERVIEW: 

Organizationally located in the Office of Rural Health Policy (ORHP), the mission of the Health Resources 

and Services Administration’s (HRSA) Intergovernmental Affairs (IGA) is to facilitate and coordinate 

HRSA’s programmatic interaction with organizations that represent units of State and local government. 

The purpose of HRSA’s Intergovernmental Affairs is to: 

•	 Provide the HRSA Administrator with a single point of contact on all activities related to important 

State and local governmental, stakeholder association, and interest group activities. 

•	 Coordinate Agency cross-Bureau cooperative agreements and activities with organizations 

representing units of State and local governments, including but not limited to the National 

Governors Association (NGA), National Conference of State Legislatures (NCSL), Association of 

State and Territorial Health Officials (ASTHO), National Association of Counties (NACo), National 

Association of County and City Health Officials (NACCHO), and National Association of Local 

Boards of Health (NALBOH). 

•	 Interact with health-focused Federal Commissions such as the Delta Regional Authority, 

Appalachian Regional Commission, Denali Commission, and United States-Mexico Border Health 

Commission. 

o	 The Denali Commission was appropriated $39,283,000 in funds in FY 2007 for health 

care facility construction and health care services. ORHP handles the awarding of these 

funds. 

•	 Serve as primary liaison to the U.S. Department of Health and Human Services’ Office of 

Intergovernmental Affairs. 

Prior to November 2006, the IGA role of HRSA was informally divided between HRSA’s Office of Planning 

and Evaluation (OPE), Office of Communications (OC), and Office of Legislation (OL). In centralizing this 

effort, the Office of Rural Health Policy believed there is an added value in coordinating the programmatic 

aspect of IGA. Thus, through the office’s involvement with the regional commissions, commitment in the 

HHS Rural Task Force and efforts to centralize the IGA role, ORHP embarked on fulfilling HRSA’s 

intergovernmental affairs mission. On November 15, 2006 a Federal Register Notice was officially 

released stating the transfer of the agency’s IGA function to ORHP. 

KEY PROGRAM ACCOMPLISHMENTS: 

Some of the primary functions of HRSA IGA are to respond and coordinate information and meeting 

requests. ORHP has developed a systematic process in managing the coordination of these requests 

which entail responding to a variety of problems, questions, or situations relevant to health services and 

intra-governmental affairs. This may involve program planning and implementation for which there may 

not be established criteria. The work facilitates national dissemination of information about HRSA's 

programs, functions, and activities to partnering organizations and agencies. Therefore, ORHP 

developed a Strategic and Operational Plan for HRSA’s Intergovernmental Affairs to serve as a 

management guide and system of performance and outcome measure. 

34 
     

 

 

Appendix A: ORHP Staff
 

Office of Rural Health Policy and Intergovernmental Affairs 

 Staff List as of March 2008 

1. The Team Structure: All staff are assigned to specific teams within the Office. These teams are: the Community-Based Team (CBT)(which 

includes all staff who work on the community based grant programs under the jurisdiction of the Office); the Hospital-State Team (HST) (which 

includes all staff who serve as regional liaisons and project officers for the Office's State-based programs), the Policy-Research Team (PRT) 

(which includes staff who oversee either regulatory issues or research issues), the Intergovernmental Affairs (IGA) Team (which includes all staff 

who coordinate HRSA's intergovernmental affairs activities), the Administrative Team (Admin) (which includes all staff who are charged with 

overseeing specific administrative duties) and the Management Team (Mgt) (which includes all staff who are charged with overseeing 

management duties). There are also five staff, based in Dallas, assigned to the Division of Border Health (BH). Two staff are also assigned to 

working with the Director to coordinate HRSA's Intergovernmental Affairs Activities (IGA). 

2. How Issues Are Assigned: All staff are also assigned issue areas. For members of the Community-Based Team, this relates to the focus areas 

of the grants on which they serve as project officers. For members of the Policy-Research team, this relates to policy areas they oversee. For 

members of the Management, IGA and Administrative Teams, this relates to those issues for which they bear responsibility. 

Name and Title Team Program or Policy Assignments Issue Areas Phone Email 

tmorris@hrsa.gov 

Tom Morris, 

Acting Associate 

Administrator 

Mgt; 

PRT; 

IGA 

Oversees all aspects of the Office, 

including rural health policy and programs; 

border health, international health and 

intergovenrmental affairs; primary staff to 

HHS Rural Task Force 

Budget, Personnel, 

Operations oversight; 

Legislation; Policy 

(301) 443-

0835 

Heather Dimeris, 

Associate Director 

Mgt; 

PRT; 

Admin 

Oversees the Administrative Team; 

quality-related policy activities; grants 

processes 

Budget; personnel; Operations 

oversight; Regulation review; 

Quality improvement 

(301) 443-

4657 hdimeris@hrsa.gov 

Staff 

Anthony 

Achampong 

HST; 

Mgt 

Region B Co-Regional Liaison (project officer for 

that region's Flex, SORH and SHIP grants); 

Data and Performance Measurement 

Coordinator; Liaison to OIT for the ORHP PIMS 

Contract, Representative on the HRSA IT 

Internal Review Board 

Data and Performance 

Measurement Coordinator 

(301) 594-

4429 aachampong@hrsa.gov 

George Brown HST 

Flex Critical Access Hospital-Health Information 

Technology Network (CAHHITN) Coordinator; 

Region B Co-Regional Liaison (project officer for 

that region's Flex, SORH and SHIP grants) 

Delta Small Rural Hospital 

Performance Improvement 

Initiative 

(301) 443-

7321 gbrown@hrsa.gov 

Karen Beckham HST; 

IGA 

Region E Co-Regional Liaison (project officer for 

that region's Flex, SORH and SHIP grants); 

Rural Best Practices Cooperative Agreement 

Intergovernmental Affairs 

coordination for HRSA 

(301) 443-

0502 kbeckham@hrsa.gov 

Julia Bryan Mgt; 

CBT 

Liaison to Grants Management, Division of 

Independent Review, Office of Financial 

Assistance Management 

Grants Coordinator; Grants 

technical assistance; Recruitment 

and Retention; Women's Health 

(301) 443-

6707 jbryan@hrsa.gov 

Jennifer Chang HST 

Small Rural Hospital Improvement Grant 

Program (SHIP) Coordinator; Executive 

Secretary, National Advisory Committee on 

Rural Health and Human Services; Region A 

Co-Regional Liaison (project officer for that 

region's Flex, SORH and SHIP grants) 

Grant Program performance 

measures, OMB approval 

(301) 443-

0736 jchang@hrsa.gov 

Carrie Cochran Mgt; 

PRT 

Policy Coordinator; Quick Data Turnaround 

Cooperative Agreement; Frontier Extended Stay 

Clinic Cooperative Agreement; Rural Policy 

Analysis Cooperative Agreement; National 

Advisory Committee on Rural Health and 

Human Services staff 

Medicare reimbursement including 

inpatient and outpatient hospital 

reimbursement; Skilled Nursing 

Care; Home Health; Medicare 

Advantage; Medicare GME; 

Supervisor for interns 

(301) 443-

4701 ccochran@hrsa.gov 

Mary Collier Admin 

Phones; meeting scheduling; travel; 

timekeeping; correspondence (SWIFT); FOIA 

requests; conference room reservations and IT 

equipment; mail pick up and distribution; meet 

and greet visitors. 

Administrative; provide services 

and support to ORHP staff and 

external customers. 

(301) 443-

0836 mcollier@hrsa.gov 

Jerry Coopey HST Region C Co-Regional Liaison (project officer for 

that region's Flex, SORH and SHIP grants) 

Rural Recruitment and Retention 

Network (3RNet) liaison; Access to 

Capital; Rural Health and 

Economic Development; safety-net 

collaboration; hospital performance 

improvement 

(301) 443-

7306 jcoopey@hrsa.gov 

Nancy Egbert HST 

Region E Co-Regional Liaison (project officer for 

that region's Flex, SORH and SHIP grants); Flex 

Monitoring Cooperative Agreement 

Clinical Advisor; health quality; 

nursing; pandemic influenza 

(301) 443-

0614 negbert@hrsa.gov 

Michelle 

Goodman 

HST; 

PRT 

Region D Co-Regional Liaison (project officer for 

that region's Flex, SORH and SHIP grants) 

Health Workforce; 

Communications Coordinator 

(301) 443-

7440 mgoodman@hrsa.gov 

Steve Hirsch HST 

Rural Hospital Flexibility (Flex) Program 

Coordinator; Rural Assistance Center 

Cooperative Agreement 

Definitions of Rural (301) 443-

7322 shirsch@hrsa.gov 

Eileen Holloran CBT 

Network Planning Grants Coordinator; Rural 

AED Coordinator; Project Officer for Outreach 

and Network programs 

Transportation; chronic disease 

management; Alzheimer's 

(301) 443-

7529 eholloran@hrsa.gov 

35 
 

 

 

Vanessa Hooker CBT 

Radiation Exposure Screening and Education 

Program (RESEP) Coordinator; Project Officer 

for Outreach and Network Development 

Diabetes, Recruitment and 

Retention 

(301) 594-

5105 vhooker@hrsa.gov 

Kristi Martinsen CBT Black Lung Program Coordinator; Project Officer 

for Outreach and Network Development Mental health; Substance Abuse (301) 594-

4438 kmartinsen@hrsa.gov 

Michael McNeely HST Region C Co-Regional Liaison (project officer for 

that region's Flex, SORH and SHIP grants) 

ORHP Technical Assistance 

Coordinator; OIT Liaison including 

web material coordinator 

(301) 443-

5812 mmcneely@hrsa.gov 

Jeanene Meyers HST Region A Co-Regional Liaison (project officer for 

that region's Flex , SORH and SHIP grants) Pharmacy & 340B (301) 443-

2482 jmeyers@hrsa.gov 

Keith J. Midberry HST; 

Mgt 

State Offices of Rural Health Program 

Coordinator Human Resources Coordinator (301) 443-2669 kmidberry@hrsa.gov 

Erica Molliver PRT 

Targeted Rural Health Research grants; 

National Advisory Committee on Rural Health 

and Human Services, Rural Health Clinic 

Technical Assistance 

Physician and ambulance fee 

schedule(s); Medicare Part D; 

Medicaid waivers; HHS J1 Visa 

waivers; health professional 

shortage areas; Frontier health 

(301) 443-

1520 emolliver@hrsa.gov 

Nisha Patel CBT 

Rural Health Care Services Outreach Grant 

Program Coordinator; Project Officer for 

Network Development program 

Cardiovascular health; obesity; 

nutrition; elder care 

(301) 443-

6894 npatel@hrsa.gov 

Michele PrayGibson 

Mgt; 

Admin 

Budget Coordinator; National Advisory 

Committee on Rural Health and Human 

Services 

Executive Officer; Budget 

Coordinator; backup on contracts 

coordination 

(301) 443-

7320 mpray@hrsa.gov 

Sherilyn Pruitt CBT Rural Network Development Grant Program 

Coordinator; Project Officer for Outreach grant 

Health information technology; 

telehealth 

301-594-

0819 sadams@hrsa.gov 

Elizabeth Rezaizadeh 

Border; 

CBT 

Small Health Care Provider Quality 

Improvement Program Coordinator; Project 

Officer for Quality, Outreach, and Network 

Development grant programs; and U.S.-Mexico 

Border Health Advisor 

Border Health; Central Office 

liaison to Dallas Division of Border 

Health 

(301) 443-

4107 erezai@hrsa.gov 

Jacob Rueda CBT Project Officer for Black Lung, RESEP, 

Outreach and Network Development grant 

Emergency medical services and 

trauma; pharmacy; Medicaid 

(301) 443-

0649 jrueda@hrsa.gov 

Lilly Smetana CBT 

Grants Files coordinator; Electronic Handbook 

Liaison; Grants Program Administrator; RESEP, 

Outreach programs 

Earmarks; health literacy; health 

professions education; oral health 

(301) 443-

6884 lsmetana@hrsa.gov 

Lakisha Smith CBT 

Delta Network Development Program 

Coordinator; Delta Liaison to HST; Project 

Officer for Outreach and Network Development 

Safety net collaboration; HIV/AIDS; 

minority health and cultural 

competence; school-based health 

(301) 443-

0837 lsmith2@hrsa.gov 

Sonja Carter 

Taylor 

CBT; 

Mgt 

Project Officer for Rural Health Outreach and 

Rural Health Network Development grant 

programs 

General rural health; school-based 

health; Inter-Agency agreement 

coordinator; backup on contracts 

and budget 

(301) 443-

1902 staylor@hrsa.gov 

Shelia Tibbs CBT Project Officer for Network Development and 

Black Lung grant programs 

Public health; capital construction 

monitoring for Delta Health 

Initiative 

(301) 443-

4304 stibbs@hrsa.gov 

Amal Thomas Admin 

Phones; meeting scheduling; travel; Com. Corps 

timekeeping; Secretary's Forecast; training 

coordinator; HR assistant; office supplies; 

conference room reservations and IT equipment; 

mail pick up and distribution; meet and greet 

visitors 

Administrative coordinator; provide 

services and support to ORHP 

staff and external customers 

(301) 443-

0139 athomas@hrsa.gov 

Kathryn Umali 

CBT; 

HST; 

IGA 

Delta Health Initiative Program Coordinator; 

Region D Co-Regional Liaison (project officer for 

that region's Flex grants, SORH grants and 

SHIP grants) 

Intergovernmental Affairs 

coordination for HRSA 

(301) 443-

7444 kumali@hrsa.gov 

Joan Van 

Nostrand PRT Rural Health Research Coordinator; Rural 

Health Research Center Cooperative Agreement 

Disability; long-term care; research 

data; Healthy People 2010-access 

chapter 

(301) 443-

0613 jvan_nostrand@hrsa.gov 

April Ward Admin 

Phones; meeting scheduling; travel; NAC 

administrative duties; timekeeping; 

correspondence backup; conference room 

reservations and IT equipment; mail pick up and 

distribution; meet and greet visitors. 

Administrative; provide services 

and support to ORHP staff and 

external customers. 

(301) 443-

3999 award@hrsa.gov 

Sheila Warren CBT Project Officer for Outreach and Network 

Development grant programs 

Contracts Coordinator; Health 

promotion and disease prevention; 

Health education 

(301) 443-

0246 swarren@hrsa.gov 

Division of Border Health 

Frank Cantu Border Coordinates HRSA's border health activities Budget, personnel, administration (214) 767-

3881 fcantu@hrsa.gov 

Margarita 

FigueroaGonzalez 

Border Pan-American Health Organization contract 

project officer; NM border health liaison HIV/AIDS (214) 767-

8068 mfigueroa@hrsa.gov 

Michelle Mellen Border AZ border health liaison Maternal and Child Health (214) 767-

3070 mmellen@hrsa.gov 

Lilia Salazar Border CA border health liaison Travel, administrative (214) 767-

3073 lsalazar@hrsa.gov 

Erma Woodard Border Administrative support Phones, scheduling, meetings (214) 767-

3171 ewoodard@hrsa.gov 

36