Coronavirus Disease (COVID-19) Frequently Asked Questions – Federal Office of Rural Health Policy

Updated: 5/20/2020

We know that many of HRSA’s rural health program recipients and stakeholders are concerned about coronavirus disease 2019 (COVID-19) and its impact on your programs and your communities. We encourage you to be proactive in your emergency preparedness planning and to coordinate with partners at the state and local level in emergency response.

Online Resources for Updated Information

  • CDC Updates on the Coronavirus. The Centers for Disease Control and Prevention (CDC) provides daily updates on the Coronavirus with guidance for health providers and local public health officials.
  • Information for HRSA Grant Programs. Frequently asked questions for multiple programs including Health Centers, National Health Service Corp, 340B Drug Pricing, and other programs.
  • Rural Response to Coronavirus Disease 2019 HRSA Exit Disclaimer. The Rural Health Information Hub has created a guide to help you learn about activities underway to address COVID-19.

Please continue to check this page for updates and contact your Project Officer directly with any questions not addressed below.

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We have organized the answers on this page into the following categories:

Funding for Rural Health Clinics

How does the $225 million in Rural Health Clinic Testing funding differ from the recent $10 billion Rural Distribution funding? (Added: 5/20/2020)

The $225 million in Rural Health Clinic Testing is specifically to support COVID-19 testing and related expenses in Rural Health Clinics (RHCs). Under this distribution, HHS will make uniform payments to all RHCs listed in either the Centers for Medicare and Medicaid (CMS) Provider of Service file (March 2020) or the CMS Survey & Certification's Quality, Certification and Oversight Reports (QCOR) before May 7, 2020. 

The previous $10 billion Rural Distribution provided funds not only to RHCs but to rural acute care general hospitals, Critical Access Hospitals (CAHs), and Community Health Center sites located in rural areas, to assist these providers in addressing the effects of the COVID-19 pandemic beyond testing, recognizing that many were already operating on thin margins.

Who is eligible to receive the Rural Health Clinic Testing funds? (Added: 5/20/2020)

All RHCs that have CMS Certification Numbers (CCNs) and are listed in either the CMS Provider of Service file (March 2020) or the CMS Survey & Certification's Quality, Certification and Oversight Reports (QCOR) before May 7, 2020, were eligible to receive Rural Health Clinic Testing funds.

What is the Rural Health Clinic Testing funding amount and how did HHS determine the amount? (Added: 5/20/2020)

Each RHC with a unique, active CCN listed in either the CMS Provider of Service file (March 2020) or the CMS Survey & Certification's Quality, Certification and Oversight Reports (QCOR) before May 7, 2020, received a uniform, flat amount of just under $50,000.

What are permissible expenses under the $225 million Rural Health Clinic Testing payment? (Added: 5/20/2020)

Rural Health Clinic Testing funding may be used for COVID-19 testing and related expenses. As set forth in the Terms and Conditions, examples of related expenses include, but are not limited to, planning for implementation of a COVID-19 testing program, procuring supplies to provide testing, training providers and staff on COVID-19 testing procedures, and reporting data to HHS on COVID-19 testing activities. Further, the Rural Health Clinic Testing funds may be used for building or construction of temporary structures, leasing of properties, and retrofitting facilities as necessary to support COVID-19 testing.

If an organization has multiple RHC sites, which RHC will receive the Rural Health Clinic Testing funds? (Added: 5/20/2020)

Rural Health Clinic Testing funds will be distributed to the banking account information associated with the organization’s billing TIN, based on the organization’s number of eligible RHC sites. Billing TINs receiving a payment that operate more than one RHC site have discretion to distribute the payment among their RHC sites.

How will HHS disperse the $225 million Rural Health Clinic Testing funds? (Added: 5/20/2020)

Most Rural Health Clinic Testing funds will be dispersed electronically based upon banking account information associated with the organization’s TIN. If the organization’s TIN does not have a bank routing number associated with it, the organization will receive a paper check.

What actions must an RHC take after receipt of the Rural Health Clinic Testing funds? (Added: 5/20/2020)

Each organization will need to complete the attestation process to accept or reject the Rural Health Clinic Testing funds within 45 days of receipt of payment via ACH or within 60 days of check payment issuance. Not returning the payment or attesting to the receipt of funds within this timeframe will be viewed as acceptance of the terms and conditions.

Where can I go for more information on implementing a COVID-19 testing program? (Added: 5/20/2020)

The National Association of Rural Health Clinics (NARHC) will be receiving funds from the Federal Office of Rural Health Policy to provide technical assistance to RHCs in implementing COVID-19 testing programs in alignment with the Terms and Conditions. The Centers for Disease Control and Prevention (CDC) has published information for healthcare professionals on COVID-19 Testing

Funding and Other Resources

Has HRSA has made a decision to extend grant submission deadlines amid the COVID-19 pandemic, or will HRSA consider extending grant submission deadlines on a case-by-case basis? (Added: 3/27/2020)

At this time, we have extended the Notice of Funding Opportunity (NOFO) submission deadlines for three rural health programs:

We encourage you, if possible, to submit an application prior to the published deadline in Grants.gov. We will continue to monitor and assess if, and when, the deadlines for other NOFOs need to be extended. Please see the COVID-19 Grantee Frequently Asked Questions for information about requesting an extension from HRSA's Division of Grants Policy to a published NOFO deadline.

What funding for rural hospitals is available from the Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136)? (Revised: 5/1/2020)

The Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy received $150 million through the Coronavirus Aid, Relief, and Economic Security (CARES) Act to support small rural hospitals responding to the COVID-19 health crisis. These funds have been awarded to state Small Rural Hospital Improvement Program (SHIP) grantees to assist small rural hospitals.

Telehealth

What changes to telehealth policy have been implemented to respond to the COVID-19 pandemic? (Updated: 3/27/2020)

  • As a result of the National Emergency, CMS is expanding Medicare’s telehealth benefits under the 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act. Visit the CMS Latest Emergencies page for updates.
  • CMS developed Medicare Telehealth Frequently Asked Questions (PDF - 112 KB, released 3/17/2020), to clarify telehealth services covered during the emergency. A range of healthcare providers, such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers, and others, may offer telehealth to Medicare beneficiaries. Beneficiaries may receive telehealth services in any healthcare facility including a physician’s office, hospital, nursing home or rural health clinic, as well as from their own homes.
  • A FORHP-funded Telehealth Resource Center maintains a page dedicated to tracking telehealth coverage updates related to COVID-19 HRSA Exit Disclaimer.
  • While the public health emergency remains in effect, DEA-registered practitioners may issue prescriptions for controlled substances to patients for whom they have not conducted an in-person medical evaluation, provided certain conditions are met. See DEA Telehealth Guidance

How can rural health care providers get help to start or expand telehealth services for our patients? (Updated: 4/8/2020)

Travel

My program includes activities providing on-site TA to hospitals using consultants. If the hospital needs to cancel or the consultants need to travel, is there flexibility to delay items on my work plan? (Added: 3/20/2020)

Yes, you should adjust the schedule to make sure hospitals are able to meet the needs of the community and that your consultants are comfortable with travel. You could look into potential alternative methods to continue to provide some technical assistance (through phone calls or video conferencing) in the short term, but we understand that delaying timelines could be the best option.

Our coalition has scheduled group meetings as part of HRSA-funded activities. We will be unable to meet in the near future, as we are all health care professionals in some capacity. Do you have any guidance on next steps? (Added: 3/20/2020)

We understand that meetings, both virtual and in-person, may be reduced or canceled as a result of COVID-19. If you need to make changes to your work plan, please stay in contact with your FORHP point of contact to keep us informed of specific changes in your HRSA approved work plan goals and objectives, and the impact those specific changes would have on your HRSA project.

How does COVID-19 impact my ability to travel to fulfill the project-related activities of my HRSA grant? (Added: 3/20/2020)

We recommend abiding by the recommendations and regulations of your state and local officials as well as using your best judgement regarding grant-funded travel. FORHP understands that this is a public health emergency and that you may need to change or postpone some grant activities, including those requiring travel. Please continue to monitor the CDC website for updates and to find information about COVID-19. If you are planning to travel as part of your grant, please ensure you have up to date domestic and/or overseas travel information from the CDC travel advisory website. You can also find updates via the State Department travel advisory site.

Grants Management

How should recipients of rural health grants and cooperative agreements manage activities and services in the event that critical staff members are unable to work due to either illness or COVID-19 quarantine? (Added: 3/27/2020)

HRSA’s FORHP recognizes that many recipients are working to address or may be impacted by COVID-19 emergencies within their communities, which may impact their ability to meet grant requirements. We encourage recipients to continue to provide rural health services and grant activities in a safe and efficient manner. Please talk with your project officer regarding alternative approaches to planned activities. Once the emergency has waned, we will work with you on the completion of required activities.

What flexibilities are available to recipients of rural health grants if our projects and activities are interrupted or we are unable to complete required reports? (Added: 3/27/2020)

Please see the HRSA COVID-19 Grantee Frequently Asked Questions and discuss your specific situation with your FORHP project officer.

Health Care Delivery and Policy Information

What flexibility has CMS provided for rural and critical access hospitals (CAHs) to support the COVID-19 response? (Updated: 3/27/2020)

CMS is waiving the requirements that Critical Access Hospitals limit the number of beds to 25, and that the length of stay be limited to 96 hours. CMS has developed a COVID-19 fact sheet for health care providers (PDF - 430 KB) that addresses this and other frequently asked questions. For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.

I participate in quality measurement and reporting efforts as part of my grant-related activities and/or as a health care entity. Have there been any changes to quality reporting requirements due to the COVID-19 pandemic? (Updated: 3/27/2020)

On March 22, 2020, CMS announced relief for clinicians, providers, hospitals, and facilities that participate in the Quality Reporting Programs in response to COVID-19. Read the release for full details.

What information is available for rural health care providers? (Updated: 3/27/2020)

Date Last Reviewed:  May 2020