Rural Health Information Hub Latest News

New Report: Perceived Facilitators and Barriers to Rural Nursing Practice

A new report from the Rural and Minority Health Research Center provides the results of a web-based survey disseminated to a geographically diverse sample of nurses throughout the U.S. to assess perceived barriers and facilitators to nursing practice; job satisfaction; and self-identified challenges in nursing work environments and patient care. Of particular interest were nurses in ambulatory care practices.  The full report can be accessed here.

Creative Recruiting Helps Rural Hospitals Overcome Doctor Shortages


The wide-open spaces of Arco, Idaho, appeal to some doctors with a love of the outdoors.

In the central Idaho community of Arco, where Lost Rivers Medical Center is located, the elk and bear outnumber the human population of a thousand. The view from the hospital is flat grassland surrounded by mountain ranges that make for formidable driving in wintertime.

“We’re actually considered a frontier area, which I didn’t even know was a census designation until I moved there,” says Brad Huerta, CEO of the hospital. “I didn’t think there’s anything more rural than rural.”

There are no stoplights in the area. Nor is there a Costco, a Starbucks or — more critically — a surgeon. With 63 full-time employees, the hospital is the county’s largest employer, serving an area larger than Rhode Island.

Six years ago, the hospital declared bankruptcy and was on the cusp of closing. Like many other rural hospitals, it was beset by challenges, including chronic difficulties recruiting medical staff willing to live and work in remote, sparsely populated communities. A hot job market made that even harder.

But against the odds, Huerta has turned Lost Rivers around. He trimmed budgets, but also invested in new technologies and services. And he focused on recruitment. He targeted older physicians — semiretired empty nesters willing to work part time. He also lured recruits using the area’s best asset: the great outdoors.

Read the full story here.

The Ryan White CARE Act Turns 29

August 18 marked the 29th anniversary of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. First authorized in 1990, the Ryan White CARE Act is the legislation that created the HRSA HIV/AIDS Bureau (HRSA HAB) Ryan White HIV/AIDS Program.

The Ryan White HIV/AIDS Program provides a comprehensive system of HIV primary medical care, medications, and essential support services for low-income people with HIV. The Program funds grants to states, cities/counties, and local community-based organizations. More than half of people with diagnosed HIV in the United States – more than 500,000 people – receive services through the Ryan White HIV/AIDS Program each year. In 2017, 85.9% of Ryan White HIV/AIDS Program clients were virally suppressed, exceeding national average of approximately 59.8%.

The Ryan White HIV/AIDS Program is a critical component of the “Ending the HIV Epidemic: A Plan for America” initiative, which was announced earlier this year during the State of the Union address.

For more information, visit

2018 Health Center Program Data Released

The new Uniform Data System (UDS) data are out and show that health centers continue to provide increased access to high quality, value-based, comprehensive primary care for their communities. Health centers treat one in 12 people nationwide, one in every nine children, and are increasingly well-positioned to meet the nation’s most common and pressing health care needs, as well as emerging health priorities.

In 2018:

  • 93% of health centers provided mental health counseling and treatment.
  • 67% of health centers provided substance use disorder (SUD) services.
  • One in six people living with HIV received care from a HRSA-funded health center.

See the 2018 Health Center Program national-level grantee data from the UDS.

View the HRSA Health Center Program fact sheet.

Watch our Chalk Talk video overview of the Health Center Program.

Executive Order Issued to Protect and Advocate for Vulnerable Pennsylvanians

On July 31, Pennsylvania Gov. Tom Wolf acknowledged the long-standing issues with existing state systems and announced — by executive order — an overhaul of the state systems and services to protect the most vulnerable Pennsylvanians.

Gov. Wolf’s “Protection of Vulnerable Populations” executive order establishes the Office of Advocacy and Reform to be maintained by the Governor’s Office, led by an executive director. Positions within the new office will include a new child advocate position, integration of the Long-term Care Ombudsman, and a Council on Reform, including 25 voting members appointed by Gov. Wolf, to support this effort by looking at protecting vulnerable populations from three perspectives: prevention and diversion, protection and intervention, and justice and support.

Both the Council on Reform and the Office of Advocacy and Reform will identify reforms needed for Pennsylvania to better protect and support individuals relying upon services and assistance from the commonwealth.

“I want to be clear that I am not disparaging the hardworking and, frankly, underpaid and underappreciated workers within this system,” Gov. Wolf said. “This is not their fault and the failures are not of their making. But we’ve had a series of incidents in our commonwealth that have revealed inadequacies in the system’s ability to protect and uplift Pennsylvanians in vulnerable situations.”

“I want to know what else we can do because this is what we’re here to do as a department, is to protect people and people who are in institutions or facilities. If we can’t do that, that’s not government that works. So this is really important, it’s why it’s so important to the governor, it’s why it’s so important to me,” DHS Secretary Miller says.

The Council on Reform held its first meeting immediately following the announcement. The council is charged with reporting its findings to the governor by Nov. 1 after seeking input from various stakeholder groups.

Read the executive order online.

Responding to Human Trafficking: Developing Infrastructure and Multisystem Approaches

The risk of human trafficking is higher for children and youth in foster care, and the child welfare field has increased its efforts to develop an effective response. With funding from the Children’s Bureau, grantees across the nation have been developing programs to address human trafficking that leverage available resources and form partnerships in local communities.

Read these lessons learned briefs to see what grantees have learned during their journey to address various human trafficking issues, and help your community take advantage of their findings to keep children safe and thriving.

  • Human Trafficking: Coordinating Resources
    Bringing together specialized resources to better serve victims of human trafficking can have unique challenges. Grantees are building service capacity in their communities by establishing awareness, building multidisciplinary teams, and making sure the appropriate information gets shared between agencies and partners.
  • Human Trafficking: Working with Faith Based Groups
    Learn about the partnerships grantees formed with faith-based organizations and the benefits and challenges they encountered. Using real-life examples, this publication shows how child welfare agencies can identify service gaps, find community resources that can help, and build successful partnerships.
  • Human Trafficking: Developing Housing Options
    Securing safe and appropriate housing for victims of human trafficking is a challenge in many areas. Read how agencies identified appropriate housing options, took advantage of the resources they had—such as existing foster parents—to fill gaps, and supported the providers in their area.

Stay connected to quarterly grantee updates by subscribing to The Grantee Connection.

Listen to how the Miami CARES Project brings together more than 10 government and community agencies within Miami-Dade (FL) County to forge a collaborative, systematic approach to identifying minors who are, or are at risk of becoming, victims of human trafficking.

Your feedback is important. Be sure to let us know how we’re doing by taking our survey! For more information, visit our website, email us at, or call us toll-free at 1.800.394.3366.


Comments Requested: Current Use of Telemental Health for Suicide Prevention in Emergency Department Settings

This request for information (RFI) jointly issued by several Federal offices, including Health and Human Services’ National Institutes for Health, Veterans Affairs, and the Department of Defense, seeks information about the use of telehealth in hospital emergency medical care settings to facilitate the care of individuals with suicide risk.  Topics of interest include what telehealth services are being used, what contributed to the selection and implementation of those services, what are the characteristics of the emergency department (i.e. urban/rural setting), and approaches used to identify suicide risk of patients in the emergency department.  In 2015, suicide death rates in rural counties were higher than the rates in larger metropolitan counties.   Comments are due on August 29, 2019. More information is available here.

A Quarter of the World’s Population Faces Water Crises 

Countries that are home to one-fourth of Earth’s population face an increasingly urgent risk: the prospect of running out of water. From India to Iran to Botswana, 17 countries around the world are currently under extremely high water stress, meaning they are using almost all the water they have, the World Resources Institute said in a report published August 6, 2019. Read more.


Sigounas Steps Down, Engels Steps Up into HRSA Administrator Role 

Thomas Engels was named Acting Administrator for the Health Resources and Services Administration (HRSA) on August 1, 2019 and will oversee the execution of HRSA’s $11.7 billion annual budget, including the Health Center Program, the National Health Service Corps and NURSE Corps, the Ryan White HIV/AIDS Program and more. Before joining HRSA six months ago as Principal Deputy Administrator, Mr. Engels was Deputy Secretary of the Wisconsin Department of Health Services from 2015 to 2019. He was an active member of the Governor’s Task Force on Opioid Abuse and also chaired the Governor’s Human Resources Shared Services Executive Committee. Read more. Mr. Engel’s predecessor, Dr. George Sigounas, has been reassigned to an advisor role in the office of the HHS Secretary.