This announcement solicits applications for the Delta States Rural Development Network Grant Program (Delta Program). The purpose of the Delta Program is to fund organizations located in the eight Delta States that promote, through planning and implementation, the development of integrated health care
networks that have combined the functions of the eligible entities participating in the networks in or to: achieve efficiencies; expand access to, coordinate, and improve the quality of essential health care services; and strengthen the rural health care system as a whole.
The Delta Program provides resources to help rural communities develop partnerships to jointly address health problems that could not be solved by single entities working alone. A goal of the Federal Office of Rural Health Policy is to fund programs that have demonstrated a level of evidence through improved health outcomes.
For FY 16, the program will require applicants to focus efforts around diabetes, cardiovascular disease, obesity and acute ischemic stroke. The program will also place an emphasis on population health.
Population health is defined as the health outcomes of a group of individuals, including the distribution of such outcomes within the group.
The groups may be geographic populations or other groups such as employees, ethnic groups, adolescents, school aged children, or any other defined group.
The health outcomes of these groups may help in informing policy decisions on a national and local level.
In addition, it is anticipated that recipients will coordinate the services and activities related to chronic disease management.
These efforts may include the appropriate utilization of healthcare resources such as efforts resulting in a reduction of unnecessary emergency department encounters, hospital admissions, or 30-day readmissions for target populations as a significant in the coordination of services. This goal should be accomplished through improved disease management and care coordination in one of the following focus areas:
1) diabetes; 2) cardiovascular disease; 3) obesity; or 4) acute ischemic stroke. An important component of integrated care is the ability of the primary care provider to properly screen patients for behavioral health conditions.
Because individuals who live with a chronic disease are at risk for having depression etc., as comorbidity, applicants are also encouraged to incorporate mental health services for effective and efficient program implementation.
All recipients are required to adopt an evidence-based or promising practice approach that has been proven to demonstrate improved outcomes and may be replicable in other communities. Evidence-based practices are those that are developed from scientific evidence and/or have been found to be effective based on the results of rigorous evaluations. “A ‘promising model’ is defined as one with at least preliminary evidence of effectiveness in small-scale interventions or for which there is potential for generating data that will be useful for making decisions about taking the intervention to scale and generalizing the results to diverse populations and settings.” An example of a promising practice would be a small-scale pilot program that has generated positive outcome evaluation results that justify program expansion to new access points and/or to new service populations. Applicants are required to propose multi-County/multi-parish projects that address delivery of preventive or clinical health services for individuals with, or at risk of developing chronic health diseases which disproportionately affect rural Delta communities. Due to the high disparities in the region applicants are required to propose a program based on one of the following focus areas:
1) diabetes; 2) cardiovascular disease; 3) obesity; or 4) acute ischemic stroke; or 5) mental including related behavioral health and target the program to the services.
Rural counties or parishes with the highest unmet needs and more hard to reach communities that are underserved must be specifically targeted in need the application. Initiatives can be in programs focused on prevention, self-management, care coordination, clinical care, or population health, but must be outcomes oriented.
For example, the programs should include activities focused on producing changes in one or more of the following areas:Knowledge (e.g.
understanding of effective self-management strategies, understanding of key disease risk factors or prevention strategies) Attitudes (e.g.
increased self-efficacy in prevention or self-management strategies) Behaviors (e.g.
increase in level of physical activity, increase intake of fruits and vegetables) Clinical biometrics (e.g.
BMI, weight, A1C, blood pressure) Policies and procedures (e.g.
improved health care services delivery model, changes to school physical activity and/or cafeteria policies) Systems (e.g.
improved coordination among health and social services agencies) Appropriate utilization of healthcare resources Many of the largest drivers of health care costs fall outside the clinical care environment.
In addition to the required key focus area(s), grantees may devote a percentage of grant funds toward another issue which may be of need in the service area.
This addition may help develop and strengthen the health care networks through the coordination of services and the improvement in the quality of health care services.
For example, applicants could work with the target population to connect those in need with resources related to issues that align with the broader determinants of health. Other issue areas may include areas such as pharmacy assistance, electronic health record management (funds should not go toward implementation, but rather towards enhancing the system in place), oral health, cancer screening, women’s health, or child poverty, etc.
Applicants should demonstrate the need of this additional topic area, as well as how it will improve the project and the population being served.
On May 20th, the White House released a report entitled:
Opportunity for All:
Fighting Rural Child Poverty (May 2015 Report) https://www.whitehouse.gov/sites/default/files/docs/rural_child_poverty_report_final_non-embargoed.pdf .
The report documents the 1. 5 million children who continue to live in poverty in rural America. In support of the subsequent initiative to combat rural childhood poverty, applicants are encouraged to focus an aspect of their project in this area.
Sustainability of program activities beyond the funding period is a goal of the Federal Office of Rural Health Policy. Under health services delivery programs, HRSA funding may support recipients’ efforts to develop necessary capabilities and the ability to obtain funding from non-Federal sources.
It is anticipated that applicants will provide a sustainability plan with the application.
 National Opinion Research Center (NORC) Walsh Center for Rural Health Analysis, “Promising Practices for Rural Community Health Worker Programs”, FORHP 330A Grant Issue Brief, Y series-No.1 (January 2011)  Department of Health and Human Services Administration for Children and Families Program Announcement.
Federal Register, Vol.
131, (July 2003), p.