Pennsylvania Office of Rural Health (PORH)

Enhancing the Health Status of Rural Pennsylvanians

The Pennsylvania Office of Rural Health (PORH) works with local state and federal partners to achieve equity in, and access to, quality health care for Pennsylvania's rural residents. We strive to be the premier rural health leadership organization in the state and one of the most effective State Offices of Rural Health in the nation.

Headlines

2013 Pennsylvania State Health Assessment Released

The Bureau of Health Planning is pleased to announce the release of the 2013 Pennsylvania State Health Assessment. This comprehensive assessment provides a “one-stop” summary of information on health status, health risks and healthcare services in Pennsylvania. It will support the department’s and our partners’ work in developing priorities and policies, garnering resources and planning actions to improve the population’s health.

Swimming Pool Pesticide Applicators Training Program

Registration is now open for spring Swimming Pool Pesticide Applicators Training Program.

    2014 Migrant and Immigrant Farmworker Health Conference

    • 2014 Migrant and Immigrant Farmworker Health Conference has been postponed until further notice.


    PORH Announces Annual Report & Spring 2014 Magazine

    We are pleased to present our annual report and Spring 2014 Magazinefor your review.

    For Information Contact:
    Lisa Davis Director and Outreach Associate Professor of Health Policy and Administration Pennsylvania Office of Rural Health 202 Beecher-Dock House University Park, PA 16802

    Bureau of Health Planning Announces Funding Opportunity

    COMMUNITY-BASED HEALTH CARE PROGRAM

    Applications and Information: http://www.emarketplace.state.pa.us/Solicitations.aspx?SID=67-28

    Applications Due: Wednesday, April 9, 2014

    Evidence-based Mental Health Toolkit Released

    The Office of Rural Health Policy (ORHP) is pleased to announce the release of the evidence-based mental health toolkit. As mental health and substance abuse continues to be a challenge in rural communities, this toolkit provides valuable and proven methods on ways to address the issue, make an impact in rural communities, be replicable and sustainable.

    This toolkit, located on the Rural Assistance Center, Community Health Gateway, is the 5th in a series of evidence-based toolkits released within the last two years. The gateway, launched in 2012, was developed in response to the President’s Rural Healthcare Initiative, which identified evidence-based as a priority area for ORHP, and has allowed ORHP an opportunity to focus on demonstrating program outcomes. The easy-to-use toolkits have been developed through extensive literature reviews, and in partnership with the National Opinion Research Center (NORC) and the Rural Assistance Center (RAC), and serve as a resource for rural communities looking to develop and implement a similar program. Rural communities also avoid having to reinvent the wheel, as proven models have been studied and evaluated, and highlighted as replicable models on the Gateway. ORHP encourages you to visit the Community Health Gateway http://www.raconline.org/communityhealth/ and explore the website to learn about the various tools and resources available.

    For further questions, please contact:
    Nisha Patel, Director
    Community-Based Division/ORHP
    npatel@hrsa.gov

    Where You Live Matters to Your Health

    The County Health Rankings provide a health snapshot for nearly every county in all 50 states. See how well your county is doing on 29 factors that influence health, including smoking, high school graduation, employment, physical inactivity, access to healthy foods, and more.

    Discharge to Swing Bed or Skilled Nursing Facility: Who Goes Where?

    This Findings Brief examines health conditions of patients discharged from rural Prospective Payment System (PPS) hospitals and Critical Access Hospitals (CAHs) to swing beds and skilled nursing facilities (SNFs). Patients discharged to facility-based, post-acute care from CAHs are sent to SNFs and swing beds almost equally. Those discharged from rural PPS hospitals predominantly are sent to SNFs. This is the fourth and final brief in a series of studies to better understand swing bed utilization and cost.

    Contact Information:
    Victoria A. Freeman, RN, DrP
    North Carolina Rural Health Research and Policy Analysis Center
    Phone: 919-966-6168
    victoria_freeman@unc.edu

    2012 Rural Medicare Advantage Quality Ratings and Bonus Payments

    The Patient Protection and Affordable Care Act of 2010 established bonus payments to reward Medicare Advantage (MA) plans with high quality ratings (4 stars or higher) beginning in 2012. In addition, the Centers for Medicare and Medicaid Services created a demonstration project that expanded the quality-based bonus payments to plans with lower quality ratings (3 stars or higher) from 2012 through 2014. This brief analyzes differences in quality and payment and suggests reasons why quality ratings vary by geography. Overall, the quality rating of MA plans in rural areas is lower than in urban areas, a result of the availability of, and enrollment in, different types of MA plans. This suggests that the focus on quality improvement for MA plans should be on the type of plan, not its location.

    Contact Information:
    Keith J. Mueller, PhD
    RUPRI Center for Rural Health Policy Analysis
    Phone: 319.384.3831
    keith-mueller@uiowa.edu

    Meaningful Use of Electronic Health Records by Rural Health Clinics

    Little information is available on the rate of Electronic Health Record (EHR) adoption by Rural Health Clinics (RHCs). This study was conducted to identify the rates of EHR adoption among a national random sample of RHCs and the extent to which RHCs that have adopted an EHR are likely to achieve Stage 1 meaningful use. To achieve Stage 1 meaningful use and qualify for meaningful use incentive payments, eligible health professionals must, at a minimum, meet CMS defined criteria for the required 14 core measures. Fifty-nine percent of RHCs report having an EHR, and independent RHCs were more likely than hospital-based RHCs to have an EHR. Common barriers to EHR adoption by RCHs include acquisition and maintenance costs, lack of capital, and potential productivity or income loss during transition.

    Contact information:
    John A. Gale, MS
    Maine Rural Health Research Center
    Phone: 207-228-8246
    jgale@usm.maine.edu

    Pennsylvania Partnerships for Children Releases 2014 Report

    Pennsylvania Partnerships for Children is releasing its 2014 State of Child Welfare report today, and it shows the commonwealth has made some notable progress in recent years to reduce the number of children living in foster care and provide more in-home services - trends we should strive to continue as new child abuse laws take effect.

    The Uninsured: An Analysis by Age, Income, and Geography

    Using the 2010 Small Area Health Insurance Estimates, we analyze the rural and urban uninsured populations by age, showing that in both places, uninsured rates decline dramatically with age. We find that, within each age group, rural uninsured rates are somewhat lower than urban uninsured rates at income levels below 400% of the Federal Poverty Level. However, since a greater proportion of the rural population falls into the age and income categories with high uninsured rates, rural people as a group stand to benefit slightly more from subsidized coverage through the Health Insurance Marketplaces (HIM) or Medicaid expansion (if enacted). Furthermore, we discuss the potential for age differences between rural and urban uninsured populations to drive HIM premiums upward, an effect which may be mitigated or compounded by various other factors.

    Contact Information:
    Keith J. Mueller, PhD
    RUPRI Center for Rural Health Policy Analysis
    Phone: 319.384.3831
    keith-mueller@uiowa.edu

    Which Medicare Patients Are Transferred from Rural Emergency Departments?

    This study analyzes transfers of Medicare beneficiaries who received emergency care in a CAH or rural hospital and were transferred to another hospital for care. Key findings include the following:

    • Among Medicare beneficiaries who received same-day emergency care and inpatient care in 2010, the inpatient stay was in a different hospital for 76.1% of the Critical Access Hospital (CAH) emergency claims, compared to 9.0% for rural non-CAHs, and 2.1% for urban hospitals.
    • The majority of transferred CAH and rural non-CAH emergency patients went to urban hospitals for inpatient care. By diagnosis, most transferred patients with intracranial injuries and cardiac-related diagnoses went to urban hospitals, while 42%-48% of patients with certain mental health diagnoses were transferred to other CAHs or rural non-CAHs.

    Contact Information:
    Michelle Casey, MS
    University of Minnesota Rural Health Research Center
    Phone: 612.623.8316
    mcasey@umn.edu

    New Rural Mental Health and Substance Abuse Toolkit Launched

    March 18, 2014 -- The Rural Assistance Center (RAC), the University of Minnesota Rural Health Research Center, and the NORC Walsh Center for Rural Health Analysis, today launched the new Rural Mental Health and Substance Abuse Toolkit. This toolkit is designed to help rural communities and organizations develop and implement programs that meet the targeted mental health needs of communities based on proven approaches and strategies. The toolkit is available for free on the RAC website.

    “Mental health and substance abuse issues facing rural communities are often complex and require comprehensive approaches and proven strategies to coordinate and focus available resources for success,” commented Walt Gregg, MA, MPH, Senior Research Fellow at the University of Minnesota Rural Health Research Center.

    The Rural Mental Health and Substance Abuse Toolkit contains eight modules with information and links to resources, websites, publications, and tools. The toolkit includes:

    • an overview on mental health issues in rural areas
    • program model examples
    • guidance on implementation, evaluation methods, and more.

    “Many rural communities are looking for programs that can be adapted to their unique situation,” said Alana Knudson, PhD, Co-Director of the NORC Walsh Center. “This toolkit’s program clearinghouse provides many rural examples and also includes contact information so that communities can directly connect with rural program directors who have successfully implemented their programs.”

    Content for the Mental Health and Substance Abuse Toolkit was developed by the University of Minnesota Rural Health Research Center, in collaboration with the NORC Walsh Center for Rural Health Analysis, as part of the Rural Community Health Gateway. The Gateway, located on the RAC website, is designed to help rural communities learn about proven methods of providing rural residents with better access to health care services. Development of these resources is part of an ongoing effort by NORC, UMN, and RAC to provide evidence-based health information to rural America.

    “Addressing behavioral health issues is such a challenge for rural communities given that they often lack specialized providers and infrastructure. We are pleased to provide this toolkit on the RAC website to help rural communities find evidence-based strategies that can make a difference, even with limited resources,” noted Kristine Sande, MBA, Program Director of the Rural Assistance Center.

    Funding for this project is provided by the federal Office of Rural Health Policy, part of the Health Resources and Services Administration.

    National Advisory Committee on Rural Health & Human Services Releases Policy Briefs

    The National Advisory Committee on Rural Health and Human Services (NACRHHS ), which advises the Secretary of HHS on rural issues, has released two new policy briefs. The health brief examines the challenges and opportunities presented by outreach, education, and enrollment in the Affordable Care Act’s new Health Insurance Marketplaces for rural and frontier populations. The Committee provided the Secretary with several recommendations to broaden outreach efforts in rural areas for upcoming enrollment periods. The human services brief examines the intersection of rural poverty and Federal human services programs. In 2013 the Committee visited Montrose County, Colorado and Gallatin County, Montana to learn about unique human service approaches toward addressing local need. The Committee wrote about the promising practices for administering and delivering social services they identified during their visits. For more information on the Committee see http://www.hrsa.gov/advisorycommittees/rural/.

    Flex Monitoring Releases Findings on the Evidence for Community Paramedicine in Rural Areas

    The Flex Monitoring Team is pleased to share with you findings from their study examining the evidence base for community paramedicine in rural communities, the role of community paramedics in the rural healthcare delivery system, challenges faced by states in implementing community paramedicine programs, and the role of the state Flex programs in supporting development of community paramedicine programs. Additionally, the briefing paper and policy brief provide a snapshot of community paramedicine programs currently being developed and/or implemented in rural areas.

    Challenges & Opportunities for Improving Mental Health Services in Rural Long-Term Care

    Despite high levels of need, individuals in long-term care often fail to receive appropriate mental health services, especially in rural areas. In this policy brief and accompanying working paper, we consider challenges and opportunities for improving mental health treatment delivered to long-term care recipients in rural settings.

    For more information, please contact:
    Jean A.Talbot, PhD, MPH
    Maine Rural Health Research Center
    Email: jatalbot@usm.maine.edu
    Office: 207-671-5724

    The Rural H1N1 Experience: Lessons Learned for Future Pandemics

    Data have been collected and methods have been developed to estimate the impact of H1N1 prevalence and trends nationally. However, there has been little study of this pandemic for rural communities, where fewer resources for vaccination and care may exist. The results of this study can be used to guide policy recommendations for prevention in rural populations during future pandemics.

    For more information, please contact:
    Cynthia Armstrong Persily PhD, RN, FAAN
    West Virginia Rural Health Research Center
    Email: cpersily@hsc.wvu.edu
    Office: (304) 347-1253

    Second Biennial Pennsylvania Health Equity Conference SAVE THE DATE Aug. 21 & 22, 2014

    “Engaging and Empowering YOU to Enhance Health Equity”

    Aug. 21 and 22, 2014 - Capitol Region

    Second biennial conference aimed towards increasing knowledge about health equity and sharing best practices to reduce health disparities that affect underserved and vulnerable populations in Pennsylvania. The focus at this year’s conference will be the impact of chronic diseases and its associated risk factors for diverse populations, particularly for immigrants/refugees, as well as the role that socioeconomic differences, race and ethnicity, sexual orientation, age, disabilities, etc., play in creating health disparities. It includes, but it is not limited to, cultural competence, language issues, health literacy, as well as the impact of the social determinants of health in achieving health equity.

    WHEN: Aug. 21 and 22, 2014

    WHERE: Radisson Convention Center, 1150 Camp Hill Bypass, Camp Hill, PA 17011

    For more information please contact:
    Dr. Hector R. Ortiz | Director Department of Health | Office of Health Equity Health and Welfare Building | Room 905 625 Forster Street | Harrisburg, PA 17120 Phone: 717.547.3315 Fax: 717.780.4827 hectoortiz@pa.gov | www.health.state.pa.us