- Biden-Harris Administration Releases National Strategy for Suicide Prevention and First-Ever Federal Action Plan
- Biden-Harris Administration Takes Historic Action to Increase Access to Quality Care, and Support to Families and Care Workers
- Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don't Meet Them.
- Rural Jails Turn to Community Health Workers To Help the Newly Released Succeed
- Rural Communities Face Primary Care Physician Shortage
- Miles for Milk: How Student-Run Grocery Store Reshaped Rural Community's Food Access
- Native Americans Have Shorter Life Spans, and It's Not Just Due to Lack of Health Care
- Promotoras Play Essential Role in Connecting Farmworkers with Health Care in Rural NorCal
- Using Medicaid to Address Young People's Mental Health Needs in School Settings
- Across the Country, Amish Populations Are on the Rise
- Sunsets, Wildlife and Limited Care: Challenges of Aging in Place in Rural America
- City-Country Mortality Gap Widens amid Persistent Holes in Rural Health Care Access
- Tribal Environmental Impact Network
- Minnesota's Rural Ambulance Providers Look to State Capitol for Their Own Lifeline
- Biden-Harris Administration Takes Action to Support the Primary Care Workforce
VA Announces Final Community Care Regulations under MISSION Act
VA Announces Final Community Care Regulations under MISSION Act. On June 5, the U.S. Department of Veterans Affairs (VA) announced the publication of two final regulations as part of its new Veterans Community Care Program under the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018. One of the rules focuses on a new urgent care benefit. VA also published the final regulation for the Veterans Community Care Program governing how eligible Veterans receive necessary hospital care, medical services, and extended care services from non-VA entities or providers in the community. The new Veterans Community Care Program replaces the Veterans Choice Program, which expired June 6, 2019. Of note, the final rule addresses payment of higher rates to health care providers in highly rural areas. The term “highly rural area” means an area located in a county that has fewer than seven individuals residing in that county per square mile.
CMS Requests Feedback Reducing Regulatory Burden
CMS Requests Feedback Reducing Regulatory Burden – August 12. On June 6, the Centers for Medicare & Medicaid Services (CMS) issued a Request for Information (RFI) seeking new ideas from the public on how to reduce administrative and regulatory burden as part of the agency’s Patients over Paperwork initiative. CMS is especially seeking innovative ideas that broaden perspectives on potential solutions to relieve burden and ways to improve: reporting and documentation requirements; coding and documentation requirements for Medicare or Medicaid payment; prior authorization procedures; policies and requirements for rural providers, clinicians, and beneficiaries; policies and requirements for dually enrolled (i.e., Medicare and Medicaid) beneficiaries; beneficiary enrollment and eligibility determination; and CMS processes for issuing regulations and policies.
HRSA Requests Public Feedback on Health Center Service Areas
HRSA Requests Public Feedback on Health Center Service Areas – July 8. The Health Resources and Services Administration (HRSA) is seeking input from the public on service area considerations that may inform decisions to expand the program through the addition of new service delivery sites onto existing health centers. The considerations include factors such as proximity to existing health centers, parameters for unmet need, and consultation with other local providers.
Unmet Need for Personal Care Assistance Among Rural and Urban Older Adults
Unmet Need for Personal Care Assistance Among Rural and Urban Older Adults. Despite differences in health, health services, economic, and demographic characteristics, little is known about whether rural and urban areas differ in unmet need for personal care for older adults with functional limitations. This brief from the University of Minnesota Rural Health Research Center addresses that gap by analyzing rural-urban differences in unmet need for help across 11 activities
HRSA Releases Allied Health Workforce Projections for 2016–2030
HRSA Releases Allied Health Workforce Projections for 2016–2030. The Health Resources and Services Administration (HRSA) recently released Allied Health Workforce Projections providing national-level health workforce estimates for the following occupations: chiropractors and podiatrists, emergency medical technicians and paramedics, medical and clinical laboratory technologists, occupational and physical therapists, optometrists and opticians, pharmacists, registered dieticians, and respiratory therapists. While shortages of health care providers in rural areas is well-known, consistent data on rural allied health professionals has been difficult to collect and analyze. Visit HRSA’s Bureau of Health Workforce website to see more data, projections, and federal programs.
Challenges of the Rural Opioid Epidemic: Treatment and Prevention of HIV and Hepatitis C.
Challenges of the Rural Opioid Epidemic: Treatment and Prevention of HIV and Hepatitis C. Previous research on HIV and hepatitis C (HCV) among people who inject drugs (PWID) has focused on urban or international populations, yet the US opioid epidemic is moving away from metropolitan centers. In this report, researchers examine the increasing rurality of opioid injection, the challenges to treatment and prevention that are unique to rural areas, and the public health interventions needed to address them.
Pennsylvania Has Third-highest Rate of Drug Overdose Deaths in the U.S., Study Finds
(June 12, 2019) Philadelphia Inquirer. A new study measuring the effectiveness of state health systems around the country found that Pennsylvania has the third-highest rate of drug overdose deaths in the country.
The “scorecard,” released by the Commonwealth Fund, a private health-care research foundation, rated Pennsylvania highly on other measures, including access to health care. The state’s 2015 Medicaid expansion has allowed hundreds of thousands to obtain care, including about 20,000 people with substance use disorders, state health officials say.
But Pennsylvania’s opioid crisis is so severe, and so much worse than almost anywhere else in the country, that it’s bringing down life expectancy in the state, researchers said.
The study measured “drug poisoning deaths” in 2017, the last year for which full statewide data are available. Only Ohio and West Virginia had higher overdose death rates than Pennsylvania that year. All three states had more than twice the national rate of drug overdose deaths in 2017. Along with seven other states, including Delaware, the trio have seen overdose deaths increase threefold since 2005.
In Pennsylvania, Maryland, and Ohio, overdose death rates were at least five times higher than alcohol-related deaths (including acute alcohol poisoning and more chronic diseases like liver cirrhosis), and about three times higher than suicide deaths.
East Coast and Southeastern states have been particularly hard-hit by the opioid crisis, the researchers wrote. In the West, alcohol and suicide deaths generally outstrip drug deaths.
Still, said Sarah Collins, the fund’s vice president for health-care coverage and access, “In other indicators, including coverage, Pennsylvania’s ranked very high. What that does for the state is, it puts it in a position where it’s better able to manage a crisis.”
State officials said they were seeing some encouraging signs of progress. After losing more than 5,400 Pennsylvanians to overdoses in 2017, estimates for 2018 were closer to 4,200 overdose deaths — a drop of about 22 percent, Rachel Levine, state secretary of health, said Tuesday.
Philadelphia had 1,217 overdose deaths in 2017 and 1,116 overdose deaths the following year.
The contamination of much of Pennsylvania’s illicit drug supply with fentanyl, a synthetic opioid that is significantly more powerful than heroin, is driving most of the state’s drug deaths, she said.
But Commonwealth Fund researchers said it’s hard to say why certain states — even Medicaid expansion states like Pennsylvania with relatively good health-care access — are affected more by overdose deaths than others.
“We do not have all the correlates of what’s driving [alcohol, suicide, and drug poisoning deaths], of why there are so many regional differences, and we don’t have a broad-base understanding of what’s effective in terms of preventing the rise in what we see,” Collins said.
Levine said that though overdose deaths decreased in 2018, the state’s approach to the opioid crisis is still “all hands on deck.”
Pennsylvania is about to declare its seventh successive disaster declaration over the overdose crisis, which enables state agencies to collaborate in an “opioid command center” and allows state officials to bypass regulations that might hinder a quicker response to the crisis.
The state Centers of Excellence, 45 opioid addiction recovery programs mainly for people on Medicaid, have treated 18,760 people in the last two years. (In Philadelphia alone, city officials have estimated, 50,000 to 70,000 people are addicted to opioids.)
The state has also distributed thousands of doses of the overdose reversal drug naloxone.
“We’re not done by any means, we’re not declaring victory, but we have made a lot of progress,” Levine said. “I’m a positive and optimistic person, and I think we will be successful, but we’re keeping our nose to the grindstone.”
NTIA Releases Comprehensive Guide to Federal Broadband Funding
The National Telecommunications and Information Administration (NTIA) has announced a new searchable database of 50 federal broadband programs, spanning a dozen federal agencies with billions of dollars for broadband grants, loans and other resources. The database, created with help of participating federal agencies, fulfills a goal set out in the American Broadband Initiative announced in February to make it easier for community leaders to find federal funding and permitting information.
“Consolidating these critical resources into a one-stop, easy-to-use resource provides an important tool in spurring efforts to expand our nation’s broadband infrastructure projects,” said Diane Rinaldo, Acting Assistant Secretary for Communications and Information.
The federal programs provide funding for state and local governments, schools, libraries, small businesses and other community institutions that are interested in expanding broadband access. Applicants can search for programs by agency, program purpose and eligible recipients. The inventory includes well-known infrastructure efforts at the U.S. Department of Agriculture and the Federal Communications Commission. A number of other programs offer grants and loans for targeted purposes or specific regions of the country.
For instance, the Commerce Department’s Economic Development Administration provides economic development grants that can be used to support broadband infrastructure projects, digital skills training and smart cities development. The agency’s FY2018 funding of $600,000,000 was mainly targeted for weather-related disaster relief but also supported broadband projects. In May, EDA announced it was investing $290,000 to help the Seneca Nation of Indians plan and install broadband fiber throughout the Cattaraugus Territory in Western New York. And in March, U.S. Secretary of Commerce Wilbur Ross announced a $1 million grant to St. Joseph County, Indiana, to expand high-speed broadband infrastructure in a project expected to create 230 jobs and spur $710 million in private investment.
Other programs in the NTIA inventory that recently made broadband grants include:
- The Appalachian Regional Commission awarded a $40,000 grant to the SEDA-Council of Governments (link is external) last October, a public development organization serving 11 Central Pennsylvania counties, for a feasibility study of broadband access in Northumberland, Union, Lycoming, and Clinton Counties.
- The Institute for Museum and Library Services (IMLS) provided a nearly $250,000 grant to address Native American digital access in New Mexico and the potential of TV Whitespace (TVWS) networks to improve tribal internet connectivity.
As the U.S. works to fill the gaps in connectivity that persist despite significant investments, NTIA is developing a new mapping platform that paints a more precise picture of the current infrastructure and services that are available around the country. This will help policymakers make better decisions about how broadband funds should be allocated.
NTIA’s most recent Internet Use Survey found that nearly 28 million households did not use the Internet at home, including 5 million living in rural areas. NTIA, the Department of Commerce and the Trump Administration are committed to putting the right tools in the hands of local leaders and service providers, to expanding opportunities so that all Americans benefit from our digital future.
Commonwealth Fund Releases 2019 Scorecard on State Health System Performance
(June 12, 2019) The Commonwealth Fund’s 2019 Scorecard on State Health System Performance reveals that most states are losing ground on key measures related to life expectancy as premature deaths from suicide, alcohol, and drug overdose continue to increase. Several states that most recently expanded eligibility for their Medicaid programs saw meaningful gains in access to health care; in other states prior gains eroded between 2016 and 2017. Finally, the Scorecard found that health care costs are placing an increasing financial burden on families across the nation.
In addition, you can download the full report, and a two-page summary for each state.
Child Diversity in Pennsylvania, 2009 to 2017
This research brief from the Pennsylvania State Data Center, Child Diversity in Pennsylvania, examines trends in the changing racial and ethnic makeup of Pennsylvania’s child population. The brief accompanies an interactive visualization which shows trends in race and ethnicity by school district and age group for those under 20 years.
The report shows that nearly a third of all children in Pennsylvania are children of color as of 2017, up from a quarter in 2009. Meanwhile, just one in five adults are persons of color. Four out of five school districts had higher shares of children of color in 2017 than 2009. Click here to read more in the full report, or click here to go straight to the visualization.
The report and visualization were developed in collaboration with our affiliate, Pennsylvania Partnerships for Children. Learn more about their important work at https://www.papartnerships.org/.