On October 17, 2019, the U.S. House of Representatives’ Energy & Commerce Committee passed an updated version of House Speaker Nancy Pelosi’s drug pricing legislation (H.R. 3). According to Politico, “The committee also approved on voice votes bills that would direct expected savings from the government drug price negotiations required by the legislation to new dental, vision and hearing benefits for seniors in Medicare as well as new financial support for low-income Medicare beneficiaries.” It is not likely this legislation will pass the Senate, but our team believes that these voice votes demonstrate that there is traction behind addressing the lack of oral health coverage in the Medicare program. The House Ways & Means Committee is set to mark up this package next week, so stay tuned

The Health Resources and Services Administration (HRSA) has updated all automatically designated Health Professional Shortage Areas (Auto-HPSAs) scores. All Auto-HPSA organizations have the opportunity to submit rescore requests via the online Auto-HPSA portal. The deadline to guarantee that your rescore requests are processed before 2020 NHSC Loan Repayment Program (LRP) application cycle is November 1, 2019. You can find the Rural Health Voices Blog post on this subject here.

National Rural Health Day was created to increase awareness of rural health-related issues and challenges; as well as recognize those who are working to improve the health and well being of the millions of people living in America’s rural communities. The week of November 18-21 there will be twitter chats, webinars, a virtual job fair, and a special webcast HRSA celebration with Health and Human Services Deputy Secretary Eric Hargan and several HHS agencies.

Learn more about National Rural Health Day.

October 10 – Today, the U.S. Department of Health and Human Services published a new Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics (PDF – 118 KB). Individual patients, as well as the health of the public, benefit when opioids are prescribed only when the benefit of using opioids outweighs the risks.  But once a patient is on opioids for a prolonged duration, any abrupt change in the patient’s regimen may put the patient at risk of harm and should include a thorough, deliberative case review and discussion with the patient. The HHS Guide provides advice to clinicians who are contemplating or initiating a change in opioid dosage.

“Care must be a patient-centered experience. We need to treat people with compassion, and emphasize personalized care tailored to the specific circumstances and unique needs of each patient,” said Adm. Brett P. Giroir, M.D., assistant secretary for health. “This Guide provides more resources for clinicians to best help patients achieve the dual goals of effective pain management and reduction in the risk for addiction.”

Read the new guide (PDF – 118 KB)

HRSA’s Bureau of Primary Health Care (BPHC) Associate Administrator Jim Macrae presided over two days of meetings (September 18-19) with state officials working to speed the adoption of health information technology in health centers nationwide. Computerized record systems promise to revolutionize care delivery while dramatically cutting costs and medical errors.

HRSA Acting Administrator Tom Engels — who oversaw adoption of a statewide health information system in Wisconsin —  addressed officials from state Primary Care Associations, which recently were awarded almost $42 million to expand and maintain Health Center Controlled Networks to promote the use of digital technology.

“Overall, Health Center Controlled Networks … serve 24 million patients at over 10,000 participating health center sites,” observed the Acting Administrator, “(and) help health centers navigate the operational and clinical challenges related to the use of health information technology … And many of you are working to ensure that patients have better access to their own personal health data.”

Read more about the adoption of health information technology in health centers.

More than half of the 1.1 million people diagnosed with HIV in America get medication and care through HRSA’s Ryan White Program — and more than 8 out of 10 of those in care — are able to lead normal lives as a result. But some 400,000 people with the virus are outside the HRSA system, and 1 in 7 are unaware they are infected. Making HIV testing an essential part of routine primary health care offered by community health centers could be key to getting the remainder into treatment, the agency’s senior leaders say.

Widely recognized for having helped transform the once deadly illness into a manageable disease, the Ryan White HIV/AIDS and Health Center Programs will be integral to making it preventable, agreed HRSA Acting Administrator Tom Engels and Associate Administrators Laura Cheever (HAB) and Jim Macrae (BPHC).

The trio addressed the annual gathering of HAB’s National Partners on September 17.

“The agency,” Engels pledged, “will play a leading role in helping to diagnose, treat, prevent, and respond to end the HIV epidemic in the United States.”

Read more about ending the HIV epidemic.

Harrisburg, PA – On October 18, 2019, Pennsylvania Department of Human Services (DHS) Secretary Teresa Miller joined the Center of Excellence (COE) Regional Learning Network to meet with COEs in Central Pennsylvania and hear directly from their employees about the successes and challenges of fighting the opioid epidemic. Since 2017, Pennsylvania’s 45 COEs have expanded access to and improved engagement in treatment to more than 20,500 Medicaid recipients around Pennsylvania.

“It goes without saying that our goal is to save lives and help people get the treatment they need to live healthy lives,” said Secretary Miller. “We want to be sure we are doing everything we can to fight the opioid epidemic and give people the resources they need to be successful in recovery, and the COE model is making that possible for more Pennsylvanians.  We know, though, that there is still more work to be done. The Regional Learning Network gives us the opportunity to learn from COE employees since they are hearing directly from the people we are helping and can help inform our response to the opioid crisis moving forward.”

Prior to the COEs, as few as 48 percent of Medicaid beneficiaries diagnosed with opioid use disorder were receiving treatment. Of those, only 33 percent remained engaged in treatment for more than 30 days. Today, more than 70 percent receive treatment after being diagnosed with an opioid use disorder, and 62 percent remain in treatment for more than 30 days.

The Regional Learning Network is made up of representatives from each COE in a region. The networks meet regularly to determine best practices for addressing the opioid epidemic. Each year, all of the Regional Learning Networks come together for a Statewide Learning Network to share and explore best practices.

COEs provide treatment that is team-based and whole-person focused, with a goal of integrating substance use disorder treatment, behavioral health, and primary care. The centers’ care managers work to keep people with OUD engaged in treatment by coordinating follow-up care and community supports. Their work confronts the most common barriers to treatment and provides vital support to maintain recovery.

COEs work as a hub-and-spoke network, with the designated center serving as the hub. The spokes can include primary care practices, the criminal justice system, emergency departments, social services providers, and other treatment providers and referral sources. With a commitment to educating the community, the COE team works to ensure health care, education, and law enforcement organizations can identify those who need treatment and refer them to the center.

For more information on the state’s efforts to battle the opioid epidemic, visit www.pa.gov/opioids.