During the week of February 10, 2020, Congressman Jodey Arrington (R-TX-19) announced the introduction of the Save Rural Communities Act (H.R. 5808). This legislation seeks to grant rural hospitals more flexibility in the services they provide. Specifically, it allows them to convert to an outpatient only, 24-hour emergency care center. The proposed change would allow hospitals to tailor their business model and balance their budgets, while also meeting the health care needs of their community.

Harrisburg, PA – In February 2020, the Pennsylvania Department of Human Services (DHS) released a bulletin with guidance and requirements for providers that wish to become a specialized child residential setting under the Family First Prevention Services Act.

“The Wolf Administration remains committed to protecting vulnerable populations across Pennsylvania, and the Family First Prevention Services Act will help strengthen Pennsylvania’s child welfare system in line with this goal,” said DHS Secretary Teresa Miller. “We want to be sure that every service we provide offers the necessary supports to meet children and families’ needs and help them on a path to safe, healthy lives. This certification process will help DHS ensure that specialized settings for children will be available, safe, and suitable.”

The Family First Prevention Services Act is a federal law that prioritizes keeping children with their families. It allows states to use federal payments for trauma-informed evidence-based prevention services to allow children who would otherwise be placed in foster care to stay with their parents or relatives. The implementation of this law, scheduled for October 1, 2020, aligns with the Wolf Administration’s goals of serving children safely with their families or family-like settings when necessary.

In the event placement outside the home becomes necessary, the law directs federal funding towards family-like settings or other specialized settings that are best suited to a child’s individual needs. Specialized settings are trauma-informed child residential facilities or supervised independent living programs specializing in providing care and treatment for children and youth with special circumstances, including:

• Pregnant, expecting, and parenting youth;
• Youth who are transitioning to adulthood; or
• Youth who are, or at risk of becoming, sex trafficking victims.

Specialized settings should offer programming for participants and training for staff tailored to the needs of children and youth with these special circumstances. Public and private children and youth social service agencies, providers and stakeholders that provide services to these populations are encouraged to request certification as a specialized setting.

The specialized settings emphasize a trauma-informed approach to care. This approach integrates knowledge and effects of trauma into policies, procedures, and practices while actively seeking to avoid re-traumatization. Trauma-informed care is informed by six principles: organizational safety, trustworthiness and transparency, peer support, collaboration and reciprocal relationships, empowerment among and between staff and participants, and cultural sensitivity. Standards of trauma-informed care are in line with recommendations made by the Council on Reform established by Governor Wolf’s Vulnerable Populations Executive Order and the Wolf Administration’s effort to make Pennsylvania a trauma-informed state.

More information, the bulletin, and the certification approval process can be found here. Applications to be considered a specialized setting must be submitted by March 15, 2020.

DHS’ Office of Children, Youth, and Families is hosting webinars to review the bulletin and application process for child residential facilities or supervised independent living programs providing or planning to provide services to the above identified populations. Session opportunities are 9:30 a.m. to 12:00 p.m. on February 25 and 28. To register, email cwtpreg@pitt.edu.

Visit www.dhs.pa.gov or email ra-PWFamilyFirst@pa.gov for more information.

MEDIA CONTACT: Erin James – 717-425-7606

During the week of February 10, 2020, the Trump Administration released its federal FY 2021 budget proposal, and the bottom-line impact to programs serving kids and families is stark. The silver lining, if any, is that the likelihood of the plan gaining any momentum in Congress is slim to none.

The proposed budget cuts Medicaid spending by at least $1 trillion over the next 10 years and makes further cuts to CHIP, undoubtedly impacting health care coverage for kids in Pennsylvania and across the country. While little detail is provided in the proposal, what is known is that states would be allowed to select between moving to either a Medicaid block grant program or a per capita cap option.

The budget advances a one-time increase of $1 billion for child care, but masks other elements including the flat-funding of Head Start and the Child Care Development Block Grant, as well as the elimination of Preschool Development Grants, which Pennsylvania received in 2019. While a $1 billion increase is eye-catching, it should also be noted that Congress passed a $2.4 billion increase for child care in 2018.

Read more about the Medicaid proposal from the Georgetown Center for Children and Families.

in late 2019, the Office of Advocacy and Reform was created in Pennsylvania with the intent of overhauling state systems and services and identifying strategies to better protect vulnerable individuals. In addition to convening a council of reform, the position of Child Advocate was created and has recently been filled by Nicole Yancy, J.D.  Ms. Yancy will be a liaison between the systems serving children and their families, triaging concerns and complaints, and making recommendations for system-wide improvements.

The Office of Children, Youth and Families, in partnership with the Pennsylvania Department of Human Services and the Office and Advocacy and Reform, is conducting roundtables around the state to engage local child welfare agencies, county leaders, advocates and elected officials in brainstorming ways to improve the child welfare system.  The roundtables are an opportunity to openly discuss the struggles faced by child welfare agencies, and to develop recommendations on strength-based and solution-focused outcomes. Read more about the first roundtable held in York County.

The Agency for Healthcare Research Quality (AHRQ) recently updated their toolkit to help primary care providers manage patients who use opioids to treat chronic pain.  The new Self-Service How To Guide adds an important component to AHRQ’s Six Building Blocks opioid treatment toolkit, a structured, systems-based approach to improving management of patients who use long-term opioid therapy.

Community Health Workers (CHWs) can provide ongoing behavioral support for patients and help decrease health care costs.  In this program evaluation, the Centers for Disease Control report on a CHW-based care model that aimed to improve outcomes and lower costs for high-risk diabetes patients in rural Appalachia.

The Centers for Medicare & Medicaid Services (CMS) seek public comments regarding rural maternal health care. Specifically, the CMS Office of Minority Health is seeking information related to opportunities to improve health care access, quality, and outcomes for women and infants in rural communities, before, during, and after pregnancy. This includes the reduction of maternal health disparities across this timeframe between rural and urban communities, within rural communities, and racial and ethnic disparities within rural communities. This notice also seeks public comments regarding readiness of rural providers, including emergency medical services to handle obstetric emergencies (i.e., emergencies related to pregnancy, birth, and after birth) in rural areas.  Comments are due on April 12 and can be submitted here.

The Economic Research Service (ERS) at the U.S. Department of Agriculture updated their topic page on the factors that affect the poverty status of rural residents.  The ERS uses Census data to track poverty over time, analyze the severity and persistence of poverty over decades, and provide a rural/urban breakdown by race, family structure and age.  Read more here.

In a free-access article, the Journal of the American Medical Association (JAMA) presents findings from a cross-sectional study of 71,901 Census tracts.  Researchers sought to examine the association between social/neighborhood characteristics and health outcomes and create indices with multiple variations for different types of rural, urban and suburban neighborhoods.