Rural Health Information Hub Latest News

Community Health Centers Sue HHS to Install Method to Handle 340B Violations After Drugmaker Feud

FIERCE Healthcare

An association representing community health centers is suing the Department of Health and Human Services (HHS), seeking help in combating drug manufacturers that are refusing to give their products to 340B contract pharmacies.

Filed last week in the U.S. District Court for the District of Columbia by the National Association of Community Health Centers, the lawsuit is the latest salvo in an escalating feud over the 340B drug discount program. The centers want HHS to install a dispute resolution process to give 340B entities a pathway to remedy program violations.

The lawsuit comes after several drug companies announced they won’t provide 340B-discounted products to contract pharmacies, third-party entities that are hired by a 340B entity to dispense the drugs.

Read more.

Data Show More Than 539,000 Confirmed COVID-19 Cases in Appalachia

Appalachia reached two grim milestones last week when the Region recorded 500,000 confirmed COVID-19 cases and 10,000 covid-related deaths. From March 6, 2020, COVID-19 cases increased at a gradual pace. In the past few months, the number of confirmed cases increased faster, and has continued to increase every day since October 2. This week, Appalachia set a new record high for the seven-day rolling average of new daily cases with 5,062 on October 20th. The seven-day average of new daily cases was 4,425 a week ago and 3,805 two weeks ago.

The seven-day rolling average of new daily deaths stands at 68 per day, up from 60 a week ago and 53 two weeks ago. As of 11:30am today, October 22, 2020, there were 545,567 cumulative cases throughout Appalachia and 10,666 cumulative deaths in 383 of Appalachia’s 420 counties.

For more information on the coronavirus in Appalachia, visit here.

New Report Estimates How Many Households May Be At Risk of Eviction Because of the COVID-19 Pandemic

COVID-19 and associated economic shutdowns have led to unprecedented job losses and concerns about how households will pay rent while unemployed and make up for missed payments once reemployed. While the CDC has temporarily halted evictions until December 31, 2020, accrued rental debt will put many households at risk of eviction once the moratorium expires. Household Rental Debt During COVID-19 provides new estimates of the number of households with rental debt, and the amount of debt owed, resulting from pandemic-related job losses.

Key findings:

  1. As a result of pandemic-related job losses, we estimate that by December 2020, 1.3 million renter households will owe $7.2 billion in rent, which is around $5,400 each. These 1.3 million households contain 3.9 million individuals: 2.8 million adults and 1.1 million children. This is in addition to any household debt that existed before the pandemic.
  2. Policies designed to replace lost income for unemployed workers — such as standard state UI, the supplementary $600 per week CARES Act UI benefit available from April through the end of July, and the Economic Impact Payments sent to households in April — have been very effective at preventing rental debt for those households that receive them.
  3. Hispanic households, Black households, and family households headed by single women are disproportionately likely to experience rental debt by December 2020.
  4. There is substantial variation in rental debt outcomes by state, as detailed in the report.

Read the report.

Even With ACA’s Fate in Flux, Open Enrollment Starts Soon. Here’s What’s New

Facing a pandemic, record unemployment and unknown future costs for COVID-19 treatments, health insurers selling Affordable Care Act plans to individuals reacted by lowering rates in some areas and, overall, issuing only modest premium increases for 2021.

“What’s been fascinating is that carriers in general are not projecting much impact from the pandemic for their 2021 premium rates,” said Sabrina Corlette, a research professor at the Center on Health Insurance Reforms at Georgetown University in Washington, D.C.

Although final rates have yet to be analyzed in all states, those who study the market say the premium increases they have seen to date will be in the low single digits — and decreases are not uncommon.

That’s good news for the more than 10 million Americans who purchase their own ACA health insurance through federal and state marketplaces. The federal market, which serves 36 states, opens for 2021 enrollment Nov. 1, with sign-up season ending Dec. 15. Some of the 14 states and the District of Columbia that operate their own markets have longer enrollment periods.

The flip side of flat or declining premiums is that some consumers who qualify for subsidies to help them purchase coverage may also see a reduction in that aid.

Here are a few things to know about 2021 coverage.  Read more.

Pennsylvania Downtown Center Partners with USDA to Provide Rural Placemaking Technical Assistance

United States Department of Agriculture (USDA) Deputy Under Secretary for Rural Development Bette Brand announced that USDA has signed cooperative agreements with five organizations to support placemaking technical assistance throughout the United States.

USDA is providing the assistance through the Rural Placemaking Innovation Challenge (RPIC). The department and its partners will help rural communities develop actionable strategies to capitalize on local community assets and potential through the creation of quality public spaces that contribute to the community’s social, physical, and economic well-being. Through RPIC, USDA is empowering rural communities to improve their quality of life and prosperity through revitalization, workforce development, entrepreneurship, broadband, housing, and tourism efforts.

The department is partnering with only five organizations throughout the country who will help develop placemaking plans with leaders in rural communities for the next two years. These organizations are listed below.

In the Northeast, the Pennsylvania Downtown Center (PDC), in Harrisburg, will use a $140,000 grant to provide placemaking services to support downtown revitalization in five separate community revitalization initiatives throughout Pennsylvania: three individual municipalities and partners – New Castle – New Visions; Clarion – Clarion Blueprint Community, Inc. and Reynoldsville – Reynoldsville Community Association  and two “regional” programs – The Allegheny-Clarion Valley Blueprint Community (Emlenton, Foxburg and the City of Parker), and the Juniata River Blueprint Communities (Mount Union, Mapleton, and Shirley Township). Funds will be used to develop community assessments, revise and refresh vision statements, strategic action plans, annual work plans, and provide supportive technical assistance through September 2022.

In the South, Winrock International Institute for Agricultural Development will use a $215,000 grant to help develop a plan to support rural tourism opportunities; in the Midwest, McClure Engineering Company will use a $215,000 grant to develop a plan to support housing, workforce and broadband development;  in the Midwest, Pierce County, Neb., will use a $215,000 grant to develop a plan to support outreach to students and recent graduates for rural entrepreneurship opportunities in the agricultural sector; and in the West, Tolani Lake Enterprises in Winslow, Ariz., will use a $215,000 grant to provide technical assistance to develop a plan to support Tribal lands and tourism for the Navajo Nation.

To be innovative, local placemaking efforts need to understand and adapt to the challenges of current issues. Placemaking is a process that connects vision, strategy, implementation, and funding, into a unified effort that will improve the overall environment and quality of life in a community. To be sustainable, placemaking needs to provide local organizations with the knowledge and skills to understand, to adapt, and to change outdated perceptions and attitudes. We intend the RPIC effort to help communities do just that – Innovate-Succeed-Sustain.

PDC intends for the RPIC effort to help communities innovate, succeed, and sustain with these outcomes: improved community perceptions, increased organizational capacity, better informed organizations, increased volunteerism, and overall increased buy-in to the communities’ revitalization effort.

Existing local, regional, statewide, and national public, private, nonprofit, and philanthropic partnerships will be assessed and encouraged to be expanded during this project.  Newly identified partners will be encouraged to participate, including but not limited to diversity, equity, and inclusion practices so that organizational representation better matches the socio-economic profile of the communities they serve.

“We are thrilled to be partnering with USDA Rural Development and honored to be one of only five selected programs.  We look forward to using this new and exciting initiative to bring more attention to Pennsylvania’s rural communities, by helping to increase local capacity, and by growing and enhancing existing implementation and funding partners.  This is an opportunity to build from recent investment from the Federal Home Loan Bank in Pittsburgh (FHLBank) Blueprint Communities program and assist the communities in their next phase of revitalization,” says PDC’s Executive Director, Julie Fitzpatrick.

Founded in 1987, the mission of Pennsylvania Downtown Center is to build and support the capacity of local nonprofit organizations, municipalities, and individuals to enhance the overall well-being and sustainability of Pennsylvania’s core communities.  PDC accomplishes this mission by engaging and educating local community leaders and volunteers, to advance the sense of place, quality of life and economic vitality of the Commonwealth’s downtowns, traditional neighborhood business districts and nearby residential areas. For more information about designated Main Street or Elm Street programs or nationally accredited communities, contact Maria Wherley at (717) 870-9334 or email here.

Contact: Maria Wherley, Pennsylvania Downtown Center, Inc.
(717) 870-9334 or mariawherley@padowntown.org
PO Box 1265
Harrisburg, PA 17108
(717) 233-4675

Department of Homeland Security Launches New Center for Countering Human Trafficking

WASHINGTON—U.S. Department of Homeland Security (DHS) Acting Secretary Chad Wolf announced the opening of the DHS Center for Countering Human Trafficking, the U.S. government’s first-ever integrated law enforcement operations center directly supporting federal criminal investigations, victim assistance efforts, intelligence analysis, and outreach and training activities related to human trafficking and forced labor.

The center, which has been operational since early September, is based in Washington and led by U.S. Immigration and Customs Enforcement (ICE), a global leader of criminal investigations into human trafficking and sexual exploitation. The center will be staffed with law enforcement officials from Homeland Security Investigations (HSI) and across DHS, as well as subject matter experts and support staff from 16 DHS components—all focused on the “4 Ps” of the center’s mission: prevention, protection, prosecution and partnerships.

“Human trafficking is modern day slavery. There is no other way to say it,” said Acting Secretary Chad Wolf. “The words are strong because the actions are evil. The forms of exploitation, sex trafficking, forced labor, and domestic servitude that constitute human trafficking are antithetical in every way to the principles of human dignity that Americans hold dear. The launch of this Center for Countering Human Trafficking represents the investment of resources, attention, and time by President Trump to combat and dismantle all forms of human trafficking.”

On Jan. 15, Wolf signed and released the DHS Strategy to Combat Human Trafficking, the Importation of Goods Produced with Forced Labor, and Child Sexual Exploitation (https://www.dhs.gov/publication/strategy-combat-human-trafficking-importation-goods-produced-forced-labor-and-child) which pledged to bolster DHS efforts to combat human trafficking and forced labor.

“Human Trafficking, whether through sex or labor, is a detriment to our society and threatens the moral conscience of our nation. Criminal organizations target those who are most vulnerable and exploit them through any means necessary, Victims are treated as commodities rather than human beings, with no regard for their health and well-being,” said ICE Senior Official Performing the Duties of Director Tony Pham. “ICE, along with our internal and external partners, will continue to fight against these atrocities and answer victims’ cries for help. The Center for Countering Human Trafficking will serve as evidence that when we work collectively against such heinous acts, we combat the threat they pose to national security and to public safety.”

ICE’s HSI has long been a global leader in investigating human trafficking and sexual exploitation cases and bringing offenders to justice. The Center will build on the agency’s “victims first” approach, which balances victim identification, rescue and support with prevention, investigation, and prosecution of traffickers. ICE HSI is uniquely positioned to utilize criminal, immigration, and trade-based authorities to proactively identify, disrupt and dismantle cross-border human trafficking organizations.

In fiscal year 2019, ICE initiated 1,024 human trafficking and forced labor related cases which led to 2,197 criminal arrests. These effective actions resulted in nearly 700 convictions and the rescue of more than 400 victims.

Reporting suspected sexual or labor exploitation can help decrease or stop further victimization, as well as lead to the identification and rescue of other possible victims. To report suspicious activity or instances of sexual abuse or exploitation, contact your local law enforcement agency. Tips can be submitted online at https://www.ice.gov/tipline, by phone at 866-DHS-2-ICE or by contacting your local ICE office.

For more information about the Department of Homeland Security’s overall efforts against human trafficking, visit http://www.dhs.gov/blue-campaign

COVID-19 Patients Swamp Rural Hospitals

Stateline, Pew

The nation’s pandemic hotspots have shifted to rural communities, overwhelming small hospitals that are running out of beds or lack the intensive care units for more than one or two seriously ill patients.

And in much of the Midwest and Great Plains, hospital workers are catching the virus at home and in their communities, seriously reducing already slim benches of doctors, nurses and other professionals needed to keep rural hospitals running.

Nationwide, positive coronavirus cases started rising in mid-September as children and college students returned to school, more businesses reopened and more people started resuming daily activities outside of their homes. Wisconsin and other less populous states became the new hotspots.

This week, per capita rates of COVID-19 were highest in North Dakota, followed by South Dakota, Montana, Wisconsin, Nebraska, Idaho, Utah, Wyoming, Iowa, Arkansas and Illinois. Hospitalization rates also were rising in those states and others.

Health care experts expect that a seasonal spike in flu and pneumonia, combined with a steady rise in COVID-19 cases, will swamp many health care systems, particularly in rural areas.

Wisconsin recently opened a 530-bed field hospital on state fairgrounds in Milwaukee that was set up in the early days of the pandemic but sat unused until now. Last week, 50 beds were readied for patients, and the staff was working on transfers with hospitals that were hitting their capacity limits. The number of hospitalized COVID-19 patients in the state tripled in the last 30 days.

In Oklahoma City and the surrounding area, no ICU beds were available last week, according to the University of Oklahoma. The lack of beds required medical professionals in those already understaffed hospitals to spend hours on the phone arranging patient transfers to other Oklahoma hospitals.

Fewer than 20 ICU beds were available in the entire state of North Dakota, according to state data. That meant patients had to be transferred hundreds of miles, in some cases to South Dakota and Montana.

Read more.

Pennsylvania Department of Military and Veterans Affairs Reminds Veterans to Secure Their Military Paperwork

Leaving the military can be a hectic and stressful time, especially with the current COVID-19 challenges. Transitioning veterans often forget how important it is to properly record and safeguard their most important military paperwork – the DD Form 214. That is where the Pennsylvania Department of Military and Veterans Affairs (DMVA) can help.

The DD-214 is a document of the United States Department of Defense, issued upon a military service member’s retirement, separation, or discharge from active duty in the Armed Forces of the United States. It contains information needed to verify military service for benefits, retirement, employment, and membership in veterans’ organizations.

“Of the thousands of requests for assistance we receive each year, veterans seeking help locating their DD-214 is the most common,” said Maj. Gen. (ret.) Eric Weller, deputy adjutant general of veterans affairs. “The DMVA has continued to prioritize these assistance requests throughout the pandemic.“

The DMVA can also assist with locating the DD-215, which is used to correct errors or make additions to a DD-214, helping to assure that veterans have accurate discharge documentation.

Weller said that the easiest way to manage military documents and avoid having to frantically search for them is to make sure they are filed in a safe place upon leaving the military.

“Every service member exiting the military should stop by the courthouse in their county of record to file their DD-214/215 with the Prothonotary’s Office,” said Weller. “This way, veterans and their family members will always know where to find an official copy and avoid a time-consuming search in the event that the original paper version gets lost. Regardless, if a Pennsylvania veteran needs our help, the DMVA will work hard to find these important documents for them.”

Anyone needing assistance from the DMVA to locate their DD-214/215, or other military documentation, can call toll-free 1-800-547-2838 or e-mail RA-REQ@pa.gov. More information about locating military documents can be found by visiting the Records Request Program.

Another way to stay in touch is for veterans, family members and people who work with veterans to sign up for the DMVA’s Veterans Registry by visiting www.register.dmva.pa.gov.   Registration is available by computer or mobile device.

Pennsylvania Governor, Secretary of Health Present Latest Data, Ask Pennsylvanians to Unite Against COVID

As a fall resurgence of COVID-19 becomes more evident in Pennsylvania and across the country, Pennsylvania Governor Tom Wolf and Sec. of Health Dr. Rachel Levine today presented an update on the COVID-19 Early Warning Monitoring System Dashboard and case data, and asked Pennsylvanians to unite against COVID.

“The fall resurgence is here,” Gov. Wolf said. “And while we must always take this deadly virus seriously, now is the time for all of us to double down on our efforts to keep ourselves and those around us safe. We’ve seen what happens when masks aren’t worn and social distancing isn’t practiced – people get sick, so we need to stay vigilant and work together to stop the spread of COVID-19.”

Last week, Dr. Levine introduced the team of public health experts leading the work to make sure all Pennsylvanians are as protected as possible from both COVID-19 and influenza. The team is prepared for the resurgence, is managing a robust testing plan, preparing for vaccine distribution when a vaccine is available, and working to track influenza (flu) cases across the state.

“Our data, including case counts, hospitalizations and percent positivity reflect the fall resurgence occurring,” Secretary Levine said. “The department and the Wolf Administration are working continuously to ensure we are prepared for this resurgence and to protect Pennsylvanians. We all must unite to protect ourselves and loved ones from COVID-19 by washing our hands, wearing a mask, social distancing, avoiding large gatherings and downloading the COVID Alert PA app.”

Dr. Levine also presented the latest data from the state’s COVID-19 Early Warning Monitoring System Dashboard, which tracks the level of community transmission as a basis for the recommendations for Pre-K to 12 schools to determine instructional models; data on cases among 5-18-year-olds; cases that reported visiting a business among potential locations where exposures may have occurred; and updated travel recommendations.

The dashboard is designed to provide early warning signs of factors that affect the state’s mitigation efforts. The data available on the early warning monitoring dashboard includes week-over-week case differences, incidence rates, test percent-positivity, and rates of hospitalizations, ventilations and emergency room visits tied to COVID-19.

This week’s update compares the period of October 9 – October 15 to the previous seven days, October 2 – October 8.

As of Thursday, October 15, the state has seen a seven-day case increase of 8,723; the previous seven-day increase was 7,398, indicating a 1,325-case increase across the state over the past week.  The statewide percent-positivity went up to 4.3% from 3.9% last week.

“COVID is tough, but together, Pennsylvanians are tougher,” Gov. Wolf said. “The last seven and a half months have shown us that when we unite, we can defeat this virus. Pennsylvanians came together to stop COVID in its tracks and we can do it again and stop this fall resurgence in its tracks if we stand united against COVID.

“You matter, and so do your actions. When we make good choices and follow health and safety measures, we see results. Let’s work together to stop the spread.

New Report Examines Gender Differences in Financial Outcomes

New report released from the Federal Reserve Bank of Philadelphia

Gender Disparities in Financial Well-Being from the Survey of Household Economics and Decisionmaking provides in-depth analysis of gender differences in banking, credit access, and retirement outcomes. This new report also explores whether financial literacy helps explain these gender differences.

Overall, the research finds significant gender differences in the majority of financial outcomes analyzed from the descriptive analysis. Men are more likely to experience better banking and retirement accounts outcomes than women. Women are more likely to own at least one credit card than men, but they are also more likely to report a recent credit denial and have lower credit confidence than men. Accounting for financial literacy, however, mitigates most of these gender differences.

The results from Gender Disparities in Financial Well-Being from the Survey of Household Economics and Decisionmaking illustrate that familiarity and frequent use of one type of financial product does not automatically guarantee the same for other financial products and outcomes.

Read the full report: Gender Disparities in Financial Well-Being from the Survey of Household Economics and Decisionmaking