Rural Health Information Hub Latest News

OMH Announces New Culturally and Linguistically Appropriate Services (CLAS) in Maternal Health Care e-Learning Program

The U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH) has launched a free, accredited, 2-hour e-learning program, which is designed for providers and students seeking knowledge and skills related to cultural competency, cultural humility, person-centered care, and implicit bias across the continuum of maternal healthcare. You can register for the Maternal Health e-Learning Program here.

Analysis: Redefining Nonmetro Counties Could Affect Rural Identity, Development, and Federal Funding

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By Tony Pipa and Natalie Geismar, Brookings Institution

The impact of the proposed change is so little understood that the Office of Management and Budget should take a much closer look before deciding, according to an analysis from the Center for Sustainable Development at the Brookings Institution.
Read more

Read more coverage about the proposal to redefine metro and nonmetro counties here.

Pennsylvania Announces Operational Changes at State Parks, Forests

In line with Pennsylvania Governor Tom Wolf’s latest orders intended to prevent the spread and mitigate the impacts of COVID-19, Pennsylvania Department of Conservation and Natural Resources (DCNR) Secretary Cindy Adams Dunn announced an upcoming return of outdoors programming at state parks and expansion of occupancy limits within park and state forest buildings effective Sunday, April 4.

“Environmental education and other outdoors programs helped our state parks system attain national prominence and we know they were sorely missed by our visitors,” Dunn said. “This and other operational changes follow Department of Health guidelines while broadening the enjoyment of state park and forests visitors. Since the pandemic’s outset we kept our lands open to all so that people can safely enjoy outdoor recreation to maintain positive physical and mental health.”

At Pennsylvania’s state parks and forests, the following will be in effect starting Sunday, April 4:

  • Outdoor, in-person programs will resume with a limit of 40 participants per program. Masks and social distancing are required;
  • Visitor center exhibit halls, interpretive areas and theaters will open with a 75 percent capacity visitation allowance. Masks and social distancing are required;
  • Volunteer work days will resume with a limit of 40 participants per group. Masks and social distancing are required;
  • Virtual and self-guided programs will continue to be offered;
  • Scheduled programs will be listed on DCNR’s Calendar of Events; and
  • Large, DCNR-sponsored events remain canceled until further notice.

State park and forest visitor centers, offices, theaters and interpretive wings will return to an occupancy limit of 75 percent of capacity. All visitors and staff must wear masks and practice social distancing and frequent hand sanitizing or washing.

Volunteer Friends group meetings must be virtual or outdoors at park or forest facilities.  Outdoor facilities must be under the 50 percent occupancy limit, and social distancing must be practiced and masks worn.

Not considered organized park or forest events, volunteer work days are permitted to resume. Guidelines include maximum at 40 per group. Multiple groups are permitted in separate locations, multiple groups may attend at different times, and masks and social distancing are required.

Third-party events can continue if established guidelines are followed. DCNR staff may be present to assist with public safety and to maintain compliance with the event agreement.

All occupancy changes are subject to reevaluation going forward and will maintain consistency with all applicable Centers for Disease Control and Prevention (CDC) and Pennsylvania Department of Health guidance.

Secretary Dunn noted visits to Pennsylvania state parks have increased by more than one million visitors a month since the start of mitigation efforts, and that interest is expected to hold strong through spring and into summer.

In a related development, DCNR announced last month that campsites will be available at an additional 17 state parks to accommodate fishing enthusiasts who want to stay overnight on April 2 for the new statewide trout opener the following day. A total of 34 parks throughout the state will provide camping at this time.

To help avoid exposure to COVID-19 and still enjoy the outdoors:

  • Don’t hike or recreate in groups – go with those under the same roof, and adhere to social distancing (stay 6 feet apart)
  • Take hand sanitizer with you and use it regularly
  • Avoid touching your face, eyes, and nose
  • Cover your nose and mouth when coughing and sneezing with a tissue or flexed elbow
  • If you are sick, stay home

Visitors can help keep state parks and forest lands safe by following these practices:

  • Avoid crowded parking lots and trailheads
  • Bring a bag and either carry out your trash or dispose of it properly
  • Clean up after pets
  • Avoid activities that put you at greater risk of injury, so you don’t require a trip to the emergency room

Pennsylvania has 121 state parks and 20 forest districts; all are open year-round.

Information about state parks and forests is available on the DCNR website and here.

Women’s Experiences with Health Care During the COVID-19 Pandemic: Findings from the KFF Women’s Health Survey

The Kaiser Family Foundation has released it report “Women’s Experiences with Health Care During the COVID-19 Pandemic: Findings from the KFF Women’s Health Survey.”

The report examines experiences accessing health care during the COVID-19 pandemic have differed by gender, age, race/ethnicity, insurance coverage, and income and what this could mean moving forward.

Review the report at https://www.kff.org/womens-health-policy/issue-brief/womens-experiences-with-health-care-during-the-covid-19-pandemic-findings-from-the-kff-womens-health-survey/

Multilingual Resources and Materials for Medicare Providers

The HHS Office of Minority Health has partnered with the Centers for Medicare & Medicaid Services (CMS) and other HHS agencies to identify and compile multilingual resources and materials for Medicare providers to assist them in providing culturally and linguistically appropriate services.

Translated resources include materials and information regarding specific diseases and conditions, health insurance, women’s health topics, substance use, emergency preparedness and response, and more.

Translated resources include materials and information regarding specific diseases and conditions, health insurance, women’s health topics, substance use, emergency preparedness and response, and more.

Download the file here to access translated resources and materials for Medicare providers.

Anniversary of the Affordable Care Act

On March 22, 2021, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra released the following statement on the eve of 11th anniversary of the Affordable Care Act:

“In the eleven years since it became law, the Affordable Care Act has saved lives, brought down health care costs, and expanded Medicaid to our most vulnerable neighbors. The lifesaving law has been a game changer, protecting roughly 133 million people with pre-existing conditions and extending quality, affordable health care to millions more.

“While health care is more in reach today, we have more work to do. The COVID-19 pandemic has thrust families into crisis. Over the last year, too many people have had to mourn lost love ones or struggle to pay their bills. President Biden promised to bring down health care costs and that is exactly what we at the Department of Health and Human Services will do, beginning with implementation of the American Rescue Plan.

“Beginning on April 1, millions of Americans will be eligible for even more affordable options on HealthCare.gov. Because of the American Rescue Plan, four out of five enrollees will be able to qualify for coverage for as little as $10 per month.

“As HHS Secretary, I’m committed to building on this monumental progress to bring every American the peace of mind that comes with knowing you can take care of your family without going into debt.”

2021 Special Enrollment Period Access Extended to August 15, 2021 on HealthCare.gov for Marketplace Coverage

On March 23, 2021, President Biden announced that the Centers for Medicare & Medicaid Services (CMS) is extending access to the Special Enrollment Period (SEP) until August 15 – giving consumers additional time to take advantage of new savings through the American Rescue Plan. This action provides new and current enrollees an additional three months to enroll or re-evaluate their coverage needs with increased tax credits available to reduce premiums.

“Every American deserves access to quality, affordable health care – especially as we fight back against the COVID-19 pandemic,” said HHS Secretary Xavier Becerra. “Through this Special Enrollment Period, the Biden Administration is giving the American people the chance they need to find an affordable health care plan that works for them. The American Rescue Plan will bring costs down for millions of Americans, and I encourage consumers to visit HealthCare.gov and sign up for a plan before August 15.”

To read the HHS press release, visit: HHS Press Release

To view the extended opportunity SEP fact sheet, visit: Extended Opportunity 2021 SEP Fact Sheet

See the updated technical guidance on the SEP at: SEP Technical Guidance

For FAQs on the 2021 SEP and the American Rescue Plan visit: SEP and ARP FAQs

Social Media

Please help us to amplify this announcement on your social channels:

Today, @POTUS announced that @CMSgov is extending access to the Marketplace Special Enrollment Period until August 15.  Access the tweet at:  https://twitter.com/HHSGov/status/1374479825897844737?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Etweet

Pennsylvania Insurance Department Issues Guidance to Insurers for Consumer Protection, Calls for Clarity in Telehealth Policies

Pennsylvania Insurance Commissioner Jessica Altman announced that the Department of Insurance has issued guidance on health insurance-related services to protect consumers, and to call for clarity in insurers’ telehealth policies during the ongoing COVID-19 pandemic. A notice, which was included in the March 6 Pennsylvania Bulletin, outlines expectations regarding coverage by insurers of testing and vaccine administration to Pennsylvanians, and urges continued telehealth flexibility to make both COVID-related services and non-COVID-related services available to consumers.

“As we continue our fight against COVID-19, it is vital to make sure all Pennsylvanians have access to the resources needed to combat this public health crisis, and that includes testing and vaccination options,” Commissioner Altman said. “Health insurers play a critical role in access and affordability of these services and should ensure that most consumers can access these services at no cost to the consumers. The carriers have been an important partner in the commonwealth’s response to COVID, and we look forward to that continued partnership as we forge through the next stages of our pandemic response.”

The notice highlights the expectation that insurers will continue to cover COVID testing and vaccination without cost-sharing as required under The Families First Coronavirus Response Act (FFCRA) and Coronavirus Aid, Relief, and Economic Security Act (CARES Act). The notice also calls for health insurers to assist consumers in accessing in-network or publicly funded health services to avoid balance billing or surprise balance bills. Mechanisms should already be in place to prevent surprise balance billing for COVID-related services, but the department urges insurers to take steps now to make necessary changes to billing services in anticipation of the No Surprises Act, taking effect in 2022.

The notice also calls for clarity and consistency in insurers’ telehealth policies across the commonwealth while the COVID-19 health emergency is ongoing. A previous notice encouraged health insurers to allow for flexibility in telehealth services, and many insurers implemented flexibilities in their policies and coverage of telehealth services, some permanently. However, different approaches and timelines has caused confusion for both providers and consumers.

“We appreciate the insurers that have made an effort to expand access to telehealth services during the pandemic, allowing for continued routine and urgent health care for the duration of the public health emergency,” said Altman. “The department is now encouraging insurers to implement consistency in these policy flexibilities, most particularly by aligning policies with emergency declaration dates and offering network flexibility for providers that offer both telehealth and in-person services.”

The department notice encourages telehealth policy flexibilities to be extended through the end of the federal or Pennsylvania public health emergency and suggests a 60-day wind-down period for flexibilities to provide for an orderly transition for both providers and patients.

“As we enter the second year of the COVID-19 pandemic and the situation continues to evolve, we ask insurers for their continued readiness to make any necessary changes in policy to address the crisis head on,” added Altman. “We appreciate the commonwealth-wide response we have seen thus far in providing coverage and care for all Pennsylvanians.”

The department has submitted various notices to the Pennsylvania Bulletin to help ease the hardships that are being felt by Pennsylvanians during this crisis and ensure minimum disruption to the department and commonwealth-regulated operations.

If a consumer receives an unexpected bill related to COVID-19, or other healthcare services, they are encouraged to contact the department at 1-877-881-6388.

What Have We Learned About Health Systems – A Synthesis

As part of the RAND Center of Excellence on Health System Performance, researchers from RAND Corporation, Penn State, UCLA, Stanford, and Harvard have taken a “deep dive” into 24 health systems and their affiliated physician organizations in four regions of the United States. For these studies, a health system is defined as having at least one hospital and at least one physician organization affiliated through shared ownership or a contractual relationship.

In brief:

  • If you’ve seen one health system, you’ve seen one health system
  • Integration is a multi-layered concept—structural, functional, and clinical—each of which may affect health system performance
  • A single interoperable EHR—accessible to allaffiliated physicians—is considered the gold standard—but implementation is by no means universal
  • Health systems are taking a highly individualized approach to care delivery redesign, with an emphasis on standardizing and increasing the efficiency of existing practices over disruptive innovation
  • The pace at which value-based payment arrangements are being implemented by the government and commercial payers may be too slow to support transformation of care delivery
  • Structural integration does not necessarily signal clinical integration

READ MORE

Pennsylvania Launches Emergency Rental Assistance Program

Pennsylvania Governor Tom Wolf announced the launch of a program that will deliver rapid relief to millions of Pennsylvanians at risk of eviction or loss of utility service. With federal funds allocated through the Consolidated Appropriations Act of 2021, the Wolf Administration built the Emergency Rental Assistance Program (ERAP) in partnership with the General Assembly through Act 1 of 2021 to distribute about $569 million to Pennsylvania households through partnerships with local leaders. An additional $278 million in rental assistance was directly allocated to Pennsylvania’s largest counties by the federal government.

“With thousands of COVID-19 vaccines administered to Pennsylvanians every day, we are starting to see the light at the end of this year-long tunnel. But we must remain focused on the fact that so many of our neighbors are still struggling to cope with the pandemic’s economic fallout,” Governor Wolf said. “Millions of Pennsylvania households are less financially secure today than they were a year ago because a pandemic stole jobs and income from Pennsylvania workers. The ERAP is designed to provide housing security and utility assistance for these families and individuals so that they can focus on caring for their loved ones, getting back to work and healing from this traumatic experience.”

Pennsylvanians can submit applications for the Emergency Rental Assistance Program online at www.compass.state.pa.us. Forty-seven counties have opted to collect applications from county residents through the COMPASS website provided by the Department of Human Services (DHS). DHS will route applications submitted through COMPASS directly to counties for processing.

The online application is available in English and Spanish. Applicants can also download and print an application or obtain an application from their county ERAP office.  DHS has also translated the paper application into RussianVietnameseArabicChinese and Cambodian and made those available to all participating counties.

Twenty counties have opted to accept applications from county residents through their own application process. However, residents of all counties can visit COMPASS for information on how to apply for ERAP, including residents of counties that have developed their own process. If a person tries to apply through COMPASS but indicates that they reside in one of the 20 counties with its own application, they will be provided with information about how to apply, including a link to the county application if available.

“The Department of Human Services designed this program to quickly and efficiently get help to people who need it. We stand ready to work with our partners in every Pennsylvania county to make this program a success,” DHS Secretary Teresa Miller said. “I encourage all Pennsylvania families and individuals struggling with rent and utility bills to apply for assistance through ERAP.”

Households may be eligible for up to 12 months of assistance to cover past-due or future rental and/or utility payments. The amount of a household’s monthly rent or utility bills does not preclude eligibility, but the amount of ERAP assistance provided to a household is determined by program administrators at the county level.

Assistance can be provided to a tenant for future rental payments, and for unpaid rental or utility arrears that were accrued on or after March 13, 2020 on a residential rental property. Counties may choose to provide additional assistance to eligible households if funds remain available.

Residential tenants can apply for themselves, or a landlord/utility provider can apply on behalf of a current tenant. Additionally, landlords do not have to agree to participate in the program for tenants to receive assistance.

To qualify for assistance, a household must be responsible to pay rent on a residential property and meet each of the following criteria:

  • One or more people within the household has qualified for unemployment benefits, had a decrease in income, had increased household costs, or experienced other financial hardship due directly or indirectly to the COVID-19 pandemic; AND
  • One or more individuals in the household can show a risk of experiencing homelessness or housing instability; AND
  • The household has an income at or below 80 percent of area median income, which varies by county. Income limits by county are available on the DHS website. Resources (like bank accounts and cars) are not relevant to ERAP eligibility.

Applicants will need to provide the following information: head of household’s personal information; income information for all household members 18 and older; rental lease and amount owed; landlord’s name and contact information. If applying for utility assistance, applicants must provide utility expenses and utility provider information.

Applicants should be prepared to provide documents that substantiate information provided, such as pay stubs, tax filings, unemployment letters, and rental/utility arrears. However, if applicants do not have documents, county ERAP offices will work with applicants to obtain documents or written attestations.

The program will end when all funds have been expended, which DHS expects to happen by September 2021. Per Act 1 of 2021, all funds must be spent by December 31, 2021.

More information about ERAP can be found at www.dhs.pa.gov.