Rural Health Information Hub Latest News

State Echoes Latest CDC Guidance for Fully Vaccinated Individuals

Pennsylvania Department of Health Acting Secretary Alison Beam announced that the commonwealth’s mask order for fully vaccinated individuals reflects the announcement made by the Centers for Disease Control and Prevention (CDC). On March 16, 2021, the commonwealth amended the commonwealth’s mask order by adding language directing to the CDC’s guidance for fully vaccinated people allowing for no face coverings in many settings. That means that the CDC guidelines automatically goes into effect in Pennsylvania. Masking requirements will remain in place for unvaccinated individuals until 70 percent of Pennsylvanians age 18 and older are fully vaccinated. For more information on the CDC guidance, visit here.

Representatives Sewell (D-AL) and McKinley (R-WV) Reintroduce the NOPAIN Act 

Representatives Terri Sewell (D-AL) and David McKinley (R-WV), along with Representatives Ann Kuster (D-NH) and Brian Fitzpatrick (R-PA), led the bipartisan reintroduction of the NOPAIN Act (H.R. 3259). The Senate companion bill, S. 586, was introduced earlier this Congress by Senators Shelley Moore Capito (R-WV) and Jeanne Shaheen (D-CA). NRHA is helping advance this legislation alongside our coalition partner Voices for Non-Opioid Choices, also known as Voices, to incentivize the utilization of non-opioid pain management approaches by addressing outdated federal reimbursement policy. You can advocate on behalf of this legislation by visiting the Voices’ action center webpage.

Senator Hyde-Smith (R-MS) Questions CDC Director on Office of Rural Health 

During the Senate Appropriations Labor Health and Human Services, Education and Related Agencies Subcommittee hearing title, “Review of the FY2022 Budget Blueprint for the Centers for Disease Control and Prevention,” Senator Cindy Hyde-Smith (R-MS) questioned CDC Director Rochelle Walensky on the need to establish an Office of Rural Health within the CDC. She notes that COVID-19 has highlighted health disparities for rural Americans and asks how CDC and Congress could work together to establish this new office. Establishing an Office of Rural Health within the CDC is one of NRHA’s priority appropriations requests, so we commend Senator Hyde-Smith for her questions and comments during the hearing and publishing this statement on the need for establishing such an office.

Senate HELP Committee Holds Hearing on Growing the Health Care Workforce 

During the Senate Health, Education, Labor, and Pensions (HELP) Primary Health and Retirement Security Subcommittee hearing titled “A Dire Shortage and Getting Worse: Solving the Crisis in the Health Care Workforce,” senators displayed bipartisan support for addressing the nation’s physician shortages. Members of the subcommittee expressed their support for increasing funding for Medicare-supported residency programs and tweaking and expanding those programs to entice medical students to go into primary care practice in medically underserved and rural areas. NRHA is supportive of proposal that prioritize increasing rural residency training slots, as enrolling trainees with rural backgrounds and training residents in rural settings are strategies shown to successfully encourage graduates to practice in rural settings, where health professional shortages are most severe. In NRHA’s fiscal year (FY) 2022 appropriations requests, we urge Congress to expand the Rural Residency Planning and Development Program to support the development of new rural residency programs.

Senate Finance Committee Holds Hearing on Telehealth  

The Senate Finance Committee held a hearing titled “COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned,” in which some senators, including Finance Committee Chairman Ron Wyden, signaled their support for permanently lifting a number of telehealth restrictions under Medicare. NRHA supports maintaining the telehealth flexibilities that were created in response to the COVID-19 pandemic and expanding the authority of the Office for the Advancement of Telehealth within HHS to include the ability to advise the Secretary on telehealth issues, create and staff an HHS Telehealth Advisory Committee, and administer grants, cooperative agreements, and contracts. The support for making permanent Medicare telehealth flexibilities echoed in the hearing suggests this is a priority the Senate is interested in advancing.

New GAO Report on Rural Maternal Mortality Programs  

The Government Accountability Office (GAO) researches Federal government operations and reports fact-based, non-partisan information. GAO recently made recommendations to CDC and HHS on ways to improve programs focused on rural maternal mortality, and their recommendations echo what NRHA has been saying for years: disaggregate and analyze data by rural areas. The report notes that data collected for federal maternal health programs is not always separated and analyzed for rural and underserved areas and provides an update on recommendations GAO made to the Secretary of Health and Human Services.

CDC Reports on Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties 

In the latest Morbidity and Mortality Weekly Report, the Centers for Disease Control and Prevention (CDC) collected data on vaccine doses administered across the rural-urban continuum and found that coverage was lower overall, among all age groups, and among men and women in rural compared with urban counties. To address lagging rural vaccination rates, NRHA is communicating to the administration and external partners the need for rural-appropriate messaging and stakeholder engagement. The factors that motivate rural Americans to get vaccinated are often different than those of their urban counterparts, and thus, the messages rural community leaders share should be different. NRHA believes that to increase rural COVID-19 vaccine confidence and uptake, it is important we develop a local approach that empowers and encourages trusted community leaders to share clear, concise, and often personal messages about vaccine safety, efficacy, and social impact.

Pennsylvania Senior Food Box Program: No One Should Go Hungry

Eating well has an impact on our health and how we feel, especially as we age. Seniors in Pennsylvania should never go hungry or miss out on nutritious meals. The Senior Food Box program is a monthly food package tailored for older adults, age 60 and above, that helps stretch food dollars and adds nutritious foods to promote good health.

The Senior Food Box Program works to improve the health of low-income seniors by supplementing their diets with nutritious food. In Pennsylvania, eligible participants include low-income individuals who are at least 60 years old and whose household income is at or below 130 percent of the U.S. poverty level.

The boxes do not provide a complete diet, but rather are good sources of the nutrients typically lacking in the diets of older Americans. Among the types of foods included in the food boxes are: non-fat dry and shelf-stable fluid milk, juice, oats, ready-to-eat cereal, rice, pasta, dry beans, peanut butter, canned meat, poultry, or fish, and canned fruits and vegetables.

The USDA’s Commodity Supplemental Food Program supports the Senior Food Boxes. The USDA purchases the food and makes it available to the Pennsylvania Department of Agriculture (PDA), which works with local non-profit agencies to facilitate distribution of the monthly food boxes to seniors in need at central locations where seniors have easy access.

How to Participate

Seniors should fill out the self-certification form and submit it to PDA via email at PDA will then route the application to the appropriate food bank providing service in the applicant’s county of residence.

Applicants can also call 800-468-2433 to be directed to the regional food bank distributing the Senior Food Box in their county of residence.

Refer to the Income Eligibility Guidelines.

For more information, visit the PDA Senior Food Box Web Page.

Hospital Closures Cause New Public Health Concern

From Modern Healthcare

The steep rise in rural hospital closures over the past decade is hurting many emergency medical service providers, worrying public experts tracking response times.

The average length of ambulance trips increased by 22% among municipally-run, EMS agencies and 10% among privately-owned providers between 2012 and 2018 in locations where a recent rural hospital closure took place, according to a new study from the University of Minnesota School of Public Health.

The actual number of trips those providers made did not change during the study period. But the analysis found rural EMS providers decreased their number of non-emergency and inter-facility transfer trips by 31%. Lead study author Sayeh Nikpay, associate professor in the division of health policy and management at the University of Minnesota School of Public Health, said the drop in planned trips made it harder for EMS providers to dispatch ambulances in a way that ensured communities had adequate coverage.

“Taking someone from the community to a hospital-based clinic is more predictable and has the benefit of bringing people in the community access to their primary care,” Nikpay said.

Nikpay said the burden of hospital closures is particularly acute among municipal EMS providers. While private firms have the option to discontinue providing ambulance services when it no longer is financially viable, municipal agencies are forced to adjust, which Nikpay said often leads to limited resources and personnel that can affect the quality of those services.

“It’s difficult for EMS agencies to retain people, to recruit new people, and the people that are there feel a lot of strain,” Nikpay said.

Researchers said the problems facing rural public EMS agencies is a growing public health concern. It’s putting more wear and tear on their equipment and increasing the “dead time” being spent traveling back to ambulance bases. EMS providers also have less time to restock and maintain vehicles.

Nikpay said the strain on rural EMS providers has only been exacerbated by the pandemic.

Last year, 19 rural hospitals closed, according to figures from the Cecil G. Sheps Center for Health Services Research at the University of North Carolina-Chapel Hill, the highest number for a single year since the center began tracking. Overall, 180 rural hospitals have closed since 2005, with more than three-fourths occurring since 2010.

Nikpay said the study’s findings suggest policymakers need to also look at ways of supporting EMS providers when addressing issues related to bolstering the country’s rural healthcare system.

“We shouldn’t just be thinking about the hospitals when we talk about rural healthcare, we should also think about the EMS agencies as well,” Nikpay said.

Analysis: We Got the Broadband Benefit We Asked For; Now What?

In 2009, the last time federal agencies gave away billions of dollars for broadband, there were two agencies tasked with dispensing roughly $3.5 billion each. They had a year and a half to do what was then considered miracle work pushing that that much money out the door that quickly. Sometimes it wasn’t pretty, but they got it done.

Today, the Federal Communications Commission (FCC) is responsible for dispersing more than three times as much money through E-rate and the Emergency Broadband Benefit (EBB) programs. The money comes with a mandate to act as quickly as possible.

So things are predictably frantic, the rules are not particularly clear, and there’s a lot of wailing and gnashing of teeth about incumbents (the local telecommunications companies that were in place before deregulation in 1996) lining up at the “socialist trough.”

Read more.