In February, Senate and House Committees held a number of hearings on behavioral health, including two Senate Finance Committee hearings on youth mental health, a Senate HELP Committee hearing on mental health and substance use, a House Energy and Commerce Committee hearing on mental health, and two House Ways and Means Committee hearings on the mental health crisis, substance use, and suicide. Senate Finance Chair Wyden (D-OR) reportedly hopes to introduce a broad bipartisan package this summer focused on the integration of primary and mental health care, telehealth, parity, and children’s behavioral health.

Gov. Tom Wolf this week announced that Pennsylvania’s state-based health insurance marketplace, Pennie, has added a new qualifying life event to allow low-income Pennsylvanians the ability to enroll in health insurance throughout the year. This new qualifying life event will allow Pennsylvanians with an annual household income equal to or below 150% of the federal poverty level to shop and enroll in health insurance through Pennie. Financial assistance, which nearly 90% of the almost 375,000 Pennie customers receive, is also available. Pennsylvanians enrolling during 2022 can also benefit from the increased subsidies provided by the American Rescue Plan, which has changed the affordability of health coverage across the nation.

To receive this new qualifying life event through Pennie, new customers will need to visit pennie.com, click “Get Covered” and apply. If the customer meets the income qualifications, a Special Enrollment Period will automatically open. Once the Special Enrollment Period opens, the customer will have 60-days to shop and enroll in a healthcare plan through Pennie. Currently, this opportunity is only available for those currently not receiving health coverage through Pennie. Beginning June 2022, existing Pennie customers whose income is lower than or equal to the 150% federal poverty level can update their application and change their current plan using this qualifying life event.

If finalized, a proposed rule from the U.S. Department of Veterans Affairs (VA) would place medical residents in existing or new residency programs and reimburse certain costs associated with graduate medical education.  The VA is considering factors for determining clinical needs in certain areas, i.e., the ratio of veterans to VA providers, and for placement of residents in facilities outside of the VA.  This will include an evaluation of the range of clinical specialties of VA and non-VA providers in underserved rural and tribal communities.  A future request for proposal will announce opportunities for placement of residents at certain underserved VA facilities as well as certain Rural Health Clinics and Federally Qualified Health Centers.  By statute, the pilot program prioritizes the placement of residents in Indian Health Service facilities, and Indian tribal or tribal organization facilities.

Three strategy directives announced by the White House include: 1) Strengthen system capacity to expand the supply, diversity, and cultural competency of the mental health workforce, particularly in rural and underserved areas.  This effort will include training and opportunities for paraprofessionals such as community health workers and peer recovery coaches. 2) Connect patients to care by expanding and strengthening access to mental health and recovery services. The President’s budget for fiscal year 2023 will propose that all health plans cover robust behavioral health services with an adequate network of providers, including three behavioral health visits each year without cost-sharing. 3) Create healthy environments by addressing social determinants of health.  This will involve adjustment to standards and practices for online marketing and social media, expansion of early childhood and school-based intervention services, and mental health resources for incarcerated individuals. According to the 2020 results from the National Survey on Drug Use and Health, approximately 7.7 million nonmetropolitan adults reported having any mental illness, accounting for 20.5 percent of nonmetropolitan adults.  At HRSA, our work to implement this strategy means taking action.

In a significant step toward changing how federal funds are distributed, the Biden administration has preliminarily identified nearly a third of the nation’s census tracts as “disadvantaged” and in line for more help from the federal government.

A week after taking office last year, Biden said he wanted to address historic inequities that have left disadvantaged communities around the country behind in receiving federal funding.

Federal agencies are still working through exactly how to do this. But in the meantime, the White House Council on Environmental Quality has provided a preliminary glimpse at which communities might benefit from Biden’s vision.

The first draft of the database identified 23,410 census tracts, or nearly a third of the nation, as disadvantaged. They represent a sweeping list of communities that could see more federal funds headed their way for climate change, clean energy and energy efficiency, clean transit, affordable and sustainable housing, training and workforce development, the remediation and reduction of legacy pollution, and the development of critical clean water infrastructure.

Among the communities described as “distressed” in the draft Climate and Economic Justice Screening Tool are big cities like Newark, New Jersey, but also rural areas like Mason County, Washington, which has seen a decline in the timber industry after protections were put in place decades ago to preserve the spotted owl.

To identify the areas, the administration considered a wide range of factors, from the expected loss of agriculture and population due to climate change, to traffic volume and diesel particulate exposure, to the cost of housing, to the rate of asthma, diabetes and heart disease in the community.

A solace for areas initially not considered distressed is that the database is a work in progress. Saying it wants to make sure it is not missing any communities in need, the environmental council posted a notice in the Federal Register, asking local and state government officials, academics and members of the public to examine the database and suggest ways to refine it by April 25.

“The hope is that the tool reflects the realities on the ground and we are properly identifying disadvantaged communities,” the council official said.

Particularly valuable will be national datasets that allow the government to compare communities around the country, the official said. But the council would also welcome local studies and data to further refine the tool.

Monica Lewis-Patrick, a member of a White House advisory committee and president and CEO of a Michigan water justice organization, We the People of Detroit, said she hoped relevant data not usually considered in federal funding decisions, like data gathered by community activists, will be included.

Read more.

In the State of the Union Address, President Biden proposed his solutions to the biggest concerns we are currently facing as a nation, including those facing rural health.

The National Rural Health Association (NRHA) has been pleased to see a focus on rural communities early in the President’s term, recognizing that for too long rural communities have faced underinvestment and persistent poverty. Significant investments in rural through the American Rescue Plan and Bipartisan Infrastructure Package include addressing rural health coverage gaps, keeping rural hospitals open, addressing rural healthcare workforce shortages, as well as maintaining and expanding telehealth. These are in line with NRHA’s advocacy focus since the onset of the Biden Presidency.

Of note, the President used the speech to launch a new Strategy to Address our National Mental Health Crisis. Rural America suffers from the effects of long-standing shortages of specialty mental health services, long travel distances to obtain treatment, and stigma and cultural/ societal attitudes toward receiving behavioral health services. Last fall, NRHA provided comments to a Senate Finance Committee request for information on mental health care. Upon initial review of the President’s proposed mental health strategy, NRHA is pleased to see many of our recommendations reflected in this new initiative, especially around investing in a strong behavioral health workforce, integration of behavioral health and primary care, and addressing the opioid crisis. HHS Secretary Becerra will kick off the National Tour to Strengthen Mental Health to hear directly from Americans across the country about the behavioral health challenges they are facing and engage with local elected officials and leaders to strengthen the mental health and crisis care system in our communities.

Last night President Biden announced his proposals to address several issues important to rural areas, including:

• COVID-19 “test to treat” program which will allow individuals to receive antiviral pills on the spot when doing in person testing at local pharmacies and locations like community health centers and long-term care facilities.
• Addressing the cost of prescription drugs including Medicare drug negotiation.
• Continuing to advance maternal health care in America.
• Veterans health and addressing toxic exposure.
• Creating of ARPA-H, the Advance Research Projects Agency for Health.

Of potential concern, the President announced measures to improve nursing home quality, including minimum staffing levels and increased inspections.  Given historic under-reimbursement by public payers and recent staffing shortages associated with COVID-19, NRHA is concerned about implications for rural nursing home facilities ability to meet the potentially burdensome new standards. NRHA will closely monitor developments and advocate on behalf of rural long-term care providers across the country.

NRHA supports the Administration’s Unity Agenda to bring together all parts of our country to address disparities among our citizens. NRHA looks forward to continuing work with the Administration and Congress to ensure that rural communities have access to critical health care they need and deserve.

Funding continues to be available for eligible individuals and families in Pennsylvania experiencing financial hardship due to the COVID-19 pandemic through the Low-Income Household Water Assistance Program (LIHWAP). This assistance can aid in maintaining households’ access to drinking and wastewater services essential to ongoing health and overall wellbeing.

Program funds are issued directly to the service providers in the form of grants, or crisis grants depending on situation severity. To qualify for the program, participants must either rent or own their home, have overdue water bills, and meet program income guidelines.

The Department of Human Services (DHS) developed a media toolkit to assist in the awareness of the Water Assistance program within the commonwealth. Below are example social media posts. Additional social media images, newsletter text, and flyer text are available on the DHS website.  Click here to apply!