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Pennsylvania’s Indiana Regional Medical Center Introduces First Residency Program for Rural Family Medicine
The Indiana Gazette
Indiana Regional Medical Center (IRMC, Indiana, PA) officials introduced the hospital’s first residency program as well as six new family medicine residents during a press conference Thursday at IRMC.
IRMC’s Rural Family Medicine Residency Program officially started July 1 after six resident physicians from a pool of roughly 600 applicants matched with IRMC. The resident physicians are Esther Ezeani, of Baltimore, Md.; Narinder Sangha, of California; Mohit Chhatpar, of New York; Tanvi Bharathan, of Indiana, Pa.; Nawar Al Janabi, of Baghdad, Iraq; and Robin Rodriguez, of Corpus Christi, Texas.
The resident physicians will work with/report to an attending physician as they learn and practice family medicine over the next three years. This will benefit patients, who will get access to two physicians for the price of one, according to IRMC Residency program director Dr. Amanda Vaglia.
“Whenever you see a resident physician, you actually get two physicians, because the resident physicians, particularly at the beginning of their training, are not allowed to see patients on their own,” Vaglia said.
The program will help increase access to family medicine for local and regional residents, a service everyone in the country needs, according to IRMC Chief Medical Officer Dr. Richard Neff.
Vaglia and IRMC CEO Steve Wolfe said they hope the program will bring new physicians into the area and improve access to quality health care in local, rural communities.
“Rural communities across the nation suffer from a shortage of health care, primarily primary care health care,” Vaglia said. “There have been studies done that indicate that the more rural education that (resident physicians) have throughout their medical training, the more likely they are to practice in a rural area.”
Wolfe said hospitals across the country are currently struggling to recruit family medicine physicians. A residency program will not only increase the number of physicians coming into the area, but it will also increase the number of physicians who stay, according to Wolfe.
The new residency program has a specific focus on rural medicine, which impacted how resident physicians were selected.
Residents were chosen based on how they ranked on a list of qualities and attributes, including their commitment to living and working rurally, commitment to family medicine, maturity, resilience and service, according to Vaglia.
Vaglia said that because Indiana is “100 percent rural,” medicine is practiced differently, and physicians must be in-tune with the specific needs of rural health care.
“Here, out in rural areas, you have to be a little more versatile; you have to be a little bit more brave; you have to be willing to learn; you have to get to know your patient,” Vaglia said. “If we have a patient in our population who comes down with an unusual disease, we can’t just refer them up the street because specialists are far away. So, we have to learn more about that patient; we have to learn more about their disease state; we have to be comfortable communicating with them and coordinating their care.”
Beyond better access to quality health care, the residency program could help boost the local economy, too, according to Wolfe, by bringing new physicians into the area to live and work. Wolfe’s sentiments were echoed by state Rep. Jim Struzzi, R-Indiana, and state Sen. Joe Pittman, R-Indiana, who also spoke at the press conference.
“For us, this is about our economy, this is about the future of our community and it’s also about quality health care in rural communities,” Pittman said.
Over the past two years, Pittman and Struzzi have worked to help fund IRMC’s residency initiative, and they said they couldn’t be happier with the results.
“When this initiative came forward, Jim and I came together, and … we were able to allocate $1 million specifically to the hospital for this initiative,” Pittman said. “I’m pleased to say today … we’ve been able to replicate that commitment. So, we’ve been able to bring $2 million to this initiative. I think our desire is to allow that to continue in the years ahead; certainly there are no guarantees.”
“We’re very pleased that we were able to get this included in this year’s budget, and we’ll continue to work for additional funding moving forward to make sure that not only is IRMC strong … but Indiana County is strong,” Struzzi said. “(IRMC is) bringing people here and providing that quality health care that people need. We all know that that’s lacking in rural areas right now.”
IRMC is considering developing another residency program in a specialty outside of family medicine; though, nothing has been finalized yet, according to Wolfe.
Pennsylvania Medicaid Program: Vaccines for Kids Older Than Six Months Now Available
COVID-19 vaccines are now available for children 6 months through 5 years of age. As a result of the recommendation from the CDC’s Advisory Committee on Immunization Practices (ACIP) as well as the Food and Drug Administration (FDA), nearly 20 million additional children are now eligible nationally for vaccination.
The pediatric COVID-19 vaccine is safe, and it is highly effective at protecting children against COVID-19-related illness, hospitalization, and death. Vaccinating children against COVID-19 is the best way to help keep families and communities healthy and schools safer this fall.
All children, including children who have already had COVID-19, should get vaccinated.
Distribution of pediatric vaccinations for these younger children has started across the country, and will be available at thousands of pediatric practices, pharmacies, Federally Qualified Health Centers, local health departments, clinics, and other locations. Children in this younger age group can be vaccinated with whichever vaccine is available (either Moderna or Pfizer-BioNTech). Parents can reach out to their doctor, nurse, local pharmacy, or local health department, or visit vaccines.gov to see where vaccines for children are available.
Learn more about COVID-19 vaccines for children:
- COVID-19 Vaccines for Children — Pennsylvania Department of Health
- COVID-19 Vaccines for Children and Teens — Centers for Disease Control and Prevention
Finding a Vaccine is Easy!
Many vaccine providers now take walk-ins and offer same-day appointments. You can find a vaccine provider near you:
- Online – go to Vaccine Finder and search by zip code.
- Text – send your zip code to GETVAX (438829) for English, or VACUNA (822862) for Spanish and receive three possible vaccination sites in your area, with phone numbers to call for an appointment.
Phone – if you need help or do not have internet access, call the PA Department of Health Hotline at 1-877-724-3258.
About the Pediatric Vaccine
Vaccine Dosage
The dosage for the pediatric COVID-19 is based on the child’s age on the day of vaccination, not the child’s size or weight. Children get a smaller dose of COVID-19 vaccine than teens and adults that is the right amount for their age group. COVID-19 primary series vaccination for children and teens. As of June 18, 2022:
|
Child’s Age |
Pfizer-BioNTech |
Moderna |
J&J/Janssen |
| 6 months–4 years old | 3 dose primary series | 2 dose primary series | Not authorized |
| 5 years old | 2 dose primary series | 2 dose primary series | Not authorized |
| 6–17 years old | 2 dose primary series | 2 dose primary series | Not authorized |
More than 596 million doses of COVID-19 vaccine had been given in the United States since December 2020.
- View the CDC COVID Data Tracker — See current total COVID-19 vaccinations administered in the United States.
- Enroll in V-Safe — V-safe provides personalized and confidential health check-ins via text messages and web surveys so you can quickly and easily share with CDC how you, or your dependent, feel after getting a COVID-19 vaccine.
COVID-19 vaccines are safe and effective. COVID-19 vaccines were evaluated in tens of thousands of participants in clinical trials. The vaccines met the FDA’s rigorous scientific standards for safety, effectiveness, and manufacturing quality needed to support authorization.
The Pfizer-BioNTech, Moderna, and Johnson & Johnson/Janssen COVID-19 vaccines will continue to undergo the most intensive safety monitoring in U.S. history. This monitoring includes using both established and new safety monitoring systems to make sure that COVID-19 vaccines are safe.
Spread Vaccine Awareness!
The Pennsylvania Department of Health has created a number of resources to help you share accurate vaccine information with children and families regarding the COVID-19 vaccines.
- Download social media graphics that you can post as shareable posts.
- Download printable flyers to share with children and their families.
- Request informational materials and handouts to be shipped to your organization
Additional COVID-19 Vaccine Resources
- Pfizer-BioNTech COVID-19 Vaccine Overview and Safety — Centers for Disease Control and Prevention
- Moderna COVID-19 Vaccine Overview and Safety — Centers for Disease Control and Prevention
COVID-19 Public Health Emergency Extended in the U.S.
The Biden administration on July 15, 2022 extended the Covid-19 public health emergency for another three months.
U.S. Department of Health and Human Services Secretary Xavier Becerra officially renewed the declaration, extending it through October 13, 2022.
The emergency declaration has been in place since January 2020, and the latest renewal comes as the Omicron offshoot BA.5, the most contagious variant yet, continues to stake its claim in the US. Daily case rates, though vastly undercounted, are the highest they’ve been in months, as are Covid-19 hospitalizations and deaths.
Data published this week by the US Centers for Disease Control and Prevention shows that more than half of the country’s population lives in a county with a “high Covid-19 Community Level,” where the health care system is at risk of becoming overburdened and universal indoor masking is recommended.
“The Public Health Emergency declaration continues to provide us with tools and authorities needed to respond to the highly transmissible COVID-19 subvariants that are currently circulating around the country,” a Biden administration official told CNN. “The PHE provides essential capabilities and flexibilities to hospitals to better care for patients, particularly if we were to see a significant increase in hospitalizations in the coming weeks.”
Indeed, ensemble forecasts from the CDC published this week do predict that hospitalizations in the US will rise over the next month. It’s the first time in weeks that the forecasts have predicted an increase in hospitalizations, instead of a stable outlook.
“Without the PHE in place, we would be limited in our ability to provide broad and equitable access to lifesaving treatments through our Test to Treat initiative, for example, which relies on flexibility for telehealth and operations,” the official said. “Not renewing the PHE would leave us with fewer tools to respond and mean more Americans would get severely ill and end up in the hospital.”
The public health emergency declaration allows many Americans to obtain free Covid-19 testing, therapeutic treatment and vaccines. Once it ends, people could face out-of-pocket costs depending on whether they are covered by Medicare, Medicaid or private insurance. But vaccinations would generally continue to be free for those covered by Medicare and private insurance, while state Medicaid programs would determine whether to continue covering vaccinations for their enrollees.
Also, Medicare has relaxed the rules governing telehealth so that many more beneficiaries can access such services during the declaration. Telehealth services are no longer limited just to those living in rural areas, and enrollees can conduct visits at home, rather than having to travel to a health care facility, and they receive a wider array of services via telehealth. These flexibilities will end for most beneficiaries after the emergency expires.
And states are not involuntarily disenrolling residents from Medicaid during the declaration, in exchange for receiving more generous federal matching funds. As many as 14 million people could lose Medicaid coverage after the emergency ends, according to separate projections by Kaiser and the Urban Institute.
Plus, many low-income families are receiving enhanced food stamp benefits thanks to the declaration, though some states have ended their own public health emergencies and stopped the beefed-up allotments.
A separate emergency declaration allows for the emergency use authorization of testing, treatments and vaccines. Its end date will be determined by the secretary of the US Department of Health and Human Services.
Explore ARC’s County Status Map for FY 2023
Every year, the Appalachian Regional Commission (ARC) compares each of Appalachia’s 423 counties with national averages. By analyzing unemployment rates, per capita market income, and poverty rates, counties are classified within one of five economic status designations:
- Distressed,
- At-risk,
- Transitional,
- Competitive, or
- Attainment
The designations are used to determine the match requirements for ARC grants, as well as research topics and investment strategies targeting resources to the region’s most distressed areas.
We’ve seen an uptick in at-risk (+14) and distressed (+1) counties, especially in the wake of COVID-19, but Appalachians throughout the region are more resolved than ever to address distress and believe in the potential for progress.
Has your county’s status designation changed this year? Check out our interactive map to find out.
National Maternal Mental Health Hotline Now Available
The Health Resources and Services Administration (HRSA) officially launched the National Maternal Mental Health Hotline on Mother’s Day, May 8, 2022.
Available 24/7, the National Maternal Mental Health Hotline provides free, confidential support, resources, and referrals from professional counselors to pregnant and postpartum individuals facing mental health challenges. Counselors offer support in English and Spanish and interpreter services are available in 60 additional languages.
In a press release announcing the hotline, HHS Secretary Xavier Becerra said, “This new Maternal Mental Health Hotline will not only advance our priorities of tackling the nation’s mental health crisis, but also support our efforts to ensure healthy pregnancies and support new parents.”
If you have any questions about the hotline service please see our online Frequently Asked Questions, also available in Spanish, or contact hotline@postpartum.net. This email address should not be distributed to help-seekers. It will not connect anyone to the 24/7 hotline service. It is for informational questions only.
New from the RUPRI Center for Rural Policy Analysis: Nursing Homes in Rural America: A Chartbook
A new chartbook is available from the RUPRI Center for Rural Health Policy Analysis, Nursing Homes in Rural America: A Chartbook by Hari Sharma; Lili Xu; Fred Ullrich; Clint MacKinney; Keith J. Mueller
Closure of nursing homes and hospitals with swing beds in recent years has changed the availability of post-acute and long-term care services in rural areas. This study examines the availability of post-acute and long-term care services as well as characteristics of residents and nursing homes in noncore, micropolitan, and metropolitan counties.
Please click here to read the brief.
The American Academy of Pediatrics and Department of Health and Human Services Partner on COVID-19 Public Education Campaign
The American Academy of Pediatrics (AAP) is partnering with the U.S. Department of Health and Human Services (HHS) on their “We Can Do This” public education campaign to increase COVID-19 vaccine confidence. In the wake of the newly-authorized COVID-19 vaccine for young children, the AAP and HHS collaborated on a new toolkit for medical professionals engaged in thoughtful discussions with parents and families on the importance of immunization. The toolkit contains new informational content, posters, flyers, social media graphics, AAP videos, and more. These resources will also be available in Spanish here.
Enhanced Strategy to Vaccinate and Protect At-Risk Individuals from the Monkeypox Outbreak Released
The U.S. Department of Health and Human Services (HHS) announced an enhanced nationwide vaccination strategy to mitigate the spread of monkeypox. The strategy will vaccinate and protect those at risk of monkeypox, prioritize vaccines for areas with the highest numbers of cases and provide guidance to state, territorial, tribal, and local health officials to aid their planning and response efforts. Read more about the strategy here. For more information regarding Monkeypox clinical diagnosis and treatment review the Centers for Disease Control and Prevention (CDC) Clinician Outreach and Communication Activity (COCA) Call. There have been confirmed cases of Monkeypox in Pennsylvania to date, including one identified by a western Pennsylvania Community Health Center.
Five Steps to Starting a Telehealth Practice
Looking to further integrate telehealth into your medical practice? This useful tip sheet highlights the five important steps you need to plan your telehealth workflow.
Nursing Fellows Can Help Address Social Determinants of Health
The National Nurse-Led Care Consortium (NNCC) and Pennsylvania Action Coalition are recruiting nursing students and hosting sites for the AmeriCorps Public Health Nursing Fellowship. The fellowship will provide community-based primary care and public health clinical experiences serving vulnerable communities. NNCC is seeking partnerships with organizations across Pennsylvania for placement of nursing students who will support Social Determinants of Health (SDOH) screening and navigation of services. Nursing students will screen new and current patients for SDOH, support patient navigation of services, and conduct vital signs screening and documentation, with the potential to support vaccination efforts. If you are interested in hosting students, contact Christine Simon.