Several times a month, Jim Maybach drives 5 miles from his house in Hay Creek, Minnesota, toward the Mississippi River.

When he reaches Red Wing, a city of nearly 17,000 people, the 79-year-old retired engineer stops to pick up a senior whom he then delivers to an appointment, such as a dentist visit or an exercise class. When the appointment ends, Maybach is there to drive the person home.

It’s a route and routine he repeats a handful of times each month.

Maybach is unpaid, a volunteer among a cadre organized by Faith in Action in Red Wing, a nonprofit that relies on retirees to ferry residents to essential services.

The riders, mostly seniors, are people who don’t have immediate access to transportation, especially in rural areas where public transit options are either limited or nonexistent.

There are several such programs serving rural counties in Minnesota, but, as with other services across the country, their existence has become precarious because the number of volunteer drivers has steadily declined, according to transportation advocates. Volunteers either get to a point where, because of age, they can no longer drive, or the costs associated with their volunteerism are no longer sustainable. For decades, Congress has refused to increase the rate at which the drivers’ expenses can be reimbursed.

Experts say that with public transit in rural areas already insufficient and the long distances that residents in rural communities must travel to access health care, a decimated volunteer driver network would leave seniors with even fewer transportation options and could interrupt their health management. Already, social service organizations that rely on volunteers have begun to restrict their service options and deny ride requests when drivers aren’t available.

Read more.

We’re excited to share that our new Rural Desk is up and running. Meet our team. On Oct. 25, we will launch a monthly newsletter featuring KHN stories from across the country that dive into the health issues and policies impacting people who live in America’s rural reaches.

A new guidebook from the Substance Abuse and Mental Health Services Administration describes various methods of adapting evidence-based practices for substance use disorder (SUD) to meet the needs of populations who experience barriers in receiving behavioral health services due to a variety of factors including race, ethnicity, geography, income, sexual orientation, and disability.

 The recording for the October 12 webinar explains the REH provider type and other FORHP-funded activities to support hospitals exploring the REH option.

 The Rural Health Value team recently released two new rural innovation profiles. The first covers a critical access hospital in Susquehanna, PA’s Experience in the Pennsylvania Rural Health Model: Barnes-Kasson County Hospital. This profile provides insight into the hospital’s experience participating in the Pennsylvania Rural Health Model, which includes a global budget and transforming care to address community health needs. The other profile on MaineHealth ACO – Integrating and Using Data to Support Care Delivery highlights a predominantly rural network of hospitals and clinics in Maine and how they have integrated clinical and claims data to support improvements in care delivery and target patient needs as part of their Accountable Care Organization. The Rural Health Value team is funded by the Federal Office of Rural Health Policy.

  The North Carolina Rural Health Research and Policy Analysis Center provides a basic financial framework for considering the incremental revenues, costs, and avoided costs that may be expected if a hospital eliminates inpatient care to convert to an REH.  Another paper from the same research center examines hospitals with low emergency department volumes that are eligible to convert to an REH and found common characteristics.  See FORHP-funded technical assistance to support hospitals exploring the REH option under Resources of the Week below.

 On October 13, HHS extended the COVID-19 Public Health Emergency declaration for another 90 days. The extension means the continued surveillance of the outbreak, access to emergency funding, modified telemedicine practice, and flexibilities for healthcare providers, such as the Coronavirus waivers issued by the Centers for Medicare & Medicaid Services.

Surveillance by the Centers for Disease Control and Prevention (CDC) shows the highest levels of respiratory illness were reported in Georgia, South Carolina, Tennessee, and Texas for the week ending October 8.  Earlier this week, the CDC reported only half of Americans got a flu vaccine during the 2021-2022 flu season.  Long term, CDC found data showing that flu hospitalization rates were nearly 80 percent higher among Black adults than White adults from 2009-2022. In a rural-urban comparison of vaccine uptake in Florida, researchers found no significant association between residing in rural counties and not receiving a flu vaccine. Instead, their findings showed that increasing age, higher education, and having health insurance had a positive association with flu vaccine use.  Locations for flu vaccines in almost every county can be found at vaccines.gov.

  Earlier this year, the U.S. Department of Transportation (DOT) released a National Roadway Safety Strategy to bring down the number of people who die in motor vehicle crashes.  One of the five key objectives of this plan is post-crash care, emergency response, and trauma care which is critical to the survivability of crashes.  Recent research has shown that nearly half of fatal crashes in the United States occur on rural roads.  The National EMS Advisory (NEMSAC)  Council seeks input from rural emergency medical services (EMS) on their formal submission to DOT’s National Highway Transportation and Safety Administration about the proposed plan.  There are two NEMSAC letters for your consideration: the first provides advice on major actions the DOT can take to reduce fatalities; the second calls for the adoption of the National Model EMS Clinical Guidelines (3^rd Edition) and the 2021 National Trauma Field Triage Guidelines.  Comments and questions must be submitted to NHTSA.NEMSAC@dot.gov by October 21, 2022, at 5 pm ET.

 A July 2020 survey of more than a thousand physicians who provided treatment for opioid use disorder (OUD) showed that many used telehealth for the first time during the pandemic when regulations were loosened.  More than half of the respondents, 54 percent, found it more effective than expected.  A significant majority – 85 percent – were in favor of the temporary telehealth flexibility being permanently extended.