This policy brief from the University of Minnesota Rural Health Research Center presents findings from interviews with national LGBTQ+ support organizations regarding challenges to physical and mental health and well-being for LGBTQ+ individuals in rural communities, as well as considerations for improving the ability to meet the needs of LGBTQ+ individuals living in rural areas.

Through its Bureau of Health Workforce’s National Center for Health Workforce Analysis, HRSA recently awarded $5 million in funding to nine Health Workforce Research Centers to help decision-makers at the federal, state, and local levels understand health workforce needs. In collaboration with the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration, two of the nine centers have been awarded, specifically, to expand research into public health and behavioral health areas.

New data show the outbreak is slowing; as of Wednesday, September 28, there were there were 25,509 confirmed cases.  The Centers for Disease Control and Prevention (CDC) continues to provide updates on trends and resources, recently focusing on reducing stigma.  CDC also recommends health care personnel adhere to recommended infection prevention and control measures and stay up to date on pain management for infected patients.  See Funding and Opportunities below for the CDC’s Monkeypox Vaccine Equity Pilot Program.

The federal agency charged with examining how taxpayer dollars are spent reports on the effects of temporary waivers issued by the U.S. Department of Health & Human Services (HHS) to ease the use of telehealth during the COVID-19 pandemic.  For beneficiaries of Medicare – the public health insurance that allows access to care for those who are 65 years and older, and younger people with certain disabilities – use of telehealth increased from about 5 million services pre-pandemic to more than 53 million services from April to December 2020.  GAO also found that, while telehealth use increased across all provider specialties, 5 percent of providers delivered over 40 percent of services.  The difference in telehealth use between rural and urban Medicare beneficiaries was slight – 33 percent versus 39 percent respectively.  In considering whether to make these changes permanent, GAO makes three recommendations to the Centers for Medicare & Medicaid Services: 1) clarify guidance for billing audio-only telehealth to allow tracking of these visits, 2) require providers to use available place of service codes, and 3) make a comprehensive assessment of the quality of services delivered via telehealth to insure improved outcomes for patients.

The National Academy for State Health Policy (NASHP) provides another layer of insight into how a new provider type, the Rural Emergency Hospital (REH), will work when it goes into effect at the start of next year.  Eligible hospitals that receive the designation may reduce their risk of closure and receive an additional payment from Medicare – regardless of facility size or volume of patients – to maintain emergency services in rural areas.  As reported here a few weeks ago, the National Conference of State Legislatures is tracking the way states are tailoring REH licensing requirements.  In spring 2023, NASHP will join HRSA in a day-long, in-person peer-to-peer learning opportunity for state officials to develop implementation plans for individual states.  In the near term, the Federal Office of Rural Health Policy (FORHP) will host a webinar on Wednesday, October 12 at 3:00 pm ET to explain the Rural Emergency Hospital and other FORHP-funded activities to support hospitals exploring the REH option.

The U.S. Preventive Services Task Force released a final recommendation statement on screening for syphilis infection in nonpregnant adolescents and adults. The Task Force recommends screening people at increased risk for infection. To view the recommendation, the evidence on which it is based, and a summary for clinicians, please go here.

The Pennsylvania Department of Health (PA DOH) is alerting healthcare providers, laboratories, infection control specialists, and local health departments about an unvaccinated adult with poliovirus infection and acute flaccid paralysis along with wastewater detection in adjacent counties reported July 2022 in Rockland County, New York. PA DOH urges healthcare providers to consider polio as a possible cause of sudden onset of limb, facial, oropharyngeal, or respiratory muscle weakness, especially in persons who are not vaccinated or who are under-vaccinated for polio and have traveled to areas with a higher risk of polio or who have had contact with such persons. If providers have a clinical suspicion of a case of polio after they have evaluated a patient, they are to contact their local or state health department to discuss the case and to determine to test. Healthcare providers should immediately identify and schedule appointments for patients in your practice who are not up to date on the poliovirus vaccine. To read the full PA DOH Advisory, click here.