Rural Health Information Hub Latest News

New Data on Appalachia’s Economy, Income, Education

ARC has released the 13th update of The Appalachian Region: A Data Overview from the 2017-2021 American Community Survey, also known as “The Chartbook.” The report, written in partnership with the Population Reference Bureau, features more than 300,000 data points comparing Appalachia’s economy, income, education, and more with the rest of the nation.

The 2023 report shows that Appalachia continued to make progress in educational attainment, labor force participation, income levels, and poverty rates from 2017-2021. Despite positive trends, work remains for the Appalachian Region — particularly its oldest, youngest, and most rural residents — to achieve parity with the nation.

To address Appalachia’s key vulnerabilities, ARC launched the Appalachian Regional Initiative for Stronger Economies (ARISE) for large-scale economic transformation. The funding opportunity has a new application process that will be reviewed in detail during ARC’s pre-application webinar on June 22.

CMS Announces Making Care Primary (MCP) Model

The Centers for Medicare & Medicaid Services (CMS) announced a new primary care model – the Making Care Primary (MCP) Model – that will be tested in eight states. Access to high-quality primary care is associated with better health outcomes and equity for people and communities. The model seeks to improve care for people with Medicare and Medicaid by equipping primary care clinicians with tools to form partnerships with specialists and leverage community-based connections to address patients’ health and health-related social needs.

CMS plans to partner with State Medicaid Agencies in the eight states to engage in full care transformation across payers. The model will support participants with varying levels of accountable care experience, including Federally Qualified Health Centers (FQHCs) and physician practices with limited experience in value-based care, in driving toward a system that reduces disparities in care and results in better patient experience and outcomes.

CMS will test this advanced primary care model in Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington. CMS will work with model participants to address priorities specific to their communities, including care management for chronic conditions, behavioral health services, and health care access for rural residents.

Primary care organizations within participating states may apply when the application opens in late summer 2023. The model will launch on July 1, 2024.

For more information, review the detailed official press release.

To view the MCP webpage, visit: https://innovation.cms.gov/making-care-primary.

To view a model key highlights video, visit: https://youtu.be/8vy3PHHlCe4.

Highmark Foundation Announces Bright Blue Futures Award Opportunity

The Highmark Bright Blue Futures Awards is an exciting new grant awards and recognition program, and is now accepting nominations!  As part of the accolade, this program will allocate grant awards ranging from $25,000 to $100,000 and honor outstanding organizations, programs, collaborative efforts, and philanthropic initiatives.  The theme for the inaugural year is “A Look at Health Equity, Social Determinants of Health and Philanthropy to Advance Community Health.”

Submit nominations by July 10 for the Highmark Bright Blue Futures Awards here.

This program is made possible by the Highmark Foundation and is an expansion of Highmark’s corporate giving and community involvement program, Highmark Bright Blue Futures.  Highmark Bright Blue Futures is designed to ensure healthier, brighter, stronger futures for all. The focus is on improving equitable access to care, quality of life, and economic resilience in the communities the enterprise serves. Specifically, it aims to improve outcomes in two critical areas: Community Health and Community and Economic Resilience.

This is an amazing opportunity to further highlight impactful initiatives across our enterprise footprint that are helping to build healthier, brighter futures.   Additional information about the awards can be found here.

PA WalkWorks Announces Funding Opportunity

Walking, biking, using a wheelchair, and accessing transit are independent, reliable, and resilient transportation modes that are healthy for our minds, bodies, finances, communities, and the environment. We look forward to a time when everyone in Pennsylvania has a full range of transportation options available to them.

To that end, WalkWorks is pleased to announce a new program to assist low-capacity, high interest municipalities with the pre-planning steps they must undertake in order to be ready to apply for funding to develop active transportation plans in 2024. A small amount of money and structured pre-planning assistance will be available to selected municipal applicants. Eligible municipalities must be located either in the newly updated list of State Physical Activity and Nutrition target counties identified by the Department of Health or in an Environmental Justice area as designated by the Department of Environmental Protection, both of which are shown on this map. In addition, applicants should have an interest in applying for funding to develop an active transportation plan but lack the knowledge, professional support, or resources needed to assemble an application. Barriers may include lack of clarity among elected officials about the goals/results of developing a plan, lack of understanding among the public of the relevance of such a plan for their community, and/or an inability to establish a reasonable scope and budget for the plan.

Mini-grants and structured assistance will be offered to a limited number of municipalities between September of 2023 and March of 2024. The long term goal is to prepare additional communities to apply to develop active transportation plans which is necessary for the establishment of activity-friendly routes that connect people to everyday destinations, expanding opportunities for physical activity and improving public health.

An informational webinar reviewing the FOA will take place on Thursday, June 22, at noon, on zoom. Register at this link.

Click here to learn more.

New Resource Released: Adopting Oral Health to Advance Minimally-Invasive Care

Community Catalyst released a new resource, “Adopting Oral Health Integration to Advance Minimally-Invasive Care.” The resource provides information about how minimally invasive health care can be used in conjunction with the integration of oral health care and medical care to improve oral health and overall health, as well as people’s experiences with receiving oral health care.

Click here to view the resource.

HHS Finalizes End of COVID-19 Vaccination Rule for Hospitals

From Becker’s

The federal government is formally withdrawing the COVID-19 vaccine mandate for employees of CMS-certified healthcare facilities that was enacted in November 2021 and moving to treat the virus, from an oversight standpoint, more like the flu.

The Biden administration announced on May 1 that HHS would begin the process to end the COVID-19 vaccine requirement for employees of CMS-certified healthcare facilities. Requirements under the Omnibus COVID-19 Health Care Staff Vaccination rule were no longer enforced at the end of the day May 11, 2023, the same day the COVID-19 PHE ended, a CMS spokesperson told Becker’s.

While CMS might be done enforcing the rule, it still needs to come off the books. To do so, CMS has issued an 82-page final rule formalizing the end of the vaccination requirement. In the final rule set to be published in the Federal Register June 5, HHS and CMS withdraw the 2021 vaccination requirement, outline reasoning for its end, and note upcoming plans to regulate healthcare workers’ protections against COVID-19 as part of certain Medicare quality programs.

The final rule is set to take effect 60 days after the date it is published in the federal register. As scheduled, that would be Aug. 4. CMS told Becker’s it will not enforce the vaccination requirement before the effective date of the rule — it is no longer in effect as of May 11.

“As conditions and circumstances of the COVID-19 PHE have evolved, so too has CMS’ response. At this point in time, we believe that the risks targeted by the staff vaccination [interim final rule with comment] have been largely addressed, so we are now aligning our approach with those for other infectious diseases, specifically influenza,” the 82-page final rule states. “Accordingly, CMS intends to encourage ongoing COVID-19 vaccination through its quality reporting and value-based incentive programs in the near future.”

Hospitals’ COVID-19 vaccination rates will effectively go from being a condition of participation in Medicare to being part of a quality reporting process, which hospitals are familiar with.

“CMS has been pretty clear that it no longer needs the condition of participation mechanism to follow through on the vaccination process,” Mark Howell, director of policy and patient safety for the American Hospital Association, told Becker’s. “It feels comfortable with the outlook that the quality measures provide. The [public health emergency] is over and COVID-19 has moved from pandemic to endemic stage, but that doesn’t mean COVID is gone. It makes sense [CMS] would want some measurement there.”

Hospitals and health systems would learn of the vaccination-related measures under consideration for inclusion in CMS programs by Dec. 1, the deadline by which HHS is required to publicly release a list of measures on the table for adoption in certain Medicare programs.

CMS, in its Hospital Inpatient Prospective Payment System proposed rule for fiscal year 2024, had proposed adjusting the measure for COVID-19 vaccination among healthcare personnel to go from reporting on the primary vaccination series only to reporting on the cumulative number of healthcare personnel who are up to date with recommended COVID-19 vaccinations.

Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, said the association is prepared to give CMS feedback that recommends the shift from primary series to up-to-date vaccination reporting coincide with improvements to the recommended cadence of COVID-19 vaccinations. U.S. health officials proposed simplifications to COVID-19 vaccine protocol, making it more like the routine process for annual flu shots, earlier this year.

“There is a challenge with the measure right now in trying to figure out if someone is up to date in their vaccination,” Ms. Foster told Becker’s. “It is so haphazard. When we know everyone should have gotten their shot sometime between September and December, for instance, that will make it administratively much easier to know who has been vaccinated if they are up to date.”

In the new final rule from HHS and CMS, the agencies note that withdrawal of the vaccination rule does not prohibit healthcare organizations from instating their own COVID-19 vaccination requirements for staff, consistent with other federal, state and local laws. It is likely that hospitals and health systems are in internal conversations and decision-making about what changes, if any, to make to their own individual COVID-19 vaccination requirements in light of the federal-level change.

The final rule from HHS and CMS also requires long-term care facilities to educate and offer the COVID-19 vaccine to residents, resident representatives and staff, as well as perform the appropriate documentation for these activities, as terms of participation in Medicare and Medicaid.

Pennsylvania EMS Workers Say Problems ‘Kicked Down the Road’ Caused Crisis

Pennsylvania’s emergency services face a serious financial crisis — and a dire situation to recruit first responders and ensure their health.

The state’s inaction, combined with mounting demands, leaves firefighters frustrated. Emergency workers scale back their voluntary commitments or quit for easier jobs with higher pay. Many of them suffer from PTSD and health problems. Suicide rates eclipse the generation population.

During a House Republican Policy Committee hearing on Tuesday, politicians heard this and more about the plight of rural and smaller departments trying to provide public safety.

“Our fire service is imploded already. We’re past a crisis mode,” Whitehall Township Fire Chief David Nelson said. “All the stuff we’ve been talking about should’ve been done 10-15 years ago.”

Fire chiefs said their departments remain stretched thin. Fundraisers and grants keep them operating in the absence of local and state support.

“This is a problem that gets kicked down the road every time,” Slatedale Fire Department Captain Dennis Wetherhold said. “There is never a resolution.”

The Emerald Star Hose Fire Company in Lehigh County, for example, has a budget of about $200,000. It gets a $26,000 donation from the township, $12,000-$15,000 from state grants, and $11,000 from firemen’s relief, about $52,000.

“We have to make up the rest by fundraising,” Emerald Fire Chief Tito Burgos said.

“My vehicles are paid for by our hoagie money and our money that we raise here,” he added. Preventative maintenance, too, runs about $30,000 a year.

Grants are not automatic or easy to get, either. Simply finding grants to apply for takes time.

“You can go on Google and look for a grant, but you can’t go to one place to find all the state grants,” Burgos said. “A one-stop shop would be great if there was such a certain thing.”

The financial issue isn’t the full equation. A smaller cadre of volunteer firefighters means a heavier burden on the company, making more people less reluctant to answer a call.

“Burnout, not enough volunteers, relying on the same individuals — it’s hard for us to have families and life balance,” Burgos said.

Much of that burnout doesn’t come from devastating fires, but from less-critical problems like EMS calls, “water in the basement” calls, and medical calls.

“I really don’t think the general public has any idea — or very little idea — in the situation that we’re into today, and really how it could dynamically change in the next few years,” Brian Carl, deputy chief of the Weisenberg Volunteer Fire Department, said. “When you dial 911, you might be waiting a while.”

Burgos and Carl listed some ideas to boost recruitment, such as earned income tax credits, retirement plans, tax incentives for employers who let workers leave to respond to a call, length of service rewards, and recruitment at the high school level.

Regionalization and consolidation, in some cases, could also help firefighters pool resources and lower costs, Carl said.

“County-wide services is where we need to start going,” Nelson said.

“This committee really needs to come up with some bold moves and suggestions,” said John Price, director of emergency services and fire chief in Emmaus.

Without such changes, officials warned of more-dire consequences. EMS providers have noticed a greater threat of physical violence against their workers in recent years, at the hands of the public and themselves.

“A disturbing trend has been realized over the last several years. Suicides in EMS and emergency services have surpassed line-of-duty deaths,” said Donald DeReamus, the legislative committee chair for the Ambulance Association of Pennsylvania and a paramedic.

If reform comes, firefighters want to see the changes be straightforward.

“We would appreciate any help you guys can provide for this situation, but please try to make it simple,” Carl said.

Legislators spoke of how more rules and regulations have worsened the position of first responders.

“We make it harder, it seems like every year, for someone to become a firefighter, and then we complain or are concerned that there’s not more people becoming firefighters,” Rep. Josh Kail, R-Beaver, said. “We’re creating a part of the problem ourselves.”

They also showed a recognition that change won’t come without more government spending.

“I do want fellow legislators to understand that there’s gonna be a cost involved, there’s gonna be a vote involved — we cannot vote to do nothing,” Rep. Mark Gillen, R-Reading, said. “We have to proactively decide what is the best route to the finish line.”

The Republican Policy Committee hearing comes a few weeks after a similar one from House Democrats. That hearing, as The Center Square previously reported, focused on the decline of fundraising and volunteer staff, and talked of potential state-level fees to cover costs.