- USDA Partners With White House, National Rural Water Association to Strengthen Cybersecurity for Rural Water Systems
- On-Call Maternity Care in Rural Arizona Boosted by AHCCCS Funding
- Ask an Expert: Solutions to Social Isolation in Rural Communities
- Share Your Rural Health Story in Honor of National Rural Health Day
- On Navajo Nation, a Push to Electrify More Homes on the Vast Reservation
- Agriculture Secretary Vilsack Visits North Carolina to Highlight Federal Resources Available to Help Farmers, Families and Communities Recover from Hurricane Helene
- Pratt Is the Latest Kansas Town Facing Nitrate Pollution. One-Quarter of Its Water Supply Is Off
- NRHA Releases 2024 Compendium of Best Practices for Rural Age-Friendly Care
- Northern Forest Center Focuses on Rural Middle-Income Housing Needs
- Medical Academy Serves High School Students and Their Communities
- Rural Georgians Face Long Distances to Maternity Care - Community Clinics Can Help Fill the Gaps
- FACT SHEET: Biden-Harris Administration Announces New Actions to Support North Carolina's Hurricane Recovery
- Biden-Harris Administration Takes Groundbreaking Action to Expand Health Care Access by Covering Traditional Health Care Practices
- FCC Waives Certain RHC Program Rules in Response to Hurricane Milton
- Food Bank Bounces Back From Helene to Tackle Hunger Crisis in Western NC
What Are We Doing to Address Loneliness as a Social Driver of Health?
The U.S. is experiencing an epidemic of loneliness, and studies suggest that cultivating better relationships with the people who live nearby is crucial for your happiness. An early 2023 Gallup survey found that 17% of American adults said they felt lonely “a lot of the day yesterday.” A lack of social connections is linked to poor mental health and even premature death. But living within a mile of a happy friend increases the likelihood that you’ll be happy by 25%, according to a multi-generational study. The problem is that a majority of Americans don’t know most of their neighbors. This sounds like a challenge that FQHCs as community-based organizations are up to! What can you do to support meaningful human connections in the communities you serve?
New Federal Office Will Focus on Long COVID
On Monday, the U.S. Department of Health & Human Services announced a new office that will lead the federal response to Long COVID, the lingering effects of infection currently estimated to affect up to 23 million people in the U.S. Researchers and even insurers have already considered that long COVID could be “a mass disabling event” affecting economic productivity. The implications for rural communities are tied to higher rates of infection, lagging vaccination uptake, and lower rates of health insurance. Read more about the rural experience with Long COVID in a recent edition of The Rural Monitor.
Here You Can Read About State Differences in Recommended Components of Care Received During Postpartum Visits for Rural and Urban Residents, 2016-2019
Among key findings from the University of Minnesota Rural Health Research Center: there is substantial state-level and rural-urban variation in the number of recommended care components (contraceptive counseling, depression screening, smoking screening, abuse screening, eating and exercise discussions, and birth spacing counseling) received during postpartum visits.
Here Are the Findings From the American Community Survey on Housing Quality by Disability, Race, Ethnicity, and Rural-Urban Location
The University of Minnesota Rural Health Research Center examines information collected by the U.S. Census Bureau’s ongoing, annual survey that collects information on social, economic, housing, and demographic characteristics.
Comments Have Been Requested on Requirements Related to the Mental Health Parity and Addiction Equity Act
In this proposed rule, the Departments of Labor, Health and Human Services, and the Treasury propose several updates to strengthen the Mental Health Parity and Addition Equity Act of 2008 and better ensure that people seeking coverage for mental health and substance use disorder (SUD) care can access treatment as easily as people seeking coverage for medical treatments. In addition, this rule seeks public input on ways to improve the coverage of mental health and SUD benefits through other provisions of Federal law. Sixty percent of rural Americans live in mental health professional shortage areas. Non-metro adults were more likely than metro adults (43.7% vs. 34.5%) to see a general practitioner or family doctor, as opposed to a mental health specialist for depressive symptoms, and among non-metro adults with depression, fewer than 20% received treatment from a mental health professional. Comments are due by October 2, 2023.
CMS Updates Hospital Policies for Fiscal Year 2024, Including Rural Emergency Hospital Policies
On August 1, 2023, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the Inpatient Prospective Payment System (IPPS) and Long-term Care Hospital payments (LTCH-PPS) for fiscal year 2024. Effective October 1, 2023, the IPPS rates will increase by 3.1% overall, increasing hospital payments by $2.2 billion. The rule continues the low wage index policy for FY 2024 and will treat rural classified hospitals as geographically rural for purposes of calculating the wage index. It finalizes a policy designating Rural Emergency Hospitals (REHs) as graduate medical education (GME) training sites and codifies in regulation the information hospitals must include in their application to convert to an REH. The rule addresses policies around quality measurement, including the incorporation of a health equity adjustment for the Hospital Value-Based Purchasing (VBP) Program. In addition, CMS received feedback from stakeholders on the potential future inclusion of two geriatric measures and on the establishment of a publicly reported hospital designation for geriatric care.
Medicare Finalizes SNF, IRF, IPF, and Hospice Payment Rules
CMS released final rules for Skilled Nursing Facilities (SNF), Inpatient Rehabilitation Facilities (IRF), Inpatient Psychiatric Facilities (IPF), and Hospices. Each rule updates Medicare payment and quality measurement policies for Fiscal Year 2024, which begins October 1. The final rules indicate a 3.3 percent increase in payments for rural SNFs, a 3.6 percent increase in payments for rural IRFs, a 2 percent increase in payments for rural IPSs, and a 2.8 percent increase in payments for rural hospices.
Read About the Frontier of Harm Reduction: Expanding Services for Rural People Who Use Drugs
Feature article in the latest Rural Monitor describes harm reduction approaches to help reduce health risks related to substance use. It explains how these approaches are being adopted in rural areas.
Pennsylvania Health Care Providers Tell Lawmakers the State’s Rural Hospitals Are in Crisis
Pennsylvania’s rural hospitals are dealing with a shortage of physicians and mental health providers that has become dire, leaving patients in rural communities with dwindling options for care.
That was the message members of the Center for Rural Pennsylvania heard on Thursday during a hearing with hospital and health care center executives, and public health experts.
The center, a bicameral, bipartisan legislative agency, heard from hospital and health center executives, as well as public health experts about the challenges facing rural health care providers at a public hearing in Bradford.
Dr. Jill Owens, president of Upper Allegheny Health System, put it bluntly: “Rural hospitals are in crisis,” she told the panel.
Owens said that difficulty attracting and retaining health care providers, low Medicaid and Medicare reimbursement and other challenges have led to care deserts and declining health outcomes for rural Pennsylvanians. And without action to reform the struggling health care system and more funding and resources for local providers, the situation is unlikely to improve any time soon.
Attracting Providers
Jeannine McMillan, executive director of the Center for Population Health, a nonprofit focused on population and public health initiatives in rural Cambria and Somerset counties, said that both counties suffer from a lack of primary care physicians and mental health providers.
“Extreme challenges, including lack of adequate public transportation, availability of broadband, food deserts and difficulty recruiting clinicians are magnified in rural communities,” McMillan said.
While her organization has been fortunate to receive funding from philanthropic groups, McMillan said that “significant investments are needed” to improve health outcomes in rural communities.
A study conducted by the Hospital and Healthsystem Association of Pennsylvania (HAP) found that rural hospitals have struggled to fill 39% of vacant registered nurse positions. By comparison, HAP found the average vacancy rates for direct care RNs to be more than 30% statewide.
Kate Slatt, vice president of Innovative Payment and Care Delivery for the Hospital and Healthsystem Association of Pennsylvania, said that HAP supports efforts to strengthen the education and training pipeline for those pursuing health care careers and the creation of an office within Democratic Gov. Josh Shapiro’s administration to focus on “health care workforce innovation and reform,” it does not support legislative attempts to limit the staff-to-patient ratios at Pennsylvania hospitals.
In late June, the House passed HB 106, also known as the “Patient Safety Act.” The bill, co-sponsored by state Reps. Thomas Mehaffie, R-Dauphin, and Kathleen Tomlinson, R-Bucks, would outline the number of patients per-nurse required in different hospital settings.
Supporters of the legislation, including nurses who weathered unmanageable caseloads during the COVID-19 pandemic and the unions representing them, said the legislation protects patients and improves health care outcomes.
In July, the bill was referred to the Senate Health and Human Services Committee.
Maternal Health Deserts
Public health officials also warned lawmakers at the hearing about an “alarming” trend in rural health — a lack of labor and delivery services.
From January 2010 to April 2022, 30 Pennsylvania hospitals closed their doors. Many others were forced to cut specific services — such as OB/GYN — in order to remain financially viable, according to HAP.
Similarly, of Pennsylvania’s 42 rural hospitals, 60% do not have labor and delivery services, an analysis from the Center for Healthcare Quality and Payment Reform found.
“Many pregnant persons in rural areas need to drive almost 40 minutes to reach a hospital that can assist them during birth, which exceeds the recommended 30-minute travel time once a person begins labor,” Lisa Davis, director of the Pennsylvania Office of Rural Health and Outreach explained. “These challenges also contribute to increases in births outside of hospitals versus in hospitals without OB units and in preterm birth, all of which carry greater risks for both mothers and newborns.”
A 2022 report from the March of Dimes found that six of Pennsylvania’s 67 counties — Cameron, Forest, Greene, Juniata, Sullivan, and Wyoming counties — classified as “maternal health deserts” because they lacked hospitals providing obstetric care and birth centers, and had no OB/GYN or certified nurse midwives.
State Sen. Judy Schwank, D-Berks, said she was “very concerned” about the impact maternal health care deserts in rural Pennsylvania could have on the commonwealth’s maternal mortality rate.
“There are hospitals in the state that close maternity care that send persons in labor to another facility by either lifeflight helicopter or ambulance during the times when they can go but those are really expensive, or they may end up just having to deliver in the emergency department if they can’t travel,” Davis explained. “So this is something I think we really need to focus on.”
Davis offered that alternative services, such as birthing centers, may be an effective option for rural communities across the commonwealth.
New Public Health Resource Published: Understanding Air Quality
The ongoing wildfires in Canada (including a blaze that crossed the U.S.-Canada border this past weekend) and an intense nationwide heat wave are having harmful effects on air quality–putting public health at risk. Although a decrease in air quality affects everyone, certain communities and individuals are more vulnerable to its harmful effects.
PHCC’s newest resource, Protect Your Health: Understanding Air Quality, will help you communicate about air quality and protective measures people can take to stay safe. This resource is available in English and Spanish and includes:
- The fundamentals of understanding air quality and the Air Quality Index (AQI)
- A visual guide to the major sources of air pollution
- Recommendations for protecting your health routinely and during air-quality alert days
Download and share the guide with your community to promote the importance of understanding air quality and protecting your health