Designed to serve Spanish-speaking communities, the online tool from the Substance Abuse and Mental Health Services Administration (SAMHSA) offers confidential and anonymous access to nearby treatment facilities and practitioners.

The report from the National Rural Health Resource Center was done in collaboration with FORHP and is a product of the May 2024 Rural Health Workforce Summit.  Each of the report’s four key strategies include specific and practical actions that can be adopted to address workforce shortages.

– Comment by November 12. This proposed rule from the Centers for Medicare & Medicaid Services (CMS) sets standards for Affordable Care Act (ACA) Marketplaces and issuers, as well as requirements for agents, brokers, web-brokers, direct enrollment entities, and assisters that help Marketplace consumers. It includes proposals to:

• prevent unauthorized activity among agents and brokers,
• mitigate health disparities by incentivizing plans that focus on underserved communities, and
• simplify plan choices.

Since 2018, the number of Marketplace plans in rural areas has grown, increasing the choices of coverage available to consumers.

Researchers from the North Carolina Rural Health Research and Policy Analysis Center created a model for predicting rural hospital closures in 2017. This update for 2024 was published last week in The Journal of Rural Health.

The latest Morbidity and Mortality Weekly Report from the Centers for Disease Control (CDC) highlights just how connected Adverse Childhood Experiences (ACEs) are to adolescent health.  Billed as the most comprehensive data yet on this subject, the report concludes that preventing ACEs could reduce suicide attempts by as much as 89 percent, prescription pain medication misuse by as much as 84 percent, and persistent feelings of sadness or hopelessness by as much as 66 percent. Earlier this year, the CDC issued a Rural Policy Brief showing suicide rates have been consistently higher in rural areas than in urban areas over the past two decades.  Between 2000-2020, suicide rates increased 46 percent in non-metro areas compared to 27.3 percent in metro areas.  A separate CDC Rural Policy Brief on suicide prevention released in July features a case study from a successful program for adolescents in tribal community in New Mexico.  In 2018, the National Advisory Committee on Rural Health and Human Services delivered an in-depth report on the rural context for ACEs, with recommendations for federal policy.

The Multi-Purpose Community Facilities program grants — approved for 49 projects in 26 counties — will give people free, digital access in public places like schools, local libraries, and community health centers.

 The Pennsylvania Broadband Development Authority (PBDA) Executive Director Brandon Carson announced the approval of $45 million in Multi-Purpose Community Facilities grant funding to 49 projects in 26 counties across Pennsylvania. This funding will support key projects in local communities and help connect Pennsylvanians to the internet at places like a primary care health center in Allegheny County, affordable housing in Delaware County, and a public library in Northumberland County.

The PBDA Board of Directors approved the grants to eligible entities with public-facing facilities such as schools, local libraries, and community health centers to make improvements that will ensure people have free access to reliable, high-speed internet.

Today’s approval of the Multi-Purpose Community Facilities grants will help ensure that Pennsylvanians can access the resources they need to further their education, advance career opportunities, and utilize telemedicine options no matter where they live.

“Pennsylvania is leading the way when it comes to driving out these federal dollars to ensure more people have access to the internet. By expanding access to affordable, high-speed internet to every Pennsylvanian, we can create real opportunities for our students, our businesses, and our communities to learn, grow, and thrive,” said Governor Josh Shapiro. “Thanks to this historic investment from the federal government, my Administration has the resources to work with our community partners across the Commonwealth to bring reliable internet at high speeds and for affordable prices to every corner and every community in Pennsylvania — and we’ll continue to do that work effectively and efficiently.”

“Investing in public facilities improvements is an essential step in ensuring Pennsylvanians have access to reliable, high-speed internet across the Commonwealth,” said Executive Director Carson. “Public places like our libraries, health centers, and non-profit organizations are the fabric of our communities and this funding will help them better serve Pennsylvanians.”

The Multi-Purpose Community Facilities program was established by the PBDA utilizing a portion of the $279 million in Capital Projects Funds (CPF) awarded to Pennsylvania in June 2022 under the American Rescue Plan Act.

Eligible applicants for funding included, but weren’t limited to, schools, libraries, recreation centers, community health centers, non-profit organizations, municipalities, and local government institutions. The program requires projects be for construction or improvements to full-service community buildings, structures, and public spaces that directly enable work, education, and health monitoring. The physical structure must also be available year-round to the public.

A complete listing of the grants approved by the PBDA Board of Directors can be found here and includes:

$2,000,000 to Primary Care Health Services Inc. in Pittsburgh, Allegheny County

The new 44,112-square-foot Wilford A. Payne Medical Center and office building will be constructed on a surface parking lot adjacent to the current facility. It will become the most significant anchor for the redevelopment of the Homewood community — accommodating significant growth in patient services and providing publicly accessible internet.

$1,500,000 to the Chester Housing Authority in Chester County

The proposed project will launch a Chester e-Health Center to address the health disparities of seniors, lack of access to technology for employment and healthcare, improve access to e-learning training and job boards which are barriers to success for residents in the City of Chester.

$1,617,435 to Fox Township in Elk County

The township is planning to construct a History and Humanities Center to serve Fox Township and surrounding communities. The center will feature, among other things, a public cybercafe and Wi-Fi Hot spot for the public.

$522,205 to Allentown School District in Lehigh County

The Family and Community Engagement & Welcome Center project involves providing a 3,650-square-foot area for central registration for Allentown School District students and families. The space will accommodate activities aimed at creating a fast and easy registration process where students are directly connected to the services they need, including workforce and health monitoring for the public.

$379,000 to the Ralpho Township Public Library in Northumberland County

This project entails the renovation and adaptation of community space within the library. The space will be equipped with amenities such as public computers and privacy pods to support the public’s ability to engage in internet enabled workforce, education, and health monitoring activities.

$787,323 to Liberty Township in Susquehanna County

This project involves the rehabilitation of a public venue, Grange Hall, to enable Liberty Township to establish a centralized hub for the community and address the public’s critical need for broadband access to essential services.

“The Biden-Harris Administration is making progress across the country to ensure Americans have access to affordable high-speed internet,” said U.S. Deputy of the Treasury Wally Adeyemo. “With these investments in libraries and other community facilities, families in Pennsylvania will gain access to critical services like health care and education.”

In addition to approving the Multi-Purpose Community Facilities funding, under the Shapiro Administration the PBDA has also:

• Announced in March 2024 that Pennsylvania secured a$20 million federal investment to provide laptops for distribution to schools, libraries, municipalities, workforce training organizations, and other non-profits who can make them available to individuals that lack the technology needed to access the internet through American Rescue Plan Capital Projects Funding. On June 18, 2024, the PBDA announced it was accepting applications for the funding.
• Governor Shapiro and Executive Director Carson announced in June 2023 the Commonwealth will receive more than$1.16 billion in federal funding to expand broadband in unserved and underserved areas to make sure every Pennsylvanian has access to affordable, high-speed internet. The funding is coming to Pennsylvania through the federal BEAD Program and is part of President Biden’s “Internet for All” initiative.
• The Shapiro Administration is also investing $204 million in funding through the Capital Projects Fund Broadband Infrastructure Program to connect unserved and underserved areas.

Visit the Pennsylvania Broadband Development Authority’s website to learn more about its work to close the digital divide in the Commonwealth.

From the Pittsburgh Post-Gazette

An emergency childbirth on the side of Route 219 in Elk County, four months after the closing of the maternity unit at the nearest hospital, is stoking health care worries in the sparsely populated county, 2½ hours northeast of Pittsburgh.

Ridgway Ambulance Corp. paramedic Missy Lecker, 54, and her crew delivered a healthy baby girl on the side of the road Sept. 24, when it became clear they were not going to make it to Penn Highlands Healthcare’s maternity hospital in Clearfield County, about 29 miles from where the call was received.

“She was in labor,” Ms. Lecker said about the 27-year-old mother. “Her water had broken.”

Penn Highlands, which reported an operating loss of $36.4 million for the year ending June 30, closed the maternity unit at its St. Marys hospital in May.

“Unfortunately, this is becoming way too commonplace with the closure of Penn Highlands Elk maternity,” the ambulance service posted on its Facebook page. Ms. Lecker declined further comment.

A Penn Highlands spokeswoman said the hospital system had no plans to reopen the closed unit at the St. Marys hospital or create a freestanding birthing center alternative for moms-to-be.

Operating losses for the eight-hospital, DuBois-based system for fiscal years ending June 30 in 2023 and 2024 totaled $68.7 million, spurring a Fitch Ratings bond issuer default and revenue bond ratings cut to BBB from A-minus in August.

Elk County is part of a six-county swath of the state — twice the size of Delaware — that has no hospital maternity care, which concerns Ridgway Borough Council member Zack Pontious, who has met with Penn Highlands officials to discuss its decision to end obstetrics services at the local hospital.

“A more vibrant, community-minded health care delivery system delivers high-quality care, even for the most basic medical needs,” he said. “We do not have that in Elk County today.”

In response, a group of local residents and business owners have formed the Elk County HealthCare Coalition, with the aim of creating an independent, countywide authority that would find ways of enhancing health care services. The county commissioners will conduct a public hearing on the proposal to create the Elk County Health Care Authority on Oct. 11.

“It did seem the idea had merit,” Elk County Commissioner Matthew G. Quesenberry said. “It’s an idea worth pursuing. They’ve got their facts together.”

The Penn Highlands spokeswoman said the health care system would continue consulting with county commissioners on the creation of the authority, but said it was premature to say whether the discussions would result in a partnership.

Elk County has a population of just 31,000, smaller than some Pittsburgh-area townships, which includes 4,500 women between the childbearing ages of 15 and 44, according to the U.S. Census.

Rural residents generally face poorer health outcomes from cancer, heart problems and other chronic diseases while rural hospitals often face bigger fiscal challenges than their urban counterparts, according to KFF Health News, a San Francisco nonprofit.

Rural health care providers often face bigger fiscal challenges than their urban counterparts, according to KFF, while studies have shown wide disparities in longevity and how well patients do in recovering from chronic diseases, depending on whether they live in rural or urban areas.

Between 2010 and 2019, 114 rural hospitals eliminated inpatient services or closed altogether while others cut specific service lines, such as obstetrics. In 2019, the year before the start of the COVID-19 pandemic, median operating margins at rural hospitals were 1.5%, which compared to 5.2% among other hospitals.

In addition to maternity care, Mr. Pontious said a health care authority could try to find physicians and other partners and solutions for a variety of health care issues in the county, including expanding primary care.

“We hear this mantra that rural health care doesn’t work,” Mr. Pontious said. “What’s interesting is that an independent authority could find creative ways to fill a number of health care gaps in the county.”

“Everything is on the table,” he said. “The problem is so big.”

The Commonwealth of Pennsylvania is taking action against the state’s high maternal mortality rate through the development of a statewide Maternal Health Strategic Plan. They are looking to learn more about what people experience and what needs they have before, during, and/or after a pregnancy, or when receiving maternal health care such as check-ups and preventive services. This survey takes approximately 10-15 minutes to complete and all questions are optional.

The survey closes on November 4th.

Click here to take the survey.

Funding supports the White House Blueprint for Addressing the Maternal Health Crisis by investing in innovative state-based strategies

The Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (HHS), announced nearly $19 million in awards to 15 states to identify and implement innovative strategies to address the maternal health crisis. HRSA Deputy Administrator Jordan Grossman, joined by Congresswoman Robin Kelly (IL-02), Chair of the Congressional Black Caucus Health Braintrust and Co-chair of the bipartisan Maternity Care Caucus, announced these awards in Chicago, IL as part of HRSA’s latest state Enhancing Maternal Health Initiative convening.

HRSA announced the availability of this funding in December 2023 at a White House roundtable on innovation in maternal health convened by the Office of the Vice President Kamala Harris and the Domestic Policy Council in support of the White House Blueprint for Addressing the Maternal Health Crisis.

“Supporting community solutions to the maternal mortality crisis means listening to moms and women with lived experience,” said HRSA Deputy Administrator Grossman. “At the Health Resources and Services Administration, we are proud to invest in our State Maternal Health Task Force initiative to create community tables across the country that are innovating and deploying community-driven solutions and strategies to advance women’s health.”

“Our nation’s crisis of maternal mortality requires urgent action. Pregnancy and birth should be one of the happiest moments for a family, but too many moms and women are suffering,” said Rep. Kelly. “I’m grateful to HRSA for elevating this conversation and for their efforts to improve maternal health outcomes in Illinois and nationwide. Together, we will ensure that every woman receives the care, support, and resources she deserves.”

State Maternal Health Innovation programs identify the key drivers of maternal mortality in their state, develop strategies and implement new interventions to address these issues tailored to their state’s needs. As part of this program, HRSA also funds State Maternal Health Task Forces that bring together health care providers, policymakers, patients, payers, and other stakeholders to develop shared solutions specific to their state’s needs and to better support pregnant women and new moms.

State Maternal Health Innovations programs have implemented a broad range of interventions to address maternal health challenges in their individual states. Examples of these interventions include early identification and treatment of hypertension to reduce preeclampsia and other risks, providing mobile simulation trainings to prepare health care providers for a range of adverse labor events, expanding access to trainings to rural and frontier hospitals that do not have a dedicated obstetrics department, and creating resources to improve first responders’ ability to respond to patients with substance use disorder during and after pregnancy.

This funding is part of the Biden-Harris Administration’s broader efforts to improve maternal health and supports HRSA’s ongoing initiative to reduce maternal mortality and health disparities. HRSA’s Enhancing Maternal Health Initiative aims to accelerate HRSA’s efforts to improve maternal health outcomes in partnership with women, grant recipients, community organizations, and state and local officials nationwide. Other key actions HRSA has taken to improve maternal health include:

• Launching the National Maternal Mental Health Hotline (833-TLC-MAMA) in 2022. The hotline provides 24/7 emotional and mental health support via call or text to expectant and new mothers and their families.
• Expanding Home Visiting services. HRSA recently awarded over $440 million in funding to expand voluntary, evidence-based home visiting services for eligible families across the country. Through the Maternal, Infant, and Early Childhood Home Visiting Program, local organizations can provide home visits from nurses, social workers, and other trained health workers who work with families to improve maternal and child health, child development and school readiness.
• Expanding Healthy Start services. HRSA recently invested $105 million in community-based organizations to improve maternal and infant health across the country through Healthy Start. Healthy Start funding will better support moms and babies to improve health in communities experiencing high disparities in maternal and infant health outcomes.
• Growing and diversifying the perinatal workforce, including doulas. HRSA has increased the number of obstetrician-gynecologists (OB/GYNs), nurses, midwives, doulas, and community health workers, especially in places without them, through grants, scholarships and loan repayment. For example, HRSA launched new programs to train more nurse midwifes who reflect the communities they serve, train and deploy more community-based doulas, and support the training of more nurse practitioners with a focus on maternal health, including in underserved and rural areas.
• Investing in new community health center efforts to address maternal health disparities. HRSA invested more than $65 million in 35 HRSA-funded health centers across the country to implement innovative approaches to improve maternal health outcomes and reduce disparities for patients at highest risk.
• Supporting maternal health care in rural communities. HRSA funds the Rural Maternity and Obstetrics Management Strategies (Rural MOMS) Program to increase access to maternal and obstetrics care in rural communities and improve health outcomes for mothers and infants. HRSA also awarded nearly $9 million over four years to five organizations to expand access to and coordinate health care services before, during, and after pregnancy in rural communities in the South.

For a complete list of State MHI awards, visit: https://mchb.hrsa.gov/programs/state-mhi/awards

See News & Announcements on HRSA.gov.