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.

The Centers for Disease Control and Prevention announced expanded eligibility for monkeypox vaccination to include pre-exposure prophylaxis (PrEP) for several high risk groups. These groups include:

• Men who have sex with men, transgender or nonbinary people who in the past 6 months have had any of the following:
• A new diagnosis of one or more sexually transmitted diseases including acute HIV, chancroid, chlamydia, or gonorrhea
• More than one sex partner
• People who in the past 6 months have had any of the following:
• Sex at a commercial sex venue (like a sex club or bathhouse)
• Sex at an event, venue, or in an area where monkeypox transmission is occurring.
• People whose sexual partner identifies with any of the above scenarios
• People who anticipate experiencing any of the above scenarios

Additionally, preliminary data has shown that those eligible who did not receive the monkeypox vaccine were about 14 times more likely to become infected than those who did receive the monkeypox vaccine. Lastly, CDC has provided additional interim clinical considerations related to intradermal administration of the monkeypox vaccine.

Pending FDA Emergency Use Authorizations (EUAs) for the new Pediatric Bivalent COVID-19 Vaccine in the next few weeks, the Centers for Disease Control and Prevention (CDC) is planning for a pre-ordering period during which certain vaccine doses will be made available to each jurisdiction based on pro-rata allocation. During this pre-ordering phase, the PA Department of Health (PA DOH) and the Philadelphia Department of Public Health will submit vaccine preorder requests on behalf of providers. For Philadelphia County the deadline to order was Sept. 27. For all other counties in the Commonwealth, the deadline to submit preorder requests is Sept. 30 at 4:00 pm. Click here to submit a vaccine request form to preorder the vaccine through the PA DOH. Please do not order pediatric Pfizer Bivalent vaccines in PA SIIS until advised to do so, as any order put on PA SIIS for this product will be deleted. Vaccine preorder requests are not guaranteed to be fulfilled, as the supply may initially be limited. Doses that are pre-ordered will be processed for delivery following the issuance of the EUA. Additionally, the deadline for HRSA Health Center COVID-19 Vaccine Program participants to pre-order Pfizer bivalent boosters for pediatric patients ages 5-11 was Sept. 28 and was capped at 100 doses per site. The updated CDC Fall Vaccination Operational Planning Guide includes more detailed information about pediatric bivalent boosters.

With students back in school, it is important for school-based telehealth providers to educate parents about how to use telehealth. This Best Practice Guide outlines how to build a school telehealth program, prepare students and guardians for school-based telehealth, the bill for telehealth, and more. (Also available in Spanish)

A blueprint for spending $279 million in federal aid for capital projects to develop broadband services was approved recently by the Pennsylvania Broadband Development Authority (PBDA). The authority at its Sept. 15 meeting approved a plan to split that amount with $200 million for an infrastructure grant program targeting locations that don’t have access to 25/3 Mbps reliable service; $45 million to finance public community projects in schools and local governments through the Digital Anchor Institution Grant Program and $20 million to increase access to laptops, tablets, and computers through the Digital Access and Opportunity Grant Program. The three programs will address broadband service infrastructure and availability, digital equity and affordability, device and technology access, and digital literacy and technical support, the board said. Click here to learn more about PBDA.