Rural Health Information Hub Latest News

Pennsylvania Broadband Authority BEAD Challenge Summary Now Available

The Pennsylvania Broadband Authority (PBDA) has posted details about the challenges received during the Challenge Submission phase of the BEAD Challenge process. The Challenge Summary can be reviewed on the PBDA’s BEAD Challenge Process webpage. The Adjudication phase is currently in-progress which means PBDA is reviewing evidence submitted during the Rebuttal phase.  All final outcomes of the Adjudication phase will be posted publicly on our website when NTIA Curing is complete.

Additional questions regarding the BEAD Challenge Process, please reach out to the PBDA via the BEAD Resource Account.

Article Published on the Integration of Primary and Oral Health

A new article in the Journal of the American Medical Association (JAMA) focuses on best practices and challenges for integrating oral health into primary care practice. “Integration of Primary and Oral Health Care – An Unrealized Opportunity” explores the solution of using a team-based approach where a variety of professionals collaborate to provide whole-person care.

Click here to read the article.

HRSA Builds Multi-state Social Worker Licensure Compact to Increase Access to Mental Health and Substance Use Disorder Treatment and Address Workforce Shortages

New investments will make it easier for social workers to practice across state lines, increase behavioral health access, and better facilitate telehealth services

Funding builds on HRSA’s work to support licensure compacts to improve access to primary care and psychology

The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced the first-ever Licensure Portability Grant Program investment in a multi-state social worker licensure compact. State licensure compacts allow states to come together on a common approach to licensing health care providers, allowing providers to practice across state lines without having to apply for a license in each state. Streamlining licensure while maintaining quality standards improves access to services both by better facilitating hiring and by easing pathways to utilizing telehealth. The announcement was made at HRSA’s National Telehealth Conference, the largest federal conference on telehealth issues.

“Social workers are essential to expanding access to behavioral health care services, a top priority of the Biden-Harris Administration,” said HHS Deputy Secretary Andrea Palm. “HRSA is leading the way in growing the behavioral health workforce both by training more providers and by breaking down barriers to allow the workforce to make mental health and substance use disorder services more accessible across the country.”

HRSA’s new $2.5 million investment in licensure compacts will support the work to launch a social worker compact as well as HRSA’s ongoing support for building and sustaining primary care, psychology, and podiatry compacts. HRSA identified behavioral health as a priority in its state licensure compact work. Since HRSA began investing in licensure compacts, the Interstate Medical Licensing Compact and the Psychology Interjurisdictional Compact (PSYPACT) have each grown to include 40 states, Washington, D.C., and one territory.

“Social workers are on the frontlines in responding to the Administration’s priorities, including meeting children’s mental health needs, responding to the opioid epidemic, and addressing maternal depression,” said HRSA Administrator Carole Johnson. “Today’s announcement is a critical step in helping social workers serve people in need, particularly in rural and underserved communities across the country.”

Today’s awards will support the Association of Social Work Boards, the Association of State and Provincial Psychology Boards, the Federation of State Medical Boards of the United States, and the Federation of Podiatric Medical Boards in working with state licensing boards to develop and implement state policies that reduce barriers to telehealth and allow for practice across state lines.

HRSA’s National Telehealth Conference brings public and private sector leaders together to discuss telehealth best practices to expand services in underserved and rural communities. This year, over 2,000 individuals registered to explore the future of telehealth including innovation, policy, and licensure issues.

To learn more about the Licensure Portability Grant Program, visit the Licensure Portability Grant Program Awardees webpage.

For more information on HRSA’s telehealth health work, visit the Office for the Advancement of Telehealth webpage.

Rural Hospitals Built During Baby Boom Now Face Baby Bust

OSKALOOSA, Iowa — Rural regions like the one surrounding this southern Iowa town used to have a lot more babies, and many more places to give birth to them.

At least 41 Iowa hospitals have shuttered their labor and delivery units since 2000. Those facilities, representing about a third of all Iowa hospitals, are located mostly in rural areas where birth numbers have plummeted. In some Iowa counties, annual numbers of births have fallen by three-quarters since the height of the baby boom in the 1950s and ’60s, when many rural hospitals were built or expanded, state and federal records show.

Similar trends are playing out nationwide, as hospitals struggle to maintain staff and facilities to safely handle dwindling numbers of births. More than half of rural U.S. hospitals now lack the service.

“People just aren’t having as many kids,” said Addie Comegys, who lives in southern Iowa and has regularly traveled 45 minutes each way for prenatal checkups at Oskaloosa’s hospital this summer. Her mother had six children, starting in the 1980s, when big families didn’t seem so rare.

“Now, if you have three kids, people are like, ‘Oh my gosh, are you ever going to stop?’” said Comegys, 29, who is expecting her second child in late August.

These days, many Americans choose to have small families or no children at all. Modern birth control methods help make such decisions stick. The trend is amplified in small towns when young adults move away, taking any childbearing potential with them.

Hospital leaders who close obstetrics units often cite declining birth numbers, along with staffing challenges and financial losses. The closures can be a particular challenge for pregnant women who lack the reliable transportation and flexible schedules needed to travel long distances for prenatal care and birthing services.

Read more.

Maternal Mortality Rates Released, State by State

KFF has released a new analysis outlining maternal mortality rates for every state and Washington, D.C.

KFF used 2018-22 data from the CDC’s National Center for Health Statistics to compile maternal deaths and mortality rates. Maternal deaths are defined as deaths of women while pregnant or within 42 days of pregnancy termination. Only causes of death from or aggravated by pregnancy are included.

Nationwide, 4,295 maternal deaths were reported between 2018 and 2022, resulting in a maternal mortality rate of 23.2 deaths per 100,000 live births. The U.S. has the highest maternal mortality rate of any developed nation, according to The Commonwealth Fund.

To address this issue, CMS has proposed adding obstetrical standards for hospitals as part of its conditions of participation requirements. Hospitals and physicians have pushed back on the suggestion, arguing the approach is too punitive and could inadvertently hinder access to obstetrical care.

Below is a breakdown of maternal mortality rates by state.

Note: KFF expressed caution at making comparisons between states, as data for many states are based on small numbers and could be statistically unreliable. The organization suppressed data for several states, if mortality rates were based on fewer than 20 deaths. Variation in state rates is likely due to differences in the quality of maternal mortality data, KFF said.

Tennessee
Maternal mortality rate: 41.1
Number of deaths: 166

Mississippi
Maternal mortality rate: 39.1
Number of deaths: 70

Alabama
Maternal mortality rate: 38.6
Number of deaths: 112

Arkansas
Maternal mortality rate: 38.3
Number of deaths: 69

Louisiana
Maternal mortality rate: 37.3
Number of deaths: 108

Kentucky
Maternal mortality rate: 34.6
Number of deaths: 91

Virginia
Maternal mortality rate: 32.7
Number of deaths: 158

South Carolina
Maternal mortality rate: 32.3
Number of deaths: 92

Georgia
Maternal mortality rate: 32.1
Number of deaths: 201

Indiana
Maternal mortality rate: 30.9
Number of deaths: 124

Arizona
Maternal mortality rate: 30
Number of deaths: 118

Oklahoma
Maternal mortality rate: 29.6
Number of deaths: 72

Texas
Maternal mortality rate: 28.2
Number of deaths: 532

New Mexico
Maternal mortality rate: 28
Number of deaths: 31

North Carolina
Maternal mortality rate: 26.7
Number of deaths: 159

New Jersey
Maternal mortality rate: 26
Number of deaths: 131

Nebraska
Maternal mortality rate: 25.1
Number of deaths: 31

Ohio
Maternal mortality rate: 24.5
Number of deaths: 161

Florida
Maternal mortality rate: 24.1
Number of deaths: 263

West Virginia
Maternal mortality rate: 23.9
Number of deaths: 21

Missouri
Maternal mortality rate: 23.8
Number of deaths: 84

Kansas
Maternal mortality rate: 22.8
Number of deaths: 40

New York
Maternal mortality rate: 22.4
Number of deaths: 241

Maryland
Maternal mortality rate: 21.3
Number of deaths: 74

Nevada
Maternal mortality rate: 20.4
Number of deaths: 35

Idaho
Maternal mortality rate: 20
Number of deaths: 22

Iowa
Maternal mortality rate: 19.5
Number of deaths: 36

Michigan
Maternal mortality rate: 19.1
Number of deaths: 101

Illinois
Maternal mortality rate: 18.1
Number of deaths: 123

Washington
Maternal mortality rate: 18
Number of deaths: 76

Pennsylvania
Maternal mortality rate: 17.5
Number of deaths: 116

Oregon
Maternal mortality rate: 16.6
Number of deaths: 34

Massachusetts
Maternal mortality rate: 16.4
Number of deaths: 56

Colorado
Maternal mortality rate: 16
Number of deaths: 50

Connecticut
Maternal mortality rate: 15.6
Number of deaths: 27

Utah
Maternal mortality rate: 15.5
Number of deaths: 36

Wisconsin
Maternal mortality rate: 13.2
Number of deaths: 41

Minnesota
Maternal mortality rate: 12.3
Number of deaths: 40

California
Maternal mortality rate: 10.5
Number of deaths: 228

Alaska
Maternal mortality rate: Data suppressed
Number of deaths: 12

Delaware
Maternal mortality rate: Data suppressed
Number of deaths: 9

District of Columbia
Maternal mortality rate: Data suppressed
Number of deaths: 12

Hawaii
Maternal mortality rate: Data suppressed
Number of deaths: 13

Maine
Maternal mortality rate: Data suppressed
Number of deaths: 7

Montana
Maternal mortality rate: Data suppressed
Number of deaths: 17

New Hampshire
Maternal mortality rate: Data suppressed
Number of deaths: 11

North Dakota
Maternal mortality rate: Data suppressed
Number of deaths: 11

Rhode Island
Maternal mortality rate: Data suppressed
Number of deaths: 9

South Dakota
Maternal mortality rate: Data suppressed
Number of deaths: 16

Vermont
Maternal mortality rate: Data suppressed
Number of deaths: 1

Wyoming
Maternal mortality rate:  Data suppressed
Number of deaths: 7

Pennsylvania Fluoride Study Featured in Journal of the American Dental Association

A Pennsylvania-based study will be featured in the upcoming August issue of the Journal of the American Dental Association (JADA). “Cross-sectional study of association between caries and fluoridated water among third-grade students in Pennsylvania,” authored by Pennsylvania Department of Health Oral Health Program epidemiologist Dr. Jun Yang, also features PCOH Executive Director Helen Hawkey as a co-author. The study found that community water fluoridation was significantly associated with a reduced risk of developing caries among Pennsylvania children.

Click here to read the article.

Oral Health and Nicotine/Tobacco Updates Available

The Association of State and Territorial Dental Directors (ASTDD) Dental Public Health Policy Committee announced a new policy statement on preventing tobacco/oral nicotine use to promote oral health. The statement provides information on the impacts to oral and overall health as well as guidance identifying effective strategies in prevention.

Click here to read the statement.

The World Health Organization (WHO) released the first-ever “Clinical Treatment Guidelines for Tobacco Cessation in Adults.” The guidelines include a set of cessation interventions for adults seeking to quit all kinds of tobacco products. These guidelines are designed to help communities and governments provide the best possible support for adults trying to quit tobacco products.

Click here to read the guidelines.

Free Clinic Association Rebrands as Pennsylvania Charitable Healthcare Coalition; Launches GiveCare Now

GiveCare Now, a statewide call for volunteer talent, including medical & dental professionals

Launching a statewide call for volunteer talent and medical professionals, the Free Clinic Association of Pennsylvania today announced a rebrand, as the organization is relaunched as the Pennsylvania Charitable Healthcare Coalition.

The organization represents charitable healthcare providers across Pennsylvania that fill a critical role, providing high-quality, free care for people who are under-insured or uninsured and lack access to care.

“Today, we’ve announced a rebrand that captures the essence of our life-changing work and launched a statewide call for volunteers to help us meet the growing needs of our communities,” said executive director Kristen Houser Rapp. “With more than 50 providers operating in the Commonwealth, free and charitable clinics deliver hope to people across Pennsylvania who lack access to healthcare. Without them, thousands of people would not have access to any type of care at all.”

Charitable healthcare providers are integral to keeping Pennsylvanians who do not qualify for Medicaid healthy, and help avoid medical debt from urgent care, emergency visits, and medications, as families move between health plans or lack other options.  While some clinics employ limited staff, the majority of clinical care is provided by volunteer talent.  

“Right now, and in the weeks and months to come, opportunities are available for volunteers to help provide care and give back to others,” said Rapp.  Anyone interested in volunteering should visit pacharitablehealth.org/volunteer, where PCHC can then connect them with a local clinic. PCHC is currently seeking volunteers that include:

  • Doctors
  • Nurses
  • Pharmacists
  • Dentists, dental assistants, & dental hygienists
  • Mental health professionals
  • Volunteers with administrative skills

Volunteer opportunities vary from clinic to clinic and by position.  All volunteers meet strict credentialing and background checks and receive training and support.

“I find that the best part of my day is always that I served in the clinic,” said Ridge Salter, M.D., a volunteer at Katallasso Family Health Center in York. “Volunteering my expertise has added so much professional fulfillment, and I know it has been an antidote — and a bit of an immunization — to burnout.”

In 2023 alone, PCHC member clinics provided at least 114,000 appointments for patients, averaging more than 3,000 per clinic.

“In the last year, hundreds of thousands of people in our state have lost their Medicaid coverage,” said Mary Herbert, MPH, MS, Clinical Director at The Program for Health Care to Underserved Populations/Birmingham Free Clinic in Pittsburgh.  “Despite their lack of state funding, free providers face the need to accommodate a major shift in the number of patients we serve, doing more than ever with limited resources.”

“PCHC’s member clinics and charitable providers fill a growing gap that many of our most vulnerable neighbors rely on for basic care, and volunteers are critical to this work,” said Highmark Foundation President Yvonne Cook. “The Highmark Foundation recognizes the vital work of charitable clinics and is proud to continue our partnership with PCHC through a $172,700 grant to further its mission to provide equitable, quality health care for all Pennsylvanians.”

 ABOUT THE PENNSYLVANIA CHARITABLE HEALTHCARE COALITION (PCHC)

PCHC is the support and advocacy organization for free and charitable healthcare providers who make up the healthcare safety net for uninsured and underinsured Pennsylvanians. Free and charitable clinics provide primary and preventative care such as medical screenings, chronic disease management, medication assistance, dental care and connections to other social services. Clinics do not receive state or federal funding and rely on community support. For information, testimonials from volunteers, and a searchable database of clinic locations, go to www.pacharitablehealth.org.