Rural Health Information Hub Latest News

Expanded Home-Heating Assistance is Available to PA Renters, Homeowners

As winter approaches and we prepare to spend even more time indoors, utility bills are only going to get more expensive. Additionally, we know that the COVID-19 pandemic and economic downturn have made it difficult for many to keep up with home energy bills.

No Pennsylvanian should ever have to worry that their heat will be shut off during the coldest and darkest months of the year.

The Low-Income Home Energy Assistance Program (LIHEAP) is a federally funded program administered by the Department of Human Services (DHS) that provides assistance for home heating bills so Pennsylvanians can stay warm and safe during the winter months. Assistance is available for both renters and homeowners. LIHEAP helps some of the commonwealth’s most vulnerable citizens — children, older Pennsylvanians, people with disabilities, and low-income families — make ends meet.

Anyone who may need help, or anyone who has loved ones or neighbors who could benefit from this program, is encouraged to apply for LIHEAP today.

LIHEAP FACTS

How do I apply for LIHEAP?
Depending on preference, different options are available to apply for LIHEAP:

  • Apply online: Pennsylvanians can apply at www.compass.state.pa.us.
  • Paper applications: Call the LIHEAP Helpline at 1-866-857-7095 to request a paper application. Paper applications can also be downloaded from the DHS LIHEAP web page.
  • County Assistance Office (CAO) services are available if clients cannot access online services or need assistance that cannot be accessed through the COMPASS website.

How long does LIHEAP season last?
The LIHEAP application period is now open and runs until May 6, 2022.

If I’m approved, how will I receive LIHEAP assistance?
LIHEAP is distributed directly to a household’s utility company or home heating fuel provider in the form of a grant. Individual or households do not have to repay assistance.

How do I know if I’m eligible?
The income limit for the program is 150 percent of the Federal Poverty Limit — for a household of four, this would be $39,750 gross income per year. Pennsylvanians do not need to know their own eligibility in order to apply for these programs. Those who applied and were denied previously but have experienced a change in circumstances can reapply.

How many Pennsylvanians receive LIHEAP assistance?
During the 2020-21 LIHEAP season:

  • 303,123: Households receiving LIHEAP cash assistance
  • 116,639: Households receiving LIHEAP Crisis Grants
  • $84,919,469: LIHEAP Cash benefits
  • $50,763,178: LIHEAP Crisis Grant benefits
  • $280: Average cash benefits per household
  • $435: Average Crisis Grant benefit per household

2021-2022 SEASON CHANGES

Due to the availability of funds through the federal American Rescue Plan Act, DHS is able to provide increased LIHEAP benefits for this season.

  • Season Extension: The 2021-2022 season will be extended one month. Instead of starting in November and ending in April, the season opened in October and closes in May.
  • Minimum Cash Grant: Eligible households will see an increase from $200 to $500.
  • Maximum Cash Grant: The maximum grant will increase from $1,000 to $1,500 for eligible households.

LIHEAP crisis grant: The benefit for people who meet the poverty limits and are in jeopardy of having their heating utility service terminated will see the maximum crisis grant increase from $800 to $1,200.

Additional Resources

THE EMERGENCY RENTAL ASSISTANCE PROGRAM (ERAP) is also available in each of Pennsylvania’s 67 counties to help eligible tenants cover the cost of overdue or upcoming rent and utilities payments. Pennsylvanians who are responsible for paying rent or utilities on a residential property, and have one or more people within the household who has experienced financial hardship during the COVID-19 pandemic that puts them at risk of homelessness or a utility shutoff, could be eligible for up to 18 months of ERAP assistance.

Former PA Secretary of Health Sworn in as First Openly Transgender Four-star Admiral

A senior Biden health appointee who made history when she became the nation’s highest-ranking openly transgender official has also become its first openly transgender four-star officer.

Rachel Levine, the U.S. assistant secretary for health, was sworn in Tuesday as an admiral of the U.S. Public Health Service Commissioned Corps, a 6,000-person force that responds to health crises on behalf of the federal government, including administering coronavirus vaccines and delivering care after hurricanes. Levine is also the organization’s first-ever female four-star admiral.

The move was hailed by advocacy groups like the gay rights organization GLAAD, and health care leaders who called it a breakthrough moment.

The group representing public health officials “is here to support you and your team defend the health of all Americans!” Michael Fraser, CEO of the Association of State and Territorial Health Officials, wrote on Twitter.

Some conservatives, meanwhile, dismissed the swearing-in as a political gesture. “Biden gang playing quota politics with public health service,” Tom Fitton, president of conservative legal group Judicial Watch, wrote on Facebook.

In an interview, Levine stressed that her new position as an admiral was “not just symbolic,” and that she would take a leadership role in shaping the public health corps’ priorities. “I’m doing this because of my dedication to service . . . [and] with the utmost respect and honor for the uniform that I will be wearing,” Levine said, adding she would begin wearing the group’s blue uniform immediately.

The public health service is one of the nation’s eight uniformed services, although it is distinct from the six military services – including the Navy, Army and Air Force – by explicitly focusing on medical issues. The National Oceanic and Atmospheric Administration Commissioned Officer Corps, whose officers command vehicles that probe hurricanes and map the seafloor, is also a uniformed service.

The 63-year-old Levine, who was previously Pennsylvania’s health secretary and had not served in the commissioned corps, is now set to take a more prominent role in the service’s operations. She will be the sixth four-star admiral in the corps’ history, according to the Department of Health and Human Services.

Political appointees are regularly tapped for senior roles in the corps. Brett Giroir, Levine’s predecessor during the Trump administration, was sworn in as an admiral after his 2018 Senate confirmation. Vivek H. Murthy, the nation’s surgeon general, also serves as a vice admiral.

The long-running health corps traces its history to 1798, but the service was formally established by Congress in 1889. The oft-overlooked corps has struggled with retirements and visibility; it was slow to get access to its own supply of coronavirus vaccines, even as its officers helped deliver shots around the nation.

Administration officials touted the significance of Levine’s elevation to admiral, praising President Joe Biden’s commitment to diversity and noting that the ceremony will occur during LGBTQ history month.

How to Read a Study About Fluoride or Fluoridation

A new guide jointly produced by the British Fluoridation Society and the American Fluoridation Society, “How to Read a Study About Fluoride or Fluoridation,” can help dental and public health professionals strengthen their ability to assess water fluoridation research quality. The guide offers nine scientifically-based suggestions for assessing the quality of published research. The guide is accompanied by a “spoof research paper” that can be used to to apply these nine suggestions.

Click here to access the guide.

WHO Adds Dental Treatments to Essential Medicines List

The World Health Organization (WHO) added glass ionomer cement, silver diamine fluoride, and topical fluoride-containing preparations such as toothpaste in its updated “Model List of Essential Medicines for Adults and Children.” This is the first time that the WHO has deemed the dental preparations to be essential. The listings aim to address global health priorities, identifying the medicines that provide the greatest benefits, and which should be available and affordable for all.

Click here for more information.

Order Your 2021-2022 Medicare Calendars

The 2021-2022 Medicare Calendar is Now Available!

Go to the CMS Product Ordering Website (POW) to place your orders now.  Look under the Featured Medicare button on the home page, or type “Calendar” into the Search box and hit Enter.  Click the link below to login to your POW account.

CMS POW Login Page

Now Available: White Paper about CMS Innovation Center Strategy

The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMS Innovation Center) is pleased to release our white paper detailing the vision for the Center over the next 10 years titled, “Driving Health System Transformation – A Strategy for the CMS Innovation Center’s Second Decade.”

The goal of this bold, new strategy is to achieve equitable outcomes through high-quality, affordable, person-centered care, carried out through five strategic objectives: Drive Accountable Care, Advance Health Equity, Support Innovation, Address Affordability, and Partner to Achieve System Transformation. These strategic objectives will guide the CMS Innovation Center’s models and priorities, and progress for each goal will be measured periodically to assess the CMS Innovation Center’s work and impact.

For additional information about the strategy, visit: https://innovation.cms.gov/strategic-direction. Additionally, we hope you will join CMS Administrator Chiquita Brooks-LaSure and CMS Innovation Center Director, Liz Fowler for a webinar about the CMS Innovation Center’s strategic direction today, October 20, at 1:00 p.m. EDT. Registration is open.

Lessons About Treating Opioid Use Disorder in Remote Areas

The most sparsely populated regions of the American West often are unable to provide local treatment for opioid use disorder. Long driving distances can be a barrier for people who need treatment, so the issue has ramifications for the health and wellness of many residents across the most rural areas of the country.

A team of researchers from Penn State and JG Research and Evaluation recently examined the effectiveness of a successful model for rural treatment of opioid use disorder in Montana, one of the nation’s most sparsely populated states.

Opioids are highly addictive, and opioid use disorder is difficult to treat. Fortunately, many people who experience opioid use disorder can reach recovery. Most treatment programs, however, are very intensive and require specialized care, highly regulated medication, and daily or weekly clinical visits. Because of this intensive specialization, people in rural areas who experience opioid use disorder often lack access to local treatment.

To address the lack of services for people with opioid use disorder in rural areas, researchers and clinicians in Vermont developed a model of care for opioid treatment. People with opioid use disorders from remote areas are stabilized at addiction care facilities in more populous areas and then receive ongoing care at rural primary care clinics that have established partnerships with these addiction care facilities. Based on this model’s success in Vermont, it has been deployed in many rural areas across the nation.

Danielle Rhubart, assistant professor of biobehavioral health at Penn State, co-authored an article in the journal Substance Abuse: Research and Treatment that evaluated the application of the Vermont model in Montana.

“There are people in Montana who have to drive 100 or even 200 miles one way to reach a physician who can prescribe medical treatments for opioid use disorder,” Rhubart explained. “This is fundamentally very different from Vermont, which is only about 80 miles wide. The model that is used in Vermont has been very successful, and a lot of good science has validated it. We needed to know, however, whether what worked in Vermont was applicable in a state as remote as Montana.”

The researchers found that the Vermont model was not successfully adopted in Montana. Addiction care facilities in Montana were often unsuccessful at forming partnerships with rural primary care offices. The rural providers who were interviewed for this research were concerned about a variety of interrelated issues.

Geographic concerns were one of the reasons that primary care physicians were reluctant to enter into addiction-care partnerships. The total area of Montana is nearly 150,000 square miles, while the area of Vermont is less than 10,000 square miles. Though Montana is home to more people, there are between nine and 10 times as many people per square mile in Vermont as there are in Montana. Prior research has shown that there are important differences between rural areas that are adjacent to urban areas compared with rural areas that are distant from urban areas. People in more remote rural areas, like most of Montana, are much less likely to have access to a variety of services. Physicians were concerned that the lack of trained staff who lived in their area would make implementing the program impractical.

The lack of available staff was cited by some rural primary care physicians as a reason not to participate in opioid use disorder treatment programs. According to the researchers, behavioral health services are more widely available in Vermont than in rural Montana. This lack of medical staff and support services led many rural health care providers in Montana to believe that they would be unable to recruit and retain staff to run an opioid use disorder treatment program.

Some rural providers in Montana reported that they did not want to participate in treatment because they were concerned that the demand would overwhelm their capacity to provide high quality care. Primary care facilities in some of the most rural and remote portions of the state cited the lack of available behavioral health staff in the area as a reason to suspect that, if they started an opioid use disorder program, they would not be able to address their patients’ needs.

In addition, there is a stigma associated with treating people with opioid use disorder in some rural areas, and some physicians expressed fear that they would lose patients if they prescribed these medications.

“The differences between Vermont and Montana go beyond population density,” Rhubart explained. “Cultures differ too. In our study, we found that some rural physicians’ offices in Montana preferred an informal relationship with addiction-treatment facilities to a formal partnership. Rural providers welcomed technical assistance, but were hesitant to formalize long-term partnerships.

One of the most significant barriers to treating opioid use disorder in rural areas is the special license required for prescribing the appropriate medication. There is concern that the medication could be abused as a street drug, so it is highly regulated. In addition, physicians expressed concerns that the Vermont model would not be financially viable for their practices.

This research shows that for treatment of opioid use disorder — and other health issues — there is no one-size-fits-all solution for rural areas.

“When states develop treatment models for opioid use disorder, public health officials must account for local variations in culture, stigma, and access to resources so that rural physicians are not overwhelmed by the prospect of treating people in need,” Rhubart explained. “Program and partnership buy-in from physicians requires attention to the geographic, economic, and cultural norms of a community. These factors are essential for developing care models that effectively support those with opioid use disorder.”

PA Disabilities Council Announces Funding Opportunities

The Pennsylvania Developmental Disabilities Council (PADDC) is pleased to announce that the first Request for Application (RFA) book for 2022-2026 State Plan is now available for download, which includes 13 separate grant opportunities. The deadline to submit applications for these grants is December 1, 2021.

Click here to read more and download the RFA book and other application resources.

In addition, PADDC is offering funding on a rolling basis through our Community Grants Program.

Get more information about the Community Grants Program.

New Policy Brief on Effects of System Affiliation on Rural Hospitals

The Flex Monitoring Team has released a new policy brief, The Association Between System Affiliation and Financial Performance in Critical Access Hospitals.

There is growing evidence to suggest that affiliation with a health system may have important implications for rural hospitals. However, most studies have not investigated the effects of system affiliation on CAHs, specifically, and it is important for hospitals and state Flex programs to anticipate the consequences and potential impact of system affiliation.

The purpose of this study is to examine the association between system affiliation and the financial indicators included in the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS).

Make Health Information Understandable During Health Literacy Month

During October, the CMS Office of Minority Health (OMH) recognizes Health Literacy Month. We encourage healthcare providers to make health information easier for their patients to understand and navigate.

Healthy People 2030—an initiative that identifies public health priorities to help individuals, organizations, and communities across the United States improve health and well-being across a 10-year timeframe—addresses both personal health literacy and organizational health literacy. According to Healthy People 2020:

  • Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
  • Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

These definitions allow us to emphasize people’s ability to use health information rather than just understand it, focus on the ability to make “well-informed” decisions rather than just “appropriate” ones, incorporate a public health perspective into decision making, and acknowledge that organizations have a responsibility to address health literacy.

Hispanic adults have been shown to have the lowest level of health literacy among racial and ethnic groups, followed by Black adults and American Indian/Alaskan Native adults. Additionally, Spanish-speaking adults have an increased likelihood of inadequate health literacy, when compared to English-speaking adults.

Those with low health literacy are more likely to use the emergency department. And parents’ health literacy levels impact health outcomes for children.

The effects of low health literacy can be particularly pronounced for those over 65, with low health literacy possibly leading to poor physical functioning, pain, limitations of daily activities, and poor mental health status.

Resources

To mark Health Literacy Month, we’re highlighting resources that can help providers better explain the services that are available to their patients through their health coverage:

Download the Guide to Developing a Language Access Plan, which helps assess programs and develop language access plans to ensure persons with limited English proficiency have meaningful access to care and services.