Rural Health Information Hub Latest News

Household Rental Debt During COVID-19: Update for August 2021

Posted on by lad3

With the Centers for Disease Control and Prevention’s national eviction moratorium set to expire on July 31, 2021, new research estimates that nearly 2 million U.S. renter households will owe over $15 billion in back rent and utilities by August 2021 because of job loss or involuntary part-time work during the COVID-19 pandemic. The report updates forecasts from our March 2021 report with employment data through June and includes breakouts for each state.

These are estimates of rental debt prior to the distribution of emergency rental assistance. The estimates can help shed light on the extent to which rental assistance distributed thus far has addressed the needs of the most financially distressed households.

Read the report.

CMS: Requirements Related to Surprise Billing; Part I Video Released

Posted on by lad3

Earlier this month, the Biden-Harris Administration, through the U.S. Departments of Health and Human Services (HHS), Labor, and Treasury, and the Office of Personnel Management, issued “Requirements Related to Surprise Billing; Part I,” an interim final rule that will restrict excessive out of pocket costs to consumers from surprise billing and balance billing. Surprise billing happens when people unknowingly get care from providers that are outside of their health plan’s network and can happen for both emergency and non-emergency care. Balance billing, when a provider charges a patient the remainder of what their insurance does not pay, is currently prohibited in both Medicare and Medicaid. This rule will extend similar protections to Americans insured through employer-sponsored and commercial health plans.

“No patient should forgo care for fear of surprise billing,” said HHS Secretary Becerra. “Health insurance should offer patients peace of mind that they won’t be saddled with unexpected costs. The Biden-Harris Administration remains committed to ensuring transparency and affordable care, and with this rule, Americans will get the assurance of no surprises.”

Yesterday, we were able to publish a new 5 Things video which is a bite-size consumer friendly explainer of Round 1 of the No Surprises Act. https://www.youtube.com/watch?v=JMDEykNNZa8

The full press release with embedded links to fact sheets and the interim rule can be accessed here.

56th Anniversary of Medicare and Medicaid

Posted on by lad3

On July 30, 1965, President Lyndon B. Johnson signed into law legislation that established the Medicare and Medicaid. For 56 years since, these programs have helped to protect the health and well-being of millions of Americans throughout all of life’s key moments. HHS Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure released the following statements to mark the 56th anniversary of Medicare and Medicaid today:

“For decades, Medicare and Medicaid have been a lifeline and a steady foundation for our seniors, children, women, families, people with disabilities, and at every stage in life,” said HHS Secretary Xavier Becerra. “Nearly 140 million Americans have health insurance coverage through either Medicare or Medicaid. As we mark their 56th anniversary, the Biden-Harris Administration is proud to celebrate, strengthen, and expand these programs which have improved the health and wellbeing of the American people. President Biden’s Build Back Better agenda will extend Medicaid’s coverage to those who need it most and give older Americans additional benefits they critically need. Throughout my career, I’ve championed these vital programs for America’s families and seniors, and as HHS Secretary, I will work with President Biden to build upon Medicare and Medicaid for generations to come.”

“For 56 years, Medicare and Medicaid have made health coverage a reality for individuals and families when they have needed it,” said CMS Administrator Chiquita Brooks-LaSure. “When President Lyndon Johnson called on Congress to spare the Nation’s seniors of ‘the darkness of sickness without hope,’ nearly half of seniors were uninsured, most hospitals around the country were segregated, and health coverage was out of reach for many. Medicare and Medicaid were critical steps forward in the fight for civil rights that brought the peace of mind that health coverage provides to many, made health care access more equitable by requiring the integration of hospitals, and improved health outcomes across the country. Today, nearly 140 million Americans have coverage thanks to Medicare and Medicaid.  The health needs of those who rely on these vital CMS programs are always evolving, and because of that, the Biden-Harris Administration will continue to work to expand and strengthen Medicare and Medicaid so they remain quality and reliable health programs.  Ensuring these programs also work to advance health equity nationwide is also a top priority for CMS. Access to health coverage is a right and no one should be left out, left behind, or left on the sidelines.”

For more on the statements, visit: https://www.hhs.gov/about/news/2021/07/29/hhs-secretary-xavier-becerra-cms-administrator-chiquita-brooks-lasure-56th-anniversary-medicare-medicaid.html

Social Media

Join us in celebrating the anniversary today, by sharing the posts in our toolkit found here: https://www.cms.gov/files/document/56thanniversarysocialmediatoolkit.pdf; and links to the zip file here: https://www.cms.gov/files/zip/56thanniversary.zip.

You can also join the Twitter Storm at 12 p.m. local time today, please post on Twitter (and other social media platforms) using hashtag #56Covered with a graphic from this toolkit to celebrate the anniversary of Medicare and Medicaid.

Even Before Coronavirus, Almost Half of Adults in Rural Areas Went Without Dental Care

Posted on by lad3

Millions of rural residents have not seen a dentist in over a year, a recent CDC report reveals.

In 2019, before the coronavirus pandemic forced dentists to shut down, 42 percent of adults in rural areas did not receive dental care, according to the survey. In urban areas, roughly a third of adults did not see a dentist that year.

In both groups, people of color and low-income residents were less likely to have seen a dentist in 2019. These disparities were wider in rural areas, where issues such as transportation barriers, dentist and dental hygienist shortages and lack of health insurance are more common. The coronavirus pandemic has likely exacerbated the need, especially for low-income patients, the report says.

Read more.

Oral Health Care of People with Special Health Care Needs

Posted on by lad3

The Association of State and Territorial Dental Directors (ASTDD) Best Practices Committee shared an updated Best Practice Approach Report, “Oral Health Care of People with Special Health Care Needs.” This report is the result of efforts by the ASTDD Best Practices Committee to identify and provide information on developing successful practices that address people with special health care needs.

Click here to read the report.

Funding Opportunity: HRSA Residency Programs

Posted on by lad3

The Health Resources and Services Administration (HRSA) is offering grant funding through the Teaching Health Center Planning and Development Program. This funding will create new community-based residency programs to increase the primary care workforce in rural and underserved communities. Up to 50 grantees will receive a total of approximately $25 million over two years to establish these residency programs or rural residency training tracks in family medicine, internal medicine, pediatrics, internal medicine-pediatrics, psychiatry, obstetrics, and gynecology, general dentistry, pediatric dentistry, or geriatrics. The technical assistance webinar is August 5th at 2 pm ET and the application deadline is August 30th.

Click here for more information.
Click here to join the webinar on August 5th.

Vaccination to Prevent COVID-19 Outbreaks with Current and Emergent Variants — United States, 2021

Posted on by lad3

Summary
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network Health Advisory to notify public health practitioners and clinicians about the urgent need to increase COVID-19 vaccination coverage (i.e., the percentage of the population fully vaccinated) across the United States to prevent surges in new infections that could increase COVID-19 related morbidity and mortality, overwhelm healthcare capacity, and widen existing COVID-19-related health disparities. Increasing vaccination coverage is especially urgent in areas where current coverage is low. Unvaccinated persons account for the majority of new COVID-19 infections, hospitalizations, and deaths. Currently circulating SARS-CoV-2 variants of concern, especially the highly infectious Delta variant (B.1.617.2), are accelerating spread of infection. Unvaccinated and partially vaccinated people need to practice all recommended prevention measures until fully vaccinated. In areas with substantial and high transmission, CDC recommends that fully vaccinated individuals wear a mask in public indoor settings to help prevent the spread of Delta and protect others.

Background
COVID-19 case rates are rising again after a period of decline: COVID-19 cases have increased over 300% nationally from June 19 to July 23, 2021, along with parallel increases in hospitalizations and deaths driven by the highly transmissible B.1.617.2 (Delta) variant. While significant progress has been made to make COVID-19 vaccine widely available, disparities in vaccination coverage persist across population groups and geographic areas. As of July 23, 2021, 1,856 (63.0%) of the 2,945 counties with available vaccination data have particularly low vaccination coverage, defined here as <40% of the population being fully vaccinated. As of July 23, 2021, among the counties with vaccine coverage <40%, 36.0% (N = 668) have COVID-19 incidence rates in the high burden level (≥100 cases/100,000 over the last seven days) (see figure below, and further data at COVID Tracker).

Overall, the majority (81.4%) of counties with high COVID-19 incidence rates are found in communities with low vaccination coverage. As COVID-19 case counts continue to rise nationally, areas with lower vaccination coverage are at especially high risk for a surge in cases.

Most cases of COVID-19 and hospitalizations are in unvaccinated individuals:  While COVID-19 vaccines authorized in the United States remain effective against SARS-CoV-2 infection and severe disease, some infections among vaccinated persons (i.e., breakthrough infections) are anticipated and have been reported. However, the majority of COVID-19 cases and hospitalizations are occurring among individuals who are not fully vaccinated.  From January through May 2021, of the more than 32,000 laboratory-confirmed COVID-19-associated hospitalizations in adults ≥18 years of age for whom vaccination status is known, <3% of hospitalizations occurred in fully vaccinated persons.

The COVID-19 Delta variant is widely prevalent and more infectious than prior strains: The COVID-19 Delta variant currently accounts for more than 80% of all COVID-19 cases in the United States. This variant is significantly more infectious than prior SARS-CoV-2 variants and has led to a rapid rise in COVID-19 cases in other countries, including the United Kingdom and Israel. Emerging evidence suggests that fully vaccinated people who do become infected with the Delta variant are at risk for transmitting it to others.

COVID-19 vaccination is our most effective strategy to prevent infection and severe disease: Vaccination is a priority national strategy to interrupt SARS-CoV-2 transmission, protect personal and public health, and preserve healthcare system capacity. COVID-19 vaccines are safe and recommended for all persons aged 12 years of age and older, even for those with prior SARS-CoV-2 infection.  Immunologic data support the role of Food and Drug Administration (FDA)-authorized COVID-19 vaccines in offering protection against the known currently circulating variants. By limiting viral spread, vaccination also minimizes opportunities for the introduction of more infectious variants through random mutation. Mutations could produce future variants that are more virulent and capable of evading diagnostic and therapeutic tools or overcoming vaccine-induced immunity.

COVID-19 vaccination coverage at skilled nursing facilities (SNF) helps prevent infection: Nursing home residents have been severely impacted by COVID-19 and are disproportionately represented in overall burden of COVID-19-related morbidity and mortality in the United States. While there has been significant progress in vaccinating SNF residents, vaccination coverage of staff at many facilities remains low. Preliminary data from CDC’s National Healthcare Safety Network (NHSN) indicate residents of SNFs in which vaccination coverage of staff is 75% or lower experience higher crude rates of preventable COVID infection.

CDC recommends urgent action by all: CDC recommends continued efforts to accelerate primary vaccination efforts, especially in areas with lower vaccination coverage. Individuals who are not fully vaccinated need to maintain all recommended prevention measures. People who are immunocompromised should be counseled about the potential for reduced immune responses to COVID-19 vaccines and to follow current prevention measures to protect themselves against COVID-19 until advised otherwise by their healthcare provider.  CDC recommends ensuring tailored, culturally responsive, and linguistically appropriate communication of vaccination benefits (see vaccine equity resources below).

Recommendations for Public Health Jurisdictions

  • Continue and increase efforts to reach and partner with communities to encourage and offer vaccination. Co-lead the conversation by participating in community education and outreach events.
  • Leverage resources to promote vaccine equity.
  • Encourage clinicians to offer and recommend COVID-19 vaccination to their patients and community members.
  • Work with community partners to make vaccination easily accessible for unvaccinated populations.
  • Implement additional prevention strategies when transmission is high and vaccination coverage is low (MMWR).
  • Continue to monitor community transmission levels, variant, and vaccination coverage levels, and focus vaccine efforts on populations with low coverage.
  • Communicate vaccination coverage, variant, and transmission levels to key partners, including the key information on risk associated with the B.1.617.2 (Delta) variant.

Recommendations for Clinicians

  • If you are a clinical provider and are not fully vaccinated, get vaccinated as soon as possible to protect yourself, your family, and your patients.
  • Increase patient outreach efforts to encourage, recommend, and offer COVID-19 vaccination.
  • Remind patients that vaccination is recommended for all persons aged 12 years of age and older, even for those with prior SARS-CoV-2 infection. Follow trusted sources carefully for any new recommendations and changes in vaccine guidance.
  • Support efforts to ensure people receiving a first dose of a COVID-19 mRNA vaccine (i.e., Pfizer-BioNTech or Moderna) return for their second dose to complete the series.
  • Communicate with unvaccinated staff, patients, and other individuals to increase confidence in vaccination. CDC has many resources for providers to help increase vaccine confidence .
  • Recommend that fully vaccinated patients who are immunocompromised continue to practice all recommended prevention measures for unvaccinated persons.

Recommendations for Healthcare Facilities and Systems, Nursing Homes, and Businesses

  • Recommend and offer COVID-19 vaccine to your staff and employees and establish policies to encourage uptake such as time off to receive the vaccine.
  • Consider offering COVID-19 vaccine at your workplace (Workplace COVID-19 Vaccine Toolkit).
  • Evaluate whether your facility can implement vaccine requirements or vaccine incentives.

For More Information

COVID Data Tracker

USDA Extends COVID-19 Relief for Single-Family Housing Borrowers

Posted on by lad3

United States Department of Agriculture (USDA) Deputy Under Secretary for Rural Development Justin Maxson announced that the Department is extending the COVID-19 Special Relief Measure for USDA’s Single-Family Housing Guaranteed Loan borrowers.

The USDA COVID-19 Special Relief Measure provides new alternatives for borrowers to help them achieve up to a 20 percent reduction in their monthly principal and interest payments. New options include an interest rate reduction, term extension and a mortgage recovery advance, which can help cover past due mortgage payments and related costs.

Borrowers will first be assessed for an interest rate reduction, and if additional relief is still needed, the borrowers will be considered for a combination rate reduction and term extension. In cases where a combination of rate reduction and term extension is not enough to achieve a 20 percent payment reduction, a third option combining the rate reduction and term extension with a mortgage recovery advance may be used to reach the target payment.

In addition, the Department of Treasury’s Homeowner Assistance Fund (HAF), a critical component of President Biden’s American Rescue Plan, provides $9.961 billion to states, Washington, D.C., territories and Tribes for relief to homeowners impacted by the COVID-19 economic crisis. These funds can be used for assistance with mortgage payments, homeowner’s insurance, utility payments and other specified purposes. Homeowners can access these funds in addition to the payment reduction options discussed above.

For more information, see the White House Fact Sheet: Biden Administration Announces Additional Actions to Prevent Foreclosures.

If you’d like to subscribe to USDA Rural Development updates, visit our GovDelivery subscriber page.

New Pocket Guides from MidAtlantic AETC Available

Posted on by lad3

The MidAtlantic Aids Education and Training Center (AETC) has created several new pocket guides on the following topics:

  • Rapid Initiation of HIV Treatment
  • HIV and Medication Assisted Treatment Centers (MAT)
  • Differential Diagnosis of HIV and SARS-COV-2
  • Best Practices & Tips for Clinicians Providing Care for Patients with HIV via Telehealth
  • Integrating Geriatric Principles into an HIV Clinic
  • Workplace Burnout Guide for Health Professionals
  • Addressing Social Determinants of Health and Persons with HIV

The pocket guides were created by Dr. Linda Frank and the regional partners of the MidAtlantic AETC and are available for download here or with all of their pocket guides and clinical tools by clicking here.