Rural Health Information Hub Latest News

Increasing Number of Grandparents Raising Grandchildren

Increasing Number of Grandparents Raising Grandchildren.  An analysis from the U.S. Census Bureau shows that, in 2016, there were over 7.2 million grandparents nationwide living with grandchildren under the age of 18.  Reports from media outlets and nonprofit organizations suggested that a recent rise in these arrangements is due in part to the opioid crisis.  To get an accurate and better understanding of what is happening, the Census Bureau examined data from its American Community Survey and data on opioid prescribing from the Centers for Disease Control and Prevention (CDC).  Previous research focused on the national or state level, but levels of opioid prescriptions vary widely within states, and county level data allow for a more localized analysis.  Data analysis showed a rural-urban divide in grandparents caring for grandchildren that is similar to the higher rates of overdose deaths in rural areas.  In 2016, 32 percent of grandparents were responsible for grandchildren in urban areas, compared to 46 percent of grandparents in rural areas.  The Census Bureau created an overview of their analysis, with methods, maps and data.  See frequently asked questions answered by the Administration for Children and Families on this topic and the Funding Opportunities section below for related resources.

Podcasts: Rural Chronic Obstructive Pulmonary Disease (COPD) and its Prevalence in Rural America

The National Rural Health Resource Center (The Center) has partnered with Dr. Bill Auxier of Rural Health Leadership Radio to produce a six-part podcast series about Rural Chronic Obstructive Pulmonary Disease (COPD) and its prevalence in rural America. This series from The Center provides information about COPD, how rural providers are meeting the needs of their communities, and the importance of billing and coding appropriately while ensuring quality of care is being addressed. Each podcast features a guest with expert knowledge in COPD and rural health.

Available now: Episode 6A featuring Tracy Conroy, Valerie Roark, and Connie Wilson of Daviess Community Hospital

Listen here.

  • In this episode, Tracy, Valerie, and Connie discuss Daviess Community Hospital’s pulmonary rehab program and how it started, what they have learned so far in the three years of their program, COPD from both a patient and hospital aspect, and the future of COPD care.
  • Daviess Community Hospital is a 74-bed, non-profit hospital in Washington, Indiana with an extensive pulmonary rehabilitation program. Tracy Conroy serves as the chief executive officer and provides operational, financial, and strategic leadership that supports the mission and vision of Daviess. She has over 25 years of leadership experience in both acute and long-term care, population health management, outpatient clinics, and regional partnerships. Valerie Roark is a Registered Respiratory Therapist working with Daviess Community Hospital for the past 30 years as the Director of the Cardiopulmonary Department, EEG’s, Sleep Diagnostics and Cardiac and Pulmonary Rehabilitation. Connie Wilson is currently the Cardiac/Pulmonary Rehabilitation nurse. Connie has been an RN for 34 years with 28 years in Cardiac Rehabilitation and 25 years in Pulmonary Rehabilitation.

Available now: Episode 6B featuring Dr. Steve Barnett of McKenzie Health System

Listen here.

  • In this episode, Dr. Barnett discusses their new cardiac rehab program, how it relates to pulmonary rehab programs, the financial risk, innovation, and resources necessary for this new program, and the future of COPD care.
  • McKenzie Health System is a critical access hospital in Sandusky, Michigan. Dr. Steve Barnett, President and CEO of McKenzie Health System, began his career in health care as a respiratory therapist before receiving a bachelor’s in nursing from Oakland University in Rochester, Michigan. Dr. Barnett received a master’s degree in anesthesia and practiced that for many years before getting more involved in administrative work. Dr. Barnett eventually transitioned to the CEO role of a critical access hospital and went back and received his doctorate in health care administration.

Available Now: Episode 5 featuring Lindsay Corcoran and Laurie Daigle, Stroudwater

Listen here:

  • In this episode, Lindsay and Laurie discuss the billing and coding considerations for hospitals and pulmonary rehab programs, the financial challenges hospitals with these programs face, opportunities for hospitals within their existing pulmonary rehab programs, where to find up-to-date financial resources on COPD programs, and the future of COPD care.
  • Lindsay Corcoran is an accomplished senior consultant and practice management professional with over ten years of healthcare and medical office experience. At Stroudwater Associates, Lindsay focuses on supporting and sustaining healthcare access for rural communities through hospital operational improvement and affiliation strategies, and has assisted rural and community hospitals and clinics across the country to improve operational and financial performance. Results-oriented and highly organized, Lindsay is a skilled and effective communicator with medical providers, patients, and administration.
  • Laurie Daigle, a senior consultant at Stroudwater Revenue Cycle Solution, is a certified professional coder with over 18 years of experience in medical insurance claim processing, medical billing software training, auditing, and healthcare financial management. She has years of experience as a manager for a national commercial payor, and extensive experience in Healthcare Management, from physician group practices to large academic institutions. She has been instrumental in the creation of Revenue Integrity resources to unify coding, billing, and compliance concerns for total and inclusive revenue cycle oversight. She has led successful initiatives to increase physician and departmental productivity, to improve business office efficiency and accuracy, and to develop policies and procedures for all areas within the Revenue Cycle.

Available Now: Episode 4 featuring Michelle Collins

Listen here:

  • Michelle Collins is a registered respiratory therapist at Lincoln Health, Franklin Memorial Hospital, and Central Maine Medical Center in Maine. Working in a rural, critical access, and tertiary hospital, Michelle has wide range of hospital experiences, a passion for cardio pulmonary medicine, and a strong concern for her patients and making sure they have access to the care that they need and the knowledge to utilize the tools at their disposal.
  • Michelle discusses her definition of leadership, the history of respiratory therapy, the gaps in COPD healthcare, reimbursement issues related to COPD treatment and pulmonary rehab program closures, COPD Patient obstacles, respiratory treatment and medication, respiratory and medical training, and the hope going forward with COPD care.

Available Now: Episode 3 featuring Dan Doyle, MD
Listen here:

  • Dan Doyle is a physician at New River Health Association, a Federally Qualified Community Health Center (FQHC) in West Virginia. He is a physician and consultant at Cabin Creek Health Center, another FQHC in West Virginia, Medical Director of New River Breathing Center, a Black Lung Clinic which is part of the West Virginia and Federal Black Lung Clinics Program. As of 2013, Dr. Doyle has been the Medical Director of the Grace Anne Dorney Pulmonary Rehabilitation project of West Virginia, which is a collaborative effort of Cabin Creek Health System FQHC, New River Health Association FQHC, Southern West Virginia Health System FQHC, West Caldwell County FQHC in North Carolina, Boone Memorial Hospital, and Jackson General Hospital providing community-based pulmonary rehabilitation services.
  • Doyle discusses his medical background and how he initially got involved at the New River Health Association, the impact of COPD on rural communities, the lack of access to COPD care, diagnosing COPD and pulmonary function testing, the Dorney Koppel Foundation, the COPD National Action Plan, and the future of COPD care.

Available Now:  Episode 2 featuring Paul Moore, DPh
Listen here:

  • Paul Moore is a Senior Health Policy Advisor for the Federal Office of Rural Health Policy (FORHP) and Executive Secretary for the National Advisory Committee for Rural Health and Human Services.
  • Paul discusses his background in rural health care and pharmacy, hospital administration turnover and rural recruiting challenges, the essential aspects of leadership, his professional and personal experiences with COPD, COPD’s lack of national attention and funding, COPD patient and financial statistics, the impact of COPD on rural communities, rural workforce issues with COPD, and the future of COPD care.

Available Now:  Episode 1 featuring Grace Anne Dorney Koppel
Listen here:

  • Grace Anne Dorney Koppel is President of the Dorney Koppel Foundation, the immediate former President and a current board member of the COPD Foundation, and chair of the Advocacy and Public Policy Committee for the COPD Foundation. Grace Anne is also a patient of COPD, diagnosed in 2001.
  • Grace Anne explains COPD’s prevalence, its symptoms, the stigma surrounding the disease, her personal experiences with COPD, the challenges of COPD treatment in rural communities, her work with the Dorney Koppel Foundation, and the path to success with COPD.

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,100,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

2018 County Population Estimates Released

The U.S. Census Bureau has released estimates of the total population of counties in the nation and Pennsylvania as of July 1, 2018. The estimates show that the Southeast and South Central regions of Pennsylvania continue their growth since 2010 with Cumberland County in the lead as the fastest growing county. Click here to read the Penn State Data Center brief.

Enhancements to the CMS Mapping Medicare Disparities (MMD) Tool

The Mapping Medicare Disparities (MMD) tool provides interactive maps to illustrate disparities between subgroups of beneficiaries on key measures of health outcomes, use, and spending.  CMS recently added rural and urban data to the population view, so users can view and compare across rural and urban counties. They also added four opioid use disorder indicators, including hospital and ER visits and medication-assisted therapy utilization.

Additional Telehealth Benefits for Medicare Advantage Finalized

To implement provisions of the Bipartisan Budget Act of 2018, CMS has finalized provisions allowing Medicare Advantage (MA) plans to offer additional telehealth benefits as part of the basic benefits.  While Medicare Advantage plans have always been able to offer more telehealth benefits than traditional Medicare, this rule gives MA plans even more flexibility with paying for these services, which could expand telehealth further.  For example, enrollees in urban and rural areas may be able to receive telehealth from their homes. In 2017, about one in four rural Medicare beneficiaries were enrolled in an MA plan.

Latest CMS Podcast Episode Features Rural Providers

During the week of April 1, 2019, CMS released the latest episode of their podcast, CMS: Beyond the Policy. This episode brings highlights from the 2019 CMS Quality Conference, including perspectives from rural providers at the conference. The theme of this year’s conference was “Innovating for Value and Results.”

HRSA Requests Public Feedback on Health Center Service Areas

The Health Resources and Services Administration (HRSA) recently announced an upcoming request for information (RFI) on its Health Centers Program. HRSA will be seeking input from the public on service area considerations that may inform decisions to expand the program through the addition of new service delivery sites onto existing health centers.  The considerations include factors such as proximity to existing health centers, parameters for unmet need, and consultation with other local providers.   The Service Area RFI announcement will begin with a 30-day preview period. Instructions on how to submit feedback are forthcoming. Following the preview period, HRSA will accept public feedback for 60 days.

Penn State Health Policy Student Receives Community Achievement, Alumni Awards

UNIVERSITY PARK. Pa. — Hannah Ross, a student in the integrated undergraduate/Master of Health Administration program in the Department of Health Policy and Administration (HPA), has recently received two different Penn State awards in recognition of her leadership, scholarship and service to the community.

Hannah Ross, a student in the integrated undergraduate/Master of Health Administration program in the Department of Health Policy and Administration, has received the 2019 Jennifer S. Cwynar Community Achievement Award and the 2019 Edith Pitt Chace Award. IMAGE: Master of Health Administration program at Penn State

2019 Jennifer S. Cwynar Community Achievement Award

Ross is 2019 recipient of the Jennifer S. Cwynar Community Achievement Award, which was presented on April 8 during the Annual Stanley P. Mayers Endowed Lecture and Health Policy Administration student awards ceremony. Lisa Davis, director of the Pennsylvania Office of Rural Health (PORH) and outreach associate professor of health policy and administration, presented the award.

The Jennifer S. Cwynar Community Achievement Award recognizes community achievement by an HPA senior undergraduate student who has demonstrated service and commitment to a community or an underserved population, preferably, but not exclusively, in a rural area of Pennsylvania.

Ross was nominated for the award by Diane Spokus, associate director of professional development in HPA. In her nomination, Spokus noted that Ross’ contributions to the HPA undergraduate program have been invaluable.

Spokus noted that she has seen Ross develop leadership, facilitation and management skills through her participation in many educational and professional development activities. She noted these skills were evident when Ross served as the 2018 Jennifer S. Cwyner Undergraduate Intern at Pennsylvania Office of Rural Health (PORH).

While anintern with the PORH, Ross assisted in advocacy and research efforts to guide rural Pennsylvanians and health care providers in improving physical and mental health issues. She also prepared pilot site information about sexual assault exam training in rural hospitals for the Sexual Assault Forensic Examiner Telehealth Center, a project designed to improve sexual assault exams in rural areas.

“We are very pleased to present this award to Hannah Ross and to honor the legacy of Jennifer Cwynar, who was an exceptional student and intern with our office,” Davis said.  “This is one way in which we can encourage excellence in those who will become leaders in advocating for the health of vulnerable populations.”

“In my time as an intern with the Pennsylvania Office of Rural Health, I was honored to continue the work of Jennifer Cwynar by looking for ways to assist disadvantaged groups in rural Pennsylvania, such as children, human trafficking survivors and those without transportation to healthcare services,” Ross said. “I was therefore doubly honored to be selected for the Jennifer S. Cwynar Community Achievement Award, and to know that I could help carry on Jennifer’s dedication to helping those in need.”

The Jennifer S. Cwynar Community Achievement Award was established in memory of Cwynar, a 2008 graduate of HPA and a 2008 undergraduate intern at PORH. The award is given in recognition of Cwynar’s commitment to community service, advocacy for underserved and rural populations, and focus on public health. The award is issued to a senior undergraduate HPA student who has advanced those commitments, and is intended to encourage and foster personal and professional development.

2019 Edith Pitt Chace Award

Ross is also recipient of the 2019 Edith Pitt Chace Award, presented by the College of Health and Human Development Alumni Society. She was recognized on April 5 at the College of Health and Human Development’s Alumni Society Board awards dinner.

The Edith Pitt Chace Award, named in memory of the director of the Penn State home economics program from 1918 to 1937, recognizes an outstanding student leader and scholar in the College of Health and Human Development.

“So many people within HPA, the College of Health and Human Development, and Penn State encouraged me to grow as a leader and provided me with chances to learn what leadership truly means,” Ross said. “I learned that Edith Pitt Chace led not just for the sake of leading, but with the intention of serving others. I’m honored to be a recipient of the Edith Pitt Chase Award; her example of gracious leadership and empowerment is one I hope to emulate in my own leadership style.”

Ross is a participant in the HPA Peer Mentoring Program, where she provides guidance to mentees transitioning into the HPA major at the University Park campus, and was a teaching assistant for the course, HPA 101, Introduction to Health Services Organization.

She also serves as a resident assistant (RA), providing guidance, support, policy enforcement and campus resource information for 50 students in a residence hall. As an RA, she responds to multiple emotional and psychological crisis scenarios.

Ross has served as the president of the American College of Healthcare Administrators Club. As a Schreyer Honors Scholar, she has been active with the Schreyer Ambassador Team, representing the Schreyer Honors College on student panels and by giving tours to prospective students and their families.

What Happens When a Rural Hospital Closes?  Scenes from Rural Nevada

 When a car crashed outside of tiny Tonopah, Nevada, volunteer EMS workers raced to the scene in minutes. But ever since Tonopah’s hospital closed, the town is now hours away from the nearest emergency room. Across the United States, rural hospitals are shutting their doors at a staggering rate—and many more are on the brink of closing. As rural America shrinks and ages, healthcare for millions of Americans is falling out of reach. In this video, NBC Left Field spends time with an EMS worker as she fights to help neighbors in need.

Published by NBC Left Field, April 10. 2019

Announcing the Appalachian Leadership Institute!

Apply now to become an Appalachian Leadership Institute Fellow!

Applications are now being accepted for the inaugural class of the Appalachian Leadership Institute, a new leadership and economic development training opportunity for community leaders who currently live and/or work in Appalachia. The Appalachian Leadership Institute is an extensive nine-month program running from October–July and includes skill-building seminars, best practice reviews, and field visits during six separate sessions across the Region to be followed by a capstone graduation event held in Washington, D.C.

As part of the Appalachian Leadership Institute, participating Fellows will learn how to:

  • Design effective economic development project proposals;
  • Integrate community assets into long-lasting economic development strategies;
  • Identify resources available to spur economic development;
  • Locate and access investment capital from a variety of public and private sources;
  • Prepare competitive applications for public grant opportunities;

Use expanded leadership skills to create strong coalitions; and much more!

Upon completion of the program, Appalachian Leadership Institute Fellows will automatically become part of the Appalachian Leadership Institute Network, a peer-to-peer working group committed to Appalachia’s future.

The Appalachian Leadership Institute is limited to 40 Fellows annually, drawn from Appalachia’s public, private and non-profit sectors. Fellows are chosen via a competitive application process and each class will include representatives from each of the thirteen state in the ARC footprint to reflect the region’s diverse economic development challenges, opportunities, and strategies. Apply now!

The Appalachian Leadership Institute is an advanced community capacity leadership training program developed by the Appalachian Regional Commission in partnership with the University of Tennessee, Knoxville; The Howard H. Baker Center for Public Policy; Tuskegee University; and Collective Impact.

More information about the Appalachian Leadership Institute is available at