Rural Health Information Hub Latest News

State Strategies for Overcoming Barriers to Advance Health Equity

The COVID-19 pandemic has highlighted long-standing health inequities that have resulted in an increased risk of sickness and death for people of color. The crisis has also propelled a nationwide focus on understanding and addressing health inequities. As compared to white, non-Hispanic individuals, American Indians or Alaska Natives are over five times as likely to be hospitalized, and black or African-American individuals are over twice as likely to die from COVID-19.

While COVID-19 and the reckoning on racial justice have mobilized some state officials working in Medicaid, public health, insurance departments and Marketplaces alike, states are at different places on their journeys to confront systemic racism and inequities in healthcare, and each faces unique and challenging barriers. As early as August of this year, over one-third of states had launched task forces to take a closer look at health disparities (or differences in health based on population group) in response to the pandemic. These new task force efforts stand in contrast to decades of siloed and often poorly funded work to advance health equity by state offices of minority health or health equity. The new wave of state health equity activities aims to mitigate structural, institutional, political, financial and analytical barriers to ensure everyone has a fair opportunity to be as healthy as possible.

In a new issue brief for the Robert Wood Johnson Foundation’s State Health and Value Strategies program, Manatt Health explores impediments and accelerants to advancing health equity as states are increasingly being called upon to drive change.

To read the full issue brief, click here.

CMS Proposes New Rules to Address Prior Authorization and Reduce Burden on Patients and Providers

On December 10, CMS issued a proposed rule that would improve the electronic exchange of health care data among payers, providers, and patients and streamline processes related to prior authorization to reduce burden on providers and patients. By both increasing data flow and reducing burden, this proposed rule would give providers more time to focus on their patients and provide better quality care.

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Nation-Leading Pennsylvania Farmland Preservation Program Ends Year with 177 Farms, 14,727 Acres Preserved

Pennsylvania safeguarded 2,710 acres on 32 farms in 17 counties through the state’s nation-leading Farmland Preservation Program. In 2020, the state board, in collaboration with county boards, preserved 177 farms and 14,727 acres of farmland across the commonwealth.

The director and staff of the Bureau of Farmland Preservation were recently recognized by the Wolf Administration for continuing their work while overcoming telework obstacles throughout the COVID-19 pandemic.

“The disruptive impacts of the COVID-19 pandemic on Pennsylvania’s agricultural system have been broad and varied,” Agriculture Secretary Russell Redding said. “This year, we’ve watched farmers and consumers bridge the gap from farm to table. Producers and households have depended on each other for certainty and our state’s Farmland Preservation Program has made food security possible for our families and farmers across the commonwealth.”

Preserved farms are protected from future residential, commercial or industrial development. They represent targeted investments in the future of farming and food security in Pennsylvania.

The 32 farms preserved today are in Adams, Berks, Bucks, Butler, Clinton, Cumberland, Dauphin, Lancaster, Lawrence, Lehigh, Lycoming, Monroe, Northampton, Washington, Wayne, Westmoreland, and York counties.

These farms include fruit, vegetable, equine, crop, livestock, sheep, goat, and dairy operations.

Since the program began in 1988, federal, state, county, and local governments have purchased permanent easements on 5,813 Pennsylvania farms totaling 591,819 acres.

Notable farms preserved today include the Taggart Family Farm, a 73.45-acre bicentennial crop farm located in Butler County. The farm has been in the family for 220 years. John Taggart, who immigrated from Ireland in 1800, purchased the farm, which will remain in agriculture with certainty for future generations. Statewide, there are now 190 bicentennial farms, many of which are also preserved.

Barrick Farms LLC, a 482.25-acre dairy operation in Cumberland County, is the largest farm secured by the county board to date. The Barrick’s donated half of the easement value to the program, further leveraging funds for additional farms to be preserved.

The David James Nolt Farm, a 95.68-acre crop farm in Lancaster County, is nearly all Class 1 soils. According to USDA, Class 1 soils are the most productive prime farmland in the nation.  Lancaster County is a leader, with over 1,000 farms preserved through the state program and in partnership with Lancaster Farmland Trust, a non-profit organization.

Pennsylvania Governor Announces 327,000 Pennsylvanians Will Gain Access to High-Speed Internet through Federal Auction

Pennsylvania Governor Tom Wolf announced that more than 327,000 Pennsylvanians will gain access to high-speed Internet service through the Federal Communications Commission’s (FCC) Rural Digital Opportunity Fund Phase I auction.

Thirteen providers in Pennsylvania successfully bid in the auction and will provide high-speed Internet access in locations across the state that are underserved or do not have access to broadband that meets current federal standard. The FCC will allocate $368.7 million to these providers over the next 10 years. Virtually every Pennsylvania county will benefit from the broadband build out supported by this funding.

“In the 21st century, reliable high-speed internet service is a critical utility for homes and businesses alike. The lack of this technology in our communities inhibits our students and educators, businesses, the healthcare system and more from truly connecting locally and globally. If we want to support our economy, give our students the tools to learn, and improve quality of life, we must expand broadband access,” Gov. Wolf said. “The current pandemic has vividly demonstrated the pressing need to expand high speed internet access to enable telehealth and allow students to connect with their classmates and teachers. As a result of this auction, hundreds of thousands of Pennsylvanians will gain this access, which is a significant step toward bridging the digital divide.”

The Rural Digital Opportunity Fund is an effort by the FCC to ensure high-speed Internet access in underserved communities. In total, the FCC will allocate $9.2 billion to 180 bidders, who will deploy high-speed broadband to more than 5.2 million unserved homes and businesses across the country.

Nearly a million Pennsylvanians lack access to reliable high-speed internet access, according to the FCC. Ensuring that all Pennsylvanians have access to high-speed Internet access is a top priority of the Wolf Administration. The governor’s Restore Pennsylvania plan, a $4.5 billion bipartisan proposal funded through a commonsense severance tax, would provide funding to completely bridge the digital divide in every community in Pennsylvania. Funding would be available to support installation of infrastructure to bring high speed internet to every corner of the commonwealth.

Similarly, the Pennsylvania Public Utility Commission (PUC) has also strongly advocated for universal access to broadband and a presence in the federal auction process.

“I commend the Public Utility Commissioners for their strong leadership in expanding broadband to underserved areas, and pursuing every available dollar for the state, as well as the many stakeholders–including particularly Penn State University’s Rural Extension Program–that have helped to lay groundwork to ensure the success of bidders in the most recent auction.” Gov. Wolf said. “I look forward to continuing to work with the Commissioners, Penn State, and other committed stakeholders to make progress towards our goal of universal broadband access across the commonwealth.”

New COVID-19 Mitigation Efforts Announced for Pennsylvania. Here’s What to Know.

Stricter COVID-19 mitigation efforts, announced Thursday by Gov. Tom Wolf and Secretary of Health Dr. Rachel Levine, aim to put Pennsylvania “on pause” for the next three weeks.

The limited-time mitigation orders place restrictions on in-person dining and alcohol sales, gatherings and events, businesses and K-12 sports. Wolf — who tested positive for the coronavirus earlier this week — and Levine announced the new measures during a virtual press conference Thursday.

“This is a bridge to that better future we all know that we can get to in Pennsylvania,” Wolf said. “We know that COVID-19 thrives in places where people gather together. Therefore, these mitigation measures target high-risk environments and activities and aim to reduce the spread of this devastating virus.”

In the last two days, Pennsylvania has reported the highest number of COVID-19 deaths since the beginning of the pandemic.

“The virus continues to strain our health care systems and the dramatic rise in cases among all age groups, including among school-age children, is alarming,” Levine said. “Since the start of the pandemic, there have been more than 37,500 cases among children age 5 to 18, yet 9,500 of those cases occurred in the past two weeks.”

The new order takes effect 12:01 a.m. on Saturday and will remain in effect until 8 a.m. on Jan. 4, 2021.

“We will be saving lives, but we have to do it together,” Wolf said.

Here’s what to know about the guidelines:

In-person dining and alcohol sales

  • All in-person indoor dining at restaurants, bars and other food service establishments is prohibited.
  • Outdoor dining, take-out food service and take-out alcohol sales are permitted and may continue.

Gatherings and events

  • Indoor gatherings and events of more than 10 people are prohibited.
  • Religious services and worship are specifically excluded from the limitations set forth above during religious services, but faith leaders are “strongly encouraged” to find alternative ways to gather.
  • Outdoor gatherings and events of more than 50 people are prohibited.

Business closures, capacity limits

  • All in-person businesses may operate at up to 50% of the maximum capacity stated on the applicable certificate of occupancy, except as limited by existing orders to a smaller capacity limit.
  • In-person businesses in the entertainment industry — theaters, concert venues, museums, movie theaters, arcades, casinos, bowling alleys and private clubs — are prohibited from operating.

Gyms and fitness facilities

  • Indoor operations at gyms and fitness facilities are prohibited, but outdoor facilities and classes may continue.
  • All participants are required to wear a mask and social distance during outdoor activities.

K-12 sports, extracurricular activities

  • Voluntary, school-sponsored activities are suspended, but participants may gather virtually. This includes, but is not limited to, attendance at or participation in activities such musical ensembles, school plays, student council, clubs and school dances.
  • All K-12 sports are paused. This includes all competition at public, nonpublic and private schools as well as all club, travel, recreational, intermural and intramural sports.
  • The Pennsylvania Principals Association is recommending a delay to the start of the winter sports season. The surge in cases among school-age children increases the risk that asymptomatic participants will spread the virus at a game or practice, in the locker room, while traveling to and from events, or at team meals, parties or other gatherings.

Professional, collegiate sports

  • Professional and collegiate sports activities may continue in accordance with guidance from the Centers for Disease Control and Prevention and the Department of Health.
  • Spectators are prohibited from attending events.
Read more here: https://www.centredaily.com/news/coronavirus/article247758555.html?ac_cid=DM341579&ac_bid=-1180439669#storylink=cpy

Confirmed COVID Cases in Appalachia Top 1.1 Million While Deaths Top 18,000

On Friday, December 4, 2020, the cumulative number of COVID cases in Appalachia surpassed 1 million. New cases have risen considerably since Thanksgiving.

The Region set a new record high for the seven-day rolling average of daily new cases with 17,331 on Sunday, December 6. The seven-day average of daily new cases was 13,077 a week ago and 13,113 two weeks ago.

The number of deaths has also risen considerably in the past few weeks. A new record high for the seven-day rolling average of daily new deaths was also set on Sunday, December 6 at 231. The rate was 139 deaths per day a week ago and 173 two weeks ago.

As of 11:30am December 10, 2020, there were 1,118,068 cumulative cases throughout Appalachia and 18,011 cumulative deaths.

There were 65,188 new cases and 979 new deaths since 12am Monday, December 7, 2020. The total number of COVID-related deaths are 18,011 in 407 of Appalachia’s 420 counties.

Appalachia Nonprofit Resource Center Navigates Beyond COVID-19 to Sustainability

The Appalachia Nonprofit Resource Center (ANRC) was established during COVID-19 to assist regional nonprofit organizations by offering free online access to curated resources. Information is updated regularly. Check out recent additions about:

Other topics including financial management, mission and operations, and fundraising are also available. Register now!

Introducing NRHA’s VoterVoice Advocacy Tool

Congress needs to hear voices of rural America as they tackle COVD-19 relief and kick off the 117th Congress. The National Rural Health Association (NRHA) has taken action to make rural health advocacy easier than ever before for our members and is introducing NRHA’s VoterVoice advocacy tool.

NRHA’s VoterVoice advocacy tool connects you and hundreds of our fellow rural health stakeholders with local, state, and federal lawmakers, ensuring our message to support or oppose legislation is heard by those with the power to enact change at every level. The tool supplies pre-filled information, which means that you can take reach your members of Congress with one click, while customizing content as needed. VoterVoice’s support team also checks for and corrects undelivered messages resulting in 100 percent deliverability to legislative officials.

NRHA’s VoterVoice advocacy tool enables the NRHA government affairs team to create campaigns that will exist on NRHA’s new Rural Health Advocacy Campaigns webpage. Additionally, the NRHA government affairs team will alert NRHA membership of new public campaigns as they become available via NRHA Connect.

If you are eager to test it out – no need to wait! Our first advocacy campaign is waiting for you here.

Introducing PLACES: Local Data for Better Health (An Extension of 500 Cities Project)

The Centers for Disease Control and Prevention (CDC), in collaboration with RWJF and the CDC Foundation, has launched PLACES, an extension of the 500 Cities project.

The PLACES project provides estimates, obtained using model-based small area estimation methods, for 27 health measures for four U.S. geographic levels: counties, places, census tracts, and ZIP Code Tabulation Areas (ZCTAs). It includes nationwide data at a granular level to cover smaller cities and rural areas, data that were previously unavailable. Measures include unhealthy behaviors (e.g., current smoking), health outcomes (e.g., coronary heart disease, diabetes), and prevention practices (e.g., health insurance coverage, cholesterol screening).

The data can be used to:

  • Identify the health issues facing a local area or neighborhoods.
  • Establish key health objectives.
  • Develop and implement effective and targeted prevention activities.

Information on the methods used can be found here.