Rural Health Information Hub Latest News

New KHN Reporting Reveals Half of Nation’s Counties Lack Intensive Care Beds As COVID-19 Cases Rapidly Increase

Free Lookup Tool Available To See Your Local Situation

The rapidly increasing number of national COVID-19 cases is raising alarm among experts and state and local officials about health systems’ capacity to treat patients effectively and revealing the uneven geographic distribution of the country’s health care resources.

A special report by KFF’s Kaiser Health News (KHN) shows that more than half the counties in the United States have no intensive care unit (ICU) beds, which poses a particular danger to patients age 60 or older who fall victim to the coronavirus. Hospital ICUs have sophisticated equipment, such as bedside machines to monitor a patient’s heart rate and ventilators to help them breathe ― trouble breathing is a common symptom among seriously ill COVID-19 patients. Even in communities that do have ICU beds, the numbers vary wildly ― with some having just one bed available for thousands of senior residents.

KHN’s coverage includes a 50-state map that shows which counties have no lCU beds as well as which lack a hospital altogether. Thirty seven million Americans reside in such counties. An online “lookup” tool lets readers check the ICU bed capacity near their homes or in surrounding counties.

This report is part of KFF’s continuing efforts on the coronavirus outbreak. The national story also ran in USA Today and, as always, KHN content is available to republish free of charge. News organizations can request localized data by contacting Chris Lee.

Pennsylvania Billing Guidance for Alternative Screening Sites Related to COVID-19

On March 6, 2020, Pennsylvania Governor Wolf issued a disaster declaration in response to the presence of the COVID-19 coronavirus in Pennsylvania. Pursuant to this disaster declaration, the Office of Medical Assistance Programs (OMAP) in the Pennsylvania Department of Human Services (DHS) is issuing guidance to hospitals and community providers regarding submitting claims for services provided in alternative screening sites for COVID-19.

On March 9, CMS issued a Memorandum regarding “Emergency Medical Treatment and Labor Act (EMTALA) Requirements and Implications Related to Coronavirus Disease 2019 (COVID-19), which applies to both Medicare and Medicaid providers.

The memorandum discussed a hospitals options to mitigate exposure to COVID-19 and set up alternative screening sites both on and off the hospital campus.

The Pennsylvania Department of Health, the entity licensing hospitals in the state, issued guidance on the ability of hospitals to set up alternate screening sites for COVID-19. The guidance can be found here.

Hospitals do not need to enroll their on-campus or off-campus temporary screening sites separately in the Medical Assistance (MA) program. The Department of Human Services understands the Department of Health considers these sites part of the hospital and the areas are set up as part of the hospital’s emergency preparedness plan. Thus, hospitals should use their existing acute care hospital enrollment (01-010) or a hospital outpatient unit (01-183) to submit claims for services performed at these on or off campus screening sites.

Community Screening Sites Not Under the Control of a Hospital

Other non-hospital community providers may choose to set up COVID-19 screening sites. Community screening sites not under the control of a hospital and being conducted by a health care provider, such as an independent clinic, federally qualified health care center, rural health center, physician or physician office, laboratory or certified registered nurse practitioner, also do not need to enroll these sites separately.

As these sites are temporary in nature, providers should bill from office or clinic sites already enrolled in MA using a place of service that best describes where the service was provided.

This guidance will remain in effect for 90 days or while a valid disaster declaration authorized by the Governor related to the COVID-19 virus remains in effect, whichever is earlier. OMAP may re-issue these guidelines as appropriate.

Additional information about EMTALA requirements and COVID-19 can be found here.

Additional information is also available on the CDC website and through CMS.

Information on MA Program coverage related to COVID-19, including an FAQ document and instructions regarding the procedure codes to use for COVID-19 lab screenings, can be found on the Department of Human Services website here.

The Pennsylvania Department of Health has a dedicated page for COVID-19 that provides regular updates.

Click here for the most up to date information regarding COVID-19.

NIOSH Provides Updates on COVID-19

As part of National Institute for Occupational Safety and Health’s (NIOSH) efforts to keep our stakeholders up to date on the CDC and NIOSH COVID-19 response, below is a summary of new information posted this week for workers.

General 

  • Guidance on Preparing Workplaces for COVID-19
    This document helps guide employers to implement engineering, administrative, and work practice controls and personal protective equipment (PPE), as well as considerations for doing so. It is intended for planning purposes. Employers and workers should use this guidance to help identify risk levels in workplace settings and to determine any appropriate control measures to implement. Additional guidance may be needed as COVID-19 outbreak conditions change, including as new information about the virus, its transmission, and impacts, becomes available.

Healthcare Worker Resources

  • Return to Work for Healthcare Personnel
    New criteria for return to work for healthcare personnel (HCP) with confirmed or suspected COVID-19 is now available on the CDC website. This guidance is for occupational health programs and public health officials making decisions about return to work for HCP with confirmed COVID-19, or who have suspected COVID-19 (e.g., developed symptoms of a respiratory infection [e.g., cough, sore throat, shortness of breath, fever] but did not get tested for COVID-19).
  • Clinician Toolkit
    CDC’s Prepare to Care for COVID-19 is a resource with practical tools clinicians can use to care for patients with COVID-19. This resource will be regularly updated to help clinicians adapt as the outbreak unfolds.
  • New NIOSH Science Blog: Proper N95 Respirator Use for Respiratory Protection Preparedness
    Healthcare facilities should ensure that healthcare workers who may be called to care for COVID-19 patients are prepared to use respiratory protection, among other personal protective equipment. Healthcare facilities should make sure their healthcare workers are fit tested, if possible, medically evaluated, and receive ongoing training in proper use. This resource has reminders and illustrations about proper respiratory use.

To stay up to date on the response please visit the COVID-19 webpage or sign up for the COVID-19 newsletter

COVID-19 Multiple Sclerosis Resources Provided

The National Multiple Sclerosis Society is focused on the needs of people living with MS and that the health and safety of them and their families are their first priority as we move through the COVID-19 pandemic together. To protect the well-being of our communities, the society will not gather for in-person events, programs or advocacy activities through May 17. Instead, they are reimagining how to ensure everyone in the MS movement feels connected, supported and informed. They want everyone to reach out to the people they know in the MS movement – no matter where they are. And they are here to provide the tools and support needed to raise awareness and funds. they know that times of uncertainty can isolate us from each other. By connecting, we strengthen each other. The society has gathered information and resources below to keep you up to date on COVID-19 and what you can do. Stay tuned to the Coronavirus Resource Page for the latest updates and information.

 

Free Mental Health Resources Available in Spanish

The National Institute of Mental Health (NIMH) offers basic information on mental health disorders and related topics for patients, their families, healthcare professionals and the public. Higher quantities of materials are available for free now and can be ordered here. Be sure to do this as soon as possible if you are interested as we do not know the number of supplies that are being offered.

New Federal Data Rules Aim to Give Patients Control of Their Health Records

The Department of Health and Human Services (HHS) released groundbreaking rules that will let patients download their electronic health records and other health care data onto their smartphones. “Patients should have control of their records, period. Now that’s becoming a reality,” said Health and Human Services Secretary Alex Azar. “These rules are the start of a new chapter in how patients experience American health care.”  Officials said the rules likely will give patients a greater say in health care decisions and put an end to a long-standing practice in which some doctors and hospitals resist handing complete medical files over to patients upon demand.

The ONC final rule:

  • Establishes new rules to prevent “information blocking” practices (e.g., anti-competitive behaviors) by healthcare providers, developers of certified health IT, health information exchanges and health information networks.
  • Requires electronic health records to provide standardized, core data elements through the U.S. Core Data for Interoperability (USCDI) such as clinical notes, allergies and medications, to help improve the flow of electronic health information and ensure that the information can be effectively understood when it is received.
  • Establishes secure, standards-based application programming interface (API) requirements to support a patient’s access and control of their electronic health information.

The CMS Interoperability and Patient Access final rule:

  • Requires health plans in Medicare Advantage, Medicaid, CHIP and through the federal Exchanges to share claims data electronically with patients effective Jan. 1, 2021.
  • Requires that patients must be able to access their medical records on a smartphone at no cost and share those records as they choose.
  • Requires insurers to advise patients of their network of health providers through an app effective Jan. 1, 2021.
  • Establishes a new Condition of Participation (CoP) for all Medicare and Medicaid participating hospitals, requiring them to send electronic notifications to another healthcare facility or community provider or practitioner when a patient is admitted, discharged or transferred.
  • Requires states to send enrollee data daily beginning April 1, 2022 for beneficiaries enrolled in both Medicare and Medicaid, improving the coordination of care for this population.

Many of the provisions are set to take effect in 2022. While some are applauding the new rules, others have raised concerns about privacy as technology companies, such as Google, Microsoft, Apple and Amazon, open up new markets for providing medical records through mobile apps.

Read more.

2020’s Best & Worst States for Doctors – WalletHub Study

With doctors on the front lines against the threat of coronavirus, National Doctors’ Day coming up on March 30 and “physician” being the highest-paid job of 2019, the personal-finance website WalletHub has released its report on 2020’s Best & Worst States for Doctors as well as accompanying videos.

To identify the best states for those in the business of saving lives, WalletHub compared the 50 states and the District of Columbia across 19 key metrics. The data set ranges from average annual wage of physicians to hospitals per capita to quality of public hospital system.

Best States for Doctors

Worst States for Doctors

1. Montana 42. Hawaii
2. Wisconsin 43. Delaware
3. Idaho 44. Maryland
4. North Dakota 45. District of Columbia
5. Minnesota 46. New Jersey
6. Kansas 47. Alaska
7. Iowa 48. Massachusetts
8. Tennessee 49. Connecticut
9. Mississippi 50. Rhode Island
10. Nebraska 51. New York

Best vs. Worst:

  • Mississippi has the highest average annual wage for surgeons (adjusted for cost of living), $313,491, which is 2.1 times higher than in the California, the lowest at $152,850.
  • Minnesota has the lowest number of physicians per 1,000 residents, 1.09, which is 6.2 times lower than in the District of Columbia, the highest at 6.71.
  • Florida has the highest projected share of the population aged 65 and older by 2030, 27.08 percent, which is two times higher than in Utah, the lowest at 13.21 percent.
  • Wisconsin has the lowest annual malpractice liability insurance rate, $6,699, which is 6.1 times lower than in New York, the highest at $40,826.

To view the full report and your state or the District’s rank, please visit:
https://wallethub.com/edu/best-and-worst-states-for-doctors/11376/

Now Open! 2020 Nurse Corps Scholarship Program

Accepting applications through Thursday, April 30, 7:30 p.m. ET

Apply to the Nurse Corps Scholarship Program today.

The Nurse Corps Scholarship Program (Nurse Corps SP) provides funding to students enrolled in diploma, associate, baccalaureate, or graduate degree nursing programs. The award is in exchange for a commitment to serve in high-need, underserved communities. Scholarship support includes payment of tuition, required fees, other reasonable educational costs, and a monthly living stipend.

After graduation, scholarship recipients fulfill their service commitment at an approved health care facility with a critical shortage of nurses. Each scholar serves for a minimum of two years and receives one year of financial support (up to four years) for each additional year of service.

This year, Nurse Corps anticipates making up to 20 percent of awards to nurse practitioner students specializing in psychiatric mental health. This group is at the forefront of national efforts to combat substance use disorder. There is also special funding for nursing students specializing in women’s health.

Apply Here.

Before you apply

Before you apply, read the annually updated Application and Program Guidance. Make sure you understand the terms and conditions of the Nurse Corps contract, which outlines the requirement for fulfilling your minimum two years of service at an eligible critical shortage facility.

Eligibility

To be eligible for a scholarship, all applicants must:

  1. Be a U.S. citizen (born or naturalized), a national, or a lawful permanent resident;
  2. Be enrolled—or accepted for enrollment—in a professional nursing degree program at an accredited school of nursing in the U.S.;
  3. Begin classes no later than September 30, 2020;
  4. Be free from any federal judgment liens;
  5. Be free from any other existing service commitment;
  6. Not be overdue on a federal debt.

Application Help

To learn more about the Nurse Corps Scholarship Program and its application process, join us for a webinar and technical assistance call. Prepare for these sessions by reading the Application and Program Guidance.

Webinar
Thursday, March 26, 3-4:30 p.m. ET
Dial-in: 1-888-455-2923
Passcode: 9998967
Access Link

Technical Assistance Call
Thursday, April 16, 3-4:30 p.m. ET
Dial-in: 1-888-455-2923
Passcode: 9998967

Rural Emergency Medical Services Integration Guide

Rural Emergency Medical Services Integration Guide is a guide for rural EMS considering collaboration and integration with other organizations. This document is a practical guide for ambulance services (agencies) to use in their pursuit of sustaining effective and efficient delivery of patient care and developing into an integrated system with other agencies. Integration is intended to provide and sustain improved patient care by capitalizing on efficiencies. It will provide insights into various means, which have been used by agencies within the industry to promote integration between agencies to the benefit of the agencies, the staff, and, most importantly, to the patients.

HHS Issues Strategy to Reduce EHR Regulatory Burden

HHS Issues Strategy to Reduce EHR Regulatory Burden. As part of the U.S. Department of Health and Human Services (HHS) Patients over Paperwork initiative, the Department on Friday, February 21, issued the Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs. The report describes recommendations and next steps to reduce burden related to EHRs and describes sources of electronic health record (EHR)-related burden, referencing stakeholder feedback including challenges relevant to small and rural hospitals.