This guide from the U.S. Department of Health & Human Services covers the advantages of telehealth accreditation, clinical and technical standards, and educational and training standards.

The toolkit is intended to help Critical Access Hospitals (CAHs) and other rural providers improve workforce recruitment and retention efforts with resources that address four topics: organizational culture and leadership, leveraging partnerships, emergency medical services workforce, and administrative and support staff workforce. The Flex Monitoring Team is a FORHP-supported consortium of researchers who evaluate the impact of HRSA’s Medicare Rural Hospital Flexibility Program.

The Government Accountability Office (GAO), a federal agency that examines how taxpayer dollars are spent, issued a new report with recommendations on rural communities known as Colonias.  These are predominantly rural, Hispanic communities near the U.S.-Mexico border. Many have poor access to drinking water, inadequate sewage systems, and substandard housing.

– Submit by December 6. If you are a clinician or health official with a background in primary care, oral health, or mental/behavioral health, we invite you to apply for the National Advisory Council on the National Health Service Corps (NHSC). Rural communities are often the least represented on the board, and the NHSC wants your input! Self-nominations are accepted.

A study published in the Journal of Graduate Medical Education evaluates the outcomes of 25 grantees in cohort 1 of HRSA’s program to create new residency training programs in rural areas.  Results indicate sufficient success to support program continuation; about a third of placed residents were from the states where the residency programs are located, and these residency programs filled at similar rates as more established residency programs. View a list of RRPD grantees from 2019 to 2024.

On Tuesday of this week, HRSA and the U.S. Department of Health & Human Services announced new funding administered by the Federal Office of Rural Health Policy that will:

• Expand rural access to services for pregnant women and new mothers.  Cooperative agreements between HRSA and rural organizations within the federal Delta Regional Authority will help build community-level networks that support care coordination for perinatal health.
• Help rural hospitals stay open. Over the next three years, the Rural Hospital Stabilization Pilot Program will provide in-depth technical assistance to rural hospitals to enhance or expand service lines to meet local needs.
• Launch and expand services for SUD.  New awards extend the federal effort to improve access to treatment and recovery for substance use disorder (SUD) in rural communities in 13 states.

How will building community capacity help us strengthen Appalachia? 🌱

Many organizations serving the region do not have enough resources, or “capacity,” to plan, strategize or steer complex projects. Organizations often need training and funding to hire more staff, build organizational skills and expand services to create the greatest positive impact in their communities. 💚

That’s why we’re excited to announce the launch of READY Grants to Grow. This new $9M funding opportunity will award grants of up to $500K to organizations seeking to build individual, organizational or community capacity in Appalachia.

Any organization that is eligible to apply for an ARC grant is eligible to apply for READY Grants to Grow. Join us at a pre-application webinar on October 10 to learn more!

Announcement of Public Comment Period for the Fair Contracting for Health Care Practitioners Act, Act 74 of 2024

As directed by the Fair Contracting for Health Care Practitioners Act (act), Act 74 of 2024, the Health Care Cost Containment Council (Council) has begun studying the prevalence and impact of non-compete agreements in the Commonwealth. The Council will be collecting public comments for analysis and inclusion within the final report. Comments received between September 21, 2024, and October 21, 2024, will be included for analysis.

Persons who wish to comment on the act may do so by contacting the Health Care Cost Containment Council

• Email: publiccomment@phc4.org
• Letter by Mail:
  PA Health Care Cost Containment Council
  225 Market St, Suite 400, Harrisburg, PA 17101

Thank you in advance for your consideration. If you have any questions, please feel free to contact Jake Muskovitz, PHC4’s project manager for the study: jmuskovitz@phc4.org.

By Donna Kallner September 27, 2024

People who travel overseas are usually advised to do a bit of research beforehand about how to behave there. Closer to home, though, they may be unintentionally obtuse about the etiquette of rural places they visit.

n the hospitality business it’s common knowledge that doctors and lawyers, judges and business executives like to cut loose where their professional colleagues, customers and constituents are unlikely to notice. And rural places, whether they’re across the country or across the county, are just the ticket.

My theory, for what it’s worth, is that people who’ve been trained to never take no for an answer in their day jobs forget that negotiation isn’t part of every interpersonal exchange.

Some people raise misbehaving to an art form worthy of lyrics in country songs. But mostly, it’s not worthy. Manners matter, even when you’re around people you think you’ll never see again. So here are things you might wish to know about how to behave in rural areas.

There’s a reason. For every sign posted in a rural area, there’s a reason. Sadly, though, there are always people who think they only apply to other people. Often, as they disregard a sign, they declare, “I’m only going to be here a minute.” And somehow they always seem to have missed childhood lessons about how long a minute is. So here’s one of the simplest rules of behavior in rural areas: Don’t block driveways, mailboxes, gates, dry hydrants or anything else marked by a sign.

People pay attention. Where there are fewer people and fewer vehicles on the roads, there’s not much anonymity. So you can assume folks note the make and model of unfamiliar vehicles. Recently, I stopped to visit with someone who told me about a pickup truck that’s been racing past his place. I’ve seen that truck and think it might belong to someone working a construction project nearby.

When a project is expected to take several months, an out-of-town work crew might find rental housing (good luck) or park a trailer somewhere. They might never actually meet the people who live on that narrow, curvy, hilly road – people who may be reluctant to flag down an unfamiliar vehicle to ask the driver to slow down. So visitors might want to know that rural populations skew older, and behave as if behind every window there’s someone with all the time in the world to take down license plate numbers, note patterns of activity, and call the sheriff.

Word gets around. I have to assume that misunderstood manners are why, in the city, Uber drivers get to review guests like guests review drivers. VRBO and AirBnB short-term rental hosts also get to review guests. But even when there’s no formal mechanism to record bad behavior, word gets around. When we hear a business owner mutter, “That guy’s as welcome as a fart in church,” we take note. It’s best to assume that people in a rural area all know each other, and the person behind the bar is texting her cousins about the unruly patron who might be headed their way after she invites the bad boy to leave. As a rule, it’s best to treat rural bartenders like tough mothers, regardless of gender.

Patience is a virtue. I know people with years of experience in the hospitality industry who will not work on Friday nights. Here in Wisconsin, that’s when people go out for fish fry. Here in the Northwoods, that’s also when people with cottages head north to relax after leaving more populated places with more restaurant options. I don’t know why some reality show doesn’t drop celebrities and CEOs into Northwoods taverns to work Friday fish fries (or maybe they have but I don’t watch those shows).

People skilled in other lines of work might not fully appreciate the careful preparation, teamwork and timing it takes to get fried fish orders through the line and out of the kitchen. People who know and love this culinary tradition just order a brandy old fashioned (sweet) and wait patiently for their food. Unless they see a large party with fussy children arguing with the wait staff about making 20 or 30 minor substitutions: Then locals take our orders to-go.

Planning is appreciated. In rural areas, it’s safe to assume that there are no simple solutions to supply problems nearby. So we try to plan ahead as much as possible. That includes not just restaurants but also volunteer fundraisers like fish boils and pancake breakfasts. An order of 50 meals to-go is most appreciated when we know in advance it’s coming. Then we can have sufficient containers on hand not just for that one order but for all the other folks who want carryout, and set up for food prep that doesn’t extend the wait time for people standing in line. The volunteers flipping flapjacks can’t make their griddles larger, or shorten the distance to town to send someone for more to-go boxes.

Make eye contact. This may be difficult to comprehend for people who spend most of their time trying to avoid making eye contact with strangers. But in rural areas, we actually look at each other when we talk. Pair that with a smile and folks will be treating you like family in no time. Add a friendly wave if you’re driving by. But don’t slow down unless there’s a deer in the ditch or you may seem creepy.

Language matters. In general, in rural places you can’t go wrong with please, thank you, and “may I ask…” Respectful questions are generally appreciated in both private homes (would you prefer I take off my shoes?) and in businesses (is it too close to closing time to order food?). Even respectful questions may not yield the hoped-for answer. Back when my husband and I owned a paddling school on a whitewater river, we said no to a lot of people who thought they should be able to rent a canoe or kayak – whether or not they knew how to paddle in whitewater rapids. Some of them seemed to think no meant talk louder using coarse language. The first time it happened to me, I asked the guy, “Would you speak that way if your mother was standing behind you?” He actually looked over his shoulder.

To avoid any misunderstanding, cussing at the person behind the counter is not good manners. Cussing where families are present (and by that I mean people of every age) – not good manners. Anybody on a ladder helping a neighbor get a fallen tree off a roof gets a free pass on language. But otherwise, watch your mouth. Anything else I might have to add can be best expressed by Wisconsin musicians Pete and Lou Berryman in their song, A Chat With Your Mother:

I can’t control how you young people 

Talk to one another,

But I don’t want to hear you use 

That F word with your mother.

Once you hear that sung to the accordion, it’ll be with you forever.