Rural Health Information Hub Latest News

Black Pennsylvanians 50% Less Likely to Receive Naloxone, Despite Soaring Overdose Deaths

recent study from the Pennsylvania Department of Health (DOH) has found that Black people who died from opioid overdoses were half as likely as white people to receive the life-saving drug naloxone, otherwise known as Narcan. The study also found that Black overdose deaths in Pennsylvania increased by more than 50% between 2019 and 2021, compared with no change in white overdose deaths. A DOH representative said that similar rises in overdose deaths are being seen across the country, especially among Black, American Indian and Alaska Native populations, but researchers are still investigating what’s behind the spike. Read more.

Drug Manufacturers’ Assault on 340B Program Continues

Two more manufacturers have announced contract pharmacy restrictions (CPRs) on Community Health Centers and a third has tightened them:

·    Alkermes – who makes Vivitrol, an SUD treatment drug that CHCs often prescribe – announced CPRs that will go into effect on July 22. Due to varying payor rules about whether Vivitrol must be dispensed by a regular pharmacy or contract pharmacy, it will soon be impossible for most CHCs to obtain all their Vivitrol at the 340B price.

·    Sobi announced CPRs effective July 1, but they should have little impact on CHCs.

·    Effective July 1, Bristol Meyers Squibb will require CHCs with a single, designated contract pharmacy site to report data to ESP on that site. This data must be reported within 14 days of the drug being dispensed and include 16 elements for each claim. CHC experts say that meeting these requirements will be an extremely heavy lift, and possibly impossible.

·    Sanofi’s policy of treating free-standing CHC-owned pharmacies like contract pharmacies appears to have been adopted by Alkermes, Bausch & Lomb, and Sobi. More information will be forthcoming, but we’re told that health centers should prepare for most of their free-standing pharmacies to lose access to 340B-priced Sanofi, Bausch & Lomb, and Sobi drugs starting July 1, and Alkermes drugs starting July 22.

Maternal and Child Health Stillbirth Prevention Act Passes out of Congress

The Maternal and Child Health Stillbirth Prevention Act of 2024, HR 4581, passed through both the House and the Senate, and now awaits President Biden’s signature before it becomes law. The bipartisan bill amends the Maternal and Child Health Service Block Grant program to allow states to use those dollars for stillbirth prevention and research activities but does not include additional funding.

Responding to the Primary Care Payment Congressional RFI

Senators Whitehouse and Cassidy introduced S. 4338, the Pay PCPs Act. The Pay PCPs Act would encourage the Centers for Medicare and Medicaid Services (CMS) to accelerate its existing efforts to support value-based primary care and improve the adequacy of pay for primary care providers in Medicare. This legislation serves as a marker for future primary care legislation and includes a request for information on hybrid payments for primary care providers, risk adjustment criteria, quality measures and services to be included in hybrid models, cost sharing and technical advisory committees. Please send any feedback on the RFI questions to federalpolicy@nachc.org by June 28.

Work Resumes in Pennsylvania to Finalize Rules to Reduce Barriers for Those with Criminal Records to Earn Professional Licenses

State officials are taking another crack at finalizing proposed rules that would make it easier for Pennsylvania residents with criminal records to earn professional licenses in fields ranging from accounting and nursing to cosmetology and real estate. The PA Department of State (DOS), which oversees professional licensure, issued a revised version of the rules this month after an earlier draft was rejected in April by the Independent Regulatory Review Commission (IRRC). IRRC questioned whether the rules adequately protect public health and safety and was concerned, in part, that certain crimes were not listed as being “directly related” to certain professions, thus triggering a closer look from licensing boards. The rules, for example, did not make prior convictions for forgery or identity theft an automatic impediment for people seeking to become state-licensed CPAs. In its latest version, DOS added stronger language emphasizing that licensing boards have a responsibility to consider individual applications for licensure. The language also clarifies that boards can still consider offenses as part of a licensing decision even if they are not listed as “directly related.” The IRRC met this week and approved the updated version. The rules implement Act 53 of 2020, a state law enacted in 2020.

PRISM Study Summary: Preparing Behavioral Health Clinicians for Success and Retention in Rural Safety Net Practices

This study assesses how, among behavioral health clinicians working in rural safety net practices, the amount of exposure to care in rural underserved communities received during training relates to confidence in skills important in their work settings, successes in jobs and communities, and anticipated retention.

This study summary provides a quick overview of the study published by the Journal of Rural Health.

View the Study Summary here.

FEMA Publishes National Risk Index

The National Risk Index is a dataset and online tool to help illustrate the United States communities most at risk for 18 natural hazards. It was designed and built by FEMA in close collaboration with various stakeholders and partners in academia; local, state and federal government; and private industry.

The Risk Index leverages available source data for natural hazard and community risk factors to develop a baseline risk measurement for each United States county and Census tract.

Quality of EMS Care Varies Widely Across the U.S.

From AXIOS

The level of care patients receive in a medical emergency varies widely based on where 911 is being dialed.

Why it matters: A first-of-its-kind study of emergency medical service systems’ performance across the country points to opportunities to improve patient care when the pressure is on.

What they did: Researchers at the Icahn School of Medicine at Mount Sinai reviewed more than 26 million responses from nearly 9,700 EMS agencies in 2019.

  • They assessed how those agencies performed on safety and clinical quality measures that had been outlined by a nonprofit industry organization that year.
  • The researchers said it’s a shift from looking primarily at response times to determine EMS performance, which they say is an imprecise metric for most calls.

What they found: Agencies largely responding in rural areas were less likely to treat low blood sugar or improve trauma patients’ pain, researchers found.

  • They were also more likely to use lights and sirens unnecessarily, which other studies have found raises the risk of crashes.
  • Delivery of time-sensitive treatment also varied during EMS calls. For instance, 4 in 10 kids with wheezing or asthma attacks didn’t get breathing treatment, and about 1 in 3 suspected stroke patients didn’t have a stroke assessment documented.

What they’re saying: “We have to move away from solely looking at response times and start looking at performance that directly impacts the people we are meant to treat,” said lead author Michael Redlener, an associate professor of emergency medicine.