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Fighting for Health Care: Rural America Struggles with Loss of Doctors, Clinics

U.S. Today, March 6, 2020

FAIRFIELD, Washington — Drive 20 minutes south of Spokane and pine trees give way to rolling hills, which in fall are golden with remnants of the wheat harvest and in winter dusted with snow. This part of eastern Washington state is the beginning of the Palouse region. Its small farm towns once thrived but now struggle to offer essential services such as health care.

For decades in Fairfield, residents received care from a doctor in a community clinic on Main Street. Alongside a post office, community center (which doubles as Town Hall), drug store, bank and library, a stucco building where the health clinic used to be sits vacant.

Longtime Fairfield residents recall giving birth to their children at the clinic and visiting for regular checkups. But in 2019, after Kaiser Permanente acquired the health care group that operated the clinic, it closed and the doctor moved to Spokane, a 30-minute drive north.  The drive is reasonable for some Fairfield residents, but it’s not feasible for others. As the Spokane-based Spokesman-Review reported, the majority of residents at Palouse Country Assisted Living, one of Fairfield’s largest employers, cannot drive.

Nationally, more than one in five people over age 65 live in rural areas, Census data show, and in Washington state, 20 percent of people 65 and older live in rural communities.

Read more.

Pennsylvania Governor’s Administration Hosts Roundtable to Boost PASS Program Connecting Hungry Families with Farmers’ Excess Food 

On March 5, 2020, Pennsylvania Agriculture Secretary Russell Redding and Human Services Secretary Teresa Miller led a roundtable discussion of PASS, the Pennsylvania Agricultural Surplus System, which provides farmers funding to get food that would otherwise go to waste to vulnerable families who need it most. Governor Wolf requested a $1 million funding increase for the program in his 2020-’21 budget proposal.

Lancaster-based Hess Brother’s Fruit Company, which has donated more than 373,000 pounds of fresh fruit to the program, hosted the discussion among contributing growers as well as charitable food organizations and processors who are program partners.

“Agriculture is the antidote to hunger,” Secretary Redding said. “Pennsylvania farmers produce some of the best and most plentiful food in the world, but the extra food they produce isn’t always where hungry families are. PASS gets that food where it is needed, while supporting the generosity of farmers like the Hess family.”

Since the PASS program was first funded in April 2016, more than 11.4 million pounds of food has been distributed to all 67 counties in the state through partners that are part of the Feeding Pennsylvania and Hunger-Free Pennsylvania networks of food banks. Sixty different Pennsylvania-produced foods have been sourced from 134 farmers, processors, and growers across the state. The foods include fresh fruits and vegetables, milk, cheese and other items that are often difficult for food pantries to obtain.

According to the USDA, in 2017, more than 1.53 million Pennsylvanians – that’s one in every eight people – don’t always know where their next meal is coming from. The roundtable sought to gather input from program partners, including the charitable food organizations facing challenges stemming from new federal rules limiting who can participate in programs like the Supplemental Nutrition Assistance Program.

“The Supplemental Nutrition Assistance Program, otherwise known as SNAP, helps more than 1.7 million Pennsylvanians afford and access healthy, nutritious food every day,” said DHS Secretary Miller. “When I visit local food banks and meet SNAP recipients, I hear how people stretch their SNAP dollars as far as possible before they need to turn to other government assistance programs and local food networks to help get to the end of the month. Through partnerships like PASS, we are able to bridge the growing hunger gaps and expand access to fresh, healthy foods to citizens across Pennsylvania.”

Find out more about the Wolf Administration’s strategy to end hunger in Pennsylvania at For more on the PASS program, including a map of distributors, visit

Photos, video and audio for news stories will be available on

MEDIA CONTACT: Shannon Powers, Agriculture  – 717.783.2628

Community Health Workers: Evidence of Their Effectiveness

The Association of State and Territorial Health Officials and the National Association of Community Health Workers recently published a summary of the research examining community health workers over the past fifty years. This research has focused on assessing their effectiveness in improving health outcomes, reducing healthcare costs, and bridging the gap in health disparities. This work is supported through HRSA’s cooperative agreement with the National Organizations of State and Local Officials.

Read the summary (PDF – 281 KB).

Wellness Funds: Flexible Funding to Advance the Health of Communities

The accountable communities for health (ACH) model is a multi-sector, community-based partnership that brings together health care, public health, social services, and other sectors such as education and the justice system to collectively address priority health and social issues.  To promote Wellness Funds that help build ACHs, the Funders Forum on Accountable Health created this support to explain the model and provide case studies on the work of three communities, two of them rural.

New Medicare ACO Beneficiary Engagement Case Studies and Video

The Centers for Medicare & Medicaid Services released a new video and case studies that provide ideas and strategies promoting value-based care in current and prospective Accountable Care Organizations (ACOs).  These resources highlight how ACOs can provide nonclinical support for beneficiaries with end-stage renal disease (ESRD); maintain patient advisory committees to improve care for beneficiaries with ESRD; and leverage health navigators to identify and resolve care gaps for beneficiaries in rural areas.  The information can be accessed here.

New Data on Drug Overdose Deaths in the United States

The National Vital Statistics System is the oldest and most successful example of data sharing  in Public Health across all levels of government.  Among the key findings in this most recent report on drug overdose deaths, is an overall decline of 4.1 percent between 2017 and 2018.  The rate of overdose deaths involving synthetic opioids other than methadone (drugs such as fentanyl, fentanyl analogs, and tramadol) increased by 10 percent.  Click here for more information.

Testing for HIV and TB Coinfection

In 2006, the Centers for Disease Control and Prevention (CDC) issued new recommendations for HIV testing that was to increase the early diagnosis of human immunodeficiency virus (HIV) infection by recommending it be a routine part of medical care. But were you aware that HIV is the most important known risk factor for the progression from latent tuberculosis infection (LTBI) to TB disease? Individuals testing positive for LTBI and HIV infection that are not treated for both conditions have a high risk of progressing from LTBI to TB disease. By clicking here, you can read more on this issue from information that will be included in the Pennsylvania Department of Health’s TB Manual.

Pennsylvania State Board of Medicine Offers Discrepancy Guide for Physician Licensure Applications

The Pennsylvania Department of State’s (DOS) Bureau of Professional and Occupational Affairs (BPOA) offers guides to help physicians avoid common discrepancies on initial licensure and physician assistant supervising physician applications. Discrepancies delay the processing and approval of applications. The instructions outline the necessary documentation and information needed to successfully complete an application and avoid delays. Access the Discrepancy Guide for Initial Physician Licensure Applications here. Each of the professional licensure boards has an application checklist listing all of the requirements and needed documents for a licensure application to be complete.