The Josiah Macy Jr. Foundation has released a blog on Social Determinants of Health: A required Curriculum. The blog discusses the importance of understanding all the social factors that can affect a patient’s health and how medical professionals need to understand the conditions in their communities if they are going to help their patients live their healthiest lives. This blog can be applied to all health professionals.

Click here to read the blog.

Pittsburgh’s NPR news station reports that starting in early October, Sam’s Club members in Pennsylvania as well as Michigan and North Carolina will be able to buy one of four bundles of healthcare services ranging in annual fees from $50 for individuals to $240 for a family of up to six members. Each bundle offers savings on dental services with a network of providers through the health insurer Humana as well as unlimited telehealth for $1 per visit through a Seattle-based company called 98point6.The bundles also offer discounted vision exams and optical products, and free prescriptions on certain generic medications. The number of free generics range from 5 to 20 of the most popular medications, depending on what the member chooses. Customers will be introduced to a new form of care from 98point6 where patients can be diagnosed and treated without talking to or seeing the doctor. Patients who click on the 98point6 app first tell their symptoms to a chatbot or automated assistant that uses artificial intelligence. The information then get passed along to a doctor for diagnosis and treatment. Video and phone conversations will also be available when needed.  Read more.

The Pennsylvania Insurance Department partnered with the Pennsylvania Association of Community Health Centers and other organizations to produce a total of 10 health insurance literacy videos that help consumers understand why and when to buy insurance, as well as how to select a plan and read an explanation of benefits (EOB).  See  below for links to the resources that are available.

• Why Buy Health Insurance?
  • Part of staying healthy is receiving essential and routine preventive services
• When to Buy Health Insurance
  • Marketplace open enrollment runs from Nov. 1 through Dec. 15
• Health Care Costs You Should Know
  • How to distinguish between a premium, co-pay, deductible, co-insurance, etc.
• Provider Networks
  • Know the difference between in-network and out-of-network
• How to Choose a Health Insurance Plan
  • The type of insurance impacts the way doctors and providers can be accessed
• Prescription Drug Coverage
  • If a specific prescription is needed, be sure to check it is covered under a plan
• You Bought Health Insurance, Now What?
  • Look for a welcome packet from the insurance company
• Insurance Cards Are Important
  • Be sure to always carry the provided card from the insurance company
• What If I Get Sick?
  • Know the difference between primary care, urgent care and emergency care
• What Is an EOB?
  • “This is NOT a bill”

Pennsylvania Governor Wolf’s administration announced it handed out 6,774 kits of free naloxone as part of September opioid overdose prevention events. The kits were made available at 95 locations across the state. Secretary of Health Dr. Rachel Levine said more than 4,400 people died from a drug overdose in Pennsylvania in 2018. Issued by Levine in 2018 and most recently updated in July, a standing order prescription is available to any Pennsylvanian to get naloxone at a pharmacy for anyone who may need it. According to the PA Department of Health, more than 25,000 people have been revived with naloxone by police officers and EMS providers in the commonwealth since Nov. 2014. The FY 2019-20 state budget included a $1.5 million increase in funding for first responders, who have access to free naloxone and are permitted to administer it as part of their treatment of someone who has overdosed.

Qualified Opportunity Zones are economically-distressed communities where new investments, under certain conditions, may be eligible for preferential tax treatment. This can help bring new investments into previously under-capitalized areas. Localities qualify as Opportunity Zones if they have been nominated for that designation by the state, and that nomination has been certified by the Secretary of the U.S. Treasury via his delegation of authority to the Internal Revenue Service. As Appalachia is home to 737 Opportunity Zones, or 8.5 percent of the country’s total, ARC is actively working with communities to leverage Opportunity Zone designations, and ARC’s Federal Co-Chair serves on President Trump’s White House Opportunity and Revitalization Council to better coordinate Federal resources to these areas.

Two of Appalachia’s designated Opportunity Zones are along the Oostanaula River in Rome, Georgia. In these neighborhoods, the City of Rome is performing needed water infrastructure upgrades using ARC support.  This will help the Rome Downtown Development Authority, the Rome-Floyd Chamber of Commerce, and surrounding property and business owners make the area shovel-ready for major development, attract capital, and create jobs.

In Kentucky, there are Opportunity Zones tracts in every one of the state’s 54 Appalachian counties. The Kentucky Cabinet for Economic Development (KCED) has stood up kyoz.org,  a dedicated dashboard for potential Opportunity Zone investors. With ARC assistance, KCED will expand this resource to engage marketing, site and project development, project financing, and other professionals to work closely with local leaders to identify and cultivate additional Opportunity Zone investment prospects to help communities better leverage Opportunity Zone investment incentives.

During the week of September 26, 2019, the Appalachian Regional Commission (ARC) announced 40 Fellows as members of the inaugural class of the Appalachian Leadership Institute. These Fellows include public policy, community development, education, investment, and other professionals who live and/or work in every one of the Region’s 13 states. As a Fellow, each will participate in an extensive nine-month program focusing on skill-building seminars, best practice reviews, field visits, mentoring, and networking anchored by six multi-day seminars around the region. The first session will take place in Morehead, Kentucky, October 21–24, 2019, with a capstone graduation to be held in Washington, DC in July, 2020.

“I congratulate the participants in this inaugural class of the Appalachian Leadership Institute for being selected through a very competitive process. Our hope is that this program will help them further develop their abilities in the areas of leadership and problem solving, allowing them to help bring advancement, growth, and greater prosperity to their communities,” said ARC Federal Co-Chairman Tim Thomas. “Leadership is the essential foundation on which all of our collective efforts to enhance the Region rest. I am excited by the future opportunities our Region will create, and am confident that these individuals will discover and capitalize on them.”

Appalachian Leadership Institute Fellows were chosen via a competitive application process. ARC received 180 applications for the 2019–2020 Appalachian Leadership Institute class, resulting in an acceptance rate of 22 percent. Applications for the 2020–2021 class will open in March, 2020.

DENVER — One patient at Denver Health, the city’s largest safety net hospital, occupied a bed for more than four years — a hospital record of 1,558 days.  Another admitted for a hard-to-treat bacterial infection needed eight weeks of at-home IV antibiotics, but had no home.  A third, with dementia, came to the hospital after being released from the Denver County Jail. His family refused to take him back.

In the first half of this year alone, the hospital treated more than 100 long-term patients. All had a medical issue that led to their initial hospitalization. But none of the patients had a medical reason for remaining in the hospital for most of their stay.

Legally and morally, hospitals cannot discharge patients if they have no safe place to go. So patients who are homeless, frail or live alone, or have unstable housing, can occupy hospital beds for weeks or months — long after their acute medical problem is resolved. For hospitals, it means losing money because a patient lingering in a bed without medical problems doesn’t generate much, if any, income. Meanwhile, acutely ill patients may wait days in the ER to be moved to a floor because a hospital’s beds are full.

“Those people are, for lack of a better term, stranded in our hospital,” said Dr. Sarah Stella, a Denver Health physician.

To address the problem, hospitals from Baltimore to St. Louis to Sacramento, Calif., are exploring ways to help patients find a home. With recent federal policy changes that encourage hospitals to allocate charity dollars for housing, many hospitals realize it’s cheaper to provide a month of housing than to keep patients for a single night.

Click here to access the full article from Kaiser Health News.

On October 3, 2019, President Trump signed an Executive Order directing HHS to take a number of actions to improve the Medicare program. Secretary Azar issued the following statement:

“President Trump’s Executive Order delivers on the clear promise he’s made to Americans about their healthcare: protect what works in our system and fix what’s broken. America’s seniors are overwhelmingly satisfied with the care they receive through traditional Medicare and Medicare Advantage, and the President is continuing to take action to strengthen and improve these programs. The President has directed HHS to take a number of specific, significant steps that will meaningfully improve the financing of Medicare, advance the care American seniors receive from their doctors, and improve the health they enjoy.

“The steps include expanding options and providing savings for seniors on Medicare Advantage; eliminating unnecessary burdens on providers; focusing Medicare payments on time spent with patients rather than on procedures performed; accelerating access to the latest medical technologies; cutting waste, fraud, and abuse; and expanding freedom and control for seniors on Medicare. All of these steps together will help create a healthcare system that puts patients at the center. These kinds of improvements, rather than a total government takeover of the healthcare system, are the path to our ultimate goal: better health for all Americans. That’s the President’s promise, and that’s what he has been delivering for American patients.”

The full Executive Order can be read here here.

As the Pennsylvania Partnerships for Children continues to serve on the Kinship Navigator Oversight Committee, they are pleased to report initial successes with the Department of Human Services’ (DHS) KinConnector Program!

In August alone, the toll-free hotline received more than 140 calls from kin caregivers providing loving homes and basic needs to children who cannot be with their biological parents. Through the program, caregivers connect with compassionate KinConnectors and receive guidance applying for federal, state, and local benefits such as CHIP, Social Security and other services, as well as training and parenting support.

The program was only recently implemented, so please join us and help spread the word by sharing this newly released KinConnector brochure from DHS.

WASHINGTON, Oct. 3, 2019 – U.S. Department of Agriculture (USDA) Deputy Under Secretary for Rural Development Donald “DJ” LaVoy today announced that in accordance with the provisions of the Agriculture Improvement Act of 2018 (the Farm Bill), USDA is changing rural population limits, fees and funding priorities for some loan guarantee programs administered through the Rural Housing Service and the Rural Utilities Service.

USDA will increase the rural population eligibility limit to 50,000 residents for the Community Facilities Guaranteed Loan Program and the Water and Waste Disposal Loan Program.

For fiscal year 2020, projects financed through the Community Facilities Guaranteed Loan Program will receive priority in rural areas of 20,000 or fewer residents. Projects financed through the Water and Waste Disposal Guaranteed Loan Program will receive priority in rural areas of 10,000 or fewer residents.  USDA will increase the Community Facilities Guaranteed Loan Program’s one-time guarantee fee from 1 percent to 1.5 percent. The Agency also will establish an annual renewal fee of 0.5 percent of the loan’s principal balance each year. There are no changes to the Water Waste Disposal Guaranteed Loan Program fee rates.

These changes are effective Dec. 2, 2019. However, applications for Community Facilities or Water and Waste Disposal loan guarantees for projects serving rural areas with populations up to 50,000 may be filed with the Agency starting today. The Agency will not act on any applications received under this notice until the effective date. For additional information, see page 52869 of the Oct. 3, 2019, Federal Register.

USDA encourages applications that will support recommendations made in the Report to the President of the United States from the Task Force on Agriculture and Rural Prosperity (PDF, 5.4 MB). Applicants are encouraged to consider projects that provide measurable results in helping rural communities build robust and sustainable economies through investments in infrastructure, partnerships and innovation. Key strategies include:

• Achieving e-Connectivity for Rural America
• Developing the Rural Economy
• Harnessing Technical Innovation
• Supporting a Rural Workforce
• Improving Quality of Life