“When you look at the data [about the opioid crisis], it may be a little sobering.  The reality however is that people in rural communities are not waiting for data to tell them what they should do. They’re implementing their own solutions,” said ARC’s Kostas Skordas, Director of Research and Evaluation during a recent Atlantic Festival panel discussion about Health Equity in America. Moderated by journalist Vann Newkirk, the panel also included comments by Sana Chehimi, Director of Policy and Advocacy, Prevention Institute; and Michael Meit, Co-Director, NORC, Walsh Center for Rural Health Analysis, and touched on a variety of topics including the intersection of health equity and economic development. “Infrastructure, economic and social development, leadership, access to education, jobs and employment.  All of that is definitely related to broader health issues and certainly related to the opioid crisis,” Skordas added.

Last year, ARC published case studies of ten “Bright Spot” counties, each defying predictions for health with better-than-expected outcomes as part of Creating a Culture of Health in Appalachia: Disparities and Bright Spots, a health research initiative to identify and explore Appalachian communities with better-than-expected health outcomes. Among the greatest assets these Bright Spot counties have are their people, who generate collective pride and power through volunteerism, a steadfast commitment to community, and shared values for health. The Bright Spot counties also benefit from “anchor institutions” such as schools, businesses, churches, and hospitals that work to improve community health and the social factors that affect health. A summary of the Bright Spots research, plus other data about health in Appalachia, is available at healthinapplachia.org.

The 2020 National Health Service Corps (NHSC) Students to Service (S2S) Loan Repayment Program (LRP) application cycle is open. Medical and dental students in their final year of school can receive awards of up to $120,000 in exchange for a three-year commitment providing primary care services at NHSC-approved sites in high-need areas. Review the 2020 Application and Program Guidance (PDF – 1.2 MB) for more information on how to apply. The NHSC S2S LRP application cycle closes on October 31, 2019 at 7:30 p.m. EDT.

HRSA will release 2018 data from the National Survey of Children’s Health (NSCH) on October 7. The NSCH provides the latest national and state-level data on the health and health care needs of children as well as information about their families and communities.

Survey topics include children’s:

• Physical and mental health,
• Health insurance status,
• Access and utilization of health care services, including
  • Receipt of preventive and specialty care, and
  • Care in a patient-centered medical home,
• Services to support transition to adult health care for adolescents,
• Lifetime exposure to adverse childhood experiences, and more.

The NSCH is funded and directed by HRSA’s Maternal and Child Health Bureau and conducted by the U.S. Census Bureau, which oversees sampling, survey administration, and production of a final data set for public use.

Learn more about the National Survey of Children’s Health.

Staying up to date on alerts sent by the Centers for Disease Control and Prevention (CDC) is now a way for clinicians to earn Continuing Education credits.  The most recent alerts for which the credits are offered provide up-to-date information and guidance from the CDC on transmission of HIV, care for homeless persons who are at risk of contracting Hepatitis A, and Methicillin-resistant staphylococcus aureus (MRSA) infections – all conditions that have been related to needle-sharing behavior.  The credits are offered through a CDC partnership with Medscape, a website providing news and resources for health professionals.  The CE credits can be accessed here.

On September 26, the Centers for Medicare and Medicaid Services (CMS) issued a final rule updating regulations for hospitals, Critical Access Hospitals (CAHs), and home health agencies (HHAs) on the transition from acute care into post-acute care (PAC), a process called “discharge planning.” For CAHs, the final rule adds a new, separate condition of participation (CoP) specific to discharge planning. The new regulatory language outlines the standards for the discharge planning process, beginning with identifying those patients (at an early stage of hospitalization) likely to suffer adverse health consequences upon discharge in the absence of adequate discharge planning. Detail on the specific requirements is provided in the Federal Register. These regulations will go into effect on November 29, 2019.

On September 26, the Centers for Medicare and Medicaid Services (CMS) issued a final rule to remove or update Medicare regulations the agency has identified as unnecessary, obsolete, or excessively burdensome on hospitals and other healthcare providers. This includes regulatory updates for Critical Access Hospitals (CAHs), rural health clinics (RHCs) federally qualified health centers (FQHCs), and hospital and CAH swing-bed providers. Among other updates for CAHs, the final rule replaces the current requirement on systems for infection control with a new infection prevention and control and antibiotic stewardship Condition of Participation (CoP). CMS is also requiring that CAHs develop, implement, and maintain Quality Assessment and Performance Improvement Programs (QAPI) programs, that will replace the existing annual evaluation and quality assurance review requirement. In implementing the QAPI requirements, CMS encourages CAHs to utilize the technical assistance and services available through the State Flex Programs, including the Medicare Beneficiary Quality Improvement Project (MBQIP). For RHCs and FQHCs, the final rule reduces the frequency of review of the patient care policies and facility evaluation from annually to every two years. The final rule also makes changes to other requirements such as those pertaining to emergency preparedness. To see all the facility types and regulations affected, you may access the final rule in the Federal Register. These regulations will go into effect on November 29, 2019, except for the CAH QAPI and antibiotic stewardship requirements (March 30, 2021 and March 30, 2020, respectively).

The Rural Health Information Hub (RHIhub) recently announced a new toolkit that compiles resources and model programs to aid organizations in implementing suicide prevention programs in rural communities.  According to data collected by the Centers for Disease Control and Prevention (CDC), suicide rates are higher in rural areas of the country.  Earlier this year, the CDC released a map of suicide mortality, showing a concentration in states that are mostly rural.

October 1, 2019

Harrisburg, PA – The Wolf Administration today announced a 14-county expansion of the Living Independence for the Elderly (LIFE) program, a long-term care program that helps seniors live in their home and coordinates their health and personal needs. Through this expansion, LIFE programs, under the jurisdiction of the Department of Human Services (DHS), will be established in Bradford, Cameron, Carbon, Centre, Clearfield, Elk, Fulton, Jefferson, Monroe, Potter, Sullivan, Susquehanna, Tioga, and Wayne Counties.

“All Pennsylvanians deserve to age in place in their community with family and peers as they are able. LIFE programs around Pennsylvania help make this possible,” said DHS Secretary Teresa Miller. “We are pleased to be able to bring the LIFE program to more Pennsylvanians around the commonwealth.”

Many older Pennsylvanians wish to continue living in their homes and their communities for as long as economically and medically feasible; and Pennsylvania’s LIFE program enables participants to stay out of nursing homes and remain in their own homes and communities and live happier, more productive, and more fulfilling lives.

“This LIFE expansion will give seniors and their loved ones what we know they want — the opportunity to get the care they need without being separated from the community and family they’ve grown comfortable with,” said Department of Aging Secretary Robert Torres. “Social isolation remains an enormous concern for the aging population, so having this long-term care option made more accessible in 14 counties will benefit many Pennsylvania families.”

The program was first implemented in Pennsylvania in 1998 and is known nationally as the Program of All-Inclusive Care for the Elderly (PACE). People who are 55 or older who meet the level of care for a skilled nursing facility or special rehabilitation facility, are able to be safely served in the community, and live in an area served by a LIFE provider are eligible for LIFE. LIFE participants must also meet financial eligibility requirements or privately pay for services.

The Wolf Administration is committed to serving people in the community, and LIFE is an option that allows older Pennsylvanians to live independently while receiving services and supports that meet their health and personal needs. The LIFE program is one of Pennsylvania’s home and community-based services options, currently serving more than 7,000 people across the state.

The expansion of the program will allow more people in more parts of the state to be served by LIFE. The service areas of Carbon, Monroe, Susquehanna, Wayne and Centre counties have been assigned to LIFE Geisinger. LIFE Geisinger is currently active in nine other counties. The Clearfield, Jefferson, Elk and Cameron service areas have been assigned to LIFE Northwestern Pennsylvania, who is currently active seven other counties. In addition, the Bradford, Potter, Sullivan, Tioga, and Fulton service areas have been assigned to Community LIFE, who is currently active in two other counties.

For more information on the LIFE program, visit http://dhs.pa.gov/citizens/life/.

During the week of September 23, 2019, Modern Healthcare released its 2019 ranked list of the “Best Places to Work in Health Care,” featuring hospitals, suppliers, and other organizations in the industry. For this year’s edition, Modern Healthcare ranked 75 providers and insurers on one list and 75 suppliers on another. (Source: Modern Healthcare, 9/26)