- Biden-Harris Administration Takes Historic Action to Increase Access to Quality Care, and Support to Families and Care Workers
- Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don't Meet Them.
- Rural Jails Turn to Community Health Workers To Help the Newly Released Succeed
- Rural Communities Face Primary Care Physician Shortage
- Miles for Milk: How Student-Run Grocery Store Reshaped Rural Community's Food Access
- Native Americans Have Shorter Life Spans, and It's Not Just Due to Lack of Health Care
- Across the Country, Amish Populations Are on the Rise
- Using Medicaid to Address Young People's Mental Health Needs in School Settings
- Promotoras Play Essential Role in Connecting Farmworkers with Health Care in Rural NorCal
- Sunsets, Wildlife and Limited Care: Challenges of Aging in Place in Rural America
- City-Country Mortality Gap Widens amid Persistent Holes in Rural Health Care Access
- Tribal Environmental Impact Network
- Minnesota's Rural Ambulance Providers Look to State Capitol for Their Own Lifeline
- Biden-Harris Administration Takes Action to Support the Primary Care Workforce
- Over 3,000 Homes on the Navajo Nation Receive Accurate Addresses for the First Time
Disparities Relating to HIV and PrEP
The Centers for Disease Control and Prevention (CDC) recently released two reports which may be of interest to health center providers:
- HIV and Gay and Bisexual Men: Difference in Knowledge of Status, Prevention, Treatment, and Stigma Exist by Race/Ethnicity: https://www.cdc.gov/vitalsigns/hivgaybimen/
- Racial, Ethnic, and Gender Disparities in Awareness of Pre-Exposure Prophylaxis Among HIV-Negative Heterosexually Active Adults at Increased Risk for HIV Infection: https://www.cdc.gov/mmwr/volumes/70/wr/mm7047a3.htm
America’s Youngest Adults are Overweight
According to new research conducted by Johns Hopkins and published in the Journal of the American Medical Association, 56% of American adults ages 18 to 25 are overweight or obese. Using data from a nationally representative sample of 8,015 people in that age bracket, the researchers compared average weights over the past four decades. In that time, that population’s average body mass index, a measure of body fat based on a person’s height and weight, had increased by 4.6 points – from 23.1 (considered normal weight) to 27.7 (considered overweight). That shifted the number of overweight young adults from about 18% in the late 1970’s to nearly 24% by 2018.
No Changes for Pennsylvania HealthChoices Physical Plans
The Pennsylvania Department of Human Services (DHS) has confirmed that there will be no changes to the Physical HealthChoices managed care organization (MCO) assignments in early 2022. Results of two of the four MCO challenges to DHS’ decisions in response to the 2021 RFP process have been announced. The Commonwealth Court of Pennsylvania upheld on November 17, 2021, the state’s decision to deny protests filed by Aetna Better Health of Pennsylvania and Centene/Pennsylvania Health & Wellness after the two plans failed to win contracts in the state’s recent Medicaid managed care procurement. Rulings on protests from Gateway Health Plan and UnitedHealthCare have not been released publicly. Implementation of the new contracts, originally slated for January 1, 2022, have been suspended until the protests are resolved. In Behavioral HealthChoices, Magellan will change to CCBH in Delaware County effective July 1, 2022.
The list of MCO assignments are:
- BehavioralHealth MCO’s https://www.dhs.pa.gov/HealthChoices/HC-Services/Pages/BehavioralHealth-MCOs.aspx
- PhysicalHealthChoices MCO’s https://www.dhs.pa.gov/HealthChoices/HC-Services/Pages/PhysicalHealthChoices-MCOs.aspx
- CommunityHealthChoices MCO’s https://www.dhs.pa.gov/HealthChoices/HC-Services/Pages/CHC-MCOs.aspx
Strategies to Prepare for Public Health Emergency Unwinding
The Centers for Medicare and Medicaid Services (CMS) released a “punch list” of strategies states and the U.S. territories can adopt to maintain coverage of eligible individuals as they return to normal operations after the end of the public health emergency. The strategies are organized around seven topics areas:
- strengthening renewal processes
- updating mailing addresses
- improving consumer outreach, communication, and assistance
- promoting seamless coverage transitions
- improving coverage retention
- addressing strains on the eligibility and enrollment workforce
- enhancing oversight of eligibility and enrollment operations
In the resource, CMS also flagged strategies expected to have the biggest impact on mitigating coverage losses. https://www.medicaid.gov/state-resource-center/downloads/strategies-for-covrg-of-indiv.pdf
Successful Community Health Worker Programs
The National Committee for Quality Assurance (NCQA) and the Penn Center for Community Health Workers with support from the Commonwealth Fund and the Community Health Acceleration Partnership (CHAP), have published a white paper, “Critical Inputs for Successful Community Health Workers Program.” The white paper will be presented during a webinar on December 14, 2021 at 4 pm ET. Organizations employing or looking to hire Community Health Workers can learn about how to support Community Health Workers and maximize their impact. Speakers will discuss the process of developing inputs, share reactions from the field, and discuss ways to incorporate the information into current and future work.
For more information and to register for the webinar: https://ncqa-org.zoom.us/webinar/register/7816376153451/WN_6BABThWqScCdBHbB-thaLA?mc_cid=c8f998257c&mc_eid=3de0fb2a18
National Association of Chronic Disease Directors Announces Launch of the Center for Advancing Healthy Communities
The National Association of Chronic Disease Directors (NACDD) announces the launch of its Center for Advancing Healthy Communities (CAHC), which will work to foster healthy communities for all by advancing health equity and eliminating social barriers.
“Despite incredible advances in the health field, disparities across our country are profound. Access to healthy living opportunities should be available to everyone,” said John W. Robitscher, MPH, NACDD’s CEO. “Through this Center, we are committed to making public health programs in communities across states and territories more effective, more equitable, and more inclusive.”
Led by Jennie Hefelfinger, MS, the Center’s efforts will leverage best practices and evidence-based programming to impact food and nutrition security, physical activity and the built environment, tobacco cessation, obesity, social connectedness, chronic disease-related mental health, and equity/social justice. It will build upon successful NACDD-led projects such as Building Resilient Inclusive Communities, the Walkability Action Institutes, Worksite Wellness, and more.
At Center launch, programs and team members include:
- Center Director: Jennie Hefelfinger, MS
- Associate Director: Vishwarupa (Vish) Vasani, MPH
- Arthritis Portfolio: Heather Murphy; Lisa Erck, MS
- Building Resilient Inclusive Communities (BRIC) program: Mara Galic, MHSc, RD; Joann Donnelly, MA, BCC, CSM; Leah Rimkus, MPH, RD; and Crystal Doxie, MBA
- Healthy Military Communities: Catherine McCann, PhD, MSPH
- State Partnerships Improving Nutrition and Equity (SPINE) program: Patrilie Hernandez, MS and Charita James, MS, RD
- Worksite Wellness: Lisa Erck, MS and Laura DeStigter, MPH
- Walkability Action Institutes: Karma Harris, MSPH
“We want to make every community healthier and stronger. Over the years, we’ve learned that the best way to accomplish this is to work together; to listen, to share, to nurture, and to work collectively to maximize the impact of each program,” said Hefelfinger. “We are excited to launch this Center, which will coordinate programs that logically work together, provide thought leadership to our partners, and continue to advance the mission of NACDD.”
CAHC will provide technical assistance and training for program implementation while expanding capabilities and resources, promoting healthful policy and environmental change, and collaborating to foster mutually beneficial partnerships.
“Our team of public health professionals at NACDD has been implementing chronic disease prevention and health promotion programs for more than 30 years,” Robitscher said. “Not only do we know how to make the programs effective, but we know where the opportunities are to integrate programs, share best practices, and make public health more impactful.”
Visit https://chronicdisease.org/the-center-for-advancing-healthy-communities/ to learn more.
CMS Publishes 2022 Physician Fee Schedule (PFS)
The annual Physician Fee Schedule (PFS) final rule announces policy changes which sets the rates for Medicare payments made under the PFS, and updates for the Quality Payment Program (QPP) for Calendar Year 2022 has been released/published.
The annual Physician Fee Schedule (PFS) final rule announces policy changes which sets the rates for Medicare payments made under the PFS, and updates for the Quality Payment Program (QPP) for Calendar Year 2022 has been released/published. Please review the following links for further information on those items.
- Press Release: https://www.cms.gov/newsroom/press-releases/cms-physician-payment-rule-promotes-greater-access-telehealth-services-diabetes-prevention-programs
- Fact Sheet – CY22 Physician Fee Schedule: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2022-medicare-physician-fee-schedule-final-rule
- 2022 QPP resources Fact Sheet: https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1654/2022%20Quality%20Payment%20Program%20Final%20Rule%20Resources.zip
- Fact Sheet – Medicare Diabetes Prevention Program (MDPP): https://www.cms.gov/newsroom/fact-sheets/final-policies-medicare-diabetes-prevention-program-mdpp-expanded-model-calendar-year-2022-medicare
Should you wish to contact CMS QPP directly please use the following below information.
- By Phone: Monday – Friday 8 a.m. – 8 p.m. ET 1-866-288-8292 (TRS: 711)
- By Email: QPP@cms.hhs.gov
Pennsylvania Senior Food Box Program: No One Should Go Hungry
Eating well has an impact on our health and how we feel, especially as we age. Seniors in Pennsylvania should never go hungry or miss out on nutritious meals. The Senior Food Box program is a monthly food package tailored for older adults, age 60 and above, that helps stretch food dollars and adds nutritious foods to promote good health.
The Senior Food Box Program works to improve the health of low-income seniors by supplementing their diets with nutritious food. In Pennsylvania, eligible participants include low-income individuals who are at least 60 years old and whose household income is at or below 130 percent of the U.S. poverty level.
The boxes do not provide a complete diet, but rather are good sources of the nutrients typically lacking in the diets of older Americans. Among the types of foods included in the food boxes are: non-fat dry and shelf-stable fluid milk, juice, oats, ready-to-eat cereal, rice, pasta, dry beans, peanut butter, canned meat, poultry, or fish, and canned fruits and vegetables.
The USDA’s Commodity Supplemental Food Program supports the Senior Food Boxes. The USDA purchases the food and makes it available to the Pennsylvania Department of Agriculture (PDA), which works with local non-profit agencies to facilitate distribution of the monthly food boxes to seniors in need at central locations where seniors have easy access.
How to Participate
Seniors should fill out the self-certification form and submit it to PDA via email at RA-fooddist@pa.gov. PDA will then route the application to the appropriate food bank providing service in the applicant’s county of residence.
Applicants can also call 800-468-2433 to be directed to the regional food bank distributing the Senior Food Box in their county of residence.
Refer to the Income Eligibility Guidelines.
For more information, visit the PDA Senior Food Box Web Page.
SBA Working Capital Loan Deadline Approaching in Pennsylvania for Disaster Declaration
The U.S. Small Business Administration is reminding small businesses, small agricultural cooperatives, small businesses engaged in aquaculture, and most private nonprofit organizations of the April 28 filing deadline for federal Economic Injury Disaster Loan applications in Pennsylvania due to freeze and frost from April 6 through May 15, 2020.
The loans are available in the following counties: Bucks, Delaware, Monroe, Northampton, Philadelphia and Pike in Pennsylvania.
“These counties are eligible because they are contiguous to one or more primary counties in New Jersey. The Small Business Administration recognizes that disasters do not usually stop at county or state lines. For that reason, counties adjacent to primary counties named in the declaration are included,” said Kem Fleming, director of SBA’s Field Operations Center East.
Under this declaration, the SBA’s Economic Injury Disaster Loan program is available to eligible farm-related and nonfarm-related entities that suffered financial losses as a direct result of this disaster. Apart from aquaculture enterprises, SBA cannot provide disaster loans to agricultural producers, farmers or ranchers.
The loan amount can be up to $2 million with interest rates of 3.75 percent for small businesses and 2.75 percent for private nonprofit organizations, with terms up to 30 years. These working capital loans may be used to pay fixed debts, payroll, accounts payable, and other bills that could have been paid had the disaster not occurred. The loans are not intended to replace lost sales or profits.
Applicants may apply online using the Electronic Loan Application (ELA) via SBA’s secure website at DisasterLoan.sba.gov and should apply under SBA declaration # 16638, not for the COVID-19 incident.
Disaster loan information and application forms may also be obtained by calling the SBA’s Customer Service Center at 800-659-2955 (800-877-8339 for the deaf and hard-of-hearing) or by sending an email to DisasterCustomerService@sba.gov. Loan applications can be downloaded from the SBA’s website at sba.gov/disaster. Completed applications should be mailed to: U.S. Small Business Administration, Processing and Disbursement Center, 14925 Kingsport Road, Fort Worth, TX 76155.
Submit completed loan applications to SBA no later than April 28, 2021.
How 18 Million Americans Could Move Into Rural Areas – Without Leaving Home
From Route Fifty
COMMENTARY: A pending proposal would reclassify dozens of communities from metropolitan to rural, potentially affecting their eligibility for certain federal funding and programs.
About 46 million Americans – 14% of the nation’s inhabitants – are currently classified as living in rural areas. That number could jump to 64 million – an increase of nearly 40% – without anyone moving into a new home. That could actually hurt small cities and rural communities across the country.
The federal government classifies communities’ characteristics based on their populations, according to a definition created by the federal Office of Management and Budget. The criteria haven’t substantially changed since the 1940s. Since then, the U.S. population has more than doubled, from 152 million in 1950 to more than 328 million in 2019.
The main dividing line is between communities – which include both towns and cities and their surrounding counties – with more than 50,000 people and those with fewer than that number. Over the past 70 years, the number of areas with at least that many people has increased from 168 to 384 as small towns have grown into small cities. For example, from 1950 to 2010, the population of Lawrence, Kansas, grew from 23,351 to 87,643.
Under the current definition, Colbert County, Alabama – population 54,428 – is in the same category as Los Angeles County – population over 10 million. As the Trump administration ended, federal officials decided some more nuance would be useful in understanding American communities. They proposed to change the dividing line to populations of more than 100,000 – and the effort appears to be continuing under the Biden administration.
That change would effectively move everyone who lives in places with 50,000 to 100,000 from urban to rural life, because their cities, including San Luis Obispo, California, and Battle Creek, Michigan, will no longer be considered large enough to count as metropolitan.
Redefining Rural
The government doesn’t specifically use this system to label places as “urban” or “rural.” Instead, there are three government categories – “metropolitan,” “micropolitan” and “outside a core based statistical area.” However, most government agencies, researchers, advocates and media outlets use these classifications to sort communities into two groups – equating “metropolitan” with “urban” and the other two categories together as “rural.”
Making the proposed change would mean 144 areas with populations between 50,000 and 100,000, and the 251 counties they occupy, would no longer be classified as “metropolitan,” but rather as “micropolitan” – and therefore effectively rural – including Flagstaff, Arizona, and Blacksburg, Virginia. The change would leave Wyoming without any metropolitan areas at all.
The Office of Management and Budget is accepting comments about this proposed change until March 19.
Looking at the Numbers
Changing how rural areas are defined could change Americans’ understanding of rural life.
For instance, the current data reveal that rural areas have less access to broadband internet and health care services.
But if the homes and communities of 18 million more Americans are added to those rural statistics, the numbers could look better. That rosier picture – which would not be the result of any actual changes to Americans’ lives – could reduce public and political pressure to improve life in rural communities.
It’s also not clear whether 100,000 is the right boundary for urban living – or of there is an exact number at all. To people in major cities, a community of 80,000 like Santa Fe, New Mexico, may be more similar to the 22,000-person Roseburg, Oregon, than to Chicago or Miami. To a rancher on the Plains, with fewer than one person per square mile, though, Santa Fe may qualify as a “big city,” with chain stores, hospitals and government offices.
More than a Statistical Shift
Though the government’s proposal says it’s meant as a statistical change only, the classifications are commonly used by government agencies, charities and other organizations to determine which communities are eligible for their funding or programs.
The change could make many small American cities, which would be newly identified as rural, ineligible for money to help community planning and public transit – even if they currently get that money.
Communities currently designated as rural may be hurt, too. If Congress and states don’t allocate more funds to serve the increased number of people classified as living in rural areas, the money that is available – like rural health grants – would be spread more thinly.
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