Suicide Rates Still Rising, Especially in Rural

Suicide Rates Still Rising, Especially in Rural.  On Friday, the Journal of the American Medical Association (JAMA) released a new report on county-level suicide rates, specifically comparing trends and contributing factors that varied between urban and rural areas.  The study included all individuals aged 25 to 64 years who died by suicide between January 1, 1999 and December 31, 2016.  Results showed that 77 percent of the decedents were male and that suicide rates were higher and increased more rapidly in rural than in large metropolitan counties.

Read the study here:

Comments Requested: PTAC Proposal on Remote Specialist Care

Comments Requested:  PTAC Proposal on Remote Specialist Care – October 1.  ThePhysician-Focused Payment Model Technical Advisory Committee (PTAC) requests public comment on a proposal for a new payment model that would create either Regional Referral Centers (RRCs) or a single National Referral Center (NRC) to provide remote specialists and experts for most health issues. The specialists would support field providers such as visiting nurses, community providers, PCPs, or hospital doctors and would serve any geographic location. Comments can be emailed to with the subject line “Public Comment – [name of document].”

Read the document here:


Pennsylvania Office of Rural Health to Host Rural Human Trafficking Summit on October 29

Pennsylvania Office of Rural Health to Host Rural Human Trafficking Summit on October 29


University Park, Pa. – The Pennsylvania Office of Rural Health (PORH) will hold the first Pennsylvania Rural Human Trafficking Summit on October 29, 2019 at the Penn Stater Hotel and Conference Center in State College, PA.


The summit will focus on national and state efforts to address human trafficking, the law enforcement response to trafficking, and community- and health care facility-based strategies and education to address trafficking.


According to the Human Trafficking Hotline (NHTH), approximately 40.3 million modern slaves are in service worldwide, with approximately 25 million being forced into labor and sex trafficking. It is estimated that forced labor and human trafficking is a $150 billion industry worldwide.


Human trafficking is not just a global issue, but a local issue. Rural America, and rural Pennsylvania, are not immune to trafficking. According to data from the NHTH, 275 reported cases of human trafficking were reported in 2018 in Pennsylvania, ranking the state 11th in the nation for human trafficking.


Isolation, geography, and transportation routes that facilitate human trafficking in rural areas allow human trafficking to go undetected. The lack of economic opportunities in many rural areas also make individuals more vulnerable to trafficking. Education, awareness, and an understanding of local, state, and federal resources are essential to identifying potential human trafficked individuals and assisting them in getting the help they need.


The October summit will feature a “surthriver,” a victim of human trafficking who was able to escape this modern day slavery. She will share her compelling journey into and through human trafficking and how she survived—and thrived. She now directs a human trafficking recovery program in northeastern Pennsylvania to aid others to escape the bonds of trafficking.


Human trafficking involves the use of force, fraud or coercion to obtain some type of labor or commercial sex act. It can happen in any community and victims can be any age, race, gender or nationality. Traffickers might use violence, manipulation or false promises of well-paying jobs or romantic relationships to lure victims into trafficking.


Trauma caused by traffickers can be so great that many may not identify themselves as victims or ask for help, even in highly public settings. Language barriers, stigma, fear of their traffickers, and/or fear of law enforcement frequently keep victims from seeking help, making human trafficking a hidden crime.


National estimates indicate that approximately 80 percent of human trafficking victims are women, and health care providers are often the first professionals to have contact with trafficked women and girls. Nearly 50 percent of trafficked individuals saw a health care professional during their exploitation, putting health care providers and facilities on the front lines of identifying and potentially stopping human trafficking.


The summit is sponsored by PORH; the Region III Office of the Health Resources and Services Administration; the U.S. Department of Health and Human Services; the Eastcentral and Northeast Pennsylvania Area Health Education Center; the Pennsylvania Coalition Against Rape, and the Governors Office of Homeland Security.


Registration and additional conference information can be found on the Rural Human Trafficking Summit website at


PORH formed in 1991 as a joint partnership between the federal government, the Commonwealth of Pennsylvania, and Penn State. The office is one of 50 state offices of rural health in the nation funded under a program administered by FORHP and is charged with being a source of coordination, technical assistance, networking, and partnership development.


PORH provides expertise in the areas of rural health, agricultural health and safety, and community and economic development. PORH is administratively housed in the Department of Health Policy and Administration in the College of Health and Human Development at Penn State University Park.




Editors:  For more information, contact Terri Klinefelter, outreach coordinator, Pennsylvania Office of Rural Health, at 814-863-8214 or

Nursing Podcast Series

Season One of “At the Core of Care”

The first season of the At the Core of Care podcast series is available NOW. At the Core of Care highlights the consumer experience of patients, families, and communities and the creative efforts of nurses and other partners to better meet their health and healthcare needs through diversity, leadership, and practice innovation. The stories are based in Pennsylvania but tell a much bigger story about important trends shaping health and health care across America.

We’ve made all the episodes in our first season available immediately. Subscribe, binge, and rate today!

Season One:
Episode 1: Sexual Assault Nurse Examiners
Episode 2: Breastfeeding Support at the Philadelphia Nurse-Family Partnership
Episode 3: The Fight for Full Practice Authority in Pennsylvania
Episode 4: Pediatric Home Care for Medically Complex Children

Funding for this project is provided by AARP and the Robert Wood Johnson Foundation as part of the Future of Nursing: Campaign for Action Innovations Fund.

Listen here:

Are Changes to Team-Based Care Models Needed for the Future?

Researchers have called for a new model of team-based care called “advanced team care with in-room support” in a report in the Annals of Family Medicine. They state that old primary care team models are “underpowered” and where the new model has been deployed, there has been improved productivity and growth, as well as enhanced patient and staff satisfaction. The researchers also contend the model would “allow clinicians to shed that portion of clinical and administrative work that a well-trained, well-staffed team could easily perform.” Attend “Team-Based Care: Empowering Patients, Reducing Provider Burnout and Achieving Quality” at our Annual Conference & Clinical Summit.  You’ll hear how one health center has created a financially sustainable structure that is transparent, promotes both patient and provider buy-in to team-based care, and incorporates performance improvement, care coordination, behavioral health and primary care providers in a synergistic manner in utilizing their team-based care model.

Addressing Diabetes Factors through School & Community Partnerships 

The National Nurse-Led Care Consortium and School-Based Health Alliance have created a resource, “Addressing Diabetes Factors in Elementary School Children Through School and Community Partnerships.” Health centers can play a powerful role in performing appropriate screening, prevention and management of elementary-aged children with obesity and other pre-diabetic indicators by collaborating with schools and other community partners.

96% of U.S. Counties See Decline in Share of White Population

Axios reports that America is more racially diverse than at any point in history, and racial minorities are becoming more geographically dispersed than ever before. Nationally, Hispanics and Asian Americans are the fastest-growing racial minority groups, increasing by 18.6% and 27.4%, respectively, between 2010 and 2018, according to an analysis by the Brookings Institution demographer Bill Frey, whose 2018 book “Diversity Explosion” outlined the country’s majority-minority future. Atlanta, Charlotte, Orlando, Dallas, Phoenix, Las Vegas, and Seattle registered substantial growth in their black populations. The nation’s white population has grown only 0.1% since 2010 and is projected to decline over the next decade. Read more.

Check Out the Pennsylvania Health Insurance Exchange Webpage

Keep up to date on the creation and rollout of Pennsylvania’s state-based health insurance exchange on the Department of Insurance’s State-Based Exchange webpage. Pennsylvania has been a federally facilitated marketplace or exchange since 2013. For the 2020 enrollment period, Pennsylvania has moved to a state-based exchange (SBE) using the federal platform (SBE-FP) and will fully transition to a SBE in 2021. For 2020, this will allow Pennsylvanians to continue to choose plans and enroll into the marketplace using, but the state is responsible for performing all marketplace functions for the individual market and the Small Business Health Insurance Options Program (SHOP).


Pennsylvania Governor Wolf’s Administration to Distribute More Free Naloxone

Later in September, Pennsylvania will recognize “Stop Overdoses in PA: Get Help Now Week” by making free Naloxone available at 95 location across the state. The free Naloxone will be available on two days while supplies last: Wednesday, Sept. 18, from 11:00 am to 7:00 pm, and Wednesday, Sept. 25, from 9:00 am to 3:00 pm.  Click here for a list of the locations.  Other commonwealth opioid use disorder activities and progress:

  • Through a standing order, Naloxone, used to reverse an overdose caused by an opioid by blocking the effects of opioids on the brain, is available to any Pennsylvanian through pharmacies across the commonwealth for anyone who may need it
  • According to the state Department of Health, more than 25,000 people have been revived with Naloxone by police officers and EMS providers in Pennsylvania since November 2014
  • In December 2018, the commonwealth distributed over 5,000 naloxone kits across Pennsylvania
  • Gov. Wolf announced in August that opioid related overdose deaths have decreased by 18 percent over the past 12 months
  • Gov. Wolf this week announced another renewal of the state opioid disaster declaration, the seventh one since he first made the declaration on Jan. 10, 2018

Research Brief: Technical Assistance for Hospitals Applying to the Pennsylvania Rural Health Model—A CMMI-Sponsored Rural Hospital Global Budget Model

The Rural Health Value team recently released a new Rural Innovation Brief focused on technical assistance for rural hospitals considering participation in the Pennsylvania Rural Health Model.

Technical Assistance for Hospitals Applying to the Pennsylvania Rural Health Model—a CMMI-Sponsored Rural Hospital Global Budget Model – Rural hospitals, interested in participating in the Pennsylvania Rural Health Model, participated in a rapid cycle process to develop plans to transition from being volume-oriented to focusing on community health, facilitated by a global budget. This brief summarizes Rural Health Value’s process to facilitate hospital development of a transition plan for those considering developing or participating in a global budget or other transformation models for rural hospitals. (August 2019)

The report can be accessed here.