Rural residents grapple with shifting long-term care system

Across the nation, Americans are making tough decisions about long-term health care for themselves and their loved ones. Access to a level of care that meets their unique needs can determine if families remain together, or if their loved ones will have to move miles away.

Long-term care facilities, commonly referred to as nursing homes, are crucial to providing a level of care that many families cannot offer to their loved ones. In rural areas of our country, accessing long-term care is becoming increasingly challenging. Read more. Check out our latest white paper on elder care.

CMS Releases 2017 Quality Payment Program Results

CMS Releases 2017 Quality Payment Program Results. The Centers for Medicare & Medicaid Services (CMS) recently released performance information from the first year of the Quality Payment Program (QPP). Results show rural practices performed well in the QPP’s Merit-based Incentive Payment System (MIPS). Overall, 93 percent of rural practices earned positive payment adjustments, including 65 percent who earned additional adjustments for exceptional performance. CMS continues to offer options to help rural and small practices participate in the QPP, including no-cost, customized technical assistance and the opportunity to participate in MIPS through the virtual group option.

Scope of Practice Policies for Clinicians by State

Scope of Practice Policies for Clinicians by State.  The National Conference of State Legislatures provides this interactive map to educate state policymakers about scope of practice issues for behavioral health providers, nurse practitioners, oral health providers and physician assistants.  The site features an in-depth look at three professions that are essential for recovery from opioid misuse: peer support specialists, licensed professional counselors, as well as nurse practitioners and physician assistants who can prescribe buprenorphine-containing products. While more than 60% of rural counties lack a physician with a waiver to prescribe buprenorphine, rural communities tend to have more providers like these, who require fewer years of education and training.

Trends in Hospital System Affiliation, 2007-2016

A new rural policy brief is available from the RUPRI Center for Rural Health Policy Analysis:


Trends in Hospital System Affiliation, 2007-2016

Authors: Onyinye Oyeka, MPH; Fred Ullrich, BA; and Keith J. Mueller, PhD

Previous work by the RUPRI Center showed significant growth in hospital system membership among non-metropolitan hospitals from 2007 to 2012. Re-examining data from the American Hospital Association through 2016 shows continued growth in system membership among all categories of hospital size, location, and Critical Access Hospital (CAH) status. However, the growth rate in system membership declined in metropolitan hospitals in the South census region and non-metropolitan CAHs in all census regions. Our analysis also indicates that non-metropolitan CAHs and hospitals make up a small portion of hospitals in the largest healthcare systems. Non-metropolitan hospitals and non-metropolitan CAHs face unique challenges given the demographics of the population they serve, payer mix, and reimbursement levels.

Click to download a copy: Trends in Hospital System Affiliation, 2007-2016


Additional Resources: Trends in Hospital Network participation and System Affiliation, 2007-2012


Gov. Tom Wolf Proclaims November 12-16, 2018 Rural Health Week in Pennsylvania

University Park, Pa. – In an effort to draw attention to the wide range of issues that impact rural health, Gov. Tom Wolf has declared Nov. 12-16, 2018, as Rural Health in Pennsylvania week at the request of the Pennsylvania Office of Rural Health (PORH) and the Pennsylvania Rural Health Association.

Continue reading “Gov. Tom Wolf Proclaims November 12-16, 2018 Rural Health Week in Pennsylvania”

Tooth Fairy Visits Rural School

The tooth fairy (PORH’s Kelly Braun) visited two schools within the Bangor Area School District on October 30 to promote oral health.  Students received toothbrushes in addition to education.  This opportunity was made possible by St. Luke’s Anderson Campus Community Health and a grant that they received from the Two Rivers Health & Wellness Foundation.


Pictured, left to right, Rosemarie Lister, St. Luke’s Community Health, Deb Bowman, School Health, Kelly Braun, Pennsylvania Office of Rural Health, and Todd Nemura, St. Luke’s Community Health

Federal Resource Guide for Substance Use Disorder in Rural Communities

Federal Resource Guide for Substance Use Disorder in Rural Communities. This comprehensive guide was created specifically for rural communities facing substance use disorder and opioid misuse.  It organizes federal grant programs and resources by 26 categories that include prevention, treatment and recovery, but also include social services, employment, economic development, transportation and justice.  The guide was created by the Rural Opioid Federal Interagency Working Group to help address the opioid crisis by improving coordination of and reducing potential overlap among the Federal responses in the nation’s rural communities.  Last year, the Centers for Disease Control and Prevention (CDC) issued data showing that the rate of drug overdose deaths in rural areas surpassed the rate in urban areas.

Community Health Needs Assessments and Implementation Plans for CAHs

The Flex Monitoring Team’s latest briefing paper examines how Critical Access Hospitals (CAHs) use information gathered from the CHNA process and implementation plans to address community needs. Our report describes the needs most commonly identified through the CHNA process and opportunities for CAHs to strengthen their efforts to address the unmet needs of the people they serve. It also identifies resources to help CAHs meet their community obligations and to improve their population health performance.

Please click here to access the report.

New Approaches to Oral Health Infrastructure and Capacity 724.972.7242 PO Box 242, Delmont, PA 15626 Working to improve oral health for all Pennsylvanians by uniting stakeholders to advance advocacy, policy, education and innovative approaches.

Project Background: The Pennsylvania Department of Health, in partnership with oral health stakeholders across Pennsylvania, has received grant funding from the Health Services and Resources Administration (HRSA) for the project titled “New Approaches to Oral Health Infrastructure and Capacity.” Using a strategic and multidisciplinary approach, the project aims to:

  • Address dental workforce needs in dental health professional shortage areas (DHPSAs) through activities that promote careers in oral health and by preparing practitioners to provide competent care to vulnerable and underserved groups.
  • Encourage and support innovation to increase oral health services by providing leadership for oral health initiatives, building the capacity of the project partners and other oral health agencies to collect data, and supporting the implementation of oral health projects that target the unique communities within DHPSAs.
  • Sustain innovative and effective programs through leveraged resources and increase the accessibility and quality of oral health services by implementing new service models that target vulnerable and underserved populations such as low-income children and adults, and individuals with disabilities.

About the Pennsylvania Coalition for Oral Health: The Pennsylvania Coalition for Oral Health (PCOH) serves as the dynamic leading voice to improve oral health across the Commonwealth. PCOH supports the advancement of policies and practices that increase access to oral health services, education, and prevention especially for the most vulnerable Pennsylvanians. Serving as the sole source oral health contractor to the Pennsylvania Department of Health, PCOH is leading the administration and oversight of grant funding from HRSA.

Project Goals: This portion of “New Approaches to Oral Health Infrastructure and Capacity” aims to integrate oral health services into two Rural Health Clinics (RHCs) located in DHPSAs. The goal is to provide community-based preventive oral health services to patients within the DHPSA, reaching at least 2400 patients within each facility through August 31, 2022.

Scope of Work and Deliverables: Two (2) RHCs will receive dental equipment to outfit one operatory, including the following: portable dental unit, portable chair, portable light, portable stool, curing light, ultrasonic scaler, instruments/cassettes, and a portable sterilizer, not to exceed a total expense of $12,820 for each clinic. The equipment may be stationary or portable, based upon each clinic’s unique needs. Each clinic will be responsible for providing qualified staff to utilize the equipment which will ideally be used for preventive procedures including but not limited to dental screenings, prophylaxis, fluoride applications, and sealant application. Clinics will be required to report:

  • Number of patients treated,
  • Type and number of community-based oral health services provided, and
  • Hours of services provided annually. 724.972.7242 PO Box 242, Delmont, PA 15626 Working to improve oral health for all Pennsylvanians by uniting stakeholders to advance advocacy, policy, education and innovative approaches.

Timeline: Letters of Intent due: November 28, 2018

RHCs notified of selection for participation by: December 10, 2018

RHCs begin receiving equipment: January 2019

All data from year one due: August 1, 2019

** Please note that the Pennsylvania Office of Rural Health will be available to offer technical assistance to RHCs.

Criteria for Selection: Clinics must be in a DHPSA and demonstrate dental need. Additionally, clinics must demonstrate readiness and ability to provide dental services.

Format: The Letter of Intent should be no more than two pages. The following elements should be included:

  • Background information about the RHC (independent vs. provider based, number of patients served annually, and any current focus on oral health)
  • Demonstrated community need
  • Plans to accommodate and utilize dental equipment within existing practice (designated space, staffing, purchase of necessary disposable supplies, plan to add dental to scope practice if necessary)
  • Demonstrated ability to collect and submit required data for project reporting purposes

Please submit letters of intent to:

Helen Hawkey, Executive Director, PA Coalition for Oral Health

Questions? Please contact Helen Hawkey at (724) 972-7242 or

Maternal Opioid Use Disorder and Neonatal Abstinence Syndrome Among Rural US Residents

Maternal Opioid Use Disorder and Neonatal Abstinence Syndrome Among Rural US Residents. In a study published this week in the Journal of Rural Health, researchers from the HRSA/FORHP-supported University of Minnesota Rural Health Research Center found that diagnosis of maternal opioid use disorder (OUD) and neonatal abstinence syndrome are steadily increasing among rural residents.  Despite the fact that hospital discharge data from the all‐payer National Inpatient Sample shows that rural women with OUD and other clinical complications were more likely to give birth in urban teaching hospitals findings from the Minnesota study show that more than 60 percent of rural moms with opioid use disorder give birth locally.  “Rural hospitals may have more limited capacity to care for them and their babies,” said Center Director Katy Kozhimannil.