Emergency Broadband Benefit Snapshot

Posted on by lad3

Rural LISC has launched a new tool, developed in collaboration with Heartland Forward, that maps 2021 enrollment in the Federal Communications Commission’s (FCC) Emergency Broadband Benefit (EBB) Program. The map presents a nationwide view of household EBB enrollment based on eligibility by ZIP Code. On average across the country, an estimated 17% of households that were eligible for the benefit enrolled.

The tool is designed to aid Digital Navigators and other partner organizations in identifying the communities that can benefit most from outreach and awareness efforts on broadband access. A new, long-term federal discount on internet service for low-income households, the Affordable Connectivity Program (ACP), replaced EBB on January 1, 2022.

Users are invited to engage with the map by entering the ZIP Code, city name, county name, or an address of their choice. Users can also toggle on a terrestrial broadband layer, depicting if wired or fixed wireless broadband internet is available in an area.

Click here to access the map.

End of the COVID-19 Public Health Emergency: Medicaid/CHIP ‘Unwinding Period’ Tools and Guidance

Posted on by lad3

The Centers for Medicare and Medicaid Services (CMS) compiled a webpage with state resources for the ‘unwinding period’ when the Public Health Emergency (PHE) provisions for continuous Medicaid/CHIP coverage will terminate. Recent guidance for state programs establishes a 12-month period for re-determinations of eligibility after the end of the PHE. It is anticipated that millions of people nationwide will lose coverage including many in rural communities. On this webpage CMS has provided state Medicaid/CHIP programs with toolkits for planning an orderly transition for individuals losing Medicaid/CHIP eligibility to affordable private offerings under state health exchanges.

See the resource compilation webpage here:  Unwinding and Returning to Regular Operations after COVID-19 | Medicaid

Pennsylvania Prepares for Changes to the HealthChoices Medicaid Organizations

Posted on by lad3

The Pennsylvnia Department of Human Services (DHS) leadership announced in mid-January that they intend to implement changes to the managed care plans operating the physical health (PH) HealthChoices program effective July 1, 2022. Approximately 460,000 Medicaid consumers will be required to choose a new managed care plan or be auto-assigned into one. The remaining 2.3 million consumers in the HealthChoices program will have the option to choose a new managed care plan and will have new plan options available. This will affect dental coverage and dental providers as well.

Click here to read more on this from the PA Health Law Project.

Evaluating State Flex Program Population Health Activities

Posted on by lad3

The Flex Monitoring Team has released a new policy brief, Evaluating State Flex Program Population Health Activities.

The Medicare Rural Hospital Flexibility (Flex) Program funds initiatives to improve the health of rural communities under Program Area 3: Population Health Improvement. This brief: (a) provides an overview of the expectations for Program Area 3; (b) summarizes State Flex Program (SFP) initiatives under this Program Area; (c) describes promising population health strategies implemented by SFPs; and (d) discusses outcome measurement issues for population health. It also describes a pathway to connect Flex Program population health efforts to the U.S. Department of Health and Human Services’ Healthy Rural Hometown Initiative (HRHI), a five-year multi-program effort to address the factors driving rural disparities in heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke.

A companion brief, An Inventory of State Flex Program Population Health Initiatives for Fiscal Years 2019-2023, provides a detailed description of population health initiatives proposed by the 45 SFPs.

Pennsylvania Publishes Annual State Health Improvement Report

Posted on by lad3

The Pennsylvania Department of Health has published the State Health Improvement Plan Fiscal Year 2020-2021 Report.

The Healthy Pennsylvania Partnership (HPP) is a multi-sector collaboration that identifies key health challenges in Pennsylvania and works to solve them. Within the HPP, there are two major and interrelated initiatives: the State Health Assessment (SHA) and the State Health Improvement Plan (SHIP). The SHA identifies population health priorities and the populations most impacted by major health issues.
The State Health Improvement Plan (SHIP), based on the SHA, is a five-year strategic

The State Health Improvement Plan (SHIP), based on the SHA, is a five-year strategic plan developed by the Pennsylvania Department of Health (DOH) in collaboration with the HPP. The purpose of the SHIP is to describe how the health department and the community it serves will work together to improve the health of the Pennsylvania population.The community, stakeholders, and partners can use this health improvement plan to set priorities, direct the use of resources, and develop and implement projects, programs, and policies. Implementation of the plan began with its release in May 2016.

The three health priorities addressed by the SHIP are obesity, physical inactivity, and nutrition; primary care and preventive services; and mental health and substance use. For each SHIP priority, strategies, the target populations, collaborators, targets, and data sources are identified. Across these priority areas are cross-cutting themes that are key to implementing the strategies: health literacy, the public health system, health equity, social determinants of health, and integration of primary care and mental health.

During the past year, three task forces have implemented and promoted the strategic initiatives. This annual report documents progress toward the goals and the implementation of strategies. As the public health environment changes, new opportunities that may impact goals are considered by the task forces. Adjustments to the SHIP strategies are implemented by the task forces. Task forces meet quarterly throughout the year to report on progress in implementing the identified strategies, assess progress, and make recommendations for adjustments.

This report provides the health outcome measures identified in the SHIP, and implementation and progress made on strategic initiatives. It is presented to stakeholders and the public, so they may know how the commonwealth is performing on the priority issues and can prioritize based on performance results. Organizations and individuals are invited to participate. For information, email RA-ship@pa.gov.

Updated! Catalog of Value Based Initiatives for Rural Providers

Posted on by lad3

The Rural Health Value team has released the annual update of the Catalog of Value Based Initiatives for Rural Providers.  This is your “go to” resource for staying current on CMMI payment demos that are germane for rural health care organizations and clinicians. Please share this resource as appropriate with your networks and stakeholders:

Catalog of Value Based Initiatives for Rural Providers
One-page summaries describe rural-relevant, value-based programs currently or recently implemented by the Department of Health and Human Services (HHS), primarily by the Centers for Medicare & Medicaid Services (CMS) and its Center for Medicare & Medicaid Innovation (CMMI).

Link:https://ruralhealthvalue.org/files/Catalog%20Value%20Based%20Initiatives%20for%20Rural%20Providers.pdf

NRHA: Congress Releases FY 2022 Appropriations Package

Posted on by lad3

On March 9, the U.S. House and Senate released the long-awaited compromise for the fiscal year (FY) 2022 appropriations package. The National Rural Health Association (NRHA) is pleased with the attention lawmakers have placed on rural providers throughout the pandemic. This week’s package continued that focus with significant provisions for supporting the rural health safety net the following provisions of note.

Support for Rural Hospitals  

  • $3.45 billion for the Rural Community Facilities Program and $2 million for the Rural Hospital Technical Assistance Program thru the United States Department of Agriculture Rural Development (RD) programs. NRHA is happy to see maintained funding for these critical programs and will continue advocating for additional TA funds in FY 2023. 
  • $62 million for the Medicare Rural Hospital Flexibility Grants Program, an increase of nearly $7 million over FY 2021 funding levels. The $62 million includes $21 million for the Small Rural Hospital Improvement Grant Program and $5 million to establish a Rural Emergency Hospital (REH) Technical Assistance Program. Since the REH designation was established in December 2020, NRHA has been advocating lawmakers explaining that technical assistance is needed to support providers interested in transitioning to this designation.  

Continuation of Core Rural Health Care Programs 

  • $12.5 million for State Offices of Rural Health 
  • $135 million for the Rural Communities Opioid Response Program  
  • $10.5 million for the Rural Residency Development Program 
  • $122 million for the National Health Service Corps  
  • $6 million for the Rural Maternity and Obstetrics Management Strategies (RMOMS) program, including an increase of $1 million over FY 2021 included in this package.  

Supplemental Public Health Provisions  

As an omnibus package, non-appropriations related provisions will pass along with it, including several that NRHA advocated for.  

  • Legislative text to ensure providers maintain their 340B status by waiving the DSH percentage qualification requirement during COVID-19 cost report years. We have heard tremendous concerns from providers on this issue. Congress taking this action is a tremendous victory to upholding the integrity of the program. In February, NRHA sent this letter to HHS Secretary Becerra outlining our concerns with attacks on the 340B program, and the need for this fix.  
  • Substantive maternal health legislative language. This includes training grants for health care providers in the maternal health lens, support for pregnant women to understand the true benefit of the COVID-19 vaccine, and additional support for post-partum care. Also included is the NRHA developed Rural Maternal and Obstetric Modernization of Services (Rural MOMS) Act to:  
    • Improve rural maternal and obstetric care data;  
    • Create rural obstetric network grants (authorization of FORHP’s current program); 
    • Adds rural obstetric care to the telehealth programs at HRSA; 
    • Creates a rural maternal and obstetric care training demonstration on workforce specific to rural communities.  
  • Extension of telehealth flexibilities beyond the duration of the public health emergency (PHE), including allowance for rural health clinics (RHC) and Federally Qualified Health Centers (FQHC) at their current reimbursement methodology and furnishment of audio-only telehealth services. The bill continues current Coronavirus Aid, Relief, and Economic Security (CARES) Act telehealth provisions as currently written for 151 days beyond the duration of the PHE, which is anticipated to end in July 2022. This timeframe will allow for telehealth to be continued until mid-December, where they will have another opportunity to address this issue.  

NRHA is thrilled with the number of our advocacy priorities included in this package as outlined above. They will continue advocating for delay reinstatement of Medicare sequestration, tools rural providers need to combat the remainder of the pandemic, and creation of a quality reporting program for provider-based RHCs in exchange for cost-based reimbursement moving forward.  

NRHA expects consideration of this package in the House and Senate before the deadline of March 11, with the President expected to sign it into law soon after. They will keep members apprised of developments on this important package and work we’re doing to continue improving the rural health safety net.  

Pennsylvania Distributing No Cost OTC COVID-19 Rapid Tests for Vulnerable Populations

Posted on by lad3

In order to close gaps in COVID-19 equity across the Commonwealth, the Pennsylvania Department of Health is providing OTC COVID-19 rapid tests at no cost to vulnerable populations across the Commonwealth and is seeking partners to help distribute tests in high-need communities. Partners can request tests via online form here: OTC Test Request Form. Any questions for the COVID-19 Testing Team should also be submitted using this form.

Participating organizations/entities must:

  • Be able to receive delivery of and store tests on-site
  • Determine test pickup times/dates, and local distribution strategy
  • Communicate test availability to local vulnerable populations

Please note:

  • Test quantity allocated is dependent on DOH’s supply on hand and submitting a request does not guarantee fulfillment
  • Priority will be given to sites that can access high-need populations, e.g.,
    • Areas with high social vulnerability index
    • Limited COVID-19 testing alternatives
  • Request fulfillment is limited to 2 requests per month
  • For organizations that will broadly distribute to greater communities, we will periodically update the testing website (COVID-19 Testing | PA.GOV) to list location/time/dates for distribution

Social Vulnerability:

  • Social vulnerability refers to the resilience of communities (the ability to survive and thrive) when confronted by external stresses on human health, stresses such as natural or human-caused disasters, or disease outbreaks. Reducing social vulnerability can decrease both human suffering and economic loss. Socially vulnerable populations include those who have special needs, such as, but not limited to, people without vehicles, people with disabilities, older adults, and people with limited English proficiency. The Social Vulnerability Index includes the following themes and social factors:
    • Socioeconomic status (below poverty, unemployed, low/no income, no high school diploma)
    • Household composition & disability (aged 65 or older, aged 17 or younger, older than age 5 with a disability, single-parent households)
    • Minority status & language (minority, speak English “less than well”)
    • Housing type & transportation (multi-unit structures, mobile homes, crowding, no vehicle, group quarters)
  • Additional information from CDC on the Social Vulnerability Index can be found here: CDC/ATSDR SVI Frequently Asked Questions (FAQ) | Place and Health | ATSDR

National Strategy to Address Mental Health Crisis

Posted on by klb520

Three strategy directives announced by the White House include: 1) Strengthen system capacity to expand the supply, diversity, and cultural competency of the mental health workforce, particularly in rural and underserved areas.  This effort will include training and opportunities for paraprofessionals such as community health workers and peer recovery coaches. 2) Connect patients to care by expanding and strengthening access to mental health and recovery services. The President’s budget for fiscal year 2023 will propose that all health plans cover robust behavioral health services with an adequate network of providers, including three behavioral health visits each year without cost-sharing. 3) Create healthy environments by addressing social determinants of health.  This will involve adjustment to standards and practices for online marketing and social media, expansion of early childhood and school-based intervention services, and mental health resources for incarcerated individuals. According to the 2020 results from the National Survey on Drug Use and Health, approximately 7.7 million nonmetropolitan adults reported having any mental illness, accounting for 20.5 percent of nonmetropolitan adults.  At HRSA, our work to implement this strategy means taking action.

Health Experts Urge Against COVID-19 Complacency: 12 Calls to Action in New 136-page Plan

Posted on by lad3

A team of 53 epidemiologists, pharmacologists, virologists, immunologists and policy experts published a 136-page report on the heels of the new COVID-19 preparedness plan released by the White House. Their plan shares similarities with that from the Biden administration but also differences, such as broadening the nation’s response to include all major respiratory viruses.

The group behind “A Roadmap for Living with COVID” is led by Ezekiel Emanuel, MD, PhD, vice provost for global initiatives at the University of Pennsylvania in Philadelphia and former advisory board member of the now-dissolved COVID-19 panel that guided President Joe Biden’s transition into office. The group includes former officials from both Republican and Democratic administrations. Find the complete listing of authors, contributors and reviewers here.

“The shift to the next normal should not induce complacency, inaction or premature triumphalism,” the authors note in their executive summary, which does not mention the Biden administration’s March 2 COVID-19 preparedness plan by name.

The roadmap is centered upon 12 calls to action:

1. Expand the focus of U.S. preparedness and response from COVID-19 to major respiratory viruses, including flu and RSV infection, with the interim goal to reduce annual deaths below the worst influenza season of the last decade.

2. Create, maintain and disseminate a transparent infectious disease dashboard to guide the public and policymakers at national, state and local levels on the introduction, modification and lifting of public health measures.

3. Strengthen testing, surveillance and data infrastructure. This includes production capacity for 1 billion at-home rapid tests per month, test-to-treat infrastructure that links testing to medical consults and treatment, and the establishment of infrastructure to rapidly collect and analyze data on population immunity.

4. Regulate the improvement and monitoring of indoor air quality. The group calls for the administration to direct the Environmental Protection Agency and Occupational Safety and Health Administration to create standards that protect workers from inhalation exposure.

5. Direct and fund HHS, including the NIH and FDA, to accelerate the development of new, more effective therapeutics, particularly multi-drug oral antivirals and next-generation vaccines that offer better, broader and longer-lasting protection. The authors want the administration to direct and fund HHS to achieve a vaccination rate of at least 85 percent by the end of 2022, which would include CMS reimbursing clinicians for discussing vaccinations with patients who are insured by Medicare and Medicare.

6. Shift the goal of U.S. contributions to the global vaccination effort from stopping infections through population vaccination coverage alone to improving the distribution and administration infrastructure necessary to fully vaccinate the most vulnerable.

7. Strengthen research on long COVID-19. The authors urge for coordinated and expanded research to answer questions on its frequency, risk factors, prognosis and benefits of vaccines and therapies for long COVID-19 within the next year, along with support for individuals experiencing the condition.

8. Create a permanent cadre of community health workers who will support populations highly susceptible to adverse outcomes from respiratory viruses.

9. Expand and support the healthcare workforce. Calls to action include greater pay, health benefits, tuition assistance, loan forgiveness and safe working conditions for workers. The group wants industrywide incentives to accelerate the adoption of automation for routine paperwork and chores, and the extension and expansion of temporary regulatory flexibilities that allowed healthcare organizations to operate telehealth and hospital-at-home programs throughout the pandemic.

10. Create a new post to fight biosecurity pandemic threats. The yet-to-be post, deputy assistant to the president for national security affairs and biosecurity, would sit within the National Security Council and be responsible for the preparation and response to any biosecurity and pandemic threats, including foreign and domestic sources of anti-science misinformation.

11. Redesign U.S. public health communications to regain public trust in a fast-moving, deeply polarized environment to promote the best health outcomes for Americans. The proposed redesign includes the creation of a Joint Information and Communication Center to oversee the sharing of infectious disease data, and infrastructure for dissemination of public health messages.

12. Roll out policies and programs to enable schools and child care facilities to remain open and safe for in-person learning and care without need for special public health mitigation measures. These measures include improved air filtration and expanded school nurse programs.

“Unfortunately, health crises in the United States are often followed by collective amnesia,” the authors contend, saying the roadmap is a plan for the United States to get to the next normal while building the systems and infrastructure needed to reduce risk of another pandemic and the consequences if one does occur.

Both “A Roadmap for Living with COVID” and the new COVID-19 preparedness plan released by the White House March 2 approach planning with a focus on living alongside the virus while continuing to combat it. The Biden administration’s 96-page plan is built around four goals: (1) protect against and treat COVID-19, (2) prepare for new variants, (3) prevent economic and educational shutdowns and (4) vaccinate the world. Read more about its contents here.