The Appalachian Regional Commission (ARC) awarded nearly $11.5 million to 39 projects through its Investments Supporting Partnerships in Recovery Ecosystems (INSPIRE) Initiative, which aims to address the impact of substance use disorder (SUD) in Appalachia with investments in projects that create or expand services in the recovery ecosystem leading to workforce entry and re-entry.

ARC’s 2024 INSPIRE grantees will strengthen the SUD recovery ecosystem in 127 counties in nine Appalachian states—Kentucky, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and West Virginia—by expanding recovery-focused partnerships, peer support and other wraparound services, and skills and workforce training programs that help prepare individuals in recovery for meaningful job opportunities.

“Substance use disorder is a region-wide epidemic that impacts Appalachian families and community workforces,” said ARC Federal Co-Chair Gayle Manchin. “I commend our 2024 INSPIRE grantees for their dedication in helping Appalachians who have struggled with substance use disorder regain a sense of hope and purpose by enabling them to rejoin their communities, bolster workforce development, and make positive impacts on the region.”

“In order to truly address substance use disorder, we must create an environment that includes support for wrap-around services such as housing, job training, and counseling,” said ARC States’ Co-Chair Tennessee Governor Bill Lee. “INSPIRE funding helps make this possible by empowering organizations to make an impact across the Appalachian region. We are proud of Tennessee’s nine grantees who are focused on this important work.”

Federal Co-Chair Manchin made the award announcement with North Carolina Health and Human Services Secretary Kody H. Kinsley, grantees, and state partners during a press conference at the headquarters of Land of Sky Regional Council—INSPIRE grantee and local development district—in Asheville, North Carolina.

“Communities in the Appalachian region, especially rural towns, have borne the brunt of the disease of addiction,” said Secretary Kinsley. “We are grateful to our federal partners for tackling these disparities head-on by investing in behavioral health services and supports.”

With this award package, ARC has invested $53.6 million in 166 projects across all 13 Appalachian states since INSPIRE was established in April of 2021. Together, ARC’s INSPIRE investments will impact 360 Appalachian counties, improve over 3,000 businesses and help prepare nearly 16,200 individuals for new opportunities in the workforce.

New Data Reveals Reduction in SUD-related Deaths in Appalachia
SUD recovery-to-work initiatives may be starting to make an impact, according to a new ARC research report that examines trends in diseases of despair including overdose, suicide, and liver disease. From 2021 to 2022, the overall diseases of despair mortality rate decreased 4 percent in the Appalachian Region while remaining virtually unchanged in the rest of the United States. However, work remains to be done, as these rates—in both Appalachia and the rest of the country—remain much higher than the pre-pandemic figures of 2019.

ARC expects to issue a Notice of Solicitation for Applications (NOSA) for the next round of INSPIRE funding in early 2025.

Learn more about ARC’s INSPIRE Initiative and the newest INSPIRE grantees

Have you watched the BPHC Workforce recent webinar on designing and implementing a Workforce Well-being Strategy? BPHC invites you to join their virtual office hours where they will clarify your questions and go over common challenges health center leadership face when developing such a strategy. Examples may include securing executive buy-in, balancing competing priorities, and integrating initiatives into organizational culture. BPHCs TA facilitators will also point out ways in which you can tackle these issues and address topics requested by health center staff. Don’t forget to download their Workforce Well-being Strategy Template to support your health center in building an effective strategy. TA Modality Office Hours are Sept. 10, 2024, from 2:00-3:00 pm. For more information about BPHCs full range of Technical Assistance opportunities, access to publications and resources, and details on past events, please visit their website.

CDC’s Advisory Committee on Immunization Practices updated its flu vaccine recommendations for the 2024-2025 flu season. Primary changes and updates include the composition of the vaccines and updated recommendations for vaccination of adult solid organ transplant recipients. See the full announcement in CDC’s Morbidity and Mortality Weekly Report.

– Comment by October 4. The Centers for Medicare & Medicaid Services (CMS) is revisiting possible changes to Medicare Administrative Contractor (MAC) jurisdictions and contract duration. In this RFI, CMS seeks feedback from industry leaders about potentially combining 4 MAC jurisdictions into 2 and extending MAC contracts to 10 years.  A CMS MAC is a primary health care insurer that has been awarded a geographic jurisdiction to process fee-for-service claims, e.g., Medicare Part A, Part B, and durable medical equipment claims. The MAC serves as the primary contact between Medicare and health care providers, and is a multi-state, regional contractor responsible for administering both Part A and Part B claims. To see if your MAC jurisdiction may be affected by CMS’ proposed updates, please review the RIF on SAM.gov.

To improve implementation of parity in Medicaid and the Children’s Health Insurance Program (CHIP), the Centers for Medicare & Medicaid Services (CMS) seeks comments on a new set of templates and instructional guides for state agencies to document how mental health and substance use disorder benefits provided through a state’s Medicaid managed care program, Medicaid alternative benefit plans, and/or Children’s Health Insurance Program (CHIP) comply with Medicaid and CHIP Mental Health Parity and Addiction Equity Act Final Rule requirements. These new tools are intended to standardize, streamline, and strengthen the process for states to demonstrate, and for CMS to determine, compliance with, mental health/substance use disorder parity requirements in coverage and delivery of state Medicaid and CHIP benefits.  Medicaid and CHIP are important sources of insurance in rural areas, and they play a key role in financing care for people with behavioral health needs.

The Centers for Medicare & Medicaid Services Innovation Center (CMMI) published a list of urban and rural acute care hospitals located in one of the Core Based Statistical Areas selected for mandatory participation in TEAM, a new episode-based, alternative payment model, in which selected acute care hospitals will coordinate care for people with Traditional Medicare undergoing one of the surgical procedures included in the model and assume responsibility for the cost and quality of care from surgery through the first 30 days after the Medicare beneficiary leaves the hospital. CMS requests that a representative from each hospital on the list complete the online TEAM Primary Point of Contact Identification Form to identify points of contact for TEAM-related communications.

The Centers for Medicare & Medicaid Services (CMS) updated its guidance regarding the REH enrollment and conversion process for eligible facilities as well as the Frequently Asked Questions (FAQs). Congress established REHs as a new type of Medicare provider that cannot have acute care inpatient beds, must provide emergency and observation care, and may provide other outpatient services. In 2022, CMS published a final rule codifying the Conditions of Participation (CoPs) that REHs must meet in order to participate in the Medicare and Medicaid programs along with payment policies, quality measures and enrollment policies. This revised guidance addresses questions that have been raised since that time. For example, it includes a question clarifying that meeting the FORHP definition of rural will not meet the statutory requirements for converting to an REH. Final interpretive guidance for REHs is pending and will be provided in a future release.

This brief from the RUPRI Center for Rural Health Policy Analysis presents financial performance trends of hospitals who participated in Medicare’s Shared Savings Program (SSP) from 2011 to 2018. Trends in six financial outcomes are compared between SSP and non-SSP hospitals over time and between rural and urban hospitals.

The Economic Research Service (ERS) at the U.S. Department of Agriculture reports that 13.5 percent (18 million) of U.S. households were food-insecure, meaning they were uncertain of having, or unable to acquire, enough food to meet the needs of all their members because they had insufficient money or other resources for food.  Last week, the ERS updated State Fact Sheets for rural economic factors including population, income, poverty, food security, education, employment, and more.