The Federal Office of Rural Health Policy announced $11.2 million awarded to 15 recipients for the new competitive cycle of the Black Lung Clinics Program (BLCP). The purpose of this program is to reduce the morbidity and mortality associated with occupationally-related coal mine dust lung disease through the provision of quality medical, outreach, educational, and benefits counseling services for active, inactive, retired, and disabled US coal miners. In an effort to address current disease trends, the program includes an emphasis on Coal Workers’ Pneumoconiosis & Progressive Massive Fibrosis. Additionally, the University of Illinois at Chicago received funding for the Black Lung Data and Resource Center. The program aims to strengthen the operations of BLCP recipients through programmatic assistance and improved data collection and analysis related to the health status and needs of U.S. coal miners. Find more information here.
Bipartisan Policy Center: Rural Health Report Update
The Bipartisan Policy Center (BPC) held a two-hour webcast on April 21, 20202, to mark the release of a new rural health policy report. This latest report is an update of its previous report. It has some new perspectives reflecting experiences of rural communities during the COVID-19 pandemic. The new report can be read here: BPC_Rural-Health-Care-Report – 2020.
There are multiple payment-related recommendations in the new report which would affect CAHs, RHCs and FQHCs. Many of these recommendations could become the basis of future COVID-19 relief legislation.
During the webcast Rural Health Task Force members provided their individual perspectives on the challenges facing rural health care. Many of the policy positions were shared by Task Force members:
- The need for payment reforms is emphasized by the BPC Task Force. Many of these are incremental changes, though there is great interest in the global payment approach being explored in PA.
- There is a strong shared sentiment that many hospitals need to transition to a smaller, reduced service operation. This sentiment is embodied in the Task Force recommendation for the establishment of a new CMS hospital designation – the Rural Emergency and Outpatient Hospital (REO). Transition of hospitals to the new model would be accomplished through a community-wide transformation planning process to be supported with Federal funds.
- The Task Force also sees a potential role for FQHCs and RHCs that might wish to expand services into the inpatient arena. This would be permitted under a new Extended Rural Services (ERS) Program.
- The Task Force looks for payment reforms and expanded workforce training programs to address the need to improve access to maternal care in rural areas.
- Multiple rural health workforce program expansions are recommended. These include expansions of the J-1 Visa Waiver program and rural training track program, New support programs – including rural provider tax credit programs modeled after successful OR and NM programs – are also recommended.
- A variety of recommendations related to rural broadband and telehealth expansions are presented.
- The need for rural relevant quality measurement and performance monitoring is recognized in the report.
BPC recommendations, if implemented, may lead to an expansion of SORH activities. The REO and ERS programs would require planning efforts which could easily be coordinated with SORH participation.
For those interested in hearing the full webcast, check the following link:
Report: Rural Co-ops Can Close the Digital Divide
By Jan Pytalski
Locally owned utility cooperatives have the skills and motivation to provide better internet service for rural America. The Institute for Local Self Reliance recommends policies that could help get the job done. Read the article here.
Native American Tribes’ Pandemic Response Is Hamstrung by Many Inequities
By Lindsey Schneider
History of systemic inequities from disrupted food systems to extractive industries exploiting native lands hamper tribal response to the coronavirus outbreak, resulting in more deaths among Native Americans. Read the article here.
Grain Bin Accidents and Deaths Rising Due to Poor Crop Conditions
By Bart Pfankuch
Bad weather resulting in poor crop quality put farmers at a much higher risk of deadly accidents inside of grain bins. Read the article here.
Rural People Are Just as Worried about Covid-19 as Nation, Online Poll Says
By Tim Marema
There’s a perception out there that rural residents are less concerned about the pandemic. A national poll says otherwise. Read the article here.
New Research Brief: Process of Identifying Measures and Data Elements for the HRSA School-Based Telehealth Network Grant Program
A Research & Policy Brief is available from the Rural Telehealth Research Center:
To demonstrate how telehealth can expand access to, and coordinate and improve the quality of health care services offered in schools, the Health Resources and Services Administration (HRSA) Federal Office of Rural Health Policy (FORHP) Office for the Advancement of Telehealth (OAT) awarded grants to 21 organizations across the country for the School-Based Telehealth Network Grant Program (SB TNGP) in September 2016. Grants were targeted to rural, frontier, and underserved communities providing telehealth services for school children, with a particular focus on five clinical areas: asthma, behavioral health, diabetes, healthy weight, and oral health. As part of this initiative, FORHP funded the Rural Telehealth Research Center (RTRC) to identify a set of measures for the SB TNGP. The principal activities for this project included developing an inventory of potential SB TNGP measures, defining a methodology for evaluating this inventory of measures to determine which were most relevant and applicable for evaluating the SB TNGP initiative, applying the methodology to identify a final list of measures, translating the measures into data elements, and creating a dictionary and tool that could be used to systematically collect and report data by SB TNGP grantees. The goal of the project was to identify a common set of measures that could be collected from each of the grantees on all of their grant-funded telehealth encounters for a cross-grantee assessment of school-based telehealth services, utilization, process, and outcomes.
Please click here to read the brief.
Pennsylvania Governor’s Administration Outlines Impacts of Ending Disaster Declaration
Pennsylvania Governor Wolf’s Administration outlined the potential impact of ending the March 6 disaster declaration while clarifying that the legislature cannot end it unilaterally. The disaster declaration aids in speeding up the state’s response to the pandemic and provides protections for businesses, workers and residents. Importantly, ending the disaster declaration would not end any orders issued by the Secretary of Health that set guidelines for business operations.
Last night, the General Assembly voted to end the disaster declaration with many members claiming their actions ended the business guideline orders. That is not true. Not only does any concurrent resolution need to come to the Governor for approval or disapproval, but the disaster declaration is separate from the orders signed by Secretary of Health Dr. Rachel Levine under the Disease Prevention Act that include provisions for business reopening and for worker and building safety. Those orders remain in place. The legislature did nothing to end those.
Rather, the legislature chose to attempt to end the disaster declaration – a measure that would ostensibly end protections passed for businesses, workers, and residents.
If the declaration were to end, these protections would go away:
- Burdensome eligibility requirements for more than a million Unemployment Compensation claimants would immediately go back into effect, and employers across the commonwealth would no longer receive relief from charges.
- Certification requirements under the public-school code and child protective services law would end.
- A school meal eligibility waiver, which has allowed more than 300 meal sites to open for distribution of food to school-age children in need, would end.
- Telehealth and other health care services provided by out-of-state providers for Pennsylvanians would end.
- Utility assistance for thousands of families and individuals would end, leaving people without water or electricity.
- Hospitals and alternative care sites would no longer be able to add capacity or repurpose facilities (i.e., beds) without having to abide by the 60-day notice requirement.
- License renewal and training requirement suspensions for health care professionals, child care workers, direct care workers, direct support professionals, among other professional groups who provide life sustaining services to our children, seniors, and vulnerable residents would end, meaning all of these workers would need to choose between not returning to work until those credentials could be renewed or trainings completed and the option of returning to work with the understanding that they are practicing out of compliance with Pennsylvania law and regulation, very well opening themselves up to personal liability.
- PennDOT waivers for commercial motor vehicle weight limitations and permitting requirements for the transport and delivery of agricultural feed, food, and dairy products, fuel, pharmaceuticals, and medical supplies to assist in supply chain challenges would end and motor carriers would be restricted in their ability to directly assist in supporting emergency relief efforts necessary to respond to the pandemic.
- Mortgage foreclosure and eviction moratoriums that offer protection to vulnerable Pennsylvanians at risk of losing their homes during the pandemic would end.
In addition to these immediate waiver and legislative enactments being removed, ending the disaster declaration also would remove many practical aspects of the state’s response to this disaster, including the authority to activate the National Guard to help with nursing homes; deploying commonwealth personnel, services and distributing supplies and equipment; implementing emergency funding; suspending rules and regulations that would hinder or delay necessary action in coping with the emergency; and using all available resources of the commonwealth government and its political subdivisions to deal with the emergency.
The state could also lose federal public and individual disaster assistance, and any additional state funding sources available through transfer of unused General Fund dollars.
During a state of emergency declared by the governor, commonwealth agencies and departments may implement their emergency assignments without regard to procedures required by other laws pertaining to performing their work, entering into contracts, purchasing supplies and equipment, and employing temporary workers.
Faculty Research Examined Attitudes of Rural Pennsylvanians on Key Policy Issues
MIDDLETOWN, Pa. — With support from the Center for Survey Research at Penn State Harrisburg, researchers, led by Daniel Mallinson, collaborated to survey the attitudes of rural Pennsylvanians on a variety of topics, and how these attitudes affect their perspectives on issues relevant to state and local government, policymakers, community leaders, and other stakeholders. The research was conducted in 2019, before the coronavirus pandemic began in the U.S.
“Knowledge of the attitudes of rural Pennsylvania residents specifically is needed not only so that policymakers may respond to this quarter of the population, but also because there is evidence that attitudes of rural residents differ from those of urban residents and that attitudes may further vary within rural areas,” said Mallinson, assistant professor of public policy and administration in the college’s School of Public Affairs. “This project provides the data required to inform policymakers of the attitudes of this population concerning several key policy issues.”
Rural areas have been recovering from the recession, managing shifting demands for natural resources, realizing the need for broadband access for daily life, trying to provide access to quality healthcare, and trying to meet the challenge of the opioid crisis, to name only a few trends. According to Mallinson, the attitudes that rural Pennsylvanians hold on these issues, what issues they consider priorities, and what actions they would prefer policymakers take may have shifted over the last 10 years as these developments and others have occurred.
According to the Center for Rural Pennsylvania (CRPA), there are 3.4 million residents across the 48 rural counties in the commonwealth that policymakers serve. The researchers surveyed 2,000 Pennsylvanians (1,200 rural and 800 urban, as defined by the center).
Survey topics included attitudes about respondents’ communities, satisfaction with how things are going in Pennsylvania, trust in government, most-important policy problems, natural resource management, and the opioid crisis. For questions asked in this survey and one conducted in 2008, researchers compared responses to those collected in 2008, which was also funded by CRPA. Researchers also compared rural and urban attitudes to identify commonalities and divergences in opinion on key issues.
“Since the most recent survey had been done in 2008, social, political, economic and demographic changes have occurred which could lead to shifting outlooks or new issues to consider,” Mallinson said. “This project provides up-to-date data on rural views, as well as allows for future opinion polls to continue to assess trends in these views over time.”
Mallinson added that the 2008 report came amid the Great Recession. “At the time of this survey the U.S. economy had recovered, but somewhat unevenly. Urban areas generally recovered better than rural. New issues were at the forefront. For instance, Pennsylvania adopted medical marijuana [a topic of the 2008 study] and the conversation has now moved on to recreational marijuana [a topic of the current study].”
He added that one of the most important differences from 2008 is the decline in engagement in community activities, such as community clubs or organizations and local government commissions, committees, or boards.
Findings include that rural residents agree with their urban counterparts on a number of issues, including general satisfaction with their communities and how things are going in Pennsylvania; general agreement that most community and state issues should receive the same or higher priority; similar viewpoints on legalizing marijuana, keeping the death penalty, arming school teachers and staff, a graduated instead of flat income tax, the need to regulate fracking, support for a severance tax on natural gas, and support for renewable energy development; and some level of trust in state government institutions and officials.
Urban and rural residents also have some key differences, according to the study, including top priorities — jobs for rural residents, roads and infrastructure for urban residents. Both want action on opioids, but disagree on the forms — urban more supportive of treating this as a health care issue, rural more supportive for greater criminal justice response.
“Even though urban and rural perspectives are often thought to be quite different, we find that there is a lot of agreement,” Mallinson said. “There are some fundamental differences on important policies. There is far more agreement than we expected. We also think the decline in civic engagement is concerning. Lawmakers should think about whether there are policies surrounding things like voting and civic education that can address this problem.”
The project was originally developed as a collaboration between Chelsea Kaufman and the Institute for State and Regional Affairs when Kaufman was a postdoctoral scholar in the Penn State Harrisburg School of Public Affairs. Kaufman continued the collaboration after becoming a faculty member at Wingate University. She serves at a subject matter expert on the project.
“The similarities in rural and urban views on some issues show the importance of surveying citizens on state and local issues to inform policymakers at this level,” Kaufman said. “If we rely on national surveys alone, the views of rural Pennsylvanians on these types of issues may not be clear and policymakers may be forced to extrapolate from rural perspectives on national issues.”
Mallinson added that the final report highlights more nuance in terms of rural and urban differences, as well as how personal and demographic characteristics impact those differences.
The research was funded by a $50,000 grant from CRPA.
Pennsylvania Governor Announces Additional COVID-19 Testing Sites Opening in Areas with Limited Access
Pennsylvania Governor Tom Wolf announced that beginning Wednesday, June 10, five more COVID-19 drive-thru testing sites will open in Walmart parking lots across the state.
Quest Diagnostics and Walmart are working with the Pennsylvania Department of Health to provide testing for residents living in areas with limited access. On Friday, June 5, five testing sites opened at Walmart locations in Clarion, Erie, Montoursville, Clearfield and Hermitage to test Pennsylvanians for COVID-19.
Beginning tomorrow these sites will be open on Monday, Wednesday and Friday from 7:00 AM to 9:00 AM to test up to 50 registered patients daily. Registration is required one day in advance. There is no COVID-19 testing inside Walmart stores or Quest Diagnostics Patient Service Centers.
The testing sites that will open on June 10 include:
- Walmart Supercenter parking lot, 167 Hogan Blvd, Mill Hall, PA
- Walmart Supercenter parking lot, 21920 Route #119, Punxsutawney, PA
- Walmart Supercenter parking lot, 50 Foster Brook Blvd, Bradford, PA
- Walmart Supercenter parking lot, 10 Kimberly Ln, Cranberry, PA
- Walmart Supercenter parking lot, 2901 Market St, Warren, PA
Additional testing sites will be announced in upcoming days and will be listed on the department’s website.