The Government Accountability Office (GAO) examines the federal Child Care and Development Fund and its efficacy at increasing access to quality child care for low-income families.  The fund supports 142 family childcare networks, primarily through coaching, training, and peer-to-peer networking opportunities for childcare providers at the community level.  Most of these are licensed providers, though many of the networks serve license-exempt family, friend, and neighbor providers.  Earlier this year, the National Advisory Committee on Rural Health & Human Services recommended creation of a Childcare Shortage Area designation similar to the Health Professions Shortage Area designation.

 In a letter to governors, the Secretary of Health & Human Services announced several new options states can use to help eligible individuals and families maintain their Medicaid and Children’s Health Insurance Program (CHIP) coverage as requirements change with the end of the public health emergency.  The new flexibilities include allowing managed care plans to assist people with completing their Medicaid renewal forms and allowing pharmacies and community-based organizations to facilitate reinstatement of coverage for those who were recently disenrolled for procedural reasons based on presumptive eligibility criteria. A complete list of flexibilities available to states can be found here. The Centers for Medicare and Medicaid Services has created outreach and educational resources. The Kaiser Family Foundation Medicaid Enrollment Tracker reports that at least 1,027,000 Medicaid enrollees had been disenrolled as of June 12, 2023, based on the most current data from 20 states. There is also a call to action for community organizations, employers, providers, and others can help in this effort.

The U.S. Department of Agriculture (USDA) announced awards made in 19 states under the Bipartisan Infrastructure Law.  Grantees and loan recipients of USDA’s ReConnect Program must serve a rural area that lacks access to service at speeds of 100 megabits per second, and must also commit to building infrastructure that can deliver service at that speed to every location in the area. Additionally, to ensure that rural households that need internet service can afford it, all awardees will be required to participate in the Bipartisan Infrastructure Law’s Affordable Connectivity Program (ACP). The ACP offers a discount of up to $30 per month towards internet service to qualifying low-income households and up to $75 per month for households on qualifying Tribal Lands.

 The Federal Office of Rural Health Policy awarded $2 million to 20 awardees for this one-year, community-driven program designed to assist in the planning and development of an integrated healthcare network at the local level. By emphasizing the role of networks, the program creates a platform for both rural and urban medical care providers, social service providers, and community organizations to coalesce key elements of a healthcare delivery system for the purpose of improving local capacity and coordination of care in rural communities. Administered by the Federal Office of Rural Health Policy (FORHP) at HRSA, the Network Planning program is an opportunity for healthcare providers to implement new and innovative approaches to care that may in turn serve as a model for other rural communities. The incoming cohort of Network Planning grantees have projects that focus on care coordination, health information technology/data analytics, behavioral health (including mental health and substance use disorder), health equity, and telehealth. Visit the Rural Health Information Hub online to learn more about successful program models and evidence-based toolkits that have come from the work of FORHP-funded projects.

  Last week, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that withdraws the regulations on COVID-19 healthcare staff vaccination requirements issued in a November 2021 interim final rule. COVID-19 vaccination policies and procedures for healthcare staff will no longer be required under Medicare Conditions of Participation and Conditions for Coverage, effective August 4, 2023.

The No Surprises Act required the Secretary of HHS and the Secretary of Transportation to form an advisory committee for the purpose of reviewing options to establish standards for quality, patient safety, and clinical capability in air ambulances. CMS is seeking nominations now through June 28 from each of the following groups: state insurance regulators; health care providers; health insurers offering coverage plans for groups and individuals; patient advocacy groups; and accrediting bodies with experience in quality measures. Nominations for health care providers should include physicians and other clinicians, as well as health care operations professionals experienced with air ambulance services and/or experience in addressing the challenges associated with transport in rural areas. 

Apply by June 28.

  This study from the WWAMI Rural Health Research Center describes the characteristics of rurally oriented family medicine obstetrical (OB) fellowships and the challenges these programs face in providing OB training.