Rural Health Information Hub Latest News

Biden HHS Pick a Long-Time Health Equity Champion

President-elect Biden announced Xavier Becerra as his choice to lead the U.S. Department of Health and Human Services (HHS). Becerra, California’s attorney general, has a reputation as a long-time champion of health equity and competition, two areas he can impact as Secretary HHS.

COVID-19 Vaccination Update

The Pennsylvania Department of Health (DOH) is managing the distribution of COVID-19 vaccines that will be received from the federal government. Providers can access the COVID-19 Vaccine Providers page on the DOH website for the most up-to-date information available. The state is expected to receive the Pfizer vaccines the week of Dec. 15 and the Moderna vaccine the week of Dec. 22. On a call last week, Tom McCleaf, Director, Division of Immunizations, DOH Bureau of Communicable Diseases, noted that the distribution phase 1A will cover all health care providers, or about one percent of the population. Phase 1A does not equate to week one. Pfizer vaccine comes in packages of 975 doses and requires extreme cold for storage. It is recommended that providers review their application:

·     If you have not already done so, submit a COVID-19 Vaccine Administration application to DOH to be eligible to administer the vaccine if you are interested in doing so

·     Visit the CDC Advisory Committee on Immunization Practices (ACIP) website, an excellent resource for providers

·     Review the document Interim Recommendations for Allocating Initial Supplies of COVID-19 Vaccine

·     Develop your plan for testing staff based on the guidance

NIOSH Offers Resources for Health Care Workers Administering Vaccines 

Health care workers who are exposed to needles, for example, while administering vaccines, are at risk of sharps injury and exposure to bloodborne pathogens. NIOSH and our partners have many resources on how to keep health care workers safe. This includes information on how to reduce sharps injuries and what to do if you have a sharps injury.

We hope the resources below are useful. We encourage you to share this information with other health care personnel at risk for sharps injuries.

CDC/NIOSH Resources

OSHA Resources

Pennsylvania Announces Newest Participants in Rural Health Model to Ensure Pennsylvanians in Rural Areas Have Access to Care

Pennsylvania Secretary of Health Dr. Rachel Levine, who also serves as Chair of the Pennsylvania Rural Health Redesign Center Authority (RHRCA) Board, today announced that four more hospitals have agreed to participate in the Pennsylvania Rural Health Model (PARHM), aimed at ensuring the financial viability of hospitals in rural areas across Pennsylvania, and the latest step in transforming health care delivery in the commonwealth.

“The Rural Health Model is a transformative step that changes the financial model for hospitals in rural areas,” Dr. Rachel Levine said. “Rural hospitals are essential to the overall health of Pennsylvanians, especially during the COVID-19 pandemic. This is an important initiative to ensure that everyone across the state has access to quality health care within a reasonable distance from home.”

The Model helps ensure that rural hospitals, which are often an economic driver in rural areas, stay open, that jobs stay local and that sustainable access to health care is available to residents living in rural areas.

To support the continued evolution of this Model, the Rural Health Redesign Center Authority (RHRCA) was established in May 2020 with a dual focus—to lead continued development of the PARHM, working in partnership with the federal Center for Medicare and Medicaid Innovation (CMMI) and the Pennsylvania Department of Health, and build solutions for rural hospitals and communities across the country to promote financial sustainability while improving the health of the populations in these communities. The RHRCA is building on lessons learned in combining payment transformation with health care delivery transformation to develop a sustainable model for community-based care, not only in Pennsylvania but across the country.

“With 17 Hospitals and six payers now in the program, the PARHM is projected to serve more than one million Pennsylvanians in rural communities in 2021 and will have approximately $725 million in net patient revenue in the global budget model,” Gary Zegiestowsky, Executive Director of the RHRCA said.  “The scale that Pennsylvania has achieved with this model provides a solid base to drive transformative change for rural health care and we are excited about the opportunity to grow the model further over the next year.  I would add our thanks to the hospitals and payers that have joined us in the journey to transform rural healthcare across the state. This program is truly about coming together to serve rural Pennsylvania.”

In March 2019, the department announced the first five hospitals participating in the model and in December 2019, announced eight more.

The four newest hospitals participating in the PARHM include:

  • Clarion Hospital, Clarion County
  • Highlands Hospital, Fayette County
  • Indiana Regional Medical Center, Indiana County
  • Meadville Medical Center, Crawford County

Many of the rural hospitals in Pennsylvania are operating with negative margins and are at risk of closure.

The current number of hospitals eligible for participation in the model is 65 based on the definition of a rural hospital developed by the Center for Rural Pennsylvania. With the above 17 hospitals involved in the program, 26 percent of eligible hospitals will be participating in the program in 2021. While this is a credit to the desire of these hospitals to provide transformative care in their area, it also means there is still much work to be done to bring sustainability to rural hospitals in Pennsylvania. Eligible rural hospitals are encouraged to participate in this Model to improve population health, access and financial stability.

The Department of Health has developed three main strategies for improving health in rural communities including:

  • Transforming health care delivery in rural communities;
  • Improving the population health status in rural communities; and
  • Creating health care services that match the needs of the community.

For more information about rural health, visit the Department of Health website at www.health.pa.gov or www.rhrco.org, or follow the department on Facebook and Twitter.

MEDIA CONTACT: Nate Wardle, Health, 717-787-1783 or ra-dhpressoffice@pa.gov

FDA Takes Key Action in Fight Against COVID-19 By Issuing Emergency Use Authorization for First COVID-19 Vaccine

The U.S. Food and Drug Administration (FDA) has issued an Emergency Use Authorization (EUA) for the Pfizer-BioNTech vaccine  for the prevention of 2019 coronavirus disease (COVID-19) for individuals 16 years of age and older caused by SARS-CoV-2. This EUA represents the first vaccine authorized for the prevention of COVID-19.

The FDA has determined that the Pfizer-BioNTech COVID-19 Vaccine has met the statutory criteria for issuance of an EUA. The totality of the available data provides clear evidence that the Pfizer-BioNTech COVID-19 Vaccine may be effective in preventing COVID-19. The data also support that the known and potential benefits outweigh the known and potential risks, supporting the vaccine’s use in millions of people 16 years of age and older, including healthy individuals. In making this determination, the FDA can assure the public and medical community that it has conducted a thorough evaluation of the available safety, effectiveness and manufacturing quality information.

A link to the full FDA press release is here. The press release also provides information and discussion on available safety and effectiveness data.

You can review the full Pfizer-BioNTech COVID-19 Vaccine EUA Letter of Authorization here.

In addition to the EUA letter, see below:

Fact Sheet for Healthcare Providers Administering Vaccine (Vaccine Providers)

Fact Sheet for Recipients and Caregivers

Operation Warp Speed and private sector partners now begin distributing the first allocation of doses to sites designated by the public health jurisdictions and five federal agencies with which OWS and CDC have been working to plan distribution. HHS Secretary Alex M Azar II and Acting Secretary of Defense Christopher C. Miller have issued statements on this next step, and they can be viewed here.

For more information on COVID-19 vaccines, the EUA process, and guidance to industry for developing a COVID-19 vaccine please visit:

COVID-19 Vaccines

Emergency Use Authorization for Vaccines Explained

Emergency Use Authorization for Vaccines to Prevent COVID-19; Guidance for Industry

Development and Licensure of Vaccines to Prevent COVID-19; Guidance for Industry

Report: Rural Counties’ Being Reclassified as Urban Can Mask Their Successes

Researchers from Montana say that the well-established narrative about rural decline tells only a part of the story. Looking at the counties that went from rural to urban reveals what propelled growth among some of the rural areas.

Research by Headwaters Economics shows we’ve been measuring rural growth wrong. As rural counties add population, they can grow out of their rural category and take their economic growth with them.

“Rural America is reported as declining in part because we no longer count as Rural those counties that grew into a Metro classification. We are measuring those counties that stay Rural which, by definition, have not grown,” stated the report.

The research showed that 48% of counties that were classified as rural in 1970 grew into metropolitan counties by 2018. But the ones that remained rural had their share of success as well. For example, the average poverty rate in rural counties overall dropped 26% between 1970 and 2018.

The team from Bozeman, Montana found commonalities among counties that switched from rural to urban and among those that remained rural.

While the majority of “switcher” counties are located close to existing cities, they are also more likely to have diversified economies and be home to a university.

Read more.

State Strategies for Overcoming Barriers to Advance Health Equity

The COVID-19 pandemic has highlighted long-standing health inequities that have resulted in an increased risk of sickness and death for people of color. The crisis has also propelled a nationwide focus on understanding and addressing health inequities. As compared to white, non-Hispanic individuals, American Indians or Alaska Natives are over five times as likely to be hospitalized, and black or African-American individuals are over twice as likely to die from COVID-19.

While COVID-19 and the reckoning on racial justice have mobilized some state officials working in Medicaid, public health, insurance departments and Marketplaces alike, states are at different places on their journeys to confront systemic racism and inequities in healthcare, and each faces unique and challenging barriers. As early as August of this year, over one-third of states had launched task forces to take a closer look at health disparities (or differences in health based on population group) in response to the pandemic. These new task force efforts stand in contrast to decades of siloed and often poorly funded work to advance health equity by state offices of minority health or health equity. The new wave of state health equity activities aims to mitigate structural, institutional, political, financial and analytical barriers to ensure everyone has a fair opportunity to be as healthy as possible.

In a new issue brief for the Robert Wood Johnson Foundation’s State Health and Value Strategies program, Manatt Health explores impediments and accelerants to advancing health equity as states are increasingly being called upon to drive change.

To read the full issue brief, click here.

CMS Proposes New Rules to Address Prior Authorization and Reduce Burden on Patients and Providers

On December 10, CMS issued a proposed rule that would improve the electronic exchange of health care data among payers, providers, and patients and streamline processes related to prior authorization to reduce burden on providers and patients. By both increasing data flow and reducing burden, this proposed rule would give providers more time to focus on their patients and provide better quality care.

For More Information:

Nation-Leading Pennsylvania Farmland Preservation Program Ends Year with 177 Farms, 14,727 Acres Preserved

Pennsylvania safeguarded 2,710 acres on 32 farms in 17 counties through the state’s nation-leading Farmland Preservation Program. In 2020, the state board, in collaboration with county boards, preserved 177 farms and 14,727 acres of farmland across the commonwealth.

The director and staff of the Bureau of Farmland Preservation were recently recognized by the Wolf Administration for continuing their work while overcoming telework obstacles throughout the COVID-19 pandemic.

“The disruptive impacts of the COVID-19 pandemic on Pennsylvania’s agricultural system have been broad and varied,” Agriculture Secretary Russell Redding said. “This year, we’ve watched farmers and consumers bridge the gap from farm to table. Producers and households have depended on each other for certainty and our state’s Farmland Preservation Program has made food security possible for our families and farmers across the commonwealth.”

Preserved farms are protected from future residential, commercial or industrial development. They represent targeted investments in the future of farming and food security in Pennsylvania.

The 32 farms preserved today are in Adams, Berks, Bucks, Butler, Clinton, Cumberland, Dauphin, Lancaster, Lawrence, Lehigh, Lycoming, Monroe, Northampton, Washington, Wayne, Westmoreland, and York counties.

These farms include fruit, vegetable, equine, crop, livestock, sheep, goat, and dairy operations.

Since the program began in 1988, federal, state, county, and local governments have purchased permanent easements on 5,813 Pennsylvania farms totaling 591,819 acres.

Notable farms preserved today include the Taggart Family Farm, a 73.45-acre bicentennial crop farm located in Butler County. The farm has been in the family for 220 years. John Taggart, who immigrated from Ireland in 1800, purchased the farm, which will remain in agriculture with certainty for future generations. Statewide, there are now 190 bicentennial farms, many of which are also preserved.

Barrick Farms LLC, a 482.25-acre dairy operation in Cumberland County, is the largest farm secured by the county board to date. The Barrick’s donated half of the easement value to the program, further leveraging funds for additional farms to be preserved.

The David James Nolt Farm, a 95.68-acre crop farm in Lancaster County, is nearly all Class 1 soils. According to USDA, Class 1 soils are the most productive prime farmland in the nation.  Lancaster County is a leader, with over 1,000 farms preserved through the state program and in partnership with Lancaster Farmland Trust, a non-profit organization.