The country is reckoning with the many largely structural and systemic factors that contribute to poor maternal outcomes for women and birthing people, especially those of color. However, with the ever increasing threat of COVID-19, most do not understand how this also exacerbates the intersecting oppressions and brutal hardships Black women face. The truth is in the facts and they are grave: Black women are three times more likely to experience a pregnancy-related death than white women.

The Pennsylvania Department of Human Services (DHS) and Pennsylvania Department of Health (DOH) are working to ensure that all women have the rights, respect, and resources for a healthy pregnancy and births. We are joining with Black Mamas Matter to observe Black Maternal Health Week (#BMHW2021) and support their mission of improving outcomes for black mothers and their babies.

Black Maternal Health Statistics

• The U.S. has an infant mortality rate of 5.8 per 1000 live births in 2017, with an infant mortality rate among  Black infants of 10.8 deaths per 1,000 live births in 2018, almost twice as high.
• Black mothers are more likely to suffer from PMADs (Perinatal Mood and Anxiety Disorders) like postpartum depression, in silence and without clinical help.
• Only about 66% of Black infants are breastfed compared to more than 82% of white and Latinx moms.
• Hospitals in areas with higher percentages of Black residents were less likely to provide adequate breastfeeding information and support to new mothers.
• Black women disproportionately lack necessary reproductive health care—including contraception, abortion, STI screenings, and reproductive cancer screenings. This leaves them vulnerable to many risk factors around pregnancy. Recent improvements in maternal and infant health across the 20th century are due, in part, to expanded contraceptive access and use.
• Research indicates that 22% of Black women receive lower quality of care than white women and are subject to discrimination in the healthcare field.
• People from some racial and ethnic minority groups are more likely to be uninsured than non-Hispanic whites.

Learn more about Black Maternal Health Week and Black Mamas Matter at blackmamasmatter.org

Reform Plan

Last year, the Wolf Administration unveiled a plan that addresses comprehensive health reforms focusing on both physical and behavioral health and promoting affordability, accessibility and value in health care. The plan includes three main components:

1. Interagency Health Reform Council (IHRC) The council will be composed of commonwealth agencies involved in health and the governor’s office. The initial goal will be to develop recommendations by December 30 to find efficiencies in the health care system by thinking about how to align programs where feasible, including the joint purchasing of medications, aligning value-based purchasing models, and using data across state agencies to promote evidence-based decisions.
2. Regional Accountable Health Councils (RAHCs) RAHCs will be required to collectively develop regional transformation plans – built on community needs assessments – to reduce disparities, address social determinants of health, and align value-based purchasing arrangements.
3. Health Value Commission The Health Value Commission would be established through legislation, and would be charged with keeping all payors and providers accountable for health care cost growth, to provide the long-term affordability and sustainability of our health care system, and to promote whole-person care.

Read more about the Health Reform Plan.

DHS Health Equity Initiatives

Health equity is the attainment of the highest level of health for all people. Studies in Pennsylvania have shown that there is more than ten percent difference in access to well child visits between black infants and white infants. Furthermore, the life expectancy of a baby born in Pennsylvania is strongly tied to zip code. A newborn in certain census tracts of North Philadelphia has a life expectancy of 63 years, when just a couple miles to the south newborns are expected to live to 86. In the U.S., it has been estimated that the combined cost of health disparities and subsequent deaths due to inequitable care is $1.24 trillion dollars. Health shouldn’t be predetermined by the color of your skin, the language that you speak, the country that you were born in, the zip code that you live in, the religion that you practice, or your sexual orientation, gender, or gender identity. As such, DHS has:

• Created the new Equity Incentive Program, starting in 2020, which incentivizes Physical Health Managed Care Organizations (MCOs) to achieve national benchmarks for Black members. The total eligible pool of incentives was $26 million in 2020. The Equity Incentive contained two quality measures in 2020, Timeliness of Prenatal Care (HEDIS®) and Well Child Visits (HEDIS®) and will grow to include measures for racial disparities in chronic condition management in 2021.
• Required Physical Health, Behavioral Health, and Community Health Choices MCOs to achieve or be working towards the National Committee for Quality Assurance (NCQA) Distinction in Multicultural Health Care. The first MCO in the country to achieve the distinction is from Pennsylvania, and almost all Physical Health MCOs have now achieved the distinction.
• Created a new Maternity Care Bundled Payment (a type of value-based purchasing), that will reward providers that reduce racial inequities and achieve national benchmarks in physical health, behavioral health, social determinants of health, and health equity. This bundled payment aims to close racial disparities that lead to a 3:1 maternal mortality inequity between Black and White women.

Launched the Regional Accountable Health Councils (RAHCs). RAHCs—comprised of payors, providers, and community-based organizations— will address health equity as a top priority and will use a collaborative regional approach to focus on communities with a high burden of disease called Health Equity Zones (HEZs). The RAHCs will work to identify the root causes of such disparities and will establish policies and interventions to reduce these disparities. View the RAHCs regions and membership.

Visit the DHS Health Innovations site and view the PA Health Equity Analysis Tool (HEAT)

What is the Emergency Broadband Benefit (EBB) Program?

The Federal Communications Commission (FCC) recently established the Emergency Broadband Benefit (EBB) program.  The EBB uses $3.2 billion in federal funding Congress approved in December 2020. The EBB gives qualifying households money to buy internet service or equipment to use the internet if they are eligible. The COVID-19 pandemic has shown the important role that affordable broadband plays in education, employment, health and other purposes as people are now relying on broadband access to the internet more than ever.

How Much is the Average EBB Support?

The program will provide eligible households with discounts of up to $50 a month for broadband service. Eligible households can also get a one-time discount of up to $100 on equipment to use the internet. Equipment includes a computer or tablet if they contribute $10-$50 toward the price for the equipment. The benefit is limited to one monthly service discount and one device discount per household. This EBB is in addition to, not in place of, the current Lifeline Program that provides $9.25 a month to support affordable broadband service.

Who is Eligible for the EBB?

The program is open to Lifeline subscribers and households that currently participate in an existing low-income or pandemic relief program offered by a broadband provider. This includes consumers whose income is at or below 135% of the federal poverty guidelines or who receive Medicaid, SNAP, SSI, Federal Housing or Veterans benefits. The EBB also is available to households if they receive free or reduced-price school lunch or school breakfast, federal Pell grants, or experienced a substantial loss of income since Feb. 29, 2020..

When Will the EBB Begin?

While the program has been authorized by the FCC, the start date has not yet been established. The FCC has adopted rules for the program and is identifying eligible providers who will deliver this benefit.

How Can Consumers Apply for the EBB?

At the current time, the program is not yet in operation, although the FCC is required to make it available within 60 days of Feb. 26, 2021. In the meantime, consumers may wish to contact their current wireless, telephone or cable provider to ask if they are planning to participate in this program. For more information about broadband availability, visit the FCC’s website.  The FCC also posted a new consumer FAQ on the EBB. The FAQ provides answers to common questions on benefit eligibility, how the discount will be applied to broadband services costs and program length.

For more information, contact the Pennsylvania Public Utility Commission 1-800-692-7380 or www.puc.pa.gov.  For people with speech or hearing loss, dial 7-1-1 (Telecommunications Relay Service)

Unanimous Vote Creates Rules and Procedures to Move Forward with Round 2 of Program to Support Health Care Providers During the Pandemic

On March 30, 2021, the Federal Communications Commission (FCC) voted to formally adopt a Report and Order and Order on Reconsideration to establish Round 2 of the COVID-19 Telehealth Program, a $249.95 million federal initiative that builds on the $200 million program established as part of the CARES Act.  The FCC’s COVID-19 Telehealth Program supports the efforts of health care providers to continue serving their patients by providing telecommunications services, information services, and connected devices necessary to enable telehealth during the COVID-19 pandemic.  The application window is expected to open within 30 days of release of the Order and the FCC will provide notice in advance of that date.

“Today the FCC announced it is moving forward with Round 2 of its COVID-19 Telehealth Program.  This past year has proven, without a doubt, that telehealth technology is critical to helping address inequities in access to health care services.  And with today’s unanimous approval of the Report and Order, the FCC remains ready to address these challenges head on.

“As part of the Consolidated Appropriations Act of 2021, Congress called on the FCC to increase transparency of the FCC’s COVID-19 Telehealth Program and to establish a clear set of rules and guidelines for evaluating applications.  With today’s action, we have answered that call.  The pandemic has affected communities both large and small throughout the country, from our urban centers to our most rural corners.  Round 2 of this program will mirror this far-reaching impact to better ensure that each state and territory can be approved for funding.  In addition, to facilitate a more equitable funding window, we will set an application deadline so that all applications can be evaluated collectively.  By working together, we can continue to make an impact on the health and well-being of all Americans now and well into the future,” said Acting Chairwoman Jessica Rosenworcel.

In January 2021, as directed by Congress in the Consolidated Appropriations Act, the FCC’s Wireline Competition Bureau sought public input on Round 2.  This Report & Order establishes a clear way to rate applications that takes into consideration objective factors about the health care provider and the area it serves.  Round 2 will also distribute funding to each state, territory, and the District of Columbia and will have an application filing window so all applicants are on equal footing during the review.  Finally, applicants will be able to provide additional information to supplement their applications if necessary.

For more information about the FCC’s COVID-19 Telehealth program, visit https://www.fcc.gov/covid19telehealth.

The U.S. Department of Health and Human Services (HHS) marked Black Maternal Health Week by announcing actions to expand access to continuous health care coverage and access to preventative care in rural areas to improve maternal health outcomes. HHS Secretary Xavier Becerra announced that Illinois is the first state to provide continuity of full Medicaid benefit coverage for mothers by offering extended eligibility for a woman during the entire first year after delivery. A new data brief shows that more than half of pregnant women in Medicaid experienced a coverage gap in the first 6 months post-partum and disruptions in Medicaid coverage often lead to periods of uninsurance, delayed care, and less preventive care.  The American Rescue Plan provides an easier pathway for states to extend Medicaid postpartum coverage from 60 days to 12 months.

Secretary Becerra also announced a Notice of Funding Opportunity (NOFO) that will make $12 million available over four years for the Rural Maternity and Obstetrics Management Strategies (RMOMS) program that will allow awardees to test models to address unmet needs for their target population, including populations who have historically suffered from poorer health outcomes, health disparities and other inequities.

“Improving maternal health outcomes – particularly among Black women – is priority for the Biden administration and for the Department,” said HHS Secretary Becerra. “Expanding access to health insurance coverage, preventative care and investing in rural maternity care is one step forward. With the American Rescue Plan, President Biden gave states tools to combat the racial disparities in pregnancy-related deaths by providing an easier pathway for states to ensure mothers access to the care they need after birth. Continuous health care coverage reduces health care costs and improves outcomes. By expanding Medicaid eligibility for a full year after delivery, Illinois is setting an important model for other states across the country to follow.”

To read the HHS press release, visit: https://www.hhs.gov/about/news/2021/04/12/hhs-marks-black-maternal-health-week-announcing-measures-improve-maternal.html.

To watch the HHS press conference, visit:  https://www.hhs.gov/live/live-1/index.html#13215.

The U.S. Department of Agriculture (USDA) Farm Service Agency (FSA) announced Monday the availability of $2 million to establish partnerships with organizations to provide outreach and technical assistance to socially disadvantaged farmers and ranchers.

The funding was made possible by USDA’s new Pandemic Assistance for Producers initiative, an effort to distribute resources more broadly and to put greater emphasis on outreach to small and socially disadvantaged producers impacted by the pandemic.

To learn more, please follow the link here.

On a preserved farm in Cumberland County, Pennsylvania Agriculture Secretary Russell Redding announced the opening of the $1 million Farm Vitality Grant Program. One of the largest of the programs in Governor Tom Wolf’s Pennsylvania Farm Bill, the Farm Vitality Program aims to enhance the long-term health and vitality of Pennsylvania’s farms.

“Pennsylvania’s more than 53,000 farms are the backbone of our reliable food system. They are the heart of Pennsylvania, just like this $1 million Farm Vitality Grant Program is the heart of the Pennsylvania Farm Bill,” said Redding. “Pennsylvania’s farm families need sound business plans, because their success is success for all of Pennsylvania.”

Trever Gill, fourth generation Cumberland County farmer, received a $7,200 Farm Vitality grant last year to seek succession and business planning services, through Ag Choice Farm Credit, to help their family navigate the transition of their 95-acre Boiling Springs farm to Gill from his grandparents. Gill is one of 133 grantees in 46 counties from the first round of Farm Vitality funding.

The 2020-21 Farm Vitality Grant Program will help fund professional services for those planning for the future of a farm. It aims to enhance the long-term health and vitality of Pennsylvania’s farms through sound business planning, efficient transitions of farm ownership, strategic farm expansion, diversification of agricultural production, and financial and technical expertise.

Farmers and prospective farmers are eligible for up to $7,500, which can cover no more than 75% of the project cost, through this program. Applications to the program will be accepted starting April 19, 2021. The program will remain open until all funds are exhausted.

Pennsylvania has long faced a looming agricultural workforce shortage, at one point estimating a deficit of 75,000 workers as farmers retire and new, technology-based positions become available. Many Pennsylvania Farm Bill programs – including Ag & Youth, Farm to School, Beginner Farmer Tax Credits, and Farm Vitality – were designed to address this workforce shortage and secure a stronger future for the industry. In fall 2020, the U.S. Department of Agriculture’s National Agricultural Statistic Service released data noting that with 12,598 producers under age 35, Pennsylvania has the highest percentage of young producers in the nation.

“The Farm Vitality Grant Program is just one more tool in our toolbox making Pennsylvania’s leading industry accessible and attainable to new and beginning farmers,” added Redding. “Attracting a new generation to this industry and removing barriers to access is critical to ensuring a strong industry and food-secure Pennsylvania.”

For more information about the PA Farm Bill, and investments to support Pennsylvania agriculture, visit agriculture.pa.gov/pafarmbill.

The Pennsylvania Department of Human Services (DHS) believes that protecting Pennsylvania’s children from abuse and neglect is a shared responsibility. Protecting children from abuse and neglect unites lawmakers, community partners, the child protective services system, citizens, and families to provide a safe environment for children throughout the commonwealth.

In partnership with counties, schools, and community organizations, the department is promoting evidence-based programs that give parents the skills and supports, both formal and informal, that they need to ensure that their children grow up in safe and loving homes. By working together and relying on natural supports like family members and neighbors, we can improve outcomes for families and protect our children.

April is Child Abuse Prevention Month and we all need to do our part to make sure that children are safe and cared for during this stressful time.

With more Pennsylvanians getting vaccinated everyday, we are headed towards the light at the end of the tunnel. However, continued social distancing can leave some children and families isolated and this can increase the risk of child abuse and neglect. Be watchful and aware of the children in your community. If you have concerns that a child is not safe or being cared for, take action – it could save a child’s life.

For more information on critical components impacting child protection, visit www.KeepKidsSafe.pa.gov. To learn more about the #ProtectPAKids campaign, visit www.pablueribbonchampion.org.

Every quarter the Rural Health Information Hub releases Grants in Motion, highlighting some of the exceptional work FORHP awardees are achieving in their communities.  The focus of this edition is on how Community Health Workers (CHWs) can help improve health outcomes by providing culturally appropriate care.  Rural Health Projects, an awardee through the Rural Health Network Development Program, found success as they employed Community Health Workers to provide outreach to Oklahoma’s Marshallese community.