Philadelphia Inquirer, Jason Nark, April 5, 2023

Berwick, a town of about 10,000 in Columbia County, is without a hospital for the first time in more than a century.

The emergency room was dark, the doors locked for months now, and a young woman stood outside in the rain, clutching her stomach and sobbing. No one was coming out to help.

The frantic people who drove the ailing woman to the hospital stood, dumbfounded, in the mostly empty parking lot.

“This is insane,” the driver said. “I’m going to have to call 911.”

On Sept. 17, the Pennsylvania Department of Health shut down Berwick Hospital Center’s emergency room because of a lack of staffing, accelerating a closure its owners planned out earlier that summer. Signs on the doors still advise patients to head to hospitals in Hazleton, 20 miles to the south, or Bloomsburg, 14 miles west, for emergencies. The 90-bed facility is currently operating only as a 14-bed inpatient geriatric psychiatry facility — but not everyone in this town of 10,349 on the Susquehanna River in Columbia County, knows that.

On that dreary March morning, the ill woman was carried back to a car to wait for an ambulance. Bette Grey, a Berwick resident and private medical advocate who fought, unsuccessfully, to keep the hospital open, was there to talk to The Inquirer. First, she watched her fears unfold.

“Hey, stay awake. Open your eyes,” Grey yelled, to the woman in the car, clapping her hands.

Read more.

 Yesterday, the U.S. Food and Drug Administration (FDA) announced that the makers of Narcan, an opioid overdose treatment, have the agency’s approval to make the drug widely available over the counter (OTC).  Narcan is the brand name of the drug naloxone, a fast-acting overdose reversal. Until now, availability varied by state – typically restricted to licensed health care providers, approved opioid overdose programs, and first responders. This is an important consideration for rural counties given that research shows that these areas are nearly three times more likely than metropolitan counties to be a low-dispensing county for naloxone.

 In 2021, the Centers for Disease Control and Prevention carved out $427 million in state funding to focus on combatting COVID-19 in rural communities as part of a multibillion-dollar national initiative to address COVID-19-related health disparities among at-risk and underserved populations. This case study by the FORHP-Supported Southwest Rural Health Research Center explores the circumstances around this emphasis on rural America by interviewing relevant decision-makers and key stakeholders.

A sweeping report from the Administration of Children and Families (ACF) delivers insight into the rural-specific barriers to the agency’s programs – e.g., for housing, early childhood, and family development, Healthy Marriage, and Responsible Fatherhood.  Some of these barriers are well known and understood, such as distance to services and negative perceptions of public assistance.  But through qualitative and quantitative data collection, ACF researchers find details of how factors such as race, digital access, and housing are realized in the rural context and hinder the effectiveness of human services.

 The Commonwealth Fund examines programs that send paramedics and other staff to peoples’ homes to stabilize their health and avoid the need for 911 calls down the line.  The report cites 129 programs in the U.S., with more than 40 of these in rural areas.

The Centers for Medicare & Medicaid Services (CMS) recently published a new fact sheet summarizing the Medicare rules and regulations for Critical Access Hospitals (CAHs).  This latest version includes the revised CAH location requirement relative to other facilities to include areas with only secondary roads available and the requirement to inform the patient or the representative of their rights before starting or ending care and establish a grievance process.

 This month, the Substance Abuse and Mental Health Services Administration (SAMHSA) released the updated certification criteria for Certified Community Behavioral Health Clinics (CCBHCs), a model designed to ensure access to coordinated comprehensive behavioral health care. This new document follows from a draft version of SAMHSA released in December. SAMHSA also posted a summary of changes between the new criteria and the previous version and deadlines for implementation of the updated criteria. Currently, there are over 500 CCBHCs operating across the country, including some CCBHCs in rural areas.