The U.S. Department of Health and Human Services’ (HHS) Health Resources and Services Administration (HRSA) announced more than $80 million in awards to rural communities in 39 states to support key strategies to respond to the overdose risk from fentanyl and other opioids. These awards help advance President Biden’s commitment to beat the opioid epidemic as part of his Unity Agenda for the nation.

HRSA funding will support interventions such as distributing the lifesaving overdose reversal drug naloxone to prevent overdose; creating and expanding treatment sites in rural areas to provide medications to treat opioid use disorder; expanding access to behavioral health care for young people in rural communities; and, caring for infants in rural areas who are at-risk for opioid exposure or experiencing symptoms related to opioid exposure.

“Far too many rural families have faced the devastation of overdose, and these deaths are felt deeply across rural communities – where often everyone knows someone lost too soon,” said HRSA Administrator Carole Johnson. “At the Health Resources and Services Administration, we know that funding based on population size or other broad-based rubrics can miss the vital treatment and response needs of rural communities. That’s why the investments we are announcing today are targeted to rural communities and tailored to the unique challenges of helping rural health care leaders expand access to treatment and build recovery pathways to prevent overdose.”

More than 100,000 people die each year from overdose. Individuals who call rural communities home and who are experiencing opioid use disorder – including from fentanyl, heroin or other opioids – can face challenges in accessing treatment and recovery services. Geographic isolation and transportation barriers can make finding treatment particularly challenging and limited mental health and substance use disorder health care providers in the community can further complicate access. The stigmatization of substance use disorder and its treatments are additional barriers to access. HRSA’s funding is targeted to helping communities address these critical needs and expand access to services.

Today’s announcement includes the following investments:

• Expanding Access to Medication to Treat Opioid Use Disorder: $24 million will support 26 awards to rural communities to establish treatment sites for individuals to access medications to treat opioid use disorder. The use of medication to manage opioid use disorder is the standard of care, but not always readily available.
• Supporting Rural Communities in Preventing and Responding to Overdoses: $14 million will support 47 awards to help rural communities respond to their specific and immediate needs, including the distribution of life-saving opioid overdose reversal medications.
• Meeting the Behavioral Health Needs of Young People: Nearly $9 million will support 9 awards to focus on building, strengthening and expanding mental health and substance use disorder services for young people in rural communities to expand treatment and help prevent overdose.
• Preventing and Addressing Neonatal Exposure: Nearly $20 million will support 41 awards to develop and implement interventions in rural communities to prevent, treat and care for opioid exposed infants by focusing on systems of care, family supports, and social determinants of health.
• Investing in and Disseminating Best Practices: $10 million will support three Rural Centers of Excellence on Substance Use Disorders to disseminate treatment and prevention best practices to help inform rural communities’ response strategies, and $5 million will support evaluation of this overall initiative.

To view the full list of awardees, see https://www.hrsa.gov/rural-health/opioid-response/fy2023-rcorp-awards-overview.

To learn more about the RCORP program, visit the RCORP Webpage.

The Centers for Medicare & Medicaid Services (CMS) will begin displaying the ‘Birthing-Friendly’ designation icon on CMS’s Care Compare online tool. CMS created the new designation to identify hospitals and health systems that participate in a statewide or national perinatal quality improvement collaborative program and that implement evidence-based care to improve maternal health. The public can use the Care Compare tool — along with a complementary interactive map —  to find a hospital or health system with the ‘Birthing-Friendly’ designation in their area. Today’s action is one of many key efforts being implemented as part of the White House Blueprint for Addressing the Maternal Health Crisis and is part of Vice President Harris’ nationwide call to action to reduce maternal mortality and morbidity. It also meets a milestone in the CMS Maternity Care Action Plan.

“Today’s launch of the ‘Birthing-Friendly’ designation is another important step to increase and further ensure access to high-quality maternity care,” said Vice President Kamala Harris. “America’s maternal mortality rates are the highest in the developed world, and in response, President Biden and I have made it a key priority to address this crisis by directing government agencies to come up with deliberate and actionable plans. We will always remain committed to supporting the health and well-being of all women, their families, and communities across the nation.”

“Tackling the maternal health crisis is a top priority for the Biden-Harris Administration. We are doing everything in our power to help pregnant and postpartum people find high-quality maternity care. The hospitals and health systems that are designated as ‘Birthing-Friendly’ are an important tool for consumers in their search for first rate care,” said HHS Secretary Xavier Becerra. “We will continue to take action to further advance maternity care quality, safety, and equity.”

“It’s important to center CMS’ work in actions that are results-driven and empower the people we serve. The ‘Birthing-Friendly’ designation is part of our ongoing efforts to improve maternal health in the U.S.,” said CMS Administrator Chiquita Brooks-LaSure. “By highlighting hospitals and health systems demonstrating a strong commitment to maternity care quality, the ‘Birthing-Friendly’ designation is one powerful example of how we are centering health equity in everything we do. As maternal health inequities persist across the nation, the designation offers a tangible marker of the evidence-based practices that hospitals and health systems can pursue to close these gaps and ultimately provide the kind of care all expectant parents deserve.”

Eighty percent of pregnancy-related deaths are preventable, and Black, American Indian and Alaska Native, and Native Hawaiian and Pacific Islander people have the highest rates of pregnancy-related death. Pregnant and postpartum people from some racial and ethnic minority groups are also more likely to have negative health care experiences during pregnancy and delivery that impact the quality of care they receive and health outcomes. The ‘Birthing-Friendly’ designation is a step towards ensuring that all pregnant and post-partum people can find high-quality maternity care.

Last December, CMS hosted the agency’s first-ever Maternal Care Health Convening with government and industry leaders, where more than two dozen health plans committed to using the ‘Birthing-Friendly’ designation on their consumer websites, collectively reaching over 150 million people.

Today’s announcement is the latest in a series of actions CMS has pursued to further advance maternity care quality, safety, and equity. The Biden-Harris Administration has prioritized maternal health, including by urging all states, Washington, D.C., and all U.S. territories to offer pregnant people and their families the relief of continuous postpartum coverage. Through the American Rescue Plan Act (ARP) of 2021, which allows states to provide continuous Medicaid and Children’s Health Insurance Program (CHIP) coverage for an entire year after pregnancy, CMS has approved Medicaid postpartum coverage extensions in 39 states plus Washington, D.C. and the Virgin Islands.

Visit Medicare.gov/care-compare to see hospitals with the ‘Birthing-Friendly’ designation.

The HHS Office of Minority Health joins federal partners this month in raising awareness of Alzheimer’s disease and its impact on the health of racial and ethnic minorities. According to the most recent data available from the Centers for Disease Control and Prevention (CDC), Alzheimer’s disease was one of the 10 leading causes of death in 2021. Racial and ethnic minority and Tribal communities often face discrimination when seeking health care for Alzheimer’s disease and related dementias. Findings from two national surveys show that Black Americans reported the highest level of discrimination in dementia health care followed by Native Americans, Asian Americans, and Hispanic Americans.

In an effort to implement public health strategies that promote brain health, the Healthy Brain Initiative was created in 2005 to guide public health action. The newly released Healthy Brain Initiative: State and Local Road Map for Public Health, 2023-2027 from the Alzheimer’s Association and the CDC builds on previous work and guides public health professionals through expert-developed actions to help address brain-health in their communities. Visit the CDC’s website to learn more and access the plan.

Please read the information below to see how USDA Rural Development can help your community!

The Community Facilities Program provides affordable funding to develop essential community facilities in rural areas under 20,000 population. The loan rate is currently 3.875% and would be fixed for the life of the loan. Terms can be up to 40 years for acquisition or renovation of real estate and the useful life of equipment purchased. This loan program has no fees or prepayment penalties and does not require prevailing wages.

CF video (lumen5.com) Check out this video of for more information on the Community Facilities program and great projects USDA Rural Development has funded in PA.

See below for more examples of recent projects funded through our program in Pennsylvania.

USDA Rural Development Community Facilities Loan & Grant Program and Pennsylvania Nonprofits

What can Rural Development do for your organization and community?

• Purchase, construct, and/or improve essential community facilities, and pay related eligible project expenses
• Computer and technology upgrades
• Construction, acquisition, or rehabilitation of facilities an ADA compliance
• Parking and paving improvements
• HVAC equipment, electrical upgrades, emergency generators
• Interior improvements
• Training equipment

Examples of Projects in Pennsylvania include:

• LifeQuest Assisted Living in Bucks County received a Community Facilities Direct Loan of $39.9 Million to construct 123 new assisted living units and renovation of the existing nursing center to implement a 10-15 bed memory care unit.
• Bear Creek Foundation in Luzerne County received a Community Facility Direct Loan of $11.4 Million to construct a 36,000 square-foot addition to its existing charter school.
• Meadville Public Library in Crawford County received a Community Facility Direct Loan and Grant of $132,460 for a roof replacement.
• Big Valley Ambulance Club, Inc in Mifflin County received a Community Facilities Direct Loan and Grant of $128,200 for the purchase of a 2023 Life Line Victory liner ambulance.
• Penn Township in Clearfield County received a Community Facilities Direct Loan and Grant of $85,000 for the purchase of a Freightliner chassis with dump box and appurtenances.
• Sutersville Volunteer Fire Company in Westmorland County received a Community Facility Direct Loan and an Economic Impact Initiative Grant of $187,700 to purchase a new pumper truck, hose and spreader package for the fire department.

Please note that all applications are considered as loan only first. Grant funding is awarded based on financial need, availability of funds, and are a maximum of $50,000.

For more information on our program and how to apply, contact:

Crawford, Erie, Forest, Venango & Warren Counties
Courtney Bailey – Courtney.Bailey@usda.gov #814-547-5938

Allegheny, Armstrong, Beaver, Butler, Greene, Lawrence, Mercer & Washington Counties
Keith Lehman – Keith.Lehman@usda.gov #724-482-5289

Clarion, Fayette, Indiana, Jefferson & Westmoreland Counties
Eli Bratich – Eli.Bratich@usda.gov #724-482-5283

Blair, Cambria & Somerset Counties
Ron Moore – Ronald.Moore3@usda.gov #724-261-3891

Cameron, Columbia, Centre, Clearfield, Clinton, Elk, Lycoming, McKean, Montour, Northumberland, Potter, Snyder, Sullivan, Tioga and Union Counties
Judy Bartlett – Judy.Bartlett@usda.gov #570-749-3051

Bradford, Lackawanna, Luzerne, Susquehanna, Wayne & Wyoming Counties
Charles Garnett – Charles.Garnett@usda.gov #570-836-5111, x121

Berks, Bucks, Carbon, Chester, Lancaster, Lehigh, Monroe, Montgomery, Northampton, Pike, Schuylkill & Philadelphia Counties
Tonya St. Clair – Tonya.Stclair@usda.gov #484-795-7614

Adams, Bedford, Fulton, Franklin, Huntingdon, Juniata & Mifflin Counties
Ana Liza Setters – Analiza.Setters@usda.gov #717-601-3247

Cumberland, Dauphin, Delaware, Lebanon, Perry & York Counties
Melissa Kuhns – Melissa.Kuhns@usda.gov #717-601-3245

The Rural Health Value team is pleased to share updates to the Catalog of Value-Based Initiatives for Rural Providers. Two new models are now included: AHEAD and GUIDE

Catalog of Value-Based Initiatives for Rural Providers

This catalog summarizes rural-relevant, value-based programs primarily by the Centers for Medicare & Medicaid Services (CMS) and its Center for Medicare & Medicaid Innovation (CMMI), to help rural leaders and communities identify HHS value-based programs appropriate for rural participation.

The following models are now included in the catalog:
States Advancing All-Payer Health Equity Approaches and Development Model (AHEAD) – a state total cost of care model that seeks to drive state and regional health care transformation and multi-payer alignment, with the goal of improving the total health of a state population and lowering costs. CMS will release a Notice of Funding Opportunity in late Fall 2023, with applications due in Spring 2024.

Guiding an Improved Dementia Experience (GUIDE) – participants in the GUIDE Model will establish dementia care programs (DCPs) that aim to improve quality of life for people with dementia, help them remain in their homes and communities, and reduce strain on their unpaid care givers. A Request For Applications was released in Fall 2023, with model launch July 2024.

Related resources on the Rural Health Value website:

• Rural Community Engagement Resource Guide – Provides rural health care leaders a variety of toolkits, strategies, and information to help initiate, improve, and inspire community engagement strategies that support value. The accompanying infographic highlights strategies for community engagement and benefits aligned with value-based care (2023)
• Demonstrating Your Value: A Guide to Potential Value-Based Care Partnerships for Rural Health Care Organizations – This Rural Health value resource assists CAH leadership in demonstrating the value CAHs bring to networks, affiliations, payers, community-based organizations, or accountable care organizations (updated 2023)

In an effort to draw attention to the wide range of issues that impact rural health, Gov. Josh Shapiro has declared November 13-17, 2023, as Rural Health in Pennsylvania week at the request of the Pennsylvania Rural Health Association (PRHA).

Gov. Shapiro made the proclamation to promote awareness of the full range of issues that impact rural health care throughout the Commonwealth and the health status of rural Pennsylvanians. Nationally, Pennsylvania ranks as one of the states with the highest number of rural residents, with 26 percent of Pennsylvanians residing in rural areas. In recognition of Pennsylvania’s diverse rural needs, the Commonwealth has supported the development of the Center for Rural Pennsylvania, the Pennsylvania Office of Rural Health, and other agencies and initiatives to address the needs of rural Pennsylvanians.

The week encompasses November 16, which is National Rural Health Day, established in 2011 by the National Organization of State Offices of Rural Health (NOSORH) to showcase rural America; increase awareness of rural health issues; and promote the efforts of NOSORH, State Offices of Rural Health (SORHs) and others in addressing those issues.

“Nearly 59.5 million Americans, including 3.4 million Pennsylvanians, live in rural communities,” said Lisa Davis, PORH director and outreach associate professor of health policy and administration at Penn State. “These small towns and communities continue to be fueled by the creative energy of citizens who step forward to provide a wealth of products, resources, and services.

Rural communities also face unique health care concerns: a lack of providers; accessibility issues, particularly in terms of transportation and technology; and affordability issues as the result of larger percentages of uninsured and underinsured citizens and greater out-of-pocket health costs. Rural hospitals and health care providers, which frequently are the economic backbone of the communities they serve, deserve special consideration so that they can continue to provide high-quality services and meet the needs of rural residents.”

To celebrate the work being done to achieve health care access and equity in Pennsylvania, the Pennsylvania Office of Rural Health will present Pennsylvania Rural Health Awards during virtual ceremonies across rural Pennsylvania.

PRHA is dedicated to enhancing the health and well-being of Pennsylvania’s rural citizens and communities. Through the combined efforts of individuals, organizations, professionals, and community leaders, the Association is a collective voice for rural health issues and a conduit for information and resources. More information can be found at paruralhealth.org.

Editors:  For additional information, please contact Lisa Davis, Director, Pennsylvania Office of Rural Health, at 814-863-8214 or lad30@psu.edu.