Rural Health Information Hub Latest News

New Funding: CMS Transforming Maternal Health (TMaH) Model Released

– Apply by September 20.  The TMaH Model’s primary focus is improving health outcomes for mothers and their infants who are enrolled in Medicaid and Childrens’ Health Insurance Program (CHIP). Under TMaH, selected state Medicaid agencies will receive targeted technical support to develop a whole-person approach to pregnancy, childbirth, and postpartum care.  Medicaid pays for nearly half of all births nationally and covers a greater share of births in rural areas.  Rural residents have a 9 percent greater chance of experiencing severe maternal morbidity and mortality compared with urban residents.  The Centers for Medicare & Medicaid Services (CMS) expects to award cooperative agreements to up to 15 state Medicaid agencies.

CMS Now Accepting Applications from States for Innovation in Behavioral Health Model 

– Apply by September 9.  Last week, the Centers for Medicare & Medicaid Services (CMS) released a Notice of Funding Opportunity (NOFO) for the Innovation in Behavioral Health (IBH) Model. The IBH Model is focused on improving the behavioral and physical health outcomes and quality of care for people with Medicaid and Medicare who experience moderate to severe behavioral health conditions. The IBH Model is a state-based model, led by state Medicaid agencies (SMAs), and CMS will select up to eight SMAs to participate in the IBH model via cooperative agreement funding. CMS is hosting a webinar for states interested in applying on Thursday, July 11 at 2:00 pm Eastern.

HRSA Announces New Policy Action to Improve Access to Housing for People With HIV

New Guidance Will—For the First Time—Enable Ryan White HIV/AIDS Program Recipients to Use Funds for Housing Security Deposits for Eligible Patients

The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced new policy action to facilitate access to housing for people with HIV served by the Ryan White HIV/AIDS Program recipients. The new guidance enables—for the first time—the use of Ryan White HIV/AIDS Program funds to cover housing security deposits for eligible clients. This guidance advances critical elements of the National HIV/AIDS Strategy (PDF – 1 MB) announced by President Biden and the Ending the HIV Epidemic in the U.S. Initiative and addresses a key barrier that has been raised by patients and advocates.

HRSA Deputy Administrator Jordan Grossman announced this guidance during the Advancing Housing, Health, and Social Care Partnerships Conference, which is bringing together federal agencies, states, and housing and services organizations across the country participating in the HRSA-supported Health and Housing Initiative, the U.S. Interagency Council on Homelessness ALL INside Initiative, and the HHS and HUD-supported Housing and Services Partnership Accelerator.

“We know that lack of access to stable housing impacts health outcomes for individuals living with HIV,” said Carole Johnson, HRSA Administrator. “This new action will help individuals with HIV by addressing one of the barriers to remaining engaged in care. We look forward to this action helping to facilitate more housing opportunities which will support better health outcomes.”

The Ryan White HIV/AIDS Program provides care and treatment services to more than 560,000 low-income people with HIV, with a strong focus on tailoring approaches to best meet the needs of high-need communities and addressing factors like access to housing and transportation that directly affect clients’ ability to enter and stay in care. In 2022, 77.9% of Ryan White HIV/AIDS Program clients with unstable housing who received medical care reached viral suppression—meaning they cannot sexually transmit HIV to other people and can live a long, healthy life—compared to 90.6% of those with stable housing.

Current program guidelines have been viewed as an obstacle to assisting clients with security deposits. The guidance issued today explains how recipient can use Ryan White Program funds for security deposits for their clients provided that they ensure the deposits are returned to the program, not the client, at the end of the lease.

The National HIV/AIDS Strategy, developed by the White House Office of National AIDS Policy (ONAP) in collaboration with federal partners and with input from the HIV community across the country, outlines a vision for ending the HIV epidemic in the United States through goals, objectives, and strategies to prevent new infections, treat people with HIV to improve health outcomes, reduce HIV-related disparities, and better integrate and coordinate the efforts of all partners.

The Ending the HIV Epidemic in the U.S. initiative builds upon the foundational efforts of the Ryan White HIV/AIDS Program to reach people newly diagnosed with HIV and those who are disconnected from care by enhancing linkage to and engagement in care, decreasing disparities, and improving viral suppression.

HRSA thanks the HIV community for its invaluable contributions in advancing health outcomes for individuals at risk of or experiencing housing instability and homelessness and for sharing insights which have been instrumental in shaping this new guidance.

To access the Security Deposit guidance, please see the Housing Security Deposits in the Ryan White HIV/AIDS Program letter (PDF – 81 KB).

See News & Announcements on HRSA.gov.

Philly Fed Assesses Small Business Conditions in Region

For the third year in a row, more than half of small businesses in Pennsylvania, New Jersey, and Delaware said their financial conditions were poor or fair. Their top operational challenges? Hiring or keeping qualified staff. Reaching customers or growing sales. Supply chain issues.

Distilling data from the Fed’s national 2024 Report on Employer Firms: Findings from the 2023 Small Business Credit Survey, these briefs offer a view into business conditions in Pennsylvania, New Jersey, the Philadelphia metro, and the Third District states overall (Delaware, New Jersey, and Pennsylvania).

Additional findings from the survey for Delaware, New Jersey, and Pennsylvania:

  • More firms said they experienced no change in their revenues between 2022 and 2023 than did between 2021 and 2022.
  • Fewer firms carried debt, although about the same number of firms applied for loans, lines of credit, or merchant cash advances compared with the previous year.

Read the briefs.

Dental Publication Focuses on Integration of Behavioral Health and Oral Health

The Journal of the California Dental Association published a special issue focused on the integration of behavioral health and oral health. The issue discuses the bi-directional relationship, a framework for integrating behavioral health and oral health in predoctoral education, and resource to support the integration of behavioral health into dental settings.

Click here to read the issue.

New Resource: Using Public Health Hygienists in Health Centers

The Pennsylvania Association of Community Health Centers (PACHC) and the Pennsylvania Office of Rural Health (PORH) created a resource for health centers interesting in adding a public health dental hygiene practitioner (PHDHP) to their team. The resource includes guidance on what PHDHPs are and are not permitted to do and information on employing a PHDHP in federally qualified health centers (FQHCs).

Click Here to View the Resource

Closing of Rural Hospitals Leaves Towns With Unhealthy Real Estate

In March 2021, Jellico, TN, a town of about 2,000 residents in the hills of east Tennessee, lost its hospital, a 54-bed acute care facility. Campbell County, where Jellico is located, ranks 90th of Tennessee’s 95 counties in health outcomes and has a poverty rate almost double the national average, so losing its health care cornerstone sent ripple effects through the region.

“Oh, my word,” said Tawnya Brock, a health care quality manager and a Jellico resident. “That hospital was not only the health care lifeline to this community. Economically and socially, it was the center of the community.”

Since 2010, 149 rural hospitals in the United States have either closed or stopped providing in-patient care, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. Tennessee has recorded the second-most closures of any state, with 15, and the most closures per capita. Texas has the highest number of rural hospital closures, with 25.

Each time a hospital closes there are health care and economic ripples across a community. When Jellico Medical Center closed, some 300 jobs went with it. Restaurants and other small businesses in Jellico also have gone under, said Brock, who is a member of the Rural Health Association of Tennessee’s legislative committee. And the town must contend with the empty husk of a hospital.

Dozens of small communities are grappling with what to do with hospitals that have closed. Sheps Center researchers have found that while a closure negatively affects the local economy, those effects can be softened if the building is converted to another type of health care facility.

Read more.

Communicating Public Health to Rural Communities During a Crisis

The Georgia Department of Community Health offers a toolkit with links to comprehensive, accessible, and ready-to-use materials to provide local health department staff with information to improve communication efforts.  The material places emphasis on challenges encountered in rural settings and targeted for use among county health department nurse managers, supervisors, and other public health staff.

Informational Bulletin: Medicaid and CHIP Managed Care Monitoring and Oversight Tools

Last week, the Centers for Medicare & Medicaid Services (CMS) released the informational bulletin Medicaid and CHIP Managed Care Monitoring and Oversight Tools, including States’ Responsibility to Comply with Medicaid Managed Care and Separate CHIP Mental Health and Substance Use Disorder Parity Requirements. The bulletin will help states to improve the monitoring and oversight of managed care in Medicaid and CHIP by providing additional tools for the States. Additionally, this bulletin reminds States of Medicaid managed care and separate CHIP mental health and substance use disorder parity requirements. This is the fourth in a series of bulletins on increasing states’ monitoring and oversight of managed care.