- Rural Hospitals Built During Baby Boom Now Face Baby Bust
- Food Stamps Go Further in Rural Areas — Until You Add Transportation Costs
- CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Texas
- CMS Proposes New Payments for Digital Health Under CY2025 PFS Draft Rule
- Improving Public Health by Strengthening Community Infrastructure
- Biden Harris Administration Proposes Policies to Reduce Maternal Mortality, Advance Health Equity, and Support Underserved Communities
- Nearly Half of U.S. Counties Don't Have a Single Cardiologist
- Randolph County, Ill. Turns Unused Part of Nursing Home Into State-Of-The-Art Behavioral Health Center
- Rural RPM Program Is a Lifeline for Pregnant Women
- Safe and Stable Housing Is a Foundation of Successful Recovery
- Expert: Rural Hospitals Are Particularly Vulnerable to Increasing Cyberattacks Targeting Healthcare Facilities
- Biden-Harris Administration Invests Over $200 Million to Help Primary Care Doctors, Nurses, and Other Health Care Providers Improve Care for Older Adults
- AJPH Call for Papers Special Section on Intersections of Public Health And Primary Care
- NIH HEAL Initiative Turns Attention to Pragmatic Trials in Rural Communities
- Limited Continuing-Care Options in Rural Virginia Create Challenges for an Aging Population
FEMA Publishes National Risk Index
The National Risk Index is a dataset and online tool to help illustrate the United States communities most at risk for 18 natural hazards. It was designed and built by FEMA in close collaboration with various stakeholders and partners in academia; local, state and federal government; and private industry.
The Risk Index leverages available source data for natural hazard and community risk factors to develop a baseline risk measurement for each United States county and Census tract.
Quality of EMS Care Varies Widely Across the U.S.
From AXIOS
The level of care patients receive in a medical emergency varies widely based on where 911 is being dialed.
Why it matters: A first-of-its-kind study of emergency medical service systems’ performance across the country points to opportunities to improve patient care when the pressure is on.
What they did: Researchers at the Icahn School of Medicine at Mount Sinai reviewed more than 26 million responses from nearly 9,700 EMS agencies in 2019.
- They assessed how those agencies performed on safety and clinical quality measures that had been outlined by a nonprofit industry organization that year.
- The researchers said it’s a shift from looking primarily at response times to determine EMS performance, which they say is an imprecise metric for most calls.
What they found: Agencies largely responding in rural areas were less likely to treat low blood sugar or improve trauma patients’ pain, researchers found.
- They were also more likely to use lights and sirens unnecessarily, which other studies have found raises the risk of crashes.
- Delivery of time-sensitive treatment also varied during EMS calls. For instance, 4 in 10 kids with wheezing or asthma attacks didn’t get breathing treatment, and about 1 in 3 suspected stroke patients didn’t have a stroke assessment documented.
What they’re saying: “We have to move away from solely looking at response times and start looking at performance that directly impacts the people we are meant to treat,” said lead author Michael Redlener, an associate professor of emergency medicine.
Updated Uniform Data Set Crosswalk Released
The Rural Health Value team is pleased to announce the release of an updated version of the 2024 Uniform Data Set (UDS) Measure Crosswalk to Other Quality Reporting Programs .
The Crosswalk highlights alignment between Uniform Data Set (UDS) measures and other quality reporting programs. It is intended to help health centers identify which UDS measures are being utilized by other programs such as CMS Accountable Care Organizations (ACOs), and the CMS Quality Payment Program (QPP).
Related resources on the Rural Health Value website:
- The Catalog of Value-Based Initiatives for Rural Providers. The catalog summarizes rural-relevant, value-based programs currently or recently implemented by the Department of Health and Human Services (HHS), primarily by the Centers for Medicare & Medicaid Services (CMS) and its Center for Medicare & Medicaid Innovation (CMMI). Its purpose is to help rural leaders and communities identify HHS value-based programs appropriate for rural participation.
- Rural Innovation Profile: Iowa Community Health Centers and Value-Based. The Iowa Primary Care Association (Iowa PCA), IowaHealth+, and INConcertCare collaborate as a network to leverage resources in support of community health centers (CHCs) across Iowa. The three organizations have established a common strategic plan that supports a clinically integrated network for Medicaid and Medicare value-based care (VBC) contracting. This profile provides an overview and background information on how the partnership supports value-based care and planned next steps.
‘Too Many Old People’: A Rural Pennsylvania Town Reckons with Population Loss
“We already lost our bank,” Goldthwaite said as he took a break from trimming the grass around headstones. “We lost our liquor store, and we may be about to lose our high school.”
Across rural Pennsylvania, there is a deepening sense of fear about the future as population loss accelerates. The sharp decline has put the state at the forefront of a national discussion on the viability of the small towns that have long been a pillar of American culture.
America’s rural population began contracting about a decade ago, according to statistics drawn from the U.S. Census Bureau.
A whopping 81 percent of rural counties had more deaths than births between 2019 and 2023, according to an analysis by a University of New Hampshire demographer. Experts who study the phenomena say the shrinking baby boomer population and younger residents having smaller families and moving elsewhere for jobs are fueling the trend.
New PBS Documentary Series Explores Hidden Public Health Infrastructure in America
The CDC Office of Rural Health is creating awareness of a new four-part documentary series that was made possible by Bloomberg Philanthropies and is available for streaming on PBS.org and the PBS App. This series, The Invisible Shield, includes discussions on many important topics, including public health infrastructure, public health data, health equity, and more.
The fourth episode in the series may be of particular interest, as it explores the societal roots of many health problems and discusses the challenges faced by a rural community in Washington State as they work to prevent “deaths of despair,” such as those due to opioid overdose and suicides.
Please note that this is being forwarded for informational purposes only and such dissemination should not imply any endorsement by CDC or the appearance of such, of the creator and distributor, PBS, the series itself, the content contained therein, or the views, products, services, or organizations referenced in the broadcast.
Pennsylvania Releases Child Welfare Workforce Study
The Pennsylvania Office of Children, Youth, and Families released a child welfare workforce recruitment and retention study, analyzing the trends, challenges, and needs to stabilize the system. Several partners were engaged in developing the report, including 10 county child welfare agencies, the Child Welfare Resource Center, Pennsylvania Children and Youth Administrators, Pennsylvania Council for Children, Youth, and Families, the Civil Service Commission, and OCYF. Some leading factors contributing to the significant turnover in the field include compensation, organizational culture, working conditions, and partner/stakeholder relationships. The report concludes by outlining 43 recommendations across six themes: cross-cutting, compensation, recruiting, caseworker workloads, training, and safe, supportive workplaces. It is further recommended that a recruitment and retention investment fund and a working group be created to strategize on each recommendation. With the staffing crisis impacting many child welfare agencies across the commonwealth, it will be important for the administration, policymakers, and stakeholders to partner and make these recommendations achievable.
Pennsylvania Broadband Development Authority to Open Application Period for New $20 Million Program to Provide Laptops for Libraries, Non-Profits, & Community Institutions Across Pennsylvania
The $20 million Digital Connectivity Technology Program, which will distribute laptops to community institutions to help connect Pennsylvanians who lack digital technology, will accept applications beginning June 20 through August 19.
The Shapiro Administration is committed to closing the digital divide in the Commonwealth.
The Pennsylvania Broadband Development Authority (PBDA) Executive Director Brandon Carson announced that the application period for the new Digital Connectivity Technology Program will be open beginning Thursday, June 20 through Monday, August 19, 2024. Online applications can be made through the PBDA website starting June 20.
Through the new program, the PBDA will purchase and distribute $20 million in laptops for eligible public-facing institutions such as libraries, municipalities, workforce training organizations, not-for-profit organizations, and other community anchor institutions located in areas where affordability has been identified as a barrier to broadband adoption and use who will then make them available to individuals who lack the technology needed to access the internet.
The PBDA will begin reviewing Digital Connectivity Technology Program applications on August 20 and anticipates announcing the grant awards in November. Projects are expected to begin in early 2025. Grant recipients are required to make digital skills training available through their own program or the free options on the PBDA website, however end users are not required to participate in a training program.
“We are working hard to provide the resources Pennsylvanians need to make ‘internet for all’ a reality across the Commonwealth,” said Executive Director Brandon Carson. “The Digital Connectivity Technology Program will provide libraries and other community institutions with the technology required to give Pennsylvanians the internet access they need to have better health, education, and economic outcomes.”
Across Pennsylvania there are currently 286,000 households, businesses, schools, and libraries that either have no access or insufficient access to broadband. The funding for the Digital Connectivity Technology Program was made available through the American Rescue Plan Capital Projects Funding, announced by the PBDA in March 2024.
Through the federal Broadband Equity, Access, and Deployment (BEAD) Program the Commonwealth will receive more than $1.16 billion in federal funding to expand broadband in unserved and underserved areas to make sure every Pennsylvanian has access to affordable, high-speed internet. In May, the PBDA received federal approval of its Volume II BEAD Initial Proposal, an important step forward in Pennsylvania’s efforts to invest $1.16 billion in federal funding. The Volume II BEAD Initial Proposal outlines the Commonwealth’s plan to expand internet service for unserved and underserved Pennsylvanians.
In addition to the Digital Connectivity Technology Program and BEAD funding, the Commonwealth also received:
- $204 million in funding through the Capital Projects Fund Broadband Infrastructure Program to connect unserved/underserved areas, and
- $45 million through the Multi-Purpose Community Facilities Program for community projects to construct, acquire, or improve facilities that are open to the public and will directly enable work, education, and health monitoring.
These significant investments are providing the Shapiro Administration with the resources it needs to connect Pennsylvanians to the internet and ensure that no matter where they live across the Commonwealth, they can go to school, start and grow businesses, and access telemedicine.
For a detailed look at the Digital Connectivity Technology Program, please view this helpful program overview and this video presentation.
Visit the Pennsylvania Broadband Development Authority’s website to learn more about its work to close the digital divide in the Commonwealth.
CMS Celebrates 10 Years of Coverage to Care!
The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) is proud to celebrate the 10th anniversary of our Coverage to Care (C2C) initiative. Since its inception, the initiative has helped people understand their health coverage and connect to the primary care and preventive services that are right for them, so they can live a long and healthy life.
To ensure that people are aware of these benefits, C2C has released a suite of resources – available in as many as 9 languages – designed to help people navigate their coverage, access care, receive preventive care, and manage their chronic conditions. C2C’s original resource, the Roadmap to Better Care, has also been updated over the past decade to better help people navigate the evolving health coverage landscape.
Community Partners
C2C began as a grassroots effort, relying on our trusted community partners to directly reach those they serve. It is because of the efforts of navigators, libraries, and others like these around the country, that C2C has been able to have such a lasting impact across the U.S.
Over the last decade, C2C resources:
- Have been distributed to every state and zip code, and
- Ordered more than 1 million times, including the Roadmap to Better Care.
Through our Community Connections Tour, we have collaborated with local organizations across the country to help educate people about getting the most out of their health coverage. C2C has participated in events across the country at local health fairs, community events, virtual webinars, and train the trainers, and looks forward to continuing this work with you.
Stay Up to Date with C2C
From our newest resource to the latest community events, stay in touch:
- Subscribe to our listserv
- Email us at CoverageToCare@cms.hhs.gov
- Visit our website, https://go.cms.gov/c2c
As we celebrate a decade of C2C, we also look forward to how the program will continue to develop over the next decade and beyond.
Montana Creates Emergency ‘Drive-Thru’ Blood Pickup Service for Rural Ambulances
Crystal Hiwalker wonders if her heart and lungs would have kept working if the ambulance crew had been able to give her a transfusion as the blood drained from her body during a stormy, 100-mile ride
Because of the 2019 snowstorm, it took 2.5 hours to drive from her small town of Lame Deer, Montana, to the advanced trauma center in Billings.
Doctors at the Billings Clinic hospital revived Hiwalker and stopped the bleeding from her ruptured ectopic pregnancy. They were shocked that she not only survived after her heart stopped beating and she lost nearly all her blood, but that she recovered without brain damage.
The Montana State Trauma Care Committee, which works to reduce trauma incidents and to improve care, later realized the ambulance that carried Hiwalker had passed near two hospitals that stocked blood. What if Hiwalker had access to that blood on her way to Billings, committee members asked.
That realization, and question, inspired committee members to create the Montana Interfacility Blood Network, which they say is the first program of its kind in the U.S. The network allows ambulance crews to pick up blood from hospitals and transfuse it to patients on the way to the advanced care they need.
“We kind of came up with the idea of having a blood handoff — like driving through a fast-food restaurant drive-thru — and picking up blood on the way,” said Gordon Riha, a trauma surgeon at the Billings Clinic trauma center, where Hiwalker was treated. Riha said timely blood transfusions can prevent death or permanent brain injury.
Flood Hazards in PA, NJ, AND DE: How Lower-Income Communities Fare
Damaged or destroyed homes, displaced families, and personal harm. Millions of Americans face the impacts of flooding each year. Two new reports examine flood hazards and risk in Pennsylvania, New Jersey, and Delaware.
One study finds that in noncoastal areas in the three states, properties in low- and moderate-income neighborhoods face greater risks when compared with their higher-income counterparts. When it comes to coastal areas, the opposite is true. Yet, increased flood hazards touch all residents in shore communities.
A companion report compares the Federal Emergency Management Agency’s well-established Special Flood Hazard Areas with a new, alternative measure from the First Street Foundation. The study seeks to understand the implications for residents in less advantaged communities.
For more on climate risks and adaptation in our region, the Federal Reserve Banks of Philadelphia and New York invite you to a one-day event on workforce solutions for community climate resilience. Learn more and register.