Important Notice for Physicians Renewing Licenses in Pennsylvania

Help Us Maintain Accurate Provider Data

Your Role in Addressing Workforce Shortages

Why Accurate Data Matter:

Maintaining accurate and current information on providers is essential for effectively analyzing, designing, and designating areas with health care workforce shortages across Pennsylvania. The Pennsylvania Department of Health’s Primary Care Office (PCO) relies on these data to ensure that health care resources are allocated where they are needed most.

How Your Participation Makes a Difference:

• Support Workforce Analysis: Accurate provider data help identify regions with health care provider shortages, ensuring targeted interventions and support.
• Improve Health Care Access: By updating your information, you contribute to a more efficient allocation of health care resources, improving access to care for underserved populations.
• Enhance Statewide Planning: Your data help the PCO and other stakeholders design effective strategies for addressing health care needs in various regions.

How We Collect and Update Provider Information:

The PCO uses several methods to ensure that provider data remains accurate and up to date:

• Self-Reported Survey Responses: When you renew your license, please provide detailed and accurate information about your practice, including address, office hours, specialty, and patient care details. The information from licensure surveys is the most critical of all data sources.
• Annual Medicaid Claims File: We obtain practitioner information from Medicaid claims, which helps verify and update provider data.
• Statewide Organization Input: We receive periodic updates from various organizations, which contribute to our data accuracy.
• Direct Outreach: Occasionally, PCO staff may contact you directly to collect and verify practice-related information.

While the PCO can update existing provider information, we cannot add new providers to the computer system used for shortage designation. Your updates are crucial for maintaining the quality of data used in health care planning.

How You Can Help:

1. Respond to Surveys: Provide thorough and accurate responses to surveys at the time of your license renewal.
2. Keep Information Current: Go to the Center for Medicare and Medicaid Services website to update your practice details in the National Provider Identifier system regularly to reflect any changes in address and specialty.
3. Participate in Outreach Efforts: Engage with PCO staff during direct contact initiatives to verify and update your practice information.

Pennsylvania Department of Health
Primary Care Office
RA-DHSHRTDESIGNATION@pa.gov

As a result of the recent severe weather events along the east coast, a major manufacturer of intravenous fluids has been adversely impacted, resulting in the temporary closure of one of their facilities. This closure may cause a supply chain disruption for an undetermined length of time.

To help ensure crystalloid solutions are available for patients requiring IV infusions, the Medical Advisory Committee would like to offer the following advice to EMS clinicians in conjunction with guidance offered by your agency’s medical director while awaiting more formal guidance from the Bureau of EMS.

1. Whenever possible, use a saline lock/flush to obtain and maintain a patent IV in patients who would benefit from prehospital IV placement.
2. Only initiate IV fluid boluses when necessary for specific clinical indications as outlined in the statewide ALS and ALS protocols. For example, nausea/vomiting for those with clinical signs of dehydration and inability to tolerate any PO, volume-related hypotension, or continuous medication infusions.
3. Statewide Protocol #1000 (excerpted below) provides guidance on the substitution of other crystalloids in place of normal saline at the discretion of your agency medical director.

“(3) Crystalloid isotonic solutions, including normal saline solution (NSS): NSS is a safe and useful “isotonic” solution for hydration and medication delivery by EMS. When intravenous fluids are indicated, NSS is used throughout these protocols. NSS has the advantage of being compatible with all EMS medications and being preferred for patients with traumatic head injury. Lactated Ringers and other balanced salt solutions may be carried as an option by an EMS agency if approved by the agency medical director, but it is up to the agency medical director to educate providers when another isotonic fluid is preferred by the medical director over NSS. The EMS agency medical director must develop a written policy that identifies which fluid is preferred in specific patient conditions, with specific attention to compatibility of other isotonic solutions with medications administered by EMS providers. When compliant with these requirements, EMS providers may substitute these other isotonic solutions where the protocol states NSS, without contact with a medical command physician. Solutions with hypertonic concentrations of any electrolyte or other solvent that exceed physiologic concentration, are not acceptable as substitutions for NSS.”

“(4) Infusion mixtures – EMS regions or agencies may set standards for the mixture of medications that are to be given by infusion. When such standard concentrations are established, it is recommended that the region or agency also provide ALS providers with a table to assist in administering the correct infusion dosage.”

As always, on behalf of the residents and visitors to our Commonwealth, we appreciate your continued dedication to prehospital clinical excellence.

Applications are currently being accepted by the Pennsylvania Department of Health in accordance with the the Request for Applications (RFA) # 67-192.

All questions regarding this RFA must be directed by e-mail to RA-DHLOANREPAYMENT@pa.gov, no
later than 12:00 p.m. ET on October 18, 2024. All questions must include the specific section of the RFA about which the potential applicant is requesting clarification. Answers to all questions will be posted here.

Submit one application via the on-line Pennsylvania Primary Care Loan Repayment Program Practitioner
Application found here. Applications must be received no later than 11:59 p.m. ET on November 15, 2024. Applications can be submitted as soon as they are ready for submission; to prevent late submissions, applicants are encouraged to not wait until this closing date and time.

LATE APPLICATIONS WILL NOT BE ACCEPTED REGARDLESS OF THE REASON.

We expect that the evaluation of applications and the selection of Grantees will be completed within eight
weeks of the submission due date.

The PBDA would like to remind stakeholders of recent updates to the Pennsylvania Broadband Map, to include posting of BEAD Broadband Serviceable Areas (BSAs). A BSA is a Census Block Group or an aggregation of multiple Census Block Groups, which eligible applicants will use to develop proposed project areas for consideration under BEAD. When opening the map, BSAs are identified on the initial layer. Once you zoom in to a specific area on the map and click on an individual BSA you will find additional information about the selection to include the tentative number of eligible BSLs (Broadband Serviceable Locations), estimated reference cost per BSL, and an estimated cost to build out the entire BSA. Note that these costs are estimated and may differ from applicant’s anticipated costs.

While the eligible BSLs are not yet final for each BSA, this level of detail will help interested BEAD applicants begin to evaluate potential project areas. PBDA is collaborating with NTIA to finalize the list of BSLs, and upon approval by NTIA, the map will be updated with this information and a CSV file of all locations will be available on the PBDA website. The final listing of eligible BSLs will be posted for at least 10 days prior to PBDA beginning to accept applications for the BEAD Program.

This Centers for Medicare & Medicaid Services (CMS) listserv includes the following Medicaid/Children’s Health Insurance Program (CHIP) renewal information:

• Recent CMS Releases
• Updated Toolkit: Reaching Children and Families in School-Based and Early Education and Care Settings
• Free CMS Printed Product Ordering

RECENT CMS RELEASES

In September 2024, CMS released an informational bulletin to provide updated information on the timing and expectations for all states to achieve compliance with all federal renewal requirements, including states that implemented CMS-approved mitigation strategies and those who have since identified areas of non-compliance with renewal requirements. Compliance plans will detail how states will achieve compliance with all applicable requirements no later than December 31, 2026. To accompany the informational bulletin, CMS also released a compliance template, which the state should use to submit the compliance plan and a slide deck to serve as an additional resource on renewal compliance guidance.

• Informational Bulletin: State Compliance with Medicaid and CHIP Renewal Requirements by December 31, 2026
• Compliance Template: Assessment and Plan for Compliance with All Federal Medicaid and CHIP Renewal Requirements
• Slide Deck: Overview of Medicaid and CHIP Eligibility Renewals 

UPDATED TOOLKIT: REACHING CHILDREN AND FAMILIES IN SCHOOL-BASED AND EARLY EDUCATION AND CARE SETTINGS 

CMS recently updated the Reaching Children and Families in School-Based and Early Education and Care Settings Toolkit on the Medicaid and CHIP Renewals Outreach and Educational Resources page. This update includes evergreen language that education and early education professionals can use to share information about regular Medicaid and CHIP renewals with parents and families. The toolkit includes ready-to-use resources, such as:

• Letter from School/ECE Leadership to Teachers, Nurses, Counselors, etc.
• Letter from Schools/ECE, Teachers, Nurses, Counselors, etc. to Parents/Students
• Social Media Messages
• “Three Things You Can Do” Checklist
• Robocall Script
• No Reply Text/Group Message/Email

FREE CMS PRINTED PRODUCT ORDERING

Select CMS Medicaid and CHIP renewals materials are available to order for free through the CMS Product Ordering website. To order free printed materials, visit the CMS Product Ordering website. If you do not have an account, you will need to request an account on the login page. Once you log into your account, you can enter the term “Unwinding” in the search bar to view the materials that are available for order.

Materials on enrolling in health coverage through the Health Insurance Marketplace are also available to order for free through the CMS Product Ordering website. Once you log into your account, you can select the tab titled “Marketplace” to view materials related to Marketplace enrollment, Coverage to Care, and more that are available to order.

Largest POWER funding package to date is expected to create more than 2,400 new jobs and train over 10,500 workers for new opportunities in Appalachia’s coal-impacted communities across 10 states.  

The Appalachian Regional Commission (ARC) awarded $68.2 million to 65 projects through its Partnerships for Opportunity and Workforce and Economic Revitalization (POWER) Initiative. POWER directs federal resources to economic diversification and revitalization projects in Appalachian communities affected by the downturn of the coal industry.

Today’s award package is ARC’s largest POWER investment since the initiative was launched in 2015, with projects impacting 188 counties in 10 Appalachian states: Alabama, Kentucky, Mississippi, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Virginia and West Virginia. ARC recognizes that Hurricane Helene has impacted multiple Appalachian communities and grantees, including some POWER award recipients. ARC will continue working with affected state and grantee partners to address their needs as they recover and rebuild.

“ARC’s POWER initiative supports coal-impacted communities’ preparation for the next phase of Appalachia’s economy, while ensuring that residents have a say in the course of their own futures,” said ARC Federal Co-Chair Gayle Manchin. “The investments announced in this round of POWER will help train workers, advance new industries, and build upon the progress already being made toward a brighter future full of economic opportunity for our region.”

ARC’s 2024 POWER awardees and their partners will use funding to strengthen a variety of industries – including advanced manufacturing, entrepreneurship, healthcare, and workforce development – to enhance job training and employment opportunities, create jobs in existing and new industries, and attract new sources of private investment in coal-impacted communities.

ARC Federal Co-Chair Gayle Manchin announced the awards alongside state and federal partners and grantees at the Mill 19 in Pittsburgh, Pennsylvania, headquarters of POWER grantee Catalyst Connection and sub-grantees Carnegie Mellon University’s Manufacturing Futures Institute and the Advanced Robotics for Manufacturing (ARM) Institute. Catalyst Connection’s CEO Petra Mitchell spoke about the new $2 million POWER grant to help create pathways to employment in advanced manufacturing.

“We are excited for our new POWER project, which will allow us to build on our progress of preparing our regional workforce for in-demand jobs in the advanced manufacturing industry,” said Catalyst Connection President and CEO Petra Mitchell. “Manufacturing jobs offer workers from hard hit Appalachian communities hope and opportunities for family-sustaining wages and community development. When manufacturing companies and workers succeed, everyone in the local community can benefit.”

Since 2015, ARC has invested $484.7 million in 564 projects impacting 365 coal-impacted counties. Collectively, these investments are projected to support nearly 54,000 jobs and prepare nearly 170,000 workers and students for new opportunities in growing industries.

ARC plans to release a notice of solicitations of applications (NOSA) for the POWER Initiative in early 2025.

Learn more about ARC’s POWER Initiative and our new POWER grantees at arc.gov/POWER.

Twice a month, a 40-foot-long truck transformed into a mobile clinic travels the Rio Grande Valley to provide rural Texans with women’s health care, including birth control.

The clinic, called the UniMóvil, is part of the Healthy Mujeres program at the University of Texas Rio Grande Valley School of Medicine.

The U.S. has about 3,000 mobile health programs. But Saul Rivas, an OB-GYN, said he wasn’t aware of any that shared the specific mission of Healthy Mujeres when he helped launch the initiative in 2017. “Mujeres” means “women” in Spanish.

It’s now part of a small but growing number of mobile programs aimed at increasing rural access to women’s health services, including long-acting reversible contraception.

There are two kinds of these highly effective methods: intrauterine devices, known as IUDs, and hormonal implants inserted into the upper arm. These birth control options can be especially difficult to obtain — or have removed — in rural areas.

“Women who want to prevent an unintended pregnancy should have whatever works best for them,” said Kelly Conroy, senior director of mobile and maternal health programs at the University of Arkansas for Medical Sciences.

The school is launching a mobile women’s health and contraception program in rural parts of the state this month.

Rural areas have disproportionately fewer doctors, including OB-GYNs, than urban areas. And rural providers may not be able to afford to stock long-acting birth control devices or may not be trained in administering them, program leaders say.

Mobile clinics help shrink that gap in rural care, but they can be challenging to operate, said Elizabeth Jones, a senior director at the National Family Planning & Reproductive Health Association.

Money is the greatest obstacle, Jones said. The Texas program costs up to $400,000 a year. A 2020 study of 173 mobile clinics found they cost an average of more than $630,000 a year. Mobile dental programs were the most expensive, averaging more than $1 million.

While many programs launch with the help of grants, they can be difficult to sustain, especially with over a decade of decreased or stagnant funding to Title X, a federal money stream that helps low-income people receive family planning services.

For example, a mobile contraception program serving rural Pennsylvania lasted less than three years before closing in 2023. It shut down after losing federal funding, said a spokesperson for the clinic that ran it.

Read more.