– Comment by January 27. The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would revise the Medicare Advantage (MA) Program and Medicare Prescription Drug Benefit Program (Part D).  Proposals include permitting Medicare and Medicaid coverage of anti-obesity medications, further clarifications to the rules on what MA plans must cover, limits on enrollee cost-sharing for behavioral health, expanded topics that agents/brokers must cover when assisting beneficiaries, parameters around the use of debit cards for supplemental MA benefits, codifying requirements for the Medicare Prescription Payment Plan, and integrating member identification cards for individuals dually eligible for Medicare and Medicaid. As of January 2023, about 45 percent of rural Medicare beneficiaries were enrolled in an MA plan.

– Comment by December 30.  The Centers for Medicare & Medicaid Services (CMS) would like public feedback on 41 Measures Under Consideration for quality reporting and value-based programs before the measures are formally proposed through the rulemaking process. Categories of quality measures for hospitals receiving payment through Medicare, including CMS-designated Rural Emergency Hospitals (REHs), are:

• Post-Acute Care/Long-Term Care Measures
• Clinician Measures
• Hospital Measures

For example, CMS would like early feedback on including the measure Median Time to Pain Medication for Patients with a Diagnosis of Sickle Cell Disease with Vaso-Occlusive Episode in the Rural Emergency Hospital Quality Reporting Program, and the measure Proportion of Patients who Died from Cancer Admitted to Hospice for Less than 3 Days in the Hospital Inpatient Quality Reporting Program. CMS will hold three listening sessions, one for each of these categories, December 17-19.  Register to make live comments or ask questions during these sessions.  You may also enter a comment for public viewing on a form halfway down the page in the headline link.

New data from the Centers for Disease Control and Prevention show that, in 2023, the percentage of adults with diagnosed chronic obstructive pulmonary disease (COPD) was 3.8 percent.  The prevalence of COPD among adults increased as urbanization level decreased.

HRSA’s National Center for Health Workforce Analysis collects data, conducts research, and generates information to inform and support public- and private-sector decision making.  This brief examines the supply of physicians, physician assistants (PA), and nurse practitioners (NP) practicing in primary care specialties: family medicine, general pediatric medicine, general internal medicine, and geriatric medicine.  While rural areas generally have lower primary care physician ratios than urban areas, the data show that NPs and Pas are important in providing primary care in rural areas.  Approximately half of PAs were interested in practicing in rural locations (44 percent), Medically Underserved Areas (58 percent), or Health Professional Shortage Areas (54 percent).

In their most recent brief, “Observed Factors Influencing REH Conversion Decisions,” the Rural Emergency Hospital (REH) Technical Assistance Center (TAC) summarizes the key findings from financial modeling activities and discusses common barriers identified by hospitals considering conversion. In 2023, REHs became a new Medicare rural provider type focused on emergency and observation services, not inpatient care.  The TAC found that while the REH conversion is a viable option for some hospitals, barriers exist for others. To date, 31 hospitals have been designated REHs.  If you are interested in receiving updates and key findings from the TAC, subscribe to the newsletter or visit their website, the Rural Health Redesign Center.

The National Advisory Committee on Rural Health and Human Services is a citizens’ panel of rural health experts that convenes twice each year to examine pressing issues and make recommendations to the U.S. Department of Health & Human Services.  The most recently reports come from a meeting in Austin, Texas in April of this year, with an in-depth look at How Technology and Innovation Can Help Address Rural Health Care Challenges and Supporting Quality Measurement for Rural Health Clinics.

– January 9.   The Association of Schools and Programs of Public Health (ASPPH) and the U.S. Department of Agriculture (USDA) offer a one-year fellowship based in Washington, DC beginning in June 2025.  Hybrid/remote candidates will also be considered for work that contributes to USDA programs related to rural health, including collaborations with federal and nonfederal partners.  To be eligible for this program, applicants must have received their Masters or Doctorate degree prior to the beginning of the fellowship (no later than June 2025) or within the last five years (no earlier than May 2020). Graduate degrees must come from an ASPPH member graduate school or program of public health accredited by the Council on Education for Public Health.

The Pennsylvania Trauma Systems Foundation (PTSF) Board of Directors is pleased to announce the appointment of Amy Kempinski, MSN, RN, CEN, TCRN as its next President. She will assume this role on January 1, 2025, upon the retirement of current President, Juliet Altenburg.

“We are delighted to welcome Amy Kempinski as our new President,” said Dr Henry Boateng, Chair of the PTSF Board of Directors. “After a rigorous nationwide search, including input from trauma care experts, organizational partners, and PTSF Board members, Amy’s comprehensive understanding of trauma systems and professional leadership made her the clear choice to lead PTSF into the next chapter of innovative trauma system development.”

Kempinski, who previously served as the Foundation’s Vice President, brings extensive experience in trauma systems and clinical expertise to this role. Her distinguished career spans the trauma spectrum, and her national influence is exemplified through her role as a member of the American College of Surgeons System Consultation Team, and her work as a consultant and site surveyor for trauma centers across the United States.

A Past President of the Society of Trauma Nurses (STN), Kempinski demonstrated her commitment to advancing trauma care through numerous leadership positions and educational initiatives. She is an active member in multiple professional organizations and has notable contributions to the field, including publications focused on trauma accreditation, performance improvement, crew resource management, leadership, and injury prevention.

In her new role, Kempinski will oversee PTSF’s mission of improving outcomes for trauma patients through accreditation, education, and research across Pennsylvania’s trauma centers. She will lead strategic initiatives to enhance the state’s trauma care system and strengthen collaboration among healthcare providers.

PTSF extends their gratitude to Juliet Altenburg MSN, RN, for her dedicated service to PTSF since 2000. Her time with PTSF caps a 40-year career in trauma nursing, trauma system development, and advocacy.

Former high school athlete Tyrone (Ty) Patillo of Aliquippa, PA, has community service in his blood. His father was the first minority firefighter in the community. Ty continues the family tradition of giving back. His dedication to helping his hometown led him to look for solutions to make healthy food options more accessible in the area.

Autumn Vogel of the Keystone Development Center (KDC) shares a similar passion for public service and community work. As the co-op developer with KDC, she loves to help communities use the power of co-ops to solve local problems.

Now, with the help of USDA Rural Development (RD), Autumn and Ty will be partnering together to help realize his vision of more equitable food access for the community, with the formation of the Aliquippa Food Co-op. Ty has already been working with the KDC to learn about co-ops, draft plans, and form a steering committee. With a $150,000 Healthy Food Financing Initiative (HFFI) grant in hand, KDC will help Ty and the steering committee move into the organizing and pre-construction phase.

In 1991, Ty and teammates such as NFL Hall-of-Famer Ty Law, led the Aliquippa High School football team to their first state championship. Ty used football as a path to success. His performance led him to play at Division 1 – The University of Akron in Ohio and then generated a successful career in real estate development.

Ty describes his community of more than 9,000 residents as being close knit – where everybody knows everybody. In communities like Aliquippa, cooperation can make or break a community. With family still living in Aliquippa, Ty became aware of the low-access food areas that exist in several parts of Beaver County – including his hometown.

After several ideas to address this issue fell through, Ty decided to combine the need for healthy foods and a close-knit community into a regional solution. He began the plan to develop a food co-op.

“This gives me an opportunity with this food co-op to get involved and really create something that the community can own,” Ty said.

None of this would be possible without local, state, and federal partnerships, and of course local champions like Ty Patillo. On Nov. 1, 2024, USDA RD announced the HFFI investment to aid the Aliquippa Food Co-op.

“Many low-income communities in Pennsylvania lack adequate, affordable access to healthy food,” Pennsylvania State Director Bob Morgan for USDA RD said. “USDA is proud to partner with KDC to ensure that these funds and resources reach the communities where they are needed most, so people can find nutritious food options anywhere they live.”

This announcement was part of USDA’s comprehensive set of efforts, bolstered by funding made available through the American Rescue Plan Act (ARPA), to create more and better markets that benefit both producers and American consumers.

Without partnerships such as those with KDC, it would be difficult to reach the communities that need these investments the most.

Autumn has been a co-op developer with KDC for about five years. Autumn posits that her passion for public service and community work began during her childhood and college education at Allegheny College.

“Many of us look at the world around us and wish that it could be a little different,” she said. “I have a belief in people’s ability to work together for the place that they are in for a shared wealth, prosperity, and well-being.”

“Co-ops have been a really good way for me to see people coming together, to make decisions together, to work for things they can share and have,” she said. “They can address needs together that they could not address on their own. It is a really powerful model.”

Since 2021, USDA has invested more than $1.56 million in its partnership with KDC through programs such as the Rural Cooperative Development Grant (RCDG), Socially Disadvantaged Groups Grant (SDGG), Rural Business Development Grant (RBDG), and HFFI programs.

“Our [KDC’s] history is bound up in USDA funding,” Autumn said. “We wouldn’t really exist without that partnership. It is the bulk of funding that our center gets, and I know that is true for other centers as well.”

The Aliquippa Food Co-op is an inspiring group and KDC is in a supporting role, she said.

“They are so committed to that place, and they really do have a vision for the co-op and what it could mean for the area,” Autumn said.

Ty learned how to run, organize, and launch a successful cooperative in one of KDC’s co-op academies and graduated from the program in 2023. He left the program with the message that you can’t run a co-op by yourself, so he established a steering team and plan with the help of KDC. KDC was then able to provide further technical assistance to Ty and the steering committee thanks to funding support from NCBA-CLUSA’s Strengthening Co-op Capacity for Historically Underserved Farmers program.

The Healthy Food Financing Initiative was a little more flexible of a program for KDC because it allows co-development centers like KDC to support urban organizations. Because Aliquippa is located close to Pittsburgh, it is considered an urban community through federal regulations.

Ty and his food co-op steering committee have selected a site for the future co-op. They also conducted a feasibility study into the site’s potential performance and the local market. The co-op sees supporting local food entrepreneurs and farmers as core to its mission.

Now that the outreach and community engagement has begun, they plan to open the food co-op in the next three years and anticipate the co-op will serve about 30,000 people in a four-mile radius.

“Getting local food into this market is critical,” Autumn said. With partnerships such as these in Aliquippa, access to affordable healthy food will be possible.

The Rural Health Care Services Outreach Program (Outreach) is open and accepting applications for the program’s 4-year period of performance (May 1, 2025-April 30, 2029).  HRSA will make up to 50 awards to support rural communities to expand the delivery of health care services. These awards include:

• An estimated 40 awards, each up to $250,000 per year, under the program’s regular track to support healthcare needs identified by the rural community applicant;
• Up to 10 awards, each up to $300,000 per year, under the program’s special track to address the underlying factors that drive rural health disparities related to heart disease, cancer, unintentional injury/substance use, chronic lower respiratory disease, stroke, and maternal health.

Eligible applicants include all domestic public and private, nonprofit, and for-profit entities with demonstrated experience serving, or the capacity to serve, rural underserved populations.  Applicants are also required to propose projects that serve exclusively HRSA-designated rural areas and be a part of a network comprised of three or more organizations with at least two-thirds or 66% percent network organizations physically located in a HRSA-designated rural area.

Successful Outreach Program awardees will: 1) expand the delivery of health care services to include new and enhanced services exclusively in rural communities; 2) use innovative, evidence-based and promising practice models to inform their approach to addressing needs specific to their community; 3) demonstrate health outcomes;  and 4) plan for sustainability after grant funding ends.

A technical assistance webinar via Zoom will be held for applicants on Wednesday, Dec 11 at 2:00 pm Eastern.   

Examples of previously funded projects under this program are available at this link.  Applicants may also benefit from the availability of Evidence-Based Toolkits for Rural Community Health which are informed by previous program investments by the Federal Office of Rural Health Policy and the Rural Health Information Hub.

For more information about this funding opportunity, contact the Program Coordinator, Mew Pongsiri, at RuralOutreachProgram@hrsa.gov.

The application deadline is January 27, 2025.

Helpful links

• Notice of Funding Opportunity on Grants.gov
• Profiles of current and past Outreach Program grantees
• Evidence-Based Toolkits for Rural Community Health