A color-coded map of the U.S. provides a seven-day heat forecast that indicates where temperatures may reach levels that could harm health.  It’s a collaboration between the National Oceanic and Atmospheric Administration and the Centers for Disease Control and Prevention (CDC).  As part of this effort, the CDC also provides a HeatRisk Dashboard with resources for high-heat days, details on local air quality, and actions to stay safe in these conditions.  Finally, the CDC has a site with clinical guidance for heat health, focused initially on treating children with asthma, pregnant women, and people with cardiovascular disease.

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Also known as LIHEAP, the program provides federally funded assistance to reduce the costs of home energy bills, energy crises, weatherization, and post-disaster needs.  In fiscal year 2023, the Administration for Children and Families (ACF) invested $4 billion for grantees in each state and in five territories, with set-aside for tribal assistance.  In turn, these grantees assist households with low incomes, particularly those that have a high home energy burden and/or have members who are elderly, disabled, and/or a young child.  Any community-based organization can use ACF’s Cooling Season Outreach toolkit with fliers, videos, and social media content in several languages.  There’s also a LIHEAP search tool that individuals can use to find help.

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On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting final rule. This rule aims to hold nursing homes accountable for providing safe and high-quality care for nearly 1.2 million residents living in Medicare and Medicaid-certified long term care facilities. Central to the rule are comprehensive minimum nurse staffing standard requirements, which aim to significantly reduce the risk of residents receiving unsafe and low-quality care within LTC facilities.  As the long-term care sector continues to recover from the COVID-19 pandemic, the final standards also consider the local realities in rural and underserved communities via staggered implementation and exemptions processes. Highlights of finalized policies include a total nurse staffing standard of 3.48 hours per resident day (HPRD), which must include at least 0.55 HPRD of direct registered nurse (RN) care and 2.45 HPRD of direct nurse aide care. CMS also finalizing enhanced facility assessment requirements and a requirement to have an RN onsite 24 hours a day, seven days a week, to provide skilled nursing care. Finally, CMS finalizing to define “rural” in accordance with the Office of Management and Budget (OMB) definition. OMB designates counties as Metropolitan (metro), Micropolitan (micro), or neither. “A Metro area contains a core urban area of 50,000 or more population, and a Micro area contains an urban core of at least 10,000 (but less than 50,000) population. All counties that are not part of a Metropolitan Statistical Area (MSA) are considered rural”. As of 2022 the Rural Health Research & Policy Centers Nursing Home Chartbook, 87 percent of non-core counties have dually/Medicaid certified nursing homes while 82 percent of non-core counties have dually/Medicare-certified nursing homes.

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On April 18, the Health Resources and Services Administration released a final rule establishing an Administrative Dispute Resolution (ADR) process for the 340B Drug Pricing Program that is effective on June 18.  The federal 340B program allows certain hospitals and clinics, aka ‘covered entities,’ that treat low-income and uninsured patients to buy outpatient prescription drugs from manufacturers at a discount, and it is intended to help these providers stretch scarce federal resources as far as possible.  This rule finalizes new requirements and procedures to make the resolution of disputes between covered entities and manufacturers more accessible and efficient.

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Together, these rules from the Centers for Medicare & Medicaid Services (CMS), advance access to care, access to quality of care and aim to improve health outcomes across Medicaid fee-for-service (FFS) and managed care plans. The Access Rule addresses dimensions of access across both Medicaid FFS and managed care delivery systems, including increasing transparency and accountability, standardizing data and monitoring, and creating opportunities for states to promote beneficiary engagement.  The Managed Care Rule addresses standards for timely access to care and states’ monitoring and enforcement efforts; quality and fiscal and program integrity standards for state directed payments; the scope of in lieu of services and settings; establishment of a quality rating system (QRS) for Medicaid and CHIP managed care plans.

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There is limited information on the extent to which Rural Health Clinics (RHC) provide pediatric and pregnancy-related services to individuals enrolled in state Medicaid/CHIP programs. In part, this is because methods to identify RHC encounters within Medicaid claims data are outdated. This brief from the Maine Rural Health Research Center describes a methodology for identifying RHC encounters within the Medicaid claims data using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files.

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From 2019-2020, rural lesbian, gay, and bisexual adults were more likely to report poor/fair self-rated health than rural heterosexual adults.  This  Recap summarizes several policy briefs from the University of Minnesota Rural Health Research Center examining self-rated health, chronic conditions, mental health, and social and emotional support systems for LGBTQ+ populations.

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The new program aims to address social determinants of health and will have hospitals serve as community-based hubs, or regional leads, to direct strategy and coordinate the efforts of health care providers, community-based organizations (CBOs), and social service agencies within a designated rural community. Medicaid funds will support hub activities, such as leadership, data analysis, and management of community partnerships, and community partners may request funds to pay for additional space, purchase IT or other equipment, purchase a vehicle, or obtain new training for staff.  Additional ToRCH funds will be available to reimburse CBO partners for approved health related social needs services identified in the ToRCH communities, such as supplemental health-related transportation, food and nutrition education, home-delivered medically appropriate meals, and housing remediation to address health risks, on a per-person, per-service basis.  The first cohort of six hospitals will begin on July 1 of this year.

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The U.S. Department of Health & Human Services released details of a plan for more than 200 actions across the federal government to address high rates of suicide.  Populations in the United States disproportionately impacted by suicide include non-Hispanic American Indian and Alaska Native youth, middle-aged and older adults, non-Hispanic White males, rural populations, and veterans, among others. In particular, rural communities continue to see increases in suicide rates. According to 2023 data from the Centers for Disease Control and Prevention, suicides in non-urban environments increased 46 percent between 2000 and 2020.

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Last week, the Pennsylvania Workforce Development Association reinstituted their annual NextGen Youth Summit after a five-year hiatus to help Pennsylvania youth program providers collaboratively discover new opportunities for youth and young adults entering the workforce. Caitlin Wilkinson, Co-Director of the Pennsylvania Primary Care Career Center, represented PACHC and made some exciting new connections with the attendees that could lead to innovative collaborations that will help address Community Health Center workforce needs. Over the next few weeks, Caitlin will be meeting with these new connections but is happy to discuss individual health center needs or ideas in the meantime.