September 19, 2019

Stratis Health announced eight critical access hospital (CAH) staff who will serve as national Virtual Quality Improvement Mentors through a new initiative that aims to broadly transfer knowledge from leading CAH quality improvement staff to others across the country. The initiative is organized through Rural Quality Improvement Technical Assistance (RQITA), a program of Stratis Health supported by the Federal Office of Rural Health Policy (FORHP).

These eight outstanding mentors were selected from a pool of candidates across the country who were nominated by their respective state Flex programs as quality improvement leaders. They each successfully report and use data to support quality improvement activities in their small rural hospitals. They represent the diversity of CAHs across the nation, with varying rural locations, service lines, and patient volumes which average 2.5 to 16 patients per day and 1,300 to 13,000 emergency room visits annually.

“Critical Access Hospital” is a Centers for Medicare & Medicaid Services (CMS) designation given to eligible rural hospitals, with 25 beds or less, to reduce the financial vulnerability and improve access to health care by keeping essential services in rural communities.

“Quality improvement initiatives are essential to improve outcomes and provide the highest quality care to every patients,” said Sarah Brinkman, Stratis Health rural quality expert. “These Quality Improvement Mentors work with limited resources and hold many roles within their hospital, all the while looking for ways to provide the best care for their patients. We believe other small rural hospitals can learn from their experience and be inspired by their drive.”

Of the 1,343 CAHs across the U.S., more than 1,320 were participating in FORHP’s Medicare Beneficiary Quality Improvement Project (MBQIP) at the end of 2016.

The new Virtual Quality Improvement Mentors are:

• Amy Arnett, Horizon Health – Paris Community Hospital, Paris, IL,
• Cindy Gilman, Carroll County Memorial Hospital, Carrollton, MO
• Mariah Hesse, Sparrow Clinton Hospital, St. Johns, MI
• Karen Hooker, Kit Carson County Health Service District, Burlington, CO
• Christy Mintah, Avera Holy Family Hospital, Estherville, IA,
• Ben Power, Barrett Hospital & Healthcare, Dillon, MT
• ArvaDell Sharp, Pembina County Memorial Hospital, Cavalier, ND
• Brenda Stevenson, Titusville Area Hospital, Titusville, PA

The Virtual Quality Improvement Mentors will share their examples and advice on how to address common quality improvement challenges that occur in CAHs. RQITA will capture these strategies, tips, and ideas to disseminate them broadly to others serving in CAH quality roles. Articles and podcasts will be made available to advance the quality improvement work of others.

The initiative kicked off September 18 at the 2019 National Rural Health Association CAH Conference, in Kansas City, Missouri.

The Academy of Nutrition and Dietetics, American Academy of Pediatric Dentistry, American Academy of Pediatrics, and American Heart Association recommend breast milk, infant formula, water, and plain milk as part of a new set of comprehensive beverage recommendations for children, outlined by age (birth through age 5). They caution against beverages with added sugars such as flavored milks, caffeinated beverages, and low-calorie sweetened beverages.

Click here to view the report.
Click here to view the infographic.

The National Conference of State Legislatures (NCSL) recently released an article addressing children’s dental screening laws in schools. Dental screening programs can use the screening procedure as an opportunity to establish a child’s dental home. It is also an opportunity to collect data on childhood caries.   Click here to read the article.

The Federal Drug Administration ‘s (FDA) online Safety Reporting Portal (SRP) is a tool that provides a standardized way for users—including consumers, health care professionals, manufacturers, and researchers—to tell the FDA about unexpected health or safety issues with various products, including e-cigarettes and other tobacco products believed to not be working properly or causing an unexpected health problem.

Harrisburg, PA (September 23, 2019 ) – Department of Human Services (DHS) Secretary Teresa Miller today submitted public comment to the Trump Administration opposing its proposal to drastically reduce Broad Based Categorical Eligibility (BBCE) for the Supplemental Nutrition Assistance Program (SNAP). The changes would jeopardize food access for more than 200,000 people and would adversely affect children, seniors, and people with disabilities.

“The Wolf Administration vehemently opposes any changes that would risk more Pennsylvanians going hungry. Forcing already-struggling families to choose between putting food on their table or covering child care, rent, or other basic needs is unconscionable and traps people in a cycle of poverty,” said Secretary Miller. “We strongly oppose any and all attacks on SNAP and will continue to fight against any attempt to take the program away from Pennsylvanians who need it.”

SNAP, previously known as food stamps, helps more than 1.8 million Pennsylvanians access nutritional meals and puts food on their tables. BBCE is a policy that gives states, including Pennsylvania, the flexibility to determine appropriate income thresholds and extend SNAP benefits to low-income families and individuals who would otherwise struggle to afford food.

With BBCE, a Pennsylvania family of four is eligible for SNAP if they earn no more than about $40,000 a year. If BBCE is reduced, that family of four’s SNAP income limit will drop from about $40,000 a year to no more than $32,000 a year. For elderly single-person households, the income limit would change from approximately $24,000 a year to about $15,000. Reducing BBCE will have the direct opposite effect of promoting economic mobility and employment and will destabilize families, making it harder for them to move out of poverty.

Reducing BBCE would also jeopardize free lunches for nearly 22,600 households whose children who currently qualify. This would not only cause more students to go hungry at schools – it also risks access to programs that provide nutritious meals for children after school and during summer months.

Reduced BBCE would increase Medicaid spending and reduce long-term health outcomes due to the direct connection between food security, proper nutrition, and good health. Additionally, reduced BBCE could yield a loss of over $200- $250 million per year to Pennsylvania retailers, as purchases made through SNAP go directly back into the local economy and food providers. Over 10,000 authorized retailers participate in SNAP across Pennsylvania. These retailers redeemed about $2.6 billion in SNAP benefits in 2018 according to the United States Department of Agriculture.  

“Our mission at DHS is to help people achieve a better life without public assistance. Attacks on SNAP make it harder for us to make people’s lives better,” said Secretary Miller. “These mean-spirited changes to SNAP do nothing to help people get off public assistance. They will only increase hunger across Pennsylvania and will disproportionately impact working families, individuals with disabilities, and seniors. It is cruel and unacceptable.”

Read DHS’ comments to the Trump Administration here.

For more information on SNAP and DHS services, visit http://www.dhs.pa.gov/citizens/supplementalnutritionassistanceprogram.

By Beth O’Connor, published by the National Rural Health Association

In just a few months, the rural communities of this nation will have the once-in-a-decade chance to represent themselves alongside the hundreds of millions of folks who call America home.

On April 1, 2020, staff from the Census Bureau will fan out in communities small and large to tally all those who make their home in the United States. Surveying will occur in every corner of the country, from the remote coasts of Alaska to the Maine seaboard, from the Arizona desert to the Florida Everglades, and all points in between.

In terms of importance, being counted in the census is more essential than voting.

Casting a ballot gives people a voice in representative government by electing officials who serve locally and in Washington. The decisions made by elected officials can sometimes feel like faraway things until they impact your community or way of life.

The census may also feel like a faraway thing. But the truth is being included in the census can have a real impact on people in local communities. Having an accurate assessment of the diversity that makes up the American portrait is vital to ensure our communities receive the funding to which they are entitled.

Each year, an estimated $675 billion in federal funding is distributed to communities across the nation based on census data. That funding supports a wide range of essential programs that help provide health care, housing, education, transportation infrastructure, and so many other public services.

In states with larger rural populations, that funding is substantial. In 2016, Virginia received nearly $18 billion in census funding — an amount roughly equivalent to one-fifth of the commonwealth’s annual budget.

In many states, census funds are used to plan highway construction projects, support mass transit, and extend the electric grid in rural communities. Census dollars help fund health care for children, expectant mothers, and disabled individuals. The funds support adoption services and grants to help young people attend college and technical training.

And that’s just scratching the surface of all the vital programs the census funds.

Reading that, you might say to yourself: “That is all well and good, but what does it have to do with me and my family?”

The answer: Quite a lot.

Each person who goes uncounted in the 2020 census could result in communities missing out on thousands of dollars in annual funding. If just 10 people in your community miss being counted, that could result in $200,000 in resources shifted to another area over the next 10 years.

Studies show that millions of missing or incorrect residential addresses only compound the issue. If even a tiny fraction of people in any state go uncounted in 2020, it could result in millions in lost funding.

As a person, you have innate, intrinsic value. You matter on an individual level. That’s why it is critical for you and members of your community to be counted during the 2020 census — so your community receives the funding and support it deserves to keep it a great place to work, play, and live.

The census is a time-honored national tradition dating to 1790. Over the centuries it has endured social, political, and societal changes. What has remained constant to this day is that data collected during the census is confidential and only used to ensure federal resources are fairly allocated. So people living in rural areas, including those in traditionally marginalized or undercounted communities, should have confidence about participating in the 2020 census for the good of their families and their communities.

Undercounted is underfunded, underrepresented, and under-resourced. The message you can bring to your neighbors is simple: Get counted in the 2020 census.

Beth O’Connor is executive director of the Virginia Rural Health Association and a member of the Virginia Complete Count Commission.

As part of HRSA’s ongoing effort to assess the extent to which their rural health grant programs are meeting the needs of rural communities, the agency has published a Request for Information seeking public comment.

Specifically, HRSA is looking looking for comments on the eligibility criteria governing the Federal Office of Rural Health Policy’s (FORHP) community-based grant programs. Does the eligibility criteria affect the rural communities’ ability to leverage FORHP grant funding? If so, how?

Your feedback may be used (without attribution) by HRSA and HHS for program planning and decision making in the future.

Send comments via email with the subject line, “Rural Health Grants Eligibility RFI.” Submissions are due no later than 11:59 p.m. EDT on November 2, 2019.

With the start of a new school year upon us, no fewer than 15 major metropolitan areas in the U.S. have “hotspots” of unvaccinated children that make them vulnerable to preventable diseases similar to the recent measles outbreak in New York City, experts warned in a recent webcast. The trend has major implications for health centers, health departments, hospitals and schools alike.

Learn more about the health effects of vaccine opposition

At a time when increasing numbers of children are showing up in emergency rooms with mental health issues, less than half of the nation’s hospitals have written protocols in place for care coordination and management of kids in crisis – and that number falls to about a third in rural areas, two senior HRSA leaders reported in a recent webcast.

Suicide is now the second leading cause of death among young people, age 10 to 19 years old. And absent immediate intervention, the risk of a suicide attempt or death by self-harm is highest within 30 days of discharge from an emergency department.

Those findings are the impetus behind a new HRSA toolkit to help emergency room staff manage young people in psychiatric distress, said Associate Administrators Dr. Michael Warren and Tom Morris.

Learn more about the new toolkit.