Earlier this year, the Rural Health Information Hub (RHIhub) launched a toolkit that provides steps and resources for connecting with philanthropic organizations focused on rural health.  The RHIhub recently released two videos featuring participants and highlights of the seventh annual Public-Private Collaborations in Rural Health Meeting that took place in May. The agenda this year included topics related to housing and the opioid epidemic, and featured a discussion of the Surgeon General’s Health and Prosperity Initiative.  Click here to access the toolkit.

Last year, the Centers for Medicare & Medicaid Services (CMS) created a scorecard to improve public transparency and accountability of two state-based programs, Medicaid and the Children’s Health Insurance Program (CHIP), and recently added new data.  The Scorecard reports measures on State Health System Performance (i.e. postpartum care and follow-up after hospitalization for mental illness), State Administrative Accountability (i.e., days to get information on State Plan Amendments), and Federal Administrative Accountability (i.e., time to approve waiver requests) with the intent of driving improvement in beneficiary outcomes and administration of the programs.  Medicaid is an important source of health coverage for rural populations covering about a quarter of nonelderly rural individuals.   The scorecard can be accessed here.

Harrisburg, PA – (July 25, 2019)  Pennsylvania Department of Human Services (DHS) Secretary Teresa Miller and Pennsylvania Department of Community and Economic Development (DCED) Secretary Dennis Davin have submitted comments to the United States Department of Housing and Urban Development (HUD) indicating the Wolf Administration’s strong opposition to a federal proposal that would withhold housing assistance from some immigrant families.

In a letter to HUD Secretary Ben Carson, secretaries Miller and Davin advocate for the continuation of the current prorating system, which provides a method for public housing authorities (PHAs) to support the housing needs of low-income children and adults who are U.S. citizens or have an eligible immigration status who live with someone who is ineligible. These are considered mixed status families.

Under the proposed rule, a household would no longer receive any housing assistance unless every member residing in the home is of eligible immigration status, eliminating the current policy of prorating assistance according to the number of eligible persons in the home.

“Children are the largest group benefitting from the current policy, and they would be the most harmed by a rule change to exclude mixed-eligibility families from access to affordable housing,” Secretary Miller said. “We are speaking up on behalf of those children and urging the Department of Housing and Urban Development to reconsider this discriminatory proposal.”

At the very least, the secretaries argue, a grandfathering provision should be included to allow families that are currently receiving a prorated subsidy to remain until they choose to no longer participate in a Section 214 program.

“Rather than stripping away housing assistance from the families and children who need it most, the federal government should be focusing on strengthening our communities and empowering individuals to break the cycle of poverty,” Secretary Davin said. “This policy would place undue burden on our public housing authorities that are providing crucial housing services. We urge HUD to rethink this approach.”

If implemented, this new policy would add unnecessary stress to an already overburdened system of Pennsylvania Public Housing Authorities. Instead of working with low-income families to secure stable housing, the PHAs would be forced to spend valuable time and money to exclude mixed-eligibility families from access to affordable housing.

“The departments of Human Services and Community and Economic Development exist to strengthen Pennsylvania communities, but this federal proposal undermines that mission,” Secretary Miller said. “We call on the Trump Administration to reverse course and abandon its effort to implement a policy that will discriminate against the most vulnerable families and ultimately harm children.”

For more information about housing assistance in Pennsylvania, visit https://dced.pa.gov/housing-and-development/ and http://www.dhs.pa.gov/citizens/housing/.

MEDIA CONTACT: Erin James, DHS – 717-425-7606; Michael Gerber, DCED – 717-783-1132

The Pennsylvania State Data Center recently updated their Detailed Population Estimates Dashboard. Now powered by Tableau, users can access state and county level data on the total population, the change in population since 2010, and detailed characteristics like sex, age, race, and Hispanic origin.  Click here to visit the dashboard.

Did you know?

Pennsylvania’s number of self-employed drivers more than doubled from 2015 to 2017, according to the latest Nonemployer Statistics (NES) from the U.S. Census Bureau, adding over 18,000 drivers (+142%).  Click here to view the percent change by county.  Click here for more information on self-employed drivers from the U.S. Census Bureau.

Other Highlights from the Data Center

     2018 Detailed Population Estimates Report

This brief uses data from the U.S. Census Bureau’s 2018 Detailed Population Estimates to report changes in Pennsylvania’s Population by age, sex, race, and Hispanic origin. Click here to read the full brief.

     Neighboring Municipalities and Commuting Flows Visualization

This interactive visualization shows patterns in the place of residence and place of work for Pennsylvanians. It includes four categories which expand our understanding of commuter flows by considering those who work (or do not work) in a municipality that neighbors the municipality in which they live. Click here to view.

Establishing a Recovery Ecosystem to include multiple sectors and services. Addressing recovery needs and developing recovery communities. Coordinating services to help individuals in recovery navigate needed services. Expanding education skills training opportunities and recovery-friendly workplaces. Sharing effective practices to help communities assess, plan, and develop strategies that promote the recovery ecosystem. These are some of the key themes outlined in a recently released synopsis report from the six that the Appalachian Regional Commission (ARC) hosted Recovery-to-Work Listening Sessions. At each of the six sessions — held between December, 2018 – April, 2019 in Big Stone Gap, Virginia; Wilkesboro, North Carolina; Muscle Shoals, Alabama; Pineville, Kentucky; Portsmouth, Ohio; and Beckley, West Virginia — ARC leadership discussed substance abuse related workforce issues with representatives from local and state government, treatment and recovery service providers, workforce development entities, employers, law enforcement, and individuals currently in recovery.

Drawing on the Listening Session themes,  ARC’s Substance Abuse Advisory Council (SAAC) — a 24-member volunteer advisory group of leaders from law enforcement, recovery services, health, economic development, private industry, education, state government, and other sectors representing each of the Region’s 13 states — met in Washington, DC this week to continue developing recommendations to anchor ARC’s strategy to help address the workforce impacts of Appalachia’s substance abuse epidemic. The Council’s final recommendations will be formally presented to the Commission in early September. “ARC’s continued efforts to study and address the substance abuse crisis in our region are well-reflected by this report and by the continued efforts of the SAAC, which can positively impact Appalachian communities,” said ARC Federal Co-Chair Tim Thomas.  “I am very pleased with the progress of the Advisory Council, and look forward to reviewing their work alongside the rest of the Commission.”

July 17, 2019 – The Washington Post

Death rates from opioids soared in the towns, cities and counties that were saturated with billions of prescription pain pills from 2006 through 2012, according to government death data and a previously undisclosed database of opioid shipments made public this week.

The highest per capita death rates nationwide from opioids during those years were in rural communities in West Virginia, Kentucky and Virginia. In those seven years, those communities also were flooded with a disproportionate share of the 76 billion oxycodone and hydrocodone pain pills from some of the country’s largest drug companies, an analysis by The Washington Post reveals.

The national death rate from opioids was 4.6 deaths per 100,000 residents. But the counties that had the most pills distributed per person experienced more than three times that rate on average. Thirteen of those counties had an opioid death rate more than eight times the national rate, according to the government data. Seven of them were in West Virginia.

Access the entire article, including graphs and maps, here.

This interactive online training is sponsored by the American Public Health Association and the U.S. Department of Health and Human services to help clinicians and public health officials understand safe and effective use of opioids to manage chronic pain.  Continuing education credits are available for the one-hour course.  The training can be accessed here.

Section 1332 of the Patient Protection and Affordable Care Act permits states to apply for State Innovation Waivers (aka Section 1332 Waivers or State Relief and Empowerment Waivers) to pursue innovative strategies for providing high value and affordable individual health insurance regardless of income, geography, age, gender, or health status.  As a follow-up to the guidance released last year, CMS has created concept papers and templates for four waiver concepts to help states develop new approaches to providing health coverage: State Specific Premium Assistance, Adjusted Plan Options, Account-Based Subsidies, and Risk Stabilization Strategies.  In 2018, rural areas had fewer insurers offering individual health insurance and higher average adjusted premiums compared to urban areas.

On July 10, 2019, CMS put on public display a proposed rule that would implement two new mandatory Medicare payment models under section 1115A of the Social Security Act—the Radiation Oncology Model (RO Model) and the End-Stage Renal Disease (ESRD) Treatment Choices Model (ETC Model). The proposed RO Model is an innovative payment model designed to improve the quality of care for cancer patients receiving radiotherapy treatment and reduce provider burden by moving toward a simplified and predictable payment system. The ETC Model is one of five new payment models CMS announced last week aimed at transforming kidney care to improve access to high quality care and reducing Medicare expenditures. The rule details the proposed geographic units of section for model participation, Core Based Statistical Areas (CBSAs) for the RO Model and Hospital Referral Regions (HRRs) for the ETC Model, with implications for rural participation. The proposed rule is scheduled to be published in the Federal Register on July 18, and public comments are due 60 days after publication.  Click here for more information.

On July 11, 2019, CMS released a proposed rule that would remove the regulatory text that sets forth the current required process for states to document whether Medicaid payments in fee-for-service systems are sufficient to enlist enough providers to assure beneficiary access to covered care and services consistent with the Medicaid statute. In the proposed rule, CMS noted that states have raised concerns over the administrative burden associated with the current regulatory requirements. CMS also issued on July 11 an informational bulletin announcing the agency’s strategy to measure and monitor beneficiary access to care across Medicaid. For more information on rural Medicaid issues in general, the Rural Health Research Gateway provides a selection of policy briefs on the topic. Click here for more information.