Rural Health Information Hub Latest News

Challenges of the Rural Opioid Epidemic: Treatment and Prevention of HIV and Hepatitis C.

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Challenges of the Rural Opioid Epidemic: Treatment and Prevention of HIV and Hepatitis C. Previous research on HIV and hepatitis C (HCV) among people who inject drugs (PWID) has focused on urban or international populations, yet the US opioid epidemic is moving away from metropolitan centers. In this report, researchers examine the increasing rurality of opioid injection, the challenges to treatment and prevention that are unique to rural areas, and the public health interventions needed to address them.

Pennsylvania Has Third-highest Rate of Drug Overdose Deaths in the U.S., Study Finds

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(June 12, 2019)  Philadelphia Inquirer.  A new study measuring the effectiveness of state health systems around the country found that Pennsylvania has the third-highest rate of drug overdose deaths in the country.

The “scorecard,” released by the Commonwealth Fund, a private health-care research foundation, rated Pennsylvania highly on other measures, including access to health care. The state’s 2015 Medicaid expansion has allowed hundreds of thousands to obtain care, including about 20,000 people with substance use disorders, state health officials say.

But Pennsylvania’s opioid crisis is so severe, and so much worse than almost anywhere else in the country, that it’s bringing down life expectancy in the state, researchers said.

The study measured “drug poisoning deaths” in 2017, the last year for which full statewide data are available. Only Ohio and West Virginia had higher overdose death rates than Pennsylvania that year. All three states had more than twice the national rate of drug overdose deaths in 2017. Along with seven other states, including Delaware, the trio have seen overdose deaths increase threefold since 2005.

In Pennsylvania, Maryland, and Ohio, overdose death rates were at least five times higher than alcohol-related deaths (including acute alcohol poisoning and more chronic diseases like liver cirrhosis), and about three times higher than suicide deaths.

East Coast and Southeastern states have been particularly hard-hit by the opioid crisis, the researchers wrote. In the West, alcohol and suicide deaths generally outstrip drug deaths.

Still, said Sarah Collins, the fund’s vice president for health-care coverage and access, “In other indicators, including coverage, Pennsylvania’s ranked very high. What that does for the state is, it puts it in a position where it’s better able to manage a crisis.”

State officials said they were seeing some encouraging signs of progress. After losing more than 5,400 Pennsylvanians to overdoses in 2017, estimates for 2018 were closer to 4,200 overdose deaths — a drop of about 22 percent, Rachel Levine, state secretary of health, said Tuesday.

Philadelphia had 1,217 overdose deaths in 2017 and 1,116 overdose deaths the following year.

The contamination of much of Pennsylvania’s illicit drug supply with fentanyl, a synthetic opioid that is significantly more powerful than heroin, is driving most of the state’s drug deaths, she said.

But Commonwealth Fund researchers said it’s hard to say why certain states — even Medicaid expansion states like Pennsylvania with relatively good health-care access — are affected more by overdose deaths than others.

“We do not have all the correlates of what’s driving [alcohol, suicide, and drug poisoning deaths], of why there are so many regional differences, and we don’t have a broad-base understanding of what’s effective in terms of preventing the rise in what we see,” Collins said.

Levine said that though overdose deaths decreased in 2018, the state’s approach to the opioid crisis is still “all hands on deck.”

Pennsylvania is about to declare its seventh successive disaster declaration over the overdose crisis, which enables state agencies to collaborate in an “opioid command center” and allows state officials to bypass regulations that might hinder a quicker response to the crisis.

The state Centers of Excellence, 45 opioid addiction recovery programs mainly for people on Medicaid, have treated 18,760 people in the last two years. (In Philadelphia alone, city officials have estimated, 50,000 to 70,000 people are addicted to opioids.)

The state has also distributed thousands of doses of the overdose reversal drug naloxone.

“We’re not done by any means, we’re not declaring victory, but we have made a lot of progress,” Levine said. “I’m a positive and optimistic person, and I think we will be successful, but we’re keeping our nose to the grindstone.”

NTIA Releases Comprehensive Guide to Federal Broadband Funding

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The National Telecommunications and Information Administration (NTIA) has announced a new searchable database of 50 federal broadband programs, spanning a dozen federal agencies with billions of dollars for broadband grants, loans and other resources. The database, created with help of participating federal agencies, fulfills a goal set out in the American Broadband Initiative announced in February to make it easier for community leaders to find federal funding and permitting information.

“Consolidating these critical resources into a one-stop, easy-to-use resource provides an important tool in spurring efforts to expand our nation’s broadband infrastructure projects,” said Diane Rinaldo, Acting Assistant Secretary for Communications and Information.

The federal programs provide funding for state and local governments, schools, libraries, small businesses and other community institutions that are interested in expanding broadband access. Applicants can search for programs by agency, program purpose and eligible recipients. The inventory includes well-known infrastructure efforts at the U.S. Department of Agriculture and the Federal Communications Commission. A number of other programs offer grants and loans for targeted purposes or specific regions of the country.

For instance, the Commerce Department’s Economic Development Administration provides economic development grants that can be used to support broadband infrastructure projects, digital skills training and smart cities development. The agency’s FY2018 funding of $600,000,000 was mainly targeted for weather-related disaster relief but also supported broadband projects. In May, EDA announced it was investing $290,000 to help the Seneca Nation of Indians plan and install broadband fiber throughout the Cattaraugus Territory in Western New York. And in March, U.S. Secretary of Commerce Wilbur Ross announced a $1 million grant to St. Joseph County, Indiana, to expand high-speed broadband infrastructure in a project expected to create 230 jobs and spur $710 million in private investment.

Other programs in the NTIA inventory that recently made broadband grants include:

  • The Appalachian Regional Commission awarded a $40,000 grant to the SEDA-Council of Governments (link is external) last October, a public development organization serving 11 Central Pennsylvania counties, for a feasibility study of broadband access in Northumberland, Union, Lycoming, and Clinton Counties.
  • The Institute for Museum and Library Services (IMLS) provided a nearly $250,000 grant to address Native American digital access in New Mexico and the potential of TV Whitespace (TVWS) networks to improve tribal internet connectivity.

As the U.S. works to fill the gaps in connectivity that persist despite significant investments, NTIA is developing a new mapping platform that paints a more precise picture of the current infrastructure and services that are available around the country. This will help policymakers make better decisions about how broadband funds should be allocated.

NTIA’s most recent Internet Use Survey found that nearly 28 million households did not use the Internet at home, including 5 million living in rural areas. NTIA, the Department of Commerce and the Trump Administration are committed to putting the right tools in the hands of local leaders and service providers, to expanding opportunities so that all Americans benefit from our digital future.

 

Commonwealth Fund Releases 2019 Scorecard on State Health System Performance

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(June 12, 2019)  The Commonwealth Fund’s 2019 Scorecard on State Health System Performance reveals that most states are losing ground on key measures related to life expectancy as premature deaths from suicide, alcohol, and drug overdose continue to increase. Several states that most recently expanded eligibility for their Medicaid programs saw meaningful gains in access to health care; in other states prior gains eroded between 2016 and 2017. Finally, the Scorecard found that health care costs are placing an increasing financial burden on families across the nation.

In addition, you can download the full report, and a two-page summary for each state.

Child Diversity in Pennsylvania, 2009 to 2017

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This research brief from the Pennsylvania State Data Center, Child Diversity in Pennsylvania, examines trends in the changing racial and ethnic makeup of Pennsylvania’s child population. The brief accompanies an interactive visualization which shows trends in race and ethnicity by school district and age group for those under 20 years.

     The report shows that nearly a third of all children in Pennsylvania are children of color as of 2017, up from a quarter in 2009. Meanwhile, just one in five adults are persons of color. Four out of five school districts had higher shares of children of color in 2017 than 2009. Click here to read more in the full report, or click here to go straight to the visualization.

     The report and visualization were developed in collaboration with our affiliate, Pennsylvania Partnerships for Children. Learn more about their important work at https://www.papartnerships.org/.

Office of National Drug Control Policy Releases Resources, Opportunities, Continuing Education Information

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The 2020 Rx Drug Abuse Heroin & Drug Summit Call for Presentations is now open. The Rx Drug Abuse & Heroin Summit is the largest national collaboration of professionals from local, state, and federal agencies, business, academia, treatment providers, and allied communities impacted by substance use disorder. We encourage proposals from rural and tribal communities. Here is the link to submit a presentation proposal: https://www.abstractscorecard.com/cfp/submit/login.asp?EventKey=PUEJLGXY. The deadline is August 23, 2019. There is a limit of 3 presentation proposals per submitter.

Below please find a few resources and opportunities that may be of interest:

  • The Office of Population Affairs (OPA) within the Office of the Assistant Secretary for Health (OASH) announces the availability of funds for Fiscal Year (FY) 2019. This notice solicits applications for projects to conduct research on 1) innovative family planning clinical service delivery models and 2) clinical interventions for linking family planning services and substance use disorder screening and treatment. OPA seeks applications from public and private nonprofit entities for up to 10 grants with a ceiling of up to $800,000 each in order to conduct research to improve the delivery of family planning services. Deadline June 14, 2019
  • Improving Reentry for Adults with Co-occurring Substance Abuse and Mental Illness: The U.S. Department of Justice (DOJ), Office of Justice Programs (OJP) Bureau of Justice Assistance (BJA) is seeking applications for funding under the Second Chance Act for state and local government agencies, and Indian tribes seeking to provide reentry services and programs for offenders with co-occurring substance abuse and mental illness returning from incarceration. By facilitating successful integration, this program furthers the Department’s mission to reduce recidivism and combat violence, thereby supporting public health and safety. Deadline June 25, 2019
  • USDA Rural Housing Preservation Grant (HPG) program provides funds to sponsoring organizations to establish grants or low-interest loan programs for homeowners to repair or rehabilitate individual housing, rental properties, or co-ops owned and/or occupied by very low- and low-income rural persons. Priority will be given to projects designed to reduce the morbidity and mortality associated with Substance Use Disorder (including opioid misuse) in high-risk rural communities by strengthening the capacity to address prevention, treatment and/or recovery at the community, county, state, and/or regional levels. Click here to learn more. Deadline July 8,  2019
  • Women in Apprenticeship and Nontraditional Occupations (“WANTO”) Technical Assistance Grant Program: The Women’s Bureau (“WB”), U.S. Department of Labor (“DOL,” or “the Department,” or “we”), announce the availability of $1.5 million in grant funds. This program is intended to provide technical assistance (“TA”) to employers and labor unions to encourage employment of women in apprenticeable occupations and nontraditional occupations (“A/NTO”).  If you have difficulty accessing the full announcement electronically, please contact Marc Purvis Grants Management Specialist purvis.marc@dol.gov. Deadline: July 8, 2019
  • The U.S. Department of Justice (DOJ), Office of Justice Programs (OJP), Office for Victims of Crime (OVC) is seeking applications to support crime victims and to enhance community-driven responses to the current opioid crisis. This program furthers the Department’s mission by providing resources to support state, local, and tribal efforts to assist crime victims. The purpose of this solicitation is to address an urgent gap in crime victim services related to the opioid epidemic and to expand upon existing or establish new programs to provide services to children and youth who are victimized as the result of the opioid crisis. Click here to learn more.  Deadline July 11, 2019
  • Public Transportation in Appalachia – Inventory and Assessment: The Appalachian Regional Commission (ARC) invites proposals to conduct research and provide guidance regarding public transportation in the Appalachian Region, with a particular focus on rural public transportation issues.  ARC recognizes that those with reliable access to opportunities and services are more likely to be successful and have a high quality of life than those with poor access.  Public transportation is an important lifeline for those with limited vehicle availability, especially in non-urban areas where biking or walking are unrealistic.  This project will help ARC better understand the extent to which existing public transportation services are adequately creating or enhancing access for disadvantaged populations, particularly in rural areas.  It will also help us better connect transportation, economic development, education, and health practitioners throughout the region to best practices and guidance regarding public transportation. Learn more at www.arc.gov. Proposals are due by 5:00 p.m. EDT on July 12, 2019.
  • WILLIAM G. MCGOWAN CHARITABLE FUND is offering grants in support of programs and initiatives in Colorado, Kansas/Missouri, New York, and Pennsylvania that seek to correct, and ultimately eliminate, the circumstances contributing to the condition of homelessness.  Deadline:  Letters of Inquiry 7/15/2019.  Click here for guidelines and to apply
  • Funding Opportunity Available for Workforce Development! The U.S. Department of Labor is making $29 million available via the Workforce Opportunity for Rural Communities (WORC) initiative to implement innovative approaches to provide enhanced training and support activities to dislocated workers, new entrants in the workforce, incumbent workers, and individuals affected by substance use disorder returning to work. Successful awards, ranging from $150,000 – $2.5 million, will support workforce development activities that prepare eligible participants for good jobs in high-demand occupations aligned with a state, regional, or community economic development strategy. Communities across Appalachia, especially those underserved by other resources, are encouraged to apply. Deadline to apply July 15 2019.
  •  DELTA REGIONAL AUTHORITY is offering the Delta Leadership Institute Executive Academy, an educational opportunity that trains leaders from diverse backgrounds, sectors, and industries to improve the economic competitiveness and social viability of the Mississippi River Delta and Alabama Black Belt, with an emphasis on economic, public health, educational, and infrastructure challenges.  Residents of Alabama, Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri, or Tennessee may apply. Application deadline:  7/16/2019.  Click here for more information and to apply.
  • NHSC Rural Community Loan Repayment Program: The National Health Service Corps (NHSC) provides loan repayment assistance for medical, nursing, and behavioral/mental health clinicians with specific training and credentials to provide evidence-based substance use disorder (SUD) treatment in rural communities designated as Health Professional Shortage Areas (HPSAs). Deadline July 18, 2019
  • CITIZENS’ INSTITUTE ON RURAL DESIGN, A PROGRAM OF THE NATIONAL ENDOWMENT FOR THE ARTS has issued a Request for Host Applicants. This is an opportunity to host a leadership initiative and/or participate in a learning cohort that connects rural communities to design resources, enabling communities to act on ideas for improvements to a community’s streets, buildings, public spaces, or landscapes to address the specific physical, environmental, social, and economic challenges facing rural areas.  Deadline to apply:  7/22/2019.  Click here to review application guidelines.
  • The Kent Richard Hofmann Foundation is a private foundation dedicated to the fight against HIV and AIDS. The Kent Richard Hofmann Foundation awards grants to community-based organizations providing care and direct services, education, and/or research in the areas of HIV and AIDS. Grants support both developing and established programs, with an emphasis on direct benefit to clients or target audiences. The foundation has an interest in smaller communities and rural areas. Submit a Letter of Inquiry through the online grant portal by July 26, 2019.
  • Comprehensive Corrections Training and Technical Assistance: The U.S. Department of Justice (DOJ), Office of Justice Programs (OJP) Bureau of Justice Assistance (BJA) is seeking applications for training and technical assistance providers in eight areas: support to Second Chance Act grantees and practitioners to improve reentry and reduce recidivism and  support to grantees and practitioners to improve correctional substance abuse treatment programming and outcomes for inmates/detainees post-release. Deadline July 31, 2019
  • USDA NIFA – Tribal Colleges Research Grants Program (TCRGP) This program was designed to assist 1994 Land-Grant Institutions (Tribal Colleges) in building institutional research capacity through applied projects that address student educational needs and meet community, reservation or regional challenges.  Awards are to be made on the basis of a competitive review process. Collaboration with 1862 or 1890 Land-Grant Institutions, the USDA Agricultural Research Service (ARS), a Non-Land-Grant College of Agriculture (NLGCA), or at least one forestry school funded under the McIntire-Stennis Cooperative Forestry Research Program  is a requirement. Eligible institutions may propose projects in any discipline of the food, agricultural or natural resource sciences. Click here to learn more. Deadline August, 9 2019
  • Rural Health Fellows Program; A year-long, intensive fellowship program designed to develop a community of rural health leaders. The Rural Health Fellows Program is designed to educate, develop and inspire a networked community of rural health leaders who will step forward to serve in key positions in the National Rural Health Association, affiliated rural health advocacy groups and local and state legislative bodies. Selected participants will meet in person 3 times throughout the year to undergo intensive leadership and advocacy training. Applicants will also participate in conference calls and mentorship activities and should be dedicated to advocating on behalf of rural health. Chick here to learn more. Deadline to apply, August 27, 2019.
  • Small Rural Hospital Transition (SRHT) Project Technical Assistance: The Small Rural Hospital Transition (SRHT) Project provides technical assistance to small hospitals in rural, persistent-poverty areas to help prepare and assist them in moving from a fee-for-service and volume based payment system to one that is dependent on value and quality. Letter of Intent (Required): Sep 15, 2019; Application: Oct 16, 2019

Information/Ideas:

  • Telepsychiatry Pilot in Rural North Dakota Middle School: Southwestern District Health Unit (SWDU) and the Center for Psychiatric Health are implementing a pilot project to bring telepsychiatry services to students at Dickinson Middle School in North Dakota. While the school does have counselors that can provide some mental health services to students, this pilot is expected to dramatically increase access to psychiatric services, specifically, which would normally take students several hours of travel time to access. If successful, this pilot project will be expanded to other schools in North Dakota. Read more.
  • Telemedicine for Infectious Disease Services: Faced with a growing need for and a dwindling supply of ID specialists, health systems are using virtual care platforms to access these experts when and where needed. One organization tooling up to provide tele-ID services is University of Pennsylvania Medical Center.  UPMC Enterprises has developed ID Connect, a connected care platform that now serves 15 hospitals (10 in the UPMC system and five outside) and is aimed at the 4,000 small acute care hospitals across the country who may lack the resources. Read more.
  • U.S. Department of Labor Provides National Health Emergency Dislocated Worker Grant to Combat Opioid Crisis in Ohio – The U.S. Department of Labor announced an opioid-crisis Dislocated Worker Grant (DWG) to the Ohio Department of Job and Family Services for up to up to $11,000,000, with $3,666,667 released initially. This grant will provide disaster-relief jobs and employment services to eligible individuals in Ohio impacted by the health and economic effects of widespread opioid use, addiction, and overdose. Funding will provide eligible participants disaster-relief employment in positions addressing the impacts of the opioid crisis, such as peer recovery coaches and social service aids assisting children placed in foster care resultant of parental substance abuse. The project will also provide training and employment services to eligible participants impacted by the crisis and seeking careers in in-demand jobs related to addiction, treatment, prevention, and pain management. The state anticipates serving approximately 893 participants in Ohio.
  • U.S. Department of Labor Provides Disaster Relief Employment Funding for West Virginia: The U.S. Department of Labor announced an opioid-crisis Dislocated Worker Grant (DWG) to Workforce West Virginia for up to up to $10,000,000, with $3,333,333 released initially. This grant will provide disaster-relief jobs and employment services to eligible individuals in West Virginia impacted by the health and economic effects of widespread opioid use, addiction, and overdose. This grant will provide eligible participants with disaster-relief employment in positions addressing the crisis, such as responders to deliver humanitarian assistance to the opioid-impacted homeless population and peer recovery coaches to help affected individuals navigate the path to recovery. The grant will also provide eligible individuals with training in healthcare professions related to addiction, treatment, prevention, and pain management. West Virginia anticipates serving approximately 534 grant participants in the following metropolitan communities across the state:  Beckley, Bluefield, Charleston, Huntington, Martinsburg, Morgantown, Parkersburg, and Wheeling.
  •  HRSA awards $24 million to 120 rural organizations for opioid response. U.S. Department of Health & Human Services Health Resources and Services Administration’s Federal Office of Rural Health Policy awarded $24 million for the second round of Rural Communities Opioid Response Program (RCORP) planning grants. Recipients across 40 states will receive $200,000 for one year to formalize partnerships with local stakeholders, conduct needs assessments, and develop plans to implement and sustain substance use disorder (SUD), including opioid use disorder (OUD), prevention, treatment, and recovery interventions.
  • ARC Announces Substance Abuse Advisory Council ARC has announced the formation of the Substance Abuse Advisory Council (SAAC) to develop recommendations for ARC to consider as part of a strategic plan to build and strengthen a recovery ecosystems in Appalachian communities. The 24 member volunteer advisory group represents each of the Region’s 13 states, and includes leaders from law enforcement, recovery services, health, economic development, private industry, education, state government and other sectors. Read the press release.
  • he Northwest Addiction Technology Transfer Center (ATTC) is excited to offer a new training product for peer support specialists about opioid use disorder. Supporting Recovery from Opioid Use: A Peer’s Guide to Person-Centered Care is a one-hour, self-paced course designed to equip peers and other outreach workers with information, resources, and practical tips to help them better understand opioids and their impact on individuals. The course features 4 modules: Role of Peers in Recovery; Opioids and the Brain; Treatment Options; and Supporting Those Using Opioids. Learn about effective treatment options and strategies for using person-centered care to engage people with opioid use disorder in their path to recovery. Click here to learn more.

Events:

  • Conversation on Maternal Health Care in Rural Communities Wed., June 12 at 8:30 am ET. Register here for virtual participation This interactive event hosted by CMS, HRSA, the National Rural Health Association, and others will provide an overview of the state of maternal healthcare in rural communities, with a focus on access to maternal health services before, during, and after pregnancy. The event will be held in Washington, DC, and virtual attendance will be available via webcast.
  • On Tuesday, June 18, at 2 p.m. EDT, the Federal Transit Administration (FTA) will host a second webinar for potential applicants and other stakeholders interested in the Integrated Mobility Innovation (IMI) Demonstration Program. FTA staff will provide further information on the application process, key requirements, including data, and will answer frequently asked questions. FTA announced the $15 million IMI funding opportunity on May 8, and the application period closes on August 6. Don’t miss this chance to learn from FTA about the application process.
  • Telehealth Forum:  The 2019 South Central Telehealth Forum will be held on August 19th & 20th at the Sheraton City Music Hotel in Nashville, Tennessee. Make sure to check back here for updates on the agenda, exhibit and sponsorship opportunities, speaker announcements, and much more!  Click here to learn more.

 Resources at your fingertips:

 

Pennsylvania Governor Wolf Releases Seven Detailed White Papers on Restore Pennsylvania Initiative

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(June 6, 2019)  Harrisburg, PA – With nearly a majority of the General Assembly supporting Restore Pennsylvania, Governor Tom Wolf released detailed summaries of the plan to address critical infrastructure needs across Pennsylvania.

“Restore Pennsylvania is the most aggressive infrastructure plan in generations,” said Governor Wolf. “This is a rare opportunity to make lasting improvements and tackle investiture problems from our big cities to rural communities. We can finally address blight in our communities, better protect homes and businesses from floodwaters, bring high-speed internet to rural communities and position people and businesses as leaders in the 21st century.”

Restore Pennsylvania was introduced in the General Assembly this week with strong bipartisan support. House Bill 1585, sponsored by Rep. Jake Wheatley and Rep. Thomas Murt, has 99 cosponsors and Senate Bill 725, sponsored by Sen. John Yudichak and Sen. Tom Killion has 25 cosponsors. More than 60 stakeholders and municipal leaders are also endorsing the proposal.

To accompany the legislation, the governor released a series of white papers detailing the investments Restore Pennsylvania would make, helping local communities prevent flooding, eliminate blight, expand broadband, and address other critical infrastructure needs.

Storm Preparedness and Disaster Recovery
Restore Pennsylvania will provide funding to help towns and cities prepare for flooding and severe weather, upgrade flood walls and levees, replace high-hazard dams, and conduct stream restoration and maintenance.

Providing High-Speed Internet Access
Broadband is essential to education, quality of life, and the economy. Lack of high-speed internet puts hundreds of thousands of Pennsylvanians at a disadvantage. Restore Pennsylvania will provide funding to completely bridge the digital divide in every community in Pennsylvania, making Pennsylvania a better place to work, do business, and live.

Combatting Blight
There are an estimated 300,000 blighted structures in rural and urban communities throughout Pennsylvania. Restore Pennsylvania will increase resources for addressing blight by providing financial resources at the local level to establish land banks and acquire and demolish blighted buildings in order to create new development opportunities or provide new green space.

Contaminant Remediation and Brownfield Cleanup
Many communities face issues with harmful contaminants, such as lead and Perfluoroalkyl and Polyfluoroalkyl Substances (PFAS). Abandoned industrial and commercial sites are also still waiting for cleanup to unlock their potential as commercial, residential, or industrial sites. Restore Pennsylvania will address contaminant remediation and help brownfield clean-up throughout the commonwealth.

Green Infrastructure 
Restore Pennsylvania will provide significant new funding to enable new environmental projects and new recreational opportunities across the state, including infrastructure and maintenance in state parks, creation, and revitalization of new local parks, funding best management practices to improve local water quality, and funding for new hiking, biking, and ATV trail projects.

Transportation Capital Projects
Restore Pennsylvania will provide funding for local road and bridge upgrades, create new flexible funding options for businesses that need local infrastructure upgrades to enable development projects and multimodal and large-scale capital projects for transit.

Downstream Manufacturing
Restore Pennsylvania will provide funding for infrastructure that helps build manufacturing facilities and other downstream businesses for the natural gas produced in Pennsylvania.

Business Development, and Energy Infrastructure
Restore Pennsylvania will help businesses and individuals use more of Pennsylvania’s natural gas in their homes, creating jobs, lowering costs, and improving energy efficiency.

Restore Pennsylvania will invest $4.5 billion over the next four years in significant, high-impact projects throughout the commonwealth to help catapult Pennsylvania ahead of every state in the country in terms of technology, development, and infrastructure. The plan is funded through the monetization of a commonsense severance tax. The existing impact fee will remain in place.

The projects would be identified by local stakeholders and evaluated through a competitive process to ensure that high-priority, high-impact projects are funded and needs across Pennsylvania are met.

MEDIA CONTACT: J.J. Abbott, 717.783.1116

CMS Publishes PACE Final Rule

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 CMS Publishes PACE Final Rule– The Centers for Medicare & Medicaid Services (CMS) finalized a rule updating and modernizing the Programs of All-Inclusive Care for the Elderly (PACE), which provides comprehensive medical and social services to certain frail, elderly individuals (many of whom are “dually eligible” for both Medicare and Medicaid) who qualify for nursing home care but can still live safely in the community.  This rule strengthens protections for PACE participants,  provides administrative flexibility  for PACE organizations, and reduces administrative burden for  clinicians. The  RHI Hub provides examples of PACE programs in rural areas as well as toolkits on how to get started. 

New Opportunity to Apply to be a Medicare Shared Savings Program ACO

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New Opportunity to Apply to be a Medicare Shared Savings Program ACO—Notice of Intent June 28.  For provider groups interested in becoming a Medicare Shared Savings Program Accountable Care Organization (ACO) in 2020, CMS will accept Notices of Intent Apply (NOIA) between June 11 and June 28, 2019.  An NOIA is required in order to submit an application, which will be due by July 29.  The ACO Program was restructured for 2019 and offers rural providers a path to take on financial risk for shared savings and losses.   Email questions to SSPACO_Applications@cms.hhs.gov.