Philadelphia Inquirer, Jason Nark, April 5, 2023

Berwick, a town of about 10,000 in Columbia County, is without a hospital for the first time in more than a century.

The emergency room was dark, the doors locked for months now, and a young woman stood outside in the rain, clutching her stomach and sobbing. No one was coming out to help.

The frantic people who drove the ailing woman to the hospital stood, dumbfounded, in the mostly empty parking lot.

“This is insane,” the driver said. “I’m going to have to call 911.”

On Sept. 17, the Pennsylvania Department of Health shut down Berwick Hospital Center’s emergency room because of a lack of staffing, accelerating a closure its owners planned out earlier that summer. Signs on the doors still advise patients to head to hospitals in Hazleton, 20 miles to the south, or Bloomsburg, 14 miles west, for emergencies. The 90-bed facility is currently operating only as a 14-bed inpatient geriatric psychiatry facility — but not everyone in this town of 10,349 on the Susquehanna River in Columbia County, knows that.

On that dreary March morning, the ill woman was carried back to a car to wait for an ambulance. Bette Grey, a Berwick resident and private medical advocate who fought, unsuccessfully, to keep the hospital open, was there to talk to The Inquirer. First, she watched her fears unfold.

“Hey, stay awake. Open your eyes,” Grey yelled, to the woman in the car, clapping her hands.

Read more.

During April, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) recognizes National Minority Health Month. This health observance promotes education around the health inequities affecting people from underserved and marginalized communities, and the theme for this year’s observance is “Better Health Through Better Understanding.”

Our office is proud to embody this theme through initiatives like the Coverage to Care (C2C) program. C2C resources and programs aim to help patients understand their health coverage and connect to various primary care and preventive services, in line with the CMS Framework for Health Equity 2022–2032. Priority 4 of the Framework is to advance language access, health literacy, and the provision of culturally tailored services, which C2C incorporates by offering resources in up to ten different languages. As 36% of adults in the United States have basic or below basic health literacy, C2C resources also take care to explain health coverage in an easily digestible way and to break down information about preventive services by audience.

National Minority Health Month is a great opportunity to encourage those in your community to make the most of their health coverage in order to live a long, healthy life. Share the resources below throughout the month to help members of your community understand their health care.

In addition, we are happy to announce that registration for the inaugural CMS Health Equity Conference is now open. The conference will be held at Howard University in Washington, D.C. on June 7 and 8. Participants will have the option of attending in-person or virtually. This event will provide an opportunity to learn more about health disparities that exist within our communities as well as give participants the chance to connect with peers, build relationships, learn about new initiatives, and share research findings. There is no cost to attend, so be sure to register soon as spots will fill up quickly. Visit our CMS Health Equity Conference website for more information and to register by May 19.

We hope to see you there!

Resources:

• View the C2C Roadmap to Better Care, which is available in 9 languages. This resource explains what health coverage is and how to use it to get primary care and preventive services through 8 clear steps.
• Download materials through the C2C Prevention Resources webpage so your patients can learn about services available at no cost to them under most health coverage. These resources are each available in 8 languages and are individually tailored to adults, men, women, teens, children, and infants.
• Read about the Connected Care campaign, which describes the benefits of chronic care management (CCM) for patients with multiple chronic conditions and provides health care professionals with resources to implement CCM, like the CCM Connected Care Toolkit.
• Review the CMS Framework for Health Equity 2022–2032, which informs all of CMS OMH’s work and aims to further advance health equity, expand coverage, and improve health outcomes for the more than 150 million individuals supported by CMS programs. Similarly, the CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities explains how CMS is working to promote access to high-quality, equitable care in rural, Tribal, and geographically isolated communities.
• Follow the Guide to Developing a Language Access Plan to ensure persons with limited English proficiency have meaningful access to your organization’s programs through high quality language services.
• Use the Mapping Medicare Disparities Tool to identify disparities between subgroups of Medicare enrollees (e.g., racial and ethnic groups) in health outcomes, utilization, and spending.
• Explore the Health Equity Technical Assistance Program to receive guidance on taking action against health disparities and embedding health equity into your organization’s work.

Visit the Department of Health and Human Services Office of Minority Health website to find additional resources that you can use and share during National Minority Health Month.

 Yesterday, the U.S. Food and Drug Administration (FDA) announced that the makers of Narcan, an opioid overdose treatment, have the agency’s approval to make the drug widely available over the counter (OTC).  Narcan is the brand name of the drug naloxone, a fast-acting overdose reversal. Until now, availability varied by state – typically restricted to licensed health care providers, approved opioid overdose programs, and first responders. This is an important consideration for rural counties given that research shows that these areas are nearly three times more likely than metropolitan counties to be a low-dispensing county for naloxone.

 In 2021, the Centers for Disease Control and Prevention carved out $427 million in state funding to focus on combatting COVID-19 in rural communities as part of a multibillion-dollar national initiative to address COVID-19-related health disparities among at-risk and underserved populations. This case study by the FORHP-Supported Southwest Rural Health Research Center explores the circumstances around this emphasis on rural America by interviewing relevant decision-makers and key stakeholders.

A sweeping report from the Administration of Children and Families (ACF) delivers insight into the rural-specific barriers to the agency’s programs – e.g., for housing, early childhood, and family development, Healthy Marriage, and Responsible Fatherhood.  Some of these barriers are well known and understood, such as distance to services and negative perceptions of public assistance.  But through qualitative and quantitative data collection, ACF researchers find details of how factors such as race, digital access, and housing are realized in the rural context and hinder the effectiveness of human services.

 The Commonwealth Fund examines programs that send paramedics and other staff to peoples’ homes to stabilize their health and avoid the need for 911 calls down the line.  The report cites 129 programs in the U.S., with more than 40 of these in rural areas.

The Centers for Medicare & Medicaid Services (CMS) recently published a new fact sheet summarizing the Medicare rules and regulations for Critical Access Hospitals (CAHs).  This latest version includes the revised CAH location requirement relative to other facilities to include areas with only secondary roads available and the requirement to inform the patient or the representative of their rights before starting or ending care and establish a grievance process.