- Gaps in Mental Health Training, Rural Access to Care Compound Az's Maternal Mortality Crisis
- Enticing Rural Residents to Practice Where They Train
- New Round of Federal Funding Open for Rural Health Initiatives
- UAA Training for Health Care Providers Keeps Victims of Violent Crimes from Falling Through the Cracks
- Helene Exacerbated Rise in Homelessness Across Western North Carolina
- 'It's a Crisis': How the Shortage of Mental Health Counselors Is Affecting the Rural Northwest
- FCC Launches New Maternal Health Mapping Platform
- How Mobile Clinics Are Transforming Rural Health Access for Cochise County Farmworkers
- Struggling to Adapt
- Rural Governments Often Fail To Communicate With Residents Who Aren't Proficient in English
- Mental Health Association Launches Hub To Help Rural Residents
- Prescription Delivery in Missouri Faces Delays under USPS Rural Service Plan
- Getting Rural Parents Started On Their Breastfeeding Journey
- USDA Announces New Federal Order, Begins National Milk Testing Strategy to Address H5N1 in Dairy Herds
- Creating a Clearer Path to Rural Heart Health
CDC Office of Rural Health Showcases Rural Health Initiatives
In case you missed it, the CDC released its inaugural Rural Public Health Strategic Plan in September. Our work with many of you helped us to develop a strategy to ensure rural health needs are considered in all our programs and initiatives. We are committed to using the best research and data available to develop and disseminate tailored resources and build and improve rural public health activities.
Here are some examples of CDC’s rural work and recent successes you can share with your networks:
Electronic Case Reporting (eCR). eCR is the automated, real-time exchange of case report information between electronic health records and public health agencies. This information exchange is vital for public health facilities that treat under-resourced communities like critical access hospitals (CAHs). CAHs are rural hospitals with 25 or fewer acute care inpatient beds that are typically located more than 35 miles from another hospital. The number of CAHs using eCR increased 368% between 2022 and 2024. Click here to learn more about this successful onboarding of CAHs.
Population Level Analysis and Community Estimates (PLACES). PLACES is a free CDC web tool that expands access to data for rural communities, delivering hyper-local model-based data for the entire U.S. population at 4 levels of geography. The latest release included estimates for seven new nonmedical factors for health including transportation barriers, food insecurity, and lack of social and emotional support.
Insight Net. Through CDC investments, a team at Clemson University is collaborating with Clemson Rural Health, South Carolina’s Department of Public Health, and two large health systems to integrate respiratory disease trend data with information about available medical resources and community needs. Analysis and modeling using these data elements helps the state and health systems direct resources like mobile health clinics to high-risk rural communities. This tool has the potential to reduce thousands of preventable hospitalizations and deaths, drastically increase the number of high-risk patients served, and could be applied in other rural communities once evaluated.
High Obesity Program (HOP). CDC’s HOP investments in states, universities, territories, and tribes reach rural populations with proven interventions and innovative projects. HOP is a 5-year cooperative agreement to fund 16 land-grant universities to work with community extension services to improve access to healthier foods and safe places for physical activity where 40% or more of adults have obesity. From 2018 to 2023, all HOP recipients worked with rural counties. Overall, their work reached more than 338,000 people through improved access to safe places for physical activity and over 116,000 people through improved guidelines for healthier eating.
To learn more about CDC’s rural health work, visit us online at www.cdc.gov/rural-health and contact us at ruralhealth@cdc.gov.
Medicare Announces Cap on Out-of-Pocket Costs and Medicare Prescription Payment Plan
Beginning in 2025, all Medicare plans will include a yearly $2,000 cap on covered out-of-pocket prescription drug costs. The cap only applies to drugs that are covered by their Medicare plan, making it especially important for those with Medicare to review their plan to make sure their specific drugs are covered. If people with Medicare have prescription drugs that are not covered by the plan they choose, they will not be able to fully benefit from the cap.
Plan Finder provides an opportunity to input your prescriptions to be able to easily see if a plan covers them and their preferred pharmacy.
Likewise, starting in January 2025, the Medicare Prescription Payment Plan will take effect. The Medicare Prescription Payment Plan is a new payment option in the Inflation Reduction Act, also known as the prescription drug law, that works with the current drug coverage to help manage beneficiary’s out-of-pocket costs for drugs covered by their plan by spreading them across the calendar year (January–December), participation is voluntary.
How does the Medicare Prescription Payment Plan help my patient?
- For a certain set of people, it will help to manage their out-of-pocket covered drug costs. This plan is not right for everyone and does not save money for patients, but helps spread out existing costs.
- Costs are spread out across the calendar year (January – December) through monthly payments through a health plan versus in a lump sum at the pharmacy counter.
How does the Medicare Prescription Payment Plan work?
- There’s no cost to participate in the Medicare Prescription Payment Plan.
- If this payment option is selected, each month the plan premium will continue to be paid, if they have one. A bill will be received from the health or drug plan to pay, instead of paying the pharmacy
- If a person with Medicare determines this program is right for them, please have them contact their plan.
We encourage you to visit:
https://www.medicare.gov/prescription-payment-plan
https://www.medicare.gov/drug-coverage-part-d.
Broadband Grant Application Process Now Open in Pennsylvania
The Pennsylvania Broadband Development Authority is now accepting applications for its $1.16 billion Broadband Equity, Access, and Deployment Program. This funding will expand high-speed internet to areas in the state that currently lack reliable access.
Applications can be submitted until January 21, 2025, for groups like nonprofits, municipalities, and internet providers.
To view more, click HERE.
705 Rural Hospitals at Risk of Closure, State by State
More than 700 rural U.S. hospitals are at risk of closure due to financial problems, with more than half of those hospitals at immediate risk of closure.
The count comes from the latest analysis from the Center for Healthcare Quality and Payment Reform, which is based on CMS’s October 2024 hospital financial information. The center’s analysis reveals two distinct levels of vulnerability among rural healthcare facilities: risk of closure and immediate risk of closure.
In the first category, nearly every state has hospitals at risk of closure, measured by financial reserves that can cover losses on patient services for only six to seven years. In over half the states, 25% or more of rural hospitals face this risk, with 10 states having a majority of their rural hospitals in jeopardy.
The report also analyzes hospitals facing immediate threat of closure meaning financial reserves could offset losses on patient services for two to three years at most. Currently, 364 rural hospitals are at immediate risk of shutting down due to severe financial difficulties.
Below is a state-by-state listing of the number of rural hospitals at risk of closure in the next six to seven years and at immediate risk of closure over the next two to three years.
Alabama
27 hospitals at risk of closing (53%)
23 at immediate risk of closing in next 2-3 years (45%)
Alaska
2 hospitals at risk of closing (12%)
1 at immediate risk of closing in next 2-3 years (6%)
Arizona
2 hospitals at risk of closing (7%)
1 at immediate risk of closing in next 2-3 years (4%)
Arkansas
25 hospitals at risk of closing (54%)
13 at immediate risk of closing in next 2-3 years (28%)
California
23 hospitals at risk of closing (40%)
10 at immediate risk of closing in next 2-3 years (17%)
Colorado
11 hospitals at risk of closing (26%)
6 at immediate risk of closing in next 2-3 years (14%)
Connecticut
2 hospitals at risk of closing (67%)
1 at immediate risk of closing in next 2-3 years (33%)
Delaware
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
Florida
8 hospitals at risk of closing (36%)
5 at immediate risk of closing in next 2-3 years (23%)
Georgia
22 hospitals at risk of closing (32%)
11 at immediate risk of closing in next 2-3 years (16%)
Hawaii
8 hospitals at risk of closing (62%)
0 at immediate risk of closing in next 2-3 years
Idaho
7 hospitals at risk of closing (24%)
0 at immediate risk of closing in next 2-3 years
Illinois
10 hospitals at risk of closing (14%)
6 at immediate risk of closing in next 2-3 years (8%)
Indiana
5 hospitals at risk of closing (9%)
4 at immediate risk of closing in next 2-3 years (7%)
Iowa
28 hospitals at risk of closing (30%)
9 at immediate risk of closing in next 2-3 years (10%)
Kansas
62 hospitals at risk of closing (63%)
32 at immediate risk of closing in next 2-3 years (33%)
Kentucky
14 hospitals at risk of closing (20%)
6 at immediate risk of closing in next 2-3 years (8%)
Louisiana
24 hospitals at risk of closing (44%)
12 at immediate risk of closing in next 2-3 years (22%)
Maine
10 hospitals at risk of closing (40%)
6 at immediate risk of closing in next 2-3 years (24%)
Maryland
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
Massachusetts
2 hospitals at risk of closing (33%)
2 at immediate risk of closing in next 2-3 years (33%)
Michigan
15 hospitals at risk of closing (23%)
7 at immediate risk of closing in next 2-3 years (11%)
Minnesota
19 hospitals at risk of closing (20%)
7 at immediate risk of closing in next 2-3 years (7%)
Mississippi
34 hospitals at risk of closing (52%)
25 at immediate risk of closing in next 2-3 years (38%)
Missouri
22 hospitals at risk of closing (38%)
10 at immediate risk of closing in next 2-3 years (17%)
Montana
14 hospitals at risk of closing (25%)
4 at immediate risk of closing in next 2-3 years (7%)
Nebraska
4 hospitals at risk of closing (6%)
2 at immediate risk of closing in next 2-3 years (3%)
Nevada
5 hospitals at risk of closing (36%)
3 at immediate risk of closing in next 2-3 years (21%)
New Hampshire
2 hospitals at risk of closing (12%)
0 at immediate risk of closing in next 2-3 years
New Jersey
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
New Mexico
7 hospitals at risk of closing (26%)
6 at immediate risk of closing in next 2-3 years (22%)
New York
29 hospitals at risk of closing (56%)
20 at immediate risk of closing in next 2-3 years (38%)
North Carolina
6 hospitals at risk of closing (11%)
5 at immediate risk of closing in next 2-3 years (9%)
North Dakota
13 hospitals at risk of closing (33%)
5 at immediate risk of closing in next 2-3 years (13%)
Ohio
5 hospitals at risk of closing (7%)
2 at immediate risk of closing in next 2-3 years (3%)
Oklahoma
39 hospitals at risk of closing (51%)
25 at immediate risk of closing in next 2-3 years (32%)
Oregon
8 hospitals at risk of closing (24%)
2 at immediate risk of closing in next 2-3 years (6%)
Pennsylvania
13 hospitals at risk of closing (30%)
7 at immediate risk of closing in next 2-3 years (16%)
Rhode Island
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
South Carolina
9 hospitals at risk of closing (38%)
5 at immediate risk of closing in next 2-3 years (21%)
South Dakota
9 hospitals at risk of closing (18%)
4 at immediate risk of closing in next 2-3 years (8%)
Tennessee
19 hospitals at risk of closing (36%)
17 at immediate risk of closing in next 2-3 years (32%)
Texas
82 hospitals at risk of closing (51%)
32 at immediate risk of closing in next 2-3 years (20%)
Utah
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
Vermont
8 hospitals at risk of closing (62%)
4 at immediate risk of closing in next 2-3 years (31%)
Virginia
9 hospitals at risk of closing (30%)
8 at immediate risk of closing in next 2-3 years (27%)
Washington
17 hospitals at risk of closing (38%)
7 at immediate risk of closing in next 2-3 years (16%)
West Virginia
12 hospitals at risk of closing (38%)
6 at immediate risk of closing in next 2-3 years (19%)
Wisconsin
7 hospitals at risk of closing (9%)
1 at immediate risk of closing in next 2-3 years (1%)
Wyoming
6 hospitals at risk of closing (23%)
2 at immediate risk of closing in next 2-3 years (8%)
National Oral Health Sealant Learning Communities Collaborative Launched
The National Network for Oral Health Access (NNOHA) is seeking interested health centers to participate in the “Sealant Learning Communities Collaborative”. The virtual collaborative will take place February-June 2025 and allow for health centers to engage in activities that will improve their UDS Sealant Measure Outcomes. Accepted health centers will participate in four 1-hour interactive virtual webinars. Applications are due December 2.
HRSA Announces $52 Million Investment for Health Centers to Provide Care for People Reentering the Community after Incarceration
With this funding and under proposed policy action, HRSA-funded health centers may provide health care services – including chronic disease, mental health, and substance use disorder treatment – to individuals soon to be released from incarceration to support their healthy return to the community
Research finds that individuals released from prison face an opioid overdose risk up to 10 times the risk of the general public
The Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (HHS), announced nearly $52 million in awards for 54 HRSA-funded health centers to increase access to high-quality primary care for people soon to be released from incarceration and reentering the community.
Aligned with the White House Second Chance Initiative, today’s funding enables health centers to implement innovative approaches to support justice-involved individuals before their release to address health risks during reentry, including elevated risk of opioid overdose and the increased risk associated with being disconnected from critical treatment for chronic diseases, including medications. As many as 80% of individuals returning to the community after incarceration have chronic medical, psychiatric, and/or substance use conditions. Researchers have reported that among individuals who are released from prison, opioid overdose is a leading cause of death with a risk more than ten-fold that of the general population. Individuals leaving incarceration also face many heightened health risks, including disproportionately higher rates of chronic conditions such as diabetes, hepatitis, and hypertension.
In addition to today’s funding announcement, HRSA issued a draft policy earlier this year for all health centers clarifying the circumstances under which they may provide pre-release care to justice-involved individuals. This policy supports health centers to better meet the needs of their entire community and describes how health centers can provide health services to incarcerated individuals who are expected to be or are scheduled for release from a carceral setting within 90 days to help ensure continuity of care.
“At HRSA, we are committed to caring for historically underserved communities,” said HRSA Administrator Carole Johnson. “People reentering the community from incarceration are particularly vulnerable to poor health outcomes and mortality. We can change that if care and services are more closely connected to the reentry experience, which is why we are working to clarify that HRSA-funded health centers can provide pre-release services and why we are investing in health centers engaging with individuals prior to their release to better support their successful and healthy reentry to the community.”
Health centers are uniquely positioned to support justice-involved individuals as they navigate the reentry period and to help them overcome potential barriers to returning home and staying healthy. HRSA’s draft policy proposes to make clear that health centers can provide health services to incarcerated individuals who are expected to be or are scheduled for release from a carceral setting within 90 days to help ensure continuity of care as people come home to their community.
Health centers receiving grant awards today will focus on the following critical health needs:
- Managing chronic conditions;
- Reducing the risk of drug overdose;
- Addressing mental health and substance use disorder treatment needs; and
- Preventing, screening, diagnosing, and treating infectious diseases.
Award recipients must also provide case management services and work with community partners to address health-related social needs, such as housing and food insecurity, financial strain, transportation barriers, and intimate partner violence.
For a list of the awardees, visit: https://bphc.hrsa.gov/funding/funding-opportunities/quality-improvement-fund-justice-involved-populations/fy25-awards.
To find a health center, visit: https://findahealthcenter.hrsa.gov/
Federal Administration Supports Rural Health Care
The Resources and Services Administration’s (HRSA) investments in rural health care have grown by more than 25%, including:
Supporting the rural health care workforce
- Supporting 6,700 primary care clinicians in 2024 who are practicing in rural communities in return for HRSA-provided loan repayment through our National Health Service Corps Program.
- Graduating more than 2,300 HRSA-funded, newly trained mental health and substance use disorder providers who now work in rural communities.
- Creating more than 400 new physician rural residency slots to train new family medicine, psychiatry, and obstetrics physicians in rural communities. In 2024 alone, more than 160 new physician residents began training in HRSA-supported rural residency programs. More than 80 new physicians graduated from HRSA-supported rural residency programs during 2023 – 2024 and began practice.
- Graduating more than 275 physician and dental residents who trained in rural areas through HRSA’s Teaching Health Center Graduate Medical Education Programs.
- Supporting interstate compacts for behavioral health providers like psychologists and social workers to make it easier for providers to serve rural communities by practicing across state lines and providing telehealth services.
- Improving access to health care services in rural communities
Rural primary care
- Expanding access to primary care in rural communities through HRSA-supported health centers,
- which see patients regardless of ability to pay and reached an additional nearly 850,000 rural
- patients since 2020, serving a total 9.7 million rural patients per year.
- Growing primary care staffing in rural communities through rural health centers by 18% since 2020.
Rural mental health and substance use disorder services
- Providing substance use disorder treatment, recovery, or prevention services to more than 6 million people living in more than 1,500 rural communities.
- Increasing mental health and substance use disorder services in rural communities by expanding services in more than 160 rural health centers serving more than 3.4 million patients.
- Supporting more than 3,000 service delivery sites in rural communities directly providing naloxone to the community.
Rural maternal health care
- Providing prenatal care to more than 110,000 patients per year in rural health centers.
- Supporting more than 26,000 pregnant and new moms in rural communities receiving community-based support—from diapers to transportation needs.
- Making voluntary home visiting services available to support pregnant and new moms with child development milestones and other critical needs in more than 600 rural counties.
- Supporting newborn screening across rural communities to ensure early identification of serious health conditions.
- Providing nearly 21,000 pregnant and new moms in rural communities with health and social service support through the HRSA-funded Rural Maternity and Obstetrics Management Strategies program since fiscal year 2021.
Rural HIV care
- Providing nearly 20,000 people with HIV care and treatment in 2022 through HRSA-supported rural providers.
- Helping more than 90% of clients in rural care settings reach viral suppression, meaning they cannot sexually transmit HIV to their partner and can live longer and healthier lives.
Sustaining rural health care services
- Providing more than 150 rural hospitals with high-touch, extensive technical assistance to assess and improve their economic viability and help them remain open.
Federal Senators Introduce Bipartisan Bill to Support Critical Access Hospitals
Penn Highlands Huntingdon Addresses, Reduces Diabetes through Patient Engagement
To highlight the wide range of issues affecting rural health, Pennsylvania Governor Josh Shapiro declared November 18-22, 2024 as Rural Health Week in Pennsylvania. This declaration comes at the request of the Pennsylvania Rural Health Association (PRHA) and the Pennsylvania Office of Rural Health (PORH).
Governor Shapiro aims to raise awareness about the various issues impacting rural health care and the health status of rural Pennsylvanians. Pennsylvania ranks among the states with the highest number of rural residents, with 26 percent of its population living in rural areas. To address the diverse needs of rural communities, the Commonwealth has supported the establishment of the Center for Rural Pennsylvania, the Pennsylvania Office of Rural Health, and other initiatives focused on improving rural health.
The week also includes November 21, which is National Rural Health Day. Established in 2011 by the National Organization of State Offices of Rural Health (NOSORH), National Rural Health Day aims to showcase rural America, raise awareness of rural health issues, and promote the efforts of NOSORH, State Offices of Rural Health (SORHs), and other organizations addressing these issues.
“Nearly 59.5 million Americans, including 3.4 million Pennsylvanians, live in rural communities,” said Lisa Davis, director of PORH and an outreach associate professor of health policy and administration at Penn State. “These small towns and communities are driven by the creative energy of citizens who step forward to provide a wealth of products, resources, and services.”
Penn Highlands Huntingdon is a small rural hospital located in the mountainous region of Huntingdon, PA. In addition to serving Huntingdon County, the hospital provides services to the surrounding counties of Bedford, Blair, Centre, Franklin, Fulton, Juniata, and Mifflin.
The population of Huntingdon County is approximately 6,927, an increase of 1.7 percent since the 2020 U.S. Census. Penn Highlands Huntingdon is continuously expanding its medical services and is committed to improving the quality of inpatient and outpatient care for the community.
According to 2024 U.S. News data and the Huntingdon County Community Health Needs Assessment, the prevalence of diabetes in Huntingdon County is 9.4 percent, which is slightly lower than the national rate of 10.6 percent. The percentage of individuals facing food and nutrition challenges in the county is 6.8 percent, higher than the national rate of 5.9 percent. The obesity rate in Huntingdon County stands at 38.4 percent, compared to the national rate of 37.4 percent. Notable nutrition-related issues include poor food options that are high in sugar and fat but low in nutritional value.
Bethany Stough, Doctor of Nursing Practice (DNP) and a leading health care provider in Huntingdon County, has observed trends in diabetes care and has taken a crucial role in developing effective solutions. Her goal is to improve health outcomes for her patients—especially those who must travel more than sixty minutes to see an endocrinologist—and to provide comprehensive education on diabetes and nutrition.
In her treatment of diabetes patients, Dr. Stough emphasizes identifying the appropriate treatment for each patient, acknowledging their current situation, and collaborating towards a shared goal. More than 90 percent of Stough’s patient population has achieved an appropriate diabetic hemoglobin A1C result, demonstrating that her patients are compliant with dietary and medication recommendations.
“Engaging patients in making lifestyle changes is crucial for effective treatment,” noted Stough. “This process requires time and a personalized approach and is critical to providing effective care for every individual.”
Lannette Fetzer, quality improvement coordinator at the Pennsylvania Office of Rural Health added, “Recognizing the importance of providing excellent quality care is crucial for achieving optimal patient outcomes, particularly for diabetic patients. The work that Dr. Stough is doing is having a profound impact on the patients she serves.”
CMS Opportunity to Help People Get Connected to Health Care Coverage
The Centers for Medicare & Medicaid Services (CMS) thanks you for your partnership in helping to share information about Medicaid and Children’s Health Insurance Program (CHIP) renewals with people in your community. Your support as a trusted voice in your community has been key to helping people keep health coverage as states return to regular operations after the COVID-19 pandemic. The Medicaid and CHIP Renewals Outreach and Educational Resources webpage includes evergreen language that partners can use to share information about regular Medicaid and CHIP renewals. We encourage partners to continue to explore the refreshed resources and share information with people in your community.