Pennsylvania Department of Human Services (DHS) Secretary Dr. Val Arkoosh visited Project HOME to discuss a recent change in Medicaid that allows certain enrolled medical providers, including FQHCs, to meet with unhoused patients covered through Medicaid and provide care outside a clinical setting– a practice known as street medicine. DHS announced the initial Medicaid expansion in July 2023 and is now furthering the reach of street medicine programs by adding more providers eligible to render street medicine services through Medicaid. By allowing more specialties and providers to bill for services rendered during visits with people experiencing homelessness, DHS aims to increase access to care for Medicaid beneficiaries and improve health outcomes. Click here to read MA Bulletin 01-23-26.

The House Education Committee recently considered HB 1478 to allow Public Health Dental Hygiene Practitioners (PHDHPs) to perform the mandated dental screenings in schools. The Pennsylvania Coalition on Oral Health (PCOH) and the Pennsylvania Dental Hygienists’ Association presented testimony to the committee. In addition, the House Health Committee considered HB 1417 to restore the comprehensive adult dental benefits to Medicaid, and HB 1585 to codify teledentistry. The three bills all passed through the committee this week, with amendments. In addition, the current fiscal code language in HB 1300 would add $24 million in state funds that managed care organizations (MCOs) must use to increase rates paid for dental services. The legislation also requires the Department of Human Services (DHS) to seek a federal match of the funds. HB 1300 is currently in consideration in the Senate.

The Federal Communications Commission (FCC) is seeking public comment on its interactive map that allows users to visualize broadband and health data at the national, state, and county levels.  A special focus on maternal health was added earlier this year with the Data Mapping to Save Moms’ Lives Act, directing the FCC to incorporate publicly available data on maternal mortality. The Commission hopes to get feedback from the public on ways to further expand, refine, and enhance the platform.  Read more details in FCC’s Notice of Inquiry and find comment procedures on page 18.  The FCC provides a recording of its hour-long webinar to explain the map platform that took place on September 27.  University of Minnesota research from 2019 found that, when controlling for sociodemographic factors and clinical conditions, “rural residents had a 9 percent greater probability of severe maternal morbidity and mortality, compared with urban residents.”

Comments are due on November 20.

 The Rural Health Information Hub updated this guide with background information on rural-focused philanthropies, identifying actions and characteristics that may make a program successful.

When the National Advisory Committee on Rural Health & Human Services met in Bend, Oregon earlier this year, their focus was the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) in rural areas.  MIECHV was established in 2010 as part of the Affordable Care Act and is administered by the Maternal and Child Health Bureau here at HRSA, in partnership with other agencies within the U.S. Department of Health & Human Services (HHS).  The committee made eight rural-specific recommendations to HHS, including an effort to distinguish between rural and urban outcomes, and to ease data and administrative burdens that come with federal funding.

The update is part of the U.S. Department of Labor’s Bureau of Labor Statistics’ Occupational Outlook Handbook. The handbook includes 300+ profiles covering over 500 occupations.  The new CHW profile reflects the core CHW duties, competencies, and training and employment sites. While the profile focuses on CHWs, it also mentions other professions such as peer support specialists, community health representatives, and promotores de salud for the first time.

On October 10, the U.S. Drug Enforcement Agency joined with the Department of Health & Human Services to announce an extension telemedicine flexibilities put in place during the COVID-19 public health emergency.  Now through December 31, 2024, authorized providers (see Updates to Requirements for Buprenorphine Prescribing below) can prescribe controlled substances to new and existing patients based on a telephone evaluation, or through other means of telemedicine.

As part of their ongoing work supported by FORHP’s Policy Research Division, the North Carolina Rural Health Research Program is tracking conversions to Rural Emergency Hospitals (REHs),  a new type of healthcare provider.  Created by Congress in response to the growing number of rural hospital closures, the REH is meant to maintain emergency service and outpatient care in rural communities.  The REH provider type is a designation that comes with a new payment system under Medicare. Based on data from the Centers for Medicare & Medicaid Services, 14 hospitals have converted to be REHs as of October 17, 2023.  The Hospital State Division at FORHP funds a technical assistance center to provide support to hospitals considering conversion to an REH.  Subject matter experts at the center provide no-cost technical assistance for hospitals considering a conversion, helping hospital leadership teams assess the pros and cons of making the change from traditional services.

 Policy experts at the Georgetown University Center for Children and Families detail the critical role of Medicaid and the Children’s Health Insurance Program (CHIP) in rural areas, where people are more likely to face challenges getting coverage. Medicaid and CHIP are public sources of insurance. Medicaid provides health care coverage for eligible low-income adults, children, pregnant women, elderly adults and people with disabilities, while CHIP provides low-cost health coverage to children for families that earn too much money to qualify for Medicaid.  Using data from the U.S. Census, Georgetown’s researchers found that Medicaid and the Children’s Health Insurance Program served a greater share of rural adults and children compared to urban areas in all states and nationwide. This is especially true of states in the South and Southwest: the highest share of adults in small towns and rural areas who are enrolled in Medicaid live in Kentucky, Louisiana, and New Mexico, covering about one-third of rural adults.  Georgetown’s issue brief also provides county-level Medicaid enrollment rates, showing the large range within and across the states.

The International Classification of Diseases (ICD) is the global standard for health data, clinical documentation, and statistical aggregation. It provides a common language for recording, reporting, and monitoring diseases. It facilitates the collection and storage of data for analysis and comparison of mortality and morbidity data. ICD-11 is the 11^th revision, a result of an unprecedented collaboration with clinicians, statisticians, classification, and IT experts from around the world. For the first time, ICD will be fully electronic, include more diagnostic codes, and can be used online or offline – a vast improvement on previous revisions.  For this Request for Information (RFI), the National Committee on Vital and Health Statistics (NCVHS), needs feedback from a wide variety of users – including those with expertise in how rural health may be impacted.  To submit comments in response to the RFI, please send by close of business January 12, 2024, to NCVHSmail@cdc.gov, and include on the subject line: Response from [your organization or name] regarding ICD–11 RFI. Comments are due by January 12, 2023.