- 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
Pennsylvania Oral Health Coalition Strongly Affirms Support for Fluoride in Water at Optimal Levels
PCOH strongly affirms our support of adjusting fluoride in water to optimal levels. Community water fluoridation (CWF) remains the single most effective public health measure to prevent tooth decay and protect oral health.
For nearly 80 years, communities across the United States have been adjusting the naturally occurring amount of fluoride in water to the amount recommended by the Centers for Disease Control and Prevention (CDC) for optimal oral health, and this practice has improved the oral health of tens of millions of Americans. As with most things, the amount you consume matters and too much of anything can be harmful. This is why the amount of fluoride in water is heavily regulated, tested, and ensured to be safe. Studies and court cases are often cited that indicate that fluoride causes negative health effects, when in reality, these studies are based on fluoride amounts that are far higher than we allow in the United States.
In Pennsylvania, each community water system makes its own decision on whether or not they will adjust the natural levels of fluoride in the water they provide to their customers. Adjusting the amount of fluoride in water reaches entire communities and addresses oral health needs for everyone in the community in a way that no other oral health tool can; it’s an accessible resource for all, regardless of insurance status, socioeconomic status, or access to dental care. As we continue to face growing dental workforce shortages, adjusting fluoride levels in water is a preventive measure that will help benefit even those who are now waiting months for a dental appointment.
In the upcoming holiday season, you may find yourself having difficult conversations with family members, friends, and community members. It is important for all of us to emphasize the evidence-based science and effectiveness of water fluoridation in preventing cavities and improving oral health. We wanted to make sure that you have the tools and resources to have these difficult conversations and have created a new resource that can be used and shared when addressing fluoride levels in water.
The Pennsylvania Coalition for Oral Health (PCOH) needs support in being able to connect at the community level on this issue, and continues to offer resources to assist individuals and communities in protecting this effective public health measure. Please consider joining the Statewide Water Action Team (SWAT) by emailing nicole@paoralhealth.org.
Pennsylvania Launches Mixed-Use Housing Development Pilot Program
Department of Community and Economic Development (DCED) Secretary Rick Siger today announced the launch of the new $10 million PA Mixed-Use Housing Development pilot program to develop mixed-use projects with a residential housing component. DCED is accepting applications for the grant funding starting today, October 23, through December 6, 2024.
Governor Josh Shapiro recently signed an Executive Order mandating Pennsylvania’s first comprehensive Housing Action Plan to address the state’s housing shortage, homelessness, and expand affordable housing options — ensuring Pennsylvanians have access to safe, affordable housing and attracting more people to live in the Commonwealth. DCED was tasked with leading the plan’s development and working with stakeholders across Pennsylvania to identify housing needs and devise a strategic response.
“The PA Mixed-Use Housing Development pilot program is a strong first step towards boosting the availability of affordable housing, increasing housing for our growing workforce, and providing crucial support for Pennsylvanians struggling to obtain housing,” said Secretary Siger. “This program and others developed under Governor Shapiro’s Housing Action Plan will improve access to safe, affordable housing which is essential for Pennsylvania’s economic growth and critical to the well-being of families and individuals throughout the Commonwealth.”
The pilot program will provide grant funding to eligible applicants for site development for a multi-use building as well as conversion or rehabilitation of existing structures for mixed-use development. A portion of the project must be devoted to development of both rental and owner-occupied residential units. The $10 million in funding for the PA Mixed-Use Housing Development pilot program is from dedicated PA SITES funding.
Eligible applicants include municipalities; economic development organizations; redevelopment authorities; municipal authorities; industrial development agencies; and for-profit organizations.
Expanding the availability of housing across Pennsylvania was a key element of Governor Shapiro’s Economic Development Strategy, the first plan of its kind in the Commonwealth in almost 20 years. Unveiled by Governor Shapiro and Secretary Siger earlier this year, the strategy will capitalize on the Commonwealth’s strengths and will reignite our economy by focusing on the Agriculture, Energy, Life Sciences, Manufacturing, and Robotics and Technology sectors.
Since day one, Governor Shapiro has worked to create real opportunities for Pennsylvanians and build an economy where everyone can chart their own course — working together with a divided legislature to deliver major investments that will help families afford to stay in their homes, address homelessness, and support our local communities by:
- Expanding the Property Tax/Rent Rebate and the Child and Dependent Care Enhancement Tax Credit
- Nearly doubling the funding cap for the Pennsylvania Housing Affordability and Rehabilitation Enhancement (PHARE) Fund to expand affordable housing
- Increasing the Homelessness Assistance Program to make sure we are protecting our most vulnerable residents
- Doubling state investments for the Neighborhood Assistance Program to encourage businesses to invest in affordable housing and community development.
For more information about the PA Mixed-Use Housing Development pilot program and DCED, visit the DCED website, and be sure to stay up-to-date with all of our agency news on Facebook, X, and LinkedIn.
CMS Announces 2025 final rules for Physician Fee Schedule, OPPS, and ASC
CMS announced the final rules for the 2025 physician fee schedule, the hospital outpatient prospective payment system (OPPS) and the Ambulatory Surgical Centers. Within these rules, CMS is finalizing new coding and payment policies for advanced primary care management services, advancing maternal safety standards, removing barriers to expand access to care for those formerly incarcerated and others in underserved communities, and setting policies to reduce the use of opioids and to increase access to high-cost drugs in tribal communities.
Physicians will see finalized average payment rates reduced by 2.93% in CY 2025 compared to the average payment rates for most of CY 2024, while payment rates for hospital outpatient and ASC services will increase by 2.9% in CY2025.
You can find more at the links below. Please contact me at (insert) with questions or if you’d like to learn more.
FINAL FULL PACKAGE: Calendar Year (CY) 2025 Physician Fee Schedule (PFS) Final Rule CMS-1807-F
Web links:
- Press Release: https://www.cms.gov/newsroom/press-releases/hhs-finalizes-physician-payment-rule-strengthening-person-centered-care-and-health-quality-measures
- PFS Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2025-medicare-physician-fee-schedule-final-rule
- MSSP Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2025-medicare-physician-fee-schedule-final-rule-cms-1807-f-medicare-shared-savings
- QPP Fact Sheet and FAQs: https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3057/2025-QPP-Policies-Final-Rule-Fact-Sheet.pdf
- IRA Fact Sheet: https://www.cms.gov/inflation-reduction-act-and-medicare/inflation-rebates-medicare
- Federal Register: https://www.federalregister.gov/public-inspection/2024-25382/medicare-and-medicaid-programs-calendar-year-2025-payment-policies-under-the-physician-fee-schedule
New Report: 2024 State of Children’s Health Finds Uninsured Rates for Pennsylvania Children Stable, Yet Remains Too High
The number of uninsured children in Pennsylvania remains stable following last year’s unwinding of the Medicaid continuous coverage provision, but no progress has been made, according to our 2024 State of Children’s Health report. The report provides the first look at the impact of resuming Medicaid renewals following a three-year federal hiatus during the COVID-19 public health emergency.
Between 2022 and 2023, the rate of Pennsylvania children without health insurance remained steady at 5.2%. However, steady rates do not mean progress. Too many children live in Pennsylvania without access to health insurance. The number of Pennsylvania children under age 19 without health insurance increased slightly from 145,000 to 147,000 from one year ago.
According to the report, factors such as age, race and ethnicity, and poverty level impact children’s access to health insurance. Demographic highlights include:
- Children under 6 are more likely to be uninsured (5.6%) than school age children (5.1%).
- Uninsured rates improved for American Indian and Alaska Native children and White children. Uninsured rates worsened for Asian children, Black children, Hispanic children, and children of multiple races.
- Children in lower-income families are more likely to be uninsured, and approximately 6.8% of PA children are financially eligible for Medicaid but not enrolled.
Accompanying fact sheets for each of the 67 counties show the local uninsured rate, race and ethnicity profiles, and public health insurance enrollment data.
The report finds that Medicaid, CHIP and Pennie™ remain significant sources of coverage with approximately 47% of Pennsylvania children relying on those programs’ health plans to meet their health care needs. A growing concern is that the Pennie™ “no wrong door” policy may not be working as intended since more than half of children enrolled through Pennie™ appear financially eligible for Medicaid or subsidized CHIP programs.
While the Medicaid unwinding process did not cause significant disruptions to children’s coverage in 2023, we will know next year if there were disruptions in 2024 as the process wrapped up in June.
Approximately 8 out of 10 children with renewals completed within Medicaid unwinding maintained public coverage. However, procedural disenrollments occurred too often with 42% of children disenrolled due to administrative reasons, not eligibility. To counter this trend, the report recommends that the state improve its poor track record of using automated “ex parte” renewals instead of enrollees submitting renewal applications.
The report also recommends strengthening the state’s continuous eligibility (CE) policy and supports DHS’ plan to provide continuous eligibility to children from birth until age 6. In a big win for kids, DHS has received federal approval last week of its plan to provide Medicaid continuous coverage for Pennsylvania’s youngest children, which is expected to start in January.
To help ensure no child is disconnected from care and to keep down costs for families and the state, the report recommends that Pennsylvania:
- Strengthen automated renewals
- Provide continuous coverage to young children
- Improve PA’s ‘no wrong door’ policy
CMS Releases New Provider Toolkit for Sickle Cell Disease
The U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) has released a new resource: CMS Sickle Cell Disease (SCD) Health Care Provider Toolkit: Resources for Health Care Professionals to Support Individuals with SCD .
This new toolkit builds on the CMS Sickle Cell Disease Action Plan (released in September 2023) to strengthen the infrastructure for primary care and other care settings to care for people with SCD, improve care management, and assist providers with supporting the needs of people with SCD and other chronic conditions. The SCD Toolkit consists of 6 sections that equip healthcare providers in delivering quality care to individuals with sickle cell disease. This toolkit is designed to assist the care team in supporting people by introducing SCD, including the common barriers to care, and summarizing CMS program coverage for services around social determinants and drivers of health as well as and new sickle cell disease treatments.
Culturally Responsive Approaches to Anti-Human Trafficking Programming in Native Communities
This policy brief from the Administration for Children and Families (ACF) examines the results of a demonstration project created by ACF’s Office on Trafficking in Persons for Native Communities. Analysts describe how six communities chosen for the project used culture as a resource to integrate values, beliefs, traditions, and activities into various project strategies and services offered.
Growing the Rural Physician Workforce: Decades of Federal Funding Impacts Rural Graduate Medical Education
A new feature article in The Rural Monitor provides a historical review of graduate medical education funding and its relationship to the supply of rural physicians.
New Resources for Providers from Experts at Rural Health Value
Rural Health Value is an initiative funded by the Federal Office of Rural Health Policy to provide analysis, technical assistance, and strategy for rural health care delivery. Along with a new website and logo, they’ve launched two new resources to help rural healthcare organizations, payers, and communities make the transition from volume-based to value-based health care and payment models:
Frontier Community Health Integration Project (FCHIP) Demonstration Updates
The Centers for Medicare & Medicaid Services (CMS) has an updated factsheet for its Frontier Community Health Integration Project (FCHIP) Demonstration. The model tests new models of health care delivery in the most sparsely populated rural counties by waiving certain Medicare requirements regarding skilled nursing facility beds, telehealth, and ambulance services. In the initial demonstration period (August 2016 through July 2019), CMS received applications from Critical Access Hospitals (CAHs) in Montana, Nevada, and North Dakota (though eligible to apply, CAHs in Alaska and Wyoming did not apply). The Consolidated Appropriations Act of 2021 extended FCHIP. Five CAHs in Montana and Nevada are continuing their participation with the goal of improving health and reducing Medicare expenditures.
Medicare Finalizes Updates to End Stage Renal Disease Prospective Payment System
– Effective January 1, 2025. On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a final rule updating payment rates and policies under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services for Medicare beneficiaries. This rule includes updates to base payment rates, a modified low volume payment adjustment, new inclusion of oral-only dialysis drugs in bundled payments, and coverage for home dialysis services for beneficiaries with acute kidney injury.