- Dental Therapists, Who Can Fill Cavities and Check Teeth, Get the OK in More States
- Colorectal Cancer Is Rising among Younger Adults. Some States Want to Boost Awareness.
- Rural Hospitals Built During Baby Boom Now Face Baby Bust
- Food Stamps Go Further in Rural Areas — Until You Add Transportation Costs
- CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Texas
- CMS Proposes New Payments for Digital Health Under CY2025 PFS Draft Rule
- Improving Public Health by Strengthening Community Infrastructure
- Biden Harris Administration Proposes Policies to Reduce Maternal Mortality, Advance Health Equity, and Support Underserved Communities
- Nearly Half of U.S. Counties Don't Have a Single Cardiologist
- Randolph County, Ill. Turns Unused Part of Nursing Home Into State-Of-The-Art Behavioral Health Center
- Safe and Stable Housing Is a Foundation of Successful Recovery
- Rural RPM Program Is a Lifeline for Pregnant Women
- Expert: Rural Hospitals Are Particularly Vulnerable to Increasing Cyberattacks Targeting Healthcare Facilities
- Biden-Harris Administration Invests Over $200 Million to Help Primary Care Doctors, Nurses, and Other Health Care Providers Improve Care for Older Adults
- AJPH Call for Papers Special Section on Intersections of Public Health And Primary Care
What Share of Nursing Facilities Might Meet Proposed New Requirements for Nursing Staff Hours?
On September 1, 2023, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would create new requirements for nurse staffing levels in nursing facilities, settings that provide medical and personal care services for nearly 1.2 million Americans. The adequacy of staffing in nursing homes has been a longstanding issue. A recent report issued by the National Academy of Sciences, Engineering, and Medicine (NASEM) raised concerns about low nursing staff levels in nursing facilities across the country and the impact on the quality of care for nursing home residents. The high mortality rate in nursing facilities during the COVID-19 pandemic highlighted and intensified the consequences of inadequate staffing levels.
The new proposed rule includes several provisions to bolster staffing in nursing homes. It proposes a minimum of 0.55 registered nurse (RN) and 2.45 nurse aide hours per resident day; requires facilities to have an RN on staff 24 hours per day, 7 days per week; strengthens staffing assessment and enforcement strategies; creates new reporting requirements regarding Medicaid payments for institutional long-term services and supports (LTSS); and provides $75 million for training for nurse aides. As noted in the proposed rule, CMS aims to balance the goal of establishing stronger staffing requirements against the practicalities of implementation and costs. Comments on the proposed rule are due by November 6, 2023.
This issue brief analyzes the percentage and characteristics of facilities that would meet the rule’s proposed requirements for the minimum number of RN and nurse aide hours to better understand the implications of the rule. The analysis does not evaluate facilities’ ability to comply with other requirements, including the requirement to always have a registered nurse on duty 24/7 or the ability to meet the new reporting and assessment requirements due to data limitations (see methods). The analysis uses Nursing Home Compare data, which include 14,591 nursing facilities (97% of all facilities, serving 1.17 million or 98% of all residents) that reported staffing levels in August 2023.
Click here to read more and to access the brief.
Final Recommendation Statement Have Been Released on Screening for Hypertensive Disorders of Pregnancy
The U.S. Preventive Services Task Force released a final recommendation statement on screening for hypertensive disorders of pregnancy. The Task Force recommends that all pregnant people have their blood pressure measured throughout pregnancy. To view the recommendation, the evidence on which it is based, and a summary for clinicians, please go here.
Higher Buprenorphine Doses and Opioid Use Disorder Treatment Study Results Published
Individuals with opioid use disorder (OUD) who were prescribed a lower buprenorphine dose were 20% more likely to discontinue treatment than those on a higher dose, according to a study of patients prescribed buprenorphine in Rhode Island from 2016 to 2020, as fentanyl became widely available. “The current recommended target dose of buprenorphine was derived from studies conducted prior to the widespread availability of fentanyl. Now, we’re seeing people with higher levels of tolerance to and dependence on opioids, and our findings suggest that a higher buprenorphine dose – up to 24 mg – may help improve treatment retention for these individuals,” said Rachel Wightman, M.D., Associate Professor of Emergency Medicine and Epidemiology at Alpert Medical School of Brown University and one of the principal investigators of the study.
Rep. Thompson Introduces Legislation Promoting Rural Telehealth Services
Representatives Glenn “GT” Thompson (PA-15) and Ann Kuster (NH-02) introduced the bipartisan Helping Ensure Access to Local TeleHealth, or the HEALTH Act, as part of National Telehealth Awareness Week. This legislation secures Medicare reimbursement for telehealth services provided by community health centers and rural health clinics. It will continue to allow providers to utilize audio-only telehealth visits for patients who do not have access to broadband services. PACHC worked with Rep. Thompson’s office on the legislation. “As the nation’s largest network of primary care providers, Federally Qualified Health Centers (FQHC) provide a wide array of services in underserved areas of the country, both rural and urban,” said Cheri Rinehart, President and CEO of Pennsylvania Association of Community Health Centers (PACHC). “The ability to use telehealth throughout and after the pandemic has clearly demonstrated how vital telehealth is in improving health equity by increasing access to care for the vulnerable populations FQHCs serve and contributing to positive outcomes. Telehealth must remain an available service to ensure continued access to critical primary and behavioral health care services.” Click here to learn more.
Alumni Association to Recognize 13 Penn Staters with 2023 Alumni Fellow Award
The Penn State Alumni Association honored 13 Penn Staters with the 2023 Alumni Fellow Award; the most prestigious award given by the Alumni Association. A ceremony to honor their achievements was held on September 20 at the State Theatre in downtown State College. Among this year’s honorees is George Garrow’s 85g Med (Shenango*), President and CEO of Primary Health Network. Congratulations Dr. Garrow. Visit the Alumni Association’s website for more information on this year’s honorees and the award.
Are You Trying to Make Sense of it All? Find COVID-19 Vaccine Bridge Access Programs Here!
The U.S. Department of Health and Human Services (HHS) has created the HHS Bridge Access Program which encompasses both the CDC Bridge Access Program and the Health Center Bridge Funding Program.
The CDC Bridge Access Program will temporarily provide no-cost 2023-2024 COVID-19 vaccine for adults without health insurance and adults with insurance that does not cover all COVID-19 vaccine costs. Health center patients can access the 2023-2024 COVID-19 vaccine at health centers, safety-net, and public health providers designated by state and local health departments, and more than 20,000 retail pharmacy locations nationwide. Provider Education Resources include a communications toolkit and FAQs.
The Health Center Bridge Funding Program is one-time funding with a 16-month period of performance (Sept. 1, 2023 – Dec. 31, 2024). Activities must be related to COVID-19 services, such as COVID-19 testing, vaccination, therapeutics, enabling/patient support services to support COVID-19 related services, community vaccination events, personnel who support COVID-19 related services, and supplies that support COVID-19-related“ services. However, health centers must make every effort to get free COVID supplies from the CDC Bridge Access Program and HRSAs Testing Supply and Therapeutics Programs. Health Center Bridge Funding post-award submission is due in electronic handbooks on Oct. 2, 2023. Health centers can submit programmatic questions via the BPHC Contact Form.
Additionally, HHS issued a provider letter reviewing the necessary steps to take to discontinue the public health emergency-era CDC COVID-19 Vaccination Program. The letter includes a reminder that with the approval of 2023-2024 monovalent XBB.1.5 variant mRNA COVID-19 vaccines, Bivalent Moderna and Pfizer-BioNTech mRNA
This New Bulletin Provides Updates to Childhood Nutrition and Weight Management Services
The Pennsylvania Department of Human Services, Office of Medical Assistance Programs has issued a new bulletin. The purpose of this bulletin is to advise providers enrolled in the Medical Assistance (MA) Program of the expansion of Childhood Nutrition and Weight Management Services (CNWMS) for MA beneficiaries under 21 years of age to include pharmacotherapy as a result of changes to coverage of obesity drugs and updated guidance from the American Academy of Pediatrics (AAP). The bulletin also addresses coding changes as a result of the 2023 Healthcare Common Procedure Coding System (HCPCS) updates.
The Rate of the Uninsured Dropped to 5.3% in 2022
The uninsured rate in Pennsylvania dropped to 5.3% in 2022, down from 5.5% in 2021, according to new data from the Census Bureau. Only 10 states had lower uninsured rates in 2022 – Connecticut, Hawaii, Iowa, Massachusetts, Michigan, Minnesota, New Hampshire, New York, Rhode Island, and Wisconsin. Twenty-seven states had a higher percentage of people with health insurance coverage in 2022 than in 2021 according to American Community Survey (ACS) 1-year estimates released today by the U.S. Census Bureau. In terms of uninsured rates, or the rate of people without health insurance, Maine was the only state where the uninsured rate increased (up to 6.6% in 2022, from 5.7%). Between 2021 and 2022, the rate of public coverage increased in Pennsylvania and 12 other states (Alabama, California, Georgia, Illinois, Indiana, Michigan, Minnesota, Missouri, Nebraska, New York, Oklahoma, and Virginia) and decreased in one (Rhode Island). Oklahoma had one of the highest increases in public coverage (up 2.3 percentage points) from 2021 to 2022.
Health Insurance Marketplaces are Trying to Reverse Decades of Racism in the Insurance Industry
Health insurance brokers play an important role in getting Americans covered, but they often aren’t representative of the communities they serve. Some state health insurance marketplaces are working to address these racial disparities, say Georgetown University’s Jalisa Clark and Christine H. Monahan on To the Point. Connecticut, for example, has created a “broker academy” to recruit from historically underserved communities and train people to become life and health insurance brokers. The program “aspires to establish a more diverse and trusted broker industry, provide individuals with at least a high-school-level education access to a stable and profitable career, and help increase insurance coverage rates in underserved communities,” the authors write. Washington State is also planning to launch its own broker academy, while other states are engaging existing brokers to improve outreach into communities of color. Pennie has begun an initiative to recruit diverse brokers through similar initiatives. Read More.
Medicaid Automatic Household Renewals Are Becoming an Issue
The Centers for Medicare and Medicaid Services (CMS) released a State Medicaid Director Letter on August 30, 2023, instructing states to determine whether they are following federal Medicaid regulations that require all renewals be conducted at the individual level. This is a result of the growing concerns surrounding “family-level” automatic renewals/disenrollments that are causing children to lose insurance coverage at alarming rates. CMS instructed state Medicaid agencies to determine if their systems have a “family-level” renewal error and to take steps to mitigate its impact.