The Pennsylvania Medicare Rural Hospital Flexibility Program received the 2024 Medicare Beneficiary Quality Improvement Project (MBQIP) Certificate of Excellence Award in recognition of outstanding critical access hospital state quality reporting and performance. The Pennsylvania program, which was ranked #1 nationally, has 16 critical access hospitals — these small hospitals of 25 beds or less are in rural counties and serve Medicare, low income and uninsured populations.

The award was presented on July 18 at the annual Medicare Rural Hospital Flexibility Program reverse site visit in Washington, D.C., by the Federal Office of Rural Health Policy in the U.S. Department of Health and Human Services’ Health Resources and Services Administration. Lannette Fetzer, quality improvement coordinator, and Sandee Kyler, rural health systems manager and deputy director, of the Pennsylvania Office of Rural Health (PORH), accepted the award on behalf of the state’s critical access hospitals. PORH, a partnership between the federal government, the state government and Penn State, is administratively housed in the Department of Health Policy and Administration in the Penn State College of Health and Human Development.

MBQIP is a quality improvement activity under the Medicare Rural Hospital Flexibility grant program of the Federal Office of Rural Health Policy. The goal of MBQIP is to improve the quality of care provided in critical access hospitals by increasing quality data reporting and driving quality improvement activities based on the data. MBQIP is a voluntary reporting system that includes quality and satisfaction measures from the Centers for Medicare and Medicaid Services Hospital Compare plus a critical access hospital-specific emergency department transfer communication measure set. Pennsylvania was one of the first four states to have 100% critical access hospital participation in MBQIP.

The Medicare Rural Hospital Flexibility Program improves access to preventive and emergency health care services for rural populations. Providing federal grant funding to eligible states, the program requires states to address rural health network development and directs significant effort into designating critical access hospitals.

“Pennsylvania’s 16 critical access hospitals work vigorously to ensure their hospital provides exceptional patient care, serving as a testament to superior quality service. It is a pleasure to work with them,” Fetzer said.

During the meeting, Fetzer was asked, for the second year, to serve as one of three panelists during a session called “Intersections of Flex: Working Across Program Areas for Greatest Impact,” where she discussed how quality affects the hospital’s bottom line and the importance of quality reporting.

“Successful quality improvement is not a one-time occurrence; it is a continuous and ongoing effort to improve outcomes in health care,” Kyler said. “Our critical access hospitals care about the people and communities they serve. This recognition demonstrates their commitment to high-quality health care in these rural communities. They are commended for their continuing efforts and focus on high-quality health care.”

PORH, which provides expertise in the areas of rural health, agricultural health and safety, and community and economic development, was formed in 1991 as a partnership between the federal government, the Commonwealth of Pennsylvania and Penn State. The office is one of 50 state offices of rural health in the nation funded under a program administered by the Federal Office of Rural Health Policy and is charged with being a source of coordination, technical assistance and networking; partnership development; and assisting in the recruitment and retention of health care providers.

When Bristeria Clark went into labor with her son in 2015, her contractions were steady at first. Then, they stalled. Her cervix stopped dilating. After a few hours, doctors at Phoebe Putney Memorial Hospital in Albany, Georgia, prepped Clark for an emergency cesarean section.

It wasn’t the vaginal birth Clark had hoped for during her pregnancy.

“I was freaking out. That was my first child. Like, of course you don’t plan that,” she said. “I just remember the gas pulling up to my face and I ended up going to sleep.”

She remembered feeling a rush of relief when she woke to see that her baby boy was healthy.

Clark, a 33-year-old nursing student who also works full-time in county government, had another C-section when her second child was born in 2020. This time, the cesarean was planned.

Clark said she’s grateful the physicians and nurses who delivered both her babies were kind and caring during her labor and delivery. But looking back, she said, she wishes she had had a doula for one-on-one support through pregnancy, childbirth, and the postpartum period. Now she wants to give other women the option she didn’t have.

Clark is a member of Morehouse School of Medicine’s first class of rural doulas, called Perinatal Patient Navigators.

The program recently graduated a dozen participants, all Black women from southwestern Georgia. They have completed more than five months of training and are scheduled to begin working with pregnant and postpartum patients this year.

Read more.

U.S. Department of Agriculture (USDA) State Director for Rural Development Bob Morgan announced four additional projects being funded through the Rural Energy for America Program (REAP) for a total of $1.4 million.

“The Biden-Harris Administration is partnering with people in rural communities across our Commonwealth to expand access to clean energy and save rural Americans money,” Morgan said. “We are hard at work, continuing what we’ve always done, supporting rural small businesses and farmers as they create jobs for their communities and drive economic prosperity.”

Here are the projects being announced today:

In Cambria County, Saint Francis University will use a REAP Renewable and Energy Audit Program grant of $100,000 to conduct 26 renewable energy assessments for rural small businesses and agricultural producers throughout Pennsylvania. These on-site assessments will provide analysis to install renewable energy systems aimed at reducing overall energy costs. This program strengthens American energy independence by increasing the private sector supply of renewable energy and decreasing the demand for energy through energy efficiency improvements.

In Northampton County, Northampton County Area Community College will use a REAP Technical Assistance grant of $449,990 to provide technical assistance for stakeholders interested in REAP Energy Efficiency Improvement opportunities for rural small businesses and agricultural producers throughout the State of Pennsylvania. Northampton County Area Community College (NCC) will provide technical assistance as well as energy audits and assessments to applicants interested in applying for REAP funds. NCC will target projects requesting $20,000 or less in grant funds, projects located in distressed or disadvantaged communities and projects with agricultural producers.

In Juniata County, Reinford Farms Inc., a dairy farm and trucking operation located in Mifflintown, Pennsylvania, will use a REAP grant of $712,572 to purchase and install a replacement motor upgrade for its anaerobic digester. Reinford Farms has been operating since 1991. The project is estimated to generate 3,705,000 kilowatt hours (kwh) per year, which is enough energy to power 341 homes.

In York County, Miller-Redding Partnership dba Mr. Storage will use a REAP grant of $132,500 to purchase and install a 104.7-kilowatt (kW) solar photovoltaic (PV) system. Mr. Storage, a 102-unit storage facility located in Hanover, Pennsylvania has been operating since 2019. This project is expected to generate 129,191 kilowatt hours (kWh) of electricity, which is enough energy to power 11 homes.

In 2024, USDA Rural Development has invested in 119 projects for a total of $19 million. Since 2021, RD has invested $44 million in 366 projects across the Commonwealth through the REAP program. Many of the projects are funded by President Biden’s Inflation Reduction Act, the nation’s largest-ever investment in combating the climate crisis. The projects also advance President Biden’s Investing in America Agenda to grow the nation’s economy from the middle out and the bottom up.

You can read the USDA national program announcement made today here.

The Pennsylvania Broadband Authority (PBDA) has posted details about the challenges received during the Challenge Submission phase of the BEAD Challenge process. The Challenge Summary can be reviewed on the PBDA’s BEAD Challenge Process webpage. The Adjudication phase is currently in-progress which means PBDA is reviewing evidence submitted during the Rebuttal phase.  All final outcomes of the Adjudication phase will be posted publicly on our website when NTIA Curing is complete.

Additional questions regarding the BEAD Challenge Process, please reach out to the PBDA via the BEAD Resource Account.

Family First Health, a federally qualified health center in Central Pennsylvania has partnered with Bro2Go to create the “Get Healthy” initiative to provide health and social services to formerly incarcerated citizens. Health services will include assistance with enrolling in and navigating insurance, free blood pressure screenings, rapid HIV testing, and education on health and nutrition. Read more.

You can improve staff satisfaction, retention, and resilience by executing a customized workforce well-being strategy. Join the Bureau of Primary Health Care for this webinar to learn about a practical tool that can hone your strategy. The speakers will also explore a real-life scenario that illustrates how to use the tool. Wednesday, July 24, 2:00-3:00 pm.

On June 13, 2024, the Centers for Disease Control and Prevention (CDC) released a Health Alert Network (HAN) regarding the U.S. Department of Justice announcement of a federal health care fraud indictment against a large subscription-based telehealth company that provides attention-deficit/hyperactivity disorder (ADHD) treatment to patients ages 18 years and older across the United States. Patients whose care or access to prescription stimulant medications is disrupted, and who seek medication outside of the regulated healthcare system, might significantly increase their risk of overdose due to the prevalence of counterfeit pills in the illegal drug market that could contain unexpected substances, including fentanyl. In addition to concerns about using illegally acquired stimulant medications, untreated ADHD is associated with adverse outcomes, including social and emotional impairment, increased risk of drug or alcohol use disorder, unintentional injuries, such as motor vehicle crashes, and suicide. Health officials and healthcare providers may need to assist affected patients seeking treatment for ADHD and should communicate overdose risks associated with the current illegal drug market as well as provide overdose prevention education and mental health support. More information is available.

The DHS (Department of Human Services) Medicaid team recently updated the MCOs by region and which PH MCOs contract with which Dental and Vision MCOs. DHS also updated the contact information for the HealthChoices/Community HealthChoices/Behavioral MCOs as of July 2024. Click here for additional HealthChoices general information. Click here for additional Behavioral HealthChoices general information.

The Centers for Medicare and Medicaid Services (CMS) have issued a proposed rule, or Notice of Public Rulemaking, that could create exceptions to the existing four walls requirement for Indian Health Service (IHS)/Tribal clinics, behavioral health clinics, and clinics located in rural areas. The official language posted to the federal register can be found on page 15 and is below.

“This proposed rule includes a proposal to create exceptions to the Medicaid clinic services benefit four walls requirement, to authorize Medicaid payment for services provided outside the four walls of the clinic for IHS/Tribal clinics, behavioral health clinics, and clinics located in rural areas. Our current regulation at 42 CFR § 440.90(b) includes an exception to the four walls requirement under the Medicaid clinic services benefit only for certain clinic services furnished to individuals who are unhoused. We believe these proposed exceptions would help maintain and improve access for the populations served by IHS/Tribal clinics, behavioral health clinics, and clinics located in rural areas.”

As a reminder, this is a proposed rule intended to announce and explain CMS’ plan to address the problem. As such, all proposed rules must be published in the Federal Register to notify the public and to give them an opportunity to submit comments. The proposed rule and the public comments received on it form the basis of a final rule. Interested parties should provide public comment on this proposed rule to the addresses listed in the federal register by Sept.9, 2024. While CMS works through this process, the Office of Mental Health and Substance Abuse Services (OMHSAS) continues to work toward a more immediate solution for Pennsylvania providers. Reminder, FQHCs are not required to comply with the four walls requirement.