This study assesses how, among behavioral health clinicians working in rural safety net practices, the amount of exposure to care in rural underserved communities received during training relates to confidence in skills important in their work settings, successes in jobs and communities, and anticipated retention.

This study summary provides a quick overview of the study published by the Journal of Rural Health.

View the Study Summary here.

From AXIOS

The level of care patients receive in a medical emergency varies widely based on where 911 is being dialed.

Why it matters: A first-of-its-kind study of emergency medical service systems’ performance across the country points to opportunities to improve patient care when the pressure is on.

What they did: Researchers at the Icahn School of Medicine at Mount Sinai reviewed more than 26 million responses from nearly 9,700 EMS agencies in 2019.

• They assessed how those agencies performed on safety and clinical quality measures that had been outlined by a nonprofit industry organization that year.
• The researchers said it’s a shift from looking primarily at response times to determine EMS performance, which they say is an imprecise metric for most calls.

What they found: Agencies largely responding in rural areas were less likely to treat low blood sugar or improve trauma patients’ pain, researchers found.

• They were also more likely to use lights and sirens unnecessarily, which other studies have found raises the risk of crashes.
• Delivery of time-sensitive treatment also varied during EMS calls. For instance, 4 in 10 kids with wheezing or asthma attacks didn’t get breathing treatment, and about 1 in 3 suspected stroke patients didn’t have a stroke assessment documented.

What they’re saying: “We have to move away from solely looking at response times and start looking at performance that directly impacts the people we are meant to treat,” said lead author Michael Redlener, an associate professor of emergency medicine.

The Rural Health Value team is pleased to announce the release of an updated version of the 2024 Uniform Data Set (UDS) Measure Crosswalk to Other Quality Reporting Programs .

The Crosswalk highlights alignment between Uniform Data Set (UDS) measures and other quality reporting programs. It is intended to help health centers identify which UDS measures are being utilized by other programs such as CMS Accountable Care Organizations (ACOs), and the CMS Quality Payment Program (QPP).

Related resources on the Rural Health Value website:

• The Catalog of Value-Based Initiatives for Rural Providers. The catalog summarizes rural-relevant, value-based programs currently or recently implemented by the Department of Health and Human Services (HHS), primarily by the Centers for Medicare & Medicaid Services (CMS) and its Center for Medicare & Medicaid Innovation (CMMI). Its purpose is to help rural leaders and communities identify HHS value-based programs appropriate for rural participation.
• Rural Innovation Profile: Iowa Community Health Centers and Value-Based. The Iowa Primary Care Association (Iowa PCA), IowaHealth+, and INConcertCare collaborate as a network to leverage resources in support of community health centers (CHCs) across Iowa. The three organizations have established a common strategic plan that supports a clinically integrated network for Medicaid and Medicare value-based care (VBC) contracting. This profile provides an overview and background information on how the partnership supports value-based care and planned next steps.

The Pennsylvania Office of Children, Youth, and Families released a child welfare workforce recruitment and retention study, analyzing the trends, challenges, and needs to stabilize the system. Several partners were engaged in developing the report, including 10 county child welfare agencies, the Child Welfare Resource Center, Pennsylvania Children and Youth Administrators, Pennsylvania Council for Children, Youth, and Families, the Civil Service Commission, and OCYF. Some leading factors contributing to the significant turnover in the field include compensation, organizational culture, working conditions, and partner/stakeholder relationships. The report concludes by outlining 43 recommendations across six themes: cross-cutting, compensation, recruiting, caseworker workloads, training, and safe, supportive workplaces. It is further recommended that a recruitment and retention investment fund and a working group be created to strategize on each recommendation. With the staffing crisis impacting many child welfare agencies across the commonwealth, it will be important for the administration, policymakers, and stakeholders to partner and make these recommendations achievable.

Damaged or destroyed homes, displaced families, and personal harm. Millions of Americans face the impacts of flooding each year. Two new reports examine flood hazards and risk in Pennsylvania, New Jersey, and Delaware.

One study finds that in noncoastal areas in the three states, properties in low- and moderate-income neighborhoods face greater risks when compared with their higher-income counterparts. When it comes to coastal areas, the opposite is true. Yet, increased flood hazards touch all residents in shore communities.

A companion report compares the Federal Emergency Management Agency’s well-established Special Flood Hazard Areas with a new, alternative measure from the First Street Foundation. The study seeks to understand the implications for residents in less advantaged communities.

For more on climate risks and adaptation in our region, the Federal Reserve Banks of Philadelphia and New York invite you to a one-day event on workforce solutions for community climate resilience. Learn more and register.

Among key findings in this brief from the University of Minnesota Rural Health Research Center:

• Nearly 30 percent of rural and urban older adults reported experiencing at least one of the selected risk factors (injury, food insecurity, or lack of social and emotional support).
• Of the three risk factors, lack of social and emotional support was the most common, reported by over 18 percent of older adults from both rural and urban areas.
• Injury was the second-most reported risk factor and was more commonly reported by rural than urban older adults.
• Food insecurity was experienced by a slightly higher percentage of rural older adults than those in urban areas.

The U.S. Preventive Services Task Force released a final recommendation statement on interventions to prevent falls in community-dwelling older adults. The Task Force found that exercise can help prevent falls in adults 65 and older who are at increased risk. Additional interventions might be helpful for some older adults. To view the recommendation, the evidence on which it is based, and a summary for clinicians, please go here.

The state tobacco-related disparities dashboard, available on the Centers for Disease Control and Prevention (CDC) website, is an intuitive visualization platform. Use it to quickly explore cigarette smoking prevalence and related disparities in states by numerous factors. It can help you identify opportunities for improvement and action with your health center patients.

A feature article in The Rural Monitor features the Feasible, Actionable, Impactful and Relevant (FAIR) EMS Measurement Project, an initiative by the Florida Department of Health which developed rural-relevant EMS quality measures for use in the state and nationally.