- 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
- NIH HEAL Initiative Turns Attention to Pragmatic Trials in Rural Communities
Senate President Pro Tem Scarnati Won’t Seek Re-Election
Not one but two top Pennsylvania General Assembly legislative leaders will not be returning for the Legislature’s new session in 2021. On the heels of House Speaker Mike Turzai’s Jan. 23 retirement announcement, Senate President Pro Tem Joe Scarnati, R-Jefferson, announced this week he would not seek re-election in the 25th Senatorial District. Senator Scarnati’s announcement brings it to a total of 17 of the state legislature not seeking re-election. In addition, two other members are running for PA Auditor General and are giving up their House seats.
Governor’s New Initiative Includes Healthcare Provider Survey
Gov. Tom Wolf announced this week that the Insurance Department, in partnership with multiple state agencies, released a survey asking healthcare providers for input on their experiences with barriers to mental health and substance use disorder treatment. The survey is part of the governor’s Reach Out PA: Your Mental Health Matters initiative, a long-term, statewide campaign that seeks to educate and empower Pennsylvania providers and consumers about consumer rights under state and federal parity laws. “The results from this survey will allow us to better inform and collaborate with providers, advocates and personnel on the front lines,” said Gov. Wolf. “Their experiences will help us enhance resources, develop more tools and create learning opportunities that will help serve the providers’ needs, which will ultimately help those in need of mental wellness services.” The provider survey will be sent directly to the email addresses provided to the Department of State through the licensing process. The deadline for responses is March 4, 2020.
Governor Signs Law Giving MCOs Access to PDMP Data
Legislation allowing Medicaid managed care organizations (MCOs) to have access to the information in Pennsylvania’s Prescription Drug Monitoring Program (PDMP) was signed by Gov. Wolf this week after passage by both the House and Senate. Senate Bill 432 is premised on the hope that by providing MCOs access to the program, the commonwealth will be able to better identify potential prescription drug abuse among individuals enrolled in the state’s Medicaid program. The legislation also requires an MCO to notify the state Attorney General’s Office if they suspect a drug is being prescribed fraudulently and bars counties and municipalities from creating their own PDMPs. Pennsylvania’s PDMP, created in 2014, documents all filled prescriptions for controlled substances to ensure healthcare providers can safely prescribe drugs and stay on top of potentially misuse or addiction.
ARC Announces $3.3 Million to Continue Economic Growth in Region’s Coal-Impacted Communities
On February 12, 2020, the Appalachian Regional Commission (ARC) announced nearly $3.3 million in investments via the POWER Initiative to continue supporting economic diversification in the Region’s coal-impacted communities. This week’s awards include: $1.5 million to Southern Tier Network in Corning, New York to expand the Southern Tier of New York’s existing high-speed dark fiber optic ring; $1,000,000 to the Somerset County Commissioners in Somerset, Pennsylvania, to assist with construction of the new detox unit of the Twin Lakes Center which treats individuals suffering from substance use disorder; and $733,000 to Opportunity Alabama, Inc. in Birmingham, Alabama to build local capacity to effectively prepare for Opportunity Fund investment. With today’s announcement, ARC has invested over $193 million in 242 POWER projects benefiting over 80 percent of Appalachia’s counties.
“These three investments in Appalachian communities well-represent the breadth of the work ARC is doing through the POWER Initiative,” said ARC Federal Co-Chairman Tim Thomas. “Whether it’s funding important broadband infrastructure to ensure citizens and businesses have competitive internet access, investing in facilities for individuals navigating the substance abuse recovery to work process, or helping communities capitalize on the transformative change Opportunity Zones can provide, POWER is helping change the narrative for coal-impacted Appalachia.”
ARC is currently accepting applications in response to the POWER 2020 Request for Proposals (RFP). Required Letters of Intent are due 5 p.m. (ET) February, 28, 2020. Final applications are due 5 pm (ET) March 27, 2020. Additional guidance on application submission is available at www.arc.gov/power
ARC Hosts Annual Governors Quorum Meeting
In February 2020, Appalachian Regional Commission (ARC) Federal Co-Chairman Tim Thomas and States’ Co-Chairman Ohio Governor Mike DeWine hosted Pennsylvania Governor Tom Wolf, Kentucky Governor Andy Beshear, Maryland Governor Larry Hogan, Tennessee Governor Bill Lee, Mississippi Governor Tate Reeves, and North Carolina Governor Roy Cooper at ARC’s annual Governors Quorum in Washington, DC. The business meeting, which is convened according to ARC statute, reviews ARC operations, activities, and highlights from the past fiscal year.
In addition to reviewing key investment accomplishments, the Commission also heard a special presentation by Scott Turner, Executive Director, White House Opportunity & Revitalization Council and Alfonso Costa Jr., Deputy Chief of Staff, Department of Housing & Urban Development, about the Trump Administrations Opportunity and Revitalization Council to promote additional private investment in America’s economically-distressed census tracks designated as Opportunity Zones. Turner noted that via the Opportunity Zone investment strategy, “there are things that we can do to bring about real results for the people of this country long after all of us are gone.” ARC is a member of the Opportunity and Revitalization Council as 737, or 8.5 percent, of the nation’s qualified Opportunity Zones are in the Appalachian region.
ARC’s next business meeting will be held in Marietta, Ohio in conjunction with the ARC Annual Summit, August 17- 19, 2020.
USDA Rural Development Designates Rural Health Liaison
WASHINGTON, Feb. 14, 2020 – U.S. Department of Agriculture (USDA) Deputy Under Secretary for Rural Development Donald “DJ” LaVoy today announced that Betty-Ann Bryce has been designated to serve as USDA’s Rural Health Liaison, a position created by Congress in the 2018 Farm Bill.
Betty-Ann Bryce returns to USDA in this role from a detail to the White House Office of National Drug Control Policy (ONDCP) where she served as a Special Advisor for Rural Affairs. In this role, she chaired the ONDCP Rural Substance Use Disorder Federal Interagency Working Group, guided the work on the Community Assessment Tool, regional workshops, Federal Rural Resources Guide, and the recently released Rural Community Action Guide. She joined ONDCP from USDA where she served as a senior policy advisor.
Prior to joining the U.S. government, she served as the Senior Policy Analyst for the Rural and Regional Unit at the Organization for Economic Cooperation and Development (OECD), for several years, in Paris, France. In this capacity, she assessed regional and rural government policies in different countries and contributed to several OECD Publications. In addition to a Juris Doctorate, she holds a Masters in Economic and Territorial Development from L’Institut d’Etudes Politique de Paris (The Paris Institute of Political Studies) in France, and a Masters in Economic and Political Development from Columbia University, School of International and Public Affairs (SIPA) in the United States.
Bryce’s start date is February 18, 2020. USDA encourages rural health stakeholders and partners to reach out to Bryce in her new role to build upon existing partnerships and facilitate new ones.
Out-of-control Prescription Drug Prices Finally Have a Solution in Pennsylvania | Opinion
Philadelphia Inquirer, Antoinette Kraus, For The Inquirer
Prescription drug pricing is reaching a crisis point.
A 2018 study showed that between 2012 and 2017, the cost of prescription drugs under Medicare increased nearly 10 times faster than the rate of inflation. And it continues to rise; the prices of more than 400 prescription drugs have already increased by an average of 5% in 2020. Americans are now spending more than double what we paid for our medications in the 1990s and much more than other developed nations. Annual spending on prescription drugs now exceeds $450 billion and is rapidly becoming one of the biggest cost drivers in our health-care system.
Meanwhile, while patients struggle to pay for their medicines, drug corporations are raking in profits. Between 2006 and 2015, 67% of drug companies increased their annual profit margins, some up to 20%. And their claims that drug prices are driven by innovation simply don’t add up; drug corporations routinely spend more than double their research and development budgets on advertising.
People throughout Pennsylvania are feeling the impact of this crisis. A recent study shows that two in three Pennsylvanians are concerned about the cost of prescription drugs, and many more are struggling to afford the prescription drugs they need, often cutting pills in half, skipping doses, leaving unfilled prescriptions at the pharmacy, or choosing between medications and necessities like food, rent, or utilities.
Pennsylvanians overwhelmingly support action that will address the drug pricing crisis. Recent polling shows that nearly nine in 10 Pennsylvanians across party lines support a range of policy solutions that would lower prescription drug prices. With Washington in gridlock and the Senate unlikely to take up a recent House-passed bill that would take aim at high drug prices, it’s left to lawmakers in Harrisburg to put forward solutions.
Fortunately, a groundbreaking solution to the prescription drug pricing crisis has emerged. Last month, State Rep. Dan Frankel (D., Allegheny) introduced legislation that would directly tackle the high prices people are paying at the pharmacy.
The Prescription Drug Affordability Act — HB 2212 — would give both lawmakers and the public greater insight into how drugs are priced, investigate how specific drug prices impact Pennsylvanians, and create a mechanism to reduce what Pennsylvanians pay for their medications by creating a new entity to directly address high drug prices.
Pennsylvania Sues Juul, Demands Ban on Maker’s Vaping Products
Philadelphia Inquirer, by Sarah Gantz,
Pennsylvania has joined a growing list of states suing leading e-cigarette maker Juul Labs, whose sleek vape pens and cartridges in fruit, dessert, and candy flavors have been blamed for contributing to a sharp rise in e-cigarette use among teenagers and adolescents.
The lawsuit, filed Monday by Pennsylvania Attorney General Josh Shapiro, alleges that Juul misled consumers about the health risks and addictive power of its nicotine vaping pods and improperly marketed the products to youths. The lawsuit seeks a statewide ban on all Juul products, including tobacco-flavored ones. If the court does not grant a full ban, the state wants to ban all of Juul’s flavored, menthol, and high-nicotine vaping products except those that are tobacco-flavored.
The U.S. Food and Drug Administration this month forbade the sale of flavored vaping pods nationwide. Over the last two years, Juul has phased out sales of flavored pods, except for those with menthol and tobacco flavors.
“Juul knowingly targeted young people with tactics similar to the tobacco companies’ playbook,” Shapiro said in a statement. “There is no proof these e-cigarettes are safe and until there is, we need to get Juul products off shelves and out of the hands of young people.”
Juul has said that adults are its target audience and that it does not aim to attract underage customers.
“While we have not yet reviewed the complaint, we remain focused on resetting the vapor category in the U.S. and earning the trust of society by working cooperatively with attorneys general, regulators, public health officials, and other stakeholders to combat underage use and convert adult smokers from combustible cigarettes,” said Austin Finan, a spokesman for Juul, in a statement.
Last year, the company ceased all major digital, print and television advertising, and said it would not lobby Congress over a federal ban on flavored e-cigarettes.
Pennsylvania’s lawsuit and similar suits in New York, Massachusetts, California and other states follow a surge of vaping-related lung illnesses and deaths that cast a spotlight on the sharp rise in vaping among teenagers. Bucks and Montgomery Counties have also sued.
Vaping-related lung illnesses spiked over the summer and have been declining in recent months. As of Jan. 21, a total of 2,711 people have been hospitalized, and 60 have died, according to the U.S. Centers for Disease Control and Prevention. The CDC found a strong link between the illnesses and vitamin E acetate, an additive in some vaping products containing THC, the psychoactive ingredient in cannabis. That ingredient has not been found in nicotine vaping pods, such as those sold by Juul. But the outbreak of illnesses drew attention to vaping’s rising popularity among young adults. More than a third of the cases involved patients between ages 18 and 25.
While combustible cigarette smoking rates have declined, nicotine vaping rates more than doubled among high schoolers between 2017 and 2019, with about a third of high school seniors reporting that they have vaped within the last 30 days, according to the National Institute on Drug Abuse’s 2019 Monitoring the Future Survey. The annual report surveys 42,500 students in grades 8, 10, and 12 at 400 public and private schools across the country. Marijuana vaping has also risen dramatically among teenagers. In response to teen vaping trends, many states and cities have pursued legislation to restrict e-cigarette sales.
Philadelphia is rolling out a ban on the sale of flavored vaping pods and those with high levels of nicotine at stores that teens and children are allowed to enter, such as 7-Eleven and Wawa, as well as smaller retailers. The FDA ban took effect Feb. 6. It affects one-time use cartridges in fruit, candy and mint flavors, which are available at convenience stores and have been popular among teens. The ban does not apply to menthol and tobacco flavors or tank-based vaping systems sold at specialty vape shops.
New Fund Helps PA Abuse Survivors Pay for Counseling Without Involving Police
Pennsylvanians who have experienced sexual assault and never reported it to police can apply for a share of $5 million to pay for counseling.
“What we have seen with the #MeToo movement, what we have seen with all the unfortunate cases that have befallen Pennsylvania — whether it’s the Jerry Sandusky case, the Bill Cosby case, the [Catholic] Archdiocese … and now we’re seeing it also with the Jehovah’s Witnesses — what that’s doing is kind of stirring up all of these old wounds that have never come forward,” said Jennifer Storm, the commonwealth’s victim advocate.
The state has previously established funds available for crime victims seeking counseling, but Storm said abuse survivors needed to have filed reports with police and claims with the state within two years from the time they gained knowledge of the abuse, which isn’t always plausible. She said the state decided to do something to address barriers to treatment when it saw the Roman Catholic Church’s response to abuse claims after the release of a historic grand jury report that outlined widespread clergy sexual abuse in six Pennsylvania archdioceses.
The church created victims’ compensation funds that put money aside for counseling, made free therapy available for survivors, and reimbursed victims if they sought private therapy before the funds were made available.
“You almost had this huge door that opened that enabled you to access funds and counseling that no other survivor in the commonwealth had,” said Storm.
That left other victims wondering: What about me?
The $5 million set aside from the state’s general fund eliminates the requirement to file a police report and has no statute of limitation.
Victims who were abused before their 18th birthday can get up to $10,000 for therapy. If the abuse occurred after turning 18, victims can access up to $5,000 for therapy with a psychiatrist, psychologist, licensed professional counselor, or licensed social worker by filling out a Sexual Assault Counseling Claim form.
Clergy abuse survivors who received financial help from the church’s compensation funds can also apply for the newly freed state dollars.
Storm said the new funds will provide help to those who have not reported their assaults to law enforcement out of fear of not being believed. According to the Rape, Abuse & Incest National Network, known as RAINN, 3 out of 4 survivors don’t report their assaults — whether out of fear of retaliation or because they thought there was not enough to report.
“It is not the norm to have an assault and then immediately report it, go to the hospital, go to law enforcement,” said Storm. “That certainly does happen, but what we know is that that’s not the norm. The norm is that there’s usually a delayed disclosure.”
But swift action is what the state’s Victims Compensation Assistance Program — the only state-sponsored financial recourse victims had until this week — requires.
VCAP offers up to $35,000 to victims of any crime — not limited to sexual abuse — and can be used to offset the costs of medical expenses, loss of earnings, and counseling. Up to $10,000 can go to therapy, depending on the victim’s age when the abuse happened.
But access to any of that money requires navigating a sometimes-retraumatizing system.
“In part, law enforcement has been a relatively hostile venue for survivors, and even when it’s supportive, it’s a very complex system to be involved in,” said Carol Tracy, executive director of the Women’s Law Project, which has long partnered with police departments to review how they handle sex crimes.
Victims are often interviewed multiple times by police, and have to go through thorough physical examinations for evidence, which is why that process has resulted in underreporting of such incidents across the country.
Survivor advocates have long argued that the quick action required of victims does not always align with how survivors respond.
As with VCAP funds, the risk of fraud is minimized through a vetting process and giving the funds directly to the treatment provider, Storm said. That medical professional is expected to confirm that the client is receiving help.
“As many of us are trying to work to reform our justice system to be more responsive to survivors of sexual assault, this is something that is an important interim measure to make sure that people do have some opportunity outside of law enforcement to get some public funds to help them,” said Tracy.
Seven people have submitted applications so far.
Connecting Medicaid Enrollees to Employment & Training Programs
Pennsylvania Department of Human Services Secretary Teresa Miller and Department of Labor & Industry Secretary Jerry Oleksiak joined PCN TV to discuss a new partnership that will connect Medicaid recipients to employment and training programs.
Medicaid Work Supports
The Medicaid Work Supports initiative will identify and connect Medicaid enrollees to resources that can help address barriers to employment and lead to more success in the workforce.
“The Wolf Administration strives to build a Pennsylvania that works for everyone, and that includes making meaningful, sustaining employment accessible to all people, particularly underserved communities that may experience greater barriers to finding and retaining employment,” said Sec. Miller. “We want all people to be able to work, but we cannot do so in a way that is punitive or risks access to the health care people need to be able to get a job. The Medicaid Work Supports initiative will create that connection to employment and training.”
The Medicaid Work Supports initiative will create a more direct and systematic introduction to employment and training resources available to Pennsylvanians. When people are deemed eligible and enroll in a new Medicaid health plan, they will be asked if they are interested in help finding a job, training programs, and opportunities to get a high school diploma or GED. The referral system will help identify this population for the first time and create the opportunity for a meaningful, encouraging partnership between the MCOs, the PA CareerLink® system, and the enrollee to facilitate connections to employment and success in the workforce.
Individuals interested in learning more about these services will receive outreach either through PA CareerLinks®, their selected health plan, or their local county assistance office to provide awareness of and referrals to resources and programs available in their local community.
DHS will work with its partners to monitor whether outreach attempts and connections to employment or training programs are being made through PA CareerLinks® and in partnership with the MCOs. This data will be used to evaluate and identify effectiveness of this referral system, opportunities for new interventions or connections, and emerging best practices as the partners gain more experience with this referral model.
“This partnership between DHS and L&I is a great example of state agencies working together to assist people,” said Sec. Oleksiak. “PA CareerLinks® matches employers with qualified and skilled candidates and helps prepare job seekers to meet local employer’s needs. Providing Medicaid recipients with a connection to the employment and training services PA CareerLinks® provide can be the first step toward individuals obtaining the skills they need to enter, or reenter, the workforce and move toward gainful employment.”
Many MCOs offer employment and education support programs for their Medicaid enrollees and are integrating remediating barriers to employment and addressing social determinants of health like housing, food security, and transportation into these programs.
PA CareerLink® has a customer-centered approach that helps prepare job seekers to meet the needs of the global economy and matches employers with qualified and skilled candidates. PA CareerLink® provides workforce services to more than 783,753 job seekers annually. In addition, over 120,000 employers post more than 212,000 jobs a year with PA CareerLink® and access a range of free services, including customized job training programs and talent matching.
The Medicaid Work Supports initiative builds upon work by DHS and L&I to redesign employment and training programs for Pennsylvanians receiving Temporary Assistance for Needy Families (TANF), many of whom are also covered by Medicaid.