CDC Reports on Suicide Rates; Largest Increase Among Native American Women.  The Centers for Disease Control and Prevention (CDC) has identified suicide as one of the leading cause of death in the U.S.  Suicide rates increased by 33 percent between 1999 and 2017, but the largest increase occurred for non-Hispanic American Indian or Alaska Native women, up 139 percent.

Sens. Amy Klobuchar, (D-Minn.), Gary Peters, (D-Mich.), and John Thune (R-S.D.) recently introduced the Broadband Deployment Accuracy and Technological Availability Act, which is intended to improve the accuracy of the Federal Communications Commission’s broadband availability maps by improving the broadband data collection process. “Broadband maps are a critical tool in our effort to close the digital divide in rural areas like those throughout my home state of South Dakota, but they are only as good as the data that’s used to produce them,” Thune says. Additionally, the U.S. Senate on June 5 passed by unanimous consent a bipartisan bill offered by Sen. Shelley Moore Capito (R-W.Va.), to conduct an assessment and analysis of the effects of broadband deployment and adoption on America’s economy.

The Health Resources and Services Administration (HRSA) has released the seventh preliminary report on automatic Health Professional Shortage Area scores (auto-HPSAs). Uses may have noticed in their scores that the Nearest Source of Care (NSC) for primary care, dental or behavioral health was inaccurate. According to the Pennsylvania Department of Health (DOH), which serves as the commonwealth’s Primary Care Office, HRSA knows that most of the NSCs for the auto-HPSAs are not correct. DOH is unable to change those providers, however, until after the national update when the HRSA auto-HPSA portal will be available to change the NSC and submit supplemental documentation. The national update will take place when the preliminary scores become official and take the place of the current scores. Information provided about NSCs cannot be entered since the portal is not yet available, so DOH is asking Community Health Centers to wait until after the national update to request a change. This will help DOH track, comply and best change requests. To request a change, please send an email to Belinda Williams, Public Health Program Administrator, at belwilliam@pa.gov.

The Health Resources and Services Administration (HRSA) is still accepting feedback for the Health Center Program Service Area Considerations Request for Information (RFI) that may inform HRSA decisions regarding Health Center Program expansion through an existing health center’s addition of new service delivery sites. The deadline is Monday, July 8. HRSA welcomes feedback on the following areas of consideration: unmet need; proximity; reasonable boundaries for service area; consultation with other local providers; demonstrated capacity and performance in existing service area; and insuring patient input/representation. Share your thoughts and thank you to those who have already submitted input.

At the start of every year, the Health Care Advisory Board conducts the Advisory Board Research Annual Health Care CEO Survey to identify the top strategic priorities for hospital and health system leaders. The survey found that 57% ranked improving ambulatory access a high priority, while strengthening primary care alignment and redesigning systems for population health were also ranked as high priorities by more than half. Read more.

Health Professional Shortage Area (HPSA) scores for National Health Service Corps scholars in Class Year 2020 have once again gone up, making the list of eligible sites even smaller. Priority for assignment of NHSC scholars at NHSC-approved sites is as follows:

• Primary medical care HPSAs with scores of 19 and above are authorized for the assignment of NHSC scholars who are primary care physicians, primary care nurse practitioners, or primary care physician assistants; primary medical care HPSAs with scores of 16 and above are authorized for the assignment of NHSC scholars who are certified nurse midwives.
• Mental health HPSAs with scores of 21 and above are authorized for the assignment of NHSC scholars who are psychiatrists; mental health HPSAs with scores of 19 and above are authorized for the assignment of NHSC scholars who are mental health nurse practitioners or mental health physician assistants; and
• Dental HPSAs with scores of 19 and above are authorized for the assignment of NHSC scholars who are dentists.

The NHSC has determined that the minimum HPSA scores listed above for all service-ready NHSC scholars will enable it to meet its statutory obligation to identify a number of entities eligible for NHSC scholar assignment that is at least equal to, but not greater than, twice the number of NHSC scholars available to serve in the 2020 class year. Read more on the HRSA website.

The School-Based Health Alliance is the national school-based health care advocacy, technical assistance, and training organization based in Washington DC. The Alliance works to improve the health of children and youth by advancing and advocating for school-based health care. As youth-friendly and accessible settings, school-based health centers (SBHCs) are uniquely positioned to deliver high quality, confidential services that equip children and adolescents with the information, tools, and support they need to be healthy and safe where they are, when they need it… in school.  Visit the website to access resources and learn more. Also stay tuned as PACHC is working with the School-Based Health Alliance to offer a webinar on Adolescent Motivational Interviewing sometime in July.

Online Training and Resources for Rural First Responders.  The Rural Domestic Preparedness Consortium provides free online training and resources to help rural communities plan for and respond to mass injuries and fatalities.  Supported by The Center for Rural Development, the site provides self-paced online training and scheduled, in-person training that has been certified by the U.S. Department of Homeland Security.

Comments Requested:  CMS Issues Draft Guidance on Hospital Co-location – July 2. The Centers for Medicare & Medicaid Services (CMS) seeks public input on draft guidance regarding how CMS and State Agency surveyors will evaluate a hospital’s co-location of space and staff when assessing the hospital’s compliance with the Medicare Conditions of Participation (CoPs).  It clarifies that sharing of staff may be done through a contractual arrangement where there are clear lines of authority and accountability and that sharing public areas, such as entrances and waiting rooms, would be permissible. RHIhub highlights several programs in rural communities that have used co-location of services and staff to improve efficiencies, including lessons learned about this approach.  See Events section below for an upcoming session on this topic.

(June 19, 2019)  Laurel Fork, VA—FCC Commissioner Brendan Carr visited a community health care clinic in rural Laurel Fork, Virginia which sits in the southwest corner of the state.  Carr announced that the FCC will be voting at its July 10th meeting to advance a $100 million Connected Care Pilot Program to support telehealth for low-income Americans across the country, including those living in rural areas and veterans.  At the clinic, two patients with diabetes demonstrated how they are using remote monitoring technologies to improve their health.

“With advances in telemedicine, health care is no longer limited to the confines of traditional brick and mortar health care facilities,” said Commissioner Carr.  “With an Internet connection, patients can now access high-quality care right on their smartphones, tablets, or other devices regardless of where they are located.  I think the FCC should support this new trend towards connected care, which is the healthcare equivalent of moving from Blockbuster to Netflix.  That’s why the FCC will vote to advance my $100 million pilot program at our July 10 meeting.  It will focus on ensuring that low-income Americans and veterans can access this technology.  Particularly in rural communities like Laurel Fork, where the nearest hospital is in a different state, access to telehealth can make a life-saving difference.”

“In Laurel Fork, telehealth is already delivering results,” continued Carr.  “Diabetes patients here that participated in a remote telehealth program saw their A1C levels decline by 2.2 points on average, which significantly reduced their risk of renal disease, heart disease, and death caused by those conditions.  Through the Connected Care Pilot Program, the FCC can build on the success of projects like these, which are helping create a model for the adoption of connected care technologies and bridging the doctor divide in rural America.”

The FCC will vote on a Notice of Proposed Rulemaking at its July Open Meeting that seeks comment on:

• Budgeting for $100 million in USF support for health care providers to defray the qualifying costs of connected care services for low-income patients, including people in medically underserved areas and veterans.
• Targeting support for innovative pilot projects to respond to a variety of health challenges, including diabetes management, opioid dependency, high-risk pregnancies, pediatric heart disease, and cancer.
• Providing an 85% discount on qualifying services for a three-year period with controls in place to measure and verify the benefits, costs, and savings associated with connected care technologies.
• Collecting relevant data to enable stakeholders to better understand the impact of telehealth and consider broader reforms that can support the trend toward connected care.

Connected care has resulted in substantial savings, particularly in the management of chronic diseases, which account for over 85% of direct health care spending in the U.S.:

• A remote patient monitoring trial in the Mississippi Delta resulted in nearly $700,000 in annual savings due to reductions in hospital readmissions alone.  Assuming just 20% of Mississippi’s diabetic population enrolled in this program, annual Medicaid savings in the state would be $189.
• The Veterans Health Administration’s (VHA) remote patient monitoring program cost $1,600 per patient compared to more than $13,000 per patient for VHA’s home-based primary services.
• A telehealth project in the Northeastern U.S. found that every $1 spent on remote monitoring resulted in a $3.30 return in savings.
• Analysts estimate that the widespread use of remote patient technology and virtual doctor visits could save the American health care system $305 billion annually.

Connected care technologies are also improving health outcomes for patients:

• A study of 20 remote patient monitoring trials found a 20% reduction in all-cause mortality and a 15% reduction in heart failure-related hospitalizations.
• The VHA’s remote patient monitoring program resulted in a 25% reduction in days of inpatient care and a 19% reduction in hospital admission for more than 43,000 veterans with conditions like hypertension, congestive heart failure, chronic obstructive pulmonary disease, depression, and PTSD.
• One remote patient monitoring initiative showed a 46% reduction in ER visits, a 53% reduction in hospital admissions, and a 25% shorter length of stay.

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For press inquiries, contact Evan Swarztrauber at evan.swarztrauber@fcc.gov or (202) 418-2261.

Office of Commissioner Brendan Carr: (202) 418-2200

Twitter: @BrendanCarrFCC

www.fcc.gov/about/leadership/brendan-carr