The Centers for Disease Control and Prevention (CDC) released the new Urban-Rural Classification Scheme for Counties. Click here for information to rural definition eligibility for rural grants.
HHS Announces Transformation to Make America Healthy Again
HHS issued a press release with initial information about the restructuring and downsizing of the Department. PACHC issued a statement. Key points for PCAs and CHCs include:
·    In total, HHS will reduce its staff by about 25%, from 82,000 to 62,000 FTE. About 10,000 employees have already separated from HHS since the start of the second Trump Administration, and another 10,000 will be receiving Reduction-in-Force (RIF) notices soon. No details are yet available about where these Reductions in Force (RIF) will occur.
·    HRSA will be absorbed into a new larger agency called the Administration for a Healthy America, or AHA. The other organizational entities being folded into AHA are:
o The Office of the Assistant Secretary for Health (OASH), which includes the Title X program, the Office of the Surgeon General, the Healthy People 2030 initiative, etc.
o The Substance Abuse and Mental Health Services Administration (SAMHSA), which is being downsized 50%.
o Agency for Toxic Substances and Disease Registry (ATSDR).
o The National Institute for Occupational Safety and Health (NIOSH), which is currently a research entity within the CDC. Note that NIOSH is different from OSHA.
There is no information on how this new agency will be structured, where it will be located, or who will lead it. However, HRSA is the largest agency being folded into AHA, and Health Centers are the largest program within HRSA, so it is expected that Health Centers will have a prominent role within the new AHA.
·    Regional offices are being downsized from 10 offices to 5 offices, but there is no definitive information yet on which ones are being eliminated. Based on a previous announcement from the HHS Office of the General Counsel, we expect that the Philadelphia, Atlanta, Kansas City, and Denver will remain, but it’s unclear where the fifth office will be.
Here are some additional points of interest:
·    A new office of the Assistant Secretary for Enforcement is being created, “to combat waste, fraud, and abuse in federal health programs.” It will include the HHS Office for Civil Rights (OCR) and oversee Departmental and Medicare hearings.
·    The CDC is not being broken up. Instead, the Administration for Strategic Preparedness and Response (ASPR), which leads HHS’ response efforts to national disaster and public health emergencies, will be transferred to the CDC.
In the press release, HHS Secretary Kennedy states that, “We aren’t just reducing bureaucratic sprawl…. This Department will do more – a lot more – at a lower cost to the taxpayer.” They estimate that the downsizing will save about $1.8 billion annually.
NGA Issues Statement on Potential Medicaid Funding Reductions Â
On March 6, National Governor’s Association (NGA) Chair Jared Polis (D-CO) and Vice Chair Kevin Stitt (R-OK) released a statement highlighting governors’ concerns over proposed Medicaid funding reductions in federal budget negotiations. The governors emphasized the need for state flexibility in administering Medicaid, SNAP, and TANF programs, warning that cuts without consultation could strain state budgets, impact rural hospitals, and disrupt healthcare providers. NGA urged Congress to ensure that governors have a voice in discussions on Medicaid policy changes and emphasized the importance of preserving state flexibility in delivering these programs. Read the full statement.
Telehealth Extended Six Months
Recent legislation authorized an extension of many of the Medicare telehealth flexibilities. This includes:
·        Waiving geographic and originating site requirements through Sept. 30, 2025.
·        Allowing eligible practitioners to furnish telehealth services through Sept. 30, 2025.
·        Allowing Federally Qualified Health Centers and Rural Health Clinics to serve as distant site providers through Sept. 30, 2025.
·        Delaying in-person requirements for tele-mental health services through Sept. 30, 2025.
·        Allowing audio-only telehealth through Sept. 30, 2025.
Click here for Telehealth Policy Updates.
U.S. Senate Bipartisan 340B Working Group Announces New Members
U.S. Senators Jerry Moran (R-KS), Tammy Baldwin (D-WI) and Shelley Moore Capito (R-WV) welcomed Sens. Tim Kaine (D-VA), Markwayne Mullin (R-OK) and John Hickenlooper (D-CO) as new members of the Senate 340B bipartisan working group. The Senate 340B working group was founded to advance bipartisan policy solutions that would make certain the program can continue to achieve its intended goal of supporting hospitals serving vulnerable populations like rural communities. Past work by the Senate 340B bipartisan working group:
·        In February 2024, the 340B working group released a legislative discussion draft and supplemental request for information which included solutions to improve the 340B program.
·        In 2023, the working group requested feedback from stakeholders on ways to improve the 340B program through bipartisan policy solutions.
Democrats Retain Majority in Pennsylvania House after Special Election
Democrats swept the pair of special elections to fill vacancies in the state Senate and House. With the win in the House special election, Democrats will retain their razor-thin majority in that chamber with 102 Democrats and 101 Republicans. The results in that House race were hardly surprising; the district leans heavily towards the Democrats. In that race, Dan Goughnour got 63% of the vote to defeat the Republican nominee Charles D. Davis. In the Senate special election, the narrow win by James Malone means Democrats flipped the district, last held by former Sen. Ryan Aument, R-Lancaster. Despite that win, Republicans still hold the majority in the state Senate.
DOJ, HHS Expand Buprenorphine Treatment via Telemedicine; Effective Date Delayed
On Monday, the Federal Register published two final rules from the U.S. Department of Justice (DOJ) and Department of Health & Human Services (HHS) titled “Expansion of Buprenorphine Treatment via Telemedicine Encounter” and “Continuity of Care via Telemedicine for Veterans Affairs Patients.” Originally scheduled to go into effect on March 21, 2025, the rules were delayed by a “Regulatory Freeze Pending Review.” Following comments from the public received by the DOJ’s Drug Enforcement Agency, the effective date of both final rules is moved to December 31, 2025.
Change in Start Date for HRSA Rural Health Care Services Outreach Program
While not accepting any new applications for this Notice of Funding Opportunity that closed on January 27, HRSA is notifying existing applicants that the expected start date has been changed from May 1 to August 1, 2025. We anticipate that successful applicants will be notified of grant funding in July 2025. We plan to fund awards in 12-month budget periods for a total four-year period of performance from August 1, 2025 to July 31, 2029. Please note that the program and awards depend on the appropriation of funds and are subject to change based on the availability and amount of appropriations. HRSA plans to make approximately 50 awards to support rural communities to expand the delivery of health care services. Approximately 40 awards are for the program’s regular track to support rural community identified healthcare needs, and approximately 10 awards under the program’s special track to address to heart disease, cancer, unintentional injury/substance use, chronic lower respiratory disease, stroke, and maternal health
With Few Dentists and Fluoride Under Siege, Rural America Risks New Surge of Tooth Decay
In the wooded highlands of northern Arkansas, where small towns have few dentists, water officials who serve more than 20,000 people have for more than a decade openly defied state law by refusing to add fluoride to the drinking water.
For its refusal, the Ozark Mountain Regional Public Water Authority has received hundreds of state fines amounting to about $130,000, which are stuffed in a cardboard box and left unpaid, said Andy Anderson, who is opposed to fluoridation and has led the water system for nearly two decades.
This Ozark region is among hundreds of rural American communities that face a one-two punch to oral health: a dire shortage of dentists and a lack of fluoridated drinking water, which is widely viewed among dentists as one of the most effective tools to prevent tooth decay. But as the anti-fluoride movement builds unprecedented momentum, it may turn out that the Ozarks were not behind the times after all.
“We will eventually win,” Anderson said. “We will be vindicated.”
Fluoride, a naturally occurring mineral, keeps teeth strong when added to drinking water, according to the Centers for Disease Control and Prevention and the American Dental Association. But the anti-fluoride movement has been energized since a government report last summer found a possible link between lower IQ in children and consuming amounts of fluoride that are higher than what is recommended in American drinking water. Dozens of communities have decided to stop fluoridating in recent months, and state officials in Florida and Texas have urged their water systems to do the same. Utah is poised to become the first state to ban it in tap water.
Health and Human Services Secretary Robert F. Kennedy Jr., who has long espoused fringe health theories, has called fluoride an “industrial waste” and “dangerous neurotoxin” and said the Trump administration will recommend it be removed from all public drinking water.
Thriving PA Releases New Early Intervention Fact Sheet
Thriving PA released a new Infant and Toddler Early Intervention fact sheet, aimed at educating policymakers about the program as part of our advocacy for the 2025-26 budget cycle. The fact sheet notes services and benefits provided by EI and highlights state-specific data. In the 2022-23 school year, 48,199 children were served by the program in Pennsylvania.
Thriving PA supports, at minimum, the Administration’s proposed increase of $16.2 million for the Infant/Toddler Early Intervention program as part of a final FY 2025-26 budget package. The proposed increase would provide $10 million for a long-overdue rate increase for providers and serve an additional 3,000 children and their families. This increase is a first step in addressing the workforce shortage of Early Intervention providers. Additional support beyond the $16.2 million is recommended, as we estimate $49 million in new funding is needed this year to address increased costs to the program and the projected children served.