Month: October 2021

Navigating Rural EMS Change

Date: October 20, 2021

Sustainable Rural EMS: Navigating Change

An Introduction and Guide

For more than five decades, rural ambulance services across the U.S. have been primarily staffed by volunteers. As volunteerism declines and rural ambulance staffing becomes more unpredictable, it would be prudent to ask if your community has an emergency medical services (EMS) problem.

 The Technical Assistance and Services Center (TASC), the Federal Office of Rural Health Policy (FORHP), and our many EMS partners are steadfast in helping communities navigate changes occurring within rural healthcare.

The Sustainable Rural EMS: Navigating Change An Introduction and Guide is designed to assist rural communities in navigating a change from unsustainable volunteer EMS and ambulance service models to sustainable ones. This guide is intended to direct community leaders through change based on a stepped process that has been used in rural communities throughout the U.S. It includes information on assessing if a community has an EMS problem, the needed ingredients to change, and a six-step process to implement change to a more sustainable model of rural EMS.

Recognizing early indicators of a problem helps ensure there is never a time when emergency medical help is needed, and no one responds. This potential situation is not hypothetical. Increasingly, rural ambulance services are being called and are unable to respond. In a survey of rural ambulance services in South Dakota in 2016, one-third reported not being able to respond because of a shortage of volunteers, and another one-third reported delays due to insufficient staffing

 

Upcoming Webinar: The State of Oral Health: Increasing Access & Reducing Disparities

Post Date: October 20, 2021

An estimated 80 million Americans currently lack access to dental care. As oral health is essential to the overall health and well-being of an individual, the large number of those without access can have potentially devastating health consequences such as an increased risk of developing cardiovascular disease, respiratory disease, chronic diseases, diabetes, and adverse pregnancy outcomes. Three main barriers to accessing dental care include coverage, provider shortages, and cultural barriers to oral health. In this webinar, we will hear from leaders in the field of oral health who are working to reduce disparities in access to and quality of care. 

Speakers will discuss:

  • Federal initiatives to reduce health disparities and advance oral health equity, while furthering oral health in pediatric populations 
  • A health plan foundation’s investment, in collaboration with the Duke Endowment, to improve oral health access in the Carolinas, including in rural communities and school-based programs

Interprofessional solutions to integrate oral health into education and care delivery models.

Speakers

Natalia Chalmers, DDS, MHSc, PhD
Centers for Medicare and Medicaid Services

Katie Eyes, MSW
Blue Cross and Blue Shield of North Carolina Foundation 

Anita Duhl Glicken, MSW 
National Interprofessional Initiative on Oral Health
University of Colorado School of Medicine 

Register Today

Event Date: November 9, 2021

Time: 1:00-2:00 PM ET

Rural Health Research Gateway

Date: October 20, 2021

The Association of Rurality and Breast Cancer Stage at Diagnosis: A National Study of the SEER Cancer Registry

Breast cancer screening is effective in early disease detection. Diagnosis of disease at an early stage results in higher cure rates and less need for aggressive treatments. Patients from rural areas have lower breast cancer screening rates and poorer cancer outcomes than urban patients. This study investigated the extent to which U.S. rural residents are diagnosed at more advanced stages of disease for breast cancer compared to non-rural residents. We found that a greater proportion of rural patients received an initial breast cancer diagnosis at a late stage compared with urban patients (14.7% compared to 13.2%, respectively) and that patients living in remote small rural counties had the highest rate of late-stage breast cancer at diagnosis (15.5% in remote small rural counties vs. 13.2% in metro counties). Other factors such as Black race and being uninsured were also associated with late stage at diagnosis. These patterns have persisted over time and suggest areas for policy change.

Contact Information:

Holly Andrilla, MS
WWAMI Rural Health Research Center
Phone: 206.685.6680
hollya@uw.edu

Click to view Research Alert

Office of Minority Health: Make Health Information Understandable During Health Literacy Month

During October, the Centers for Medicare and Medicaid Services (CMS) Office of Minority Health (OMH) recognizes Health Literacy Month. CMS encourages healthcare providers to make health information easier for their patients to understand and navigate.

Healthy People 2030—an initiative that identifies public health priorities to help individuals, organizations, and communities across the United States improve health and well-being across a 10-year timeframe—addresses both personal health literacy and organizational health literacy. According to Healthy People 2020:

  • Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
  • Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

These definitions allows for the emphasis of people’s ability to use health information rather than just understand it, focus on the ability to make “well-informed” decisions rather than just “appropriate” ones, incorporate a public health perspective into decision making, and acknowledge that organizations have a responsibility to address health literacy.

Hispanic adults have been shown to have the lowest level of health literacy among racial and ethnic groups, followed by Black adults and American Indian/Alaskan Native adults. Additionally, Spanish-speaking adults have an increased likelihood of inadequate health literacy, when compared to English-speaking adults.

Those with low health literacy are more likely to use the emergency department. And parents’ health literacy levels impact health outcomes for children.

The effects of low health literacy can be particularly pronounced for those over 65, with low health literacy possibly leading to poor physical functioning, pain, limitations of daily activities, and poor mental health status.

Resources

To mark Health Literacy Month, CMS is highlighting resources that can help providers better explain the services that are available to their patients through their health coverage:

Download the Guide to Developing a Language Access Plan, which helps assess programs and develop language access plans to ensure persons with limited English proficiency have meaningful access to care and services.

White House Rural Health Care Providers Listening Session

Posting Date: October 15, 2021

White House Rural Health Care Providers Listening Session on Access to Capital Challenges & Best Practices

Event Date: October 20, 2021

Time: 1:00 PM CT

Register

The voices of rural providers are critical as future solutions to increase access to capital for rural America’s health care delivery system are considered. This listening session offers rural health providers the unique opportunity to engage and share their valued perspectives with federal leaders from the White House Domestic Policy Council, U.S. Departments of Health & Human Services, Treasury, Agriculture, and Veterans Affairs, Small Business Administration, and Federal Communications Commission, and others representing a dedicated interagency committee focused on improving rural health. This session will inform the plans to support access to capital for rural health providers, which may include convenings and webinars with funders and finance experts or other resources.

The goal of this listening session is to hear the challenges and best practices of rural and critical access hospitals, rural health clinics, community health centers, and other rural providers in gaining access to capital for rebuilding, renovation, and overall financial viability, including short-term and long-term needs. Participating Departments want to hear what works and what doesn’t work, as well as challenges you face and best practices you’ve used. Finally, your thoughts on what would be helpful for you in navigating the funding landscape are welcomed.

Webinar: Specialty Care in the Age of COVID

Post Date: October 15, 2021

Many hospitals can’t staff out all clinical lines, especially non-procedure-based services like infectious disease, neurology, pulmonology, psychiatry, non-invasive cardiology, etc. This can be for lack of volume, lack of funds, lack of needed specialists locally, or all of the above. While this has always harmed patients and hospitals in a wide variety of financial and medical ways, in the age of COVID-19, this lack of specialist access has become catastrophic for small and rural medical facilities. With the recent changes in telemedicine coverage driven by CMS, however, hospitals have a new solution to this medical access problem: multi-specialty tele-consults. This webinar will cover the importance and benefits of offering such non-procedure based specialties locally, especially at hospitals dealing with the influx of COVID-19 patients; explore how recent coverage changes for multi-specialty tele-consults allow hospitals to bridge the medical access gap in a financially attractive manner; and answer questions around the logistics and implementation of such a service.

LEARNING OBJECTIVES:

  1. Understand the various negative medical and financial impacts of not offering key non-procedure based specialties locally, especially during COVID.
  2. Understand the recent changes in Medicare and other Payors’ telemedicine coverage and what that means for hospitals’ physician coverage options.
  3. Understand the options available for specialty tele-consults, especially for hospitals looking to provide immediate access to commonly needed specialty support for COVID patients, specifically in infectious disease & pulmonology (proper treatment and drug protocols, vent management for hospitals unused to keeping intubated patients, etc.) Additional tele-specialty coverage options to deal with COVID-19 driven peripheral needs, such as neurology, cardiology, nephrology, and psychiatry, will also be covered.
  4. Understand the logistics and technology involved in setting up a multi-specialty tele-consult service, and best practices for implementation.
  5. Understand what medical and financial benefits hospitals that have implemented remote specialty coverage have seen, including how this type of support can help facilities treat higher acuity patients locally, and related best practice takeaways.

Event Date: October 28, 2021

Time: 12:00 PM – 1:00 PM CT

Join the Day of the Webinar

Meeting ID: 889 7714 7714 Passcode: 641919

Federal Office of Rural Health Policy Announcements

Date: October 14, 2021

JAMA: Birth Volume and Geographic Distribution of U.S. Obstetric Hospitals, 2010 – 2018. In an open-access article from the Journal of the American Medical Association (JAMA), researchers report that, among more than 34 million hospital births in the U.S., 37.4 percent of the hospitals were low volume. Among low-volume hospitals, 18.9 percent were isolated and 58.4 percent of these were rural.

New Plan and Policy Statement for Climate Impacts on Health. Last week, the Department of Health and Human Services (HHS) revealed its roadmap for assuring that all parts of the Department address the effects that climate change can have on health and well-being. The plan is in response to an Executive Order for a whole-of-government approach to confronting the crisis that includes extreme weather, rising temperatures and sea levels, and increases in levels of carbon dioxide.

New Spanish Language App Helps Latinos With Health Care. A report from the Department of Health and Human Services (HHS) shows that insurance coverage and access to care improved significantly for Latinos between 2013 and 2016, but they still have among the highest uninsured rate of any racial or ethnic group within the U.S. To build on progress, HHS launched a Spanish version of its QuestionBuilder app, which can help Latino patients prepare for their in-person or telehealth appointments. The Agency for Healthcare Research and Quality built the app to help users improve their interaction with clinicians, providing questions they might want to ask with links to helpful resources. The 2020 Census reports that Hispanics are the second most prevalent racial or ethnic group in rural America, comprising 10.4 percent of the rural population. 

Rural Doulas Supporting Maternal and Infant Health. The latest feature article in The Rural Monitor spotlights a New Mexico doula program that reaches American Indian, Hispanic, and other populations who lack nearby labor/delivery units, a Minnesota program helping moms experiencing incarceration, and a North Dakota program training postpartum doulas to care for families impacted by opioid use disorder and other substance use.