From Modern Healthcare

The steep rise in rural hospital closures over the past decade is hurting many emergency medical service providers, worrying public experts tracking response times.

The average length of ambulance trips increased by 22% among municipally-run, EMS agencies and 10% among privately-owned providers between 2012 and 2018 in locations where a recent rural hospital closure took place, according to a new study from the University of Minnesota School of Public Health.

The actual number of trips those providers made did not change during the study period. But the analysis found rural EMS providers decreased their number of non-emergency and inter-facility transfer trips by 31%. Lead study author Sayeh Nikpay, associate professor in the division of health policy and management at the University of Minnesota School of Public Health, said the drop in planned trips made it harder for EMS providers to dispatch ambulances in a way that ensured communities had adequate coverage.

“Taking someone from the community to a hospital-based clinic is more predictable and has the benefit of bringing people in the community access to their primary care,” Nikpay said.

Nikpay said the burden of hospital closures is particularly acute among municipal EMS providers. While private firms have the option to discontinue providing ambulance services when it no longer is financially viable, municipal agencies are forced to adjust, which Nikpay said often leads to limited resources and personnel that can affect the quality of those services.

“It’s difficult for EMS agencies to retain people, to recruit new people, and the people that are there feel a lot of strain,” Nikpay said.

Researchers said the problems facing rural public EMS agencies is a growing public health concern. It’s putting more wear and tear on their equipment and increasing the “dead time” being spent traveling back to ambulance bases. EMS providers also have less time to restock and maintain vehicles.

Nikpay said the strain on rural EMS providers has only been exacerbated by the pandemic.

Last year, 19 rural hospitals closed, according to figures from the Cecil G. Sheps Center for Health Services Research at the University of North Carolina-Chapel Hill, the highest number for a single year since the center began tracking. Overall, 180 rural hospitals have closed since 2005, with more than three-fourths occurring since 2010.

Nikpay said the study’s findings suggest policymakers need to also look at ways of supporting EMS providers when addressing issues related to bolstering the country’s rural healthcare system.

“We shouldn’t just be thinking about the hospitals when we talk about rural healthcare, we should also think about the EMS agencies as well,” Nikpay said.

In 2009, the last time federal agencies gave away billions of dollars for broadband, there were two agencies tasked with dispensing roughly $3.5 billion each. They had a year and a half to do what was then considered miracle work pushing that that much money out the door that quickly. Sometimes it wasn’t pretty, but they got it done.

Today, the Federal Communications Commission (FCC) is responsible for dispersing more than three times as much money through E-rate and the Emergency Broadband Benefit (EBB) programs. The money comes with a mandate to act as quickly as possible.

So things are predictably frantic, the rules are not particularly clear, and there’s a lot of wailing and gnashing of teeth about incumbents (the local telecommunications companies that were in place before deregulation in 1996) lining up at the “socialist trough.”

Read more.

Although the U.S. saw its lowest birth rate in 50 years in 2020, that may not necessarily mean a dramatic decline in rural populations.

According to a recent report from the Centers for Disease Control and Prevention (CDC), more than 3.6 million babies were born last year in the U.S., Puerto Rico and the Northern Marianas, the study said, a decline of four percent over 2019. It’s the sixth year in a row that birth rates have declined.

That puts the U.S. total fertility rate, an estimate of how many babies a group of 1,000 women would have during their lifetime, at “below replacement” levels.

USDA’s Farm Service Agency released the first notice of funding availability announcing loan payments for eligible borrowers with qualifying direct farm loans. The notice will be published in the Federal Register early next week.

“A subsequent notice addressing guaranteed loan balances and direct loans that no longer have collateral and have been previously referred to the Department of Treasury for debt collection for offset, will be published within 120 days,” the department said.

The $1.9 trillion American Rescue Plan enacted in March required USDA to make payments worth 120% of the qualifying farmers’ indebtedness and included $4 billion for that purpose. The payments are intended to both pay off the loans and to cover the related taxes and fees.

The payments will be broken into two steps, USDA said, including a 20% direct deposit for taxes and fees, and then loan payment from Treasury to USDA to clear the debt.

“The American Rescue Plan has made it possible for USDA to deliver historic debt relief to socially disadvantaged farmers and ranchers beginning in June,” Agriculture Secretary Tom Vilsack said. “USDA is recommitting itself to gaining the trust and confidence of America’s farmers and ranchers using a new set of tools provided in the American Rescue Plan to increase opportunity, advance equity and address systemic discrimination in USDA programs.”

Under the law, Black, Latino or Hispanic, Native American or Alaskan Native, and Asian American or Pacific Islander producers are eligible for the payments. About 85% of the approximately 16,000 qualifying loans affected are direct loans.

More information is available at www.farmers.gov/americanrescueplan.

Pennsylvania Agriculture Secretary Russell Redding and Aging Secretary Robert Torres announced steps to increase access to Pennsylvania’s Senior Food Boxes, a supplemental food program available free to lower income seniors. Giving the program a new name and removing proof of income requirements are among the barriers to participation the state is removing, with the goal of encouraging seniors to take advantage of the program.

Formally known as Commodity Supplemental Food Program, the program previously required seniors to provide documented proof of their income when they applied to receive a food box. The new procedure requires only a statement of income.

“We want to take hunger off the table for Pennsylvania’s seniors. They shouldn’t be worrying about whether to eat or pay for utilities and prescriptions,” said Redding. “They’ve supported their families or communities for a lifetime, and we want to support them now.

“This is why we’ve removed income verification as a requirement for the Senior Food Box, we want it to be as easy as possible to receive. So now, just indicate on the application form that you are eligible for help and you’ll receive it,” added Redding.

The Pennsylvania Senior Food Box is a product of the federally funded Commodity Supplemental Food Program. It works to improve the health of low-income seniors by providing a supplement to groceries of a variety of nutritious, shelf-stable products including shelf-stable fluid milk, juice, ready-to-eat cereal, rice, pasta, dry beans, peanut butter, canned meat, poultry, or fish, and canned fruits and vegetables. The Senior Food Box is a perfect supplement to other food assistance programs in Pennsylvania such as the Supplemental Nutrition Assistance Program (SNAP) and the Pennsylvania Senior Farmers Market Nutrition Program, which provides seniors with fresh, Pennsylvania-grown fruits and vegetables from summer through fall.

More than 300,000 Pennsylvania seniors are eligible for the Pennsylvania Senior Food Box, but only about 35,000 are enrolled to receive it this year. Seniors often face barriers to access for food assistance programs such as mobility, technology, and stigma. This food box program aims to overcome those barriers by being available for drop off or drive through in addition to pick up and, now, by reducing stigma and red tape with the removal of income verification requirements.

“Supporting older adults with the nutritious foods they need requires us to understand the challenges they face in their daily lives and provide options to overcome these challenges. We want seniors to have sufficient food and a stable meal routine that enables good health, independence and a positive quality of life,” said Aging Secretary Robert Torres. “I am pleased to support the Department of Agriculture’s efforts to make this important food assistance program more accessible, and I urge eligible seniors to take advantage of it through the many options available.”

Food insecurity and hunger can have harmful impacts on the health and well-being of older adults. Poor food intake can cause nutrition deficiencies that increase disease risk or worsen existing conditions. Consuming fewer calories and nutrients can also decrease independence and the ability to remain home without assistance.

State Senator Carolyn Comitta, member of the Senate Agriculture and Rural Affairs Committee and supporter of the Chester County Food Bank, joined Redding and Torres at Kings Terrace.

“It’s vital that senior citizens can easily access nutritious food to help ensure their health, well-being, independence, and happiness,” said Comitta. “This program is another tool we have to combat hunger among seniors. Seniors should know that food boxes are readily available and safely accessible in their communities.”

Pennsylvania’s Senior Food Box Program is administered on behalf of the Department of Agriculture by Hunger-Free Pennsylvania through their network of 17 food banks serving all 67 counties. Once signed up, eligible seniors can choose to receive their monthly box via pick up, drive-through, or delivery from a program partner including senior apartment complexes, senior community centers, and food pantries.

“Seniors are the greatest generation. They survived the Great Depression of the ‘30’s, World War II, and the Korean War,” said executive director of Hunter-Free Pennsylvania Sheila Christopher. “Now, hundreds of thousands find themselves without enough food on their table. The PA Senior Food Box is available to help. Help us help them.”

The Senior Food Box is available for anyone age 60 or above whose household income is at or below 130 percent of the U.S. poverty level. That totals $16,744 annually for a household of one, or $22,646 for a household of two.

To apply, seniors may call 800-468-2433 to be directed to the regional food bank distributing the Senior Food Box in their county. Or go online at agriculture.pa.gov/seniorfoodbox and fill out the Senior Food Box Application Form.