Lance's Corner

NYSDOH Highlights Rural Health Care Improvements

Nov 22, 2024

Per the notice below, the New York State Department of Health (NYSDOH) is highlighting efforts to improve health care in rural communities.

New York State Announces Efforts to Improve Heath Care in Rural Communities

State-Funded Initiatives to Bolster Care and Expand in Rural Communities Highlighted During National Rural Health Day

New York State today highlighted efforts that are underway to bolster physical and behavioral health care and expand services for rural populations, which often encounter barriers to these services.  On National Rural Health Day, the state Department of Health, Office of Mental Health, and Office of Addiction Supports and Services detailed investments into services and supports that will help New Yorkers in rural areas access critical physical, mental and behavioral health care.

"Access to health care is vital to all New Yorkers and the State Department of Health is committed to bringing high quality health care and medical services to rural communities and creating career opportunities for the dedicated individuals who work in health care fields," Health Commissioner Dr. James McDonald said.  "National Rural Health Day is an opportunity to acknowledge the unique health needs of rural communities and the importance of providing access to local care."

"A critical part of our effort to strengthen New York State's mental health care system is focused on bringing services to underserved areas, which includes many of our rural communities," OMH Commissioner Dr. Ann Sullivan said.  "We are developing and expanding specialized programs to bring mental health care to those New Yorkers who do not currently have easy access to needed services.  Under Governor Kathy Hochul's leadership, we are making transformation investments that are helping individuals and families live and thrive in the rural areas of our state."

"People in rural areas have historically faced barriers trying to access addiction care, and we continue to work hard to expand and enhance vital services in these areas," OASAS Commissioner Dr. Chinazo Cunningham said.  "Working with our partners in government, and in the local communities, New York State is focused on continuing these important efforts so that all New Yorkers, no matter where they live, have access to the services and resources they need to keep themselves and their family healthy."

Rural communities often face numerous healthcare challenges, including having limited access, provider shortages, an aging population, and individuals with complex needs.  Founded by the National Organization of State Offices of Rural Health, National Rural Health Day honors the dedication of rural providers and other stakeholders tackling the challenges faced in these areas.  New York State has roughly 43,000 square miles of rural land area, according to U.S. Census statistics.  About 3.4 million New Yorkers – more than 17 percent of the state's population – live in areas considered rural.

Supporting Health Care

The state Department of Health provided 67 awards of $49,999 to rural organizations as part of the federal Centers for Disease Control and Prevention's COVID-19 Health Disparities grant.  Also funded through this initiative were five mobile health vehicles to provide services in rural areas, $1 million through four large wellness contracts, and more than $22,000 in personal protective equipment to communities designated as rural.  The Department of Health also provided grants to 31 rural health networks to provide innovative, locally driven, and evidence-based solutions to increase access to care.  These networks focus on issues such as transportation, chronic disease management, workforce, food insecurity, substance abuse overdose prevention, access to health insurance and prescription medications, health literacy, oral health, tobacco cessation, and suicide prevention.  In addition, the Department of Health provided support this year to 44 rural hospitals for activities focused on quality and financial improvement, equipment purchases, health information technology, facility renovations, provider recruitment, and service development.  This group included 21 Critical Access Hospitals, which provide affordable and accessible healthcare services to rural communities.  To help rural healthcare facilities develop a steady pipeline of high-quality workers, the Department of Health recently awarded more than $4.7 million in training capacity grants to help train nurses, physician assistants, and other direct care professionals.  Recipient facilities serve rural communities in Cayuga, Chemung, Orleans, Rensselaer, Steuben, Tompkins, and Washington counties.  The Department of Health's Doctors Across New York Physician Loan Repayment and Practice Support Program provided awards to 140 physicians practicing in rural counties this year.  This state-funded program provides physicians with up to $120,000 for their three years of service.  Likewise, the Nurses Across New York Loan Repayment Program provided 57 awards to professionals who practice in rural communities.  Also state-funded, this program provides registered and licensed practical nurses up to $25,000 for their three years of service.  The Primary Care Service Corps Loan Repayment Program this year issued awards to 24 professionals practicing in rural counties.  This program provides up to $60,000 for dentists and $30,000 for other health care workers, including dental hygienists, nurse practitioners, physician assistants, midwives, clinical psychologists, licensed clinical social workers, licensed marriage and family therapists, and licensed mental health counselors who practice in a National Health Service Corps site.

Mental Health Services

Governor Hochul secured a landmark $1 billion investment to strengthen New York's mental health care system in the FY 2024 State budget, and then $250 million in additional funding in the FY 2025 budget.  As a result, the Office of Mental Health has been able to expand specialized programs that are designed to reach New Yorkers that are either disconnected from or don't access traditional forms of care.  As part of this effort, New York State is tripling the number of Certified Community Behavioral Health Clinics, which provide comprehensive services and coordinate care across behavioral, physical health, and social service systems.  This fall, OMH awarded six upstate service providers $265,000 in first year start-up funding to establish new clinics in Cortland, Livingston, Yates, Ulster, Fulton County, Jefferson, and Niagara counties – each serving rural communities.  These clinics offer care to any individual needing assistance for mental health or substance use, regardless of their ability to pay, place of residence, or age.  Developed in partnership with OASAS, these clinics will expand access to care for individuals experiencing substance use or mental health issues, by providing an array of coordinated services including crisis intervention, screening and assessments, and treatment planning.  OMH also greatly expanded the Safe Options Support or 'SOS' program to include rural areas of upstate New York, including areas where traditional services are often lacking for individuals experiencing homelessness.  The SOS program uses multidisciplinary teams and Critical Time Intervention – an evidence-based practice that helps connect vulnerable individuals in crisis to housing and supports – to work with individuals experiencing homelessness and strengthen their skills and support network so that they can be successfully housed.  New York State invested $15 million over five years to establish three new teams to cover largely rural counties in Central New York and the Southern Tier.  SOS teams are now canvassing and taking referrals from Steuben, Chemung, Tioga, Tompkins, Cortland, Onondaga, and Oswego counties, providing a path for unsheltered New Yorkers to get the support they can rely on to achieve stability in their lives.  Similarly, OMH has expanded adult Critical Time Intervention teams to help New Yorkers in rural areas who have not been successfully engaged in services during periods of transition in their care, such as from a hospital back into the community.  Earlier this year, the agency awarded $5.6 million over five years to establish three teams that will begin serving individuals living in Jefferson and Lewis counties in the North Country; Montgomery, Fulton, Otsego, and Schoharie counties in the Central New York region; and Broome, Chenango, Tioga, and Delaware counties in the Southern Tier in January 2025.  OMH also invested $818,000 over five years to establish a new Assertive Community Treatment or 'ACT' team dedicated to serving underserved rural areas and ensuring that New Yorkers with serious mental illness receive critical mental health services in their community, rather than a more restrictive hospital setting.  The rural ACT team will provide in-community services to individuals who need it most, bringing a person-centered, recovery-based approach to their care.  Earlier this year, OMH reconvened the Suicide Prevention Task Force with the goal of strengthening public health approaches in the state's suicide prevention strategy and with a specific charge to look at special populations in New York, including rural communities.  The agency is also working closely with NY FarmNet, which provides free and confidential services to promote financial and emotional wellness in rural farming communities.  In addition, OMH awarded $20,000 from the New York State Tax Check-Off Fund this year to help reduce mental health stigma in Southern Erie, Chautauqua, and Cattaraugus counties and reach the Indigenous population living in Western New York.  Harmonia Collaborative Care, an Erie County-based service provider, will work with rural youth to shape short public health videos for social media that are aimed at reducing mental health stigma and increasing awareness and access to supports among rural, Native American, and youth populations.

Addiction Services

New Yorkers living in rural areas often must travel long distances to find addiction services that suit their needs –something that can pose a significant barrier to care.  OASAS is developing Mobile Medication Units, which provide the same services as brick-and-mortar opioid treatment programs, such as treatment for addiction.  This includes medication, which has been shown to reduce the risk of overdose deaths by as much as 50 percent, as well as prevention, harm reduction, and recovery services and resources.  OASAS has also made significant strides in getting harm reduction supplies statewide, including rural areas.  To date, the agency has distributed more than 12 million fentanyl test strips, nearly 9 million xylazine test strips, and more than 212,000 naloxone kits for free through an online ordering portal.  OASAS has also expanded comprehensive outpatient and opioid treatment program clinics, which provide medication for addiction treatment and other addiction services in one location.  There are now 37 in operation, with many focused on delivering life-saving care in rural areas.  The agency also provides direct treatment through state-operated addiction treatment centers, which are in every region of the state and offer services to many individuals in rural communities.  These centers provide individualized care that is responsive to the needs of New Yorkers, including those with co-occurring or underlying conditions, such as psychiatric disorders.

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc