Jan. 19, 2022

HARRISBURG – To best meet the health care challenges facing Pennsylvania’s rural communities, an expansion of telemedicine options, enhanced recruitment incentives and increased reimbursements are top priorities, according to rural health care leaders testifying before a legislative panel on Wednesday.

The virtual hearing was led by Rep. Martin Causer (R-Cameron/McKean/Potter), chairman of the House Majority Policy Committee, and Rep. Kathy Rapp (R-Warren/Crawford/Forest), chair of the House Health Committee.

“I am encouraged by the testimony today because, despite the daunting challenges we face in rural health care, we are blessed by people who are clearly committed to caring for our citizens,” Causer said. “I hear from people in my district every day who are concerned about their health care. They want to know help will be available to them when they or their loved ones need it. So while we work on some of the issues discussed today, I believe it is equally important for our health care leaders to communicate not only the challenges but also the vision they have for ensuring continued access to care during these times of change.”

“Hearing directly from hospital leaders and health care providers in some of our most sparsely populated communities was really impactful, especially for legislators who serve in more suburban districts,” Rapp said. “It’s important we have their support as we work on policy changes to support our rural hospitals and the patients who rely upon them.”

Acting Secretary of Health Keara Klinepeter testified about the agency’s commitment to rural health care as not only providing care to the communities but also providing jobs. She highlighted initiatives such as the Pennsylvania Rural Health Model, a first-of-its-kind program to address health care transformation and innovation for rural hospitals. She also pointed to loan forgiveness programs to primary care providers, mental health providers and dentists in exchange for their commitment to work in medically underserved areas, as well as visa waiver programs for international medical graduates.

Lawmakers then heard from a panel of hospital leaders serving UPMC Kane, UPMC Cole/UPMC Wellsboro, Warren General Hospital and Upper Allegheny Health System. Each shared common concerns about declining populations in the communities they serve, declining revenues for their facilities, and staffing and recruitment challenges.

Dr. Jill Owens, chief medical officer and vice president for quality at Upper Allegheny Health System, stressed the need to train more physicians in general medicine and general surgery, and specifically those with an interest in serving in rural communities.

Rick Allen, CEO of Warren General Hospital, emphasized the need to offer incentives to enter the field of nursing and particularly to work in medically underserved areas, noting that it can be a helpful recruiting tool when paired with other incentives rural hospitals offer individually.

Janie Hilfiger, president of both UPMC Cole and UPMC Wellsboro, highlighted UPMC’s expanded recruitment and retention offerings to employees and prospective employees, as well as job fairs to attract new team members.

They also talked about the important role telemedicine can play in meeting patient needs in a cost-effective way. James Donnelly, chief nursing officer and vice president of patient care services at UPMC Hamot and testifying on behalf of UPMC Kane, explained its hybrid-micro acute care hospital model that will allow it to keep care local for residents of the Kane area. For example, the model maintains the hospital’s current emergency department and staffs it with advanced practice providers who work with emergency medicine physicians at Hamot via a telemedicine link.

Don Boyd, president and chief operating officer for Kaleida Health, offered testimony specific to his company’s transformation plan at Bradford Regional Medical Center (BRMC) and their vision of regionalizing care to establish centers of excellence at both BRMC and Olean General Hospital. He acknowledged the pandemic and unforeseen staffing challenges have impacted those efforts and outlined his organization’s response to boost staffing and staffed beds at BRMC to meet community needs.

The committee next heard from a panel of health care professionals, including a general surgeon, former emergency department director, EMS provider and long-term care facility leader.

Dr. Nathaniel Graham, general surgeon at Surgical Associates of Bradford, agreed with hospital leaders about the importance of incentives to recruit providers to rural areas, noting that being a surgeon in a rural community requires a broad set of skills rather than more narrow specialties. He expressed concern about the reduction in services at rural hospitals and how it impacts the ability of surgeons like him to access operating room facilities that are conveniently located for patients.

Anne Hardy, former director of the emergency department and nursing administration at Bradford Regional Medical Center (BRMC), shared her experiences and concerns with changes in operations at BRMC and its impact the reduction in services has had on the community.

Sally Scrivo, EMT and president of Bradford Area Transport Service, testified about difficulties her ambulance crews have encountered in trying to get hospital treatment for their patients, as well as the costs put on those patients when they have to be transported by ambulance to another hospital after being turned away.

Charlotte Floravit, CEO at Lutheran Home at Kane, also testified about staffing challenges similar to those expressed by hospital officials earlier in the hearing. She discussed overcoming vaccine hesitancy among her staff and shared how she and her management team each obtained emergency Temporary Nurse Aide Certification to help meet staffing shortages.

The hearing closed with testimony from Lisa Davis, director and associate outreach professor of health policy and administration at the Pennsylvania Office of Rural Health, and Janice Walters, chief operating officer of the Rural Health Redesign Center/Pennsylvania Rural Health Model.

For written testimony submitted to the committee, or to watch the hearing in its entirety, visit PAGOPPolicy.com.

Representative Martin T. Causer
House Majority Policy Committee Chairman
67th District, Pennsylvania House of Representatives