{"database": "press", "table": "releases", "rows": [["https://www.manchin.senate.gov/newsroom/press-releases/after-manchin-urging-dozens-of-west-virginia-rural-health-providers-will-soon-be-eligible-for-funding", "After Manchin Urging, Dozens Of West Virginia Rural Health Providers Will Soon Be Eligible For Funding", "2020-10-16", "2020", "2020-10", "Democrat", "House", "WV", "Joe Manchin", "M001183", "www.manchin.senate.gov", null, null, "legacy", "October 16, 2020\n\t\t\t After Manchin Urging, Dozens Of West Virginia Rural Health Providers Will Soon Be Eligible For Funding \n\t\t\t\n\t\t\tCharleston,\r\nWV  Today, U.S. Senator Joe Manchin (D-WV) submitted comments to the Health\r\nResources and Services Administration (HRSA) on the proposed changes to their\r\nrural classification methodology, which determines a large percentage of grants\r\nand awards for rural health providers in West Virginia. This revision includes\r\nchanges for Boone, Clay, Hampshire, Lincoln, Preston and Wirt counties from urban\r\nto rural. Senator Manchin also urged HRSA to include Fayette County in this\r\nrevision. Senator\r\nManchin said in part,\r\nI appreciate the opportunity to comment on the Health Resources and Services\r\nAdministration (HRSA), Department of Health and Human Services (HHS) proposed\r\nRevised Geographic Eligibility for Federal Office of Rural Health Policy\r\nGrants. HRSA's Federal Office of Rural Health Policy (FORHP) establishes\r\nmethods of defining rural areas in the United States to receive services funded\r\nby its rural health grant program. These funds are instrumental to providing\r\naccess to quality health care and health professionals in rural communities\r\nacross the country. I appreciate HRSA addressing concerns expressed by\r\nstakeholders to ensure that rural is properly defined across the United States,\r\nespecially in West Virginia. Senator\r\nManchin successfully included\r\nlanguage in Fiscal Year 2020 Appropriations, directing the Economic\r\nResearch Services and FORHP to work on developing an update to their rural\r\nclassification methodology. On September 23rd, HRSA released a\r\nproposed rule updating their methodology for determining what is rural. The\r\nmethodology is based on economic and geographic measures known as the\r\nRural-Urban Commuting Areas (RUCA) Codes. Under the current classification, 20\r\ncounties in West Virginia are labeled urban including counties like Preston\r\nand Boone, making health providers in these counties ineligible for rural\r\ngrants and assistance. The\r\nFederal Office of Rural Health Policy is the agency in charge of promoting\r\nhealth services in rural America. It issues millions of dollars in grant\r\nfunding to critical programs including black lung/coal miner clinics programs,\r\nrural opioid response programs, rural HIV/AIDS planning programs, rural\r\ntelehealth programs, State Offices of Rural Health, hospital flex grants, and\r\nmany more. To\r\nview a map of current West Virginia county classifications, please click here. The\r\nSenator continued,\r\nWest Virginia is the only state that lies completely within the Appalachian\r\nMountain region. It also has a higher mean elevation than any state in the\r\neast. According to the Census Bureau, West Virginia\r\nis the third most rural state in the nation with 51.8% of the state's population\r\nliving in rural areas. West Virginia has 52 Rural Health Clinics, 28\r\nFederally Qualified Health Centers and 3 Look-Alike Organizations (including\r\n390 satellite sites, 179 of which are School-Based Health Centers), and 6 free\r\nclinics. Additionally, there are 59 licensed\r\nhospitals in West Virginia, including 21 Critical Access Hospitals. However,\r\nseveral of West Virginia's Critical Access Hospitals, Rural Health Clinics, and\r\nother rural providers lie in counties HRSA has designated as urban. I find this\r\nconcerning, as these critical providers have been ineligible for necessary\r\nFORHP grant opportunities. Read\r\nthe full letter below or click\r\nhere.  Dear\r\nAdministrator Engels: I\r\nappreciate the opportunity to comment on the Health Resources and Services\r\nAdministration (HRSA), Department of Health and Human Services (HHS) proposed Revised\r\nGeographic Eligibility for Federal Office of Rural Health Policy Grants. HRSA's\r\nFederal Office of Rural Health Policy (FORHP) establishes methods of defining\r\nrural areas in the United States to receive services funded by its rural health\r\ngrant program. These funds are instrumental to providing access to quality\r\nhealth care and health professionals in rural communities across the country. I\r\nappreciate HRSA addressing concerns expressed by stakeholders to ensure that\r\nrural is properly defined across the United States, especially in West\r\nVirginia. West\r\nVirginia is the only state that lies completely within the Appalachian Mountain\r\nregion. It also has a higher mean elevation than any state in the east. According to the Census Bureau, West Virginia is the third\r\nmost rural state in the nation with 51.8% of the state's population living in\r\nrural areas. West Virginia has 52 Rural Health Clinics, 28 Federally\r\nQualified Health Centers and 3 Look-Alike Organizations (including 390\r\nsatellite sites, 179 of which are School-Based Health Centers), and 6 free\r\nclinics. Additionally, there are 59 licensed\r\nhospitals in West Virginia, including 21 Critical Access Hospitals. However,\r\nseveral of West Virginia's Critical Access Hospitals, Rural Health Clinics, and\r\nother rural providers lie in counties HRSA has designated as urban. I find this\r\nconcerning, as these critical providers have been ineligible for necessary\r\nFORHP grant opportunities. Specific Comments Inclusion of Outlying MSAs with No Urban Areas The\r\nproposed change to the rural methodology would list outlying Metropolitan\r\nStatistical Area (MSA) counties with no Urban Area (UA) populations to the list\r\nof eligible areas. This change would affect six counties in West Virginia\r\nincluding: Boone, Clay, Hampshire, Lincoln, Preston and Wirt. I am extremely\r\nsupportive of this change. By including these six counties as rural,\r\nhealth providers will be able to apply and compete for FORHP grants. Prior to the COVID-19 pandemic, nearly half of all rural hospitals\r\nwere operating at a loss and rural closure rates were escalating dramatically.\r\nToday, these already financially fragile hospitals face catastrophic cash\r\nshortages. Many have furloughed staff, instituted massive cuts, or are\r\nshuttering their doors. Any and all resources available to these facilities\r\nwill not only help stabilize their financial infrastructure but allow them to\r\nexpand to better serve their patients. This is a long overdue change for these six\r\ncounties and I appreciate the recognition that proximity to a metro area does\r\nnot mean a county is not rural. In fact, West Virginia is uniquely located\r\nbetween several large MSAs, but only has roughly 1.8 million residents. Our\r\npopulation density is only roughly 44 people per square mile, and our largest\r\ncity is less than 50,000 people. Providing\r\nException for Mountainous/Difficult Terrain While\r\nI appreciate the update to include counties in MSAs with no UAs, I believe that\r\nFORHP is still missing the mark when it comes to measuring rurality in West\r\nVirginia. Currently the USDA Economic Research Service (ERS) has developed Rural-Urban\r\nCommuting Area (RUCA) codes to define labor commuting of rural populations and\r\nthe Frontier and Remote Area Codes to measure sparsely settled and remote\r\nareas, however an adequate measure for sparsely populated mountain regions, and\r\ncommuting times for difficult terrain are not adequately measured. Compounding this issue, we have a deficiency of high-speed\r\ninternet access due to the terrain, making delivery of health care through\r\nother means, such as telehealth, even more difficult. While many sites\r\nare trying to adopt telehealth services, the mountainous region often makes\r\ntechnology infrastructure inaccessible and unreliable. In\r\nparticular, Fayette County in West Virginia should be included as rural for\r\npurposes of FORHP grant eligibility. Fayette\r\nCounty is home to just over 42,000 residents, the New River, New River Gorge\r\nBridge, and hundreds of miles of hiking and biking trails. Fayette County sees\r\nover a million visitors each year to explore its scenic landscape. Its largest\r\ncity is Oak Hill, which only has about 8,000 residents, well under the\r\ndefinition of Micropolitan area. Fayette County is served by two Critical\r\nAccess Hospitals - Plateau Medical Center and Montgomery General Hospital - New\r\nRiver Health centers, including school-based health centers, and several other\r\nhealth providers. The unique landscape of West Virginia, and in particular\r\nFayette County, reflects the need for additional exceptions for mountainous or\r\ndifficult terrain. In areas like Fayette County, the density per square mile is\r\nhigher than you would find in a larger geographic landscape, where travel by\r\nroad is on primary roads over flat terrain. Travel through the secondary roads\r\nand mountainous terrain of West Virginia makes access to health care more\r\ndifficult, and requires health providers be more closely located to ensure\r\npatients are served in a timely manner, especially for emergent health\r\nconcerns. Currently\r\nFORHP provides exceptions to census tracts with a RUCA codes of 2 or 3 that are\r\n400 square miles in area with a population density of no more than 35 people\r\nper square mile. FORHP should consider including an exception aimed at the\r\nAppalachian region, which is a highly mountainous and rural region. The Centers\r\nfor Medicare & Medicaid Services (CMS) recognized the need to provide a\r\nshorter distance requirement for rural areas in mountainous terrain with a lack\r\nof primary roads, and requires critical access hospitals to only have 15 miles\r\nto the next nearest like facility, instead of the required 35 miles. Fayette\r\nCounty is not included in this recent change due to UAs from Charleston and\r\nBeckley reaching into part of the county. However, these UAs only take into\r\naccount density per square mile, and not the terrain where you may find a\r\nhigher density, but longer commuting times. The topography of Fayette County\r\nand its largest city only having 8,000 residents, support Fayette County being\r\nincluded as rural for purposes of FORHP grants. Hub\r\nSites That Serve Majority Rural Population (We/I)\r\nwould also like to encourage FORHP to consider expanding eligibility to health\r\ncenters that primarily serve rural populations but may be connected to a hub\r\nsite located in an MSA UA. Several health centers located in rural counties in\r\nWest Virginia, have a hub site registered inside a nearby county that FORHP\r\nconsiders urban. Several of these satellite sites serve a majority rural\r\npopulation and provide critical health services. For purposes of applying for\r\ngrants, FORHP requires centers apply through their primary location, which is\r\noften their hub site, and not the location where services are rendered. FORHP\r\nshould review this criterion and consider allowing health centers with service\r\nsites that serve a majority rural population be eligible to apply for grants\r\nbased on the location of the service being rendered. Thank\r\nyou again for the opportunity to comment on this notice. If you have any\r\nquestions regarding our comments, please contact my office at 202-224-3954.", 1, "2026-03-30T12:14:52Z", "2026-03-30T12:14:52Z"]], "columns": ["url", "title", "date", "year", "month", "party", "chamber", "state", "member_name", "bioguide_id", "domain", "scraper", "source", "date_source", "text", "has_text", "collected_at", "updated_at"], "primary_keys": ["url"], "primary_key_values": ["https://www.manchin.senate.gov/newsroom/press-releases/after-manchin-urging-dozens-of-west-virginia-rural-health-providers-will-soon-be-eligible-for-funding"], "units": {}, "query_ms": 2.194833941757679, "source": "dwillis/congress-press", "source_url": "https://github.com/dwillis/congress-press", "license": "MIT", "license_url": "https://github.com/dwillis/congress-press/blob/main/LICENSE"}