Rural Health Information Hub Latest News

Appalachian Community Capital Distributes $3.65 Million to Extend Capital to Appalachia’s Small Businesses

This week, Appalachian Community Capital (ACC) announced $3.56 million in grants under an Emergency Business Response Assistance Program to strengthen and stabilize 31 Regional Community Development Financial Institutions (CDFIs) and other mission-driven community development finance lenders, such as Revolving Loan Funds (RLFs), serving small businesses impacted by COVID-19 related losses.

With support from ARC, the program will help designated community-based lenders cover operational costs and offset some of the income they are losing by suspending, or reducing, payments from their borrowers during the COVID-19 crisis. Eligible uses of funding will consist of operational support and direct technical assistance to Appalachian small business and non-profit borrowers. It is anticipated that recipients will serve 400 businesses and organizations and improve at least 200 companies; $15 million in leveraged private investment will be attracted; and 200 jobs will be retained across the Appalachian Region.

“The Appalachian Regional Commission is committed to helping businesses and financial institutions throughout the region during this economic crisis. By strengthening our Community Development Financial Institutions, we’re ensuring they can continue to support our small businesses with access to capital, which is incredibly important during this difficult time,” said Mike DeWine, Ohio Governor and ARC States’ Co-Chair.

Census Analysis Finds Appalachian Region Experiencing Positive Economic Growth Before COVID Crisis

The Appalachian Regional Commission (ARC) released the 10th annual version of the The Appalachian Region: A Data Overview from the 2014–2018 American Community Survey, also known as “The Chartbook.”  The report draws on the American Community Survey and comparable Census Population Estimates available as of 2018 to present over 300,000 data points about Appalachia’s demographics, income, employment, as well as education, computer access, housing, transportation and other indicators—all presented at the regional, subregional, state, and county level with comparisons to the rest of the nation.

“The Chartbook relies on data collected from Census sources, illustrating the importance of full, accurate Census participation in our region. I encourage all Appalachians to complete the Census form, and do their part to inform ARC investments,” said ARC Federal Co-Chairman Tim Thomas. “This annual ARC report, defining and illuminating the most important economic and demographic data and trends in our Region, provides critical information to policymakers and stakeholders seeking to contribute to Appalachia’s growth.”

The Chartbook indicates that before the COVID-19 crisis, the Region was experiencing positive economic growth, although continued to lag behind the rest of the nation. For instance:

  • Median household income in Appalachia rose 5 percent to $49,747 in 2014–2018 but remained at only 83 percent of the national average.
  • Since 2009–2013, the share of Appalachian residents in poverty fell 1.2 percentage points to 15.8 percent in 2014–2018, yet remained 1.7 percentage points higher than the national average.
  • The share of Appalachia’s working-age adults ages 25 and over in the Region with at least a bachelor’s degree rose 2.2 percentage points since 2009–2013 to 25.7 percent. Despite this increase, the share of available working-age adults in Appalachia with a bachelor’s degree or more was 7.2 percentage points below the national average in 2014–2018.

The Chartbook can be a useful tool in benchmarking economic developments as the COVID-19 crisis continues.

The U.S. Census is currently underway. Get counted here.

Pennsylvania Oral Health Plan 2020-2030 Draft Published

 

We are pleased to present a draft of the Pennsylvania Oral Health Plan 2020-2030. We invite you to review the document and welcome any comments and suggestions on behalf of yourself or your organization.

Please submit your comments and suggestions using this link.

Comments are due by Thursday, June 25th at 12 p.m.

Keep in mind this is a high-level document. Specific programming and action plans will be established on an annual basis with continuous input from stakeholders.

We hope to continue the conversation and look forward to your participation and support for the implementation of this plan in the coming years.

Click here to view the Pennsylvania Oral Health Plan 2020-2030 Draft.
Click here to submit comments and suggestions.

Pennsylvania Governor’s Administration Releases Guidance Now Available for COVID-19 Relief Statewide Small Business Assistance Grants

Pennsylvania Department of Community and Economic Development (DCED) Secretary Dennis Davin announced that program guidelines and additional details for the COVID-19 Relief Statewide Small Business Grants are now available on DCED’s website.

Governor Wolf announced the program’s creation earlier this week. Under the program, $225 million is available for COVID-19 relief to small businesses through a distribution to Community Development Financial Institutions (CDFIs) for loan payment deferment and portfolio loan loss reserves, main street business revitalization grants, and historically disadvantaged business revitalization grants.

The funds will be available through three programs:

  • $100 million for the Main Street Business Revitalization Program for small businesses that experienced loss as a result of the governor’s March 19, 2020 order relating to the closure of all non-life-sustaining businesses and have or will incur costs to adapt to new business operations related to COVID-19;
  • $100 million for the Historically Disadvantaged Business Revitalization Program for small businesses that experienced loss as a result of the business closure order, have or will incur costs to adapt to new business operations related to COVID-19, and in which socially and economically disadvantaged individuals own at least a 51 percent interest and also control management and daily business operations.
  • $25 million for the Loan Payment Deferment and Loss Reserve Program, which will allow the CDFIs the opportunity to offer forbearance and payment relief for existing portfolio businesses that are struggling due to the impact of COVID, as well as shore up the financial position of the CDFIs that are experiencing significant increased defaults in their existing loan portfolios.

Eligible businesses with 25 or fewer employees may receive a maximum grant of $50,000 so long as the business was in operation on February 15, 2020 and, if required, paid income taxes to the state and federal government, as reported on individual or business tax returns; COVID-19 has had an adverse economic impact and makes this grant request necessary to support the ongoing operations of the applicant; the grant will be used cover COVID-19 related costs; and during the period beginning on June 1, 2020 and ending on December 31, 2020, the applicant has not and will not receive another grant under this state program.

Pennsylvania Agriculture Secretary Announces $13.9 Million Invested in Newly Safeguarded Farms, Reducing Threats to Farmland, Food Security

At the Deckman family farm in Cumberland County today, Pennsylvania Agriculture Secretary Russell Redding announced an $11.9 million investment in food security by safeguarding 4,432 acres on 48 farms in 25 counties through the state’s nation-leading farmland preservation program. County governments invested an additional $2 million in the farms preserved today, bringing the total investment to $13.9 million.

The announcement was held in Mechanicsburg at the 55-acre Deckman Farm, one of the 48 farms preserved by Pennsylvania’s Agricultural Land Preservation Board.

According to a 2020 American Farmland Trust report, Farms Under Threat, Pennsylvania lost an alarming 244,000 acres to housing development from 2001 to 2016. This loss was countered by permanently preserving 347,000 acres of farmland during that same time period. Since the inception of Pennsylvania’s Farmland Preservation Program in 1988, the state has preserved more than 5,700 farms and 584,000 acres of Pennsylvania’s agricultural land for perpetuity with a more than $1.6 billion investment.

The COVID-19 pandemic has shown many Pennsylvanians empty grocery store shelves for the first time in their life, leading to a heightened awareness of where food comes from and how it gets from farm to shelf. Access to farmland is vital to food security and meeting demands in both a regular and crisis climate.

In 2019, an agriculture research study funded by the department and conducted by Dr. Thomas Daniels, University of Pennsylvania, found the total economic impact of farmland preservation in Pennsylvania to be valued from $1.8 to $2.9 billion annually. The report also concluded environmental benefits of farmland preservation to be estimated at an additional $1.9 billion annually. Through his research, Dr. Daniels found that farmland contributes more in tax dollars than in demands in services.

The 48 farms preserved today are in Adams, Armstrong, Berks, Bucks, Chester, Columbia, Cumberland, Erie, Franklin, Greene, Lackawanna, Lawrence, Lehigh, Luzerne, Mifflin, Monroe, Montgomery, Northampton, Schuylkill, Somerset, Susquehanna, Washington, Wayne, Westmoreland, and York counties. Since the program began in 1988, federal, state, county, and local governments have purchased permanent easements on 5,724 farms totaling 584,487 acres in 59 counties for agricultural production.

The farms preserved today include crop, fruit and vegetable, dairy, nursery, beef and livestock operations.

The full release and list of farms preserved can be found here.

New Research Brief: Process of Identifying Measures and Data Elements for the HRSA School-Based Telehealth Network Grant Program

A Research & Policy Brief is available from the Rural Telehealth Research Center:

To demonstrate how telehealth can expand access to, and coordinate and improve the quality of health care services offered in schools, the Health Resources and Services Administration (HRSA) Federal Office of Rural Health Policy (FORHP) Office for the Advancement of Telehealth (OAT) awarded grants to 21 organizations across the country for the School-Based Telehealth Network Grant Program (SB TNGP) in September 2016. Grants were targeted to rural, frontier, and underserved communities providing telehealth services for school children, with a particular focus on five clinical areas: asthma, behavioral health, diabetes, healthy weight, and oral health.  As part of this initiative, FORHP funded the Rural Telehealth Research Center (RTRC) to identify a set of measures for the SB TNGP. The principal activities for this project included developing an inventory of potential SB TNGP measures, defining a methodology for evaluating this inventory of measures to determine which were most relevant and applicable for evaluating the SB TNGP initiative, applying the methodology to identify a final list of measures, translating the measures into data elements, and creating a dictionary and tool that could be used to systematically collect and report data by SB TNGP grantees. The goal of the project was to identify a common set of measures that could be collected from each of the grantees on all of their grant-funded telehealth encounters for a cross-grantee assessment of school-based telehealth services, utilization, process, and outcomes.

Please click here to read the brief.

Pennsylvania Governor’s Administration Outlines Impacts of Ending Disaster Declaration

Pennsylvania Governor Wolf’s Administration outlined the potential impact of ending the March 6 disaster declaration while clarifying that the legislature cannot end it unilaterally. The disaster declaration aids in speeding up the state’s response to the pandemic and provides protections for businesses, workers and residents. Importantly, ending the disaster declaration would not end any orders issued by the Secretary of Health that set guidelines for business operations.

Last night, the General Assembly voted to end the disaster declaration with many members claiming their actions ended the business guideline orders. That is not true. Not only does any concurrent resolution need to come to the Governor for approval or disapproval, but the disaster declaration is separate from the orders signed by Secretary of Health Dr. Rachel Levine under the Disease Prevention Act that include provisions for business reopening and for worker and building safety. Those orders remain in place. The legislature did nothing to end those.

Rather, the legislature chose to attempt to end the disaster declaration – a measure that would ostensibly end protections passed for businesses, workers, and residents.

If the declaration were to end, these protections would go away:

  • Burdensome eligibility requirements for more than a million Unemployment Compensation claimants would immediately go back into effect, and employers across the commonwealth would no longer receive relief from charges.
  • Certification requirements under the public-school code and child protective services law would end.
  • A school meal eligibility waiver, which has allowed more than 300 meal sites to open for distribution of food to school-age children in need, would end.
  • Telehealth and other health care services provided by out-of-state providers for Pennsylvanians would end.
  • Utility assistance for thousands of families and individuals would end, leaving people without water or electricity.
  • Hospitals and alternative care sites would no longer be able to add capacity or repurpose facilities (i.e., beds) without having to abide by the 60-day notice requirement.
  • License renewal and training requirement suspensions for health care professionals, child care workers, direct care workers, direct support professionals, among other professional groups who provide life sustaining services to our children, seniors, and vulnerable residents would end, meaning all of these workers would need to choose between not returning to work until those credentials could be renewed or trainings completed and the option of returning to work with the understanding that they are practicing out of compliance with Pennsylvania law and regulation, very well opening themselves up to personal liability.
  • PennDOT waivers for commercial motor vehicle weight limitations and permitting requirements for the transport and delivery of agricultural feed, food, and dairy products, fuel, pharmaceuticals, and medical supplies to assist in supply chain challenges would end and motor carriers would be restricted in their ability to directly assist in supporting emergency relief efforts necessary to respond to the pandemic.
  • Mortgage foreclosure and eviction moratoriums that offer protection to vulnerable Pennsylvanians at risk of losing their homes during the pandemic would end.

In addition to these immediate waiver and legislative enactments being removed, ending the disaster declaration also would remove many practical aspects of the state’s response to this disaster, including the authority to activate the National Guard to help with nursing homes; deploying commonwealth personnel, services and distributing supplies and equipment; implementing emergency funding; suspending rules and regulations that would hinder or delay necessary action in coping with the emergency; and using all available resources of the commonwealth government and its political subdivisions to deal with the emergency.

The state could also lose federal public and individual disaster assistance, and any additional state funding sources available through transfer of unused General Fund dollars.

During a state of emergency declared by the governor, commonwealth agencies and departments may implement their emergency assignments without regard to procedures required by other laws pertaining to performing their work, entering into contracts, purchasing supplies and equipment, and employing temporary workers.

Faculty Research Examined Attitudes of Rural Pennsylvanians on Key Policy Issues

MIDDLETOWN, Pa. — With support from the Center for Survey Research at Penn State Harrisburg, researchers, led by Daniel Mallinson, collaborated to survey the attitudes of rural Pennsylvanians on a variety of topics, and how these attitudes affect their perspectives on issues relevant to state and local government, policymakers, community leaders, and other stakeholders. The research was conducted in 2019, before the coronavirus pandemic began in the U.S.

“Knowledge of the attitudes of rural Pennsylvania residents specifically is needed not only so that policymakers may respond to this quarter of the population, but also because there is evidence that attitudes of rural residents differ from those of urban residents and that attitudes may further vary within rural areas,” said Mallinson, assistant professor of public policy and administration in the college’s School of Public Affairs. “This project provides the data required to inform policymakers of the attitudes of this population concerning several key policy issues.”

Rural areas have been recovering from the recession, managing shifting demands for natural resources, realizing the need for broadband access for daily life, trying to provide access to quality healthcare, and trying to meet the challenge of the opioid crisis, to name only a few trends. According to Mallinson, the attitudes that rural Pennsylvanians hold on these issues, what issues they consider priorities, and what actions they would prefer policymakers take may have shifted over the last 10 years as these developments and others have occurred.

According to the Center for Rural Pennsylvania (CRPA), there are 3.4 million residents across the 48 rural counties in the commonwealth that policymakers serve. The researchers surveyed 2,000 Pennsylvanians (1,200 rural and 800 urban, as defined by the center).

Survey topics included attitudes about respondents’ communities, satisfaction with how things are going in Pennsylvania, trust in government, most-important policy problems, natural resource management, and the opioid crisis. For questions asked in this survey and one conducted in 2008, researchers compared responses to those collected in 2008, which was also funded by CRPA. Researchers also compared rural and urban attitudes to identify commonalities and divergences in opinion on key issues.

“Since the most recent survey had been done in 2008, social, political, economic and demographic changes have occurred which could lead to shifting outlooks or new issues to consider,” Mallinson said. “This project provides up-to-date data on rural views, as well as allows for future opinion polls to continue to assess trends in these views over time.”

Mallinson added that the 2008 report came amid the Great Recession. “At the time of this survey the U.S. economy had recovered, but somewhat unevenly. Urban areas generally recovered better than rural. New issues were at the forefront. For instance, Pennsylvania adopted medical marijuana [a topic of the 2008 study] and the conversation has now moved on to recreational marijuana [a topic of the current study].”

He added that one of the most important differences from 2008 is the decline in engagement in community activities, such as community clubs or organizations and local government commissions, committees, or boards.

Findings include that rural residents agree with their urban counterparts on a number of issues, including general satisfaction with their communities and how things are going in Pennsylvania;    general agreement that most community and state issues should receive the same or higher priority; similar viewpoints on legalizing marijuana, keeping the death penalty, arming school teachers and staff, a graduated instead of flat income tax, the need to regulate fracking, support for a severance tax on natural gas, and support for renewable energy development; and some level of trust in state government institutions and officials.

Urban and rural residents also have some key differences, according to the study, including top priorities — jobs for rural residents, roads and infrastructure for urban residents. Both want action on opioids, but disagree on the forms — urban more supportive of treating this as a health care issue, rural more supportive for greater criminal justice response.

“Even though urban and rural perspectives are often thought to be quite different, we find that there is a lot of agreement,” Mallinson said. “There are some fundamental differences on important policies. There is far more agreement than we expected. We also think the decline in civic engagement is concerning. Lawmakers should think about whether there are policies surrounding things like voting and civic education that can address this problem.”

The project was originally developed as a collaboration between Chelsea Kaufman and the Institute for State and Regional Affairs when Kaufman was a postdoctoral scholar in the Penn State Harrisburg School of Public Affairs. Kaufman continued the collaboration after becoming a faculty member at Wingate University. She serves at a subject matter expert on the project.

“The similarities in rural and urban views on some issues show the importance of surveying citizens on state and local issues to inform policymakers at this level,” Kaufman said. “If we rely on national surveys alone, the views of rural Pennsylvanians on these types of issues may not be clear and policymakers may be forced to extrapolate from rural perspectives on national issues.”

Mallinson added that the final report highlights more nuance in terms of rural and urban differences, as well as how personal and demographic characteristics impact those differences.

The research was funded by a $50,000 grant from CRPA.

Pennsylvania Governor Announces Additional COVID-19 Testing Sites Opening in Areas with Limited Access

Pennsylvania Governor Tom Wolf announced that beginning Wednesday, June 10, five more COVID-19 drive-thru testing sites will open in Walmart parking lots across the state.

Quest Diagnostics and Walmart are working with the Pennsylvania Department of Health to provide testing for residents living in areas with limited access. On Friday, June 5, five testing sites opened at Walmart locations in Clarion, Erie, Montoursville, Clearfield and Hermitage to test Pennsylvanians for COVID-19.

Beginning tomorrow these sites will be open on Monday, Wednesday and Friday from 7:00 AM to 9:00 AM to test up to 50 registered patients daily. Registration is required one day in advance. There is no COVID-19 testing inside Walmart stores or Quest Diagnostics Patient Service Centers.

The testing sites that will open on June 10 include:

  • Walmart Supercenter parking lot, 167 Hogan Blvd, Mill Hall, PA
  • Walmart Supercenter parking lot, 21920 Route #119, Punxsutawney, PA
  • Walmart Supercenter parking lot, 50 Foster Brook Blvd, Bradford, PA
  • Walmart Supercenter parking lot, 10 Kimberly Ln, Cranberry, PA
  • Walmart Supercenter parking lot, 2901 Market St, Warren, PA

Additional testing sites will be announced in upcoming days and will be listed on the department’s website.

Already in Fiscal Crisis, Rural Hospitals Face COVID-19

LDI Virtual Seminar Eyes Coronavirus’ Spread Through America’s Hinterlands

The eighth virtual “Experts at Home” seminar convened by the University of Pennsylvania’s Leonard Davis Institute of Health Economics (LDI) focuses on the impact of the COVID-19 pandemic in rural America. New evidence suggests that rural populations are at heightened risk for contracting the virus due to factors such as age, race/ethnicity, and prevalence of multiple chronic health conditions. The seminar brought together experts from academia and top government positions to discuss the unique challenges the pandemic poses for the health and economies of the country’s rural areas.

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