- Fact Sheet: The Biden-Harris Administration Highlights Investments in Rural America, Invites Public Nominations for Rural Innovators Initiative
- Rural Victims of Intimate-Partner Violence Need More Resources and Support, Study Finds
- A Tribe in Maine Is Using Opioid Settlement Funds on a Sweat Lodge to Treat Addiction
- Fact Sheet: USDA, HHS Announce New Actions to Reduce Impact and Spread of H5N1
- Call for Experts: Forum on Aging, Disability, and Independence
- Bill to Expand Definition of 'Village' Qualifying for Water Funds Passes Alaska House
- Child Care Workers Caught in Middle of Michigan's Broken Child Care System
- Few Options Available for Substance Abuse Treatment in the Big Bend
- In Rural Texas, ERs Are Facing a Growing Mental Health Crisis
- Ways and Means Members Put Forth Solutions to Strengthen Telehealth Access and Improve Health Care for Rural Communities
- Sage Memorial Hospital in Navajo Nation Constructs New Facility to Improve Health Care
- How the State, Tribes and Federal Government Are Working to Curb SD's Syphilis Epidemic
- Rural Children Struggle to Access Hospital Services, Say Researchers
- RPHARM Program Fulfills Need for Rural Pharmacists
- A Pilot Program in Rural Vermont Hopes to Build a Blueprint for Substance Abuse Recovery
COVID-19 Vaccine “Do’s and Don’ts”
As Pennsylvania and the nation continue to ramp up to get individuals vaccinated to control the pandemic and help us return to some sense of normalcy, new implementation questions arise each week and the Department of Health modifies its Pennsylvania COVID-19 Vaccination Plan. Some of the points DOH has repeatedly emphasized include:
- Focus should be on vaccination of Phase 1A eligible individuals (healthcare workers and elderly in long-term care facilities) at the present time
- That said, when confronted with the option of wasting dosages in a vial because no eligible Phase 1A candidates are available or giving to someone in a different phase, DOH urges NOT to waste any vaccine
- FQHCs and Hospitals were the first to receive vaccine supply—DOH is requiring these vaccine administrators to use at least 10% of supply received to vaccinate “non-affiliated” Phase 1A eligible individuals
- Administer vaccines you receive, DO NOT reserve or hoard them—failure to do so will limit additional supplies both to you and the state and hamper vaccination progress (to date, only 26.31% of vaccines supplied to Pennsylvania are in arms rather than storage)
- Do NOT order or reserve vaccine for second doses—DOH will automatically send second doses at the appropriate time
PACHC participates in DOH’s weekly Vaccine Open Forum and provides a summary of the questions asked and answers given along with our weekly summary of information shared during our regular Wednesday All FQHC CEO Call. If you have questions on vaccine administration, please let us know by contacting Eric Kiehl, PACHC Director of Policy and Partnerships.
State Launches COVID-19 Vaccine Distribution Dashboard
Gov. Wolf noted that the new Department of Health COVID-19 Vaccine Dashboard launched last week. The dashboard provides the number of vaccinations administered by county and demographic information about the people being vaccinated. The data on the dashboard comes from vaccine providers that are reporting information relating to the individuals to whom they administer the COVID-19 vaccine. That information is reported into the Pennsylvania Statewide Immunization Information System (PA-SIIS).
New Pennsylvania General Assembly Sworn In
As the 2021-22 legislative session gets underway in Pennsylvania, it will be shy two members right from the start with Saturday’s passing of Westmoreland County Republican Rep. Mike Reese and the Senate GOP leader’s decision to not seat anyone to represent the 45th state senatorial district due to an election challenge. There are 25 representatives in the House’s freshmen class and five in the Senate’s. The number of women in the two chambers currently sets a new record of 73, topping the number at the start of the last session by 11. That breaks down to 14 in the Senate and 59 in the House. However, with a vacancy in each chamber the possibility remains that a new record could be set later this session. The party breakdown of the chambers at the start of this session is 112 Republicans and 90 Democrats in the House and in the Senate, 28 Republicans, one independent who caucuses with the Republicans, and 20 Democrats.
Rural Healthcare Provider Transition Project: Technical Assistance Application Period Open Through January 16
The competitive application period is currently open for technical assistance support under the Rural Healthcare Provider Transition Project. The program provides technical assistance to eligible small rural hospitals and rural health clinics (RHCs) in strengthening key elements of value-based care: quality, efficiency, patient experience and patient safety. Technical assistance is designed to give hospitals and RHCs a clear understanding of value-based care and the strategies they can implement to be effective. Interested hospitals and RHCs that meet the eligibility requirements can submit an application now through January 16.
Recap of the December COVID-19 relief and appropriations package
The appropriations portion of this large package was largely in-line with what had been introduced in the House and Senate earlier last year. The legislation included $329 million for carrying out rural health programs within HHS, $120 million allocated for the National Health Service Corps, $43 million allocated for Area Health Education Centers, and $975 million for Maternal and Child Health Programs. For the fiscal year (FY) 2022 appropriations process, NRHA will continue to advocate for the inclusion of the creation of an Office of Rural Health within the Centers for Disease Control and Prevention (CDC) and specified funding for the Rural Maternal and Obstetric Management Strategies (RMOMS) program during the FY 2022 appropriations process.
Included in the text was $69 billion for the Public Health and Social Services Emergency Fund (PHSSEF). Within the PHSSEF, $9 billion is directed to the CDC for vaccine distribution, $22 billion for testing, tracing, and mitigation programs – including a $2.5 billion set aside for rural health providers – and $3 billion for the Provider Relief Fund. The language also included $250 million for the FCC COVID-19 Telehealth Program, the extension of Medicare sequestration relief until March 31, 2021, a moratorium on Disproportionate Share Hospital (DSH) reductions through FY 2023, a moratorium on recent cuts in the most recent Physician Fee Schedule final rule until 2024, a three-year extension for important public health provisions, a five-year extension of the rural community hospital demonstration program, an extension of the Frontier Community Health Integration Program (FCHIP) Demonstration, and the injection of $3 billion into the current Physician Fee Schedule for enhanced reimbursement until the funding runs out.
The legislation also includes an agreement as to how to handle ‘surprise’ medical and air ambulance bills using the independent dispute resolution (IDR) methodology, the creation of the Rural Emergency Hospital (REH) model, and changes to the payment model for rural health clinics (RHC). The legislation also makes rural friendly changes to the Medicare Graduate Medical Education (GME) rural training tracks (RTT) programs providing greater flexibility urban and rural hospitals to partner, expands Medicare telehealth to allow mental health services to be furnished, and allows for the direct payment under Medicare to physician services furnished to beneficiaries beginning in 2022.
HHS Releases Advisory Opinion Clarifying that 340B Discounts Apply to Contract Pharmacies
The U.S. Department of Health and Human Servies (HHS) Office of the General Counsel released an advisory opinion concluding that drug manufacturers are required to deliver discounts under the 340B Drug Pricing Program to contract pharmacies. The release says, “HHS has become aware of drug manufacturers refusing to provide 340B discounts to covered entities when covered entities order the drugs themselves but then have the drug physically delivered to patients through “contract pharmacies.” Through the new advisory opinion, HHS has clarified that drug manufacturers must provide 340B discounts when a contract pharmacy is acting as an agent of a covered entity, providing services on behalf of the covered entity.” Read the full advisory here.
PPP Reopens January 11, 2021
The U.S. Small Business Administration, in consultation with the Treasury Department, announced that the Paycheck Protection Program (PPP) will re-open the week of January 11 for new borrowers and certain existing PPP borrowers. To promote access to capital, initially only community financial institutions will be able to make First Draw PPP Loans on Monday, January 11, and Second Draw PPP Loans on Wednesday, January 13. The PPP will open to all participating lenders shortly thereafter. Updated PPP guidance outlining Program changes to enhance its effectiveness and accessibility was released on January 6 in accordance with the Economic Aid to Hard-Hit Small Businesses, Non-Profits, and Venues Act.
This round of the PPP continues to prioritize millions of Americans employed by small businesses by authorizing up to $284 billion toward job retention and certain other expenses through March 31, 2021, and by allowing certain existing PPP borrowers to apply for a Second Draw PPP Loan.
“The historically successful Paycheck Protection Program served as an economic lifeline to millions of small businesses and their employees when they needed it most,” said Administrator Jovita Carranza. “Today’s guidance builds on the success of the program and adapts to the changing needs of small business owners by providing targeted relief and a simpler forgiveness process to ensure their path to recovery.”
“The Paycheck Protection Program has successfully provided 5.2 million loans worth $525 billion to America’s small businesses, supporting more than 51 million jobs,” said Treasury Secretary Steven T. Mnuchin. “This updated guidance enhances the PPP’s targeted relief to small businesses most impacted by COVID-19. We are committed to implementing this round of PPP quickly to continue supporting American small businesses and their workers.”
Key PPP updates include:
- PPP borrowers can set their PPP loan’s covered period to be any length between 8 and 24 weeks to best meet their business needs;
- PPP loans will cover additional expenses, including operations expenditures, property damage costs, supplier costs, and worker protection expenditures;
- The Program’s eligibility is expanded to include 501(c)(6)s, housing cooperatives, direct marketing organizations, among other types of organizations;
- The PPP provides greater flexibility for seasonal employees;
- Certain existing PPP borrowers can request to modify their First Draw PPP Loan amount; and
- Certain existing PPP borrowers are now eligible to apply for a Second Draw PPP Loan.
A borrower is generally eligible for a Second Draw PPP Loan if the borrower:
- Previously received a First Draw PPP Loan and will or has used the full amount only for authorized uses;
- Has no more than 300 employees; and
- Can demonstrate at least a 25% reduction in gross receipts between comparable quarters in 2019 and 2020.
The new guidance released includes:
- PPP Guidance from SBA Administrator Carranza on Accessing Capital for Minority, Underserved, Veteran, and Women-owned Business Concerns
- Interim Final Rule on Paycheck Protection Program as Amended by Economic Aid Act
- Interim Final Rule on Second Draw PPP Loans.
For more information on SBA’s assistance to small businesses, visit sba.gov/ppp or treasury.gov/cares.
Poll Finds Rural Residents More Hesitant to Get Vaccinated
By Tim Marena
About a third of rural residents are reluctant get to vaccinated, while about a quarter of metropolitan residents are.
Rural residents are more hesitant than their metropolitan counterparts to get a Covid-19 vaccination, even though rural areas have higher rates of infections and deaths from the coronavirus, according to a new report.
About a third (35%) of people living in rural areas said they probably would not or definitely would not get a Covid-19 vaccine, compared to about a quarter of suburban (27%) and urban residents (26%) who said the same.
The increased reluctance of rural residents to get vaccinated for Covid-19 was evident even when researchers controlled for other factors such as age, education, and party affiliation.
The poll, part of the Kaiser Family Foundation’s vaccine monitor project, was conducted November 30 to December 8, the week before the first doses of Covid-19 were administered in the U.S. The poll asked approximately 1,700 respondents whether they would get a vaccine if it was free, safe, and effective.
Party affiliation was the biggest indicator of whether a person said they would refuse vaccination. Forty-two percent of Republicans said they probably or definitely would not get vaccinated. Only 12% of Democrats said they would not take the vaccine.
Introducing Telehealth to Rural and Indigenous Communities
Access the recordings of a five-part Telehealth Virtual Workshop hosted by the Health Resources and Services Administration, in collaboration with the North Dakota Department of Health and Spirit Lake Tribe of North Dakota. Find more information here.
8 Things to Know about the U.S. COVID-19 Vaccination Program
The Centers for Disease Control and Prevention provide answers to some of the most frequently asked questions.