- Telehealth Study Recruiting Veterans Now
- USDA Delivers Immediate Relief to Farmers, Ranchers and Rural Communities Impacted by Recent Disasters
- Submit Nominations for Partnership for Quality Measurement (PQM) Committees
- Unleashing Prosperity Through Deregulation of the Medicare Program (Executive Order 14192) - Request for Information
- Dr. Mehmet Oz Shares Vision for CMS
- CMS Refocuses on its Core Mission and Preserving the State-Federal Medicaid Partnership
- Social Factors Help Explain Worse Cardiovascular Health among Adults in Rural Vs. Urban Communities
- Reducing Barriers to Participation in Population-Based Total Cost of Care (PB-TCOC) Models and Supporting Primary and Specialty Care Transformation: Request for Input
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- 2025 Marketplace Integrity and Affordability Proposed Rule
- Rural America Faces Growing Shortage of Eye Surgeons
- NRHA Continues Partnership to Advance Rural Oral Health
- Comments Requested on Mobile Crisis Team Services: An Implementation Toolkit Draft
- Q&A: What Are the Challenges and Opportunities of Small-Town Philanthropy?
Pennsylvania Governor Provides Vaccine Update for Long-Term Care Facilities, Expands Rite Aid Partnership to Residential Drug and Alcohol Treatment Facilities
The Wolf Administration provided an update on Pennsylvania’s progress administering COVID-19 vaccines to residents and staff of long-term and congregate care facilities eligible in Phase 1A. To date, more than 193,000 residents and staff of nursing facilities, personal care homes, and assisted living facilities have received their first COVID-19 vaccine dose through the federal Pharmacy Partnership Program. Additionally, nearly 10,000 residents and staff of other long-term and congregate care facilities licensed by the Department of Human Services (DHS) have received their first vaccine dose through the partnership with Pennsylvania-based Rite Aid, and this partnership is being expanded to include residential drug and alcohol treatment providers licensed by the Department of Drug and Alcohol Programs (DDAP) who identified as needing a vaccine provider.
Vaccinating residents and staff of long-term and congregate care facilities – people who are often most at-risk of a severe case of COVID-19 if exposed – protects our most vulnerable residents who are not leaving their facilities and homes themselves but are most affected by rates of COVID-19 in our broader community,” said DHS Secretary Teresa Miller. “This progress is a much-needed reprieve for long-term care facilities that have been particularly challenged by COVID-19 and community transmission, and it’s a line of defense for our health care system as a whole.”
Pennsylvanians living in these facilities eligible for the federal program are receiving vaccines from CVS Pharmacy and Walgreens. As of February 19 all skilled nursing facilities have had their first round of COVID-19 vaccine doses, CVS has completed 100 percent of the second dose clinics and Walgreens is working to vaccinate the remaining second dose clinics before all nursing facilities are complete. More than 70 percent of personal care homes and assisted living facilities covered through the partnership have received their first round of vaccine doses, and CVS and Walgreens expect to finish first rounds before the end of the month. To date, the partnership has administered:
Vaccinations as of Feb. 19 |
First Doses |
Second Doses |
Total Doses |
CVS Pharmacy |
161,935 |
86,567 |
248,502 |
Walgreens |
31,358 |
9,788 |
41,146 |
Through the work of the Federal Pharmacy Partnership’s (FPP) we are able to ensure every nursing home resident and staff member who wants a vaccine can receive it – and we are proud of the progress thus far,” Acting Secretary of Health Alison Beam said. “As nursing homes finish administering the remaining second dose clinics, we know that when the federal government’s mission for the FPP program is complete we will remain committed to getting vaccine to incoming residents and staff in the future. The Department of Health and long term care facilities remain vigilant and will continue to vaccinate through existing relationships with health care providers, just as with routine medication and flu vaccinations.”
Other long-term and congregate care settings included in Phase 1A of Pennsylvania’s Interim Vaccination Plan, including group homes for people with disabilities; residential treatment facilities and long-term structured residences for adults with behavioral health needs; and private psychiatric hospitals, are not included in the federal partnership but are still in the Phase 1A due to the risk of COVID-19 outbreaks in congregate settings.
These settings serve people who have co-occurring medical needs that put them at higher risk of severe cases and death if they contract the virus. Some personal care homes and assisted living facilities also were not enrolled in the Federal Pharmacy Partnership program and may be served by the Rite Aid partnership for DHS-licensed facilities.
Vaccine clinics for these facilities are being held on-site for facilities where people served are not able to travel off-site. Additional clinics are being scheduled at centralized locations when possible to accommodate more facilities and community group homes, which are typically small, private residences. To date, the partnership has administered:
Facilities with First Doses Administered |
Total Doses Administered to Date |
Facilities Scheduled for Vaccination |
Expected Doses through Scheduled Clinics |
|
Office of Developmental Programs Facilities |
1,512 |
4,978 |
102 |
753 |
Office of Long-Term Living Facilities |
83 |
3,539 |
32 |
1,920 |
Office of Mental Health and Substance Abuse Services Facilities |
13 |
1,342 |
13 |
988 |
Nearly 9,900 people have been vaccinated so far through this partnership. Approximately 3,660 people living and working in 147 DHS-licensed facilities and group homes are currently scheduled to be vaccinated through this partnership. Expected reach of this partnership has shifted as some facilities have ended up receiving vaccinations through other contacts.
Additionally, the Rite Aid partnership is expanding to vaccinate residential drug and alcohol treatment providers licensed by DDAP who identified as needing an established partnership with a vaccine provider through a survey administered by the department. Approximately 450 people will be vaccinated at 12 scheduled clinics at residential treatment providers where people served are not able to travel off site through early March.
“Often, residential drug and alcohol treatment providers are forgotten among other congregate care settings, however some of Pennsylvania’s most vulnerable citizens are receiving treatment for the disease of addiction in these facilities,” said DDAP Secretary Jen Smith. “The Rite Aid partnership is another tool in our COVID-19 toolbox to minimize community transmission and ensure all health care providers have established partnerships with vaccine providers.”
Learn more about the partnership with Rite Aid and view more data here.
COVID-19 Vaccine Distribution
Every day tens of thousands of Pennsylvanians are receiving the COVID-19 vaccine. Vaccination numbers for Pennsylvania do not include Philadelphia, which is its own jurisdiction, or federal facilities, which are working directly with the federal government.
- This week, a total of 326,850 doses will have been allocated through February 20:
- 183,575 first doses will have been allocated this week.
- 143,275 second doses will have been allocated this week.
- To date, of the 2,766,400 doses allocated through February 20, we have administered 1,867,240 doses total through February 18:
- First doses, 86 percent (1,387,443 administered of 1,610,175 allocated)
- Second doses, 41 percent (479,797 administered of 1,156,225 allocated)
Vaccine Order signed Feb. 12
Sec. Beam signed an order outlining appropriate steps and recognized best practices to ensure vaccine providers deliver 80 percent of doses within seven days of receipt, provide a phone number where people can speak to an individual to make an appointment and report race and ethnicity data for everyone vaccinated.
Your Turn tool
Last week, Pennsylvania launched the Your Turn tool to help everyone understand where they fall in the vaccination prioritization effort. The Your Turn tool directs eligible residents to the department’s vaccine provider map online to locate a trusted local provider and schedule a vaccination appointment. Your Turn also allows people to register to receive updates about vaccine distribution and allows the department to let you know when it is your turn to get vaccinated.
In addition to the Your Turn tool and while vaccine supply from the federal government remains limited, the Department of Health is working to ensure the vaccine is provided in a way that is ethical, equitable and efficient.
- A commonwealth COVID-19 vaccination guide explains the current process for getting one. Pennsylvanians with questions about the vaccination process can call the Department of Health hotline at 1-877-724-3258.
- Vaccine provider map to find a COVID-19 vaccine provider near you.
- All of the locations that received vaccine and how much they have received can be found on the COVID-19 Vaccine Distribution webpage.
- Vaccine dashboard data can also be found on the website to find more information on the doses administered and showcase demographic information.
- Pennsylvanians can provide feedback on the Pennsylvania COVID-19 Interim Vaccination Plan by clicking on the Plan Feedback Form square under Popular Vaccine Topics here.
- Frequently asked questions can be found here.
The Wolf Administration stresses the role Pennsylvanians play in helping to reduce the spread of COVID-19:
- Wash your hands with soap and water for at least 20 seconds or use hand sanitizer if soap and water are not available.
- Cover any coughs or sneezes with your elbow, not your hands.
- Clean surfaces frequently.
- Stay home to avoid spreading COVID-19, especially if you are unwell.
- If you must go out, you are required to wear a mask when in a business or where it is difficult to maintain proper social distancing.
- Download the COVID Alert PA app and make your phone part of the fight. The free app can be found in the Google Play Store and the Apple App Store by searching for “covid alert pa”.
Updated Coronavirus Links: Press Releases, State Lab Photos, Graphics
- Daily COVID-19 Report
- Press releases regarding coronavirus
- Latest information on the coronavirus
- Photos of the state’s lab in Exton (for download and use)
- Coronavirus and preparedness graphics (located at the bottom of the page)
Community Catalyst Shares New Oral Health Advocacy Resource
The Dental Access Project at Community Catalyst has developed a new one-pager, “Why Does Oral Health Matter?” The new resource makes the link between oral health, overall health, community empowerment, and racial and economic justice. This is intended to help draw links for policymakers, funders, coalition members, and others.
Pennsylvania Oral Health Coalition Releases Annual Report
Pennsylvania: Expansion to SNAP for Qualifying College Students
The Pennsylvania Departments of Human Services (DHS) and Education (PDE) announced a temporary change in eligibility for the Supplemental Nutrition Assistance Program (SNAP), expanding eligibility to certain college students who qualify based off their families’ income but normally would be ineligible for the program due to being a student.
Eligibility rules set by the federal government dictate that students ages 18 through 49 who are enrolled in college at least half time are not eligible for SNAP unless they meet certain exemptions, including working an average of 20 hours or more per week, participating in a state or federal work study program, having a disability, or being a parent of a child under age six. Even if students reside at home with parents who qualify for and receive SNAP, they are not counted in the household unless they meet one of the exemptions.
Under the Consolidated Appropriations Act of 2021, college students who are eligible for a state or federal work study program, regardless of whether they are actually participating, or students who have an estimated family contribution of $0 on their federal student aid determination are now eligible for SNAP. For those under the age of 22 and living at home with their parents, the parents’ incomes are still factored into determining if college students qualify for SNAP but at least for now, these students will receive a benefit more commensurate to their household size that they would otherwise not get because they are a student.
This eligibility will remain in place until 30 days after the public health emergency ends. Since the Biden Administration has advised that the declaration will most likely remain in place at least until the end of 2021 and states will have 60 days-notice before it ends, this policy change will more than likely be something that can help families for the remainder of the crisis.
A Government Accountability Office report released in January 2019 found that at least one in three college students do not always have enough to eat. Additionally, 71 percent of college students today do not fit the model of a “typical” college student and may be financially independent, work at least part time, enroll in and stay in college at a later age, or have dependent children. These factors, when paired with other challenges students face like cost of tuition, lodging and/or transportation, books, and supplies, can create significant barriers to making ends meet. The report includes a literature review of 31 studies of college hunger and indicated there was a range of 9-50 percent of students who experienced food insecurity on campuses but that in 22 of these studies, food insecurity was estimated to be above 30 percent of the students surveyed.
Apply for SNAP online with COMPASS. For more information about food assistance resources for people around Pennsylvania impacted by COVID-19 and the accompanying economic insecurity, visit the Department of Agriculture’s food security guide.
What Partners Need to Know Now about Health Insurance Coverage during the Pandemic
As COVID-19 vaccines begin rolling out across the country, CMS is taking action to protect the health and safety of our nation’s patients and providers and keeping you updated on the latest COVID-19 resources from HHS, CDC and CMS.
With information coming from many different sources, CMS has compiled resources and materials to help you share important and relevant information on the COVID-19 vaccine with the people that you serve. You can find these and more resources on the COVID-19 Partner Resources Page and the HHS COVID Education Campaign page. We look forward to partnering with you to promote vaccine safety and encourage our beneficiaries to get vaccinated when they have the opportunity.
The Importance of Community-Based Organizations during the Pandemic
With the COVID-19 national emergency, many people are facing unprecedented challenges. Some have lost their jobs, and have lost health insurance coverage for themselves and their families. Others may be underinsured with unaffordable health coverage, or may have health insurance, but aren’t sure how to access the services that they need for their health problems.
With these uncertainties, Community-Based Organizations (CBOs) are key players who can help link community members to valuable resources, including how and where to obtain health insurance. CBOs also play a major role in educating community members about COVID-19 vaccines, raising awareness about the benefits of vaccination, and addressing common questions and concerns. As many communities are waiting for their turn to get the vaccine, CBOs can encourage them to take the time to consider their health insurance coverage.
What can CBOs do now to help your community access valuable resources on the vaccine and health insurance coverage?
- Use the NEW Community-Based Organizations COVID-19 Vaccine Toolkit. Soon the communities you serve will have access to vaccines to help protect against COVID-19. CDC has designed a toolkit to help CBOs educate communities about this important new prevention tool. This toolkit is designed for staff of organizations serving communities affected by COVID-19.
- Share COVID-19 Vaccine information and Resources with the communities that you serve. Here’s some messaging to share with your communities through newsletters, e-mail listserv announcements or other channels:
- You can receive the COVID-19 vaccine at no cost. People without health insurance or whose insurance does not provide coverage of the vaccine can also get the COVID-19 vaccine at no cost.
- State governments are handling the distribution of COVID-19 vaccines. Look for updates from your state and local officials as more doses of the vaccine become available for additional priority groups.
- Link community members to information on how to obtain health insurance or use their existing coverage:
- Consumers can take advantage of a special enrollment period (SEP) for individuals and families to apply and enroll in the coverage they need starting February 15, 2021 through May 15, 2021. This SEP will be available to consumers in the 36 states served by Marketplaces that use gov. Read the press release here.
- Those in states with State Based Exchanges should check their state’s exchange website to find out specific enrollment options for their state. Go to gov to find out more information or be directed to your state’s exchange.
- See if you qualify for Medicare, Medicaid or the Children’s Health Insurance Program or check on your health benefits if you already have coverage.
- The From Coverage to Care initiative, has resources such as the Roadmap to Better Care to help consumers understand their health coverage and connect to primary care and the preventive services that are right for them.
- Continue to promote safe practices and vaccine safety and encourage your community members to get the vaccine once it becomes available to them:
- Remind them to continue practicing the 3Ws (Wear a Mask, Watch your distance, Wash your hands).
- Encourage correct and consistent mask use, and share information on how they can make sure their mask works the best it can.
- Share information on the benefits of the vaccine, and how it will help keep you from getting COVID-19.
- Visit the CDC Things to Know page for additional information on the COVID-19 vaccine, which is also available in multiple languages.
- Know the facts about COVID-19 vaccines.
- Share what to expect after receiving a COVID-19 vaccine when it is their turn to get vaccinated.
Questions? Please e-mail us: Partnership@cms.hhs.gov
Record Number of People Have Died of Drug Overdoses During Pandemic, CDC Says
From Becker’s Hospital Review
More than 83,000 Americans died of drug overdoses in the 12-month period ending June 2020, the most ever recorded in a single year, according to data from the CDC.
Five things to know:
- More than 20 million Americans have some sort of substance use disorder, but there are only 4,400 actively practicing certified addiction specialist physicians in the U.S., according to the American Society of Medicine, The Hill reported.
- Much of the U.S. still lacks access to medication-assisted treatment for substance use disorders, though medication-assisted treatment is considered the gold standard in addiction care, according to The Hill. Among the 1.6 million people in 2019 who had an opioid use disorder, only 18 percent received medication-assisted treatment, according to a survey from the Substance Abuse and Mental Health Services Administration cited by The Hill.
- Three drugs — buprenorphine, naltrexone and methadone — have been approved by the FDA to treat opioid use disorder by suppressing cravings and reducing or eliminating withdrawal symptoms, The Hill reported. Only 42 percent of substance use treatment facilities offered at least one of the drugs in 2018, according to a report from the Government Accountability Office released in December.
- Forty percent of U.S. counties have no providers who can prescribe buprenorphine, according to The Hill. A waiver requires providers to undergo eight hours of training to prescribe the drug, which is one of the most effective drugs for reducing the risk of overdose deaths. Only about 7 percent of providers in the U.S. have obtained that waiver, which allows them to prescribe buprenorphine to 275 patients per year, The Hill reported.
- Weekly counts of all drug and opioid overdoses increased by 45 percent from mid-April to October 2020 compared to the same weeks in 2019, The Hill reported. Anxiety, stress, depression and isolation caused by the pandemic, combined with a lack of treatment resources, have caused many people to relapse in their substance use disorder, addiction experts told USA Today.
Pennsylvania Ag Secretary: Proposed Third Round of PA Farm Bill Funding Will Further Strengthen Resiliency of Agriculture
Pennsylvania Agriculture Secretary Russell Redding commended Governor Tom Wolf for once again proposing to fund the Pennsylvania Farm Bill to continue strengthening the resiliency of the industry so many rely on for life’s essential needs. The 2021-22 proposal would be the third installment of funding for the PA Farm Bill, first signed into law in July 2019, and result in a total of nearly $50 million invested in the success of agriculture in the commonwealth.
“As our commonwealth works to recover from the initial impacts of COVID-19, there is a strengthened need to persevere and come through this stronger than ever,” said Redding. “We’re in the midst of opening programs from the second year of funding and can see that recipients from year one of the PA Farm Bill were able to not only survive in 2020 but thrive.
“Never in a million years could we predict what 2020 was going to bring, but if we could the PA Farm Bill has the programs we would have proposed to prepare the industry for fluctuating markets, infusing local food into food deserts, and strengthening the weak links of our food system to persevere through a pandemic,” added Redding.
In 2020, the Center for Poultry & Livestock Excellence, created and funded through the Pennsylvania Farm Bill, provided $280,000 in reimbursement to Pennsylvania’s animal ag industry for the purchase of PPE to protect the workforce. The center also provided guidance to the industry on strengthening biosecurity plans to mitigate against COVID-19.
As communities across the commonwealth faced immense challenges with food insecurity as a result of COVID-19 mitigation efforts, urban communities that took advantage of the PA Farm Bill’s Urban Agriculture Grant program had new infrastructure in place to combat food insecurity by growing their own food and improving access to food for their neighborhoods. The 2019 program funded 28 projects with $500,000.
Pennsylvania’s dairy industry was most notably affected by the pandemic, as rapidly changing markets caused farmers to dump fresh, nutritious milk down the drain. However, some dairy farmers had already diversified their markets and found new opportunities through the PA Farm Bill’s $5 million Dairy Investment Program. The program offered dairy farmers an opportunity to sustain and grow their business through on-farm innovation, organic transition, and diversification through value-added products such as cheese, yogurt, and ice cream. The 2019 program funded 46 projects.
A full review of accomplishments from the 2019 Pennsylvania Farm Bill can be found in The PA Farm Bill in Review, an article on the department’s blog.
Governor Wolf’s 2021-22 Budget proposes funding the PA Farm Bill at $13.6 million, the same level of funding received in 2020, and includes the following programs:
Resources for Business Development & Succession Planning
- PA Agricultural Business Development Center, funded at $2 million, to serve as a resource to create business, transition, or succession plans.
- Realty Transfer Tax Exemption for any transfer of preserved farmland to a qualified beginning farmer.
Creating More Processing Capabilities
- Center for Poultry & Livestock Excellence, funded at $1 million, to support the animal ag industry with biosecurity planning and disease prevention, processing capacity, and food safety and quality assurance.
- Incentivizing Access to Meat Processing Inspections, funded at $500,000, to encourage access to new and expanded markets for small or new producers.
Removing Regulatory Burdens
- Conservation Excellence Grant Program, funded at $2 million, to provide financial and technical assistance to farmers to install and implement best management practices.
- Agriculture Linked Investment Program, funded at $500,000, to re-establish this low interest loan program for the implementation of best management practices.
Strengthening the Ag Workforce
- Agriculture and Youth Grant Program, funded at $500,000, to reestablish this program to fund agricultural and youth organizations to help increase knowledge and awareness of agriculture in the commonwealth.
- The PA Farm to School Grant Program, funded at $500,000, to improve childhood nutrition while increasing exposure to agriculture.
Protecting Agricultural Infrastructure
- PA Rapid Response Disaster Readiness Account, funded at $3 million, to allow for quick response to agricultural disasters, such as Spotted Lanternfly or Avian Influenza; or providing an immediate response to a foodborne illness.
Increasing Market Opportunities
- PA Preferred Organic, funded at $1.6 million, to make PA the nation’s leading organic state by further enhancing the growth of the organic industry.
- PA Preferred Program, funded at an additional $1 million, to support the program and to bolster enrollment in Homegrown by Heroes.
- State-level Specialty Crop Block Grant Program, funded at $500,000, to invest in and encourage farming of high-priority horticultural crops like hemp, hops, and hardwoods.
- Urban Agriculture, funded at $500,000, to improve agriculture infrastructure in urban areas, the aggregation of product, sharing of resources, and support development efforts.
“Pennsylvania agriculture is resilient. We’ve seen that as the industry recovers from challenge, tackles whatever comes next, and comes out stronger than before,” added Redding. “I’m excited to see how this third round of PA Farm Bill funding will further strengthen our resiliency as we support farmers, harness the power of research and technology, and build a more food-secure tomorrow. With a strong agriculture industry comes prosperity and stability for all of Pennsylvania.”
For more about the Pennsylvania Farm Bill visit agriculture.pa.gov/pafarmbill. The department is actively working to roll out grant programs for the 2020-21 funding and will make announcements as programs are available for applications. Both the Ag and Youth Grant Program and Commonwealth Specialty Crop Block Grant Program are open now with the application period closing on March 5, 2021.
Biden Administration Announces Another Foreclosure Moratorium and Mortgage Forbearance Deadline Extension That Will Bring Relief to Rural Residents
USDA Extends Evictions and Foreclosure Moratorium to June 30, 2021 and Provides Additional Guidance for Servicing Loans Impacted by COVID-19.
The U.S. Department of Agriculture announced an extension of eviction and foreclosure moratoriums on USDA Single Family Housing Direct and Guaranteed loans through June 30, 2021. The actions announced today will bring relief to residents in rural America who have housing loans through USDA.
“USDA recognizes that the COVID-19 pandemic has triggered an almost unprecedented housing affordability crisis in the United States. That’s why USDA is taking this important action today to extend relief to the hundreds-of-thousands of individuals and families holding USDA Single Family Housing loans,” USDA Deputy Under Secretary for Rural Development Justin Maxson said. “While today’s actions are an important step for them, we need to do more. The Biden Administration is working closely with Congress to pass the American Rescue Plan to take more robust and aggressive actions to bring additional relief to American families and individuals impacted by the pandemic.”
A recent Census Bureau survey showed that 8.2 million homeowners are currently behind on mortgage payments, and of that 8.2 million, 3 million homeowners behind on payments were Black or Hispanic.
This effort underscores a commitment by USDA to bring relief and assistance to farmers, families and communities across the country who are in financial distress due to the coronavirus pandemic. In January, USDA took action to bring relief to more than 12,000 distressed borrowers of USDA farm loans by temporarily suspending past-due debt collections, foreclosures, non-judicial foreclosures, debt offsets or wage garnishments, and more. Learn more here.
Visit www.rd.usda.gov/coronavirus for additional information on USDA’s Rural Development COVID-19 relief efforts, application deadline extensions and more. USDA Rural Development will keep our customers, partners and stakeholders continuously updated as additional actions are taken to bring relief and development to rural America.
Homeowners and renters can also visit www.consumerfinance.gov/housing for up-to-date information on their relief options, protections, and key deadlines from USDA, the Department of Housing and Urban Development, the Department of Veterans Affairs, the Federal Housing Finance Agency, and the Consumer Financial Protection Bureau.
BACKGROUND:
Foreclosure Moratorium Extension
The actions announced today make it possible for the foreclosure and eviction moratorium announced by USDA, Single Family Housing Direct Loan Program (SFHDLP) and the Single Family Housing Guaranteed Loan Program (SFHGLP) on Jan. 20, 2021, to be extended until June 30, 2021. The moratorium does not apply in cases where USDA or the servicing lender has documented the property is vacant or abandoned.
Forbearance Options
Lenders may continue to provide impacted borrowers relief by offering forbearance of the borrower guaranteed loan payment for up to 180 days. In addition, the initial forbearance period may be extended up to an additional 180 days at the borrower’s request. Lenders may approve the initial 180-day COVID-19 forbearance no later than June 30, 2021. SFHGLP borrowers that received a COVID-19 forbearance prior to June 30, 2020, may be granted up to two additional three-month payment forbearances. Lenders should outline potential solutions that may be available at the end of the forbearance period and explain to borrowers that a lump sum payment of the arrearage will not be required.
During the forbearance options outlined above, no accrual of fees, penalties or interest should be charged to the borrower beyond the amounts calculated as if the borrower had made all contractual payments in a timely fashion.
Post Forbearance Options
Upon completion of the forbearance, the lender shall work with the borrower to determine if they can resume making regular payments and, if so, either offer an affordable repayment plan or term extension to defer any missed payments to the end of the loan. If the borrower is unable to resume making regular payments, the lender should evaluate the borrower for special relief measures, which include Term Extensions, Capitalization and Term Extensions, and a Mortgage Recovery Advance.
Questions regarding program policy and this announcement may be directed to the National Office Division at sfhglpServicing@usda.gov or (202) 720-1452.
USDA Rural Development provides loans and grants to help expand economic opportunities and create jobs in rural areas. This assistance supports infrastructure improvements; business development; housing; community facilities such as schools, public safety and health care; and high-speed internet access in rural areas. For more information, visit www.rd.usda.gov.
Pennsylvania Publishes State Health Assessment, Highlights Specific Challenges Residents Face
Acting Pennsylvania Secretary of Health Alison Beam announced the Department of Health has published the 2020 Pennsylvania State Health Assessment (SHA). The assessment, titled The State of Our Health: A Statewide Health Assessment of Pennsylvania, points to specific health challenges in Pennsylvania and indicates where the largest improvements can be made.
“The State Health Assessment is essential to the department’s mission, which is creating a healthy Pennsylvania for all,” Acting Secretary Beam said. “It identifies health disparities, opportunities for health improvement, and resources available to support and promote improved health status. The State Health Assessment further reinforces our commitment to promoting healthy behaviors, preventing injury and disease, and assuring the safe delivery of quality health care for all Pennsylvanians.”
The 2020 SHA was developed by the department’s Office of Operational Excellence and the Healthy Pennsylvania Partnership (HPP), along with Public Health Management Corporation and Bloom Planning. The HPP is made up of nearly 280 volunteers, including many from the department, who collaborate on the development and maintenance of the SHA, and the development and implementation of the State Health Improvement Plan (SHIP).
In addition to an overarching framework of social determinants of health and equity, there are eight themes in the 2020 SHA:
- Access to care;
- Environmental Health;
- Mental Health;
- Maternal and Infant Health;
- Substance Use;
- Injury and Violence Prevention;
- Chronic Diseases; and
- Infectious Diseases and Immunization.
From the report, we know that Pennsylvania’s population has become increasingly diverse; in 2019, 82 percent of individuals identified as white, 12 percent identified as black, 4 percent identified as Asian, and 2 percent identified as multi-racial or another race.
It is also an aging population, with 19 percent of the population aged 65 and over. In 2018, five percent of the adult population identified as lesbian, gay, or bisexual, and under one percent identified as transgender. Additionally:
- The percent of high school students who, in the past 12 months, felt sad or hopeless almost every day for two weeks or more in a row, so that they stopped doing some usual activities, increased from 28 percent in 2015 to 35 percent in 2019. An even higher percentage of Hispanic and lesbian, gay, and bisexual high school students reported feeling sad or hopeless.
- In 2019, about 17 percent of adults binge drank, 10 percent used illicit drugs, and 7 percent had a substance use disorder. Lesbian, gay or bisexual adults had a higher prevalence of binge drinking.
- Based on 2015-2017 data, approximately one in two Pennsylvania residents will be diagnosed with cancer at some point during their lifetime, and one in five will die of cancer.
- While tobacco use has declined, it remains a leading risk factor for chronic diseases. In 2019, prevalence of smoking was higher among gay, lesbian and bisexual adults, those with lower household incomes, and those with lower educational status.
- Among adults under age 65 in 2018, about 7 percent were uninsured. In 2019, among adults, 16 percent did not have a personal health care provider, and 10 percent needed to see a doctor in the past year but were unable to due to cost.
- In 2018 and 2019, non-Hispanic black adults were less likely to have health care insurance and more unable to see a doctor due to cost than white adults. Hispanics were less likely to have insurance, more unable to see a doctor due to cost, and more likely to not have a personal health care provider than non-Hispanic white adults.
- Early and adequate prenatal care is important for the health of the mother and to reduce newborn risks. In 2018, 2 percent of females who gave birth did not receive prenatal care. Black females were about four times as likely not to receive prenatal care compared to whites.
- There were 1,833 neonatal abstinence syndrome (NAS)-related newborn hospital stays in 2018. NAS was highest among white babies, those from rural counties, and from families with lower household incomes.
- Between 2003 and 2018, syphilis increased by close to 400 percent, chlamydia increased by 59 percent and gonorrhea increased by 34 percent. Black and Hispanic individuals were more likely to be diagnosed with syphilis, gonorrhea, and chlamydia.
- Air pollution is one of the greatest health challenges in Pennsylvania. In 2019, the state ranked 47 of 50 states for the general public’s exposure to acceptable levels of particulate matter.
- Violent crime in Pennsylvania decreased from 400 per 100,000 in 2008 to 306 per 100,000 residents in 2018. Between 2013 and 2018, the homicide rate among white residents held steady at two per 100,000, while for black individuals the rate increased to 29 per 100,000.
“Health departments, other agencies and nonprofit organizations use the State Health Assessment in their planning and program development,” Acting Secretary Beam said. “I encourage all organizations to use this document to educate and mobilize communities, set priorities, generate resources and adopt or revise policies to assure that Pennsylvania is a place where all people can achieve their full physical, mental and social well-being, free of inequities.”
More information on The State of Our Health: A Statewide Health Assessment of Pennsylvania can be found on the Department of Health’s website at health.pa.govOpens In A New Window or follow us on FacebookOpens In A New Window and TwitterOpens In A New Window.
MEDIA CONTACT: April Hutcheson, ra-dhpressoffice@pa.gov
In Race for COVID-19 Vaccinations, Older Residents in Rural Pennsylvania Face Tough Obstacles
Spotlight PA is an independent, nonpartisan newsroom powered by The Philadelphia Inquirer in partnership with PennLive/The Patriot-News, TribLIVE/Pittsburgh Tribune-Review, and WITF Public Media.
Robert Keen figured his year of dodging the coronavirus was over. At 84, the retired ambulance driver — who still works with his local fire department — is among the most at-risk from the disease, and thus was given top priority to get the vaccine. So he called up his doctor last month to schedule an appointment. He was told he would have to wait until April.
Keen lives in Forksville, a borough in Sullivan County about 60 miles west of Wilkes-Barre in the northeast. The county has a population of about 6,000 and does not have a hospital. There’s one stoplight, hundreds of acres of forests and state game lands, and one public school district. The pharmacy and medical center are too small to take on the work of administering coronavirus vaccines. Most residents get their health care at hospitals or doctor’s offices at least an hour away in neighboring counties.
Scheduling a vaccine appointment in Pennsylvania is already a competitive process exacerbated by a short supply and patchwork online scheduling systems. But older residents — who are supposed to be among the first in line — in rural areas face more obstacles. They live far away from major chain pharmacies such as CVS and RiteAid, and might not have internet or a means of transportation. Three rural counties — Forest, Fulton, and Sullivan — do not have major chain pharmacies that are participating in state and federal vaccine distribution programs, according to an analysis by Keith Mueller, director of the RUPRI Center for Rural Health Policy Analysis at the University of Iowa.
Rural counties also tend to have a larger share of older residents. About 17% of Pennsylvania’s 12.8 million residents are older than 65, census data show. In many rural counties, older residents make up about 20% of the population. “We’ve known that our population is very heavy on 65 and older,” Sullivan County Commissioner Brian Hoffman said. “We don’t have a large medical provider or a hospital. … Those two elements drove much of our preplanning.”
In Venango County in the northwest, Commissioner Albert Abramovic said he was worried about connecting residents who don’t have internet or cell phone service with appointments. About 21% of the county’s 50,000 residents are older than 65, according to census data, and 22% of households don’t have internet access. Abramovic said he’s heard of people waking up at 5 a.m. to log on to pharmacy scheduling websites or signing up multiple times to improve their chances of landing a spot.
In Juniata County, 19% of the population is older than 65 and a quarter of households do not have internet access. Some older residents live alone, on old family farms, said Alice Gray, one of the county’s commissioners. “Many of our older folks, they aren’t computer savvy,” Gray said. “They don’t use computers. So if the only way they have is to schedule an appointment via the internet, I don’t know if they know how to do that.”
A Weis Market and a health clinic in Mifflintown are the only sites offering vaccines in Juniata, according to state data. From the farthest reaches of the long, narrow county, getting there could be a 40-minute drive, Gray said.
In a statement in late January, State Sen. Lindsey Williams (D., Allegheny) called for a system to alert residents when it’s their turn to sign up, along with stronger partnerships with local, independent pharmacies to reach residents, such as Keen, who don’t have access to corporate chains. “After more than 10 months of the uncertainty and hardships that this pandemic has brought us, Pennsylvanians are confused and anxious to receive a vaccine, and they deserve clearer communication and more concrete answers,” Williams said.
After a January hearing featuring health-care providers distributing vaccines in rural areas and state health officials, Sen. Gene Yaw (R., Lycoming) described the state’s distribution system as a “hodgepodge” and criticized the Health Department for poor planning and communication. “The bottom line is we need more vaccine,” said Yaw, who is also chair of the Center for Rural Pennsylvania, a legislative agency focused on Pennsylvania’s rural communities. “The distribution system we have out there … I think we have to live with it,” Yaw said. “It’s too far along to go back and make a wholesale change at this point.”
As of Feb. 4, more than 880,000 people have received at least one dose of a coronavirus vaccine, state data show, but about four million people are eligible to be vaccinated as part of the state’s Phase 1A, necessitating about eight million doses. Residents who qualify now need more and better communication — such as ads or explainers in print media — that don’t require the internet or a computer to access, Yaw said.
Some local governments have raised questions about whether they can get help from the National Guard. Acting Health Secretary Alison Beam said Wednesday that its units are currently focused on responding to outbreaks in the state’s long-term care facilities but that the state is working to launch community clinics.
One recent clinic was in Pike County, in the northeast, and another in Sullivan, where Keen lives. Both were chosen by the state because those counties lack health-care infrastructure. The clinics also created an opportunity to address other distribution challenges, such as how to get vaccines to a large population of older residents and those without transportation. In Sullivan, about 27% of residents are older than 65, and 22% don’t have internet access. Officials in other counties are also preparing to launch local mass vaccination clinics.
Throughout January, Kevin Boozel, a commissioner in Butler County in Southwest Pennsylvania, said his office fielded as many as 70 calls and emails a day from residents frustrated that they don’t have information about where to get a vaccine. “I think people believe that we as county commissioners are holding back the vaccine,” said Boozel, who is also president of the County Commissioners Association of Pennsylvania.
Many counties have worked with their local emergency service departments to put plans together for community vaccination clinics, and they’re brainstorming ways to reach people living in public housing and to use plans developed during previous emergencies, such as the H1N1 flu outbreak, Boozel said. “We stand ready to help as we continue to work through this pandemic,” he said. None of their plans can be enacted until the state tells counties how many doses they will receive, where they’ll go, and when those shipments will arrive, he said.
Warren General Hospital, an 85-bed community hospital in Warren County, has been vaccinating about 600 to 1,000 people a week, Richard Allen, hospital CEO, said during a state House health committee hearing Wednesday. It is not equipped to handle a larger volume of people while still running the hospital. As more become eligible to receive the vaccine, the hospital will need help, Allen said. “In the face of these uncharted pandemic waters,” Allen said, there is “a void in terms of coordinated direction, authority, and resources.”
Primary Health Network, which serves residents in rural counties throughout the state, recently acquired a mobile health unit that will be used for both coronavirus testing and vaccines, said George Garrow, chief medical officer for the network. But even as the system gears up to vaccinate people who aren’t able to reach a vaccination site, it has had to close offices — which are sometimes as small as three people — if staff are exposed to the coronavirus, Garrow said during a January hearing with the Center for Rural Pennsylvania. “As this situation progresses, I do see it necessary to engage with the National Guard to assist in vaccinating mass quantities of communities,” he said.
Mobilizing vaccination efforts in rural areas takes more than just someone to give the shot.
After it got word from the state that a clinic could be held in Sullivan County, local officials decided it should be held at the Sullivan Elementary School in Laporte — a familiar, central location that often doubles as a space for community events. Public transportation is limited: The county got its first public bus route in October, and getting around requires “a car, or a relative who has one,” Commissioner Darlene Fenton said. The plan was to vaccinate 500 eligible people on Jan. 29 and Jan. 30.
Information was posted on the local government website earlier that week, said Hoffman, the commissioner. By the time the local weekly newspaper, the Sullivan Review, ran a summary outlining details of the event in its Jan. 27 edition, all of the appointments had been filled. “The demand for vaccines was definitely more than our available supply,” he said. The local Area Agency on Aging, which works with the county’s older residents to connect them with personal care resources, helped them register. Other eligible people heard through their local emergency medical services and fire department, including Keen. Five older residents who received vaccines Friday relied on a special service provided by the local tri-county transit system to make it to their appointments. Four are already scheduled to use the service when they return for their second dose in late February.
It took a team of at least 54 people — including local volunteers in color-coded vests to check in residents, medical workers, county employees, and state Health Department staff — to keep the clinic running, according to figures provided by Sullivan officials. Inside, however, it felt more like a gathering than a vaccination site, with laughter and neighbors catching up with each other for the first time in months. “We’re a small county,” Hoffman said. “So a lot of people already know each other and already worked together on other things.”
Maryanne Karpovich, an 85-year-old from Dushore, has a pulmonary disease and a pacemaker — “two strikes against me,” She said. Before scheduling with the clinic, she tried to track down an appointment elsewhere but was told she’d have to wait weeks. “You won’t be as afraid,” Karpovich said after receiving her shot. “But you still have to wear the mask.”
After being told by his doctor he’d have to wait until April, Keen received his first dose of the Moderna vaccine Jan. 29. “I feel great,” he said afterward.