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- Less Staff, Longer Delays and Fewer Options: Rural America Confronts a Health Care Crisis
- The Pandemic Pushed Rural Philanthropy to Change
- Warner, Blackburn Lead Bipartisan Effort to Preserve Access to Rural Health Care
- Tackling Rural America's 'Hidden' Housing Crisis
- Experts: National Physician Shortage Will Hit Rural Areas Harder
- Ensuring Health Care Quality in Rural America
- Rural Communities Want to Tap Federal Funding. But It's Hard to Know Where to Start
- Nearly Half of All Rural Hospitals Are Operating in the Red, Study Says
- Home-Based Care: Fixing the Childcare Drought in Rural America
- Rural Hospitals That Were Struggling Financially Even Before the Pandemic Are Running Out of COVID Aid
- Oklahoma Researchers Aim For More Mental Health Resources In Rural Schools
- Q&A: A Rural Healthcare Hub for Doctors and Policymakers
- February in Brief: Expanding Access to Health Care in Rural Areas and Improving Early Access to Cancer Screenings in Underserved Communities
Pennsylvania Accelerating Vaccine Strategy
Targeted Industry Workers Beginning Today; All Pennsylvanians by April 19
The Pennsylvania Department of Health (DOH) in conjunction with the COVID-19 Vaccine Task Force announced on March 31, 2021 the start of the special initiative to vaccinate targeted industry workers and to accelerate the vaccination timetable for those in Phases 1B, 1C and 2. All Pennsylvanians will be eligible to schedule vaccination appointments beginning April 19.
“The vaccine landscape continues to evolve as the federal government is increasing allocations to more retail pharmacy chains across the country,” Acting Health Secretary Alison Beam said. “To ensure that vaccine continues to get to people efficiently and equitably, Pennsylvania is adapting its plan to allow workers in targeted industries to access any of the three vaccines available at providers throughout the state, and to accelerate our eligibility for remaining phases of the state’s vaccination plan.
“Pennsylvania’s vaccine providers have dramatically stepped up the pace of vaccinations to an average of 83,000 per day, moving the keystone state higher and higher in the rankings with other states. As we complete Phase 1A vaccinations, it’s time to open eligibility to more Pennsylvanians so providers can continue to fill appointments and efficiently, effectively and equitably vaccinate more people every day.”
Pennsylvania will begin the following accelerated phased rollout:
- March 31 workers in the four targeted industries that Gov. Wolf and the Task Force announced on March 12:
- Law enforcement, which includes police, sheriffs and deputies, constables, corrections officers and staff, as well as probation and parole staff.
- Firefighters, including career and volunteer firefighters.
- Grocery Store workers, including all workers in supermarkets and grocery stores.
- Food and Agriculture workers, including all food processing company employees, including meat, poultry, and dairy processing, fresh fruit and vegetable packing operations, food manufacturing, all farmworkers, farm operators, and farm managers, including at urban agriculture operations.
- April 5 all residents in Phase 1B will be eligible to start scheduling vaccination appointments.
- April 12 all residents in Phase 1C will be eligible to start scheduling vaccination appointments.
- April 19, all residents will be eligible to start scheduling vaccination appointments.
“It is important to remember that eligibility does not guarantee an immediate vaccination appointment,” Beam said. “Vaccine providers are ready and eager to get a shot in the arm of every person who wants one while we continue to aggressively advocate for more vaccine.”
COVID-19 Vaccine Task Force members discussed the benefits of the accelerated plan.
“President Biden has asked us to make every adult eligible for vaccination with the vaccine he is providing,” said Sen. Art Haywood. “We can do it, we can make the change. We can get more vaccine to Southeast PA and across the commonwealth and target vaccine, so no one is left out.”
“Due to the successful implementation of the COVID-19 Vaccine Task Force’s revised strategic plan, along with an increasing supply of vaccine doses from the federal government and the tremendous work of our provider network, Pennsylvania is now in a position to pursue an aggressive timeline to ensure any Pennsylvanians who wants to be vaccinated is eligible to do so by April 19,” said Sen. Ryan Aument. “As we expand eligibility, we must not forget about our seniors and our commitment to prioritize them and others in Phase 1A, as well as our frontline workers such as law enforcement and first responders in Phase 1B.”
“We can meet President Biden ‘s request with the amount of vaccines he is providing,” Rep. Bridget Malloy Kosierowski said. “Pennsylvania has done the work to make this a reality. I have said time and time again that this will get better, and it is. Our dedicated providers, who are on the ground every day, Governor Wolf’s administration, and our task force have collaboratively worked together in prioritizing the health and safety of all Pennsylvanians.”
“Today is a day of hope and optimism,” said Rep. Tim O’Neal. “Earlier this month, we announced plans to prioritize our essential workers and first responders by offering the Johnson & Johnson vaccine to them in the coming weeks. We have now done that today. In addition, we have set a timeline so that anyone who wants the vaccine will get able to begin scheduling their appointment at the latest by April 19. The light at the end of the tunnel is getting brighter and brighter every day.”
Residents should continue to use the Department of Health’s Vaccine Provider Map to find a vaccine provider nearest them. The department will continue to update the map as the federal government increases the number of pharmacy chains receiving vaccine through the Federal Retail Pharmacy Partnership.
People without internet access can contact the Health Hotline by calling 1-877-PA-HEALTH (1-877-724-3258).
Temporary Claims Hold Pending Congressional Action to Extend 2% Sequester Reduction Suspension
In anticipation of possible Congressional action to extend the 2% sequester reduction suspension, we instructed the Medicare Administrative Contractors (MACs) to hold all claims with dates of service on or after April 1, 2021, for a short period without affecting providers’ cash flow. This will minimize the volume of claims the MACs must reprocess if Congress extends the suspension; the MACs will automatically reprocess any claims paid with the reduction applied if necessary.
Introducing the CareQuest Institute for Oral Health
On March 29th, the DentaQuest Partnership for Oral Health Advancement became part of a new organization called the CareQuest Institute for Oral Health.
CareQuest Institute is a nonprofit committed to building a future in which equitable systems promote excellent health, allowing people everywhere to reach their full potential. This next evolution of work amplifies and expands upon the programming, resources, and strengths of past organizations, including the DentaQuest Partnership, DentaQuest Foundation, and DentaQuest Institute.
As CareQuest Institute, the more robust portfolio reaches across grantmaking, research, health improvement programs, policy and advocacy, and education as well as dental benefits, care delivery, and innovation advancements designed to improve the oral health system. As a new organization, they can broaden their impact and move faster together toward a system designed for everyone.
CDC Initiative Creates New Water Fluoridation Technology
A Centers for Disease Control and Prevention (CDC) funded research initiative offers access to optimally fluoridated water for up to 19 million people in the U.S. for the first time. The new fluoridation method is designed to dissolve in a small amount of water, much like the chlorine tablets used in swimming pools. This tablet system could allow nearly 32,000 small public utilities – often in underserved, rural areas – to contribute to the national Healthy People goal of providing access to fluoridated water to 77.1% of the U.S. population by 2030. The new system is still pending approval in Pennsylvania.
New Resources Released from Preventing Chronic Disease
Preventing Chronic Disease released a collection of oral health articles. These articles include topics such as inequities in access to dental care, disparities in prevalence of oral disease, the relationship between oral health and chronic diseases, and the impact of COVID-19 on access to oral health services and disease monitoring. The articles provide a snapshot of why oral health needs to be elevated as a policy priority by being integrated into discussions and policy decisions about health. Addressing the social, behavioral, and environmental determinants of health as part of oral health care offers a new approach to prevention and treatment.
SBA Working Capital Loan Deadline Approaching in Pennsylvania for Disaster Declaration
The U.S. Small Business Administration is reminding small businesses, small agricultural cooperatives, small businesses engaged in aquaculture, and most private nonprofit organizations of the April 28 filing deadline for federal Economic Injury Disaster Loan applications in Pennsylvania due to freeze and frost from April 6 through May 15, 2020.
The loans are available in the following counties: Bucks, Delaware, Monroe, Northampton, Philadelphia and Pike in Pennsylvania.
“These counties are eligible because they are contiguous to one or more primary counties in New Jersey. The Small Business Administration recognizes that disasters do not usually stop at county or state lines. For that reason, counties adjacent to primary counties named in the declaration are included,” said Kem Fleming, director of SBA’s Field Operations Center East.
Under this declaration, the SBA’s Economic Injury Disaster Loan program is available to eligible farm-related and nonfarm-related entities that suffered financial losses as a direct result of this disaster. Apart from aquaculture enterprises, SBA cannot provide disaster loans to agricultural producers, farmers or ranchers.
The loan amount can be up to $2 million with interest rates of 3.75 percent for small businesses and 2.75 percent for private nonprofit organizations, with terms up to 30 years. These working capital loans may be used to pay fixed debts, payroll, accounts payable, and other bills that could have been paid had the disaster not occurred. The loans are not intended to replace lost sales or profits.
Applicants may apply online using the Electronic Loan Application (ELA) via SBA’s secure website at DisasterLoan.sba.gov and should apply under SBA declaration # 16638, not for the COVID-19 incident.
Disaster loan information and application forms may also be obtained by calling the SBA’s Customer Service Center at 800-659-2955 (800-877-8339 for the deaf and hard-of-hearing) or by sending an email to DisasterCustomerService@sba.gov. Loan applications can be downloaded from the SBA’s website at sba.gov/disaster. Completed applications should be mailed to: U.S. Small Business Administration, Processing and Disbursement Center, 14925 Kingsport Road, Fort Worth, TX 76155.
Submit completed loan applications to SBA no later than April 28, 2021.
Support for Pennsylvania Communities Now Available Through Neighborhood Assistance Program
Pennsylvania Department of Community and Economic Development (DCED) Secretary Dennis Davin announced that the Neighborhood Assistance Program (NAP) is now accepting applications for community revitalization projects across the commonwealth. NAP promotes community participation and collaborations among nonprofits, businesses, and residents while producing outcomes that assist a distressed area or the low-income population in a neighborhood.
“The Neighborhood Assistance Program demonstrates the value of developing robust public-private partnerships and the significant impact those partnerships can have on communities,” said Sec. Davin. “Through their participation in this critical program, our private sector partners improve quality of life each and every day for the cities, towns, and neighborhoods they call home.”
NAP encourages private sector investment into projects that will help improve distressed communities by providing tax credits to businesses that donate capital to support projects that address neighborhood and community problems. NAP can be used for projects in categories including affordable housing, community services, crime prevention, education, job training, charitable food, blight, special population issues, veteran’s initiatives, and long-term community revitalization.
The application window will open on March 29, 2021 and applications must be received by close of business (5:00 PM) on May 28, 2021.
Since taking office, the Wolf Administration has provided nearly $138 million in NAP tax credits, supporting 908 projects statewide. The investments have resulted in more than $20.3 million in additional funds leveraged through corporate contributions.
The program has five main components: The Neighborhood Assistance Program (NAP), Special Program Priorities (SPP), the Neighborhood Partnership Program (NPP), the Charitable Food Program (CFP), and the Enterprise Zone Program (EZP). A description of each of these components is available within the NAP fact sheet.
Effective April 4, More Options in Pennsylvania for Restaurants and Other Businesses, Mass Gathering Maximums Increase
As COVID-19 cases have declined and vaccination rates are climbing, Pennsylvania Governor Tom Wolf announced the lifting of some targeted restrictions on restaurants and other businesses, as well as increased gathering limits.
Effective April 4, restaurants may resume bar service; alcohol service will be allowed without the purchase of food; the curfew for removing alcoholic drinks from tables will be lifted; and indoor dining capacity will be raised to 75 percent for those restaurants that are currently self-certified and those that undergo the self-certification process, which involves agreeing to strictly comply to all public health safety guidelines and orders, including the cleaning and mitigation protocols and other operational requirements contained in the Governor and Secretary of Health’s mitigation and enforcement orders issued on November 23, 2020, as amended. Those restaurants that do not self-certify may raise capacity to 50 percent. Outdoor dining, curbside pick-up and takeout are still encouraged.
Requirements such as mask-wearing, and social distancing, including 6 feet between diners, also still apply.
Capacity for other businesses also will be increased effective April 4, including moving personal services facilities, gyms and entertainment facilities (casinos, theatres, malls) to 75 percent occupancy.
The governor also announced revised maximum occupancy limits for indoor events to allow for 25% of maximum occupancy, regardless of venue size, and maximum occupancy limits for outdoor events to allow for 50% of maximum occupancy, regardless of venue size. Maximum occupancy is permitted only if attendees and workers are able to comply with the 6-foot physical distancing requirement.
“Pennsylvanians have stepped up and done their part of help curb the spread of COVID-19,” Gov. Wolf said. “Our case counts continue to go down, hospitalizations are declining, and the percent positivity rate gets lower every week – all very positive signs. The number of people getting vaccinated increases daily and we are seeing light at the end of the tunnel. It’s time to allow our restaurants, bars and other service businesses to get back to more normal operations.”
While the lifting of these restrictions is good news, Gov. Wolf cautioned that mask-wearing, social distancing and business adherence to all safety orders are still imperative.
“We’ve come so far and now is not the time to stop the safety measures we have in place to protect ourselves, our families and our communities,” Gov. Wolf said. “Keep wearing a mask, social distancing, and, please, get vaccinated when it’s your turn.”
Find more on the restaurant self-certification process here.
USDA Announces ‘Pandemic Assistance for Producers’ to Distribute Resources More Equitably
USDA will dedicate at least $6 billion to develop a number of new programs or modify existing proposals using discretionary funding from the Consolidated Appropriations Act and other coronavirus funding that went unspent by the previous administration. Where rulemaking is required, it will commence this spring. These efforts will include assistance for:
- Dairy farmers through the Dairy Donation Program or other means:
- Euthanized livestock and poultry;
- Specialty crops, beginning farmers, local, urban and organic farms;
- Costs for organic certification or to continue or add conservation activities
- Other possible expansion and corrections to CFAP that were not part of today’s announcement such as to support dairy or other livestock producers;
- Timber harvesting and hauling;
- Personal Protective Equipment (PPE) and other protective measures for food and farm workers and specialty crop and seafood producers, processors and distributors;
- Improving the resilience of the food supply chain, including assistance to meat and poultry operations to facilitate interstate shipment;
- Developing infrastructure to support donation and distribution of perishable commodities, including food donation and distribution through farm-to-school, restaurants or other community organizations; and
- Reducing food waste.
Part 2: Adding $500 Million of New Funding to Existing Programs
USDA expects to begin investing approximately $500 million in expedited assistance through several existing programs this spring, with most by April 30. This new assistance includes:
- $100 million in additional funding for the Specialty Crop Block Grant Program, administered by the Agricultural Marketing Service (AMS), which enhances the competitiveness of fruits, vegetables, tree nuts, dried fruits, horticulture, and nursery crops.
- $75 million in additional funding for the Farmers Opportunities Training and Outreach program, administered by the National Institute of Food and Agriculture (NIFA) and the Office of Partnerships and Public Engagement, which encourages and assists socially disadvantaged, veteran, and beginning farmers and ranchers in the ownership and operation of farms and ranches.
- $100 million in additional funding for the Local Agricultural Marketing Program, administered by the AMS and Rural Development, which supports the development, coordination and expansion of direct producer-to-consumer marketing, local and regional food markets and enterprises and value-added agricultural products.
- $75 million in additional funding for the Gus Schumacher Nutrition Incentive Program, administered by the NIFA, which provides funding opportunities to conduct and evaluate projects providing incentives to increase the purchase of fruits and vegetables by low-income consumers
- $20 million for the Animal and Plant Health Inspection Service to improve and maintain animal disease prevention and response capacity, including the National Animal Health Laboratory Network.
- $20 million for the Agricultural Research Service to work collaboratively with Texas A&M on the critical intersection between responsive agriculture, food production, and human nutrition and health.
- $28 million for NIFA to provide grants to state departments of agriculture to expand or sustain existing farm stress assistance programs.
- Approximately $80 million in additional payments to domestic users of upland and extra-long staple cotton based on a formula set in the Consolidated Appropriations Act, 2021 that USDA plans to deliver through the Economic Adjustment Assistance for Textile Mills program.
Part 3: Carrying Out Formula Payments under CFAP 1, CFAP 2, CFAP AA
The Consolidated Appropriations Act, 2021, enacted December 2020 requires FSA to make certain payments to producers according to a mandated formula. USDA is now expediting these provisions because there is no discretion involved in interpreting such directives, they are self-enacting.
- An increase in CFAP 1 payment rates for cattle. Cattle producers with approved CFAP 1 applications will automatically receive these payments beginning in April. Information on the additional payment rates for cattle can be found on farmers.gov/cfap. Eligible producers do not need to submit new applications, since payments are based on previously approved CFAP 1 applications. USDA estimates additional payments of more than $1.1 billion to more than 410,000 producers, according to the mandated formula.
- Additional CFAP assistance of $20 per acre for producers of eligible crops identified as CFAP 2 flat-rate or price-trigger crops beginning in April. This includes alfalfa, corn, cotton, hemp, peanuts, rice, sorghum, soybeans, sugar beets and wheat, among other crops. FSA will automatically issue payments to eligible price trigger and flat-rate crop producers based on the eligible acres included on their CFAP 2 applications. Eligible producers do not need to submit a new CFAP 2 application. For a list of all eligible row-crops, visit farmers.gov/cfap. USDA estimates additional payments of more than $4.5 billion to more than 560,000 producers, according to the mandated formula.
- USDA will finalize routine decisions and minor formula adjustments on applications and begin processing payments for certain applications filed as part of the CFAP Additional Assistance program in the following categories:
- Applications filed for pullets and turfgrass sod;
- A formula correction for row-crop producer applications to allow producers with a non-Actual Production History (APH) insurance policy to use 100% of the 2019 Agriculture Risk Coverage-County Option (ARC-CO) benchmark yield in the calculation;
- Sales commodity applications revised to include insurance indemnities, Noninsured Crop Disaster Assistance Program payments, and Wildfire and Hurricane Indemnity Program Plus payments, as required by statute; and
- Additional payments for swine producers and contract growers under CFAP Additional Assistance remain on hold and are likely to require modifications to the regulation as part of the broader evaluation and future assistance; however, FSA will continue to accept applications from interested producers.
Part 4: Reopening CFAP 2 Sign-Up to Improve Access & Outreach to Underserved Producers
As noted above, USDA will re-open sign-up for of CFAP 2 for at least 60 days beginning on April 5, 2021.
- FSA has committed at least $2.5 million to establish partnerships and direct outreach efforts intended to improve outreach for CFAP 2 and will cooperate with grassroots organizations with strong connections to socially disadvantaged communities to ensure they are informed and aware of the application process.
Please stay tuned for additional information and announcements under the USDA Pandemic Assistance to Producers initiative, which will help to expand and more equitably distribute financial assistance to producers and farming operations during the COVID-19 national emergency. Please visit www.farmers.gov for more information on the details of the announcement.
Pennsylvania Governor Encourages Residents to “Pick Up Pennsylvania”
Pennsylvania Governor Tom Wolf today encouraged residents to help reduce litter by joining the statewide “Pick Up Pennsylvania” campaign of community cleanups running through May 31. The governor also invites everyone to learn about litter’s negative impacts and state efforts to reduce this scourge in a free online discussion, “Don’t Trash Pennsylvania,” hosted by the Wolf Administration this Friday.
“The past year has shown beyond a doubt what we’ve known all along: the outdoors is essential to quality of life for Pennsylvanians,” Gov. Wolf said. “Clean green spaces and waters support physical and mental health in addition to enabling the function of the ecosystem we depend on, fostering thriving communities, and supporting our recreation, tourism, and shopping economies. It is our collective responsibility to eliminate litter and I urge everyone to take steps to help keep Pennsylvania clean and green.”
“As we see increased trash around the state, we ask Pennsylvanians to start or join a litter cleanup event in their local community through ‘Pick Up Pennsylvania,’” said Pennsylvania Department of Environmental Protection (DEP) Secretary Patrick McDonnell. “Mask up, put on sturdy shoes and gloves, and head outside with a small group of family, buddies, or co-workers with supplies provided by the campaign. Even a small event makes an immediate impact.”
Keep Pennsylvania Beautiful coordinates the litter cleanup campaign. Volunteering is easy. People can organize their own local event and register it at Pick Up Pennsylvania, or can sign up to participate in an already registered event. Gloves, trash bags, and safety vests are provided by PennDOT, DEP, and the GLAD Products Company, a national sponsor.
As part of this event, DEP and the Pennsylvania Waste Industries Association are sponsoring trash disposal free of charge or at a reduced rate for registered “Pick Up Pennsylvania” participants at participating landfills throughout the month of April.
For over 20 years, hundreds of thousands of Pennsylvanians have participated in “Pick Up Pennsylvania” events, including Scout troops, businesses, watershed organizations, Trout Unlimited, Rod and Gun Clubs, and others. Groups in PennDOT’s Adopt-A-Highway program, which involves volunteers cleaning roadsides year-round, have been longtime participants.
Adopt-A-Highway volunteers collect litter on a 2-mile section of state highway at least twice a year. In 2020, the program had over 5,000 participating groups, with more than 112,000 registered volunteers, helping to clean up nearly 8,000 miles of adopted state-maintained roadways.
“The impact that litter has on PennDOT cannot be overstated,” said Pennsylvania Department of Transportation (PennDOT) Secretary Yassmin Gramian. “We are extremely grateful for our Adopt-A-Highway volunteers and the positive difference they make. However, because of the scale of the litter problem, the department is still investing millions each year to pick up litter, pulling staff and funding away from core highway and bridge maintenance activities.”
“The responsibility of clean and beautiful neighborhoods belongs to all of us. Picking up litter, planting a tree or painting a park bench are simple, easy activities that most people can do, and the results are immediate,” said Shannon Reiter, president of Keep Pennsylvania Beautiful.
Litter Discussion and Information Resources
DEP will host a free online discussion to increase Pennsylvanians’ knowledge of litter’s negative impacts; what DEP, PennDOT, and Keep Pennsylvania Beautiful are doing to reduce litter; and ways that everyone can help.
“Don’t Trash Pennsylvania” will be livestreamed from noon to 12:45 PM on Friday, March 26, on the DEP Facebook page and Webex. Anyone who’d like to watch it on Webex can register here.
Speakers from DEP, PennDOT, the Department of Conservation and Natural Resources, and Keep Pennsylvania Beautiful will discuss Pennsylvania’s litter challenge and answer questions.
A free video on the “Pick Up Pennsylvania” campaign is available in English (for streaming or download) and Spanish (for streaming or download). Media, municipalities, legislators, school and community leaders, and businesses are encouraged to share the video to help increase awareness of ways we can clean up our communities.
Although currently helpful and essential, cleanup is a costly approach to the ongoing litter problem. DEP and PennDOT, with support from Keep Pennsylvania Beautiful, aim to shift the focus of efforts to littering prevention. The Littering Action Plan initiative is assembling four work groups who’ll start working in May to develop recommended strategies in education, infrastructure, enforcement, and partnerships to change Pennsylvanians’ littering behavior.