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Pennsylvania Governor and COVID-19 Vaccine Task Force Announce Targeted Vaccination Strategies, Including for Food Processing & Farmworkers

Agriculture is essential. While so many people saw their world turn upside down last March, not much changed for this industry. People need to eat, so we continued farming, planting, growing; caring for livestock; processing and packing; and putting food on the shelves.

Governor Tom Wolf and the Legislative Vaccine Taskforce recognize agriculture’s invaluable service. On March 12, 2021, they announced that farm workers, food manufacturing employees, and grocery workers are the next targeted groups to receive the FDA approved Johnson & Johnson COVID-19 vaccine which has been approved by the FDA for targeted administration.

This effort is separate from Phase 1B, where agriculture falls in the commonwealth’s vaccine rollout plan. It’s recognition that these groups have had no choice but to continue working to keep Pennsylvania and the world fed through a pandemic.

Strengthening the resiliency of agriculture requires acknowledging the transformative power of science and research. And that’s what we have in the COVID-19 vaccine.

Read the Governor’s announcement here. Check out the FAQs here.

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 today 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.

Pennsylvania Funding for Volunteer Fire Companies to Increase Protection from Wildfires in Rural Areas

Pennsylvania Governor Wolf’s Administration announced that funding is now available to help Pennsylvania’s rural communities increase protection from wildfires.

“Weather can be friend or foe in our wildfire prevention and suppression efforts, but DCNR has no stronger ally — especially during these most difficult times of the pandemic — than the men and women of the volunteer fire companies serving rural areas and communities where forest and brush fires are common,” said Department of Conservation and Natural Resources (DCNR) Secretary Cindy Adams Dunn. “To appreciate the value of well-equipped and highly trained wildfire fighters, one only has to look outside Pennsylvania to the horrific fires that sometimes plague other states.”

Fire Commissioner Bruce Trego praised volunteer fire companies’ service to communities close to home, as well as those members who often join DCNR’s Bureau of Forestry crews battling wildfires far beyond Pennsylvania’s borders.

“Wildfires continue to pose a dangerous and growing threat to our state’s forests, economic interests and the communities that live and recreate near them,” Trego said. “Grant programs like these are vital tools for state government to ensure volunteer firefighters get needed equipment and training so they may perform their jobs as professionally and safely as possible.”

Local firefighting forces in rural areas or communities with fewer than 10,000 residents qualify for the aid, which is used for training and equipment purchases directly related to fighting brush and forest fires.

Grant applications must be electronically submitted through DCNR’s grant website by 4:00 PM, Thursday, May 13, 2021. To expedite applications and decision-making processes, DCNR is accepting only online applications.

The key objective is to better equip and train volunteers to save lives and protect property in unprotected or inadequately protected rural areas. Grant recipients are selected based on vulnerability and adequacy of existing fire protection.

In application reviews, priority will be placed on projects that include the purchase of wildfire suppression equipment and protective clothing. Grants also may be used for purchasing mobile or portable radios, installing dry hydrants, wildfire prevention and mitigation work, training wildfire fighters, or converting and maintaining federal excess vehicles. These vehicles are presented to the local departments exhibiting the greatest needs and those that commit to outfitting them for fire suppression.

Aid is granted on a cost-share basis. Grants for any project during a fiscal year cannot exceed 50 percent of the actual expenditures of local, public, and private nonprofit organizations in the agreement. The maximum grant that will be considered from any fire company in 2021 is $10,000.

Both Trego and Dunn noted the readiness of volunteer fire companies is demonstrated every spring and summer when they answer assistance calls coming from other states, while also responding regularly to local woodland and brush fires. They noted the wildfire grants help enable smaller companies to concentrate more on public safety and training while easing their fiscal constraints.

In 2020, almost $592,000 was awarded to 109 volunteer fire companies serving rural areas and communities where forest and brush fires are common. The grant program, offered through DCNR and paid through federal grants from the U.S. Department of Agriculture Forest Service, has awarded more than $13 million since it began in 1982.

Pennsylvania Transportation Department Invites Pennsylvanians to Share Feedback on Winter Services

Statewide Online Survey Available Until April 6

The Pennsylvania Department of Transportation (PennDOT) is seeking the public’s feedback on winter services through an online survey found at https://www.surveymonkey.com/r/PDWinter2021.

“PennDOT is proud of our winter operations and communications,” said PennDOT Secretary Yassmin Gramian. “The results from this survey will help us measure public expectations and identify education opportunities.”

The survey is available through April 6 and should take about five minutes to complete. All responses are completely anonymous.

The 12-question survey asks respondents about their timeline expectations for safe and passable roadways, how they rank snow-removal priorities, and how they rate PennDOT’s winter services.

Respondents are also asked how they receive PennDOT roadway information, and whether or how they use the state’s 511PA traveler information services. During the winter, www.511PA.com offers its standard traffic and incident information while adding PennDOT plow-truck locations, winter roadway conditions, and other services.

At any time, motorists can check conditions on more than 40,000 roadway miles by visiting www.511PA.com. 511PA, which is free and available 24 hours a day, provides traffic delay warnings, weather forecasts, traffic speed information, and access to more than 1,000 traffic cameras.

511PA is also available through a smartphone application for iPhone and Android devices, by calling 5-1-1, or by following regional Twitter alerts accessible on the 511PA website.

As construction season begins, information on projects occurring or being bid this year is viewable at www.projects.PennDOT.gov. Visit the “Regional Offices” page at www.PennDOT.gov to sign up for travel alerts in a specific area.

Subscribe to statewide PennDOT news at www.PennDOT.gov/news. Follow PennDOT on Twitter at www.twitter.com/PennDOTNews, like the department on Facebook at www.facebook.com/PennsylvaniaDepartmentofTransportation and Instagram at www.instagram.com/pennsylvaniadot.

Pennsylvania Releases Land and Water Trail Network Plan to Ensure Access for All Pennsylvanians

Pennsylvania Department of Conservation and Natural Resources (DCNR) Secretary Cindy Adams Dunn announced the release of Pennsylvania’s new Land and Water Trail Network Strategic Plan extending through 2024. The plan’s vision is to develop a statewide land and water trail network to facilitate recreation, transportation, and healthy lifestyles for all.

“We are proud that our trails can serve Pennsylvanians in their time of need during this pandemic,” Dunn said. “Our state has a long history of supporting trail development. This Land and Water Trail Network Strategic Plan 2020-2024 outlines goals and strategies to ensure motorized and non-motorized trails continue to facilitate recreation, transportation, and healthy lifestyles for all Pennsylvanians for years to come.”

The plan is a blueprint including seven recommendations and 40 action steps for meeting the trail needs of all Pennsylvanians.

Specifically, the plan prioritizes the closing of Priority Trail Gaps, the completion of Major Greenways, emphasis on regional initiatives, the needs of specialized trail-user groups, and ensuring everyone feels welcome on trails in Pennsylvania. These actions are designed to eventually have Pennsylvanians living within 10 minutes of a trail. 

Guided by the 20-member Pennsylvania Trails Advisory Committee, the Land and Water Trail Network Strategic Plan’s priorities, recommendations, and actions were well established before the challenges of COVID-19 and protests around racial injustice. However, the framework for state outdoors recreation addresses those and other pressing challenges of today.

In April 2019, DCNR began a more than a year-long public process of developing the plan in coordination with development of the state’s 2020-2024 Statewide Outdoor Recreation Plan.  States are required to maintain a state trail plan to receive federal funding through the Recreation Trails Program.

The plan is the result of input from thousands of state residents, including local trail providers, outdoor enthusiasts, and the public at large. With more than 12,000 miles of trails, Pennsylvania is a national leader in trails and hiking opportunities.

Pennsylvanians took to trails and greenways in unprecedented numbers in 2020, according to an analysis of 67 non-motorized trail systems throughout the state commissioned by the Pennsylvania Environmental Council (PEC). In March 2020 alone, the study showed trail traffic spiked by as much as 200 percent in some areas compared with the same period during the previous two years.

In a reflection of trail and hiking popularity, DCNR annually supports Trails Month each September. Also, each year DCNR, in partnership with the Pennsylvania Trails Advisory Committee, designates a Pennsylvania trail for Trail of the Year honors. In mid-January, DCNR named the Delaware & Hudson Rail-Trail (D & H Rail-Trail) in Northeastern Pennsylvania as Pennsylvania’s 2021 Trail of the Year.

Biden-Harris Administration Increases Medicare Payment for Life-Saving COVID-19 Vaccine

On March 15, CMS increased the Medicare payment amount for administering the COVID-19 vaccine. This new and higher payment rate will support important actions taken by providers that are designed to increase the number of vaccines they can furnish each day, including establishing new or growing existing vaccination sites, conducting patient outreach and education, and hiring additional staff. At a time when vaccine supply is growing, CMS is supporting provider efforts to expand capacity and ensure that all Americans can be vaccinated against COVID-19 as soon as possible.

Effective for COVID-19 vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies, and many other immunizers will be $40 to administer each dose of a COVID-19 vaccine. This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines and an increase from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished.

These updates to the Medicare payment rate for COVID-19 vaccine administration reflect new information about the costs involved in administering the vaccine for different types of providers and suppliers, and the additional resources necessary to ensure the vaccine is administered safely and appropriately.

CMS is updating the set of toolkits for providers, states, and insurers to help the health care system swiftly administer the vaccine with these new Medicare payment rates. These resources are designed to increase the number of providers that can administer the vaccine, ensure adequate payment for administering the vaccine to Medicare beneficiaries, and make it clear that no beneficiary, whether covered by private insurance, Medicare, or Medicaid, should pay cost-sharing for the administration of the COVID-19 vaccine.

Coverage of COVID-19 Vaccines:

As a condition of receiving free COVID-19 vaccines from the federal government, vaccine providers are prohibited from charging patients any amount for administration of the vaccine. To ensure broad and consistent coverage across programs and payers, the toolkits have specific information for several programs, including:

Medicare: Beneficiaries with Medicare pay nothing for COVID-19 vaccines and there is no applicable copayment, coinsurance, or deductible.

Medicare Advantage (MA): For calendar years 2020 and 2021, Medicare will pay providers directly for the COVID-19 vaccine (if they do not receive it for free) and its administration for beneficiaries enrolled in MA plans. MA plans are not responsible for paying providers to administer the vaccine to MA enrollees during this time. Like beneficiaries in Original Medicare, Medicare Advantage enrollees also pay no cost-sharing for COVID-19 vaccines.

Medicaid: State Medicaid and Children’s Health Insurance Program agencies must provide vaccine administration with no cost sharing for nearly all beneficiaries during the Public Health Emergency (PHE) and at least one year after it ends. Through the American Rescue Plan Act signed by President Biden on March 11, 2021, the COVID vaccine administration will be fully federally funded. The law also provides an expansion of individuals eligible for vaccine administration coverage. There will be more information provided in upcoming updates to the Medicaid toolkit.

Private Plans: CMS, along with the Departments of Labor and Treasury, is requiring that most private health plans and issuers cover the COVID-19 vaccine and its administration, both in-network and out-of-network, with no cost sharing during the PHE. Current regulations provide that out-of-network rates must be reasonable, as compared to prevailing market rates, and reference the Medicare reimbursement rates as a potential guideline for insurance companies. In light of CMS’s increased Medicare payment rates, CMS will expect commercial carriers to continue to ensure that their rates are reasonable in comparison to prevailing market rates.

Uninsured: For individuals who are uninsured, providers may submit claims for reimbursement for administering the COVID-19 vaccine to individuals without insurance through the Provider Relief Fund, administered by the Health Resources and Services Administration (HRSA).

More Information:

Signing of the American Rescue Plan

The Biden-Harris Administration announced the American Rescue Plan Act of 2021 (ARP) will help to reduce health care costs, expand access to coverage, and ensure nearly everyone who buys their own individual or family health insurance through a Marketplace can receive a tax credit to reduce their premiums. The ARP not only provides the resources for America to beat this pandemic, but it also expands access to health insurance coverage, lowers costs, and ensures that health care truly is a right for all Americans.

The fact sheets cover more details on the provisions to be implemented April 1.  Look for more communication from CMS over the next week for training sessions that will provide more information.

To read the CMS fact sheet, visit: https://www.cms.gov/newsroom/fact-sheets/american-rescue-plan-and-marketplace

To read the HHS fact sheet, visit: https://www.hhs.gov/about/news/2021/03/12/fact-sheet-american-rescue-plan-reduces-health-care-costs-expands-access-insurance-coverage.html

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@POTUS signed the American Rescue Plan, which expands access to health care and financial assistance, and lowers premiums. Read the full announcement here: https://www.hhs.gov/about/news/2021/03/12/fact-sheet-american-rescue-plan-reduces-health-care-costs-expands-access-insurance-coverage.html

NRHA Secures Big Wins for Rural Health in Latest COVID-19 Relief Package

On March 11, 2021, President Biden signed into law $1.9 trillion COVID-19 relief package. Thanks to the advocacy of NRHA and its members, the package includes a number of provisions to protect and promote rural health.

Most notably, NRHA has secured the infusion of $8.5 billion for rural providers, a key provision which NRHA worked closely with Senator Manchin’s office on. The $8.5 billion for rural providers will be provided through a fund called the Health Care Heroes Sustainability Fund (HCHSF), which will be similar to the Provider Relief Fund (PRF) but specific to rural providersAfter months of advocacy, NRHA and its members are proud to have secured this much-needed relief on behalf of rural providers. 

Additional rural health provisions of note include: 

  • Additional funding for the Paycheck Protection Program (PPP) with language increasing eligibility for rural providers. Previously, rural hospitals affiliated with a larger health system were deemed ineligible for the PPP if their affiliation brought them above the program’s 500-employee threshold, even if the rural hospital itself only had 100 or so employees. The new bill will waive the affiliation provision, which will enable many more rural providers to participate in the program. NRHA has advocated for this change since the PPP was created last March.  
  • $500 million for the creation of an ‘Emergency Grants for Rural Health Care’ program through the United States Department of Agriculture. This program will support rural hospitals’ efforts around COVID-19 response and vaccine administration, as well as telehealth services. 
  • $7.66 billion in funding for the public health workforce to carry out activities related to establishing, expanding, and sustaining public health at the state, local, and territorial levels. 
  • Supplemental appropriation allocation for the National Health Service Corps ($800 million) and the Nurse Corps Loan Repayment Program ($200 million), bringing $1 billion dollars of additional funding to health care workforce programs. NRHA has advocated for additional funding for the health care workforce in each COVID-19 relief bill, and we are pleased that Congress has decided to provide resources to rural and underserved communities. 
  • An additional $55 billion in funding for COVID-19 vaccine deployment, vaccine awareness programs, testing, tracing, and mitigation programs. 
  • $1 billion in funding to support vaccine confidence activities throughout the country. 
  • Additional funds for mental health support for rural and underserved areas, including $80 million towards Mental Health training, and $40 million in funding to support the Mental Health professional workforce.

How 18 Million Americans Could Move Into Rural Areas – Without Leaving Home

From Route Fifty

COMMENTARY:  A pending proposal would reclassify dozens of communities from metropolitan to rural, potentially affecting their eligibility for certain federal funding and programs.

About 46 million Americans – 14% of the nation’s inhabitants – are currently classified as living in rural areas. That number could jump to 64 million – an increase of nearly 40% – without anyone moving into a new home. That could actually hurt small cities and rural communities across the country.

The federal government classifies communities’ characteristics based on their populations, according to a definition created by the federal Office of Management and Budget. The criteria haven’t substantially changed since the 1940s. Since then, the U.S. population has more than doubled, from 152 million in 1950 to more than 328 million in 2019.

The main dividing line is between communities – which include both towns and cities and their surrounding counties – with more than 50,000 people and those with fewer than that number. Over the past 70 years, the number of areas with at least that many people has increased from 168 to 384 as small towns have grown into small cities. For example, from 1950 to 2010, the population of Lawrence, Kansas, grew from 23,351 to 87,643.

Under the current definition, Colbert County, Alabama – population 54,428 – is in the same category as Los Angeles County – population over 10 million. As the Trump administration ended, federal officials decided some more nuance would be useful in understanding American communities. They proposed to change the dividing line to populations of more than 100,000 – and the effort appears to be continuing under the Biden administration.

That change would effectively move everyone who lives in places with 50,000 to 100,000 from urban to rural life, because their cities, including San Luis Obispo, California, and Battle Creek, Michigan, will no longer be considered large enough to count as metropolitan.

Redefining Rural

The government doesn’t specifically use this system to label places as “urban” or “rural.” Instead, there are three government categories – “metropolitan,” “micropolitan” and “outside a core based statistical area.” However, most government agencies, researchers, advocates and media outlets use these classifications to sort communities into two groups – equating “metropolitan” with “urban” and the other two categories together as “rural.”

Making the proposed change would mean 144 areas with populations between 50,000 and 100,000, and the 251 counties they occupy, would no longer be classified as “metropolitan,” but rather as “micropolitan” – and therefore effectively rural – including Flagstaff, Arizona, and Blacksburg, Virginia. The change would leave Wyoming without any metropolitan areas at all.

The Office of Management and Budget is accepting comments about this proposed change until March 19.

Looking at the Numbers

Changing how rural areas are defined could change Americans’ understanding of rural life.

For instance, the current data reveal that rural areas have less access to broadband internet and health care services.

But if the homes and communities of 18 million more Americans are added to those rural statistics, the numbers could look better. That rosier picture – which would not be the result of any actual changes to Americans’ lives – could reduce public and political pressure to improve life in rural communities.

It’s also not clear whether 100,000 is the right boundary for urban living – or of there is an exact number at all. To people in major cities, a community of 80,000 like Santa Fe, New Mexico, may be more similar to the 22,000-person Roseburg, Oregon, than to Chicago or Miami. To a rancher on the Plains, with fewer than one person per square mile, though, Santa Fe may qualify as a “big city,” with chain stores, hospitals and government offices.

More than a Statistical Shift

Though the government’s proposal says it’s meant as a statistical change only, the classifications are commonly used by government agencies, charities and other organizations to determine which communities are eligible for their funding or programs.

The change could make many small American cities, which would be newly identified as rural, ineligible for money to help community planning and public transit – even if they currently get that money.

Communities currently designated as rural may be hurt, too. If Congress and states don’t allocate more funds to serve the increased number of people classified as living in rural areas, the money that is available – like rural health grants – would be spread more thinly.

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The Conversation

Check Out the New CMS OMH COVID-19 Vaccine Resources for Vulnerable Populations Webpage

The COVID-19 pandemic has disproportionately impacted minority and vulnerable populations. The COVID-19 vaccine can reduce the spread of the virus and help end the public health emergency. Community partners working with racial and ethnic minorities, people with disabilities, people with limited English proficiency, sexual and gender minorities, and rural populations are critical in helping consumers understand how and when they can receive the vaccine, vaccine safety and confidence, and the important ongoing precautions to slow the spread of COVID-19.

To assist our partners, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) has developed a COVID-19 Vaccine Resources website of the many Federal resources and organized them for health care professionals, partners, consumers, and for assistance in additional languages.

To view the page, visit: go.cms.gov/omhcovid19vaccine.

We encourage you to visit the website regularly, as we will continue to update the page with new resources. You can also share this page within your networks to prepare others to get the vaccine as soon as it’s available to them.

For additional COVID-19 information, visit our general COVID-19 website for Federal resources focusing on vulnerable populations: go.cms.gov/omhcovid19 and From Coverage to Care COVID-19: go.cms.gov/c2ccovid19 webpage.