Rural Health Information Hub Latest News

U.S. House of Representatives Tees Up Infrastructure & Reconciliation Legislative Packages 

The U.S. House of Representatives returned to Washington, D.C. to consider the bipartisan infrastructure package, which passed the Senate on August 10 (69-30). The House voted 220-212 along party lines to set a date for consideration of the $1 trillion bipartisan infrastructure package and pass a $3.5 trillion budget resolution, teeing up the Build Back Better reconciliation package.

Timeline for final passage of the infrastructure package in the House of Representatives remains unclear, but NRHA is continuing to monitor developments on Capitol Hill. The Senate bill includes $65 billion for broadband connectivity buildout, with significant mention of rural. However, it does not include funding for hospital capital and extends Medicare sequestration for an additional year, until 2031. NRHA is continuing to urge Congress to amend the Senate bill, particularly the Medicare sequestration pay-for.

In terms of the Build Back Better reconciliation package, Senate Committees have been instructed to finalize the draft language for their portions of the text by September 15. Senate Democrats released an outline of what they hope to see included in the final package, which includes provisions to expand Medicare to include dental, vision, and hearing benefits and lowering the eligibility age, address health care provider shortages, improve health equity via maternal, behavioral, and racial justice health investments, and invest in community colleges and pandemic preparedness.

ED Visits Involving Dental Conditions

The Agency for Healthcare Research and Quality (AHRQ) published a new statistical brief, “Emergency Department (ED) Visits Involving Dental Conditions, 2018.” This brief updates a similar report from 2009 and provides valuable information about dental-related ED visits. The brief reports that in 2018, there were more than 2 million dental-related emergency department (ED) visits, which represented 615.5 visits per 100,000 population. It is important to note that Pennsylvania is not one of the 40 states that participates in this database.

Click here to read the brief. 

Geisinger Requiring COVID-19 Vaccine for All Employees

Officials called it “a necessary step to protect the health of our patients and their colleagues.”

Geisinger Health System announced Wednesday that all employees will be required to be vaccinated against COVID-19 by October 15.

All workers must complete a Pfizer, Moderna, or Johnson & Johnson vaccine series by October 15. All new employees will be required to be vaccinated against COVID-19 as a condition of employment beginning on October 15, according to a release.

Officials called it “a necessary step to protect the health of our patients and their colleagues.”

The COVID-19 vaccine requirement includes all new employees, faculty, medical staff, residents, fellows, temporary workers, trainees, volunteers, students, and temporary staff, regardless of employer.

An exemption process is available for employees who have a documented and specific medical reason or sincerely held religious belief that preclude them from receiving the COVID-19 vaccine.

Geisinger claims that about 70 percent of employees are fully vaccinated against COVID-19.

In a statement, Geisinger’s CEO said: “We understand that some employees who have consciously chosen to not get vaccinated may be disappointed by this decision. We hope they will understand that this is a necessary step to protect the health of our patients and their colleagues.”

Officials say they want to focus on educating employees about the benefits of the vaccine first, but those who continue to refuse will be terminated.

USDA On Track to Provide Record-Breaking Support for Rural Working Capital Needs in Fiscal Year 2021

Investments Will Help Create or Save Jobs in Rural Pennsylvania

United States Department of Agriculture (USDA) Deputy Under Secretary for Rural Development Justin Maxson announced that USDA is on track to provide a record level of support for rural working capital and other business capital needs in fiscal year 2021.

The Department has invested $1.2 billion in loan guarantees to help rural businesses in 41 states as well as Guam and the Virgin Islands. These investments – made through the Business and Industry Loan Guarantee Program and the Business and Industry CARES Act Program – are expected to create or save more than 12,000 jobs for people in rural areas.

“Under the leadership of President Biden, Vice President Harris and Agriculture Secretary Vilsack, USDA is expanding access to capital to prioritize rural economic development,” Maxson said. “As we continue to respond to the COVID-19 pandemic and restore the economy, USDA remains committed to helping rural businesses create job opportunities so rural Americans can build back better and stronger than ever before.”

USDA has invested $811 million through the Business and Industry (B&I) Loan Guarantee Program since the start of the current fiscal year. This assistance has helped businesses create or save more than 6,000 jobs in rural areas. In Pennsylvania, this program included investments of more than $9 million with several jobs created and saved.

Investments under the B&I program are 36 percent higher than they were this time last year. Applications have increased by 44 percent. These increases are due in part to a series of program improvements USDA adopted under the new OneRD Guarantee Loan Initiative.

This initiative increased the USDA loan guarantee to 80 percent for investments greater than $5 million. The previous guarantee percentages were 70 percent for loans less than $10 million and 60 percent for loans greater than $10 million. This improvement has made the program more attractive to capital-intensive businesses such as manufacturing companies.

USDA also invested $380 million in rural businesses through the Business and Industry CARES Act Program, which was established under the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This assistance has helped rural businesses create or save more than 6,000 jobs in rural areas. In Pennsylvania, this CARES program included investments of about $2 million that created four jobs and saved twelve.

To learn more about business investment resources for Pennsylvania’s rural areas, interested parties should contact the Business and Cooperative Programs Director, David Foster, at (717) 237-2181 or

To learn more, visit

If you’d like to subscribe to USDA Rural Development updates, visit our GovDelivery subscriber page.

Will Primary Care Disappear by 2026?

Primary care is facing “existential threats,” and primary care clinicians are worried, according to the most recent survey from the Larry A. Green Center and the Primary Care Collaborative. Fully 40 percent of respondents say they worry that primary care will be gone in five years, and 21 percent say they expect to leave primary care within three years. Many clinicians see a role for the federal government in changing policy in primary care. Their top request: Protect primary care as a “common good” that is available to anyone regardless of ability to pay.

Read more.

CMS Revises Guidance on Resuming Normal Medicaid Operations Post-Public Health Emergency

On August 13, the Centers for Medicare and Medicaid Services (CMS) issued its highly anticipated revisions to previous guidance on the resumption of normal Medicaid operations (or “unwinding”) when the COVID-19 Public Health Emergency (PHE) expires. Key revisions to previous guidance include:

  • Extending the timeframe for completing pending eligibility and enrollment actions to up to 12 months post-PHE
  • This does not change previous guidance on resuming timely processing of applications within four months post-PHE.
  • Completing an additional redetermination for individuals determined ineligible for Medicaid during the PHE
  • This rescinds the option under previous guidance for states to rely on an eligibility action processed within six months of the date of coverage termination post-PHE. In effect, the six-month “lookback” option for an eligibility action is no longer available.
  • States must make a full redetermination prior to taking an adverse action with respect to any beneficiary.
  • CMS reiterates that 30 days for beneficiary response to state requests to verify eligibility, along with minimum of 10 days of advance notice and fair hearing rights prior to termination or other adverse action, are required.
  • States must take steps to transition beneficiaries determined ineligible to other insurance affordability programs.

CMS reminds states of the requirement in previous guidance to adopt one of four risk-based approaches to prioritize completion of pending work. CMS encourages states to revise any existing plans considering the new 12-month timeframe for this work. CMS will require states to consider the promotion of coverage continuity within the state’s chosen risk-based strategy. More guidance will be issued on this topic and to assist states in establishing renewal workloads that will be sustainable into the future.

Biden Administration Implements 25% Boost to Food Stamp Program

The Biden administration has revised the nutrition standards of the food stamp program and prompted the largest permanent increase to benefits in the program’s history, a move that will give poor people more power to fill their grocery carts but add billions of dollars to the cost of a program that feeds one in eight Americans. At the same time, a temporary 15 percent increase in benefits as part of pandemic relief, is set to expire on Sept. 30. The $3.5 billion boost approved earlier this year provides about $27 more per person per month, or over $100 more a month for a household of four, in additional food stamp benefits. Under rules to be announced on Monday and put in place in October, average benefits will rise more than 25 percent from pre-pandemic levels. All 42 million people in the program will receive additional aid. The move does not require congressional approval, and unlike the large pandemic-era expansions, which are starting to expire, the changes are intended to last.

Pennsylvania Health Department Sets Nursing Home Target: 80% by October 1

Pennsylvania set an October 1 target for 80 percent of nursing home staff in the commonwealth to become fully vaccinated. It’s a goal that just 12.5 percent of the state’s skilled nursing facilities have reached so far, according to Department of Health (DOH) Executive Deputy Secretary Keara Klinepeter. Those unable to meet the target must subject their employees to more frequent testing according to DOH and “appropriate regulatory action” will follow if facilities don’t comply. About 72,000 residents live in 692 state-run nursing homes. LeadingAge PA, the organization that represents more than 380 of these long-term care facilities, is strongly encouraging all its members to mandate vaccination for staff. The state long-term care ombudsman said, “We have an ethical imperative to do this. They’re counting on us.”

Pennsylvania Signs Free COVID-19 Testing Agreement for Schools

Pennsylvania Governor Wolf’s administration has entered a partnership with a company to provide free COVID-19 testing in K-12 schools across the commonwealth during the 2021-22 academic year. The initiative is designed to help keep schools open and mitigate the spread of the virus. The administration has not ordered schools to begin universal masking and Gov. Wolf has repeatedly said he did not intend to do so. The turnaround time for testing results is one to two days.

Read more.