By Tim Murphy and Tim Marema
Six out of every 10 rural counties are on the red-zone list. In the Upper Midwest, all but a handful of rural counties are seeing rapid spread of the virus.
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Half of all states are reporting increases in new COVID-19 cases, and several are setting new records for new daily cases reported, including rural states such as Montana and South Dakota. Unfortunately, many of these increases are being driven by small towns in rural America, where there is limited access to health care resources. According to an NPR analysis, one fifth of the first 100,000 COVID-19 deaths were outside of large metro areas, whereas rural deaths accounted for nearly half of the second 100,000 COVID-19 deaths. On a per-capita basis, the most rural counties are facing their worst spikes of the pandemic to date; based on a rolling seven-day average, there are around 19.5 daily cases per 100,000 residents in America’s most rural counties. From Bloomberg Government (subscription required):

Rural providers are on the frontline of the pandemic facing new spikes in COVID-19 cases, and they need relief and support. NRHA understands that negotiations on further COVID-19 relief have halted abruptly, but it is important that Congress recognize that rural America’s fight against COVID-19 is currently at its height. Record high numbers of new COVID-19 cases and deaths in rural America coupled with a lack of facilities and supplies is a recipe for disaster. Rural America needs Congress’s help today, and NRHA is continuing to ask Congress to act on behalf of rural America to help patients and providers survive the pandemic.

On Monday, President Donald Trump signed an executive order (EO) titled the ‘Executive Order on Saving Lives Through Increased Support For Mental- and Behavioral- Health Needs.’ The president signed this EO to curb the ongoing suicide crisis, opioid crisis and overall mental health crisis gripping the country. In recent months, due to the continuation of the COVID-19 pandemic, these crises have grown worse. The EO establishes the ‘Coronavirus Mental Health Working Group’ with the goal of facilitating an all-of-government response to the mental health crisis.

This week, HHS announced the opening of a new round of PRF disbursements, Phase 3. The department has allocated $20 billion of the PRF for behavioral health care providers and new providers that began practicing in the first quarter of 2020. These providers may submit applications for payment until November 6th, 2020, and providers that previously received, rejected, or accepted a General Distribution PRF payment of two percent of annual revenue from patient care may also apply for this round of funding. Click here to view HHS’s PRF Phase 3 factsheet!

In September, HHS released reporting requirements for remaining Provider Relief Fund (PRF) dollars, in some cases requiring repayment. The terms and conditions have caused significant heartburn for many providers, and NRHA believes HHS’s determination runs askew of congressional intent. Notably, on October 1st, Senate Majority Leader Mitch McConnell responded to HHS’s new reporting requirements saying, in part, “HHS must not impose requirements that will disproportionately affect rural hospitals that already operate on thin margins.”