The United States Department of Agriculture (USDA) today announced that USDA is seeking comments on a final rule to expand broadband service in rural areas by simplifying program requirements to make more companies eligible to participate in USDA’s ReConnect Program.

The rule will eliminate paperwork requirements and will shorten the application process. It also enables an applicant to submit a letter of credit as proof of its financial ability to complete a project. These changes are expected to enable more companies to participate in the ReConnect program, resulting in more broadband coverage in rural areas. The changes take effect April 27, 2021, at the end of a 60-day comment period.

The ReConnect Program offers loans, grants and loan/grant combinations to facilitate broadband deployment in rural areas that do not currently have sufficient access to it.

Comments must be submitted through https://www.regulations.gov by April 27, 2021. For additional information, see page 11603 of the February 26, 2021, Federal Register.

The Centers for Medicare & Medicaid Services rural health listserv is dedicated to sharing information about programs, policies and resources to help ensure rural populations have access to quality health care. To subscribe to the new topic, click here and enter your email.

Our goal at CMS is to develop programs and policies that ensure rural Americans have access to high quality care, support rural providers and not disadvantage them, address the unique economics of providing health care in rural America, and reduce unnecessary burdens in a stretched system to advance our commitment to improving health outcomes for Americans living in rural areas.

Subscribe to the rural health care listserv to receive the latest information and resources on:

• CMS Rural Health Strategy
• Maternal health care
• Payment and billing
• Policies and regulation
• Resources for partners

In order to find more information on rural health activities at CMS, please visit go.cms.gov/ruralhealth or contact RuralHealth@cms.hhs.gov

HHS has released a new subset of objectives and a new set of health measures as part of the Healthy People 2030 initiative: Leading Health Indicators (LHIs) and Overall Health and Well-Being Measures (OHMs). Together, LHIs and OHMs will help public health and health care professionals, businesses, policymakers, national organizations, and community leaders set priorities and track nationwide progress toward improving health and well-being.

Click here for more information and for videos on the indicators and measures.

Pennsylvania project receives $490,381 grant

The United States Department of Agriculture (USDA) announced it is investing $42.3 million to help rural residents gain access to health care and educational opportunities. Rural areas are seeing higher infection and death rates related to COVID-19 due to several factors, including a much higher percentage of underlying conditions, difficulty accessing medical care, and lack of health insurance. The $42.3 million in awards includes $24 million provided through the CARES Act. In total, these investments will benefit 5 million rural residents.

“The coronavirus pandemic is a national emergency that requires an historic federal response. These investments by the Biden Administration will help millions of people living in rural places access health care and education opportunities that could change and save lives,” said Agriculture Secretary Tom Vilsack. “USDA is helping rural America build back better using technology as a cornerstone to create more equitable communities. With health care and education increasingly moving to online platforms, the time is now to make historic investments in rural America to improve quality of life for decades to come.”

These investments will benefit 5 million rural residents.

In Pennsylvania, the following project received funds through the DLT grant program today:

• O.S. Johnson Technical Institute received a DLT grant of $490,381 to implement a distance learning program in Lackawanna, Susquehanna, Pike and Wayne counties. The project will link Johnson College with four rural high schools and three libraries. Students will have interactive, two-way access to Johnson College faculty and will participate in remote education, discussions, testing and skills demonstrations. Laboratories and classrooms at Johnson College will be similarly equipped to enable maximum interaction between faculty and students. In addition, three rural libraries will be equipped with laptops to give community residents access to career development services and courses at Johnson College.

A recent report by the Rural Policy Research Institute’s Center for Rural Health Policy Analysis found infection and death rates in rural America due to COVID-19 are 13.4 percent higher than in urban areas. A recent report from USDA’s Economic Research Service, USDA ERS – Rural Residents Appear to be More Vulnerable to Serious Infection or Death From Coronavirus COVID-19, underscored the challenges facing rural Americans amidst the COVID-19 pandemic with even greater detail. Due to a confluence of factors, including higher percentages of underlying conditions, lack of health insurance, and lower access to medical facilities/care than urban counterparts, ERS analysts found rural Americans are suffering more severe illness or death due to COVID-19.

Background:

USDA is funding 86 projects through the Distance Learning and Telemedicine (DLT) grant program. The program helps rural education and health care entities remotely reach students, patients and outside expertise. These capabilities make world-class education and health care opportunities accessible in rural communities. The ability to use telehealth resources is critical, especially now during a global pandemic.

USDA also announced investments today in Alabama, Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia, American Samoa, Guam, Puerto Rico and the Virgin Islands.

To learn more about investment resources for rural areas, interested parties should contact their USDA Rural Development state office.

In January, President Biden requested all parts of the federal government to contribute resources to contain the coronavirus pandemic. USDA is responding to the President’s call to action. To date, more than 350 USDA personnel have deployed to assist with standing up vaccination sites, for example. In addition to personnel, USDA is offering its facilities, cold chain infrastructure, public health experts, disaster response specialists, and footprint in rural and Tribal communities across the country. USDA’s commitment to control the pandemic extends to our own staff and facilities, with masking and physical distancing requirements across USDA, a commitment to provide PPE to our front-line workers, and working with states to prioritize vaccinations for our workforce. For more information, visit www.usda.gov/coronavirus. USDA also encourages people seeking health insurance to go to HealthCare.gov now through May 15th due to a Special Enrollment Period. If you are recently uninsured due to a job loss or between jobs, find a plan at HealthCare.gov and keep it for as long as you need it.

USDA touches the lives of all Americans each day in so many positive ways. In the Biden-Harris Administration, USDA is transforming America’s food system with a greater focus on more resilient local and regional food production, ensuring access to healthy and nutritious food in all communities, building new markets and streams of income for farmers and producers using climate smart food and forestry practices, making historic investments in infrastructure and clean energy capabilities in rural America, and committing to equity across the Department by removing systemic barriers and building a workforce more representative of America. To learn more, visit www.usda.gov.

The National Law Review

Shortly before midnight on December 21, 2020, Congress passed with broad bipartisan support the Consolidated Appropriations Act, 2021, which contains $2.3 trillion in spending aimed at stimulating the economy and providing relief from COVID-19. The 5,593-page bill, which is believed to be by far the longest bill ever to be passed by Congress, contains $900 billion in COVID-19 relief, along with $1.4 trillion in catchall spending. Provided the president signs the bill, some of the bill’s provisions will go into effect as soon as next week.

Buried among the thousands of pages is a series of significant changes to federal funding of graduate medical education (GME) that will have substantial impacts on hospitals and future physicians. Recent reports have indicated that the United States faces a projected physician shortage of approximately 139,000 physicians within the next 10–15 years. Perhaps in recognition of that anticipated scarcity, Congress has significantly expanded the number of federally funded physician residency positions. Specifically, the legislation contains the following GME provisions:

1. Additional Federal Support for Residency Training – the bill ends a nearly 25-year freeze on Medicare funding for GME.
2. Additional GME Positions – the bill adds 200 new Medicare-funded GME positions per year over five years at both rural and urban teaching hospitals. At least 10 percent of such positions must be assigned to rural hospitals, teaching hospitals, hospitals that serve areas designated as health professional shortage areas (HPSAs), and hospitals in states with new medical schools. Any hospital assigned additional residency positions may receive up to a maximum of 25 additional full-time positions. Such slots, however, must be accompanied by an agreement to provide a commensurate amount of new training.
3. Additional Flexibilities for Rural Training Programs – the bill removes the separate accreditation requirement, which previously was required for hospitals providing rural training programs to receive federal funding. Under the bill’s provisions, rural and urban hospitals that do not meet the separate accreditation requirement may work together to offer training programs aimed at increasing the number of physicians in rural areas.
4. Opportunity to Re-Establish GME Caps and Per-Resident Amounts – the bill offers opportunities for certain hospitals with low GME caps to establish new caps in order to receive Medicare funding for GME programs they seek to grow and enhance. Likewise, the bill permits certain hospitals with low per-resident amounts (PRAs) to establish a new PRA under existing methodologies applicable to new teaching hospitals. The bill also offers a reprieve on the establishment of new GME caps and PRAs for any hospital until the hospital trained more than 1.0 full-time equivalent (FTE) resident in a year.

The COVID-19 global pandemic has significantly affected Pennsylvania workers, businesses and communities. To bolster economic recovery efforts and position Pennsylvania for economic growth, Governor Tom Wolf today unveiled his “Back to Work PA” plan.

“Pennsylvania needs a comprehensive, forward-thinking plan to jumpstart our economy and support our workforce,” Gov. Wolf said. “Back to Work PA will make strategic and comprehensive investments to build a stronger and more diverse workforce, support Pennsylvania businesses while attracting businesses to the commonwealth, and assist communities with economic recovery efforts – all of which will help us get back on track and build a brighter future for Pennsylvania.”

Back to Work PA builds on recommendations from the Keystone Economic Development and Workforce Command Center’s annual report, published in January 2020. Refocusing Restore PA, Back to Work PA would be funded by a commonsense extraction tax on the natural gas industry, which would allow for an injection of $3 billion to enhance existing initiatives and create new, innovative programs to address barriers that are holding back our workforce.

Invest in Our Workforce to Support a Fair and Equitable Economic Recovery
To build a stronger and more diverse workforce, the plan would support workers most significantly impacted by the pandemic, address inequities, direct resources to support talent development for high-demand occupations, and focus on high-quality well-paying jobs that lead to careers with family-sustaining wages:

• Invest in rapid reskilling, upskilling, and skills transfer to connect unemployed Pennsylvanians to new career opportunities.
• Invest in programs that enhance digital literacy skills.
• Expand on registered apprenticeship programs to include non-traditional occupations like health care, child care, information technology and manufacturing.
• Expand on education and training opportunities that support middle-skill jobs and the skilled-trades.
• Transform workforce development services, including individualized career coaching and enhanced wrap-around supports to address barriers to employment.
• Support child care stabilization by increasing child care subsidies, assisting employers seeking to develop or expand on-site child care, assisting child care centers to expand services during non-traditional work hours, and eliminating child care deserts.
• Support innovative programs that help re-entering citizens obtain credentials and access employment opportunities.

Catalyze Pennsylvania’s Economic Recovery through Strategic Business and Community Support 
To support and attract businesses, Back to Work PA would develop a strong reshoring initiative. Supply chain issues have affected businesses across this country, and Pennsylvania’s manufacturing sector is poised to compete nationally and globally to address those needs.

• Develop a strong reshoring initiative by prioritizing and recapitalizing existing programs such as:
  • Business in Our Sites
  • Industrial Sites Reuse Program
  • Pennsylvania Industrial Development Authority
  • Machinery and Equipment Loan Fund

• Increase investment into an aggressive business attraction marketing strategy to package and promote reshoring programs.
• Support innovation and entrepreneurs by developing a funding strategy to foster the creation of new companies and attract and retain talent in Pennsylvania.
• Provide strategic financial planning opportunities for municipalities so that they can address the revenue losses experienced during the pandemic and prepare for potential future economic disruptions:
  • Expand Municipal Assistance Program (MAP) to provide additional services to municipalities.
  • Expand and Reform Act 47.
  • Expand Strategic Management Planning Program (STMP).

Ensure Reliable Broadband for All Pennsylvanians 
COVID-19 disruptions have shown that broadband access is a necessity. Back to Work PA would prioritize making high-speed internet access available to all Pennsylvanians by building out this infrastructure in unserved areas of the commonwealth. Pennsylvanians deserve an opportunity for economic vitality and internet access is a fundamental pillar to that opportunity.

“We know that no two jobs are exactly the same, no two workers are exactly the same, and no two businesses are exactly the same. The individualized services in the governor’s Back to Work PA plan connect job seekers to the education or training that will set them up for success in the labor market, while also helping businesses connect to the skilled workforce they need to thrive,” said Department of Labor & Industry Acting Secretary Jennifer Berrier. “By making these smart investments now, we can build up our workforce to make Pennsylvania’s workers the most in-demand in the country as we emerge into the new post-pandemic world.”

“The COVID-19 pandemic has hurt our communities and businesses, and we cannot stall on taking bold, strategic action to expedite a faster recovery,” said Department of Community and Economic Development (DCED) Secretary Dennis Davin. “Bolstering our workforce benefits our economy—and by extension, our communities—and Back to Work PA would provide the critical funding necessary to address Pennsylvania’s needs both now and in the future.”

Back to Work PA is part of the governor’s 2021 legislative plan, which prioritizes cut taxes for working families and businesses, while investing more money in education and workforce development.

“Our commonwealth is competing against the world for talent. To hasten Pennsylvania’s recovery, and strengthen its long-term competitive advantage, we must make the shift to people and place-centered economic policies that enhance the pipeline to retain, train, attract, and empower a diverse, talented workforce, which in turn will strengthen our business community. The Back to Work PA Plan would do just that,” said Kevin Schreiber, president of the York County Economic Alliance.

“I’m proud to partner with Governor Wolf and support his plan to invest in working families and get our economy back on track,” said state Sen. John Kane (D-Chester/Delaware). “I was a union plumber for four decades, and I led my union through the Great Recession. I have seen firsthand the toll that this kind of economic downturn takes on working people. This is more than a paycheck. During the recession, I lost members to suicide and overdoses, and those issues have only gotten worse during this pandemic. We need to get our low-wage workers, our workers of color, folks that have been disproportionately impacted, back to work. The governor’s plan would do just that, and I’m proud to stand with him to fight for a Pennsylvania that works for working people.”

“Pennsylvanians continue to face the biggest and most critical challenges of their lifetimes due to the COVID-19 pandemic,” said state Rep. Maureen Madden (D-Monroe). “Back to Work PA offers a path to economic stability by imposing a long overdue commonsense tax on natural gas extraction. I fully support Governor Wolf’s diverse initiative to rebuild our infrastructure and get Pennsylvanians back in the workforce.”

Since the start of the pandemic, the Wolf Administration has provided more than $670 million in relief to businesses and non-profits in addition to support programs such as the Paycheck Protection; most recently, $145 million to provide much-needed immediate relief to the hospitality industry.

“Our businesses need the immediate relief that these funds will provide, but we also need long-term solutions,” Gov. Wolf said. “Getting Pennsylvania back on track after the pandemic means investing in the businesses and workers that drive our economy and developing a sustainable solution to support long-term economic recovery. Back to Work PA will foster economic recovery by investing in our businesses, our workers, and our communities.”

Pennsylvania Governor Tom Wolf announced that the U.S. Small Business Administration (SBA) approved his request to extend the deadline for survivors of Tropical Storm Isaias to apply for low-interest loans from SBA until March 18, 2021.

“We’re so grateful for this extension, so that we make sure that everyone who is eligible and wants to apply has the time they need to do so,” said Governor Wolf. “SBA is standing by to provide whatever help is needed to anyone who wants to apply.”

The storm caused devastating flooding and significant damage in early August 2020. Homeowners, renters and businesses impacted by the flooding in Berks and Philadelphia counties, as well as the neighboring counties of Bucks, Chester, Delaware, Lancaster, Lebanon, Lehigh, Montgomery, and Schuylkill may be eligible for low-interest disaster loans through the SBA Disaster Loan Programs.

Low-interest loans of up to $200,000 are available to homeowners and renters to repair or replace damaged or destroyed real estate, and SBA regulations also permit loans up to $40,000 to repair or replace damaged personal property, including vehicles. Businesses and nonprofits can borrow up to $2 million to restore damaged or destroyed buildings, inventory, equipment and other physical losses. Economic Injury Disaster Loans are also available and may also be used to pay fixed debts, payroll, accounts payable and other bills that can’t be paid because of the disaster’s impact, whether or not the business sustained physical damage from the storm.

SBA offers long-term repayment options to keep payments affordable, with terms up to a maximum of 30 years. Terms are determined on a case-by-case basis, based upon each borrower’s ability to repay.

Due to COVID-19 mitigation efforts, the SBA will not establish a physical Disaster Loan Outreach Center (DLOC) in these communities to assist applicants. However, SBA has opened a Virtual Disaster Loan Outreach Center (VDLOC) to help survivors apply online using the Electronic Loan Application (ELA) via the SBA’s secure website.

Virtual customer support representatives will be available to assist applicants with completing the online application during the following times:

Virtual Disaster Loan Outreach Centers (VDLOCs)

Open:              Monday – Sunday (7 days per week)

Hours:            8 a.m. – 8 p.m. EST

Email:             FOCE-Help@sba.gov

Phone:            (800) 659-2955

Businesses and individuals may also obtain information and loan applications by calling the SBA’s Customer Service Center at 1-800-659-2955 (1-800-877-8339 for the deaf and hard-of-hearing), or by emailing DisasterCustomerService@sba.gov.

Loan applications can also be downloaded 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.

The filing deadline to return applications for physical property damage is March 18, 2021. The deadline to return economic injury disaster loan applications is Sept. 20, 2021.