Rural Health Information Hub Latest News

Pennsylvania Announces Week-Six of Regional Testing Extension Across the Commonwealth

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Pennsylvania Secretary of Health Dr. Rachel Levine announced beginning Tuesday, January 12, regional drive-thru and indoor walk-in testing clinics will be held in Bradford, Clarion, Fulton, Lancaster and Pike counties. The counties with testing sites will continue to change weekly over the next seven weeks so that 61 counties will eventually be covered by dedicated pop-up testing sites over a 12-week period.

“Over the past several weeks, we have seen a rapid increase of positive case counts reaching record-high levels, which gives us significant cause for concern,” Dr. Levine said. “In fact, every county now has a positivity-rate greater than five percent, which is alarming. In addition, 21 counties have percent positivity above 20 percent.”

From March through January 7, the department has received 7,831,153 polymerase chain reaction (PCR) test results, which roughly equates to 61.1 percent of the population. From May through January 7, the department has received 805,895 antigen test results. The total number of tests combined equates to 8,637,048, roughly 67.4 percent of the total Pennsylvania population.

Pennsylvania is currently in the yellow level of testing – 2,000 to 2,999 tests per 100,000 population – according to the White House Task Force Weekly Report.

The department extended and expanded its initial contract with AMI to perform pop-up testing in counties across the state. Counties under the initial contract, as well as the total number of patients tested, can be found here. The initial AMI testing and the extension were funded by the federal ELC Enhancing Detection grant.

Director of Testing and Contact Tracing, Michael Huff, added that testing is going well at these sites.

“With the capacity to test up to 450 people per day, these sites are getting thousands of people tested during the course of the days-long site set-ups,” Huff said. “Testing is more important than ever in Pennsylvania and we will continue with a robust testing plan to keep Pennsylvanians safe and identify cases of COVID-19.”

The department believes that increased testing in the counties will assist in determining the prevalence of the virus and assist the county in moving forward. Concerning counties, identified as those with percent positives above five percent, which is currently every county in the state, can be found on the Early Warning Monitoring Dashboard. Each county is being monitored as the state continues to examine all available data.

“We are grateful for our tremendous partnership with AMI and participating county entities to provide pop-up testing in five regions across the commonwealth,” Dr. Levine said. “The AMI testing sites will be open to anyone who feels they need a test. It is important that even people with no symptoms who test positive isolate to stop the spread of COVID-19.”

Beginning Tuesday, January 12, drive-thru testing clinics will be held to contain the recent rapid increase in COVID-19 cases in the following three counties:

  • Bradford;
  • Clarion; and
  • Pike.

Fulton and Lancaster counties will also begin Tuesday, January 12, but will be drive-thru and indoor walk-in clinics.

Testing will be available daily from 9:00 AM to 6:00 PM starting Tuesday, January 12 through Saturday, January 16.

The testing site locations and addresses are:

  • Bradford County:  Towanda Airport, 415 Airport Road, Towanda, PA, 18848;
  • Clarion County:  100 Clarion County Park, Shippenville, PA;
  • Fulton County:  American Legion, 411 North Fifth Street, McConnellsburg, PA, 17233;
  • Lancaster County:  Old Sears Auto Center, 142 Park City Center, Lancaster, PA, 17601; and
  • Pike County:  Dingmans Ferry Park and Ride, 1838 Route 739, Dingmans Ferry, PA, 18328.

Up to 450 patients can be tested per day. Mid-nasal passage swab PCR tests will be performed. Testing is on a first-come, first-serve basis and is completely free to all patients. Testing is also open to individuals who are not county residents. Patients must be ages three and older and are not required to show symptoms of COVID-19 in order to be tested. No appointment is necessary. Patients are encouraged to bring a photo-ID or insurance card. Registration will also be completed on-site. The turnaround time for testing results is two to seven days after testing.

Individuals who are tested should self-quarantine while they await test results. Individuals who live with other people should self-quarantine in a private room and use a private bathroom if possible. Others living in the home with the individual awaiting test results should also stay at home. The department has additional instructions for individuals waiting for a COVID-19 test result. Individuals who test positive will receive a phone call from AMI while individuals who test negative will receive a secured-PDF emailed to them from AMI.

For the latest information for individuals, families, businesses and schools, visit “Responding to COVID-19” on pa.gov.

COVID-19 Vaccine Gives Pennsylvanians Hope as Plans are Updated

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Pennsylvania’s COVID-19 vaccination distribution plan was designed to be fluid and flexible to meet guidance and recommendations from the federal government. Governor Tom Wolf and Secretary of Health Dr. Rachel Levine announced the fourth version of the plan, detailing the updates and how the state is working to ensure safe, swift implementation.

“Vaccinations are an important tool in stopping the spread of COVID-19, and the Pennsylvania Department of Health and the Pennsylvania Emergency Management Agency have done a lot of hard work to facilitate a smooth, strategic vaccine rollout,” Gov. Wolf said. “But most of the vaccine distribution process is controlled by the federal government and unfortunately, that means there are a lot of unknowns.

“However, my administration is doing everything we can now to prepare for the day when the vaccine is more widely available. There are hopeful signs we must embrace. They will help us regain control in a time when many things may seem very out of control.”

The first shipments of vaccine to Pennsylvania are being given to health care workers, and through the Federal Pharmacy Partnership with information the Department of Health has shared with the federal government, people working and residing in the state’s long-term care facilities have also begun to receive the vaccine. This work continues.

While the vaccine supply remains limited the department’s goals are to prioritize persons who receive the vaccine to maximize benefits and minimize harms caused by the virus. Ongoing goals remain to promote justice, mitigate health inequities, and promote transparency.

Getting Pennsylvanians immunized with a safe and effective COVID-19 vaccine is an essential step in reducing the number of cases, hospitalizations and deaths. The Department of Health guides the distribution and administration of the COVID-19 vaccine throughout 66 of the 67 counties in the commonwealth. Philadelphia County receives independent federal funding, its own vaccine allotment, and is establishing its own COVID-19 vaccination administration plan.

The state’s vaccination plan follows the blueprint set forth by the Centers for Disease Control and Prevention (CDC) regarding a COVID-19 Vaccination Plan. The plan is an interim one that is being continuously updated to reflect the latest recommendations from the Advisory Committee on Immunization Practices (ACIP) and other guidance available and feedback received.

Dr. Levine provided details of the newly revised state plan.

“This update aligns our plan with the latest recommendations from the ACIP and CDC,” Dr. Levine said. “Phase 1A has been further defined to identify specific health care providers. Phase 1B is now a significantly larger group of people that includes people age 75 and older, those with significant health issues and essential workers. This update also creates a Phase 1C, which is those people age 65-74 and people with high-risk conditions such as cancer, COPD, hearth conditions and pregnant women, and those essential workers not included in Phase 1A or B.”

When more vaccine is available, anyone who was not previously covered and is age 16 and older, will now be vaccinated in Phase 2.

The revised plan as posted on the department’s website includes a comment form for all interested parties to provide input to be considered by the department. This form helps to fulfill the administration’s goal of promoting transparency and making this fluid process as inclusive as possible.

“Our recent success in slowing the spread of the virus, and the hope that we’ve been given with the introduction of these vaccines should energize all of us to continue the fight against this disease,” Gov. Wolf said. “We need to remain patient as vaccine distribution expands and the Department of Health works to keep everyone informed of the status of vaccine.

“It will take time, but a future without COVID-19 is possible, and I thank all Pennsylvanians for joining me in fighting for that future.”

The most up-to-date information regarding the COVID-19 vaccine, including the fourth version of the plan can be found on the vaccine section of the department’s website.

Pennsylvania Surpasses Average National Testing Rate, According to White House Task Force Report

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The Pennsylvania Department of Health highlighted that Pennsylvania is above the average national testing rate as noted in the White House Task Force Weekly Report dated January 3.

According to the report, Pennsylvania was at the yellow level for number of tests performed per 100,000 people for the previous week. The yellow level is 2,000 to 2,999 tests per 100,000 population.

Director of Testing and Contact Tracing Michael Huff reported that to date, the department collected results from 8,466,597 COVID-19 PCR and antigen tests statewide. Over the past 30 days, the department reported an average of 55,208 PCR tests and 14,421 antigen tests daily, for a total of nearly 69,629 tests each day on average.

“We want Pennsylvanians to know that if they need a test, one is available,” Sec. of Health Dr. Rachel Levine said. “This week, we have added five free testing sites and will continue to expand testing opportunities across the state weekly. As COVID-19 remains a threat in our communities, we need to take precautions to keep ourselves safe by monitoring ourselves for COVID-19 symptoms, finding a testing site near to us if we have symptoms and staying home if we are sick.”

In partnership with AMI Expeditionary Healthcare (AMI), Pennsylvania offers COVID-19 testing over the next 12 weeks as five strike teams will provide regional testing for 61 counties. The six counties not receiving testing from AMI have county health departments providing other means of COVID-19 testing.

The county pop-up testing sites are open from 9 a.m. to 6 p.m. All tests are free and are on a first-come, first-served basis. The department provides an update each week regarding the testing locations for the following week.

The White House Report also noted that Pennsylvania has seen a decrease in new cases and a decrease in test positivity. Pennsylvania had 392 new cases per 100,000 population, compared to a national average of 413 per 100,000. According to the report, Pennsylvania’s percent positivity is at a rate at or above 10.1%, or the 21st highest rate in the country.

Learn more about testing and find a map of COVID-19 testing sites here.

You can find the weekly White House Task Force Reports available on the department’s website here.

CMS COVID-19 Stakeholder Engagement Calls- January 2021

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CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

Call details are below. Conference lines are limited so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and professional networks. These calls are not intended for the press.

Calls recordings and transcripts are posted on the CMS podcast page at: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts

CMS COVID-19 Office Hours Calls (twice a month on Tuesday at 5:00 – 6:00 PM Eastern) 

Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:

  • Increase Hospital Capacity – CMS Hospitals Without Walls;
  • Rapidly Expand the Healthcare Workforce;
  • Put Patients Over Paperwork; and
  • Further Promote Telehealth in Medicare

Next Office Hours:

Tuesday, January 12th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 4688247

Audio Webcast link: https://edge.media-server.com/mmc/p/p5jw6syi

COVID-19 Care Site-Specific Call

COVID-19 Vaccine Safety: A Fireside Chat with CMS, CDC, and front line staff and providers

              Wednesday, January 13, 2021 4pm ET

Register in advance for this webinar (After registering, you will receive a confirmation email containing information about joining the webinar):   https://cms.zoomgov.com/webinar/register/WN_VQnfc77zTaOho3-yYrtGUA

Join The Centers for Medicare & Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC) for a fireside chat on vaccine safety. This is the third discussion in a special series, a part of the CMS National Nursing Home Stakeholder Call Series, aimed at addressing staff questions and concerns about the new COVID-19 vaccines. Each session will be moderated by CMS with speakers from CDC and representatives of front line staff and providers.

This chat will continue to address myths surrounding vaccine danger with the following panelist:

  • Dr. Lee Fleisher, CMS Chief Medical Officer and Director, Center for Clinical Standards and Quality (CMS)
  • Dr. Amanda Cohn, Chief Medical Officer (Acting), Office of Vaccine Policy, Preparedness, and Global Health, Office of the Director (CDC)
  • Roberta Jaramillo, Environmental Services District Manager, HealthCare Services Group

Preparing for the call:

For the most current information including call schedule changes, please click here

To keep up with the important work the White House Task Force is doing in response to COVID-19 click here: https://protect2.fireeye.com/url?k=36fa2226-6aae0b0d-36fa1319-0cc47a6d17cc-2d06c219f858d641&u=http://www.coronavirus.gov/. For information specific to CMS, please visit the Current Emergencies Website.

 

Long-Term Care Facility Toolkit: Preparing for COVID-19 Vaccination at Your Facility

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This toolkit provides long-term care facility (LTCF) administrators and clinical leadership with information and resources to help build vaccine confidence among healthcare personnel (HCP) and residents. You play a critical role in providing trusted information and ensuring high COVID-19 vaccination coverage in your facility.

Based on recommendations from the Advisory Committee on Immunization Practices (ACIP), an independent panel of medical and public health experts, CDC recommends that HCP and LTCF residents be among those offered the first doses of COVID-19 vaccines.

CMS Issues New Roadmap for States to Address the Social Determinants of Health to Improve Outcomes, Lower Costs, Support State Value-Based Care Strategies

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The Centers for Medicare & Medicaid Services (CMS) issued guidance to state health officials designed to drive the adoption of strategies that address the social determinants of health (SDOH) in Medicaid and the Children’s Health Insurance Program (CHIP) so states can further improve beneficiary health outcomes, reduce health disparities, and lower overall costs in Medicaid and CHIP.  SDOH describe the range of social, environmental, and economic factors that can influence health status—conditions that can often have a greater impact on health outcomes than the actual delivery of health services. The new guidance describes how states can leverage existing flexibilities under federal law to tackle adverse health outcomes that can be impacted by SDOH and supports states with designing programs, benefits, and services that can more effectively improve population health and reduce the cost of caring for our nation’s most vulnerable and high-risk populations.

The United States spends more on health care than almost any other country yet often underperforms on key health indicators including life expectancy, reducing chronic heart disease, and maternal and infant mortality rates. According to the CMS Office of the Actuary, national health spending is projected to grow rapidly and reach $6.2 trillion by 2028.  For its part, in 1985, Medicaid spending consumed less than 10% of state budgets and totaled just over $33 billion dollars. In 2019 that number had grown to consume 29% of total state spending at a total cost of $604 billion dollars.

To address the contradiction between rising costs and low health outcomes, CMS has committed to accelerating the industry’s shift away from traditional fee-for-service payment models to value-based models that hold clinicians accountable for cost and quality. As part of its continued efforts to advance value-based care, CMS recently issued guidance to state Medicaid directors to encourage the incorporation of value-based strategies across their healthcare systems allowing states to provide Medicaid beneficiaries with efficient, high quality care, while lowering cost and improving health outcomes. The guidance also noted that the adoption of value-based care arrangements could better provide opportunities for states to address SDOH as well as disparities across the health care system.

“The evidence is clear: social determinants of health, such as access to stable housing or gainful employment, may not be strictly medical, but they nevertheless have a profound impact on people’s wellbeing,” said CMS Administrator Seema Verma. “Unfortunately, our fee-for-service system inherently limits the doctor-patient relationship to what can be accomplished inside the four walls of a clinician’s office. Today’s letter to state health officials highlights strategies by which states can promote a value-based system that fosters treatment of the whole person and lowers healthcare costs. Patients are more than a bundle of medical diagnoses, and it’s time our healthcare system treated them as such.”

With the release of today’s SDOH guidance, CMS acknowledges that an understanding of the social, economic, and environmental factors that affect the health outcomes of Medicaid and CHIP populations can be an integral component of states’ efforts to realign incentives, reduce costs, and advance value-based care in their health systems.

The guidance recognizes that Medicaid and CHIP beneficiaries face challenges related to SDOH, including but not limited to access to nutritious food, affordable and accessible housing, quality education, and opportunities for meaningful employment.

Growing evidence indicates that these challenges can lead to poorer health outcomes for beneficiaries and higher health care costs for Medicaid and CHIP programs and can exacerbate health disparities for a broad range of populations, including individuals with disabilities, older adults, pregnant women, children and youth, individuals with mental health and/or substance use disorders, and individuals living in rural communities.

SDOH can affect health care utilization and cost, health outcomes, and health disparities.  For example, the on-going COVID-19 pandemic has exacerbated long-understood disparities in health outcomes among low-income populations, particularly children.  Recent Centers for Disease Control and Prevention data indicate that counties with greater social vulnerability, including high poverty rates and crowded housing units were more likely to become COVID-19 hotspots, potentially putting those who experience economic and housing constraints at a higher risk of contracting the virus. Additionally, with many schools closed for in-person learning due to COVID-19 restrictions, some low-income children have less access to free non-academic supports that affect their health and well-being, including food assistance, counseling services, and homelessness and maltreatment interventions.  According to CMS’s own data, some children are also forgoing key services they might receive such as child screens and vaccinations prior to the start of the school year or in-school services such as speech therapy, physical therapy, and occupational therapy, demonstrating the influence that social networks and physical environment can have on children’s health.

Current research indicates that some social interventions targeted at Medicaid and CHIP beneficiaries can result in improved health outcomes and significant savings to the health care sector.  These investments can also prevent or delay beneficiaries needing nursing facility care by offering services to facilitate community integration and participation and help keep children on normative developmental trajectories in education and social skills.

The SDOH guidance details how state Medicaid and CHIP programs can utilize a variety of delivery approaches, benefits, and reimbursement methodologies to improve beneficiary outcomes. States can use different federal authorities that can provide them with flexibility to design an array of services to address SDOH and that can be tailored, within the constraints of certain federal rules, to address state-specific policy goals and priorities, including the movement from volume-based payments to value-based care, and the specific needs of states’ Medicaid and CHIP beneficiaries.

While states have flexibility to design a number of different services to address SDOH, the guidance focuses on a set of services and supports that states can cover under current law, including housing-related services and supports, non-medical transportation, home-delivered meals, educational services, and employment supports. CMS remains committed to partnering with states to address beneficiaries’ SDOH. When used in accordance with statutory and regulatory requirements, the Medicaid and CHIP programs are uniquely positioned to help states lower health care costs, improve health outcomes, and increase the cost-effectiveness of health care services and interventions for its beneficiaries.

CMS has placed an emphasis on addressing SDOH across all of its programs in its continued efforts to move toward a value-based model of care delivery.

To view the Opportunities in Medicaid and CHIP to Address Social Determinants of Health letter, please visit: https://www.medicaid.gov/federal-policy-guidance/downloads/sho21001.pdf

Strategies for Managing a Surge in COVID-19 Cases

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In response to a surge in COVID-19 cases in many areas of the country, the federal Healthcare Resilience Working Group has released guidance detailing strategies to help healthcare providers manage patient surge (PDF – 197 KB). State, local, tribal, and territorial governments can use these strategies to enhance their health care capabilities and support a more comprehensive healthcare system response

State Strategies to Support Substance Use Disorder Treatment in the Primary Care Safety Net

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The National Academy for State Health Policy (NASHP) released a toolkit, “State Strategies to Support Substance Use Disorder Treatment in the Primary Care Safety.” It features lessons learned from five states (Alabama, Illinois, South Dakota, Virginia, and Wisconsin) that strengthen the capacity of health centers to deliver substance use disorder care.

The toolkit was produced through HRSA’s cooperative agreement with National Organizations of State and Local Officials.

Check out the Toolkit.

Ending the HIV Epidemic Through Community Engagement

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The Association for State and Territorial Health Officials (ASTHO) published a blog post that outlines the importance of community engagement in addressing the severe disparities in new HIV diagnoses as a part of the Ending the HIV Epidemic: A Plan for America.

The toolkit was produced through HRSA’s cooperative agreement with National Organizations of State and Local Officials.

Read the blog post.

Vaccine Administration for Those Without Health Care Coverage

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Health care providers who have conducted COVID-19 testing, provided treatment for uninsured individuals with a COVID-19 diagnosis, and/or incurred vaccination administration fees on or after February 4, 2020 can request claims reimbursement through the HRSA COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured program.

More than $2.8 billion in claims have been paid for COVID-19 testing and treatment of uninsured individuals. Get started today to receive reimbursement typically within 30 working days.

Learn more and apply for claims reimbursement.