- VA Announces Expansion of "Close to Me" Cancer Program as Part of the Cancer Moonshot, Bringing Cancer Diagnosis and Treatment Closer to Thousands of Veterans
- Biden-Harris Administration Releases National Strategy for Suicide Prevention and First-Ever Federal Action Plan
- Biden-Harris Administration Takes Historic Action to Increase Access to Quality Care, and Support to Families and Care Workers
- Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don't Meet Them.
- Rural Jails Turn to Community Health Workers To Help the Newly Released Succeed
- Rural Communities Face Primary Care Physician Shortage
- Miles for Milk: How Student-Run Grocery Store Reshaped Rural Community's Food Access
- Native Americans Have Shorter Life Spans, and It's Not Just Due to Lack of Health Care
- Promotoras Play Essential Role in Connecting Farmworkers with Health Care in Rural NorCal
- Across the Country, Amish Populations Are on the Rise
- Using Medicaid to Address Young People's Mental Health Needs in School Settings
- Sunsets, Wildlife and Limited Care: Challenges of Aging in Place in Rural America
- City-Country Mortality Gap Widens amid Persistent Holes in Rural Health Care Access
- Tribal Environmental Impact Network
- Minnesota's Rural Ambulance Providers Look to State Capitol for Their Own Lifeline
Pennsylvania Governor’s Administration Announces $59 Million to Support Beginning Farmers, Grow Pennsylvania Agriculture
Pennsylvania Governor Wolf’s Administration announced the availability of $59 million in Beginning Farmer Tax Credits over the next decade for those who sell or rent agricultural land, livestock, equipment, buildings or other assets to qualified beginning farmers.
“Pennsylvania’s $135.7 billion agriculture industry feeds our economy and feeds our world,” said Agriculture Secretary Russell Redding. “With our average farmer being 59 years old, we can’t grow and thrive without attracting new leaders to feed us in the future. These tax credits will combine with PA Farm Bill investments to provide incentives to current farmers and tear down barriers faced by aspiring farmers.”
The Beginning Farmer Tax Credit Program was established under the Pennsylvania Tax Code to provide tax credits to those who sell or rent agricultural assets to beginning farmers.
“The program provides a benefit to landowners who help new farmers get started,” said Senator Elder Vogel (R- Beaver, Butler, Lawrence), chairman of the Senate Agriculture & Rural Affairs Committee. “We know that the number one concern facing them is finding affordable farmland. None of our neighboring states offer a similar tax credit program, so this is a great way to show that Pennsylvania is serious about preserving its agricultural legacy.”
The Pennsylvania Department of Community and Economic Development, in consultation with the Pennsylvania Departments of Agriculture and Revenue, will allocate up to $5 million in tax year 2020, and up to $6 million annually through the 2030 tax year, for credits of five percent of the lesser of the sale price of fair market value of the agricultural asset, up to $32,000; or 10 percent of the gross rental income of the first, second and third year of the rental agreement, up to $7,000 per year.
“Pennsylvania runs on agriculture, both through the fresh food it puts on our plates and the economic activity that it generates,” said DCED Secretary Dennis Davin. “The Beginning Farmer Tax Credit Program ensures that today’s agribusinesses will continue to grow and thrive in the next generation and ensures that our communities and local economies will continue to benefit from this critical industry.”
Beginning farmers must meet eligibility criteria, including intent to farm in Pennsylvania, and provide the majority of the labor and management, related experience or transferable skills, and no federal gross income from agricultural production in the past 10 years. Applications for beginning farmer certification, which are evaluated by the Department of Agriculture, along with detailed eligibility criteria, can be found on the department’s website, agriculture.pa.gov. Beginning farmer certification is also required for the Realty Transfer Tax Exemption for owners of preserved farms who transfer ownership to new farmers, an incentive available under the PA Farm Bill.
Asset owners can apply for tax credits through DCED’s electronic single application at esa.dced.state.pa.us. Complete program guidelines and application instructions can be found on DCED’s website, dced.pa.gov.
Farmers can combine tax credits with other funding, including PA Farm Bill resources available through the new Ag Business Development Center to create business plans to enhance economic viability; transition ownership and operation of a farm to new owners and operators; expand or diversify their operations to reach new markets and increase profitability.
New CDC COVID Guidance Published on Relief Care, Especially for Rural Communities
This guidance is intended for state and local emergency medical planners and all healthcare facilities, especially facilities in rural areas. The guidance outlines considerations around the transfer of patients, staff, and supplies between healthcare facilities to optimize patient care, balance resources, and to minimize use of crisis care standards. One strategy is to identify relief healthcare facilities and either establish a federal, state, or regional Medical Operation Coordination Cell (MOCC) or coordinate with an existing MOCC. This guidance offers considerations for jurisdictions around patient safety and relief healthcare facility operations.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/relief-healthcare-facilities.html
New Resources on Health Equity
The National Academy of Medicine released “Resources on Health Equity in the Context of COVID-19 & Disproportionate Outcomes for Marginalized Groups.” The National Academy of Medicine’s Culture of Health Program works in partnership with national and local stakeholders on behalf of the fundamental changes needed to eliminate inequities for populations across the United States.
Additional Commodities Eligible for Coronavirus Food Assistance Program
U.S. Secretary of Agriculture Sonny Perdue announced an initial list of additional commodities that have been added to the Coronavirus Food Assistance Program (CFAP), and that the U.S. Department of Agriculture (USDA) made other adjustments to the program based on comments received from agricultural producers and organizations and review of market data. Producers will be able to submit applications that include these commodities on Monday, July 13, 2020. USDA’s Farm Service Agency (FSA) is accepting through Aug. 28, 2020, applications for CFAP, which helps offset price declines and additional marketing costs because of the coronavirus pandemic. USDA expects additional eligible commodities to be announced in the coming weeks.
Changes to CFAP include:
- Adding the following commodities: alfalfa sprouts, anise, arugula, basil, bean sprouts, beets, blackberries, Brussels sprouts, celeriac (celery root), chives, cilantro, coconuts, collard greens, dandelion greens, greens (others not listed separately), guava, kale greens, lettuce – including Boston, green leaf, Lolla Rossa, oak leaf green, oak leaf red and red leaf – marjoram, mint, mustard, okra, oregano, parsnips, passion fruit, peas (green), pineapple, pistachios, radicchio, rosemary, sage, savory, sorrel, fresh sugarcane, Swiss chard, thyme and turnip top greens.
- Expanding for seven currently eligible commodities – apples, blueberries, garlic, potatoes, raspberries, tangerines and taro – CARES Act funding for sales losses because USDA found these commodities had a 5 percent or greater price decline between mid-January and mid-April as a result of the COVID-19 pandemic. Originally, these commodities were only eligible for marketing adjustments.
- Determining that peaches and rhubarb no longer qualify for payment under the CARES Act sales loss category.
- Correcting payment rates for apples, artichokes, asparagus, blueberries, cantaloupes, cucumbers, garlic, kiwifruit, mushrooms, papaya, peaches, potatoes, raspberries, rhubarb, tangerines and taro.
Additional details can be found in the Federal Register in the Notice of Funding Availability (NOFA) and Final Rule Correction and at www.farmers.gov/cfap.
In Pennsylvania, Dashboard Data Confirms Need for Masking, Social Distancing
Pennsylvania Governor Tom Wolf released a weekly status update detailing the state’s mitigation efforts based on the COVID-19 Early Warning Monitoring System Dashboard comparing the seven-day period of July 3 – July 9 to the previous seven days, June 26 – July 2.
The dashboard is designed to provide early warning signs of factors that affect the state’s mitigation efforts. The data available on the dashboard includes week-over-week case differences, incidence rates, test percent-positive rates, and rates of hospitalizations, ventilations and emergency room visits tied to COVID-19.
“By looking at both statewide status and individual county status, we can take steps to stop increases before they become critical,” Gov. Wolf said. “One thing we know for certain is that we must continue to wear masks and practice social distancing. Risky behavior such as going out without a mask and congregating at a bar or in a crowded setting where social distancing isn’t being practiced are leading to spikes in cases and higher percent-positive rates.”
As of Thursday, July 9, the state has seen a seven-day case increase of 4,914; the previous seven-day increase was 4,359.
While the statewide percent-positivity rate is at 4.4%, counties with concerning percent-positivity rates include Allegheny (7.9%), Beaver (6.3%), Butler (5.5%), Clarion (14.6%), Fayette (5.2%), Greene (5.4%), Lawrence (5.8%), Lebanon (5.6%), Philadelphia (5.1%), Washington (7.2%), Westmoreland (5.4%) and York (6.3%). Each of these counties bears watching as the state continues to monitor all available data.
The Pennsylvania Department of Health updated its travel recommendations and frequently asked questions, originally announced on July 2, to include Delaware, Iowa, Kansas and Oklahoma on the list of states recommended for domestic travelers returning from to quarantine for 14 days upon return to Pennsylvania.
Gov. Wolf continues to prioritize the health and safety of Pennsylvanians through the COVID-19 pandemic. Pennsylvanians should continue to take actions to prevent the spread of COVID-19, regardless of the status of their county. This includes wearing a mask or face covering anytime they are in public. COVID-19 has been shown to spread easily in the air and contagious carriers can be asymptomatic.
New Rural Policy Brief Published on Telepharmacy Rules and Statutes
A new rural policy brief is available from the RUPRI Center for Rural Health Policy Analysis:
Telepharmacy Rules and Statutes: A 3-Year Update for all 50 States
Jason Semprini, MPP; Fred Ullrich, BA; Keith Mueller, PhD
This policy brief analyzed administrative rules and legislative statutes governing each state’s pharmacy practice. Key features of telepharmacy regulations were investigated for comparative analysis. Twenty-one states currently authorize retail telepharmacy, but between these states the regulatory activity varies considerably.
Please click here to read the brief.
Senate Bill Aims to Preserve 340B Eligibility for Hospitals Affected by COVID-19 Pandemic
Fierce Healthcare, by Robert King |
A group of bipartisan senators introduced legislation to ensure that a hospital doesn’t fall out of the 340B drug discount program due to a rapid change in patient volume sparked by COVID-19. The bill comes as hospitals continue to grapple with a financial crisis sparked by the pandemic. It also centers on a controversial program that the Trump administration has sought to cut by more than a third.
“As the ongoing pandemic disrupts our health care system, we must ensure that programs like the 340B program can be there to support our hospitals and our communities,” said Sen. Rob Portman, R-Ohio, one of the co-sponsors of the bill, in a statement.
340B hospitals get a discount on drugs if they meet certain requirements, including providing a certain amount of charity care. Pharmaceutical manufacturers agree to provide the discounts in exchange for their products getting reimbursed by Medicaid. But a critical metric for determining if a hospital is eligible for 340B is the inpatient hospital admissions of low-income Medicare and Medicaid patients.
However, patient volumes have plummeted at hospitals across the country as the pandemic forced facilities to shutter elective surgical procedures and patients have been afraid of entering a facility for fear of contracting the virus.
“Though hospitals have started resuming elective procedures, and patients have begun returning to seek care, there is concern that as a result of this year’s slowdown, some hospitals may not meet the required inpatient admission threshold to remain in the program for the following year,” according to a release on the bill.
The legislation would ensure any previously eligible 340B hospital would still be eligible for any cost reporting period during the COVID-19 public health emergency.
The current public health emergency period expires July 25. However, Department of Health and Human Services spokesman Michael Caputo tweeted last week that the agency is expected to extend the period again, although no final announcement has been made.
The other co-sponsors of the legislation are Sens. John Thune, R-South Dakota; Debbie Stabenow, D-Michigan; Tammy Baldwin, D-Wisconsin; Ben Cardin, D-Maryland; and Shelley Moore Capito, R-West Virginia.
House lawmakers have also written to leadership asking for similar protections for eligibility for hospitals.
The 340B program has been the focal point of intense opposition from the pharmaceutical industry, which charges the program has gotten too large and that hospitals are not using the savings from discounts on improving patient care. Hospitals shoot back that the discount program is needed for safety-net hospitals already struggling to meet ever-increasing drug prices.
The program has been the center of a major legal fight between hospitals and the Trump administration. Hospitals have sued to halt a nearly 30% cut to payments that the administration instituted in 2018 and 2019. A federal judge sided with the hospital industry that the administration doesn’t have the authority to install the cuts.
However, hospital groups have lately started to battle with the Centers for Medicare & Medicaid Services (CMS) over a survey sent by the agency to 340B hospitals on the acquisition costs for certain outpatient covered drugs. The agency said the survey is intended to help determine payment amounts for drugs acquired by 340B hospitals in order to repay such facilities for the payment cuts.
But hospitals have charged that CMS should instead repay hospitals in full for the payment cuts instead of creating a new solution via the survey.
House Lawmakers Want New Flexibility to Ensure Hospitals Don’t Lose 340B Eligibility Due to COVID-19 Response
Fierce Healthcare, by Robert King |
Some House lawmakers want to ensure safety net hospitals wouldn’t lose eligibility to participate in the 340B drug discount program due to their response to COVID-19. Reps. Doris Matsui, D-California, and Chris Stewart, R-Utah, wrote to House leadership outlining concerns that hospitals will be cut off from the program because they have to expand capacity to fight COVID-19.
“To support our safety net hospitals through this crisis, we write to ask that any future supplemental relief bill include policies to temporarily protect these hospitals from losing 340B eligibility,” the lawmakers wrote.
The 340B program requires drug companies to provide discounts to disproportionate share hospitals (DSHs) as a condition to participate in Medicaid. But for a DSH hospital to maintain eligibility, there are several requirements, including that they care for a certain number of DSH patients.
Hospitals, however, are boosting their bed capacity and shifting care to outpatient settings to reserve care for the most critical cases, the letter said.
“While such operational changes are essential to build capacity for crisis response at this time, ensuing shifts in payer mix could potentially reduce a hospital’s DSH adjustment percentage and jeopardize their eligibility for the 340B program,” the lawmakers added.
Lawmakers were also worried about requirements that restrict hospitals from using a group purchasing organization for covered outpatient drugs.
While the Health Resources and Services Administration has given guidance to 340B hospitals on this issue, the agency said it cannot waive the prohibition. The 340B program has been the focal point of a legal battle between the Trump administration and hospitals. Hospital groups challenged a nearly 30% cut to the 340B program and prevailed in court.
Pharmaceutical companies charge that the program has gotten too unwieldy and large and that the discounts are not helping hospitals that need them. But hospital groups and 340B advocates charge that drug companies are seeking to avoid offering much-needed discounts to high-cost products and that the program helps hospitals operating on thin margins.
National Rural Health COVID-19 TA Center Launched
Individuals in rural communities often face barriers to health stemming from economic factors, environmental differences, and feelings of isolation. The COVID-19 pandemic has presented a generational challenge and exacerbated these concerns, revealing a critical need for rapid response efforts. With the support of a generous grant of $200,000 from CoBank, the National Rural Health Association (NRHA) is helping rural health care providers overcome barriers they face through the creation of the Rural COVID-19 Technical Assistance Center.
HHS Announces COVID-19 Funding to Certain Rural and Other Providers from Small Metropolitan Areas
In May, HHS announced $10 billion in funding to almost 4,000 rural health care providers including hospitals, health clinics, and health centers. HHS is expanding the existing payment formula to include certain special rural Medicare designation hospitals in urban areas as well as others who provide care in smaller non-rural communities. These may include some suburban hospitals that are not considered rural but serve rural populations and operate with smaller profit margins and limited resources than larger hospitals. They too, have suffered in this pandemic, which is why HHS is responding. HHS estimates the funding announced today will provide relief of over $1 billion to 500 of these hospitals with payments ranging from $100,000 to $4,500,000 for rural designated providers and $100,000 to $2,000,000 for the other providers.
State-by-state breakdown – PDF
Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing approximately $3 billion in funding to hospitals serving a large percentage of vulnerable populations on thin margins and approximately $1 billion to specialty rural hospitals, urban hospitals with certain rural Medicare designations, and hospitals in small metropolitan areas. HHS is also opening the provider portal to allow dentists to apply for relief. HHS recognizes the urgent need these vital funds play in supporting safety net providers and those serving large rural populations facing financial devastation catalyzed by the pandemic.
“We’ve been distributing the Provider Relief Funds as quickly as possible to those providers who have been hardest hit by the pandemic,” said HHS Secretary Alex Azar. “President Trump is supporting hospitals in continuing to provide COVID-19 care and returning to everyday procedures, especially hospitals that serve vulnerable and minority populations. Close work with stakeholders informed how we targeted this new round of funds to hard-hit safety-net and rural providers.”
As COVID-19 continues to disrupt daily lives, HHS is providing support to healthcare providers fighting the pandemic through the bipartisan CARES Act and the Paycheck Protection Program and Health Care Enhancement Act, which allocated $175 billion in relief funds to hospitals and other healthcare providers, including those disproportionately impacted by this pandemic.
Additional $3 Billion to Safety Net Hospitals
On June 9th, HHS announced plans to distribute $10 billion in Provider Relief Fund payments to safety net hospitals serving our most vulnerable citizens. Throughout this pandemic, HHS has continued to maintain an open line of communication with Members of Congress, state and local officials, providers and stakeholders to inform our response to this public health emergency. Accordingly, we learned some acute care hospitals did not qualify for funding from this initial announcement. HHS is now expanding the criterion for payment qualification so that certain acute care hospitals meeting the revised profitability threshold of less than of 3 percent averaged consecutively over two or more of the last five cost reporting periods, as reported to the Centers for Medicare and Medicaid Services (CMS) in its Cost Report filings, will now be eligible for payment. HHS expects to distribute over $3 billion across 215 acute care facilities, bringing the total payments for safety net hospitals from the Provider Relief Fund to $12.8 billion to 959 facilities.
State-by-state breakdown – PDF
$1 Billion to Certain Rural Providers and Other Providers from Small Metropolitan Areas
In May, HHS announced $10 billion in funding to almost 4,000 rural health care providers including hospitals, health clinics, and health centers. HHS is expanding the existing payment formula to include certain special rural Medicare designation hospitals in urban areas as well as others who provide care in smaller non-rural communities. These may include some suburban hospitals that are not considered rural but serve rural populations and operate with smaller profit margins and limited resources than larger hospitals. They too, have suffered in this pandemic, which is why HHS is responding. HHS estimates the funding announced today will provide relief of over $1 billion to 500 of these hospitals with payments ranging from $100,000 to $4,500,000 for rural designated providers and $100,000 to $2,000,000 for the other providers.
State-by-state breakdown – PDF
Enhanced Provider Relief Fund Payment Portal and Dentists
In June, HHS announced the launch of the Enhanced Provider Relief Fund Payment Portal where eligible Medicaid, Medicaid managed care and CHIP providers were the first to begin reporting their annual patient revenue information for funding. Today, HHS is announcing this portal and an application process is now open to dentists who may not have previously been eligible to receive funding through the Provider Relief Fund. Eligible dentists will receive a reimbursement of two percent of their annual reported patient revenue and will have until July 24, 2020 to apply for funding through the Enhanced Provider Relief Fund Payment Portal. This second phase of General Distribution will continue to expand to include other providers submitting applications for future relief funding opportunities or as directed by HHS.