Rural Health Information Hub Latest News

Restaurants in Pennsylvania Can Safely Increase Indoor Capacity to 50 Percent with Self-Certification   

Pennsylvania Department of Community and Economic Development (DCED) Secretary Dennis Davin and Agriculture Secretary Russell Redding reminded Pennsylvania restaurant, bar and club owners that they may increase indoor capacity from 25 percent to 50 percent through self-certification, which will increase consumer confidence but will not lead to additional inspections or penalties.

“Contrary to what business owners may have heard, the self-certification process will not create any negative impacts, lead to increased inspections, or pose threats or penalties,” said Sec. Davin. “Rather, this process is a win-win for both restaurants and consumers, as it will inspire consumer confidence and lead to increased patronage and sales.”

As of November 2, nearly 8,300 restaurants—or approximately 32 percent of all restaurants—have self-certified. The self-certification process is still open for restaurants that wish to self-certify. There is no cost to self-certification.

Restaurants can access the online self-certification form on PA.GOV/COVID. Self-certification enables restaurants, private social clubs and ​food service businesses that serve dine-in, sit down food in a regular, non-event capacity to increase indoor occupancy to 50 percent while adhering to mitigation efforts that will keep employees and customers safe.

The occurrence of regularly scheduled or complaint-based inspections from enforcement agencies will not be affected by certification status. In fact, certifying proves that a business is committed to protecting employees and providing patrons a safe dining experience.

“We encourage all Pennsylvania restaurants to take advantage of this opportunity to both increase capacity and improve visibility of your business,” said Sec. Redding. “Now more than ever, Pennsylvanians want to make educated dining decisions to keep their families safe. Self-certification gives restaurant owners a tool to reassure customers that they are working to keep them, and the staff who serve them, safe.”

The Wolf Administration has released Frequently Asked Questions as a reference for restaurant owners and the public, along with updated restaurant guidance.

Business owners with additional questions about the self-certification program can contact covidselfcert@pa.gov.

Are You Eligible for Assistance Through the Coronavirus Food Assistance Program 2?

Signup for the Coronavirus Food Assistance Program 2 (CFAP 2) began on Sept. 21, 2020 and will continue through Dec. 11, 2020. CFAP 2 provides eligible producers with direct financial assistance due to market disruptions and associated costs because of COVID-19.

Many more commodities are eligible for CFAP 2 than CFAP 1. Our new, easy-to-use CFAP 2 Eligible Commodities Finder makes finding payment rates specific to your operation simple.

Try it out here.

Pennsylvania Secretary of Agriculture Announces PA Farm Show Fall Food Fest

Pennsylvania Agriculture Secretary Russell Redding announced that Pennsylvanians can get their PA Farm Show food fix at an outdoor Fall Food Fest in November. The fest will take place at the Pennsylvania Farm Show Complex & Expo Center from November 13-15, 2020.

“While our traditional Pennsylvania Farm Show in January has transitioned to virtual with public health and safety in mind, we know that everyone’s been wondering how they’ll get their favorite Farm Show foods,” said Redding. “The answer is the Fall Food Fest!

“We’re excited to welcome some of your Farm Show fan favorites to the fest – including milkshakes, fried mushrooms, French fries, pulled pork and more – along with some loyal food truck vendors,” added Redding. “We hope Pennsylvanians will come out to support, and taste, Pennsylvania agriculture.”

The Fall Food Fest will take place in the North Lot of the Pennsylvania Farm Show Complex & Expo Center from Friday, November 13 through Sunday, November 15. Vendors will be open from 11:00 AM to 6:00 PM daily.

While the fest will not include the full offering of the traditional Farm Show food court, many fan favorites will be available from the following vendors:

  • PA Dairymen’s Association (Saturday & Sunday only)
  • PA Livestock Association
  • PA Mushroom Farmers
  • PA Potato Growers
  • Snyder’s Concessions
  • Rachel’s Soft Pretzels (Friday only)
  • Forrests Feeds Co.
  • German Roasted Nuts
  • Uglies Acres
  • Hillbilly Jerky
  • Whispering Brooke Cheese Haus
  • Chocolate Moonshine
  • Pennsylvania Beekeepers Association

A full menu of product offerings is available online.

“We’re thrilled to see a new event at the PA Farm Show Complex & Expo Center,” said Visit Hershey & Harrisburg President & CEO Mary Smith. “The facility and its hardworking staff are a crucial component of the region’s local economy and tourism success. We applaud the extraordinary efforts made to safely host the Fall Food Fest in our destination.”

Parking is free for this outdoor event, where food and beverages will be available for purchase to grab-and-go only. Onsite seating will not be available. Masks are required onsite and patrons are asked to be respectful of six-foot social distance while waiting in vendor lines.

The virtual 2021 Pennsylvania Farm Show is scheduled to take place from Saturday, January 9-Saturday, January 16, 2021. Virtual events will be focused on education and awareness for both the general public and the agriculture industry.

 

In Pennsylvania, COVID-19 is Now a Rural, Urban, and Suburban Problem

 

The coronavirus first entered Pennsylvania with a vengeance in the Philadelphia region. Much of the rest of the state was spared as hospitalizations and deaths mounted here and farther north.

During the summer, the virus concentrated on Pittsburgh and Southwestern Pennsylvania, said Rachel Levine, Pennsylvania’s secretary of health.

Now, maps of infections show a new pattern. “It’s everywhere,” Levine said. Just as the virus has taken off in Midwestern and Western states that had previously seen little infection, it is spreading in Pennsylvania’s rural counties, along with smaller cities and the big metropolitan areas. Only a few sparsely populated counties have still seen little of the virus, she said.

Some of the places with the highest incidence rates — cases per 100,000 in population — are counties that usually don’t make much news: Huntingdon, Bradford, Montour, and Lackawanna. Some smaller Southeastern Pennsylvania counties — Lebanon, Schuylkill, and Berks — also have rates well above the state average. Philadelphia and Delaware Counties are also above the state average incidence rate, while nearby Bucks, Chester and Montgomery are below it.

Read more.

CMS’ New One-Stop Nursing Home Resource Center Assists Providers, Caregivers, Residents

On October 30, CMS launched a new online platform – the Nursing Home Resource Center – to serve as a centralized hub bringing together the latest information, guidance, and data on nursing homes that is important to facilities, frontline providers, residents, and their families, especially as the fight against COVID-19 continues.

The Resource Center consolidates all nursing home information, guidance, and resources into a user-friendly, one-stop-shop that is easily navigable so providers and caregivers can spend less time searching for critical answers and more time caring for residents. Moreover, the new platform contains features specific to residents and their families, ensuring they have the information needed to make empowered decisions about their health care.

With the new page, people can efficiently navigate all facility inspection reports and data – including COVID-19 pandemic and Public Health Emergency (PHE) information. This tool will remain active through and beyond the COVID-19 PHE.

Full text of News Alert.

Home Health Agencies: CY 2021 Payment and Policy Changes and Home Infusion Therapy Benefit

On October 29, CMS issued a final rule that finalizes routine updates to the home health payment rates for Calendar Year (CY) 2021 in accordance with existing statutory and regulatory requirements. This rule also finalizes the regulatory changes related to the use of telecommunications technology in providing care under the Medicare home health benefit.

CMS estimates that Medicare payments to Home Health Agencies (HHAs) in CY 2021 will increase in the aggregate by 1.9 percent, or $390 million, based on the finalized policies. This increase reflects the effects of the 2.0 percent home health payment update percentage ($410 million increase) and a 0.1 percent decrease in payments due to reductions in the rural add-on percentages mandated by the Bipartisan Budget Act of 2018 for CY 2021 ($20 million decrease). This rule also updates the home health wage index including the adoption of revised Office of Management and Budget statistical area delineations and limiting any decreases in a geographic area’s wage index value to no more than 5 percent in CY 2021.

This final rule also:

  • Finalizes Medicare enrollment policies for qualified home infusion therapy suppliers
  • Updates the home infusion therapy services payment rates for CY 2021
  • Finalizes a policy excluding home infusion therapy services from home health services as required by law
  • Finalizes policies under the Home Health Value Based Purchasing Model published in the interim final rule with comment period, as required by law

For More Information:

ESRD PPS: CY 2021 Payment Policies and Rates

On November 2, CMS issued a final rule that updates payment policies and rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to beneficiaries enrolled in Original Medicare on or after January 1, 2021. This rule also updates the Acute Kidney Injury (AKI) dialysis payment rate for renal dialysis services furnished by ESRD facilities to individuals with AKI and finalizes changes to the ESRD Quality Incentive Program.

The final CY 2021 ESRD PPS base rate is $253.13, which represents an increase of $13.80 to the current base rate of $239.33. This amount reflects the application of the updated wage index budget-neutrality adjustment factor (.999485), the addition to the base rate of $9.93 to include calcimimetics, and a productivity-adjusted market basket increase, as required by section 1881(b)(14)(F)(i)(I) of the Act (1.6 percent), equaling $253.13 (($239.33 x .999485) + $9.93 x 1.016 = $253.13).

CMS finalized the following:

  • Update to the ESRD PPS wage index to adopt the 2018 Office of Management and Budget delineations with a transition period
  • Changes to the eligibility criteria and determination process for the Transitional add-on Payment adjustment for New and Innovative Equipment and Supplies (TPNIES)
  • Expansion of the TPNIES to include new and innovative capital-related assets that are home dialysis machines
  • Change to the low-volume payment adjustment eligibility criteria and attestation requirement to account for the COVID-19 public health emergency

For More Information:

CMS COVID-19 Stakeholder Engagement Calls

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, November 3rd at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 2394789

Audio Webcast link: https://engage.vevent.com/rt/cms2/index.jsp?seid=2612

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.

CMS Provides Transparency on Cost and Quality in State Medicaid and CHIP Programs

2020 Scorecard continues to build upon a new era of accountability in Medicaid and Children’s Health Insurance Program

Today, the Centers for Medicare & Medicaid Services (CMS) released the third annual update to its Medicaid and Children’s Health Insurance Program (CHIP) Scorecard. The Scorecard is the signature Medicaid accountability initiative that highlights state and federal performance on the administration and health outcomes of the Medicaid and CHIP programs that collectively account for approximately $600 billion in annual spending and serve over 74 million Americans. For the first time, the Scorecard now provides identified per capita spending data across all states, highlighting variation in program costs alongside the quality and performance data. First released in 2018, the Medicaid and CHIP (MAC) Scorecard is a key part of President Trump’s efforts to ensure greater transparency and accountability of the nation’s largest health coverage programs.

“From the beginning of his administration, President Trump has made giving states more flexibility to provide high quality accessible care for our most vulnerable citizens on Medicaid and CHIP a priority,” said Administrator Seema Verma. “At the same time, we also recognize that with greater autonomy must come greater accountability. The Medicaid and CHIP Scorecard provides unprecedented transparency on cost and quality across state Medicaid and CHIP programs.”

This year’s release builds on the success of the previous Scorecards with a variety of updates and improvements for users, including the debut of a new way to view state-specific data on the Medicaid.gov State Profile “Quality of Care” section.  CMS has also improved the overall design and navigation across the 2020 MAC Scorecard to enhance the user experience.

The Scorecard includes healthcare quality measures of asthma medication management for children and adults as well as a measure of follow-up care for adults after an emergency department visit for mental illness. It also contains new administrative accountability measures including CMS and state approval times for managed care contract reviews; and CMS approval times for enhanced federal funding to support states’ eligibility, enrollment and information technology systems.

The 2020 Scorecard provides per capita expenditure data across all states. For the 2018 T-MSIS based per capita expenditure data, seventeen states had a high level of data usability, and an additional eleven states showed a moderate level of data usability.  The remaining states fell into the category of having a low level of data usability. The median per capita expenditures, based on CMS calculations, for all states in 2018 is $8,126, with a range of $1,807 in Puerto Rico to $14,387 in North Dakota.

This year, new data were added to the MAC Scorecard’s National Context page.  For example, these new data show the percentage of each state’s population that is enrolled in Medicaid, which ranges from 9.0% to 36.3 % and that nationally, about half of those enrolled in Medicaid and CHIP are children. The National Context page also has new data on the national percentage of beneficiaries enrolled in Medicaid and CHIP by eligibility group and the national rate of improper payments in Medicaid and CHIP.

Further, the national context now provides information on the percentage of Medicaid beneficiaries currently enrolled in Medicare (i.e., dually eligible beneficiaries); the percentage of dually eligible beneficiaries in programs that integrate the delivery of Medicare and Medicaid benefits; and the approval status for states’ transition plans for home and community-based services. For example, nearly half of all states (23) have a Medicaid population where 11.8%-24.2% are dually eligible beneficiaries and 36 states now enroll dually eligible beneficiaries in integrated care programs. The addition of these new data in the Scorecard help to further underscore the importance of understanding the dually-eligible population’s role in the Medicaid program.

CMS continues to engage stakeholders in identifying enhancements to the MAC Scorecard, including receiving input from Medicaid agencies through a collaboration with the National Association of Medicaid Directors.

CMS analyzed trends in median state performance on a subset of Child and Adult Core Sets measures that are included in the MAC Scorecard’s State Health System Performance pillar. Under this pillar, five states reported all measures in Federal Fiscal Year (FFY) 19: Connecticut, Massachusetts, New Hampshire, Tennessee and Washington. Across all states that reportedperformance improved from FFY 2017 to FFY 2019 on several measures, suggesting progress in the quality of care provided to Medicaid and CHIP beneficiaries. These measures include:

  • Well-Child Visits in the First 15 Months of Life (performance improved from 60.2% to 65.1%)
  • Adolescent Well-Care Visits (performance improved from 44.9% to 50.7%)
  • Immunizations for Adolescents (performance improved from 74.5% to 79.2%)
  • Percentage of Eligibles Who Received Preventive Dental Services (performance improved from 48.2% to 49.0%)
  • Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (performance improved from 40.9% to 38.3%). Lower rates are better for this measure.

Overall, under the State Health System Performance pillar, states that reported for FFY19 have opportunities to improve in measures such as: emergency department utilization rate for children and adolescents; the percentage of children ages 3 to 6 who had at least one well-child visit with a primary care provider; the percentage of women delivering a live birth who had a timely postpartum care visit; and inpatient hospital admission rates for short-term complications of diabetes (e.g., diabetic ketoacidosis, hyperosmolarity) in adults ages 18 and older.

The State and Federal Administrative Accountability pillar measures show, for example, that the percentage of State Plan Amendments and 1915 waivers approved in within the first 90 day review period has increased between 2016 and the second quarter of 2020.

When viewing data in the MAC Scorecard, CMS would caution against making direct state-to-state comparisons based solely on data presented. For example, for measures drawn from Child and Adult Core Set, reporting methods can vary among states. States have access to different data on populations covered under fee-for-service as compared to populations covered under managed care. This variation in data availability can impact measure performance. Users should review the state-specific measure notes to better understand states’ reported rates. CMS is committed to working with states to improve standardized measure calculation and reporting which will increase the ability to do direct state-to-state comparisons in the future.

CMS is committed to working with states to improve standardized measure calculation and reporting on measures across the Scorecard. As with other measurement-focused initiatives, CMS offers states technical assistance and quality improvement opportunities to assist states in collecting and reporting measures displayed in the Scorecard, as well as sharing best practices to support improved state performance.

To view the 2020 MAC Scorecard, please visit: https://www.medicaid.gov/state-overviews/scorecard/index.html  

For more information pertaining to the 2020 MAC Scorecard, please visit:

https://www.medicaid.gov/media/file/2020-medicaid-chip-scorecard-factsheet.pdf

Pennsylvania Team Develops Domestic Violence Awareness Toolkit

The Pennsylvania Coalition Against Domestic Violence (PCADV) and the Office of Child Development and Early Learning (OCDEL) have teamed up to create a domestic violence awareness toolkit to educate family support workers and Family Supports staff on how domestic violence may impact the clients and families they serve while screening for intimate partner violence. The toolkit also aims to provide domestic violence programs with a deeper understanding of the OCDEL network and the services their programs provide within all communities across the Commonwealth.

Research shows that exposure to violence, especially during childhood, adolescence and young adulthood can significantly increase the likelihood of serious physical, emotional, and behavioral health problems. Children who live with domestic violence are also at increased risk to become direct victims of child abuse and are at an increased risk of becoming perpetrators themselves. Children who have been exposed to domestic violence often learn destructive lessons about the use of violence and power in relationships. They may also believe that it is acceptable to exert control or relieve stress by using violence, or that violence is in some way linked to expressions of intimacy and affection. Children also associate experienced abusive tactics with their view of adulthood, and how adults behave.

Trauma can be exacerbated by environmental factors and relational behaviors. During COVID-19, health professionals are urging the public to use wear face masks to help mitigate the spread of the virus. A face mask can activate a fear response, though, according to the National Center on Domestic Violence, Trauma, & Mental Health.

The National Center on Domestic Violence, Trauma & Mental Health (NCDVTMH) offers a tip sheet about face mask requirements using an accessible, culturally responsive, and trauma-informed approach, which can help in interactions with parents, caregivers, and children.

Partnerships between PCADV and OCEL’s programs are fundamental to preventing, and appropriately intervening in, domestic violence. Collaborating at the local level is key to building capacity to fully support survivors. Cross education allows staff from both systems an opportunity to connect and understand the best ways to develop protocols, make warm referrals, and engage in professional development.

With October being Domestic Violence Awareness Month, both OCDEL and PCADV wanted to support survivors of domestic violence. Both organizations realize that communities are stronger together and coordinated agency collaboration to make resources widely available to better support survivors is a step closer to ending domestic violence.

Domestic Violence Awareness Month serves as a reminder that domestic violence isn’t a private matter. It affects the safety and well-being of whole families and communities and can quickly turn lethal. In 2019, 112 women, men, and children lost their lives from domestic violence. Additional statistics about domestic violence fatalities can be found in PCADV’s 2019 Fatality Report.

If you or someone you know is in an abusive situation call the 24/7 National Domestic Violence Hotline at 1-800-799-7233, text “LOVEIS” to 22522, or chat online: thehotline.org. If you are in immediate danger, contact 911.