Rural Health Information Hub Latest News

Payment Protection Program Interim Final Rule Released

The U.S. Department of Treasury (Treasury) and Small Business Administration (SBA) released an interim final rule on the Paycheck Protection Program (PPP). While SBA still needs to confirm some administrative details, loans will be provided on a first-come, first-served basis and producers can get started on the application now.

Below please find additional details about the PPP program. We will answer outstanding issues once SBA provides further guidance.

  1. Program Eligibility
    1. All businesses (including farm and ranch businesses) are eligible for a PPP loan if they (1) have fewer than 500 employees; (2) meet the definition of a “small business concern”; and (3) are subject to SBA’s affiliation rules (unless those rules were specifically waived in the CARES Act).
  2. Waiting on SBA to clarify the definition of “small business concern” – do not anticipate any undue restrictions.
  3. Waiting on SBA to confirm whether H2A workers are counted as “employees” for the purposes of determining size.
    1. Financial institutions, including the Farm Credit system, will be responsible for processing loan applications and administering the loan.
  1. Loan Terms
    1. Loan amounts are calculated based on the payroll costs for all employees whose “principal place of residence” is in the U.S. Please note that this definition excludes H-2A workers, which will likely reduce the loan amount available to some agricultural producers.
    2. This loan has a maturity of 2 years and an interest rate of 1%. Loan payments will be deferred for the first six months.
    3. The loan will be fully forgiven if at least 75% of the funds are used for payroll costs, and the remainder is used for interest on mortgages, rent, and utilities.
  1. Forgiveness is based on the employer maintaining or quickly rehiring employees and maintaining salary levels.  Forgiveness will be reduced if full-time headcount declines, or if salaries and wages decrease.
  1. The best POC for questions on the Paycheck Protection Program is the Lender Relations Specialist in your local SBA Field Office.  The local SBA Field Office may be found at https://www.sba.gov/tools/local-assistance/districtoffices.

Why Coronavirus Could Hit Rural Areas Harder

Daily Yonder, March 24, 2020

By Transmission rates may be lower in rural areas, the percentage of cases resulting in death and other serious complications could be higher in rural than in urban areas.

As rates of coronavirus (COVID-19) infection and death continue to rise, it is important to consider how rural areas may be differentially affected. On the one hand, rural parts of the U.S. may be comparatively better off than urban places due to lower population density in rural areas. Lower population density reduces opportunities for virus spread. On the other hand, there are several features of rural populations and places that increase their risk of coronavirus-related mortality and other long-term health impacts.

These include the realities that rural populations are older and have higher rates of several chronic health conditions, and rural areas have a less robust health care infrastructure to deal with coronavirus cases. Rural economies may also be affected in different ways than their urban counterparts, which has implications for long-term rural population health outcomes.

Read more.

States with the Biggest Increases in Unemployment Due to Coronavirus – WalletHub Study

With the U.S. experiencing a record number of initial unemployment claims, WalletHub today released its report on the States with the Biggest Increases in Unemployment Due to Coronavirus, along with accompanying videos.

To identify which states have experienced the largest unemployment increases, WalletHub compared the 50 states and the District of Columbia across two key metrics. These metrics compare initial unemployment claim increases for the week of March 23, 2020 to both the same week in 2019 and the first week of 2020. Below, you can see highlights from the report, along with a WalletHub Q&A.

States with Biggest Unemployment Increases

States with Smallest Unemployment Increases

1. Louisiana 42. Idaho
2. North Carolina 43. New York
3. Indiana 44. Illinois
4. New Hampshire 45. Arkansas
5. Florida 46. Alaska
6. Virginia 47. West Virginia
7. Michigan 48. Wyoming
8. Kentucky 49. Wisconsin
9. District of Columbia 50. Connecticut
10. New Mexico 51. Oregon

CDC Guidance on People Experiencing Unsheltered Homelessness

The Centers for Disease Control and Prevention (CDC) has released interim guidance for responding to COVID-19 among people experiencing unsheltered homelessness. The guidance provides information and actions for health departments, homeless service organizations, housing authorities and others serving people without homes during the COVID-19 pandemic. You can also access resources on the National Health Care for the Homeless website.

Government Temporarily Suspends Federal Student Loan Payments, Waives Interest

The U.S. Department of Education announced on March 20 that the Office of Federal Student Aid is providing student loan relief to tens of millions of borrowers during the COVID-19 national emergency. All borrowers with federally held student loans will automatically have their interest rates set to 0% for a period of at least 60 days. In addition, each of these borrowers will have the option to suspend their payments for at least two months to allow them greater flexibility during the national emergency. This will allow borrowers to temporarily stop their payments without worrying about accruing interest. Sec. DeVos has directed all federal student loan servicers to grant an administrative forbearance to any borrower with a federally held loan who requests one. The forbearance will be in effect for a period of at least 60 days, beginning on March 13, 2020. To request this forbearance, borrowers should contact their loan servicer online or by phone. The Secretary has also authorized an automatic suspension of payments for any borrower more than 31 days delinquent as of March 13, 2020, or who becomes more than 31 days delinquent, essentially giving borrowers a safety net during the national emergency. See the Department of Education website for more information.

Suspended Licensing Regulations for Health-care Professionals in Pennsylvania

The Pennsylvania Department of State issued a directive indicating that due to COVID-19, additional healthcare practitioners will be needed to treat ill Pennsylvanians. This need may extend beyond the capacity of the professionals currently licensed by Pennsylvania’s health-licensing boards. To increase the available number of practitioners, the Department of State requested from Gov. Wolf a suspension to several provisions that create barriers to temporary licensure. Click on the links below for detail on the suspensions granted by the Governor and additional information for healthcare professionals on how to obtain temporary licenses:

Pennsylvania COVID-19 Enrollment Updates

COVID-19 has impacted nearly every aspect of the world we are living in and enrollment is not exempt from the impact. Here are some actions that do or will have an effect on enrollment:

  • State Waiver Request for Reduction of Administrative Burden. The Pennsylvania Department of Human Services (DHS) submitted an 1135 Waiver to ease some of the administrative burden and procedures for Medicaid, Medicare and CHIP in Pennsylvania, tapping into the authority and temporary flexibility given when a disaster and public health emergency are declared.
  • County Assistance Offices (CAOs). CAOs are closed to the public but operating. CAOs do not currently have a policy for telework. Staff shifts have been adjusted and staggered to allow processing of applications to continue.
  • Marketplace Open Enrollment. Last week, Gov. Wolf sent a formal letter to the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services requesting the federal marketplace,Healthcare.gov, be re-opened to individuals who are uninsured or underinsured in response to the COVID-19 outbreak. Other states have joined the push for this administration to make significant changes to allow for additional enrollment opportunities. In addition, nine states, who operate their own state-based Marketplaces, have issued special enrollment periods with some ending as late as June for uninsured consumers.
  • Enrollment Assistance. Navigators, Certified Application Counselors and enrollment assisters are permitted to assist consumers remotely and virtually, permitted prior consent is obtained in accordance with CMS Guidance. Questions, contact Tia Whitaker, Statewide Director for Outreach and Enrollment at the Pennsylvania Association for Primary Care.

Pennsylvania Primary Will Move to June 2

Using new temporary rules allowing for remote voting, the House and Senate unanimously approved, and Governor Wolf indicated he will sign, a proposal to move Pennsylvania’s April 28 primary to June 2. The bill also provides flexibility for counties to consolidate polling places as an additional safety precaution.

Pennsylvania Releases New Revised Dental Guidance on COVID-19

Recently, the Pennsylvania Department of Health (DOH) convened stakeholders to discuss COVID-19 dental guidance and any needed changes. In response, they announced a new Revised DOH Guidelines on COVID-19 for Dental Health Professionals in Pennsylvania. The new guidelines eliminate the negative pressure room requirement, follow CDC recommendations and draw greater distinction between treatment for COVID-19 positive and negative patients.

Recordings for CMS National Stakeholder Calls on COVID-19

CMS has been hosting regular calls with a variety of clinicians, hospitals, and other facilities in an effort to keep stakeholders updated on our COVID-19 efforts.  As we know not everyone is available to attend the calls live, we are happy to share that you can access recordings of the calls along with transcripts on the following link: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts. We will continue to host calls and share information through our list serves and media.

To keep up with the important work of the White House Coronavirus Task Force in response to COVID-19, visit https:/www.coronavirus.gov.  For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.