By Kerry Thomson, Executive Director of the Center for Rural Engagement at Indiana University

When we think of the painful toll of Covid-19, we often picture urban scenes: lines for tests, overflowing hospitals, refrigerated trucks serving as makeshift morgues. Yet, staggering new data shows that the death rate from Covid in rural areas is now double what it is in urban ones. You would think that fact, coupled with medical professionals pleading with people in rural America to get vaccinated, would lead more to get their shots. Yet, people in rural states lead the list of those who remain unvaccinated, putting themselves and others at risk.

It’s enough to make increasingly angry vaccinated people shout: “Why won’t you listen to your doctor?”  To which, I respond: “What if they don’t have one?”

Many in rural America aren’t vaccinated because two pernicious forces — the implosion of the rural health care system and the decay of local news — have left them with limited sources of information. That has allowed them to become prey to misinformation and overconfident quacks.

Instead of blaming them for their vaccine hesitancy, we need to acknowledge that we all share responsibility for the crisis. We all failed to invest in the doctors and nurses who could be trusted sources of accurate information for rural patients. We all failed to provide adequate funding for rural hospitals and local clinics. We all failed to help a rural health system adapt, instead of decay.

Read more.

The Pennsylvania Department of Health Acting Physician General Dr. Denise Johnson and the Children’s Hospital of Philadelphia Director of the Vaccine Education Center and Professor of Pediatrics Dr. Paul Offit developed a video resource for Pennsylvanians to answer questions about vaccine safety.

Anyone can access and share this video resource, which already has more than 26,000 views, on Facebook or PAcast. In this video, Dr. Johnson and Dr. Offit review the vaccine approval process through the U.S. Food and Drug Administration, including the Emergency Use Authorization. Pennsylvanians requested information on how reporting vaccine data through the Centers for Disease Control and Prevention’s Vaccine Adverse Event Reporting System works to enhance vaccine safety. Additionally, discussion includes information on the increasing scientific data on the safety of vaccines for children and pregnant people. They cover another highly requested topic regarding the effectiveness of the vaccine against variants, with a highlighted focus on effectiveness against the delta variant.

The Pennsylvania Department of Health and the United Way of Pennsylvania today announced an expansion of the Local Innovations in Vaccine Equity in Pennsylvania project (LIVE PA), which aims to reduce vaccine hesitancy and ensure an equitable vaccine distribution throughout the commonwealth. The United Way will administer an additional $630,000 in grants to support the efforts of local faith-based organizations.

“The [Pennsylvania Governor] Wolf Administration is committed to ensuring an effective and equitable COVID-19 vaccine distribution plan across the commonwealth,” Acting Secretary of Health Alison Beam said. “The expansion of LIVE PA to include our faith-based organizations shows our commitment to reaching individuals where they are and feel most comfortable, which is in their communities. We look forward to continuing the positive impact the LIVE PA project is making to further combat COVID-19.”

In June 2021, the Wolf Administration first announced the launch of the LIVE PA grant pilot program. LIVE PA is a collaboration between the Wolf Administration’s Office of Advocacy and Reform and the departments of Health and Human Services, working closely with the United Way of Pennsylvania to fund hyper-local, grassroots nonprofit organizations to partner with certified vaccine providers to help the populations they serve overcome barriers to vaccination.

The grant program is specifically designed for faith-based and non-profit organizations with a goal of administering vaccinations, as well as COVID-19 education and outreach. With a reimbursement rate of $10 per shot achieved and a matching rate of $10 per direct person-to-person outreach, the grants are designed initially to range from $400 to $40,000 per vaccination event. It also includes a requirement that the non-profits and local United Way chapters involved promote the events using traditional and digital media to help fight vaccine hesitancy.

“Faith-based organizations are trusted community groups who have opportunities to make COVID-19 vaccines more accessible. These grant resources can be used by faith-based organizations to contribute to healthy and safe communities in the face of climbing rates of infection related to COVID variants. We encourage faith-based organizations, as well as nonprofits, to apply for the LIVE PA grant,” Kristen Rotz, President of United Way of Pennsylvania said.

Interested non-profit and faith-based organizations can use the United Way information formOpens In A New Window to apply for the grant. If you would like to talk to your local United Way before applying, please use the Find Your United Way toolOpens In A New Window to find your local United Way. Questions can be directed to info@uwp.org.

MEDIA CONTACT: Mark O’Neill – RA-DHpressoffice@pa.gov

Applications open on September 29

The Health Resources and Services Administration at the U.S. Department of Health & Human Services (HHS) is making $25.5 billion in new funding available for health care providers affected by the COVID-19 pandemic. This funding includes:

• $8.5 billion from the American Rescue Plan (ARP) for providers who serve rural Medicaid, Children’s Health Insurance Program (CHIP), or Medicare patients. ARP rural payments to providers will be based on the amount of Medicaid/CHIP and Medicare services provided to patients living in rural areas as defined by the Federal Office of Rural Health Policy; and
• $17 billion for Provider Relief Fund (PRF) Phase 4 payments for a broad range of providers who can document revenue loss and expenses associated with the pandemic. For these Phase 4 payments, smaller providers—who tend to operate on thin margins and often serve vulnerable or isolated communities—will receive reimbursements for lost revenues and COVID-19 expenses at a higher rate compared to larger providers. Phase 4 will also include bonus payments based on the amount of services providers furnish to Medicaid/CHIP and Medicare patients, who tend to be lower income and have greater and more complex medical needs.

Providers will apply for both programs with a single application, and the application portal will open on September 29, 2021.

For more information about eligibility requirements, the documents and information providers will need to complete their application, and the application process for Phase 4 and ARP Rural payments, visit: https://www.hrsa.gov/provider-relief/future-payments.

Today’s announcement also includes an important update about PRF reporting for payments received in the first half of 2020. Given challenges from recent natural disasters and the Delta variant, HHS announced a 60-day grace period to help providers complete their PRF Reporting requirements if they fail to meet the September 30, 2021 deadline for reporting payments received from April 10, 2020 to June 30, 2020. While the deadlines to use funds and the Reporting Time Period will not change, HHS will not initiate collection activities or similar enforcement actions for noncompliant providers during the grace period.

See the HHS press release for more information.

The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities to protect both them and patients from the virus and its more contagious Delta variant.  Facilities across the country should make efforts now to get health care staff vaccinated to make sure they are in compliance when the rule takes effect.

The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), announced that emergency regulations requiring vaccinations for nursing home workers will be expanded to include hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies, among others, as a condition for participating in the Medicare and Medicaid programs. The decision was based on the continued and growing spread of the virus in health care settings, especially in parts of the U.S. with higher incidence of COVID-19.

“There is no higher priority for us than patient health and safety. As the Delta variant strengthens, the Biden-Harris Administration is committed to doing everything we can to keep patients, and those who care for them, safe,” said U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra. “There is no question that staff, across any health care setting, who remain unvaccinated pose both direct and indirect threats to patient safety and population health. Ensuring safety and access to all patients, regardless of their entry point into the health care system, is essential.”

Nursing homes with an overall staff vaccination rate of 75% or lower experience higher rates of preventable COVID infection. In CMS’s review of available data, the agency is seeing lower staff vaccination rates among hospital and End Stage Renal Disease (ESRD) facilities. To combat this issue, CMS is using its authority to establish vaccine requirements for all providers and suppliers that participate in the Medicare and Medicaid programs. Vaccinations have proven to reduce the risk of severe illness and death from COVID-19 and are effective against the Delta variant.  CMS will continue to work closely with all Medicare and Medicaid certified facilities to ensure these new requirements are met.

“We know that those working in health care want to do what is best for their patients in order to keep them safe,” said CMS Administrator Chiquita Brooks-LaSure.  “As the Delta variant continues to spread, we know the best defense against it lies with the COVID-19 vaccine. Data show that the higher the level of vaccination rates among providers and staff, the lower the infection rate is among patients who are dependent upon them for care. Now is the time to act. I’m urging everyone, but especially those fighting this virus on the front lines, to get vaccinated and protect themselves, their families, and their patients from COVID-19.”

CMS is developing an Interim Final Rule with Comment Period that will be issued in October.  CMS expects certified Medicare and Medicaid facilities to act in the best interest of patients and staff by complying with new COVID-19 vaccination requirements.  Health care workers employed in these facilities who are not currently vaccinated are urged to begin the process immediately. Facilities are urged to use all available resources to support employee vaccinations, including employee education and clinics, as they work to meet new federal requirements.

Projects to Help Combat the COVID-19 Pandemic, Address Impacts of Climate Change and Advance Equity Will Receive Funding Priority

U.S. Department of Agriculture (USDA) Deputy Under Secretary for Rural Development Justin Maxson today announced that USDA Rural Development will give funding priority for projects to address some of the top challenges in rural America.

This funding priority supports the Biden-Harris Administration’s mission to help the people of rural America build back better. USDA will notify stakeholders that a program is offering funding priority when the program’s application window opens and will continuously update the Priority Points Program Chart.

Rural Development will award priority points on funding applications for projects that will:

1. Help rural communities recover economically from the impacts of the COVID-19 pandemic, particularly in disadvantaged communities.
2. Ensure all rural residents have equitable access to Rural Development programs and will benefit from projects Rural Development funds.
3. Reduce climate pollution and increase resiliency to the impacts of climate change by providing economic support to rural communities.

USDA is incorporating these key priorities into its work across the agency. The Department is working with our partners to encourage potential applicants to focus on strategic investments that complement these priorities.

For more information, visit www.rd.usda.gov/priority-points.

Application scoring criteria for the programs offering priority points will be included in funding announcements and published in the Federal Register when the application window opens.

If you’d like to subscribe to USDA Rural Development updates, visit our GovDelivery subscriber page.

The Technical Assistance and Services Center (TASC), in coordination with the Federal Office of Rural Health Policy (FORHP), are pleased to provide an update of the COVID-19 Funding Sources Impacting Rural Providers guide. This funding resource is intended to support rural health care providers, along with their state and local partners, navigate the availability of federal funds to support the novel coronavirus (COVID-19) pandemic response and recovery efforts. This guide is updated regularly to capture changes in funding sources.

Seven tables, or matrices, are provided for quick reference at the beginning of this resource. The tables can be used to check eligibility of participation in funding sources by provider types: rural prospective payment system (PPS) and critical access hospitals (CAH), rural health clinics (RHC), federally qualified health centers (FQHC), long-term care (LTC) or skilled nursing facilities (SNF), tribal facilities, and emergency medical services (EMS). The tables also provide an at-a-glance view for each provider type sharing the different types of funds that may be accessed from various funding sources dependent on their participation eligibility. Each funding source is described in its own section of this resource with an executive summary followed by further detail on the use of funds, reporting requirements, hyperlinks to the legislation and detailed information. The majority of the updates are in sections on the RHC COVID-19 Testing and Mitigation Program and the HRSA Health Center Grants.

The guide can be found in COVID-19 Collection located on The National Rural Health Resource Center’s website. This collection consists of trusted and reliable resources, such as the COVID-19 Funding Sources Impacting Rural Providers Guide, along with standing links to additional organizations’ COVID-19 resources, FAQs, webinars, tools, and trainings. The Center aims to help direct the most up-to-date and relevant tools and resources to rural hospitals, clinics, and their communities. This Collection will be updated regularly to help assist with the abundance of circulating information relating to COVID-19.

With a focus on protecting students and keeping them in classrooms, Pennsylvania Governor Wolf joined the Departments of Health, Human Services and Education to discuss the current state of COVID-19 and a new Secretary of Health order requiring masks to be worn inside K-12 school buildings, early learning programs and child care providers, which will take effect at 12:01 am on Tuesday, Sept. 7, 2021. Universal masking in schools, which the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics recommend, reduces the risk that entire classrooms will need to quarantine due to a positive COVID-19 case. For eligible adolescents in Pennsylvania, 18.2 percent of children ages 12-14 are fully vaccinated and 38.3 percent of children ages 15-19 are fully vaccinated. The order applies to everyone indoors at K-12 public schools including brick and mortar and cyber charter schools, private and parochial schools, career and technical centers (CTCs), and intermediate units (IUs). The order also applies to early learning programs and childcare providers for children ages 2 and older, as recommended by the CDC.

See the initial FAQs on the new order.

Workers are more likely to get vaccinated when their employers require them to, according to the latest installment of the Axios/Ipsos Coronavirus Index.

• Respondents Whose Employer Require COVID-19 Vaccination: 80% said they were already vaccinated; 10% said they were likely to get a vaccine and 11% said they were either “not likely” or were a “hard pass” on the idea.
• Respondents Whose Employer Had No COVID-19 Vaccination Requirement: 68% said they’d already been vaccinated; another 6% were likely to get the vaccine, and 27% said they were either “not likely” or were a “hard pass” on vaccination.

Mandates will likely accelerate over the next several months, according to a new report by advisory firm Willis Towers Watson that found that 52% of the employers surveyed said they may impose a mandate, which would be a dramatic increase from the 21 percent who mandate vaccines now. Nearly a third of employers said they might make vaccination a requirement to gain access to the workplace, while about one in five are considering making vaccination a condition of employment.

Read more.