If a health care provider is eligible to participate in the Medicare Promoting Interoperability Program, they must successfully demonstrate meaningful use of their certified electronic health record (CEHRT) each year to avoid a downward payment adjustment. Eligible hospitals and CAHs may be exempted from the Medicare downward payment adjustment if they can show that compliance with the requirement for being a meaningful EHR user would result in a significant hardship. To be considered for an exception (to avoid a downward payment adjustment), eligible hospitals and CAHs must complete and submit a Hardship Exception Application. CMS recently extended the deadline to September 1 for hospitals (previously July 1). The deadline to submit a Hardship Exception Application is November 30 for CAHs.

On April 30, CMS issued another round of regulatory waivers and rule changes during the COVID-19 Public Health Emergency. These changes build on temporary regulatory waivers and new rules CMS announced March 30 and April 10. Highlights of the waivers and rule changes include flexibilities to increase hospital capacity, health care workforce changes, efforts to reduce administrative burden, and a number of expansions of telehealth in Medicare. For more information on the COVID-19 waivers and guidance, and the Interim Final Rule, please go to the CMS COVID-19 flexibilities webpage.

The Centers for Disease Control and Prevention (CDC) provides daily updates and guidance. New this week: 1) updated guidance on caring for someone sick at home; 2)  an interactive map with the number of cases and deaths for each state, and 3) a recording of La Vida Durante la Pandemia del Coronavirus, an all-Spanish webcast from April 29.  CDC also does regular clinical calls for public health emergency response, called Clinician Outreach and Communication Activity (COCA).

Pursuant to the Governor’s authorization, as conferred in the Proclamation of Disaster Emergency issued on March 6, 2020 and the Governor’s Order to Enhance Protections for Health Care Workers issued on May 6, 2020, all statutory and regulatory provisions or portions thereof, that would impose an impediment to implementing the guidance outlined below are suspended. Said suspensions will remain in place throughout the duration of the Governor’s Proclamation.

The Bureau of EMS issues the following guidance as it relates to the utilization of out of state EMS personnel, as detailed below:

• EMS providers that hold an active credential with another state’s EMS certifying body, or whom hold an active certification with the National Registry of Emergency Medical Technicians, may practice in Pennsylvania on the sole basis of that certification. This suspends requirements found at 35 Pa. C.S. § 8113 and 28 Pa. Code § 1021.21.
• Individuals holding an out-of-state certification and are practicing in Pennsylvania with a licensed Pennsylvania EMS agency should not exceed the scope of practice or training that they received and are credentialed to perform in their home state. However, regardless of the scope of their home state, they may not exceed the established Pennsylvania Scope of Practice
• Prior to utilizing individuals whom do not hold Pennsylvania EMS certification, Pennsylvania EMS agencies should make a good faith effort to verify that the individual holds the credentials that they claim to hold, and should document what those efforts entailed. All NREMT certifications can be verified online at www.nremt.org in addition, many states have online verification options as well. Please visit https://www.nremt.org/rwd/public/states/state-ems-agencies, select the state you are trying to verify, then click the green button that says verify a state license. If available, you will be taken to that state’s certification portal. Please note, this is not an option for every state.
• Irrespective of certification level, the EMS agency medical director must approve all individuals with an out-of-state credential prior to their service with a Pennsylvania EMS agency.
• For the purposes of PCR documentation, any out of state provider should be entered with their name, and OOS as the certification number
• This guidance does not apply to out-of-state individual providers who are operating under an EMS service/vehicle licensed in another state. Pursuant to EMSIB 2020-09 Out of State Licensed EMS Agencies out-of-state EMS agencies may operate within Pennsylvania pursuant to the laws and regulations of the state in which they are licensed.

Please address any questions to your Regional EMS Council.

Pennsylvania Governor Tom Wolf was joined by Attorney General Josh Shapiro to announce that he signed an executive order that protects Pennsylvanians from foreclosures or evictions through July 10. The action builds on a Pennsylvania Supreme Court order which closed court eviction proceedings until May 11 and ensures no renter or homeowner will be removed from their home for 60 more days.

In almost all circumstances, renters and homeowners are required to continue making monthly payments. If you are a Pennsylvanian struggling to make your monthly payments, you should contact your landlord or mortgage servicer immediately.

The Wolf Administration provided recommendations last week to stem foreclosures, evictions and help people experiencing homelessness. The Department of Human Services activated the commonwealth’s Sheltering Taskforce and is working with local and state partners to coordinate resources for people without housing. The Department of Community and Economic Development is also accepting applications for Emergency Solutions Grants to assist with the rapid rehousing of people experiencing homelessness, street outreach, homelessness prevention, and emergency shelter activities.

PHFA is also taking action to help homeowners and renters. The agency has stopped foreclosures and evictions and is offering forbearances with late fee waivers to homeowners with a PHFA mortgage who are experiencing a financial hardship because of COVID-19. PHFA also developed a list of renters’ rights and responsibilities to clarify the situation for apartment residents and is working with landlords and property managers to distribute it to renters. PHFA is also encouraging Low-Income Housing Tax Credit building managers to be flexible on rent payments and to waive late fees for tenants whose employment has been affected by the crisis.

USDA announced $3 million in competitive grants is available for urban agriculture and innovative production projects. USDA will accept applications on Grants.gov until midnight July 6, 2020.

Planning Projects should initiate or expand efforts of farmers, gardeners, citizens, government officials, schools, and other stakeholders in urban areas and suburbs. Projects may target areas of food access; education; business and start-up costs for new farmers; and development of policies related to zoning and other needs of urban production.

Implementation Projects should accelerate existing and emerging models of urban, indoor, and other agricultural practices that serve multiple farmers. Projects will improve local food access and collaborate with partner organizations and may support infrastructure needs; emerging technologies; educational endeavors; and urban farming policy development.

To learn more please follow this link.

Pennsylvania Governor Wolf’s Administration received approval from the Food and Nutrition Service of the U.S. Department of Agriculture (USDA) for a plan to provide Supplemental Nutrition Assistance Program (SNAP) benefits to students who are eligible to receive free or reduced-price meals at school through the National School Lunch Program. This program, known as Pandemic Electronic Benefit Transfer (P-EBT), will be temporary and is designed to bridge the gap left by schools closing and help families who may have strained resources due to the COVID-19 pandemic.

The approved P-EBT plan will allow for DHS to provide SNAP funds to households with children who have lost access to free or reduced-price school meals through the National School Lunch Program due to pandemic-related school closures. P-EBT benefits will be issued through EBT cards issued to qualifying families. A family’s benefit will be determined based off the federal reimbursement rate for the daily rate of free school breakfasts and lunches, or approximately $5.70 per child. This benefit will be calculated for the remainder of the school year, leading to an approximate benefit of $370.50 per child if they were receiving free or reduced-price school meals when school closures began. Now that the program is approved, benefits will begin to be issued to qualifying families within approximately 15 business days.

If a family’s economic situation has changed since school closures began, they can still apply for the National School Lunch Program and, if determined eligible, receive P-EBT benefits. Families can apply online at www.compass.state.pa.us.

The Department of Health and Human Services has extended the deadline for healthcare providers to attest to receipt of payments from the Provider Relief Fund and accept the Terms and Conditions. Providers will now have 45 days, increased from 30 days, from the date they receive a payment to attest and accept the Terms and Conditions or return the funds. As an example, the initial 30-day deadline for providers who received payment on April 10, 2020, is extended to May 24 from May 9, 2020. With the extension, not returning the payment within 45 days of receipt of payment will be viewed as acceptance of the Terms and Conditions.

President Trump is providing support to healthcare providers fighting the COVID-19 pandemic through the bipartisan CARES Act and Paycheck Protection Program and Health Care Enhancement Act which provide $175 billion in relief funds to hospitals and other healthcare providers on the front lines of the coronavirus response. This funding will be used to support healthcare-related expenses or lost revenue attributable to COVID-19 and to ensure uninsured Americans can get treatment for COVID-19.

In allocating the funds, the Administration is working, among other things, to address both the economic harm across the entire healthcare system due to the stoppage of elective procedures, and addressing the economic impact on providers particularly impacted by COVID-19, and to do so as quickly and transparently as possible.

Visit hhs.gov/providerrelief for more information on the allocations. Recipients of payments from any of these allocations must attest and accept the Terms and Conditions within 45 days.

• HHS is distributing $50 billion across the healthcare system to providers and facilities that bill Medicare.
• Recognizing the financial strain from COVID-19 inpatient admissions, HHS is distributing $12 billion to hospitals that reported at least 100 COVID-19 inpatient admissions through April 10 to HHS.
• HHS is distributing $10 billion to rural hospitals and clinics.
• HHS is distributing $400 million to tribal healthcare providers.
• HHS is using a portion of the Provider Relief Fund to reimburse healthcare providers, at Medicare rates, for COVID-related treatment of the uninsured.
• HHS is working to provide relief to additional healthcare providers including skilled nursing facilities, dentists, and other providers significantly impacted by COVID-19.

Pennsylvania First Lady Frances Wolf, Pennsylvania Department of Human Services Secretary Teresa Miller, and Pennsylvania Department of Agriculture Secretary Russell Redding outlined food assistance programs available for Pennsylvanians to enroll in to get them through current COVID-19-induced tough times. They said Pennsylvanians should feel no shame in accepting state and federal food benefits that were, in fact, designed for unprecedented times like the coronavirus pandemic.

While most eligibility verifications for food assistance have been waived to reduce barriers to access during COVID-19 mitigation in Pennsylvania, there are several state programs that still require individuals to seek out and enroll in individually to qualify and receive benefit. These programs include:

• Supplemental Nutrition Assistance Program (SNAP): Formerly known as food stamps, SNAP provides assistance to low-income and working Pennsylvanians, allowing them to purchase produce and groceries for themselves and their family. SNAP helps more than 1.8 million Pennsylvanians, including about 700,000 children, about 690,000 people with disabilities, and about 300,000 older adults, expand purchasing power to ensure their household has enough food to avoid going hungry. SNAP is issued through a monthly payment to an electronic benefit transfer card, and benefits are based off income and household size. People can apply for SNAP online at compass.state.pa.us online at any time.
• Senior Farmers Market Nutrition Program: This program runs from June 1 through November 30 each year. Seniors must be 60 or older by December 31 of the program year and have income at or below 185% of the U.S. poverty level. Eligible seniors should call their county Aging office for information on distribution of vouchers. Vouchers are distributed on a first come, first serve basis.
• WIC Farmers Market Nutrition Program: This program runs from June 1 through November 30 each year, and recipients must be on the WIC program to receive this benefit. Children 1-year and older, and pregnant/post-partum women will receive vouchers for the program during their quarterly WIC visit (May through September).
• Commodity Supplemental Food Program: Eligible participants include individuals who are at least 60 years old and whose household income is at or below 130% of the U.S. poverty level. To qualify, individuals must complete an application with proof of income. Questions about where/how to access this program can be directed to the Department of Agriculture’s Bureau of Food Assistance by calling 1-800-468-2433 or emailing ra-fooddist@pa.gov.
• Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Women who are pregnant or have had a baby in the past six months, or twelve if breastfeeding; infants and children under the age of five; and fathers, grandparents, and foster parents who are the legal guardian of a child under age five, may apply for WIC. WIC applicants must reside in Pennsylvania, have a medical or nutritional risk, and have a gross household income that does not exceed 185% of the U.S. poverty level.

In addition to applying for the benefits above, Pennsylvanians can receive immediate access to food resources by visiting a Feeding Pennsylvania or Hunger-Free Pennsylvania member food bank. Pennsylvanians out of work and without pay as a result of COVID-19 are eligible to receive state and federally sourced foods from Pennsylvania’s food banks and pantries

With the coronavirus pandemic costing roughly 33.5 million Americans their jobs so far and a growing number of states beginning to reopen some businesses in an attempt to help, WalletHub today released updated rankings for the States with the Biggest Increases in Unemployment Due to the Coronavirus, along with accompanying videos, as a follow-up to our report on the Cities with the Biggest Growth in Unemployment Due to COVID-19.

To identify which states’ workforces have been hurt most by COVID-19, WalletHub compared the 50 states and the District of Columbia based on increases in unemployment claims. We used this data to rank the most impacted states in both the latest week for which we have data (April 27) and overall since the beginning of the coronavirus crisis (March 16). Below, you can see highlights from the report, along with a WalletHub Q&A. To see the states most impacted since the beginning of the COVID-19 pandemic, click here.

Increase in Pennsylvania Unemployment Due to Coronavirus (1=Worst, 25=Avg.):

•  706.57% Increase in Unemployment Claims (April 2020 vs April 2019)
  • 96,603 the week of April 27, 2020 vs 11,977 the week of April 29, 2019
  • 5th lowest increase in the U.S.
•  253.88% Increase in the Number of Unemployment Claims (April 2020 vs January 2020)
  • 96,603 the week of April 27, 2020 vs 27,298 the week of January 1, 2020
  • 5th lowest increase in the U.S.
• 2,108.14% Increase in Unemployment Claims Since Pandemic Started
  • 1,713,729 between the week of March 16, 2020 and the week of April 27, 2020 vs 81,291 between the week of March 18, 2019 and the week of April 29, 2019
  • 19th lowest increase in the U.S.

To view the full report and your state’s rank, please visit:
https://wallethub.com/edu/states-with-the-biggest-increase-in-unemployment-due-to-coronavirus/72730/.