Through the Coronavirus Aid, Relief, and Economic Security (CARES) Act, the Administration for Community Living (ACL) will administer grants to boost programs that deliver meals, ensure safe transitions home following hospitalizations, and provide other essential services to older Americans and Americans with disabilities during this challenging time.

The U.S. Department of Health and Human Services (HHS) through the Health Resources and Services Administration (HRSA) awarded nearly $165 million to combat the COVID-19 pandemic in rural communities. These investments will support 1,779 small rural hospitals and provide additional funding to 14 HRSA-funded Telehealth Resource Centers (TRCs) to provide technical assistance on telehealth to help rural and underserved areas combat COVID-19.

The Agency for Healthcare Research and Quality (AHRQ) provides a sample telehealth consent form and guidance for health care providers to use with patients.

Click here to access the form.

 On April 19, the Centers for Medicare & Medicaid Services (CMS) issued new recommendations specifically targeted to communities that are in Phase 1 of the Guidelines for Opening Up America Again with low incidence or relatively low and stable incidence of COVID-19 cases. The recommendations update earlier guidance provided by CMS on limiting non-essential surgeries and medical procedures. The new CMS guidelines recommend a gradual transition and encourage health care providers to coordinate with local and state public health officials, and to review the availability of personal protective equipment (PPE) and other supplies, workforce availability, facility readiness, and testing capacity when making the decision to re-start or increase in-person care.

On April 21, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule for the FY 2021 Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS). The proposed rule includes a 2.9 percent payment increase ($270 million total) which rural areas will experience as an average increase of 3.2 percent. CMS is also proposing to amend the regulations to remove the post-admission physician evaluation requirement and to allow non-physician practitioners to perform certain requirements that currently a rehabilitation physician must perform. The rule also includes a five percent cap on wage index decreases and adopts the most recent Office of Management and Budget statistical area delineations with 34 urban counties becoming rural and 47 rural counties becoming urban.  Comments are due on Juen 15, 2020.

On March 30, the Centers for Medicare & Medicaid Services (CMS) issued an array of temporary regulatory waivers and new rules in response to the 2019 Novel Coronavirus (COVID-19) pandemic. CMS’s actions are designed to increase hospital capacity, rapidly expand the health care workforce, and further promote telehealth in Medicare. This interim final rule with comment period includes updates specific to rural health clinics and federally qualified health centers. A full list of CMS waivers and flexibilities for COVID-19 response is available online.  Comments are due on June 1, 2020.

By Bryce Oates

The bill contains provisions meant for rural America, but critics believe it misses an opportunity to expand crucial federal programs like SNAP, or extend protections for vulnerable groups, like farmworkers, meatpackers, and family farms.

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By Brianna Bailey

Eight nurses are the overwhelming majority of employees who remain at Haskell County Community Hospital in Oklahoma. The future of the 25-bed hospital, which has been whittled down to operating only an emergency room since 2019, is increasingly grim.

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By Bryce Oates

Recreation counties’ reliance on tourism and outdoor recreation may pose an existential threat to some of their publicly funded healthcare systems.

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The National Institute for Occupational Safety and Health (NIOSH) has published new respirator information and guidance:

• Understanding the Use of Imported Non-NIOSH-Approved Respirators
  The CDC and FDA have determined additional respirator options to protect healthcare workers during the pandemic when respirator shortages are reported across the nation. If a healthcare facility needs more filtering facepiece respirators, employers should understand these options. One to consider in a time of shortage is non-NIOSH approved respirators manufactured internationally. This NIOSH Science Blog provides information on how to determine the reliability of imported respirators, NIOSH’s efforts to assess imported respirators, and how to tell if a respirator is NIOSH-approved.
• NIOSH Respirator Assessments to Support the COVID-19 Response: Assessment Results
  NIOSH has begun sampling respirators received from other countries and from stockpiles, along with respirators that have gone through decontamination cycles (without the respirator being contaminated). These preliminary assessments will inform respirator users whether the products meet similar filtration performance requirements as those for NIOSH-approved N95 respirators. Results of this testing are now being posted to the NIOSH website and include a summary and report for each model tested.
• Powered Air-Purifying Respirators and Elastomeric Respirators Guidance
  CDC has released guidance for optimizing the supply of powered air-purifying respirators (PAPRs) and for using reusable elastomeric particulate respirators. The guidance aims to provide respiratory protection options to healthcare practitioners as a component of a formally developed and implemented written respiratory protection program. These guidance materials address conventional, contingency, and crisis surge use and maintenance practices. They will assist respiratory protection program managers, health officials, and other program leaders responsible for developing and implementing policies and procedures to prevent pathogen transmission, including those developed to prevent the spread of the virus that causes COVID-19.

For more information, please visit the COVID-19 webpage. To stay up to date on new developments, sign up for the COVID-19 newsletter.