Rural Health Information Hub Latest News

NCSL Provides Summary of $2T Stimulus Package

Posted on by lad3

In a move that will immeasurably assist the nation’s states and territories, the U.S. Senate just approved a $2 trillion stimulus package to battle the harmful effects of the COVID-19 pandemic. At this time, the House is expected to approve the bill and send it to the president.  The National Conference of State Legislators (NCSL) wants you to be the first to know how the bill affects the states. Read NCSL’s full summary of the bill here.

NCSL worked closely with Congress and the administration to secure $150 billion in stimulus for state, local and tribal governments. The Coronavirus Aid, Relief, and Economic Security Act, as passed by the Senate, provides immediate and flexible aid for states to weather massive public health and economic challenges.

For states, here are some highlights of the bill:

  • $45 billion for the Disaster Relief Fund for the immediate needs of state, local, tribal and territorial governments to protect citizens and help them respond and recover from the overwhelming effects of the coronavirus.
  • $30 billion for an Education Stabilization Fund for states, school districts and institutions of higher education for costs related to the coronavirus.
  • $4.3 billion, through the Centers for Disease Control and Prevention, to support federal, state and local public health agencies to prevent, prepare for and respond to the coronavirus.

Working on behalf of state legislatures, NCSL advocated to secure these and other provisions of the legislation. NCSL is grateful to Congress and the administration for their recognition of the role states take in leading the economic recovery, as well as aggressively battling the health crisis.

Access NCSL’s full suite of coronavirus resources, updated daily.

COVID-19 Highlights Rural Health Care Disparities In Pennsylvania

Posted on by lad3
By , WESA-FM
NEPA Community Health Center in Susquehanna County

NEPA Community Health Center in Susquehanna County, NEPA Community Health Center

While U.S. cities may be seeing the initial wave of COVID-19 cases, the novel coronavirus is expected to spread to nearly every community in the nation.

Approximately one quarter of Pennsylvanians live in rural counties, where populations skew older and poorer than the state average. Health care resources there are stretched thin, with an acute shortage of providers and transportation issues topping a list of complex structural challenges.

“These hospitals that are already struggling to make payroll, to meet the demand in their communities, are now being asked to do a whole new set of tasks,” said Lisa Davis, director of the Pennsylvania Office of Rural Health.

One particular rural health care disparity that COVID-19 highlights is a lack of high-speed internet.

Providers across the country have been ramping up telemedicine visits, so as to promote social distancing. To encourage this, Medicare will temporarily pay clinicians the same reimbursement rate for telehealth services as it pays for in-person visits.

However, the Federal Communications Commission estimates that some 800,000 Pennsylvanians, most of whom live in rural areas, lack high-speed internet access.

“They may have access to the internet, but it might be a very, very slow connection, and it might be inconsistent,” said Davis.

Some have hypothesized that more sparsely populated areas have an advantage over denser communities, as it’s easier to practice social distancing with fewer people around. But there isn’t enough epidemiological data to know if that’s the case.

“The transmission pattern of any infectious disease and any virus is quite variable,” said Dr. Donald Yealy, UPMC’s chief of emergency medicine. “Just being less dense doesn’t make less risk, it means it’s just even less predictable. And predictions are hard anyway.”

In northwest Pennsylvania, Susquehanna County’s NEPA Community Health Center has yet to see any COVID-19 cases. The clinic said it’s currently conserving medical equipment, including soap and hand sanitizer, and has discussed loaning staff to the area’s two critical-access hospitals.

“We don’t have the supplies we need,” said clinic CEO Mary Wetheral. “It’s not if but when we’ll be overwhelmed.”

Wetherall said there are “zero” intensive care unit beds in Susquehanna County, which has a population of approximately 41,000. Instead, area hospitals have what are called high-acuity units. While high-acuity units tend to have a lower patient-to-nurse ratio, it’s still higher than in an ICU.

“Critical access hospitals are not expected to be able to sustain these high acuity patients,” said Wetherall. “Those high acuity beds are where needs are managed…It’s just stabilize [patients] and move them down to the true ICU beds in different hospitals.”

One possible advantage rural Pennsylvania has in the face of COVID-19 is space. Many small Pennsylvania towns have experienced significant population loss. Hospitals built decades earlier have closed due to a lack of patients, and others struggle to remain solvent.

While these empty hospital beds could be put to good use, a lack of providers in rural communities means there might not be enough doctors and nurses to go around.

Phase 3 Coronavirus Legislation Expands Telehealth to RHCs

Posted on by lad3

***This story is developing and will updated as more details become available***

On March 25, 2020, Senate leaders announced a deal on “phase 3” of the COVID-19 legislation, and it includes a key provision expanding the Medicare telehealth services to rural health clinics as the distant site. The legislation now moves to the House for an expedited vote either today or tomorrow.

This victory for rural health clinics comes after weeks of pressure on Congress and the Trump Administration from National Association of Rural Health Clinic (NARHC) and the Rural Health Clinic (RHC) community. It means that as of the date of enactment, RHCs can confidently provide telehealth visits to Medicare patients and know that they will be paid for those telehealth visits.

However, the details of what the exact telehealth payment will be are still to-be-determined. We do know that the payment for the telehealth visit will not be the all-inclusive rate. Instead, the Centers for Medicare and Medicaid Services (CMS) will create a specific payment mechanism for RHCs and Federally Qualified Health Centers (FQHCs) that is based on the average payments under the physician fee schedule. Keep a close eye on NARHC.org for updates and for a webinar as soon as those specifics are finalized.

Due to the Coronavirus, CMS and Congress have greatly expanded the Medicare telehealth benefit to allow Medicare beneficiaries to safely seek care through a video-conference style system.

Before this pandemic, telehealth was only available for rural Medicare beneficiaries, and was typically used to get specialty care from specialists in larger towns and cities. Medicare patients still had to physically go to an “originating site” and thus the convenience was limited. Now however, both of these requirements have been eliminated and all Medicare patients can receive a telehealth visit from the comfort of their home.

Congress and the Administration have also waived the requirement that telehealth visits only be with established patients and Medicare is allowing providers and patients to use popular video chat applications such as Facetime, Facebook Messenger video chat, Google Hangouts video, or Skype.

Pennsylvania Governor Wolf Announces Financial Assistance Available to Small Businesses

Posted on by lad3

March 25, 2020

Harrisburg, PA – Pennsylvania Governor Tom Wolf announced that new funding is available to help small businesses impacted by the novel coronavirus, COVID-19, through a new program under the Pennsylvania Industrial Development Authority’s (PIDA) Small Business First Fund, the COVID-19 Working Capital Access Program (CWCA).  

The Commonwealth Financing Authority (CFA) recently authorized the transfer of $40 million to the Small Business First Fund for CWCA. PIDA authorized making $60 million available to provide loans of $100,000 or less to for-profit businesses with 100 or fewer full-time employees. Funds are expected to become available this week.

As of 12:00 AM, March 25, there are 276 additional positive cases of COVID-19, bringing the statewide total to 1,127 in 44 counties. The Department of Health also reported four new deaths, bringing the statewide death total to 11. County-specific information and a statewide map are available here. All people are either in isolation at home or being treated at the hospital.

Gov. Wolf has enacted stay-at-home orders for 10 counties: Allegheny, Bucks, Chester, Delaware, Erie, Lehigh, Monroe, Montgomery, Northampton, and Philadelphia counties. The newest order, for Lehigh and Northampton counties, takes effect at 8:00 PM today, Wednesday, March 25. All orders will continue until April 6, 2020.

“My top priority is to save Pennsylvania lives, then save their livelihoods. I am utilizing every resource available to assist Pennsylvania’s business during this incredibly difficult time, and this small business funding availability is a step in the right direction. It will help provide a little peace of mind to hundreds of small business owners and their employees,” Wolf said. “I will continue to develop ways to assist Pennsylvania’s business community, as well as our workforce. I also need every Pennsylvanian to step up and do their part. The best way we can preserve our economic future is by minimizing the spread of COVID-19.”

“In the wake of the unprecedented Coronavirus pandemic, it’s important that state government is trying to respond to all manner of its impacts, and that includes providing support to our small business community,” said Senate Democratic Leader Jay Costa, Jr. “The CFA took necessary and swift action to provide low interest loans to small businesses to help keep them afloat during these difficult times. I commend the leadership of Governor Wolf and the other caucuses of the General Assembly for working together so quickly to come up with a viable plan to provide this assistance.”

For the purposes of this program a retail or service enterprise is defined as a for-profit business entity that is involved in the business-to-business service, business-to-public service, mercantile, commercial, or point of sale retail sectors.  An agricultural producer is defined as a business involved in the management and use of a normal agricultural operation for the production of a farm commodity.  A “farm commodity” is any Pennsylvania-grown agricultural, horticultural, aquacultural, vegetable, fruit, and floricultural product of the soil, livestock and meats, wools, hides, furs, poultry, eggs, dairy products, nuts, mushrooms, honey products and forest products. 

“There’s been major disruption to small businesses and their employees,” said House Democratic Leader Frank Dermody. “This is a bipartisan down payment to get some working capital out quickly. Much more help is needed and we’ll keep working on that.”

Eligible costs include working capital, which for purposes of this program is considered capital used by a small business for operations, excluding fixed assets and production machinery and equipment.

Any eligible working capital cost, as defined above, incurred by the eligible business enterprise three months prior to submission of the loan application will count as an eligible cost toward either the loan amount or, if applicable, the matching investment requirement. Retail / service enterprises are able to incur eligible working capital costs up to six months prior to submission of the loan application.

All loan applications must be submitted through a Certified Economic Development Organization (CEDO). For the list of CEDO’s operating within Pennsylvania, please refer to dced.pa.gov/programs/covid-19-working-capital-access-program-cwca/.

Businesses seeking guidance from DCED can also contact its customer service resource account at ra-dcedcs@pa.gov. For the most up-to-date information on COVID-19, Pennsylvanians should follow www.governor.pa.gov and www.doh.pa.gov.  

MEDIA CONTACTS: Lyndsay Kensinger, RA-GVGOVPRESS@pa.gov
                                   Casey Smith, casesmith@pa.gov

Critical Pennsylvania DHS Services Are Still Available Online Despite Closures

Posted on by lad3

The Pennsylvania Department of Human Services (DHS) closed county assistance offices (CAOs) in coordination with Governor Wolf’s mitigation guidance regarding social distancing to prevent the spread of COVID-19. In-person visits will not be available, and staffing for phone lines may be diminished. As we focus on keeping Pennsylvanians safe and healthy, now is a great time to utilize DHS online resources.

COMPASS

COMPASS is an online tool for Pennsylvanians to apply for many health and human service programs and manage benefit information. With COMPASS, you can:

  • Look up your benefits wherever you are, at any time
  • Review any information you receive
  • Check the status of applications you submit
  • Upload documents
  • Report changes directly from your phone or desktop computer

Visit COMPASS or download the MyCOMPASS phone app to apply for benefits for programs, such as:

Report Abuse or Neglect

People who are mandated reporters under the Child Protective Services Law (CPSL) should report abuse online at www.compass.state.pa.us/cwis, but ChildLine is also available to anyone wishing to report, 24/7 at 1-800-932-0313.

Adult Protective Services protects adults who are between the ages of 18 and 59 with a physical or intellectual disability that limits one or more major life activities. Reports can be made 24/7 to 1-800-490-8505.

Clearances & Licensing

DHS encourages individuals to submit clearance applications online whenever possible. Mandated reporters are encouraged to use the self-service portal on the Keep Kids Safe website, to avoid long hotline wait times.

You can find forms and information on the DHS Clearances & Licensing webpage.

DHS Updated Information

Program Office helplines and email addresses

📌 The latest information on COVID-19 is available from the Pennsylvania Department of Health.

A Message from State Oral Health Coalition about COVID-19

Posted on by lad3

As the reach of the COVID-19 pandemic intensifies around the state, the PA Coalition for Oral Health (PCOH) is increasingly concerned about access to emergency dental care for everyone in Pennsylvania who may need it. We applaud Governor Wolf for prohibiting elective dental procedures in his statement around life-sustaining businesses last week. It may be increasingly difficult for people to find care as restrictions are announced, and we do have concerns that very few offices in the state will be able to continue providing emergency dental treatment. We are addressing these concerns to those in leadership and continue to work towards a solution to offer palliative care and emergency treatment in the safest manner possible to all who need it.

“What Constitutes a Dental Emergency” 
American Dental Association

“Infection Control Guidelines for Healthcare Personnel” 
Centers for Disease Control and Prevention

“Guidance on COVID-19 for Dental Health Care Personnel in Pennsylvania” 
Pennsylvania Department of Health

USDA Implements Immediate Measures to Help Rural Residents, Businesses and Communities Affected by COVID-19

Posted on by lad3

WASHINGTON, March 25, 2020 – USDA Rural Development has taken a number of immediate actions to help rural residents, businesses and communities affected by the COVID-19 outbreak. Rural Development will keep our customers, partners, and stakeholders continuously updated as more actions are taken to better serve rural America.

OPPORTUNITIES FOR IMMEDIATE RELIEF

Rural Housing Service

Single-Family Housing

Effective March 19, borrowers with USDA single-family housing Direct and Guaranteed loans are subject to a moratorium on foreclosure and eviction for a period of 60 days. This action applies to the initiation of foreclosures and evictions and to the completion of foreclosures and evictions in process.

Guaranteed Loan Program:

• Guaranteed Loan borrowers who are in default or facing imminent default due to a documented hardship can have payments reduced or suspended by their lender for a period not to exceed 12 months delinquency. Once the hardship is resolved, the lender can modify the loan to cure the delinquency or make up the missed payments based on the borrower’s individual circumstances.

• Guaranteed Loan servicing questions should be directed to: sfhgld.program@usda.gov.

Direct Loan Program:

  • USDA has waived or relaxed certain parts of the application process for Single-Family Housing Direct Loans, including site assessments, and has extended the time period that certificates of eligibility are valid.
  • A Direct Loan borrower who is experiencing a reduction of income by more than 10 percent can request a Payment Assistance package to see if he/she is eligible for payment assistance or for more assistance than currently received.
  • Moratorium Assistance is available for Direct Loan borrowers experiencing medical bill expenses (not covered by insurance) or job loss because of COVID-19. Qualifying borrowers can receive a moratorium on house payments for a period of time, repaid at a later date.
  • Direct Loan questions should be directed to USDA’s Customer Service Center at 800-414-1226 (7:00 a.m.-5:00 p.m. Eastern Time Monday-Friday) or https://www.rd.usda.gov/contact-us/loan-servicing. Call volume and wait times are high at this time.

Multi-Family Housing

Multi-Family Housing is taking several steps to help owners, management agents and tenants maintain quality housing during the COVID-19 outbreak. Specifically, three immediate steps are effective for Section 515 Multi-Family properties:

  • Tenant certifications due March 31, April 30 and May 31 for Multi-Family properties have been extended to June 30 with no late fees or overage charges, as allowed in Multi-Family guidance (HB-3-3560, Chapter 4, Section 4.11). This extension will allow for additional time to complete needed certifications while avoiding face-to-face meetings as recommended by the Centers for Disease Control and Prevention (CDC). • Late fees on Section 515 mortgages will be waived, subject to waiver authority in 7 CFR 3560.403 (c)(3).
  • Section 515 Annual Financial Statements due March 31 will be extended 30 days, as per Multi-Family guidance (HB-2-3560 Chapter 4, Section 4.16-H). USDA is exploring whether a longer extension is appropriate and will provide further guidance.
  • Current policy states that owners must process an interim recertification at the tenant’s request if there is a change in income of $50 or more per month. The owner should already have this policy in writing and apply it consistently. To the maximum extent possible, we encourage all owners to work with all tenants with impacted income to adjust rent payments.
  • USDA encourages all owners to work with impacted residents and families to adjust rent payments, enter into forbearance agreements, and lessen the impact on affected residents. At this time, no additional subsidy funding has been made available. If borrowers are temporarily unable to make loan payments, the Agency may waive late fees and enter into an official workout plan.

Rural Utilities Service

  • On March 20, 2020, USDA extended for 60 days the deadline for Telecommunications and Electric Program borrowers and grantees to submit their annual CPA audit. In most cases, such audits are due to the agency by April 30, 2020.
  • USDA is waiving borrower covenant requirements for loan agreement financial ratios for the period from Jan. 1, 2020, through Dec. 31, 2020. Additionally, USDA is waiving all financial reporting requirements associated with existing Rural Utilities Service (RUS) loan and grant covenants beginning Jan. 1, 2020 through June 30, 2020.
  • The RUS Administrator has delegated authority to the RUS Telecommunications, Electric, and Water and Environmental Programs to consider requests to waive certain site inspection requirements during the current COVID-19 National Emergency.
  • Applicants will be able to use alternative methods to notify the public, such as through videoconferences, teleconferences and public notices on websites and in local newspapers, as a substitute for the public meeting notification requirement for water and waste projects.
  • On a case-by-case basis, USDA will help Electric Program borrowers gain access to obligated funds more quickly at current low interest rates by considering extensions of loan terms (within statutory limits); considering requests to move obligated funds between the Electric Program’s six budget purposes where the new purpose has cleared environmental review; and by considering Temporary Normal Inventory (TNI) requests.

For assistance, please contact:

Rural Business-Cooperative Service

Beginning immediately, through July 31, 2020, USDA Business and Industry Loan Guarantees (B&I) and Rural Energy for America Program (REAP) Guaranteed lenders may assist borrowers experiencing temporary cash flow issues by deferring payments for a period no longer than 120 days. The lender must notify The Agency in writing of any payment deferments. Written notification to the Agency will meet the standard for concurrence until July 31, 2020. A response from the Agency is not required. This guidance applies to ALL borrowers that had a current repayment status as of March 1, 2020.

  • If the guaranteed loan has been sold on the secondary market, the secondary market holder and lender must agree to the deferment actions being taken. The Agency will expect a written agreement from both parties in these instances.

RBCS intermediary borrowers continue to have authority to service loan portfolios independent of USDA. Intermediary borrowers participating in these programs may approve loan payment deferrals may to their borrowers without USDA approval. These programs are: Ø Intermediary Relending Program (IRP)

  • Rural Business Development Grant (RBDG)
  • Rural Economic Development Loan and Grant (REDL and REDG)
  • Rural Microentrepreneur Assistance Program (RMAP)

For existing Intermediary Relending Program (IRP) and Rural Economic Development Loan (REDL) borrowers, the Agency is committed to maintaining well-capitalized intermediary lenders and will work with you on loan servicing requests on a case-by-case basis to make sure you remain a pillar in our rural business communities.

EXTENSION OF APPLICATION DEADLINES

USDA is extending the application window for the following programs:

Rural Business-Cooperative Service

  • USDA extended the application deadline for the Rural Business Development Grant (RBDG) program to no later than April 15, 2020. Contact the Rural Development office for the deadline in your state. USDA announced the extension in an Unnumbered Letter posted March 19, 2020.
  • USDA extended the application deadline for the Rural Energy for America Program (REAP) to April 15, 2020. For additional information, see page 16925 of the March 25, 2020, Federal Register.

USDA is an equal opportunity provider, employer and lender.

Pennsylvania Food Assistance Programs and Resources, Encourage Volunteerism to Keep Life-Sustaining Food Services Available 

Posted on by lad3

Pennsylvania Governor Wolf’s administration reminded Pennsylvanians of food assistance resources available and what actions it is taking to ensure access to food does not stop in spite of the COVID-19 mitigation efforts. 

Pennsylvanians who need help feeding themselves or their family should find and contact their local food bank or pantry through Feeding Pennsylvania and Hunger-Free Pennsylvania. 

The Pennsylvania Department of Human Services (DHS) is continuing to process applications and benefit renewals for the Supplemental Nutrition Assistance Program (SNAP).  Emergency SNAP applications can be expedited and issued in five days. Pennsylvanians can apply for SNAP online at www.compass.state.pa.us. 

DHS will continue to process application and renewal benefits, so people should continue to send in paperwork as usual. But, for anyone currently on SNAP who misses a deadline, who is not able to submit the paperwork or complete an interview or provide verifications for any reason during this emergency, DHS will ensure their SNAP benefit continues. DHS submitted a waiver request to the federal Food and Nutrition Service (FNS) to ensure this continuity in benefits.  

The Pennsylvania Department of Agriculture has provided resources for Pennsylvanians to access emergency food assistance during COVID-19 mitigation, including locations of food banks and food pantries that are assisting individuals and families during this time. And to ensure that food banks and community feeding organizations remain operable with healthy volunteers, the department provided guidance for ways to limit contact while providing their essential services. 

Businesses who have resources to help feed and shelter Pennsylvanians in need are encouraged to fill out this survey to assist the task force as they look to direct resources. Any Pennsylvanian who is suddenly in need of food should complete this survey so the task force can better understand where resources should be directed 

Third Stimulus Package on Track to be Signed on March 24

Posted on by lad3

The Senate package, expected to soon be passed by the Senate and then the House, promises a Marshall Plan for hospitals with possibly as much as $130 billion in immediate emergency relief for hospitals and rapid help on accessing needed supplies such as ventilators, masks, COVID-19 tests, and workforce.

Billions of additional dollars were included for hospitals because of your efforts. Also included are $150 million in rural HRSA grants, temporary relief from devastating sequestration cuts, a 15% increase in COVID-19 Medicare PPS reimbursement rates, and a critical $1 billion for tribes and IHS funding.

Rural providers will also have access to a $562 million small business emergency relief fund to keep doors open. It is unclear exactly how the healthcare system funding will be distributed, as legislative text has not yet been released.

HHS Awards $100 Million to Health Centers for COVID-19 Response

Posted on by lad3

March 24, 2020

The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), awarded $100 million to 1,381 health centers across the country with funding provided by the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020.  HRSA-funded health centers may use the awards to address screening and testing needs, acquire medical supplies and boost telehealth capacity in response to the Coronavirus Disease 2019 (COVID-19) pandemic.

On Friday, March 6, 2020, President Trump signed into law the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, which provides $8.3 billion in emergency funding for federal agencies to respond to the COVID-19 outbreak, including $100 million for HRSA-funded health centers. Recognizing the urgency of the situation, and the important role health centers play in communities nationwide, HHS is making this funding for health centers available immediately.

“HRSA-funded health centers have been and will be critical players in our national response to the COVID-19 pandemic,” said HHS Secretary Alex Azar. “The new grants we’re releasing today are a rapid injection of resources secured by President Trump from Congress in the supplemental funding bill, building on the strong investments HHS has made in health centers over the years. President Trump has emphasized a whole-of-government, whole-of-America response to the pandemic, and these grants will help health centers, which know the needs and resources of their communities best, to play their part.”

The funding supports health centers across the country in their emergency planning and response efforts. The awards will give health centers the flexibility to meet the evolving COVID-19 needs in their respective communities including but not limited to, expanding COVID-19 screening and testing capacity, purchasing supplies such a personal protective equipment (PPE) and providing safety education.

“HRSA-funded health centers provide high-quality primary care services to 28 million people in the United States. That is 1 in 12 people nationwide. These grantees operate 13,000 service delivery sites that are lifelines to services and networks of resources in their communities every day, and especially during a crisis,” said HRSA Administrator Tom Engels. “HRSA-funded health centers will receive this funding as quickly as possible so they can maintain their ability to deliver quality primary health care services to their patients while responding to developing needs in their communities.”

For a list of award recipients, visit https://bphc.hrsa.gov/emergency-response/coronavirus-covid19-FY2020-awards.

For more information about COVID-19, visit http://coronavirus.gov/.