On January 15, the Department of Health and Human Services (HHS) postponed the first deadline for providers to report on how they used their Provider Relief Fund (PRF) funding. This deadline had been set for Feb. 15, 2021; HHS has yet to set a new deadline. HHS also issued updated PRF reporting requirements, which supersede all previous versions. The most significant update is the option to define “lost income” using “any reasonable method. These and other deadlines/requirements around federal COVID-19 funding are available on the NACHC COVID-19 “mega-spreadsheet”.  Some highlights of the updated PRF reporting requirements:

• PRF funds must be spent to cover unreimbursed COVID-related expenses before they can be allocated to lost revenues.
• The definition of “COVID-19 related expenses” continues to be broad, and can include mortgage payments, HIT systems, utilities, etc.
• For CY 2020, providers can define “lost revenues” in one of three ways:
• Difference between CY2019 and CY2020 actual patient care revenue
• Difference between 2020 budgeted and 2020 actual patient care revenue. Providers who use this approach must provide evidence and attestation that their budgeted revenue was determined prior to March 27, 2020.
• Using “any reasonable method of estimating revenue.” Providers using this approach must describe their methodology, explain why it is reasonable, and demonstrate that the lost revenues were due to COVID-19. HHS explicitly states that providers using this approach are more likely to be audited.
• For CY 2021, providers are not permitted to calculate lost revenues using “any reasonable method.” Rather, Jan-June 2021 actual revenue must be compared to 2019 actual revenue or 2020 budgeted revenue for the same 6-month period.

As in previous versions of the reporting requirements, providers receiving over $500,000 in PRF funding must report their expenses in greater detail than those receiving less than $500,000. If a provider earned interest in PRF payments, they must provide information on that interest and how it was used.

In view of the fact that many Pennsylvanians will go to their local pharmacy for vaccination, and to eliminate any confusion or uncertainty regarding qualified pharmacists’ ability to enroll as providers and to order and administer the COVID-19 vaccine, the Department of State requested, and the Governor approved, a temporary suspension of the order/written protocol requirements set forth in 49 Pa. Code § 27.404. Read more.

On January 15, 2021, then President-Elect Biden announced his COVID-19 and stimulus plan, the American Rescue Plan, hoping Congress will take up and pass the legislation. Biden specifically included Community Health Centers, wanting to increase partnerships with health centers and boost their federal funding. In it, Biden calls to “launch a new partnership with Federally Qualified Health Centers nationwide.” Other elements of the plan include:

• Mount a $20 billion national vaccination program in partnership with states, localities, and Tribes. This will include launching community vaccination centers nationwide and deploying mobile vaccination units to hard-to-reach areas. Also, ensure that everyone receives the vaccine for free, regardless of their immigration status.
• Invests $50 billion in a massive expansion of testing, including for purchasing rapid tests, expanding lab capacity, and helping schools and local governments implement regular testing protocols.
• Funding 100,000 public health workers to perform vaccine outreach and contact tracing in the short term, and eventually to transition into community health roles.
• Address shortages of critical supplies, including PPE, by investing $30 billion to provide 100% federal reimbursement for critical emergency response resources to states, local governments, and Tribes, including deployment of the National Guard. Also invest $10 billion to expand domestic manufacturing for pandemic supplies.
• Extend and expand emergency paid leave measures until Sept. 30, 2021.
• Reduce the number of uninsured persons by having Congress subsidize (COBRA) through the end of September and expand and increase Premium Tax Credits for Marketplace plans.
• Expand access to behavioral health services by asking Congress to appropriate $4 billion to HRSA and SAMHSA. (Presumably, some of this would go to FQHCs.)

Pennsylvania Secretary of Health Dr. Rachel Levine announced that the Department of Health requested the federal government launch the Retail Pharmacy Partnership with two retail partners, TopCo Associates, LLC, and Rite Aid, to expand access to vaccinate healthcare personnel, and eventually other phases of the state’s vaccine plan.

January 22, 2021

The Daily Yonder is monitoring the spread of Covid-19 in rural America with maps, charts, and related reporting from across the nation.

See the state of the pandemic in your county

By Bill Bishop
The country has been scratching its way back to more normal levels of employment after the spring economic shutdown. But the recovery shows signs of stalling in the most recent county employment report.
Read more

By Liz Carey and Olivia Weeks
There’s no public data on how much vaccine is making it to each U.S. county. So the story of vaccine distribution in rural America is anecdotal and diverse.
Read more

By Tim Murphy and Tim Marema
The number of new Covid-19 cases in rural America declined last week, but deaths stemming from the coronavirus continued to occur at record levels.
Read more

As part of NIOSH’s efforts to keep our stakeholders up to date on the CDC and NIOSH COVID-19 response, below is a summary of new information posted this week.

Resources for Essential Workers

COVID-19 Vaccine Communication Toolkit for Essential Workers

A new communication toolkit is available to help employers build confidence in their workforce for this important new vaccine. The toolkit will help employers across various industries provide information about COVID-19 vaccines, increase awareness about vaccination benefits, and address common questions and concerns. The toolkit contains a variety of resources including key messages, FAQs, posters, newsletter content, and more. Partners are encouraged to adapt the key messages to the language, tone, and format that will resonate with the organizations and industries they serve.

Interim List of Categories of Essential Workers Mapped to Standardized Industry Codes and Titles

An interim list is now available to help state, local, tribal, and territorial officials and organizations prepare for the allocation of initially limited COVID-19 vaccine supply. The interim list maps essential industries to corresponding COVID-19 vaccination phases and workforce categories, as recommended by the Advisory Committee on Immunization Practices.

For More Information

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