HHS released new FAQs on June 2, 2020 related to the Provider Relief Fund distributions.  The FAQs are attached and available at the link below.  One on page 5 expands on the definition of allowable expenses and determination of lost revenue.  There are new FAQs scattered throughout the FAQ document.  See ww.hhs.gov/sites/default/files/…

Individuals in rural communities often face barriers to health stemming from economic factors, environmental differences, and feelings of isolation. The COVID-19 pandemic has presented a generational challenge and exacerbated these concerns, revealing a critical need for rapid response efforts. With the support of a generous grant of $200,000 from CoBank, the National Rural Health Association (NRHA) is helping rural health care providers overcome barriers they face through the creation of the Rural COVID-19 Technical Assistance Center.

The Technical Assistance Center will focus on two key areas: finance/reimbursement and operations/supplies, including personal protective equipment (PPE) sourcing and distribution, testing and contact tracing, and long-term care collaboration. NRHA will assess and triage needs from across the country to ensure rural communities are equipped with knowledge, connections, and resources throughout the pandemic. This is being accomplished through various partnerships and collaborations with organizations such as Project N95, Project C.U.R.E., Heart4Heroes, and NRHA Platinum Partner Intalere.

“With more than 84,000 COVID-19 cases in rural counties and more than 3,200 rural deaths, the need for rural assistance is growing,” says NRHA CEO Alan Morgan. “Through the generous support of CoBank, NRHA is proud to collaborate with so many dedicated stakeholders to provide technical assistance and critical support to rural health care providers across the country.”

On June 4, 2020, H.R.7010, the Paycheck Protection Program Flexibility Act of 2020 was passed in the Senate by unanimous consent. This bill amends the PPP and provides small business recipients with necessary flexibility to receive the forgivable loans they need to keep their businesses open and their employees on their payrolls. Specifically, H.R.7010:

1. Increases the loan forgiveness period from eight weeks to 24 weeks;
2. Changes the 75/25 payroll / non-payroll requirement for loan forgiveness to 60/40
3. Increases the loan repayment period from two to five years;
4. Allows payroll tax deferral for PPP recipients; and
5. Extends the June 30 rehiring deadline to December 31, 2020.

The full text of this legislation is available at: www.congress.gov/bill/116th-congress/house-bill/7010/…. The bill had previously passed the U.S. House of Representatives and was sent to President Trump for his signature. Following its enactment, the SBA will be required to update its loan forgiveness application and process.

The Pennsylvania Department of Education (PDE) today said elementary and secondary schools in the state’s yellow and green phases may resume in-person instruction and activities beginning July 1 under a phased reopening approach that first requires schools to develop health and safety plans based on guidelines from the Centers for Disease Control and Prevention (CDC) and the state Department of Health (DOH).

PDE also released guidance that allows postsecondary institutions and adult basic education programs, effective June 5, to begin in-person instruction immediately following the development of a health and safety plan outlining strategies for safe operations.

The preliminary documents follow Governor Wolf’s Process to Reopen Pennsylvania, which has been updated to reflect the new guidance.

The two guidance documents released today provide a list of decisions that schools need to consider prior to reopening.

Pennsylvania Governor Tom Wolf today renewed the 90-day disaster declaration he originally signed on March 6 following the announcement of the first two presumptive positive cases of COVID-19 in the commonwealth. The declaration was set to expire on June 4.

The emergency disaster declaration provides for increased support to state agencies involved in the continued response to the virus and recovery for the state during reopening.

The Pennsylvania Department of Health’s Department Operations Center at the Pennsylvania Emergency Management Agency is still active as is the CRCC there.

Also today, Gov. Wolf announced that he would allow the amended stay-at-home order to expire at 11:59 p.m., June 4. The-stay at-home requirements were only in effect for counties in the red phase.

WASHINGTON, June 3, 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.

View the full stakeholder announcement.

Governor Tom Wolf announced that the Pennsylvania Department of Health reached its testing goals in May with more than 283,000 COVID-19 diagnostic test results reported to the department. The department achieved its 2 percent testing goal for the month by more than 11 percent.

In addition, beginning Friday, June 5, various Walmart and Quest Diagnostics drive-thru testing locations across the state will provide testing for residents living in areas with fewer testing sites. No COVID-19 testing will take place inside Walmart stores or Quest Diagnostics Patient Service Centers.

“We appreciate the hard work done by health systems, pharmacies, FQHCs, medical clinics and other entities that are providing testing for COVID-19 across Pennsylvania,” Gov. Wolf said. “This goal is just one step in ramping up the state’s testing capabilities and it demonstrates the tremendous progress made to ensure all Pennsylvanians who need to be tested are.”

Secretary of Health Dr. Rachel Levine said, “When we established our testing strategy, we wanted testing to be accessible, available and adaptable and we are working to meet that challenge. Anyone who believes they have symptoms of COVID-19 can get tested today in Pennsylvania.”

A soft launch of five drive-thru testing sites will begin on June 5. These sites will be open on Monday, Wednesday and Friday from 7:00 AM to 9:00 AM to test up to 50 registered patients. Registration is required one day in advance. The testing sites that will open on Wednesday include:

• Walmart Supercenter parking lot, 63 Perkins Rd, Clarion, PA
• Walmart Supercenter parking lot, 2711 Elm Street, Erie, PA
• Walmart Supercenter parking lot, 1015 N Loyalsock Ave, Montoursville, PA
• Walmart Supercenter parking lot, 100 Supercenter Drive, Clearfield, PA
• Walmart Supercenter parking lot, 1275 N Hermitage Rd, Hermitage, PA

Additional testing sites will be announced in upcoming days and will be listed on the department’s website.

“After testing, you are required to return home and self-isolate,” Dr. Levine said. “If your symptoms worsen while you are waiting for your test results, talk to your doctor. If you experience a medical emergency, please seek immediate care.”

The Department of Health is partnering with Quest Diagnostics to process the tests. At this time, the tests are being provided at no cost to Pennsylvanians. Patients will create an account on Quest’s patient portal and answer some eligibility questions to determine if they meet the criteria to get tested. The site will be available for appointment scheduling at 6:00 PM this evening.

If the patient is eligible, they will be notified of a testing location within a 50-mile radius of them with available appointment times. The patient will schedule an appointment time, print a voucher and bring the voucher to the location with them to their appointment. Patients will receive an email with their test results within 24 to 48 hours, and physicians will call any patient who has a positive test result.

Through the work of a number of entities, testing is accessible for Pennsylvanians. As entities such as Rite Aid, CVS, Patient First and Walmart offer testing regardless of symptoms, more Pennsylvanians can get tested close to home. Adding these locations to those already offered by hospitals, health systems, FQHCs, health clinics and other locations has expanded the testing network in the state.

With increased testing supplies through state and federal partners and Pennsylvania businesses, testing has become more available in Pennsylvania. This has helped ensure that the swabs and medium are available to conduct testing, and to also roll out universal testing at long-term care facilities.

The department’s testing plan remains adaptable. This includes ensuring everyone in a long-term care facility can be tested, providing all counties with at least one testing location, and other efforts based on the latest data and science surrounding COVID-19.

Symptoms of COVID-19 include:

• Fever
• Cough
• Shortness of breath or difficulty breathing
• Diarrhea
• Chills
• Repeating shaking with chills
• Muscle pain
• Headache
• Sore throat
• New loss of taste or smell

Symptoms may appear in as few as two days or as long as 14 days after exposure. Reported illnesses have ranged from people with little to no symptoms to people being severely ill and dying.

For the latest information for individuals, families, businesses and schools, visit “Responding to COVID-19” on pa.gov.

The Wolf Administration stresses the role Pennsylvanians play in helping to reduce the spread of COVID-19:

• Wash your hands with soap and water for at least 20 seconds or use hand sanitizer if soap and water are not available.
• Cover any coughs or sneezes with your elbow, not your hands.
• Clean surfaces frequently.
• Stay home to avoid spreading COVID-19, especially if you are unwell.
• If you must go out for a life-sustaining reason, please wear a mask.

Updated Coronavirus Links: Press Releases, State Lab Photos, Graphics

• Daily COVID-19 Report
• Press releases regarding coronavirus
• Latest information on the coronavirus
• Photos of the state’s lab in Exton (for download and use)
• Coronavirus and preparedness graphics (located at the bottom of the page)
• Community preparedness and procedures materials
• Map with the number of COVID-19 cases

All Pennsylvania residents are encouraged to sign up for AlertPA, a text notification system for health, weather, and other important alerts like COVID-19 updates from commonwealth agencies. Residents can sign up online at www.ready.pa.gov/BeInformed/Signup-For-Alerts.

MEDIA CONTACT:  Lyndsay Kensinger, ra-gvgovpress@pa.gov or  Nate Wardle, Health, 717-787-1783 or ra-dhpressoffice@pa.gov

New CMS Payment Model Flexibilities For COVID-19

The coronavirus has taken a devastating toll on Americans across the country, in lives lost and economic impacts. The health care system has been impacted along with many other aspects of American life. Providers have been greatly affected as they strive to do the right thing by delaying elective surgeries; they have faced disruption in critical revenue streams, and simultaneously experienced increased costs for Personal Protective Equipment. That’s why President Trump signed legislation providing $175 billion for the health care system, in addition to $100 billion in advance and accelerated payments to Medicare providers.

That’s why, in response to COVID-19, CMS is providing new flexibilities and adjustments to current and future CMMI models to address the emergency. We’re releasing a chart today that outlines the models and the new changes.

To read the full Health Affairs blog, go to: https://protect2.fireeye.com/url?k=8b32cb01-d767c2d1-8b32fa3e-0cc47a6a52de-9c90d78754c08b6a&u=https://www.healthaffairs.org/do/10.1377/hblog20200602.80889/full/

The CDC and the Department of Labor jointly developed and released new interim COVID-19 guidance for agricultural workers and employers.  It is available at https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-agricultural-workers.html.

This guidance provides a template of action to protect agriculture workers from coronavirus disease 2019 (COVID-19).  Agricultural employers can adapt these recommendations to protect workers at their particular work sites or in specific work operations.

Questions concerning this guidance may be directed to ruralhealth@cdc.gov.

Amid a surge in mail-in ballots, the COVID-19 public health emergency and civil disturbances in six counties, Governor Tom Wolf today signed an executive order extending the deadline for county election offices in Allegheny, Dauphin, Delaware, Erie, Montgomery and Philadelphia counties to receive absentee or mail-in ballots by mail to 5 p.m. June 9, 2020. The ballot must be postmarked no later than Tuesday, June 2, 2020. The deadline to hand deliver absentee or mail-in ballots remains 8 p.m. June 2, 2020.

The six counties included in today’s executive order are part of a disaster emergency declaration the governor signed Saturday in response to civil unrest to provide all necessary assistance to the municipalities.

While the vast majority of counties have been able to process their applications and mail their ballots, the volume of applications in the six counties caused by the COVID-19 crisis combined with the recent civil disturbance make it necessary to extend the deadline for the counties to receive completed civilian absentee and mail-in ballots. Curfews, travel restrictions and other unforeseen circumstances have made returning ballots more difficult in these counties. The extension will help to ensure that voters in those counties are not disenfranchised through no fault of their own.