The federal funding will help Pennsylvania expand broadband in unserved/underserved areas

Pennsylvania Broadband Development Authority (Authority) Executive Director Brandon Carson announced the approval of grant guidelines for the Pennsylvania Broadband Infrastructure Program, which will provide $200 million in funding to businesses, non-profits, local government, and economic development organizations. The guidelines will be posted on the Authority’s website on Monday, April 10, 2023 and the application process for this program will open on May 10, 2023.

Too many communities lack access to high-speed internet, and many more cannot afford it. This creates a divide between those who have internet access and those who do not. From day one, Governor Josh Shapiro has said extending and expanding access to broadband across the commonwealth and making connection more reliable and affordable is a top priority of the Shapiro Administration.

The Pennsylvania Broadband Infrastructure Program, funded through the Capital Projects Fund, will fund line extension and development projects, as well as large-scale regional infrastructure projects. Upon completion, projects must deliver service that meets or exceeds symmetrical download and upload speeds of 100 Megabits per second, with prioritization being given to fiber-optic deployment. Projects must include a viable sustainability strategy to maintain, repair, and upgrade networks to ensure their continued operation.

“The Authority is pleased to provide this funding to achieve last-mile connections and increase speed for underserved and unserved regions in Pennsylvania,” said Executive Director Carson. “This is the first grant program the Authority is offering, and we look forward to seeing the impact it makes as we work to close the Commonwealth’s digital divide.”

Key Program requirements include:

• 25-percent match: Federal, state, or local funding received by the applicant is eligible towards the match requirement.
• Grant amounts: The minimum request considered will be $500,000 and the maximum may not exceed $10 million.
• Universal coverage: Applicants are required to ensure that all projects either achieve or are part of a plan to achieve universal broadband for the locality or region.
• Affordability: Applicants must participate in the Affordable Connectivity Program and will be asked to describe and document their digital equity efforts to ensure low- to moderate-income households in the proposed project area will have sustained and affordable access.
• Labor: The Pennsylvania Prevailing Wage Act may apply to projects funded under this program. Prevailing Wage requirements are generally applicable to grants for construction, demolition, reconstruction, alteration, repair work, renovations, build-out and installation of machinery and equipment more than $25,000.

The application period will begin May 10, 2023, and will close July 10, 2023, at 11:59 PM. The Authority expects to award grants prior to the end of 2023. Funded projects must reach substantial completion ― defined as services being delivered to end users ― by December 31, 2026. The program will be administered in accordance with U.S. Treasury guidelines and Act 96 of 2021.

For more information about the Pennsylvania Broadband Development Authority, visit the Authority’s website.

The Appalachian Regional Commission (ARC) is now accepting applications for the fifth class of the Appalachian Leadership Institute (ALI)!

ALI is a free, nine-month leadership and economic development training program that helps prepare the next generation of Appalachia’s public, private, and nonprofit leaders to build a stronger future for the region.

We’re looking for 40 Fellows from all 13 Appalachian states — and all walks of life — for the Class of 2023-2024.

Learn more and apply by June 1 at arc.gov/leadership.

Proposed Rule Would Reward Hospitals that Deliver High-Quality Care to Underserved Populations

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for inpatient and long-term care hospitals that builds on the Biden-Harris Administration’s key priorities to advance health equity and support underserved communities. As required by statute, the fiscal year (FY) 2024 inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) rule updates Medicare payments and policies for hospitals. The rule would also adopt hospital quality measures to foster safety, equity, and reduce preventable harm in the hospital setting. CMS is proposing to recognize homelessness as an indicator of increased resource utilization in the acute inpatient hospital setting, which may result in higher payment for certain hospital stays. This action aligns with the Administration’s goal of providing support to historically underserved and under-resourced communities.

“CMS is helping to build a resilient health care system that promotes good outcomes, patient safety, equity, and accessibility for everyone,” said CMS Administrator Chiquita Brooks-LaSure. “This proposed rule reflects our person-centric approach to better measure health care quality and safety in hospitals to reduce preventable harm and our commitment to ensure that people with Medicare in rural and underserved areas have improved access to high-quality health care.”

For acute care hospitals paid under the IPPS that successfully participate in the Hospital Inpatient Quality Reporting program and are meaningful electronic health record users, the proposed increase in operating payment rates for FY 2024 is projected to be 2.8%. This reflects an FY 2024 projected hospital market basket update of 3.0%, reduced by a projected 0.2 percentage point productivity adjustment. For FY 2024, CMS expects the proposed increase in operating and capital IPPS payment rates would generally increase hospital payments by $3.3 billion. For LTCHs, CMS proposes to increase the LTCH PPS standard Federal payment rate by 2.9%.  Overall, CMS expects LTCH payments under the dual-rate payment system to decrease by 0.9%, or $24 million, primarily due to a projected decrease in high-cost outlier payments in FY 2024 compared to FY 2023.

“With this proposed rule, CMS is more accurately paying hospitals and recognizing for the first time that homelessness, as a social determinant of health, also impacts resource utilization,” said CMS Deputy Administrator Dr. Meena Seshamani. “Creating incentives for hospitals to provide excellent care for underserved populations lays the foundation for a health system that delivers higher-quality, more equitable, and safer care for everyone.”

Advancing Health Equity

CMS is proposing to make health equity adjustments in the Hospital Value-Based Purchasing Program by providing incentives to hospitals to perform well on existing measures and to those who care for high proportions of underserved individuals, as defined by dual eligibility status.  This builds on previous efforts to advance health equity through the finalized health equity adjustment in the Medicare Shared Savings Program and finalized policies in Medicare Advantage and Part D Star Ratings Program. CMS also proposes to recognize the higher costs that hospitals incur when treating people experiencing homelessness, when hospitals report social determinants of health codes on claims. In addition, CMS is requesting comment on how to further support safety-net hospitals.

CMS is also proposing that rural emergency hospitals could be designated as graduate medical education training sites. As a result, more medical residents would be able to train in rural settings, which can help address workforce shortages in these communities. This proposal builds on other policies to support access to care in rural and other underserved communities.

Promoting Patient Safety

Consistent with the CMS National Quality Strategy and the HHS National Healthcare System Action Alliance to Advance Patient Safety goals to promote the highest quality outcomes and safest care for all individuals, the proposed set of quality measures aims to foster safety and equity and to reduce preventable harm in hospital settings. Among this set is a proposal to measure the rate of patients and residents in long-term care hospitals who are up to date on their COVID-19 vaccinations and new, additional measures for screenings for cancer and social drivers of health.

For a fact sheet on the proposed payment rule, visit: https://www.cms.gov/newsroom/fact-sheets/fy-2024-hospital-inpatient-prospective-payment-system-ipps-and-long-term-care-hospital-prospective.

The FY 2024 IPPS/LTCH PPS proposed rule has a 60-day comment period. The proposed rule can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection/2023-07389/medicare-program-proposed-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals

Starting April 17, the Pennsylvania Department of Human Services (DHS) DHS will decide who qualifies for the Children’s Health Insurance Program and process all new applications and renewals. The current 130,000 CHIP families—and all new enrollees—must go through DHS instead of their CHIP health insurance plan to determine eligibility.

The transition of eligibility processing and determinations from the CHIP plans to caseworkers in local DHS County Assistance Offices (CAO) is on the heels of the unwinding process of Medicaid continuous coverage that began on April 1st.

CAOs, which already have full workloads with the unprecedented task of Medicaid unwinding, will now be responsible for processing CHIP applications and renewals.

And while the CHIP eligibility transition had been in the works long before the COVID-19 pandemic, the state ultimately was able to determine its timing.

Check out CHIP changes webpage for more details about how this change will impact CHIP families.

Proposed Rule Would Reward Hospitals that Deliver High-Quality Care to Underserved Populations

Yesterday, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for inpatient and long-term care hospitals that builds on the Biden-Harris Administration’s key priorities to advance health equity and support underserved communities. As required by statute, the fiscal year (FY) 2024 inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) rule updates Medicare payments and policies for hospitals. The rule would also adopt hospital quality measures to foster safety, equity, and reduce preventable harm in the hospital setting. CMS is proposing to recognize homelessness as an indicator of increased resource utilization in the acute inpatient hospital setting, which may result in higher payment for certain hospital stays. This action aligns with the Administration’s goal of providing support to historically underserved and under-resourced communities.

“CMS is helping to build a resilient health care system that promotes good outcomes, patient safety, equity, and accessibility for everyone,” said CMS Administrator Chiquita Brooks-LaSure. “This proposed rule reflects our person-centric approach to better measure health care quality and safety in hospitals to reduce preventable harm and our commitment to ensure that people with Medicare in rural and underserved areas have improved access to high-quality health care.”

For acute care hospitals paid under the IPPS that successfully participate in the Hospital Inpatient Quality Reporting program and are meaningful electronic health record users, the proposed increase in operating payment rates for FY 2024 is projected to be 2.8%. This reflects an FY 2024 projected hospital market basket update of 3.0%, reduced by a projected 0.2 percentage point productivity adjustment. For FY 2024, CMS expects the proposed increase in operating and capital IPPS payment rates would generally increase hospital payments by $3.3 billion. For LTCHs, CMS proposes to increase the LTCH PPS standard Federal payment rate by 2.9%.  Overall, CMS expects LTCH payments under the dual-rate payment system to decrease by 0.9%, or $24 million, primarily due to a projected decrease in high-cost outlier payments in FY 2024 compared to FY 2023.

“With this proposed rule, CMS is more accurately paying hospitals and recognizing for the first time that homelessness, as a social determinant of health, also impacts resource utilization,” said CMS Deputy Administrator Dr. Meena Seshamani. “Creating incentives for hospitals to provide excellent care for underserved populations lays the foundation for a health system that delivers higher-quality, more equitable, and safer care for everyone.”

Advancing Health Equity

CMS is proposing to make health equity adjustments in the Hospital Value-Based Purchasing Program by providing incentives to hospitals to perform well on existing measures and to those who care for high proportions of underserved individuals, as defined by dual eligibility status.  This builds on previous efforts to advance health equity through the finalized health equity adjustment in the Medicare Shared Savings Program and finalized policies in Medicare Advantage and Part D Star Ratings Program. CMS also proposes to recognize the higher costs that hospitals incur when treating people experiencing homelessness, when hospitals report social determinants of health codes on claims. In addition, CMS is requesting comment on how to further support safety-net hospitals.

CMS is also proposing that rural emergency hospitals could be designated as graduate medical education training sites. As a result, more medical residents would be able to train in rural settings, which can help address workforce shortages in these communities. This proposal builds on other policies to support access to care in rural and other underserved communities.

Promoting Patient Safety

Consistent with the CMS National Quality Strategy and the HHS National Healthcare System Action Alliance to Advance Patient Safety goals to promote the highest quality outcomes and safest care for all individuals, the proposed set of quality measures aims to foster safety and equity, and to reduce preventable harm in hospital settings. Among this set is a proposal to measure the rate of patients and residents in long-term care hospitals who are up to date on their COVID-19 vaccinations and new, additional measures for screenings for cancer and social drivers of health.

For a fact sheet on the proposed payment rule, visit: https://www.cms.gov/newsroom/fact-sheets/fy-2024-hospital-inpatient-prospective-payment-system-ipps-and-long-term-care-hospital-prospective

The FY 2024 IPPS/LTCH PPS proposed rule has a 60-day comment period. The proposed rule can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection/2023-07389/medicare-program-proposed-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals

The federal funding will help Pennsylvania expand broadband in unserved/underserved areas.

Pennsylvania Broadband Development Authority (Authority) Executive Director Brandon Carson announced the approval of grant guidelines for the Pennsylvania Broadband Infrastructure Program, which will provide $200 million in funding to businesses, non-profits, local government, and economic development organizations. The guidelines will be posted on the Authority’s website on Monday, April 10, 2023 and the application process for this program will open on May 10, 2023.

Too many communities lack access to high-speed internet, and many more cannot afford it. This creates a divide between those who have internet access and those who do not. From day one, Governor Josh Shapiro has said extending and expanding access to broadband across the commonwealth and making connection more reliable and affordable is a top priority of the Shapiro Administration.

The Pennsylvania Broadband Infrastructure Program, funded through the Capital Projects Fund, will fund line extension and development projects, as well as large-scale regional infrastructure projects. Upon completion, projects must deliver service that meets or exceeds symmetrical download and upload speeds of 100 Megabits per second, with prioritization being given to fiber-optic deployment. Projects must include a viable sustainability strategy to maintain, repair, and upgrade networks to ensure their continued operation.

“The Authority is pleased to provide this funding to achieve last-mile connections and increase speed for underserved and unserved regions in Pennsylvania,” said Executive Director Carson. “This is the first grant program the Authority is offering, and we look forward to seeing the impact it makes as we work to close the Commonwealth’s digital divide.”

Key Program requirements include:

• 25-percent match: Federal, state, or local funding received by the applicant is eligible towards the match requirement.
• Grant amounts: The minimum request considered will be $500,000 and the maximum may not exceed $10 million.
• Universal coverage: Applicants are required to ensure that all projects either achieve or are part of a plan to achieve universal broadband for the locality or region.
• Affordability: Applicants must participate in the Affordable Connectivity Program and will be asked to describe and document their digital equity efforts to ensure low- to moderate-income households in the proposed project area will have sustained and affordable access.
• Labor: The Pennsylvania Prevailing Wage Act may apply to projects funded under this program. Prevailing Wage requirements are generally applicable to grants for construction, demolition, reconstruction, alteration, repair work, renovations, build-out and installation of machinery and equipment more than $25,000.

The application period will begin May 10, 2023, and will close July 10, 2023, at 11:59 PM. The Authority expects to award grants prior to the end of 2023. Funded projects must reach substantial completion―defined as services being delivered to end users―by December 31, 2026. The program will be administered in accordance with U.S. Treasury guidelines and Act 96 of 2021.

For more information about the Pennsylvania Broadband Development Authority, visit the Authority’s website.