Unanimous Vote Creates Rules and Procedures to Move Forward with Round 2 of Program to Support Health Care Providers During the Pandemic

On March 30, 2021, the Federal Communications Commission (FCC) voted to formally adopt a Report and Order and Order on Reconsideration to establish Round 2 of the COVID-19 Telehealth Program, a $249.95 million federal initiative that builds on the $200 million program established as part of the CARES Act.  The FCC’s COVID-19 Telehealth Program supports the efforts of health care providers to continue serving their patients by providing telecommunications services, information services, and connected devices necessary to enable telehealth during the COVID-19 pandemic.  The application window is expected to open within 30 days of release of the Order and the FCC will provide notice in advance of that date.

“Today the FCC announced it is moving forward with Round 2 of its COVID-19 Telehealth Program.  This past year has proven, without a doubt, that telehealth technology is critical to helping address inequities in access to health care services.  And with today’s unanimous approval of the Report and Order, the FCC remains ready to address these challenges head on.

“As part of the Consolidated Appropriations Act of 2021, Congress called on the FCC to increase transparency of the FCC’s COVID-19 Telehealth Program and to establish a clear set of rules and guidelines for evaluating applications.  With today’s action, we have answered that call.  The pandemic has affected communities both large and small throughout the country, from our urban centers to our most rural corners.  Round 2 of this program will mirror this far-reaching impact to better ensure that each state and territory can be approved for funding.  In addition, to facilitate a more equitable funding window, we will set an application deadline so that all applications can be evaluated collectively.  By working together, we can continue to make an impact on the health and well-being of all Americans now and well into the future,” said Acting Chairwoman Jessica Rosenworcel.

In January 2021, as directed by Congress in the Consolidated Appropriations Act, the FCC’s Wireline Competition Bureau sought public input on Round 2.  This Report & Order establishes a clear way to rate applications that takes into consideration objective factors about the health care provider and the area it serves.  Round 2 will also distribute funding to each state, territory, and the District of Columbia and will have an application filing window so all applicants are on equal footing during the review.  Finally, applicants will be able to provide additional information to supplement their applications if necessary.

For more information about the FCC’s COVID-19 Telehealth program, visit https://www.fcc.gov/covid19telehealth.

The U.S. Department of Health and Human Services (HHS) marked Black Maternal Health Week by announcing actions to expand access to continuous health care coverage and access to preventative care in rural areas to improve maternal health outcomes. HHS Secretary Xavier Becerra announced that Illinois is the first state to provide continuity of full Medicaid benefit coverage for mothers by offering extended eligibility for a woman during the entire first year after delivery. A new data brief shows that more than half of pregnant women in Medicaid experienced a coverage gap in the first 6 months post-partum and disruptions in Medicaid coverage often lead to periods of uninsurance, delayed care, and less preventive care.  The American Rescue Plan provides an easier pathway for states to extend Medicaid postpartum coverage from 60 days to 12 months.

Secretary Becerra also announced a Notice of Funding Opportunity (NOFO) that will make $12 million available over four years for the Rural Maternity and Obstetrics Management Strategies (RMOMS) program that will allow awardees to test models to address unmet needs for their target population, including populations who have historically suffered from poorer health outcomes, health disparities and other inequities.

“Improving maternal health outcomes – particularly among Black women – is priority for the Biden administration and for the Department,” said HHS Secretary Becerra. “Expanding access to health insurance coverage, preventative care and investing in rural maternity care is one step forward. With the American Rescue Plan, President Biden gave states tools to combat the racial disparities in pregnancy-related deaths by providing an easier pathway for states to ensure mothers access to the care they need after birth. Continuous health care coverage reduces health care costs and improves outcomes. By expanding Medicaid eligibility for a full year after delivery, Illinois is setting an important model for other states across the country to follow.”

To read the HHS press release, visit: https://www.hhs.gov/about/news/2021/04/12/hhs-marks-black-maternal-health-week-announcing-measures-improve-maternal.html.

To watch the HHS press conference, visit:  https://www.hhs.gov/live/live-1/index.html#13215.

The U.S. Department of Agriculture (USDA) Farm Service Agency (FSA) announced Monday the availability of $2 million to establish partnerships with organizations to provide outreach and technical assistance to socially disadvantaged farmers and ranchers.

The funding was made possible by USDA’s new Pandemic Assistance for Producers initiative, an effort to distribute resources more broadly and to put greater emphasis on outreach to small and socially disadvantaged producers impacted by the pandemic.

To learn more, please follow the link here.

On a preserved farm in Cumberland County, Pennsylvania Agriculture Secretary Russell Redding announced the opening of the $1 million Farm Vitality Grant Program. One of the largest of the programs in Governor Tom Wolf’s Pennsylvania Farm Bill, the Farm Vitality Program aims to enhance the long-term health and vitality of Pennsylvania’s farms.

“Pennsylvania’s more than 53,000 farms are the backbone of our reliable food system. They are the heart of Pennsylvania, just like this $1 million Farm Vitality Grant Program is the heart of the Pennsylvania Farm Bill,” said Redding. “Pennsylvania’s farm families need sound business plans, because their success is success for all of Pennsylvania.”

Trever Gill, fourth generation Cumberland County farmer, received a $7,200 Farm Vitality grant last year to seek succession and business planning services, through Ag Choice Farm Credit, to help their family navigate the transition of their 95-acre Boiling Springs farm to Gill from his grandparents. Gill is one of 133 grantees in 46 counties from the first round of Farm Vitality funding.

The 2020-21 Farm Vitality Grant Program will help fund professional services for those planning for the future of a farm. It aims to enhance the long-term health and vitality of Pennsylvania’s farms through sound business planning, efficient transitions of farm ownership, strategic farm expansion, diversification of agricultural production, and financial and technical expertise.

Farmers and prospective farmers are eligible for up to $7,500, which can cover no more than 75% of the project cost, through this program. Applications to the program will be accepted starting April 19, 2021. The program will remain open until all funds are exhausted.

Pennsylvania has long faced a looming agricultural workforce shortage, at one point estimating a deficit of 75,000 workers as farmers retire and new, technology-based positions become available. Many Pennsylvania Farm Bill programs – including Ag & Youth, Farm to School, Beginner Farmer Tax Credits, and Farm Vitality – were designed to address this workforce shortage and secure a stronger future for the industry. In fall 2020, the U.S. Department of Agriculture’s National Agricultural Statistic Service released data noting that with 12,598 producers under age 35, Pennsylvania has the highest percentage of young producers in the nation.

“The Farm Vitality Grant Program is just one more tool in our toolbox making Pennsylvania’s leading industry accessible and attainable to new and beginning farmers,” added Redding. “Attracting a new generation to this industry and removing barriers to access is critical to ensuring a strong industry and food-secure Pennsylvania.”

For more information about the PA Farm Bill, and investments to support Pennsylvania agriculture, visit agriculture.pa.gov/pafarmbill.

The Pennsylvania Department of Human Services (DHS) believes that protecting Pennsylvania’s children from abuse and neglect is a shared responsibility. Protecting children from abuse and neglect unites lawmakers, community partners, the child protective services system, citizens, and families to provide a safe environment for children throughout the commonwealth.

In partnership with counties, schools, and community organizations, the department is promoting evidence-based programs that give parents the skills and supports, both formal and informal, that they need to ensure that their children grow up in safe and loving homes. By working together and relying on natural supports like family members and neighbors, we can improve outcomes for families and protect our children.

April is Child Abuse Prevention Month and we all need to do our part to make sure that children are safe and cared for during this stressful time.

With more Pennsylvanians getting vaccinated everyday, we are headed towards the light at the end of the tunnel. However, continued social distancing can leave some children and families isolated and this can increase the risk of child abuse and neglect. Be watchful and aware of the children in your community. If you have concerns that a child is not safe or being cared for, take action – it could save a child’s life.

For more information on critical components impacting child protection, visit www.KeepKidsSafe.pa.gov. To learn more about the #ProtectPAKids campaign, visit www.pablueribbonchampion.org.

The National Clinician Consultation Center (NCCC) offers free, confidential point-of-care tele-consultation to any U.S. based clinicians seeking guidance on substance use evaluation and management, hepatitis C, and HIV/AIDS prevention and management. For 30 years, the NCCC has established itself nationally as a consultation and educational resource that helps clinicians of all experience levels and practice settings.

Through its six tele-consultation lines, the NCCC aims to be an easily accessible “one-stop shop” in supporting the delivery of care that is evidence-informed, person-centered, and promotes health equity:

• The Substance Use Warmline (855-300-3595) offers guidance on substance use evaluation, management, overdose prevention strategies, and treatment of co-morbid conditions, including chronic pain and co-occurring psychiatric disorders.
• The HIV/AIDS Warmline (800-933-3413) provides decision support on questions about HIV antiretroviral medications, drug resistance, testing, and HIV/HCV co-infection.
• The Perinatal HIV/AIDS Hotline (888-448-8765) addresses topics regarding the care of HIV‐positive pregnant people and their infants.
• The Hepatitis C Warmline (844-437-4636) offers advice on screening, staging, monitoring, and treatment for hepatitis C.
• The PrEPline (855-448-7737) provides guidance on the initiation and management of pre-exposure prophylaxis as an HIV prevention option.
• The PEPline (888-448-4911) offers advice on bloodborne pathogen exposure evaluation and management, including occupational and non-occupational exposures to HIV, hepatitis B and

All lines are staffed by a multidisciplinary team of expert primary care and specialist-trained physicians, advanced practice nurses, and specialty clinical pharmacists with over 500 years of collective professional experience across these fields. The NCCC has received consultation requests from clinicians of varied backgrounds and experience levels, including nurses, physician assistants, pharmacists, and primary care as well as specialty physicians.  The NCCC has assisted providers in rural and urban locations across the U.S.  Callers rate NCCC consultations very highly on usefulness and quality, and also note the NCCC’s value and role in helping to achieve positive patient outcomes. NCCC consultants are available Monday through Friday, 9 AM to 8 PM Eastern Time (with the exception of the Perinatal HIV Hotline which is available 24/7).  

To learn more or to submit a question securely through the NCCC website, please visit nccc.ucsf.edu.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U1OHA30039 (AIDS Education and Training Centers National Clinician Consultation Center) in partnership with the HRSA HIV/AIDS Bureau (HAB) and the Bureau of Primary Health Care (BPHC) awarded to the University of California, San Francisco.

Changing the definition of Metropolitan Statistical Areas (MSAs) can have important financial implications for many Pennsylvania municipalities in terms of federal reimbursements for health care, funding for housing, and investments in transportation. Those are just a few of the important implications that were discussed during a virtual public hearing held by the Center for Rural Pennsylvania Board of Directors, chaired by Sen. Gene Yaw (R-23), on redefining MSAs.

“The proposed changes to defining MSAs by the federal Office of Management and Budget (OMB) has the potential to impact 10 counties in Pennsylvania,” said Sen. Yaw, “and the change may have potentially significant impacts for rural Pennsylvania.”

According to Anthony Pipa, senior fellow of Global Economy and Development at Brookings, while OMB clearly says that the MSA standards are to be used for statistical purposes only, and that “nonmetro” is not meant to define “rural,” there are many federal programs and policies that rely on the definition when determining funding, and financial incentives. And Pennsylvania would have the most people impacted of any state, with almost 1.2 million people living in counties that would be reclassified from metro to nonmetro.

“Federal programs often use the MSA standards to set eligibility requirements, allocation formulas, scoring criteria, and several other dimensions of program administration,” Mr. Pipa said. “It’s important to recognize and emphasize that the impact of the proposed change on these programs has not been fully analyzed, nor is it well-understood. Previous federal attempts to evaluate the implications of changes to the MSA for program administration are woefully incomplete.”

Ronald Grutza, senior director of Regulatory Affairs and assistant director of Government Affairs with the Pennsylvania State Association of Boroughs, said one funding implication is the Community Development Block Grant. “We are concerned that some boroughs may lose this direct funding because of OMB’s change,” he said, adding that the change could have a ripple effect in communities, especially among lower income populations.

Kim E. Wheeler, executive director of SEDA-Council of Governments, said the redefinition may affect the status of Metropolitan Planning Organizations (MPOs) and result in a redesignation to Rural Planning Organizations (RPOs). “The SEDA-COG MPO and eight other MPOs in the Commonwealth stand to lose engagement and investment in the Pennsylvania Department of Transportation planning and programming process as well as the critical funding that supports that process.”

According to the Hospital and Healthsystem Association of Pennsylvania (HAP), preliminary analysis shows that there could be 24 Pennsylvania hospitals impacted by the definition change, of which 17 could see a negative impact. The total Pennsylvania impact is estimated to be an annual loss of $43 million in Medicare reimbursement to hospitals.  (Based on hospitals in core-based statistical areas that have a population between 49,999 and 99,999, and are currently flagged to go from urban to rural if OMB changes the definition – using the 2010 census).

“It’s clear that OMB needs to put the break on this definition change, as it has the potential to have a significant impact on rural Pennsylvania,” Sen. Yaw said. “To implement these changes now, without first considering all of the potential ramifications, would be shortsighted.”

For more information on the hearing, visit https://www.rural.palegislature.us/publications_redefining_metropolitan_areas.html and listen to the briefing here: HEARING VIDEO

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The Center for Rural Pennsylvania is a bipartisan, bicameral legislative agency that serves as a resource for rural policy within the Pennsylvania General Assembly. The Center works with the legislature, educators, state and federal executive branch agencies, and national, statewide, regional, and local organizations to maximize resources and strategies that can better serve Pennsylvania’s nearly 3.4 million rural residents

U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra announced that more than half a million consumers have already signed up for health insurance through HealthCare.gov as a result of the Biden Administration’s Special Enrollment Period (SEP) for the COVID-19 Public Health Emergency. The SEP, along with the additional financial assistance afforded by the American Rescue Plan (ARP), offers the opportunity for individuals and families to take advantage of significantly reduced premiums, increased savings, and quality, affordable health coverage through the Marketplaces using the Federal Platform.

“Access to quality, affordable health care is essential – especially as we tackle the COVID-19 pandemic and its aftermath,” said HHS Secretary Xavier Becerra. “Since the beginning of this Special Enrollment Period’s availability on HealthCare.gov, more than 500,000 Americans have already signed up for coverage on HealthCare.gov. Now, thanks to the American Rescue Plan, health care coverage is more affordable and millions of Americans are seeing their premiums reduced. At HHS, we are going to build on the Affordable Care Act (ACA) and work tirelessly to ensure Americans have the chance to sign up for quality, affordable health care coverage that meets their needs.”

To read the HHS press release, visit: https://www.hhs.gov/about/news/2021/04/07/hhs-secretary-becerra-announces-more-than-500000-americans-have-enrolled-in-marketplace-coverage.html.

To read the CMS report, visit: www.cms.gov/newsroom/fact-sheets/2021-marketplace-special-enrollment-period-report-0.