Rural Health Information Hub Latest News

More Pennsylvanians to Benefit from Rental and Mortgage Relief Programs

Pennsylvania Governor Tom Wolf announced today the Pennsylvania Housing Finance Agency is improving the COVID Relief Mortgage and Rental Assistance Grant Program to help more renters and homeowners remain in their homes. Effective Oct. 17, landlords and mortgagees will have a new option to reach agreements with renters and homeowners for repayment of rent and mortgage payments above the program’s $750 monthly cap. The program previously required them to forgive the balance of the payment.

Earlier this week the governor signed an executive order extending the application deadline to Nov. 4.

“We cannot allow thousands of families to become homeless because of the pandemic,” said Gov. Wolf.  “Improving the program and giving people more time to apply will help families to stay in their homes. That will reduce the strain on social services and help landlords to pay their mortgages.

“These are positive steps, but we still need a larger solution. I continue to urge the legislature to fix the program’s other flaws so more struggling families have a place to live.”

The program has been helping fewer renters and homeowners than intended. Under the new guidance, landlords can still forgive the balance of rent and mortgage payment above $750, but creating the option to enter into repayment agreements with tenants and homeowners, and therefore recoup balance of payments, should encourage more participation in the relief program.

The federal Coronavirus Aid, Relief and Economic Security (CARES) Act, passed by Congress in March, provided $3.9 billion for Pennsylvania. As part of Pennsylvanian’s response to the pandemic, the governor signed legislation in May directing $175 million of the CARES funds to PHFA to provide $150 million for rental assistance and $25 million for mortgage assistance.

Governor Tom Wolf has repeatedly urged the General Assembly to remove the barriers so more Pennsylvanians can qualify.

The governor’s proposal would:

  • Raise the $750 monthly cap on rent relief to at least 130% of HUD limits – In some parts of the state rent payments exceed $750 a month, therefore landlords decline to participate, leaving tenants without payment assistance.
  • Eliminate the requirement that households be 30 days behind on rent to be eligible for assistance – The requirement creates an unfair burden on applicants who prioritize rent and mortgage payments over paying for food, medicine or other bills.
  • Eliminate verification that applicants applied for unemployment compensation – The added administrative step creates unnecessary processing delays of applications and availability of assistance.

“Program changes are still needed to keep people in their homes, but in the meantime, these changes will let more people get rental assistance and avoid eviction,” said Gov. Wolf. “I continue to urge the General Assembly to make changes to allow more affected residents to qualify because, now more than ever, all Pennsylvanians need and deserve an affordable and safe place to live.”

The Centers for Disease Control and Prevention halted some rental evictions nationwide until Dec. 31; however, some tenants and all homeowners are still at risk.

Free School Meals Extended Throughout the School Year

Pennsylvania First Lady Frances Wolf is proud to recognize the U.S. Department of Agriculture (USDA)’s announcement that allows schools to provide free meals to all students for the rest of the school year. These flexibilities, for which First Lady Wolf recently advocated alongside 17 other first partners and spouses, ensure that schools can continue to provide the meals despite the uncertainty and hardship caused by the pandemic.

“I am so glad that the USDA has taken this important step in guaranteeing that no child has to wonder where they might find their next meal,” said First Lady Wolf. “This forward-thinking provides much-needed certainty to families, school nutrition professionals, agricultural entities and community partners working to ensure that all children have access to nutritious meals as we continue to navigate a global health crisis and its subsequent economic effects. This is one piece of the puzzle for ensuring food security, and we look forward to continuing to work with USDA on the implementation of this and related efforts.”

These flexibilities, which have been extended through June 30, 2021, allow school feeding programs to avoid unnecessary barriers as they navigate health and safety concerns, staff limitations, technical restrictions, time constraints and more. From March through August of this year, Pennsylvania schools provided more than 25 million meals to children in need.

“With the USDA’s extension of the school feeding program waivers, students are promised access to nutritious food for the rest of the school year,” said Pennsylvania Agriculture Secretary Russell Redding. “Throughout the COVID-19 mitigation response, these waivers have worked well for schools navigating many changes. Whether students are learning from home, at the school or a mix of both, these flexibilities will keep kids fed. Hungry kids can’t learn. Because of programs like this, no Pennsylvania student should go hungry.”

According to recent projections from Feeding America, more than 54 million people, including 18 million children, may experience food insecurity this year, marking a 45 percent increase in general food security rates and a 65 percent increase in child food insecurity rates compared to pre-COVID-19 statistics.

In Pennsylvania, 2.04 million Pennsylvanians, including nearly 630,000 children, face food insecurity. This marks an increase of 45.2 percent to the general food security rate and a 57.6 percent increase to the child food insecurity rate when compared to 2018 statistics.

In letters sent to USDA Secretary Sonny Perdue and Congressional leadership on September 18, 2020, First Lady Wolf and the first spouses and partners of California, Colorado, Delaware, Hawaii, Illinois, Kansas, Kentucky, Massachusetts, Minnesota, Montana, New Jersey, North Carolina, Rhode Island, Virginia, Washington, Wisconsin and Wyoming encouraged both parties to work together to extend and fully fund the necessary school feeding program waivers throughout the remainder of the 2020-21 academic year.

Yesterday’s action by the USDA comes at the heels of the passage of continuing resolution HR 8337 by the United States House and Senate and its signing by President Trump on October 1, 2020. HR 8337, in addition to maintaining federal government funding through December 11, 2020, further extends the USDA’s necessary nutrition authority and funding through September 20, 2021, for child nutrition programs, Pandemic EBT, Summer EBT for Children, Special Supplemental Program for Women, Infants, and Children (WIC), Supplemental Nutrition Assistance Program (SNAP), Commodity Supplemental Food Program (CSFP) and more. Further USDA action is needed to implement the extensions of these other programs. 

As Negotiations Stall, COVID-19 Hits Rural America Harder Than Ever Before 

Half of all states are reporting increases in new COVID-19 cases, and several are setting new records for new daily cases reported, including rural states such as Montana and South Dakota. Unfortunately, many of these increases are being driven by small towns in rural America, where there is limited access to health care resources. According to an NPR analysis, one fifth of the first 100,000 COVID-19 deaths were outside of large metro areas, whereas rural deaths accounted for nearly half of the second 100,000 COVID-19 deaths. On a per-capita basis, the most rural counties are facing their worst spikes of the pandemic to date; based on a rolling seven-day average, there are around 19.5 daily cases per 100,000 residents in America’s most rural counties. From Bloomberg Government (subscription required):

Rural providers are on the frontline of the pandemic facing new spikes in COVID-19 cases, and they need relief and support. NRHA understands that negotiations on further COVID-19 relief have halted abruptly, but it is important that Congress recognize that rural America’s fight against COVID-19 is currently at its height. Record high numbers of new COVID-19 cases and deaths in rural America coupled with a lack of facilities and supplies is a recipe for disaster. Rural America needs Congress’s help today, and NRHA is continuing to ask Congress to act on behalf of rural America to help patients and providers survive the pandemic.

CMS Officially Updates MAAP Repayment Terms 

Due to a provision included in the Continuing Resolution (CR) (H.R. 8337), which was passed by Congress and signed into law by President Trump last week, the Centers for Medicare and Medicaid Services (CMS) announced new repayment terms for funds received through the Medicare Accelerated and Advance Payment (MAAP) program. Below is an excerpt of the special news bulletin sent by CMS on Thursday:

“Providers were required to make payments starting in August of this year, but with this action, repayment will be delayed until one year after payment was issued. After that first year, Medicare will automatically recoup 25% of Medicare payments otherwise owed to the provider or supplier for 11 months. At the end of the 11-month period, recoupment will increase to 50% for another 6 months. If the provider or supplier is unable to repay the total amount of the AAP during this time-period (a total of 29 months), CMS will issue letters requiring repayment of any outstanding balance, subject to an interest rate of 4%.”

President Trump Signs Mental Health Executive Order 

On Monday, President Donald Trump signed an executive order (EO) titled the ‘Executive Order on Saving Lives Through Increased Support For Mental- and Behavioral- Health Needs.’ The president signed this EO to curb the ongoing suicide crisis, opioid crisis and overall mental health crisis gripping the country. In recent months, due to the continuation of the COVID-19 pandemic, these crises have grown worse. The EO establishes the ‘Coronavirus Mental Health Working Group’ with the goal of facilitating an all-of-government response to the mental health crisis.

HHS Announces $20 Billion in New Phase 3 Provider Relief Funding 

This week, HHS announced the opening of a new round of PRF disbursements, Phase 3. The department has allocated $20 billion of the PRF for behavioral health care providers and new providers that began practicing in the first quarter of 2020. These providers may submit applications for payment until November 6th, 2020, and providers that previously received, rejected, or accepted a General Distribution PRF payment of two percent of annual revenue from patient care may also apply for this round of funding. Click here to view HHS’s PRF Phase 3 factsheet!

HHS Releases New, Confusing Provider Relief Fund Reporting Requirements 

In September, HHS released reporting requirements for remaining Provider Relief Fund (PRF) dollars, in some cases requiring repayment. The terms and conditions have caused significant heartburn for many providers, and NRHA believes HHS’s determination runs askew of congressional intent. Notably, on October 1st, Senate Majority Leader Mitch McConnell responded to HHS’s new reporting requirements saying, in part, “HHS must not impose requirements that will disproportionately affect rural hospitals that already operate on thin margins.”

2019 National Survey of Children’s Health Data Now Available

The 2019 data from the National Survey of Children’s Health (NSCH), released on Child Health Day, provides the latest on national and state-level data on the health and health care needs of children as well as information about their families and communities. Survey topics include children’s physical and mental health; health insurance status; access to and utilization of health care services, including receipt of preventive and specialty care; Patient-Centered Medical Home and services to support transition to adult health care for adolescents; lifetime exposure to adverse childhood experiences; and more.

New Definitions of Health Literacy Released

With the release of Healthy People 2030 last month, the U.S. Department of Health and Human Services (HHS) provided a definition of personal health literacy and a definition of organizational health literacy. Earlier versions of Healthy People did not make this distinction. The HHS update emphasizes people’s ability to use health information rather than just understand it. The new definitions also acknowledge that organizations have a responsibility to address health literacy. Visit the Centers for Disease Control and Prevention website for the new definitions, and to view a great video on personal, clinical and organizational health literacy.

Department of Health Releases Oral Health Plan

Secretary of Health Dr. Rachel Levine and the Pennsylvania Department of Health (DOH) released the “Pennsylvania Oral Health Plan 2020-2030.” This is a 10-year roadmap to improve the oral health of all Pennsylvanians. As this plan is implemented, DOH will continue to involve partners and stakeholders to gather feedback, assess continued needs, and incorporate new thoughts and ideas as needed to best support oral health and wellness across the commonwealth. Read the press release.