- Health Care Providers Try Novel Ways to Get Shots in Arms of Rural Residents
- New COVID-19 Cases Drop by 5% in Rural Counties While Urban Areas See a 15% Drop
- Why Lagging COVID Vaccine Rate at Rural Hospitals 'Needs to Be Fixed Now'
- HHS Announces Nearly $1 Billion from American Rescue Plan for Rural COVID-19 Response
- HHS Announces $250 Million from American Rescue Plan to Develop and Support a Community-Based Workforce to Increase COVID-19 Vaccinations in Underserved Communities
- Top Critical Access Hospitals Announced
- Farm Bureau Launches Farm State of Mind Resource Directory to Support Mental Health Month
- Finding a Doctor Is Tough and Getting Tougher in Rural America
- HHS Launches New Reimbursement Program for COVID-19 Vaccine Administration Fees Not Covered by Insurance
- 2021 National Health Service Corps (NHSC) Three Loan Repayment Programs Deadline Extended to May 27
- FCC Now Accepting Applications for Round 2 of COVID-19 Telehealth Program
- HHS Awards Over $32 Million in American Rescue Plan Funding to Expand COVID-19 Training and Support for Health Centers
- Public Inspection: CMS: Medicare Program: Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2022 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Proposed Changes to Medicaid Provider Enrollment; and Proposed Changes to the Medicare Shared Savings Program
- Public Inspection: CMS: Medicare Program: Modification of Limitations on Redesignation by the Medicare Geographic Classification Review Board
- Fully Vaccinated Adults 65 and Older Are 94% Less Likely to Be Hospitalized with COVID-19
The U.S. Small Business Administration is reminding small businesses, small agricultural cooperatives, small businesses engaged in aquaculture, and most private nonprofit organizations of the April 28 filing deadline for federal Economic Injury Disaster Loan applications in Pennsylvania due to freeze and frost from April 6 through May 15, 2020.
The loans are available in the following counties: Bucks, Delaware, Monroe, Northampton, Philadelphia and Pike in Pennsylvania.
“These counties are eligible because they are contiguous to one or more primary counties in New Jersey. The Small Business Administration recognizes that disasters do not usually stop at county or state lines. For that reason, counties adjacent to primary counties named in the declaration are included,” said Kem Fleming, director of SBA’s Field Operations Center East.
Under this declaration, the SBA’s Economic Injury Disaster Loan program is available to eligible farm-related and nonfarm-related entities that suffered financial losses as a direct result of this disaster. Apart from aquaculture enterprises, SBA cannot provide disaster loans to agricultural producers, farmers or ranchers.
The loan amount can be up to $2 million with interest rates of 3.75 percent for small businesses and 2.75 percent for private nonprofit organizations, with terms up to 30 years. These working capital loans may be used to pay fixed debts, payroll, accounts payable, and other bills that could have been paid had the disaster not occurred. The loans are not intended to replace lost sales or profits.
Applicants may apply online using the Electronic Loan Application (ELA) via SBA’s secure website at DisasterLoan.sba.gov and should apply under SBA declaration # 16638, not for the COVID-19 incident.
Disaster loan information and application forms may also be obtained by calling the SBA’s Customer Service Center at 800-659-2955 (800-877-8339 for the deaf and hard-of-hearing) or by sending an email to DisasterCustomerService@sba.gov. Loan applications can be downloaded from the SBA’s website at sba.gov/disaster. Completed applications should be mailed to: U.S. Small Business Administration, Processing and Disbursement Center, 14925 Kingsport Road, Fort Worth, TX 76155.
Submit completed loan applications to SBA no later than April 28, 2021.
From Route Fifty
COMMENTARY: A pending proposal would reclassify dozens of communities from metropolitan to rural, potentially affecting their eligibility for certain federal funding and programs.
About 46 million Americans – 14% of the nation’s inhabitants – are currently classified as living in rural areas. That number could jump to 64 million – an increase of nearly 40% – without anyone moving into a new home. That could actually hurt small cities and rural communities across the country.
The federal government classifies communities’ characteristics based on their populations, according to a definition created by the federal Office of Management and Budget. The criteria haven’t substantially changed since the 1940s. Since then, the U.S. population has more than doubled, from 152 million in 1950 to more than 328 million in 2019.
The main dividing line is between communities – which include both towns and cities and their surrounding counties – with more than 50,000 people and those with fewer than that number. Over the past 70 years, the number of areas with at least that many people has increased from 168 to 384 as small towns have grown into small cities. For example, from 1950 to 2010, the population of Lawrence, Kansas, grew from 23,351 to 87,643.
Under the current definition, Colbert County, Alabama – population 54,428 – is in the same category as Los Angeles County – population over 10 million. As the Trump administration ended, federal officials decided some more nuance would be useful in understanding American communities. They proposed to change the dividing line to populations of more than 100,000 – and the effort appears to be continuing under the Biden administration.
That change would effectively move everyone who lives in places with 50,000 to 100,000 from urban to rural life, because their cities, including San Luis Obispo, California, and Battle Creek, Michigan, will no longer be considered large enough to count as metropolitan.
The government doesn’t specifically use this system to label places as “urban” or “rural.” Instead, there are three government categories – “metropolitan,” “micropolitan” and “outside a core based statistical area.” However, most government agencies, researchers, advocates and media outlets use these classifications to sort communities into two groups – equating “metropolitan” with “urban” and the other two categories together as “rural.”
Making the proposed change would mean 144 areas with populations between 50,000 and 100,000, and the 251 counties they occupy, would no longer be classified as “metropolitan,” but rather as “micropolitan” – and therefore effectively rural – including Flagstaff, Arizona, and Blacksburg, Virginia. The change would leave Wyoming without any metropolitan areas at all.
The Office of Management and Budget is accepting comments about this proposed change until March 19.
Looking at the Numbers
Changing how rural areas are defined could change Americans’ understanding of rural life.
But if the homes and communities of 18 million more Americans are added to those rural statistics, the numbers could look better. That rosier picture – which would not be the result of any actual changes to Americans’ lives – could reduce public and political pressure to improve life in rural communities.
It’s also not clear whether 100,000 is the right boundary for urban living – or of there is an exact number at all. To people in major cities, a community of 80,000 like Santa Fe, New Mexico, may be more similar to the 22,000-person Roseburg, Oregon, than to Chicago or Miami. To a rancher on the Plains, with fewer than one person per square mile, though, Santa Fe may qualify as a “big city,” with chain stores, hospitals and government offices.
More than a Statistical Shift
Though the government’s proposal says it’s meant as a statistical change only, the classifications are commonly used by government agencies, charities and other organizations to determine which communities are eligible for their funding or programs.
Communities currently designated as rural may be hurt, too. If Congress and states don’t allocate more funds to serve the increased number of people classified as living in rural areas, the money that is available – like rural health grants – would be spread more thinly.
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Pennsylvania Agriculture Secretary Russell Redding today announced grants totaling $1.287 million to eight organizations for research on issues critical to sustaining and growing Pennsylvania’s agriculture industry. Grant recipients include Pennsylvania State University, Temple University, University of Pennsylvania School of Veterinary Medicine, American Mushroom Institute, Baarda Farms, Coexist Build, Pasa Sustainable Agriculture and Team Ag, Inc.
“Meeting the challenges of feeding a growing population amid rapid changes in climate, technology and animal and plant diseases demands investment in research and development,” said Redding. “These investments hold the promise and potential to spur the innovation we need to increase productivity; advance human and animal medicine; and support cleaner water, healthier soil and a safer food supply.”
The grants, awarded by the Pennsylvania Department of Agriculture, focus on a broad range of research topics including detecting COVID-19 exposure in livestock, increasing farm productivity and profits, protecting pollinators, safely controlling Spotted Lanternfly and other invasive species and improving soil and water quality and sustainability through regenerative farming.
This funding supplements $900,000 in agricultural research support through the department’s budget to Rodale Institute, the Penn State University Center for Agricultural Law, Penn State Extension, and the Centers for Beef, Dairy, Poultry and Livestock Excellence.
Following is a list of 27 grantees, amounts awarded and project titles:
- American Mushroom Institute, Avondale, Chester Co. – $42,242 – Carbon Sequestration through Spent Mushroom Compost
- Baarda Farms, Mt. Bethel, Northampton Co. – $6,000 – Refrigeration to Expand Capacity for Fresh Food Access
- Coexist Build, Blandon, Berks Co. – $4,500 – Developing Marketing Strategy for Agritourism Highlighting Regenerative, Organic Farm Featuring Hemp-based Construction
- Pasa Sustainable Agriculture, Millheim, Centre Co. – $87,791 – Soil Health and Economic Benchmarks for Conservation and Climate Resiliency
- Pasa Sustainable Agriculture – $91,179 – Understanding Keys to Direct Market Success through Collaborative Financial Benchmarking
- Pasa Sustainable Agriculture – $79,533 – Linking Soil Health and Nutrient Density for Improved Specialty Crop Marketing
- Pennsylvania State University, State College, Centre Co. – $89,044 – Assessment of Farmers’ Adoption and Implementation of Conservation Plans: A Case of Pennsylvania
- Pennsylvania State University – $86,862 – Re-envisioning Multifunctional Buffers to Improve Water Quality, Profitability and Manage Risk
- Pennsylvania State University – $34,987 Pennsylvania State University – Establishing Pennsylvania’s First Digital Pollen Library
- Pennsylvania State University – $130,300 – Drug Delivery Systems Using Milk Proteins
- Pennsylvania State University – $87,999 – Protecting Bees from Fungicides Applied to Tree Fruits and from Insecticides Used to Control Spotted Lanternfly
- Pennsylvania State University – $104,236 – Impacts of Spotted Lanternfly Feeding on Tree Health
- Pennsylvania State University – $87,614 – Are bee pollinator populations declining in Pennsylvania?
- Pennsylvania State University – $60,291 – Spotted Lanternfly Monitoring Pole Traps; Saving Labor and Increasing Monitoring
- Pennsylvania State University – $9,906 – Spotting and Stopping Spotted Lanternfly in Vineyards: Economic Impact and Decision Management Tools
- Pennsylvania State University – $42,953 – Innovative LIPS Assay to Evaluate Exposure of Livestock to COVID-19
- Pennsylvania State University – $22,080 – Dynamics of the Respiratory Resistome in the Pre- and Postweaning Dairy Calf
- Pennsylvania State University – $11,870 – Improving Molecular Characterization of C. Perfringens and Correlating Strain Type with Histology
- Pennsylvania State University – $25,000 – Molecular Serotyping of Avibacterium Paragallinarum Using Next Generation Sequencing
- Pennsylvania State University – $28,800 – Establish a Metagenome-based Surveillance System to Determine Prevalence and Distribution of Commercial, Backyard and Wildlife Birds in PA
- Team Ag, Inc., Ephrata, Lancaster Co. – $60,000 – Connecting Capital with Pennsylvania Farmers using Regenerative Farming Practices to Draw Down Carbon
- Temple University, Philadelphia – $24,455 – Detection and Genotyping Method Targeting the Apicomplexa Mitochondrial Genome: Piroplasmida
- University of Pennsylvania School of Veterinary Medicine, Philadelphia – $25,000 – Targeted Next Generation Sequencing Panel for Equine Pathogen Detection
- University of Pennsylvania School of Veterinary Medicine – $10,000 – Evaluation of Reproductive Efficiency on Pennsylvania Dairy Farms
- University of Pennsylvania School of Veterinary Medicine – $9,348 – Novel Implementation of FARM on Dairy Farm: A Pilot Project
- University of Pennsylvania School of Veterinary Medicine – $14,432 – Development of Sensitive Method for Analysis of Cannabinoids in Bovine Serum and Hemp Seed Samples
- University of Pennsylvania School of Veterinary Medicine – $10,578 – Comparison of Different Management Strategies on Quality of Reclaimed Sand Used for Bedding
CMS hosts recurring online sessions to share information related to COVID-19. These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.
The Affordable Care Act (ACA) has been under fire from its inception. Currently the future of the landmark decision and healthcare reform legislation is uncertain. California vs Texas (known as Texas vs U.S. in lower courts) is scheduled to begin oral arguments on Tuesday, Nov.10, 2020. This was sparked by a group of 20 states led by Texas to sue the federal government in February 2018. This case challenges the ACA’s individual mandate which was reduced to zero dollars on Jan.1, 2019 by way of the 2017 Tax Cuts and Jobs Act. The U.S. Court of Appeals for the 5th Circuit affirmed the decision that the individual mandate was no longer constitutional because the individual mandate would no longer produce revenue for the federal government. Instead of striking down the entire ACA, the case was sent back to trial court for additional analysis. The implications for Pennsylvanians and Americans could be disastrous should the law be struck down. Consider:
- Over 760,000 Pennsylvania Medicaid eligibles would lose coverage
- Over 307,000 Pennsylvania Health Insurance Marketplace consumers would lose coverage, 87% of those accessing Advance Premium Tax Credits and 44% with cost-saving reductions
- More than 2.3 million young adults under age 26 nationwide would lose access to coverage through their parents’ group coverage
- Over 2,105,000 Pennsylvanians with a prevalence of pre-existing conditions could be eliminated from purchasing health insurance
- 87% of covered workers with employer-sponsored insurance (approximately 133 million people) were enrolled in plans that must provide free preventive services as of 2019
- Prior to the ACA, 75% of non-group health plans did not cover maternity care, 45% did not cover substance use disorder (SUD) treatment and 38% did not cover mental health services
- Prior to the ACA, 59% of covered workers’ employer-sponsored health plans had a lifetime limit
- Prior to the ACA, only 19% of covered workers had no limit on out-of-pocket expenses
- Reinstating the Medicare coverage gap would increase costs incurred by Part D enrollees who have relatively high drug spending
- Employers with 50 or more employees must now provide adequate break time for breastfeeding women and a private space that is not a bathroom for nursing and pumping
- The ACA prohibits discrimination against individuals on the basis of race, color, national origin, sex, age, or disability in certain health programs or activities, under Section 1557, which builds on long-standing and familiar federal civil rights laws
The ACA is an enormous law and the potential impacts of it being eliminated are monumental.
Eighty-five percent of the growth in the United States natural gas production over the past decade has occurred in Northern to Central Appalachia. Additionally, petrochemical manufacturing, currently in development in the Region, is projected to attract between $16-20 billion in capital investment, and create more than 9,800 jobs directly and indirectly in Appalachia by 2025 noted The Appalachian Energy and Petrochemical Renaissance which was released by the Department of Energy earlier this year.
This week, Dr. Dean Foreman, Chief Economist for the American Petroleum Institute and an expert on domestic and global natural gas markets, briefed ARC staff on the current economic state and future growth potential for the Region’s significant shale gas resources. He noted that U.S. natural gas supply/demand fundamentals remain solid, with prospective market opportunity hinging largely on electricity generation, and that developing regional pipeline capacity enables Appalachian gas to reach diverse markets, thereby increasing demand and prices. Moreover, Dr. Foreman noted that natural gas demand and supply have held up relatively well through the COVID-19 pandemic, and with low prices are expected to support record 38.9% penetration of natural gas into U.S. electricity generation in 2020.
With hunting and other outdoors activities increasing at a time when woodlands and brush can become tinder dry in just a few days, the Wolf Administration is urging all residents to guard against increased wildfire dangers in Pennsylvania’s 17 million acres of forestlands.
State officials noted a sustained dry period over much of the state comes at a time when wildfire dangers normally are high, and critical conditions can develop almost overnight in many forested areas of Pennsylvania.
“With rainfall varying greatly across the commonwealth, a dry windy span of just a few days quickly can make wildfires a very real threat,” said Department of Conservation and Natural Resources (DCNR) Secretary Cindy Adams Dunn. “Amid the pandemic we know so many are seeking outdoors pursuits. Hunting soon will be popular and fall foliage is a joy to behold, but when the leaves begin dropping and drying, they become added fuel for woodland fires.”
“Amid these conditions, it takes only a careless moment to ignite a devastating wildfires. We know debris burning is leading cause of wildfires throughout the state and more than 95 percent of Pennsylvania wildfires are caused by people,” Dunn said.
“While most Pennsylvanians are used to wildfires being confined to relatively far off places, these catastrophic events pose an escalating risk to communities throughout the commonwealth,” said State Fire Commissioner Bruce Trego. “Increasingly, our state is being affected by weather patterns that turn fields and forests into accidents waiting to happen.”
The wildfire warning comes amid sparse rainfall and drying conditions, and as drought advisories are widening in Pennsylvania.
DCNR is responsible for administering a grant program paid through federal grants from the U.S. Department of Agriculture Forest Service. This program has awarded more than $14.5 million since it began in 1982. In 2019, more than $617,800 was awarded to 133 volunteer fire companies. Both Dunn and Trego encourage eligible departments to learn more about this important program for future grant opportunities.
With several deer and small-game hunting seasons opening in the coming weeks, both Dunn and Trego urged hunters and other woodlands visitors to be especially careful with smoking and fires amid dry vegetation.
Dunn noted the need to guard against wildfires increases each year as more development encroaches on heavily wooded tracts. Homeowners always should be diligent when burning trash and debris, she said.
Property owners should always consider the weather and conditions when burning outdoors. If it’s windy or dry, burning should be postponed until conditions change. A hose, rake, and shovel should be handy when burning outdoors, and any burnable materials cleared within 10 feet of a fire.
The Bureau of Forestry is working through state agencies and local fire companies to educate Pennsylvania citizens on procedures to make their homes in forest environments safer from wildfires. Information can be obtained from the Bureau of Forestry, county Emergency Management Office, or the Office of the State Fire Commissioner.
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), awarded over $35 million to more than 50 rural organizations across 33 states as part of a sustained federal effort to increase access to high quality care in rural communities. The awards reflect investments in key areas including telehealth, health workforce training, health research, technical assistance for vulnerable rural hospitals and HIV care and treatment.
“President Trump has made it a priority to strengthen rural health infrastructure and promote the health of rural Americans,” said HHS Deputy Secretary Eric Hargan. “As someone who grew up in rural America and with rural healthcare providers in my family, I know the challenges they face, and I know there’s a need for transformation. These awards are in line with the actions the President called for in his Executive Order on Improving Rural Health and Telehealth Access and are part of our overall effort to improve rural access to care in sustainable and innovative ways.”
The awards through HRSA’s Federal Office of Rural Health Policy (FORHP) include:
- $8.8 million awarded to 30 organizations across 23 states as part of the Telehealth Network Grant Program (TNGP). Awardees will promote rural tele-emergency services by enhancing emergency care consults from health care providers via telehealth through increased access and training.
- Nearly $2 million to support the Telehealth Focused Rural Health Research Center (TF RHRC) Program. TF RHRC awardees will carry out a comprehensive evaluation of nationwide telehealth investments in rural areas and populations, and conduct research to expand the evidence base for rural telehealth services.
- Nearly $1 million to establish the new Rural Telementoring Training Center (RTTC). The RTTC will train academic medical centers and other centers of excellence to create technology-enabled telementoring learning programs to disseminate best practice specialty care to primary care providers in rural and underserved areas.
- Over $8 million to support the Rural Residency Planning and Development (RRPD) Program across 10 states. Each awardee will focus on strengthening its health care workforce through the development of newly accredited, sustainable rural residency programs in family medicine, internal medicine and psychiatry.
- Nearly $5 million to support the Rural Health Research Center (RHRC) Program. Each awardee will conduct rural research to assist providers and policymakers at the federal, state and local levels to better understand problems faced by rural communities. The research will inform population health improvement efforts, including health care access and delivery.
- $10 million to support vulnerable hospitals in rural communities through the Delta Region Community Health Systems Development (DRCHSD) Program. This funding will provide specialized technical assistance to 30 hospitals across 252 counties and parishes served by the Delta Regional Authority, which often have the highest number of hospital closures or hospitals in financial distress.
- Over $680,000 through the Rural HIV/AIDS Planning Program to develop an integrated rural network for HIV care and treatment in four out of the seven states with the heaviest rural HIV burden. Awardees will implement the Administration’s Ending the HIV Epidemic: A Plan for America initiative to target gaps and challenges that stand in the way of early HIV diagnosis and treatment.
“The HRSA programs highlighted today put in practice HHS’ broader vision and plan for transforming the nation’s rural health care system so that it can better support the unique needs of rural communities,” said HRSA Administrator Tom Engels. “Through these HRSA programs and by working hand in hand with our rural partners across the nation, we can improve access, quality and outcomes for rural communities.”
You can view the full press release here
For a list of today’s award recipients, visit: https://www.hrsa.gov/rural-health/fy20-awards
To learn about the Federal Office of Rural Health Policy, visit: https://www.hrsa.gov/rural-health
The National Academies of Medicine (NAM) addresses the treatment gap in medically-assisted treatment for opioid use disorder (OUD), and presents strategies for increasing access to medicines such as buprenorphine and methadone.
CMS issued Frequently Asked Questions (FAQs) clarifying requirements and considerations for hospitals and other providers related to the Emergency Medical Treatment and Labor Act (EMTALA) during the COVID-19 pandemic. The FAQs address questions around patient presentation to the emergency department, EMTALA applicability across facility types, qualified medical professionals, medical screening exams, patient transfer and stabilization, telehealth, and other topics.