Pennsylvania Governor’s Administration Awards $10 Million to Fund Access to Fresh Food, COVID-19 Mitigation Efforts in Low-Income Communities

At Karimar Grocery in Franklin County today, Pennsylvania Agriculture Secretary Russell Redding and Community and Economic Development Secretary Dennis Davin announced that more than 100 projects, funding access for fresh food in low-income communities, have received grants through Pennsylvania’s $10 million Fresh Food Financing Initiative.

“There are three keys to food security — Is food available, is food affordable, and is food safe?” said Redding. “The Fresh Food Financing Initiative helps make ‘yes’ the answer to all three questions. Early in the pandemic, we were all shocked by the empty grocery store shelves. This program has given us the ability to offset the costs food retailers have incurred in making fresh, nutritious food available while safeguarding their employees and customers.”

The Fresh Food Financing Initiative (FFFI) was funded at $10 million through the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act and opened in July to for-profit, nonprofit, or cooperative entities including grocery stores, corner stores, convenience stores, neighborhood markets, bodegas, food hubs, mobile markets, farmers markets, on-farm markets, urban farms, and food aggregation centers with a direct connection to direct-to-consumer retail outlets.

To be eligible, more than 70 percent of sales were required to be from staple, perishable foods to consumers and the retailer must serve customers who live in a low-to-moderate income area. Applicants were also required to demonstrate limited food access as a result of COVID-19 or that direct-to-consumer retail expansion is necessary due to lost or disrupted markets. Eligible applicants were required to accept SNAP and WIC or have plans to accept them through completion of the project.

“The COVID-19 pandemic laid bare the challenges that many Pennsylvanians face in accessing fresh, local food,” said Davin. “The Fresh Food Financing Initiative was developed to ensure that no one in our commonwealth will struggle to fill their pantry and the food supply chain will remain stable, whether during a crisis, emergency, or during times of normalcy.”

Karimar Grocery, a minority, woman-owned neighborhood store in Chambersburg, experienced increased demand for perishable and staple food products throughout the pandemic. Their $55,000 grant will fund the purchase of equipment – such as refrigerators, freezers, coolers, and a meat grinder – to allow them to store more fresh meat, dairy, and produce and will cover expenditures already made to create a safe, healthy shopping environment in the low-income, Black, Indigenous, and People of Color (BIPOC) community they serve.

“It is important to keep residents of the commonwealth safe and informed. COVID-19 has disproportionately affected the Latino community, placing this population at a greater disadvantage,” said Luz B. Colón, executive director to the Governor’s Advisory Commission on Latino Affairs. “Programs like the Fresh Food Financing Initiative help secure food resources to our minority communities and ensure that it will reach the families that need it the most.”

The $10 million FFFI grant program funded 115 projects in 39 counties. The projects fund expenses related to PPE and other in-store COVID-19 mitigation efforts, expansions, refrigeration, online marketing materials, mobile market enhancements, and more.

A full list of funded projects can be found online. Applicants could apply for impacts related to COVID-19 incurred between March 1, 2020 and November 30, 2020, such as:

  • Higher operating costs related to cleaning and social distancing requirements, including costs related to outside contracting associated with managing social distancing, limited occupancy, and cleaning;
  • Infrastructure improvements, including renovation, new construction, or adaptive reuse directly related to COVID-19;
  • Equipment purchases that improve the availability of quality fresh food, such as additional refrigeration to manage volume, or personal protective equipment such as plexiglass dividers;
  • Inventory (higher cost of goods, higher transportation or delivery costs, or procuring Pennsylvania-grown produce, meat, and dairy products, or loss of product);
  • Innovative food access technology such as mobile or pop-up markets, or mobile EBT reader technology;
  • Costs to expand access to Pennsylvania grown or processed produce, dairy, and meat products or provide stable market access for Pennsylvania farmers that have lost or limited markets; and
  • Other one-time or increased expenses incurred related to COVID-19.

For more information on the Fresh Food Financing Initiative or about the Wolf Administration’s efforts surrounding food security, visit agriculture.pa.gov. For information as it relates to agriculture during COVID-19 mitigation in Pennsylvania visit agriculture.pa.gov/COVID. For the most accurate, timely information related to health in Pennsylvania, visit on.pa.gov/coronavirus.

New Publications on Oral Health and Telehealth from the National Organizations of State and Local Officials (NOSLO)

The National Academy for State Health Policy posted a case study on how Medicaid agencies in Colorado, Maine, and Oregon are leveraging primary care-based accountable care programs to improve the delivery of oral health care to adults and children.

The Association of State and Territorial Health Officials (ASTHO) published a brief on the Impact of Telehealth on Maternity Care (PDF – 228 KB) offering ways states can improve access to maternal care.

Both publications were developed through HRSA’s cooperative agreement with NOSLO.

Rural Health Resources Roundup: Rural Healthcare Surge Readiness Web Portal

In September’s session of the Rural Health Resources Roundup Series, CAPT Renee Joskow talks about the Rural Healthcare Surge Readiness Web Portal. The portal provides key and essential resources, tools, and training to prepare for and respond to COVID-19 in rural communities. It was developed by the Federal Healthcare Resilience Working Group and the Rural Surge Readiness Team.

Listen to the Rural Healthcare Surge Readiness Web Portal session.

Medical Errors Increase by Nearly 20% Around Daylight Saving, Study Finds

From Becker’s Hospital Review

In the days following the switch to daylight saving time, human mistakes tied to patient safety-related incidents increased by almost 20 percent, according to a study in the Journal of General Internal Medicine.

Researchers analyzed voluntarily reported data from Rochester, Minn.-based Mayo Clinic that occurred seven days before and after the spring and fall time changes for 2010-17. Patient safety-related incidents included defective systems, equipment failure or human error.

Researchers didn’t report significant differences in overall errors in the weeks before and after the time changes. However, when analyzing human error only, they found the number of human errors increased by a statistically significant 18.7 percent after daylight saving in the spring. Most of the errors involved medications, such as administering the wrong dose or wrong drug.

CMS Announces Innovative Payment Model to Improve Care, Lower Costs for Cancer Patients

Radiation Oncology Model will modernize Medicare payments for radiotherapy services  

On September 18, CMS finalized a new Innovation Center model expected to improve the quality of care for cancer patients receiving radiotherapy and reduce Medicare expenditures through bundled payments that allow providers to focus on delivering high-quality treatments. The new Radiation Oncology (RO) Model allows this focus on value-based care by creating simpler, more predictable payments that incentivize cost-efficient and clinically effective treatments to improve quality and outcomes. The RO Model, part of a final rule on specialty care models issued by CMS, will begin on January 1, 2021 and is estimated to save Medicare $230 million over 5 years.

“President Trump knows that, for cancer patients, what matters is their quality of life and beating their cancer.  But today, Medicare payment for radiotherapy is based on the number of treatments a patient receives and where they receive it, which can lead to spending more time traveling for treatment with little clinical value,” said CMS Administrator Seema Verma. “That’s why the Trump administration has developed a new innovative model that allows patients and providers to focus on better outcomes for patients.”

For More information:

These Models are a part of a CMS final rule on Medicare Program; Specialty Care Models To Improve Quality of Care and Reduce Expenditures (CMS-5527-F).

CMS Announces Transformative New Model of Care for Medicare Beneficiaries with Chronic Kidney Disease

Model focuses on reducing costs and improving quality of care for patients

On September 18, CMS announced it has finalized the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model, to improve or maintain the quality of care and reduce Medicare expenditures for patients with chronic kidney disease. The ETC Model delivers on President Trump’s Advancing Kidney Health Executive Order and encourages an increased use of home dialysis and kidney transplants to help improve the quality of life of Medicare beneficiaries with ESRD. The ETC Model will impact approximately 30 percent of kidney care providers and will be implemented on January 1, 2021 at an estimated savings of $23 million over five and a half years.

“Over the past year, the Trump Administration has taken more action to advance American kidney health than we’ve seen in decades,” said HHS Secretary Alex Azar. “This new payment model helps address a broken set of incentives that have prevented far too many Americans from benefiting from enjoying the better lives that could come with more convenient dialysis options or the possibility of a transplant.”

For More Information:

CMS Announces New Guidance for Safe Visitation in Nursing Homes During COVID-19 Public Health Emergency

On September 17, CMS issued revised guidance providing detailed recommendations on ways nursing homes can safely facilitate visitation during the coronavirus disease 2019 (COVID-19) pandemic. After several months of visitor restrictions designed to slow the spread of COVID-19, CMS recognizes that physical separation from family and other loved ones has taken a significant toll on nursing home residents. In light of this, and in combination with increasingly available data to guide policy development, CMS is issuing revised guidance to help nursing homes facilitate visitation in both indoor and outdoor settings and in compassionate care situations. The guidance also outlines certain core principles and best practices to reduce the risk of COVID-19 transmission to adhere to during visitations.

See the full text of this excerpted CMS Press Release (issued September 17).

Final Evaluation of the Medicare ACO Investment Model

This week, the CMS Innovation Center released the final evaluation results of the Accountable Care Organization (ACO) Investment Model (AIM), which operated under the Shared Savings Program (SSP) from 2015 to 2018. AIM provided up-front payments to select ACOs to invest in infrastructure and staffing and targeted small ACOs, many of which were in rural areas.  Overall, participating ACOs reduced total Medicare spending and utilization without decreasing quality of care.  Read more here.

Advancing Value-Based Care in States

This week, the Centers for Medicare & Medicaid Services (CMS) released guidance to states on pathways they can use to advance value-based care, which seeks to reward providers based on quality of care instead of volume of services.   This letter describes several models that can be used across many types of payers, key features of these models, and relevant Medicaid authorities needed for adoption.  It includes several models identified in 2019 by Rural Health Value as appropriate for rural clinicians or health care delivery organizations.  Read more here.

Comments Requested: Part I of the CY 2022 Advance Notice of Medicare Advantage and Part D Payment Policies—November 13

This week, the Centers for Medicare & Medicaid Services (CMS) released earlier than usual their proposal for contract year 2022 to calculate risk scores for Medicare Advantage (MA) payments using only encounter data submitted by MA organizations and the 2020 CMS Hierarchical Conditions Categories (HCC) model.  The intent of risk adjustment is to ensure that payments to MA plans reflect the relative risk, or characteristics and health conditions, of the enrollees.  Research has found lower average risk scores for beneficiaries served by rural providers than urban, which is contrary to extensive research showing rural populations are less healthy than urban.  Read more here.