By Jan Pytalski and Tim Marema
The Postal Service delivers economic access and democracy to small communities during the Covid-19 crisis, says a rural letter carrier. Privatization would leave rural America behind, he says. Read more here.
For Rural Hospital, Pandemic Hasn’t Materialized, but the Fiscal Harm Arrived on Schedule
By Liz Carey
Folks at Ferry County Memorial Hospital in northeast Washington are grateful that the steps they took to prevent Covid-19 appear to be working. But the cost to the hospital and community have still been substantial. Read more here.
Providing in a Pandemic: The Challenges of Rural Maternity Care Just Got More Difficult
By Mikhal Ben Joseph
Rural moms already faced a host of obstacles to get good prenatal care. Rural nurse midwives and doulas are trying to fill the gap. (Part of a series.) Read more here.
Rural Hotspots: A Handful of Counties Produce Over Half of New Infections
By Tim Marema
More than half of the latest new Covid-19 cases in rural America came from a small number of hotspot counties, most of which are in the Southeastern United States. Read more here.
New Brief: Provision of Mental Health Services by Critical Access Hospital-Based Rural Health Clinics
Residents of rural communities face longstanding access barriers to mental health (MH) services due to chronic shortages of specialty MH providers, long travel distances to services, increased likelihood of being uninsured or under-insured, limited choice of providers, and high rates of stigma. As a result, rural residents rely more heavily on primary care providers and local acute care hospitals to meet their MH needs than do urban residents. This reality highlights the importance of integrating primary care and MH services to improve access to needed care in rural communities. Critical Access Hospitals (CAHs) are ideally positioned to help meet rural MH needs as 60 percent manage at least one Rural Health Clinic (RHC). RHCs receive Medicare cost-based reimbursement for a defined package of services including those provided by doctoral-level clinical psychologists (CPs) and licensed clinical social workers (LCSWs).
This policy brief explores the extent to which CAH-based RHCs are employing CPs and/or LCSWs to provide MH services, describes models of MH services implemented by CAH-based RHCs, examines their successes and challenges in doing so, and provides a resource to assist CAH and RHC leaders in developing MH services. It also provides a resource for State Flex Programs to work with CAH-based RHCs in the development of MH services.
Pennsylvania Governor’s Administration Urges USDA to Maintain Flexibility for States Administering SNAP Benefits in Response to Continued Threat of COVID-19
Pennsylvania Governor Tom Wolf sent a letter to the United States Department of Agriculture (USDA) Secretary Sonny Perdue urging the USDA to extend waivers granted to provide states for longer than a month at a time to preserve flexibility they need to ensure the uninterrupted and safe administration of public benefits during the COVID-19 public health crisis. The flexibilities granted by waivers from the USDA specifically related to the Supplemental Nutrition Assistance Program (SNAP) reduce the need for in-person interactions between Department of Human Service (DHS) staff and current and potential clients, keeping both safer from COVID-19 while allowing DHS to continue to meet needs of Pennsylvanians during this period of economic uncertainty.
Numerous waivers previously granted by the USDA for the SNAP program were set to expire on June 30. Thus far, the Pennsylvania Department of Human Services (DHS) has been granted a one-month extension for the following waivers:
- Elimination of Face-to-Face and Quality Control Interviews: Under normal circumstances, a face-to-face interview must be conducted to determine benefit eligibility and at random for quality control processes. Due to COVID-19, these waivers allows states to perform interviews over the phone to accommodate social distancing and keep DHS staff and clients safe while ensuring continuity of benefits and eligibility determinations.
- Extension of Fair Hearing and Administrative Disqualification Hearings Timeframes: These waivers help Pennsylvania remain in compliance with SNAP regulations by granting DHS staff more time to conduct appeals and disqualification hearings. DHS’ Bureau of Hearings and Appeals is currently operating under a blended on-site and telework model, but there is currently a backlog of cases being worked through from when the stay at home order first began in March. Without these waivers, Pennsylvania would be out of compliance with federal regulations.
- Temporary Suspension of Claims Collections: This waiver allows Pennsylvania’s Office of Inspector General to pause recoupment if SNAP benefits are overpaid. Without this waiver, SNAP households with a previous overpayment would receive less benefits during the COVID-19 health emergency and would have complicated households’ ability to receive emergency SNAP payments. Given current economic uncertainty, the Wolf Administration would like to continue this temporary pause to prevent further strain on households until circumstances improve.
These waivers are set to expire on July 31, 2020, but Pennsylvania is requesting a longer term, 90-day extension. Waiver extensions of up to 90 days, instead of the current 30 days, would allow for greater predictability and efficiency in DHS operations, as the certainty would eliminate the need to reapply for waivers each month and prepare processes for changes necessary if waivers are not granted.
DHS has also requested wavier extensions to extend SNAP certification periods so current recipients do not have to submit additional paperwork in order to maintain benefits, and to adjust interview requirements, which can slow issuance of benefits and increase rates of people churning off and back on to SNAP. These waivers are also set to expire on June 30.
Governor Wolf also encouraged the USDA to continue to allow states to extend emergency SNAP allotments to current SNAP households. These payments, which are authorized under the Families First Coronavirus Response Act, grant an additional payment to SNAP households that do not receive the maximum monthly benefit for their household size to bring these households to the monthly maximum.
Pennsylvania was approved for this benefit for July, but states lose the authority to issue the supplemental payments if the federal or state disaster declarations are rescinded. Without this, Pennsylvania would lose $100 million per month in additional federal funds that get returned to grocers, farmers markets, and other small businesses in local economies, and SNAP households would receive only the normal benefit amount when many counties still experiencing economic challenges as well as increases in the cost of groceries.
Governor Wolf also urged Secretary Perdue and the USDA to recognize the important role the SNAP program plays in helping more than 1.9 million Pennsylvanians avoid going hungry, which can have adverse effects on a person’s health and well-being. Because SNAP primarily serves populations like the elderly and low-income communities that have been disproportionately affected by the pandemic, removing flexibilities that could potentially remove people from the program would be another way of directing support away from vulnerable Pennsylvanians.
Read the full letter here.
Pollinators Need Pennsylvanians Help to Sustain Future of Food Security
Pennsylvania Agriculture Secretary Russell Redding today reminded Pennsylvanians – from kids and parents, to homeowners, to farmers – the importance of taking steps to protect our valuable population of pollinators to protect the future of food security.
Earlier this week, Department of Agriculture Deputy Secretary Cheryl Cook and State Apiarist Karen Roccasecca joined The GIANT Company at their headquarters in Carlisle at their new, seven-acre pollinator field. The all native meadow will create a habitat for pollinators, birds, and other small wildlife while improving the quality of the soil and reducing runoff.
June 22-28, 2020 is National Pollinator Awareness Week. It’s a time to celebrate pollinators and spread the word about what you can do to protect them and their valuable services to our ecosystem.
A pollinator is anything that helps move pollen to fertilize flowers. Bees and butterflies are the most commonly known pollinators, but they also include moths, birds, flies, and small mammals such as bats. More than 75 percent of the world’s food crops depend on pollination. Everyone can play a role in protecting pollinators and their vital work.
- Teach kids about the big job that bees and other pollinators have and teach practical ways for them to protect the population;
- Downsize your lawn – lawns don’t have much to offer pollinators so consider converting some of your grass to a garden bed full of heavy pollen and nectar producing plants;
- Grow native plants in your garden – pollinators and plants need each other to survive. Planting a diverse group of native plants that flower at different times of the year can make a huge different to pollinator populations;
- Avoid or limit the use of pesticides, fungicides, and herbicides in your home garden. They can kill pollinators and poison hives. If you do use them, follow the label directions carefully. Apply to plants when they are not flowering, at dusk and when the air is calm, to limit exposure to pollinators.
More bees mean a secure future for food availability, and it even means that our food tastes better. Farms with well managed pollination can increase their production by 24 percent and well pollinated plants produce larger, more uniform fruit. To foster a healthy natural pollinator habitat, farmers are encouraged to leave some areas of their farm under natural habitat and implement hedgerows.
Growers and beekeepers are also encouraged to sign up for FieldWatch and BeeCheck free, voluntary programs that allows participants to register their farmland and bee yards to protect it from chemical drift, which can affect honey bees, organic production, herbicide-sensitive crops, and pollinator protection efforts. The program encourages communication between beekeepers, sensitive crop growers, and pesticide applicators and will allow them to map bee yards, fields or pollinator gardens. Pesticide and herbicide applicators can also notify growers and beekeepers of spray applications through the program.
Save-the-Dates: CMS 2020 National Training Program Virtual Workshops
Registration for the 2020 Centers for Medicare & Medicaid Services (CMS) National Training Program (NTP) virtual workshops will open in mid-July. You’ll receive an email with registration information. To help you plan, the dates for the sessions are listed below. You’re invited to attend the session(s) of your choice to meet your schedule and learning needs. Sessions will be recorded for later viewing. Sessions will open at 12pm, with the live presentations starting at 1pm and conclude no later than 3:30pm (ET).
July 2020
28th – Medicare Basics, Enrollment, & Eligibility
29th – Introduction to Medicare Coverage Options (Part A and Part B)
30th – Medicare Supplement Insurance (Medigap) & Differences with Medicare Advantage
August 2020
4th – Medicare Prescription Drug Coverage
5th – Medicare Coverage Options: Medicare Advantage
6th – Medicare Appeals and How Medicare Works with Other Insurance
11th – Programs for People with Limited Income and Resources
12th – Medicare Plan Finder Demonstration & Tips
13th – Medicare Current Topics
18th – Preventing Medicare Fraud
19th – CMS’ Actions in Response to COVID-19
20th – CMS’ Actions to Address Opioid Crisis
25th – Social Security Benefits
27th – Where Do I Find? (Online Resources)
September 2020
1st – Tax Favored Programs & Medicare
3rd – Medicare- Spanish Language Presentation
Session materials will be available for download during the events.
NOTE: Registration requests will be considered on a first-come, first-serve basis until each session reaches capacity. The number of attendees from the same organization may be limited. If any session reaches capacity, we’ll work to schedule an additional offering for a later date.
Pennsylvania Department of Aging Seeks Community and Stakeholder Input
Now through June 26, the Pennsylvania Department of Aging is looking for your input on services and the issues affecting older adults to help build the next state plan. This plan will guide the direction of Pennsylvania’s aging services for the next 4 years. You can take the short, 3-5-minute survey in English or Spanish by visiting https://bit.ly/PAAgingStatePlan.
The Department of Aging will also host a virtual community conversation from noon to 1:30 PM on Tuesday, July 7 to discuss its State Plan on Aging for 2020-2024 and invites feedback from the public and community stakeholders throughout Pennsylvania. People interested in participating can be an observer only or can make comments for up to two minutes on aging issues that are important to them. Participants can join the conversation by WebEx on the internet, or can call 1-855-797-9485 and enter the access code:161 264 3439 when prompted.
Pennsylvania Governor: Masks Help Stop the Spread of COVID-19
Pennsylvania Governor Tom Wolf noted that research confirms the importance of wearing masks to stop the spread of COVID-19 and that Pennsylvanians are required to wear masks when entering any business in all counties in both yellow and green phases of reopening.
The mask requirement is part of Pennsylvania Secretary of Health Dr. Rachel’s Levine’s order, “Directing Public Health Safety Measures for Businesses Permitted to Maintain In-person Operations,” which pertains to all counties regardless of the phase of reopening. The order requires businesses to enforce mask-wearing unless someone has an underlying health condition that prevents them from wearing a mask. Children two or younger are not required to wear masks.
According to a recent study in the Institute of Physics, wearing simple medical masks or improvised facial coverings reduces community exposures from asymptomatic, but unknowingly infectious, individuals.
The study concludes that while people may perceive them to be ineffective or burdensome to wear, “wearing some form of exhaled barrier (mask) out in public during pathogen outbreaks is an altruistic act serving not only as a form of enhanced cough or sneeze etiquette, but also to reduce the aerosols emitted from normal breathing or when talking. Without daily testing, nobody can be certain that they are not an asymptotic disease vector. Scientifically, this is a positive step towards helping combat the current COVID-19 pandemic.”
U.S. Surgeon General Dr. Jerome Adams took to twitter on Sunday to advise that mask-wearing is contributing to and not infringing on freedom, tweeting in part, “Some feel face coverings infringe on their freedom of choice- but if more wear them, we’ll have MORE freedom to go out.”
In addition to mask wearing, Gov. Wolf and Sec. of Health Dr. Rachel Levine have advised that robust testing and contact tracing in green counties are keys to safe, phased reopening