- Rural Hospitals Built During Baby Boom Now Face Baby Bust
- Food Stamps Go Further in Rural Areas — Until You Add Transportation Costs
- CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Texas
- CMS Proposes New Payments for Digital Health Under CY2025 PFS Draft Rule
- Improving Public Health by Strengthening Community Infrastructure
- Biden Harris Administration Proposes Policies to Reduce Maternal Mortality, Advance Health Equity, and Support Underserved Communities
- Nearly Half of U.S. Counties Don't Have a Single Cardiologist
- Randolph County, Ill. Turns Unused Part of Nursing Home Into State-Of-The-Art Behavioral Health Center
- Rural RPM Program Is a Lifeline for Pregnant Women
- Safe and Stable Housing Is a Foundation of Successful Recovery
- Expert: Rural Hospitals Are Particularly Vulnerable to Increasing Cyberattacks Targeting Healthcare Facilities
- Biden-Harris Administration Invests Over $200 Million to Help Primary Care Doctors, Nurses, and Other Health Care Providers Improve Care for Older Adults
- AJPH Call for Papers Special Section on Intersections of Public Health And Primary Care
- NIH HEAL Initiative Turns Attention to Pragmatic Trials in Rural Communities
- Limited Continuing-Care Options in Rural Virginia Create Challenges for an Aging Population
Pennsylvania Governor Administration Announces Business Loan Deferrals
The Pennsylvania Department of Community and Economic Development (DCED) Secretary Dennis Davin announced that the Pennsylvania Industrial Development Authority (PIDA), Pennsylvania Minority Business Development Authority (PMBDA), and Commonwealth Financing Authority (CFA) are deferring loans and that the maturity dates and amortization schedules of all applicable loans are extended by three additional calendar months.
PIDA borrowers with payments due in April, May, and June of 2020 are deferred. All other terms and conditions of all applicable loans remain unchanged.
PMBDA borrowers with payments due in April, May, and June of 2020, including principal, interest, and any associated feeds are deferred. Accrual of interest that would be included with deferred payments is suspended. All other terms and conditions of all applicable loans remain unchanged.
CFA borrowers except for PENNWORKS loans, with payments due in April, May, and June of 2020, including principal, interest, and any associated fees are deferred. Accrual of interest that would be included with deferred payments is suspended. All other terms of all applicable loans remain unchanged.
USDA Increases Monthly SNAP Benefits by 40%
The U.S. Secretary of Agriculture Sonny Perdue announced emergency benefit increases have reached $2.0 billion per month for Supplemental Nutrition Assistance Program (SNAP) households across all 50 states and 3 territories to increase food security during the coronavirus national emergency. These emergency benefits represent a 40% increase in overall monthly SNAP benefits, significantly increasing food purchasing power for American families
PennState Extension – How to Bid for the USDA Food Box Distribution Program
PennState Extension is giving information on how to apply for the USDA Food Box Distribution Program, which is a procurement opportunity for farms, food processors, and distributors. The program will procure $3 billion in food boxes and is designed to address food supply chain and emergency food relief needs resulting from COVID-19.
The RFP should be available for download at the USDA’s Food Box Distribution Program website beginning April 24th. Completed applications should be emailed to USDAFoodBoxDistributionProgram@usda.gov and further instructions will be found in the RFP.
Rural Hospitals are Facing Financial Ruin and Furloughing Staff During the Coronavirus Pandemic
A nurse conducts a COVID-19 test in the drive thru site at Scotland County Hospital in Memphis, Missouri.
Williamson Memorial Hospital was more than the place where Carole Steele had surgery on her elbow. It was more than the place that treated her husband Samuel when his severe allergies make it hard for him to breathe.
One doctor there was her grandniece’s godfather. Another was a trusted friend. Going to the hospital was “like going home to us,” the 73-year-old retired schoolteacher said. “For Samuel and I, that is the only hospital we have ever known.”
Now, in the middle of the coronavirus pandemic, the hospital will close its doors Tuesday after serving the community for more than 100 years. The only hospital in the coal mining community of Mingo County, West Virginia, Williamson Memorial filed bankruptcy last year. And it’s not alone. As the deadly virus has spread beyond urban hotspots, many more small hospitals across the country are on the verge of financial ruin as they’ve been forced to cancel elective procedures, one of the few dependable sources of revenue.
Pennsylvania Publishes Recovery Plan
Pennsylvania Governor Tom Wolf announced a Plan for Pennsylvania that will set citizens and businesses on a path to recovery from the COVID-19 pandemic while continuing to protect life from the dangers of this deadly virus.
The plan includes acknowledgement of Pennsylvania’s diverse agriculture industry, robust food processing sector, farmers markets, and the many industries that support a safe food supply. While the industry is life-sustaining, it has suffered a severe disruption in its supply chain, and recovery must ensure the certainty and future of Pennsylvania’s agriculture industry.
- Governor Wolf proposed full funding of $23.1 million for the historic PA Farm Bill in his FY 20-21 budget proposal, in addition to a $1 million increase to the PA Agriculture Surplus System (PASS) Program to improve food security while supporting PA agriculture. PA Farm Bill programs such as the Small Meat Processor grants, Urban Agriculture Infrastructure Grants and the Ag Business Development Center all help to increase processing infrastructure and strengthen local food systems, and provide tools to help producers bring more products to market and plan a path to recovery and resiliency.
- Establish a food processing reimbursement fund through the Department of Agriculture that would cover the costs borne by food processing facilities to invest in worker safety measures.
Fund and codify in statute the Pennsylvania Fresh Food Financing Initiative to provide grants and low-interest loans for the construction, rehabilitation, or expansion of grocery stores, farmers markets, and other healthy food retail establishments in low- to moderate-income areas in need and other undeserved communities.
CMS Releases Additional Blanket Waivers for Long-Term Care Hospitals, Rural Health Clinics, Federally Qualified Health Centers and Intermediate Care Facilities
CMS continues to release additional blanket waivers to the healthcare community in order to provide the flexibilities needed to take care of patients during this public health emergency. Today, CMS is providing additional blanket waivers related to care for patients in Long-Term Care Hospitals (LTCHs), temporary expansion locations of Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), staffing and training modifications in Intermediate Care Facilities for individuals with Intellectual disabilities, and the limit for substitute billing arrangements (locum tenens).
Census Response Rate in Pennsylvania – 52.2%
The 2020 Census is continuing even in the midst of a global pandemic. As of Tuesday, the self-response rate for Pennsylvania was 52.2% with roughly 46% completed online. As comparison, the final 2010 self-response rate was 70%. Townships can go online at 2020census.gov/en/response-rates to keep tabs on their local response rates. The map is updated daily around 3 p.m.
Congress, Administration Reach Deal on COVID-19 Funding
The Senate passed a $484 billion deal for small businesses and hospitals today after cash for sorely needed loans dried up last week. Congress and the Administration have agreed on a $484 billion COVID-19 relief package to provide funding to small businesses and hospitals and for testing. The proposal includes $310 billion for the Paycheck Protection Program, which was depleted. Read full story.
Rural Cases Increase by a Third over the Last Week
The broad trend is that rural counties are adding cases at a slightly faster rate than urban counties, although the number of rural cases remains only about 6% of the U.S. total.
That’s slightly faster than the metropolitan growth rate of about 23%. The growth continues a familiar trend as the rural infection rate inches up relative to the metropolitan rate.
As the rural infection rate climbs relative to the metropolitan rate, rural cases are becoming a slightly larger percentage of the nation’s overall Covid-19 cases. On Monday, April 13, rural cases constituted 4.1% of all Covid-19 cases in the U.S. On Sunday, April 19, they were 4.7% The growth is small but steady.
Seventy-nine rural counties had their first case of Covid-19 from April 13 to 19. There are still 410 rural counties, out of about 2,000, that do not have a case of the virus.
Beyond these large trends, the spread of the virus is an ever-growing collection of local events, in most cases unique to specific people and places.
The largest increase in rural cases during the last week occurred in Marion County, Ohio, where an outbreak at a state prison caused the case count to rocket from 91 to 1,743. Marion, with a population of about 65,000, now has the highest number of cases in the state.
In the Midwest, outbreaks seem tied to meat-processing plants. Marshall County, Iowa, the site of a Swift pork plant, saw its cases increase from 37 to 118 last week. Ford County, Kansas, increased from 16 to 127 cases. In Dodge City, the county seat, National Beef closed its plant from April 16 to April 21 to install safety gear and take other measures. Cargill also confirmed cases of coronavirus at its plant.
Parts of Indian Country are being hit hard. McKinley County, New Mexico, added 172 cases of Covid-19 last week, nearly doubling the number it had on April 13. The county’s population is 75% Native American and includes parts of the Navajo Nation and Pueblo of Zuni. Arizona counties in the region also saw dramatic increases. Navajo County, Arizona, grew by more than 100 cases to a total of 459, and Apache County, Arizona, doubled its cases, growing from 89 to 178.
The rural South continued to see significant increases, with a band of counties running from East Texas across Louisana, Mississippi, Alabama, southwest Georgia, and the coastal regions of South Carolina and North Carolina.
Moore County in Texas, however, said its nearly five-fold increase in cases came from better means of testing. An Amarillo television station reports that the county has rapid coroavirus test that can return results in 15 minutes.
“Whenever we first got these tests, we brought them here to Moore County, and then we tested them against our own known … positive and negative patients, and we had 100 percent accuracy,” Steve Agle, the general surgeon at the local hospital, told KFDA television news. The county judge said Moore County is the only one in the state to use the test and report numbers from them.
Rural America Could Be Weeks away from Peak in Coronavirus Cases
Two infectious-disease experts say reopening industries that don’t allow social distancing could cause hotspots.
While larger urban areas may be seeing the number of coronavirus cases slow, cases in rural areas are just beginning, two experts said during a briefing from the Infectious Diseases Society of America Tuesday.
During the 45-minute long briefing, Dr. Angela Hewlett, associate professor, Department of Internal Medicine, University of Nebraska Medical Center, and Dr. Andrew T. Pavia, chief of the Division of Pediatric Infectious Diseases, University of Utah School of Medicine, told reporters that rural communities are beginning to see outbreaks of the coronavirus that differed from those seen in more urban communities, and that the outbreaks in rural America are far from reaching their peak.
Pavia said that disparities between rural communities and urban communities prior to the outbreak of COVID-19 in the U.S. may mean the disease will be a part of rural communities for a long time to come.
“The health disparities between big cities and rural communities means we may see long, sustained outbreaks in rural areas for weeks and months to come,” he said. “The resources in rural communities are just not the same.”
Smaller hospitals with staff that is not as adequately trained, coupled with existing health issues in the community and in some cases poverty conditions, all contribute to how well rural communities are able to contain and combat the disease.
While Hewlett said rural communities are much better at social distancing, the culture of those communities may contribute to outbreaks. From large community gatherings to large industries providing jobs in close quarters to the community, the way rural communities thrive may be a part of how easily it is spread, she said.
The number of cases of the disease in rural communities could continue to rise for weeks, she said. It may be two or three more weeks before many rural communities see their case numbers peak, she said.
In states like South Carolina, Texas, Tennessee and Georgia, where governors are pushing to slowly open up their state’s economies in coming days, how those economies open up could have an impact on the health of rural communities, as well, they said.
If the jobs that start up again are ones that put social distancing and other protective measures in place – like agriculture – things could go well, Pavia said.
But opening up the wrong businesses could cause an uptick in cases and small micro-outbreaks, Hewlett said.
“We have to be really careful about this,” she said. “I agree that this should be a local- or state-level decision, but there is a way to do this right.”
Re-opening industrial sites which supply jobs to rural communities may not be a good idea, Pavia said, because of the close contact workers have with one another. That contact could end up spreading the disease again.
“Opening up industries in rural facilities – I just don’t know how you open those up and open them up safely,” he said.
Both doctors said rural communities need enhanced testing, enhanced contact tracing before they open up again.