On June 9th, the Center for Medicare and Medicaid Services (CMS) released a guide, directed by the Trump Administration, for providers considering in-person care services. The COVID-19 pandemic resulted in postponing non-emergency, in-person services. CMS has presented recommendations to ensure non-emergency and needed care, postponed during the pandemic, resumes safely. Phase 1 recommendations for re-opening were issued by CMS on April 19th to areas with a relatively low incidence of the COVID-19 pandemic, and CMS will continue to make recommendations as the situation changes. It is important that rural health facilities are able to resume operation, despite the emergence of telehealth in hospital care settings, while recognizing that COVID-19 is an ongoing health crisis. Considering the safety of patients and healthcare workers is highly important and reopening hospital facilities must be managed carefully.

The U.S. Department of Health & Human Services (HHS) has announced additional distributions from the Provider Relief Fund to eligible providers that participate in state Medicaid and CHIP programs. HHS expects to distribute approximately $15 billion to eligible providers that have not received a payment from the Provider Relief Fund General Allocation. HHS is also announcing the distribution of $10 billion in Provider Relief Funds to safety net hospitals that serve our most vulnerable citizens. The safety net distribution will occur this week. This is not a rural specific distribution, but Medicaid is an important source of coverage in rural areas.

Rural hospitals are closing during this public health emergency. The Rural Hospital Closure Relief Act (S.3103, H.R. 5481) would update Medicare’s “Critical Access Hospital” (CAH) designation so more rural hospitals can qualify for this financial lifeline and continue to serve their communities with quality, affordable health care services. Small hospitals are the backbone of rural communities, and often the largest employers, yet more than 120 rural hospitals have closed nationwide in the past decade, with many more hospitals operating with negative margins. The Rural Hospital Closure Relief Act is the immediate fix to help rural hospitals facing extreme strains from the COVID-19 pandemic.

In a wide-ranging talk to biotech executives, Dr. Anthony S. Fauci delivered a grim assessment of the devastation wrought around the world by the coronavirus. COVID-19 is the disease that Dr. Fauci always said would be his “worst nightmare” – a new, highly contagious respiratory infection that causes a significant amount of illness and death. “In a period of four months, it has devastated the whole world,” Dr. Fauci, Director of the National Institute of Allergy and Infectious Diseases, said on Tuesday during a conference held by BIO, the Biotechnology Innovation Organization. “And it isn’t over yet.” Read more.

The Wolf administration issued an order requiring nursing homes to test all residents and staff by mid-summer for coronavirus. Facilities are responsible for contracting with a commercial laboratory for the testing. According to a report issued by the Department of Health, within 615 facilities, there were 16,167 cases among patients, 2,807 among staff, and 4,094 deaths or approximately 69 percent of the overall COVID-19 attributable deaths statewide. The order from Department of Health Secretary Dr. Rachel Levine applies to all 693 nursing homes in the state, requiring them to complete the tests by July 24.

All employers, not just those with high levels of coronavirus exposure in the workplace, now must determine whether employees who have COVID-19 contracted it at work. The new Occupational Safety and Health Administration (OSHA) requirement reverses the previous, April 10, 2020 guidance which required only employers in the healthcare industry, emergency-response organizations and correctional institutions to record work-related coronavirus cases. To comply with the May 26 OSHA’s guidance, whenever an employee becomes ill with COVID-19, the employer needs to conduct a mini-investigation. Employers will have to look for information about the cause of an employee’s virus infection while respecting the employee’s privacy. If the employee contracted the coronavirus at work or while performing work-related activities, the employer must record the illness on the OSHA Form 300.

This week, the Department of Health and Human Services (HHS) distributed approximately $15 billion in Provider Relief Funds (PRF) to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs and have not received a previous payment from the Provider Relief Fund General Allocation. Most of these providers are Medicaid-only providers, meaning that Medicaid is their only source of reimbursement. Although few if any FQHCs are likely to qualify for this latest PRF funding, most FQHCs have already received at least one direct deposit from the PRF. There is $50 billion remaining in the fund and NACHC this week sent a letter to HHS Sec. Azar urging that a portion of this funding go to health centers and particularly to health centers with more than 500 employees (who were ineligible for a Paycheck Protection Program loan) and look-alikes, that only qualified for one of the three FQHC COVID-19 funding streams from HRSA.

Last week, Gov. Tom Wolf announced the creation of the Commonwealth Civilian Coronavirus Corps, a public service initiative that will support efforts this fall to increase testing and contact tracing and provide critical new job opportunities in the public health sector. As announced by the Administration, the Corps will also provide a unique opportunity for Pennsylvania to recruit and train COVID-19-impacted dislocated and unemployed workers into public service for contact tracing roles, which would help address Pennsylvania’s health and economic needs. The goals/responsibilities of this task force include:

• Partnering with local public health agencies, community organizations and the nonprofit community to expand Pennsylvania’s existing testing and contract tracing initiatives
• Leveraging additional resources to fund testing and contact tracing initiatives
• Exploring creative ways to recruit experienced Pennsylvanians with health care and public health experience to support this initiative
• Coordinating existing resources deployed by the commonwealth, including community health nurses and county health departments who are currently conducting testing and contact tracing throughout the state
• Engaging partners in the workforce development system, existing allied health training program and AmeriCorps programs to build and strengthen a public health workforce across the commonwealth
• Leveraging existing workforce development resources to recruit, train, and connect the public health workforce with employment opportunities
• Engaging public health and healthcare employers to connect trained workers with long-term career opportunities