Pennsylvania’s administration announced that event and gathering maximum occupancy limits will be increased to 50 percent for indoor events and gatherings and 75 percent for outdoor events and gatherings effective Monday, May 17 at 12:01 AM.

“As more Pennsylvania adults get vaccinated and guidance from the CDC evolves, we can continue to move forward with the commonwealth’s reopening efforts,” said Governor Wolf. “We recognize the significant strain businesses have faced during COVID-19 mitigation efforts. Throughout the last year and half, we have seen businesses continue to put the safety of their patrons first and I believe they will continue to do so even with this capacity increase.”

This update will not prevent municipalities, school districts, restaurants and venues from continuing and implementing stricter mitigation efforts. Based on current CDC guidance, social distancing is strongly recommended for municipalities, school districts, restaurants, and venues.

An event or gathering is defined as a temporary grouping of individuals for defined purposes, that takes place over a limited timeframe, such as hours or days. For example, events and gatherings include fairs, festivals, concerts or shows and groupings that occur within larger, more permanent businesses, such as shows or performances within amusements parks, individual showings of movies on a single screen/auditorium within a multiplex, business meetings or conferences, or each party or reception within a multiroom venue.

Face coverings are still to be worn indoors and outdoors if you are away from your home. In accordance with the latest Centers for Disease Control and Prevention (CDC) guidance, fully vaccinated Pennsylvanians are not required to wear a mask during certain activities. The current order requiring Pennsylvanians to wear masks will be lifted when 70 percent of Pennsylvanians age 18 and older are fully vaccinated.

“As we continue implementing our reopening plan as quickly as possible, the safety of Pennsylvanians remains at the forefront of our decision making,” said Gov. Wolf. “During the pandemic, all Pennsylvanians have worked collaboratively to stop the spread of COVID-19. We must continue that same mindset during our reopening efforts. I urge each eligible Pennsylvanians to get vaccinated to help protect your neighbors and loved ones as we work to safely reopen our beloved commonwealth communities.”

Currently, maximum occupancy is 25 percent for indoor events and gatherings and 50 percent for outdoor events and gatherings, regardless of venue size and only if attendees and workers are able to comply with the 6-foot physical distancing requirement.

All Pennsylvanians ages 16 and older are eligible to schedule a COVID-19 vaccine. To find a vaccine provider, visit vaccines.gov. Pennsylvanians with questions about the vaccination process can call the Department of Health’s hotline at 1-877-724-3258.

A Tool to Increase Vaccine Confidence in Rural Areas

The White House launched the Rural Community Toolkit to increase confidence in the COVID-19 vaccines while reinforcing basic prevention measures in rural communities. This toolkit features tailored materials you can use to educate rural residents about the vaccines.

This material is intended for all organizations that communicate directly with rural audiences. Access the user guide to learn how to use it in your community.

Findings from New Medicaid & CHIP Data Analysis Correspond with Reports of Adverse Mental Health Conditions for Vulnerable Populations

The Centers for Medicare & Medicaid Services (CMS) released data today highlighting the continued impact the COVID-19 Public Health Emergency (PHE) is having on Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries and utilization of health services.  The data show that, from March through October 2020, beneficiaries have foregone millions of primary, preventive, and mental health care visits due to the COVID-19 PHE, compared to the same time period in 2019. Although utilization rates for some treatments have rebounded to pre-pandemic levels, mental health services show the slowest rebound.

This decline in utilization is occurring at a time when preliminary evidence shows mental health conditions have worsened nationwide. The gap in service utilization due to the PHE, particularly for mental health services, may have a substantial impact on long-term health outcomes. Medicaid and CHIP-funded mental health services, in addition to primary and preventative services, cover the majority of children, people living in poverty, and those with special health care needs. Medicaid and CHIP also cover millions of racial and ethnic minorities.

To help close this gap in services, CMS is emphasizing mental health care in its recently launched Connecting Kids to Coverage National Campaign, a national outreach and enrollment initiative funded under the Children’s Health Insurance Program Reauthorization Act (CHIPRA) and the Affordable Care Act, that reaches out to families with children and teens eligible for Medicaid and CHIP.

The Biden-Harris Administration is committed to achieving mental health parity, expanding access to mental health care, and eliminating mental health stigmas. In addition to improving access to mental health services provided to Medicaid and CHIP beneficiaries, President Biden’s American Rescue Plan provided funding to addresses our mental health and substance use challenges, including $3 billion in funding for block grants to address mental health and substance use prevention, treatment, and recovery services. This is alongside $1.4 billion to support the mental health needs of health care professionals and first responders, as well as funding specifically for pediatric mental health.

“More than 100 million Americans, including 43 million children, relied on us to deliver access to mental health and other services they needed through Medicaid and CHIP in 2020. Medicaid is the largest payer in the nation for mental health and that care is a lifeline for many,” said CMS Acting Administrator Liz Richter. “This new data provides a window into the impacts of the pandemic for marginalized communities – particularly children and other vulnerable people – and is critical as we work towards meeting the needs of those that rely on Medicaid and CHIP. While we’re encouraged that people are accessing some health care services at pre-pandemic levels, there is work to do to connect people to mental health care services and to ensure we fill the gap in other types of services that was caused by the pandemic. The Centers for Medicare & Medicaid Services is committed to connecting people and children to health care – including mental health care.”

Specifically, the results demonstrate a 34% decline in the number of mental health services utilized by children under age 19, compared to the same time period in 2019, and 22% decline in the number of mental health services utilized by adults aged 19 to 64, compared to the same time period in 2019. This translates to approximately 14 million fewer mental health services for children and approximately 12 million fewer mental health services for adults, for a total of nearly 26 million fewer mental health services utilized across both groups. Similarly, although there are preliminary reports of increased drug-related mortality due to the COVID-19 PHE, substance use disorder service utilization fell by 3.6 million services (13% decline) when compared to the same time period in 2019.

It is important to note that the data does show that utilization rates for certain primary and preventive services for children under age 19 have recovered to pre-pandemic levels, or have started to rebound across many areas of the country. While this recovery is encouraging, millions of services still need to be delivered to make up for those missed between March and October 2020. Preliminary 2020 data shows 9% fewer childhood vaccinations for beneficiaries under age two (1.8 million services), 21% fewer child screening services (4.6 million services) among children under age 19, and 39% fewer dental services (11.4 million services) among children under age 19 when compared to pre-pandemic levels. This data takes into account increases in telehealth utilization of services via telehealth.

Throughout the pandemic, CMS has encouraged states to consider telehealth options to combat COVID-19 and increase access to care. This updated data snapshot demonstrates a marked increase in the number of services delivered via telehealth compared to prior years. The number of services delivered via telehealth surged 2,700% during the PHE to nearly 68 million between March and October 2020. However, this increase has not been enough to offset the decline in service utilization in other areas.

For COVID-19 treatment and acute care use, the preliminary findings show more than 1.2 million Medicaid and CHIP beneficiaries received COVID-19 treatment, and nearly 124,000 were hospitalized through October 2020. Despite significant variance across states regarding this data, preliminary results suggest that the COVID-19 treatment rate increases with age. In addition, Medicaid and CHIP paid for nearly 10 million COVID-19 tests or testing related services, although this data does not include tests provided free of charge or covered by other insurance programs, including Medicare.

CMS will continue monitoring and working with states, providers and stakeholders to develop and implement innovative ways to provide access to critical health care such as preventive childhood vaccinations and mental health services to beneficiaries enrolled in Medicaid and CHIP.

The data released today can be found here: https://medicaid.gov/state-resource-center/downloads/covid-19-medicaid-data-snapshot.pdf

For a fact sheet on the Medicaid & CHIP and the COVID-19 Public Health Emergency, please visit: https://www.cms.gov/newsroom/fact-sheets/fact-sheet-medicaid-chip-and-covid-19-public-health-emergency

As part of the ongoing response to address the COVID-19 pandemic and to improve health care access and reduce the risk of severe illness and death from COVID-19, CMS issued a rule that will ensure long-term care facilities, and residential facilities serving clients with intellectual disabilities, educate and offer the COVID-19 vaccine to residents, clients, and staff. These requirements apply to Long-Term Care (LTC) facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID) and align with existing requirements for influenza and pneumococcal vaccines in LTC facilities.

The rule also requires LTC facilities to report weekly COVID-19 vaccination status data for both residents and staff. The new vaccination reporting requirement will not only assist in monitoring uptake amongst residents and staff but will also aid in identifying facilities that may be in need of additional resources and/or assistance to respond to the COVID-19 pandemic.

“These new requirements reinforce CMS’ commitment of ensuring equitable vaccine access for Medicare and Medicaid beneficiaries,” said Dr. Lee Fleisher, MD, CMS Chief Medical Officer and Director of CMS’ Center for Clinical Standards and Quality (CCSQ). “Today’s announcement directly aids nursing home residents and people with intellectual or developmental disabilities who have been disproportionately affected by COVID-19. Our goal is to increase COVID-19 vaccine confidence and acceptance among these individuals and the staff who serve them.”

To ensure LTC facilities receive support for COVID-19 vaccination efforts, they are now required to report weekly vaccination data of residents and staff to the CDC National Healthcare Safety Network (NHSN), the nation’s most widely used health care-associated infection tracking system. LTC facilities are already required to report COVID-19 testing, case, and mortality data to the NHSN for residents and staff but have not been required to report vaccination data. As data becomes available, CMS will post facility-specific vaccination status information reported to the NHSN for viewing by facilities, stakeholders, and the public on CMS’ COVID-19 Nursing Home Data website.

While this announcement is specific to LTC facilities and ICFs-IID, CMS is also seeking comment on opportunities to expand these policies to help encourage vaccine uptake and access in other congregate care settings, such as psychiatric residential treatment facilities, group homes, and assisted living facilities. By requiring vaccine education and offering within LTC facilities and ICFs-IIDs, CMS is improving health care access and reducing the risk of severe illness and death from COVID-19.

More Information:

• Interim final rule
• COVID-19 Vaccine Immunization Requirements for Residents and Staff

The Health Resources and Services Administration’s (HRSA) FORHP will be making new U.S. Department of Health and Human Services (HHS) funding available for Rural Health Clinics (RHCs) to strengthen COVID-19 testing and mitigation and increase vaccine confidence.

Rural Health Clinic Vaccine Confidence (RHCVC) Program – Coming Soon!
Interested RHCs should watch for the upcoming funding opportunity and start the process to register to apply for a HRSA grant.  HRSA will fund all eligible RHCs that have a complete and acceptable application.  RHCs may use this funding to increase vaccine confidence, improve health care in rural areas, and reinforce key messages about prevention and treatment of COVID-19 and other infectious diseases.

For additional information please register in advance and join the National Association of Rural Health Clinic’s (NARHC) RHC COVID Initiatives webinar on Wednesday May 19^th, at 12 PM ET. Please join the RHC Vaccine Confidence Program mailing list for additional program announcements and updates by clicking here. For additional questions: RHCVaxConfidence@hrsa.gov.

Rural Health Clinic COVID-19 Testing and Mitigation Program – Coming Soon!
RHCs that have met the requirements for the RHC COVID-19 Testing Program will receive a one-time allocation of up to $100,000 per clinic site automatically deposited in the bank account of the corresponding TIN organization in June 2021. RHCs will not have to apply for payments for this program. Ineligible RHCs that are not current with reporting of testing data on rhccovid19reporting.com will have the opportunity to catch up for future program consideration, dependent on the availability of funds.  Please join the RHC COVID-19 Testing Program mailing list for additional program announcements and updates by clicking here. For additional questions: RHCCOVID-19Testing@hrsa.gov.

New payment policy for at-home administration

As part of the ongoing response to address the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) has increased the Medicare payment rate for administering monoclonal antibodies to treat beneficiaries with COVID-19, continuing coverage under the Medicare Part B COVID-19 vaccine benefit. Beneficiaries pay nothing out of pocket, regardless of where the service is furnished – including in a physician’s office, healthcare facility or at home.

The national average payment rate will increase from $310 to $450 for most health care settings. In support of providers’ efforts to prevent the spread of COVID-19, CMS will also establish a higher national payment rate of $750 when monoclonal antibodies are administered in the beneficiary’s home, including the beneficiary’s permanent residence or temporary lodging (e.g., hotel/motel, cruise ship, hostel, or homeless shelter).

The new national payment rate for at-home administration of monoclonal antibodies accounts for increased costs associated with the one-on-one nature of this care model. These higher national average payment rates reflect additional information provided to CMS about the costs of providing these services in a safe and timely manner, such as clinical staff and personal protective equipment. This action also means Medicare payments to providers and suppliers will be more aligned to their costs to administer these products.

CMS’s goal during the COVID-19 PHE has been to ensure that the agency is supporting beneficiary access to care. This new policy is based on timely, valuable input from stakeholders including the home health and ambulatory infusion industries on the costs associated with administering monoclonal antibodies.

CMS is updating the set of toolkits for providers, states and insurers to help the health care system swiftly administer monoclonal antibody treatment with these new Medicare payment rates, at https://www.cms.gov/medicare/covid-19/monoclonal-antibody-covid-19-infusion.  In addition, CMS is updating coding resources for providers, at https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies.

For additional clinical information about COVID-19 monoclonal antibodies, please visit:

• https://www.covid19treatmentguidelines.nih.gov/anti-sars-cov-2-antibody-products/anti-sars-cov-2-monoclonal-antibodies/
• https://www.covid19treatmentguidelines.nih.gov/therapeutic-management/
• https://combatcovid.hhs.gov/hcp/resources