Senators Roger Wicker (R-MS), Tina Smith (D-MN), Doug Jones (D-AL), and Cindy Hyde-Smith (R-MS) have introduced bipartisan legislation that would waive the Small Business Administration’s (SBA) Affiliation Rules for the small health-care facilities, the PPP Access for Rural Hospitals Act (S. 4217). This bill would enable the facilities to qualify for Paycheck Protection Program (PPP) loans. The Coronavirus Aid, Relief, and Economic Security (CARES) Act established the PPP to give immediate relief to small businesses. In addition to the more immediate concerns related to COVID-19, hospitals have lost significant revenue because of having to stop non-emergency and elective procedures. Therefore, providing PPP to smaller rural hospitals will allow them to continue to employ healthcare workers and provide access to necessary healthcare services in rural communities.

The U.S. Department of Health and Human Services (HHS) released additional reporting requirements for healthcare organizations that received financial support under the CARES Act. The notice requires healthcare organizations that received more than $10,000 to submit reports detailing the use of the funds and compliance with payment terms and conditions. Providers must report on their expenditures through the end of the December. HHS states that more details about reporting requirements will be released August 17th. This announcement comes after months of questions from providers about how to use and report the funds they received; this includes Paycheck Protection Program (PPP) dollars. NRHA is working with rural health champions in the Administration and Congress to ensure that rural providers are not disadvantaged by these new requirements due to their unique payment structures.

Senators Richard Durbin (D-IL) and James Lankford (R-OK) discussed the challenges facing rural hospitals in the wake of COVID-19 on the Senate floor. These senators helped secure $175 billion to protect the health care system and meet the emergency needs of health systems during the pandemic. However, hundreds of rural hospitals, especially in downstate Illinois, are continuing to struggle. Rural hospitals were facing financial uncertainty even before the pandemic, and in Illinois, rural hospitals have lost $1.4 billion during the pandemic, most of which can be attributed to the cancelation of non-emergency and elective procedures. Nationwide, 76 percent of revenue for rural hospitals comes from these procedures. To address the closure crisis, Sens. Durbin and Lankford have introduced the Rural Hospital Closure Relief Act of 2019 (S. 3103). Their bill, which is strongly supported by NRHA, would allow a limited number of the nation’s most financially vulnerable rural Prospective Payment System (PPS) hospitals to convert to Critical Access Hospitals (CAH), even if they do not meet the 35-mile distance requirement.

On July 28, the HHS Office of the Assistance Secretary for Planning and Evaluation (ASPE) released an issue brief examining changes in Medicare fee-for-service primary care visits and use of telehealth at the start of the COVID-19 public health emergency (PHE). This brief seeks to address the issue of how and whether the Medicare telehealth flexibilities introduced to address the COVID-19 pandemic may have helped maintain access to primary health care during the PHE. The analysis found Medicare primary care visits dropped precipitously from mid-March at the start of the pandemic, at the same telehealth visits increased for primary care. However, telehealth use was lower in rural areas.

The Rural Health Information Hub posted a guide to help you learn about activities underway to address COVID-19. New:  Rural Healthcare Surge Readiness a tool developed by the COVID-19 Healthcare Resilience Working Group that helps rural healthcare facilities prepare for and respond to a COVID-19 surge. The tool provides the most up-to-date resources for rural healthcare systems preparing for and responding to a COVID-19 surge in a range of healthcare settings (EMS, inpatient and hospital care, ambulatory care, and long-term care) and covers a range of topics including behavioral health, healthcare operations to telehealth, and more.

Last week, the U.S. Department of Health & Human Services (HHS) launched a website with data on the COVID-19 response at federal, state, and local levels.  The hub includes estimated and reported hospital capacity by state, with numbers updated daily.

Pennsylvania Governor Tom Wolf released a weekly status update detailing the state’s mitigation efforts based on the COVID-19 Early Warning Monitoring System Dashboard comparing the seven-day period of July 24 – July 30 to the previous seven days, July 17 – July 23.

The dashboard is designed to provide early warning signs of factors that affect the state’s mitigation efforts. The data available on the dashboard includes week-over-week case differences, incidence rates, test percent-positivity, and rates of hospitalizations, ventilations and emergency room visits tied to COVID-19.

“The mitigation efforts we took on July 15 were a proactive step to get in front of the rise of cases that we continue to see,” Gov. Wolf said. “Our percent positivity decreased this week, which is a positive sign, but in order to continue to see numbers decrease, we must continue to wear masks and practice social distancing.

“Going out without a mask and congregating at a bar or in a crowded backyard party where social distancing isn’t being practiced continues to lead to spikes in cases. We need to recommit to these simple measures to stop the spread and go back to more freedoms.”

As of Thursday, July 30, the state has seen a seven-day case increase of 6,228, the previous seven-day increase was 6,010, alerting that cases are continuing to rise throughout the state.

The statewide percent-positivity went down to 4.6% from 4.7% last week. Counties with concerning percent-positivity include Lawrence (7.4%), Franklin (7.2%), Indiana (7.2%), Fayette (7.1%), Armstrong (7.0%), Beaver (6.5%), Delaware (6.5%), Allegheny (6.4%), Lancaster (5.8%), Berks (5.6%), Philadelphia (5.4%) and Chester (5.3%). Each of these counties bear watching as the state continues to monitor all available data.

The Department of Health updated its travel recommendations, originally announced on July 2, to remove Wyoming to the list of states recommended for domestic travelers returning from to quarantine for 14 days upon return to Pennsylvania.

It is important that people understand that this recommendation is in place to prevent the spread of COVID-19 in Pennsylvania. A significant number of recent cases have been linked to travel, and if people are going to travel, we need them to take steps to protect themselves, their loved ones and their community, and that involves quarantining.

Gov. Wolf continues to prioritize the health and safety of Pennsylvanians through the COVID-19 pandemic. Pennsylvanians should continue to take actions to prevent the spread of COVID-19, regardless of the status of their county. This includes wearing a mask or face covering anytime they are in public. COVID-19 has been shown to spread easily in the air and contagious carriers can be asymptomatic.

The Pennsylvania Department of Health announced that beginning Wednesday, August 5, various Walmart locations across the state will begin providing drive-thru testing for residents living in areas where there is a need for testing sites.

“We appreciate the hard work done by health systems, pharmacies, Federally Qualified Health Centers (FQHCs), medical clinics and other entities that are providing testing for COVID-19 across Pennsylvania,” Secretary of Health Dr. Rachel Levine said. “When we established our testing strategy, we wanted testing to be accessible, available and adaptable and we are working to meet that challenge. Anyone who believes they are in need of a COVID-19 test and meet testing criteria can get tested today in Pennsylvania.”

Nine new drive-thru testing sites will launch on August 5. There is no testing in stores. These sites will be open weekly to test up to 50 registered patients. Registration is required one day in advance. The following drive-thru testing sites will be open Monday-Friday from 9:00 AM to 4:00 PM starting Wednesday, August 5th:

• Walmart Supercenter pharmacy drive-thru, 355 Walmart Drive, Uniontown, PA
• Walmart Supercenter pharmacy drive-thru, 2601 Macarthur Rd Relocation, Whitehall, PA
• Walmart Supercenter pharmacy drive-thru, 2010 Village Center Dr, Tarentum, PA
• Walmart Supercenter pharmacy drive-thru, 134 Daniel Kendall, West Brownsville, PA

The following drive-thru testing sites will be open Monday, Wednesday, Friday from 7:00 AM to 9:00 AM starting Wednesday, August 5th:

• Walmart Supercenter parking lot, 20245 Route 19, Cranberry Township, PA
• Walmart Supercenter parking lot, 200 Kocher Lane, Elizabethville, PA
• Walmart Supercenter parking lot, 50 Newberry Parkway, Etters, PA
• Walmart Supercenter parking lot, 1355 East Lehman St, Lebanon, PA
• Walmart Supercenter parking lot, 100 Chippewa Town Center, Beaver Falls, PA

These nine new sites are in addition to existing Walmart drive-thru sites in Clarion, State College, New Castle and Edinboro. The most updated testing sites and information is available on the Department of Health’s website.

Pennsylvania Governor Tom Wolf visited the Susquehanna Township Police headquarters to discuss the important roles education and understanding play in the enforcement of the various COVID-19 mitigation orders in place across the state.

“We have to do everything we can to keep our communities safe and healthy, including wearing a mask and following mitigation orders so our business operate safely,” Gov. Wolf said. “We have the ability to enforce these rules, and we are going to continue to work closely with commonwealth agencies and local officials to enforce public safety orders.”

The governor was joined by representatives of commonwealth agencies and local law enforcement involved in mitigation order enforcement, including Secretary of Heath Dr. Rachel Levine, Secretary of Agriculture Russell Redding, Pennsylvania State Police Lt. Col. Scott Price, and Susquehanna Township Chief of Police Rob Martin.

Each representative focused on the role their agency plays in education and enforcement of the various orders in place to keep Pennsylvanians safe and stop the spread of COVID-19.

“Wearing a mask is so important to protecting each other. I implore all Pennsylvanians to do right thing,” Dr. Levine said. “When you wear a mask you are not only telling that person you pass on the street that you care about their safety, you are telling police and other first responders that you care about their safety, too.”

“Pennsylvania’s restaurant owners and staff and have delivered for us, putting safe, healthy food on our tables,” Redding said. “We can all deliver for them by wearing a mask and following the COVID-19 measures to keep them safe and healthy.”

“As some of the most visible public servants in the commonwealth, the state police will continue working collaboratively with the Department of Health and local police departments to remain at the forefront of law enforcement pandemic response efforts,” said Lieutenant Colonel Price.  “We are grateful to the majority of Pennsylvanians who have stepped up to follow mitigation requirements and for all the support our troopers and liquor control enforcement officers have received during the past several months.”

Local law enforcement’s role is a collaborative one with state agencies and local officials, and Chief Martin stressed his department’s work to educate businesses and residents, and to refer any suspected violations of the governor and Dr. Levine’s orders to the proper state agency if necessary.

“Our citizens in Susquehanna Township have been inspiring. On many occasions they have contacted our police department and our government center for advice, guidance, and our assistance. We wish to meet our citizens where they are and be an educational voice of gentle persuasion,” Martin said. “Of the times that we have had to make referrals to our commonwealth partners, we have been met with cooperation and understanding. I want to thank the commonwealth for being a valued partner, and thank Governor Wolf for his always civil mannered discourse, as what our country needs right now is civility.”

The governor also asked local elected officials and business owners to work with local law enforcement to protect their communities and constituents.

“I’m calling upon every Pennsylvanian to do their part to help us get as close as we can to 100 percent compliance on masking,” Gov. Wolf said. “We need the help of our business owners to get workers masking. We need the help of our local elected officials to emphasize the importance of masking on keeping the community safe.”

According to a recent poll by Franklin & Marshall College, two-thirds of registered voters in Pennsylvania believe it is “extremely important” to wear a mask whenever they leave home.

“We need to come together, unified, against COVID-19,” Gov. Wolf said. “I’m calling upon every Pennsylvanian to do their part to help us get as close as we can to 100 percent compliance on masking.”

Appalachia’s first COVID-19 cases were confirmed in early March. 143 days later, on July 26, Doddridge County, West Virginia became the final of Appalachia’s 420 counties to report a confirmed COVID-19 case. Drawing on data from the Johns Hopkins University, COVID-19 Cases in Appalachia maps COVID-19’s spread in the region in relation to the rests of the country.  

More county-level information regarding COVID-19 cases can be found using the searchable database offering demographic data snapshots of confirmed cases and deaths in relation to hospital bed counts, population and businesses, and categories of people at risk for COVID-19. By hovering over each statistical icon, users can learn more about the supporting data. COVID-19 related data is updated daily.