By Michael Ollove

Rural counties with prisons have seen some of the highest coronavirus infection rates in the United States. Protecting the incarcerated population is also an important step toward protecting the health of nearby communities.

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On June 25, 2020, the Department of Health and Human Services released more than $50 Million dollars in Relief Fund payments to Rural Health Clinics (RHCs) that were left out of the original May 1 RHC distribution. This money is in addition to the more than $500 Million distributed to all other RHCs in early May.

“We are pleased that our advocacy efforts on behalf of these RHCs has paid off,” said Bill Finerfrock, Executive Director of the National Association of Rural Health Clinics.

On April 22nd, the Secretary Alex Azar announced that the Department of Health and Human Services was reserving $10 Billion of the $100 Billion authorized by Congress for Provider Relief Payments, for Rural Health Clinics and Rural Hospitals. True to their word, a few weeks later, thousands of RHCs received money from the COVID-19 Provider Relief Fund.

It quickly became apparent that due to unknown problems with the way CMS maintained the official list of RHCs and the formula used by HHS to determine RHC eligibility for payments, many RHCs that should have been eligible did not receive any money from this fund. Immediately upon learning of this oversight, NARHC reached out to HHS Leadership to make them aware of the problem and express our desire that HHS correct this oversight.

For the past 6 weeks, NARHC has been working with HHS leadership and senior staff at the Federal Office of Rural Health Policy to identify the RHCs that were left out of the original distribution and secure the funds necessary to make Provider Relief Payments to these RHCs.

Each RHC in this 500+ group received, on average, slightly more than $103,000. Payments were distributed to RHCs that have an electronic banking relationship with CMS. RHCs that do not have an electronic banking relationship with HHS should be receiving a check in the mail within 7 – 10 days (depending on mail service). RHCs owned by hospitals in “urban” areas should check with their parent hospital entity to verify that this payment was received.

NARHC would like to thank the leadership at HHS and in particular, the staff at the Federal Office of Rural Health Policy (FORHP), who worked diligently with NARHC to identify those RHCs that were overlooked.

The National Organization of State Offices of Rural Health (NOSORH) has released a new Issue Brief:  Identifying Vulnerable Rural Populations During COVID-19: The CDC’s Social Vulnerability Index

Social vulnerability refers to a community’s capacity to prepare for and respond to the stress of hazardous events — including natural disasters and pandemics. The Centers for Disease Control and Prevention (CDC) has created a multifactor Social Vulnerability Index (SVI) which can be used to identify vulnerable rural populations at greatest risk of impact by hazardous events. The SVI is calculated at two levels — one set of variables for all US counties and a second set for all US census tracts — and updated bi-annually.

The SVI can be useful in planning efforts to prevent and respond to COVID-19 infections in local communities. The NOSORH COVID-19 Data Tool includes the latest SVI data displayed in a visual format. Overlaying the SVI data layers with other available layers aids in the identification of high need areas, assisting in delivery of resources where they are most needed.

The Pennsylvania Emergency Health Services Council has distributed two guidelines for EMS providers on PPE and the Department of Health’s Universal Face Coverings Orders.  Both documents can be accessed below.

EMSIB 2020-26 PPE Reminders (Updated)

20200701-SOH-Universal-Face-Coverings-Order

The National Practitioner Data Bank (NPDB) is extending the query fee waiver for one-time queries, continuous queries, and continuous query renewals retroactive from June 1 through September 30. The NPDB previously offered the waiver through May 31. The waiver supports efforts to mobilize and deploy health professionals during the COVID-19 pandemic by reducing costs and expediting credentialing, hiring, privileging, and licensing processes.

For updated information about the waiver, visit the Coronavirus (COVID-19) Information page on the NPDB website.

For technical assistance, contact the NPDB Customer Service Center.

The COVID-19 Pandemic has had an immense, unprecedented impact on the people and economy of Pennsylvania. Businesses have closed, people have lost their jobs, and life in general has been severely disrupted. Within the most vulnerable communities of Pennsylvania the impact of this pandemic has been exacerbated by the ongoing conditions of social injustice, poverty, and neglect. Due to the effects of this situation on the people and economy of Pennsylvania there will be a special emphasis on and priority given to projects that seek to address critical issues related to the pandemic and its aftermath for program year 2020-2021. Within these guidelines there are activities highlighted as being priorities for COVID-19 Pandemic and Social Justice Issues. While some of these priorities are based on individual services many of them are more community focused as it will take the efforts of entire communities to fully recover from this historical event.

Applicants who are planning to submit applications that address these critical needs are encouraged to do so when the NAP application is opened. The Department reserves the right to determine whether a project qualifies as a priority under these special circumstances. Those projects deemed not to be a priority will be considered after all other priority projects have been awarded if there are any tax credits remaining.

Please follow the link for more information.

As the holiday weekend approaches, Pennsylvania Governor Wolf’s Administration is reminding Pennsylvanians to avoid large gatherings and to wear masks around other people to help prevent further spread of COVID-19. On July 1, Governor Tom Wolf announced an order, signed by Secretary of Health Dr. Levine, requiring masks to be worn whenever anyone leaves home.

On July 3, Lebanon County, the remaining county still in yellow, will join the green phase with the rest of the state. The green phase prohibits large gatherings of more than 250 people. The newly expanded mask-wearing order also requires mask-wearing in any public space, not just in businesses.

If you have traveled, or plan to travel, to an area where there are high amounts of COVID-19 cases, it is recommended that you stay at home for 14 days upon return to Pennsylvania. If you travel to the following states, you will need to quarantine for 14 days upon return:

• Alabama
• Arizona
• Arkansas
• California
• Florida
• Georgia
• Idaho
• Louisiana
• Mississippi
• Nevada
• North Carolina
• South Carolina
• Tennessee
• Texas
• Utah

Pennsylvanians are encouraged to continue to practice social distancing and other preventive measures, including washing your hands frequently, covering coughs and sneezes, cleaning surfaces often, wearing a mask and staying home if you are sick to help reduce the spread of COVID-19.

The COVID-19 Map Series is a searchable data base offering data of confirmed COVID-19 cases, county trends, number of days since last new case, recent outbreaks, mortality rates, active cases per 100,000 people, deaths per 100,000 people, and more in each of the nation’s counties. The data is collected by Johns Hopkins University CSSE, and also appears in their US Cases by County Dashboard. Due to frequent changes, it is advised that users refresh their browsers often when viewing the map. As of today, July 2nd, at 10:30 am (ET), there were 110,639 cases in 418 Appalachian counties.

For more information about COVID-19 trends, visit the Country Level Trends Story Map for global data and check out the full methodology for details.

Expanding on the business safety order signed by Pennsylvania Secretary of Health Dr. Rachel Levine in April that requires the wearing of masks in businesses, Governor Tom Wolf today announced a new order signed by Dr. Levine that takes the mask-wearing directive one step further.

With this order, signed under Dr. Levine’s authority under the Disease Prevention and Control Act, masks must be worn whenever anyone leaves home. The order takes effect immediately.

The order outlines the situations when a mask must be worn and includes limited exceptions to the face-covering requirement.

Each of the state’s mitigation efforts has helped to slow the spread of COVID-19, kept our health care systems from being overwhelmed, and allowed for Gov. Wolf’s measured, phased reopening to proceed. But, with nearly every county is the green phase of reopening, complacency cannot be the norm.

More and more health experts have called for mask wearing, including Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who said during a June 30 Senate hearing on COVID-19, “Americans who don’t wear masks may ‘propagate the further spread of infection.’”

The mask-wearing order will be sent to state and local officials, law enforcement and others tasked with education about the order for those not in compliance.

Pennsylvania Governor Wolf’s Administration reminded Pennsylvanians of the requirements put in place for restaurants and bars to protect the health and safety of workers and patrons from COVID-19.

Under the governor’s Process to Reopen Pennsylvania, in the green phase of the state’s reopening plan restaurants and bars may open at 50 percent occupancy.

Pennsylvania’s restaurant industry guidance was developed in coordination with the Restaurant and Lodging Association. Pursuant to the guidance, all businesses and employees in the restaurant and retail food service industry are required to do the following:

• Require all customers to wear masks while entering, exiting, or otherwise traveling throughout the restaurant or retail food service business. Face coverings may be removed while seated.
• Provide at least six feet between parties at tables or physical barriers between customers where booths are arranged back to back. If tables or other seating are not movable, seat parties at least six feet apart.
• Where possible, stagger work stations to avoid employees standing next to each other. Where six feet of separation is not possible, consider spacing options that include other mitigation efforts with increased frequency of cleaning and sanitizing surfaces.
• Establish a limit for the number of employees in shared spaces, including break rooms, and offices to maintain at least a six-foot distance.
• Don’t use shared tables among multiple parties unless the seats can be arranged to maintain six feet of distance between parties.
• Train all employees on the importance and expectation of increased frequency of handwashing, the use of hand sanitizer with at least 60 percent alcohol, and provide clear instructions to avoid touching hands to face.
• Assign employee(s) to monitor and clean high touch areas frequently while in operation.
• Provide physical guides, such as tape on floors or sidewalks and signage on walls to ensure that customers remain at least six feet apart in lines or waiting for seating or in line for the restroom.

All businesses must follow Centers for Disease Control and Prevention (CDC) and Department of Health guidance for social distancing and cleaning.

No business is required to conduct in-person operations and should not do so if unable to follow applicable guidance.

As the Wolf administration closely monitors public health indicators, strict compliance with the guidance is critical to prevent spread, and the need for more stringent restrictions.

The administration also supports local governments’ more stringent protections for dining establishments’ workers and customers, such as those actions taken this week by Allegheny and Philadelphia counties.

The Pennsylvania State Police Bureau of Liquor Control Enforcement (BLCE) will be conducting compliance checks at licensed facilities to ensure that the requirements of the guidance are observed. Failure to comply risks citation by the BLCE, a fine of up to $1,000, and possible suspension and/or revocation of the liquor license.