Medicare provided extra time for people to pay their Medicare premiums because of the Coronavirus Disease 2019 (COVID-19) public health emergency.  This extra time ends on September 30, 2020.  Letters were sent to impacted people with Medicare last month.  Please see the attached sample letter.  This message is a reminder that the deadline to pay any owed Medicare premiums is approaching at the end of this month.

People with Medicare who owe past due Medicare premiums must pay the full amount owed before September 30, 2020, to keep their Medicare coverage. If there are people with Medicare who are unable to pay their past-due premiums in full by the end of September, they should contact their local Social Security Office as soon as possible to see if they are eligible for a payment plan with the Social Security Administration.

A Message from Pennsylvania Secretary of Health, Rachel Levine, MD

Technology connects us to resources and plays a powerful role in our lives. And at no time is technology more important than during the COVID-19 pandemic.

Pennsylvanians listen to our press briefings, gather data from our enhanced statewide and early warning monitoring dashboards, and follow us on Facebook and Twitter for the most up-to-date information.

Still, COVID-19 continues to impact our state. Nearly 142,885 Pennsylvanians have been diagnosed with COVID-19 so far, and we are still seeing cases increase each day.

It is upon each of us to help mitigate the spread of COVID-19. Here in Pennsylvania, we are adding another tool in the toolbox residents can use to protect themselves and their loved ones:  COVID Alert PA, an app that uses Bluetooth technology to notify you of a potential COVID-19 exposure.

This app uses Bluetooth technology, the same technology that helps your phone connect with your car to play music or use wireless headphones. This technology does not track or collect any location data or personal data from your phone – only your phone’s proximity to other phones with the app enabled. It is strictly designed to notify you if you may have been in close contact with someone who tested positive for the virus. If you test positive for the virus, and you choose to confirm that information into the app, it will notify those that may have been in close contact with you.

Often, it can be difficult for someone to either name or even know all the close contacts they were exposed to while they were infectious — like a person you spoke to for 15 minutes at the bar or someone you sat next to on the bus. This is where COVID Alert PA becomes extremely useful and augments value to the state’s contact tracing efforts.

When an individual tests positive for COVID-19, a public health professional from the Pennsylvania Department of Health or a county and municipal health department contacts them to begin a case investigation. During the investigation the individual learns about their test results and is asked to recall who they have been in close contact with during their infectious period.

The public health professional also will encourage the COVID-19 positive individual to open the COVID Alert PA and enter a six-digit validation code. After the validation is complete, the app will alert other individuals who were within six feet of the COVID-19 positive individual for at least 15 minutes.

Anyone getting an exposure alert is provided with public health advice and resources to talk to a public health professional about next steps or how to find the nearest testing site.  People with a confirmed exposure are bound to have questions and concerns, and we want to provide the information people need to make informed decisions about their health and the health of the people closest to them.

Remember, all this is done through Bluetooth technology, which means no personal or identifying information will be collected through the app. The person notified will not know the identity of the person to whom they were exposed.

The Wolf Administration has taken additional measures to ensure the safety and well-being of Pennsylvanians. Now that the state is reopened, though mitigation efforts remain in place, there is still an opportunity for COVID-19 to spread, so we need to prepare ourselves by washing hands, wearing masks, practicing social distancing and downloading the COVID Alert PA app. The more people who download the app, the better our chances are of preventing an outbreak and keeping our communities healthy.

When the app is available later this month, please download it through the Google Play or Apple App Store and add your phone to the fight to help stop the spread of COVID-19.

Together, we can help ourselves, our loved ones and our neighbors across the commonwealth stay safe.

USA Today

Pennsylvania doctors who treat child abuse say they are seeing a wave of more serious injuries in younger victims.  It’s part of a disturbing trend they first observed in the spring: as the coronavirus continues to spread across the state, so does the number of severe injuries in abused children.

The virus didn’t recede in the summer as anticipated, nor did the abuse.

Penn State Children’s Hospital saw a wave of serious injuries that began in mid-June, according to Dr. Lori Frasier, chief of the hospital’s child abuse pediatrics division.  “We’re seeing a surge of some kind,” she said last month.  The hospital doesn’t provide specific patient numbers, but it is “seeing pretty serious physical abuse injuries,” Frasier said.

The children range in age from “young to very young,” she said, and often end up in critical condition in the intensive care unit.  “What really kills kids is head and abdominal trauma,” Frasier said. “That’s what they die from in those early 1- to 7-day periods.”

Fatal and nearly fatal

At least 155 children died or nearly died this year in Pennsylvania as a result of suspected child abuse or neglect, according to state data from Jan. 1 to July 15.  Those cases were referred to child welfare investigators, according to Ali Fogarty, communications director at the state Department of Human Services.  There were 144 children who died or nearly died in all of 2019 because of substantiated abuse or neglect, according to state data.  But, to clarify, measuring the differences between suspected cases and substantiated cases is not an apples-to-apples comparison.

In the cases last year, most abuse came at the hands of a parent, according to state data. The majority of victims were younger than 4 years old.  Overall, there were more than 5,200 substantiated cases of child abuse in Pennsylvania last year, with more than 40 percent of those cases attributed to sexual abuse. The rate of abuse in rural counties was more than double the rate in urban counties.  During the past five years, the number of fatalities and near fatalities in children has steadily increased from 95 in 2015 to 144 in 2019.

Waves of trauma

Penn State Children’s Hospital has seen waves of child abuse trauma in the past, even before a public health crisis changed American life.   But families are facing added pressure as the virus has a systemic effect in Pennsylvania, and that’s leading to more abuse, Frasier said.  Unemployment or having one parent at home to take care of the kids is a big source of stress, she said.  “They don’t feel like the pandemic has passed,” Frasier said.

There were 835 additional positive cases of Covid-19 and 20 deaths reported in Pennsylvania on Friday, bringing the statewide total to nearly 132,000. More than 7,600 state residents have died.  The state can track the number of positive cases and deaths, but the overall effect the virus is having on vulnerable children is unclear.   I don’t think we’ll have the full picture for a year,” Frasier said. “We’re right in the middle of it.”

‘A lot of stress’

St. Christopher’s Hospital for Children in Philadelphia saw an increase in severe injuries in the spring.  In July, Dr. Norrell Atkinson, section chief of the child protection program at the Level 1 trauma and burn center, started seeing an increase of toxic ingestions in young children.   “They come in with illegal substances in their system — opiates, marijuana, amphetamines,” she said.   Close to a third of the hospital’s cases are ingestions, and the patients are generally younger than 5 years old, Atkinson said.   “I’ve been at this hospital for two years,” she said, “and I haven’t seen a cluster like this.”

In most cases, the child lives in a home where the drugs are present and they are left unsupervised long enough to ingest the substances.  During June and July, the hospital saw cases often in which there were “supervision issues, and (parents and guardians) were more stressed and medicating differently,” Atkinson said.  The hospital doesn’t disclose the number child trauma cases treated, but all of the ingestion patients have survived, she said.  “We’re busier this year, and that could be due to a variety of factors, including the pandemic,” Atkinson said. “We’re not seeing decreased rates of abuse or neglect. We see a lot of stress.

Hidden dangers

The trend in Pennsylvania is in line with what’s occurring nationwide.  Doctors across the country are seeing more severe injuries in children in a week than they’re used to seeing in a month, according to medical providers at the American College of Emergency Physicians.  “The current pandemic is changing all of our lives in ways we can see, but the unseen may be even more vital than the seen,” said Dr. Jacque Johnsen, vice chair of the American College of Emergency Physicians. “Knowing additional risks to the most vulnerable patient populations at this time may save even more lives.”

The U.S. Centers for Disease Control and Prevention cited safety issues among its reasons that students should return to school in the fall.  “Extended school closures deprive children who live in unsafe homes and neighborhoods of an important layer of protection from neglect as well as physical, sexual, and emotional maltreatment and abuse,” the CDC reported.  Teachers and educational staff report suspected child abuse more than any other type of mandated reporter, according to state and federal data.

When students weren’t in classrooms in the spring, child abuse reports decreased. But severe child injuries increased, according to emergency room doctors.  The CDC cited an example of that in Washington, D.C.: The Washington, D.C. Child and Family Services Agency recorded a 62 percent decrease in child abuse reporting calls between mid-March and April this year compared to the same time period in 2019, but saw more severe presentation of child abuse cases in emergency rooms.

In Pennsylvania, Frasier said she’s “hoping against hope” the trend changes soon.  “I hope families reach out to resources and know they’re not alone,” she said. “I don’t want families to feel so isolated and stressed.”  And she doesn’t want to see another child with an injury that can’t be healed.

Candy Woodall is a reporter for the USA Today Network. She can be reached at 717-480-1783 or on Twitter at @candynotcandace.

Pennsylvania Governor Wolf and the Office of Child Development and Early Learning (OCDEL) announced the distribution of $116 million in CARES funding to nearly 7,000 child care providers throughout Pennsylvania. This round of funding is the third distribution allocated to sustaining the child care sector during the current health crisis, with a total investment of $220 million, $104 million of which was distributed earlier this summer. The latest round of funding was largely based on findings from a research study undertaken by Penn State Harrisburg’s Institute of State and Regional Affairs, which studied the impact of the COVID-19 pandemic on Pennsylvania’s child care industry.

As part of his fall legislative agenda, Governor Wolf last week announced a proposed a $250 million investment in the child care sector to help families in need of child care for school-aged children due to hybrid K-12 programs in the 2020-21 school year. Wolf also proposed $27 million to expand access to child care deserts in Pennsylvania, or areas where few providers exist. Finally, $50 million in grants also was proposed for programs serving low-income communities and offering part-day school-age care.

OCDEL has also offered guidance for families and child care centers to ensure school-age children have access to reliable child care. The announcement provides guidance to non-licensed community-based entities and individuals planning to care for groups for school-age children during the 2020-21 school year. Additionally, OCDEL is directing an entity or person operating a non-licensed part-day school-age child care (SACC) program or Learning Pod to notify the Department of Human Services (DHS) and OCDEL if they intend to care for more than six school-age children for the school year.

A new change to child care subsidy payments recently announced by OCDEL also took effect this week. Due to the pandemic, OCDEL was making child care subsidy payments to providers based on the provider’s subsidy enrollment in March 2020. However, effective September 1^st, OCDEL returned to pre-pandemic procedures, now basing subsidy payments on actual attendance.

Continuing to help students learn during the pandemic, Pennsylvania Governor Tom Wolf is dedicating $15 million for schools to secure broadband, mobile hot spots, and other platforms that increase equitable access to remote learning.

“The COVID-19 pandemic has forced our schools to rethink and rework how to provide instruction to students who are learning completely at home or in a hybrid model,” said Gov. Wolf. “As schools reopen this fall, students need Internet connectivity, computers and other technology, and access to remote-learning platforms. This funding will help our students as we enter the new school year.”

The Coronavirus Aid, Relief and Economic Security (CARES) Act authorizes governors to determine the educational use of Governor’s Emergency Education Relief (GEER) Funds.

The initiative will employ a multi-pronged approach that includes the use of state library networks and other partnerships, including the Pennsylvania Technical Training and Assistance Network (PaTTAN).

Specifically, the funding will be used to:

• Enable public libraries to coordinate work with the Internet Disaster Recovery Center to expand Internet connectivity in targeted county-wide geographic service areas identified as most in need. Expand the inventory of Wi-Fi hot spots and lendable technology through public libraries and addressing the technology deficit among libraries (estimated $1.4 million).
• Strengthen and expand the existing 24/7 online homework help through the POWER Library Chat with a Librarian service and additional electronic resources (estimated $100,000).
• Create and deploy Open Educational Resources (OER) for students and educators (estimated $500,000). OERs give students access to a wider range of instructional materials, including textbooks, videos and research, free of charge.
• Establish a statewide datacasting initiative with Pennsylvania PBS to connect students to learning content who don’t have access to the Internet (estimated $8 million). Datacasting uses over-the-air TV signals to deliver educational content that can be used on computers without having to access the Internet. Using a datacasting antenna, students can download lesson plans, videos, and worksheets from their schools.
• Distribute devices to be used in conjunction with datacasting technology for households without a connection to the Internet (e.g. datacasting antenna, laptops), and provide the technical supports and professional development to connect students to learning (estimated $3 million).
• Distribute accessible/assistive technology, including but not limited to software, tablets, tablet mounts, screens, smart pens, hotspots, devices, for K-12 students with exceptionalities in collaboration with the PaTTAN system (estimated $2 million).

“In response to the pandemic, PDE and others have created new partnerships and strengthened existing ones to ensure Pennsylvania’s students continue to be served, whether that is academically, nutritionally, or socially and emotionally,” said Secretary of Education Pedro A. Rivera. “This new initiative is another way in which communities are working together to benefit our students.”

This initiative builds on the Department of Education’s efforts to support schools’ efforts to implement continuity of education plans during the 2019-20 academic year when schools closed unexpectantly as a result of COVID-19, which included Equity Grants and a partnership with Pennsylvania’s PBS stations to air standards-aligned programming across the state.

To date, the Wolf Administration has awarded $102.5 million in GEER funding to help keep students and educators safe and meet the unique challenges of COVID-19. In addition to the $15 million for connectivity, the Wolf Administration has directed $17 million for schools designated for Additional Targeted Support and Improvement under the federal Every Student Succeeds Act; $15 million for special education; $28 million to postsecondary institutions and adult basic education providers; $14 million to K-12 schools to support equity in continuity of education; $10.5 million to Career and Technical Education Centers; and $3 million for Preschool Early Intervention Programs.

Last week, Pennsylvania’s new mobile COVID-19 response unit–Community-Accessible Testing and Education or “CATE”–visited Wilkes-Barre through a partnership of several agencies and companies: Highmark Blue Cross Blue Shield, the Pennsylvania Department of Health, Independence Blue Cross, Latino Connection and the Wright Center for Community Health . CATE offers free information, testing and a bag of useful items for any takers, all free. The Latino Connection specializes in helping companies reach the Latino demographic, but CATE is open to all. CATE is visiting sites across the commonwealth, partnering with FQHCs and other local providers who do the testing at each location. More information is available online at www.CATEmobileunit.com

The model created by the Institute for Health Metrics and Evaluation at the University of Washington posted an update this week predicting an additional 224,000 Americans will die by the beginning of next year. Read more.

Nine pharmaceutical companies this week issued a rare joint pledge seeking to reassure the public about the safety and efficacy of their potential vaccines for coronavirus. Read more.

Seventy-eight percent of Americans worry the COVID-19 vaccine approval process is being driven more by politics than science, according to a new survey from STAT and the Harris Poll, a reflection of concern that the Trump administration may give the green light to a vaccine prematurely. The response was largely bipartisan, with 72 percent of Republicans and 82 percent of Democrats expressing such worries, according to the poll, which was conducted last week and surveyed 2,067 American adults. Read more.

The economic fallout from the COVID-19 pandemic has led to a sizable growth in the nation’s Medicaid rolls over the past six months, new analysis by Families USA found. According to the study, which examined Medicaid enrollment trends in 38 states, more than half have seen enrollment grow by seven percent or more from February through early summer. Among those states that have released August enrollment data, growth reached about 11 percent since February. Read more.