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- Enticing Rural Residents to Practice Where They Train
- New Round of Federal Funding Open for Rural Health Initiatives
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- Helene Exacerbated Rise in Homelessness Across Western North Carolina
- 'It's a Crisis': How the Shortage of Mental Health Counselors Is Affecting the Rural Northwest
- FCC Launches New Maternal Health Mapping Platform
- How Mobile Clinics Are Transforming Rural Health Access for Cochise County Farmworkers
- Struggling to Adapt
- Rural Governments Often Fail To Communicate With Residents Who Aren't Proficient in English
- Mental Health Association Launches Hub To Help Rural Residents
- Prescription Delivery in Missouri Faces Delays under USPS Rural Service Plan
- Getting Rural Parents Started On Their Breastfeeding Journey
- USDA Announces New Federal Order, Begins National Milk Testing Strategy to Address H5N1 in Dairy Herds
- Creating a Clearer Path to Rural Heart Health
States Hit Hardest by COVID-19’s Impact on Tourism – WalletHub Study
With declining travel threatening to wipe out 5.9 million jobs by the end of April and the tourism industry greatly impacted by social distancing, WalletHub today released its report on the States Hit Hardest by COVID-19’s Impact on Tourism, along with accompanying videos.
To identify the states where tourism is most affected by COVID-19, WalletHub compared the 50 states and the District of Columbia across 10 key metrics. Our data set ranges from share of businesses in travel and tourism-related industries to travel spending per travel employee and presence of stay-at-home orders. Below, you can see highlights from WalletHub’s report and a Q&A with WalletHub analysts.
|
States with Most Impacted Tourism Industry |
States with Least Impacted Tourism Industry |
| 1. Hawaii | 42. North Dakota |
| 2. Montana | 43. South Dakota |
| 3. Nevada | 44. Mississippi |
| 4. Vermont | 45. Indiana |
| 5. Massachusetts | 46. Wisconsin |
| 6. Florida | 47. Alabama |
| 7. New Hampshire | 48. Nebraska |
| 8. District of Columbia | 49. Oklahoma |
| 9. New York | 50. Iowa |
| 10. California | 51. Arkansas |
Key Stats
- New York has the highest share of businesses in travel and tourism-related food industries, 12.19 percent, which is 1.8 times higher than in Utah, the lowest at 6.89 percent.
- Nevada has the highest share of employment in travel and tourism-related accommodations industries, 16.09 percent, which is 23 times higher than in Ohio, the lowest at 0.70 percent.
- The District of Columbia has the highest share of travel and tourism consumer spending, $19,869, which is 10.8 times higher than in Ohio, the state with the lowest at $1,847.
- Connecticut has the highest travel spending per travel employee, $168,811, which is 2.2 times higher than in Mississippi, the state with the lowest at $76,458.
- The District of Columbia has the highest default probability on loans of businesses in the travel and tourism-related accommodations industry, 3.85 percent, which is 1.8 times higher than in Alaska, the state with the lowest at 2.17 percent.
To view the full report and your state’s rank, please visit:
https://wallethub.com/edu/states-hit-hardest-by-covid-impact-on-tourism/72974/
Federal Reserve Survey on Impact of COVID-19 on Communities
The Federal Reserve System is conducting a survey to understand and help inform how the COVID-19 crisis is affecting organizations that support community needs. Please take a moment to complete the survey today!
Take the survey.
States, Including Pennsylvania, Announce Regional Efforts to Restart the Economy
Route Fifty, Bill Lucia
Two blocs of states, one in the east and the other on the west coast, separately unveiled plans on Monday to coordinate on combating the coronavirus outbreak and eventually reopening their regional economies when the initial threat from the deadly disease that the virus causes subsidies.
In the east, the governors of six states—New York, New Jersey, Connecticut, Pennsylvania, Delaware and Rhode Island—said that they were creating a multi-state council that would focus on restoring the economy and developing a regional framework to gradually lift stay-at-home orders and other restrictions that have been put in place to control the spread of the virus.
“The state boundaries mean very little to this virus,” said New York Gov. Andrew Cuomo.
He explained that each state would be represented within the council initiative by a public health official, an economic development official, and the governor’s chief of staff. These officials will form a working group, the governor said, which will focus on designing a reopening plan that accounts for both public health and economic concerns.
Cuomo said he didn’t believe the council’s work would lead to a fully common strategy across the region, given that there will be different circumstances surrounding the virus within each state. “If unison isn’t possible,” he said, “let’s at least know what each other is doing so we’re not counterproductive with each other.”
The three west coast states of Washington, Oregon and California moved in a similar direction, with their governors announcing an agreement that they would work together on a shared approach for restarting their economies and controlling the disease going forward.
In a joint statement, the western governors emphasized that this effort would be data-driven and would involve identifying “clear indicators for communities to restart public life and business.”
“We need to see a decline in the rate of spread of the virus before large-scale reopening, and we will be working in coordination to identify the best metrics to guide this,” they added.
The announcements on regional cooperation came as President Trump tweeted on Monday that it would be up to him and the federal government to decide when the appropriate time would be “to open up the states.” But he also said he would work with governors on this.
Cuomo responded to Trump’s comments by pointing out that the federal government had largely left it to the states to decide how and when to adopt restrictions aimed at controlling the virus.
The governor didn’t voice outright opposition to an approach where the federal government has greater input over when these sorts of policies are reversed. “If they want to change the model, they can change the model,” he said.
“But then change the model and explain it,” he added. “What does that mean, the federal government is in charge of opening?”
Covid-19, the respiratory illness that the virus causes has now claimed upwards of 23,000 lives nationwide since late February. And there are over 570,000 confirmed cases in the U.S.
To help slow the spread of the virus, government officials have ordered people to stay at home, except for essential trips, like going to the grocery store, and they’ve called on a wide range of businesses to close. This has resulted in a massive disruption to the economy.
As the weeks wear on with these measures in place, an increasingly pressing question has become how the nation will begin dialing back the restrictions on commerce and personal travel, and begin shifting the country back towards some semblance of normalcy.
On Monday, neither of the groups of governors offered a specific timeline for when these sorts of restrictions might finally be lifted, or when different types of businesses would be permitted to reopen.
Cuomo did say that the eastern states council would begin talking on Tuesday and he expects that the group will come up with a game plan of some sort within weeks.
He also noted that it appears cases in New York had reached a plateau and were not rising at the same high rate that they had been. The New York City region, in particular, had become one of the nation’s epicenters for the virus outbreak in recent weeks.
New Jersey Gov. Phil Murphy, said the number of new cases in his state still hadn’t leveled off. “We’re not out of the woods yet,” he said. “An economic recovery only occurs on the back of a complete health care recovery and that order is essential.”
Medicare FFS Claims: 2% Payment Adjustment Suspended (Sequestration)
Section 3709 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act temporarily suspends the 2% payment adjustment currently applied to all Medicare Fee-For-Service (FFS) claims due to sequestration. The suspension is effective for claims with dates of service from May 1 through December 31, 2020.
CMS Announces that Using CS Modifier When Cost-Sharing is Waived
This clarifies a prior message that appeared in CMS’ April 7, 2020 Special Edition.
CMS now waives cost-sharing (coinsurance and deductible amounts) under Medicare Part B for Medicare patients for certain COVID-19 testing-related services. Previously, CMS made available the CS modifier for the gulf oil spill in 2010; however, CMS recently repurposed the CS modifier for COVID-19 purposes. Now, for services furnished on March 18, 2020, and through the end of the Public Health Emergency, outpatient providers, physicians, and other providers and suppliers that bill Medicare for Part B services under specific payment systems outlined in the April 7 message should use the CS modifier on applicable claim lines to identify the service as subject to the cost-sharing wavier for COVID-19 testing-related services and to get 100% of the Medicare-approved amount. Additionally, they should NOT charge Medicare patients any co-insurance and/or deductible amounts for those services.
The Giant Company Announces $250,000 Emergency Grant Program to Support Small Businesses During Covid-19 Pandemic
The GIANT Company announced a $250,000 emergency grant program, in partnership with Team Pennsylvania, to support small businesses in Pennsylvania’s food supply chain impacted by the ongoing COVID-19 pandemic.
Applications are now being accepted online through April 24 from any small business involved in growing, making or processing food within the Commonwealth. The GIANT Company and Team Pennsylvania worked with the Pennsylvania Department of Economic and Community Development, the Pennsylvania Department of Agriculture, the Pennsylvania Chamber, and Pennsylvania Food Merchants Association to develop the program.
For additional information on criteria and to apply for an emergency grant from, visit The GIANT Company online. Recipients will be notified in early May.
CMS Updates CAH Swing Bed Guidelines
On March 13, 2020, President Trump declared the 2019 Novel Coronavirus Disease (COVID-19) situation a national emergency, which allows CMS to waive certain federal requirements in the Medicare, Medicaid, and CHIP programs to ensure continued access to quality of care for all Medicare beneficiaries pursuant to section 1135(b) of the Social Security Act (Act). To streamline the section 1135 waiver request and approval process, CMS is continuously issuing a number of blanket waivers for many Medicare provisions, which primarily affect requirements for individual facilities, such as hospitals, long term care facilities, home health agencies, and so on. These waivers are in effect, with a retroactive effective date of March 1, 2020, through the end of the emergency declaration and DO NOT require a request to be sent to the 1135waiver@cms.hhs.gov mailbox or that notification be made to any of CMS’s regional offices.
The Act permits certain small, rural hospitals to enter into a swing bed agreement, under which the hospital can use its beds, as needed, to provide either acute or skilled nursing facility (SNF) care. As defined in the regulations, a swing bed hospital is a hospital or CAH participating in Medicare that has CMS approval to provide post-hospital SNF care and meets certain requirements. To qualify for SNF-level services, a beneficiary must have been hospitalized in a participating or qualified hospital or participating CAH for medically necessary inpatient hospital or inpatient CAH care for at least 3 consecutive calendar days, not counting the date of discharge.
CMS is waiving this 3-day prior hospitalization for coverage of a SNF stay, noted above, in the newly issued rules and waivers. This waiver provides temporary emergency coverage of SNF services without a qualifying hospital stay, for those people who experience dislocations or are otherwise affected by COVID-19. This waiver applies to swing bed hospitals, which are hospitals or CAHs participating in Medicare that have CMS approval to provide post-hospital SNF care and meets certain requirements. See Swing Bed Factsheet located at https://www.cms.gov/Outreachand-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/SwingBedFactsheet.pdf to learn more about hospitals who may provide swing bed services. Currently, there is no waiver modifying the definition of a swing bed hospital and rules that were not amended as a result of 1135 waivers are still in place.
The recently released summary of the “COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers” which is located on the website page at https://www.cms.gov/about-cms/emergency-preparednessresponse-operations/current-emergencies/coronavirus-waivers, is a listing of helpful website resources.
CMS is continuously issuing additional waivers and flexibilities, and it is vital to stay updated.
Please visit https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page for more of CMS’ actions concerning COVID-19.
Additionally, please browse our MLN Connects at https://www.cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Provider-Partnership-Email-Archive to keep abreast of changes and updates impacting the provider community.
Trump Administration Announces Expanded Coverage for Essential Diagnostic Services Amid COVID-19 Public Health Emergency
Agencies Implement Legislation Guaranteeing Coverage of COVID-19 Diagnostic Testing, Including Antibody Testing, and Certain Related Services without Cost Sharing for Enrollees in Private Health Coverage
The Centers for Medicare & Medicaid Services (CMS), together with the Departments of Labor and the Treasury, issued guidance today to ensure Americans with private health insurance have coverage of 2019 Novel Coronavirus (COVID-19) diagnostic testing and certain other related services, including antibody testing, at no cost. As part of the effort to slow the spread of the virus, this guidance is another action the Trump Administration is taking to remove financial barriers for Americans to receive necessary COVID-19 tests and health services, as well as encourage the use of antibody testing that may help to enable health care workers and other Americans to get back to work more quickly.
“It is critical that Americans have peace of mind knowing that cost won’t be a barrier to testing during this national public health emergency,” said Administrator Seema Verma. “Today’s action under the leadership of President Trump allows millions of Americans to access the vital health services they need to fight COVID-19, including antibody testing once it becomes widely available.”
In March, representatives of major health insurance companies met with President Trump, where they voluntarily committed to covering COVID-19 testing without cost sharing such as copays and coinsurance. Building on this commitment, today’s guidance implements the recently enacted Families First Coronavirus Response Act (FFCRA) and Coronavirus Aid, Relief, and Economic Security (CARES) Act, which require that private health issuers and employer group health plans cover COVID-19 testing and certain related items and services furnished during the COVID-19 pandemic, with no out-of-pocket expenses.
Specifically, today’s announcement implements the requirement for group health plans and group and individual health insurance to cover both diagnostic testing and certain related items and services provided during a medical visit with no cost sharing. This includes urgent care visits, emergency room visits, and in-person or telehealth visits to the doctor’s office that result in an order for or administration of a COVID-19 test. Covered COVID-19 tests include all FDA-authorized COVID-19 diagnostic tests, COVID-19 diagnostic tests that developers request authorization for on an emergency basis, and COVID-19 diagnostic tests developed in and authorized by states. It also ensures that COVID-19 antibody testing will also be covered. Once broadly available, a COVID-19 antibody test could become a key element in fighting the pandemic by providing a more accurate measure of how many people have been infected and potentially enabling Americans to get back to work more quickly.
To see the guidance, visit: https://www.cms.gov/files/document/FFCRA-Part-42-FAQs.pdf
This action, and earlier CMS actions in response to COVID-19, are part of the ongoing White House Coronavirus Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, visit www.coronavirus.gov. For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.
COVID-19 Disease Continues Steady Spread in Rural Areas from April 5-9
Daily Yonder, By Bill Bishop
Nearly three out of every four rural counties have officially reported having a case of COVID-19 by the end of Thursday, according to data compiled from state health care agencies by USA Facts.
The map shows the spread of the novel coronavirus through rural America. The 130 rural counties in red reported their first case of COVID-19 between Sunday and Thursday, April 5-9, 2020. Only 31 counties (out of 1,164) metro counties have yet to report their first case of the virus as of the end of Thursday (April 9).
As of April 9, there have been 563 deaths from the virus in rural America. For the past week, the number of deaths from COVID-19 in rural counties has increased 12 to 17 % each day. Deaths in rural counties are increasing at about the same rate as the nation as a whole.
Deaths have been increasing the fastest in the suburbs of the nation’s major metropolitan areas, those with over a million people. Rural America still has a per capita rate of infection that is just a quarter of the national rate.
Click on the map and you can find data for your county. We have included the number of confirmed cases of COVID-19 and the number of deaths as of April 9.
Within the national picture of spreading cases and deaths are local stories that explain why some places have suffered more from the virus than others. For instance, we noticed that Mitchell County, Georgia, reported 12 deaths between Sunday and Thursday. News reports tells us that there was an outbreak of the virus at a nursing home, infecting 26 residents and killing nine in the last week.
There was also an outbreak at a Tyson Foods plant in Camilla, the county seat. Two Tyson workers have died after testing positive for COVID-19, according to the Retail, Wholesale and Department Store Union, which represents workers at the plant. Many workers at the Camilla plant commute from Albany, Georgia, which has had a large outbreak of the virus stemming from a funeral.
Kent County, Delaware, reported the largest number of new cases of COVID-19 in the last week of any rural county, with 128. It was followed by Litchfield County, Connecticut, with 118 and Sumter County, Georgia, with 111.
The COVID-19 pandemic is a world-wide event, but every community is experiencing it differently. Please tell us what’s happening in your community in the comments below or on our Facebook page. We can learn from each other.
USDA Unveils Tool to Help Rural Communities Address the COVID-19 Pandemic
USDA’s COVID-19 Federal Rural Resource Guide Lists Federal Programs That Can Help Rural Communities, Organizations and Residents Impacted by COVID-19
WASHINGTON, April 13, 2020 – U.S. Secretary of Agriculture Sonny Perdue today unveiled a one-stop-shop of federal programs that can be used by rural communities, organizations and individuals impacted by the COVID-19 pandemic. The COVID-19 Federal Rural Resource Guide (PDF, 349 KB) is a first-of-its-kind resource for rural leaders looking for federal funding and partnership opportunities to help address this pandemic.
“Under the leadership of President Trump, USDA is committed to being a strong partner to rural communities preparing for and impacted by COVID-19,” Perdue said. “This resource guide will help our rural leaders, whether they are in agriculture, education, health care or any other leadership capacity, understand what federal assistance is available for their communities during this unprecedented time.”
USDA has taken many immediate actions to assist farmers, ranchers, producers, rural communities, and rural-based businesses and organizations impacted by the COVID-19 pandemic. For more information on these actions, visit www.usda.gov/coronavirus.