Daily Yonder

By Craig Settles

Rural America already has a shortage of hospital beds. Telehealth could help move some patients to a new type of facility powered by broadband. New temporary regulations in response to COVID-19 will allow the change.

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Daily Yonder

By Bill Bishop, Tim Marema and Jan Pytalski

The novel coronavirus continues to spread across rural America, according to data USA Facts has compiled from state health authorities. Yesterday, April 1, an additional 58 rural counties reported their first Covid-19 cases.

The impact of the novel coronavirus varies across the rural landscape. On average, there were 14.1 cases of COVID-19 for every 100,000 rural residents. That rate is well below the national rate of 55.9 cases per 100,000 residents.

But most of us don’t live in an “average” county. There are 80 rural counties with infection rates above the national average (shown in red in the map). And some rural counties have COVID-19 infection rates among the highest in the country.

Some of the highest rates are in Rocky Mountain ski counties. (The Yonder reported this phenomenon last week.)  Blaine County, Idaho, has a COVID-19 infection rate of 1,164 per 100,000. For comparison, the Bronx in New York City reported a rate of 598.6, the highest tally of any central city area.

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Fred Ullrich, BA; and Keith J. Mueller, PhD

While the majority of confirmed COVID-19 cases in the United States are found in urban centers, rural areas are not free of cases. As of April 1, 2020, there were a total of 234,040 cases and 5,398 deaths identified in counties (data provided by USAFacts.org), with 8,866 cases and 206 deaths (about 3.8 percent of both) reported in non-metropolitan counties.

This RUPRI data brief shows the current nonmetropolitan and metropolitan spread of the disease, and the associated map shows how the disease has spread over time.

Click to down the updated maps, and the “progression” of cases throughout the country.

https://rupri.public-health.uiowa.edu/publications/policybriefs/2020/COVID%20History/

New Video Available on Medicare Coverage and Payment of Virtual Services

CMS released a video providing answers to common questions about the Medicare telehealth services benefit. CMS is expanding this benefit on a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act.

Video

CMS Approves Additional State Medicaid Waivers and Amendments to Give States Flexibility to Address Coronavirus Pandemic

CMS approved its 45th Medicaid waiver to the District of Columbia, delivering urgent regulatory relief to ensure the District can quickly and effectively care for their most vulnerable citizens. In light of the urgent and evolving needs of states during the COVID-19 crisis, CMS developed a toolkit to facilitate expedited application and approval of State waivers requests in record time. The waivers support President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported.

CMS also approved an additional state waiver amendment request for Oklahoma to give emergency flexibilities in their programs that care for the elderly and people with disabilities, bringing the total to 18 approvals across 16 states.

Section 1135 Waivers  

1915(c) Appendix K Waivers

 Guidance for Processing Attestations from Ambulatory Surgical Centers (ASCs) Temporarily Enrolling as Hospitals during the COVID-19 Public Health Emergency

CMS is providing needed flexibility to hospitals to ensure they have the ability to expand capacity and to treat patients during the COVID-19 public health emergency. As part of the COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers CMS is allowing Medicare-enrolled ASCs to temporarily enroll as hospitals and to provide hospital services to help address the urgent need to increase hospital capacity to take care of patients.

Guidance

April 5, 2020

Under her authority as Secretary of the Department of Health to take any disease control measure appropriate to protect the public from the spread of infectious disease, Dr. Rachel Levine today signed an order providing direction for maintaining and cleaning buildings for businesses authorized to maintain in-person operations under her and the governor’s life-sustaining business orders announced March 19.

According to the Building Safety Measures order, “Cleaning, disinfecting, and other maintenance and security services performed by building service employees are critical to protecting the public health by reducing COVID-19 infections in the commonwealth.”

The measures outlined in the order are for owners of buildings of at least 50,000 square feet used for commercial, industrial or other enterprises, including but not limited to facilities for warehousing, manufacturing, commercial offices, airports, grocery stores, universities, colleges, government, hotels, and residential buildings with at least 50 units.

In addition to maintaining pre-existing cleaning protocols, the order outlines these new protocols:

• Clean and disinfect high-touch areas routinely in accordance with CDC guidelines, in spaces that are accessible to customers, tenants, or other individuals.
• Maintain pre-existing cleaning protocols established in the facility for all other areas of the building.
• Ensure that the facility has a sufficient number of employees to perform the above protocols effectively and in a manner that ensures the safety of occupants and employees.
• Ensure that the facility has a sufficient number of security employees to control access, maintain order, and enforce social distancing of at least 6 feet, provided the security employees are otherwise responsible for such enforcement.

The order goes into effect at 12:01 a.m., April 6.

View the full order as a PDF here or on Scribd.

Over the past several weeks, the Pennsylvania departments of Community & Economic Development, Health, General Services, and the Pennsylvania Emergency Management Agency have heard from countless manufacturers and other businesses from across the commonwealth about how they can help through their existing means and through new innovative techniques.

Many of you have also reached out to share your challenges, supply chain disruptions and workforce issues, which are impeding your ability to produce more of what is most needed to battle COVID-19.

Earlier today, we announced the creation of the Pennsylvania Manufacturing Call to Action Portal, which will help streamline those requests and facilitate the connections you need to overcome your challenges and provide critical supplies to Pennsylvania.

It is our goal to connect you directly with a dedicated team of case managers who will thoroughly evaluate your company’s needs, seamlessly connecting you with the appropriate resource or partner organization(s) who will provide additional support.