CMS Releases Additional Blanket Waivers for Long-Term Care Hospitals, Rural Health Clinics, Federally Qualified Health Centers and Intermediate Care Facilities

April 22, 2020

CMS continues to release additional blanket waivers to the healthcare community in order to provide the flexibilities needed to take care of patients during this public health emergency. Today, CMS is providing additional blanket waivers related to care for patients in Long-Term Care Hospitals (LTCHs), temporary expansion locations of Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), staffing and training modifications in Intermediate Care Facilities for individuals with Intellectual disabilities, and the limit for substitute billing arrangements (locum tenens).

Guidance

HHS Announces $10 Billion for Rural Health Clinics and Rural Hospitals

On April 22, 2020, HHS updated their provider relief website with additional information about how they plan to spend the rest of the $100 billion allocated for healthcare providers by the CARES Act.

In this update, HHS made it clear that rural health clinics and rural hospitals will receive $10 billion. Specifically, the announcement states:

Allocation for rural providers

$10 billion will be allocated for rural health clinics and hospitals, most of which operate on especially thin margins and are far less likely to be profitable than their urban counterparts.

  • This money will be distributed as early as next week on the basis of operating expenses, using a methodology that distributes payments proportionately to each facility and clinic.
  • This method recognizes the precarious financial position of many rural hospitals, a significant number of which are unprofitable.
  • Rural hospitals are more financially exposed to significant declines in revenue or increases in expenses related to COVID-19 than their urban counterparts.

We do not know the exact methodology CMS will use to allocate this money between hospitals and rural health clinics but it will be based at least somewhat on operating expenses.

When we learn more about the details we will be sure to get those out.

This $10 billion is not to be confused with the $225 million RHCs are set to receive as a part of the “phase 3.5” legislation. Instead, this “provider relief” money is to help providers make up lost revenue while the money in the “phase 3.5” legislation is designed to help providers with COVID-19 testing and related expenses.

While, the COVID-19 crisis has undoubtedly been heartbreaking and very difficult for rural providers, it is nice to see that Congress and the Trump Administration are recognizing our issues and dedicating resources to bolster the rural health community. We strongly believe that this is the byproduct of the entire rural health community standing up and advocating to our policy makers over the years.

Webinar: Mental Health in a Time of COVID-19: Preparing Leaders to Address the Challenges

Date: April 28, 2020

Time: 11:00 AM CST

REGISTER HERE

The outbreak of COVID-19 has placed overwhelming stress on people, families, communities, and our nation. Fear and anxiety about an unseen disease can provoke strong emotions in adults and children. Even our friends and neighbors without mental health diagnoses are experiencing increased challenges.

During normal times, many people turn to faith leaders when they have a concern. That’s why some leaders are predicting there will be a wave of people seeking to share their challenges involving the impact of COVID-19. Faith and community leaders can prepare now to be ready to engage the myriad of questions people will have.

The goal of this webinar is to help you understand what research tells us may be coming, the perspective of mental health professionals in this moment, and what faith leaders are preparing to address.

SAVE THE DATES
Save the dates for the second and third webinar in this series. More details to come!

  • May 12, 11 AM CST — PART 2: “When Trauma, Fear, and Anxiety Become Overwhelming”
  • May 26, 11 AM CST PART 3: “Task-Shifting to Address Increasing Challenges”

Trump Administration Launches New Toolkit to Help States Navigate COVID-19 Health Workforce Challenges

April 22, 2020

At President Trump’s direction, the Centers for Medicare & Medicaid Services (CMS) and the Assistant Secretary of Preparedness and Response (ASPR) released a new toolkit to help state and local healthcare decision makers maximize workforce flexibilities when confronting 2019 Novel Coronavirus (COVID-19) in their communities. This toolkit includes a full suite of available resources to maximize responsiveness based on state and local needs, building on President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported. This work was developed by the Healthcare Resilience Task Force as part of the unified government’s response to COVID-19.

“The Administration has taken swift and unprecedented emergency action to lift regulatory constraints, ease federal rules and approve waivers that help local hospitals, clinics and other healthcare facilities boost their frontline medical staffs and increase their ability to care of patients in the face of crisis. This new resource will help states apply all of these important changes on the ground in order to maximize their workforce to ensure care for patients,” said CMS Administrator Seema Verma.

In response to this pandemic, the Trump Administration has provided sweeping flexibility to the U.S. healthcare system. To bolster the healthcare workforce, barriers for hiring and retaining of physicians, nurses, and other healthcare professionals to keep staffing levels high have been removed. Medical practitioners are now able to practice at the top of their license and across state lines, offering more flexibility for rural providers and expanding the available workforce. CMS has also allowed additional healthcare providers to enroll in Medicare temporarily to provide care during the public health emergency. Finally, an unprecedented expansion of telehealth services covered by Medicare, allows patients to have doctor’s visits at home, no matter where they live, to reduce potential exposure to the virus.   

The COVID-19 Healthcare Workforce Toolkit builds on the steps CMS has taken to ensure healthcare facilities across the nation are fully staffed and equipped to treat COVID-19 patients as efficiently as possible. This comprehensive toolkit for individuals managing workforces during the COVID-19 pandemic provides helpful information on funding flexibilities, liability protections, and workforce training all in one place. For example, state and local communities will be able to access the COVID-19 Healthcare Workforce Toolkit to see how and where workforce waivers can be applied based on information from other areas.

The COVID-19 Healthcare Workforce Toolkit also provides up-to-date best practices so that state and local healthcare decision makers have a go-to resource to know what’s been implemented in the field and to find out how it’s working. The toolkit is available online and includes an assistance center, information exchange of case studies and additional peer-to-peer communications that can be used to help local communities determine the best way to battle the COVID-19 based on their unique needs.

The Healthcare Workforce Toolkit is housed on the ASPR Technical Resources, Assistance Center, and Information Exchange (TRACIE). ASPR TRACIE is a healthcare emergency preparedness information gateway that ensures all stakeholders—at the federal, state, local, tribal, and territorial government levels; in nongovernmental organizations; and in the private sector—have access to information and resources to improve preparedness, response, recovery, and mitigation efforts. The platform helps to fill gaps in healthcare system preparedness by providing timely, innovative ways to share information and promising practices during planning efforts.

To view the COVID-19 Healthcare Workforce Toolkit, visit: https://asprtracie.hhs.gov/Workforce-Virtual-Toolkit.

The COVID-19 Healthcare Workforce Toolkit 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.

Federal Office of Rural Health Policy

April 23, 2020

What’s New

HHS Awards Nearly $165 Million to Combat COVID-19 in Rural Communities. Yesterday, the U.S. Department of Health and Human Services (HHS) through the Health Resources and Services Administration (HRSA) awarded nearly $165 million to combat the COVID-19 pandemic in rural communities. These investments will support 1,779 small rural hospitals and provide additional funding to 14 HRSA-funded Telehealth Resource Centers (TRCs) to provide technical assistance on telehealth to help rural and underserved areas combat COVID-19.

HHS Launches New Telehealth Website. For patients, the website provides resources so that they can learn more about accessing health care through telehealth; for providers, the site is a resource to help them incorporate telehealth into their practices.

ACL Announces $1 Billion in CARES Act Grants to Support Older Adults and People with Disabilities. Through the Coronavirus Aid, Relief, and Economic Security (CARES) Act, the Administration for Community Living (ACL) will administer grants to boost programs that deliver meals, ensure safe transitions home following hospitalizations, and provide other essential services to older Americans and Americans with disabilities during this challenging time.

SAMHSA to Release $110 in Emergency Grant Funding. The Substance Abuse and Mental Health Services Administration (SAMHSA) has expedited its process to release emergency grants to strengthen access to treatments for substance use disorders and serious mental illness during the COVID-19 pandemic. SAMHSA has also updated its list of Frequently Asked Questions about provision of methadone and buprenorphine for treatment of opioid use disorder during the emergency.

Bipartisan Policy Center: Confronting Rural America’s Health Care Crisis. The Bipartisan Policy Center (BPC) is a think tank combining ideas and solutions from both parties. In this report, the BPC’s Rural Health Task Force makes policy recommendations to stabilize rural health care in the current emergency and the long term.

The Journal of Rural Health: Accepted Articles on Coronavirus-Related Issues. The publication is providing free access to its collection of accepted, unedited articles on how the pandemic is affecting existing issues for rural health in the United States. Subjects include suicide, substance use disorder, telehealth, and emergency medical services. The journal has an ongoing Call for Timely Papers on COVID-19 in Rural Areas.

Federal Office of Rural Health Policy FAQs for COVID-19. A set of Frequently Asked Questions (FAQs) from our grantees and stakeholders, updated regularly.

CDC COVID-19 Updates.  The Centers for Disease Control and Prevention (CDC) provides daily updates and guidance. New this week is a breakdown of factors that influence racial and ethnic minority group health.  Another page updated daily has demographic characteristics of known cases in the U.S.  A CDC site for rural-specific information will have a recording of yesterday’s Coronavirus update for rural stakeholders and communities, along with an archive of previous calls.  CDC also does regular clinical calls for public health emergencies, called Clinician Outreach and Communication Activity (COCA).

Confirmed COVID-19 Cases, Metropolitan and Nonmetropolitan Counties. The RUPRI Center for Rural Health Policy Analysis provides up-to-date data and maps on rural and urban confirmed cases throughout the United States. An animated map shows the progression of cases beginning January 21.

Rural Response to Coronavirus Disease 2019.  The Rural Health Information Hub has created a guide to help you learn about activities underway to address COVID-19.