Federal cash is flowing into Pa. neighborhood well being facilities, however leaders say there are too many limits on it

If she had her Druther, Cheri Rinehart would have every doctor and staff working in underserved communities wear a pin that said, “I’m vaccinated against Covid. Ask me about the vaccine. “

Rinehart, President and CEO of the Pennsylvania Association of Community Health Centers, said the pins would facilitate conversation and engagement about the COVID-19 vaccine and reduce vaccine reluctance in low-income communities.

Amid the urgency to vaccinate minorities and the small disparities in health care, the pins represent a small financial investment as community health centers have a significant impact on the health of underserved communities, especially during the coronavirus pandemic.

“We think this is a very gentle way to start a conversation when you bring someone back to the exam room or weigh them. If he sees a needle on your collar, he may be more open to talking to the person taking their blood pressure than even a doctor or nurse, ”said Rinehart.

Rinehart recently tabled a proposal for the lapel pins, just one item in a litany of needs and financial inquiries vying for the tens of millions of dollars in federal funding.

In fact, community health centers officials say there has been no shortage of funds to help them support impoverished urban or rural communities, especially since the pandemic began. But often the money comes with constraints that limit their options.

“We wish it wasn’t that specific. These uses weren’t that specific, ”said Jeannine Peterson, CEO of the Hamilton Health Center. “Of course the first pot was money to test and we tested a lot. When the vaccine hit the market in January, testing slowed down, but all that testing money is still there and you can’t use it for anything other than testing.

The most recent source of funding was released in June by the U.S. Centers for Disease Control and Prevention, which allocated $ 27 million to Pennsylvania specifically to address health inequalities in minority and rural communities. The state health ministry has not yet released the money but is completing a number of initiatives.

Nationwide qualified community health centers in Pennsylvania are on the verge of getting a sizable chunk of the money.

Peterson announced programs that would improve human resource development, recruitment, salaries for healthcare professionals and personnel, as well as a number of other initiatives, including infrastructure, that could affect the six locations under the Hamilton Health umbrella.

His missions, she says, are vital.

“The county has mental health and substance abuse responsibility, but it really has no health care responsibility, and that doesn’t exist anywhere in town,” said Peterson. “Things fell to the community health centers. We want to be there to answer. Here we lack the resources to meet the public health needs of the population. These are concrete things. The Covid money is plentiful, but what about everything else we have to do? “

the Hamilton Health Center provides free or discounted health care to more than 20,000 Harrisburg residents and rural communities in Dauphin and Perry counties. The center employs 160 people and provides medical, social, behavioral and dental services to tens of thousands of otherwise unmedically unsupervised residents. It operates on a budget in excess of $ 16 million.

The Hamilton Health Center and the other state-qualified health centers in Pennsylvania continue to benefit from the CARES bill. Much of this money is earmarked for COVID-19 tests and vaccinations. Part of the funding is determined by formulas, such as the number of patients treated in the last year.

In fact, most of the federal aid has yet to be used to help Pennsylvania recover from the COVID-19 pandemic. Pennsylvania received nearly $ 7.3 billion in federal aid through the US rescue plan; $ 1 billion is earmarked for the new state budget.

Regardless, the money is carefully scrutinized and channeled, and is generally targeted towards initiatives such as testing and vaccinations. There Peterson said she wished the flow of funding could be a little more flexible.

Community health centers are required to follow strict guidelines for the use of federal funds. Funds earmarked for testing cannot, for example, be used for vaccination programs or to meet staffing needs.

“It is very difficult to manage all of the funds … to make sure you are spending according to guidelines and having the impact you want to make in the community,” said Peterson.

Brian Lentes, director of operational excellence for the Department of Health, said state officials are working closely with regional ethnic and minority groups and health care providers in rural and urban settings to identify needs and provide the latest federal grants.

“This is a really exciting opportunity for the department to use federal funds to create opportunities for four major strategies,” said Lentes.

These strategies include funding field workforce training; Programs to address inequalities in rural health and the disabled population and initiatives within the ministry.

The funding stream has a designated pot of approximately $ 5 million to be used to address rural health care and inequalities there, and approximately $ 8 million is dedicated to Philadelphia.

“It comes from many different ideas that have been generated by grants to address health inequalities and their relation to COVID-19,” Lentes said. “We know that certain populations contracting COVID-19 have more severe consequences, and this is a great way to address those differences. How can you improve the response in the future? “

Pennsylvania is one of the states that does not provide state funding for community health centers. Health centers in the Commonwealth receive their funding largely from federal sources, including Medicaid and Medicare, as well as from critical grant funding streams.

Extensive studies have confirmed the difference that community health centers are making in their communities and the quality of care they provide, especially during the pandemic.

“We had health inequalities before the pandemic,” said Rinehart. “Many of these churches – where we see big differences in health – are the same churches where our most important workers had to work in the early days. Often they were dependent on public transport. They live in smaller neighborhoods with more people, which increases the risk of infection. It was important to give these people access to the vaccine as soon as possible. “

Nationwide Qualified Health Centers in Pennsylvania provided medical care to nearly 1 million Pennsylvania residents last year – in fact, 917,000 people received medical care at more than 330 clinic locations in 53 of the Commonwealth of Counties. Nationwide, this number is 29 million people.

The federal grant is available until 2023, a fact that, depending on your point of view, makes the situation even more urgent.

Lentes guarantees that the money will be paid out on time and carefully. Will it be enough to address and contain the persistent disparities?

“I think this is a very good place to start and it is appropriate at this point to keep looking at the additional options,” he said. “This is a great start, but there is always room for more. As we continue to address health inequalities and improve our response to Covid and underserved racial and ethnic groups, we are generally looking for additional funding to continue building existing programs but have other areas and agencies do the same. “

Rinehart said she was happy with the speed at which the state is processing the grants.

“I would prefer you to make a well-considered decision,” she said. “It’s a lot of money that has flowed out of it since the beginning.”

Peterson agrees: Funding was ample, if limited.

“If we had our Druther it would have been displayed differently,” said Peterson. “But it is what it is and we are very grateful. After all, we were able to bring initiatives that the community needs on the street. “

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Clear Vitality ETFs Take a Hit, however Cash Retains Flowing In

Investors lost a whole bunch of bets on manufacturers of solar modules and wind turbines this year. Your answer: to double.

A year ago, Green stocks and the funds that track them recovered enormously from a pandemic faint after the market recovered. Solar panel and wind turbine companies were among the firms driven by a surge in investors and consumers Renewable Energy Demandalthough many are small, unprofitable businesses.

This year, returns are behind the broader stock market. This is due in part to past share price history and uncertainty about the Federal Reserve’s interest rate rate and the potential impact of its actions on growth stocks.

Exchange-traded funds that track renewable energy indices have seen double-digit declines so far this year.

BlackRock‘s

iShares Global Clean Energy ETF

has fallen 18% since December;

Invesco GmbH.

is popular

Solar ETF

has seen a decrease of 17%.

Nevertheless, money continues to flow. According to data from Refinitiv Lipper, professional asset managers and retailers have invested $ 6.2 billion in green energy ETFs so far this year. Inflows are on track to eclipse last year’s record of $ 7.2 billion.

Index makers and asset management firms say large declines in prices do not reflect investors’ desire to bet on green companies for now.

“We see continued demand in this area,” said Ari Rajendra, senior director of strategy and volatility indices at S&P Dow Jones Indices.

At BlackRock, the world’s largest asset manager, Clean Energy Funds have seen $ 2.7 billion in inflows and $ 1 billion in a European clean energy fund so far this year, according to FactSet. The interest was so great that S&P had to expand its clean energy benchmark, used by BlackRock funds, to solve the problem of having too much money in mostly small, difficult-to-trade companies.

Such changes don’t happen often, said S & P’s Rajendra, but strong investor demand justified revising the index from just 30 to 82. Among other things, the company lowered the criteria for listing shares.

Ross Gerber, CEO of Gerber Kawasaki Wealth and Investment Management, believes renewable energy stocks, from solar panel makers to alternative battery manufacturers, will transform transportation and other facets of everyday life.

A solar farm in Maine. Because clean energy stocks are expensive, they and the funds that replicate them can be more susceptible to market or political changes.


Photo:

Robert F. Bukaty / Associated Press

Mr. Gerber has invested more client money in Invesco’s Clean Energy Fund, adding to the total $ 446 million in ETF inflows this year. He avoids oil stocks, which are among the top performers in the stock market this year.

“The more speculative the stock, the higher the valuation. But in this market people are more interested in fantasy than reality, ”said Gerber. “So at Solar you also have a bit of imagination.”

Invesco’s solar ETF rose 233% in 2020 while BlackRock’s global clean energy fund rose 140% – by far the best years of all time for both as green stock valuations skyrocketed.

Although both funds have declined over the year to date, valuations are up. Invesco’s solar ETF trades at a forward price / earnings ratio of 36, according to FactSet, up from 21 for the S&P 500.

Meanwhile, clean energy companies trade at a 70% premium over traditional energy companies based on the ratio of enterprise value to earnings before interest, taxes, depreciation and amortization, a standard valuation measure, Strategists at

Bank of America

said. They found that rating is down from its highs earlier this year, but is still well above the five-year average.

Because stocks are expensive, they and the funds that track them can be more susceptible to market or political changes. For example, its pull could wane if the Fed starts raising rates earlier than expected, which takes some of the luster from growth stocks.

Or volatility could increase if there are hiccups for a $ 1 trillion infrastructure plan President Biden and some US Senators agreed. Green stocks rebounded last year after Mr Biden won the November presidential election as investors bet the new administration would accelerate the US transition to wind and solar and away from fossil fuels.

Investors are already experiencing some of this volatility. In the past few weeks, clean energy stocks have rallied alongside growth stocks. Invesco’s solar fund is up nearly 11% over the past month, while BlackRock’s ETF is up 2.2%.

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The willingness of investors to continue to invest money in this part of the market shows that they are positioning themselves for a potential longer-term realignment of the energy sector and the energy industry.

Rene Reyna, Head of Thematic and Specialty Product Strategy at Invesco, said the expectations are based on the belief that the technology will eventually lower the cost of batteries, solar panels and other green efforts to the point that it will gain wider adoption and big profits become. In this sense, clean energy is the “trade of hope,” he said.

Construction of a wind farm in New Mexico last year. Clean energy companies trade at a 70% premium over traditional energy companies.


Photo:

Cate Dingley / Bloomberg News

Write to Michael Wursthorn Michael.Wursthorn@wsj.com

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