Provider Notice Issued 10/09/2020

​Date:  October 9, 2020

          To:      Physicians, Nurses, Podiatrists, Audiologists, Speech Therapists, Occupational Therapists, Physical Therapists, Behavioral Health Clinics, Birthing Centers, Long Term Care Providers, Hospitals, Federal Qualified Health Clinics, Encounter Rate Clinics, Rural Health Clinics, Ambulatory Surgical Treatment Centers, Transportation Providers, Hospice, Laboratory, Early Intervention Services, Community Mental Health Providers, School Based Health Services, Supportive Living Facilities, Waivers

           Re:    CARES Act Coronavirus Relief Fund Budget Guidance and Instructions

______________________________________________________________________________ 

This provider notice offers information to help all eligible providers apply for the State CARES Pandemic Related Stability Payments Program (CARES payments) in support of their response to the Coronavirus Disease (COVID-19) pandemic. Specific information is also included here for Round 1 subrecipients.  

HFS CARES Portal

As described in our previous provider notice dated September 29, 2020, Medicaid healthcare providers enrolled with HFS can apply for funds by submitting an online application through the HFS CARES Portal. Applicants can create a portal log-in and begin reviewing and collecting required application documents to be submitted. It is recommended that providers use Chrome or Edge browsers when accessing the HFS CARES portal for optimal performance.

For applications, the HFS CARES Portal is available through 12:00 noon on Saturday, October 31, 2020. While the portal is available 24/7 during this timeframe, online and call-in assistance is available from 7 a.m. to 5 p.m. CST, Monday through Friday at 866-385-0600. Call center support is available in English and Spanish. Providers may also send questions regarding the CARES payments via email to HFS.CARES@illinois.gov.

A FAQ, which will be updated regularly, is posted on the portal website here:

                     https://caresapp.hfs.illinois.gov/faq/

HFS will be posting additional resources on the HFS dedicated CARES payment page which can be found here:

https://www.illinois.gov/hfs/Pages/CARESUpdatePage.aspx

Budget template and instructions for Round 1 Subrecipients

A budget to be submitted with Round 1 subaward agreements only applies to providers which have received Round 1 funding, specifically Federally Qualified Health Centers, select Safety-Net designated hospitals, and long term care providers including nursing homes.  We have heard from Round 1 providers a desire to have a budget template to work from. An excel document is posted on the dedicated CARES page at https://www.illinois.gov/hfs/Pages/CARESUpdatePage.aspx which provides instructions and a budget template to guide providers who have received Round 1 funds through the Coronavirus Aid, Relief, and Economic Security (CARES) Act Coronavirus Relief Fund.  

Round 1 subrecipients are required to prepare a budget equal to the total amount received. The template allows for the entry of up to 50 facility/provider level budgets for those subrecipients which own, operate or receive payments on behalf of multiple providers and whose award amount relates to multiple providers. The budget includes cost categories that subrecipients may utilize to represent eligible expenditures incurred or planned between March 1 and December 30, 2020 totaling their exact subaward amount. These eligible costs can include items or services previously purchased and utilized, which no other federal sources have directly reimbursed by December 30, 2020. A text box is included for each line item for subrecipients to explain in their own terms how the costs are determined. Budget and cost categories are intended to provide flexibility to the subrecipient to identify and describe incurred or planned costs. This budget is required for all Round 1 subrecipients which intend to retain and use the Round 1 payments. Completed budgets should be returned by October 16to the HFS CARES E-mail box: HFS.Cares@illinois.gov

HFS understands that there are specific outstanding questions about certain line items for Round 1 subrecipients.  We are working to update these questions in the CARES Portal FAQ as soon as possible.

For Round 1 funding, it is possible that multiple payments were made to be consistent with the split between State appropriation requirements for disproportionately impacted areas and all other payments under the program. The purposes and accountability are the same regardless of the amount of money or number of payments.

If Round 1 subrecipients automatically received funds and do not plan to sign the agreements and utilize the funds, they must immediately remit the funds to: Receipt Accounting at Illinois Department of Healthcare and Family Services, Bureau of Fiscal Operations, 2200 Churchill Road A-2, Springfield, Illinois 62702.

As a reminder, subaward agreements must have a wet signature and be scanned and returned to HFS as soon as possible through the HFS.CARES@illinois.gov email address. The subaward agreements and budget do not necessarily need to be submitted in the same email.  

Budget and instructions for All Eligible Applicants using the CARES Portal

Round 2 and any potential subsequent rounds of CARES payments will come after eligible applicants submit an application through the CARES provider portal at:

                https://caresapp.hfs.illinois.gov 

Eligible applicants should apply no later than October 31, 2020. Additional information about the eligibility of applicants and FAQs are found at the portal link above.

Integrated into the portal, all eligible applicants, including entities which received Round 1 funding, will submit an analysis of their full costs.  As part of the application, applicants are required to provide an estimate of allowable expenditures incurred or planned between March 1 and December 30, 2020. Again, eligible costs can include items or services previously purchased and utilized, which no other state or federal sources have directly reimbursed by December 30, 2020.

For Round 1 subrecipients which wish to apply for Round 2 funding, HFS expects the estimate of total expenditures submitted in the Round 2 application to be inclusive of the amount represented in the Round 1 budget. HFS will take the Round 1 funding into consideration when determining Round 2 funding.

All provider notices and additional resources regarding the HFS CARES payment program will continue to be updated on the dedicated CARES Payment link on the Department’s special Coronavirus (COVID-19) Updates website at: 

 https://www.illinois.gov/hfs/Pages/CARESUpdatePage.aspx

Additional information on CARES funding

As explained in previous notices, HFS payments must be used to cover health care expenses related to the COVID-19 pandemic and expenditures made despite losses of revenue due to the COVID-19 pandemic. Lost revenue may be used as a factor in determining the amount of CARES payment, but the funds may only be used on specific CARES qualifying expenditures between the period of March 1 and December 30, 2020.

Medicaid healthcare providers operating in the State of Illinois have the opportunity to apply for assistance, but not all will be eligible for funding. CARES payments will be distributed based on a schedule and framework to be established by the Department with recognition of the pandemic related acuity of the situation for each provider, taking into account the factors including, but not limited to, the following;

(A) the impact of the pandemic on patients served, impact on staff, and shortages of the personal protective equipment necessary for infection control efforts for all providers;

(B) providers with high incidences of COVID-19 among staff, or patients, or both;

(C) pandemic-related workforce challenges and costs associated with temporary wage increased associated with pandemic related hazard pay programs, or costs associated with which providers do not have enough staff to adequately provide care and protection to the residents and other staff;

(D) providers with significant reductions in utilization that result in corresponding reductions in revenue as a result of the pandemic, including but not limited to the cancellation or postponement of elective procedures and visits; and

(E) pandemic-related payments received directly by the providers through other state or federal resources.

The Department encourages applicants to utilize the available fields in the application to list and otherwise describe the impact of the pandemic on your healthcare response, preparation and delivery capacity.

Funding will be awarded based on applicants meeting the eligibility criteria outlined in the HFS CARES Program. Funds will be prioritized for providers serving Medicaid members and to fill gaps not addressed by other resources. Per the appropriation set by the General Assembly, at least 30% of the funds will be allocated to high impact areas of the state, based on positive COVID-19 cases. 

Federal guidelines require an agreement between the Department and subrecipients must be signed and any funds awarded through this process must be utilized on specific CARES qualifying expenditures between the period of March 1 and December 30, 2020. The deadline is a federal requirement and cannot be changed by HFS.

Federal guidance places certain limitations on how federal award funds may be expended. Since the State CARES Pandemic Related Stability Payments Program is an extension of the US Treasury’s Coronavirus Relief Fund, Treasury requirements are applicable to HFS Subrecipients and do not permit lost revenue as a use of federal funds. Subawards are required to be spent for the reimbursement of actual costs incurred between the period of March 1 and December 30, 2020, examples of which include expenses such as payroll, mortgages, rent and personal protective equipment (PPE).

For budgets submitted to the Department using the Round 1 template and/or using the portal in Round 2 and subsequent rounds of funding, eligible subrecipients may modify their initially submitted budget plans, if their circumstances change. The subrecipient should make the necessary amendments on their own internal documents and retain the documentation of the change and spending on eligible costs for final submission to HFS at the end of the reporting period. Budget changes will not need to be submitted or approved by HFS in order to allow maximum flexibility among allowable costs. Subrecipients are encouraged to utilize their own internal controls, best judgment, and policies when creating, amending, and documenting their subaward spending. All unspent subaward funds must be returned to the Department at: Receipt Accounting at Illinois Department of Healthcare and Family Services, Bureau of Fiscal Operations, 2200 Churchill Road A-2, Springfield, Illinois 62702.

All subrecipients will be required to submit a final report no later than January 31, 2021 to the Department including:

·         Summary narrative description of how funds were utilized and their impact.

·         Itemized list of expenditures including type, description, vendor (if applicable), dollar amount, date incurred.

·         Identification of the dollar amount of any unspent funds and return as described above (if applicable).

·         Documentation to support the payment of the itemized expenditures.

·         Copies of any reporting to the U.S. Department of Health and Human Services (“HHS”) on Provider Relief Fund (“PRF”), Federal Emergency Management Agency (“FEMA”) Streamlined Project Applications, and any other reporting for other sources of funding for financial recovery from COVID-19.