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Provider Notice Issued 09/28/2020

Date:   September 28, 2020                                                                               


To:      Long Term Care Facilities - Nursing Facilities (NF), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), Supportive Living Program (SLP) Providers, Medically Complex for the Developmentally Disabled Facilities (MC/DD) and Specialized Mental Health Rehabilitation Facilities (SMHRF)


Re:   CARES Act Funding – Round 1 Distribution to LTC Providers



This notice is a follow up specifically for Long-Term Care (LTC) providers to the September 15, 2020 Provider Notice regarding the distribution of CARES payments related to the federal CARES Act. The September 15, 2020 notice is targeted to all Medical Assistance providers and provides general information on:

-       a provider portal that will be used to apply for and submit supporting documentation for CARES payments,

-       a subaward agreement necessary to utilize CARES payments,

-       CARES payment timelines, and

-       the process, methodology and accountability of the CARES payments.

The provider portal will be available for online submissions beginning the week of September 28, 2020, with an additional provider notice posted offering relevant details, including a phone line for technical support when using the portal. Providers with questions about the CARES payments can send an email to


LTC Provider Eligibility:

CARES payments for LTC providers are intended to be used to cover COVID-19 pandemic-related health care expenses that were not part of the provider’s annual budget established before March 1, 2020. Eligible providers must have experienced economic hardship in the form of increased health care expenses, planned expenditures to respond to the COVID-19 pandemic and/or decreased utilization and revenues as a direct result of the COVID-19 pandemic.


Allowable Expenses:

CARES Payments shall be exclusively for expenses incurred related to the pandemic associated with the 2019 Novel Coronavirus (COVID-19) Public Health Emergency issued by the Secretary of the U.S. Department of Health and Human Services (HHS) on January 31, 2020, and the national emergency issued by the President of the United States on March 13, 2020, between March 1, and December 30, 2020. Eligible providers will be required to attest that they will be able to demonstrate that their expenses are pandemic related, were not part of their annual budgets established before March 1, 2020 and are directly associated with health care needs. Eligible expenses include:


1.    Acquisition and distribution of medical equipment and supplies, personal protective equipment (PPE), or infection control supplies

2.    General COVID-19 testing, treatment, contact tracing, and isolation expenditures and general healthcare operational and infrastructure expenses

3.    Expansion of testing access in the community through the use of “pop-up test sites” with a focus on protecting vulnerable populations

4.    Expansion of capabilities related to case identification, timely reporting of case data, contact identification, disease transmission characterization, and tracking of relevant epidemiologic characteristics including hospitalization and death

5.    Expansion of infection control and contact tracing for high-risk populations

6.    Surveillance to monitor virologic and disease activity in long-term care facilities, group living facilities, businesses, healthcare workers, schools, colleges and universities, and other large community institutions

7.    Enhanced coordination of public health messaging and emergency public information with key partners and stakeholders

8.    Public education and information efforts

9.    Increased payroll

10. Hazard pay

11. Temporary staff contracts

12. Telemedicine enhancements

13. Telework enhancements

14. Expanded clinic or patient capacity

15. Sanitization and social distancing expenses


In addition, individual rounds of funding may be further targeted by the Department for a subset of these allowed uses.


Subaward Amounts and Timelines:

Funding for the HFS CARES payment program was appropriated to HFS in the FY2021 budget to provide support to long-term care providers due to needs resulting from the COVID-19 pandemic in the form of subawards to eligible entities. The appropriation language included a variety of long term care facilities and outlined minimum allocations to disproportionately impacted areas. A separate appropriation was included for Specialized Mental Health Rehabilitation Facilities (SMHRFs).

Subawards for LTC providers will occur in phases. Round 1 awards for LTC providers were issued the week of September 21, 2020. The amounts were based on a formula estimating increased costs for three months of enhanced labor costs or “hazard pay,” adjusted for statutory constraints. Key elements to the formula included:

1.    Funding of enhanced hourly wages compared to pre-COVID statewide average staffing levels ($5/nursing hour and $2.50/non-administrative direct care hour)

2.    Facility Medicaid census during the beginning of the pandemic

3.    Amounts increase with early pandemic community rates of COVID infection based on zip codes grouped into ranked quartiles (an additional +$1/hour for nurses and +$.50/hour for others per quartile)

4.    Amounts decrease based on facility staffing versus regulatory standards for skilled nursing facilities


Round 1 payments were intentionally less than a quarter of available CARES funding for LTC providers so that individual subaward recipients would not exceed their reportable costs. Future subawards will come after application and will be assessed based on allowable expenses and other resources as discussed above. All subaward recipients must register at the HFS CARES portal.

Subaward agreements, which provide details about the federal award as well as subrecipient requirements, were mailed to subrecipients for review and signature. The subaward agreements also include details about attestation and audit requirements for subaward recipients.


Questions regarding HFS CARES payments should emailed to



Kelly Cunningham

Interim Medicaid Director