Biden Signs $1.9 Trillion Stimulus Bill- New Funding Assistance for Testing, Vaccines, and States

COVID-19; Provider Relief Fund

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This week, President Biden approved and signed into law the $1.9 trillion COVID relief package, the American Rescue Plan Act of 2021 (H.R. 1319). While the bill includes an array of COVID-related funding for states and economic stimulus, it also has notable implications for post-acute and long term care providers.

Relief Funds Aimed at Vulnerable Populations and the Providers Who Support Them: The legislation provides a total of $25.2 billion for addressing health disparities and protecting vulnerable populations. Provisions of importance to AHCA/NCAL members include: 

  • $1.8 billion for HHS to support the purchase, procurement, or distribution of COVID-19 test and testing supplies, PPE, and vaccines for staff and individuals in congregate settings at the Secretary’s discretion. This would include support to states, localities, territories, and tribes for strategies and activities to detect, diagnose, trace, or monitor COVlD-19 in congregate settings, including prisons, jails, detention centers, long term care facilities, psychiatric hospitals and residential treatment facilities, intermediate care facilities. and other settings providing care for individuals with disabilities.
  • $500 million for nursing home strike teams to help facilities manage COVID-19 outbreaks when they occur. Of the total $500 million, $250 million is provided for in the Medicaid section of the bill. 
  • $200 million for Quality Improvement organizations to provide support to skilled nursing facilities for vaccination uptake and infection control support.
  • $800 million to the National Health Service Corps to support primary health care clinicians in high-need areas. 
  • $331 million for Teaching Health Centers to expand the number of sites nationwide, increase resident allocations, and provide administrative support for expanding the program.
  • $240 million to support the Nurse Corps Loan Repayment.

Under a different behavioral health provision, the bill also includes $140 million to develop a program for mental and behavioral health to prevent burnout among health care providers and public safety officers, including training and outreach which would include the post-acute and long-term care workforce. 

State and Local Coronavirus Relief Fund: The bill includes $350 billion for states, territories, and localities. After subtracting funds earmarked for territories and tribal nationals, $195.3 billion remain for the states and localities. Under the bill, the $195.3 billion is distributed to the states as follows -- $25.5 billion is equally divided among the states, and the District of Columbia receives an addition $1.25 billion. The remainder is distributed based on the average estimated number of the unemployed using Bureau of Labor Statistics data from a three-month period ending December 2020 as well as Census data. Summed up, state-specific and local awards within a state are substantial. Many AHCA/NCAL staff affiliates were successful in securing state and local funds for their memberships in the initial round of state and local funding, which you can view as a state-by-state chart.

Provider Relief Fund (PRF): The bill includes $8.5 billion in new funding for Medicare and/or Medicaid enrolled providers in rural areas. 

Medicaid: The stimulus package also includes an array of provisions providing additional federal Medicaid funds which are intended to reduce state budgetary pressure. These provisions include: 

  • 100 percent FMAP to fund coverage for COVID-19 vaccines and vaccine administration and related treatments (also prohibits beneficiary cost sharing);
  • A five percent FMAP increase for an Affordable Care Act mandatory coverage group for able bodied adults at a specific poverty level; and
  • 7.35 percent increase for home and community-based services for one year and targeted to states which meet specific criteria. 
Paycheck Protection Program (PPP) Loans: $7.25 billion is included for the Paycheck Protection Program.