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CARES Act
Health Care Relief Fund - Frequently Asked Questions


Program Eligibility

  1. Who is eligible to apply?
    Health care organizations & providers who serve patients or clients in Delaware will be eligible to apply.  There will be formula-based awards for long-term care providers, home health agencies, intellectual/developmental disabilities service providers, behavioral health providers, and hospital systems.  Other health care organizations may apply for technology awards, environmental modifications & supply awards, and community resilience award. 


  2. I received relief funds already from another CARES Act source. Am I eligible to apply?
    Possibly.  Applicants who receive funds from another CARES Act source may be eligible to apply for the Health Care Relief Fund if they are not receiving relief funds for the same expenses. 


    For instance, if a provider purchased PPE in March received CARES Act funds from another source (HHS Provider Relief, Delaware Relief Funds or the Non Profit Relief Funds) to cover that cost, then they cannot receive funds for the same expenses.  However, they can apply for other expenses or future expenses that occur prior to 12/30/2020.  The grantee must retain all documentation of these purchases  and follow all CARES Act purchasing rules. 


  3. What provider types are eligible to apply?
    There are 5 broad Health Care Industry categories that health care providers/organizations may apply for, which include:
      • Intellectual/Developmental Disabilities;
    • Home Health Care Agencies;
    • Long-Term Care;
    • Behavioral Health; and
    • Hospital Systems.

    There are three health care subject categories that health care organizations/providers NOT in the industry specific categories can apply for:
      • Technology – Upgrades to technology needed to support telehealth and social distancing
    • Environmental Modifications & Supply – Items such as personal protective equipment (PPE), physical office changes, or air filtration equipment
    • Resiliency Funds – Will be administered by Healthy Communities Delaware to address the disproportionate impact of COVID-19 on communities of color.


  4. Can I apply to multiple DHSS CARES Act Health Care Relief Fund programs?
    Applicants who receive funds from an industry-based program may not receive funds from any subject-based program. However, applicants not receiving industry-based program funds may apply to multiple subject-based programs.


  5. Are there any other eligibility criteria?
    Yes, to be eligible, a health care provider/applicant must meet the following criteria and must include documentation of such in their application:
      • Licensed Delaware business/nonprofit;
    • Was operating on or before February 1, 2020;
    • Serve patients or clients in Delaware; and
    • Agrees to the terms & conditions of the grant.


  6. What is the difference between the Health Care Relief Fund, the Nonprofit support program, and the Delaware Relief Grants Program. Can I be eligible for all three?
    To be eligible for the Health Care Relief Fund you need to be a health care organization or provider in Delaware.  Both non profit and for-profit health care providers/organizations are eligible to apply.

    The Delaware Nonprofit Support Program is for all Delaware 501(c)3 organizations that do not qualify for the Delaware Relief Grants Program.

    The Delaware Relief Grants Program is for small businesses. Nonprofit organizations in the arts, historic preservation, and cultural sectors are also eligible.


  7. What if I received a Medicaid retainer payment?
    Providers who received a Medicaid retainer payment should consider how those payments may overlap with CARES funds, including but not limited to this Health Care Relief Fund. In the event that a provider is overpaid across relief sources, accepts payment for ineligible expenses, and/or receives funding for the same expense more than one, repayments may be due from the provider to the State and/or other funders.

Industry Specific Awards & Questions

  1. What can I do to qualify as an Intellectual/Developmental Disabilities Provider?
    Applicants applying for funds via the Intellectual/Developmental Disabilities Health Care Industry must be a Division of Developmental Disabilities Services (DDDS) authorized Home and Community-Based Service Provider serving adults with intellectual/developmental disabilities in the State of Delaware.

    Providers who do not qualify under this category may be eligible for a subject area award.


  2. What can I do to qualify as a Home Health Agency?
    Applicants must be a Home Health Agency (HHA) licensed by the Delaware Division of Health Care Quality (DHCQ). Skilled home health agencies, home health agencies- aide only, and personal assistance service agencies are all eligible to apply for this funding. 

    Applicants must serve clients in Delaware and have been in operation as of February 1, 2020.

  3. What can I do to qualify as a Long Term Care Provider?
    Long Term Care (LTC) providers must be a nursing home or assisted living facility licensed by the Delaware Division of Health Care Quality (DHCQ).

    Applicants must serve clients in Delaware and have been in operation as of February 1, 2020.

  4. What can I do to qualify as a Behavioral Health or Substance Use Disorder provider?
    For the Health Care Relief Fund, a Behavioral Health/Substance Use Disorder (BH/SUD) provider was defined as an entity identified by Delaware’s Division of Substance Abuse and Mental Health (DSAMH) as rendering BH/SUD services to Delawareans as well as other BH/SUD provider entities who had Delaware Medicaid/CHIP claims (fee-for-service or managed care) incurred in the fourth quarter of calendar year 2019 based on common BH/SUD-related taxonomy codes applicable to the billing provider on the claim. State-operated vendors, non-BH/SUD providers, providers affiliated with hospitals or out-of-state entities were excluded.

    Applicants must serve clients in Delaware and have been in operation as of February 1, 2020
  5. What is the formula based on?
    Information about the formulas will be released as application information is made available. 

  6. Intellectual/Developmental Disabilities Formula:
    Intellectual/Developmental Disabilities Home and Community-Based Service Providers requesting funds for unexpected expenses directly related to the COVID-19 pandemic will be awarded up to 4% of the agency’s CY2019 Home and Community-Based claims from January 1, 2019 through December 31, 2019.

    Intellectual/Developmental Disabilities Home and Community Based Day Habilitation, Prevocational Services or Supported Employment Providers applying for funds due to a service interruption/business disruption due to suspending operations (all or in part) resulting in at least a 50% reduction in service delivery will be awarded funds using the approved Medicaid Retention payment formula.

  7. Home Health Agencies (HHA) Formula:
    The HHA industry distribution formula was based on the proportion of Medicaid/CHIP fee-for-service and managed care claim payments incurred in the fourth quarter of calendar year 2019 attributed to each provider. Inpatient hospital, I/DD or IMD related services were excluded. 

    Claims payments were arrayed by provider and each provider’s proportion of the total was computed. The percentage of total Medicaid/CHIP claims payments was then applied to the total HHA Relief Fund amount to create provider-specific relief fund payment amounts.

    For example, if HHA entity #123 had 2.50% of the Medicaid/CHIP claims payments, HHA entity #123 is eligible to receive up to 2.50% of the total HHA Relief Fund amount. Each provider listed can receive up to their respective amount.

    Eligible HHA providers who did not receive an industry award amount under this category may be eligible for a subject area award.

    To see what your HHA entity could be eligible for, check this list: Home Health Agency

  8. Long Term Care Providers Formula:
    The LTC industry distribution formula was based on a multi-step process. First, of the total LTC Relief Fund amount, 70%, was allocated to nursing facilities serving the Medicaid/CHIP program. The remaining 30% was allocated to all other providers. The 70% was distributed to each Nursing Facility (NF) based on estimated Medicaid/CHIP paid bed days (i.e., utilization) in the fourth quarter of calendar year 2019 incurred fee-for-service and managed care claims data. For example, if Medicaid/CHIP NF #1 had 3.50% of total Medicaid NF day utilization, Medicaid/CHIP NF #1 would be eligible to receive up to 3.50% of the 70% (less the amounts directed to two NFs with low/no utilization data). Each provider listed can receive up to their respective amount listed.

    The remaining 30% was distributed to each remaining Nursing Facility and Assisted Living provider based on the distribution of State licensed beds as provided by the Delaware Division of Health Care Quality as of October 21, 2020. For example, if Assisted Living provider #456 had 5.25% of the total of State licensed beds in this group, assisted living provider #456 would be eligible to receive up to 5.25% of the 30%. Each provider listed may receive up to their respective amount.

    Eligible LTC providers who did not receive an industry award amount under this category may be eligible for a subject area award.

    To see what your facility could be eligible for, check this list: Long Term Care Formula

    Providers that own more than one LTC entity may submit one application on behalf of all entities, provided that they list the names of the covered entities in their application.

  9. Behavioral Health/Substance Use Disorder Formula:
    The Behavioral Health/Substance Use Disorder (BH/SUD) industry distribution formula was primarily based on the proportion of total Medicaid/CHIP fee-for-service and managed care claim payments incurred in the fourth quarter of calendar year 2019 (4Q CY2019) combined with any direct vendor payments that DSAMH made for services incurred in the 4Q CY2019 attributed to each provider. Inpatient hospital, I/DD, non-BH/SUD or IMD related services were excluded.

    Due to a large volume of provider entities having low claims/vendor payments, any provider entity with claims/vendor payments less than $5,000.00 in total from the 4Q CY2019 was assigned an up to $2,500.00 relief fund amount. This resulted in $580,000.00 of the total BH/SUD $15,000,000.00 fund being initially allocated. The remaining $14,420,000.00 was then distributed to each remaining provider based on the proportion of total Medicaid/CHIP claims plus DSAMH vendor payments from the 4Q CY2019 for those providers.

     For example, if BH/SUD entity #012 had 2.50% of total claims/vendor payments, BH/SUD entity #012 was assigned 2.50% of $14,420,000.00. Each provider listed can receive up to their respective amount. Eligible BH/SUD providers who did not receive an industry award amount under this category may be eligible for a subject area award.

    To see what your facility could be eligible for, check this list: Behavioral Health Formula
  10. What are eligible expenditures for industry-based awards?
    Eligible expenses for the Health Care Relief Fund must comply with all terms of the application and Terms & Conditions set by DHSS. 

    In addition, the CARES Act requires that payments from the Coronavirus Relief Fund (CRF) only be used to cover costs that are necessary expenditures incurred due to the public health emergency with respect to COVID-19.  The expenditures must occur between March 1, 2020, and December 30, 2020, and cannot be in any budget approved as of March 27, 2020.

    Expenditures for health care organizations eligible for industry-based awards may cover a broad range of items and services that were purchased to prevent, prepare for, and respond to the coronavirus pandemic.  All expenditures must follow the federal guidance, and could include :
      • supplies used to provide health care services for possible or actual COVID-19 patients;
    • equipment used to provide health care services for possible or actual COVID-19 patients;
    • workforce training (i.e. infection control training) related to the COVID-19 pandemic;
    • developing and staffing emergency operation centers;
    • reporting COVID-19 test results to federal, state, or local governments;
    • building or constructing temporary structures to expand capacity for COVID-19 patient care or to provide health care services to non-COVID-19 patients in a separate area from where COVID-19 patients are being treated; and
    • acquiring additional resources, including facilities, equipment, supplies, health care practices, staffing, and technology to expand or preserve care delivery related to the COVID-19 pandemic.


  11. Can I use my industry-specific award to replace lost revenue?
    No. The Health Care Relief Fund is not a provider relief payment and cannot be used to replace lost revenue.  However, providers can use these awards to support efforts to maintain network adequacy and integrity that may be jeopardized due to COVID-19.

  12. What is a network adequacy and integrity?
    Network integrity may cover the following:
      • Expenditures related to the costs of business interruption caused by required closures related to the COVID-19 pandemic; AND
    • Expenditures necessary to ensure that capacity to provide services post-pandemic is preserved; AND
    • Services and items for which your organization did not already receive any State or Federal grant or relief funding for COVID-19 related expenses; AND
    • Meet all other requirements for Delaware’s Health Care Relief Fund for industry-specific grants
    Fixed and indirect costs (such as rent, utilities, etc.) not related to the direct cost of care may be eligible; however, grantees must be able to demonstrate that the impact of the business interruption on these cost (i.e. provide financial statements and proof of payment upon audit) and that the purchase occurred in the required time frame. 


  13. What kind of payroll expenses are eligible?
    Payroll is not an eligible expense for the Technology and Environmental Modifications subject matter groups. 

    For the industry-based groups, the following may be eligible:

      • New staff or overtime needed to respond to the COVID-19 pandemic; AND
    • Staff whose salaries & benefits were not included in the most recent budget prior to March 27, 2020; AND
    • Time & effort can be documented as related to the pandemic response; AND
    • The organization has retained payroll records.

    If the reimbursement is related to network adequacy, payroll may be eligible; however, those expenses must be documented in line with all requirements for network adequacy payments. 

Subject Area awards

  1. What is the Technology Fund?
    The goal of this fund is to help applicants better adapt to working digitally during the pandemic. Eligible expenses can include, but are not limited to: Wi-Fi hotspots, webcams, tablets, HIPAA-compliant web platforms, and software licenses. All expenses should meet program requirements and comply with the Department of the Treasury guidance and FAQ documents.

    To receive an award from this fund, applicants must fill out an application form, a signed certification form, a line-item budget, and a 12 month financial statement listing the applicant’s CY 2019 operating budget. Submission instructions will be included once the applications is available.


  2. What is the Environmental Modifications and Services Fund?
    This fund provides support for applicants to make modifications to their place of business to more safely serve their clients and patients. Eligible expenses can include, but are not limited to: PPE, testing costs for employees, HVAC upgrades, infrared thermometers to screen clients/staff, plexiglass barrier installation, outdoor visitation structures, and enhanced cleaning methods. All expenses should meet program requirements and comply with the Department of the Treasury guidance and FAQ documents.

    To receive an award from this fund, applicants must fill out an application form, a signed certification form, a line-item budget, and a 12 month financial statement listing the applicant’s CY 2019 operating budget. Submission instructions will be included once the applications is available.

  3. How can I find out if I am eligible for the Technology and/or Environmental Modification Funds?
    Applicants must be a health care organization or provider serving clients or patients in Delaware and have been in operation as of February 1, 2020. Eligible applicants must have an active license from the Division of Health Care Quality (DHCQ) or from the Division of Professional Regulation (DPR). A list of eligible DPR licenses can be found below. Applicants who have received funding from a Health Care Relief Fund industry-based program are ineligible to apply for any subject-based fund.

  4. What are the licensure categories that are eligible to apply for the Environmental or Technology Funds?
    Eligible industries are listed below.  Please be advised that awards will not be made to individuals; awards are granted to businesses or health care organizations. 

      •  Acupuncture
    • Acupuncture Detox
    • Art Therapy
    • Audiology
    • Chemical Dependency Professionals
    • Chiropractic
    • Counselors of Mental Health
    • Dental
    • Dieticians
    • Eastern Medicine Practitioner
    • Genetic Counselor
    • Marriage and Family Therapy
    • Massage and Bodywork
    • Medical Practice
    • Mental Health
    • Midwife (non-Nursing)
    • Nursing
    • Nutritionist
    • Occupational Therapy
    • Optometry
    • Paramedic
    • Pharmacy
    • Physical Therapy
    • Physician
    • Physician Assistant
    • Podiatry
    • Polysomnographer
    • Psychology
    • Respiratory Care
    • Social Workers
    • Speech Pathology


  5. I am an individual who owns my own health care business, am I eligible for an subject-matter award?
    If you are an individual who is licensed in one of the areas above AND owns your business, you may be eligible to apply.  You will need to provide your professional license number (from the Division of Professional Regulation) to prove that you a health care provider AND your Tax Identification Number (TIN) for documentation of your business.


  6. I’m a health care worker (paramedic, nurse, physician). Am I eligible to apply for relief? 
    Only health care organizations (non profits or businesses) are eligible to apply.  This is not a grant to individuals. 


  7. How much am I eligible to receive for the Technology and/or Environmental Modifications awards?
    Awards for the Technology and Environmental Modifications Subject-Based Awards will based on provider's operating budget as documented by the Calendar Year 2019 financial statement.

    Awards will be allocated as follows:  

      • Under $100,000 in operating expenses, maximum award of $10,000
    • $100,001- $500,000 in operating expenses, maximum award of $20,000
    • $500,001 - $1,000,000 in operating expenses, maximum award of $40,000
    • $1,000,000 - $5,000,000 in operating expenses, maximum award of $100,000
    • $5,000,001 or more in operating expenses, maximum award of $150,000


  8. What are the Resiliency Funds?
    The Community Resiliency Fund is intended to assist communities who have been disproportionately impacted by COVID-19. This fund will be administered in conjunction with Healthy Communities Delaware (HCDE) and include a review panel with members of community organizations from across the state. Please check back for more information as it is posted.

    Community Resiliency Fund applications and guidelines for eligibility are available here: https://dhss.delaware.gov/dms/caresact/crf.html

    The Health Trade Organization Resiliency Fund will assist health care industry trade and member organizations help their members pivot to adapt to providing services during the pandemic. Eligible expenses could include funds for strategic planning or trainings. This is not an exhaustive list, review the Department of the Treasury guidance and FAQ documents for specific requirements.

  9. What is the Health Trade Organization Relief Fund?
    The Health Trade Organization Relief Fund will assist health care industry trade and professional organizations help their members pivot to adapt to providing services during the pandemic. Eligible expenses could include funds for strategic planning or trainings. This is not an exhaustive list, review the Department of the Treasury guidance and FAQ documents for specific requirements.

    Applicants must be a health care trade or membership organization in Delaware and have been in operation as of February 1, 2020. Applicants who have received funding from a Health Care Relief Fund industry-based program are ineligible to apply for any subject-based fund.

Eligible Expenditures & Revenue

  1. Will I need to provide receipts and/or proof of purchase?
    Receipts and/or proof of purchase and/or proof of payment will not be a required part of the application. However these will be required documentation as part of a post-grant audit.  If recipients cannot provide documentation for their grant-related expenditures they will be required to repay the State. 


  2. What if I do not have the receipts from purchases earlier in the fiscal year?
    If your agency does not have sufficient documentation to support that this is a COVID-19 related expense, then do not use the grant funding for this expense.  If recipients cannot provide documentation for their grant-related expenditures they will be required to repay the State. 


  3. Can I apply for funds to pay down another state or federal loan program related to COVID-19?
    No.

Application Process & Questions

  1. When is my application due?
    Please refer to the DHSS Health Care Relief website for the most up to date information.  It can be accessed at  https://dhss.delaware.gov/dhss/dms/caresact


  2. What is required in the application?
    The application consistent of:
      1. An application with basic organizational information
    2. A certification agreeing to the Terms & Conditions of receiving Delaware CARES Act funds
    3. Line item budget of request for relief funds
    4. 12-month financial statement listing the applicant’s Calendar Year (CY) 2019 operating budget (subject area applicants only).


  3. What is a line item budget?
    A specific line item budget format is not required.  The state needs to be able to understand what the funding will be used for to ensure that it is in line with federal guidance, and allow for a reference upon audit at a later date.  The budget should fulfill that requirement.

    However, if you do not have a preferred format, one that can be used is available here: Sample Template

  4. Do I need to report federal assistance already received?
    Not at this time.  However, applicants shall not use these funds to pay for expenses where federal or state assistance has already been received. If expenses are found to have already been reimbursed by state or federal assistance, applicants may be required to repay the State. 


  5. What is the application submission timeline?
    Please refer to the DHSS Health Care Relief website for the most up to date information.  It can be accessed at  https://dhss.delaware.gov/dhss/dms/caresact


  6. Can I submit my application, attestation, and supporting documentation separately?
    No. Submit the information together in a single email to DHSS_CaresAct@Delaware.gov or your application will be marked as incomplete.  Incomplete applications will not receive funding.

  7. What is the FSF supplier ID? What if I don’t have one?
    An FSF supplier ID is the vendor number your organization has in order to initiate payment from First State Financials (FSF), the State’s accounting System.  All payments will be processed via FSF.

     If your organization does not have one, please register here.  You will need to register in order to receive payment if your application is approved.  Failure to do so may delay receipt of your award.  Additional information is available at the State of Delaware eSupplier Portal.  The eSupplier Portal is only for securely registering for a new supplier or updating an existing supplier record. 

    The Esupplier poral does not have payment information or status of any payments, grant applications, etc.  Please allow 4-5- weeks for review & processing of applications and awards.  If you have questions about the status of your award, please contact DHSS_CaresQuestions@delaware.gov

  8. I started the process to get an FSF supplier ID, but don’t have it yet. Can I still submit? 
    Yes!  Please continue along the process.  It is currently taking 7-10 days for a new registration to be approved because of all the internal steps necessary to ensure information is accurate. 

  9. How can I find out if I have an FSF supplier ID?
    You can all the FSF Supplier Maintenance team.  Typically organizations have identified individuals within their financial and/or accounting offices to work with the State.  The individual calling in will need to know the organization’s Tax ID number (Social Security Number or Employer Identification Number), Business Name and/or the “Doing Business As” name, and an address currently listed on the supplier record.  Information will only be released to those identified as a “responsible party” in State accounting records. 

    You may need to leave a voicemail due to high call volume.  If leaving a voicemail, clearly provide the name of the business and spell it. 

  10. What is the FSF supplier ID? What if I don’t have one?
    An FSF supplier ID is the vendor number your organization has in order to initiate payment from First State Financials (FSF), the State’s accounting System.  All payments will be processed via FSF.

    If your organization does not have one, please register here.  You will need to register in order to receive payment if your application is approved.  Failure to do so may delay receipt of your award.  Additional information is available at the State of Delaware eSupplier Portal.


  11. Are electronic signatures sufficient or does it need to be a “wet” signature?
    An electronic signature, via DocuSign or other technology, is appropriate.  Wet signatures will also be allowed, but all submissions must be electronic via email.

Awards & Funding

  1. When will I receive my award?
    Applications will be reviewed in the order in which they are received.  If the application is complete and eligible for funding, your organization will then receive an approval letter and additional terms & conditions.  Once you have received a letter, please allow for 10 business days for DHSS financial staff to process your payment in the First State Financials (FSF) accounting system.  You must be a registered vendor (supplier) in FSF to receive your award.

    We anticipate that this process will take 4-5 weeks from the date of application.


  2. Once approved, how will I receive my check?
    Grant awards will be processed in the First State Financials (FSF) accounting system. Please make sure you are signed up as a vendor/supplier in FSF (State of Delaware eSupplier Portal).


  3. What reporting must I submit to the State after I receive my award?
    More information on this topic will be forthcoming.  However, in order to be prepared, please prepare all documentation in line with the Terms & Conditions. 


  4. What are the terms & conditions of this award?
    Any expenses used for this funding must be in compliance with the U.S. Department of the Treasury’s FAQs and guidance.  In addition, applications must be submitted with an attestation to be considered complete.


  5. Is this award taxable?
    Yes.

 



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