The FY 22 budget includes a total of $75 million in American Rescue Plan Act (ARPA) funding for long term care providers. Uses are outlined in corresponding language in the FY 22 Budget Implementation Act (BIMP; see 305 ILCS 5/5-5.7a(7) and (8)). There are specific pass-through percentages for July, August, and September 2021 to be paid to frontline workers as follows: 50% for July, 62.5% for August, and 75% for September 2021. The remaining funding can be used for additional COVID-related purposes, as described.
This new funding for the financial support of workers in long term care facilities comes amidst an enduring threat to nursing facility residents and staff from the COVID pandemic, as the Federal government makes plans to implement a COVID vaccination requirement for nursing facility staff, the Governor issued a vaccine mandate for all workers in Illinois health care facilities yesterday, and as nursing shortages remain a concern in Illinois and across the country.
The following outlines the formula and accompanying guidelines with which ARPA funds will be distributed to skilled nursing facilities actively serving the Medicaid program as prescribed by the Illinois General Assembly.
- HFS has established a rate to distribute the $75 million using the latest available staffing data for total nurse hours across the state.
- Each facility’s share of the $75 million distribution reflects its estimated share of total nursing hours for the most recently available quarter.
- Staffing levels were based on nursing hours from the federal Payroll Based Journal for 4Q2020, where available.
- Each facility will receive $4.43 per hour of nursing, at previously-observed nurse staffing levels, for each of the three months included in the $75 million distribution.
- Nursing facilities are required to spend the monthly percentage of pass-through to front line workers on the following pandemic-related uses:
- Vaccine bonus(es) paid March 3, 2021 or later
- Pandemic bonus pay to employees on or after July 1, 2021 (hazard, hero, premium pay and premium wages, or other temporary wage increases)
- Temporary benefits such as day care, etc. provided July 1, 2021 or later
- Signing bonuses for new hires paid out March 3, 2021 or later
- Nursing facilities may spend the remainder of their distributions on either the above uses or on other financial support for their workers provided on or after March 3, 2021, or other purposes permitted by paragraphs (7) and (8) of 305 ILCS 5/5-5.7a which includes purposes permitted by Section 9901 of the American Rescue Plan Act of 2021 including but not limited to:
- Payment of education expenses to enhance direct care staff recruitment
- Enhanced and expanded training for nursing facility staff to better achieve patient outcomes, such as training on infection control, proper personal protective equipment, best practices in quality of care, and culturally competent patient communications
- Additional forms of pandemic-related financial support for the nursing facility workforce (to be specified by the provider)
- Costs incurred due to the COVID-19 Public Health Emergency
- Unreimbursed costs for testing and treatment of COVID-19
- Costs of COVID-19 mitigation and prevention
- Medical expenses related to aftercare or extended care for COVID-19 patients with longer term symptoms and effects
- Each nursing facility will be required to complete a simple budget form reflecting its plan to utilize the awarded funds.
- All facility budgets will be posted on the HFS website.
- The total amounts of ARPA funds received by nursing facilities will be posted on the HFS website.
- The July distribution will be required to be spent by September 30, 2021. The August and September distributions must be spent by November 30, 2021.
- Payments for July and August will be distributed upon receipt of the signed subaward agreement.
- Payments for September will be released upon receipt of the budget template.
- Signed subaward agreements and budget templates must be submitted by September 30, 2021 or funding may be reallocated to other providers.
HFS will be sending out specific instructions for accessing the subaward agreements and budget templates to individual providers starting early next week. The emails will be sent to provider contacts from the CARES Act funding.