Economic Relief Bills in Response to the COVID-19 Crisis: Updated links and FAQ’s:

H.R. 6074: Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 — (March 4, 2020). Provided $8.3 billion in emergency funding for federal agencies to respond to the coronavirus outbreak related to developing a vaccine, medical supplies, grants for public health agencies, small business loans, and assistance for health systems in other countries. Allowed for temporarily waiving Medicare restrictions and requirements regarding telehealth services.

H.R. 6201: Families First Coronavirus Response Act (FFCRA) — Paid leave provisions are now in effect as of April 1, 2020, and apply to leave taken between April 1, 2020, and December 31, 2020.  Please review the following:

• Department of Labor’s (DOL’s) Q&A to learn important definitions, what it means for your community organization as an employer, and what it means for you as an individual should you need to take leave.
• Guidance Explaining Paid Sick Leave and Expanded Family and Medical Leave for information to employees and employers about how each will be able to take advantage of the protections and relief offered by the FFCRA.  Review the Fact Sheet for Employees, a Fact Sheet for Employers, and a Questions and Answers documents to better understand what benefits are available under this law.

H.R.748: (CARES) Coronavirus Aid, Relief, and Economic Security Act – (March 27, 2020).  Includes direct payments to Americans, an aggressive expansion of unemployment insurance, billions of dollars in aid to large and small businesses, and a new wave of significant funding for the health care industry. Review Coronavirus (COVID-19): Small Business Guidance & Loan Resources and the Also see: FAQ Regarding Participation of Faith-Based Organizations in PPP and EIDL

• Paycheck Protection Program (PPP): An U.S. Small Business Administration (SBA) loan that helps businesses (including non-profits) keep their workforce employed during the Coronavirus (COVID-19) crisis.
• Economic Injury Disaster Loan (EIDL) Emergency Advance: Loan advance providing up to $10,000 of economic relief to businesses that are currently experiencing temporary difficulties. These funds are available to faith communities.
• SBA Express Bridge Loans: Enables small businesses which currently have a business relationship with a SBA Express Lender to access up to $25,000 quickly.
• SBA Debt Relief: The SBA is providing a financial reprieve to small businesses during the COVID-19 pandemic.

Visit www.sba.gov for a list of SBA lenders. There is a funding cap, so the Treasury Department recommends applying as soon as possible.

Additional Resources:

FAQ Regarding Participation of Faith-Based Organizations in PPP and EIDL

Last week the SBA released this FAQ regarding the participation of Faith-based Organizations in the Paycheck Protection Program (PPP) and the Economic Injury Disaster Loan Program (EIDL).

Interim Final Rule Business Loan Program Temporary Changes; Paycheck Protection Program

The SBA also issued an interim final rule regarding the Paycheck Protection Program  under the CARES act.  Faith-based organizations should review page 6, #2 to better understand how they may participate in the program while maintaining their right to exercise their faith according to their tradition’s polity.

Coronavirus Emergency Loans Guide and Checklist for Small Businesses and Nonprofits

The U.S. Chamber of Commerce Foundation’s Coronavirus Emergency Loans Guide and Checklist for Small Businesses and Nonprofits — Starting April 3, small businesses and sole proprietorships can apply for loans through existing SBA lenders. Starting April 10, independent contractors and self-employed individuals can apply for loans through existing SBA lenders. Other regulated lenders will be available to make these loans as soon as they are approved and enrolled in the program.

Accessing Care at Community Health Centers

Federally Qualified Health Centers (FQHCs) may be a viable option for someone in your community seeking medical attention. Health centers are an important component of the national response to the COVID-19 pandemic. Your local Community Health Center can assess whether a patient needs further testing, which may be done over the phone or using telehealth. Individuals may also receive primary health care services at their local health center at a reduced cost or free of charge depending on their economic status.

Call your nearest health center or health department to discover their availability for COVID-19 screening and testing. Find a Health Center near your community!

CMS Approves Additional State Medicaid Waivers and Amendments to Give States Flexibility to Address Coronavirus Pandemic

CMS approved its 44th state Medicaid waiver delivering urgent regulatory relief to ensure States can quickly and effectively care for their most vulnerable citizens. In light of the urgent and evolving needs of states during the COVID-19 crisis, CMS developed a toolkit to facilitate expedited application and approval of State waiver requests.  More on Section 1135 Waivers and 1915(c) Appendix K Waivers.

How to Help:

FEMA’s Coronavirus Response: How to Help

Everyone has a role to play in the fight against COVID-19 and care of our fellow Americans. Learn how to help if you are a company with medical supplies to donate or sell, a volunteer who is medically trained, or a member of the general public.

You may also want to check with the Local Emergency Management Response Effort in your state.

The Partnership Center is aware of several virtual platforms currently available to harness and connect volunteers to the needs in their immediate community including Aunt Bertha, the Be a Neighbor Campaign through VOMO, CarePortal, and the Nextdoor platform. Also look to your local safety net organizations — such as The Salvation Army, Catholic Charities, or United Way serving your community — for how you may be able to assist with identified needs.

SAMHSA’s Virtual Recovery Support Resources  

In an infectious disease outbreak, when social distancing and self-quarantine are needed to limit and control the spread of the disease, continued social connectedness to maintain recovery is critically important.  This tip sheet describes resources that can be used to virtually support recovery from mental/substance use disorders. It also provides resources to help local recovery programs create virtual meetings.

Please also consider sharing mobile apps that nurture and sustain virtual recovery communities such as Sober Grid, rTribe, Connections, WEconnect, and Nomo for those supporting persons in recovery.  Many of them are free and offer peer coaching support (usually with a fee).

Stroudwater Associates, a rural health care consulting firm based in Portland, ME has created a set of resources for rural hospitals to access support from the CARES Act of 2020.  This resource on the most relevant sources of assistance available to hospitals and health systems as a result of the COVID-19 pandemic, includes Medicare accelerated payments, the Small Business Administration Payroll Protection Program, and other traditional cash management strategies.

Please click here to access the resources.

CMS recently updated recommendations to postpone non-essential surgeries and other procedures to conserve critical healthcare resources and limit exposure of patients and staff to COVID-19. Developed in collaboration with medical societies and associations, the recommendations outline a tiered approach for state and local officials, clinicians, and delivery systems to consider to prioritize services and care to those who require emergent or urgent attention to save a life, manage severe disease, or avoid further harms from an underlying condition.

Recommendations

CMS posted a letter to clinicians that outlines a summary of actions CMS has taken to ensure clinicians have maximum flexibility to reduce unnecessary barriers to providing patient care during the unprecedented outbreak of COVID-19. The summary includes information about telehealth and virtual visits, accelerated and advanced payments, and recent waiver information.

Letter

• The CARES Act included Medicare telehealth flexibility for FQHCs and RHCs for the duration of the crisis. It authorizes Medicare reimbursement for health centers and rural health clinics as distant sites for the duration of the emergency, not reimbursed at PPS rate but instead “such payment methods shall be based on payment rates that are similar to the national average payment rates for comparable telehealth services under the physician fee schedule under section 1848.”
• Since 2019, FQHCs could bill Medicare for virtual communication services (aka phone calls) using code GOO71. (This is in lieu of the codes 99441, 99442, and 99443, which only those providers who bill under the fee schedule can use.) The payment is around $14, and FQHCs cannot bill for it if the patient had a related evaluation/management service within the previous 7 days or has an on-site appointment within the next 24 hours. These services must be initiated by a patient and as long as the provider responding to the call is an employee or contractor of the health center, he or she does not have to be physically located at the health center while delivering these services. CMS also has an FAQ document on virtual communication.

On March 30 the Centers for Medicare & Medicaid Services (CMS) issued an array of new rules and waivers of federal requirements offering maximum flexibility to respond to the COVID-19 pandemic including a section entitled “Further Promote Telehealth in Medicare.” There is a provider-specific fact sheet on new waivers and flexibilities for FQHCs and RHCs but it does not address telehealth.

The Small Business Administration (SBA) released the loan application for the Paycheck Protection Program and an information sheet containing loan guidelines. Some highlights of the guidelines:

• April 3, 2020: Loan applications will start being accepted for businesses and sole proprietors
• April 10, 2020: Loan applications will start being accepted for independent contractors and self-employed individuals
• More lenders will be added as they are approved/enrolled. To apply, you should reach out to one of the approved lenders
• There are no changes to affiliation standards from those specified in the CARES Act. However, additional guidance may be released by SBA as appropriate
• All loan terms will be the same for everyone
• Due to anticipated high demand, SBA anticipates allowing not more than 25% of the forgiven loan amount to be used for nonpayroll costs (utilities, rent and interest on a mortgage)
• Interest Rate: 1% fixed rate, lowered from 4%
• Maturity: 2 years, shortened from 10 years