President Signs Largest Stimulus Package in History
The President has signed the Coronavirus Aid, Relief, and Economic Security Act (CARES), a $2.2 trillion bill largely focused on economic stimulus related to the COVID-19 outbreak. The bill also includes more than $180 billion in new spending to support the healthcare sector and communities addressing the coronavirus epidemic. Below is a summary of the provisions of the law most relevant to state I/DD agencies, individuals with I/DD, I/DD provider agencies, and individual service providers.
Coronavirus Relief Fund
The centerpiece of the non-stimulus aid is the $150 billion Coronavirus Relief Fund, which state, tribal, and local governments can use this year to meet costs connected to the virus. According to estimates from the Center for Budget and Policy Priorities (CBPP), each state will receive at least $1.25 billion, while the most populous states (California and Texas) will receive over $10 billion each. A portion of each state’s allocation will go to local governments with populations over 500,000, in states where such exist. CBPP estimates that state governments will receive about $110 billion of the total allocation, or 79 percent of the total that is not set aside for tribes, the District of Columbia, Puerto Rico and other territories. Local governments will receive the other 21 percent of the funds — about $29 billion.
Isaiah Baker and Margie Harris-Austin Act
This provision, originally a standalone bill, allows people receiving home and community based services (HCBS) under 1915c waivers to have their direct support professional assist them during a short-term hospital stay, and expands the services DSPs can provide in hospitals under 1915 (k), under the following conditions:
- The hospital is identified in the individual’s person-centered service plan,
- The services are not a substitute for services the hospital is otherwise obligated to provide under Federal or state law,
- The services are designed to ensure smooth transitions between acute care settings and home and community-based settings, or to preserve the individual’s functional abilities.
States will need to amend their waivers to start providing these services.
Money Follows the Person
Money Follows the Person has been funded through November.
Administration for Community Living
The Administration for Community Living received $995 million related to pandemic response, including $85 million to support Centers for Independent Living.
Individuals with Intellectual and Developmental Disabilities
One of the best known provisions of CARES involves sending stimulus checks directly to many Americans.
- $1,200 for individuals and $2,400 for married couples who filed jointly.
- There is a $500 supplemental payment per child.
- People whose adjusted gross income was less than $75,000 for a single individual or $150,000 for married filing jointly are eligible for the full payment.
- The payment is gradually reduced for incomes above those levels, tapering off altogether at $99,000 for individuals and $198,000 for couples.
These checks come with special considerations for people with disabilities who rely on SSI, SSDI, Medicaid, and other programs with income or asset limits. Because the payments are provided as tax rebates (even for individuals who paid no taxes in 2018 or 2019), these individuals will be able to receive stimulus checks without jeopardizing their eligibility for such programs. Like other tax rebates, the recovery rebates “shall not be taken into account as resources for a period of 12 months from receipt, for purposes of determining the eligibility of such individual (or any other individual) for benefits or assistance (or the amount or extent of benefits or assistance) under any Federal program or under any State or local program financed in whole or in part with Federal funds” (26 U.S. Code § 6409).” This means that the checks will not be counted as income, and will not be counted as assets for the first twelve months after receipt.
However, because the payments will be issued by the Internal Revenue Service (IRS), like a tax refund, a person must file (or have filed) a tax return in 2018 or in 2019, and the payment will be made automatically to the bank account or address that the IRS has on file. This means that many individuals with I/DD will need to file a tax return even though they are paying no taxes. For many, this may require additional support.
The bill includes significant funding for Housing and Urban Development (HUD) programs that individuals with I/DD and their families may rely on for housing security or support. These funds generally address the needs of sheltered and unsheltered people experiencing homelessness, including those who have been infected; provide funds for existing housing programs for any additional COVID-19 related needs/costs and to make-up for funds lost dues to tenant changes in income; and protect some homeowners from immediate foreclosure and tenants from immediate eviction. According to the Consortium for Citizens with Disabilities (CCD) Housing Task Force, the specific allocations include:
- $4 billion for Emergency Solutions Grants (ESG) for homelessness assistance
- The local match requirement on ESG is waived and that the funds can be used for motel vouchers for homeless individuals that need to self-isolate or quarantine.
- $5 billion in Community Development Block Grants
- Public service caps are waived for FY19 and FY20 monies and new funding
- The Coronavirus Relief Fund can cover many of the same uses as CDBG
- $1.25 billion for the Housing Choice Voucher program
- $850 million for both administrative expenses and other expenses of public housing agencies for their section 8 programs, including Mainstream vouchers
- $400 million for adjustments in the calendar year 2020 section 8 renewal funding allocations, including Mainstream vouchers, for public housing agencies that experience a significant increase in voucher per-unit costs due to extraordinary circumstances or that, despite taking reasonable cost savings measures, as determined by the Secretary, would otherwise be required to terminate rental assistance for families as a result of insufficient funding
- $1 billion for Project-Based Rental Assistance
- $15 million for Section 811 Housing for Persons with Disabilities
- A broad moratorium on eviction for tenants with subsidized rent (including the Low-Income Housing Tax Credit).
- Time-limited foreclosure protection for homeowners with federally-backed mortgages as long as they commit to not evicting tenants.
Small Business Interruption Loans
Employers with 500 or fewer employees are eligible to receive a loan to cover costs incurred by the employer between February 15 and June 30. Self-employed individuals are also eligible to receive a loan. Medicaid providers who support people with disabilities will be able to access these small business loans and can apply for a limited pool of new Medicaid funding to respond to the pandemic.
Payroll Tax Credit
CARES provides a refundable payroll tax credit for 50% of wages paid by employers to employees during the COVID-19 crisis. The credit is available to employers whose operations were fully or partially suspended due to a COVID-19-related shut-down order, or whose gross receipts declined by more than 50% when compared to the same quarter in the prior year.
- For employers with more than 100 full-time employees, qualified wages are wages paid to employees when they are not providing services due to the COVID-19-related circumstances.
- For employers with 100 or fewer full-time employees, all employee wages qualify for the credit, whether the employer is open for business or subject to a shut-down order.
- The credit is provided for the first $10,000 of compensation, including health benefits, paid to an eligible employee and is provided for wages paid or incurred from March 13, 2020 through December 31, 2020.
CARES provides additional funding and flexibilities for IT and telehealth that may be accessible to state agencies or I/DD providers. The legislation:
- Reauthorizes the Health Resources and Services Administration’s (HRSA’s) Telehealth Resource Centers grant program at $29/m year for fiscal years 2021-2025. Telehealth Resource Centers (TRCs) assist health care organizations, health care networks, and health care providers in the implementation of cost-effective telehealth programs to serve rural and medically underserved areas and populations.
- Requires the Secretary of HHS to issue HIPAA-related guidance within 180 days on the sharing of patient health information during the public health emergency
- Provides $200 million for the Federal Communications Commission (FCC) to support the efforts of health care providers by providing telecommunications services, information services, and devices necessary to enable the provision of telehealth services during the COVID-19 emergency period
- Provides $27 billion for the Public Health and Social Services Emergency Fund, for activities including telehealth access and infrastructure
- Provides $180 million for Health Resources and Services Administration (HRSA) to carry out telehealth and rural health activities
The Public Health Service received an additional $1.3 billion dollars to expand funding of Health Centers. While there has been some discussion of whether I/DD providers might be able to access this money, this funding stream is generally focused on entities that provide primary health services or additional health services necessary for the adequate support of primary health services, to a population that is medically underserved. While additional health services can include the types of behavioral and mental health services provided by some providers who are part of the I/DD service system, the funding stream CARES expands, found in Section 330 of the Public Health Service Act, is generally intended for rural hospitals and Federally Qualified Health Centers like Community/Migrant Health Centers (C/MHC), Community Health Centers (CHC), and 330 Funded Clinics.
Individual Service Providers
CARES expands currently existing unemployment benefits through federal emergency funding:
- There will be an extra $600 per week in benefits through July 31, 2020.
- There will be funding to eliminate the traditional waiting period.
- 13 extra weeks of benefits will be added on to the existing number of weeks of benefits.
- $100 million of funding to states to support “short-term compensation” programs, where employers reduce workers’ hours instead of laying off workers and those workers whose hours are reduced and are eligible to receive a pro-rated unemployment benefit. This funding is available through December 31, 2020.
CARES also creates a new Pandemic Unemployment Assistance program (through December 31, 2020) to help those not traditionally eligible for Unemployment Insurance (UI), including self-employed individuals, independent contractors, those with limited work history and those who are unable to work as a result of the coronavirus public health emergency. The benefit pays 50% of the unemployment insurance costs incurred by state, local and tribal governments and non-profit organizations, not part of the UI system.
Paid Family Leave
CARES allows an employee who was laid off by an employer March 1, 2020, or later to have access to paid family and medical leave in certain instances if they are rehired by the employer. The employee would have had to work for the employer at least 30 days prior to being laid off.
FMI: To read the legislation, go to https://www.congress.gov/bill/116th-congress/house-bill/748/text#toc-HC046FE005624457B9FFAD21FDD55C5E4. CBPP estimates of Coronavirus Relief Fund distribution by state: https://www.cbpp.org/research/state-budget-and-tax/how-will-states-and-localities-divide-the-fiscal-relief-in-the