ARPA: Adult Day Health Center and AIDS Adult Day Health Center State Plan Amendment Fund Opportunity

  • Presentation is also available in Portable Document Format (PDF)

Informational Webinar Presented by NYSDOH OALTC

January 2024

ARPA Team Presenters

Karen Meier, Director, Division of LTC Policy
NYS DOH Office of Aging and Long-Term Care

Jennifer Alhart, Long-Term Care Specialist
NYS DOH Office of Aging and Long-Term Care

Sarah Erickson, Project Manager
NYS DOH Office of Aging and Long-Term Care

Webinar Info

Attendees:

  • This webinar is intended for Adult Day Health Centers and AIDS Adult Day Health Centers, potentially eligible for the American Rescue Plan Act funding through the State Plan Amendment, to the extent the funding is approved by the Centers for Medicare and Medicaid Services (CMS).

Agenda

  • ARPA 9817 - Eligibility, Responsibilities,
    Funding, Requirements
  • Address pre-submitted questions

ARPA 9817 - Eligibility, Responsibilities, Funding, Requirements

Key Partners

CMS
  • ADHC SPA Approval

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NYSDOH
  • APRA Fund Distribution

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Eligible ADHCs
  • ARPA Fund Recipients

This process and funding will follow the approved State Plan Amendment (SPA) 23-0020.
New York State received approval from CMS for the SPA on June 21, 2023.

State Responsibilities

  • State determines site payments based on spot capacity at the time of release of funding and eligibility requirements.
  • State oversees the site attestation and reporting processes.
  • State communicates payments to Sites.
  • State coordinates payment process, including any coordination with CMS, prior to making payments.

Payment Methodology and Example

New York State will distribute these funds based on the spot capacity at each program through a one-time lump sum payment in early 2024. The total funds available, will be distributed proportionally by spot capacity.

ADHC Site Spot Capacity Percent of total Spots Fund Amount
Site 1 5 16.67% $1,000,000.00
Site 2 15 50.00% $3,000,000.00
Site 3 10 33.33% $2,000,000.00
Total 30 100% $6,000,000.00

SPA Funding Process

Sites receive funds

Sites will respond through surveys and/or documentation upload quarterly to evaluate funding impact and spend down

Eligible Sites

  • ADHC sites must
    • Be open,
    • Hold a valid operating certificate,
    • Have submitted HCBS policies and procedures to NYSDOH for review or confirm their compliance to the HCBS Settings Rule as stated in the HCBS Final Rule Statewide Transition Plan, and
    • Be compliant to programmatic regulations, including but not limited to 10 NYCRR Part 425 and Part 759 for AADHCs.
  • Open sites are those with the appropriate staff and are open and actively providing services.
    • In accordance with the SPA 23-0020, the program must have been open by August 1, 2023, and must also be actively providing services in order to be eligible for this fund opportunity.
  • Sites must also submit an attestation of their intended use of funds and confirm funding will not be used for capital investments.

Ineligible Sites

  • Sites which do not have staff per 10 NYCRR Part 425 - Adult Day Health Care and are not providing Adult Day Health Services under the Medical Model.
  • Sites which do not provide HCBS through the medical model of Adult Day Care Services.
  • Sites that were not open and providing services by August 1, 2023.
    • This requirement was determined in coordination with Centers for Medicare and Medicaid Services (CMS).
  • Sites which fail to confirm that funds will not be used for capital investments
    • Site may not use funds to buy or pay for physical improvements such as transportation vans, medical or office equipment, etc.
  • Any false claims or non-approved use of funds are strictly prohibited and will result in becoming disqualified for any further funds under this program and may result in civil or criminal fines and/or prosecution under applicable federal and state laws.

Provider Investment Categories

  • Awards must be used and spent for at least one of the following areas:

Workforce choices

  • Workforce retention strategies.
  • Development, implementation, and promotion of training programs for staff.
  • Recruit and retain a racially and ethnically diverse and culturally competent workforce.

Service Support

  • Supplement Community Integration activities.
  • Transportation subsidy fund which may not supplant Medicaid funded transportation.

Emergency Preparedness

  • Build appropriate personal protective equipment (PPE) stockpiles from state- authorized sources for ensuring that staff can deliver care in a safe and effective manner during public health emergencies.

Budgeting Considerations

  • Sites may use their awards to fund recruitment, retention, and training for medical and support staff that provide services at the ADHC program.
    • Funding cannot be used to pay for current wage levels for any employees or salary increases for administrative staff, managers, and executive staff.
  • Funding cannot be used to supplant current or already planned expenses.
  • Sites that fail to expend funds, or expend funds on non-approved uses, will be ineligible for future awards and/or subject to recoupment of their award.

Site Responsibilities

  • Attestation
  • Spending Plan
  • Surveys

Site Attestation

  • In order to qualify for funding, sites must complete an attestation confirming that the funding is being used for approved expenses.
  • Sites that do not complete the attestation by the due date will not be eligible for funding.
  • The attestation also collects site and member information which will be used to determine eligibility.

Spending Plan

  • NYSDOH will provide a template for sites to use to document their spending plan.
  • The template includes examples of how to complete each section.
  • The spending plan is used to describe, and document planned fund use.
  • This file should be submitted with the attestation, by the due date, in order to qualify for funding.

Survey and Documentation

  • The initial survey will be due 5 business days after the submission of the attestation and spending plan.
  • Surveys and documentation on spending must be completed and submitted quarterly from January 2024 through March 2025.
  • Follow-up surveys and the documentation on spending will provide data to measure the impact of investments.
  • Sites must complete these activities quarterly to retain their awards and maintain eligibility for future HCBS enhanced FMAP funding opportunities.
  • More information regarding the quarterly reports will be provided following the release of provider awards.

ADHC/AADHC Timeline

FAQs

Spending

  • Q: What if the costs of a planned fund use exceed or will be funded by non- ARPA funds?
  • A: The spending for planned fund use only needs to be described for the specific areas which will be supported by ARPA funds. The ADHC/AADHC does not need to provided the entire spending plan for non-ARPA funds.

    • Spending - Allowable Expenses

    • Q: Can funds be used toward existing programs that fit the categories or do all funds need to go to new programs?
    • A: Funding cannot be used to cover existing expenses or legal requirements, even if they fall into the allowable categories. Funding must be spent on new or augmented programs, services, and/or purchases.

    • Q: Can agencies use this funding to hire consultants to help implement new programs and strategies?
    • A: Funding can be used to pay for consultant fees as long as the scope of work being covered is strictly focused on one of the approved investment areas.

    • Q: Can agencies use this funding to pay for capital expenses that further one of the approved investment areas?
    • A: Capital expenses are not allowable uses of this funding.

    Budget and Spending Narrative

    • Q: Does DOH have a preference for awardee spending?
    • A: DOH shared guidance with potentially eligible ADHCs that provides descriptions of each spending category as well as investment examples. ADHCs have flexibility to spend their awards in ways that are most appropriate for their agencies while staying within the bounds of the spending categories DOH has identified.

    • Q: Is the approximate award amount listed in the award letter the exact amount that will be awarded or will the amount change? Is the budget that agencies submit final?
    • A: The award amount provided in the letter is approximate. Please use this amount as the basis for your budget. The range is currently between 35K to 479K depending on your site's capacity.

    • Q: How detailed does the spending plan narrative need to be?
    • A: The narrative should provide a comprehensive overview of your spending plan but does not need to include specific details such as vendor names. Narratives should be as accurate as possible.

    Survey

    • Q: Will all ADHCs complete the survey?
    • A: Only eligible ADHCs will complete the survey.

    • Q: How many hours are considered full-time?
    • A: The number of hours that qualify an employee as full-time is determined by individual employers.

    • Q: Is this survey related to any other data collection DOH currently requires?
    • A: This survey is in addition to other data collection DOH will require. The survey specific to ADHCs will be required at the time of attesting and again in March of 2025. Documentation of spending will be required quarterly. A bi-annual survey will also be requested by DOH independently for all ARPA recipients.

    Thank You!

    • Reminders:
      • Please email any questions or comments regarding the State Plan Amendment process or policies to ADHC_ARPA@health.ny.gov.
      • Please remember that successful submission of the attestation and survey does not guarantee funding.