COVID-19: CARES Act Provider Payments

The second round of applications for the state's CARES Act Provider Payments (CAPP) Program is now closed. Under this program, specific health care provider types applied for funds to offset COVID-19-specific losses and expenses they incurred during June, July, and August 2020. The funds for these payments were provided to the state under the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act.

     

    Update: The Wisconsin CAPP portal was taken down on Friday, December 11, 2020.  Specific questions about individual applications should be directed to the DHS CAPP team.

    The CAPP review team has completed all reviews at this time and checks are in process for those applicants that were found eligible for payment. This is a busy time of year for our delivery personnel, so please allow until January 4, 2021 for your check to arrive.

    If your Round 2 application status was “Pending Approval,” your payment is in the process of being determined. You will receive an email notification noting your application has been “Approved” when the payment has been processed.

    If your Round 2 application status was “Audit Review Complete,” your status will update to either “Approved” or “Denied” when payments are processed.

    • If “Approved,” you will receive an email noting that status and should expect a payment as described above.
    • If “Denied,” you will receive an email notifying you of that decision. This means your request was found to be not eligible for CAPP funding. You likely discussed this outcome during the audit review process with a member of our team, but you may also have been denied because the audit review team did not receive a response needed to resolve audit issues by the given deadlines.

    Information About the Second Round of Applications

    What time period was covered by the second round?

    • Providers who received funding in the first round were able to identify additional COVID-19-related expenses and lost revenue incurred in the months of June, July, and August 2020 and receive additional funding. Figures for March, April, and May expenses and lost revenue from the original application will be used in the round two calculation to account for the change regarding federal CARES Act payments. Providers cannot change information for March, April, or May.
    • Providers who were denied in the first round were able to apply for COVID-19-related losses and costs for June, July, and August. Figures for March, April, and May expenses and lost revenue from the original application will be used in the round two calculation to account for the change regarding federal CARES Act payments. Providers cannot change information for March, April, or May.
    • Providers who had not previously submitted an application were able to apply and include COVID-19-related revenue losses and costs for March, April, May, June, July, and August 2020.

    What providers were eligible to apply?

    The same provider types eligible for the first round were eligible in the second round. Some additional services offered by providers were added (in bold, below) for the second round.

    The providers eligible for round two CARES Act Provider Payments were: 

    • Home and community-based service providers who deliver the following services: 
      • Day services 
      • Home health
      • Personal care
      • Pre-vocational and supported employment
      • Respite care
      • Supportive home care
      • Daily living skills training for adults and children
      • Counseling and therapeutic
      • Consumer education and training

    For more information on each of these services and which providers qualify, see the next question, Which home and community-based service providers are eligible to apply?

    • Assisted living facilities, including:
      • Adult family homes
      • Community-based resident facilities (CBRFs) providing long term care services
      • Resident care apartment complexes (RCACs)
    • Nursing homes, including:
      • Skilled nursing facilities
      • Intermediate care facilities
    • Emergency medical service agencies
    • Clinics and health centers, including:
      • Rural health clinics
      • Federally qualified health centers
      • Tribal health clinics
      • Free and low-cost clinics
    • Emergency physician practices

    Which home and community-based service providers were eligible to apply?

    To help home and community-based service providers better understand which service categories are eligible for CARES Act provider payments, DHS has provided definitions for each eligible category.

    Supported employment is ongoing support provided to individuals with disabilities who, because of their disabilities, need assistance to obtain and maintain competitive, customized, or self-employment in an integrated work setting in the general workforce. Supported employment services may include any combination of the following activities:

    • Vocational and job-related discovery or assessment
    • Person-centered employment planning
    • Job placement
    • Job development
    • Meeting with prospective employers
    • Job analysis
    • Training and systematic instruction
    • Job coaching
    • Work incentive benefits analysis and counseling
    • Training and work planning
    • Transportation
    • Career advancement services
    • Other workplace support services that are specifically related to job skill training that enable the individual to be successful in integrating into the job setting.

    Supported employment services do not include supervision, training, support, or adaptations that are typically available to workers without disabilities who fill similar positions in the business.

    Prevocational services help create a path to integrated community-based employment for individuals with disabilities. This employment includes compensation at or above the minimum wage and cannot be less than the customary wage and level of benefits paid by the employer for the same or similar work performed by individuals without disabilities.

    Prevocational services allow individuals with disabilities to develop general, non-job-task-specific strengths and skills that help them access paid employment in integrated, community settings.

    Services intend to develop general skills that lead to employment, including the ability to:

    • Communicate effectively and establish appropriate boundaries with supervisors, coworkers, and customers.
    • Express and understand expectations.
    • Engage in generally accepted community workplace conduct and adopt appropriate workplace dress.
    • Follow directions.
    • Attend to tasks.
    • Workplace problem solve.
    • Manage conflicts.
    • Adhere to general workplace safety.

    Supportive home care is the provision of services to directly assist individuals with disabilities or frail elders with daily living activities and personal needs and to assure adequate functioning and safety in their home and community.

    Services include assistance with or supervision of activities of daily living, such as the following:

    • Dressing and undressing
    • Bathing
    • Feeding
    • Managing medications and treatments that are normally self-administered
    • Toileting
    • Assistance with ambulation (including the use of a walker, cane, etc.)
    • Carrying out professional therapeutic treatment plans
    • Grooming, such as care of hair, teeth, or dentures or instrument activities of daily living
    • Routine housekeeping and cleaning activities performed for an individual, consisting of tasks that take place on a daily, weekly, or other regular basis. These tasks may include washing dishes, doing laundry, dusting, vacuuming, cooking, shopping, and similar activities that do not involve hands-on care of the individual.

    Personal care services are medically-oriented activities that assist an individual with disabilities or frail elder with activities of daily living necessary to keep the individual in their place of residence in the community.

    Assistance with activities of daily living include the following tasks:

    • Assistance with getting in and out of bed
    • Toileting, including use and care of bedpan, urinal, commode, or toilet
    • Assistance with bathing
    • Assistance with feeding
    • Teeth, mouth, denture, and hair care
    • Assistance with dressing and undressing
    • Care of eyeglasses and hearing aids
    • Assistance with mobility and ambulation, including use of walker, cane, or crutches
    • Simple transfers, including bed-to-chair or wheelchair and reverse
    • Skin care, excluding wound care

    Home health services are services provided by an agency to individuals with disabilities or frail elders that are reasonable and medically necessary services provided in the home to treat the individual's condition. Home health services include the following services for which the agency is licensed to provide, delivered in an individual’s place of residence other than a hospital or nursing home:

    • Skilled nursing services
    • Home health aide services
    • Physical therapy
    • Occupational therapy
    • Speech pathology services

    Respite is a service provided for an individual with disabilities or a frail elder on a short-term basis to ease the individual’s family or other primary caregiver(s) from daily stress and care demands. These services may include assistance with or activities of daily living or supervision to ensure the individual’s health and safety during the family or primary caregiver’s absence.

    Daily living skills training is the provision of education and skill development to teach individuals with disabilities and frail elders the skills involved in performing activities of daily living, including skills intended to increase the individual's independence and participation in community life. This service may include teaching:

    • Money management.
    • Home care maintenance.
    • Food preparation.
    • Mobility training.
    • Self-care skills.
    • Skills necessary for accessing and using community resources.

    Daily living skills training may also involve training the individual or the natural support person to assist the individual.

    Counseling and therapeutic services (nonbehavioral health) are professional, treatment-oriented services that address the needs of an individual with disabilities or a frail elder, specifically for personal, social, physical, or medical disorders.

    Consumer education and training is designed to help individuals with disabilities develop self-advocacy skills, support self-determination, exercise civil rights, and acquire skills needed to exercise control and responsibility over other support services.

    If a provider applied during the first round of funding, were they able to apply in the second round?

    Providers that submitted an application during the first round were able to apply again for the second round.  

    • Providers who received funding in the first round were able to identify additional COVID-19-related expenses and losses incurred from June to August 2020 and receive additional funding.  
    • Providers who were denied in the first round could apply for COVID-19-related losses and costs for June, July, and August but were not able to change information to reapply for March, April, and May. Providers that did not submit a final 2019 federal tax return were asked to upload their final return. This will be used in determining the payment amount for the second round.

    If a provider did not apply or did not finish their application for the first round, what were they able to apply for?

    Providers who did not previously submit an application were able to apply and include COVID-19-related revenue losses and costs for March through August 2020.

    How did providers apply in the second round?

    The program relied on information submitted via the web-based application and used actual COVID-19-related revenue losses and costs to determine eligibility for the payment and determine the payment amount.

    Did the second round allow providers to apply for projected revenue losses and expenses?

    No, inclusion of projected revenue losses and expenses were not allowed in the second round.

    Was there be both a first payment and a second payment in round two?

    No, there was only one payment.

    How were payment amounts in round two calculated?

    In the second round of the program, DHS did not deduct federal CARES Act payments that providers had received (including Payroll Protection Program loans) from the amount of COVID-19 expenses and losses cited in their application. In addition, for previous applicants only, expenses and losses submitted in round one were carried forward from their original submission and used in the round two calculation. This may have resulted in an award of funds for March, April, and May 2020 expenses and losses that were not awarded in the first round.

    The net lost revenue and expenses related to the COVID-19 pandemic were calculated as:

    1. COVID-19-related lost revenue (March through August 2020) plus
    2. COVID-19-related expenses (March through August 2020) minus
    3. Any first round Wisconsin CARES Act provider payments made to the provider equals
    4. Net lost revenue and expenses

    Providers may not have received the full amount of the net lost revenue and expenses. The amount of each payment will depend on additional considerations, such as the amount of funds available, the percentage of payment requested compared to gross revenue, and the percentage of payment requested compared to the average amount of payments requested within the same provider type.

    Although DHS is no longer deducting for other federal funds received, the full amount of federal funds received plus the full amount of state funds received related to the COVID-19 pandemic may only be used to pay for COVID-19-related lost revenue and expenses. Federal funds could be used to cover COVID-19-related lost revenue and expenses not covered by the state CARES Act Provider Payments Program payments. Funds received from the state CARES Act Provider Payments Program could not exceed lost revenue and expenses incurred between March 1 and August 31, 2020. Providers should not accept funds from all sources, whether state or federal, that exceeded their total COVID-19 lost revenue and expenses.

    Am I able to make updates to my application?

    Applications for the CAPP program can no longer be modified, except via the submission of materials specifically requested by DHS.

    What Catalog of Federal Domestic Assistance (CFDA) number should agencies use to categorize CAPP payments?

    According to the Wisconsin Department of Administration, Coronavirus Relief Funds are assigned a separate CFDA number, #21.019, and should also be designated as “COVID-19” in the reporting workbook. These funds are 100% federal funds. Government providers, nursing homes, or any provider that has an annual audit will need this information.

    Information About the First Round of Applications

    I submitted my application. When can I expect to receive payment?

    A majority of the first and second payments for round 1 have been mailed to providers. Providers with individual questions should email the help desk.

    Why were there two payments?

    The initial payment amounts were set to ensure that sufficient funding was available to cover the maximum number of providers included in the CARES Act Provider Payments Program. This also helped make sure that a second round of payments could be made to those who applied and had COVID-19-related costs and losses (offset by federal payments being made to providers for the same purpose) that exceeded the initial payment amount.

    How much was the first payment?

    The first payment was calculated to reimburse providers for lost revenue, plus expenses, minus COVID-19-related government payments received. This payment allowed up to a maximum amount per provider type as shown in this table:

    Maximum first payment by provider type
    Provider Type Maximum First Payment for June Applications
    Emergency medical services  $1,240
    Home and community-based services (including adult family home 1-2 beds) $5,725
    Adult family home 3-4 beds $1,000
    Assisted living facility 5-15 beds $2,280
    Assisted living facility 16-25 beds  $5,150
    Assisted living facility 26-40 beds  $8,450
    Assisted living facility 41-60 beds  $12,870
    Assisted living facility 61-100 beds $19,790
    Assisted living facility >100 beds $34,380
    Nursing home <50 beds $14,270
    Nursing home 50-100 beds $29,000
    Nursing home >100 beds $41,860
    Community health center $38,010
    Tribal FQHC $38,010
    Rural health clinic $38,010
    Free and low cost clinic $2,500

    How much was the second payment?

    The second payment was calculated to reimburse providers for: lost revenue, plus expenses, minus COVID-19-related government payments received, minus the first payment. This payment allowed up to a maximum percentage of the provider’s gross revenue or a maximum payment amount.

    If a provider did not receive a second payment that covers all remaining costs or lost revenue, it is because their remaining costs exceeded either a maximum percentage of provider’s gross revenue or a DHS-set maximum payment amount. Both the maximum gross revenue amount and maximum payment amount were calculated as one standard deviation above the mean for each provider type, to reflect their respective experience. Standard deviation tells you how spread out the data is; it is a measure of how far each observed value is from the mean (or average). The intent of this policy is to pay out CARES Act Payments for the large majority of providers with remaining costs or lost revenue, while also accounting for outlier applications.

    The maximum payment and percent of 2019 gross revenue, along with percent of provider cost covered in the second payment, is summarized below:

    Maximum second payment by provider type and percent of gross revenue
    Provider Type Maximum Payment Maximum % of 2019 Gross Revenue Estimated Average Payment, Pending Completion of Desk Reviews
    Assisted living $126,500 45% $29,947
    Home and community-based services $385,662 41% $69,211
    Nursing home $640,476 13% $179,232

    I am a government entity provider and my payment amount is lower than I expected. Why?

    On June 30, 2020, the U.S. Treasury Department issued additional guidance to recipients of CARES Act funding that impacts state and local government entities as well as tribal governments. According to the guidance, public providers may not receive funding for lost revenues: “Although a broad range of uses is allowed, revenue replacement is not a permissible use of Fund payments.”

    DHS identified public providers that submitted applications and removed lost revenues from the payment calculations. As a result, some applicants:

    • Were eligible for less funding than initially anticipated.
    • Were no longer be eligible for funding if other federal funding received outweighed the amount of other expenses reported after the removal of lost revenue or if COVID-19-related expenses were not reported.

    How can I check the status of my application?

    You can check the status of your application by logging into your account and viewing the status of each application in the table.

    Note: You will only see the table if you have submitted application(s). Statuses include In Progress, Submitted, Under Review, Pending More Information, Pending Approval, Canceled, Denied, or Approved.

    Am I able to make updates to my application?

    Applications for the CAPP program can no longer be modified, except via the submission of materials specifically requested by DHS.

    What are examples of relevant supporting documentation I must keep for audit purposes?

    Providers who receive CARES Act provider payments may be subject to audit at any time. A failed audit may result in a recoupment of CARES Act provider payments. Providers are required to retain all relevant supporting documentation used when completing the CARES Act provider payments application for six years post-attestation and submit it to DHS upon request.

    Last Revised: December 14, 2020