COVID-19 in Healthcare Relief Grants

Senate Bill (SB) 8, 87th Legislature, 3rd Called Session, 2021, appropriates funds to the Health and Human Services Commission (HHSC) for grants to support Texas healthcare providers affected by the COVID-19 pandemic:

  • $75,000,000 for rural hospitals (SB 8, Section 12);
    • $38,000,000 ($250,000 per rural hospital) via direct awards;
    • $37,000,000 distributed via a competitive award process, or Request for Applications (RFA);
  • $200,000,000 for nursing facilities (NF) (SB 8, Section 33);
    • $90,000,000 ($75,000 per licensed facility) in direct awards;
    • $110,000,000 distributed via a competitive award process, or Request for Applications (RFA);
  • $178,300,000 million for Assisted Living Facilities (ALFs), home health agencies (HHA), Intermediate Care Facilities for Individuals with Intellectual and Developmental Disabilities or related conditions (ICFs/IID), and providers of Community Attendant Services (SB 8, Section 33) distributed via competitive award processes (RFAs).

Competitive Award Process – Request for Applications (RFA): Requirements and Important Information

The following information regarding the competitive award processes (“Tier 2”) is available for prospective applicants on the Request for Applications (RFAs). A prospective RFA applicant can use this information to assist them in preparing to apply for their respective RFA prior to the posting of the RFA Solicitation. Eligible applicants should rely on the final information published in each RFA Solicitation, as each RFA may have additional or different information than what is provided here.

Request for Applications (RFA) Solicitations

Each individual RFA solicitation will be posted on the Procurement and Contracting Services Request for Applications (RFA) webpage on the start date of the solicitation period. Each RFA will have a 30 calendar-day solicitation period, including an informational webinar or applicant conference, and a question-and-answer period.

COVID-19 in Healthcare Relief: RFAs for TIER II/Competitive Award Process

The lists of the seven RFAs and provider types for each RFA in the order in which the RFAs will be posted is available here. The provider types are based on SB 8 appropriations, and each includes unique eligibility and scoring criteria that correspond with each provider type.

The potential eligible applicants for the ICF/IID, Rural Hospital, ALFs, NFs, HHAs, non-Consumer Directed Services (CDS) Community Attendant, and CDS Community Attendant RFAs are based on the criteria outlined in the above file. HHSC has provided a list of those potential eligible applicants for the ICF/IID, Rural Hospital, ALFs and NFs RFAs. The potential eligibility list for HHAs and the non-CDS Community Attendant RFA will be published once finalized. The CDS Community Attendant potential eligibility list will not be published as these individuals are Medicaid recipients who employ a community attendant(s). Potential eligible applicants should be aware that appearance on the list, or lack of appearance on the list, does not serve as the final determination of eligibility for an award. If a potential applicant believes they have been omitted from the list in error, please contact ProviderFinanceDept@hhs.texas.gov. Additional information will be shared once the solicitations for the RFAs are posted.

Pursuant to SB 8, HHSC considered providers’ access to other available COVID-19 relief funds when determining the chronological posting order of the RFA solicitations. This order will also allow HHSC to accommodate the estimated 30,000 providers who will be eligible for at least one of the RFAs and address specific questions for each provider type during their respective solicitation posting periods.

Texas Identification Number (TIN) and Payments

If the eligible applicant is selected for an award, the applicant must have a valid TIN on file with HHSC to receive the award fund payment. An acceptable TIN is an 11-digit number that begins with a “1” for a business and must be associated with the legal entity or a “7” for an individual.

For all RFAs, except for the CDS community attendant RFA, each applicant will be required to provide a valid TIN with their application.

For CDS employers: HHSC anticipates that most, if not all, individuals eligible for the CDS Community Attendant RFA will not have a TIN set up. This is because payments for award funding will not flow to the CDS employers’ financial management services agencies; instead, the payments must be sent directly to the CDS employers. Since CDS employers are considered “individual recipients not owning a business,” HHSC will use information collected on the RFA application and HHSC records to create TINs for eligible applicants who submitted an application for the CDS Community Attendant RFA.

For ICFs/IID, ALFs, and NFs wishing to use the TIN of their management company: HHSC will not accept a management company’s TIN for these awards. If an applicant provides the TIN of its management company, the payment request will be rejected.

Compliance with Reporting Requirements

SB 8 directs HHSC to prioritize awards to providers that comply with the reporting requirements prescribed by Rider 143, SB 809, or equivalent reporting requirements established by HHSC. Providers who are required to submit the reports and are compliant with all SB 809/Rider 143 reporting will receive one extra point on the scoring of their RFA application. Applicants’ compliance will be determined by HHSC on the 15th calendar day after the respective RFA solicitation posts.

To submit the required initial and monthly reports, providers can submit directly through an online form with the following links:

Providers with multiple entities may also use an offline reporting template from the PFD website under the Monthly SB 809/Rider 143 COVID-19 Reporting dropdown and submit the completed form to the PFD Survey Inbox.

To confirm compliance, please check the healthcare institution list on the PFD website under the SB 809/Rider 143 COVID-19 Reporting Healthcare Institution List dropdown. PFD updates this compliance list weekly.

Legally Authorized Signatory

Each RFA application must be submitted by a person that is legally authorized to bind the respective eligible legal entity to a contract. This restriction will help HHSC streamline the processing of the applications and awards while ensuring financial and contracting safeguards are maintained.

Medicaid Eligibility of CDS Employers

For the CDS Community Attendant RFA, the CDS employer may apply to provide their employee(s) (community attendant) with a lump-sum bonus or retention payment, per the terms of the RFA. A CDS employer selected for an award under this RFA would act as a “pass-through entity,” so payments under this RFA are not considered income to the CDS employers and therefore would not impact CDS employers’ Medicaid eligibility.

Awards for Rural Hospitals

Texas hospitals eligible for these awards are those that, as of November 8, 2021, meet the definition of a “rural hospital” per the 2022-23 General Appropriations Act, Senate Bill 1, 87th Legislature, Regular Session (Article II, Health and Human Services, Rider 8). The awards will support rural hospitals that have been affected by the COVID-19 pandemic. Read more about eligibility for the rural hospitals-healthcare relief grant.

The awards for rural hospitals are discretionary and can be used by rural hospitals to support staffing, infrastructure, or revenue losses related to the COVID-19 pandemic.

The distribution of awards will be in two tiers, as described below.

Tier 1: Rural Hospital Direct Awards

Each rural hospital will be eligible to receive $250,000 as a direct award. To receive funds, each eligible entity will be required to provide certain information that will be used to create an award agreement and fully execute an award agreement in the manner prescribed by HHSC. A web-based form to submit the required information will be made available for eligible providers to complete. These representatives will have 15 business days after the distribution of the award agreements to sign and submit the agreement. Either the owner or operator of a facility may submit the agreement, but only one award will be made per facility.

Six months after the direct award, awarded providers must submit documentation in the form of a short survey to HHSC to describe what types of costs were paid for with the funds by category (staffing, infrastructure, lost revenue, etc.), how much was used per category, and how long the funds lasted before they were fully expended. HHSC will establish and distribute the tool that awarded providers must use to report this information prior to the end of the six-month period.

Tier 2: Rural Hospital Competitive Awards

The remaining funds for rural hospitals will be awarded through the Request for Applications (RFA) process. Additional information regarding the RFA process will be updated on this webpage as it becomes available.

If you have specific questions, please email ProviderFinanceDept@hhs.texas.gov.

Awards for Nursing Facilities

The awards for nursing facilities are intended to address critical staffing needs resulting from frontline health care workers affected by COVID-19, including recruitment and retention bonuses for staff.

Texas nursing facilities that are licensed as of Nov. 8, 2021, are eligible for the nursing facility grants. Read more about eligibility for nursing facility awards.

The distribution of awards will be in two tiers, as described below.

Tier 1: Nursing Facility Direct Awards

Each licensed nursing facility will be eligible to receive $75,000 as a direct award. To receive funds, each eligible facility will be required to provide certain information that will be used to create an award agreement and to fully execute an award agreement in the manner prescribed by HHSC. A web-based form to submit the required information will be available for eligible facilities to complete. These representatives will have 15 business days after the distribution of the award agreements to sign and submit the agreement. Either the owner or operator of a facility may submit the agreement, but only one award will be made per facility. A separate grant agreement must be signed for each individual facility ID.

Six months after the award, grantees must submit the following information to HHSC: a description of how revenues were used (one-time recruitment bonuses, contracted staffing services, overtime pay, etc.) and information about how long the funds lasted before they were fully expended. HHSC will establish and distribute the tool that providers must use to report this information prior to the end of the six-month period.

Tier 2: Nursing Facility Competitive Awards

The remaining funds for nursing facilities will be awarded through the RFA process. Additional information regarding the RFA process will be updated on this webpage as it becomes available.

If you have specific questions, please email ProviderFinanceDept@hhs.texas.gov.

Awards for ALFs, Home Health Agencies, ICFs/IID, and Community Attendant Providers

The awards for ALFs, home health agencies, ICF/IIDs, and community attendant providers are intended to address critical staffing needs resulting from frontline health care workers affected by COVID-19, including recruitment and retention bonuses for staff.

Competitive Awards for ALFs, Home Health Agencies, ICFs/IID, and Community Attendant Providers

The funds will be awarded through each individual RFA. Additional information regarding the RFA process will be updated on this webpage as it becomes available.

If you have specific questions, please email ProviderFinanceDept@hhs.texas.gov.

Interested applicants should rely on the information in each individual RFA because the RFAs may have additional or different information than what is provided on this site.