Provisions of the CARES Act Involving HHS
Published: March 30, 2020
On Friday, the president signed the Coronavirus Aid, Relief, and Economic Security (CARES) Act, also referred to as the Stimulus Package, into law to aid the nation during the coronavirus pandemic. Some provisions of the legislation affect the Department of Health and Human Services by providing funding, regulatory authority, and added flexibility.
- $127B to the Public Health and Social Services Fund administered by Health and Human Services.
- $4.3B for CDC to provide for public health preparedness and response.
- $6.3B for the Administration for Children and Families
The act is divided into two divisions:
- Division A – Keeping Workers Paid and Employed, Health Care System Enhancements, and Economic Stabilization
- Division B – Emergency Appropriations for Coronavirus Health Response and Agency Operations.
Division B provides clearly defined emergency supplemental funding of $340 billion for federal agencies, state and local governments, and hospitals to respond to the COVID-19 crisis.
HHS plays a critical role in responding to the coronavirus pandemic. A summary of the CARES Act provisions that appear to involve or impact HHS along with any described funding is listed below:
Divison A – Keeping Workers Paid and Employed, Health Care System Enhancements, and Economic Stabilization
- Directs HHS and the National Academies to submit a report on the dependence of U.S. on critical drugs sourced/manufactured abroad (including supply chain), and the public health security or national security risks associated with the dependence.
- Makes revisions under the Federal Food, Drug, and Cosmetic Act to expand manufacturing reporting requirements in response to drug shortages.
- Makes revisions under the Federal Food, Drug, and Cosmetic Act requiring the reporting of medical device shortages and accelerates the review of other devices during a public health emergency that could help mitigate or prevent existing device shortages. Instructs HHS to keep an updated, thorough list of medical device shortages with additional descriptions surrounding the shortage.
- Amends the Families First Coronavirus Response Act to incorporate coverage of diagnostic testing for COVID-19.
- Provides $1.3B in supplemental awards to HHS for National and Community Health Centers in FY 2020.
- Amends sections of the Public Health Service Act to expand telehealth network services and telehealth resource centers grants programs, particularly beyond medically underserved areas to rural areas.
- Allocates an additional $29M under the Telehealth Resource Centers Grants Program for each of FY 2021-2025. It also expands rural health care services outreach and improves rural health network development, extending small health care provider quality improvement grant programs.
- Allocates $79.5M for the Small Health Care Provider Quality Improvement Grant program for each of FY 2021 to 2025. Additionally, it modifies verbiage to establish U.S. Public Health Service Ready Reserve Corps in times of public health and national emergencies. It also establishes a limitation on liability for volunteer health care professionals during COVID-19 response.
- Clarifies provisions regarding the confidentiality and disclosure of records relating to substance use disorder, provides definitions surrounding nutrition services transfers, home-delivered services, and dietary guidelines.
- Ensures the continuity of services and opportunities for participants in community service activities. Reauthorizes the healthy start program, requiring a GAO review no more than 4 years after reauthorization of the program. Additionally, establishes a blood supply awareness campaign.
- Removes the cap on Other Transaction Authority (OTA) used by HHS during public health emergencies and bans the termination of such OTAs based on the expiration of a public health emergency before completion of the terms of agreement.
- Prioritizes and expedites the research and development of zoonotic animal drugs.
- Reauthorizes health professions workforce programs at $23.7M per FY 2021-2025.
- Directs HHS to develop a comprehensive and coordinated plan with respect to HHS health care workforce development programs, including education and training programs.
- Directs HHS to award grants, contracts, or cooperative agreements to entities for the establishment or operation of Geriatrics Workforce Enhancement Programs at $40.7M per FY 2021-2025.
- Directs HHS to support nursing workforce development by establishing nurse managed health clinics, reporting to Congress on nursing workforce program improvements, developing authorized clinical nurse specialist programs, and evaluating and reporting on nurse loan repayment programs. Appropriates $138M per FY 2021-2025, plus an addition $117M per fiscal year.
- Expands from $4.8M to $20M the funds routinely transferred to the Centers for Medicare & Medicaid Services Program Management Account. Available through Nov 2020.
- Via CMS, provides $13M for state health insurance programs.
- Through CMS provides funding for aging programs – $7.5M for agencies focused on aging and $5M for Aging and Disability Resource Centers.
- Through CMS, provides $12M in additional funding for contracts with the National Center for Benefits and Outreach Enrollment.
- Extends CMS funding for the Money Follows the Person rebalancing demonstration program by $337.5M.
- Provides public health funding for Community Health Centers. $4B for FY 2020 (up from $2.575B) and $668M for Oct 2020 through Nov 2020.
- Provides public health funding of $362M for National Health Service Corps through Nov 2020.
- Provides $21M in additional funding for graduate medical education programs from October through November 2020.
- Provides $25M in additional funding for diabetes programs from October through November 2020.
- Provides $25M in additional funding for Indian health programs from October through November 2020.
Divison B – Emergency Appropriations for Coronavirus Health Response and Agency Operations
- $80M in additional funding to FDA to support the development of necessary medical countermeasures and vaccines, advance domestic manufacturing for medical products, and monitor medical product supply chains.
- $1.032B to Indian Health Service to addresses critical response needs in Indian Country, along with the ability to transfer $125M for facility needs. Funding provides for medical and equipment supplies; mobile triage units; surveillance; medicines; purchased and referred care; transportation; backfilling for public health service corps; and increased capacity for telehealth and other teleworking capacity.
- $127B to the Public Health and Social Services Fund administered by Health and Human Services for the following:
- $100B to ensure healthcare providers continue to receive the support they need for COVID-19 related expenses and lost revenue.
- $16B for the Strategic National Stockpile to procure personal protective equipment, ventilators, and other medical supplies for federal and state response efforts.
- $11B for vaccines, therapeutics, diagnostics, and other medical or preparedness needs. Includes at least $3.5B to advance construction, manufacturing, and purchase of vaccines and therapeutic delivery to the American people. This is in addition to the billions already provided for these activities in the first supplemental.
- $250M for hospital preparedness to improve the capacity of healthcare facilities to respond to medical events.
- $275M for the Health Resources and Services Administration to expand services and capacity for rural hospitals, telehealth, poison control centers, and the Ryan White HIV/AIDS program. Language is also included to allow Community Health Centers to use FY2020 funding to maintain or increase staffing and capacity to address the coronavirus.
- Includes $4M for HHS Office of Inspector General for oversight activities.
- $4.3B for CDC to provide for public health preparedness and response, which includes funding to state and local public health responders (including reimbursement of funds used thus far in response to the coronavirus), as well as enhanced nationwide surveillance, diagnostics, laboratory support, communication campaigns to the public, guidance to physicians and health care workers, and global health preparedness.
- $945.5M for NIH for vaccines, therapeutic, and diagnostic research to increase our understanding of COVID-19, including underlying risks to cardiovascular and pulmonary conditions.
- $425M for SAMHSA to address mental health and substance use disorders as a result of the coronavirus pandemic.
- $200M for CMS, $100M of which is for additional infection control surveys for facilities with populations vulnerable to severe illness from coronavirus.
- $6.3B for the Administration for Children and Families which includes the following:
- $3.5B for the Child Care and Development Block Grants to states for immediate assistance to child care providers.
- $750M for the Head Start program.
- $1B for the Community Services Block Grant.
- $900M for the Low Income Home Energy Assistance Program which funds grants to states to support immediate home energy assistance for low-income households affected by coronavirus.
- $45M to provide additional support to family violence shelters.
- $2M in additional support for the National Domestic Violence Hotline.
- $25M for runaway and homeless youth programs.
- $45M for grants to states to support the child welfare needs of families during this crisis, and to help keep families together.
- $955M for the Administration for Community Living for aging and disability services programs, including senior nutrition; home and community-based supportive services; family caregivers; elder justice; and independent living.
HHS will likely need assistance in fulfilling many of the CARES Act directives. Research institutes, academia, and federal contractors may find opportunities to assist HHS in fighting COVID-19 and providing national relief through the additional funding provided by this stimulus package.