Dear Benchmarks' Members, 

We are sharing with you the latest information from today related to guidance, information and resources for your consideration.

Take care of each other and stay safe and healthy!

The Benchmarks' Team

Click this Link to Read the Order:  Governor Cooper Declares a Stay in Place Executive Order Effective on Monday, March 30, 2020 and will remain in effect for 30 days.

From the Neuse News: Based on information Neuse News has been able to obtain, this expected order will not preempt any local ordinances which are already in place or which may be imposed. This means that local governments may impose more restrictive requirements. Also, Cooper intends to reduce the permitted size of mass gatherings to a maximum of 10 people with exceptions for grocery stores and other essential businesses that continue to be in place. The order is expected to go into effect at 5:00 pm on Monday and remain in effect for 30 days.

Individuals will be required to stay in their residences or outdoor spaces surrounding their residence unless engaged in permitted travel or activities. Permitted travel includes travel for health and safety, to obtain necessary supplies and services (including food, health products, supplies to work from home), for outdoor activity, to care for others, to attend worship services, participate in volunteer activities, to receive goods and services provided by an Essential Business or to work at an Essential Business.

Businesses, Non-profits, and Educational Institutions are required to cease operations or direct employees to work from home unless they fall within one of the following categories of an "Essential Business" which may continue to operate. Essential Businesses include:
  • Any business that can operate while meeting social distancing requirements (6 feet apart) between and employees and between employees and customers, except for the point of sale and purchase. 
  • Businesses operating in federally designated (CISA) critical infrastructure sectors:  https://www.cisa.gov/identifying-critical-infrastructure-during-covid-19.
  • Healthcare and public health operations.
  • Essential infrastructure operations (food and beverage production, transportation, utilities, etc).
  • Grocery stores, agricultural goods and services, charitable and social services, religious entities, media, financial institutions and insurance, construction, hardware stores, professional services, mail, education, manufacturing and supply chain, hotels, liquor stores, and funeral services. 
  • Businesses that do not fall within one of the designated categories of Essential Businesses who believe they may be essential, may apply to the Dept of Revenue to be deemed an Essential Business. The Dept of Revenue may grant such an application if it determines that it is in the best interest of the State to have the business continue operations. The business may continue to operate while an application is pending with DOR.
This is a developing story. Stay tuned to Neuse News for information.


Benchmarks' Written COVID-19 Update:  March 27, 2020

As of Friday, March 27, 2020 North Carolina has had 715 individuals test positive for Covid-19. Since Wednesday of this week, 2,421 tests have been completed and a total of 12,910 test have been given in NC. Three people have died.

NC DHHS is stressing that individuals do NOT go to the ED or a drive thru location to be tested unless it is recommended by your doctor or you have risk factors. This is to avoid unnecessary use of PPEs, that are in very scarce supply right now, and to avoid spread. They are recommending that if you are not high risk, but have Covid-19 symptoms, you keep yourself quarantined as most individuals do not have serious complications from the virus.

A few health systems have designed their own Covid-19 tests which take 4-6 hours for results. Other hospitals must swab and send off to a lab which is averaging about 7-10 day wait times for results.

Stay in Place Order
Governor Cooper announced a statewide Stay in Place executive order for North Carolina effective Monday 3-30-2020 at 5:00. We have been told repeatedly by DHHS leadership that our member agencies fall under the "essential services" and should be able to travel as needed. We STRONGLY encourage all staff to have an agency ID with them at all times while traveling and suggest that the agency provide each employee a letter (on agency letterhead) explaining that the employee is an essential employee.

Federal Response to Covid-19
The federal government has put forward three bills so far.
  • Public Health Funding for Prevention, Preparedness and Response\
    • $2.2 billion primarily to CDC
    • Funding for surveillance and prevention
    • Emergency telehealth waiver
  • Families First Coronavirus Response Act
    • Temporary increase in FMAP amount (To qualify for the new 6.2% FMAP increase, states cannot disenroll any Medicaid beneficiaries enrolled as of March 18, 2020, or anyone who newly enrolls until after the national emergency declaration has been lifted.
    • Medicaid coverage for corona virus testing and treatment for the uninsured
  • Coronavirus Aid, Relief and Economic Security Act (CARE Act)   This bill was passed on Friday, March 27,2020 and has been sent to the President for his signature. A few of the big items in this $2 TRILLION dollar bill!
    • $150 billion Relief Fund - Minimum allocation of $1.25 billion per state to cover expenditures due to Covid-19.
    • $100 billion Public Health and Social Services Emergency Fund - specific funding to health care organizations on the front line of the crisis. NC DHHS Secretary has discretion of who all this funding may go to.
    • $560 billion Small Business Administration Disaster Loans Program - ***IMPORTANT*** this is to support companies with under 500 employees that need assistance. While the original version of the bill did not include nonprofits receiving Medicaid payments, this language was CHANGED and now they ARE INCLUDED as eligible recipients
    • $955 million Administration for Community Living - to support home and community-based services , protections for individuals with I/DD and for nutrition programs.
    • $425 million SAMHSA Emergency Allocation - includes $50 million for suicide prevention programs, $250 million for community behavioral health agencies, $100 million for SAMHSA programs.
    • Provisions to provide:
      • Emergency Unemployment relief for Nonprofit Organizations for half of the costs they incur for unemployment benefits through Dec 2020
      • Pandemic Emergency Unemployment Compensation that give an additional 13 weeks of unemployment benefits ($600 per week) after state unemployment benefits are no longer available.
      • Allows Employer to receive advance tax credit rather than waiting to be reimbursed on the back end.
      • Funds existing state short-time compensation programs, where employers reduce hours employee hours rather than laying them off and the employees can receive pro-rated unemployment benefits. The federal government would pay 100% of the costs in providing this short-time compensation through December 2020.
      • *** NONPROFITS PLEASE READ!!*** Modifies the limitations on charitable contribution during 202 by increasing the limitations on deductions for charitable contributions by individuals who itemize and for corporations. Suspends the 50% of adjusted gross income limits for individuals for 2020. Suspends the 10% limitations and increases it to 25% of taxable income for corporations. Allows individuals to deduct up to $300 of charitable cash contributions, whether they or not they itemize their deductions.
      • Modifies 42 CFR Part 2 (protects SUD records) to allow records be shared with prior written consent for all future uses for treatment, payment and health care operations.
      • Payments to Individuals - all residents with adjusted gross income up to $75,000 ($150,000 for married couples) will get a $1,200 ($2,400 for couples) "rebate" payment. They are also eligible for an additional $500 per child. The payments will start phasing out for earners above those income thresholds and will not go to single filers earning more than $99,000; head-of-household filers with one child, more than $146,500; and more than $198,000 for joint filers with no children.
      • Businesses will get a tax credit for keeping idled workers on their payrolls during the coronavirus pandemic, so long as the businesses meet certain criteria. They will get a refund for half of what they spend on wages, up to $5,000 per worker. 
NC Legislative Response
The legislature has established a House Select Committee on Covid-19. It has created 4 subcommittees that include:
  • Economic Support Working Group
  • Continuity of State Operations Working Group
  • Education Working Group
  • Health Care Working Group 
Lawmakers have set aside $3.9 billion in the unemployment trust fund and $1.1 billion in the savings reserve fund or rainy day fund. There is $2.2 billion of cash on hand in unappropriated funds, $184 million in the Medicaid contingency reserved and $74 million in the disaster relief fund.
The Economic Support and Health Care Working group have both met. The Health Care group was primarily focused on Hospital and Physician responses. MH/DD/SA was recognized multiple times as being critical during this pandemic. I would note that the legislators were reaching out in the meeting and eager to know what they could do to help first responders and others on the front line.
 
The Economic group was very focused on the unemployment rate and how to help those that were struggling from being displaced as result of Covid-19. They have developed a draft bill (partially would codify the Executive Order from the Governor) that would:
  • Eliminate the one week waiting period to receive assistance
  • Eliminates the work search requirements
  • Does not charge employer accounts
  • Would allow benefits for partial unemployment
  • Eliminates in-person interviews
  • Would allow employers to file claims on behalf of employees
  • Eliminates the first quarter employer payroll tax 
The Health committee will be meeting again next week and we have heard that they are interested in putting a bill together to provide emergency HHS funding. **Benchmarks has identified the need to purchase smart devices to allow telehealth for many of our clients, the need for supplemental funds for foster families and support for increased food insecurity needs. We really welcome all your ideas that we can submit to legislators of what support would help meet the needs of our clients.
   
Foundation support
This week, the Kate B. Reynolds Charitable Trust, one of the largest private foundations in the state, announced $1.5 million in immediate funding to address issues related to COVID-19, the disease caused by the new coronavirus, in Forsyth County and throughout North Carolina. At its headquarters in Rocky Mount, the Golden LEAF Foundation, another charitable giant, is deploying $15 million to launch a COVID-19 Rapid Recovery Loan Program. In Charlotte, the Foundation for the Carolinas and United Way launched their combined COVID-19 Response Fund last week. Lending Tree, with headquarters in the Queen City, and the Charlotte City Council got the fund off the ground with a combined $2 million contribution.

Nearby, the Gaston Community Foundation, in partnership with United Way and other organizations, created the Gaston County Virus Relief Fund to help fill public health gaps through front-line nonprofits. In Western North Carolina, the new Emergency and Disaster Response Fund expects to announce its first grants later this week. Led by The Community Foundation of Western North Carolina in concert with Dogwood Health Trust and other regional foundations, the fund will use a growing, dedicated pool of money to make grants on a weekly basis
 
Telehealth Expansion
DHHS continues to work on expanding access of telehealth, telephonic, telepsychiatry, and telemedicine. Some of the changes include:
  • Payment parity for telehealth visits.
  • Allowing the use all secure technologies for telehealth visits, such as iPhone apps, tablets, etc.
  • Expanding the types of providers who can use and bill for telehealth visits, such as mental health counselors and addiction specialists.
  • Associate Level (Provisional) Clinicians are also allowed to provide appropriate telehealth and telephonic services.
  • Expanding the location of the patient to include community sites and at home.
  • No need for referrals and prior authorizations, removing barriers for providers to see new patients.
These changes will be retroactive to March 10, 2020 and will remain in effect until the North Carolina State of Emergency is declared over or when this policy is rescinded, whichever comes first.
Details on the temporary modifications are included in the following Special Bulletins:
LME/MCO Responses
Many of our LME/MCOs have been taking aggressive steps to increase access to telemedicine and provide fiscal support for providers. We have been posting all the updates from LME/MCOs that we have seen that include innovative practices such as VAYA's hardship and retainer payments, Sandhills 15% reimbursement increase for residential facilities and 5% increase across all other Medicaid services. You can track many of these updates on the Benchmarks Covid-19 website. We strongly encourage you to reach out to your LME/MCOs with in lieu of services or ideas about how services can be delivered during this pandemic as they are very open to ideas and responding quickly.

We have also asked that they work together to try and standardize their response as much as possible to streamline the changes taking place for providers. They have been very responsive to this request and have a group of CEOs meeting weekly to coordinate the response.

Benchmarks' Child Welfare Providers

Benchmarks will holding weekly webinars/conference calls for our child welfare service providers, beginning next Thursday, April 2, 2020, at 8:00 am.  

We will be joined by DSS staff, Linda Waite and Lisa Cauley, to share issues and concerns and work together to craft solutions.  

Benchmarks' Child Welfare Call
Thursday, April 2, 2020
8:00 am thru 9:00 am
One Tap Mobile: +16465588656,,944285382# US (New York)
Dial in:   +1 646 558 8656 US (New York) Meeting Id: 944 285 382

We hope you will join us!

Letter from Dave Richard, NC Medicaid:

First of all, on behalf of the department, I want to thank you for everything you are doing to serve North Carolinians. We know you and your teams are going above and beyond the call of duty to continue to make sure that everyone who needs care is able to access it.
 
Effective Monday, March 30, 2020, NC DHHS is temporarily modifying enhanced behavioral health policies and telemedicine and telepsychiatry policies to better enable the delivery of remote care to Medicaid and state-funded beneficiaries during the COVID-19 outbreak. This will include dates of service on or after March 10, 2020 and will remain in effect until the State of Emergency is declared over or when this policy is rescinded.

Details on the temporary modifications are included in the following Special Bulletins:
It is the Department's goal to support the continuation of quality, medically necessary services for beneficiaries and reduce the number of disruptions in care which could lead to increased anxiety and exacerbation of symptoms. 
Again, thank you for continued dedication to serve North Carolina beneficiaries.
- Dave

House Select Committee on COVID-19
(Note:  Most of these handouts are worthy of review for interesting information you may not find elsewhere quickly)

Health Care Working Group Documents:  March 26, 2020

 
Guidance for infection control and COVID-19 prevention can be hard to find. We can help. 

The National Council's COVID-19 Guidance for Behavioral Health Residential Facilities offers general guidance for residential programs on how to respond if a client develops symptoms of COVID-19, handle clients returning from the hospital and prepare for the return of health care personnel to work. Our new report also offers insights into work practice and work restrictions, as well as crisis strategies to mitigate staffing shortages. 

Our thoughts and prayers go out to all of you as you are working in the midst of the coronavirus (COVID-19) pandemic to best support the people who depend on you, as well as staff and co-workers. As COVID-19 continues to evolve and impact communities across the United States, please know that CQL is monitoring this crisis closely and adapting the way that we carry out our services, to best assist the organizations we work with every day.

We are meeting organizations 'where they are,' regarding their specific situation and needs, as well as their individual response to COVID-19. Some organizations are choosing to delay activities with CQL, and we are happy to reschedule, process extensions, etc. Other organizations have moved forward with remote activities which we can accommodate through conference calls and video-sharing platforms. We encourage organizations to take some time and reflect on what would be best fit for them. CQL will adjust accordingly to ensure organizations are able to focus on what's most important - the health and safety of the people you support and your stakeholders

Message from CARF CEO regarding coronavirus

The safety and well-being of persons served, staff of accredited programs and services, and CARF surveyors are our priority. CARF has postponed all surveys with start dates of March 16 through April 30, 2020, to help with community transmission mitigation efforts. We continue to schedule for future on-site surveys, but recognize that such events are highly dependent on air travel; surveyor availability; and the course of COVID-19 and its impact on communities, health and human service organizations, and the persons served.      

I want to assure you that CARF is open and fully operational. Most CARF staff members are working remotely during regular business hours, Monday through Friday, from 8 a.m. to 4:30 p.m. MST, to ensure continued support of our accredited programs in meeting ongoing regulatory accreditation requirements and, more importantly, doing their very best to ensure continued quality services to the persons served during this pandemic. 

We encourage everyone to continue  everyday preventive actions and to follow ongoing recommendations from state and local health authorities on social distancing and sheltering in place, when and where possible, to prevent exposure to and spread of the virus. 

CARF continues to monitor and assess the evolving situation and appropriately respond based on guidance issued by public health authorities. We will communicate updates on this webpage if there are additional changes to CARF's activities.
For more coronavirus information, please visit:
We wish all the very best during this public health crisis and recognize our accredited programs for their courageous work in continuing to serve their communities. With our many partners and stakeholders, we can all make the changes necessary to flatten the curve of this pandemic and ensure continuation of quality services for those in need.

Regards,
Brian J. Boon, Ph.D.
President/CEO

COVID-19 update from our President & CEO

As you know, we are living in a very challenging time that continues to evolve and change, often by the hour.  I want to take this opportunity to share with all of you how COA is planning for and addressing the current situation.

Many of you have heard me say that accreditation is not just a box to tick and that is apparent now more than ever.  We are a community - a strong community - that always comes together and pushes forward even in the most demanding of times in order to continue to support our most vulnerable populations.  Your dedication to your missions is unwavering and so is our support and dedication to all of you - you are our mission. 

First and foremost, the health, well-being, and safety of our staff, volunteers, organizations, and those they serve is our primary concern and highest priority.  COA continues to monitor this challenging and constantly developing situation with COVID-19 and has focused the utmost attention on protocols needed to keep our entire COA community safe and healthy.  

We have been following the guidance, recommendations, and mandates of federal, state, and local governmental and public health entities to ensure that we are taking the best course of action possible.   We have compiled some key informational resources and best practices for navigating the current landscape that we will continue to update.

Based on the guidance we have received,  we will be suspending all volunteer travel and cancelling all Site Visits that were scheduled to begin the week of March 23, 2020.  These restrictions will remain in place through the end of April and we will revisit and update them on an ongoing basis as more information becomes available.  Any questions or concerns that our volunteers have can be directed to  Darrell Woodliff, Associate Director of Volunteer Engagement. Organizations that are in-process should direct all questions to their COA Accreditation Coordinator and out-of-process organizations should contact   Joseph Seoane, VP of Client Relations.

Here at COA's office in New York City, we are also taking proactive measures to ensure the well-being of our staff while maintaining business continuity so that we can successfully support you and all of our stakeholders.  While it is hardly business as usual given the current climate, COA has put into effect protocols and processes to protect
our staff and allow for the continued functioning of our regular operations with minimal disruption. 

Effective immediately we have suspended all staff travel and instituted remote work for all COA employees. Please rest assured that our systems have been tested to ensure that you will continue to receive the same high-level of customer service that you have come to expect from us.  While business is presently as near to normal as possible for us, we do ask for your patience and understanding as there will inevitably be a few unexpected bumps in the road as we transition to a virtual work environment and the situation progresses.

I want to reassure you that even during these uncertain and unprecedented times, our leadership team and board are working tirelessly to make the best decisions.  I want to personally thank each and every one of you for your continued support, partnership, and tireless commitment to the individuals and communities you serve. 

As always, please do not hesitate to reach out to me directly if you have any questions.

Be well and thank you again,

Jody Levison-Johnson
President & CEO

The Joint Commission recognizes the incredible challenge that health care organizations and front-line workers face with the COVID-19 crisis.
Read a  letter and watch a  video from our CEO.

March 27, 2020 - Public Statement on the Shortages of Critical Medical Equipment.

Our goal in creating this resource page is to support health care professionals and organizations on the front lines of the COVID-19 pandemic. The situation is changing rapidly, and recommendations have been changing with similar speed. We also know everyone is facing a deluge of information. Therefore, we are trying to provide only the information that best meets the needs of health care workers and leaders. We will continue to update this library of internal and external resources for our customers and the public. If you have other questions, need other resources, or have leading practices you would like to share, please visit our contact us page.


Health Care Webinar on COVID-19 An Employer's Legal Guide to Planning, Response, and Mitigation 

On March 26th, Parker Poe hosted a webinar distilling the most critical information for health care employers in this rapidly changing environment of the COVID-19 pandemic.
 
The presentation addressed:
* The Families First Coronavirus Response Act
o FMLA Expansion Leave
o Emergency Paid Sick Leave
o The "health care provider" exception
* DOL guidance on wage payment and leave issues
* CDC guidance for businesses and employers
 
Do you want to refer to the information or did you miss the webinar? 
Summary of the $2 Trillion Federal CARES Act
Congress just passed legislation designed to pump $2 trillion into the economy and help millions of American workers and businesses survive the effects of the novel coronavirus pandemic gripping the country. The United States Senate voted late Wednesday to approve the CARES Act by a vote of 96-0. The House passed the legislation this afternoon by a voice vote. The bill now heads to the president's desk for his signature.

The CARES Act is the largest single injection of federal cash into the economy in U.S. history. This third phase of the government's coronavirus response amounts to 10 percent of America's total economic output for an entire year. But many economists believe it will need to be followed by a fourth phase and possibly more after that. How much more is needed will depend on when the country can return to something resembling normal business.

Our team is helping clients navigate this legislation and advocating on their behalf as Congress and state legislatures craft additional relief.
Click here for our breakdown of how the CARES Act impacts businesses, hospitals, educational institutions, local governments, and others.


 
Alliance continues to take steps to help ensure that our network of providers is able to continue to provide access to services for individuals with behavioral health needs and to support members already in care during this COVID-19 crisis. Our continued focus is on implementing flexibility and other supports to ensure services are still delivered in a safe and effective manner during this time. 

Alliance recognizes the operational and financial impact the COVID-19 crisis has on our network and is taking action to provide support around this issue. Our initial focus has been on developing a short-term financial stability payment for providers of enhanced and outpatient services. We recognize that all providers are impacted by this crisis, however we would like to focus our initial efforts by addressing providers of outpatient and enhanced services and the associated complications from the implementation of social distancing practices and other precautions to reduce the risk of COVID spread. The immediate availability of these services will help prevent overcrowding in the EDs and prevent the unnecessary use of other crisis services and inpatient care. These services are also critical to ensure that individuals can transition out of those settings as expeditiously as possible.

We will work quickly to provide needed supports to other service lines and to support providers of Innovations services and TBI services in accordance with NC DHHS LME-MCO Joint Communication Bulletin # J357 that have been approved by CMS.  

Here is how the initial phase focused on providers of enhanced and outpatient services will work:

Enhanced service providers that billed at least $40,000 between dates of service from October 1, 2019, through January 31, 2020, for a combination of outpatient services (including research-based behavioral health treatment for children with autism spectrum disorders), enhanced services, and certain B3 services, will receive a financial stability payment equal to 80% of an average four-week period of paid claims during the aforementioned timeframe. 

Providers that do not provide enhanced services but offer outpatient psychotherapy, evaluation and management services, and/or research-based behavioral health treatment, and have provided these services to 100 or more Alliance members and have billed at least $50,000 during the October 1, 2019 through January 31, 2020 timeframe will also receive a financial stability payment calculated in the same manner as described above.  

These financial payments will be issued to eligible providers by April 3, 2020. Providers must receive payments via EFT to be eligible for these financial stabilization payments.  If your agency does not currently receive payments via EFT, 
please follow these instructions.

By June 1, 2020, Alliance will review paid claims for dates of service March 15, 2020, through April 11, 2020. Providers are required to bill for all services provided to Alliance members for these dates of service. If the claims submitted, combined with the 80% payment as part of the Financial Stabilization Program, are greater than 110% of the average four-week billing amount, the provider will be responsible for issuing payment back to Alliance Health for any amounts over 110%.

We are hopeful that this payment provides some immediate relief and serves as a bridge as network providers begin seeking relief from the federal government. There are three pieces of federal legislation that make up the Congressional response to COVID 19. These large scale bills either have just passed or are likely to pass shortly. The three pieces of Congressional Legislation are:
  • Coronavirus Preparedness and Response Supplemental Appropriations Act (H.R.6074)
  • Families First Coronavirus Response Act (H.R.6201)
  • Coronavirus Aid, Relief, and Economic Security (CARES) Act (H.R.2)
Alliance will provide helpful links regarding these pieces of legislation as they become available.  We encourage providers that are not eligible for a stability payment at this time pursue these options.

In the coming days, eligible providers will receive an individualized communication from Alliance that will provide the dollar amount and supporting details for the stability payment. 

Alliance will continue to take steps to ensure that our members continue to receive services during this very stressful time and ensure providers have the means to do so. As always, specific questions can be directed to   [email protected].



Beginning March 31, Cardinal Innovations Healthcare will host virtual Provider Huddles to help providers stay up to date on developments related to providing care during the new coronavirus ( COVID-19 ) pandemic.

Network Management will host the 45-minute Provider Huddle webinars, which are scheduled for four days each week for the next four weeks, beginning with the first huddle on March 31. If additional huddles are needed beyond the four weeks, they will be announced. The webinars will be on Tuesdays through Fridays on weeks one through three, and on Monday through Thursday on week four.

Provider Huddles are an opportunity to receive the latest updates from Cardinal Innovations, share creative solutions among providers, pose new questions and collaborate concerning challenges providers are experiencing as a result of the COVID-19 social distancing recommendations and mandates. Who To accommodate our extensive network of providers, Cardinal Innovations has identified four groups to help organize the Provider Huddle webinars. Each group will be scheduled on a different day of the week. The groups are:  
  • Comprehensive Community Clinics (CCCs) and Mobile Crisis Management (MCM)
  • Outpatient Therapy (OPT) and/or Medication Management (MM)
  • Intellectual/Developmental Disabilities (I/DD) - Innovations
  • Mental Health/Substance Use Disorder (MH/SUD) Residential/Community Based Services 
When and How Providers should register for the date, time and group that best fits their needs by selecting the appropriate link below:
  • Specific questions may be submitted to  [email protected] by using the SUBJECT LINE: COVID 19 Provider Huddle Question. Questions received by noon on Friday will be included in the following week's webinars. 
  • Questions can only be taken during the webinar through the Chat Box function for those accessing the webinar through their computers
  • Those with audio access only (calling in) will not be able to ask questions during the webinar
  • Each Provider Huddle will last 45 minutes  
  • FOR SCHEDULE READ HERE
March 25, 2020:  Family Centered Treatment - Shared Risk Reviews
Cardinal Innovations Healthcare understands that, during this time, providers need to focus on members and that there are many situations outside of their control. We continue to believe that Family Centered Treatment (FCT) H0036 HK is an essential service for our families. 

To remove any additional financial barriers from providers delivering this service, we will waive the shared risk assessment of payback for members that typically is conducted by Utilization Management (UM). This change is applicable to the Fiscal Year 2020 third quarter (January-March) review, which would have occurred in April, and to the Fiscal Year 2020 fourth quarter review, which would have occurred in July under usual circumstances. We will re-evaluate this change following the waived fourth quarter review to determine if the review should be reinstated. 

If providers have questions, they should reach out to their   Network Specialist, or email us at  [email protected].

March 25, 2020:  NC Innovations Service Flexibility
Cardinal Innovations is following the state communication outlined in  Joint Communication Bulletin #J357  regarding additional flexibilities related to the delivery of Innovations Services as result of COVID-19 related issues. The goal of Cardinal Innovations at this time is to ensure the needs of our members continue to be met.
 
Specifically, providers at this time have the flexibility to do the following:
  • Allow for services provided by direct care staff to be provided in alternative locations including, but not limited to, hotels, shelters, churches, alternative facilities, or the home of the direct care worker
  • Allow Day Supports and Community Networking to be provided in the home of the member, home of the direct care worker, or in the member's residential setting
  • As Day Supports are allowed to occur in alternative settings, the typical requirement to have beneficiaries present at the Day Support facility at least once a week is waived
  • Allow Day Support Group hours to be utilized as Day Support Individual hours as appropriate
  • Increase the number of Community Living and Support hours to children who are out of school to the hours typically allowed on non-school days
  • Allow for Respite to be provided out of state when necessary when family is out of state due to evacuation/displacement until they return home (providers should document in their records the reason this was needed)
  • Out of home Respite in excess of 30 days is allowed on a case-by-case basis. For these scenarios, please communicate with the member's care coordinator so that they can ensure there are no barriers experienced.
  • Community Networking and Supported Employment services can be delivered by relatives that live in the home of the adult Innovations member
  • Increase other plan services as necessary to meet the needs of the Innovations members at this time without completion of a plan update/prior authorization. The updates can be completed later and made retroactive to March 13, 2020. However, if members/families request and wish to complete updates at this time, they still remain able to do so.
  • Community Living and Support and Respite can be provided in acute care hospital or short-term institutional stay when the member is displaced because of COVID-19 and the participant needs direct assistance with ADLs, behavioral supports, or communication supports on a continuous and ongoing basis for three or more days
Specific to providers of Supported Living:
  • We are requesting that providers reach out to members and their families about the ability for relatives to provide Supported Living to members receiving this service to allow for additional staffing
  • The waiver is allowing for these relatives to provide these services prior to background checks and training for 90 days 
Other flexibilities not listed above that are also allowed under Appendix K that can be considered on a case-by-case basis:
  • Waive $135k individual limit on a case-by-case basis for individuals who are currently receiving waiver services
  • Waive HCBS settings requirement in alternative settings on a case-by-case basis (quarantine/social distancing/etc.) 
Other things important to note that are intended to be covered under Appendix K for administrative areas:
  • Members who choose not to receive services at this time related to COVID-19 concerns will not be subject to waiver termination
  • If annual plans are expiring and new plans are unable to be developed due to ongoing recovery efforts, these plans can be extended by three months. As telephonic monitoring of Innovations members will be ongoing during this time, Care Coordinators will be identifying situations where this is necessary to ensure that services can continue.
  • Allow for annual reassessment of level or care that exceeds 60-calendar-day approval
  • Allow for existing staff to continue to provide services, for 90 days, when CPR and NCI re-certification has lapsed
  • Face-to-face meeting between care coordination and members are able to be waived and monitoring will occur telephonic
  • Waive Support Intensity Scale Assessments/Reassessment during this amendment
  • Alternate Family Living (AFL) reviews and new admission reviews can be conducted via Desk Reviews, including use of videos of the site 
We understand that providers may have additional questions on the above, and we will continue to provide additional communication related to Innovations services. However, at this time we encourage providers to follow the above guidance to implement services as needed to support our Innovations members. Continue to communicate with Cardinal Innovations any barriers as they are identified.
 
We also understand that many providers have financial concerns about sustaining operations beyond the service delivery. We ask that providers continue to share these concerns with their Network Specialist as we know each provider may have unique needs to be considered. We will continue to work to share additional communication related to emergency funds and retainer payments separately.
 
The full Appendix K submission can be found here  and additional questions can be submitted to DHHS through  [email protected] .
 
If providers have any questions please reach out to your  Network Specialist , email us at  [email protected]  or contact our provider line at 1-855-270-3327.
March 27, 2020:    IMPORTANT NOTICE:
Greetings from the Executive Board of the Behavioral Health Section - Carolina (BHS-Carolina)!! As we support and comply with the decisions from the leadership of our state in reference to COVID-19 and in the best "health" interest of our membership and speakers, we have decided to cancel the 1 st Annual Behavioral Health Section - Carolina Meeting originally scheduled for June 10-12, 2020 in Raleigh, NC. The current Executive Board will continue for the 2020-2021 year and will make plans for the 2021 annual meeting. Mark your calendars now and please join us for our Annual Meeting next year which will be June 9th, 10 th ,11 th of 2021. Information will be forthcoming.


March 26, 2020:  Service Changes Due to COVID-19  (There were other notifications about meetings held today that have since passed.)

Partners is working with our fellow  LME/ MCOs and the North Carolina Department of Health and Human Services (NC DHHS) to develop and implement In Lieu of Service Definitions to address barriers to traditional treatment provision s  during the COVID-19 pandemic. NC DHHS is fast-tracking  its   review of In Lieu of Service Definitions. 

The submission process is moving  quickly,  and we are collaborating with our peer  LME/ MCOs to streamline these definitions across  LME/ MCO's.  
Until we have approved In Lieu of Service Definitions in place for the services outlined in this bulletin, Partners is implementing the following changes. All service notes during this time must include the following statement:  This service was delivered during the COVID-19 State of Emergency requiring social distancing. Services can start IMMEDIATELY using the telehealth approaches included below for all members participating in these services: 

The following codes are being loaded into contracts for 15 min increments and can be provided according to the telehealth guidelines below. Staff can bill these codes for the duration of the service provided. All team members of team-based services can bill these codes. 

 
March 25, 2020:  RE: Program and Payment Changes in Response to COVID-19
 
Sandhills Center appreciates the work of our Provider Network in continuing critical behavioral health services to our communities during the difficult times associated with the spread of COVID-19. Along with the steps already taken to assist providers during this situation, Sandhills Center is today announcing the programmatic and payment changes below to help strengthen and solidify our network of services.
 
State and Local Funds
Historically, Sandhills Center has maintained a variety of contracts with providers, including Unit Cost Reimbursement (UCR), 1/12th contracts paid evenly during the year, and Non-UCR paid on invoice showing expenses related to the services provided. For contracts that were not paid based on UCR services, shadow claims are submitted to monitor the services provided. During the current situation, Sandhills Center will continue to pay the 1/12th and Non-UCR contracts as usual and understands the volume of shadow claims submitted may be lower if service levels have declined during the COVID-19 pandemic.
 
State and locally funded UCR contracts will experience the greatest disruption in cash flow if service levels decline. Therefore, Sandhills Center has reviewed the monthly billing for the fiscal year to date for all of the UCR contracts with a maximum exposure amount greater than $100,000. We intend to leave all of those contracts in place to allow any UCR services billed to be paid through the usual process. 
 
We are planning to add to each provider, with an effected contract, a Non-UCR amount based on average billing for the current fiscal year, as funding is available. That non-UCR supplement will be billed on invoice. The funding will cover staff time and other program expenses needed to ensure the availability of previously contracted behavioral health services in our local communities during the COVID-19 pandemic. The amount invoiced should reflect the amount of program expenses during the pandemic less any program revenue billed through other Federal, State, local or 3rd party funding. Sandhills Center will reach out to each provider with the Non-UCR amount specific to the individual provider.
 
Medicaid Funds
The North Carolina Department of Health and Human Services (NC DHHS) letter, dated March 20, 2020, announced the flexibility offered to LME-MCOs to use up to 15% from their current risk-reserves for supporting providers who are accepting referrals, maintaining consumers in their existing residential placements, utilizing telehealth capabilities to the maximum extent possible, providing services that keep consumers from needing access to emergency departments and inpatient services and otherwise making efforts to deliver high quality services during this crisis.

Sandhills Center is using the flexibility granted to offer a 15% reimbursement rate increase for Medicaid funded residential services, with dates of service on and after April 1, 2020. The increased rate is planned to last through June 30, 2020, or as later amended by Sandhills Center. Medicaid funded residential services receiving this temporary enhancement include:
  • Psychiatric Residential Treatment Facilities
  • Behavioral Health Long Term Residential
  • Innovations Residential Services (Residential Supports 1-4, Supported Living 1-3 and Supported Living Periodic)
  • Community Based Intermediate Care Facilities
The additional Medicaid services listed below will also receive a 15% reimbursement rate increase for the same dates of service:
  • Assertive Community Treatment Team
  • Community Support Team
  • Psychosocial Rehabilitation Services
Finally, all other Medicaid services will receive a 5% increase, again for the same effective dates of service listed above.

It is our expectation that additional revenue generated from the temporary enhanced service rates will be used to supplement direct care staff costs during this time. We reserve the right to conduct a post payment review of providers to ensure compliance with this expectation.

Early and Periodic Screening, Diagnostic and Treatment (EPSDT)
As a reminder, the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid. EPSDT requires that any additional health care services that are coverable under the Federal Medicaid program be provided if they are found to be medically necessary to treat, correct or reduce illnesses and conditions discovered regardless of whether the service is covered in a state's Medicaid plan. Medical necessity must be determined on a case-by-case basis.

During the response to COVID-19, Sandhills Center recognizes the challenges of providing community behavioral health services while implementing the social distancing and other mitigation efforts recommended by NC DHHS and the Centers for Disease Control and Prevention (CDC). To assist in ensuring service availability during this crisis, Sandhills Center is encouraging providers to use EPSDT as appropriate to request authorization for services in a modified service delivery model, when needed. When an authorization request is submitted for an EPSDT covered member, under the age of 21 (most likely services including Day Treatment, Intensive In-Home, Multi-Systemic Therapy or Outpatient Services), the requesting provider should include in the authorization request the specific modifications to the usual service delivery model that are being considered to help mitigate the spread of the COVID-19 virus. Requests will be considered using the EPSDT criteria on a case by case basis as they are submitted for review.

Outpatient Services
Sandhills Center is following the guidance issued by NC DHHS in
Special Bulletin COVID-19 #9: Telehealth Provisions - Clinical Policy Modification. Providers can bill for allowed services as described in this Medicaid Bulletin beginning March 23, 2020, for dates of service on or after March 10, 2020.

The United States Department of Health and Human Services (US DHHS) has indicated the announced telehealth provisions allow covered health care providers that want to use audio or video communication technology to provide telehealth to patients during the COVID-19 nationwide public health emergency to use any non-public facing remote communication product that is available to communicate with patients. Covered health care providers may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype to provide telehealth without risk that the Office of Civil Rights (OCR) might seek to impose a penalty for noncompliance with the HIPAA Rules related to the good faith provision of telehealth during the COVID-19 nationwide public health emergency.

The codes announced in the Special Bulletin are being automatically added to all providers' contracts that currently contain the standard Outpatient Service CPT codes or the E&M codes. Provider Network and Finance staff are prioritizing the addition of these codes for provider use as quickly as possible.

Special Bulletin #9 includes the eligible providers who can offer the telemedicine and telepsychiatry services listed, including clinical pharmacists, licensed clinical social workers (LCSWs), licensed clinical mental health counselors (LCMHCs), licensed marriage and family therapists (LMFTs), licensed clinical addiction specialists (LCASs) and licensed psychological associates (LPAs). Additionally, the telephone assessment and management codes included in the Special Bulletin expand the list of eligible providers for those services to include a listing of associate level clinicians. 
 
When billing the codes, it is important to bill with a GT modifier to indicate the service has been provided via interactive audio-visual communication. This modifier is not appropriate for services performed telephonically or through email or patient portal. A modifier CR (catastrophe/disaster related) must be included for codes listed in the policy to relax frequency limitations defined in code definitions.
Telehealth and telepsychiatry claims should be filed with Place of Service (POS) 02 (telehealth). If providing the service from the staff's home, that is operating as a temporary office, the place of service for office POS (11) should continue to be used.

Opioid Treatment Services
To allow Opioid Treatment providers to continue services to our members and take the precautionary measures outlined by The Centers for Disease Control and Prevention (CDC), Sandhills Center will temporarily allow reimbursement for additional take-home doses of methadone and buprenorphine for members receiving Opioid Treatment (H0020). This will allow reimbursement of doses typically received on site to be provided off site via take-home doses if there is no other method for reimbursement of the medication costs. To simplify this process and not require additional coding changes at this time, providers can bill the number of units per day equivalent to the number of doses.

Providers may review the guidance issued by The Substance Abuse and Mental Health Services Administration (SAMHSA) for additional information.
 
It is Sandhills Center's expectation that Opioid Treatment providers ensure quality care and close oversight of member progress, clinical and crisis planning and member appropriateness for increased off-site dosing as determined by the provider's medical staff. Providers may use the approved telephonic codes or telehealth codes as appropriate to support the member as well.

Provider Administrative Workload
As a reminder to the information previously announced, Sandhills Center is focused on reducing administrative work for our providers during this time. In an effort to assist you in reducing the number of visitors to your facilities, Sandhills Center has temporarily suspended all external audits, reviews and oversight monitoring, except for reviews involving member health and safety, that would require travel to your site. The desktop review process will continue during this suspension to expedite the conclusion of each in progress review when appropriate.

Again, Sandhills Center appreciates the important work our network is doing in response to the current situation. Our commitment to our network is to continue to review any flexibility that can be offered to providers to reduce administrative and regulatory requirements as we move forward. We will announce further information as it is available

March 27, 2020:  ALL Innovations Waiver Providers
 
Trillium is working with the North Carolina Department of Health and Human Services (NC DHHS) as they are actively working on service specific guidance in response to the COVID-19 virus. The North Carolina Division of Health Benefits (DHB) requested waivers that support flexibility in service delivery that both protects the public while ensuring our most vulnerable citizens are able to continue receive support for their Behavioral I/DD needs.
 
Please see the following guidance which once approved will be retroactive to 3-13-2020. In anticipation of this approval, Trillium is moving forward with implementation of the following to keep cash flow for providers moving we will use existing codes for now. We will likely require replacement claims in the future once we have modifiers in place to capture the COVID 19 related events outlined below:  
  • Trillium is able to allow for an increase in service hours from what is in the Individual Support Plan (ISP) without prior authorization during this emergency. Trillium is currently building codes with modifiers for providers to use for services that do not require prior authorization. These codes will be retroactive to 3-13-2020. For now we recommend that providers continue to bill existing codes under existing authorizations until such a time as we are able to get the codes into our systems to bill under this approval. 
  • Respite can be provided when family is out-of-state due to evacuation/displacement until they return home. Out-of-home Respite may be provided in excess of 30 days on a case by case basis. 
  • In the event that a member needs assistance because of COVID-19 related issues, Trillium can allow for the direct care provider to provide direct care services in a hotel, shelter, church, alternative facility-based setting, or home of a direct care worker. 
  • Trillium can also allow for relatives of adult waiver beneficiaries to provide services to those beneficiaries in Supported Living arrangements prior to background checks and training for 90 days. 
  • Additionally, relatives of adult and child waiver beneficiaries who reside in the home and out of the home will be able to provide services prior to background check and training for 90 days. It is understood that the background check will be completed by the agency as soon as possible after the service begins and training will occur as soon as possible without leaving the beneficiary without necessary care. 
  • The guidance from the State will also allow for existing staff to continue to provide service, for 90 days, when CPR and/or NCI recertification have lapsed. Trillium will also be able to allow for additional services to be provided by relatives who live in the home of the adult waiver beneficiary (current waiver only allows for Community Living and Supports) to temporarily include Community Networking and Supported Employment for 90 days. To utilize this option, providers will send a secure email to [email protected], including the following information: member name and date of birth, service(s) being provided, and the date the service was implemented. 
  • Trillium will also allow relatives, of child waiver beneficiaries who reside in the home and out of the home to provide Supported Living, Supported Employment, Community Living and Supports, and Community Networking when other providers are not available. Trillium will review these request for RAP needs individually. To utilize this option, providers will send an email to [email protected], including the following information: member name and date of birth, service(s) being provided, and the date the service was implemented. 
  • As we move forward, Individual Support Plans/revisions will be approved with a retroactive approval date dating back to 3/13/2020 for service needs identified to mitigate harm or risk directly related to COVID-19. Service limits in the Individual Support Plan may be exceeded in the amount, frequency and duration to address the needs of waiver participants who were impacted by COVID-19 and need new waiver services during this event. 
  • For service plans that are expiring and currently meeting an affected waiver participant's needs, but a new person-centered plan cannot be developed due to ongoing COVID-19 recovery efforts, Trillium will be allowed to extend the time limit to approve the plan (by the last day of the birth month) by 3 months after the birth month, and monthly telephonic monitoring will be provided by the care coordinator to ensure the plan continues to meet the participant's needs. 
  • During COVID 19 emergency, Community Living and Supports and Respite can be provided in acute care hospital or short-term institutional stay, when the waiver participant is displaced from home because of COVID-19 and the waiver participant needs direct assistance with ADLs, behavioral supports, or communication supports on a continuous and ongoing basis for 3 or more hours per day. Room and board is excluded. 
  • Trillium will support direct care workers to receive retainer payments from providers and Employer of Records (EOR) to address emergency related issues. In an effort to ensure retention of direct care workers, Innovation Waiver provider agencies and Employer of Record(s) are encouraged to pay staff their current rate of pay even in situations when the staff isn't able to deliver services due to COVID-19 emergency related issues. This could be due to state of emergency requirements to not leave one's home, staff sickness, staff unavailability due to caring for sick family member, member sickness, or the need to limit staff from coming into the member's home due to health and safety concerns for the member (e.g. member is in a high risk category and at greater risk of infection/complications). Staff retainer payments may only be made for currently authorized Innovations Waiver services that include a personal care or habilitative component such as Day Supports, Supported Employment, Community Networking, Supported Living, Community Living and Supports, etc. Provider agencies and EOR(s) shall maintain documentation (as usual) via the required service documentation grid by entering COVID-19 on the Grid with QP signature/EOR signature and date. This shall be effective beginning 3-13-2020 and will end when the member is again available for services following the COVID-19 emergency. To register for and receive retention payments, Provider agencies and EOR(s) providing retainer payments to direct care workers will register and provide Trillium information weekly (every Monday for the previous week), using the form at the following link:  Innovations Waiver Staff Retainer Payment Requests (right click on this link with your mouse and select Open hyperlink to open the link to this form) 
  • Trillium is able to waive monthly face-to-face care coordinator/beneficiary meeting for individuals receiving residential supports, are new to the waiver, or relative as provider during this COVID-19 emergency. We are also able to waive quarterly face-to-face care coordinator/beneficiary meeting on case-by-case basis during the COVID-19 emergency. 
  • The guidance also waives Support Intensity Scale Assessments/reassessment during the COVID-19 emergency. 
  • Additionally, there is a waiver of the requirement for a beneficiary to attend the Day Supports provider once per week.
 
Effectively immediately, LME/MCOs are temporarily implementing Desk Reviews, including use of videos or still photographs of the site, for managing on-site AFL reviews and new admissions to unlicensed AFLs.

March 27, 2020: COVID-19 Provider Financial Hardship Requests
On March 23, 2020, N.C. DHHS provided LME/MCOs with direction on available funding options and other mechanisms to support behavioral health and IDD providers during the COVID-19 State of Emergency. This direction included authorizing LME/MCOs to access up to 15% of their existing Medicaid risk reserve funds, as well as newly released state funding, to support qualifying contracted providers.
 
Despite the robust changes we are making across the system to support the providers who are continuing to engage and support our members during this crisis, we realize that providers still may experience cash flow and staffing issues that cannot be addressed with federal relief to private employers. To support providers in continuing to ensure access to medically necessary services and minimize impact on hospitals by dramatically reducing hospital emergency department and/or inpatient admissions for behavioral health reasons, we have developed a process for contracted providers to demonstrate hardship and request supplemental funding.
 
 
 
If you have questions about the form, please email 

WEBINAR: TELEWORKING AND REFERRALS TO QUITLINENC
Thursday, April 2, 2020, 2 -3 p.m.
During this time, it's more important than ever to help individuals decrease their susceptibility to infection and potential for severe symptoms by becoming tobacco-free. The agenda for this webinar includes:  
  • What services QuitlineNC offers 
  • Why is it still a good time to quit, even with COVID-19
  • How to refer using EHR, secured emails and fax
  • How to enroll in QuitlineNC services online
  • How to use social media to increase utilization of QuitlineNC
 
To register, email [email protected]  to receive a calendar tag and webinar link.

(Big THANKS to Ryan Estes, Coastal Horizons, for the heads up on this!)
CARES Act Provisions for Nonprofits
The Coronavirus Aid, Relief, and Economic Security Act (CARES Act), a bipartisan stimulus bill, provides significant relief for nonprofits struggling through the COVID-19 crisis and for many of their employees and clients. Several provisions are of particular importance to nonprofits, including:
  1. The availability of forgivable small business loans to nonprofits with 500 or fewer employees;
  2. Unemployment relief for workers and (partially) for many nonprofits;
  3. A (limited) universal charitable deduction for 2020; and
  4. A variety of appropriations that will help many types of nonprofits.
Forgivable Small Business Loans That are Available to Most Nonprofits
One important provision in the CARES Act would provide funding for a new small business loan program (emergency SBA 7(a) loans) that would provide many nonprofits and small businesses  up to $10 million to cover costs of payroll, operations, and debt service. These loans would be available to nonprofits with 500 or fewer employees that existed on March 1, 2020 and had paid employees. Loan funds could be used to make payroll and associated costs, including health insurance premiums, facilities costs, and debt service.  Notably, employers that maintain employment between March 1 and June 30 would be eligible to have their loans forgiven, essentially turning the loan into a grant.

In a major victory for charitable nonprofits, the final bill does not include a provision in earlier drafts that would have disqualified nonprofits that are eligible for Medicaid payments. For most nonprofits, these SBA 7(a) loans will be a much better option than the emergency SBA loans that were approved for North Carolina small businesses and nonprofits last week. Those loans, which could cover up to $2 million to pay fixed debts, payroll, accounts payable, and other bills that cannot be paid because of the disaster's impact, carry a 2.75% interest rate for nonprofits (lower than the 3.75% rate for small for-profit businesses), but are not forgivable.

For larger nonprofits (between 500 and 10,000 employees) that are not eligible for SBA 7(a) loans, the industry stabilization provisions in the CARES Act provide for (non-forgivable) loans at interest rates of 2% or lower with no interest or repayments required in the first six months. Large nonprofits must retain at least 90% of their staff at their full compensation to qualify for these loans.

For organizations that don't receive 7(a) loans, the CARES Act provides a refundable payroll tax credit of up to $5,000 for each employee on the payroll when certain conditions are met. The credits are available to organizations that were operating at the beginning of 2020 and saw a drop in revenue of at least 50% in the first quarter compared to the first quarter of 2019. The availability of the credit would continue each quarter until the organization's revenue exceeds 80% of the same quarter in 2019. For tax-exempt organizations, the entity's whole operations must be taken into account when determining the decline in revenues.
Unemployment Relief for Workers and Nonprofits  Three provisions in the CARES Act provide significant unemployment insurance (UI) relief to workers and to nonprofits, most notably:
  1. A new Pandemic Unemployment Assistance (PUA) program extends UI benefits to self-employed workers and others who are typically not eligible for UI benefits from the state of North Carolina. Notably, this means that employees of churches, religious nonprofits, and small charitable nonprofits (fewer than four employees) who are out of work due to COVID-19 may now receive UI benefits under PUA. For more details about nonprofit employees who are generally ineligible for UI benefits, see the  Center's recent blog post.
     
  2. The federal government would pay states for half of the cost of benefits that self-funded nonprofits owe as reimbursement for their laid-off employees' UI claims. While this will still leave significant costs for self-insured nonprofits, it is an important first step. The Center is continuing to advocate for the state of North Carolina to hold harmless these nonprofits for Coronavirus-related UI claims (see below). For more details on self-insured nonprofits, see the Center's recent blog post .
     
  3. In addition to state UI benefits, unemployed workers would receive $600 per week for up to four months. As context, the maximum weekly UI benefits in North Carolina are currently $350 per week, so North Carolinians who are out of work could receive up to $950 per week in UI benefits.
Temporary (and Limited) Universal Charitable Deduction
After significant advocacy by the Center and other nonprofits over the past three years, the CARES Act includes a temporary, above-the-line deduction for total charitable contributions (also known as a universal or non-itemizer charitable deduction), which would be capped at $300. The incentive applies to contributions made in 2020 and would be claimed on tax forms next year. While the cap is lower than most nonprofits would prefer, it will nonetheless help encourage many more Americans to make charitable contributions this year at a time when nonprofits have never had greater revenue challenges.
The bill also lifts the existing cap on annual contributions for those who itemize, raising it from 60% of adjusted gross income to 100% (meaning high-income taxpayers could receive a full tax deduction if they donate all of their income to nonprofits). For corporations, the bill raises the annual limit from 10% to 25%. Food donations from corporations would be available up to 25%, up from the current 15% cap.

Appropriations in CARES Act of Interest to Nonprofits
To help preserve jobs and businesses, the CARES Act also provides direct appropriations for several programs that directly support nonprofits. Some of these appropriations include:
  • $130 billion for hospitals;
  • $15.5 billion in additional funding for the Supplemental Nutrition Assistance Program (SNAP);
  • $8.8 billion for child nutrition programs;
  • $450 million for nonprofit food banks through The Emergency Food Assistance Program (TEFAP);
  • $50 million for legal services;
  • $400 million in election grants to states to help with vote by mail and expansion of early voting and online voter registration programs;
  • $75 million for the National Endowment for the Arts and $75 million for the National Endowment for the Humanities, much of which will go to support the operations of nonprofit arts and cultural organizations;
  • $3.5 billion for the Child Care Development Block Grant program;
  • $750 million for Head Start;
  • $1 billion for the Community Service Block Grant;
  • $5 billion for the Community Development Block Grant;
  • $4 billion in Emergency Solutions Grants to help families who are experiencing homelessness or are at risk of losing their homes; and
  • $3 billion in rental assistance for low-income Americans.