The Department of Human Services (DHS) is administering the program, which consists of two funding streams: $100 million for eligible acute care hospitals, critical access hospitals, and children's hospitals based on licensed bed capacity; and $110 million for eligible high-Medical Assistance (MA) hospitals, critical access hospitals, and behavioral health providers based on licensed bed capacity. The Department of Health (DOH) is assisting DHS in determining hospital eligibility and licensed bed capacity. 

These funds are separate from the Provider Relief Funds (PRF) hospitals received from HRSA that were funded through the CARES act. These funds are also outside of state Medicaid hospital-specific DSH limit calculations as they are not for payment of medical services. The funds received under Act 2 of 2022 are American Rescue Plan Act funds and are specifically for staff recruitment and retention payments. 

DHS sent payment notification to facilities in mid-March. This notification was sent to the email address on the hospital contact list used by DHS for communication on hospital cost reporting and will include a PROMISe reason code that is unique to the type of payment under Act 2. DHS began making payments on  April 11, 2022. DHS posted the list of eligible recipients on this website at the top of the page. Hospitals and behavioral health providers do not need to apply for the funding and will receive an allocation based on eligibility and licensed bed capacity as of December 30, 2021, as determined in consultation with DOH. 

Specialty hospitals, long term acute care hospitals (LTACH), free standing rehab hospitals, inpatient rehabilitation facilities, and community behavioral health organizations are not eligible hospitals or behavioral health providers under Act 2 of 2022. 

Specifically, LTACH, rehab hospitals and other special hospitals that treat disorders within the scope of specific medical specialties or that treat a limited classifications of diseases are not included in the definition of a "hospital" per Act 2 of 2022. Only acute care, children's, and critical access hospitals qualify for hospital recruitment and retention payments under Section 102-J(a). Per Act 2 of 2022, a hospital under clause (i) of the definition needs to be both licensed under section 808 of the Health Care Facilities Act and meet the requirements of providing inpatient medical care and other related services for surgery, acute medical conditions, or injuries. This provision of care and services language mirrors the definition of "acute care hospital" as defined by the Centers for Medicare & Medicaid Services and is also the scope of services historically used by the Department of Health to identify acute care hospitals and does not extend to special hospitals. See https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/ResearchGenInfo/Downloads/DataNav_Glossary_Alpha.pdfOpens In A New Window  

In contrast, a special hospital is tailored to treat a narrow scope of disease and includes both acute and chronic stages. A "special hospital" is specifically defined under 28 Pa. Code § 101.4 as a hospital equipped and staffed for the treatment of disorders within the scope of specific medical specialties or for the treatment of limited classifications of diseases in their acute or chronic stages on an inpatient basis of 24 or more hours."  As such, the description of services provided by special hospitals is not included in the definition of a "hospital" under Act 2 of 2022. 

¹ The only official list of eligible recipients is the list available on DHS’s website. Any list of recipients that may have been previously shared or received should be disregarded as preliminary.

Eligible entities were informed of the amount(s) via email. Payments to MA-enrolled providers will be processed on their remittance advice (RA) as early as April 11, 2022.  DHS issued an RA banner notifying the MA-enrolled providers of the RA date for these payments.  

Hospitals and behavioral health providers (recipients) can only spend the money on recruitment and retention payments to qualified staff and must make payments directly to their qualified staff. Recipients do not need to wait until they receive the payments from DHS to make payments to qualified staff, but they must spend the funds within the required timeframes. Act 2 of 2022 requires recipients to spend retention payments within 90 calendar days and recruitment payments within 180 calendar days of receipt of the funds. 

Hospitals that are eligible for funding out of both the $100 million and $110 million appropriations can expect to receive all payments at the same time, and all payments must be spent within 90 or 180 calendar days, respectively. Hospitals and behavioral health providers can choose to allocate funds based on the needs of their workforce, including pooling within a hospital system to more equitably distribute funding. Hospitals must spend funds received for high-MA hospitals, critical access hospitals, and behavioral health beds at those types of facilities. Ex: Funding received for a critical access hospital may only be spent at a critical access hospital. Funding received for a high-MA hospital may only be spent at a high-MA hospital. Funding for behavioral health providers may only be spent at an eligible behavioral health provider. Recipients should spend funds at all eligible hospitals. 

If a hospital or behavioral health provider chooses not to use the funding, the funding must be returned to DHS by check. 

Hospitals and behavioral health providers may use the money in the following ways: 

• Retention payments to qualified staff 
• Recruitment payments to qualified staff, including sign on bonuses

Hospitals and behavioral health providers may not use the money to: 

• Supplant existing staff wages 
• Reimburse for other Federal or State funding 
• Pay for incentives other than retention or recruitment payments to qualified staff 
• Pay retention or recruitment payments to staff that do not qualify, including behavioral health executives, hospital executives, contracted staff, administrators and administrative support staff or physicians. 
• Pay more than one retention or recruitment payment to qualified staff with Act 2 of 2022 funding. 
• Reimburse for retention and recruitment payments made prior to the effective date of Act 2 of 2022 (January 26, 2022) or after the 90 and 180 calendar day deadlines established in Act 2 of 2022.

Hospitals and behavioral health providers are responsible for ensuring that they do not make a retention or recruitment payment to a qualified staff who already received an Act 2 of 2022 retention or recruitment payment from another hospital or behavioral health provider. 

DHS is interpreting Act 2 of 2022 to include laundry, janitorial and cleaning staff as eligible environmental services staff. Dietary services staff may be eligible if they are providing direct patient care services, such as assisting with feeding patients. 

Hospitals, behavioral health providers, and qualified staff must pay regular payroll taxes on these payments. Act 2 does not prohibit deducting payroll taxes from the funds received. 

Question: DHS guidance states that hospitals, behavioral health providers, and qualified staff must pay regular payroll taxes on Act 2 payments.  Are providers permitted to use a portion of their total payment to cover administrative expenses such as payroll taxes and payment processing? 

​The intention of Act 2 funds is to be utilized as recruitment and retention payments for staff. These funds are not intended to cover administrative expenses, such as payment processing. However, Act 2 does not prohibit deducting payroll taxes from the retention and recruitment payments made to qualified staff.  

Hospitals and behavioral health providers can determine which qualified staff will receive payments and how much each qualified staff member will receive based on the needs of their workforce. Hospitals and behavioral health providers should engage frontline staff in the decision-making process and must report on how they fulfilled this expectation. Hospitals and behavioral health providers also must report the criteria used for determining a staff payment or bonus. Act 2 requires facilities to report any additional retention and recruitment incentives provided to staff in addition to the Act 2 payments, regardless of funding source. Hospitals and behavioral health providers that are able to dedicate additional funding or other incentives for recruitment and retention payments for staff, above and beyond the funding provided through Act 2 of 2022, are encouraged to do so and should include this as part of their report. Required reporting documentation can be found linked at the top of this page.  

DHS has published reporting guidelines that can be found linked at the top of this page. Act 2 of 2022 requires reports for staff retention payments be submitted to DHS by September 30, 2022. Reports for staff recruitment payments are due to DHS by December 31, 2022. Please submit reports, including a completed Federal Funding Accountability and Transparency Act (FFATA) form, to RA-pwdshpymt@pa.gov and ra-obslfrf_data@pa.gov

​Hospitals and behavioral health providers may not use the money to reimburse for retention and recruitment payments made prior to the effective date of Act 2 of 2022 (January 26, 2022) or after the 90 and 180 calendar day deadlines established in Act 2 of 2022. 

The Department of Human Services will review reports as needed and is authorized to audit payments.  

As noted in the statute, DHS may recover payment from an entity that receives payment from the Department if the entity does not comply with the provisions of Act 2 of 2022 or with federal or state law or guidance. An entity that receives a payment from the Department may be asked to provide documents, records, and other information related to payment in the manner and format requested by either the DHS or any other Commonwealth of federal agency that is authorized to audit the payments.  

Facilities should keep internal decision-making records in case an audit may be needed by federal or state entities. Further, per Act 2, an entity that receives a payment from the department shall provide documents, records and other information related to a payment made under this section in the time, manner and format requested by either the Department of Human Services or by any other Commonwealth or Federal agency that is authorized to audit the payments. 

 The Commonwealth may recover payments if an entity does not comply with the provisions of Act 2.  

MA providers that have open obligations due to DHS would have had their Act 2 of 2022 payments reduced by the obligation owed regardless of the type of funding that was processed through the Commonwealth's accounting system.  Please verify this is not the case before contacting RA-pwdshpymt@pa.gov  

​A high Medical Assistance hospital is a hospital determined under the Medical Assistance dependency adjustment provisions of the Commonwealth's approved Title XIX State Plan, based on a hospital's approved Medical Assistance cost report for fiscal year 2018-2019.  

​As a condition of payment, an entity receiving a payment from DHS under Act 2 of 2022 must be in operation as of December 30, 2021 and must maintain operations until at least December 31, 2022.  If a hospital or behavioral health provider closes operations in 2022, the funding must be returned to DHS by check. 

​The CFDA number assigned to the American Rescue Plan Act funding is 21.027.  

​Yes, payments are subject to the following requirements in the federal Uniform Guidance (2 C.F.R. Part 200): 2 C.F.R. § 200.303 regarding internal controls, 2 C.F.R. §§ 200.330 through 200.332 regarding subrecipient monitoring and management, and subpart F regarding audit requirements.  

​For these payments to be considered a federal award, there needs to be a subrecipient relationship between the entity and DHS.  These payments would not affect the subrecipient vs. contractor determinations under the Uniform Guidance (see 2 CFR Part 200, Section 200.330).  That is, if the entity has a subrecipient relationship with DHS, the ARPA payments would not change that and the entity would consider the ARPA payments to be a federal award.  Conversely, if the entity has a contractor relationship with DHS, the ARPA payments would not be considered a federal award.    

​DHS recommends that if the entity is uncertain of their designation as a subrecipient or a contractor by DHS that they contact their Certified Public Accountant (CPA) or other financial representative.  Entities that do not have a CPA or other financial representative or when the designation between a subrecipient or a contractor is not known by the financial representative, the entity can contact DHS, Audit Resolution Section at ra-pwauditresolution@pa.gov   

​Qualified Staff are defined in the statute.  Advanced practitioners, supervisors, and managers meet this definition if they are not considered an executive and/or acting in a supervisory or administrative capacity only. 

​Facilities should review the definition of direct patient care activities found in the statute. As identified in the enacted legislation, acts of assessment, examination, treatment, and administration of medication, rehabilitation, direct care services, and preparation for clinical care services directly to a patient would be considered direct patient care. If a clear line can be drawn from the qualified staff person to performance of COVID-19 response direct patient care, clinical care, or environmental services, the qualified staff person would be eligible. 

Providers must document why specific staffing categories were determined to be eligible for COVID-19 response restricted funds. If payments were to be audited, facilities would need to provide documentation regarding the provision of payments in accordance with the requirements of Article I-J. Further, per Act 2, an entity that receives a payment from the department shall provide documents, records and other information related to a payment made under this section in the time, manner and format requested by either the Department of Human Services or by any other Commonwealth or Federal agency that is authorized to audit the payments. 

Facilities should review the definition of direct patient care activities, clinical care services found in the statute. If a clear line can be drawn from a pharmacist to clinical care services or direct patient care activities the staff person would be eligible. As noted above, DHS is interpreting Act 2 to include laundry, janitorial and cleaning staff as eligible environmental services staff. Dietary services staff may be eligible if they are providing direct patient care services, such as assisting with feeding patients. 

DHS recognizes that each hospital or behavioral health facility will have different needs and will have utilized their staff differently during outbreaks of COVID-19; however, facilities should be mindful that the legislative intent of this funding is to support hospital or behavioral health staff who have been vital in caring directly for patients during the pandemic response and capacity surge experienced in early 2022.  

​Dietary services staff may be eligible if they are providing direct patient care services, such as assisting with feeding patients. 

​Yes, if they are considered qualified staff as defined in the statute and are not excluded from the definition.  

​EMTs could be eligible if the EMT is employed by a hospital or behavioral health facility and is determined to be a qualified staff person. Providers should be mindful that EMS agencies were eligible for Act 10 of 2022 which created a $25 million grant program specifically to support EMS agencies. More information about the Emergency Medical Services COVID-19 Recovery Grant Program can be found here. 

​Facilities should review the definitions of qualified staff, direct patient care activities, and clinical care services found in the statute. If an individual meets the definition of "qualified staff" and a clear line can be drawn from a teacher or aide to clinical care services or direct patient care activities, the staff person would be eligible. DHS recognizes that each hospital or behavioral health facility will have different needs and will have utilized their staff differently during outbreaks of COVID-19; however, facilities should be mindful that the legislative intent of this funding is to support hospital or behavioral health staff who have been vital in caring directly for patients during the pandemic response and capacity surge experienced in early 2022. 

​Act 2 funding was appropriated to hospitals based on eligibility and licensed bed capacity established due to their hospital or behavioral health licensure. Funds must be spent in the locations and on qualified staff supporting the licensed beds for which the hospital received the funding. Health systems are welcome to utilize other funding they may have available to provide payments to staff employed at other locations, but Act 2 funding must be spent on qualified staff working in the settings for which the hospital received funding. 

​No, Act 2 funds must be used for qualified staff employed by the hospital and working in the hospital settings. The Governor has proposed using additional ARPA funding to support retention and recruitment payments in long-term care settings, however, this will require legislative action.  

 Question: If the same dollar amount per bed was allocated to any Specialty Hospital designated as Behavioral, Critical Access, or High Medical Assistance. Because Pennsylvania's distribution of funds to each hospital was executed in this manner, can employers choose to a distribution method of two separate pools, one for the Inpatient Hospital Group and one for the Specialty Hospital Group?  

​Funds provided to a hospital for its licensed, behavioral health beds should go to support the staff working in the behavioral health unit and may also be used to support staff that provide direct patient care services or clinical care services to patients in the behavioral health unit and to other patients. This could include qualified staff working in the emergency department who provided direct patient care or clinical care services to patients that are admitted to the behavioral health unit, etc. 

​Act 2 does not define payments as premium pay. Premium pay is a classification established by the U.S. Treasury in their guidance. Hospitals should review both Act 2 and the U.S. Treasury guidance (https://home.treasury.gov/system/files/136/SLFRF-Final-Rule-Overview.pdf) when determining if any payments made using Act 2 funding are considered premium pay.  

​Act 2 funds must be spent within 90 or 180 days starting from the date funds are deposited in a providers account. Act 2 does not provide any authority for additional time to spend funds, regardless of circumstance. 

​No, each behavioral health facility and hospital has responded to the pandemic differently and, therefore, the statute does not specify specific amounts to be allocated to either retention or recruitment payments. U.S. Treasury guidance specifies that premium pay cannot exceed $25,000 to one individual. 

​There is nothing in the statute that prohibits this type of requirement; however, hospital and behavioral health facilities should discuss with their legal counsel.  

There is nothing in the statute that prohibits this type of requirement; however, hospital and behavioral health facilities should discuss with their legal counsel.  

Hospitals and behavioral health providers are responsible for ensuring that they do not make a retention or recruitment payment to a qualified staff who already received an Act 2 of 2022 retention or recruitment payment from another hospital or behavioral health provider. 

​Act 2 funds must be spent within 90 or 180 days starting from the date funds are deposited in a providers account. 

​Hospitals and behavioral health providers cannot use Act 2 funds to supplant wages. However, how a facility chooses to calculate a retention payment is not specified in Act 2.  

​Act 2 of 2022 requires recipients to spend retention payments within 90 calendar days and recruitment payments within 180 calendar days of receipt of the funds. 

Question: If there are eligible staff that receive retention bonuses within in the timeframe the hospital can use to include in Act 2 reporting but then later resign or move to an ineligible job function before the reporting date, is the payment made to them while eligible still applicable to Act 2? 

​Payments must be made to qualified staff. Once the payment is made, there is nothing in the statute requiring or allowing hospitals or behavioral health providers to take money back from qualified staff who either resign or move to an ineligible position after the payment is made. However, the statute only permits a qualified staff member to receive only one payment for retention or recruitment under the act.  

​Reports submitted to DHS to satisfy the requirements of Act 2 of 2022 will be subject to the RTKL. If a submission contains confidential proprietary information and/or a trade secret, the provider must also submit, along with its report, a signed written statement that the record contains confidential information and/or a trade secret.  The statement should specifically identify the protected information. DHS developed and published reporting guidelines to further clarify the reporting requirements and streamline the process for reporting information. 

The hospital or behavioral health entity is responsible for making eligibility determinations that align with the statute and guidance.  Documentation to support the determination should be maintained by the entity.