DHS COVID-19 PROVIDER GUIDANCE // OLTL
Coronavirus Aid, Relief, and Economic Security Act (CARES Act) Funding for Office of Long-Term Living
(OLTL) Home and Community-Based Service (HCBS) Providers
Issued: June 22, 2020
Governor Wolf signed Act 24 of 2020, which allocates funding from the federal Coronavirus Aid, Relief,
and Economic Security Act – also known as the CARES Act. Act 24 established funding from the CARES
Act to be used to cover necessary COVID-19 related costs for identified persons and entities incurred
between March 1, 2020 and November 30, 2020. Act 24 includes $457,000,000 of COVID-19 relief funds
for providers of Long-Term Living Programs. To qualify for the one-time payment, the person or entity
must be in operation as of March 31, 2020. This funding will be used to provide the following payments
to providers of HCBS services:
- COVID-19 Adult Day Care Services (ADS) Provider Payment
The total funds available for a one-time payment to ADS Providers pursuant to Act 24 (ADS
COVID-19 Payment) is $13,000,000.
The ADS COVID-19 Payment for each ADS Provider is calculated by dividing the ADS Provider’s
Medical Assistance (MA) fee-for-service (FFS) and Community HealthChoices (CHC) payments in
the third quarter of calendar year 2019 by the sum of the MA FFS and CHC payments of all ADS
Providers in the third quarter of calendar year 2019 to obtain a specific quotient for each ADS
Provider. The ADS Provider’s quotient is then multiplied by $13,000,000 to determine its ADS
COVID-19 Payment. - COVID-19 Home Health Care Provider or Home Care Agency Personal Assistance Payment
The total funds available for a one-time payment to Home Health Care Providers and Home Care
Agencies of Personal Assistance Services (PAS) to MA beneficiaries pursuant to Act 24 (Agency
PAS COVID-19 Payment) is $112,000,000.
The Agency PAS COVID-19 Payment for each Home Health Care Provider and Home Care Agency
is calculated by dividing the number of MA PAS 15-minute units, excluding overtime, invoiced in
the third quarter of calendar year 2019 by the Home Health Care Provider or Home Care Agency
by the sum of MA PAS 15-minute units, excluding overtime, invoiced in the third quarter of
calendar year 2019 by all Home Health Care Providers to obtain a specific quotient for each
Home Health Care Provider and Home Care Agency. Each entity’s quotient is then multiplied by
$112,000,000 to determine its Agency PAS COVID-19 Payment. - COVID-19 Residential Habilitation (Res Hab) Services Provider
The total funds available for a one-time payment Res Hab Providers pursuant to Act 24 (Res Hab
COVID-19 Payment) is $1,000,000. The Res Hab COVID-19 Payment for each Res Hab Provider is calculated by dividing the Res Hab
Provider’s MA FFS and CHC payments in the third quarter of calendar year 2019 by the sum of
the MA FFS and CHC payments of all RES HAB Providers in the third quarter of calendar year
2019 to obtain a specific quotient for each Res Hab Provider. The Res Hab Provider’s quotient is
then multiplied by $1,000,000 to determine its Res Hab COVID-19 Payment.
OLTL is preparing for the distribution of the funds as one-time gross adjustments for ADS, PAS, and Res
Hab services. Providers should expect to see the payment appear as a gross adjustment
transaction/lump sum payment on a PROMISe remittance advice with payment issuance occurring nine
days after the transaction appears on their remittance. OLTL’s intention is to distribute the payments in
July. Payment information will be posted to the Department of Human Services’ website.
Providers do not need to submit requests for the funding. All currently enrolled providers that provided
the above listed services and have a provider agreement for Waiver services and were in operation as of
March 31, 2020 will receive the funding as described above.
Act 24 of 2020 requires these funds to be expended by November 30, 2020 or returned to the
commonwealth. Additionally, these funds must be used for COVID-19 related expenses incurred
between March 1, 2020 and November 30, 2020. Providers must keep documentation to prove that
these funds were used for their response to the COVID-19 pandemic in case of an audit. Any person or
entity accepting a COVID-19 payment agrees to provide documentation to the Department, upon
request, for purposes of determining compliance with Act 24 requirements. Instructions on
expenditure reporting will be provided in the future.
Providers are advised to review guidance for eligible expenses on the U.S. Department of Treasury
website: