Informational Letter No 2383 Mc Ffs Date September

Informational letter no 2383 mc ffs date september

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DATE: September 30, 2022
TO: Home- and Community-Based Services (HCBS) Waiver and State Plan
HCBS Habilitation, Community-Based Neurobehavioral Rehabilitation
Services (CNRS)
APPLIES TO: Managed Care (MC), Fee-for-Service (FFS)
FROM: Iowa Department of Health and Human Services (HHS), Iowa Medicaid
RE: American Rescue Plan Act (ARPA) HCBS Remote Monitoring Grant
EFFECTIVE: Upon Receipt
Beginning October 1, 2022, Iowa Medicaid will accept applications from eligible providers to
receive funds from the ARPA HCBS Remote Monitoring Grant

Grants will serve the purpose of assisting qualified HCBS providers with funding remote
support services involving the use of technology to provide real-time assistance from direct
support professionals in remote locations. Grant funds are intended to be used for covering
costs related to implementing technology-enabled services that will improve, enhance, and/or
expand provider capacity to serve HCBS waiver and HCBS habilitation participants

Eligible providers for the HCBS Remote Monitoring Grant include:
• 1915(c) HCBS waiver supported community living and supported employment providers

• 1915(i) state plan HCBS habilitation, home-based habilitation, and supported employment

To be eligible for grant funds, providers must meet these requirements:
• They billed a managed care organization (MCO) or FFS Medicaid for eligible services
provided between July 1, 2020, and June 30, 2021

• They continued to provide patient care after April 1, 2021

• They have not permanently ceased providing patient care directly or indirectly

• With respect to Medicare, any state Medicaid program, and any federal health care
program, the recipient is not:
All Informational Letters are sent to the Managed Care Organizations
Iowa Medicaid – 1305 E Walnut St. – Des Moines, IA 50319
o suspended or excluded from participation

o suspended from receiving payments

o under any other sanction or penalty

Eligible Projects
Projects may include but are not limited to those listed below

• Projects that expand providers’ capacity to serve HCBS participants by providing remote
support services using technology to provide real-time assistance from direct support
professionals in remote locations, including but not limited to:
o Purchase of consultation services to implement technology-enabled services

o Purchase of smart technology (hardware and software) or home automation devices to
augment direct service delivery

• Computer equipment
• Monitors, cameras, and speakers
• Sensors (infrared, magnetic, audio, pressure, and motion)
• Smart appliances such as refrigerators, washers, dryers, stoves, ovens, and microwaves
• Home security systems including keyless entry and video doorbells
• Safety equipment such as smoke and carbon monoxide detectors
• Training and technical assistance costs related to implementing the technology
o Purchasing of two-way, real-time communication technology systems that enable individuals
to communicate with remote staff by using phones or web-based technology

• Technology and equipment must comply with all relevant safety laws, rules, regulations,
and codes for technology and technical safety for devices that interact with patients or
are integral to diagnostic capabilities

• Technology and equipment utilized in the provision of telemedicine services must be
compliant with the Health Insurance Portability and Accountability Act (HIPAA)

• Training and technical assistance costs related to implementing the technology
• One-time purchases of supportive technology to increase HCBS participant independence and
community access (when purchases are not otherwise available by other dedicated funding
sources, or otherwise covered services). Examples include, but are not limited to:
o Assistive technology – equipment, software program, or products/systems used to increase,
maintain, or improve the functional capabilities for HCBS participants not otherwise
available through the HCBS waiver or state plan Medicaid
• Medication reminders and dispensers
• Wearable technology (smart watches, pendants, bracelets)
• Health trackers
• Augmentative communication devices
• Computer accessibility devices
• Frequency modulation (FM) systems, coupling accessories, and loop systems
• Optical character recognition (OCR) software systems and screen readers
o Other assistive or supportive technology recommended by professionals of occupational
therapy, physical therapy, speech, hearing, and language services; assistive technology
professionals and certified enabling technology integration specialists (ETIS)
o Training and technical assistance in using assistive or supportive technology
• Purchasing of technology or other equipment for HCBS staff to support community-based
services and programs
o Smart phones (excluding monthly service fees)
o Tablets
o Laptops/desk top computers
o Training and technical assistance
• Other projects which meet the intent of improving, enhancing, or strengthening Iowa’s HCBS
• Projects aligning with those described above, and that have been implemented since April 1,
2021, are eligible for grant funds. Providers must include a detailed description of the project,
its intended outcomes, and a detailed budget to support the request for funds

The department will assess the amount of proposed funding along with the number of
participants the project(s) would affect. Entities may submit proposals for more than $100,000,
with the knowledge they may not be funded for the entire amount. Entities should entertain
fundraising or identify other sources of funding to supplement any funding gaps. The department
will distribute grant funds to eligible providers until the fund has been fully expended

Funding Restrictions
All awarded funds have the following restrictions:
• Funds shall not be used for the purchase or development of multi-family units serving more
than five (5) individuals, including apartments and duplexes

• Funds shall not be used for anything other than the projects specified in the project proposal

• Funds shall not be used to pay for administrative costs or clinical care

• Funds shall not be used to pay for indirect costs. All costs must be related to the project
proposal and be outlined and justified in the budget

• Funds shall not be used for wages, retention, or other bonuses for staff

• Funds shall not be used for disposable or single-use items for a single person. Projects must
be for the benefit of individuals served overall (as applicable). Evaluation of the project will
reflect this restriction and proposals are subject to disqualification if for a single person only
unless the project or item can be transferred or used multiple times

• If awarded only a portion of the requested funding, and the submitted proposal application
indicates the project can be completed with other funding sources, the project must be fully
completed by March 31, 2024. Any unspent funds shall be remitted to the department

• Entities must maintain complete records of fund expenditures and understand that project
budgets are subject to potential post-payment review or audit

Applying for Grant Funds
Agency providers enrolled under multiple national provider identifiers (NPIs) for eligible HCBS
should list those NPIs and their corresponding tax ID number and pay-to-legacy numbers on
the application. Providers should submit only one application per organization. Duplicate
applications will be rejected

Agency providers may apply for the Remote Monitoring Grant funds beginning October 1,
2022. The application period will remain open until the funds allocated for this project have
been expended. Providers may request grant funds by completing the online application1 and
attestation and uploading the required documents and minority impact statement. The
department will only accept complete applications which include the submission of the required
documents listed below

Proposals from entities that have multiple locations may be awarded for only one location or all
locations at the department’s discretion. Entities should indicate the location(s) in their
proposal application. Entities can submit proposals for multiple projects (if applicable, submit
one proposal application with all projects listed)

The Remote Monitoring Grant application must include:
• A Brief Project Description and Point of Contact (POC)

o Identify or name the entity submitting the application

o Provide a brief description and purpose of the project, in no more than five sentences

o Include total amount of funds requested

o Identify a POC for the application, including name, position/title, address, phone
number, and email address

• Entity Information
o List the entity’s current programs and activities

o Provide the entity’s national provider identification (NPI) Number
o Provide the entity’s tax identification number (TIN)
• Project Description
o Describe the project in detail explaining how it will enhance improve or expand HCBS
o Provide a timeline of the project, purchases or expenditures using grant funds that
shows major milestones for the project
o If the applicant will be collaborating with any other entities (e.g., individuals,
organizations, associations, facilities, etc.) on the initiative, the other entities should be
identified. Include any entity and whether the entity will be applying for ARPA grant
funds. Explain what specific deliverables the other entity is responsible for

• Budget
o Describe the budget for the project, including other funding sources and allocations

Include the source of the pricing as applicable

o Provide a detailed line-item budget proposal using a table format outlining the specific
cost requirements within each of the following budget categories:
• Personnel/consultants
• Travel
• Equipment purchases and rentals
• Training
• Cost of project activities to be undertaken by a sub-contractor. Each subcontractor
is budgeted separately

• Other direct costs (expenses not covered in any of the previous costs)
• Total indirect costs
o If the entity is purchasing goods and services that are available from multiple
sources, the entity must include three competitive quotes for the cost of any
equipment, construction, and labor. The quotes shall be from businesses that
comply with federal, state, and local laws as required

o Please note budget amounts for anything prohibited by the ARPA section 9817
guidelines or federal and state rules will be disallowed

• Sustainability Plan
o Describe the sustainability plan for the project after grant funds awarded have been

Application Processing
• Iowa Medicaid Provider Services will record receipt of the applications, project descriptions,
budgets, and MIS as they are received and notify the HCBS Quality Improvement
Organization (QIO) project team

• The ARPA HCBS QIO project team will verify that the provider submitting the application
had claims paid during SFY21 and are in good standing with the department by sharing the
provider listings with program integrity to ensure that the providers are not:
• suspended or excluded from participation

• suspended from receiving payments

• under any other sanction or penalty

• The ARPA HCBS project team will review a project and the associated budget and make a
recommendation on the eligibility of the project and the amount of funds to distribute

• During the bi-monthly award meeting, the ARPA HCBS team will review the
recommendation for the award for each project and make a final determination on the
eligibility and amount of the award. Providers or projects identified as not eligible will be
notified by Provider Services

• The process above will be repeated monthly until all project funds have been expended

Distribution of Funds to Providers
• Each month the ARPA HCBS project team will approve the amount of ARPA project funds
to be awarded to the providers applying during the prior month

• The ARPA HCBS project lead will identify the amount to be distributed to each provider
based on the approved project and budget and send the final agency provider listing to
CORE services to enable the one-time payment to the provider

• The provider will receive the gross payment on the regularly scheduled payment date the
month following the month of application and award determination

An FAQ will be posted to the department’s ARPA webpage2

If you have questions, please contact Iowa Medicaid Provider Services at 1-800-338-7909 or by
email at [email protected]

American Rescue Plan Act (ARPA) 2021 | Iowa Department of Human Services

All Informational Letters are sent to the Managed Care Organizations Iowa Medicaid – 1305 E Walnut St. – Des Moines, IA 50319 INFORMATIONAL LETTER NO. 2383-MC-FFS DATE: …

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