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Federal Register/Vol. 87, No. 18/Thursday, January 27, 2022/Rules and Regulations 4355 <br /> industries without any further analysis eligible for services that mitigate or category of eligible uses they should <br /> of impacts of the pandemic on those prevent COVID-19 spread.As such, a review to assess a potential use of funds. <br /> entities and whether the service is small business,nonprofit, or impacted For discussion of eligibility for <br /> responsive. industry receiving assistance to programs to expand health insurance <br /> In some cases,this means that an implement COVID-19 mitigation coverage, see section Assistance to <br /> entity not otherwise eligible to receive measures is a beneficiary of assistance Households. <br /> assistance to respond to negative (e.g.,granting funds to a small business <br /> economic impacts of the pandemic,for to develop an outdoor patio to reduce c. Behavioral Health Care <br /> example an entity that did not transmission).In contrast, if a recipient Background:Recognizing that the <br /> experience a negative economic impact, contracts with, or grants funds to,a public health emergency,necessary <br /> may still be eligible to receive assistance small business,nonprofit, or impacted mitigation measures like social <br /> under this category for COVID-19 industry to carry out an eligible use for distancing,and the economic downturn <br /> mitigation and prevention services. COVID-19 mitigation on behalf of the have exacerbated mental health and <br /> Uses of funds can include loans, recipient,the entity is a subrecipient substance use challenges for many <br /> grants, or in-kind assistance to small (e.g., contracting with a small business Americans,the interim final rule <br /> businesses,nonprofits,or other entities to operate COVID-19 vaccination sites). included an enumerated eligible use for <br /> to implement COVID-19 prevention or For further information on mental health treatment, substance use <br /> mitigation tactics, such as vaccination; distinguishing between beneficiaries treatment, and other behavioral health <br /> testing; contact tracing programs; and subrecipients, as well as the services, including a non-exhaustive list <br /> physical plant changes to enable greater impacts of the distinction on reporting of specific services that would be <br /> use of outdoor spaces or ventilation and other requirements, see section eligible under this category. <br /> improvements; enhanced cleaning Distinguishing Subrecipients versus Public Comment:Many commenters <br /> efforts; and barriers or partitions.For Beneficiaries. expressed support for the interim final <br /> example,this would include assistance rule's recognition of behavioral health <br /> to a restaurant to establish an outdoor b.Medical Expenses impacts of the pandemic and eligible <br /> patio,given evidence showing much Background:The interim final rule uses under this category. Several <br /> lower risk of COVID-19 transmission also included as an enumerated eligible commenters requested clarification on <br /> outdoors.76 Uses of funds can also use medical expenses,including the types of eligible services under this <br /> include aid to travel,tourism, medical care and services to address the category, specifically whether both <br /> hospitality,and other impacted near-term and potential longer-term acute and chronic care are included as <br /> industries to implement COVID-19 impacts of the disease on individuals well as services that often do not <br /> mitigation and prevention measures to infected. directly accept insurance payments, like <br /> enable safe reopening,for example, Public Comment:Some commenters peer support groups. Some commenters <br /> vaccination or testing programs, sought clarification on the types of highlighted the importance of cultural <br /> improvements to ventilation,physical medical expenses eligible and for competence in providing effective <br /> barriers or partitions, signage to whom,including whether funds could behavioral health services. Some <br /> facilitate social distancing,provision of be used under this category for commenters suggested that funding <br /> masks or personal protective equipment, expanding health insurance coverage should be available broadly and quickly <br /> or consultation with infection (e.g., subsidies for premiums, expanding for this purpose,recommending that <br /> prevention professionals to develop safe a group health plan),improvements to funding available for behavioral health <br /> reopening plans. healthcare facilities or establishment of not be tied to the amount of revenue <br /> Recipients providing assistance to new medical facilities, direct costs of loss experienced by the recipient. <br /> small businesses, nonprofits,or medical services,and costs to a self- Treasury Response:In the final rule, <br /> impacted industries that includes funded health insurance plan(e.g.,a Treasury is maintaining this enumerated <br /> capital expenditures (i.e., expenditures county government health plan)for eligible use category and clarifying that <br /> on property,facilities,or equipment) COVID-19 medical care. it covers an expansive array of services <br /> should also review the section Capital Treasury Response:In the final rule, for prevention,treatment,recovery, and <br /> Expenditures in General Provisions: Treasury is maintaining this enumerated harm reduction for mental health, <br /> Other,which describes eligibility eligible use category and clarifying that substance use,and other behavioral <br /> standards for these expenditures. it covers costs related to medical care health challenges caused or exacerbated <br /> Recipients providing assistances in the provided directly to an individual due by the public health emergency. The <br /> form of loans should review the section to COVID-19 infection(e.g.,treatment) specific services listed in the interim <br /> Treatment of Loans Made with SLFRF or a potential infection(e.g.,testing). final rule also remain eligible.77 <br /> Funds in General Provisions: Other. This can include medical costs to Treasury is further clarifying that <br /> Recipients should also be aware of the uninsured individuals; deductibles,co- when providing behavioral health <br /> difference between beneficiaries of pays, or other costs not covered by services,recipients can identify the <br /> assistance and subrecipients when insurance; costs for uncompensated care impacted population as the general <br /> working with small businesses, at a health provider; emergency medical public and, as with all enumerated <br /> nonprofits, or impacted industries.As response costs;and,for recipients with eligible uses,presume that all programs <br /> noted above,Treasury presumes that the a self-funded health insurance plan, and services are reasonably proportional <br /> general public, as well as small excess health insurance costs due to responses to the harm identified unless <br /> businesses,nonprofits,and impacted COVID-19 medical care.These are a response is grossly disproportionate to <br /> industries in general,has been impacted medical expenses due to COVID-19 and the type or extent of harm experienced. <br /> by the COVID-19 disease itself and is distinguish this category of eligible uses In contrast,capital expenditures are not <br /> from other related eligible uses,like <br /> 76 See Centers for Disease Control and Prevention, COVID-19 mitigation and prevention 77 Hotlines or warmlines,crisis intervention, <br /> Participate in Outdoor and Indoor Activities, and health insurance expenses to overdose prevention,infectious disease prevention, <br /> https://www.cdc.govlcoronavirusl2019-ncov/daily- and services or outreach to promote access to <br /> life-coping/outdoor-activities.html(last visited households,to provide greater clarity physical or behavioral health primary care and <br /> November 8,2021). for recipients in determining which preventative medicine. <br />