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The final rule maintains the presumptions identified in the interim final rule, as well as <br />recipients' ability to identify other impacted or disproportionately impacted classes. The final <br />rule also allows recipients to presume that low-income households were disproportionately <br />impacted, and as discussed above, defines low- and moderate -income. Finally, under the final <br />rule recipients may also presume that households residing in the U.S. territories or receiving <br />services from territorial governments were disproportionately impacted. <br />Households presumed to be impacted: Impacted households are those that experienced a <br />public health or negative economic impact from the pandemic. <br />With regard to public health impacts, recipients may presume that the general public <br />experienced public health impacts from the pandemic for the purposes of providing services for <br />COVID-19 mitigation and behavioral health. In other words, recipients may provide a wide <br />range of enumerated eligible uses in these categories to the general public without further <br />analysis. As discussed in the introduction, COVID-19 as a disease has directly affected the health <br />of tens of millions of Americans, and efforts to prevent and mitigate the spread of the disease are <br />needed and in use across the country. Further, the stress of the pandemic and resulting recession <br />have affected nearly all Americans. Accordingly, the final rule presumes that the general public <br />are impacted by and eligible for services to respond to COVID-19 mitigation and prevention <br />needs, as well as behavioral health needs. <br />With regard to negative economic impacts, as with the interim final rule, under the final <br />rule recipients may presume that a household or population that experienced unemployment, <br />experienced increased food or housing insecurity, or is low- or moderate -income experienced <br />negative economic impacts resulting from the pandemic. The final rule's definition of low- and <br />37 <br />