Details on eligible and ineligible uses of supplemental payment funding may be found in the supplemental payment agreements signed by each hospital in October 2021 and March 2022.
1. Q: There are some behavioral health personnel whose titles are not referenced in the payment agreements, including one-to-one watches, milieu counselors, psychologists, and therapists). Are they eligible for support through this funding? Does this funding support also include staff such as housekeepers, environmental staff, and cafeteria workers?
A: Qualified personnel include those who are considered clinical and direct care employees who provide care, services, or supports to individuals and families. These may include one-to-one watches, milieu counselors, psychologists, and therapists, in addition to other examples listed in the payment agreements. Expenditures toward staff who do not provide clinical or direct care are not allowed. This includes administrative staff, housekeepers, environmental staff, and cafeteria workers.
2. Q: Could training to increase competency of the behavioral health workforce be included? For instance, would it be an allowed use of this funding to provide successive training with a bonus structure for mental health workers to both increase their competency and to lighten the workload on RNs?
A: Training and other related recruitment and continuing education benefits for clinical and direct care staff is a permissible use of this funding, assuming all staff will be working within appropriate scope of clinical training and licensing.
3. Q: If a hospital increases staffing levels, both provider and staff, based on capacity expansion and census increase, what elements are covered? Are the overall base salaries of incremental new personnel covered or are only certain components covered?
A: All expenditures are expected to be incremental to current workforce spending—that is, they do not replace current salaries or other spending. Wages for new personnel would be an acceptable expenditure so long as the spending does not replace current salaries or workforce expenses.
4. Q: Can funding be used for staffing for both existing inpatient beds and new beds?
A: Yes, direct care staffing for any inpatient psychiatric beds is allowed, so long as the spending is incremental to current expenses—that is, it does not replace current salaries or other spending.
5. Q: Does the funding cover both employees and contracted behavioral health personnel?
A: This funding covers eligible hospital employees who are clinical and direct care staff. Funding may also be used for clinical and direct care staff who are hired by contract, such as a travel nurse.
6. Q: How would training costs to onboard new staff be included? For example, could the funding be used to support additional paid hours related to onboarding before they can start their new roles?
A: Onboarding and training costs related to recruitment of direct care staff are allowed, so long as expenditures are tied to benefits received by eligible categories of employees. Expenditures related to Human Resources staff or activities for recruitment that are not directly related to eligible employees are not allowed.
7. Q: Are direct recruiting costs to fill behavioral health positions permitted? For example, could the funding be used for the costs for underlying recruiting activities and recruiting personnel?
A: Recruitment expenditures must be directly tied to benefits received by eligible categories of employees, such as reimbursement for travel during the recruitment process or signing bonuses. Recruitment expenditures are allowable so long as expenses are not paid to the hospital’s administrative or other non-eligible staff, or are not used to offset current spending on recruitment activities. Administrative costs from activities such as job fairs or payment of third-party recruitment agencies would not be covered.
8. Q: What expenditures are permitted for personnel who care for special populations, such as individuals with dementia or autism, etc.?
A: Any treatment population receiving services in a bed licensed by the Department of Mental Health (DMH) is considered eligible as long as funding is used toward clinical and direct care staff treating that population.
9. Q: Since EOHHS has released two tranches of payments, are there any limitations or requirements on the timing of when the funds must be used? How far into the future can they be used? Can they be used retrospectively?
A: Providers may use payments received through either tranche to cover expenditures made on or after June 1, 2021. Providers must expend all funds received through either tranche by September 30, 2022.
10. Q: Where can I find more information on the amount and timing of the tranche 1 and 2 payments?
A: The methodology for the tranche 1 payments is described in the following documents, as applicable.
- RY21 Psychiatric Hospital Request for Applications (Psychiatric Hospital RFA)
- RY21 Acute Hospital Request for Applications and Contract (Acute Hospital RFA), and
- RY22 Chronic Disease and Rehabilitation Hospital (CDRH) Contract and Payment Agreement.
The methodology for the tranche 2 payments is described in the following documents, as applicable.
- RY22 Psychiatric Hospital RFA
- RY22 Acute Hospital RFA, and
- RY22 CDRH Contract and Payment Agreement.
11. Q: There is a reference to spending reports in the payment agreement. How will organizations be required to document the use of expenditures specifically for behavioral health inpatient staffing expenses?
A: The reporting tool is still under development. EOHHS will be share it when it is available