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Federal Register / Vol. 86, No. 10 / Friday, January 15, 2021 / Notices
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In addition, pursuant to section 5001(b) of
Division A of the CARES Act, payments from the
Fund are subject to the requirements contained in
the Further Appropriations Act of 2020 (Pub. L.
116–94) for funds for programs authorized under
section 330 through 340 of the Public Health
Service Act (42 U.S.C. 254 through 256). Section
5001(b) thereby applies to payments from the Fund
the general restrictions on the Department of Health
and Human Services’ appropriations. Of particular
relevance for the Fund, payments may not be
expended for an abortion, for health benefits
coverage—meaning a package of services covered
by a managed health care provider or organization
pursuant to a contract or other arrangement—that
includes coverage of abortion, for the creation of a
human embryo or embryos for research purposes,
or for research in which a human embryo is
destroyed, discarded, or knowingly subjected to risk
of injury or death greater than that allowed for
research on fetuses in utero under 45 CFR 46.204(b)
and 42 U.S.C. 289g(b)). The prohibition on payment
for abortions and health benefits coverage that
includes coverage of abortion does not apply to an
abortion if the pregnancy is the result of an act of
rape or incest; or in the case where a woman suffers
from a physical disorder, physical injury, or
physical illness, including a life-endangering
physical condition caused by or arising from the
pregnancy itself, that would, as certified by a
physician, place the woman in danger of death
unless an abortion is performed. These provisions
do not prohibit the expenditure by a State, locality,
entity, or private person of State, local, or private
funds (other than a State’s or locality’s contribution
of Medicaid matching funds). These provisions do
not restrict the ability of a managed care provider
from offering abortion coverage or the ability of a
State or locality to contract separately with such a
provider for such coverage with State funds (other
than a State’s or locality’s contribution of Medicaid
matching funds). Furthermore, no government
which receives payments from the Fund may
discriminate against a health care entity on the
basis that the entity does not provide, pay for,
provide coverage of, or refer for abortions. Except
with respect to certain law enforcement and
adjudication activities, no funds may be used to
maintain or establish a computer network unless
such network blocks the viewing, downloading, and
exchanging of pornography. No payments from the
Fund may be provided to the Association of
Community Organizations for Reform Now
(ACORN) or any of its affiliates, subsidiaries, allied
organizations, or successors. For the full text of
these requirements, see Title V of Pubic Law 116–
94 (133 Stat. 2605 et seq.), available at https://
www.congress.gov/116/plaws/publ94/PLAW-
116publ94.pdf.
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See 42 CFR 433.51 and 45 CFR 75.306.
for delivery. Similarly, in recognition of
the likelihood of supply chain
disruptions and increased demand for
certain goods and services during the
COVID–19 public health emergency, if a
recipient enters into a contract requiring
the delivery of goods or performance of
services by December 31, 2021, the
failure of a vendor to complete delivery
or services by December 31, 2021, will
not affect the ability of the recipient to
use payments from the Fund to cover
the cost of such goods or services if the
delay is due to circumstances beyond
the recipient’s control.
This guidance applies in a like
manner to costs of subrecipients. Thus,
a grant or loan, for example, provided
by a recipient using payments from the
Fund must be used by the subrecipient
only to purchase (or reimburse a
purchase of) goods or services for which
receipt both is needed within the
covered period and occurs within the
covered period. The direct recipient of
payments from the Fund is ultimately
responsible for compliance with this
limitation on use of payments from the
Fund.
Nonexclusive Examples of Eligible
Expenditures
Eligible expenditures include, but are
not limited to, payment for:
1. Medical expenses such as:
• COVID–19-related expenses of
public hospitals, clinics, and similar
facilities.
• Expenses of establishing temporary
public medical facilities and other
measures to increase COVID–19
treatment capacity, including related
construction costs.
• Costs of providing COVID–19
testing, including serological testing.
• Emergency medical response
expenses, including emergency medical
transportation, related to COVID–19.
• Expenses for establishing and
operating public telemedicine
capabilities for COVID–19-related
treatment.
2. Public health expenses such as:
• Expenses for communication and
enforcement by State, territorial, local,
and Tribal governments of public health
orders related to COVID–19.
• Expenses for acquisition and
distribution of medical and protective
supplies, including sanitizing products
and personal protective equipment, for
medical personnel, police officers,
social workers, child protection
services, and child welfare officers,
direct service providers for older adults
and individuals with disabilities in
community settings, and other public
health or safety workers in connection
with the COVID–19 public health
emergency.
• Expenses for disinfection of public
areas and other facilities, e.g., nursing
homes, in response to the COVID–19
public health emergency.
• Expenses for technical assistance to
local authorities or other entities on
mitigation of COVID–19-related threats
to public health and safety.
• Expenses for public safety measures
undertaken in response to COVID–19.
• Expenses for quarantining
individuals.
3. Payroll expenses for public safety,
public health, health care, human
services, and similar employees whose
services are substantially dedicated to
mitigating or responding to the COVID–
19 public health emergency.
4. Expenses of actions to facilitate
compliance with COVID–19-related
public health measures, such as:
• Expenses for food delivery to
residents, including, for example, senior
citizens and other vulnerable
populations, to enable compliance with
COVID–19 public health precautions.
• Expenses to facilitate distance
learning, including technological
improvements, in connection with
school closings to enable compliance
with COVID–19 precautions.
• Expenses to improve telework
capabilities for public employees to
enable compliance with COVID–19
public health precautions.
• Expenses of providing paid sick and
paid family and medical leave to public
employees to enable compliance with
COVID–19 public health precautions.
• COVID–19-related expenses of
maintaining state prisons and county
jails, including as relates to sanitation
and improvement of social distancing
measures, to enable compliance with
COVID–19 public health precautions.
• Expenses for care for homeless
populations provided to mitigate
COVID–19 effects and enable
compliance with COVID–19 public
health precautions.
5. Expenses associated with the
provision of economic support in
connection with the COVID–19 public
health emergency, such as:
• Expenditures related to the
provision of grants to small businesses
to reimburse the costs of business
interruption caused by required
closures.
• Expenditures related to a State,
territorial, local, or Tribal government
payroll support program.
• Unemployment insurance costs
related to the COVID–19 public health
emergency if such costs will not be
reimbursed by the federal government
pursuant to the CARES Act or
otherwise.
6. Any other COVID–19-related
expenses reasonably necessary to the
function of government that satisfy the
Fund’s eligibility criteria.
Nonexclusive Examples of Ineligible
Expenditures
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The following is a list of examples of
costs that would not be eligible
expenditures of payments from the
Fund.
1. Expenses for the State share of
Medicaid.
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2. Damages covered by insurance.
3. Payroll or benefits expenses for
employees whose work duties are not
substantially dedicated to mitigating or
responding to the COVID–19 public
health emergency.
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