Local Fiscal Recovery Fund Toolkit for Public Health
Provided below are examples of allowable uses of ARPA local fiscal recovery funding related to public health expenses.
These ideas have been drawn directly from available guidance from the U.S. Department of Treasury. A complete listing of current guidance is available on the U.S. Department of Treasury’s website. Please be sure to check the Treasury’s website frequently to stay up to date on current guidance and funding requirements.
Please note the U.S. Department of Treasury has specific compliance and reporting requirements associated with the use of ARPA fiscal recovery funds. For more information, please refer directly to the U.S. Department of Treasury’s website.
Of note, all ARPA fiscal recovery funds must be encumbered by December 31, 2024 and all projects must be completed and all funds expended by December 31, 2026.
A broad range of services and programming are needed to contain COVID-19. Expenses related to the support of these activities, including staffing, acquisition of equipment or supplies, facilities costs, and information technology or other administrative expenses, can be funded through ARPA. Examples include:
- Enhancement of public health data systems 1
- Supports for vulnerable populations to access medical or public health services 2
- Public health surveillance (e.g., monitoring case trends, genomic sequencing for variants) 3
- Public communication efforts 4
- Enhancement of health care capacity, including through alternative care facilities 5
- Vaccination programs 6
- Testing 7
- Contact tracing 8
- Support for isolation or quarantine 9
- Purchases of personal protective equipment 10
- Support for prevention, mitigation, or other services in congregate living facilities (e.g., nursing homes, incarceration settings, homeless shelters, group living facilities) and other key settings like schools 11
- Ventilation improvements in congregate settings, health care settings, or other key locations 12
1 Final Rule, 31 CFR 35.6(b)(3)(i)(A)
2 Final Rule, 31 CFR 35.6(b)(1)
3 Supplementary information for 31 CFR Part 35 – Section II.A.1.
4 Supplementary information for 31 CFR Part 35 – Section II.A.1.
5 Supplementary information for 31 CFR Part 35 – Section II.A.1.
6 Final Rule, 31 CFR 35.6(b)(3)(i)(A)
7 Final Rule, 31 CFR 35.6(b)(3)(i)(A)
8 Final Rule, 31 CFR 35.6(b)(3)(i)(A)
9 Final Rule, 31 CFR 35.6(b)(3)(i)(A)
10 Final Rule, 31 CFR 35.6(b)(3)(i)(A)
11 Final Rule, 31 CFR 35.6(b)(3)(i)(A)
12 Final Rule, 31 CFR 35.6(b)(3)(i)(A)
The best tool for moving past COVID-19 is vaccination. ARPA funds may be used for expenses related to COVID-19 vaccination programs. See Final Rule 31 CFR 35.6(b)(3)(i)(A). Additionally, funds may be used for local vaccine incentive programs. Programs that provide incentives reasonably expected to increase the number of people who choose to get vaccinated, or that motivate people to get vaccinated sooner than they otherwise would have, are an allowable use of funds so long as such costs are reasonably proportional to the expected public health benefit. Please note the state offered a vaccine incentive program in the Summer/ Fall of 2021. More information on the statewide vaccine incentive program can be found at https://covidvaccine.mo.gov/win/.
A robust and responsive testing infrastructure is essential to Missouri’s success in stopping the spread of SARS-CoV-2, the virus that causes COVID-19. ARPA funds may be used for testing expenses associated with COVID-19. See Final Rule, 31 CFR 35.6(b)(3)(i)(A).
Testing requires the acquisition of several key resources in order to perform testing successfully and safely: personnel, personal protective equipment, and lab test collection kits/processing. Data collection is another element that is key to tracking the individuals tested, the results notification process, and the aggregation of results data from community testing. Some ideas to acquire testing resources include:
Utilize existing healthcare entities already involved in testing in your county. This could be hospitals, federally qualified healthcare centers, the local public health agency, local Medical Reserve Corps units, or other private healthcare providers. These entities may be able to provide all or some of the resources with reimbursement for the service(s).
Utilize vendors from the state’s three different Qualified Vendor Lists established for end-to-end testing services/events, PCR laboratory testing, and antigen test kits. Visit the Office of Administration's Bidding & Contracts page, and under "Statewide Contract Search," type "COVID" to view various contracted testing vendors available for the purchase of these testing goods and services.
The costs associated with partnering with a local entity or testing vendor is determined by the agreement between the partner/vendor and the county.
Contact tracing and case investigation are crucial components of a robust public health response. While universal case investigation and contact tracing is no longer recommended at this state in the pandemic, prioritization of these activities is necessary at times based upon case rates and outbreak situations occurring in the most vulnerable populations. As case rates increase, activities must focus on ensuring the safety of those citizens most at-risk for serious complications from COVID-19 infections and also in settings where infections can spread rapidly. Gathering data through case investigations is also vital to making sound public health decisions and guiding future mitigation strategies especially when different COVID-19 variants emerge as a concern.
County governments are encouraged to fund contact tracing efforts with ARPA funding. Contact tracing is one of the tools in the overall COVID-19 reduction strategy. See Final Rule, 31 CFR 35.6(b)(3)(i)(A).
The hiring of additional staff and cross training existing staff on contact tracing are acceptable strategies to help stop the spread of COVID-19 at the community level. LPHAs are encouraged to create plans to ensure appropriate staffing for contact tracing in a variety of COVID-19 scenarios using ARPA and other funding provided by DHSS. DHSS can provide contact tracing training to local health agencies. Online training for contact tracers is also available.
Contact tracing support can be found by utilizing vendors from the state’s Qualified Vendor List. Visit the Office of Administration's Bidding & Contracts page, and under "Statewide Contract Search," type "COVID" to view various contact tracing vendors available.
ARPA funds may be used for payroll and covered benefits expenses for public health employees as their services are devoted to mitigating or responding to the COVID–19 public health emergency. These funds may be used to support the payroll and covered benefits for the portion of the employee’s time that is dedicated to responding to the COVID-19 public health emergency. See Final Rule, 31 CFR 35.6(b)(3)(ii)(E)(1).
For administrative convenience, the recipient may consider public health employees to be entirely devoted to mitigating or responding to the COVID-19 public health emergency, and therefore fully covered, if the employee, or his or her operating unit or division, is primarily dedicated to responding to the COVID-19 public health emergency. Recipients may consider other presumptions for assessing the extent to which an employee, division, or operating unit is engaged in activities that respond to the COVID-19 public health emergency, provided that the recipient reassesses periodically and maintains records to support its assessment, such as payroll records, attestations from supervisors or staff, or regular work product or correspondence demonstrating work on the COVID-19 response. Recipients need not routinely track staff hours.
DHSS will continue to provide messaging and public information dissemination regarding COVID-19 and mitigation measures. DHSS can provide county governments with a base information package for testing site promotion and COVID-19 prevention methods. Several vaccine education assets are also available for use. Contact the Center for Local Public Health Services at (573) 751-6170 for assistance with messaging and promotion information.
County governments may partner with media outlets leveraging ARPA funding to help with messaging related to COVID-19 prevention, testing opportunities, etc.
County governments may also partner with LPHAs and healthcare providers to promote testing sites, vaccinations and many other COVID-19 related responses.
County governments may also consider supporting local public health agencies with GIS and data analytics software that allows for creation of storyboards to map current data for situational awareness and link citizens to the closest resources.
The COVID-19 public health emergency has emphasized the importance of having a strong public health infrastructure. State and local health agencies maintain core capabilities critical to promoting and protecting the public’s health, in both times of crisis and calm.
Jurisdictions need consistent resources to respond to emergencies like COVID-19 and simultaneously keep up their other critical responsibilities. DHSS encourages counties to invest in their public health workforce through development, training and retention of current staff and the development of future public health professionals. See Final Rule, 31 CFR 35.6(b)(3)(ii)(E)(1), (2), and (3).
CDC Crisis Response Cooperative Agreement: COVID-19 Public Health Workforce Development Supplemental Funding FAQs: This document summarizes CDC responses to a variety of questions related to the $2 billion in funding that CDC awarded to support COVID-19 workforce development in 65 jurisdictions.
CDC Guidance for Use of Federal Funds to Provide Incentives to Support COVID-19 Response: This document provides general guidance on the use of CDC funds for incentives.
Overview of Select Fiscal Year 2021 CDC COVID-19 Funding Opportunities: This table outlines select CDC funding resources provided to state, tribal, local, and territorial governments and other organizations to support their COVID-19 response activities. It does not represent all CDC resources but outlines the funding streams where recipients have requested further clarification and where there are perceived similarities in the intended purpose and allowable activities.
U.S. Department of Treasury’s website on Coronavirus State and Local Fiscal Recovery Funds (including ARPA funding): https://home.treasury.gov/policy-issues/coronavirus/assistance-for-state-local-and-tribal-governments/state-and-local-fiscal-recovery-funds
Final Rule 87 Fed. Reg. (January 27, 2022): https://www.govinfo.gov/content/pkg/FR-2022-01-27/pdf/2022-00292.pdf
Compliance and reporting information (required for use of ARPA funds): https://home.treasury.gov/policy-issues/coronavirus/assistance-for-state-local-and-tribal-governments/state-and-local-fiscal-recovery-funds/recipient-compliance-and-reporting-responsibilities