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Catalog of Federal Domestic Assistance

Program Descriptions

93.151:  Health Center Grants for Homeless Populations

Popular Name:  Health Care For the Homeless

Objectives:  To award grants for the purpose of enabling grantees, directly or through contracts, to provide for the delivery of primary health services and substance abuse (alcohol and/or illicit drugs) services to homeless individuals including homeless children. The grants may be used to continue to provide the services listed above for up to 12 months to individuals who have obtained permanent housing if services were provided to these individuals when they were homeless. For the purpose of this program, the term "homeless individual" means an individual who lacks housing (without regard to whether the individual is a member of a family), including an individual whose primary residence during the night is a supervised public or private facility that provides temporary living accommodations or an individual who is a resident in transitional housing.

PROGRAM AND AWARD	FINANCIAL AND INFORMATION CONTACTS
ELIGIBILITY REQUIREMENTS	FINANCIAL AND ADMINISTRATIVE INFO.
APPLICATION AND AWARD PROCESS	INFORMATION CONTACTS
RELATED PROGRAMS	ASSISTANCE CONSIDERATIONS
PROGRAM ACCOMPLISHMENTS	POST ASSISTANCE REQUIREMENTS

93.151 ELIGIBILITY REQUIREMENTS:

Applicant Eligibility:  Nonprofit private organizations and public entities, including State and local governmental agencies. Grantees and other organizations with whom they may contract for services under this program must have an agreement with a State under its Medicaid program, Title XIX of the Social Security Act (if they provide services that are covered under the Title XIX plan for the State), and be qualified to receive payments under the agreement.

Beneficiary Eligibility:  Homeless individuals including but not limited to, children, elderly persons, handicapped persons, families with children, Native Americans, and veterans.

Credentials/Documentation:  Costs will be determined in accordance with 45 CFR, Part 74, Subpart Q, for nonprofit organizations and OMB Circular No. A-87, "Cost Principles for State and Local Governments."

93.151 APPLICATION AND AWARD PROCESS:

Preapplication Coordination:  Informal inquiries regarding the program and intent to submit an application should be directed to the appropriate HRSA Field Office, Health Care for the Homeless coordinator. (See Appendix IV of the Catalog for listing of locations.) The application package will be made available by the Department of Health and Human Services (DHHS) (Form PHS-5161-1, with revised factsheet, DHHS-424). The application kit contains a list of States which have been chosen to set up a review system and will provide a point of contact in the States for that review. This program is eligible for coverage under E.O. 12372, "Intergovernmental Review of Federal Programs." An applicant should consult the office or officials designated as the single point of contact in his or her State for more information on the process the State requires to be followed in applying for assistance, if the State has selected the program for review. The standard application forms, as furnished by DHHS and required by 45 CFR 92 must be used for this program. This program is subject to the requirements of the Public Health System Impact Statement.

Application Procedure:  Application is made by the submission of the DHHS Application, Form PHS-5161-1. Applications may be obtained from the HRSA Grants Management Application Center, 50 East Gude Drive, Rockville, MD, 20850. Applicants must submit a written plan and including a description of nonfederal contributions and must contain assurances required by statute. This program is subject to the provisions of 45 CFR 92 for State and local governments and 45 CFR 74 for nonprofit organizations.

Award Procedure:  Applications will be reviewed by a committee composed of experts in the delivery of health care to the homeless. Applications are reviewed for merit and are recommended for approval or disapproval. Grant awards will be made by the Director, Office of Grants Management upon approval of the Director, BPHC.

Deadlines:  Contact appropriate HRSA Field Office for further information.

Range of Approval/Disapproval Time:  About 120 days.

Appeals:  None.

Renewals:  Support is recommended for a specified project period, not in excess of 5 years. After initial awards are made, continuation projects will be reviewed annually and funded if approved.

Criteria for Selecting Proposals:  For service expansions, the review of applications for grant support will consider the following: (1) Justification of need based upon demographic and/or health status indicators for the use population; (2) where applicable, justification of need for enhancing the organization's information systems capability; (3) identification of new populations to be served; (4) clarity and appropriateness of the proposed goals and objectives; (5) feasibility of the planned implementation within the resources and time frame proposed; (6) extent to which integration of services is planned with local agencies which provide services and support to the target population; (7) relationship of the proposal to the existing project plan of the applicant agency; (8) evidence of a system or program to track progress and outcomes; and (9) adequacy and appropriateness of the budget. For special initiatives, the review of applications for grant support will consider the following: (1) Need for the initiative and assessment of its potential impact upon the user population; (2) degree to which the initiative is consistent with the grantee's overall project plan; (3) extent to which linkages and/or coalitions are planned to strengthen outreach and referral systems; (4) extent to which the initiative will facilitate the delivery of effective primary health care; (5) extent to which integration of services is planned with State and local agencies which provide services and support to the target population; (6) appropriateness of the plan to continue support for the initiative after the expiration of Federal support; and (7) adequacy and appropriateness of the budget.

Examples of Funded Projects:  A Health Care for the Homeless Program formed a coalition of community representatives and providers for the provision of primary health, substance abuse, and mental health services to homeless individuals. Health care provider teams will travel to areas with heavy concentrations of homeless individuals. Homeless persons will be provided with primary care outpatient services either at a community health center or in off-site locations, such as shelters for the homeless or welfare hotels. The program will refer for inpatient hospitalization services if necessary. Substance abuse services and mental health services will be provided through existing facilities within the community. The community coalition represents organizations responsible for the provision of other services for homeless individuals such as food, clothing and shelter. Through a system of case management, the program will serve to guide homeless persons to these services. Arrangements for 24-hour emergency services have been made through a community hospital.

Range and Average of Financial Assistance:  From $62,000 to $2,000,000; $285,000.

93.151 RELATED PROGRAMS:

• 93.224 Community Health Centers;
• 93.246 Health Centers Grants for Migrant and Seasonal Farmworkers;
• 93.927 Health Centers Grants for Residents of Public Housing.

93.151 PROGRAM ACCOMPLISHMENTS:

93.151 FINANCIAL AND ADMINISTRATIVE INFO:

Federal Agency:  HEALTH RESOURCES AND SERVICES ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES

Type of Assistance:  Project Grants.

Obligations:  (Grants) FY 99 $79,961,000; FY 00 est $88,025,000; and FY 01 est $92,325,000.

Budget Account Number:  75-0350-0-1-550.

Authorization:  Public Health Service Act, Section 330(h), Public Law 104-299.

Regulations, Guidelines, and Literature:  Pertinent information is contained in the 52 CFR 32347, "Availability of Funds for Project Grants for Health Services to the Homeless Population."

93.151 INFO CONTACTS:

Regional or Local Office:  Contact the appropriate HRSA Field Offices.

Headquarters Office:  Program Contact: Regan Crump, M.S.N., Dr. P.H., Acting Director, Division of Programs for Special Populations, Bureau of Primary Health Care, Health Resources and Services Administration, Department of Health and Human Services, 4350 East-West Highway, 9th Floor, Bethesda, MD 20814. Phone: (301) 594-4420. Grants Management Contact: Office of Grants Management, Bureau of Primary Health Care, Health Resources and Services Administration, Department of Health and Human Services, 4350 East-West Highway, 11th Floor, Bethesda, MD 20814. Phone: (301) 594-4235. Use the same numbers for FTS.

(See Appendix IV for more contact info.)

93.151 ASSISTANCE CONSIDERATIONS:

Formula and Matching Requirements:  None.

Length and Time Phasing of Assistance:  Awards are made annually. After funds are issued, funds are released in accordance with payment procedures of DHHS, which may be an Electronic Transfer System or a monthly cash request system.

Uses and Use Restrictions:  Grant funds must be used to provide the following services, directly or through contract: (1) Primary health care and substance abuse services at locations accessible to homeless individuals; (2) 24-hour emergency primary health and substance abuse services; (3) referral, as appropriate to medical facilities, for necessary hospital services; (4) referral of homeless individuals who are mentally ill to entities that provide mental health services; (5) outreach services to inform homeless individuals of the availability of primary health and substance abuse services; and (6) aid in establishing eligibility for assistance, and in obtaining services under entitlement programs. Federal funds may not supplant existing public or private resources that are currently allocated to assist homeless populations. Separate grants will be awarded to a limited number of organizations to provide outreach, primary care services, and referral exclusively to homeless children. These grants will be limited to the same restrictions as the other grants.

93.151 POST ASSISTANCE REQUIREMENTS:

Reports:  Grantees will be required to submit reports annually on the quantity, type, and cost of services provided to homeless individuals. Reports will follow Uniform Data System (UDS) requirements. Annual progress and financial status reports are required at the end of each budget period and final reports must be submitted at the end of the project period.

Audits:  In accordance with the provisions of OMB Circular No. A-133 (Revised, June 24, 1997), "Audits of States, Local Governments, and Non-Profit Organizations," nonfederal entities that receive financial assistance of $300,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $300,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133.

Records:  Financial records must be kept available for 3 years after submission of expenditure reports and 3 years after final disposition of non-expendable property. If questions remain such as those raised as a result of an audit, records must be retained until the problem is resolved.