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Catalog of Federal Domestic Assistance

Program Descriptions

93.211:  Rural Telemedicine Grants

Popular Name:  Rural Telemedicine Grant Program

Objectives:  The purpose of this grant program is to expand access to, coordinate, restrain the cost of, and improve the quality of essential health care services, including preventive and emergency services, through the development of integrated health care delivery systems or networks in rural areas and regions. Specifically the purpose of the Rural Telemedicine Grant Program is to demonstrate how Telemedicine can be used as a tool in developing integrated systems of health care, improving access to health services for rural citizens and reducing the isolation of rural health care practitioners. The purpose is also to collect information for a systematic evaluation on the feasibility, costs, appropriateness and acceptability of rural Telemedicine.

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

93.211 ELIGIBILITY REQUIREMENTS:

Applicant Eligibility:  An entity that is a health care provider and a member of an existing or proposed Telemedicine network, or an entity that is a consortium of health care providers that are members of an existing or proposed Telemedicine network shall be eligible for a grant under this section. An eligible network may include for-profit entities so long as the network grantee is a nonprofit entity.

Beneficiary Eligibility:  Rural health care providers, patients, and rural communities will benefit from this grant program.

Credentials/Documentation:  The basis for determining the allowance and allocability of costs charged to Public Health Service (PHS) grants is set forth in 45 CFR, Part 74, Subpart Q. The four separate sets of cost principles are: (1) OMB Circular No. A-87 for State and local governments, (2) OMB Circular No. A-21 for educational institutions, (3) 45 CFR, Part 74, Appendix E for hospitals, and (4) OMB Circular No. A-122 for nonprofit organizations.

93.211 APPLICATION AND AWARD PROCESS:

Preapplication Coordination:  Preapplication coordination is not required. This program is eligible for coverage under E.O. 12372, "Intergovernmental Review of Federal Programs." An applicant should consult the office or official 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. Applicants are required to notify their State Office of Rural Health (or other appropriate State entity) of their intent to apply for this grant program and to consult with such agency regarding the content of the application.

Application Procedure:  The standard application forms (Form PHS-5161-1, revised 5/96), as furnished by the PHS and required by 45 CFR, Part 92, must be used for this program. This program is subject to the provisions of 45 CFR, Part 92 for State and local governments and OMB Circular No. A-110 for nonprofit organizations and hospitals. Application kits can be obtained by writing HRSA Grants Application Center, 40 West Gude Drive, Suite 100, Rockville, MD 20850, or by calling toll-free: 1-888-300-4772.

Award Procedure:  The review of applications is carried out by Federal and nonfederal experts in Telemedicine and rural health care services development, coordination, and delivery. Applications are evaluated for merit and are scored according to the review criteria described in the HRSA Preview. Final decisions are made by the Director, Office for the Advancement of Telehealth.

Deadlines:  Contact Headquarters Office listed below for deadline dates.

Range of Approval/Disapproval Time:  From 4 to 5 months.

Appeals:  None.

Renewals:  Renewals have not been determined.

Criteria for Selecting Proposals:  Grant applications will be evaluated on the basis of the following criteria: (1) Extent to which the project facilitates development of an integrated system of care for the rural areas served by the project by providing referral linkages, facilitating consultations among health care professionals, and reducing the isolation of health care practitioners; as evidenced by the strength of the contractual arrangements among the members of the telemedicine network. (2) Extent to which the applicant has justified and documented the need(s) for the project, developed measurable goals and objectives for meeting the need(s), and designed a project that could be replicated in rural areas with similar needs and characteristics. (3) Demonstrated managerial, technical and clinical capability, experience and knowledge by the applicant and other network members to carry out the project. (4) Demonstrated ability to monitor the performance of the project, collect data, and participate in an evaluation of telemedicine. 5) The level of local commitment and involvement with the project, as evidenced by the extent of cost participation by the applicant and/or other organizations, letters of support, and the feasibility of plans to sustain the project after Federal grant support has ended. (6) Reasonableness of the budget proposed for the project.

Examples of Funded Projects:  High Plains Rural Health Network, Fort Morgan, Colorado: Lee Green, 303-867-6195. The High Plains Rural Health Network is a consortium of hospitals, clinics, and physician practices in the tri-state region encompassing Colorado, Nebraska, and Kansas. Its telemedicine network will have two hub facilities — one in Denver and one in Ft. Collins — serving nine rural hospitals, one community health center, and a long-term care facility. The telemedicine system will utilize a video conferencing system and an electronic bulletin board for ongoing communications among all network practitioners. The network also will facilitate "shared call," so a single physician can be "on call" for the largely frontier area served by the network. University of Kentucky Medical Center, Lexington, Kentucky: Dr. James Norton, 606-323-8018. The University of Kentucky Medical Center (UKMC) and Outpatient Clinic will provide specialty consultations to 13 rural clinics, 2 small rural hospitals, 5 rural secondary care level hospitals, and one community college student health service clinic. The secondary care hospitals will also provide consultations. The telemedicine system will use a variety of technologies, including video conferencing and computer-based image transfer. This project builds upon a 1-800 phone consultation and referral system called UKMDs. One goal of the project is to alleviate the isolation experienced by health professions in the Appalachian region served by the project.

Range and Average of Financial Assistance:  The average amount is $400,000.

93.211 RELATED PROGRAMS:

93.211 PROGRAM ACCOMPLISHMENTS:

93.211 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 $5,104,955; FY 00 est $5,000,000; and FY 01 est $5,000,000.

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

Authorization:  Public Health Service Act, Title III, Section 330A as amended by the Health Centers Consolidation Act of 1996, Public Law 104-299; Public Law 104-208 (DHHS Appropriations Act for fiscal year 1997) provides funding for the Rural Telemedicine Grant Program.

Regulations, Guidelines, and Literature:  Program guidelines may be obtained by contacting the Headquarters Office for PHS Grants Policy Statement, DHHS Publication No. (OASH) 94-50,000, (Rev.) April 1, 1994.

93.211 INFO CONTACTS:

Regional or Local Office:  Not applicable.

Headquarters Office:  Ms. Cathy Wasem, Office for the Advancement of Telehealth, Health Resources and Services Administration, Public Health Service, 5600 Fishers Lane, Rm. 11A-55, Rockville, MD, 20857. Phone: (301) 443-0447. Grants Management contact: Mr. Lawrence Poole, Grant Management Officer, Grants Management Office, Bureau of Primary Health Care, Health Resources and Services Administration, PHS, East-West Bldg., 11th Floor, 4350 East-West Highway, Rockville, MD 20814. Phone: (301) 594-4235. Use the same numbers for FTS.

(See Appendix IV for more contact info.)

93.211 ASSISTANCE CONSIDERATIONS:

Formula and Matching Requirements:  There are no statutory formula or matching requirements for this program.

Length and Time Phasing of Assistance:  Awards are made annually with up to a 3-year project period. Payments are made through an electronic transfer system or cash demand system.

Uses and Use Restrictions:  Funds may be used to demonstrate the use of Telemedicine in facilitating the development of rural health care networks and for improving access to health care services for rural citizens; provide a baseline of information for a systematic evaluation of Telemedicine systems serving rural areas; purchase or lease and install equipment; and to operate the Telemedicine system and evaluate the Telemedicine system. Not more than 40 percent of grant funds may be expended for equipment. Not more than 20 percent of grant funds may be expended for indirect costs. Grant funds may not be used for purchasing and installing telecommunications transmission equipment (e.g., microwave towers, satellite dishes, amplifiers, digital switching equipment or laying cable or phone lines). Constructions costs are allowable only for minor renovations related to the installation of equipment.

93.211 POST ASSISTANCE REQUIREMENTS:

Reports:  Annual progress and financial status reports are required 90 days from the end of the budget period and the final performance report and final financial status report are due 90 days from the end of the project period. Progress reports are to be submitted every 6 months.

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. In addition, grants are subject to inspection and audits by DHHS and other Federal officials.

Records:  Grantees are required to maintain grant accounting records for 3 years after the end of the budget period. If any litigation, audit, or other action involving the records has been started before the expiration of the 3-year period, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the regular 3-year period expires, whichever is later.