Grant Community.com

Catalog of Federal Domestic Assistance

Program Descriptions

93.252:  Community Access Program

Objectives:  To assist communities and consortia of health care providers to develop the infrastructure necessary to fully develop or strengthen integrated health care systems of care that coordinate health services for the uninsured.

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

93.252 ELIGIBILITY REQUIREMENTS:

Applicant Eligibility:  Applications may be submitted by the public, private, and nonprofit entities who demonstrate a commitment to and experience with providing a continuum of care to uninsured individuals. Each applicant must represent a community-wide coalition that is committed to the project and includes safety net providers (where they exist) that have traditionally provided care to the community's uninsured and underinsured regardless of ability to pay. The community-wide coalition must consist of partners from all levels of care (i.e., primary, secondary, tertiary) and partners who represent a range of services (e.g., mental health and substance abuse treatment, maternal and child health care, oral health, HIV/AIDS). Examples of eligible applicants that may apply on behalf of the community-wide coalition include but are not limited to: (1) A consortium or network of providers (e.g. public and charitable hospitals; community, migrant, homeless, public housing, and school-based health centers; rural health clinics; free health clinics; teaching hospitals and health professions education schools); (2) local government agencies (e.g., local public health departments with service delivery components); (3) Tribal governments; (4) managed care plans or other payers (e.g., HMOs, insurance companies); (5) agencies of State governments, multi-state health systems, or special interest groups may submit applications on behalf of multiple communities if they demonstrate the ability to coordinate community health care delivery systems and bring resources to the community. Competing applications for the same patient population will not be considered for funding; therefore, applicants from the same community should collaborate.

Beneficiary Eligibility:  Examples of eligible beneficiaries include but are not limited to: (1) A consortium or network of providers (e.g., public and charitable hospitals; community, migrant, homeless, public housing, and school-based health centers; rural health clinics; free health clinics; teaching hospitals and health professions education schools); (2) local government agencies (e.g., local public health departments with service delivery components); (3) tribal governments; (4) managed care plans or other payers (HMOs, insurance companies); and (5) agencies of State governments, multi-state health systems, or special interest groups may submit applications on behalf of multiple communities if they demonstrate the ability to coordinate community health care delivery systems and bring resources to the community.

Credentials/Documentation:  None.

93.252 APPLICATION AND AWARD PROCESS:

Preapplication Coordination:  There will be a series of six pre-application workshops conducted across the county between March 7 thru 16, 2000. Consultation and assistance will be available at these workshops to aid in preparing a competitive grant application. This program is excluded from courage under E.O. 12372.

Application Procedure:  Application kits (i.e., application instructions, necessary forms, and application review criteria) will be available through the HRSA Grants Application Center. Interested applicants must complete all forms included in the kit and mail their completed applications to the HRSA GAC. The HRSA GAC will then send applications to the CAP Program Office for an eligibility and conformance review.

Award Procedure:  Each of the applications will undergo an eligibility and conformance review by Federal staff at the CAP Program Office. Applications that have passed the eligibility and conformance review will be assigned to members of an Objective Review Committee (ORC) who will review them based on the evaluation criteria listed in the application guidance. The results of the ORC reviews will be shared with the HRSA Administrator and Secretary of HHS, who will make the final decisions.

Deadlines:  Applications are due on June 1, 2000.

Range of Approval/Disapproval Time:  The time required for the applications to be approved or disapproved is 90 days (July thru September 30, 2000). Applications will be reviewed between July 3 thru 17, 2000. Site visits to selected applicants will be conducted in August, 2000. Grant awards will be announced in September, 2000.

Appeals:  None.

Renewals:  None.

Criteria for Selecting Proposals:  Community Needs Assessment: (five points): (1) Extent to which the applicant has provided evidence of significant unmet needs for the target population; (2) extent to which the target population has a high or increasing rate of uninsurance or underinsurance; (3) extent to which the income status and cultural diversity of the target population indicates high need; (4) extent to which the applicant documents projected declines in public or private insurance coverage. Evidence of Progress towards Developing Integrated Systems for the Uninsured and Underinsured (20 points): (1) Evidence of collaboration partners' prior commitment to providing care to the target population; (2) evidence of results or accomplishments achieved from system integration efforts; (3) evidence of formal relationships among collaborators for project purposes; (4) capacity of the applicant to receive and administer funds on behalf of the coalition and evidence that it is authorized to act on behalf of the project partners. Statement of Project and Budget (20 points): (1) Extent to which the proposed project effectively addresses the needs of the target population as described in the needs assessment; (2) extent to which the proposed project is innovative; (3) extent to which the proposed project describes clear goals, objectives, planned activities, time frames and projected results that relate to and support the goals and objectives; (4) extent to which the proposed project has an appropriate organizational structure and staff to carry out the plan; (5) extent to which the itemized budget (with both existing funding sources and requested funding) is reasonable for the activities proposed and supports the project management plan; (6) extent to which the proposed project describes who has authority for making financial decisions and how funds will be managed and accounted for. Scope and Quality of Services (25 points): (1) extent to which the proposed project includes an appropriate range of services for the target population and adequate health care providers to carry out the project; (2) extent to which the proposed project would coordinate services among project providers, manage patient referrals, and coordinate patient information; (3) extent to which the proposed project would integrate substance abuse and mental health services into its system; (4) extent to which the proposed project describes methods and objectives that would be used for measuring clinical quality; (5) extent to which the proposed project describes methods and objectives that would be used for ensuring culturally and linguistically appropriate services; (6) extent to which the proposed project describes appropriate linkages to social services and enabling services in the community. Community Partnerships and Sustainability (20 points): (1) Extent to which the proposed project includes community participation in the design, management, and implementation of the project; (2) extent to which the proposed project includes a management structure to ensure ongoing community involvement; (3) extent to which the proposed project builds on current programs in the community that serve the uninsured and the underinsured; (4) extent to which the proposed project involves those providers who have traditionally served the uninsured in their community; (5) extent to which the ongoing governance structure involves the relevant participants in the community; (6) extent to which the proposed project demonstrates a firm commitment of State, local, and/or private funding and/or in-kind contributions dedicated to sustaining services for the target population; (7) extent to which the proposed project can demonstrate matching funding from private sources. Evaluation and Quality Improvement Plan (10 points): (1) Extent to which the proposed project has a self-evaluation plan that would track progress towards goals and objectives identified in the management plan; (2) extent to which the proposed project describes its information technology capability (e.g., capability to report the number of uninsured people in the community, the number of uninsured who receive care, and changes in health status disparities over time) and any plans for enhancement; (3) extent to which the proposed project commits to participate in a national program evaluation.

Examples of Funded Projects:  This is a new program on examples are available.

Range and Average of Financial Assistance:  Grant funding is for 20 grants of up to $1 million each.

93.252 RELATED PROGRAMS:

93.252 PROGRAM ACCOMPLISHMENTS:

93.252 FINANCIAL AND ADMINISTRATIVE INFO:

Federal Agency:  OFFICE OF THE SECRETARY, DEPARTMENT OF HEALTH AND HUMAN SERVICES

Type of Assistance:  Project Grants.

Obligations:  (Grants) FY 99 $0; FY 00 est $20,000,000; and FY 01 est $20,000,000.

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

Authorization:  Public Health Service Act, Title 111, Section 301.

Regulations, Guidelines, and Literature:  Federal Register Notice Volume 65, Number 24.

93.252 INFO CONTACTS:

Regional or Local Office:  Boston (617) 565-1420 - Ken Brown, Assistant Field Director Phone: New York (212) 264-2549 - Manely Khaleel, Chief, Primary Care; Philadelphia (215) 861-4414 - Scott Otterbein, Regional Program Consultant; Atlanta (404) 562-4127 - Stephen Dorage, Public Health Advisor; Chicago (312) 353-1254 - Stephen A. Laslo, Regional Program Consultant; Kansas City (816) 426-5296 ext. 239 - Mathew Henk, Regional Program Consultant; Dallas (214) 767-4533 - Jay McGath, Associate Field Director for Primary Care; Denver (303) 844-3203 - Nicholas Zucconi, Public Heath Advisor; San Francisco (415) 437-8113 -John Bruce, Public Health Advisor; and Seattle (206) 615-2490 - Beryl Cochran, Regional Program Consultant.

Headquarters Office:  Community Access Program Office, Health Resources and Services Administration, Parklawn Bldg., Suite 9A-30, 5600 Fishers Lane, Rockville, MD 20857. Phone: (301) 443-0536. Fax: (301) 443-0248.

(See Appendix IV for more contact info.)

93.252 ASSISTANCE CONSIDERATIONS:

Formula and Matching Requirements:  This program has no statutory formula.

Length and Time Phasing of Assistance:  Grant funds must be used in fiscal year 2000. Awards will be made as a lump sum.

Uses and Use Restrictions:  Examples of activities that could be supported with this funding include: (1) Offering a comprehensive delivery system for the uninsured and underinsured through a network of safety net providers (single registration, eligibility systems); (2) integrating preventive, mental health, substance abuse, HIV/AIDS, and maternal and child health services within the system (Block Grant funded services, other DHHS programs, State and local programs); (3) developing a shared information system among the community's safety net providers (tracking, case management, medical records, financial records); (4) developing and incorporating shared clinical protocols, quality improvement systems, utilization management systems, and error prevention systems; (5) sharing core management functions (finance, purchasing, appointment systems); (6) coordinating and strengthening priority services to specific targeted patient groups; (7) developing affordable pharmaceutical services. Funding provided through this program may not be used to substitute for or duplicate funds currently supporting similar activities. Grant funds may support costs such as: (1) Project staff salaries; (2) consultant support; (3) management information systems (e.g. hardware and software); (4) project related travel; (5) other direct expenses necessary for the integration of administrative, clinical, and information systems, of financial functions; and (6) program evaluation activities. With appropriate justification on why funds are needed to support the following costs up to 15 percent of grant funds may be used for: (1) Alteration or renovation of facilities; (2) primary care site development; (3) service expansions or direct patient care. Grant funds may not be used for: (1) Construction; (2) reserve requirements for State insurance licensure. Twenty-five million is available for up to 20 communities to further their development of integrated delivery systems for the uninsured. About 95 percent will be used for discretionary activities. Grants will vary in size based on the scope of the project and the size of the service area. A typical grant may not to exceed $1 million.

93.252 POST ASSISTANCE REQUIREMENTS:

Reports:  Awardees must provide data as required by the CAP national evaluation program.

Audits:  None.

Records:  None.