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Catalog of Federal Domestic Assistance

Program Descriptions

93.779:  Health Care Financing Research, Demonstrations and Evaluations

Popular Name:  HCFA Research

Objectives:  To support analyses, experiments, demonstrations and pilot projects in efforts to resolve major health care financing issues and to develop innovative methods for the administration of Medicare and Medicaid. These awards are in the form of research grants and cooperative agreements; small business grants; dissertation fellowship grants; Hispanic health services grants; historical black colleges and university grants. For fiscal years 1999 and 2000, the Health Care Financing Administration (HCFA) has identified a number of areas where specific information or experience is necessary to improve program effectiveness or guide decisions anticipated in the near future. These priority areas for HCFA's discretionary contracts, cooperative agreements or grants are as follows: (1) Develop and evaluate enrollment, delivery and payment systems for Medicare health plans; (2) develop and evaluate innovative systems for provider payment and health care delivery in the traditional Medicare fee-for service sector; (3) perform research to assess the impact of longer term structural reforms of the Medicare Program; (4) develop better tools for measuring health care outcomes and quality, and improved information resources to assist consumers in choosing among health plans and providers; (5) develop new payment and delivery models to improve access to health care for vulnerable populations; and (6) evaluate the Medicaid and other State health care activities; and implement and evaluate State Medicaid demonstrations to improve access to and quality of care for vulnerable Medicaid populations, and to more effectively manage the costs of providing that care.

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

93.779 ELIGIBILITY REQUIREMENTS:

Applicant Eligibility:  Grants or cooperative agreements may be made to private, or public agencies or organizations, including State agencies that administer the Medicaid program. Private profit organizations may apply. For the Small Business Innovation Research Grant Program, only for-profit organizations may apply. Awards cannot be made directly to individuals.

Beneficiary Eligibility:  Contributing retirees or specially entitled beneficiaries, the disabled or those with end stage renal disease (for Medicare) the aged, and families with children and youth (for Medicaid).

Credentials/Documentation:  Applicants should present written evidence of other agencies' willingness to cooperate when the project involves collaborative efforts or the utilization of non-HCFA facilities or services. Costs will be determined in accordance with OMB Circular No. A-102 for State and local governments. The standard forms, as furnished by DHHS and required by OMB Circular No. A-102, must be used.

93.779 APPLICATION AND AWARD PROCESS:

Preapplication Coordination:  HCFA research and demonstration projects are solicited by publication in the "Federal Register," requests of proposals for contracts in "Commerce Business Daily," targeted program announcements, and other appropriate means. Some funds are used for creative, unsolicited proposals. Applicants should maintain contact with Regional HCFA Offices (see Appendix IV of the Catalog for listing). The standard application forms, as furnished by HCFA, must be used for this program. This program is excluded from coverage under E.O. 12372.

Application Procedure:  Application forms are submitted to the Acquisition and Grants Group, HCFA, 2-21-15 Central Bldg., 7500 Security Blvd., Baltimore, MD 21244-1850. This program is subject to the provisions of OMB Circular Nos. A-102 and A-110. A letter of intent to file an application is necessary 30 days prior to the closing date of each solicitation cycle.

Award Procedure:  Official notice of approved applications is made through issuance of a Notice of Cooperative Agreement or Grant Award.

Deadlines:  Established when grants/cooperative agreements are solicited by publication in the Federal Register or a program announcement for grants/cooperative agreements and by the individual Request for Proposal for contracts. Unsolicited applications may be submitted at any time.

Range of Approval/Disapproval Time:  Range from 150 to 180 days.

Appeals:  No formal appeals procedures. If an application is disapproved, the reasons for disapproval will be fully stated. Applicants are free to resubmit applications with attention to the changes suggested by the reasons for disapproval. In the case of solicited proposals, extensions may be allowed to prepare revisions which clarify various aspects of projects.

Renewals:  Extensions and continuations of projects are available if formally applied for and approved. If a grant/cooperative agreement application is recommended for approval for 2 or more years, the awardee must annually submit a formal request for continuation accompanied by a progress report which will be evaluated prior to a recommendation of continuation.

Criteria for Selecting Proposals:  The review process for grants/cooperative agreements consists of initially screening applications for completeness and relevancy to HCFA priority areas. If the application is not relevant to HCFA priority areas, it will be returned to the applicant. If accepted as submitted it will be reviewed and evaluated. The review will be conducted by a panel of not less than three experts. HCFA Project Officer will coordinate the panel's review, but will not vote. This individual will also prepare the panel's recommendation to the Director, Office of Strategic Planning (OSP). The panel's recommendations will contain numerical ratings, rankings of applications, and a written assessment of each application. The recommendations will be based on published criteria as stated in the Federal Register. The review process for applications is also stated in the Federal Register Announcement.

Examples of Funded Projects:  Examples of funded projects in fiscal year 1999 include: (1) Expanded evaluation of Medicare and You Handbook; (2) evaluation of the Children's Health Insurance Program; (3) health status and medical treatments of the future elderly; (4) design, development, implementation, monitoring and requirement of a prospective payment system for inpatient rehabilitation; and (5) evaluation of the qualified Medicare beneficiary (QMB) and specified low-income Medicare beneficiary (SLMB) programs.

Range and Average of Financial Assistance:  The range is from $25,000 to $1,000,000; $235,000.

93.779 RELATED PROGRAMS:

• 93.773 Medicare: Hospital Insurance;
• 93.774 Medicare: Supplementary Medical Insurance;
• 93.778 Medical Assistance Program (Medicaid).

93.779 PROGRAM ACCOMPLISHMENTS:

There were 27 new cooperative agreements/grants funded and 21 new contracts funded in fiscal year 1999.

93.779 FINANCIAL AND ADMINISTRATIVE INFO:

Federal Agency:  HEALTH CARE FINANCING ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES

Type of Assistance:  Project Grants.

Obligations:  (Grants, Cooperative Agreements and Contracts) FY 99 $49,670,782; FY 00 est $61,800,000; and FY 01 est $55,000,000.

Budget Account Number:  75-0511-0-1-550.

Authorization:  Social Security Act, Title XI, Sections 1110 and 1115, 42 U.S.C. 1310 and 1315(a), Title XVIII, Section 1875, 42 U.S.C. 1395 and 42 U.S.C. 1881 (f); Section 402, Public Law 90-248, as amended; Section 222, Public Law 92-603; Small Business Innovation Development Act of 1982, Public Law 97-219, as amended; Small Business Innovation Research Program Extension, Public Law 99-443.

Regulations, Guidelines, and Literature:  Grants Administration policies (45 CFR 74 and 92) and application kits may be obtained from the Office of Acquisition and Grants Group, Health Care Financing Administration, Room C2-21-15, Central Bldg., 7500 Security Blvd., Baltimore, MD 21244-1850.

93.779 INFO CONTACTS:

Regional or Local Office:  Contact the appropriate HCFA Regional Administrator. (See Appendix IV for Regional Offices.)

Headquarters Office:  Daniel Waldo, Acting Director, Office of Strategic Planning Research, and Demonstrations (OSP), Health Care Financing Administration, Department of Health and Human Services, Room C-3-20-11, Central Bldg., 7500 Security Blvd., Baltimore, MD 21244-1850. Phone: (410) 786-7932. FTS is not available.

(See Appendix IV for more contact info.)

93.779 ASSISTANCE CONSIDERATIONS:

Formula and Matching Requirements:  Awardees are required to share in the cost of projects. Normally, the minimum cost-sharing requirement is 5 percent of total project costs. This program has no statutory formula, except in Section 1115 projects, where the statutory formula is the same as that established for the Medicaid Program, both administrative and operational.

Length and Time Phasing of Assistance:  Grants/cooperative agreements are generally funded on a 12-month basis, with support beyond the first year contingent upon acceptable evidence of satisfactory progress, continuing program relevance, and availability of funds.

Uses and Use Restrictions:  Under all authorizations, all applications must meet standards of excellence in research or evaluation design. Funds may not be used for construction or renovation of buildings. Funds authorized by Section 1115 of the Social Security Act are limited to State agencies administering the Medicaid program.

93.779 POST ASSISTANCE REQUIREMENTS:

Reports:  Reports of progress and expenditures are required on all projects. Comprehensive final reports are due no later than 90 days after termination of projects.

Audits:  All fiscal transactions identifiable to Federal financial assistance are subject to audit by DHHS audit agency.

Records:  Proper accounting records, identifiable by project number and including all receipts and expenditures, must be maintained for 3 years. Subsequent to audit, they must be maintained until all questions are resolved.