FY 2013 New Access PointFunding Opportunity

Announcement HRSA-13-228Objective Review Committee

Health Resources and Services Administration

Department of Health and Human Services

NAP TA Website: http://www.hrsa.gov/grants/apply/assistance/nap

Agenda

1. Overview• Health Center Program• New Access Point Funding Opportunity• Eligibility • Funding Priorities

2. Application Components• Project Narrative and Review Criteria• Budget Presentation• Attachments• Program Specific Forms• Program Specific Information

3. Program Review Resources and Reminders

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Overview

NAP is a competitive funding opportunity for operational support for NEW primary care service delivery site(s) under the Health Center Program.

What is a New Access Point?

• A new service delivery site for the provision of comprehensive primary and preventive medical health care services.

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OverviewThe Health Center Program

The Health Center Program provides grant support to public or private non-profit organizations that serve designated medically underserved areas/populations or special populations comprised of migratory and seasonal agricultural workers, homeless individuals and families, or residents of public housing. 

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OverviewThe Health Center Program

• Health Center Program grantees must provide primary care services to all, regardless of their ability to pay.

• Health Center Program grantees are expected to comply with the 19 program requirements included as Appendix F in the NAP funding opportunity announcement (FOA).

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OverviewNAP Highlights

• Approximately $19 million for approximately 25 NAP grant awards

• Authorized by Section 330 of the Public Health Service Act

• Supported by the Affordable Care Act

• Open to current Health Center Program grantees and new applicants

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OverviewTypes of Health Centers

Applicants may request funding to serve any combination of populations based on the proposed service area’s needs

•Community Health Centers (CHC, section 330(e)) serve the general underserved population•Migrant Health Centers (MHC, section 330(g)) serve migratory and seasonal agricultural workers and their families•Healthcare for the Homeless (HCH, section 330(h)) serve homeless individuals and families•Public Housing Primary Care (PHPC, section 330(i)) serve residents of public housing

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OverviewSpecial Populations

• Applicants proposing to serve special population(s) must address additional, specific program requirements.

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Eligibility

• Public or private, nonprofit entity, including tribal, faith based, and community based organizations.

• At least one proposed NAP site must be a full-time permanent site operating at least 40 hours per week.

• Comprehensive primary medical care must be the main purpose of the NAP application.

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Eligibility

• Ensure access to services for all service area populations. Proposed site(s) may not focus on a single age-group (e.g., children), lifecycle (e.g., geriatric), or health issue (e.g., HIV/AIDS).

• Provide comprehensive primary health care services without regard for ability to pay.

• Budget request may not exceed $650,000 in either Year 1 or Year 2.

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Eligibility

• No proposed NAP site can be in any Health Center Program grantee’s scope of project.

• Application must not exceed the 200-page limit when printed by HRSA.

• New Starts applying for Community Health Center (CHC) funding must propose a service area that is designated, in whole or in part, as an MUA and/or contains an MUP.

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Funding Priorities

A funding priority is the favorable adjustment of an application’s objective review score if specific criteria are met.

1. Unserved, High Poverty (up to 15 points)

2. Sparsely Populated (5 points)

Reviewers do not make the determination on priority points. Applications will be automatically assessed for these priorities.

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Application Components

• Project Narrative• Attachments• Program Specific Forms

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Project Narrative / Review Criteria

• The Project Narrative details the information the applicant must include to provide a comprehensive description of the proposed NAP

• The Review Criteria are used by grant reviewers to evaluate how well the applicant presented the information requested

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Review Criteria

• NEW for 2013: Review Criteria reference Project Narrative items, forms, and attachments that must be considered collectively when scoring the application

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Review Criteria

• Need (30 points)• Response (20 points)• Collaboration (10 points)• Evaluative Measures (5 points)• Resources/Capabilities (15 points)• Governance (10 points)• Support Requested (10 points)

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Highlights: Need

Need (30 points)

•20 of the 30 points available for the Need Section are determined by the Need for Assistance Worksheet (NFA – Form 9) score

•The narrative response (10 of the 30 points) should reference the data provided in the NFA Worksheet as needed

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Highlights: Response

Response (20 points)

•The narrative and referenced forms and attachments must describe the proposed project and how it will comply with the Health Center Program requirements

•NEW: Implementation Plan to demonstrate operational readiness/compliance in 120 days

•NEW: Describe plans for outreach and enrollment for Medicaid expansion and Health Insurance Exchanges

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Highlights: Collaboration

Collaboration (10 points)

•The narrative and attachments must demonstrate collaboration between service providers within the service area

•NEW for 2013: Letters of support are required from major private provider groups serving the target population

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Highlights: Evaluative Measures

Evaluative Measures (5 points)

•The narrative and performance measures forms must demonstrate realistic goals and evaluation planning

•NEW for 2013: New clinical performance measures are required

•NEW for 2013: Describe implementation of certified Electronic Health Records (EHR) for patient tracking and meaningful use

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Highlights: Resources/Capabilities

Resources/Capabilities (15 points)

•The narrative and referenced forms and attachments must demonstrate the organizational capacity and experience to successfully operate the new access point(s)

•NEW for 2013: Describe your current or planned integration with the state health care delivery plan

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Highlights: Governance

Governance (10 points)

•The narrative and referenced forms and attachments must document how the organization and its board are compliant with the Health Center Program governance requirements

•Governance requirements do not apply to health centers operated by Indian tribes, tribal groups, or Indian organizations

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Highlights: Support Requested

Support Requested (10 points)

•The budget justification and referenced forms and attachments must document a consistent budget presentation appropriate for the proposed project

•NEW for 2013: Provide the proposed total cost and federal cost per patient (by requested funding type) and explain how this is reasonable and appropriate

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Budget Presentation

• The budget presentation must provide detailed information for each year of the 2-year project period

• Required components:

– SF-424A: Budget Information – Non-Construction Programs

– Budget Justification

• The budget justification should include a line-item budget and narrative justification

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Attachments

• Attachment 1: Service Area Map and Table• Attachment 2: Implementation Plan• Attachment 3: Applicant Organizational

Chart• Attachment 4: Position Descriptions for Key

Management Staff• Attachment 5: Biographical Sketches for Key

Management Staff• Attachment 6: Co-Applicant Agreement• Attachment 7: Summary of Contracts and

Agreements25

Attachments

• Attachment 8: Independent Financial Audit• Attachment 9: Articles of Incorporation• Attachment 10: Letters of Support• Attachment 11: Sliding Fee Discount

Schedule(s)• Attachment 12: Evidence of Nonprofit or

Public Center Status• Attachment 13: Floor Plans• Attachment 14: Corporate Bylaws• Attachment 15: Other Relevant Documents

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Readiness and Full Operational Capacity

• NEW for 2013: An Implementation Plan has been added (Attachment 2), that details the steps necessary for an applicant to demonstrate that the new access point(s) will be operational (providing services to the target community/population) and compliant with Health Center Program requirements within 120 days of award.

• Full operational capacity must be achieved within 2 years of award (serving all projected patients).

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Program Specific Forms

• Form 1A: General Information Worksheet• Form 1B: BPHC Funding Request Summary• Form 1C: Documents on File• Form 2: Staffing Profile• Form 3: Income Analysis• Form 4: Community Characteristics• Form 5A: Services Provided• Form 5B: Service Sites• Form 5C: Other Activities/Locations

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Program Specific Forms

• Form 6A: Current Board Member Characteristics

• Form 6B: Request for Waiver of Governance Requirements

• Form 8: Health Center Agreements• Form 9: Need for Assistance Worksheet• Form 10: Annual Emergency Preparedness

Report• Form 12: Organization Contacts• Summary Page

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Summary Page

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• NEW for 2013: Summary Page that presents important information from application forms

• Provides at-a-glance review of:– proposed sites and service area zip codes– health center type(s)– funding requested, including one-time

funding– proposed number of patients to be served

and federal cost per patient – NFA score

• Applicants must verify accuracy of data

Program Specific Information

• One-Time Funding Project Information for Alteration/Renovation projects

• Clinical and Financial Performance Measures serve as ongoing monitoring and performance improvement tools– Clinical – 16 required measures– Financial – 5 required measures

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Clinical Performance Measures

• Diabetes• Cardiovascular Disease• Cancer• Prenatal Health*• Perinatal Health*• Child Health• Behavioral Health• Oral Health

*may be marked “not applicable” if services are provided only via referral and not paid for by the applicant 32

Clinical Performance Measures

• Weight Assessment and Counseling for Children and Adolescents

• Adult Weight Screening and Follow-Up• Tobacco Use Assessment• Tobacco Cessation Counseling• Asthma – Pharmacological Therapy• Coronary Artery Disease: Lipid Therapy• Ischemic Vascular Disease: Aspirin

Therapy• Colorectal Cancer Screening

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Financial Performance Measures

• Total Cost per Patient• Medical Cost per Medical Visit• Change in Net Assets to Expense Ratio*• Working Capital to Monthly Expense

Ratio*• Long Term Debt to Equity Ratio*

*may be marked “not applicable” by tribal and public center applicants 34

Performance Measures

• Applicants may create additional “Other” performance measures specific to their proposed projects

• Applicants applying for special population funding must include additional clinical performance measures that address the health care needs of the special population(s)

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Program Review Resources

• Funding Opportunity Announcement

• Side by Side of Project Narrative and Review Criteria

• HRSA Scoring Rubric

• Frequently Asked Questions

• NAP Application TA Website: http://www.hrsa.gov/grants/apply/assistance/NAP

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Final Reminders

• Reference the FOA

• Base your score on the Review Criteria, with reference to the Project Narrative, as needed

• Substantiate your score with strengths and weaknesses

• Your effort is appreciated

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