aha-final-foa-07132015.pdf

U.S. Department of Health and Human Services Office of the National Coordinator for Health Information Technology

Tracking Electronic Health Record Adoption and Capturing Related Insights in U.S. Hospitals

Program Guidance Funding Opportunity Announcement

Fiscal Year 2015

Release/Posted Date: July 15, 2015 Application Due Date: September 14, 2015

Anticipated Award Date: September 20, 2015

Contents

OPPORTUNITY OVERVIEW 5

Executive Summary 6

I. Funding Opportunity Description: 6

A. Background 6

B. Purpose 6

C. Scope of Services 7

D. Project Approach and Structure 7

1. Cooperative Agreement Management & Work Plan 7

2. Survey Instrument Development 7

3. Survey Instrument Production and Data Collection 7

4. Preliminary Data 8

5. Data Quality 8

6. Data Delivery 8

7. Public Availability 8

E. Goal Description, Standards, Schedule & Deliverable Table 8

II. Award Information 10

A. Summary of Funding 10

B. Performance Evaluation 10

C. Award Type 10

D. Proposal Criteria 11

E. General Funding Requirements 11

F. Project Evaluation and Measurement 11

III. Eligibility Information 13

A. Eligible Applicants 13

B. Sole Source Justification 13

C. Cost Sharing or Matching 14

IV. How to Apply Information 14

A. Address to Request an Application Package 14

B. Content and Form Submission 14

C. Submission Dates and Times 16

D. Grants.gov Registration 16

E. Applying Electronically through Grants.gov 16

F. Proof of the Applicant’s Status as a Non-Profit Entity 17

G. Intergovernmental Review of Applications 17

H. Funding Restrictions 17

V. Application Merit Review Information 17

A. Application Screening Criteria 17

B. Application Responsiveness Criteria 18

C. Application Completeness Criteria 18

D. Criteria 18

1. Discussion and Understanding of the Project – 10 points maximum 18

2. Technical Approach – 25 points maximum 18

3. Personnel Qualification and Past Performance – 50 points maximum 18

4. Management Plan – 15 points maximum 19

VI. Award Administration Information 19

A. Public Materials Use 19

B. Award Notices 19

C. Notice of Award 19

D. FY 2015 Appropriations Provision 20

VII. Other Terms and Conditions 21

A. Administrative and National Policy Requirements 21

B. Post-Award Reporting Requirements 21

C. Financial Status and Cash Transaction Reports 21

D. Audit Requirements 21

E. Fraud, Waste and Abuse 22

F. HHS Grants Policy Statement 22

G. Records Retention 22

H. Performance Reports 22

I. Non-Disclosure Requirements 22

J. Potential for Organizational and Personal Conflicts of Interest (COI) 23

K. Cooperative Agreement Terms and Conditions of Award 23

L. Additional Terms and Conditions 25

1. Release(s) of Data 25

2. ONC Embargo Period and Availability of Data for Purchase 26

3. Guidelines for Reportable Data 26

4. Research Collaboration 26

VIII. Agency Contacts 27

IX. Other Information 27

X. Tips for Writing a Strong Application 27

Appendix A. Instructions for completing the SF-424, Budget (SF 424A) 28

Standard Form 424A 32

Standard Form 424B - Assurances 36

Appendix B. Budget Narrative/Justification, Page 1 – Sample Format with EXAMPLES 37

Appendix C. Budget Narrative/Justification –– Sample Template 40

Appendix D. Project Work Plan, Page 1 – Sample Template 41

OPPORTUNITY OVERVIEW

Funding Opportunity Announcement Title: Tracking Electronic Health Record Adoption And Capturing Related Insights in U.S. Hospitals

Federal Funding Agency: Office of the National Coordinator for Health Information Technology (ONC), U.S. Department of Health and Human Services (HHS)

Announcement Type: Cooperative Agreement

Funding Opportunity Number: NAP-AX-15-006

Catalog of Federal Domestic Assistance (CFDA) Number: 93.851

Statutory Authority: Consolidated and Further Continuing Appropriations Act, 2015'', Pub. L. No. 113-235, Division G, Title II, and Title XXX, §§ 3001 (c)(2) and 3011 of the Public Health Service Act

Approximate Amount of Funding Available: $204,000

Anticipated number of Awards: 1

Approximate Range of funding per award: N/A

Period of Performance: Two (2) years

Important Dates:

The application review and funding process for this cooperative agreement will take place according to the table below. The applicant will need to submit an application that will undergo an objective review. A successful application will result in the award of a two (2) year cooperative agreement.

FOA Details Date1 FOA Public Release July 15, 2015 Application Due Date

September 14, 2015 by 11:59pm EST

Estimated Award Announcements

September 20, 2015

Anticipated Project Start Date

October 1, 2015

1 The announcements and start dates are approximate.

Executive Summary

This funding opportunity announcement (FOA) will provide funds in the form of a sole source, single award, through a cooperative agreement, between the Office of the National Coordinator for Health Information Technology (ONC) and American Hospital Association (AHA). The AHA has an ongoing data collection effort in place designed to capture information on the adoption of and attitudes towards electronic health records in U.S. hospitals.

Tracking the adoption of health information technology (health IT) is critical to evaluating the effects of the Office of the National Coordinator of Health IT ONC programs and the relationship between the use of health IT and quality improvements and cost-savings. Since 2008, the AHA and ONC have worked collaboratively to collect data for these purposes through an annual AHA Information Technology Survey (IT Supplement), a supplementary data collection that is separate from the AHA’s annual general census of hospitals. The survey has enabled ONC to track health IT adoption, evaluate its programs and inform policy, and examine the link between health IT and health care system improvements. Additionally, the survey has furthered health IT research in inpatient settings, with many collaborative partners and independent researchers using the data in their work

I. Funding Opportunity Description:

A. Background

The Health Information Technology for Economic and Clinical Health (HITECH) Act, Title XIII of Division A and Title IV of Division B of the American Recovery and Reinvestment Act of 2009 (ARRA), Pub. L. No.

111-5, set forth a plan for advancing a nationwide health IT infrastructure to facilitate the electronic use and exchange of information and to improve the quality and efficiency of health care, among other objectives.

Central to this vision of nationwide electronic health information exchange is the use of electronic health records (EHRs). The HITECH Act authorizes the Centers for Medicare & Medicaid Services (CMS) to administer incentive payments to eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) for adopting, implementing, or upgrading certified EHR technology (Medicaid incentives only), and for demonstrating “meaningful use” of certified EHR technology (Medicare and Medicaid incentives).” Since 2008, ONC has partnered with the AHA through grants administered through NIH to track the use of health IT and related insights in U.S. hospitals. ONC is explicitly tasked through the HITECH Act with overseeing many federal efforts relating to health IT. As a result, continuing to track the adoption of electronic health records and related attitudes and insights in U.S. hospitals is critical to the responsibilities of ONC and evaluating the impact of Medicare and Medicaid incentives and related ONC programs.

B. Purpose

Significant federal investments to accelerate the adoption of electronic health records and exchange of clinical data are now in place. It is critical to continue to track the adoption of electronic health records and related attitudes and insights to: (1) ascertain the status of adoption and evaluate existing and proposed policy decisions; (2) evaluate the impact of ONC programs and related incentives for meaningful use; and (3) make resources available to ONC and external researchers to assess the effects of health IT adoption and exchange on key aspects of care, such as quality and efficiency. The data is generated under this funding opportunity will enable ONC and researchers to carry out these important activities for inpatient settings.

Without funding to supplement the cost of the data collection, the AHA would not conduct an information technology survey of this scope. The survey currently reaches every non-federal acute care hospital in the U.S.

ONC’s input on the survey instrument also allows the agency to track specific functionalities of EHRs, such as those that are intended to support current Stage 1, Stage 2, and potential stage 3 meaningful use objectives.

Sound policy decisions around what functionalities to include in meaningful use require solid understanding of their current adoption status. ONC’s ability to have input on the content of the IT Supplement to measure current and proposed meaningful use functionalities is critical to informing and evaluating these policy decisions. In addition, the survey has served the public good in that it has been the foundation of important public research on EHR adoption and the link between quality and efficiency of care in inpatient settings, including Jha et al. 2009, Jha et al. 2010, Furukawa et al. 2010, and McCullough et al. 2010.i,ii,iii

C. Scope of Services

This potential cooperative agreement involves data collection designed to capture information on the adoption of and attitudes towards electronic health records in U.S. hospitals. In this instance, the AHA is uniquely positioned as the sole organization that can work with ONC to develop the survey instrument necessary to track the progress of health IT adoption and use among U.S. hospitals that ONC monitors. ONC will use the results of this data collection effort for public dissemination of health IT progress.

D. Project Approach and Structure

1. Cooperative Agreement Management & Work Plan

Subgoal 1.1: Initial Meeting - The awardee shall meet with ONC staff within seven (7) working days of the award of the cooperative agreement to discuss the work plan, which will include work schedule, the data collection plan, and general insights on the direction of this year’s survey.

Subgoal 1.2: Work Plan – The awardee shall produce a draft work plan within seven (7) working days of the initial meeting that reflects the discussions from the initial meeting. ONC staff will provide comments/approval of the plan within five (5) working days.

2. Survey Instrument Development

The awardee shall gain insight from the Project Officer and, other applicable representatives from ONC, to help determine relevant subject matter for the given survey year. The awardee will consider this insight in the context of competing goals to both capture most relevant data and maintain data continuity across years. The awardee will update both the mailed survey instrument and a web-based version based on the insight gained from ONC representatives.

3. Survey Instrument Production and Data Collection

The awardee shall:

Goal 3.1. Update the paper survey instrument and web-based survey Goal 3.2. Mail the initial request and ask that responses be completed online or by regular mail Goal 3.3. Contact non-respondents by email and telephone to encourage participation; contacted respondents are identified in the data Goal 3.4. Complete and finalize data collection

4. Preliminary Data

The awardee must provide ONC a preliminary data file when responses total roughly half the expected number of respondents. To the extent possible, the awardee will ensure all data quality measures (Goal 5) have been applied for this preliminary group of respondents.

5. Data Quality

The awardee must ensure all data have been properly coded and cleaned prior to delivery to ONC. For example, the data shall not contain: (1) multiple responses/codes referring to the same intended response;

and/or (2) inconsistent responses across questions that do not follow the proper skip pattern (e.g. a mail-respondent reports the hospital does not have access to an exchange arrangement, but the same respondent reports, via an on-line submission that they are participating in an exchange and activity exchange data.)

6. Data Delivery

The awardee must deliver the finalized data file in an approved format finalized in the government-approved work plan (e.g. .txt, .csv, .sas7bdat (SAS)). Accompanying the delivery must be the most relevant year of AHA general hospital census data, for the purposes of added characteristics for responding hospitals, in addition to a comprehensive data dictionary for both the general survey and the IT supplement.

7. Public Availability

The awardee must make available to the public the micro-level data at a fee schedule designed to recoup remaining costs of conducting the survey. The schedule for public availability is governed by this document’s terms and conditions. The purpose of public availability is to allow independent researchers to examine health IT adoption and its relationship with quality improvement and cost savings.

E. Goal Description, Standards, Schedule & Deliverable Table

The table below identifies specific milestones to support the execution of the cooperative agreement and the due date by which the milestones will be met.

Item Description/Standard Due Date GOAL 1 Cooperative Agreement & Work Plan

Overall cooperative agreement management ensures successful and timely performance by providing the technical and functional activities required by the cooperative agreement

Continuous

Subgoal1.1: Initial Meeting Meeting minutes/summary inclusive of Work Plan discussions during initial meeting

Within seven (7) working days of the initial meeting

Subgoal 1.2: Work Plan Draft Work Plan is appropriate for accomplishing the goals and includes the schedule, the data collection plan, and general insights on the direction of this year’s survey.

Within seven (7) working days of the initial meeting; Draft work plan reflects the discussion from the initial meeting. ONC staff will provide comments/approval of the plan within five (5) working days.

Goal 2: Update Survey Instrument

The awardee shall gain insight from the Project Officer and other applicable representatives from ONC to help determine relevant subject matter for the given survey year. The awardee will consider this insight to capture the most relevant data and maintain data continuity across years.

October 2015

Goal 3: Survey Instrument Production and Data Collection

Subgoal 3.1. Update the web-based survey instrument based on product of Goal 2.

Web-based instrument enables sound data collection

October 2015

Subgoal 3.2. Mail the initial request to complete the survey online or by returning the completed instrument

Mail-based instrument enables sound data collection

October 2015

Subgoal 3.3. Contact non-respondents by email and telephone to encourage participation.

ONC is provided examples of AHA email follow-up to non-respondents; respondents gained through AHA follow-up are identified in the data

October 2015 – February 2016

Subgoal 3.4. Complete and finalize data collection

Final response rate exceeds 50 percent of all non-federal acute care hospitals

February 2016

Goal 4: Preliminary Data

ONC receives a preliminary data file when responses total roughly half the expected number of respondents. To the extent possible, the awardee will ensure all data quality measures (Goal 5) have been applied for this preliminary group of respondents.

January 2016

Goal 5: Data Quality

The awardee shall ensure all data have been properly coded and cleaned prior to delivery to ONC.

The data shall not contain multiple versions of “like” responses and/or obvious inconsistencies

March 2016

Goal 6: Data Delivery Data file is delivered in an approved format and on time.

Accompanying the delivery shall be the most relevant year of AHA general hospital census data, for the purposes of added characteristics for responding hospitals.

March 2016

Goal 7: Public Availability Data file is made available to the public at a fee schedule designed to recoup remaining costs of data collection effort

See Terms and Conditions

(VII.F)

II. Award Information

A. Summary of Funding

Type of Award Cooperative Agreement Approximate Total Funding $204,000 Number of Awards 1 Anticipated Award Date September 20, 2015 Project Period Length 2 years Budget Period Length 2- 12 month increments Estimated Start Date October 1, 2015

Throughout the project period, ONC’s commitment to continuation of awards will be conditioned on the availability of funds, evidence of satisfactory progress by the awardee (as documented in required reports), and the determination that continued funding is in the best interest of the Federal Government.

B. Performance Evaluation

The Awardee’s performance will be evaluated on a quarterly basis by ONC to ensure that the project is meeting program objectives.

C. Award Type

The funding instrument used for this program will be a cooperative agreement, an award type in which substantial ONC programmatic involvement with the awardee is anticipated during the performance of the activities. Under the cooperative agreement, ONC’s purpose is to support and stimulate an awardee’s activities by involvement in and otherwise working jointly with the awardee in a partnership role; it is not to assume direction, prime responsibility, or a dominant role in the activities. Consistent with this concept, the dominant role and prime responsibility resides with the awardee for the project as a whole, although specific tasks and activities may be shared among the awardee and ONC as defined in this funding agreement.

ONC will work closely with the awardee to plan and implement processes in a collaborative fashion.

Specifically, ONC staff is substantially involved with the program activities, above and beyond routine cooperative agreement monitoring. These activities include, but are not limited to: a) review and approval of the work plan and all other deliverables submitted to meet the goals of the project (identified in the Deliverable Table); b) providing tactical guidance and feedback during project execution; and c) engaging with leadership of the organization, as necessary, to ensure successful execution of the cooperative agreement.

D. Proposal Criteria

Applicant must address the following in their proposal:

• How the awardee will update the survey and the web-based survey tool to collect health IT information among U.S. hospitals;

• How will the survey instrument be administered;

• How the awardee plans to achieve a statistically representative response rate;

• How the data collected will be reviewed and cleaned for quality; and

• How the data will be delivered to ONC.

E. General Funding Requirements

The application must address the following requirements:

• Adoption of electronic health records;

• Find, send, receive, and use of electronic exchange of health information;

• Adoption and use of electronic health record functionalities that correspond with the criteria for the

Centers of Medicare & Medicaid (CMS) Electronic Health Record Incentive Program; and

• Delivery of data within a timely manner.

F. Project Evaluation and Measurement

This FOA provides the awardee with flexibility to propose methods that continue to improve the IT Supplement to ensure the collection and quality of U.S. hospital health IT data. ONC will measure the success of the awardee through project goals, including, but not limited to the following:

Project Goals

1. Successfully capture a statistically representative sample of the U.S. hospital population. To be consistent with past implementations, the survey instrument should have a response rate of no less than 60%. Individual questions in the survey should have a response rate of no less than 85%.

2. The survey should continue to capture trend data on key health IT measures.

Key health IT measures include the adoption of Basic electronic health records; the adoption of functionalities that meet the criteria of the first two stages of the CMS Electronic Health

Record(EHR) Incentive Programs; exchange of health information (i.e. laboratory results, radiology reports, medication histories, and summary of care records); the capability to find, send, receive, and use health information from sources outside the hospital, and the adoption of functionalities for patient engagement.

3. The timely release of the data.

In order to best compare the progress of health IT adoption, the survey should be conducted over a similar time period each year. ONC expects the results of the data collection no later than March of the fiscal year in which the survey was administered.

III. Eligibility Information

A. Eligible Applicants

This is a non-competitive funding opportunity and is restricted to the organization designated below.

Organizations not designated as such are not eligible to apply for this opportunity, and therefore should not submit an application. Applications submitted by organizations not designated below will not be considered.

Designated Organization: The American Hospital Association (AHA)

B. Sole Source Justification

The AHA has an ongoing data collection effort in place designed to capture information on the adoption of and attitudes towards electronic health records in U.S. hospitals. Since 2008, ONC has supported the data collection and acquired the resulting data through a single-source cooperative agreement.

AHA is uniquely situated to successfully carry out the kind of survey work that they have done with NIH and ONC in the past. The IT Supplement currently reaches every non-federal acute care hospital in the U.S. The IT Supplement is a separate collection effort from the AHA’s general census tracking survey project that has been conducted continuously since 1946.2 Over this time span, the general census tracking survey has enjoyed an average response rate in excess of 85 percent. Such a high level of response is exceptional for a voluntary survey that includes both member and non-member hospitals. Building on the success of the general survey, the response rates for the IT Supplement have exceeded 60 percent each year since its inception, an exemplary response rate for a comparatively newer data collection effort.

As the leading acute care hospital membership organization (approximately 80 percent of non-federal acute care hospitals are members), the AHA is uniquely suited to build on the response rate successes of prior years.

Its credibility and reputation as a hospital advocacy and research center are unmatched by any other organization. In addition, the AHA has more than 60 years of experience in survey development and design and effective data collection through mail-based, and now Internet-based, efforts.

With regard to government performance reporting and policy-making, the AHA’s IT Supplement is the only known source that tracks key performance measures regarding IT use in hospitals, such as the presence of a “basic” EHR as defined in Jha et al. 2009. In addition, no other existing data collection effort has the capability to track the same specific functionalities currently included in meaningful use or specific functionalities currently under consideration for inclusion in future stages of the program. Sound policy decisions on what functionalities to require under meaningful use is helped substantially by a solid understanding of their current adoption status. ONC’s ability to have input on the content of the IT Supplement to measure current and proposed meaningful use functionalities is critical to informing and evaluating these policy decisions.

2 American Hospital Association. http://www.ahadataviewer.com/ http://www.ahadataviewer.com/

C. Cost Sharing or Matching

There is no cost sharing or match requirement for this award.

IV. How to Apply Information

A. Address to Request an Application Package

Application materials will be available for download at http://www.grants.gov. ONC requires the applicant to submit application materials as a complete package. Such materials must be delivered through the electronic mail function at http://www.grants.gov.

APPLICATION WILL NOT BE ACCEPTED THROUGH ANY OTHER WEBSITE, AND WILL NOT BE

ACCEPTED THROUGH PAPER MAIL, COURIER, OR DELIVERY SERVICE.

APPLICANT IS STRONGLY ENCOURAGED TO COMPLETE AND SUBMIT ITS APPLICATION AS

FAR IN ADVANCE OF THE SUBMISSION DEADLINE AS POSSIBLE. THE APPLICATION

INCLUDING ALL REQUIRED ATTACHMENTS AND INCLUDED FILES FOR POTENTIAL

CONSIDERATION IN THE REVIEW PROCESS MUST BE RECEIVED BY 11:59 PM EASTERN TIME

ON THE DATE SPECIFIED IN SECTION IV C, BELOW.

Applications Procedures:

1. You must access the electronic application for this program via http://www.grants.gov. You must search the downloadable application page by the Funding Opportunity Number NAP-AX-15-006 or CFDA number (93.851).

2. Applicant should have a Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number and register in the System for Award Management (SAM). Allow a minimum of five days to complete the SAM registration. It is critical to know that SAM registration requires an annual renewal.

3. Submit all documents electronically, including all information included on the SF-424 and all necessary assurances and certifications.

4. Ensure that the application complies with any page limitation requirements described in this Program Guidance.

5. After electronically submitting your application, an automatic email notification will be sent to confirm the email was received. This notification does not provide assurance that your application was complete, only that the email was received.

After ONC reviews submission, a return receipt will be emailed to the applicant contact indicating the files that were received and able to be successfully opened and read.

B. Content and Form Submission

Project Abstract

Applicant shall include a one-page abstract (no more than 500 words) of the application. This abstract is often distributed to provide information to the public and Congress and represents a high-level summary of the project. As a result, applicant should prepare a clear, accurate, concise abstract that can be understood without reference to other parts of the application and that provides a description of the proposed project, including:

the project’s goal(s), objectives, overall approach, anticipated outcomes, products, and duration.

http://www.grants.gov/ http://www.grants.gov/

The applicant shall place the following information at the top of the Project Abstract (this information is not included in the 500 word maximum):

• Project Title

• Applicant Name

• Address

• Contact Name

• Contact Phone Numbers (Voice, Fax)

• E-Mail Address

• Web Site Address, if applicable

Budget Forms

The applicant is required to fill out the following forms and submit these forms through grants.gov as part of the application package:

Application for Federal Assistance (SF-424) Budget Information for Non-Construction Programs (SF-424A) Assurances for Non-Construction Programs (SF-424B) Disclosure of Lobbying Activities (SF-LLL)

Please note that these forms do not replace program-specific guidance provided in this funding opportunity announcement. Additional instructions regarding these forms can be found in Appendix B.

Project Narrative

The Project Narrative is the part of the application that will offer the most substantive information about the proposed project, and it will be used as the primary basis to determine whether or not the project meets the minimum requirements for awards. The Project Narrative should provide a clear and concise description of your project. See Section II,D for a list of criteria that should be included in the narrative.

The Project Narrative must be double-spaced, formatted to 8 ½” x 11” (letter-size) pages with 1” or larger margins on top, bottom, and both sides, and a font size of not less than 11 point. The maximum length allowed for the Project Narrative is 10 pages. A full application with a Project Narrative that exceeds 10 pages will not be accepted. Resumes of Key Personnel are not counted as part of the Project Narrative for purposes of the 10-page limit.

(Note: a concise resource offering tips for writing proposals for HHS grants and cooperative agreements can be accessed)

Budget Narrative

The applicant is required to outline proposed costs that support all project activities in the Budget Narrative/Justification. The application must include the allowable activities that will take place during the funding period and outline the estimated costs that will be used specifically in support of the program. Costs are not allowed to be expended until the start date listed in the Notice of cooperative agreement Award.

Whether direct or indirect, all costs must be allowable, allocable, reasonable and necessary under the applicable Uniform Guidance: http://www.ecfr.gov (2 CFR 200 Subpart E) and based on the programmatic requirements for administering the program. The budget period will consist of 12 month increments.

http://www.ecfr.gov/

C. Submission Dates and Times

The applicant will be required to submit an application that will undergo screening for completeness and responsiveness and, if indicated, an objective review process. The application must be submitted via grants.gov no later than 11:59 p.m. EST September 14, 2015.

FOA Released Applications Due Cooperative Agreements

Awarded

Anticipated Start Date

July 15, 2015 September 14, September 20, October 1, 2015

D. Grants.gov Registration

Registration with Grants.gov can take several days. The applicant is strongly encouraged to locate and test current logins and passwords for this system well in advance of the deadline date. For assistance with www.grants.gov, please contact them at support@Grants.gov or 1-800-518-4726 24 hours a day/7 days a week.

E. Applying Electronically through Grants.gov

All information needed to submit the application electronically through this site can be found at Grants.gov.

Additionally, there are a variety of requirements that are critical to know and comply with in order to meet the application deadline and submission requirements:

• The applicant will be able to download a copy of the application packet, complete it off-line, and then upload and submit the application via the website.

• The applicant can access the electronic application for this program on Grants.gov. Applicants must search the downloadable application page by the Funding Opportunity NAP-AX-15-006 or CFDA number 93.851.

• ONC strongly recommends that applicant not wait until the application due date to begin the application process through Grants.gov.

• To complete an application in Grants.gov, applicant must have a Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number and be registered in the System for Award Management (SAM). Applicant should allow a minimum of five days to complete the SAM registration. It is critical to know that SAM registration requires an annual renewal. As a result, ONC strongly encourages applicant to ensure that their registrations are current or to renew their registration well in advance of the application deadline. For more information or to check or renew registration, go to http://www.sam.gov.

• The applicant must submit all documents electronically, including all information included on the SF424 and all necessary assurances and certifications.

• Prior to application submission, if Microsoft Vista and Office 2007 are used, applicant should review the Grants.gov compatibility information and submission instructions provided at Grants.gov (click on “Vista and Microsoft Office 2007 Compatibility Information”).

• If the application fails to meet the application due date, it will not be reviewed and will receive no further consideration.

• After application is submitted electronically, applicant will receive an automatic acknowledgement from Grants.gov that contains a Grants.gov tracking number.

http://www.grants.gov/ mailto:support@Grants.gov http://www.sam.gov/

• After ONC reviews the submission, a return receipt will be emailed to the awardee contact indicating the files that were received and able to be successfully opened and read.

• Application must be submitted via http://www.grants.gov no later than 11:59p.m. EST on June 24, 2015.

F. Proof of the Applicant’s Status as a Non-Profit Entity

If the applicant is a US-based non-profit entity it must provide documentation of its 501C status or IRS determination letter, IRS tax exemption certificate, or letter from state taxing body verifying tax-exempt status.

G. Intergovernmental Review of Applications

The application for this cooperative agreement is not subject to review by states under Executive Order 12372, “Intergovernmental Review of Federal Programs” (45 CFR 100). Please check box “C” on item 19 of the SF 424 (Application for Federal Assistance).

H. Funding Restrictions

Funds under this announcement cannot be used for the following purposes:

• To supplant or replace current public or private funding.

• To purchase or improve land, or to purchase, construct, or make permanent improvements to any building.

• To reimburse pre-award costs.

If you are requesting indirect costs in your budget, you must include a copy of your indirect cost rate agreement. If your indirect cost rate is a provisional rate, the agreement should be less than 12 months of age.

Guidance for completing your budget can be found in Appendix A.

V. Application Merit Review Information

A. Application Screening Criteria

If the application fails to meet the following screening criteria described below, it will not be reviewed and will receive no further consideration.

In order for an application to be reviewed, it must meet the following screening requirements:

• The application must be submitted electronically via http://www.grants.gov by 11:59 p.m., Eastern Time, September 14, 2015.

• The Project Narrative section of the application must be double-spaced, on 8 ½” x 11” plain white paper with 1” margins on both sides, and a font size of not less than 11.

• The Project Narrative must not exceed 10 pages. Any pages over the limit will not be reviewed.

NOTE: Letters of Commitment and Resumés of Key Project Personnel are not counted as part of the Project Narrative for purposes of the 10-page limit.

B. Application Responsiveness Criteria

If the application does not meet the following responsiveness criteria, it will receive no further consideration:

• The application clearly addresses the project theme.

• The applicant meets the eligibility criteria as required by Section III.A, Eligible Applicants.

• The application is complete and includes the required components stated in Section I.B, including all elements of the program narrative needed to forward it for merit review.

C. Application Completeness Criteria

ONC will screen the application to identify those that do not meet criteria outlined below. The application screening criteria are:

• The application is received by the deadline required under Section IV.C, Submission Dates and Times.

• The application meets the formatting and length requirements found in Section IV.B, Content and Form of Application Submission.

• Appendices and attachments are not used as a mechanism to exceed page limits in Project Narrative.

D. Criteria

A panel that may include both expert peer reviewers and federal staff will review the application to ensure that it meets the responsiveness and screening criteria outlined in this section. The purpose of this review is to determine if the approach and strategy are aligned with cooperative agreement requirements. The detailed results of this review will be shared with the applicant upon request. The application will be scored according to the following point system:

1. Discussion and Understanding of the Project – 10 points maximum

The applicant demonstrates knowledge and understanding of the adoption of EHRs and survey methodology.

2. Technical Approach – 25 points maximum

The applicant’s approach is succinct and logical in format and demonstrates methods consistent with the tasks to be accomplished. The applicant proposes a clear and detailed approach for collecting and analyzing the survey data. The applicant must clearly identify an approach for verifying the accuracy of the data through audit or other approved means.

3. Personnel Qualification and Past Performance – 50 points maximum

The applicant must demonstrate and provide evidence of experience for the following. All evidence must be provided in the specific format outlined below and be submitted as an appendix to the applicant’s proposal.

• 3.1: An existing data collection effort on EHR adoption with accompanying survey instrument(s) that have the capacity to track both a “basic” and “comprehensive” electronic health record as defined by Jha et al. 2009.iv

4. Management Plan – 15 points maximum

The applicant must provide the names of staff that will be overseeing the analysis of the data and preparation of the ongoing reports. The applicant must also provide evidence of their past work producing this type of reports for other clients and a list of client names and contract information.

MAXIMUM TECHNICAL SCORE = 100 POINTS

The application will be reviewed for completeness by the Office of Procurement and Grants, and for responsiveness by ONC. An incomplete application and application that is non-responsive to the eligibility criteria will not advance through the review process. The applicant will be notified that their application did not meet submission requirements.

An objective review panel will evaluate your application according to the criteria listed in the Criteria section above.

VI. Award Administration Information

Type of Award: Cooperative Agreement

Total Amount of Funding Available: $204,000

Number of Awards: 1

Project Period End Date: Two (2) Years

A. Public Materials Use

Section 508-compliant materials developed through this funding will be made publicly available at the end of the project period, if not released over the course of the program period.

B. Award Notices

A letter of notification will be issued, acknowledging that an award was funded. However, this does not provide authorization for the applicant to begin performance and expend funds associated with the award until the start date of the award as indicated in the notice.

C. Notice of Award

The Notice of Grant Award (NGA) is signed by the ONC Grants Management Officer. The successful applicant’s Authorized Representative will receive the NGA electronically from ONC. The NGA is considered the official authorizing award document.

The NGA will include amount of funds awarded, the terms and conditions of the cooperative agreement, the effective date of the award, the budget period for which support will be given, the total project period timeframe, and the total approved budget.

The NGA will provide pertinent instructions and information including, at a minimum, the following:

1. Legal name and address of performing organization or institution to whom ONC has issued an award under the terms of this request for applications;

2. Title of project;

3. Name(s) of institution(s) or Project Directors (PDs) chosen to direct and control approved activities;

4. Identifying award number assigned by ONC;

5. Project period, specifying the amount of time ONC intends to support the project without requiring re-competition of funds;

6. Total amount of financial assistance approved by ONC during the project period;

7. Legal authorities under which the award is issued;

8. Appropriate Catalog of Federal Domestic Assistance (CFDA) number;

9. Applicable award terms and conditions;

10. Approved budget plan for categorizing allocable project funds to accomplish the stated purpose of the award; and

11. Other information or provisions deemed necessary by ONC to carry out its respective awarding activities or to accomplish the purpose of a particular award.

In accepting an ONC award, the awardee assumes legal, financial, administrative, and programmatic responsibility for administering the award in accordance with the terms and conditions of the award, as well as applicable laws, rules, regulations, and Executive Orders governing HHS assistance awards, all of which are to be incorporated into the award by reference. Failing to comply with these requirements may result in suspension or termination of the award and/or ONC’s recovery of award funds.

D. FY 2015 Appropriations Provision

Department of Health and Human Services (HHS) recipients must comply with all terms and conditions outlined in their grant award(s), including grant policy terms and conditions contained in applicable HHS Grants Policy Statements, and requirements imposed by program statutes and regulations, Executive Orders, and HHS grant administration regulations, as applicable; as well as any requirements or limitations in any applicable appropriations acts.

VII. Other Terms and Conditions These special terms and conditions of the award are in addition to and not in lieu of otherwise applicable OMB administrative guidelines, HHS grant administration regulations in 2 CFR Part 200, Subparts B through D, and other HHS and ONC policy statements.

This cooperative agreement is for a period of five years. By accepting an award, the awardee is required to abide by 2CFR Part 200, Subparts B through D, and other HHS and ONC policy statements. Drawdown of funding for this cooperative agreement serves as official acceptance of this cooperative agreement. If you do no plan to accept the award, please send a letter of declination to the ONC Project Officer within 30 days of receipt of the Notice of Grant Award.

A. Administrative and National Policy Requirements

The award is subject to HHS Administrative Requirements, which can be found in 2 CFR 200, Subparts B through D and the Standard Terms and Conditions implemented through the HHS Grants Policy Statement (GPS) located at http://www.hhs.gov/asfr/ogapa/aboutog/hhsgps107.pdf.

B. Post-Award Reporting Requirements

All reporting requirements will be provided to the applicant of a successful application, adherence to which is a required condition of any award. In general, a successful applicant under this guidance must comply with reporting and review activities.

C. Financial Status and Cash Transaction Reports

Quarterly expenditures must be submitted for each fiscal year during the period of performance (October 1 through September 30) using SF-425, Federal Financial Report (FFR). Reports are due to HHS no later than April 30 of each year the award is active for funds expended between October and March, and no later than October 31 for funds expended between April and September. The quarterly FFR will be submitted using the Online Data Collection (OLDC) system. ONC will not accept reports sent directly to the ONC Grants mailbox.

The FFR Cash Transaction Report is submitted via the Payment Management System (PMS) every calendar quarter for the life of the grant. The report must be submitted within 30 days after the end of the quarter (January 30, April 30, July 30, and October 30). The awardee is still required to complete the FFR Cash Transaction Report via the PMS each calendar quarter.

D. Audit Requirements

The awardee must comply with audit requirements of Office of Management and Budget (OMB) Uniform Guidance as codified in 2 CFR Part 200, Subpart F. Information on the scope, frequency, and other aspects of the audits can be found at http://www.ecfr.gov/cgi-bin/text-idx?SID=ed90f54836feb6a994f657188eb05e33&node=2:1.1.2.2.1&rgn=div5.

http://www.ecfr.gov/cgi-bin/text-idx?SID=ed90f54836feb6a994f657188eb05e33&node=2:1.1.2.2.1&rgn=div5 http://www.ecfr.gov/cgi-bin/text-idx?SID=ed90f54836feb6a994f657188eb05e33&node=2:1.1.2.2.1&rgn=div5 http://www.hhs.gov/asfr/ogapa/aboutog/hhsgps107.pdf

E. Fraud, Waste and Abuse

The HHS Office of the Inspector General (OIG) maintains a toll-free number (1-800-HHS-TIPS [1-800-447- 8477]) for receiving information concerning fraud, waste, or abuse under grants and cooperative agreements.

Information also may be submitted by e-mail to hhstips@oig.hhs.gov or by mail to Office of the Inspector General, Department of Health and Human Services, Attn: HOTLINE, 330 Independence Ave., SW, Washington, DC 20201. Such reports are treated as sensitive material and submitters may decline to give their names if they choose to remain anonymous.

F. HHS Grants Policy Statement

ONC awards are subject to the requirements of the HHS GPS that are applicable to the grant/cooperative agreement based on awardee type and purpose of award. This includes, as applicable, any requirements in Parts I and II of the HHS GPS that apply to the award, as well as any requirements of Part IV. The HHS GPS is available at http://www.hhs.gov/asfr/ogapa/aboutog/hhsgps107.pdf. The general terms and conditions in the HHS GPS will apply as indicated unless there are statutory, regulatory, or award-specific.

G. Records Retention

The awardee generally must retain financial and programmatic records, supporting documents, statistical records, and all other records that are required by the terms of a grant, or may reasonably be considered pertinent to a grant, for a period of three years from the date the final annual FFR is submitted. For awards where the FFR is submitted at the end of the competitive segment, the three-year retention period will be calculated from the date the FFR for the entire competitive segment is submitted. The awardee must retain the records pertinent to the entire competitive segment for three years from the date the FFR is submitted. See 2 CFR 200.333 for exceptions and qualifications to the three-year retention requirement (e.g., if any litigation, claim, financial management review, or audit is started before the expiration of the three-year period, the records must be retained until all litigation, claims, or audit findings involving the records have been resolved and final action taken). Those sections also specify the retention period for other types of grant-related records, including indirect cost proposals and property records. See 2 CFR 200.326 for record retention and access requirements for contracts under grants.

H. Performance Reports

The awardee’s performance will be evaluated on a quarterly basis by ONC. Awardee will partner with ONC to establish quarterly reporting mechanisms to track and monitor progress towards goals (quantitative and qualitative data). The awardee shall submit one Final Project Report related to the overall project performance. A specific Final Project Report format will be finalized by ONC following the award date.

I. Non-Disclosure Requirements

Since this cooperative agreement may require a awardee to have access to information relating to any and all aspects of grants management operation that may be of a technical; legal; sensitive and/or confidential nature;

and which may be of the sole property of the U.S. Government, each awardee must ensure that all its personnel (to include chief executives, directors, any consultants, sub-awardees, or any other personnel that are substantially involved in the performance of this cooperative agreement) who will be personally and substantially involved in the performance of this cooperative agreement:

mailto:hhstips@oig.hhs.gov http://www.hhs.gov/asfr/ogapa/aboutog/hhsgps107.pdf

• Execute and submit Non-Disclosure Agreements prior to the commencement of any work on the cooperative agreement; and

• Put in place appropriate procedures for the protection of such information, and must be liable to the Government for any misuse or unauthorized disclosure of such information by its personnel, as defined above.

J. Potential for Organizational and Personal Conflicts of Interest (COI)

The term “organizational conflict of interest” means that the applicant (to include its chief executives, directors, any consultants, sub-awardees, or any other personnel that are substantially involved in the performance of this cooperative agreement) has interests in which:

i. May diminish its capacity to give impartial, technically sound, objective assistance and advice in performing these tasks;

ii. May otherwise result in a biased work product under this cooperative agreement; or

iii. May result in an unfair competitive advantage to itself or others.

In accordance with Section 200.112, the applicant and non-federal entities must disclose in writing any potential conflicts of interest (COI) that they have with the HHS awarding agency and/or any other pass-through entities. The applicant must notify the HHS awarding agency and their respective grants management officer (GMO) when they believe a COI may exist. If after award, the awardee discovers a COI, with respect to this cooperative agreement, must make an immediate and full disclosure in writing to the GMO. The disclosure must include identification of the conflict, the manner in which it arose, and description of the action the awardee has taken or proposed to take to avoid, eliminate, or neutralize the conflict.

In the event the awardee was aware of an organizational COI prior to award of the cooperative agreement and did not disclose the conflict to the GMO or becomes aware of an organizational COI after award of this cooperative agreement and dose not disclose the COI within ten (10) days of becoming aware of such conflict, the Government may terminate the cooperative agreement and the awardee will not be entitled to reimbursement of any cost incurred in performing the cooperative agreement or payment of any fee thereunder.

The rights and remedies of the Government provided in this clause must not be exclusive and are in addition to any other rights and remedies of the Government provided by law or under this cooperative agreement.

K. Cooperative Agreement Terms and Conditions of Award

The following special terms of award are in addition to, and not in lieu of, otherwise applicable OMB administrative guidelines, HHS grant administration regulations at 2 CFR Part 200, Subpart B through D, and other HHS and ONC grant administration policies.

The administrative and funding instrument used for this program will be the cooperative agreement, an “assistance” mechanism, in which substantial ONC programmatic involvement with each awardee is…