BPHC HRSA-22-009 (U86) FY2022_HCCN_Modification Updated_12.02.21.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Bureau of Primary Health Care Health Center Program

Fiscal Year 2022 Health Center Controlled Networks

Funding Opportunity Number: HRSA-22-009 Funding Opportunity Type(s): New

Assistance Listings (AL/CFDA) Number: 93.527

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2022

Application Due Date in Grants.gov: February 1, 2022 Supplemental Information Due Date in EHBs: March 2, 2022

Ensure your SAM and Grants.gov registrations and passwords are current immediately!

HRSA will not approve deadline extensions for lack of registration.

Registration in all systems may take up to 1 month to complete.

Issuance Date: October 26, 2021

Modified on December 3, 2021 to update or clarify the following: Grants.gov and EHBs submission due dates, eligibility requirements, application components to be submitted in Grants.gov, Attachment requirements, Governance section of project narrative and review criteria, and character limit for activity field in the project work plan, Accessibility Provisions and Non-Discrimination Requirements.

Tracey Smith, Public Health Analyst, Office of Policy and Program Development Bureau of Primary Health Care Contact: BPHC Contact Form Telephone: (301) 594-4300 HCCN Technical Assistance webpage

Authority: Section 330(e)(1)(C) of the Public Health Service Act, (42 U.S.C. 254b(e)(1)(C)) https://bphccommunications.secure.force.com/ContactBPHC/BPHC_Contact_Form https://bphc.hrsa.gov/program-opportunities/hccn

HRSA-22-009 i

508 COMPLIANCE DISCLAIMER

Note: Persons using assistive technology may not be able to fully access information in this file. For assistance, please email or call one of the HRSA staff listed in Section VII.

Agency Contacts.

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2022 Health Center Controlled Networks (HCCNs) cooperative agreement. The purpose of this funding is for HCCNs to support health centers in leveraging health information technology (IT) and data to deliver high-quality, culturally competent, equitable, and comprehensive primary health care, with a specific focus on improvements in:

• Clinical quality,

• Patient-centered care, and

• Provider and staff well-being.

Funding Opportunity Title: Fiscal Year 2022 Health Center Controlled Networks

Funding Opportunity Number: HRSA-22-009 Due Date for Applications – Grants.gov:

February 1, 2022 (11:59 p.m. ET)

Due Date for Supplemental Information – HRSA Electronic Handbooks (EHBs)

March 2, 2022 (5 p.m. ET)

Anticipated Total Annual Available FY 2022 Funding:

$42,000,000

Estimated Number and Type of Awards: Approximately 49 awards Estimated Award Amount: Varies, dependent on the proposed number of participating health centers (PHCs) within the HCCN

Cost Sharing/Match Required: No Period of Performance: August 1, 2022 through July 31, 2025

(up to 3 years)

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Eligible Applicants: Organization must be either:

• A network that is at least majority controlled and, as applicable, at least majority owned by Health Center Program award recipients;

or

• An individual Health Center Program award recipient, funded for at least the two consecutive preceding years, and applying on behalf of an HCCN.

See Section III.1 of this notice of funding opportunity (NOFO) for complete eligibility information.

Application Guide You (the applicant organization/agency) are responsible for reading and complying with the instructions included in HRSA’s SF-424 Two-Tier Application Guide, available online at https://www.hrsa.gov/sites/default/files/hrsa/grants/apply/applicationguide/sf-424-app-guide-2-tier.pdf, except where instructed in this NOFO to do otherwise.

Technical Assistance HRSA will hold a pre-application Technical Assistance (TA) webinar for applicants seeking funding through this opportunity. Webinar details and application resources, as well as form instructions and samples, and frequently asked questions are available at the HCCN technical assistance webpage. Refer to “How to Apply for a Grant”, available at http://www.hrsa.gov/grants/apply, for general (i.e., not HCCN specific) information on a variety of application and submission components.

The HRSA Primary Health Care Digest is a weekly email newsletter containing information and updates pertaining to the Health Center Program, including competitive funding opportunities. Organizations interested in seeking funding under the Health Center Program are encouraged to have several staff subscribe at:

https://public.govdelivery.com/accounts/USHHSHRSA/subscriber/new?topic_id=USHH

SHRSA_118.

The Health Information Technology Evaluation, and Quality Center (HITEQ), the current health IT National Training and Technical Assistance Partner (NTTAP), has materials that may advance your Project Work Plan and support its successful implementation.

For a list of HRSA supported PCAs and other NTTAPs, refer to HRSA’s Strategic Partnerships webpage.

Summary of Changes since the FY 2019 HCCN Funding Opportunity

• The funding mechanism has changed from a grant to a cooperative agreement.

https://www.hrsa.gov/sites/default/files/hrsa/grants/apply/applicationguide/sf-424-app-guide-2-tier.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/apply/applicationguide/sf-424-app-guide-2-tier.pdf https://bphc.hrsa.gov/program-opportunities/hccn http://www.hrsa.gov/grants/apply https://public.govdelivery.com/accounts/USHHSHRSA/subscriber/new?topic_id=USHHSHRSA_118 https://public.govdelivery.com/accounts/USHHSHRSA/subscriber/new?topic_id=USHHSHRSA_118 https://hiteqcenter.org/ https://bphc.hrsa.gov/qualityimprovement/strategicpartnerships/index.html https://bphc.hrsa.gov/qualityimprovement/strategicpartnerships/index.html

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• HCCN award recipients may request supplemental funding at any point in their period of performance to address unique or emerging health IT and data needs of PHCs that are aligned with, but not duplicative of, the funded scope of work.

• Eligible applicants must be a domestic public or private entity.

• Attachment 1: Proof of Organizational Status is required for all applicants.

• Applicants will submit a PHC communication plan.

• The Project Work Plan contains two new fields, one that links proposed activities with identified PHC needs, and another that indicates which partner organization(s) will support achieving the Objectives.

• Salary of project staff shall not exceed Level II of the Federal Executive pay scale, as required by the Consolidated Appropriations Act, 2021 (P.L. 116-260), Division H, § 202 and Division A of the FY 2022 Extending Funding and Emergency Assistance Act (P.L. 117-43) and detailed in Budget section in this NOFO.

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Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING/MATCHING

3. OTHER

IV. APPLICATION AND SUBMISSION INFORMATION

1. ADDRESS TO REQUEST APPLICATION PACKAGE

2. CONTENT AND FORM OF APPLICATION SUBMISSION

i. Project Abstract

ii. Project Narrative (Submit in Grants.gov, update in EHBs)

iii. Budget (Submit inGrants.gov, update in EHBs)

iv. Budget Narrative (Submit in Grants.gov, update in EHBs)

v. Program-Specific Forms

vi. Attachments

3. DUN AND BRADSTREET DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER TRANSITION

TO THE UNIQUE ENTITY IDENTIFIER (UEI) AND SYSTEM FOR AWARD MANAGEMENT (SAM)

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSMENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

APPENDIX A: OBJECTIVES AND MEASURES

APPENDIX B: PARTICIPATING HEALTH CENTER (PHC) LIST INSTRUCTIONS

APPENDIX C: PROJECT WORK PLAN INSTRUCTIONS

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I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the fiscal year (FY) 2022 Health Center Controlled Networks (HCCNs) cooperative agreement. With FY 2022 funding, HCCNs will support health centers in leveraging health information technology (IT) and data to deliver high-quality, culturally competent, equitable, and comprehensive primary health care, with a specific focus on improvements in:

• Clinical quality,

• Patient-centered care, and

• Provider and staff well-being.

FY 2022 award recipients will receive funding for the costs of networks that are at least majority controlled and, as applicable, at least majority owned by health centers that receive grant funding under section 330 of the Public Health Service Act. For the purposes of this funding opportunity, HCCNs are networks of health centers1 that work together to strengthen and leverage health IT to improve health centers’ operational and clinical practices that result in better health outcomes for the communities the health centers serve.

Health IT has become essential in enabling the delivery of high-quality, culturally competent, equitable, and comprehensive primary health care, which has increased the need for health centers to expand their use of digital health tools. HCCNs will help health centers access and efficiently use digital health tools such as Electronic Health Records (EHRs), telehealth, patient portals, and electronic registries, along with virtual care platforms that support their integration. HCCNs will also support health centers with translating robust clinical and population data into quality improvement and culturally competent, patient-centered care using, in part, data collected through digital health tools. With this data, health centers’ can improve clinical quality, while more effectively advancing health equity.

2. Background

HCCNs are authorized by Section 330(e)(1)(C) of the Public Health Service Act (42 U.S.C. 254b(e)(1)(C)). The Department of Health and Human Services (HHS) is committed to improving the health and well-being of the nation through Healthy People 2030 (HP2030), which establishes national health objectives with targets and monitors and catalyzes progress over time to measure the impact of research and prevention efforts. HP2030 includes health IT objectives, which highlight the need for providers and patients to access health IT and use it more effectively. In addition, health IT and data support health centers in addressing health disparities by enabling providers to develop data-informed and coordinated interventions.

1 For the purposes of this document, the term “health center” encompasses Health Center Program (H80) award recipients, as well as organizations with look-alike (LAL) designation. For more information on LALs, see: https://bphc.hrsa.gov/programopportunities/lookalike/index.html.

http://www.health.gov/healthypeople http://www.health.gov/healthypeople https://bphc.hrsa.gov/programopportunities/lookalike/index.html

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When addressing issues of equity2, you should apply your understanding of intersectionality and how multiple forms of discrimination impact individuals’ lived experiences. Individuals and communities often belong to more than one group that has been historically underserved, marginalized, or adversely affected by persistent poverty and inequality. Individuals at the nexus of multiple identities often experience unique forms of discrimination or systemic disadvantages, including in their access to needed services.3 HRSA encourages you to consider how your proposed activities will support the cultural and clinical competence of your participating health centers (PHCs), and patients’ barriers to seeking care, such as trauma, stigma, and other social determinants of health (SDOH).4,5,6 Addressing SDOH is a HRSA objective with the purpose of improving the health and well-being of individuals and the communities in which they reside.

Collection and analysis of disaggregated, patient-level data is needed for health centers to advance health equity in the communities they serve. Currently, the Uniform Data System (UDS) primarily collects aggregated patient data from health centers. HRSA will collect disaggregated, deidentified patient-level data in UDS+, a reporting section of UDS. The UDS+ structure will increase the understanding of PHC patients while simultaneously reducing burden within the annual UDS reporting cycle. HCCNs will assist PHCs with having their clinical data mapped, interoperable, and ready for reporting with standards-based application programming interfaces (API). UDS+ will be specified and reported using HL7 Fast Healthcare Interoperability Resources (FHIR) as the underlying standard. More information about the transition will be released in the future.

2 HHS defines equity as “[T]he consistent and systematic fair, just, and impartial treatment of all individuals, including individuals who belong to underserved communities that have been denied such treatment, such as Black, Latino, Indigenous and Native American persons, Asian Americans and Pacific Islanders, and other persons of color; members of religious minorities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons; persons with disabilities; persons who live in rural areas; and persons otherwise adversely affected by persistent poverty or inequality.” Executive Order 13985 on Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, 86 FR 7009, at § 2(a) (Jan. 20, 2021), https://www.govinfo.gov/content/pkg/FR-2021-01-25/pdf/2021- 01753.pdf.

3 Executive Order 13988 on Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation, 86 FR 2023, at § 1 (Jan. 20, 2021).

4 HHS defines social determinants of health as the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Social determinants of health can be grouped into 5 domains: economic stability; education access and quality; health care access and quality; neighborhood and built environment; social and community context. Healthy People 2030:

https://health.gov/healthypeople/objectives-and-data/social-determinants-health.

5 You can explore evidence-based resources at the following link: https://health.gov/healthypeople/tools-action/browse-evidence-based-resources.: CDC: https://www.cdc.gov/socialdeterminants/index.htm; CDC Social Vulnerability Index (SVI) County Maps: https://svi.cdc.gov/prepared-county-maps.html; HHS National Partnership to End Health Disparities: Toolkit for Community Action; Opportunity Zones:

Guidance and Examples of language.

6 Culturally and linguistically appropriate services are respectful of and responsive to the health beliefs, practices and needs of diverse patients. By tailoring services to an individual's culture and language preference, health professionals can help bring about positive health outcomes for diverse populations.

US Department of Health and Human Services-Office of Minority Health: Cultural and Linguistic Competency.

https://ecqi.healthit.gov/fhir https://www.govinfo.gov/content/pkg/FR-2021-01-25/pdf/2021-01753.pdf https://www.govinfo.gov/content/pkg/FR-2021-01-25/pdf/2021-01753.pdf https://www.govinfo.gov/content/pkg/FR-2021-01-25/pdf/2021-01761.pdf https://www.govinfo.gov/content/pkg/FR-2021-01-25/pdf/2021-01761.pdf https://health.gov/healthypeople/objectives-and-data/social-determinants-health https://health.gov/healthypeople/tools-action/browse-evidence-based-resources https://health.gov/healthypeople/tools-action/browse-evidence-based-resources https://www.cdc.gov/socialdeterminants/index.htm https://svi.cdc.gov/prepared-county-maps.html https://minorityhealth.hhs.gov/npa/files/Plans/Toolkit/NPA_Toolkit.pdf https://intranet.hhs.gov/sites/default/files/s3fs-public/s3fs-public/2021-01/guidance-for-hhs-opdivs-on-oz-targeting-11-18-2020.pdf https://intranet.hhs.gov/sites/default/files/s3fs-public/s3fs-public/2021-01/guidance-for-hhs-opdivs-on-oz-targeting-11-18-2020.pdf https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=1&lvlid=6 https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=1&lvlid=6

HRSA-22-009 3

To effectively support health centers, HCCNs work with state and regional Primary Care Associations (PCAs) and HRSA’s National Training and Technical Assistance Partners (NTTAPs), including the Health Information Technology, Evaluation, and Quality Center (HITEQ), the current health IT NTTAP, as appropriate.

HCCNs have provided health IT and data support to health centers for over 20 years, with approximately 86 percent of current health centers participating in HCCNs.

The partnership between the HCCNs and PHCs has demonstrated success in improving access to care, enhancing quality of care, and supporting practice redesign to integrate services and optimize patient outcomes. HCCN activities include:

• Sharing resources and providing training and technical assistance,

• Performing data analytics to support quality measurement and improvement,

• Facilitating cost effective procurement processes by leveraging economies of scale, and

• Supporting Health Information Exchange (HIE) and interoperability between platforms.

FY 2022 award recipients will build upon the demonstrated success of previous HCCN awards. Funds will advance progress on the Objectives to achieve the Purpose of leveraging health IT and data to deliver high-quality, culturally competent, equitable, and comprehensive primary health care.

Funding Requirements

Your application must document an understanding of your PHCs’ needs, with specific focus on clinical quality improvement, patient-centered care, and provider and staff well-being.

For the purposes of this funding opportunity:

• You must demonstrate written commitment of PHC participation by at least 10 unique Health Center Program (H80) award recipients and look-alikes (LALs), the majority of which must be H80 award recipients, as described in the Eligibility Information section.

• You cannot require PHCs to become network members or pay to receive the services provided through this award.

• If you are an H80 award recipient, you may apply on behalf of an HCCN and also be a PHC within an HCCN.

• A health center may contract for or otherwise receive services from multiple HCCNs, but may only be included on one HCCN’s PHC List throughout the period of performance.

• A single health center with multiple sites counts as one PHC and all sites of a PHC must participate in applicable HCCN activities.

• You must develop an individualized work plan with each PHC within 90 days of award, which should be reviewed and updated at least annually. Work plans will be required for review during site visits and must be available on request by

HRSA.

• You must engage all PHCs in applicable HCCN activities detailed in the project work plan.

https://hiteqcenter.org/

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• If your HCCN is also a HRSA-funded PCA, you must submit scope differentiation documentation post-award.

• You must inform HRSA of changes to the number of PHCs in your HCCN.

• You must utilize health IT systems and products, including EHRs, certified to the

2015 Edition of certification criteria under the ONC Health IT Certification Program, where available.7,8,9

II. Award Information

1. Type of Application and Award Type(s) of applications sought: New

HRSA will provide funding in the form of a cooperative agreement. A cooperative agreement is a financial assistance mechanism where HRSA anticipates substantial involvement with the recipient during performance of the contemplated project. Current HCCN award recipients will apply for funding as new awardees under this funding mechanism. The amount of funding that may be requested by each applicant is based on the number of PHCs, as outlined in Table 1.

HRSA program involvement will include:

• Collaborate with award recipients to refine and approve the Project Work Plan according to HRSA priorities and changes in the health care landscape through such activities as identifying and prioritizing health IT and data needs to be addressed using federal funds;

• Monitor and support implementation of the Project Work Plan through collaborative meetings and progress report reviews;

• Review and support the development of key deliverables, including approval of a publication plan and specialized materials for general distribution prior to publication, distribution, and/or online posting;

• Attend and participate in HCCN-related meetings, as appropriate;

• Coordinate with other federally-funded cooperative agreements, and Bureaus and

Offices within HRSA to support collaboration in achieving the Purpose;

• Conduct an HCCN site visit during the 3-year period of performance to review and assess activities, review key accomplishments and PHC individualized work plans, and identify promising practices in supporting the health IT and data needs of PHCs.

The cooperative agreement recipient’s responsibilities shall include:

• Collaborate with HRSA on refining and implementing the Project Work Plan based

7 See 2015 Edition certification criteria at https://www.healthit.gov/topic/certification-ehrs/2015-edition.

8 Where certified health IT systems are not available or where there are no relevant certification criteria for the use case, you must utilize health IT systems and products that meet standards and implementation specifications adopted under section 3004 of the PHSA (these standards are identified in 45 CFR Part 170).

9 Where funded activities and/or a specific use case are not addressed by either certification criteria or standards in 45 CFR Part 170, you must consider use of additional standards identified in the ONC Interoperability Standards Advisory. See Interoperability Standards Advisory at https://www.healthit.gov/isa/.

https://www.healthit.gov/topic/certification-ehrs/2015-edition https://www.healthit.gov/isa/

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on HRSA priorities and changes in the health care landscape;

• Engage with HRSA to update the Project Work Plan at least annually, or more frequently as needed (e.g., in response to site visit findings, to establish new activities to address significant changes in HRSA priorities);

• Provide a plan for publications and specialized materials to be created or disseminated with HCCN funds. Information should include each publication’s purpose, target audience, title, publication mode or type, summary description, expected impact/benefit, and projected publication date.

• Adhere to the requirements to acknowledge Federal funding by adding disclaimers on all publications and specialized materials produced with HRSA funds (see https://www.hrsa.gov/grants/manage/acknowledge-hrsa-funding);

• Participate in HRSA and related stakeholder meetings, as appropriate;

• Coordinate with national, federal, state, and local organizations to strengthen

Project Work Plan development and implementation;

• Engage all PHCs in HCCN activities based on PHC needs; and

• Participate in a HRSA-led HCCN site visit during the 3-year period of performance.

2. Summary of Funding

HRSA estimates approximately $42,000,000 to be available annually to fund approximately 49 recipients. You may apply for a ceiling amount of up to the maximum annual award amount (includes both direct and indirect, facilities and administrative costs) listed in Table 1 below, based on your number of PHCs.

The actual amount available will not be determined until enactment of the final FY 2022 federal appropriation. This program notice is subject to the appropriation of funds, and is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds in a timely manner.

The period of performance is August 1, 2022 through July 31, 2025 (3 years). Funding beyond the first year is subject to the availability of appropriated funds for HCCNs in subsequent fiscal years, satisfactory progress, and a decision that continued funding is in the best interest of the Federal Government.

If an HCCN maintains fewer PHCs than required for a given funding tier for a period of longer than 90 days, HRSA may reduce funding in accordance with the funding tiers in Table 1, or may reduce or discontinue funding if the number drops below 10 unique PHCs for a period of longer than 90 days.

All HRSA awards are subject to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements at 45 CFR part 75. See Section IV.2.iii for instructions on developing the application budget.

Table 1: Maximum Annual Awards

Number of PHCs

Maximum Annual Award

< 10 Not eligible for funding https://www.hrsa.gov/grants/manage/acknowledge-hrsa-funding http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75

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Number of PHCs

Maximum Annual Award

10 - 14 $500,000 15 - 19 $625,000 20 - 24 $750,000 25 - 29 $875,000 30 - 34 $1,000,000 35 - 39 $1,125,000 40 - 44 $1,250,000 45 - 49 $1,375,000 50 - 54 $1,500,000 55 - 59 $1,625,000 60 - 64 $1,750,000 65 - 69 $1,875,000 70 - 74 $2,000,000 75 - 79 $2,125,000 80 - 84 $2,250,000 85 - 89 $2,375,000 90 - 94 $2,500,000 95 - 99* $2,625,000

*HCCNs may apply for an additional $125,000 for each 5 additional PHCs after 99.

HCCN award recipients may request supplemental funding at any point in their period of performance to address unique or emerging health IT and data needs of PHCs that are aligned with, but not duplicative of, the funded scope of work. HRSA may support such supplemental projects if funding is available and allocable, the request is reasonable and allowable, sufficient time remains in the budget period to approve the request, and the activities are aligned with HRSA priorities and nonduplicative of work performed by HRSA or other funding recipients.

III. Eligibility Information

1. Eligible Applicants

a) Eligible applicants include domestic public or private entities, as demonstrated through Attachment 1: Proof of Organizational Status. Domestic faith-based and community-based organizations, Tribes, and tribal organizations are also eligible to apply.

b) You must be one of the following (see Section 330(e)(1)(C) of the Public Health Service Act (42 U.S.C. 254b(e)(1)(C)):

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• An HCCN (see description above) or

• A current Health Center Program award recipient, funded for at least the 2 consecutive preceding years, and applying on behalf of an HCCN.

c) The HCCN must be at least majority controlled by Health Center Program (H80) award recipients (e.g., the majority of governing board members of the HCCN are employed by or otherwise representatives of Health Center Program (H80) award recipients) and, as applicable, at least majority owned by Health Center Program (H80) award recipients, as demonstrated by Attachment 9: Network Bylaws. If applicable, include a list of shareholders or other proof of majority ownership by Health Center Program Award Recipients in Attachment 13: Other Documents.

d) The HCCN must have its own governing board, independent of the boards of its health center members, as demonstrated by Attachment 9: Network Bylaws.

2. Cost Sharing/Matching Cost sharing/matching is not required for this program.

3. Other HCCN PHCs must be either Health Center Program (H80) award recipients or LALs, with the majority (51 percent or more) being Health Center Program (H80) award recipients.10 HRSA will consider any application that does not demonstrate that the majority of PHCs are H80 awardees as non-responsive and will not consider it for funding under this notice.

You must demonstrate commitment of a minimum of 10 unique PHCs through submission of the Memorandum of Agreement (MOA) template and MOA signature page(s) that provides an authorizing signature for each PHC, as described in Attachment 2: PHC Memorandum of Agreement Template and Signatures. MOAs must correspond with each PHC in the Participating Health Center List. HRSA will consider any application that does not demonstrate commitment of at least 10 unique PHCs as non-responsive and will not consider it for funding under this notice.

HRSA will consider any application that exceeds the funding tier ceiling amount for the proposed number of PHCs (see Table 1) on the SF-424A and Budget Narrative as non-responsive and will not consider it for funding under this notice.

Subawards and the provision of health IT and data support to health centers that are not Health Center Program (H80) award recipients or LALs are not authorized under this cooperative agreement.

Applications that do not include all documents indicated as “required for completeness” in Section IV.2 will be considered incomplete or non-responsive and will not be considered for funding under this notice. This includes the following:

• Project Narrative described in Section IV.2.ii

• Proof of Public or Private Entity status as demonstrated in Attachment 1: Proof of

Organizational Status

10 For example, an application including 10 PHCs must have at least 6 H80 award recipients, and may have up to 4 LALs.

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• PHC MOA template and signatures as described in Attachment 2: PHC Memorandum of Agreement Template and Signatures that correspond with the Participating Health Center List

• Network Bylaws described in Attachment 9: Network Bylaws

HRSA will consider any application that fails to satisfy the deadline requirements referenced in Section IV.4 non-responsive and will not consider it for funding under this notice.

NOTE: Multiple applications from an organization are not allowable.

HRSA will only accept your first validated electronic submission, under the correct funding opportunity number, in Grants.gov. Applications submitted after the first submission will be marked as duplicates and considered ineligible for review. If you wish to change attachments submitted in a Grants.gov application, you may do so in the HRSA Electronic Handbooks (EHBs) application phase.

If you wish to change information submitted in EHBs before the deadline, you may reopen and revise your application. You must ensure that the application is resubmitted to HRSA before the EHBs deadline or HRSA will not consider it for funding under this notice.

IV. Application and Submission Information

1. Address to Request Application Package HRSA requires you to apply electronically through Grants.gov and the EHBs. You must use a two-phase submission process associated with this notice of funding opportunity (NOFO) and follow the directions provided at http://www.grants.gov/applicants/apply-for-grants.html and the EHBs.

• Phase 1 – Grants.gov – Required information must be submitted and validated via Grants.gov with a due date of February 1, 2022 at 11:59 p.m. ET; and

• Phase 2 – EHBs – Supplemental information must be submitted via EHBs with a due date of March 2, 2022 at 5 p.m. ET.

Note: The EHBs application module will be available starting November 19, 2021.

Only applicants who successfully submit the workspace application package associated with this NOFO in Grants.Gov (Phase 1) by the due date may submit the additional required information in EHBs (Phase 2).

The NOFO is also known as “Instructions” on Grants.gov. You must select “Subscribe” and provide your email address for HRSA-22-009 in order to receive notifications including modifications, clarifications, and/or republications of the NOFO on Grants.gov.

You will also receive notifications of documents placed in the RELATED DOCUMENTS tab on Grants.gov that may affect the NOFO and your application. You are ultimately responsible for reviewing the For Applicants page for all information relevant to this

NOFO.

https://grants.hrsa.gov/2010/WebEPSExternal/Interface/Common/AccessControl/Login.aspx http://www.grants.gov/applicants/apply-for-grants.html http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/applicants.html

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2. Content and Form of Application Submission

Application Format Requirements Section 5 of HRSA’s SF-424 Two-Tier Application Guide provides instructions for the budget, budget narrative, staffing plan and personnel requirements, certifications, and abstract. You must submit the information outlined in the Application Guide in addition to the program-specific information below. You are responsible for reading and complying with the instructions included in HRSA’s SF-424 Two-Tier Application Guide except where instructed in the NOFO to do otherwise. You must submit the application in the English language and in the terms of U.S. dollars (45 CFR § 75.111(a)).

The following application components must be submitted in Grants.gov:

• Application for Federal Assistance (SF-424)

• Project Abstract Summary

• Project/Performance Site Locations (list only your administrative site address)

• Project Narrative Attachment Form (attach your project narrative)

• Budget Narrative Attachment Form (attach your budget narrative)

• Budget Information – Non-Construction Programs (SF-424A)

• Grants.gov Lobbying Form

• Key Contacts

• Attachment Form (submit form with or without attachments)

The following application components must be submitted in EHBs:

• Project Narrative (you may update the version submitted in Grants.gov as needed)

• Budget Information – Non-Construction Programs (SF-424A) (you may update the version submitted in Grants.gov as needed)

• Budget Narrative (you may update the version submitted in Grants.gov as needed)

• Program-Specific Forms

• Attachments

See Section 9.5 of the SF-424 Two-Tier Application Guide for the Application Completeness Checklist.

Application Page Limit The total size of all uploaded files included in the page limit may not exceed the equivalent of 80 pages when printed by HRSA. The page limit includes the project and budget narratives, attachments, and collaboration documentation. Note: Effective April 22, 2021, the abstract is no longer an attachment that counts in the page limit. The abstract is the standard form “Project Abstract Summary.” Standard OMB-approved forms that are included in the application package do not count in the page limit.

However, if you use an OMB-approved form that is not included in the application package for HRSA-22-009, it may count against the page limit. Therefore, we strongly recommend you only use Grants.gov workspace and EHBs forms associated with this NOFO to avoid exceeding the page limit. Indirect Cost Rate Agreement and proof of nonprofit status (if applicable) do not count in the page limit. It is important for you to ensure your application does not exceed the specified page limit.

http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf https://ecfr.io/Title-45/Section-75.111 http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf

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Applications must be complete, within the specified page limit, validated by Grants.gov, and submitted under HRSA-22-009 prior to the Grants.gov and EHBs deadlines.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

1) You certify on behalf of the applicant organization, by submission of your proposal, that neither you nor your principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.

2) Failure to make required disclosures can result in any of the remedies described in 45 CFR § 75.371, including suspension or debarment. (See also 2 CFR parts 180 and 376, and 31 U.S.C. § 3354).

3) If you are unable to attest to the statements in this certification, you must include an explanation in Attachment 13: Other Documents.

See Section 5.1 viii of HRSA’s SF-424 Two-Tier Application Guide for additional information on all certifications.

Program-Specific Instructions In addition to application requirements and instructions in Sections 4 and 5 of HRSA’s SF-424 Two-Tier Application Guide (including the budget, budget narrative, personnel requirements, assurances, certifications, and abstract), include the following:

i. Project Abstract Use the Standard OMB-approved Project Abstract Summary Form 2.0 that is included in the workspace application package. Do not upload the abstract as an attachment.

Use the guidance below. It is most current and differs slightly from that in Section 5.1.ix.

of HRSA’s SF-424 Two-Tier Application Guide.

Provide a summary of the application in the Project Abstract box of the Project Abstract Summary Form using 4,000 characters or less.

• Address

• Project Director Name

• Contact Phone Numbers (Voice, Fax)

• Email Address

• Website Address, if applicable

• List all grant program funds requested in the application, if applicable

Because the abstract is often distributed to provide information to the public and Congress, prepare this so that it is clear, accurate, concise, and without reference to other parts of the application. It must include a brief description of the proposed project including the needs to be addressed, the proposed services, and the population group(s) to be served. If the application is funded, your project abstract information (as submitted) will be made available to public websites and/or databases including USAspending.gov.

In addition:

• Indicate if you are a Health Center Program or HCCN award recipient and provide your H80 or H2Q grant number, as applicable.

https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75#se45.1.75_1371 http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf http://www.usaspending.gov/

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• Provide the proposed number of PHCs (distinguishing between Health Center Program (H80) award recipients and LALs).

NARRATIVE GUIDANCE

To ensure that you fully address the review criteria, this table provides a crosswalk between the narrative language and where each section falls within the review criteria.

Any forms or attachments referenced in a narrative section may be considered during the objective review.

Narrative Section, Forms, and Attachments11 Review Criteria Need section of the Project Narrative Attachment 11: Participating Health Center Needs Assessment Summary

(1) Need

Response section of the Project Narrative Attachment 12: Communication Plan Form: Project Work Plan

(2) Response

Collaboration section of the Project Narrative Attachment 2: PHC Memorandum of Agreement Template and Signatures Attachment 8: Letters of Support Form: Participating Health Center List

(3) Collaboration

Evaluative Measures section of the Project Narrative (4) Evaluative Measures Resources/Capabilities section of the Project Narrative Attachment 3: Project Organizational Chart Attachment 6: Staffing Plan Attachment 7: Summary of Contracts and Agreements

(5) Resources/Capabilities

Governance section of the Project Narrative Attachment 3: Project Organizational Chart Attachment 9: Network Bylaws Attachment 13: Other Documents

(6) Governance

Support Requested section of the Project Narrative Form: SF-424A Budget Narrative

(7) Support Requested

ii. Project Narrative (Submit in Grants.gov and update in EHBs)

This section provides a comprehensive framework and description of all aspects of the proposed project. It should be succinct, self-explanatory, consistent with forms and attachments, and well-organized so that reviewers can understand the proposed project.

11 Forms and attachments included in the table have a specific review criteria element. All forms and attachments referenced throughout the NOFO will be considered during the application review.

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The project narrative is required for completeness. Use the following section headers for the narrative: Need, Response, Collaboration, Evaluative Measures, Resources/Capabilities, Governance, and Support Requested.

The Project Narrative must:

• Address the specific Project Narrative elements below, with the requested information appearing under the appropriate Project Narrative section header or the designated forms and attachments.

• Reference attachments and forms, as needed. Referenced items must be part of the EHBs submission.

• Address the objectives in Appendix A: Objectives and Measures.

NEED – Corresponds to Section V.1 Review Criterion 1: NEED Information provided in the NEED section must serve as the basis for, and align with the objectives and proposed activities described throughout the application and in the Project Work Plan.

1. Describe the current health IT and data needs of your PHCs and how they relate to clinical quality, patient-centered care, and provider and staff well-being, as detailed in the required objectives (see Appendix A: Objectives and Measures for details). If you conducted a recent needs assessment with your PHCs, include a summary of key findings in Attachment 11: Participating Health Center Needs Assessment Summary.

2. Describe the specific health IT and data system limitations experienced by your PHCs related to capturing and using SDOH data to meet the required objectives, if not already addressed above.

3. Describe how needs vary across your PHCs, including the need for peer-to-peer learning and mentorship.

RESPONSE – Corresponds to Section V.1 Review Criterion 2: RESPONSE The RESPONSE section should provide a comprehensive plan to meet identified needs and include engagement of all PHCs in HCCN activities.

1. Complete a detailed Project Work Plan in EHBs (see Appendix C: Project Work Plan Instructions) that will lead to improvements in clinical quality, patient-centered care, and provider and staff well-being at your PHCs and:

a) Provides realistic and achievable targets for the end of the 3-year period of performance for each objective listed in Appendix A: Objectives and Measures.

b) Outlines 2-4 activities under each objective to be completed during the first year to ensure attainment of the 3-year targets. See examples activities on the HCCN technical assistance webpage.

c) Clearly links the activities to the PHCs’ identified health IT and data needs.

2. Provide a communication plan in Attachment 12: Communication Plan describing ongoing communication with PHCs. The plan should describe how you will:

a) Identify and address PHCs’ evolving needs and challenges;

b) Inform PHCs of health IT and data resources available through your HCCN, HRSA, and other sources; and

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c) Gather performance feedback from PHCs on how you can improve the health IT and data support you provide.

3. Describe your plan to engage all PHCs in proposed activities throughout the 3-year period of performance specific to their individual needs and areas of expertise.

Include how you will encourage knowledge sharing among your PHCs through peer-to-peer learning, mentorship and other formats.

4. Outline in table format or through a narrative summary how the subsequent 2 years year of activities will build upon those activities detailed in the Project Work Plan to achieve the 3-year target for each objective.

5. Describe how you will address anticipated barriers to meeting the health IT and data needs of your PHCs.

6. Briefly describe how you will develop an individualized work plan with each PHC within 90 days of award.

COLLABORATION – Corresponds to Section V.1 Review Criterion 3:

COLLABORATION

1. Document that at least 10 unique health centers are committed to participating in the project by:

a) Completing the Participating Health Center List in EHBs, and

b) Submitting your MOA template and signatures, as instructed in Attachment 2:

PHC Memorandum of Agreement Template and Signatures that correspond with the Participating Health Center List.

2. Describe how you will work with the NTTAP for health IT (currently HITEQ) and at least one PCA to support your organization in addressing PHC health IT and data needs. Include:

a) Highlights of your current relationship with HITEQ, or plans to establish a collaborative relationship with HITEQ, including the resources and services you currently use or plan to use to support PHCs.

b) A description of your partnership, or planned partnership, with at least one PCA and how your services will be complementary in support of your PHCs.

c) Letters of Support from these organizations (or documentation of efforts made to obtain letters) that provide details on how they will help you achieve the objectives as Attachment 8: Letters of Support.

3. Describe partnerships to increase health equity through, for example, data sharing and systems interoperability. Partnerships may include other PCAs and NTTAPs in addition to those above, health departments and other state or local health agencies, professional and community organizations, institutions of higher learning, and academic medical centers. Include:

a) How you will leverage partner resources and avoid duplication of effort,

b) How these partnerships will support PHCs to achieve the objectives of this project, and

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c) Letters of Support from these organizations (and/or documentation of efforts made to obtain letters) that provide details on how they will help you achieve objectives as Attachment 8: Letters of Support.

EVALUATIVE MEASURES – Corresponds to Section V.1 Review Criterion 4:

EVALUATIVE MEASURES

1. Describe a comprehensive evaluation plan to ensure that your proposed activities are effective in meeting the identified needs of your PHCs, including:

a) How qualitative and quantitative data will be collected and used to monitor progress and measure outcomes,

b) How often you will evaluate activities and progress, and

c) How you will use data and evaluation information, including feedback from the

PHCs, to support quality improvement of your project during the period of performance.

2. Describe your proposed methods for collecting data for the required annual non-competing continuation progress report from your PHCs. If you are a current HCCN, include how you plan to improve the process to collect data in the upcoming period of performance.

3. Describe plans to disseminate results, successful strategies, and lessons learned to PHCs, PCAs, NTTAPs, and other key stakeholders.

RESOURCES/CAPABILITIES – Corresponds to Section V.1 Review Criterion 5:

RESOURCES/CAPABILITIES

1. Discuss your expertise and experience in providing health IT and data support to health centers related to improving clinical quality, patient-centered care, and provider and staff well-being.

2. Describe how the organizational structure and staffing plan presented in Attachment 3: Project Organizational Chart and Attachment 6: Staffing Plan, respectively, are appropriate for the successful oversight and implementation of the proposed activities. Describe how staff will be recruited and retained.

3. Describe how the written agreements summarized in Attachment 7: Summary of Contracts and Agreements support the proposed activities.

4. Describe the financial management, internal controls, and policies and procedures that will be used to safeguard and optimize the use of federal funds.

GOVERNANCE – Corresponds to Section V.1 Review Criterion 6: GOVERNANCE

1. Document that the HCCN is at least majority controlled and, as applicable, at least majority owned by Health Center Program award recipients, referencing the appropriate section(s) in Attachment 9: Network Bylaws, and as applicable, Attachment 13: Other Documents.

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2. Describe the HCCN’s governance structure, including its independence from the boards of its health center members. Reference Attachment 3: Project Organizational Chart and Attachment 9: Network Bylaws, as appropriate.

3. Explain the governing board’s role in monitoring the project. Reference Attachment 9: Network Bylaws, as appropriate.

4. Describe the role that your PHCs and other key stakeholders have in project oversight and network governance.

SUPPORT REQUESTED – Corresponds to Section V.1 Review Criterion 7: SUPPORT

REQUESTED

1. Provide a consistent budget presentation (i.e., SF-424A and Budget Narrative) that is reasonable and aligns with the proposed Project Work Plan and Staffing Plan.

2. Describe how the proposed project is a cost-effective approach for meeting the health IT and data needs of your PHCs.

iii. Budget (Submit in Grants.gov and update in EHBs)

Follow the instructions included in Section 5.1.iv of HRSA’s SF-424 Two-Tier Application Guide and the additional budget instructions provided below. A budget that follows the Application Guide will ensure that, if HRSA selects the application for funding, you will have a well-organized plan and, by carefully following the approved plan, may avoid audit issues during the implementation phase.

Reminder: The Total Project or Program Costs are the total allowable costs12 (inclusive of direct and indirect costs) you incur to carry out a HRSA-supported project or activity.

Include only budget information related to the activities to be supported under the proposed project when completing the SF-424A: Budget Information Form. Do not report non-federal funding. Specifically:

• In Sections A, Budget Summary, enter the HCCN funding requested in the Federal column of the New or Revised Budget section for each budget period (1 year) of funding. The total annual federal request cannot exceed the funding tier ceiling amount for the proposed number of PHCs (see Table 1).

• In Section B, Budget Categories, enter an object class category (line item) budget for each budget period. The amounts for each category in the federal columns as well as the totals, should align with the Budget Narrative.

• Leave Section C, Non-federal Resources, blank.

As required by the Consolidated Appropriations Act, 2021 (P.L. 116-260), Division H, § 202 and Division A of the FY 2022 Extending Funding and Emergency Assistance Act (P.L.