BPHC HRSA-24-080 FY 24 State and Regional PCA Cooperative Agreements _Modified.pdf

U.S. Department of Health and Human Services

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2024

Bureau of Primary Health Care

Office of Policy and Program Development

FY 2024 State and Regional Primary Care Association (PCA) Cooperative Agreements

Funding Opportunity Number: HRSA-24-080

Funding Opportunity Type(s): Competing Continuation, New

Assistance Listings Number: 93.129

Application Due Date in Grants.gov: November 3, 2023

Supplemental Information Due Date in EHBs: December 4, 2023 Ensure your SAM.gov 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: September 1, 2023

Modified on October 24, 2023 to extend the application due dates, due to Grants gov downtime October 28 – 31, 2023.

Krishna Patel Public Health Analyst, Office of Policy and Program Development Phone: (301) 594-4300 Contact: BPHC Contact Form PCA TA webpage

See Section VII for a complete list of agency contacts.

Authority: Section 330(I) of the Public Health Service Act, (42 U.S.C. 254b(I)) https://hrsa.my.site.com/support/s/ https://bphc.hrsa.gov/funding/funding-opportunities/pca

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508 COMPLIANCE DISCLAIMER

Note: Persons using assistive technology may not be able to fully access information in this file. For assistance, 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) 2024 State and Regional Primary Care Association (PCA) Cooperative Agreements. The purpose of this program is for PCAs to support the development and delivery of training and technical assistance (T/TA) to support health centers in improving the health of individuals and communities by:

• Increasing access to comprehensive, culturally competent, high-quality primary health care services;

• Recruiting and retaining a diverse health care workforce;

• Preparing for, responding to, and recovering from emergent health events;

• Implementing value-based care delivery and ensuring financial sustainability; and

• Accelerating data-informed improvements to operations, clinical quality, and care coordination.

Funding Opportunity Title: Fiscal Year 2024 State and Regional Primary Care Association (PCA) Cooperative Agreements

Funding Opportunity Number: HRSA-24-080

Due Date for Applications – Grants.gov

November 3, 2023 (11:59 p.m. ET)

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

December 4, 2023 (5 p.m. ET)

Anticipated FY 2024 Total Available Funding:

Approximately $68.3 million

Estimated Number and Type of Awards: Up to 52 cooperative agreements http://www.hrsa.gov/

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Estimated Annual Award Amount: Varies and is subject to the availability of appropriated funds.

Cost Sharing/Match Required: No

Period of Performance: July 1, 2024, through June 30, 2027 (3 years)

Eligible Applicants: Eligible applicants include domestic public, non-profit, and for-profit entities, including community-based organizations and tribes and tribal organizations. New organizations and organizations currently receiving funding as PCAs may submit applications.

See Section III 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 this NOFO and in HRSA’s SF-424 Two-Tier Application Guide. Visit HRSA’s How to Prepare Your Application page for more information.

Technical Assistance

HRSA will hold a pre-application technical assistance (TA) webinar for PCA applicants.

This TA webinar will provide an overview of this NOFO and will be an opportunity for you to ask questions. Webinar information and additional application aids and resources to guide you in the development of your application are available on the PCA TA webpage.

Visit “Apply for a Grant” for general information about the application and submission process.

The HRSA Primary Health Care Digest is a weekly email newsletter containing information and updates about the Health Center Program. If you are interested in learning more about the Health Center Program, including additional funding opportunities, subscribe to the HRSA Primary Health Care Digest:

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

SHRSA_118.

Summary of Changes since the FY 2020 PCA Funding Opportunity:

http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://bphc.hrsa.gov/funding/funding-opportunities/pca https://bphc.hrsa.gov/funding/funding-opportunities/pca https://www.hrsa.gov/grants/apply-for-a-grant https://public.govdelivery.com/accounts/USHHSHRSA/subscriber/new?topic_id=USHHSHRSA_118 https://public.govdelivery.com/accounts/USHHSHRSA/subscriber/new?topic_id=USHHSHRSA_118

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• Updated requirement that Competing Continuation applicants are no longer required to submit summary progress reports as part of their Competing Continuation application.

• Updated key staff definition.

• Updated the Project Work Plan (PWP):

o PCAs may support health centers implement multiple supplemental funding opportunities throughout the period of performance.

o PCAs may support and document preparation and recovery activities for multiple emergency preparedness and response topics throughout the period of performance.

o PCAs may include participation in the asynchronous T/TA sessions as part of their T/TA Participation Target total entered in the T/TA Participation Target field.

o PCAs must include additional details about each activity in the Activity Description field such as:

A description of the activity that details how it is tailored to the needs of the health centers.

The modality, frequency, length, and training purpose/objectives for

T/TA offerings.

The name of partner organization(s), and how they will support the development and delivery of this activity, if applicable.

A description of how the Advancing Health Center Excellence

Framework performance domain(s) aligns with the activity.

• New program expectation for PCAs to designate a Special Population(s) lead, who will coordinate or lead T/TA strategies to address the unique health care needs and barriers to care for Special Populations in their state or region and serve as a point of contact for HRSA.

• New program expectation for PCAs to allocate 1.0 FTE to health workforce support.

• New program expectation for PCAs to conduct a T/TA needs assessment in the first budget period (July 1, 2024, through June 30, 2025), and continually assess T/TA needs by collecting and analyzing qualitative and quantitative data during years 2 (July 1, 2025, through June 30, 2026) and 3 (July 1, 2026, through June 30, 2027).

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Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

3. PROGRAM OVERVIEW

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 (Required for Eligibility)

iii. Budget

v. Program-Specific Forms

vi. Attachments

3. 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: FORM 1A INSTRUCTIONS

APPENDIX B: PROJECT WORK PLAN INSTRUCTIONS

APPENDIX C: PCA OBJECTIVE GUIDE

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I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for State and Regional Primary Care Association (PCA) Cooperative Agreement funding to provide training and technical assistance (T/TA) to existing and potential Health Center Program award recipients and look-alikes (LALs), hereafter referred to as health centers.1 The Health Resources and Services Administration (HRSA) seeks to fund up to 52 organizations to develop and deliver T/TA that will support health centers in improving the health of individuals and communities by:

• Increasing access to comprehensive, culturally competent, high-quality primary health care services;

• Recruiting and retaining a diverse health care workforce;

• Preparing for, responding to, and recovering from emergent health events;

• Implementing value-based care delivery and ensuring financial sustainability; and

• Accelerating data-informed improvements to operations, clinical quality, and care coordination.

For more details, see Program Overview.

2. Background

PCAs are authorized by Section 330(I) of the Public Health Service Act, (42 U.S.C.

254b(I)).

The Health Center Program supports community-based patient-directed health centers that provide high-quality, comprehensive, and culturally competent primary health care services. Health centers deliver primary care to medically underserved2 and special populations regardless of their ability to pay. They play a pivotal role in providing access to comprehensive primary care services, screening for social risk factors, and providing enabling services that facilitate access to care and connect patients to community resources to address their health-related social needs. Health centers play critical and increasing roles in mitigating the impacts of natural and man-made disasters, public health emergencies, and extreme weather on the populations they serve.

1 LALs meet all Health Center Program statutory, regulatory, and policy requirements but do not receive funding under section 330 of the Public Health Service Act. For more information on LALs, see https://bphc.hrsa.gov/funding/funding-opportunities/health-center-program-look-alikes. Potential health centers are organizations that are applying for, or seeking information about applying for, a Health Center Program award or LAL designation.

2 Underserved communities are defined as “[The] populations sharing a particular characteristic, as well as geographic communities, that have been systematically denied a full opportunity to participate in aspects of economic, social, and civic life, as exemplified by the list in the preceding definition of ‘equity.’” Advancing Racial Equity and Support for Underserved Communities Through the Federal Government https://bphc.hrsa.gov/about-health-centers/how-become-health-center https://bphc.hrsa.gov/funding/funding-opportunities/health-center-program-look-alikes https://www.govinfo.gov/content/pkg/FR-2021-01-25/pdf/2021-01753.pdf

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HRSA funds T/TA partners and networks to develop, deliver, coordinate, and evaluate T/TA for health centers. These organizations include PCAs, Health Center Controlled Networks (HCCNs), and National Training and Technical Assistance Partners (NTTAPs). T/TA partners and networks, and the resources they develop, help health centers improve their performance in an ever-evolving health care landscape, respond to emergent health care needs, and address Department of Health and Human Services (HHS) priority areas. PCAs leverage, adapt, and complement T/TA resources developed by other HRSA-supported T/TA providers and networks and make them available for health centers.

PCAs also maximize the value and impact of the Health Center Program. PCAs use their understanding of the unique T/TA needs in their state or region to identify T/TA priorities to support health centers to innovate and respond most effectively to changes in their state or region. In addition, PCAs will develop T/TA to support health centers to improve their performance in each of the seven Advancing Health Center Excellence Framework3 performance domains (referred to as performance domains). Finally, PCAs will develop T/TA to support health centers to address the HHS priority to protect and strengthen equitable access to high quality and affordable healthcare.4

3. Program Overview

Training and Technical Assistance

For the purposes of this funding opportunity, training is defined as an educational tool designed to teach key concepts related to a particular topic and is often delivered in small or large group settings (e.g., in person and through webinars, learning communities, workshops, courses). Technical assistance is the process of providing targeted advice, assistance expertise, or information to an organization or groups of organizations with a developmental need to facilitate quality or performance improvement. T/TA activities can take many forms which may include:

• Providing support to organizations interested in becoming a Health Center Program award recipient or LAL;

• Developing and delivering training to help health centers achieve a higher level of performance, including in one or more performance domain;

• Conducting technical assistance to advance HRSA strategic priorities, improve health center performance, including in a performance domain (i.e., levels of maturity, compliance driven, fundamental, strategic, and leading), or enhance health center operations;

3 HRSA’s Advancing Health Center Excellence Framework is a conceptual structure for health center innovation and performance improvement and includes seven key health center performance domains:

Access and Affordability; Patient Experience; Quality, Patient Care, and Safety; Population Health and Social Determinants of Health; Financial Sustainability; Workforce; and Governance and Management.

4 HHS Strategic Plan FY 2022-2026—Strategic Goal 1: Protect and Strengthen Equitable Access to High Quality and Affordable Healthcare: https://www.hhs.gov/about/strategic-plan/2022-2026/goal-1/index.html https://bphc.hrsa.gov/initiatives/advancing-health-center-excellence https://bphc.hrsa.gov/initiatives/advancing-health-center-excellence https://www.hhs.gov/about/strategic-plan/2022-2026/goal-1/index.html

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• Developing and sharing key resources that respond to health center needs or help to achieve objective targets, such as readiness tools, implementation manuals, and fact sheets;

• Identifying, disseminating, and facilitating the implementation of evidence-based and promising clinical and operational practices; and

• Facilitating peer-to-peer learning, exchange of best practices, and mentorship.

PCA Types

For the purposes of this funding opportunity, you must propose to provide T/TA as a state or regional PCA. State PCAs serve as the primary PCA T/TA provider to health centers in a single or combination of states or territories. The regional PCA type provides T/TA to the health centers in collaboration and coordination with the state PCAs in their region, while ensuring no duplication of effort.

HRSA will make one award for each geographic area listed below.

• State-Specific5

Table 1: List of state specific PCAs Alabama* Indiana Nebraska Rhode Island Alaska Iowa Nevada South Carolina* Arizona Kansas New Jersey Tennessee Arkansas* Kentucky* New Mexico Texas California Louisiana New York Utah Colorado Maine North Carolina Virginia Connecticut Massachusetts Ohio Washington Florida Michigan Oklahoma* Washington, D.C.

Georgia Minnesota Oregon West Virginia Hawaii Mississippi* Pacific Islands6 Wisconsin Idaho Missouri* Pennsylvania Wyoming Illinois Montana Puerto Rico

*Maximum annual allowable funding amount includes funding to support HIV prevention T/TA to health centers in the state. These states have been identified by the Ending the HIV Epidemic (EHE) initiative.

• Multi-State: PCAs serving more than one state, in which the PCA is located in either state, and provides T/TA support to health centers in both states. The following are considered a “state PCA” for the purpose of this funding opportunity.

o Delaware and Maryland o New Hampshire and Vermont o North Dakota and South Dakota

5 Includes United States territories and freely associated states. Freely associated states refer to the three sovereign nations that have entered into Compacts of Free Association with the US.

https://www.doi.gov/oia/compacts-of-free-association 6 Pacific Islands include American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Republic of the Marshall Islands, and Republic of Palau.

https://www.hrsa.gov/ending-hiv-epidemic https://www.doi.gov/oia/compacts-of-free-association

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• Regional: PCAs that serve an HHS Region and coordinate T/TA with the state PCAs located in the states within that region.

o Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming o Region 10: Alaska, Idaho, Oregon, Washington

PCA Requirements and Expectations

PCAs develop, deliver, coordinate, and evaluate T/TA activities for health centers in their state or region. T/TA activities must support health centers in improving the health of individuals and communities by increasing access to comprehensive, culturally competent, high-quality primary health care services; recruiting and retaining a diverse health care workforce; preparing for, responding to, and recovering from emergent health events; implementing value-based care delivery and ensuring financial sustainability; and accelerating data-informed improvements in operations, clinical quality, and care coordination. Appendix C: PCA Objective Guide outlines the objectives that PCAs must work towards as they support health centers.

For the purposes of this funding opportunity:

• You will monitor the health care environment, and propose changes to your planned T/TA activities to address new and evolving issues that impact health centers in your state or region.

• You will notify HRSA of emergent public health, health care, and other challenges that may impact health centers’ ability to meet the needs of their patients in your state or region.

• You will use data to inform and evolve T/TA activities.

o In year 1 of your project, you will conduct a comprehensive T/TA needs assessment to identify the T/TA needs in your state or region.

o Throughout your period of performance, you will continue to conduct qualitative and quantitative needs assessments as necessary to ensure your T/TA activities evolve with the changing needs of health centers in your state or region.

• You will evaluate T/TA activities to assess the extent to which they support improvements in health center care coordination, clinical quality, and operations.

When possible, you will make your T/TA scalable to reach the widest audience.

• You will share data, coordinate, and align T/TA activities, and develop and share T/TA resources and tools with other PCAs and HRSA-supported T/TA partners and networks (e.g., HCCNs, NTTAPs) to amplify the impact of T/TA on health centers and reduce duplication of effort.

• You must have a minimum of two partnerships: one with a HRSA-supported HCCN or NTTAP, and one with a state public agency (e.g., state health department, state primary care office, state Medicaid agency). Note that if funds are transferred to another entity, these relationships would be considered subrecipients and must comply with applicable requirements.

• You will leverage new and existing partnerships with state-level and community-based organizations to support the development and delivery of T/TA resources and tools to health centers.

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• You will maintain 1.0 FTE to support health workforce T/TA activities.

• You will collaborate with federal partners to address current and emerging issues impacting access to health care services in your state or region, e.g., working with Centers for Medicare and Medicaid Services on outreach and enrollment activities.

• You will designate and support a Special Population(s) lead who will coordinate or lead T/TA strategies to address the unique health care needs and barriers to care for Special Populations in your state or region and who will serve as a point of contact for HRSA.

• You will identify, disseminate, and help health centers to implement evidence-based and promising practices that address HRSA priorities and improve performance within the performance domains, or both.

• You will initiate T/TA delivery within 60 days of award.

• You will tailor T/TA resources and tools developed by other HRSA-supported

T/TA partners and networks to your regional, state, and/or local context, including:

o National curricula, tools, and resources developed by NTTAPs to improve outcomes and address barriers at a national level.

o Health IT tools and resources developed by HCCNs to enhance the patient and provider experience, advance interoperability, and facilitate the use of data to enhance the value of T/TA resources and tools.

• You will regularly solicit and incorporate input from health centers and other T/TA providers to guide the development of T/TA activities that advance heath equity, address health-related social needs, and address the needs of statutorily defined special populations.

• You will engage with HRSA-supported T/TA partners and networks, and ensure access to T/TA without regard to health center award/designation status, HRSA T/TA partner membership status, or location within the state or region.7 You cannot charge for T/TA supported solely with HRSA funds. For T/TA funded with a mix of HRSA and non-HRSA funds, charging participants to offset non-HRSA funded costs is permissible if you can demonstrate that the charge is not a barrier to access.

• You will ensure that resources are accessible to the widest possible health center audience in the state or region, which may include use of free webinars, and on-demand recordings following live events. HRSA expects the majority of your T/TA activities will be directed towards groups of health centers with similar needs rather than individually targeted T/TA.

• You will make T/TA available through the health center resource clearinghouse.8

8 PCAs that refuse to work with an existing or potential health center may be deemed non-compliant with the terms and conditions associated with this award, and subject to penalties for noncompliance as outlined by 45 CFR 75.371.

8 To see the current version of the health center resource clearinghouse, visit https://bphc.hrsa.gov/technical-assistance/health-center-resource-clearinghouse.

https://bphc.hrsa.gov/technical-assistance/health-center-resource-clearinghouse

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• You will make steady progress towards meeting the objectives and attaining your targets throughout the 3-year period of performance.

• Regional PCAs:

o You will synthesize and prioritize needs that are best addressed at the regional level, and they may differ across states.

o You will actively and continuously collaborate with the state PCAs in your region throughout the period of performance to ensure that your T/TA activities are complementary and not duplicative.

o You will establish a memorandum of agreement (MOA) with all state PCAs in your region.

o You must coordinate and provide T/TA activities across your entire region, and to an audience with varying T/TA needs.

• State PCAs serving certain states with high HIV transmission (Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma, and South Carolina):

You must propose to develop and deliver T/TA activities to health centers in the state focused on supporting HIV prevention, as noted in relevant objectives.

II. Award Information

1. Type of Application and Award

Type(s) of applications sought:

• Competing Continuation: A current PCA award recipient that seeks to continue providing state or regional T/TA.

• New: An organization that is not currently receiving PCA funding that seeks to provide state or regional T/TA to health centers in one of the identified states or regions listed in the Program Overview section.

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.

In addition to the usual monitoring and TA provided directly to award recipients, HRSA program involvement will include:

• Collaborating with award recipients to refine and approve the project work plan (PWP) according to HRSA priorities and changes in the health care landscape through such activities as identifying and prioritizing T/TA needs to be addressed using federal funds.

• Monitoring and supporting the implementation of the PWP through collaborative meetings and progress report reviews.

• Reviewing and supporting the development of key deliverables, including approval of the publication plan and specialized materials for general distribution prior to publication, distribution, and/or online posting.

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• Attending and participating in state or regional PCA-related meetings, as appropriate.

• Coordinating with other Bureaus and Offices within HRSA to identify and support collaboration opportunities for PCAs across and within HRSA-supported programs.

• Identifying opportunities for PCAs to coordinate activities with other federally funded cooperative agreements.

• Conducting a PCA site visit once per period of performance to review and assess activities, review key accomplishments, and identify promising practices in supporting the T/TA needs of health centers.

In addition to adhering to all applicable federal regulations and public policy requirements, the cooperative agreement recipient’s responsibilities will include:

• Collaborating with HRSA to refine and implement the PWP based on HRSA priorities, and changes in the health care landscape at the state or regional level.

• Engaging with HRSA to update the PWP at least annually, or more frequently as needed (e.g., in response to site visit findings, to establish new activities once current activities are met, to address significant changes in HRSA priorities, to reduce or eliminate duplication of state and regional T/TA activities).

• Providing and updating a plan for publications to be created or disseminated with PCA funds. The plan should include each publication’s purpose, target audience, title, publication type, summary description, expected impact and benefit, and projected publication date. Publications must also contain an acknowledgement of Federal funding in accordance with the requirements listed at: Communicating and Acknowledging Federal Funding.

• Adhering to HRSA guidelines pertaining to data rights9 and adding required acknowledgement and disclaimer on all products produced through HRSA award funds, as noted on the Notice of Award.

• Participating in HRSA and related stakeholder meetings, as appropriate.

• Coordinating with national, federal, state, local, and tribal organizations, as appropriate, to strengthen PWP development and implementation.

• Coordinating with other PCAs to identify and disseminate resources for health centers in other states or regions.

• Ensuring that T/TA activities supported in whole or in part with PCA funds are equally available to all health centers in the state or region, regardless of Health Center Program award/LAL status or HRSA-supported T/TA partner or network membership.

• Participating in a HRSA-led PCA site visit once during the 3-year period of performance. Information about the PCA site visit process is available in the PCA Site Visit Guide.

2. Summary of Funding

9 Section VI.2 Data Rights in this NOFO details the government’s rights to publications developed with grant funding. See also 45 CFR § 75.322(d).

https://www.hrsa.gov/grants/manage/acknowledge-hrsa-funding https://www.hrsa.gov/grants/manage/acknowledge-hrsa-funding https://bphc.hrsa.gov/compliance/site-visits https://bphc.hrsa.gov/compliance/site-visits

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HRSA estimates approximately $68,300,000 to be available annually to fund 52 recipients.10 The actual amount available will not be determined until the enactment of the final FY 2024 federal appropriation. You may apply for a ceiling amount of up to the maximum award amount for your state or region annually (reflecting direct and indirect costs) per year. You can obtain the annual level of PCA funding for the proposed state or region by submitting a request to the PCA Response Team via the BPHC Contact Form. 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 appropriately.

The period of performance is July 1, 2024, through June 30, 2027 (3 years). Funding beyond the first year is subject to the availability of appropriated funds for PCAs in subsequent fiscal years, satisfactory progress, and a decision that continued funding is in the best interest of the Federal Government.

All HRSA awards are subject to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements at 45 CFR part 75.

Note: You may request supplemental funding at any point in your period of performance to address evolving T/TA needs of health centers in your state or region. The activities you propose must align with, and not duplicate, the funded scope of work. HRSA may provide support for 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 not duplicative of work performed by HRSA or other HRSA-supported T/TA partner and network award recipients.

III. Eligibility Information

1. Eligible Applicants

Eligible applicants include domestic public or private, non-profit, or for-profit entities.

Community-based organizations, tribes, and tribal organizations are eligible to apply for PCA funding. New organizations and organizations currently receiving funding as PCAs under Section 330(l) may submit applications.

2. Cost Sharing/Matching

Cost sharing/matching is not required for this program.

3. Other

Multiple Applications

HRSA may not consider an application for funding if it contains any of the non-responsive criteria below:

10 Applicants applying to be a state PCA in Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma, and South Carolina will be required to use funding to support health centers statewide with HIV prevention efforts.

https://hrsa.my.site.com/support/s/ https://hrsa.my.site.com/support/s/ 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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• Fails to satisfy the deadline requirements referenced in Section IV.4

• Does not include the Project Narrative as described in Section IV.2.ii

NOTE: You may apply for only one state or regional PCA listed in Program Overview section.

Multiple applications from an organization are not allowed. Organizations that currently receive other Health Center Program T/TA partner funding, such as NTTAP awardees, will not be considered for funding.

HRSA will only accept and review your first validated electronic submission, under the correct funding opportunity number (HRSA-24-080), 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, you may reopen and revise your application prior to the EHBs deadline. 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 Grants.gov: HOW TO APPLY FOR GRANTS and the EHBs.

• Phase 1 – Grants.gov – Required information must be submitted and validated via Grants.gov with a due date of November 3, 2023, at 11:59 p.m. ET; and

• Phase 2 – EHBs – Supplemental information must be submitted via EHBs with a due date of December 4, 2023, at 5 p.m. ET.

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-24-080 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 general instructions for the budget, budget narrative, staffing plan and personnel requirements, assurances, and certifications. You must submit the information outlined in the HRSA SF-424 Two- Tier Application Guide in addition to the program-specific information below. You are responsible for reading and complying with the instructions included in this NOFO and HRSA’s SF-424 Two-Tier Application Guide. You must submit the application in the English language and in U.S. dollars (45 CFR § 75.111(a)).

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

• Application for Federal Assistance (SF-424)

• Attachment Form (submit form with or without attachments)

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

• Project Narrative Attachment Form (attach your project narrative)

• Grants.gov Lobbying Form

• Budget Narrative Attachment Form (attach your budget narrative)

• SF-424A Budget Information – Non-Construction Programs Form

• Key Contacts

• Project Abstract Summary

The following application components must be submitted in EHBs:

• Project Narrative

• SF-424A Budget Information – Non-Construction Programs Form

• Budget Narrative

• Program-Specific Form

• Attachments

See Section 9.5 of the HRSA SF-424 Two-Tier Application Guide for the Application Completeness Checklist to assist you in completing your application.

Application Page Limit The total number of pages that count toward the page limit shall be no more than 80 pages when we print them. HRSA will not review any pages that exceed the page limit.

Using the pages within the page limit, HRSA will determine eligibility using Section III.

Eligibility Information of the NOFO.

These items don’t count toward the page limit:

http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf

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• Standard OMB-approved forms you find in the NOFO’s workspace application package

• Abstract (standard form (SF) “Project_Abstract Summary”)

• Indirect Cost Rate Agreement

If there are other items that don’t count toward the page limit, we’ll make this clear in Section IV.2.vi Attachments.

If you use an OMB-approved form that isn’t in the HRSA-24-080 workspace application package, it may count toward the page limit. We recommend you only use Grants.gov workspace and OMB-approved forms related with this NOFO to avoid going over the page limit.

Applications must be complete and validated by Grants.gov under HRSA-24-080 before the deadline.

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 8: Other Relevant 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, staffing plan and personnel requirements, assurances, certifications, and abstract), include the following:

i. Project Abstract Use the Standard OMB-approved Project Abstract Summary Form that is included in the workspace application package in Grants.gov. Do not upload the abstract as an attachment or it may count toward the page limit. For information required in the Project Abstract Summary Form, see Section 5.1.ix. of HRSA’s SF-424 Two-Tier Application Guide. You may update this information in the EHBs.

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

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NARRATIVE GUIDANCE

To ensure that you fully address the review criteria, the table below 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.

Table 2: Narrative Section, Form and Attachment to Review Criteria Crosswalk Narrative Section, Forms and Attachments Review Criteria Need section of the Project Narrative (1) Need

Response section of the Project Narrative

Form: Project Work Plan

(2) Response

Collaboration section of the Project Narrative

Attachment 5: Letters of Agreement

Attachment 6: Regional Memorandum of Agreement (Regional PCAs Only)

(3) Collaboration

Evaluative Measures section of the Project Narrative (4) Evaluative Measures

Resources and Capabilities section of the Project Narrative

Attachment 1: Project Organizational Chart

Attachment 2: Staffing Plan

Attachment 3: Job Descriptions for Key Personnel

Attachment 4: Biographical Sketches of Key Personnel

Attachment 7: Summary of Contracts and Agreements

(5) Resources and Capabilities

Support Requested section of the Project Narrative

Budget Narrative

(6) Support Requested

ii. Project Narrative (Required for Eligibility) This section provides a comprehensive description of all aspects of the proposed project. It should be succinct, self-explanatory, consistent with forms and attachments, and organized in alignment with the sections and format below so that reviewers can understand the proposed project.

Successful applications will contain the information below. Please use the following section headers for the narrative:

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NEED – Corresponds to Section V’s Review Criterion 1: Need

Information you provide in the NEED section must serve as the basis for your proposed activities, which will support the achievement of the objectives detailed in Appendix C:

PCA Objective Guide.

1) Describe the current state or regional health care landscape and expected changes to health centers’ T/TA needs, as they relate to:

a) Increasing access to comprehensive, culturally competent, high-quality primary health care services;

b) Recruiting and retaining a diverse health care workforce;

c) Preparing for, responding to, and recovering from emergent health events;

d) Implementing value-based care delivery and ensuring financial sustainability; and

e) Accelerating data-informed improvements to operations, clinical quality, and care coordination.

2) Describe how you assess the T/TA needs in your state. If you are applying as a regional PCA, describe how you will synthesize and prioritize needs that differ across states to understand what needs are most significant across the region.

In your description, list the data sources that you use. Data must be specific to the needs of the health centers in your state or region. Data sources may include, but are not limited to: Health Center Program data, Uniform Data System (UDS) 11 reports, survey results, T/TA participant feedback (as applicable), and a formal T/TA needs assessment (as applicable).

3) Describe the T/TA needs of health centers based on your recent assessment. If you are applying to be a regional PCA, describe the T/TA needs in each of the states across the region. If you are applying to be a state PCA in Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma, or South Carolina: describe the HIV prevention T/TA needs within your state.

4) Discuss your short- and long-term T/TA priorities over the 3-year period of performance, and how they align with the current health center T/TA needs in your state or region. Include the performance domain(s) you will address. If you are applying to be a regional PCA, include details about how you will prioritize the needs that are best addressed at the regional level. For the purpose of this NOFO, short-term refers to the first budget period (July 1, 2024, through June 30, 2025) while long-term refers to the remaining two years of the 3-year period of performance.

11 The UDS is a standard data set that is reported annually by health centers that receive awards under the Health Center Program, as well as Health Center Program look-alikes, and provides consistent information about health centers. For more information, visit the Uniform Data System (UDS) Training and Technical Assistance webpage.

https://bphc.hrsa.gov/data-reporting/uds-training-and-technical-assistance https://bphc.hrsa.gov/data-reporting/uds-training-and-technical-assistance

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RESPONSE – Corresponds to Section V’s Review Criterion 2: Response

Information you provide in the RESPONSE section must describe how you will respond to the T/TA needs of health centers in your state or region and meet the purpose of this funding opportunity. This will include developing T/TA activities that support achievement of targets for the objectives detailed in Appendix C: PCA Objective Description.

Note: Information you include in the RESPONSE section of your project narrative submission will expand upon your PWP that you will complete electronically in EHBs.

The PWP includes details about the T/TA activities you propose to complete in year 1, and will support objective target achievement by the end of the period of performance.

Details about the required information that must be included in your PWP are available in Appendix B: Project Work Plan Instructions. A sample PWP illustrating the level of detail required in your PWP is on the PCA TA webpage.

The RESPONSE section of the Project Narrative must contain the information below.

1) Provide an overview of your projected T/TA activities in years 2 and 3 that will support objective target achievement by the end of the period of performance (June 30, 2027). In your overview, include the T/TA need you will address, and evaluation data you will use to develop and modify T/TA activities.

2) Describe how you will effectively use available resources to achieve the established targets (such as objective target, T/TA session target, T/TA participation target, and participant rating of T/TA usefulness target), in ways that complement and do not duplicate other HRSA-supported T/TA partners and networks.

3) Describe how you will maintain compliance with the PCA Requirements and Expectations (listed in the Program Overview section).

COLLABORATION -- Corresponds to Section V’s Review Criterion 3: Collaboration

Information you include in the COLLABORATION section demonstrates how your partnerships will support the development and delivery of T/TA activities.

1) List and describe each existing and proposed T/TA partnership that will support the proposed project. For each collaborative partnership include the:

a) Name and organization type of T/TA partner;

b) Status of the partnership: current, or planned;

c) Purpose of the partnership;

d) Description of how the partnership will support your progress towards objective target achievement; and

e) Description of how the partnership complements and does not duplicate T/TA resources, for example sharing existing T/TA resources that you may customize for the health centers in your state or region.

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f) Description of how the partnership informs and does not duplicate the development of T/TA resources shared by other HRSA-supported T/TA partners and networks.

You must have a minimum of two partnerships: one partnership with a HRSA-supported HCCN or NTTAP, and one partnership with a state public agency (e.g., state health department, state primary care office, state Medicaid agency).

In addition to the required minimum partnerships outlined above, your other partners may include other PCAs, local health departments, and community-based organizations.

Provide documentation of all existing and proposed partnerships through letters of agreement as Attachment 5: Letters of Agreement.

2) All organizations applying as regional PCAs ONLY: Describe how you will coordinate and continuously collaborate throughout the period of performance with all state PCAs in your region to develop and deliver T/TA that complements, and does not duplicate, the T/TA activities developed by the state PCAs (see Program Overview).

Attach a Regional MOA documenting collaborations with all state PCAs in your region as Attachment 6: Regional Memorandum of Agreement.

3) New organizations applying to be a state PCA covered by a regional PCA ONLY: If you are new a state PCA applicant, provide an attestation of your commitment to work with the regional PCA and sign the regional PCA’s MOA, include as Attachment 8: Other Relevant Documents. See Program Overview to check if your state is covered by a regional PCA.

EVALUATIVE MEASURES -- Corresponds to Section V’s Review Criterion 4:

Evaluative Measures

Information you include in the EVALUATIVE MEASURES section should explain how you will collect, monitor, and measure quantitative and qualitative data to improve the development and delivery of T/TA activities.

1) Detail your plan for evaluating the effectiveness of your T/TA activities. The plan must include how you will:

a) Monitor and measure the impact of T/TA activities on health center performance related to: the performance domain(s), progress towards attaining targets, and expected outcomes. Include how frequently you will monitor and measure the impact of T/TA activities.

b) Use valid and reliable quantitative and qualitative data to assess the quality, reach, and utility of T/TA activities, including data from health centers, and other partners or collaborators in your state or regional.

c) Develop or modify T/TA activities based on data, including how you will determine the content, modality, frequency, length, and training objectives.

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2) Describe how you will evaluate and use participant responses to the 5-point Likert rating scale (used in the Participant Rating of T/TA Usefulness Target field in the PWP) to adjust T/TA activities.

3) Describe your plan for disseminating T/TA evaluation results to the health centers in your state or region and to HRSA-supported T/TA partners and networks.

RESOURCES AND CAPABILITIES -- Corresponds to Section V’s Review Criterion 5:

Resources and Capabilities

Information you include in the RESOURCES AND CAPABILITIES section should demonstrate your ability to ensure overall success in the development and delivery of

T/TA.

1) Demonstrate your capability to provide T/TA to health centers by:

a) Organizations applying to be a state PCA ONLY: Documenting your experience and expertise in coordinating and providing T/TA activities of similar scope, such as delivering a range of T/TA across an entire state to an audience with varying T/TA needs.

b) Organizations applying as regional PCAs ONLY: Documenting your experience and expertise in coordinating and providing T/TA activities across a region that includes multiple states, and to an audience with varying T/TA needs.

c) All Organizations: Detailing your accomplishments and lessons learned, including your experience conducting T/TA evaluation, and how you have used results to improve or modify activities.

2) Describe how your staffing plan, contracts, or agreements are appropriate for the operational and oversight needs, scope, and complexity of the proposed project.

Include how proposed staffing is appropriate to address health workforce and special population T/TA needs in your state or region.

Provide documentation that demonstrates your ability to successfully implement this project. Include your staffing plan as Attachment 2: Staffing Plan, job descriptions for key personnel as Attachment 3: Job Descriptions for Key Personnel and provide biographical sketches of the key personnel as Attachment 4: Biographical Sketches for Key Personnel. If applicable, summarize your contracts or agreements and include as Attachment 7: Summary of Contracts and Agreements.

3) Describe your recruitment and retention plan, detailing how you will recruit and retain staff to achieve and maintain the proposed staffing plan.