FINAL FORHP HRSA-24-007 (P10) Network Planning_NEW TEMPLATE.pdf

U.S. Department of Health and Human Services

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2024

Federal Office of Rural Health Policy

Community-Based Division

Rural Health Network Development Planning Program

Funding Opportunity Number: HRSA-24-007

Funding Opportunity Type(s): New

Assistance Listing Number: 93.912

Application Due Date: January 26, 2024

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

We will not approve deadline extensions for lack of registration.

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

Issuance Date: October 25, 2023

Nkem Osian

Public Health Analyst, Federal Office of Rural Health Policy

Call: 301-443-2751

Email: nosian@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 U.S.C. 254c(f) (§ 330A(f) of the Public Health Service Act) mailto:nosian@hrsa.gov

HRSA-24-007 Rural Health Network Development Planning Program i

508 COMPLIANCE DISCLAIMER

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.

SUMMARY

Funding Opportunity Title: Rural Health Network Development Planning

Program

Funding Opportunity Number: HRSA-24-007

Assistance Listing Number: 93.912

Due Date for Applications: January 26, 2024

Purpose: The Health Resources and Services Administration

(HRSA) is accepting applications for the fiscal year

(FY) 2024 Rural Health Network Development

Planning Program. The purpose of this program is to promote the planning and development of integrated health care networks to address the following legislative aims: (i) achieve efficiencies;

(ii) expand access to, coordinate, and improve the quality of basic health care services and associated health outcomes; and (iii) strengthen the rural health care system as a whole.

Program Objective(s): At the conclusion of the grant program, network partners will be able to accomplish the following

Network Planning Program goals: achieve efficiencies, increase access to care and coordination, and strengthen the rural health care system.

Eligible Applicants: To be eligible to receive a grant under this notice of funding opportunity, an entity –

(A) Shall be a domestic public or private, non-profit, or for-profit entity with demonstrated experience serving, or the capacity to serve, rural underserved populations;

http://www.hrsa.gov/ http://www.hrsa.gov/

HRSA-24-007 Rural Health Network Development Planning Program ii

(B) Should represent a network that includes the following – (i) at least three or more healthcare providers and (ii) that may be rural, urban, nonprofit, or for-profit entities, and

(C) Should not previously have received a grant under 42 U.S.C. 254c(f) (other than a grant for planning activities) for the same or similar project.

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

Anticipated FY 2024 Total

Available Funding:

$3,000,000

We’re issuing this notice to ensure that, should funds become available for this purpose, we can process applications and award funds appropriately. You should note that we may cancel this program notice before award if funds are not appropriated.

Estimated Number and Type of

Award(s):

Up to 30 new grants

Estimated Annual Award

Amount:

Up to $100,000 per award, subject to the availability of appropriated funds

Cost Sharing or Matching

Required:

No

Period of Performance: July 1, 2024 through June 30, 2025 (1 year)

Agency Contacts: Business, administrative, or fiscal issues:

Eric Brown Grants Management Specialist Division of Grants Management Operations, OFAM

Email: ebrown@hrsa.gov

Program issues or technical assistance:

Nkem Osian

Public Health Analyst Federal Office of Rural Health Policy

Email: nosian@hrsa.gov mailto:ebrown@hrsa.gov

HRSA-24-007 Rural Health Network Development Planning Program iii

Application Guide

You (the applicant organization / agency) are responsible for reading and complying with the instructions included in this NOFO and in HRSA Application Guide (Application

Guide). Visit HRSA’s How to Prepare Your Application page for more information.

Technical Assistance

We have scheduled the following webinar:

Tuesday, November 14, 2023

3 – 4 p.m. ET

Weblink: https://hrsa-gov.zoomgov.com/j/1608405541?pwd=ZGJITXJUY293b0NES1orMDdjejdOQT09

Attendees without computer access or computer audio can use the following dial-in information:

Call-In Number: 833 568 8864

Meeting ID: 160 840 5541

Passcode: 72200418

We will record the webinar. Please contact nosian@hrsa.gov to request playback information 48 hours after the live event.

http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://hrsa-gov.zoomgov.com/j/1608405541?pwd=ZGJITXJUY293b0NES1orMDdjejdOQT09 https://hrsa-gov.zoomgov.com/j/1608405541?pwd=ZGJITXJUY293b0NES1orMDdjejdOQT09

HRSA-24-007 Rural Health Network Development Planning Program iv

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 OR 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

iii. Budget ................................................................... Error! Bookmark not defined.

iv. Budget Narrative

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: PRE APPLICATION PLANNING ADVICE AND LEGISLATIVE AIMS

APPENDIX B: COMMION DEFINITIONS

APPENDIX C: PERFORMANCE MEASURES

APPENDIX D: USEFUL RESOURCES

APPENDIX E: PAGE LIMIT WORKSHEET

HRSA-24-007 Rural Health Network Development Planning Program 1

I. Program Funding Opportunity Description

1. Purpose

The purpose the Rural Health Network Development Planning Program (“Network

Planning Program”) is to plan and develop integrated health care networks that collaborate to address the following legislative aims: (i) achieve efficiencies; (ii) expand access to and improve the quality of basic health care services and health outcomes; and

(iii) strengthen the rural health care system.

This program supports one year of planning and brings together members of the health care delivery system, particularly those entities that may not have collaborated in the past, to establish and/or improve local capacity in order to strengthen rural community health interventions and enhance care coordination.

The Network Planning program uses the concept of developing networks as a strategy toward linking rural health care network members together to address local challenges, and help rural stakeholders achieve greater collective capacity to overcome challenges related to limited economies of scale for individual hospitals, clinics, or other key rural health care stakeholders.

For more details, see Program Requirements and Expectations.

2. Background

The program is authorized by 42 U.S.C. 254c(f) (§ 330A(f) of the Public Health Service

Act), which anticipates award of rural health network development grants to provide for support bringing together health care providers through a networked approach. At the conclusion of the grant program, network partners will be able to accomplish the following

Network Planning Program goals: achieve efficiencies, increase access to care and coordination, and strengthen the rural health care system.

The intent of the Network Planning Program is to allow applicants maximum flexibility to tailor their projects to the unique rural community needs based on historical health care context, community input, and relevant data sources. Due to the flexible nature of the

Network Planning Program, rural health priorities complement the program’s goals.

II. Award Information

1. Type of Application and Award

Application type: New

We will fund you via a grant.

HRSA-24-007 Rural Health Network Development Planning Program 2

2. Summary of Funding

We estimate $3,000,000 will be available each year to fund 30 recipients. You may apply for a ceiling amount of up to $100,000 annually (reflecting direct and indirect costs).

The period of performance is July 1, 2024, through June 30, 2025 (1 year).

This program notice depends on the appropriation of funds. If funds are appropriated for this purpose, we will proceed with the application and award process.

45 CFR part 75 - Uniform Administrative Requirements, Cost Principles, and Audit

Requirements for HHS Awards applies to all HRSA awards.

If you’ve never received a negotiated indirect cost rate, you may elect to charge a de minimis rate of 10 percent of modified total direct costs (MTDC)*. You may use this for the life of the award. If you choose this method, you must use it for all federal awards until you choose to negotiate for a rate. You may apply to do so at any time. See Section 4.1.v.

Budget Narrative in the Application Guide.

*Note: One exception is a governmental department or agency unit that receives more than $35 million in direct federal funding.

You may submit one application to request funding through the Network Planning

Program.

Please note: There is no implementation component to this award once the planning grant ends. The funding for this program covers one year of the planning grant only.

III. Eligibility Information

1. Eligible Applicants

You can apply if your organization is in the United States, the Commonwealth of Puerto

Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, the

Federated States of Micronesia, the Republic of the Marshall Islands, or the Republic of

Palau, and represents one or more of the following entity types:

• Public or private, non-profit or for-profit

• Community-based,

• Tribal governments (governments, organizations)

• The applicant organization may be located in a rural or urban area, but must have demonstrated experience serving, or the capacity to serve, rural underserved populations, as communicated in the applicant organization’s Project Abstract https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75

HRSA-24-007 Rural Health Network Development Planning Program 3 section of the application, describing in detail the applicant organization’s experience and/or capacity to serve rural populations.

For more details, see Program Requirements and Expectations.

2. Cost Sharing or Matching

Cost sharing or matching is not required for this program.

3. Other

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

• Exceeds the funding ceiling amount

• Fails to satisfy the deadline requirements referenced in Section IV.4

Multiple Applications

You may submit multiple applications under the same Unique Entity Identifier (UEI), if each proposes distinct projects. We will only review your last validated application for each distinct project before the Grants.gov due date. See ‘Exceptions Request’ for more information.

Exceptions Request

A. Multiple EIN exception: Multiple applications associated with the same UEI

(previously DUNS) number and/or EIN are not allowable. However, HRSA recognizes a growing trend towards greater consolidation within the rural health care industry and the possibility that multiple organizations may share an EIN with its parent organization. As a result, at HRSA’s discretion, separate applications associated with a single UEI number and/or EIN are allowable, as long as the applicants provide HRSA with all of the information requested in Attachment 10.

NOTE: Single organizations (e.g., a parent organization/headquarters) cannot submit multiple applications, even if the proposed projects are different. If the parent organization applies using the legal and/or “doing business as” name of the parent or satellite sites, for the purposes of this program, it is still considered an application submitted by the parent organization and thus, multiple applications are not allowed.

Applications associated with the same UEI number and EIN should be independently developed and written. HRSA reserves the right to deem applications that provide insufficient information in Attachment 10, or are nearly identical in application content, to be ineligible. In this instance, assuming all other eligibility criteria are met, HRSA will only accept the last submitted application for

HRSA-24-007 associated with the EIN or DUNS number.

https://www.gsa.gov/about-us/organization/federal-acquisition-service/office-of-systems-management/integrated-award-environment-iae/iae-information-kit/unique-entity-identifier-update

HRSA-24-007 Rural Health Network Development Planning Program 4

B. Tribal exception: HRSA is aware that tribes and tribal organizations may have an established infrastructure without separation of services recognized by filing for

EINs. In case of tribes and tribal governments, only a single EIN located in a

HRSA-designated rural area is necessary to meet the network requirements.

Tribes and tribal entities under the same tribal governance must still meet the network criteria of three or more entities under the single EIN are committed to the proposed approach as evidenced by a signed Letter of Commitment. Please refer to Attachment 11 for additional information on how to request this exception.

IV. Application and Submission Information

1. Address to Request Application Package

We require you to apply online through Grants.gov. Use the SF-424 workspace application package associated with this notice of funding opportunity (NOFO). Follow these directions: How to Apply for Grants. If you choose to submit using an alternative online method, see Applicant System-to-System.

Note: Grants.gov calls the NOFO “Instructions.”

Select “Subscribe” and enter your email address for HRSA-24-007 to receive emails about changes, clarifications, or instances where we republish the NOFO. You will also be notified by email of documents we place in the RELATED DOCUMENTS tab that may affect the NOFO and your application. You’re responsible for reviewing all information that relates to this NOFO.

2. Content and Form of Application Submission

Application Format Requirements

Submit your information as the Application Guide and this program-specific NOFO state.

Do so in English and budget figures expressed in U.S. dollars. There’s an Application

Completeness Checklist in the Application Guide to help you.

Application Page Limit

The total number of pages that count toward the page limit shall be no more than 50 pages when we print them. We 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.

https://www.grants.gov/ http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/s2s/applicant-system-to-system.html

HRSA-24-007 Rural Health Network Development Planning Program 5

These items do not count toward the page limit:

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

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

• Indirect Cost Rate Agreement

• Proof of non-profit status (if it applies)

If there are other items that do not count toward the page limit, we’ll make this clear in

Section IV.2.v Attachments.

If you use an OMB-approved form that is not in the HRSA-24-007 workspace application package, it may count toward the page limit.

Applications must be complete and validated by Grants.gov under HRSA-24-007 before the deadline.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

• When you submit your application, you certify that you and your principals1 (for example, program director, principal investigator) can participate in receiving award funds to carry out a proposed project. That is, no federal department or agency has debarred, suspended, proposed for debarment, claimed you ineligible, or you have voluntarily excluded yourself from participating.

• If you fail to make mandatory disclosures, we may take an action like those in 45 CFR § 75.371. This includes suspending or debarring you.2

• If you cannot certify this, you must include an explanation in Attachment 12-15:

Other Relevant Documents.

(See Section 4.1 viii “Certifications” of the Application Guide)

Program Requirements and Expectations

Applicants for the Rural Health Network Development Planning Program must meet all of the requirements stated below. Failure to respond to the requirements below may impact your application’s score.

For the purposes of this grant, planning activities are those that prepare a community to provide direct services including but not limited to, rural health care network integration, strengthening operations, creating, or improving care coordination policies and procedures, and making the necessary infrastructure changes in order to increase and sustain health care delivery among underserved communities.

1 See def initions at eCFR :: 2 CFR 180.995 -- Principal. and eCFR :: 2 CFR 376.995 -- Principal (HHS supplement to government-wide def inition at 2 CFR 180.995).

2 See also 2 CFR parts 180 and 376, 31 U.S.C. § 3354, and 45 CFR § 75.113.

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 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 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-I/part-180/subpart-I/section-180.995 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376/subpart-I/section-376.995 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376/subpart-I/section-376.995 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-I/part-180 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376 https://uscode.house.gov/view.xhtml?req=granuleid%3AUSC-prelim-title31-chapter33&edition=prelim https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-B/section-75.113

HRSA-24-007 Rural Health Network Development Planning Program 6

Applicant Organization Requirements

a. All planning activities must benefit rural communities. Proposed counties should be fully rural, but if counties are partially rural counties, please include the rural census tract(s) in the Project Abstract. It is important that applicants list the rural counties (or rural census tract(s) if the county is partially rural) that will be served through their proposed project, as this will be one of the factors that will determine the applicant organization’s ability to meet requirements to receive funding.

• To ascertain rural service areas, please refer to https://data.hrsa.gov/tools/rural-health. This webpage allows you to search by county or street address and determine whether a location is rural.

b. Applicant organizations must be able to demonstrate how the rural underserved populations in the local community or region to be served will benefit from and be involved in the development and ongoing operations of the network. Activities and services of the network must be provided in a non-metropolitan county or rural census tract.

c. Applicant organizations are required to have at least 66 percent (two-thirds) of network members located in a HRSA- designated rural area3;

d. Applicant organizations should describe how the rural community participated in identifying the focus area and should emphasize how their project will benefit the rural community.

e. HRSA strongly recommends the project director allot adequate time (at least .25

FTE) to the program and has management experience involving multiple organizational arrangements. HRSA highly recommends your staffing plan should include supporting and key personnel that total at least one full time- time FTE at the time of application.

f. The applicant organization should have the staffing and infrastructure necessary to oversee program activities.

g. The applicant organization must have demonstrated experience serving, or the capacity to serve, rural underserved populations, as well as buy-in from these communities and describe this in the Project Abstract.

h. The applicant organization is not required to represent an established rural health network at the time of submission.

3 For more information on HRSA-desig nated rural areas, visit the Rural Health Grants Eligibility Analyzer.

https://data.hrsa.gov/tools/rural-health.

https://data.hrsa.gov/tools/rural-health

HRSA-24-007 Rural Health Network Development Planning Program 7

Network Requirements

One of the purposes of the Network Planning Program is to assist in the planning of a health care network, specifically with network participants who do not have a history of formal collaborative efforts. For the purposes of this program, HRSA defines a health care network as at least three regional or local health care organizations that come together to plan and develop strategies for improving health services in a community. The entities should have a common and collective interest in improving health and addressing health care challenges in their local community.

a. Network member organizations may be physically located in rural or urban areas and can include all domestic public or private, non-profit, or for-profit entities including faith-based, community-based organizations, tribes, and tribal organizations. We recognize that rural-urban collaborations can sometimes lead to the underrepresentation of rural needs. Therefore, HRSA requires at least sixty-six percent (66%), or two- thirds of network member organizations (members with signed Letters of Commitment) of the proposed project be physically located in a

HRSA designated rural area, as defined by the Rural Health Grants Eligibility

Analyzer. The applicant organization must verify and indicate the rural or urban eligibility of each network member in Attachment 6.

b. Each applicant organization and network member must have its own EIN number unless an exception is requested (see details above in Section III.3).

c. Previous Network Planning Program award recipients who propose a continuation of an awarded project or existing networks that seek to only expand services or expand their service areas are not eligible to apply. However, existing recipients that seek to expand network services or service areas are eligible to apply if they either: (1) include new or additional stakeholders; or (2) engage a new population or new focus area. Applicant organizations representing existing networks proposing to collaborate with at least two outside organizations they have not worked with before under a formal relationship are eligible to apply.

d. Over the course of the period of performance, all networks must take steps towards creating strong infrastructure and developing a strategic plan for programmatic activities. That plan must identify the approach by which the applicant will sustain the efforts of the network beyond federal funding.

Legislative Aims:

Applicants must describe planning activities that support at least one (1) of the legislative aims below. For additional information, please see Appendix A.

https://data.hrsa.gov/tools/rural-health

HRSA-24-007 Rural Health Network Development Planning Program 8

Program-Specific Instructions Include application requirements and instructions from Section 4 of the Application Guide

(budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract). Also include the following:

i. Project Abstract

Use the Standard OMB-approved Project Abstract Summary Form that you’ll find in the workspace application package. Do not upload the abstract as an attachment or it may count toward the page limit. For information you must include in the Project Abstract

Summary Form, see Section 4.1.ix of the Application Guide.

ABSTRACT HEADING CONTENT

Applicant Organization Information

• Organization Name, Address (street, city, state, zip code)

• Facility/Entity Type (e.g., FQHC, RHC, public health department), and,

• Website Address (if applicable)

Designated Project Director Information

• Project Director Name & Title, Phone Number(s), and E-Mail Address

Network Planning Project

• Network Name

Legislative Aim(s)

• Choose at least one Legislative Aim:

➢ Aim #1: Achieve efficiencies

➢ Aim #2: Expand access to, coordinate, and improve the quality of basic health care services

➢ Aim #3: Strengthen the rural health care system

• Network Planning Program examples

Focus Area

Your application must clearly identify a focus area(s) based on the community needs. FORHP highly recommends that you include this language:

• “(Your organization’s name) focus area is (e.g., Care Coordination)

HRSA-24-007 Rural Health Network Development Planning Program 9

Proposed Service Region

• Example: states, cities, counties (required))

• NOTE: Proposed rural counties should be fully rural. For partially rural counties, include rural census tract(s)

ABSTRACT BODY CONTENT

Population to be Served

• Brief description of the population group(s) to be served

• Brief description of underserved populations who have historically suffered from poorer health outcomes, health disparities, and other inequities

Network Members

• Provide the organization names and facility/entity type of partner(s) who have agreed to be a part of the network.

• HRSA requires an attestation that at least sixty-six percent (66%), or two-thirds of network members (members with signed Letters of Commitment) of the proposed project are physically located in a HRSA-designated rural area, as defined by the

Rural Health Grants Eligibility Analyzer.

• Identify the degree to which the network members are ready to integrate their functions and share clinical and/or administrative resources.

Experience in Serving Rural Underserved Populations

• Describe experience serving or the capacity to serve, rural underserved communities. This can include collaborations, activities, program implementation and previous work of a similar nature.

• HRSA requires that applicants describe how the rural underserved populations in the local community or region to be served will benefit from and be involved in the development and ongoing operations of the network.

Funding Opportunity Notification

Briefly describe how the applicant organization learned about this funding opportunity.

• Select one: State Office of Rural Health, HRSA News Release, Grants.gov, HRSA

Project Officer, HRSA Website, Technical Assistance Provider, State/Local Health

Department, or Other (please explain) https://data.hrsa.gov/tools/rural-health

HRSA-24-007 Rural Health Network Development Planning Program 10

Funding Preference

• Applicants must explicitly document a qualifying funding preference and cite the qualification that is being met (see 42 U.S.C. 254c(h)(3)) to receive a funding preference. HRSA highly recommends you include concise language making it clear to HRSA which funding preference you qualify for. If you do not qualify for a funding preference, please state that you do not qualify.

• If applicable, you need to provide supporting documentation in Attachment 8.

Please refer to Section V.2 for further information.

NARRATIVE GUIDANCE

The following table provides a crosswalk between the narrative language and where each section falls within the review criteria. Make sure you’ve addressed everything. We may consider any forms or attachments you reference in a narrative section during the merit review.

Narrative Section Review Criteria

Introduction Criterion 1: NEED

Organizational Information Criterion 5: RESOURCES/CAPABILITIES

Need Criterion 1: NEED

Approach Criterion 2: RESPONSE

Work Plan Criterion 4: IMPACT

Resolution of Challenges Criterion 2: RESPONSE

Evaluation and Technical Support

Capacity

Criterion 3: EVALUATIVE MEASURES

Criterion 5: RESOURCES/CAPABILITIES

Budget Narrative Criterion 6: SUPPORT REQUESTED

ii. Project Narrative

This section must describe all aspects of the proposed project. Make it brief and clear.

Provide the following information in the following order. Please use the section headers.

This ensures reviewers can understand your proposed project.

▪ INTRODUCTION & NEED -- Corresponds to Section V’s Review Criterion 1

Summarize the program’s goals and expected outcomes of the program. You must address the following items:

HRSA-24-007 Rural Health Network Development Planning Program 11

Structural Need

A. Clearly describe the health care service environment and include appropriate data sources (i.e., local, tribal, state, and/or federal) in which the network is functioning.

B. Describe the structural challenges that affect health care in the service area

(e.g., poverty, uninsured or underinsured, chronic disease burdens, social determinants of health, lack of administrative resources for grant writing and funding).

Community Need

C. Outline the needs of the rural community, how the rural community participated in identifying the need and/or focus area, and how the network members will address the unmet needs to serve and benefit the rural community.

D. Describe gaps in the existing health care system and activities that the network will perform to fill those gaps (i.e., personnel, service delivery needs, shared resources, etc.)

E. Explain how a Network Planning award would assist in the development of a formal network intended to address unmet community needs. Describe the need for creating a network to address the identified area(s) of focus.

Demonstrate the need for federal funding to support network planning activities.

Health Equity

F. Describe the rural population to be served and any rural underserved communities including those who suffer from poorer health outcomes, health disparities, and other inequalities. These populations include but are not limited to; Black, Latino, and 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; and persons otherwise adversely affected by persistent poverty or inequality (the full definition of underserved communities is available in Appendix B; Common Definitions. If data is unavailable on the underserve community identified, explain why and include other support or justification for the populations ‘s need.

G. Describe how the network will improve equity in the local health care environment.

HRSA-24-007 Rural Health Network Development Planning Program 12

H. Document the socio-cultural determinants of health and health disparities impacting the population or communities. Use and cite demographic data, when possible, to support the information.

▪ ORGANIZATIONAL INFORMATION -- Corresponds to Section V’s Review Criterion

All applicants should succinctly describe the activities and contributions of the applicant organization and the network members. Provide a brief overview of the applicant organization that includes information such as:

A. your organization’s current mission

B. structure, leadership, size of organization, and staffing

C. scope of current activities

D. your organization’s ability to manage the award project and personnel

E. your organization’s financial practices and systems that assure your organization can properly account for and manage the federal funds.

Network Establishment

F. Your application must clearly describe how you plan to establish your network (if your network is newly formed), the proposed structure of your network, and how your network will address a need that cannot be addressed individually.

G. Your application must display the strength of the network’s rural composition demonstrated by at least sixty-six percent (66%), or two-thirds of network members (members with signed Letters of Commitment in Attachment 7) located in a HRSA designated rural area and, applicants should provide the address of each network member and the screenshot of the urban or rural status.

Project Director

H. Identify the project director in the Project Abstract and Attachment 4. The project director will be responsible for project/program monitoring and carrying out the award activities. The proposed network should identify a permanent project director prior to receiving award funds. If the applicant organization has an interim project director or has not yet hired a person to serve as the project director, discuss the process and timeline for hiring a permanent project director for this project.

I. The network must have a permanent network director (i.e., network executive director) or have established an interim network director capable of overseeing the network’s administrative, fiscal, and business operations at the time an award is made. HRSA strongly recommends the network director role be 1.0

HRSA-24-007 Rural Health Network Development Planning Program 13

FTE. HRSA prefers that the network director role is different from the project director role.

J. HRSA strongly recommends the project director allot adequate time (at least .25

FTE) to the program and has management experience involving multiple organizational arrangements. HRSA highly recommends your staffing plan should include supporting and key personnel that total at least one full time-time FTE at the time of application.

Key Personnel

K. Describe key personnel roles and how they relate to the network and planning project. Key personnel are individuals who would receive funds by this award or person(s) conducting activities central to this program (Attachment 4).

Network Members

L. It is recommended that applicants include a table in Attachment 6 to present the following information on each network member:

• Organization name

• Organization's address of their physical location (this will be the address used to determine the urban/rural status on the Rural Health

Grants Eligibility Analyzer)

• Primary contact person

• Employer Identification Number (EIN) associated with the organization being listed (must be provided for each network member unless the applicant is a tribe and/or requests a multiple EIN exception) and

• Verify and indicate the rural or urban eligibility of each network member (per the Rural Health Eligibility Analyzer).

M. All applicants should describe how the rural underserved populations in the local community or region to be served will be involved in the development and ongoing operations of the network. This should include a description that reflects a shared decision-making structure and capacity. Outline the roles and responsibilities within the network for each network member and address the capacity to carry out program goals. Explain why each of the proposed network members were selected, and the extent to which the network and/or its members engage the community in its planning and functions as appropriate.

▪ APPROACH -- Corresponds to Section V’s Review Criterion 2

Propose methods that you will use to address the stated needs and meet each of the previously described program requirements and expectations in this NOFO. You must address the following items:

https://data.hrsa.gov/tools/rural-health

HRSA-24-007 Rural Health Network Development Planning Program 14

A. Identify the proposed goals, objectives, and expected outcomes for both network organizational development and program planning of the project.

B. Include information on how you selected network members for inclusion in the network. Include:

• The expertise of each network member

• Describe the role of each network member in the project (as it relates to Attachment 6).

• A description of previous collaboration among network members.

C. Describe how the rural underserved populations in the local community or region to be served will experience increased access to quality health care services across the continuum of care as a result of the planning activities carried out by the network. When possible, provide and support your expected outcomes with quantifiable data.

D. if applicable, describe how the network plans to address and reduce health disparities within the target service area.

▪ WORK PLAN -- Corresponds to Section V’s Review Criterion 4

Include a project work plan that clearly illustrates the network’s goals, strategies, activities, and measurable outcomes proposed during the entire period of performance. The work plan must identify the individual or organization responsible for carrying out each activity and include a timeline for the period of performance. Include the work plan as Attachment

3.

▪ RESOLUTION OF CHALLENGES -- Corresponds to Section V’s Review Criterion 2

Discuss potential barriers and challenges that you are likely to encounter in designing and implementing the activities described in the work plan, and approaches that you will use to resolve those challenges.

▪ EVALUATION AND TECHNICAL SUPPORT CAPACITY -- Corresponds to Section

V’s Review Criterion 3 & Criterion 5

Describe how program goals will be tracked, measured, and evaluated, and how the network will measure progress toward meeting the project goals and objectives. FORHP recommends that these data are presented in a table format with the goals listed in the left-hand column (Goal 1, 2, 3, etc.). Across the top of the table, please include questions that will address how each goal will be tracked, measured, and evaluated (How will you measure program goals? How will you monitor program progress? How will programmatic success be evaluated?) Although tabular format is recommended, it is not required.

HRSA-24-007 Rural Health Network Development Planning Program 15

▪ BUDGET AND BUDGET NARRATIVE -- CORRESPONDS TO SECTION V’S

Review Criterion 6

A. Provide a complete, consistent, and detailed budget presentation for a one- year period of performance through the submission of the SF-424A budget form and a Budget Narrative that justifies the appropriateness of the requested funds. See

Section IV.2.ii for more information regarding the Budget section.

B. The budget should be reasonable, logical and clearly document how and why each line-item request (such as personnel, travel, equipment, supplies, contractual services, etc.) supports the goals and activities of the proposed award-funded activities.

iii. Budget

The Application Guide directions may differ from those on Grants.gov.

Follow the instructions in Section 4.1.iv Budget of the Application Guide and any specific instructions listed in this section. Your budget should show a well-organized plan.

Reminder: The total project or program costs are all allowable (direct and indirect) costs used for the HRSA activity or project. This includes costs charged to the award and non-federal funds used to satisfy a matching or cost-sharing requirement (which may include

MOE, if applicable).

Program Income

You must use any program income you generate from awarded funds for approved project-related activities. Use program income under the addition alternative (45 CFR §

75.307(e)(2)). Find post-award requirements for program income at 45 CFR § 75.307.

Specific Instructions

In addition, the Rural Health Network Development Planning Program requires applicants to adhere to the following budgetary requirements:

Travel: Please allocate travel funds for one (1) program staff to attend a one-and-a half (1.5) day award recipient meeting at a location to be determined and include the cost of this as a budget line item. To determine estimated travel costs to

Washington, D.C., applicants should refer to the U.S. General Services

Administration (GSA) per diem rates for FY 2024. Per diem rates can be found on the GSA’s website: https://www.gsa.gov/travel-resources.

Equipment: Equipment costs that exceed 5 percent of the total award amount may be considered unreasonable and thus, unallowable.

Legal Costs: Legal costs that exceed 20 percent of the total award amount may be considered unreasonable and unallowable. Legal costs include services and https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.307 https://www.gsa.gov/travel-resources

HRSA-24-007 Rural Health Network Development Planning Program 16 activities such as consultations, 501(c)(3) application preparation, articles of incorporation and by-laws development.

Contractual: Consistent with 45 CFR 75, you must provide a clear explanation of the purpose of each contract, how the costs were estimated, and the specific contract deliverables.

Data Collection: Costs allocated to data collection must be commensurate with organization’s staffing capacity for sustainability and strategic planning.

Other: The purpose of this program is to fund planning activities only. Applications that propose to use award funds to pay for the direct provision of clinical health services will be deemed unresponsive and will not be considered for funding under this notice.

As required by the Consolidated Appropriations Act, 2023 (P.L. 117-328), Division H, §

202, “None of the funds appropriated in this title shall be used to pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of Executive

Level II.” Effective January 2023, the salary rate limitation is $212,100. As required by law, salary rate limitations may apply in future years and will be updated.

iv. Budget Narrative

See Section 4.1.v. of the Application Guide.

In addition, the Rural Health Network Development Planning Program requires the following:

Please provide a budget narrative justification that explains the amounts requested for each line item in the budget. The budget narrative should specifically describe how each item supports the achievement of proposed objectives. The budget period is for one (1) year.

Line-item information must be provided to explain the costs entered in the SF- 424A.

Thoroughly describe how each item in the “other” category is justified. The budget narrative

MUST be concise. Do NOT use the budget narrative to expand the project narrative.

v. Attachments

Provide the following attachments in the order we list them.

Most attachments count toward the application page limit. Indirect cost rate agreement and proof of non-profit status (if it applies) are the only exceptions. They will not count toward the page limit.

Clearly label each attachment. Upload attachments into the application. Reviewers will not open any attachments you link to.

Attachment 1: Documentation from State Office of Rural Health (Required)

All applicants are required to notify their State Offices of Rural Health (SORHs) or other appropriate state entities to advise them of their intent to apply. SORHs can often provide technical assistance to applicants. Please include a copy of the SORH’s response to your https://www.congress.gov/bill/117th-congress/house-bill/2617/text

HRSA-24-007 Rural Health Network Development Planning Program 17 correspondence and/or the letter or email you sent to the SORH notifying them of your intent to apply. Applicants are strongly encouraged to notify their SORH early in the application process to give the SORH time to acknowledge it and be aware of your application. As such, please also include on the date the correspondence to your SORH was sent. SORHs applying as the applicant organization must provide an attestation that their application was independently developed and written and that they have not knowingly duplicated efforts or project ideas of non-SORH applicants within their state. By statute, all applicants are required to consult with their SORH or other appropriate state entities.

However, if applicants from the U.S. territories do not have the ability to do so, this requirement does not apply, and U.S. territories are still eligible to apply. A list of the

SORHs can be accessed at: https:/nosorh.org/nosorhmembers/nosorh-members- browse-by-state/.

Attachment 2: Areas of Impact (Required)

Include a list of the impacted areas, counties and cities, and a legible map that clearly shows the location of network members. If an organization is located in a rural census tract of an urban county, the rural census tract(s) must be clearly identified here as well as the county and census tract(s) of the network members. Note: Maps should be legible and in black and white. This attachment will count toward the page limit.

Attachment 3: Work Plan (Required)

Attach the work plan for the project that includes all information detailed in

Section IV.2.ii. Project Narrative. The work plan should illustrate the network’s goals, strategies, activities, and measurable progress and outcome measures. The work plan must outline the individual or organization responsible for carrying out each activity and include a timeline for the period of performance. This attachment will count toward the page limit.

Attachment 4: Staffing Plan and Job Descriptions for Key Personnel (see Section 4.1.

of HRSA’s SF-424 Application Guide) (Required)

Keep each job description to one page in length as much as is possible. Include the role, responsibilities, and qualifications of proposed project staff to run the network, and specifically to accomplish the proposed network planning project. Staffing needs should be explained and should have a direct link to activities proposed in the Project Narrative and budget sections of the application. Staffing plan should include in-kind personnel to the program. Your staffing plan should demonstrate supporting and key personnel that total at least one full-time FTE at the time of application. For the purposes of this application, key personnel are individuals who are funded by this award or person(s) conducting activities central to this program. This attachment will count toward the page limit.

Attachment 5: Biographical Sketches of Key Personnel (Required)

Include biographical sketches for persons occupying the key positions described in

Attachment 4 not to exceed two pages in length per person. In the event that a biographical https://nosorh.org/nosorhmembers/nosorh-members-browse-by-state/ https://nosorh.org/nosorhmembers/nosorh-members-browse-by-state/ https://nosorh.org/nosorhmembers/nosorh-members-browse-by-state/ https://nosorh.org/nosorhmembers/nosorh-members-browse-by-state/ http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf

HRSA-24-007 Rural Health Network Development Planning Program 18 sketch is included for an identified individual not yet hired, include a Letter of Commitment from that person with the biographical sketch. If the project director served in this position for other federal awards, please list the federal awards as well as the percent FTE for each respective federal award.

Attachment 6: Network Organizational Chart and Network Member Information

(Required)

Provide a one-page network organizational chart of the network that includes how decisions will be made and how communication will flow; and provide a list of all network members that includes:

o The organization’s name and type (e.g., community health center, hospital, health department, etc.);

o The organization’s address of their physical location (this will be the address used to determine the urban/rural status on the Rural Health Grants Eligibility Analyzer) o The name of the key person from the organization that will be working on the program;

o Anticipated role and responsibility in the Network Planning program;

o EIN of each proposed network member unless the applicant is a tribe and/or requests a multiple EIN exception;

o Verify and indicate that at least sixty-six percent (66%), or two-thirds of network member organizations (members with signed Letters of Commitment) of the proposed project are physically located in a HRSA-designated rural area, as defined by the Rural Health Grants Eligibility Analyzer by providing screenshots from the analyzer of the urban or rural status for each network member.

This attachment counts toward the page limit.

Attachment 7: Letters of Commitment (Required)

All applicants must provide a scanned, signed copy of a Letter of Commitment from each of the network members. Letters of commitment must be submitted with the application and must clearly identify the organizations’ roles and responsibilities in the network and project, the activities they will be included in, and how that organization’s expertise is pertinent to the Network Planning project. The letter must also include a statement indicating that the proposed partner understands that the award funds be used for the development of a health care network and are not to be used for the exclusive benefit of any one (1) network partner or to provide clinical services.

Attachment 8: Proof of Funding Preference Designation/Eligibility (if applicable)

Refer to Section V.2. and the Project Abstract for the content requirements. If you do not qualify for a funding preference, please state that you do not qualify. This attachment

HRSA-24-007 Rural Health Network Development Planning Program 19 will not count towards the 50-page limit. This attachment will not count toward the page limit.

Attachment 9: Previous Grants (if applicable)

If the applicant organization has received any funds from the Federal Office of Rural

Health Policy within the last 5 years, the grant number and the abstract from the previous award should be included. Please only provide the grant number(s) and abstract(s). (Not scored during the objective review). This attachment will not count toward the page limit.

Attachment 10: EIN/DUNS Exception Request (if applicable)

Multiple applications associated with the same UEI (previously DUNS) number and/or

EIN are not allowable. However, HRSA recognizes a growing trend towards greater consolidation…