FORHP-HRSA-24-003-(U16)-NRHPCC_FINAL.pdf

U.S. Department of Health and Human Services

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2024

Federal Office of Rural Health Policy

Policy Research Division

National Rural Health Policy, Community, and Collaboration Program Funding Opportunity Number: HRSA-24-003

Funding Opportunity Type(s): Competing Continuation and New

Assistance Listing Number: 93.155

Application Due Date: November 30, 2023

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: September 29, 2023

Alexa Ofori Senior Advisor, Federal Office of Rural Health Policy Call: 301-945-3986 Email: aofori@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: Section 711 of the Social Security Act (42 U.S.C. 912).

mailto:aofori@hrsa.gov

HRSA-24-003 National Rural Health Policy, Community, and Collaboration 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: National Rural Health Policy, Community, and

Collaboration Program

Funding Opportunity Number: HRSA-24-003

Assistance Listing Number: 93.155

Due Date for Applications: November 30, 2023

Purpose: The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2024 National Rural Health Policy, Community, and Collaboration Program. The purpose of this program is to identify, educate, engage, and collaborate with rural stakeholders on national rural health and policy issues and promising practices to improve health care in rural areas nationwide.

Program Objective(s): Program objectives include:

(1) Identifying and educating rural stakeholders about national policy issues and promising practices for rural health.

(2) Maintaining projects that will help support engagement of rural communities in a broad range of activities.

(3) Facilitating collaborations at the local, regional, state, and national levels to improve the exchange of information and promising practices that support rural health.

(4) Identifying and providing information to rural stakeholders about existing federal http://www.hrsa.gov/ http://www.hrsa.gov/ ii funding opportunities or other programs relating to health care in rural areas. .

Eligible Applicants: Eligible applicants include all domestic public, private and nonprofit organizations.

• Native American tribal governments (federally recognized) are eligible.

• Native American tribal organizations (other than federally recognized tribal governments) are eligible.

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

Anticipated FY 2024 Total Available Funding:

$2,300,000

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 1 cooperative agreement

Estimated Annual Award Amount:

Up to $2,300,000 per award, subject to the availability of appropriated funds

Cost Sharing or Matching Required:

No

Period of Performance: August 1, 2024 through July 31, 2029 (5 years)

Agency Contacts: Business, administrative, or fiscal issues:

Kimberly Dews Grants Management Specialist Division of Grants Management Operations, OFAM Email: kdews@hrsa.gov

Program issues or technical assistance:

Alexa Ofori Senior Advisor Federal Office of Rural Health Policy Email: aofori@hrsa.gov mailto:kdews@hrsa.gov 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, October 24, 2023 2 – 3 p.m. ET Weblink: https://hrsa-gov.zoomgov.com/j/1616210666?pwd=Sld2alBaRExBMnhlR0FyRDFZVERkZz09

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

Call-In Number: 1-833-568-8864 Meeting ID: 161 621 0666 Passcode: 81611236

We will record the webinar. Please contact aofori@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/1616210666?pwd=Sld2alBaRExBMnhlR0FyRDFZVERkZz09 https://hrsa-gov.zoomgov.com/j/1616210666?pwd=Sld2alBaRExBMnhlR0FyRDFZVERkZz09 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

iv. Budget Narrative

v. 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: PAGE LIMIT WORKSHEET

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the National Rural Health Policy, Community, and Collaboration Program. The purpose of this program is to identify, engage, educate, and collaborate with rural stakeholders on national rural health policy issues and promising practices to improve health care in rural areas nationwide.

Program objectives include:

1) Identifying and educating rural stakeholders about national policy issues and promising practices for rural health.

2) Maintaining projects that will help support engagement of rural communities in a broad range of activities.

3) Facilitating collaborations at the local, regional, state, and national levels to improve the exchange of information and promising practices that support rural health.

4) Identifying and providing information to rural stakeholders about existing federal funding opportunities or other programs relating to health care in rural areas.

A successful program will continue to build upon the federally funded resources that currently exist, leverage the broad network of rural health organizations and individual subject matter experts, and provide a mechanism to engage with public rural health stakeholders beyond Health Resources and Services Administration (HRSA) funded award recipients and current partners to improve health care in rural areas.

For more details, see Program Requirements and Expectations.

2. Background

The National Rural Health Policy, Community, and Collaboration Program is authorized by Section 711 of the Social Security Act (42 U.S.C. 912). FORHP, located within HRSA, is the focal point for rural health activities within the Department of Health and Human Services (HHS). FORHP is statutorily required to advise the Secretary of HHS on the effects of current policies and proposed statutory, regulatory, administrative and budgetary changes in Medicare and Medicaid programs on the financial viability of small rural hospitals, the ability of rural areas to attract and retain physicians and other health professionals, and access to and the quality of health care in rural areas. FORHP is also authorized to administer grants, cooperative agreements, and contracts to provide technical assistance and other activities as necessary to support activities related to improving health care in rural areas. To learn more about FORHP, visit https://www.hrsa.gov/rural-health.

https://www.hrsa.gov/rural-health

II. Award Information

1. Type of Application and Award

Application type(s): Competing Continuation, New

We will fund you via a cooperative agreement.

A cooperative agreement is like a grant in that we award money, but we are substantially involved with program activities.

Aside from monitoring and technical assistance (TA), we also get involved in these ways:

• Providing guidance in planning, operation, and evaluation activities;

• Providing support in the identification and selection of policy issues and the analysis of key information sources (e.g., regulations);

• Providing guidance and assistance in identifying key organizations through which to share information on emerging policy issues;

• Providing guidance and assistance in identifying key organizations with whom to partner and collaborate;

• Participating, as appropriate, in the planning of any meetings, educational activities, or workgroups conducted during the period of the cooperative agreement;

• Identifying opportunities and providing guidance on strategies for disseminating information about programs and activities;

• Reviewing and providing input on activities and findings under this award prior to public dissemination; and

• Identifying or suggesting special projects, studies, products or publications around emerging rural health issues.

You must follow all relevant federal regulations and public policy requirements. Your other responsibilities will include:

• Working collaboratively with HRSA and responding to HRSA requests, comments, and questions on a timely basis;

• Engaging HRSA and rural stakeholders in the planning, execution and evaluation of activities, including the identification of technical assistance and educational/development needs and the selection of mechanisms for implementation;

• Serving as the central organizing body for collaborator convenings, educational activities, or workgroups conducted during the period of the cooperative agreement;

• Identifying key rural health policy issues and developing educational materials to inform a broad variety of rural stakeholders, determined in collaboration with

HRSA;

• Identifying opportunities and developing dissemination strategies to share pertinent information and results with various stakeholders in rural communities, determined in collaboration with HRSA; and

• Highlighting unique examples of successful rural health initiatives through various platforms.

2. Summary of Funding

We estimate $2,300,000 will be available each year to fund 1 recipient. You may apply for a ceiling amount of up to $2,300,000 annually (reflecting direct and indirect costs).

The period of performance is August 1, 2024, through July 31, 2029 (5 years).

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.

Support beyond the first budget year will depend on:

• Appropriation

• Satisfactory progress in meeting the project’s objectives

• A decision that continued funding is in the government’s best interest

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.

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

III. Eligibility Information

1. Eligible Applicants

Eligible applicants include domestic public, nonprofit, or private organizations, such as:

domestic faith-based and community organizations; state governments and universities;

colleges; research institutions; hospitals; local governments; and federally recognized tribal governments, tribes, and tribal organizations.

• Native American tribal governments (federally recognized) are eligible.

• Native American tribal organizations (other than federally recognized tribal governments) are eligible.

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

We will only review your last validated application before the Grants.gov due date.

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-24-003 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.

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

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.

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-24-003 workspace application package, it may count toward the page limit.

Applications must be complete and validated by Grants.gov under HRSA-24-003 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 6-15:

Other Relevant Documents.

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

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

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.

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

Criterion 4: IMPACT

Work Plan Criterion 2: RESPONSE

Resolution of Challenges Criterion 5: RESOURCES/CAPABILITIES

Evaluation and Technical Support Capacity

Criterion 3: EVALUATIVE MEASURES

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 -- Corresponds to Section V’s Review Criterion #1 Need Briefly describe the purpose of the proposed project, and your knowledge of/experience working with rural stakeholders at the local, regional, state, and national level. Describe how the project will continue to build upon the federally funded resources that currently exist, leverage a broad network of rural health organizations (e.g., agricultural health and safety, state-level rural health organizations, workforce/recruitment and retention) and individual subject matter experts, and provide a mechanism to engage with public rural health stakeholders beyond current award recipients and partners to improve health care in rural areas nationwide.

Organizational Information -- Corresponds to Section V’s Review Criterion #5 Resources/Capabilities Succinctly describe your organization’s current mission and structure (including Attachment 4: Organizational Chart), scope of current activities, and existing partnerships with relevant national organizations. Describe how these elements contribute to your organization’s ability to conduct the program requirements, support the proposed work plan, and meet program expectations.

Discuss how the organization will follow the approved plan, as outlined in the application, properly account for the federal funds, and document all costs to avoid audit findings.

Describe your existing relationships and experience working with key partners and stakeholders listed below. Provide specific examples to support organizational relationships with these entities. This may include letters of support/agreement from proposed partners (Attachment #3):

a. Subject matter experts on each of the topics identified under Policy, Community, and Collaboration activities found in the Methodology section;

b. Federal entities;

c. Key state-based entities such as State Rural Health Associations (SRHAs) and State Offices of Rural Health (SORHs);

d. Rural hospitals and community health systems;

e. Philanthropies;

f. Rural health leaders;

g. Current and former HRSA award recipients with a particular focus on those at the rural community health level; and

h. Other key partners.

Describe qualified project personnel that have extensive experience to carry out all aspects of the project on a national level. Provide specific examples, data, and outcomes to support organizational experience and success in:

o Identifying and educating rural stakeholders about national policy issues and promising practices for rural health;

o Maintaining projects that will help support engagement of rural communities in a broad range of activities;

o Facilitating collaborations at the local, regional, state, and national levels to improve the exchange of information and promising practices that support rural health; and o Identifying and providing information to rural stakeholders about existing federal funding opportunities or other programs relating to health care in rural areas.

Describe your organization’s experience with and ability to convene key rural health stakeholders at the local, regional, state, and national levels.

Describe your organization’s existing relationships with and ability to convene key community-level stakeholders (i.e., not limited to national level organizations) from the start of the period of performance from the following constituency groups:

• Federally Qualified Health Centers

• Rural Health Clinics

• Hospitals/Health Systems

• Frontier Communities

• Public Health

• Research and Education

• State-Level Organizations/Resources

• Students

Describe your organization’s experience utilizing federal funding sources to strengthen or increase partnerships, obtain additional funding (both federal and non-federal), and improve the outputs and outcomes associated with your program objectives. Describe how program activities have been leveraged beyond the period of federal funding to increase impact.

NEED -- Corresponds to Section V’s Review Criterion #1 Need In order to identify, educate, engage, and collaborate with rural stakeholders on national rural health policy issues and promising practices in order to improve health care in rural areas nationwide you will be fulfilling the following program objectives referenced in the Purpose section:

(1) Identifying and educating rural stakeholders about national policy issues and promising practices for rural health.

(2) Maintaining projects that will help support engagement of rural communities in a broad range of activities.

(3) Facilitating partnerships and collaborations at the local, regional, state, and national levels to improve the exchange of information and promising practices that support rural health.

Identifying and providing information to rural stakeholders about existing federal funding opportunities or other programs relating to health care in rural areas. The need should help reviewers understand the needs to be fulfilled by the proposed project and provide the context and rationale for the proposed work plan and budget. This section should also help reviewers understand the needs of the rural stakeholders, communities, and/or entities that will be served by the proposed project and provide context and rationale for the inclusion of subject matter experts and any other proposed partners.

This section should demonstrate your knowledge of the existing nationwide issues in rural health. You should discuss any relevant data to support the discussion of need. You should also discuss the need to provide education to stakeholders about national issues, community engagement, and collaboration with nationwide rural stakeholders. Discuss barriers that the proposed project hopes to overcome in regard to a nationwide approach.

Approach -- Corresponds to Section V’s Review Criteria #2 Response and #4 Impact Propose methods that you will use to address the stated needs and meet each of the previously described program objectives in this NOFO. As appropriate, include development of effective tools and strategies for ongoing outreach, collaborations, clear communication, and information sharing/dissemination with rural stakeholders.

You should discuss the proposed approach, including innovative methods, for addressing the following objectives:

(1) Identifying and educating rural stakeholders about national policy issues and promising practices for rural health, topics may include:

a. Quality Improvement;

b. Finance;

c. Access;

d. Workforce (including Community Health Workers/Promotoras);

e. Health Information Technology/Telehealth;

f. Rural Primary Care Issues;

g. Rural Hospital Issues;

h. Substance Use Disorder;

i. Behavioral Health;

j. Health Equity;

k. Oral Health; and

l. Other existing and emerging rural health policy issues determined in collaboration with HRSA.

(2) Maintaining projects that will help support engagement of rural communities in a broad range of activities, for example:

a. Providing forums for stakeholders to share best practices on building on successful community health initiatives;

b. Highlighting unique examples of community and individual health leadership through various platforms and publications;

c. Supporting access to care in rural communities by strengthening the rural workforce (e.g., recruitment and retention efforts, community health workers/promotoras, etc.); and

d. Identifying and supporting the networks funded by grants awarded under Section 330A of the Public Health Service Act and the rural communities served by those networks. For more information about networks funded under 330A visit:

https://www.ruralhealthinfo.org/resources/lists/forhp-grantee-directories

(3) Facilitating collaborations at the local, regional, state, and national levels to improve the exchange of information and promising practices that support rural health, including:

a. Federal entities;

b. State-based entities such as SRHAs, SORHs, and other rural-relevant entities;

c. Private foundations and philanthropic organizations addressing issues of importance to rural health care; and

d. Other partners and subject matter experts, particularly those with expertise on topics such as workforce/recruitment and retention, agricultural health, telehealth, health disparities, rural health leadership and networking, and other existing or emerging areas of focus to be determined in collaboration with HRSA.

https://www.ruralhealthinfo.org/resources/lists/forhp-grantee-directories https://www.ruralhealthinfo.org/resources/lists/forhp-grantee-directories

(4) Identifying and providing information to rural stakeholders about existing federal funding opportunities or other programs relating to health care in rural areas.

Discuss your plan for including the stakeholders that will be key to the success of this program, such as:

a. Subject matter experts (both individuals and organizations) on each of the topics identified under Policy, Community, and Collaboration objectives;

b. Federal entities;

c. Key state-based entities such as SRHAs, SORHs, and state hospital associations;

d. Rural hospitals and community health systems;

e. Philanthropies;

f. Current and future rural health leaders;

g. Current and former HRSA award recipients with a particular focus at the rural community health level, as identified by HRSA; and

h. Other key partners as proposed by you as well as those identified in collaboration with HRSA.

Discuss your plans for dissemination of project results and/or the extent to which project results are national in scope and/or the degree to which the project activities are replicable, and/or the sustainability of the program, and related partnerships, beyond the period of federal funding.

Discuss your plan for developing and disseminating program materials that can be used by rural health entities and policymakers.

Discuss how any previous rural health activities have been used to create rural promising practices nationally.

Work Plan -- Corresponds to Section V’s Review Criterion #2 Response Describe the activities or steps that you will use to achieve each of the objectives proposed during the entire period of performance in the Methodology section.

Use a timeline that includes each activity and identifies responsible staff. As appropriate, identify meaningful support and collaboration with key stakeholders in planning, designing, and implementing all activities, including developing the application.

The work plan should cover a five (5) year period of performance explaining activities to begin August 1, 2024 and going no longer than July 31, 2029. You should include a year-by-year breakout of the work plan. The work plan should provide goals, objectives, activities, responsible staff, timelines (when possible), and metrics (process and outcome measures).

Resolution of Challenges -- Corresponds to Section V’s Review Criterion #5 Resources/Capabilities Discuss 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 such challenges.

You should discuss the unique challenges in the four objectives:

(1) Identifying and educating rural stakeholders about national policy issues and promising practices for rural health.

(2) Maintaining projects that will help support engagement of rural communities in a broad range of activities.

(3) Facilitating partnerships and collaborations at the local, regional, state, and national levels to improve the exchange of information and best practices that support rural health.

(4) Identifying and providing information to rural stakeholders about existing federal funding opportunities or other programs relating to health care in rural areas.

Discuss how you will overcome these challenges and what strategies you will use.

Evaluation and Technical Support Capacity -- Corresponds to Section V’s Review Criterion #3 Evaluative Measures Describe your plan for the program performance evaluation that will contribute to continuous quality improvement. The program performance evaluation should monitor ongoing processes and the progress towards the goals and objectives of the project and measure both the output and the impact of the program. Include descriptions of the inputs (e.g., organizational profile, collaborative partners, key staff, budget, and other resources), key processes, and expected outcomes of the funded activities. Quantitative and qualitative data should be used to capture program performance and impact. The final list of measures will be determined collaboratively with HRSA. Examples of potential measures include (but are not limited to):

o Number/types of convenings/forums of rural stakeholders to share promising practices and outcomes, including community impact, associated with those convenings/forums;

o Number of communities assisted in recruitment and retention efforts and the number of successful placements as a result of those efforts;

o Outputs and outcomes (including impact) of rural health educational opportunities and information dissemination campaigns around rural health promising practices;

o Number of key policy issues identified, approaches employed to educate stakeholders and impact of those efforts;

o Number of farms/agricultural businesses educated on agri-health issues and resulting number of farms/agricultural businesses certified as safe working environments;

o Number of community health workers/promotoras receiving education/training and resulting impact of those efforts (e.g., standardized competencies around a specific disease state); and o Outputs and outcomes (including impact) of activities directly related to program objectives.

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.

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.

v. Attachments

Provide the following attachments in the order we list them.

https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.307 https://www.congress.gov/bill/117th-congress/house-bill/2617/text

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: 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. Also include a description of your organization’s timekeeping process to ensure that you will comply with the federal standards related to documenting personnel costs.

Attachment 2: Biographical Sketches of Key Personnel REQUIRED

Include biographical sketches for persons occupying the key positions described in Attachment 1, not to exceed two pages in length per person. If a biographical sketch is included for an identified individual not yet hired, include a letter of commitment from that person with the biographical sketch.

Attachment 3: Letters of Agreement, Memoranda of Understanding, and/or Description(s) of Proposed/Existing Contracts (project-specific) OPTIONAL

Provide any documents that describe working relationships between your organization and other entities and programs cited in the proposal. Documents that confirm actual or pending contractual or other agreements should clearly describe the roles of the contractors and any deliverable. Make sure any letters of agreement are signed and dated.

Attachment 4: Project Organizational Chart REQUIRED

Provide a one-page figure that depicts the organizational structure of the project.

Attachment 5: For Multi-Year Budgets--5th Year Budget REQUIRED

After using columns (1) through (4) of the SF-424A Section B for a 5-year period of performance, you will need to submit the budget for the 5th year as an attachment. Use the SF-424A Section B, which does not count in the page limit;

however, any related budget narrative does count. See Section 4.1.iv of HRSA’s SF-424 Application Guide.

http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf

Attachments 6–15: Other Relevant Documents OPTIONAL

Include here any other documents that are relevant to the application, including letters of support. Letters of support must be dated and specifically indicate a commitment to the project/program (in-kind services, dollars, staff, space, equipment, etc.).

3. Unique Entity Identifier (UEI) and System for Award Management (SAM)

A UEI is required to apply for this funding. You must register in the SAM.gov to receive your UEI.

You cannot use a DUNS number to apply. For more details, visit the following webpage:

General Service Administration’s UEI Update

After you register with SAM, maintain it. Keep your information updated when you have:

an active federal award, application, or plan that an agency is considering.3

When you register, you must submit a notarized letter naming the authorized Entity Administrator.

We will not make an award until you comply with all relevant SAM requirements. If you have not met the requirements by the time we’re ready to make an award, we will deem you unqualified and award another applicant.

If you already registered on Grants.gov, confirm that the registration is active and that the Authorized Organization Representative (AOR) has been approved.

To register in Grants.gov, submit information in two systems:

• System for Award Management (SAM) (SAM Knowledge Base)

• Grants.gov

Effective March 3, 2023, individuals assigned a SAM.gov Entity Administrator role must be an employee, officer, or board member, and cannot be a non-employee. This change is to ensure entities are in control of who has permission to control roles within their entity.

Here’s what this means:

• Entity Administrators assigning roles to non-employees will only be able to assign a Data Entry role or lower.

• Any entities assigning Entity Administrator roles using an Entity Administrator Role Request Letter (formerly called “notarized letter”) will no longer be able to assign the Entity Administrator role to a non-employee.

3 Unless 2 CFR § 25.110(b) or (c) exempts you f rom those requirements or the agency approved an exemption for you under 2 CFR § 25.110(d)).

https://www.gsa.gov/entityid https://sam.gov/content/home https://www.fsd.gov/gsafsd_sp?id=gsa_kb_view2&kb_id=f66d8e6cdb76d4100d73f81d0f9619c6 https://www.grants.gov/ https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.fsd.gov%2Fgsafsd_sp%3Fid%3Dkb_article_view%26sysparm_article%3DKB0017347&data=05%7C01%7CDDixon%40hrsa.gov%7C80dfe1e3c58a4e26cd0008db143e65c3%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638126030447564740%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=nnDr7%2B8Bn1g9416eowK4Vwfx%2BO2%2BuUP1Nlu9KkvZoa4%3D&reserved=0

• Entity Administrator roles assigned to non-employees will be converted to Data Entry roles. With a Data Entry role, non-employees can still create and manage entity registration data entry but cannot manage roles.

If you are an entity using a non-employee or if you are a non-employee working with an entity to manage registrations, please read (and share) more about this change on the BUY.GSA.gov blog to know what to expect.

For more details, see Section 3.1 of the Application Guide.

Note: Allow enough time to register with SAM and Grants.gov. We do not grant application extensions or waivers if you fail to register in time.

4. Submission Dates and Times

Application Due Date Your application is due on November 30, 2023, at 11:59 p.m. ET. We suggest you submit your application to Grants.gov at least 3 calendar days before the deadline to allow for any unexpected events. See the Application Guide’s Section 8.2.5 – Summary of emails from Grants.gov.

5. Intergovernmental Review

The National Rural Health Policy, Community, and Collaboration Program must follow the terms of Executive Order 12372 in 45 CFR part 100.

See Section 4.1 ii of the Application Guide for more information.

6. Funding Restrictions

The General Provisions in Division H of the Consolidated Appropriations Act, 2023 (P.L.

117-328) apply to this program. See Section 4.1 of the Application Guide for information. Note that these and other restrictions will apply in fiscal years that follow, as the law requires.

Program-specific Restrictions

You cannot use funds under this notice for the following:

1) Purchasing or improving real estate

2) Foreign travel

You must have policies, procedures, and financial controls in place. Anyone who receives federal funding must comply with legal requirements and restrictions, including those that limit specific uses of funding.

• Follow the list of statutory restrictions on the use of funds in Section 4.1 (Funding Restrictions) of the Application Guide. We may audit the effectiveness of these policies, procedures, and controls.

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fbuy.gsa.gov%2Finteract%2Fcommunity%2F47%2Factivity-feed%2Fpost%2Fa14726f4-e2a9-47b3-80ec-7ceff5108706%2FA_Change_in_SAM_gov_will_Affect_Access_for_Some_Entity_Administrators&data=05%7C01%7CDDixon%40hrsa.gov%7C80dfe1e3c58a4e26cd0008db143e65c3%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638126030447564740%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=ZTRBuys3iNJZeAUQ7rDx56aVR1BrI3wE4z%2FHBoFbQTU%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fbuy.gsa.gov%2Finteract%2Fcommunity%2F47%2Factivity-feed%2Fpost%2Fa14726f4-e2a9-47b3-80ec-7ceff5108706%2FA_Change_in_SAM_gov_will_Affect_Access_for_Some_Entity_Administrators&data=05%7C01%7CDDixon%40hrsa.gov%7C80dfe1e3c58a4e26cd0008db143e65c3%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638126030447564740%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=ZTRBuys3iNJZeAUQ7rDx56aVR1BrI3wE4z%2FHBoFbQTU%3D&reserved=0 https://www.archives.gov/federal-register/codification/executive-order/12372.html

• 2 CFR § 200.216 prohibits certain telecommunications and video surveillance services or equipment. For details, see the HRSA Grants Policy Bulletin Number:

2021-01E.

If funded, for-profit organizations are prohibited from earning profit from the federal award (45 CFR § 75.216(b)).

V. Application Review Information

1. Review Criteria

We review your application on its technical merit. We have measures for each review criterion to help you present information and to help reviewers evaluate the applications.

Reviewers will evaluate and score the merit of your application. Six review criteria are used to review and rank National Rural Health Policy, Community, and Collaboration Program applications. Below are descriptions of the review criteria and their scoring points.

Criterion 1: NEED (10 points) – Corresponds to Section IV’s Introduction and Need The reviewers will consider:

o The extent to which the application demonstrates comprehensive knowledge and understanding of the issues facing rural communities at the national, regional, state and local levels.

o The extent to which the application describes a clear understanding of the purpose of this program as well as an understanding of the distinct unmet needs associated with identifying and educating stakeholders on policy issues, engaging rural communities, and collaborating with rural stakeholders.

o The extent to which the applicant clearly describes how the project will build upon the federally funded resources that currently exist, leveraging a broad network of rural health organizations and individual subject matter experts, and providing a mechanism to engage with public rural health stakeholders beyond current award recipients and partners to improve health care in rural areas nationwide.

Criterion 2: RESPONSE (30 points) – Corresponds to Section IV’s Approach and Work Plan Approach (15 points)

The reviewers will consider the extent to which the application clearly demonstrates an approach to fulfilling the four objectives that include:

o Identifying and educating rural stakeholders about national policy issues and promising practices for rural health.

https://www.hrsa.gov/sites/default/files/hrsa/grants/manage/grants-policy-bulletin-2021.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/manage/grants-policy-bulletin-2021.pdf o Maintaining projects that will help support engagement of rural communities in a broad range of activities.

o Facilitating partnerships and collaborations at the local, regional, State, and national levels to improve the exchange of information and promising practices that support rural health.

o Identifying and providing information to rural stakeholders about existing federal funding opportunities or other programs relating to health care in rural areas.

Work Plan (15 points)

The reviewers will consider the extent to which the application:

o Provides a detailed work plan that is logical and has objectives and goals that fulfill the purpose of this cooperative agreement and address identified needs.

o Clearly identifies responsible staff for each activity.

o Clearly identifies activities requiring collaboration with relevant partners.

o Provides a complete work plan matrix that represents the period of performance that includes goal(s), objective(s), and activities as they correlate with budget, personnel responsible, and timelines.

o Outlines a five (5) year period of performance explaining activities to begin August 1, 2023 and going no longer than July 31, 2029.

Criterion 3: EVALUATIVE MEASURES (10 points) – Corresponds to Section IV’s Evaluation and Technical Support Capacity The reviewers will consider the extent to which the application:

o Provides an effective method to monitor and evaluate the project products, impact and outcomes.

o Clearly describes an evaluation plan that will contribute to continuous quality improvement.

o Clearly describes how the evaluative measures will be able to assess to what extent the program goals and objectives have been met.

o Clearly describes how quantitative and qualitative data will be used to capture program performance and impact.

Criterion 4: IMPACT (10 points) – Corresponds to Section IV’s Methodology This includes the extent and effectiveness of plans for dissemination of project impact and/or the extent to which project impacts are national in scope and/or the degree to which the project activities are replicable, and/or the sustainability of the program beyond the period of federal funding.

Dissemination of Program Materials (3 points)

The reviewers will consider:

o The extent to which the applicant presents a plan for developing program materials that could be used by rural health entities and policymakers.

o The extent to which the applicant presents a plan for disseminating program materials that could be used by rural health entities and policymakers.

Project Results are National in Scope (7 points)

The reviewers will consider:

o The extent to which the applicant has discussed a plan for including the partners and stakeholders that will be key to the success of this program.

o The extent to which the applicant describes previous rural health activities, which promote rural promising practices nationally.

Criterion 5: RESOURCES/CAPABILITIES (35 points) – Corresponds to Section IV’s Resolution of Challenges and Organizational Information

Organizational Capacity (10 points)

The reviewer will consider:

o The extent to which the applicant clearly describes the mission and structure of the organization, the scope of current activities and provides information on the mission and structure of the organization as well as an organizational chart (Attachment #4).

o The extent to which the application clearly describes the capability of the organization to follow the proposed work plan, and properly account for the federal funds.

o The extent to which project personnel are qualified and have extensive experience to carry out all aspects of the project.

o The extent to which the application clearly provides the organization’s capability to collaborate and existing relationships with appropriate partners to carry out all the program requirements.

o The extent to which the application includes letters of support/agreement from all proposed partners (Attachment #3).

o The extent to which the application clearly provides evidence of knowledge of HRSA rural health and other relevant programs in order to link stakeholders to appropriate resources and programs.

Organizational Expertise (10 points)

The reviewers will consider:

o The extent to which the application provides specific examples of related experience that highlights the applicant’s proven ability to identify, educate, engage, and collaborate with rural stakeholders on national rural health policy issues and promising practices to improve health care in rural areas nationwide.

o The extent to which the applicant provides specific evidence of extensive organizational experience and success assisting with the development of strategies on a national level.

Collaboration with Partners (10 points)

The reviewers will consider the extent to which the application addresses:

o The clear demonstration of the applicant’s commitment and ability to form collaborative long term relationships with key rural constituencies including:

state-based entities, private foundations and philanthropic organizations, and other partners and subject matter experts, particularly those with expertise on topics such as workforce (e.g., recruitment and retention, community health workers/promotoras, etc.), agricultural health, telehealth, health disparities, rural health leadership and networking, and emerging areas of focus.

o The extent to which the application demonstrates the applicant organization’s existing long-term relationships with community-level stakeholders in the following constituency groups:

o Federally Qualified Health Centers o Rural Health Clinics o Hospitals/Health Systems o Frontier Communities o Public Health o Research and Education o State-Level Organizations/Resources o Students o Thorough…