HRSA-25-018 Final.pdf

Notice of Funding Opportunity

Application due Phase 1 (Grants.gov) - 12/2/2024 / Phase 2 (EHB) - 1/10/2025

Bureau of Primary Health Care Office of Policy and Program Development

Fiscal Year 2025 Health Center Controlled Network (HCCN) Cooperative Agreements.

Opportunity number: HRSA-25-018

Contents Before you begin 3

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 6

Program description 8

Award information 11

Step 2: Get Ready to Apply 16

Get registered 17

Find the application package 17

Application writing help 18

Step 3: Prepare Your Application 19

Application contents and format 20

Step 4: Learn About Review and Award 37

Application review 38

Selection process 42

Award notices 43

Step 5: Submit Your Application 44

Application submission and deadlines 45

Application checklist 47

Step 6: Learn What Happens After Award 49

Post-award requirements and administration 50

Contacts and Support 53

Contents 2

Before you begin If you believe you are a good candidate for this funding opportunity, secure your SAM.gov and Grants.gov registrations now. If you are already registered, make sure your registrations are active and up-to-date.

SAM.gov registration (this can take several weeks) You must have an active account with SAM.gov. This includes having a Unique Entity Identifier (UEI).

See Step 2: Get Ready to Apply

Grants.gov registration (this can take several days) You must have an active Grants.gov registration. Doing so requires a Login.gov registration as well.

See Step 2: Get Ready to Apply

Apply by the application due date Applications are due by 11:59 p.m. Eastern Time on Phase 1 (Grants.gov).

To help you find what you need, this NOFO uses internal links. In Adobe Reader, you can go back to where you were by pressing Alt + Left Arrow (Windows) or Command + Left Arrow (Mac) on your keyboard.

Before you begin 3 https://sam.gov/ https://grants.gov/

Jump to a step

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 6

Program description 8

Award information 11

Basic information Health Resources and Services Administration (HRSA)

Bureau of Primary Health Care

Office of Policy and Program Development

Key facts

Opportunity name: Fiscal Year 2025 Health Center Controlled Network (HCCN) Cooperative Agreements.

Opportunity number:

HRSA-25-018

Announcement version:

New

Federal assistance listing:

93.129

Statutory authority:42 U.S.C. 254b(e)(1)(C) (Section 330(e)(1)(C) of the Public Health Service (PHS) Act)

Have questions?

Visit the HCCN technical assistance (TA) webpage for resources to help you with your application.

Go to Contacts and Support for our contact information.

Summary The purpose of FY 2025 Health Center Controlled Networks (HCCNs) cooperative agreement funding is to support HCCNs, which are networks of participating health centers (PHCs) work collaboratively to leverage health information technology (IT) and data to enhance how they deliver affordable, accessible, and high-quality primary care, with a specific focus on:

• Data management and analytics,

• Interoperability of systems and digital health tools, and

• Uniform Data System Modernization (UDS+) implementation.

For this notice of funding opportunity (NOFO), the term health center refers to Health Center Program (H80) award recipients and organizations with look-alike (LAL) designation from HRSA. UDS+ implementation is the electronic submission of de-identified patient-level data from health centers to HRSA through automated reporting platforms.

Funding detail Application Type: New and competing continuation

Expected total available funding: $48 million

Expected number and type of awards: 49 cooperative agreements

The funding range per award varies based on the number of PHCs in your network:

$705,000 to $2,955 million per budget period. See Table 1: FY 2025 funding tier and maximum annual award amount.

The program and estimated awards depend on the future appropriation of funds and are subject to change based on the availability and amount of appropriations.

We plan to fund awards in three 12-month budget periods for a total 3-year period of performance from 8/1/2025 to 7/31/2028.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 5 https://www.govinfo.gov/content/pkg/USCODE-2021-title42/html/USCODE-2021-title42-chap6A.htm https://www.govinfo.gov/content/pkg/USCODE-2021-title42/html/USCODE-2021-title42-chap6A.htm https://bphc.hrsa.gov/funding/funding-opportunities/health-center-controlled-networks-hccn https://bphc.hrsa.gov/funding/funding-opportunities/health-center-controlled-networks-hccn

Key dates

NOFO issue date: 10/3/

Phase 1 Application Deadline in Grants.gov: 12/ 2/2024

Phase 2 Supplemental Information Deadline in HRSA Electronic Handbooks (EHBs): 1/10/

Expected award date is by:

7/1/2025

Expected start date: 8/1/

Eligibility Who can apply You can apply if you are one of the following:

• A Health Center Controlled Network, or

• A current Health Center Program (H80) award recipient, funded for at least two consecutive preceding years, applying on behalf of an HCCN.

• To be an HCCN, you must meet the following criteria throughout the period of performance:

◦ Have at least 10 PHCs,

◦ Be majority-controlled and, as applicable, at least majority-owned by Health Center Program (H80) award recipients, and

◦ Have your own governing body independent of the boards of your health center members.

Types of eligible organizations

• These types of domestic organizations may apply:

• Public institutions of higher education

• Private institutions of higher education

• Non-profits with or without having a 501(c)(3) IRS status

• For-profit organizations including small businesses

• State, county, city, township, and special district governments, including the District of Columbia, domestic territories, and freely associated states

• Native American tribal governments

• Native American tribal organizations

“Domestic” means the 50 states, the District of Columbia, 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.

Individuals are not eligible applicants under this NOFO.

Other eligibility criteria Your application will be deemed incomplete and not considered for funding under this notice if it does not contain all of the documents marked as “required for completeness” in the Attachments and Project Narrative sections.

Step 1: Review the Opportunity 6

Completeness and responsiveness criteria We will review your application to make sure it meets these requirements.

These are the basic requirements you must meet to move forward in the competition.

We will not consider an application that:

• Is from an organization that does not meet all eligibility criteria.

• Requests funding above the award ceiling shown in the funding range.

• Does not meet both deadlines for Phase 1: Grants.gov and Phase 2: EHBs.

• Does not include a Project narrative.

You must maintain your H80 award status throughout the 3-year period of performance to maintain your funding.

Application limits You may not submit more than one application. If you submit more than one application, we will only accept the last on-time submission.

Cost sharing This program does not have a cost-sharing requirement.

Step 1: Review the Opportunity 7

Program description Purpose HCCNs support PHCs as they leverage health IT and data to enhance delivery of affordable, accessible, and high-quality primary health care, with a specific focus on:

• Data management and analytics,

• Interoperability of systems and digital health tools, and

• UDS+ implementation.

Background HCCNs have provided health IT and data integration support to health centers for more than 20 years, with approximately 92 percent of health centers formally partnering with an HCCN. HCCNs provide specialized training and technical assistance (T/TA) to health centers in their network and leverage economies of scale, leading to:

• Greater sharing of resources and training, and

• Improved data analytics to support quality measurement and improvement.

The partnership between HCCNs and their network PHCs has improved access to care, enhanced quality of care, and supported practice redesign to integrate services and optimize patient outcomes.

FY 2025 HCCN award recipients will build upon the demonstrated success of previous HCCN awards. All HCCNs will support their PHCs with 3 required and 2 elective objectives as outlined in Table 4: FY 2025 HCCN Objectives. The 2 elective objectives will allow HCCNs to customize their project proposal to the needs of the PHCs in the network.

FY 2025 HCCN award recipients will also continue to support PHCs with electronic submission of de-identified patient level data (UDS+) as part of the UDS Modernization Initiative. UDS modernization is a continuous effort to improve UDS content, quality, and reporting procedures. These efforts focus on reducing reporting burden and improving data quality to better evaluate Health Center Program services and outcomes. The goal is to optimize the use and value of UDS data for health centers and HRSA while improving how health centers prepare and submit UDS data. De-identified patient-level data that will be submitted as part of UDS+ includes information that corresponds with existing UDS data elements, including health center patient demographics, health center services utilized, and some electronic Clinical Quality Measures (eCQMs). UDS+ data submissions will be automated and require more support and coordination with health center HIT vendors, and requirements for

Step 1: Review the Opportunity 8 submissions may change over time. HCCNs play a key role in assisting health centers with submitting patient-level data as required by HRSA and building on those minimum reporting requirements during the period of performance.

HCCNs will provide support to PHCs by partnering with local and state agencies, community-based organizations, and other HRSA-supported T/TA partners, such as State and Regional Primary Care Associations (PCAs) and National Training and Technical Assistance Partners (NTTAPs).

Program requirements and expectations Your application must document an understanding of your PHCs’ needs in the areas of data management and analytics; interoperability of systems and digital health tools;

and UDS+ implementation. For the purpose of this funding opportunity:

• You must have a signed Memorandum of Agreement (MOA) with all PHCs in your network.

• You must have MOAs with at least 10 PHCs (as described in the Other Eligibility Criteria section) in your network throughout the period of performance.

• You must develop an individualized work plan with each PHC within 90 days of the period of performance start date and review and update that plan at least annually. HRSA may request work plans at any time during the period of performance and will review work plans during site visits.

• You must support PHCs based on each of their needs and capacity during the period of performance.

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

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

• You may, to a limited extent, use HCCN funding to support health centers that are included as PHCs in another HCCN’s network. However, these organizations will not impact your funding tier and will not be included in objective reporting.

HCCNs must have established guidelines and processes on how you will engage with these other PHCs.

• You must engage all PHCs in applicable HCCN activities detailed in the Project Work Plan (PWP).

• A single health center with multiple sites counts as one PHC. All sites may engage in applicable HCCN activities, based on PHC needs as noted below.

• You must inform HRSA of changes to the PHCs in your HCCN network within 30 days of the change.

Step 1: Review the Opportunity 9

• If you are a Health Center Program (H80) award recipient, you may apply on behalf of an HCCN and be a PHC within an HCCN.

• You must support all PHCs to implement and maintain formally defined, secure health information and technology policies and practices that protect individual privacy and organizational access, including protection from misuse, attack threats, fraud, or other forms of harm.

• You will work with PCAs and NTTAPs to provide needed support and technical assistance as appropriate.

• If you’re also a HRSA-funded PCA, you must submit documentation that outlines the differences in scopes of service between your PCA project and HCCN project within 30 days of the period of performance start date.

• You may not change or remove any elective objectives during the period of performance, but you may add elective objectives throughout the period of performance.

• You are expected to continue to advance and make progress on the objectives, even if your objective target is met early in the period of performance.

• You and your PHCs must use health IT systems and products, including EHRs, certified to the 2024 Edition of the certification criteria found in the ONC Health IT Certification Program Overview, where available. See certification criteria in the 2024 Edition of the ONC Health IT Certification Program.

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

• Where funded activities and/or a specific use case are not addressed by either certification criteria or standards in 45 CFR Part 170, you must consider use of additional standards identified in the ONC Interoperability Standards Advisory.

See Interoperability Standards Platform.

• Publications you develop or purchase through this award must meet HRSA guidelines for data rights. As described in 45 CFR § 75.322(b), you own the copyright for materials that you develop through this award, and HHS reserves a royalty-free, nonexclusive, and irrevocable right to reproduce, publish, or otherwise use those materials for federal purposes, and to allow others to do so.

The Federal Government also can obtain, reproduce, publish, or use data produced through this award and can allow others to receive, reproduce, publish, or otherwise use such data for federal purposes. See 45 CFR § 75.322(d).

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 10 https://www.healthit.gov/sites/default/files/PUBLICHealthITCertificationProgramOverview.pdf https://www.healthit.gov/sites/default/files/PUBLICHealthITCertificationProgramOverview.pdf https://www.healthit.gov/isa/ https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.ecfr.gov%2Fcurrent%2Ftitle-45%2Fsubtitle-A%2Fsubchapter-A%2Fpart-75%23p-75.322(b)&data=05%7C02%7CEClift%40hrsa.gov%7Cdff7929c46a74b990e5a08dc5322d4d5%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638476656265172682%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=zSHHExhBGi%2FxNBsq9QvH1huIx%2BYFRRjs30iPrfiyyjw%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.ecfr.gov%2Fcurrent%2Ftitle-45%2Fsubtitle-A%2Fsubchapter-A%2Fpart-75%23p-75.322(d)&data=05%7C02%7CEClift%40hrsa.gov%7Cdff7929c46a74b990e5a08dc5322d4d5%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638476656265178943%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=n0UaHWU0sq9ZbkOk17ncUOsZHwKPog2g21yVWPZI7eQ%3D&reserved=0

Award information Cooperative agreement terms Our responsibilities Aside from monitoring and technical assistance, we also get involved in these ways:

• Collaborate with you to revise and approve the approved application objectives and activities in your PWP according to our priorities and changes in the health care landscape, such as identifying and prioritizing health IT and data needs to be addressed using federal funds.

• Monitor and support implementation of your PWP through collaborative regular meetings and progress report reviews.

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

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

• Coordinate with other federally-funded cooperative agreements and award recipients to support the established objectives.

• Conduct a site visit during the 3-year period of performance to review and assess your activities, key accomplishments, and PHC individualized work plans, and to identify promising practices that support the health IT and data needs of health centers.

• Contact PHC(s) within a HCCN network at any time during the period of performance to solicit feedback on T/TA activities.

• Provide a data use agreement (to be signed by you) before sharing data that will assist you in achieving your approved objective targets.

Your responsibilities You must follow all relevant laws, regulations, and policies. Your other responsibilities will include:

• Collaborate with us on revising and implementing your PWP based on HRSA priorities and changes in the health care landscape.

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

• Meet requirements to acknowledge Federal funding.

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

Step 1: Review the Opportunity 11

• Coordinate with national, federal, state, and local organizations to strengthen PWP development and implementation.

• Engage all PHCs and their sites in HCCN activities, based on PHC needs.

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

• Sign and adhere to all data use agreements that govern UDS and non-UDS data sources before you request data from us that is not publicly available (as applicable) to help you achieve your approved objective targets.

Funding policies and limitations Policies

• We will only make awards if HRSA receives sufficient funding from Congress.

• Support beyond the first budget year will depend on:

◦ Appropriation of funds,

◦ Satisfactory progress in meeting the project’s objectives, and

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

• All uses of funds must align with your scope of project.

• If we receive more funding for this program, we may:

◦ Fund more applicants from the rank order list,

◦ Extend the period of performance, and

◦ Award supplemental funding.

• The maximum funding amount you may request is based on the number of PHCs in your network. Refer to Table 1: FY 2025 funding tier and maximum annual award amount below to find out how much you may request.

• Although an HCCN may use funding for services provided to health centers that are not on the HCCN’s PHC List as discussed in the Program and Expectations section, these activities will not impact the maximum funding amount you can request.

Table 1: FY 2025 funding tier and maximum annual award amount

Number of PHCs Maximum Annual Funding

10 - 19 $705,000

20 - 29 $955,000

30 - 39 $1,205,000

40 - 49 $1,455,000

Step 1: Review the Opportunity 12

Number of PHCs Maximum Annual Funding

50 - 59 $1,705,000

60 - 69 $1,955,000

70 - 79 $2,205,000

80 - 89 $2,455,000

90 - 99 $2,705,000

100+ $2,955,000

Additional funding information:

• HCCNs with MOAs with 100 or more PHCs may only request a maximum of $2,955,000.

• If you do not maintain MOAs with the number of PHCs required for your funding tier for more than 90 days, we may reduce your funding to the amount listed in Table 1: FY 2025 funding tier and maximum annual award amount.

• If you have MOAs with fewer than 10 PHCs for more than 90 days, we may discontinue funding.

• As an HCCN award recipient, you may request supplemental funding, after the first 5 months of the period of performance, to address unique or emerging health IT and data needs of your PHCs. The proposed work must be aligned with, but not the same as the funded scope of work. We may support such supplemental projects if:

• Funding is available and allocable.

• The request is allowable and sufficient time remains in the budget period to complete the activities.

• The activities are aligned with our priorities, but not the same as the work performed by us or our other funding recipients.

General limitations

• For guidance on some costs we do not allow or restrict, see Budget in section 5.1.iv of the Two-Tier Application Guide. You can also see 45 CFR part 75, or any superseding regulation, General Provisions for Selected Items of Cost.

• For-profit organizations cannot earn profit from the federal award. See 45 CFR 75.216(b).

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 13 https://www.hrsa.gov/sites/default/files/hrsa/grants/sf-424-app-guide-2-tier.pdf#page=26 https://www.ecfr.gov/current/title-45/part-75/subject-group-ECFR5d90ba314caea08 https://www.ecfr.gov/current/title-45/part-75#p-75.216(b) https://www.ecfr.gov/current/title-45/part-75#p-75.216(b)

• The salary rate limitation imposed by the current appropriations act applies to this program. As of January 2024, the salary rate limitation is $221,900. Note this limitation may apply in future years and will be updated.

Program-specific limitations

• You may not spend funds for:

◦ Costs already paid for by other federal awards.

◦ Costs not aligned with the HCCN Purpose

◦ Equipment, supplies, or staffing for use at the health center level or any other individual health center operational costs.

◦ Costs for construction or renovations

◦ Purchase or upgrade of an electronic health record (EHR) that is not certified to the latest standards of the Office of the National Coordinator for Health Information Technology Certification Program

◦ Facility or land purchases

◦ Purchase of vehicles

◦ Direct patient care

◦ PHC recruiting or member incentives.

◦ Conferences

• Under existing law, and consistent with Executive Order 13535 (75 FR 15599), you must not use federal funds to provide abortions, except in cases of rape or incest, or when a physician certifies that the woman has a physical disorder, physical injury, or physical illness that would place her in danger of death unless an abortion is performed. This includes all funds awarded under this notice and is consistent with past practice and long-standing requirements.

See Manage Your Grant for other information on costs and financial management.

Indirect costs Indirect costs are those incurred for a common or joint purpose across more than one project and that cannot be easily separated by project (like utilities for a building that supports multiple projects). Learn more at 45 CFR 75.414, Indirect Costs.

You determine indirect costs using one of two methods:

Method 1 – Approved rate. You currently have an indirect cost rate approved by your cognizant federal agency at time of award. If you have an approved rate, include it as Attachment 9: Indirect Cost Rate Agreement.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 14 https://www.hrsa.gov/grants/manage-your-grant https://www.ecfr.gov/current/title-45/section-75.414

Method 2 – De minimis rate. Per 2 CFR 200.414(f) if you have never received a negotiated indirect cost rate, you may elect to charge a de minimis rate. If you choose this method, costs included in the indirect cost pool must not be charged as direct costs.

This rate is 15% of modified total direct costs (MTDC). See 2 CFR 200.1 for the definition of MTDC. You can use this rate indefinitely. If you use this rate, you must use it for all federal awards unless you negotiate a rate.

Program Income Program income is money earned as a result of your award-supported project activities. You must use any program income you generate from awarded use those funds for approved project activities. Find more about program income at 45 CFR 75.307.

The non-federal share of the project budget includes all program income sources such as fees, premiums, third party reimbursements, and payments you generate from the delivery of services, and from other revenue sources such as:

• State, local, or other federal grants or contracts,

• Private support, and

• Income generated from fundraising, and donations or contributions.

In accordance with 45 CFR § 75.307 (e)(2) relating to the use of non-cooperative agreement funds, HCCNs must use these funds, including funds in excess of those originally expected, “for the purpose and under the conditions of the Federal award.”

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 15 https://www.ecfr.gov/current/title-2/section-200.414 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Modified%20Total%20Direct%20Cost%20(MTDC)) https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.307 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.307 https://www.govinfo.gov/content/pkg/USCODE-2021-title42/html/USCODE-2021-title42-chap6A-subchapII-partD-subparti.htm

Step 2:

Get Ready to Apply

In this step

Get registered 17

Find the application package 17

Application writing help 18

Get registered SAM.gov You must have an active account with SAM.gov. This includes having a Unique Entity Identifier (UEI). SAM.gov registration can take several weeks. Begin that process today.

To register, go to SAM.gov Entity Registration and click Get Started. From the same page, you can also click on the Entity Registration Checklist for the information you will need to register. If you already registered in SAM.gov, make sure your account is active.

You must renew each year.

When you register or update your SAM.gov registration, you must agree to the financial assistance general certifications and representations. You must agree to those for grants specifically, as opposed to contracts, because the two sets of agreements are different. You will have to maintain your registration throughout the life of any award.

Grants.gov You must also have an active account with Grants.gov. You can see step-by-step instructions at the Grants.gov Quick Start Guide for Applicants.

If you already registered on Grants.gov, make sure your account is active and your Authorized Organization Representative (AOR) is approved.

Need Help? See Contacts and Support.

HRSA Electronic Handbooks (EHBs) You must also have a user account in EHBs. See the Knowledge Base for how to get started.

Find the application package The application package has all the forms you need for phase 1 of the application process. You can find it online. Go to Grants Search at Grants.gov and search for opportunity number HRSA-25-018.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 2: Get Ready to Apply 17 https://sam.gov/content/entity-registration https://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants https://grants.hrsa.gov/EAuthNS/external/account/SignIn https://help.hrsa.gov/display/public/EHBSKBFG/Registration+and+User+Accounts+FAQs#:~:text=How%20do%20I%20register%20in%20the%20EHBs%3F%201,Step%203%3A%20Submit%20your%20Organization%20Registration%20for%20Approval https://www.grants.gov/search-grants

After you select the opportunity, we recommend that you click the Subscribe button to get updates.

Application writing help Visit HHS Tips for Preparing Grant Proposals.

Visit HRSA’s How to Prepare Your Application page for more guidance.

The HCCN technical assistance (TA) webpage includes:

• Application resources, such as example forms and documents

• Answers to frequently asked questions

• Our recorded pre-application TA webinar

• Information to join the QandA session

• Contact information for questions

Join the webinar HRSA will hold a pre-application TA webinar for applicants seeking funding through this opportunity. Visit the HCCN technical assistance (TA) webpage for more details.

Need Help? See Contacts & Support.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 2: Get Ready to Apply 18 https://www.hhs.gov/grants-contracts/grants/get-ready-for-grants-management/tips-for-preparing-grant-proposals/index.html https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application

Step 3:

Prepare Your Application

In this step

Application contents and format 20

Application contents and format This program has a 2-phase submission process. You will submit Phase 1 information through Grants.gov then submit Phase 2 information in the EHBs.

There is an 80-page limit. Instructions below will specify what counts in this limit. The Application Checklist specifies what counts in this limit.

Submit your information in English and express budget figures using U.S. dollars.

Required format

You must format your narratives and attachments using our required formatting guidelines for fonts, size, color, format, and margins. See formatting guides in section 3.2 of the Two Tier Application Guide.

Phase 1: Grants.gov You must submit the following by the Grants.gov deadline. Refer to section 5.3 of the Two-Tier Application Guide to learn more about what is required for each section:

Table 2: Grants.gov application

Section Submission Format Included in page limit? Can be edited in the EHBs?

Application for Federal Assistance (SF-424)

Form No No

Project Abstract Summary Form

Form No Yes

Project/Performance Site Locations Form

(List only your administrative sites)

Form No Yes

Grants.gov Lobbying Form

Form No Yes

Disclosure of Lobbying Activities (SF-LLL)

Form No NA

Key Contacts Form Form No Yes

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 3: Prepare Your Application 20 https://www.hrsa.gov/sites/default/files/hrsa/grants/sf-424-app-guide-2-tier.pdf#page=23 https://www.hrsa.gov/sites/default/files/hrsa/grants/two-tier-application-guide.pdf#page=44

Section Submission Format Included in page limit? Can be edited in the EHBs?

Project Narrative Attachment Form

Form No NA

Project Narrative Attachment included with Project Narrative Attachment form

Yes Yes

Budget Information for Non-Construction Programs (SF-424A)

Form No Yes

Budget Narrative Attachment

Attachment Yes Yes

Attachments (up to 15) Attachments included with Attachment form

Yes, unless otherwise marked

Yes

Project abstract Complete the Project Abstract Summary Form. Include a short description of your proposed project. See Section 5.1.ix of the Two-Tier Application Guide for what to include in your abstract.

SF-424 application for federal assistance This is your application for federal assistance. Follow the instructions in section 3.1.2 of the Two-Tier Application Guide and the form instructions in Grants.gov Forms

Project/Performance site locations(s) Follow the form instructions in Grants.gov Forms. Use the “Next Site” option rather than “Additional Location(s)” to add more than one project/performance site location.

Key contacts Follow the Key contacts form instructions in Grants.gov

Grants.gov lobbying form Follow the form instructions in Grants.gov Forms.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 3: Prepare Your Application 21 https://www.hrsa.gov/sites/default/files/hrsa/grants/two-tier-application-guide.pdf%22%20/l%20%22page=43 https://www.hrsa.gov/sites/default/files/hrsa/grants/two-tier-application-guide.pdf%22%20/l%20%22page=43 https://www.hrsa.gov/sites/default/files/hrsa/grants/two-tier-application-guide.pdf#page=9 https://www.grants.gov/forms/forms-repository/sf-424-family https://www.grants.gov/forms https://www.grants.gov/forms https://www.grants.gov/forms/forms-repository/sf-424-family

Phase 2: EHBs You must submit or update the following components in the EHBs by the Phase 2 deadline.

Table 3: EHBs application sections

Components Submission Format Included in page limit?

Project Abstract Summary Form No

Project/Performance Site Locations

(List only your administrative sites)

Form No

Grants.gov Lobbying Form No

Key Contacts Form No

Project Narrative Attachment Yes

Budget Information for Non-Construction Programs

(SF-424A)

Form No

Budget Narrative and Personnel Justification Table Attachment Yes

Attachments Attachment Yes, unless otherwise marked

Project Work Plan (PWP) Form No

Participating Health Center List Form No

FY 2025 HCCN Objectives

Below are the objectives that you will work on during the period of performance.

For the 3-year period of performance, you will work on 5 objectives: 3 required objectives and 2 elective objectives. You must support your elective objectives for the entire period of performance. You are expected to continue to advance and make progress on the objectives, even if your objective target is met in years one or two of the period of performance. The Numerator will be entered in the Project Work Plan (PWP) (Form) and is the number of PHCs that meet each objective at the time of application.

Table 4: FY 2025 HCCN Objectives

Step 3: Prepare Your Application 22

Required Objectives – All HCCNs must work on these Objectives

Objectives Numerator

1 Data Management and Analytics – Increase the percentage of PHCs that advance and optimize clinical, financial, and operations data to improve clinical quality, health outcomes, and operations.

Number of PHCs that advance and improve clinical, financial, and operations data to improve clinical quality, health outcomes, and operations.

2 Interoperability and Data Sharing – Increase the percentage of PHCs that improve bidirectional interoperability with health care providers and community-based organizations by strengthening care coordination, reducing unnecessary medical testing and data duplication, and implementing more efficient and effective referral and information sharing processes to improve health outcomes and reduce provider burden.

Number of PHCs that improve bidirectional interoperability with health care providers and community-based organizations by integrating data from at least two external clinical or non-clinical sources into structured EHR fields to improve health outcomes and reduce provider burden.

3 UDS+ Implementation – Increase the percentage of PHCs that submit some or all disaggregated patient level data in their UDS+ reports in each calendar year as required by HRSA.

Number of PHCs that successfully submit some or all disaggregated patient level data in UDS+ reports in each calendar year as required by HRSA.

Elective Objectives – You must choose two objectives from the list below. You may not change your selection during the period of performance.

Objectives Numerator

1 Additional value-based care (VBC) – Increase the percentage of PHCs that use data to update operational, financial, and clinical processes in health IT systems to prepare for, deliver, participate in, or update value-based care that enhances the patient and provider experience, improves health outcomes, and reduces health disparities, including those who are uninsured.

Note: If you select this objective, your activities must augment and complement activities developed for Objective 1: Data management and analytics.

Number of PHCs that use data to update operational, financial, and clinical processes in health IT systems to deliver, participate in, or update VBC arrangements to achieve improved health outcomes, provider experience, or to address cost.

Examples of data use include but are not limited to:

• Regularly using data analytics to inform and update their operational workflows

Step 3: Prepare Your Application 23

• Utilizing data-driven insights to enhance financial management and reporting

• Implementing clinical process improvements based on data analysis.

• Preparing or adjusting VBC delivery plans based on insights gained from data analytics

2 Digital Health Tools – Increase the percentage of PHCs that adopt and expand use of digital health tools to improve health outcomes.

Number of PHCs that document an increase in patient usage of digital health tools to improve health outcomes.

Tools include but are not limited to:

• Electronic messaging through patient portal

• Telehealth provider consultation

• Remote monitoring devices

3 Strengthening Cybersecurity Support – Increase the percentage of PHCs that develop or implement assessments and advanced techniques to protect against threats to health center data.

Note: If you select this objective, your activities must enhance and provide additional cybersecurity support than what is detailed in the Program Requirements section of this NOFO.

Number of PHCs that develop or implement assessments and advanced techniques to protect health center data.

Techniques include, but are not limited to:

• Multi-factor authentication (MFA)

• Encryption

• Intrusion detection systems (IDS)

• Regular security audits

• Staff training programs on cybersecurity awareness

• Table top exercises

4 Artificial Intelligence (Applicant Choice) –

Develop one objective and associated outcome measure that will increase percentage of PHCs that use safe, fair, equitable, and informed artificial intelligence practices to reduce health disparities and improve health outcomes.

Developed by the applicant.

Note: The description you include with your PWP should begin with “the number of PHCs…” similar to the Numerators defined for the other objectives.

Step 3: Prepare Your Application 24

5 Social Risk Factors – (Applicant Choice) Develop one objective and associated outcome measure that will increase the percentage of PHCs that identify social risk factors and develop and implement care coordination plans to address patient needs.

Developed by the applicant.

Note: The description you include with your PWP should begin with “the number of PHCs…” similar to the Numerators defined for the other objectives.

Project narrative The Project Narrative is required for completeness.

Need See merit review criterion 1: Need

For each required and chosen elective objective in the PWP, you must:

1. Describe the health IT and data needs of your PHCs.

2. Describe the health IT and data system limitations experienced by your PHCs.

3. Describe how these needs vary across your network, include the need for peer-to-peer learning and mentorship.

Use and cite relevant data whenever possible. Include Attachment 10: Participating Health Center Needs Assessment Summary.

Response See merit review criterion 2: Response

This section has two parts.

Part 1: You must complete the PWP in the EHBs. In the PWP:

1. Select three required and two elective objectives that you will support throughout the 3-year period of performance.

2. Set realistic and achievable objective targets that will be reached by the end of the 3-year period of performance.

3. Detail 2-4 activities for each objective, which will be completed by the end of the first budget year.

Part 2: In the Project Narrative:

1. Describe how you will engage all the PHCs in applicable activities, while addressing their individual needs.

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

Step 3: Prepare Your Application 25

3. Summarize how year 2 and 3 activities will build upon the activities detailed in the

PWP.

4. Describe how you will address health IT and data system limitations for your PHCs.

5. Summarize how you will develop an individual work plan with each PHC within 90 days of award and will update them annually.

Collaboration See merit review criterion 3: Collaboration

The collaboration section has two parts.

Part 1: Document the health centers that have committed to be PHCs in your network:

Complete the Participating Health Center List in EHBs. Include at least 10 health centers, with at least 51% being Health Center Program (H80) award recipients.

Submit your MOA template and signatures that correspond with the Participating Health Center List, as instructed in Attachment 1: PHC MOA Template and Signatures.

Part 2: In your Project Narrative describe your collaborations and partnerships. At a minimum, you must partner with the health IT NTTAP (currently HITEQ), and a PCA.

Consider partnerships with other organizations that support data sharing, interoperability, and cybersecurity. Examples include other PCAs and NTTAPs, health departments, state or local health agencies, professional and community organizations, institutions of higher learning, and academic medical centers.

For each collaboration and partnership, you must include:

• The name and organization type of the partner (for example, if it is a NTTAP).

• If your partnership is current or planned.

• A description of the partnership and how it will support your project.

• A letter of support that details their commitment to help you address your PHCs’ health IT and data needs and reach your objective targets. Include these letters as Attachment 7: Letters of Support.

• A description of how you will ensure the security of patient data.

Resources and capabilities See merit review criterion 4: Resources and Capabilities

1. Describe your experience providing health IT and data support to health centers.

2. Describe how your organizational structure and staffing plan presented in Attachment 2: Project Organizational Chart and Attachment 5: Staffing Plan are appropriate for the successful oversight and implementation your project.

3. Describe how you will recruit and retain staff.

Step 3: Prepare Your Application 26

4. Describe how the written agreements you summarize in Attachment 6: Summary of Contracts and Agreements support the proposed activities.

5. Describe how your financial management and internal controls and policies and procedures will reflect Generally Accepted Accounting Principles (also known as GAAP) and how you will use them to safeguard and optimize the use of federal funds.

6. Describe your organization’s timekeeping process. This ensures that you’ll comply with federal standards related to recording personnel costs.

Evaluative measures See merit review criteria 5: Evaluation Measures

1. Include an evaluation plan to ensure that your proposed activities are effective.

The plan must:

2. Describe how you will use qualitative and quantitative data to monitor progress and measure outcomes.

3. Describe your timeline for evaluating activities and progress.

4. Describe how you will use data and evaluation information, including feedback from the PHCs, to inform changes and improvements to your activities within and across budget periods.

5. Describe how you will collect data from your PHCs for your annual NCC progress report.

6. Describe your plans to disseminate results, successful strategies, and lessons learned to PHCs, PCAs, NTTAPs, other HCCNs, HRSA, and other key stakeholders.

Governance See merit review criterion 6: Governance

1. Reference where in Attachment 8: Network Bylaws (or Attachment 11: Other Documents) it documents (for example, section, page number, paragraph) that you are majority controlled and, as applicable, majority owned by Health Center Program (H80) award recipients.

2. Describe your governance structure, including how you maintain your independence from your PHC boards. Reference Attachment 2: Project Organizational Chart and Attachment 8: Network Bylaws, as appropriate.

3. Explain your governing board’s role in monitoring the project. Reference Attachment 8: Network Bylaws, as appropriate.

Support requested See merit review criterion 7: Support Requested: Budget and Budget Narrative

Step 3: Prepare Your Application 27

This section has two parts.

Part 1: In your Project Narrative, describe how your budget submission will support your project.

Part 2: Make sure your budget submission (the Budget Information for Non- Construction Programs (SF-424A) and the Budget Narrative with Personnel Justification Table) is consistent and aligns with your PWP.

Budget instructions Your budget should show a well-organized plan. It should follow the instructions in Two-Tier Application Guide, Standard Forms, and any specific instructions listed in this section.

HHS now uses the definitions for equipment and supplies in 2 CFR 200.1. The new definitions change the threshold for equipment to the lesser of the recipient’s capitalization level or $10,000 and the threshold for supplies to below that amount.

Reminders:

• Make sure that the total project or program costs are all allowable (direct and indirect) costs used for the HRSA activity or project.

• Your total budget must only include the amount of funds requested under this program.

• As you develop your budget, consider:

• If the costs are reasonable and consistent with your project’s purpose and activities.

• The restrictions on spending funds. See Program-specific Limitations.

You can decide how to allocate the total budget between federal funds under this program and other funding that supports the project as long as you follow policies and federal requirements.

Budget information for non-construction programs

(SF-424A)

Complete the SF-424A Budget Information Form in EHBs. The budget information in these sections must correspond to the total cost of your project for years 1 through 3, except Section E, which records year 2. Use the instructions here if they contradict with the Two-Tier Application Guide.

• Section A – Budget Summary: Under New or Revised Budget, in the Federal column, enter the federal funding requested for each budget year (up to the maximum allowable based on the number of PHCs in your network, see Table 1: FY 2025 funding tier and maximum annual award amount).

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 3: Prepare Your Application 28 https://www.hrsa.gov/sites/default/files/hrsa/grants/two-tier-application-guide.pdf#page=26 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Equipment) https://www.ecfr.gov/current/title-2/part-200#p-200.1(Supplies)

• The federal amount refers only to requested HCCN funding, not all federal funding that you receive. Leave the Estimated Obligated Funds Column blank.

• Section B – Budget Categories: Enter an object class category (line item) budget for each budget year in the period of performance. Include only federal funding.

The amounts for each category as well as the totals, should align with the Budget Narrative.

• Section C – Non-Federal Resources: This section should be left blank as we do not include non-federal funds for this funding opportunity. Do not include projected program income.

• Section D – Forecasted Cash Needs: Enter the forecasted cash needs from federal funding for each quarter of year 1.

• Section E – Budget Estimates of Federal Funds Needed for Balance of the Project: Complete line 16 of the Future Funding Periods. For column (b) enter the amount requested for the second budget year and for column (c) enter the amount requested for the third budget year. Leave the other columns blank.

• Section F – Other Budget Information: If applicable, explain amounts for individual object class categories that may appear to be out of the ordinary in Direct Charges.

• Enter the type of indirect rate (provisional, predetermined, final, fixed, or de minimis) that will be in effect during the period of performance.

Budget narrative with personnel justification table The Budget Narrative includes added detail and supports the information you provide in Section B: Object Class Categories of the Budget Information for Non-Construction Programs (SF-424A). It includes an itemized breakdown and a clear justification of the costs you request.

Submit a detailed Budget Narrative that outlines federal costs by object class category for each requested 12-month period (budget year) of the 3-year period of performance.

For years 2 and 3, highlight the changes from the previous budget year, or clearly indicate that there are no substantive changes.

The sum of line-item costs for each category must align with those in your Budget Information for Non-Construction Programs (SF-424A). See Section 5.1.v. of the Two- Tier Application Guide.

Your Budget Narrative must:

• Demonstrate that you will use awarded funds to meet the program objectives.

• Clearly detail proposed costs for each line item on your Budget Information for Non-Construction Programs (SF-424A), section B, with calculations for how you estimated each cost.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 3: Prepare Your Application 29 https://www.hrsa.gov/sites/default/files/hrsa/grants/sf-424-app-guide-2-tier.pdf#page=38 https://www.hrsa.gov/sites/default/files/hrsa/grants/sf-424-app-guide-2-tier.pdf#page=38

• Not exceed $10,000/unit in movable equipment costs that will last more than one year. Note: HCCNs may not purchase equipment for use at an individual PHC.

• Clearly detail how you will use awarded funds separately and distinctly from other federal support (for example, PCA awards).

• Include any contractors and subawards, including how you estimated the costs.

Ensure that all contractual arrangements are appropriate for the proposed project.

• Do not include ineligible costs or non-federal funding.

• Include a personnel justification table that includes the following information for all staff you propose to support with the award:

• Name,

• Position,

• Percentage of full-time equivalent (FTE),

• Full-time base salary,

• Adjusted annual salary based on salary limitation requirements, and

• Amount of federal funding requested for the position.

Follow the instructions as shown in the example in the Two-Tier Application Guide.