hrsa-25-040 v2.FINAL.pdf

Notice of Funding Opportunity

Application due February 11, 2025

Health Resources and Services Administration (HRSA) Community-Based Division

Black Lung Clinics Program Opportunity number: HRSA-25-040

Contents Before you begin 4

Step 1: Review the Opportunity 5

Basic information 6

Summary 6

Funding details 6

Eligibility 7

Program description 11

Award information 18

Step 2: Get Ready to Apply 20

Get registered 21

Find the application package 21

Application writing help 21

Step 3: Write Your Application 23

Application contents and format 24

Step 4: Learn About Review and Award 35

Application review 36

Risk review 43

Selection process 44

Award notices 44

Step 5: Submit Your Application 45

Application submission and deadlines 46

Application checklist 48

Step 6: Learn What Happens After Award 50

Contents 2

Post-award requirements and administration 51

Reporting 54

Contacts and Support 55

Endnotes 58

Contents 3

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 February 11, 2025.

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 4 https://sam.gov/ https://grants.gov/

Jump to a step

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

Step 1:

Review the Opportunity

In this step

Basic information 6

Summary 6

Funding details 6

Eligibility 7

Program description 11

Award information 18

Basic information Federal Office of Rural Health Policy

Health Resources and Services Administration (HRSA)

Community-Based Division

Providing quality medical, outreach, educational, and benefits counseling services to reduce the morbidity and mortality associated with black lung disease.

Have questions?

Go to Contacts and Support.

Key facts

Opportunity name: Black Lung Clinics Program

Opportunity number:

HRSA-25-040

Announcement version:

New

Federal assistance listing:

93.965

Statutory authority: Sec.

427(a) of the Federal Mine Safety and Health Act of 1977 (30 U.S.C. 937(a)), 42 C.F.R. part 55a

Key dates

NOFO issue date:

December 12, 2024

Informational webinar:

December 19, 2024

Application deadline:

February 11, 2025, at 11:59 p.m. Eastern Time (ET)

Expected award date is by:

June 1, 2025

Expected start date: July 1, See other submissions for other time frames that may apply to this NOFO.

Summary The Black Lung Clinics Program (BLCP) funds clinics that support active and retired coal miners who have or may contract occupation related coal mine dust lung disease (CMDLD), also known as black lung disease. Clinics provide support through:

• Medical services.

• Outreach services.

• Educational services.

• Benefits counseling services.

Funding details Application types: Competing continuation, New

Expected total available funding in FY 2025: $12,000,000

Expected number and type of awards: Up to 15 grants. We expect to make one award per service area.

Funding range per award: Varies by service area

We plan to fund awards in five 12-month budget periods for a total five-year period of performance from July 1, 2025 to June 30, 2030.

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

Step 1: Review the Opportunity 6

Eligibility Who can apply You can apply if you are a state, or public or private entity.

Types of eligible organizations These types of domestic* organizations may apply:

• Public institutions of higher education.

• Private institutions of higher education.

• Nonprofits with or without 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 the freely associated states. This includes state health departments.

• Independent school districts.

• Federally Qualified Health Centers (FQHC), community health centers, Rural Health Clinics (RHCs) and hospitals, including Rural Emergency Hospitals

• Native American tribal governments

• Native American tribal organizations

Applicant organizations that are federally recognized tribes or tribal organizations are eligible to apply if conducting all proposed activities within federally recognized tribal areas. Documentation of federally recognized tribal status must be included for this consideration provided in [attachment 1].

Individuals are not eligible applicants under this NOFO.

* “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, and the Republic of Palau.

Other eligibility criteria We expect to make one award per service area. You must follow these guidelines in your application:

• You must propose to serve the entirety of the service area you are applying to cover, as outlined below in Table A.

Step 1: Review the Opportunity 7

• You must propose only one service area unless you are a state entity and propose to serve the entire state.

• HRSA recognizes that more than one clinic may be providing complementary services to coal miners in a given state or county. If you are proposing to serve Service Areas A, J, E, F, or G, you must detail how you intend to avoid duplicating efforts of other black lung clinics in the states or counties where there is overlap.

Note: Any individual applicant can request the full amount allocated to the service area they are proposing to serve.

Table A: Current BLCP funding allocations and service areas*

Service Areas Counties per FY24 Apps FY24 Funding Amount

Service Area A: Arizona: Apache, Coconino, Navajo $401,684

Service Area B: Kentucky: Bell, Breathitt, Boyd, Clay, Estill, Floyd, Jackson, Johnson, Harlan, Knott, Knox, Laurel, Lawrence, Lee, Leslie, Letcher, Magoffin, Martin, McCreary, Owsley, Perry, Pike, Whitley, Wolfe

$ 767,927

Service Area C: Ohio: Belmont, Carroll, Columbiana, Harrison, Jefferson, Mahoning, Monroe, Stark, Tuscarawas, Washington; West Virginia: Brooke, Hancock, Marshall, Ohio, Tyler, Wetzel

$437,129

Service Area D: Ohio: Athens, Coshocton, Fairfield, Gallia, Guernsey, Hocking, Holmes, Jackson, Licking, Meigs, Morgan, Muskingum, Noble, Perry, Ross, Vinton

$437,129

Service Area E: Pennsylvania: Allegheny, Armstrong, Beaver, Butler, Cambria, Clarion, Clearfield, Fayette, Greene, Indiana, Jefferson, Lawrence, Somerset, Washington, Westmoreland

$531,643

Service Area F: Pennsylvania: Fayette, Greene, Washington $543,456

Service Area G: Pennsylvania: Adams, Bedford, Berks, Blair, Bradford, Bucks, Cambria, Cameron, Carbon, Centre, Chester, Clearfield, Clinton, Columbia, Cumberland, Dauphin, Delaware, Elk, Franklin, Fulton, Huntingdon, Indiana, Jefferson, Juniata, Lackawanna, Lancaster, Lebanon, Lehigh, Luzerne, Lycoming, McKean, Mifflin, Monroe, Montgomery, Montour, Northampton, $424,883

Step 1: Review the Opportunity 8

Service Areas Counties per FY24 Apps FY24 Funding Amount

Northumberland, Perry, Philadelphia, Pike, Potter, Schuylkill, Snyder, Somerset, Sullivan, Susquehanna, Tioga, Union, Wayne, Wyoming, York

Service Area H: Tennessee: All counties $342,614

Service Area I: Wyoming: All counties; North Dakota: all counties Montana: All counties; Utah: all counties;

$437,129

Service Area J: Colorado: All counties; Arizona: Apache, Coconino, Maricopa, Navajo, Yavapai

$1,086,913

Service Area K: Illinois: All counties; Indiana: All counties $1,122,357

Service Area L: Kentucky: Butler, Christian, Daviess, Henderson, Hopkins, Logan, McLean, Muhlenberg, Ohio, Todd, Union, Webster

$1,098,727

Service Area M: New Mexico: All counties $862,442

Service Area N: Virginia: Buchanan, Dickenson, Lee, Russell, Scott, Smyth, Tazewell, Washington, Wise

$1,122,356

Service Area O: West Virginia: Barbour, Boone, Braxton, Cabell, Clay, Fayette, Grant, Greenbrier, Harrison, Jackson, Kanawha, Lincoln, Lewis, Logan, Marion, McDowell, Mercer, Mineral, Mingo, Monongalia, Monroe, Nicolas, Preston, Putnam, Raleigh, Randolph, Roane, Summers, Taylor, Tucker, Upshur, Webster, Wyoming

$2,162,010

*Service areas represent counties served by current BLCP recipients and funding amounts reflect the amounts BLCP recipients received in FY 2024.

Additional requirements for current BLCP recipients Current BLCP recipients whose period of performance ends June 30, 2025 should request a funding amount less than or equal to the amount allocated to the service area they propose to serve, as listed in Table A.

Exceptions:

• If you previously served a service area on behalf of a consortium, but you are now applying to serve that area separately, request a funding amount that is less than or equal to the amount received under the consortium.

Step 1: Review the Opportunity 9

• If you previously served a service area separately, but you are now applying to serve that area on behalf of a consortium, request a funding amount that is less than or equal to the combined amount that each individual BLCP recipient received in FY 2024.

Under both of these exceptions, you should demonstrate how you will ensure continuity of care to coal miners in the service area you served during FY 2020 through 2024.

Funding requirements for new BLCP applicants New applicants should request a funding amount less than or equal to the amount allocated to your proposed service area, as listed in Table A.

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

• Is submitted after the deadline.

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 has no cost-sharing requirement. If you choose to share in the costs of the project, we will not consider it during merit review. We will hold you accountable for any funds you add, including through reporting.

Step 1: Review the Opportunity 10

Program description Purpose The Black Lung Clinic Program’s primary goal is to reduce the morbidity and mortality associated with occupation related coal mine dust lung disease (CMDLD), also known as black lung disease, by providing:

• Medical services.

• Outreach services.

• Educational services.

• Benefits counseling services.

All recipients are required to provide certain services to coal miners in their service area. We also provide additional requirements to the minimum required services, to make sure that the quality and breadth of services coal miners receive is sustained in all service areas.

Background After decades of steady decline following the enactment of the Federal Coal Mine Safety and Health Act of 1969, the national prevalence of Coal Workers’ Pneumoconiosis (CWP) and its most severe form, Progressive Massive Fibrosis (PMF), is rising.

Investigators from the National Institute for Occupational Safety and Health (NIOSH) report that nationally, more than 10% of people who have been coal miners for at least 25 years now have CWP. This trend is even more pronounced in central Appalachia, where over 20% of these miners have CWP.[1] Research also shows that relatively young coal miners are being affected by CWP, even though they have spent their entire careers working under modern dust control regulations.[2] This recent data highlights the continued need for BLCP services.

Through the Black Lung Clinics Program, public, private, and state entities provide medical, outreach, educational, and benefits counseling services to active, inactive, and disabled coal miners. The goal of these services is to reduce the morbidity and mortality associated with occupation related CMDLD.

Funding allocations to BLCP recipients must take into account:

• The number of miners to be served and their needs.

• The quality and breadth of services to be provided.

Since the program’s inception, BLCP recipients have served as critical access points for coal miners seeking education and medical services pertaining to their occupation

Step 1: Review the Opportunity 11 related lung disease, and guidance on how to apply for state and federal black lung benefits.

Program requirements and expectations This program includes both minimum required services and additional requirements for further services. The minimum required services are the same for all recipients. The additional requirements vary depending on which service area you are serving.

Minimum required BLCP services All recipients must provide the following services to coal miners in their service areas:

Access to medical staff.

• Your staff must include a contracted or onsite board-certified physician with special training or experience in the diagnosis and treatment of respiratory diseases who has at least one year of experience in the diagnosis and treatment of respiratory diseases. Staff may also include non-physician primary care providers working under the direct supervision of the clinic physician.

• Your staff must include a patient care coordinator. This person may be a lay health care worker or trained health care personnel.

◦ The coordinator is responsible for helping the clinic physician maintain contact with the patient’s primary care physician and encouraging patients to participate in the prescribed treatment.

Patient education and outreach.

• You must deliver current, evidence-based information to coal miners in a variety of formats and forums. Topics should include risks associated with coal mine dust lung exposure, the recent resurgence in CWP and PMF, and available medical and compensation services.

Lung function testing.

• You must offer onsite resting spirometry and oximetry, with or without a bronchodilator challenge. Staff must have training in the proper interpretation of results and NIOSH certification in spirometry.

Chest imaging.

• You must offer posteroanterior chest x-rays (CXR) conducted by a contracted or onsite board-certified radiologist and interpreted by a NIOSH-certified B-reader.

You must do your best to meet International Labour Organization (ILO) technical standards. Facilities must also be contracted or onsite.

Pulmonary rehabilitation.

Step 1: Review the Opportunity 12

• You must offer accredited Phase II and Phase III pulmonary rehabilitation services onsite, through contract, or by referral.

Lung disease treatment.

• You must provide current, evidence-based information and treatment of coal mine dust-induced lung disease. Treatment might include medications, nutrition counseling, vaccinations, smoking cessation services, and referrals to specialty care.

• You must also evaluate and treat (or refer) coal miners for commonly associated conditions, including chronic obstructive pulmonary disease (COPD), hearing loss, substance abuse, depression, hypertension, diabetes, and cardiovascular disease.

Compensation counseling.

• You must help miners file federal black lung, state worker’s compensation, and Social Security Disability Insurance claims as appropriate. Your compensation counselors should have a minimum of a high school diploma and training to competently help with claims.

Department of Labor (DOL) examination.

• You must be able to refer patients to an approved and certified DOL medical examiner. We will expect you to meet timeliness goals as described in the DOL Employment Law Guide for Black Lung Compensation.

Data collection.

• You must collect patient-level data as prescribed by HRSA and report across all project years.

Technical assistance.

• You must participate in programmatic technical assistance from the Black Lung Data and Resource Center to enhance operations, improve the quality and breadth of services you provide, and increase the number of U.S. coal miners served. We will provide further information about this requirement upon receipt of award.

Additional requirements We provide additional requirements to the minimum required services to make sure that the quality and breadth of services coal miners receive is sustained in all service areas. These additional requirements add detail to the minimum requirements and explain our expectations for your specific service area.

In some cases, the additional requirements replace the minimum requirements. For example, the minimum requirement for staffing specifies a physician with one year of

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

Step 1: Review the Opportunity 13 https://webapps.dol.gov/elaws/elg/blklung.htm experience, but the additional requirements specify a physician with more years of experience respective to the specific service areas outlined in this section.

You may request up to two exemptions from these additional requirements for your service area. You’ll find more information about exemptions in the next section.

This approach gives you greater flexibility to tailor services to your patients’ needs and your organization’s capacity.

Additional requirements for service Areas A through I If you plan to serve service areas A through I, you should provide the following services and meet the following standards in order to ensure continuity of care:

Staffing.

• Your staff must include an onsite, board-certified physician with special training or experience in the diagnosis and treatment of respiratory diseases with at least two years of experience in the diagnosis and treatment of respiratory diseases.

Patient education and outreach.

• In addition to outreach to miners, you must conduct structured educational activities that involve other community partners within and outside of the black lung community.

Lung function testing and chest imaging.

• You must provide access to full resting pulmonary function testing, including a bronchodilator challenge, lung volume measurements, diffusion capacity, and resting arterial blood gases. Testing equipment and methods must meet American Thoracic Society/European Respiratory Society (ATS/ERS) standards.

Medical case management.

• Your patient care coordinators should have an associate’s degree or at least three years of experience in patient care coordination. Trained nurse care managers or certified nurse assistants are preferred.

Compensation counseling.

• Your compensation counseling staff should have a minimum of a high school diploma and at least three years of experience. They should guide coal miners through the federal black lung benefits process, help interpret legal correspondence, and help interpret DOL medical exam results.

Additional requirements for service areas J through O If you plan to serve service areas J through O, you should provide the following services and meet the following standards to ensure continuity of care:

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

Step 1: Review the Opportunity 14 https://www.thoracic.org/statements/pulmonary-function.php https://www.ers-education.org/guidelines.aspx

Staffing.

• Your staff must include an onsite, board-certified physician with special training or experience in the diagnosis and treatment of respiratory diseases and at least four years of experience, preferably with occupation related lung disease.

Patient education and outreach.

• You should facilitate educational workshops or presentations at local and national conferences.

Lung function and other testing.

• You must provide access to full resting pulmonary function testing and cardiopulmonary exercise testing with metabolic cart, as well as bronchodilator challenge, lung volume measurements, diffusion capacity, and resting and exercise arterial blood gases testing.

• Testing equipment and methods must meet American Thoracic Society/European Respiratory Society (ATS/ERS) standards.

• You must also be able to conduct onsite chest x-ray with B-reader interpretation and be able to do advanced chest imaging.

Medical case management.

• Your staff must include a nurse case manager or certified medical assistant with five years of experience to assist with medical follow-up of patients.

Compensation counseling.

• Your staff must include providers with medical and legal expertise to write expert medical reports and provide expert testimony and supplemental reports.

• You must be able to refer patients for legal assistance provided by a licensed attorney specializing in black lung benefits claims.

DOL examination.

• You must provide onsite DOL medical exams by an approved provider. This provider must meet all criteria by the DOL under 20 CFR part 725 to perform “complete and qualitative” medical exams as well as provide treatment under the Federal Mine Safety and Health Act of 1977, as amended.

• We also encourage you to do the following:

◦ Follow the performance measures as outlined in DOL-Office of Workers’ Compensation Programs (OWCP).

◦ Submit documents relevant to active black lung benefits claims electronically into Claimant Online Access Link (C.O.A.L.).

◦ Follow other procedures and training related to diagnostic and medical providers.

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

Step 1: Review the Opportunity 15 https://www.thoracic.org/statements/pulmonary-function.php https://www.ers-education.org/guidelines.aspx https://www.ecfr.gov/current/title-20/chapter-VI/subchapter-B/part-725

Exemptions to additional requirements We know that not all of the additional requirements to the minimum required services may be appropriate or feasible for applicants, due to organizational, clinical, or environmental factors and the fluid nature of the target population.

As a result, you may request up to two exemptions from the additional requirements for your service area by providing the requested information in attachment 6.

If you request an exemption to an additional requirement, you are not expected to address that additional requirement in your project narrative. Your application will not be scored on the exemptions to additional requirements requested, as long as the exemptions from the additional requirements for your service area requested include no more than two exemptions and include all requested information to support the exemptions indicated in attachment 6.

Note that you may not request exemptions from any of the minimum required BLCP services. The minimum required services are mandatory for all recipients. You should address all of them in your project narrative.

To request an exemption, include the following in the attachment:

• A detailed description of the requested exemption(s).

• A detailed justification for the exemption(s), including why you intend to reduce or eliminate the service or staffing guideline and how it will affect work, staffing plans, and budget.

• A description of how and where coal miners in your service area will learn about and access the same or a higher quality version of the service. Include the distance to the nearest facility that offers that service.

• A detailed description of how you will compensate for the reduced or eliminated service by enhancing or adding to the other services you provide to coal miners.

Do not propose the following changes:

• A funding amount greater than the FY 2024 funding amount allocated your service area (see Table A).

• Provision of services to fewer counties than the ones listed in your service area (see Table A).

• Elimination or reduction of any of the minimum required BLCP services.

Each exemption request should not exceed one page, single-spaced.

We reserve the right to disapprove or seek clarification on any proposed exemptions if they appear to:

• Significantly harm access or quality of services provided to coal miners.

Step 1: Review the Opportunity 16

• Violate BLCP program regulations as defined by 42 CFR part 55a.

• Otherwise negatively impact the goals of the BLCP.

If we disapprove or seek clarification on a proposed exemption, we will notify you upon issuance of the award by placing a condition on the grant. You will then be required to submit a revised budget and/or scope of project to us in the Electronic Handbooks (EHBs).

Duplication of efforts in service areas A, J, E, F, or G We recognize that more than one clinic may provide complementary services to coal miners in a given county. If you propose to serve service areas A, J, E, F, or G, you must detail how you will avoid duplicating efforts of other black lung clinics in the states or counties where there is overlap.

Include this information in attachment 7.

This attachment should not exceed one page single-spaced and must include all efforts you will take to avoid duplication. This may include, but is not limited to:

• Direct contact with the other awardees in the service area.

• Coordination or collaboration on education or outreach events.

• Memoranda of understanding (MOUs), memoranda of agreement (MOAs), or referrals to medical or benefits counseling services.

• Clarification of how your services complement or support services provided by other clinics in the service area.

• A description of unique services provided in the states or counties where there is overlap.

Partner organization coordination If you intend to form a consortium with one or more other entities, you must submit a letter of commitment (LOC) or a memorandum of agreement (MOA) with your application that, at a minimum:

• Affirms each consortium member’s commitment to and support of the project.

• Specifies the frequency and method of communication (for example, in-person, e-mail, etc.) between consortium members.

• Includes a description of the proposed process for including input from each consortium member into decision making, problem solving, and urgent or emergency situations.

This information must be submitted with your LOC or MOA in attachment 3.

Step 1: Review the Opportunity 17

Please note that your LOC or MOA represents a promise to provide the specified organizational resources for the success of the project. An LOC or MOA is not the same as a letter of support.

Award information Funding policies and limitations Policies

• We will only make awards if this program receives funding. If Congress appropriates funds for this purpose, we will move forward with the review and award process.

• HRSA will allocate funds to service areas based on the level of BLCP funding that each service area received in FY 2024. If you are applying to serve a particular service area, you should propose a level of services commensurate with current efforts in that service area, though limited exemptions may be considered. This approach intends to minimize service disruptions, ensure continuity of care to coal miners in areas currently served by BLCP recipients, and address resurgence in CWP and PMF while maintaining alignment with program regulations.

• Support beyond the first budget year will depend on:

◦ Appropriation of funds.

◦ Satisfactory progress in meeting the project’s objectives.

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

• If we receive more funding for this program, we consider options such as:

◦ Fund more applicants from the rank order list

◦ Extend the period of performance

◦ Award supplemental funding

General limitations

• For guidance on some types of costs we do not allow or restrict, see Project

Budget Information in Section 3.1.4 of the Application Guide. You can also see 45 CFR part 75, or any superseding regulation, General Provisions for Selected Items of Cost.

• You cannot earn profit from the federal award. See 45 CFR 75.400(g).

• Congress’s current appropriations act includes a salary limitation, which applies to this program. As of January 2024, the salary rate limitation is $221,900. This limitation may be updated.

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

Step 1: Review the Opportunity 18 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=19 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-E/subject-group-ECFR5d90ba314caea08 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-E/subject-group-ECFR5d90ba314caea08 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75#75.400

Program-specific statutory or regulatory limitations You cannot use funds:

• To acquire real property.

• For construction.

• To pay for equipment costs not directly related to the award.

• For any activities associated with lobbying or advocacy efforts, including planning for or conducting lobbying or advocacy events.

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

Indirect costs Indirect costs are costs you charge across more than one project that cannot be easily separated by project. For example, this could include utilities for a building that supports multiple projects.

To charge indirect costs you can select one of two methods:

Method 1 – Approved rate. You currently have an indirect cost rate approved by your cognizant federal agency.

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.

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 funds for approved project-related activities. Find more about program income at 45 CFR 75.307.

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

Step 1: Review the Opportunity 19 https://www.hrsa.gov/grants/manage-your-grant https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRd93f2a98b1f6455/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

Step 2:

Get Ready to Apply

In this step

Get registered 21

Find the application package 21

Application writing help 21

Get registered SAM.gov You must have an active account with SAM.gov to apply. 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 select Get Started. From the same page, you can also select the Entity Registration Checklist to find out what you will need to register.

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.

Find the application package The application package has all the forms you need to apply. You can find it online. Go to Grants Search at Grants.gov and search for opportunity number HRSA-25-040.

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.

See Apply for a Grant for other help and resources.

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

Step 2: Get Ready to Apply 21 https://sam.gov/content/entity-registration https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application/assurances-non-construction-programs https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application/assurances-non-construction-programs https://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants https://www.grants.gov/search-grants 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 https://www.hrsa.gov/grants/apply-for-a-grant

Join the webinar For more information about this opportunity, join the webinar on December 19, 2024 at 1:00 ET.

If you are not able to join through your computer, you can call in:

• Phone number: 833 568 8864

• Meeting ID: 161 592 6783

• Passcode: 76814232

We will record the webinar. If you are not able to join live, you can request a recording by emailing blacklung@hrsa.gov.

Have questions? Go to Contacts and Support.

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

Step 2: Get Ready to Apply 22 https://hrsa-gov.zoomgov.com/j/1615926783?pwd=B7FBUgNjAklE5AKKKe1Oqv56LVpl1N.1 mailto:blacklung@hrsa.gov

Step 3:

Write Your Application

In this step

Application contents and format 24

Application contents and format Applications include 6 main components. This section includes guidance on each.

Application page limit: 70 pages

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

Make sure you include each of these:

Components Submission format

Project abstract Use the Project Abstract Summary form.

Project narrative Use the Project Narrative Attachment form.

Budget narrative Use the Budget Narrative Attachment form.

Attachments Insert each in the Attachments form.

Other required forms Upload using each required form.

Required format You must format your narratives and attachments using our required formats for fonts, size, color, format, and margins. See the formatting guidelines in Section 3.2 of the Application Guide.

Project abstract Complete the information in the Project Abstract Summary form.

The project abstract must include:

• Organization name and full address.

• Entity type/type of facility.

• Website URL if you have one.

• Proposed service region, which includes states, cities, and counties.

• Dollar amount being requested for your project.

• Brief description of the population you will serve.

• Brief description of the service area where your project will work.

• Your organization’s proposed project goals and objectives.

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• Expected outcomes of the proposed project.

• If you are requesting a funding preference, you must explicitly request a qualifying funding preference and cite the qualification as defined by part 55a, subpart A, 55a.103.

◦ We highly recommend you include this language: “[Applicant organization name] is requesting a funding preference based on state preference.

[Applicant organization name] is a state entity.” If applicable, you need to provide supporting documentation in your attachments.

For more information, see Section 3.1.2 of the Application Guide.

Project narrative In this section, you will describe all aspects of your project. Project activities must comply with the non-discrimination requirements.

Use the section headers and the order listed.

Introduction See merit review criterion 1: Need

Need Include a detailed needs assessment that covers all of the following information.

• Number of coal miners in service area: Provide the best estimate of the number of active, inactive, and retired coal miners residing in the service area you are proposing to serve. Base your estimate on all available data from the U.S.

Department of Labor, U.S. Energy Information Administration, and other relevant national, state, and local resources.

◦ Current recipients should cite their most recent patient level data, including number of miners served and any other supporting data points.

◦ New applicants should cite the number of miners served across the last calendar year from their Electronic Medical Records (EMR).

• Health care access and utilization in service area: Describe current patterns for obtaining health care in the service area you are proposing to serve and the role of your organization in providing care.

◦ State approximately what percentage of retired and active coal miner patients seek their primary and/or specialty care at your organization.

◦ Please include information on the employment status (such as retired, disabled, inactive, or active) of the coal miners you serve.

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• Unmet health needs in service area: Describe unmet health needs in the service area you are proposing to serve. Cite publicly available local data where possible and compare them to state and/or national data.

◦ Only use indicators that are relevant to the proposed project, such as specific health status indicators (including those related to the prevalence and severity of CMDLD), age, employment status, insurance coverage, poverty level, and transportation access.

◦ Current recipients should cite their most recent patient level data, including number of miners served and any other supporting data points.

◦ New applicants should cite the number of miners served across the last calendar year from their EMR and any other supporting data points.

• Health care and social services in service area: Provide an overview of the current health care and social services available within and around the service area you are proposing to serve.

◦ Clearly describe both the number and type of relevant services (for example, pulmonary and respiratory health care, compensation counseling, or legal services) available to coal miners within and around your proposed service area.

◦ Describe the relationship of these existing services to your organization and proposed project.

◦ Describe the potential impact of your project on existing providers who are located within or around your proposed service area but are not part of your project. For example, you could discuss changes in referral and practice patterns or provider reimbursement impact.

◦ Provide a clear, well-reasoned justification for why other grant programs and resources within or around your proposed service area are unable to fill the health care gaps you have identified. Your local health department and State Office of Rural Health may be valuable resources for acquiring supporting information.

• Other: You may include any other relevant information that demonstrates the need for BLCP services in the service area you are proposing to serve. This includes publicly available data from state and federal data sources or, for current BLCP recipients, patient level data. New applicants may cite the number of miners served across the last calendar year from their EMR.

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Approach See merit review criterion 2: Response. Please use the sub-sections that follow to organize this section.

Methods for delivering minimum required BLCP services

• Tell us how you will address your stated needs and provide the minimum required BLCP services.

• As it makes sense, include strategies for ongoing staff training, teamwork, and information sharing. Also include strategies for outreach and collaboration efforts to involve patients, families, and communities.

• If it applies, include a plan to distribute reports, products, or project outputs to target audiences.

Methods for delivering additional guidelines to the minimum required services

• Tell us how you will deliver the services required under the additional guidelines to the minimum required services. If you propose any exemptions to the additional guidelines, note those exemptions here.

Continuation of services

• Propose a plan for continuing the project when federal funding ends. We expect you to keep up key strategies or services and actions that have led to improved practices and outcomes for the target population.

Payer of last resort

• Per statute, the BLCP is the payer of last resort. As such, all BLCP recipients must make every effort to pursue alternate sources of payment and use program income in a manner consistent with award requirements. Provide descriptions of the following:

◦ How you will ensure charges for services rendered are in alignment with the description in post-award requirements.

◦ Your organizational capacity to coordinate billings with multiple sources of funding.

◦ Your procedures and reasonable efforts for collecting payments from third-party payers.

Work plan See merit review criteria 2: Response and 4: Impact

• Describe your work plan. The description should include:

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◦ A brief description of how you will achieve each of the objectives during the period of performance.

◦ A brief description of each activity, including all minimum required activities and, if applicable, additional requirements for the service area you are proposing to serve.

◦ An appropriate timeline for proposed activities during the project’s funding cycle, beginning with the project start date (July 1, 2025) and ending with the project end date (June 30, 2030).

◦ Who will be responsible for overseeing implementation for each activity.

◦ A list of the short, immediate, and long-term outcomes expected, including measures or benchmarks you will use to help monitor progress for each activity and assess your project’s effectiveness.

You will also include a version your work plan as part of attachment 1. It is highly recommended that your work plan in attachment 1 is in table format.

Resolving challenges See merit review criterion 2: Response

Discuss challenges that you are likely to encounter in your work plan and explain approaches that you will use to resolve them.

Performance reporting and assessment See merit review criteria 3: Performance reporting and assessment and 5:

Resources and capabilities

Include a narrative that discusses all the following aspects of performance reporting and program assessment. Please include:

• A Data Collection Strategy that describes your strategy to collect, analyze, and track organizational and patient-level data to measure process and impact/ outcomes.

◦ Explain how you will use data to inform your project development and service delivery.

◦ Describe the sources of the data you are utilizing.

• See reporting for more information.

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Organizational information See merit review criterion 5: Resources and capabilities

• Describe a clear, comprehensive plan for staffing that meets the educational and professional requirements of the project and those by relevant certification bodies in Attachment 2. Staffing plans should include, at a minimum:

◦ Board-certified physician with special training or experience in the diagnosis and treatment of respiratory diseases.

◦ Compensation counselor.

◦ Patient care coordinator.

• The staffing plan should also include position descriptions for other staff, which may include a dietician, audiologist, physical therapist, and a pharmacist, among others.

• All staffing plans should include the following components:

◦ The number and types of staff, qualification levels, and full-time equivalents (FTEs).

◦ The information necessary to illustrate both the capabilities (current experience, skills, knowledge, and experience with previous work of a similar nature) of key staff.

◦ Job descriptions for each of the key staff.

◦ Clear alignment with the activities proposed in the project narrative and project budget.

• Describe the abilities and contributions of your organization to the project. This should include information that addresses your organization’s current mission, structure and scope of current activities.

• Your organization must also be clearly reflected in the organizational chart provided in attachment 5.

• Clearly describe existing systems within your organization (for example, financial and accounting management systems, capacity to exercise administrative and programmatic direction over the project, etc.) will support the organization’s ability to meet BLCP requirements and expectations.

Budget and budget narrative See merit review criterion 6: Support requested

Your budget should follow the instructions in Section 3.1.4. Project Budget Information

- Non-Construction Programs (SF-424A) of the Application Guide and the instructions listed in this section. Your budget should show a well-organized plan.

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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.

The total project or program costs are all allowable (direct and indirect) costs used for the HRSA award 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 maintenance of effort, if applicable).

You cannot use program funds to pay for membership dues and fees for the National Coalition of Black Lung and Respiratory Disease Clinics, Inc.

The budget narrative supports the information you provide in Standard Form 424-A.

See other required forms. It includes an itemized breakdown and a clear justification of the requested costs. The merit review committee reviews both.

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 funding policies and limitations.

• The number of coal miners to be served, as well as the quality and breadth of proposed activities.

• Conference attendance and travel budgets, and how they will enhance the quality and breadth of services provided to coal miners.

To create your budget narrative, see detailed instructions in Section 3.1.5 of the Application Guide.

Attachments Place your attachments in order in the Attachments Form. See application checklist to determine if they count toward the page limit.

Attachment 1: Work plan Attach the project’s work plan. Make sure it includes everything required in the corresponding project narrative section.

This attachment is required in addition to the description provided in the project narrative work plan section.

We recommend that you format your work plan as a table and use these headings:

• Goals and objectives.

• Key action steps (including target population where applicable).

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• Activities.

• Outputs, data sources, and program assessment methods. These might include the direct products or deliverables of program activities and how you will assess them.

• Outcomes and measurements. These might include the result of a program, typically describing a change in people or systems.

• Person and service area responsible.

• Performance period and completion date.

Attachment 2: Staffing plan and job descriptions See Section 4.1.vi of the Application Guide.

Include a clear, comprehensive staffing plan that shows the staff positions that will support the project and key information about each.

• Justify your staffing choices, including education and experience qualifications and your reasons for the amount of time you request for each staff position.

• Staffing needs should have a direct link to the activities proposed in the project narrative and budget.

• Include the number and types of staff, qualification levels, and full-time equivalents (FTEs).

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

• For each key staff position, both filled and unfilled, attach a one-page job description. It must include the person’s role, responsibilities, and qualifications.

• Staffing plans should include, at a minimum:

◦ A board-certified physician with special training or experience in the diagnosis and treatment of respiratory diseases.

◦ A compensation counselor.

◦ A patient care coordinator.

Attachment 3: Consortium plan (if applicable) Attach a Letter of Commitment (LOC) or a Memorandum of Agreement (MOA) with the application that, at a minimum:

• Affirms each consortium member’s commitment to and support of the project.

• Specifies the frequency and method of communication (for example, in-person, e-mail, etc.) between consortium members.

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• Describes the proposed process for including input from each consortium member into decision-making, problem solving, and urgent or emergency situations.

• Details narrative…