hrsa-25-042 and hrsa-25-043_final.pdf

Notice of Funding Opportunity

Application due April 14, 2025

Office for the Advancement of Telehealth Telehealth Innovation and Services Division

Regional Telehealth Resource Centers (HRSA-25-042) and National Telehealth Resource Centers (HRSA-25-043) Telehealth Resource Center Program Opportunity number: HRSA-25-042 and HRSA-25-043

Contents Before you begin 4

Step 1: Review the Opportunity 5

Basic information 6

Eligibility 8

Program description 10

Award information 13

Step 2: Get Ready to Apply 16

Get registered 17

Find the application package 17

Application writing help 17

Step 3: Prepare Your Application 19

Application contents and format 20

Step 4: Learn About Review and Award 36

Application review 37

Selection process 47

Award notices 48

Step 5: Submit Your Application 49

Application submission and deadlines 50

Application checklist 52

Step 6: Learn What Happens After Award 55

Post-award requirements and administration 56

Contacts and Support 60

Contents 2

Endnotes 63

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 April 14, 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. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 6

Eligibility 8

Program description 10

Award information 13

Basic information Health Resources and Services Administration (HRSA)

Office for the Advancement of Telehealth

Telehealth Innovation and Services Division

Providing telehealth technical assistance across the country to support medically underserved areas and people.

Have questions?

Go to Contacts and Support.

Key facts

Opportunity name:

Regional Telehealth Resource Centers (HRSA-25-042) and National Telehealth Resource Centers (HRSA-25-043) Telehealth Resource Center Program

Opportunity number:

HRSA-25-042 and

HRSA-25-043

Announcement version:

New

Federal assistance listing:

93.211

Statutory authority: 42 U.S.C. § 254c-14(d)(2) (§330I(d)(2) of the Public Health Service Act

Summary The Health Resources and Services Administration (HRSA) is accepting applications for the following related telehealth programs in FY2025:

• Regional Telehealth Resource Center program (HRSA-25-042)

• National Telehealth Resource Center program (HRSA-25-043)

Telehealth is defined as the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, health administration, and public health.

With this funding, recipients will provide expert and customized telehealth technical assistance across the country. These telehealth resource centers will provide training and support, disseminate information and research findings, promote effective collaboration, and foster the use of telehealth technologies to provide health care information and education for health care providers who serve rural areas, frontier communities[1], and medically underserved areas, and medically underserved populations[2].

It is expected that these centers will share expertise through individual consultations, training, webinars, conference presentations, and a significant web presence.

We will fund:

12 organizations under the Regional Telehealth Resource Center (RTRC) announcement (HRSA-25-042). Regional TRCs are geographically located to facilitate activities at the local level and to make sure resources are distributed evenly.

2 organizations under the National Telehealth Resource Center (NTRC) announcement (HRSA-25-043). National TRCs help provide telehealth support and technical assistance to organizations that receive funding as a regional center as well as providing support

Step 1: Review the Opportunity 6

Key dates

NOFO issue date: January 13, 2025

Informational webinar: MM/

DD/YEAR

Application deadline: April 14, 2025

Expected award date is by:

August 1, 2025

Expected start date:

September 1, 2025

See other submissions for other time frames that may apply to this NOFO.

to health care providers across the country. One award will focus on telehealth policy and the other will focus on telehealth technology.

We expect that the recipients of these awards will support effective collaboration across both programs.

You must apply to the correct announcement number.

You may not apply to both announcement numbers, and you may not apply to more than one region for the Regional TRC (HRSA-25-042). See regions.

Funding details Application type: New, Competing Continuation

Expected total available funding in FY 2025:

• $3,900,000 for Regional TRCs (HRSA-25-042)

• $650,000 for National TRCs (HRSA-25-043)

Expected number and type of awards:

• 12 cooperative agreements for Regional TRCs (HRSA-25-042)

• 2 cooperative agreements for National TRCs (HRSA-25-043)

Funding range per award: Up to $325,000 each budget period.

We plan to fund awards in four 12-month budget periods, for a total 4-year period of performance from September 1, 2025, to August 31, 2029.

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 7

Eligibility Who can apply You can apply if you are a domestic public or private, non-profit or for-profit entity.

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 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

• Independent school districts

• 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, and the Republic of Palau.

Individuals are not eligible applicants under this NOFO.

Other eligibility criteria You must target populations located in rural areas, frontier communities, and medically underserved areas, and medically underserved populations. You must demonstrate experience providing technical assistance and understanding telehealth services.

You must submit proof of consultation with the appropriate State Office of Rural Health, state offices concerning primary care, or another appropriate state government entity.

You must submit proof of this consultation in Attachment 5.

Step 1: Review the Opportunity 8

Consortium applications

Telehealth Resource Centers can be operated by a consortium of organizations, but only one organization can apply on behalf of the consortium (and will be responsible for administration of the cooperative agreement). All other organizations may be members of the consortium.

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 must apply to the correct announcement number:

◦ HRSA-25-042 for Regional Telehealth Resource Centers

◦ HRSA-25-043 for National Telehealth Resource Centers

• Multiple applications from an organization are not allowable and an organization cannot apply as both a Regional TRC (HRSA-25-042) and as a National TRC (HRSA-25-043). 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 9

Program description Purpose We welcome eligible organizations to apply for funding under the Regional Telehealth Resource Center (RTRC) program and the National Telehealth Resource Center (NTRC) program.

These telehealth resource centers will support healthcare organizations, networks, and providers with telehealth implementation and training for rural areas, frontier communities, and medically underserved areas, as well as for medically underserved populations.

Regional centers (HRSA-25-042) We will support 12 regional telehealth resource centers that focus on statewide and regional telehealth activities.

Regional TRCs provide expert technical assistance in the development of telehealth services and leverage the experience of mature telehealth programs. These regional centers will provide training and support, disseminate information and research findings, promote effective collaboration, and foster the use of telehealth technologies to provide health care information and education for health care providers.

They are located regionally to facilitate award activities at the local level and to ensure that resources are geographically distributed.

Table 1: Regions

Northeast Region Southeast Region Upper Midwest Region Northwest Region

• Connecticut

• Maine

• Massachusetts

• New Hampshire

• New York

• Rhode Island

• Vermont

• Alabama

• Florida

• Georgia

• South Carolina

• Puerto Rico

• Virgin Islands

• Illinois

• Indiana

• Michigan

• Ohio

• Alaska

• Idaho

• Montana

• Oregon

• Utah*

• Washington

• Wyoming

Mid-Atlantic Region South Region North Central Region West Region

• Delaware • Arkansas • Iowa • California

Step 1: Review the Opportunity 10

Northeast Region Southeast Region Upper Midwest Region Northwest Region

• District of Columbia

• Kentucky

• Maryland

• North Carolina

• Pennsylvania

• Virginia

• West Virginia

• New Jersey

• Mississippi

• Tennessee

• Minnesota

• Nebraska

• North Dakota

• South Dakota

• Wisconsin

South Central Region West Central Region Southwest Region* Pacific Region

• Kansas

• Missouri

• Oklahoma

• Louisiana

• Texas

• Arizona

• Colorado

• Nevada

• New Mexico

• American Samoa

• Guam

• Hawaii

• Commonwealth of the Northern Mariana Islands

• Federated States of Micronesia

• Marshall Islands

• Republic of Palau

*In this funding opportunity, Utah will be served by the Northwest TRC, except for the Four Corners Region, which will be served by the Southwest TRC. Upon award, the Southwest recipients will need to develop a coordinated strategy for serving the shared region.

National centers (HRSA-25-043) We will support 2 National TRCs, in which one award will focus on telehealth policy, and one will focus on telehealth technology.

These national centers will provide technology and policy training and support, disseminate information and research findings, support effective collaboration, and foster the use of telehealth technologies to improve access, timeliness, cost effectiveness, and quality of health care service delivery.

Objectives For both funding opportunities you are expected to:

Step 1: Review the Opportunity 11

• Advance effective use of telehealth technologies in your respective service areas.

• Collaborate with other Telehealth Resource Center Program recipients and share and combine expertise and resources to create unified telehealth technical assistance capability with effective and efficient educational tools, consulting, and support capabilities.

• Meet the needs of telehealth networks, practitioners, or organizations in your service area including, but not limited to rural health clinics, federally qualified health centers, critical access hospitals, rural emergency hospitals, skilled nursing facilities, State Offices of Rural Health, state offices concerning primary care, and other appropriate state government entities.

• Ideally include populations that suffer from poor health outcomes, health disparities, and other inequities as compared to the national average when addressing telehealth technical assistance. Examples of these populations include, but are not limited to, people experiencing homelessness, pregnant people, disabled individuals, youth and adolescents, persons experiencing hypertension, and tribes and tribal organizations.

Background This program is authorized by 42 U.S.C. § 254c-14(d)(2) (§330I(d)(2) of the Public Health Service Act. It is administered by the Office for the Advancement of Telehealth (OAT), located within HRSA’s Office of the Administrator. View more information about OAT.

Program requirements and expectations Core services Awards are expected to be used for the following core services:

• Providing technical assistance, training, and support, and providing for travel expenses for health care providers and a range of health care entities that provide or will provide telehealth services.

• Disseminating information and research findings related to telehealth services.

• Promoting effective collaboration among Telehealth Resource Centers and the HRSA Office for the Advancement of Telehealth (OAT), as well as other OAT award recipients (such as Telehealth Centers of Excellence and technical assistance (TA) providers).

• Conducting evaluations to determine the best use of telehealth technologies to meet health care needs.

• Promoting the integration of the technologies used in clinical information systems with other telehealth technologies.

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

Step 1: Review the Opportunity 12 https://www.hrsa.gov/telehealth

• Fostering the use of telehealth technologies to provide health care information and education for consumers in a more effective manner.

• Implementing special projects or studies in collaboration with OAT.

In providing services, you must collaborate, if feasible, with entities that provide telehealth services or related activities and are:

• Private or public organizations that receive Federal or State assistance.

• Public or private entities that operate centers, or carry out programs, that receive Federal or State assistance.

A Telehealth Resource Center can charge a reasonable fee for continuing assistance in excess of 10 hours of technical help. The 10-hour limit is to make sure everyone has fair access to assistance, since the TRCs are publicly funded. Any fees received by TRCs must be used to supplement the HRSA award activities and must be reported to HRSA. The report submission must include the hours and level of effort related to those fees and must be explained in progress and financial reports. Further information will be provided in the award notice.

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

• Participating in conference calls or meetings with recipients.

• Supporting effective collaboration among National and Regional TRCs.

• Identifying special projects or studies.

• Involvement and assistance with TRC contacts to other HRSA programs or other federal agencies involved with telehealth, relevant to the function of TRCs.

• Participating and planning as it relates to the strategic direction of the services provided by award recipients.

• Ongoing review of activities and suggestions on content, presentation approach, and selection of products or publications.

• Reviewing or commenting on products or publications.

• Providing input and background on current and future issues.

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

Step 1: Review the Opportunity 13

• Adhering to HRSA guidelines pertaining to acknowledgement and disclaimer on all products produced by HRSA award funds, per Section 5.1 of the Application Guide.

• Completing activities you’ve proposed and had reviewed by HRSA, except as modified in consultation with us through the appropriate prior approval processes.

• Maintaining knowledge of federal programs through HRSA, HHS, and other sources that can help link award recipients and stakeholders with appropriate resources and programs.

• Participating in conference calls or meetings with HRSA.

• Collaborating with HRSA in ongoing review of activities and budgets.

• Responding timely to requests for technical assistance to advance telehealth networks or programs.

• Providing most technical assistance at no charge.

• Coordinating with other TRC award recipients to avoid duplication of effort and provide a unified approach to advancing telehealth activity.

• Assessing the market to understand how to best identify and reach target audiences.

• Identifying appropriate professional meetings at which to exhibit each year.

• Participating in evaluation activities such as establishing evaluation metrics or tracking related data to assist in measuring the success of the cooperative agreement in advancing telehealth.

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.

• 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 may:

◦ Fund more applicants from the rank order list.

◦ Extend the period of performance.

◦ Award supplemental funding.

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

Step 1: Review the Opportunity 14 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf

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 2025, the salary rate limitation is $225,700. This limitation may be updated.

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

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

• To acquire real property.

• For expenditures to purchase or lease equipment, to the extent that the expenditures would exceed 20 percent of the total grant funds.

• To pay for any equipment or transmission costs not directly related to the purposes for which the grant is awarded.

• To purchase or install general purpose voice telephone systems.

• For construction.

• For expenditures for indirect costs, to the extent that the expenditures would exceed 15 percent of the total grant funds.

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

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. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 15 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=19 https://www.ecfr.gov/current/title-45/part-75/subject-group-ECFR5d90ba314caea08 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.hrsa.gov/grants/manage-your-grant https://www.hrsa.gov/grants/manage-your-grant 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 17

Find the application package 17

Application writing help 17

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’ll 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-25-042 or

HRSA-25-043.

After you go to 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. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 2: Get Ready to Apply 17 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 insert month insert date, 20[##], at insert time ET.

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

• Phone number: [number]

• Meeting ID: [ID].

• Passcode: [passcode]

We will record the webinar. If you are not able to join live, you can replay it at <insert replay link using a clear descriptive label>.

Have questions? See Contacts and Support.

Step 2: Get Ready to Apply 18

Step 3:

Prepare Your Application

In this step

Application contents and format 20

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

Application page limit: 60 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. Include a short description of your proposed project. Include the needs you plan to address, the proposed services, and the population groups you plan to serve. State whether or not you qualify for a funding preference described in Step 4 of this NOFO. If you do qualify for a funding preference, state which qualification you meet.

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.

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

Step 3: Prepare Your Application 20

Introduction

Regional TRC: See merit review criterion 1: Need (HRSA-25-042)

National TRC: See merit review criterion 1: Need (HRSA-25-043)

Applicants to both the Regional TRC and the National TRC should:

• Briefly describe the purpose of your project.

• Clearly report how you propose to establish or operate a telehealth resource center that provides technical assistance to existing or developing healthcare organizations, networks, and providers.

• If you are proposing a consortium, explain why a consortium is necessary.

Regional TRC (HRSA-25-042) applicants should also:

• Identify the region and states to be served. Briefly describe the demand for technical assistance and provide a summary of the services proposed.

National TRC (HRSA-25-043) applicants should also:

• Clearly demonstrate what expertise you possess and how you will support

Regional TRCs or other organizations by providing technical assistance in telehealth technology or policy issues.

Need

Regional TRC: See merit review criterion 1: Need (HRSA-25-042)

National TRC: See merit review criterion 1: Need (HRSA-25-043)

This section should help your reviewers understand the needs of the population groups/states that could be addressed through enhanced telehealth services in rural areas, frontier communities, and medically underserved areas, and for medically underserved populations. It should help reviewers understand the need for telehealth technical assistance to be addressed.

Applicants to both the Regional TRC and the National TRC should:

• Use and cite demographic data whenever possible to support the information provided.

◦ Describe and document the target population and their unmet health needs.

Include populations that suffer from poor health outcomes, health disparities, and other inequities as compared to the national average when

Step 3: Prepare Your Application 21 addressing telehealth technical assistance. Examples of these populations include, but are not limited to, people experiencing homelessness, pregnant people, disabled individuals, youth and adolescents, persons experiencing hypertension, and tribes and tribal organizations.

• Include information about other technical assistance services that may be available and how such services could be used or integrated, and not duplicated to advance telehealth.

Regional TRC (HRSA-25-042) applicants should also:

Clearly address how the Regional TRC will demonstrate how telehealth technologies could be used to:

• Meet the health care needs of rural or other populations to be served through the project, and improve the access to services of, and the quality of the services received by, those populations.

• Improve and expand the training of health care providers.

• Address the actual and potential relevant barriers that telehealth projects face in the region (for example, specific legislative or regulatory issues, specific reimbursement challenges, technical infrastructure challenges, sociocultural challenges, barriers to access, and organizational challenges).

National TRC (HRSA-25-043) applicants should also:

• Outline critical telehealth policy or technology barriers that exist and identify the demand for technical assistance as it relates to the respective telehealth policy or technology areas.

Approach

Regional TRC: See merit review criterion 2: Response (HRSA-25-042)

National TRC: See merit review criterion 2: Response (HRSA-25-043)

Applicants to both the Regional TRC and the National TRC should:

• Describe your plan to provide technical assistance to healthcare organizations, networks, and providers with telehealth implementation and training for rural areas, frontier communities, and medically underserved areas, as well as for medically underserved populations including how you will address the breadth of requests for services.

• Identify the mechanisms by which you will identify organizations in need of assistance.

Step 3: Prepare Your Application 22

• Identify the method of initial contact from communities and clients, (such as through the website, a toll-free number, or contact at a meeting or conference).

• Describe how you will clearly track the outcome of the technical assistance (for example, a new site or service was established).

• Tell us how you’ll address your stated needs and meet the program requirements and expectations described in this NOFO.

• Include strategies for ongoing staff training, teamwork, and information sharing.

• 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.

• Describe how you will coordinate with the State Office of Rural Health or other appropriate state entity.

• 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.

• Include a strategy to share information. Lessons learned and best practices should be included. Clearly indicate how you have and will collaborate and share expertise with new or existing providers of telehealth services at the national, regional, state and local levels. You should discuss your plan for the following core services:

◦ Providing technical assistance, training, and support, and providing for travel expenses for health care providers and a range of health care entities that provide or will provide telehealth services.

◦ Disseminating information and research findings related to telehealth services.

◦ Promoting effective collaboration among telehealth resource centers and the HRSA Office for the Advancement of Telehealth (OAT), as well as other HRSA award recipients such as Telehealth Centers of Excellence and TA providers.

◦ Conducting evaluations to determine the best use of telehealth technologies to meet health care needs.

◦ Promoting the integration of the technologies used in clinical information systems with other telehealth technologies.

◦ Fostering the use of telehealth technologies to provide health care information and education for consumers in a more effective manner.

◦ Implementing special projects or studies under the direction of HRSA.

Step 3: Prepare Your Application 23

Delivery modes for sharing expertise You must identify the means by which clients will contact your organization for technical assistance and the ways in which you will share expertise. Examples of potential delivery modes include:

• One-to-one: One or more telehealth resource center staff members interact directly with an individual or a group of individuals representing a single organization.

• Peer-to-peer: Arranging for an entity with a particular expertise to provide assistance to another organization or individual that requested technical assistance from the telehealth resource center.

• One-to-many: One or more telehealth resource center staff members interacting directly and simultaneously with a group of entities made up of people who represent different organizations or organizational units.

• Broad public: In cooperation with all telehealth resource centers, each center should also provide public programs and webinars, recorded and posted for later viewing (for example, on a public-facing website).

For each service you propose to provide, you must clearly specify the ways you plan to deliver the service and how you will track the volume of services provided, the products or output of the service, and, where appropriate, the outcome of the service.

Outreach tools Describe the specific tools you have or will develop to share expertise (like webinars, toolkits, workshops, focus groups, and conferences) as well as tools developed for industry adoption and sale. Lists of clients may be included (with benefits gained from tools, especially if benefits take a year or more to develop after the service was delivered).

• Include a plan for sustaining the project after federal support for the project has ended. Such plans could include affiliation with a health care program, association, or company related to telehealth, or solicitation of other funding sources like private donations or non-federal awards.

• Refer to the types of services or products you will use to help a provider or a community with its strategic development or expansion of a telehealth program.

The proposed services should be clearly linked to identified needs and must be consistent with the resources available.

• Detail the delivery modes to be used for your service (like one-to-one, peer-to-peer, one-to-many, broad public) and the outreach tools you will use.

Step 3: Prepare Your Application 24

• Explain, if you lack expertise in an area of need, how collaboration with other organizations (especially other Regional TRCs and National TRCs) might address those areas.

• Address how you may coordinate with, or avoid duplicating services from, other public resources that advance the practice of telehealth.

Regional TRC HRSA-25-042 applicants should also:

Address how you will collaborate with other HRSA-funded Regional and National Telehealth Resource Centers to leverage each other’s expertise to provide telehealth technical assistance as efficiently as possible across the nation.

Regional TRCs have historically provided technical assistance to:

• Develop organizational capacity to build telehealth networks.

• Develop and implement telehealth programs including workflow operations and development, business models, return on investment (ROI), best practices, strategic planning, provider coordination, and working with communities to establish telehealth services.

• Expand the range of clinical services using telehealth beyond ambulatory care, including critical and emergency care, inpatient, nursing home, residential and home care, and chronic disease management.

• Integrate telehealth and health information systems.

• Support distance education and training, including creation or operation of technology-enabled collaborative learning and capacity models.

• Understand or select telecommunications and telehealth technologies.

• Use mobile devices, or mHealth.

• Share resources and information related to telehealth regulation, policy, licensure, credentialing or reimbursement.

• Evaluate telehealth programs and information collection.

• Maintain a public access map or registry of telehealth providers through contact or self-reporting of telehealth networks or providers.

• Focus on HRSA priorities while addressing technical assistance and training, including but not limited to these priority areas:

◦ Maternal health

◦ Hypertension

◦ Heart disease

◦ Cancer

◦ COVID-19

Step 3: Prepare Your Application 25

National TRC HRSA-25-043 applicants should also:

• Address how you plan to track your activities and effectively provide technical assistance across the nation to address a myriad of policy or technology challenges.

• Explain how you will support the Regional TRCs.

• Examples of areas in which National TRCs could provide information and expertise include the following.

For Policy TRC:

• Telehealth reimbursement policy.

• State and national rules and issues pertaining to licensing, credentialing, and privileging of telehealth providers.

• Regulatory issues including tele-prescribing.

• Telecommunications and broadband policies and funding.

• Policies pertaining to telehealth and the Health Insurance Portability and Accountability Act (HIPAA).

• Regulatory issues pertaining to remote patient monitoring or direct-to-consumer telehealth.

• Regulatory issues concerning mobile health (mHealth).

• Telehealth service delivery standards and guidelines.

For Technology TRC:

• Telehealth system technology planning, selection, evaluating, operating, maintaining, or upgrading.

• Telecommunications and broadband technology and issues (terrestrial and wireless) relevant to telehealth.

• Technical issues of hardware interfacing or integration.

• Technical issues of system interfacing or integration, such as telehealth and health information, billing, scheduling, or administrative systems.

• Technology for remote patient monitoring.

• General technology problem-solving or referral (the TRC should not plan to perform technology troubleshooting, however).

• Cybersecurity issues relevant to telehealth.

• Technology alerts for telehealth equipment.

• Telehealth technology standards and guidelines.

Step 3: Prepare Your Application 26

Additional policy or technology areas you plan to address should be detailed and if topics above will not be addressed, explain why you are not addressing the sample topics.

High-level work plan

Regional TRC: See merit review criteria 2: Response (HRSA-25-042) and 4: Impact

(HRSA-25-042)

National TRC: See merit review criteria 2: Response (HRSA-25-043) and 4: Impact

(HRSA-25-043)

Applicants to both the Regional TRC and the National TRC should:

• Describe how you’ll achieve each of the objectives during the period of performance.

• Provide a timeline that includes each activity and identifies who is responsible for each. As needed, identify how key stakeholders will help plan, design, and carry out all activities, including the application.

• Describe, in detail, the technical assistance services you will provide, to whom you intend to provide them, and the available tools and resources to be used in providing those services. This should include the core services listed under Approach.

• Clearly address how you will assess the demand for your services and track changes in this demand over time.

• Present an implementation schedule that identifies major project tasks and milestones, as well as impact.

• Demonstrate the ability to start implementing upon receipt of award.

• Describe in detail the technical approach employed in the project and how you will stay organized and work together.

• Explain how you will track use of your services, including the number of programs or providers that use specific TRC services and the outcomes of those services (additional telehealth sites or services, expansion or clarification of reimbursement or licensing issues, resolution of technology issues, or other evidence of advancing the state of telehealth and documenting how the TRC was involved).

• Describe the expertise, resources, and services currently available to meet the project’s objectives of providing technical assistance on a wide range of telehealth issues.

Step 3: Prepare Your Application 27

• Demonstrate plans and capability for sharing best practices and lessons learned from successes and failures.

• Include goals in the work plan for the entire proposed three-year period of performance.

• Plan to comply with Section 508 of the Rehabilitation Act of 1973, as amended.

• Include your detailed work plan in Attachment 1.

Regional TRC HRSA-25-042 applicants should also:

• Describe current experience, skills, and knowledge, including those of individuals on staff, in providing technical assistance to health care providers and entities, evaluation, telehealth policy activities in your region and state, educational outreach and information dissemination, and other relevant experience. Describe specific strengths that make you uniquely qualified to work with the regions or states identified in the application. You are encouraged to reference materials published and previous work of a similar nature.

• Demonstrate the experience necessary to provide an understanding of technological, clinical, educational, and administrative aspects of relevant telehealth services. You must provide specific strategies for sharing lessons learned and collaborating with providers of telehealth services. Demonstrated ability to solve difficult challenges at the health care provider or network level for both start-up and advanced programs should be detailed.

National TRC HRSA-25-043 applicants should also:

• Describe current experience, skills, and knowledge, including those of individuals on staff, in providing assistance to health care providers or others on telehealth policy or technology and other relevant experience. You are encouraged to reference materials published and previous work of a similar nature.

• Demonstrate the experience necessary to provide an understanding of policy or technological aspects of relevant telehealth services.

• Provide specific strategies for sharing lessons learned and collaborating with Regional TRCs or telehealth programs.

• Include processes for improving telehealth access among identified vulnerable populations. You are encouraged to use the methods outlined in the National Culturally and Linguistically Appropriate Services Standards.

• Develop a common resource that can allow interested parties to draw on the collective information of Regional TRCs or direct inquiries to region or state-specific information. National TRCs focused on policy are also encouraged to maintain a calendar of telehealth training and events offered by all Telehealth Resource Centers in the program.

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

Step 3: Prepare Your Application 28 https://thinkculturalhealth.hhs.gov/clas https://thinkculturalhealth.hhs.gov/clas

Resolving challenges

For Regional TRC: See merit review criterion 2: Response (HRSA-25-042)

For National TRC: See merit review criterion 2: Response (HRSA-25-043)

Applicants to both the Regional TRC and the National TRC should:

• Discuss possible challenges you may face in designing and carrying out the activities in the work plan. Explain how you’ll resolve them.

Performance reporting and evaluation

For Regional TRC: See merit review criteria 3: Performance reporting and evaluation and 5: Resources and capabilities

For National TRC: See merit review criteria 3: Performance reporting and evaluation and 5: Resources and capabilities

Applicants to both the Regional TRC and the National TRC should:

• Evaluate the effectiveness of award fund use for project activities.

• You must conduct a self-assessment at the end of each project year as part of your annual progress report.

• The self-assessment will provide information to identify your project’s strengths and areas for improvement.

• Specifically, the self-assessment should include, but is not limited to, the following elements:

◦ Outcomes-focused: Ensure that the goals and objectives of the project are assessed.

◦ Data collection: Illustrate accuracy and consistency of data collected, producing results that are as objective as possible. Ensure that data collection methods are feasible for the project and data are collected in a timely manner. Explain how data will be used to help inform quality improvement strategies and future efforts.

◦ Sustainability: Identify progress on strategies that could lead to viability and sustainability after federal funding ends.

◦ Quality improvement: Identify areas of improvement in your work plan based on the findings of the assessment.

• Describe how you will address the following in your self-assessment:

Step 3: Prepare Your Application 29

◦ Provide baseline numbers (qualitative/quantitative) for your activities and performance measures.

◦ Describe how you will monitor TA throughout the period of performance and, when necessary, make changes to improve quality and customer service.

◦ Describe the expected outcomes (desired results) of the funded activities.

◦ Describe how you will collect and report required performance data accurately and on time.

◦ Describe how you will manage and securely store data.

◦ Describe how you will monitor and analyze performance data to support continuous quality improvement.

See Reporting for more information.

Organizational information

For Regional TRC: See merit review criterion 5: Resources and capabilities

For National TRC: See merit review criterion 5: Resources and capabilities

Applicants to both the Regional TRC and the National TRC should:

• Briefly describe your mission, structure, and the scope of your current activities.

Explain how they support your ability to carry out the program requirements.

You’ll include a project organizational chart in your attachments.

• Describe how these contribute to your ability to be a Telehealth Resource Center.

• Provide evidence of institutional commitment of the entity to the project.

• Clearly describe the extent to which you will involve representatives from the provider communities or populations in both the design and operation of the TRC.

• Discuss how you’ll follow the approved plan, keep track of all federal funds, and record all costs to avoid audit findings.

• Describe how you’ll assess the unique needs of the people who live in the areas you serve.

• Describe your organizational profile, budget, partners, key processes, and your key staff’s experience, skills, and knowledge.

• If your parent organization also provides telehealth services, explain how you will ensure that you can provide technical assistance impartially and independently.

• Provide information that demonstrates your ability and experience managing multiple projects, while addressing the details necessary for projects to run

Step 3: Prepare Your Application 30 smoothly. Given the spectrum and scope of work required, extensive organizational skills are considered an essential characteristic for a TRC. You must demonstrate your ability to track all technical assistance requests and document outcomes resulting from services provided.

Consortiums

If you are applying as part of a consortium, you must also provide information about how the various components will function, with the roles and responsibilities of all components specifically addressed in the application.

Consortium applicants must clearly demonstrate an ability to collaborate and be able to develop strong working relationships. You must also have standard protocols throughout the consortia or network for receiving, tracking, data collection, and follow-up for all technical assistance requests.

Clearly describe your partnerships as an ongoing and integral part of project planning and operation, as appropriate. (A list of partners should be included in Attachment 8).

You are responsible for all fiscal, administrative, and programmatic aspects of the application and award.

Budget and budget narrative

For Regional TRC: See merit review criterion 6: Support Requested

For national TRC: See merit review criterion 6: Support Requested

The following applies to applicants to both the Regional TRC and the National TRC:

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.

HHS now uses the definitions for equipment and supply 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).

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 costs you request. The merit review committee reviews both.

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

Step 3: Prepare Your Application 31 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=13 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Equipment) https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200#p-200.1(Supply)

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.

In addition, we require the following:

• Travel: Your travel budget should include funds for a maximum of two staff members to attend two annual recipient meetings in the Washington, DC area.

• Information on the source and amount of non-Federal funds that the entity will provide for the project.

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

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

Clearly label each attachment.

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

Attachment 2: Staffing plan and job descriptions See Section 3.1.7 of the Application Guide.

Include a 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.

For key personnel, attach a one-page job description. It must include the role, responsibilities, and qualifications.

Attachment 3: Biographical sketches Include biographical sketches for people who…