hrsa-26-050_final.pdf

Notice of Funding Opportunity

Application due 07/08/2026

Federal Office of Rural Health Policy

Policy Research Division

Rapid Response Rural Data

Analysis and Issue Specific Rural

Research Studies

Opportunity number: HRSA-26-050

Contents

Before you begin 3

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 6

Program description 8

Award information 11

Step 2: Get Ready to Apply 14

Get registered 15

Find the application package 15

Application writing help 16

Step 3: Build Your Application 17

Application checklist 18

Application contents and format 20

Step 4: Understand Review, Selection, and Award 36

Application review 37

Selection Process 43

Award notices 43

Step 5: Submit Your Application 44

Application submission and deadlines 45

Other submissions 46

Step 6: Learn What Happens After Award 47

Post-award requirements and administration 48

Reporting 51

Contacts and Support 52

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 07/08/2026.

All activities proposed in your application and budget narrative must align with applicable law, including but not limited to statutes, executive orders, federal regulations and applicable judicial holdings. Accordingly, discretionary awards shall not be used to fund, promote, encourage, subsidize, or facilitate: racial preferences or other forms of racial discrimination by the recipient, including activities where race or intentional proxies for race will be used as a selection criterion for employment or program participation; denial by the recipient of the sex binary in humans, or the belief that sex is a chosen or mutable characteristic; illegal immigration; or any other initiatives that compromise public safety. If an application does not align, the application will not receive funding to the extent permitted by law and applicable court orders.

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.

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

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 6

Program description 8

Award information 11

Basic information Health Resources Services Administration

Federal Office of Rural Health Policy

Policy Research Division

A notice of funding opportunity from the Federal Office of Rural

Health Policy to support rapid rural health research to improve rural health care under the Rapid Response Rural Data Analysis and Issue

Specific Rural Research Studies Program.

Summary This notice announces the opportunity to apply for funding under the Rapid Response

Rural Data Analysis and Issue Specific Rural Research Studies Program. This program provides rural stakeholders with timely access to data analysis on pressing rural health issues. The goal of this award is to fund analysis that furthers understanding on emerging factors affecting rural health to improve health care in rural America.

Funding details Application Types: Competing continuation, New

Expected total available funding in FY26: $600,000

Expected total number and type of awards: 1 CA (Cooperative Agreement)

Funding range per award: Up to $600,000 per award.

We plan to fund awards in five 12-month budget periods for a total 5 -year period of performance from 07/01/2026 to 06/30/2031.

Have questions?

Go to Contacts and

Support.

Key facts name:

Rapid Response Rural Data

Analysis and Issue Specific

Rural Research Studies number:

HRSA-26-050

version:

Initial

93.155

Key dates

06/05/2026 deadline:

07/08/2026

06/01/2026

07/01/2026

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

Eligibility

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

Types of eligible organizations

These types of domestic* organizations may apply:

• State governments.

• County governments.

• City or township governments.

• Special district governments.

• Independent school districts.

• Public and State controlled institutions of higher education.

• Native American tribal governments (federally recognized).

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

• Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education.

• Nonprofits without 501(c)(3) status with the IRS, other than institutions of higher education.

• Private institutions of higher education.

• For profit organizations other than small businesses.

• Small businesses.

• Faith-based organizations.

• Others (see text field entitled “Additional Information on Eligibility” for clarification).

Additional information on eligibility Only domestic* organizations are eligible.

*“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.

Completeness and responsive 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.

• Is not responsive to the purpose of the program or requirements for attachments.

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. Recipients agree that once committed, cost sharing amounts are enforceable and subject to reporting and auditing requirements under 2 CFR 200.

Post-award requirements

Before you apply, make sure you understand the requirements that come with an award.

See Step 6: Learn What Happens After Award for information on regulations that apply, reporting, and more.

Program description

Purpose Health care providers and decision makers often need quick, reliable data and analysis to support their operations and efforts to improve health care in rural areas. However, rural providers and stakeholders often lack the staff, technology, or resources to collect and analyze it themselves. Data needed for this purpose come from entities including, but not limited to, the Centers for Medicare and Medicaid Services (CMS), other federal and state agencies, and private organizations.

The recipient, in cooperation with the Department of Health and Human Services

(HHS), should identify, compile, and analyze data to inform the improvement of health care in rural areas nationwide.

Findings from these analyses will help rural health care stakeholders, including rural health care providers, states, professional associations, State Offices of Rural Health

(SORHs), State Rural Health Associations (SRHAs), and others at the federal, state, and local levels.

Goal To produce short term rural health services research and provide rural stakeholders with timely access to data analysis on pressing rural health issues.

Background The Health Resources and Services Administration’s (HRSA’s) Federal Office of Rural

Health Policy is the main office for rural health activities within the Department of

Health and Human Services (HHS).

By law, FORHP advises the Secretary of HHS on how Medicare and Medicaid policies affect:

• The financial health of small rural hospitals.

• The ability of rural areas to attract and keep health care professionals.

• Access to and quality of rural health care.

More information on FORHP.

http://www.hrsa.gov/ruralhealth/index.html

Rapid response data analysis Quick data analysis helps meet immediate needs of the public to assess the impact of the continuously evolving health policy landscape on rural health care providers. It also helps rural stakeholders identify trends and address problems in financing and access to care. These quick analyses often require resources that most rural providers are not able to access.

Examples of past rapid response data analyses resulting in public-facing tools and resources include:

• Calculating annual costs and revenues reported by Rural Health Clinics (RHCs), Critical Access Hospitals (CAHs), and other rural hospitals.

• Comparing the number of CAH swing bed admissions with acute care admissions.

• Mapping travel routes and distances between rural hospitals nationwide.

• Tracking rural hospital closures, openings, and mergers from 2005 to 2020.

Issue specific research studies Some rural health care policy topics require short-term research and analysis of emerging policy issues. This work is more elaborate and usually takes three to six months, using more resources than quicker rapid response work.

Examples of more in depth, issue-specific research studies have included:

• 2019 Wage Index Differences and Selected Characteristics of Rural and

Urban Hospitals.

• Characteristics of Communities Served by Rural Hospitals Predicted to be at High

Risk of Financial Distress in 2019.

• More examples are available on the Rural Health Research Gateway.

Rapid Response Rural Data Analysis and Issue Specific Rural Research Studies helps advance the Making America Healthy Again (MAHA) priorities, which include:

• Preventive health.

• Reducing chronic disease.

• Mental health.

• Nutrition.

• Primary and value-based care.

• Culturally appropriate services for tribes.

• Early childhood health and autism support.

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.hhs.gov%2Fmaha%2Findex.html&data=05%7C02%7CKTyner%40hrsa.gov%7Cc87e02981af24d8a2c8f08de544767b2%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C639040862814271854%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=t1VfDhf5KlsQYp7VDwbF2bxKMa%2Fki%2F9WqTDirpfg%2Fxw%3D&reserved=0

Program requirements and expectations Expectations of this program include:

• Staffing a rapid response data analysis team.

• Producing quick turnaround data analysis (e.g., within one to two business days) on a regular and recurring basis (e.g., every month) in response to emerging issues in rural health care and health policy.

• Responding regularly to requests for technical assistance.

• Designing and completing short term (e.g., three to six month) issue-specific rural health services research studies.

Activities should advance one or more of the MAHA priorities. Strategies to consider include work that informs:

• Addressing root causes of poor health.

• Improving access to primary care, behavioral health, preventive care, or developmental services.

• Expanding nutrition programs or chronic disease prevention.

• Supporting early childhood development or autism services.

• Preparing systems for value-based care.

• Partnering with tribal health systems.

Disclosure of participation in or benefit from CMS Rural Transformation Program You must disclose whether you participate in or benefit from your state’s CMS Rural

Transformation Program. If you do, you must coordinate any HRSA-funded work to ensure it is non-duplicative, coordinated, and complementary.

Statutory authority 42 U.S.C. § 912(b)(5) (§ 711(b)(5) of the Social Security Act.)

Award information

Cooperative agreement terms

Our responsibilities

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

• Consulting in the planning and development of the annual work plan and final selection of projects and rapid data analyses.

• Reviewing and commenting on project design and methodology in work plan proposals.

• Reviewing and commenting on products produced under this cooperative agreement, including the methodology, analysis, results, policy implications, format, and tone prior to public dissemination.

• Collaborating with rural stakeholders and the award recipient to provide guidance and assistance in identifying key organizations through which to share information and research findings developed through this cooperative agreement.

• Providing technical assistance to the recipient on processes for identifying rural stakeholders who would benefit from the services and resources supported under this cooperative agreement.

• Facilitating the use of HRSA and FORHP-supported communications resources as needed to support the cooperative agreement.

• Consulting in the planning and implementation of any meetings, webinars, or work groups conducted by the award recipient during the period of performance.

Your responsibilities

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

• Adhering to HRSA guidelines pertaining to acknowledgement and disclaimer on all products produced by HRSA award funds.

• Adhering to Section 508 of the Rehabilitation Act of 1973, as amended.

• Developing products that aim to produce new information in alignment with

FORHP’s charge under 42 U.S.C. § 912 (§ 711 of the Social Security Act).

• Participating in the planning and development of the recipient’s annual short term, issue specific research studies and rapid response data analysis projects.

• Responding to HRSA requests, comments, and questions within a timely manner.

• Utilizing HRSA and FORHP-supported communications resources as needed to support the cooperative agreement.

• Sharing data analysis and short term, issue-specific research briefs for HRSA review by work plan guidelines.

• Providing stakeholders and the public with data analysis regarding rural health services.

• Distributing research findings as to inform the improvement of health care in rural areas including, but not limited to, national, state, and local policymakers, state-based entities, and/or individual rural health care providers.

• Identifying rural policy issues to study in a short-term timeframe (e.g., three to six months).

• Attending HRSA rural health research meetings as applicable.

• Submitting reports, projects, or other work products to FORHP in a timely manner.

Funding policies and limitations

Changes in HHS regulations

As of October 1, 2025, HHS has adopted 2 CFR Part 200, with some modifications included in 2 CFR Part 300. These regulations replace those in 45 CFR Part 75.

Policies

• To make an award, funding must be available and allocated for this program and purpose, at which point we will move forward with the review and award process.

• Have clear policies and good financial practices to avoid spending HRSA funds on unallowable activities. Like other award rules, we may audit your policies, procedures, and controls.

• Support beyond the first budget year will depend on:

◦ Appropriation of funds.

◦ Your 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.

https://www.ecfr.gov/current/title-2/part-200

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 R&R Application Guide [PDF].

◦ You can also see 2 CFR Part 200 Subpart E - General Provisions for Selected

Items of Cost.

◦ Allowable and Unallowable Cost and Activities in the HHS Grants Policy

Statement.

• All cost must be reasonable, necessary, allocable to the award, and adequately documented (2 CFR 200.403).

• You cannot earn profit from the federal award. See 2 CFR § 200.400(g).

• Current appropriations law includes a salary limit of $228,000 as of January 2026 that applies to this program. You may pay salaries at a higher rate if the rate beyond the salary rate limit (Executive Level II) is paid with non-HHS funds. For help calculating salaries under this limit, read more at “salary rate limitation” in the R&R Application Guide [PDF].

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 at time of award.

Method 2 – De minimis rate. Per 2 CFR 200.414 (f), if you do not have a current 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 up to15% of modified total direct costs (MTDC). See 2 CFR 200.1 for the definition of MTDC. You can use this rate indefinitely for all your federal awards or until you choose to receive a negotiated rate.

Consider your indirect costs when developing your budget.

Program income

Program income is money earned as a result of your award-supported project activities. You must use those funds to add to approved project activities. Find more about program income at 2 CFR 200.307.

https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D15 https://www.ecfr.gov/current/title-2/part-200/subject-group-ECFRed1f39f9b3d4e72 https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRea20080eff2ea53/section-200.404 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRea20080eff2ea53/section-200.405 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRea20080eff2ea53/section-200.403 https://www.ecfr.gov/current/title-2/part-200#p-200.400(g) https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D15 https://www.ecfr.gov/current/title-2/section-200.414 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Modified%20Total%20Direct%20Cost%20(MTDC)) https://www.ecfr.gov/current/title-2/section-200.307

Step 2:

Get Ready to Apply

Get registered 15

Find the application package 15

Application writing help 16

Get registered

SAM.gov You must have an active account with SAM.gov to apply. 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 for the information you will need to register.

• You must agree to the financial assistance general certifications and representations specifically. Those for contracts are different.

When you register, you will also receive your required Unique Entity Identifier (UEI).

Once you register:

• You will have to maintain your registration throughout the life of any award.

• If your organization has multiple UEIs, use the one associated with your physical location.

If you need additional information about user roles in SAM.gov, see “Get registered:

SAM.gov user roles” in the R&R Application Guide [PDF].

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 and

How to Apply for Grants.

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-26-050.

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

https://sam.gov/content/entity-registration https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D4 https://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants https://www.grants.gov/applicants/grant-applications/how-to-apply-for-grants https://www.grants.gov/search-grants

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.

Join the webinar

Webinar information will be posted to the Related Documents tab on Grants.gov. We recommend you

“Subscribe” to the NOFO on Grants.gov to receive updates when documents are posted.

Have questions? Go to Contacts and Support.

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

Step 3:

Build Your Application

Application checklist 18

Application contents and format 20

Application checklist There are two types of forms in Grants.gov.

• Some forms allow you to upload components of your application to the form.

These include components like your project narrative, budget and budget narrative, and attachments, as applicable.

• Other forms are more typical, fill-in-the-blank forms.

Make sure that you have everything you need to apply.

Narratives See the instructions for the project narrative and the budget and budget narrative.

A S

Form Included in page limit*?

Research & Related Other Project Information Yes

Research & Related Budget Yes ttachments ee instructions for attachments.

Form Included in page limit*?

1. Work plan Yes

2. Staffing plan and job descriptions Yes

3. Agreements with other entities Yes

4. Project organizational chart Yes

5. Disclosure of participation in or benefit from CMS Rural

Transformation Program (if applicable) No

6.–15. Other relevant documents Yes

Other required forms See form instructions.

Form Included in page limit*?

SF-424 (R&R) No

Project Abstract Summary form No

R&R Subaward Budget Attachment(s) Yes*

Research & Related Senior/Key Person Profile form No

Project/Performance Site Location(s) No

Disclosure of Lobbying Activities (SF-LLL) No

* Unless otherwise indicated, only what you attach to a form counts toward the page limit. The form itself does not count.

Application contents and format This section includes guidance on each component found in the application checklist.

Application page limit: 80

Submit your information in English and express whole number budget figures using

U.S. dollars.

Required format Required format for project summary, project narrative, budget narrative, and attachments

Font: A readable font like Arial, Courier, CG Times, or Times New Roman.

File format: We only accept the following document formats:

• .PDF - Adobe Portable Document Format

• .DOC/.DOCX - Microsoft Word

• .RTF - Rich Text Format

• .TXT - Text

• .WPD - Word Perfect Document

• .XLS/.XLSX - Microsoft Excel

• .VSD - Microsoft Visio

Size: 12-point font.

Footnotes, charts, graphics, and budget tables may be 10-point or higher.

Ink color: Black.

Spacing: Single-spaced, including all text and tables.

Alignment: Left.

Headings: Bold all headings and align left.

Size: 8.5 x 11 (Make sure the print area is set and allows printing to 8.5 x 11.).

Margins: 1-inch on all sides.

Footer: On each page as the footer, include your organization’s name and page numbers. If a competing continuation or competing supplement, also include your

10-digit award number.

Page numbering:

• Do not number the standard OMB-approved forms.

• Number each attachment page sequentially (that is, 1, 2, 3).

• Reset the numbering for each attachment.

• Treat each attachment as a separate section.

File names: You can find guidance for naming our files in the R&R Application Guide

[PDF].

Project narrative Use the Research & Related Other Project Information form to attach the project narrative. In the project narrative, you will describe all aspects of your project.

Use the section headers and the order as listed.

Introduction

See merit review criterion 1: Need

Provide a brief overview of your proposed project. Ensure that the purpose is aligned with the purpose of the program to identify, compile, and analyze data to inform the improvement of health care in rural areas nationwide. Indicate how your project would improve health care in rural areas. Describe how your activities will advance one or more MAHA priorities. Explain how your activities build from, but do not duplicate, other federal, state, tribal, or local programs.

Need

See merit review criterion 1: Need

Your application should show that you understand:

• The unique characteristics of rural communities and the health care and health policy issues affecting rural communities nationwide.

• The need to conduct rapid data analyses and short-term research studies focused on rural health care.

• How these studies will examine the current and emerging regulatory and policy landscape, addressing key gaps in existing knowledge, so that information developed under this award can inform the improvement of health care in rural America.

https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D36 https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D36

Approach

See merit review criterion 2: Response

Explain how you will conduct rapid data analyses and conduct short-term issue-specific rural health research. Your proposed methodology must reflect the current and evolving rural health and policy environment. For all proposed analyses and studies, indicate how you will assess what is rural (i.e., rurality).

Rapid response data analyses

Describe in detail how you will conduct rapid data analyses in a timely manner (for example, within 1 to 2 business days) on a regular and recurring basis (for example, every month). This strategy may include how you will:

• Develop and maintain a repository of rural health and policy relevant datasets that are current, cleaned, and geocoded.

• Provide a way for the public to analyze and interpret data on time-sensitive rural health policy issues to understand the impact of current and emerging policies and to improve health care in rural areas.

• Develop a process to identify and review each potential topic for analysis, decide if the analysis is feasible, and identify the public benefit.

• Share analysis results with the public in a timely manner.

• Respond to technical assistance requests to help rural stakeholders use research and analysis products from this cooperative agreement.

Issue specific research studies

You should propose no more than two short-term, issue-specific research studies for the first budget year, describing how each study will:

• Occur in a short-term timeframe so it is responsive to the evolving health care landscape (e.g., 3 to 6 months).

• Produce documents such as policy briefs or reports to inform the improvement of health care in rural areas.

• Focus on topics that can help rural stakeholders understand how to improve health care in rural areas, including but not limited to rural hospital finances, health care professional recruitment and retention, and access to quality care.

• Avoid duplication of past or current projects from the Rural Health Research

Center Program and Flex Monitoring Team.

◦ Search the Rural Health Research Center Program and Flex Monitoring Team to confirm.

http://www.ruralhealthresearch.org/ http://www.ruralhealthresearch.org/ http://www.flexmonitoring.org/ http://www.ruralhealthresearch.org/ http://www.flexmonitoring.org/

◦ The Flex Monitoring Team evaluates the Rural Hospital Flexibility Program and analyzes Critical Access Hospital (CAH) quality and performance trends.

◦ For previous awardees: Do not repeat past work, but you may propose projects that build on or update it.

• Focus on issues of nationwide concern, meaning that results may inform the improvement of health care in rural areas across the country and not only in certain regions or localities.

◦ We may consider single state or regional studies with clearly demonstrated nationwide applicability.

Proposal format

Present two proposals for issue-specific research studies using the format outlined below. Limit each research proposal to a maximum of six pages. The proposals must be national in scope, as defined above.

You must avoid duplication with research that is already underway or recently completed by FORHP’s Rural Health Research Center Program. You may query the Rural

Health Research Gateway for help in identifying projects previously funded and currently underway. Projects must not duplicate or overlap with work conducted by the

Flex Monitoring Team, which evaluates the Rural Hospital Flexibility Program and also conducts larger analyses on Critical Access Hospital (CAH) trends specific to quality and performance improvement.

The recipient will consult with HRSA on the final work plan and consider priorities from

HRSA/HHS. This process may include additional input from HRSA on possible modifications, depending on emerging or pressing rural health care or other priorities to ensure funded research remains responsive to the purpose of the award.

We expect that you will complete all short-term, issue-specific research projects proposed for the first year promptly (e.g., within a three-to-six-month timeframe) during the first budget period.

Proposal summary

• Project title.

• Principal Investigator.

• Two-sentence project description.

http://www.flexmonitoring.org/ http://www.ruralhealthresearch.org/

Research proposal (maximum 6 pages per project)

• Project title.

• Statement of the problem and policy relevance:

◦ State the purpose, identify knowledge gaps, and explain policy relevance at national level.

◦ Describe potential benefits for rural communities.

◦ Explain how the proposed research will add to and enhance the current literature.

• Geographic coverage:

◦ Describe the geographic areas in the study.

◦ Describe how results apply nationally to inform the improvement of health care in rural areas.

◦ Include different levels of rurality, specifically rural versus urban analyses.

• Hypotheses, design, and analysis:

◦ State the hypothesis(es) or research questions for the research project.

◦ Describe the project design you will use to accomplish your aims (i.e., quantitative or mixed methods). All studies should have a quantitative component and should not have a primarily qualitative focus.

◦ Discuss anticipated limitations.

• Data Sources:

◦ List proposed data sources.

◦ Include information on data availability, acquisition cost, and a schedule for obtaining and preparing the data for analysis.

◦ If you plan to conduct primary data analysis, discuss your data collection plan.

▪ Include sampling methods, estimated sample size, expected response rate, and data collection schedule.

• Human subjects research:

State if human subjects are involved.

◦ If yes, note Institutional Review Board (IRB) status (pending, approved, exempt). Provide IRB approval date or exemption details, if applicable.

◦ Indicate yes even if the proposed project is exempt from Regulations for the

Protection of Human Subjects.

◦ Indicate no if no activities involving human subjects are planned, and skip to the Staff-Loading Chart, Section (g) of the Research Proposal.

◦ Include a Human Subject Assurance Number if available.

▪ Provide the IRB approval number or the approved Federal Wide

Assurance (FWA), Multiple Project Assurance (MPA), Single Project

Assurance (SPA) or Cooperative Project Assurance Number (CPA).

▪ If available, you’d have these on file with the Office of Human

Research Protections.

◦ If exempt from IRB approval, enter the exemption numbers and a short description corresponding to one or more of the exemption categories.

◦ If you have not yet been reviewed by IRB and you believe your research is exempt, justify clearly for a tentative approval by HRSA staff.

◦ Non-exempt research involving human subjects cannot be conducted under an HHS-sponsored award, unless your organization verifies the exemption.

▪ Documentation of completed IRB review and its exemption or approval must be sent to the Project Officer.

▪ This IRB certification must include: the grant number, the title of the project, name of the appropriate IRB which has reviewed and exempted or approved the proposed activity, name of the principal investigator/ program director, date of IRB exemption or approval, and appropriate signatures.

• Literature citations:

◦ Provide citations to published literature relevant to your proposal.

High-level work plan

See merit review criteria 2: Response and 4: Impact

In this section, describe the activities or steps you will take to complete the project.

Include the following:

• Explain your quality control processes:

◦ Describe how you will ensure the quality of written products.

◦ Include a plan for the Principal Investigator to review all draft reports.

• Explain how you will comply with Section 508 of the Rehabilitation Act of 1973, as amended.

• Provide a project management plan to keep each funded activity on track during the first 12 months that includes the following elements:

◦ A staff-loading chart identifying project leaders and other senior staff involvement and the number of hours for each staff member by activity (e.g., data cleaning, mapping, analysis).

http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.html#46.101(b)

◦ A timetable including deliverables and due dates, reflecting the time it will take to acquire data and get IRB approval.

• Provide a general work plan for budget periods two through five.

◦ Do not include specific proposals.

◦ Highlight activities that will span all five years.

• Explain how you will incorporate HRSA review prior to public release of products, for example:

◦ Briefs or other written products for publication.

◦ Conference presentations and any accompanying slides or materials.

• Describe your plan to share results from rapid response data analyses or issue-specific research studies on the Rural Health Research Gateway.

You will also include a more detailed work plan in your attachments.

Resolving challenges

See merit review criterion 2: Response

• Discuss challenges you expect when designing and carrying out the activities in your work plan, including handling the lack of rural/urban identifiers in data sets or encountering rural/urban identifiers misaligned with the research question.

• Explain the approaches that you will use to address and resolve these challenges.

Performance management

See merit review criteria 3: Performance management and 5: Resources and capabilities

• Outcomes.

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

• Performance measurement and reporting.

◦ Describe the performance data you will collect and how you will report this information accurately and on time.

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

See the reporting section for more information.

Organizational Information

See merit review criterion 5: Resources and capabilities

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

◦ Explain how staff will help you carry out the program requirements.

◦ Describe your expertise and your ability to conduct rapid response data analyses and issue-specific research studies.

◦ Briefly describe your capacity to manage the programmatic, fiscal, and administrative aspects of your proposed project.

◦ You’ll include a project organizational chart and staffing plan in your attachments.

• Explain the experience of your staff and how it relates to the proposed projects, including the experience of the project director.

◦ The project director should have significant experience in the areas related to rural health services research and short-term data analyses. Demonstrating this experience may include, but is not limited to, time in the field (e.g., at least 10 years of experience in these areas), extensiveness of relevant experience (e.g., breadth of publications), educational background in a relevant field (e.g., PhD or other doctoral-level degree), or a history of successfully completed projects related to rural health services research and data analysis.

• Demonstrate your program’s experience conducting similar work (from any funder). Include specific examples of:

◦ Past publications or analyses that were national in scope, contained rural-centric or rural-urban comparisons as part of the analysis, and completed in a short-term timeframe (e.g., 3 to 6 months).

◦ Past rapid data analyses of complex national data sets that included rural-urban comparisons and were completed in one to two days.

◦ Communicating complex public policy issues and data analyses to varied audiences in ways that identify key rural concerns within broader issues.

• Demonstrate your organization’s existing relationships with key rural stakeholders such as (but not limited to) State Offices of Rural Health.

• Demonstrate your organization’s access to and substantial experience working with large, national data sets. Examples are listed in the table:

Table of national data sets

Agency for Healthcare Research and Quality

• Healthcare Cost and Utilization Project

• Nationwide Inpatient Sample

American Dental Association

• Masterfile of Dentists

American Hospital Association (AHA)

• AHA Abridged Guide of U.S. Hospitals

American Medical Association

• Physician Masterfile

American Osteopathic Association

• Physician Masterfile

American Academy of Nurse Practitioners

• Professional Data

Bureau of the Census, U.S. Department of Commerce

• American Community Survey

• Current Population Survey

• 2010 Census Summary Files

• Congressional District Summary File

• Summary Files for Outlying Areas

• Topologically Integrated Geographic Encoding and Referencing System

• Census of Agriculture

• Economic Census

• Census Summary Tape Files

• Intercensal Population Estimates

• Small Area Health Insurance Estimates

• Small Area Income and Poverty Estimates

Bureau of Economic Analysis, U.S. Department of Commerce

• Personal Income

Bureau of Labor Statistics, U.S. Department of Labor

• Local Area Unemployment Statistics

• Occupational Employment and Wage Estimates

Centers for Medicare & Medicaid, U.S. Department of Health and Human Services

• Hospital Cost Reporting Information System

• Hospital Cost Reporting Information System – Skilled Nursing Facility File

• HMO Market Penetration Report File

• Hospital Market Service Area File

• Case Mix Index File

• Provider Specific File

• Provider of Services Files

• Medicare MedPAR Claims Data

• Medicare Inpatient Claims Data

• Medicare SNF Claims Data

• Medicare Outpatient Claims Data

• Medicare Carrier Claims Data

• Master Beneficiary Summary File

• Medicare Advantage Files

• Medicare Prescription Part Drug Part D Files

• National Provider Identification

• CMS Public Use Data on ACO Performance

• Medicare Enrollment

• Medicare Provider Utilization and Payment

Claritas, Inc.

• Pop-Facts Database for Census Tracts, ZIP Codes and Minor Civil Divisions

Esri Global, Inc.

• StreetMap North America

Economic Research Service, U.S. Department of Agriculture

• Rural-Urban Continuum Codes

• Urban Influence Codes

• County Typology Codes

• Frontier and Remote Area Codes

• Rural Urban Commuting Area Codes

Health Resources and Service Administration, U.S. Department of Health and Human

Services

• Health Professional Shortage Area Designations

• Medically Underserved Area Designations

• Health Area Resource File

• Uniform Data System

• National Health Service Corp Physicians

• National Health Service Corp Dentists

• List of Federally Qualified Health Centers

Centers for Disease Control and Prevention, U.S. Department of Health and Human

Services

• CDC Wonder

• National Health Interview Survey

• Compressed Mortality Analytical File

National Council for Prescription Drug Programs

• Monthly Pharmacy Data

Office of Management and Budget

• Metropolitan and Micropolitan Statistical Areas

Robert Wood Johnson Foundation & University of Wisconsin Population Health

Institute

• County Health Rankings

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

Your budget should follow the instructions in budget narrative: detailed instructions section of the R&R Application Guide [PDF] 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 R&R.

It includes an itemized breakdown and a clear justification of the costs you request. The merit review committee reviews both.

As you develop your budget, consider:

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

• The restrictions on spending funds. See funding policies and limitations.

To create your budget justification narrative, see budget narrative detailed instructions in the R&R Application Guide [PDF].

https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D36 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) https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D18

Attachments See section 3.2 of the HRSA R&R Application Guide [PDF].

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

Unless the instructions below require it, do not submit organizational brochures or other promotional materials (for example, slides, films, clips).

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 R&R Application Guide [PDF].

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: Agreements with other entities

Provide any documents that describe working relationships between your organization and others you refer to in the proposal. Documents that confirm actual or pending contracts or agreements should clearly describe the roles of subrecipients and contractors and any deliverables. It is not necessary to include the entire contents of lengthy agreements, so long as the portions you include describe the working relationship between you and the other organization. Make sure letters of agreement are signed and dated.

Attachment 4: Project organizational chart

Provide a one-page diagram that shows the full project’s organizational structure.

https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D25 https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D23

Attachment 5: Disclosure of participation in or benefit from CMS Rural Transformation Program

(if applicable)

Submit this attachment only if you participate in or benefit from their state’s CMS Rural

Transformation Program. Provide a description of the CMS-supported activities and clearly explain how the proposed HRSA-funded work is non-duplicative, coordinated, and complementary. Reviewers will not consider this information during merit review.

Attachments 6–15: Other relevant documents

You may use attachments 6 through 15 to add other relevant documents.

Other required forms You will need to complete some other forms. Upload the following forms at Grants.gov.

You can find them in the NOFO application package or review them and any available instructions at Grants.gov Forms.

Forms Submission Requirement

SF-424 (R&R) Application for Federal Assistance form

With application.

Project Abstract Summary form With application.

Research & Related Other Project Information With application.

Research & Related Senior/Key Person Profile

(Expanded)

With application.

R&R Subaward Budget Attachment(s) form With application.

Project/Performance Site Location(s) With application.

Disclosure of Lobbying Activities (SF-LLL) If applicable, with the application or before award.

Form instructions

In addition to the requirements for the budget narrative, project narrative, and attachments, following are instructions for each of the other forms required by this

NOFO. See the application checklist for a full list of all application requirements.

https://grants.gov/forms/forms-repository/sf-424-family

SF-424 (R&R) Application for Federal Assistance

This is your application for federal assistance. Follow the instructions in section 3.1.1 of the R&R Application Guide [PDF].

Project Abstract Summary form

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. For more information, see section 3.1.2 of the R&R Application Guide [PDF].

Research & Related Other Project Information

In addition to the requirements in the project narrative section, you will provide some additional information in this form.

• Complete sections 1 through 6.

• Upload a blank document in item 7: Project Summary/Abstract to avoid a cross-form error with your Project Abstract Summary Form.

• Upload your project narrative in item 8.

• Leave items 9, 10, and 11 blank.

Research & Related Senior/Key Person Profile (Expanded)

Include biographical sketches for people who will hold the key positions.

• Try to use no more than 2 pages per person.

• Do not include non-public personally identifiable information.

• If you include someone you have not hired yet, include a letter of commitment from that person with their biographical sketch.

• Upload sketches in the Research & Related Senior/Key Person Profile form.

Include:

◦ Name and title

Important: public information

When filling out your SF-424 form, pay attention to Box 15: Descriptive Title of

Applicant’s Project.

We share what you put there with USAspending. This is where the public goes to learn how the federal government spends their money.

Instead of just a title, insert a short description of your project and what it will do.

See instructions and examples.

https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D8 https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D14 https://grants.gov/learn-grants/grant-terminology#p https://www.usaspending.gov/ https://www.hhs.gov/sites/default/files/hhs-writing-award-descriptions.pdf

◦ Education and training – for each entry include Institution and location, degree and date earned, if any, and field of study.

◦ Section A, Personal Statement. Briefly describe why the individual’s experience and qualifications make them well-suited for their role.

◦ Section B, Positions and Honors. List in chronological order previous and current positions. List any honors. Include present membership on any federal government public advisory committee.

◦ Section C, Other Support. This section is optional. List selected ongoing and completed projects during the last three years. Begin with any projects relevant to the proposed project. Briefly indicate the overall goals of the projects and responsibilities of the person.

◦ Other information. If they apply, include language fluency and experience working with populations that are culturally and linguistically different from their own.

R&R Subaward Budget Attachment(s) form

You will also complete the R&R Subaward Budget Attachment form for each subaward you propose. These include subcontracts. You will do this using the R&R Subaward

Budget Attachment(s) form.

Use the following instructions:

• Once you open this form, you can select “Click here to extract the R&R Subaward

Budget Attachment”.

• Save the file and then open it to complete it.

• Once you save the file you can upload it within the form.

• Repeat the steps for each subaward.

If you have more than 10 subawards, you may upload the extra budget forms in the

Research and Related Other Project Information form in Block 12 “Other Attachments”.

Project/Performance Site Location(s)

Follow the form instructions in Grants.gov. Use the “Next Site” option rather than

“Additional Location(s)” to add more than one project/performance site location.

Disclosure of Lobbying Activities (SF-LLL) form

Follow the form instructions in Grants.gov Forms.

https://www.grants.gov/forms https://www.grants.gov/forms

Step 4:

Understand Review, Selection, and Award

In this step

Application review 37

Selection Process 43

Awar…