HRSA-26-056 Final Full.pdf

Notice of Funding Opportunity

Application due 07/08/2026

Office for the Advancement of Telehealth

Telehealth Centers of Excellence

Opportunity number: HRSA-26-056

Table of Contents

Before You Begin

Step 1: Review the Opportunity

Basic information

Funding details

Eligibility

Program description

Award information

Step 2: Get Ready to Apply

Get registered

Find the application package

Application writing help

Step 3: Build Your Application

Application checklist

Application contents and format

Step 4: Understand Review, Selection, and Award

Application review

Selection process

Award notices

Step 5: Submit Your Application

Application submission and deadlines

Other submissions

Step 6: Learn What Happens After Award

Post-award requirements and administration

Reporting

Contacts and Support

Agency contacts

Help with systems

Before You Begin

Health Resources and Services Administration

Office for the Advancement of Telehealth

Opportunity name: Telehealth Centers of Excellence

Opportunity number: HRSA-26-056

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.

Step 1: Review the Opportunity

Basic information

Tagline: Advancing innovative telehealth solutions to improve health outcomes in rural populations and populations with limited access to services.

Summary

The Health Resources and Services Administration (HRSA) is accepting FY2026 applications for the Telehealth Centers of Excellence (HRSA-26-056).

This funding opportunity will support academic medical centers. These centers will implement and evaluate innovative telehealth solutions in rural populations and populations with limited access to services. The centers will serve as national models. They will test concepts and create proven approaches that expand access to care and improve health outcomes. These approaches will be replicable across the country.

Have questions? Go to Contacts and Support.

Key facts

Opportunity name:

Telehealth Centers of Excellence

Opportunity number:

HRSA-26-056

Announcement version:

initial

Federal assistance listing:

93.467

Key dates

NOFO issue date:

06/05/2026

Informational webinar:

Application deadline:

07/08/2026

Expected award date is by:

09/01/2026

Expected start date:

09/01/2026

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

Funding details

Application Types:

Limited competition

Expected total available funding in FY:

2026: $8,500,000

Expected number and type of awards:

2 CA (Cooperative Agreement)

Funding range per award:

$4,250,000 - $4,250,000

We plan to fund awards in five 12-month budget periods for a total five year period of performance from 09/01/2026 to 08/31/2031.

Eligibility

You can apply if you are a domestic* public academic medical center that is an incumbent Telehealth Center of Excellence award recipient.

* “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.

Types of eligible organizations

These types of domestic organizations may apply:

Public and State controlled institutions of higher education

Additional information on eligibility

Eligibility is limited to the two current Telehealth Centers of Excellence award recipients.

Individuals are not eligible applicants under this NOFO.

Other eligibility criteria You can apply only if you currently receive a Telehealth Center of Excellence award and operate a successful telehealth program in a public medical center.

Completeness and responsiveness criteria

We will review your application to make sure it meets these basic requirements to move forward in the competition.

We will not consider an application that:

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

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

• Is submitted after the deadline.

Application limits

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

Cost sharing

This program has no cost-sharing requirement. If you choose to share in the costs of the project, we will not consider it during merit review. 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

The purpose of the Telehealth Centers of Excellence (COE) Program is to advance innovative telehealth solutions to improve health outcomes.

The Telehealth COEs identify and test best practices in telehealth and share effective models and lessons learned. They use their clinical and telehealth expertise to test new applications and approaches. They evaluate how well these approaches work and determine what can be used and expanded in other communities. The Telehealth COEs will test programs to improve care, such as virtual care for chronic conditions, the use of artificial intelligence (AI) in telehealth platforms, and the use of remote monitoring technologies in health care settings.

These Telehealth COEs serve as national training resources. They develop practical, evidence-based tools and provide guidance for providers, health systems, policymakers, and the public.

They provide technical assistance to the public, manage a public website with resources, and build partnerships to test programs in different settings. Their work will expand access to care, strengthen rural health systems and health systems for populations with limited access to services, and inform telehealth policy nationwide.

Award recipients will collect and report data on telehealth outcomes and effectiveness. In addition, the Telehealth COEs will work closely with HRSA and other HRSA-funded programs.

These include the National and Regional Telehealth Resource Centers, Telehealth Research

Centers and Telehealth Rapid Response Center. The goal is to align efforts, avoid duplication, and increase overall impact.

Funding Opportunity Goals

• Develop, test, and evaluate telehealth models that contribute to the evidence base and expand access to high-quality health care through telehealth, both nationwide and in rural populations.

• Expand access to care and strengthen rural health systems, and health systems in populations with limited access to services, by producing actionable data and sharing evidence-based resources, practical tools, peer-reviewed publications, and policy-relevant findings. These efforts will support telehealth implementation and inform national policy decisions.

• Each Telehealth COE must demonstrate national impact by demonstrating how tested telehealth programs improve access to care in rural populations as well as populations with limited access to services.

Background

HRSA’s Office for the Advancement of Telehealth (OAT) supports the use of telehealth to improve access to quality health care. It does this by promoting innovative telehealth solutions and advancing the evidence-base.

The Telehealth Centers of Excellence Program builds on HRSA’s experience supporting telehealth innovations, models, and evidence-based efforts. This program supports the expansion of telehealth by testing new telehealth solutions using evidence-based approaches to address chronic diseases and health conditions.

Chronic disease continues to be a leading driver of health care use and costs in the United States.

Nearly 90 percent of the nation’s annual health care spending is for people living with chronic and mental health conditions. Approximately three out of four adults have at least one chronic disease, and more than half have multiple chronic conditions.

Telehealth is an effective tool that can help address chronic disease and improve health outcomes. It can improve access to care, address provider shortages, and strengthen health services in rural populations and populations with limited access to services. As telehealth continues to grow, more evidence is needed to show which models work best and can be expanded to reach more people.

The Telehealth COEs are well positioned to develop, test, and evaluate telehealth models. These models can improve chronic disease management, expand access to specialty and behavioral health services, and reduce avoidable costs. This is especially important in rural populations where chronic disease rates are higher.

https://www.cdc.gov/chronic-disease/data-research/facts-stats/index.html https://www.cdc.gov/chronic-disease/about/index.html

The Telehealth COEs will test new telehealth approaches, measure results, and share what works. Through this work, the program will strengthen the national evidence base for telehealth, support informed policy decisions, and help integrate telehealth more fully into rural health care systems and health care systems for populations with limited access to services. This may also include working with organizations that have telehealth accreditation to support high-quality care for patients using telehealth. The Telehealth COEs will share evidence-based best practices and lessons learned.

Activities for this program should advance one or more of the Make America Healthy Again

(MAHA) priorities. Strategies to consider include:

• Address root causes of poor health.

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

• Expand nutrition programs or chronic disease prevention.

• Support early childhood development or autism services.

• Prepare systems for value-based care.

• Partner with tribal health systems.

HRSA will support two national Telehealth COEs that will engage in local, regional, and national partnerships while disseminating best practices and lessons learned nationwide.

Program requirements and expectations

Program Requirements

You will be required to:

• Implement at least 20 high-quality telehealth projects each year. Projects must be evidence-based and address public health needs. Each project must last one year. Projects must have a regional or national focus. Projects must focus on populations with limited access to services, including rural populations. Projects should address one or more of these areas:

o Chronic conditions.

o Nutrition.

o Primary care.

o Mental or behavioral health.

o Maternal and child health, including pediatric populations.

o Emerging topics or technologies, such as artificial intelligence.

• Staff a Telehealth Center of Excellence team with strong experience in managing complex grant programs.

• Summarize results from each project. Share results in reports or other products for both technical and non-technical audiences.

• Promote the use of telehealth programs across the country. Do this by testing technology, creating training protocols, and giving states templates to add telehealth into their health systems.

• Share information and research findings with the public. This includes health care providers, policymakers at all levels, and safety-net providers. Use formats such as journal articles, policy briefs, conference presentations, webinars, responses to questions, content for Telehealth.HHS.gov, and others that provide practical, evidence-based information.

• Work closely with the Telehealth Centers of Excellence, HRSA’s Office for the

Advancement of Telehealth (OAT), and other HRSA- and OAT- funded programs.

• Share access to data sources used for final deliverables with your OAT project officer.

Administrative Requirements

You must report data requested by OAT. This includes data in HRSA’s Data Collection Platform

(DCP). This data will track project outcomes and monitor progress. Examples include the number of telehealth visits and the number of patients served. OAT will provide more details about this requirement during the project period.

If you provide direct patient services within projects, you must bill all services covered by third-party payers. You must try to collect payment during the five-year period of performance. If your services may be reimbursed by Medicaid, Children’s Health Insurance Programs (CHIP), Medicare, or private insurance, you must build a sustainable network within your state’s reimbursement system. See the Center for Connected Health Policy’s Compare State Policies page for more information.

OAT may request more information about proposals, work plans and human subjects research

(see Post-award requirements).

See the Program Income section for requirements.

Statutory authority

42 U.S.C. § 254c -14 (§ 330I of the Public Health Service Act) and the Consolidated Appropriations Act, 2026 (P.L. 119-75).

Award information

Cooperative agreement terms

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

• Provide experienced HRSA Office for the Advancement of Telehealth (OAT) staff to offer guidance and support in planning, developing, and carrying out project activities and materials.

• Make sure project activities build on past work by sharing relevant materials, tools, and lessons learned from earlier efforts.

• Help connect and coordinate communication with other federally funded programs, HRSA offices, and federal agencies when needed.

• Regularly review and monitor project activities, including plans, evaluation methods, and quality improvement efforts, to ensure the program stays on track and meets its goals.

• Review and provide guidance on materials and activities.

• Assess how projects are planned and carried out, including how results are measured, and how findings improve future work.

• Provide guidance and support for project activities, progress, results, and results sharing.

This may include presentations to internal and external stakeholders, conference https://www.cchpca.org/compare/ presentations, webinars, policy briefs, research summaries, and other ways to share clear, practical research findings.

• Offer input on planning and developing the project portfolio.

• Review and provide feedback on project plans and methods.

• Review project products before they are shared publicly, including the study methods, analysis, results, policy implications, and overall format.

• Take part, as appropriate, in meetings, training sessions, or workgroups during the project period, including activities related to the website redesign.

• Host regular calls with all of the key staff on the project.

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

• Follow HRSA guidelines on acknowledgment of and disclaimer on all products produced by HRSA award funds, per Section 5.1 of the HRSA Application Guide

(Acknowledgement of Federal Funding).

• Provide a conflict-of-interest (COI) statement that discloses any potential conflicts related to federal funding and explain how those conflicts will be addressed. Review HRSA's

COI policy.

• Build and maintain strong working relationships with other HRSA-funded programs and telehealth partners.

• Take part in planning and developing the annual project portfolio, including meetings as needed.

• Submit project proposals, including timelines and milestones, to the OAT Program

Coordinator for review.

• Synthesize results of each project into reports or other work products for both technical and non-technical audiences.

• Send all products to OAT for review before they are published or shared. This includes presentations, manuscripts, abstracts, policy briefs, technical assistance materials, reports, and other documents. Submit materials within the timeframe requested by OAT.

• In collaboration with other Telehealth COE award recipients, redesign and manage a modern Telehealth COE website that clearly explains and shows the purpose of the

Telehealth COEs. The website should serve as a centralized hub for sharing project information, data, resources, tools, and findings. The website must also allow individuals to submit requests for technical assistance.

• Discuss and request approval from HRSA for any significant changes to projects, including any proposed cancelation of projects prior to cancelation. Prior approval may be required and additional documentation may be requested by OAT, such as an explanation of proposed changes, reason for changes, what has been done to address challenges, plans to address the challenges, and funds expended to date.

• Participate in regular conference calls with OAT staff and other stakeholders as needed.

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.

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf https://www.hrsa.gov/grants/standard-terms/conflict-interest-policy https://www.hrsa.gov/grants/standard-terms/conflict-interest-policy https://www.ecfr.gov/current/title-2/part-200

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:

o Appropriation of funds.

o Your satisfactory progress in meeting the project’s objectives.

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

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

o Extend the period of performance.

o Award supplemental funding.

General limitations

• For guidance on some types of costs we do not allow or restrict, see o Project Budget Information in the Application Guide.

o 2 CFR Part 200 Subpart E - General Provisions for Selected Items of Cost.

o Allowable and Unallowable Costs and Activities in the HHS Grants Policy

Statement.

• All costs 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.

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 incur 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 the 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 to 15% 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 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=13 https://www.ecfr.gov/current/title-2/part-200/subject-group-ECFRed1f39f9b3d4e72 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/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.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))

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 2 CFR 200.307.

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

o Extend the period of performance.

o Award supplemental funding.

Step 2: Get Ready to Apply

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 Application Guide.

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-26-056.

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

Application writing help

Visit HHS Tips for Preparing Grant Proposals.

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

See Apply for a Grant for other help and resources.

https://www.ecfr.gov/current/title-2/section-200.307 https://sam.gov/content/entity-registration https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=4 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 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. More information on the HRSA-

26-056 webinar will be posted at a later date to the documents tab in Grants.gov.

We recommend that you “Subscribe” to the NOFO on Grants.gov to receive updates when we post documents.

We will record the webinar.

Have questions? Go to Contacts and Support.

Step 3: Build Your Application

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

Form Included in page limit*?

◻ Project Narrative Yes

◻ Budget Narrative Yes

Attachments

Insert each in the Attachments Form in this order.

Form Included in page limit*?

◻ 1. Work plan Yes

◻ 2. Staffing plan and job descriptions Yes

◻ 3. Biographical sketches Yes

◻ 4. Agreements with other entities Yes

◻ 5. Multi-year budgets, fifth year budget No

◻ 6. Project organizational chart Yes

◻ 7. Tables and charts Yes

◻ 8. Other relevant document Yes

◻ 9. Other relevant document Yes

◻ 10. Other relevant document Yes

◻ 11. Other relevant document Yes

◻ 12. Other relevant document Yes

◻ 13. Other relevant document Yes

◻ 14. Other relevant document Yes

◻ 15. Other relevant document Yes

Other required forms

Upload using each required form in Grants.gov.

Forms Submission requirement

Application for Federal Assistance (SF-424) With application.

Project Abstract Summary Form With application.

Grants.gov Lobbying Form With application.

Disclosure of Lobbying Activities (SF-LLL), optional With application.

Project/Performance Site Location(s) With application.

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

Key Contacts With application.

*Only what you attach in these forms counts toward the page limit. The forms themselves do not count.

Application contents and format

This section includes guidance on each component found in the application checklist.

Application page limit: 60 pages.

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 o .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 your files in the Application Guide.

Project narrative

Introduction See merit review criterion 1: Need

This section describes the purpose and overview of your proposed project. Applicants should:

• Include the vision and purpose of your Telehealth Center of Excellence.

• Explain your experience in telehealth and in operating a Telehealth Center of Excellence.

Include how this will help you succeed.

• Provide a short summary of the proposed projects, who they will serve, how partners across the country will work together, and the main areas of focus.

• Describe how the proposed projects will help develop, implement, and evaluate innovative telehealth programs, and how they will strengthen the evidence base for telehealth and related technologies.

Need See merit review criterion 1: Need

This section details the needs of the populations and areas you will serve. Use and cite demographic data for rural populations and populations with limited access to services with public health reports, and peer-reviewed literature to support the information presented.

• Describe the target populations with limited access to services of the existing Telehealth

Center of Excellence and explain the needs that are currently being met by your telehealth services.

• Identify the target population and the health needs that are not being met, both nationally and in the specific areas the Telehealth Center of Excellence will focus on.

• Detail gaps in accessing care and telehealth services in the target populations.

• Discuss barriers to effective high-quality health care and telehealth in rural populations as well as populations with limited access to services. This may include health workforce shortages, limited access to specialty care, transportation challenges, and broadband or technology limitations. Then describe why telehealth is an important solution and how it can help overcome these challenges.

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=26

• Explain gaps in the telehealth research, including related to chronic disease prevention in rural populations and populations with limited access to services. Describe why we need more data to identify care models that are effective and can be expanded to reach more people.

• Describe national telehealth resources and technical assistance you or others provide.

Identify any gaps.

• Discuss the key health challenges in your local area and state. Explain how addressing these issues can provide lessons or solutions that apply nationally. Include data to support your statements.

• Explain how the Telehealth Center of Excellence will use its experience addressing the need in your service area (local and state) to address needs on a national level.

Approach See merit review criterion 2: Response

This section describes how you will address your stated needs and meet the program requirements and expectations described in this funding opportunity. Applicants should:

• Describe the proposed projects for the first budget year. You should propose projects that would produce findings that will advance telehealth nationally.

• Explain how the Telehealth Center of Excellence will conduct at least 20 telehealth projects each year, focusing on rural populations and populations with limited access to services. See the Program requirements and expectations section for the focus areas.

• Identify how the proposed projects and the Telehealth Center of Excellence will meet the needs identified. See the Needs section.

• Explain how the Telehealth Center of Excellence identifies projects each year, assesses feasibility, determines milestones, dates, measures and products, and accurately forecasts costs.

• Discuss how projects will improve outcomes, reduce costs, increase access to care, and promote best practices and innovative approaches.

• Describe how the Telehealth Center of Excellence will advance the use of telehealth on a national scale to improve health care in rural communities and populations with limited access to services.

• Identify what types of innovative telehealth technology will be used across the projects.

• Discuss what gaps the projects will address in the telehealth evidence base.

• Describe plans for ongoing staff training, teamwork, and internal information sharing.

• Identify how the Telehealth Center of Excellence will communicate and collaborate with other telehealth groups or organizations, including other HRSA-funded entities.

• Explain how the Telehealth Center of Excellence will share what it learns, both locally and across the country, so rural populations and populations with limited access to services can start or improve their own similar telehealth program. Describe how the

Telehealth Center of Excellence will share the results and products created through its projects.

• Detail how the Telehealth Center of Excellence will provide proactive technical assistance, outreach and education to health care providers, institutions, and stakeholders across the United States.

• Explain how the Telehealth Center of Excellence will create and maintain a redesigned website for projects where it will post completed projects, evaluation results, and other project materials.

• Describe how the Telehealth Center of Excellence will use its experience addressing the need in your service area (local and state) to inform addressing need on a national level as a Telehealth Center of Excellence.

• Human subjects research: Are human subjects involved in the Telehealth Center of

Excellence's proposed research project(s)? If the Telehealth Center of Excellence is planning research activities involving human subjects at any time during the five-year project period, indicate yes, even if the proposed project is exempt from the Regulations for the Protection of Human Subjects at 45 CFR Part 46.

o Indicate no if the Telehealth Center of Excellence is not planning any research activities involving human subjects.

o If the answer is yes, indicate if the Institutional Review Board (IRB) review is pending. Provide the approval date if you received IRB approval.

High-level work plan See merit review criteria 2: Response and 4: Impact

Share how you will achieve each of the objectives during the five-year period of performance.

You must also include a detailed work plan in a table format in Attachment 1: Work plan that aligns with the work plan you describe in this section.

• Describe how the Telehealth Center of Excellence will implement innovative, evidence-based telehealth approaches over the five-year project period. Include activities that strengthen the health workforce, expand access to technology-enabled care, and support collaboration to improve outcomes in rural populations and populations with limited access to services.

• Include goals, objectives and key milestones for the full five-year period of performance.

Show that your timelines are realistic and that the Telehealth Center of Excellence has the capacity to complete the work. Explain how you will meet the Telehealth Center of

Excellence's proposed objectives.

• Identify key stakeholders and explain how they will help plan, design, and carry out project activities.

• Describe the results you expect from the Telehealth Center of Excellence's activities.

Focus on how the Telehealth Center of Excellence will improve access to care, strengthen service quality, and support sustainable telehealth approaches.

• Provide plans to develop materials in the first year. These may include clinically informed manuscripts, policy briefs, reports, technical assistance documents, and other products.

• Describe the Telehealth Center of Excellence's project timeline and key steps. This includes forming partnerships, completing curriculum or protocol development, onboarding providers, and starting implementation.

• Explain how the Telehealth Center of Excellence will share reports, tools, and project results with the public and target audiences, such as health care providers, policymakers, and other partners. The Telehealth Center of Excellence must work with HRSA’s OAT to determine how this information is shared, including on platforms such as

Telehealth.HHS.gov.

• Describe how the Telehealth Center of Excellence will refine and improve project activities and products so they can be used widely and replicated in other settings beyond the original sites.

• For the first budget year, provide a short description of each of the 20 project proposals using the following outline:

o Project Title o Project Principal Investigator Information (name and degree)

▪ HRSA also strongly encourages each project to have a co-principal investigator as this information will be required as a post-award requirement.

o Health Focus Area: Identify the health focus area or chronic condition that each project will focus on. Multiple conditions may be listed, if applicable.

o Project Description (2-3 sentences) o Geographic Coverage (1-2 sentences): Describe the areas the project will serve, such as the specific states, counties, cities, or towns, and any specific groups of people within those areas.

o Organization Partners: Identify specific partners, whether they have committed to the project and the number and names of each site that will be included. See

Attachment 4: Agreements with other entities.

o Data Sources (1 sentence): Please clarify if this project will use primary or secondary data. Additional information will be required after the award. It is your responsibility to obtain reliable and accurate data. HRSA will not provide data.

o Human subjects research (1 sentence): Are human subjects involved?

• Describe how the Telehealth Center of Excellence will create and manage the public website for OAT-funded projects. The site should clearly present project materials. These include summaries, findings, reports, playbooks, toolkit, technical assistance documents, and other resources the public can use to carry out similar projects.

• Explain how the Telehealth Center of Excellence projects will comply with Section 508 of the Rehabilitation Act of 1973, as amended. This ensures that all electronic and information products are accessible.

Applicants must plan for the time needed to collect data, complete Institutional Review Board

(IRB) review or approval (if required), and finish other regulatory or administrative steps.

Include these timelines in your work plan schedule and deadlines. OAT may request more information for proposals, work plans and human subjects research (see Post-award requirements and Administrative Requirements).

Make sure this section aligns with the Approach section. Applicants must include a detailed work plan under Attachment 1: Work plan that is consistent with the Project Narrative.

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

Resolving challenges See merit review criterion 2: Response

Explain how you will address anticipated challenges or barriers that may arise during the project period. You should:

• Discuss current or expected challenges in the Telehealth Center of Excellence work plan.

These may include issues with partnerships, staffing, technology, community challenges, or sustainability.

• Explain how the Telehealth Center of Excellence will identify challenges early in each project. Include how the Telehealth Center of Excellence will determine when project leads or principal investigators need support, and how you will provide that support.

o Describe how the Telehealth Center of Excellence will address these challenges.

This may include technical support, changes in approach, or strategy adjustments.

• Explain how the Telehealth Center of Excellence will use ongoing feedback and monitoring to identify issues early and make needed changes.

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

Describe how you will effectively collect, monitor, and evaluate project results

Evaluation

• Demonstrate that the Telehealth Center of Excellence staff, organization, and partners have the ability to collect and report data on project outcomes and impact.

• Explain how the Telehealth Center of Excellence will choose evaluation measures and how the Telehealth Center of Excellence will use data to evaluate and measure each project.

• Describe the Telehealth Center of Excellence's data collection methods to measure outcomes and impact. Identify possible challenges and how the Telehealth Center of

Excellence will address them.

• Explain how the Telehealth Center of Excellence will gather input from the service area and target population to inform data collection.

Performance Management

• Demonstrate the ability of the Telehealth Center of Excellence staff, organization, and partners to collect and report data on progress and performance.

• Describe your project management plans for the Telehealth Center of Excellence.

Identify who is responsible, and how the Telehealth Center of Excellence will ensure it is on target to meet its goals and deliverables.

• Explain how the Telehealth Center of Excellence will collect and use data to track and evaluate progress toward its goals. Describe how the Telehealth Center of Excellence will regularly review performance, identify challenges, and make improvements when needed.

• Identify how the Telehealth Center of Excellence will assess the success of the products produced.

• Explain who is responsible for tracking product use. Describe how the Telehealth Center of Excellence will track who uses your products, how widely they are shared, how effective they are, and whether other organizations can use or repeat them.

• Describe how the Telehealth Center of Excellence will monitor use by health care providers, health systems, community partners, policymakers, and researchers.

• Explain the Telehealth Center of Excellence's quality control process. Describe how the

Telehealth Center of Excellence will ensure data is accurate, reliable, thorough, clear, and consistent. Also, explain how the Telehealth Center of Excellence will ensure final products are accurate, error-free, and easy to understand.

• Describe how the Telehealth Center of Excellence will manage and store data securely.

Explain how the Telehealth Center of Excellence will protect data from cybersecurity threats, breaches, or other loss of data integrity.

See Reporting for more information.

Sustainability See merit review criterion 4: Impact

You will be expected to sustain project elements that improve services, practices, and outcomes for the target population after federal funding ends. Discuss your plan to maintain the activities and services after federal funding ends.

• Explain how the Telehealth Center of Excellence will continue successful telehealth programs after federal funding ends. Describe how organizations, health systems, or communities will support these efforts.

• Discuss past HRSA-funded Telehealth Center of Excellence projects that continued or expanded, or are planned to continue or expand, after funding ended. Explain what factors supported their success.

• Identify key elements of the Telehealth Center of Excellence projects and explain how the Telehealth Center of Excellence will sustain successful telehealth programs.

• Describe how the Telehealth Center of Excellence's partnerships with health care providers, universities, community organizations, and state and local agencies will help continue and expand telehealth services over time.

• Explain how the Telehealth Center of Excellence will improve, adapt, and expand project activities and materials based on results. Describe how project results and lessons learned will help others use these approaches in different settings or with different populations.

• Describe how the Telehealth Center of Excellence will continue to share project products and evidence. Explain how providers, health systems, community partners, and policymakers will be able to use these resources to improve health outcomes, especially in rural populations and populations with limited access to services.

• Identify possible sources of support to sustain the program after the five-year period of performance.

• Describe challenges or risks to sustaining the projects and explain how you will address them.

Organizational information See merit review criterion 5: Resources and capabilities

Describe your organizational structure, your telehealth center, and your proposed partners.

Explain their ability to implement activities in the work plan.

• Describe your organization’s mission, structure, current activities, and telehealth experience. Include experience with chronic diseases and work across multiple states or at the national level. Explain how your experience, including work with populations with limited access to services, prepares you to meet program requirements.

• Explain the strengths of your telehealth program. Include how long it has existed, how it has grown, and any changes in the number of patients served or types of services offered.

• Describe the staff, systems, and resources that will support the Telehealth Center of

Excellence projects. This includes administrative support, clinical expertise, research and evaluation capacity, data support, and information technology. Clearly define each person’s role, responsibilities, and reporting structure. Complete Attachment 3:

Biographical sketches.

• Describe your organizational and staffing capacity to implement and sustain the Telehealth

Centers of Excellence projects. Complete Attachment 6: Project organizational chart.

Your staffing should include roles and FTEs as included below:

o Project Director (Overall COE Project Director) o Deputy Project Director (Overall COE Project Deputy Director) o COE Project Manager (Overall COE Project Manager) o Core project implementation team o Core data analysis team o Core research team o Technical Writer/Editor o Communications Specialist

Except for the project director and deputy project director, multiple staff roles may be filled by the same individual. For example, a member of the core research staff can also serve as the project manager. The individual should have the appropriate qualifications and time to fulfill all assigned responsibilities.

Describe the following for the project director:

• Evidence of successfully managing a Telehealth Center of Excellence team leading and sharing telehealth-related work. The project director should have at least eight years of experience working in telehealth-focused health services research, or similar experience.

• Experience informing and educating national, state, and community decision-makers about health and access issues for rural populations and populations with limited access to services.

HRSA recommends that the project director devote at least 25 percent of their time to the

Telehealth Center of Excellence. The project director must not duplicate FTE and responsibilities across other OAT funded programs.

The project director will lead the development and realization of the Telehealth Center of

Excellence projects portfolio. They will serve as the lead investigator on at least five of your proposed projects. They are also responsible for the administrative oversight of the Telehealth

Center and Excellence and for reviewing all draft products.

HRSA strongly suggests that the project director have a strong record of telehealth publications that focus on populations with limited access to services. The project director should also have at least eight years of relevant experience, including work with populations with limited access to services and telehealth-focused health services research, and a medical or doctoral degree.

Describe the following for the deputy project director:

• Experience, including roles and responsibilities in organizational lines of authority, conducting telehealth-focused research.

• Experience informing and educating national, state, and community decision-makers about health and access issues in rural populations and populations with limited access to services.

• Process to assume the project director’s duties during short-term or extended leave, such as vacation or sabbatical.

HRSA recommends that the deputy director devote at least 20 percent of his or her time to the

Telehealth Center of Excellence. The deputy program director must not duplicate FTE and responsibilities across other OAT funded programs.

• The core data analysis staff should be multi-disciplinary. They must have the education and professional experience needed to conduct data analysis to meet program goals. This includes collecting data from a variety of resources, cleaning and preparing data, using statistical tools and analytical methods, identifying trends and relationships, validating data, interpreting results, and creating data visualizations.

• The core research staff should also be multi-disciplinary. They must have education and professional experience needed to conduct the proposed research. This may include staff with social science backgrounds (such as sociology, epidemiology, demography, economics, organizational behavior, statistics, public health, political science, or geography) as well as clinical experience.

• An editor or technical writer must also be included on staff. This person should review study drafts before submission to OAT for review to ensure high quality. Identify this individual in the line-item budget.

• Describe the following for the Communications Specialist:

o Experience managing and sharing health information to different audiences across multiple platforms. These may include briefing documents, newsletters, social media, websites, and other public-facing avenues.

o Proven ability to produce clear, accurate, and high-quality communications that are carefully reviewed and free of errors. This ensures Telehealth Center of

Excellence findings and resources are shared effectively.

• Describe your experience managing partnerships. Include how you manage contracts and subawards in a timely and effective way, including across multiple states and organizations. Include additional information in Attachment 4: Agreements with other entities.

o Explain how you structure your partnerships.

o Describe how you communicate and coordinate with partners to meet project objectives.

o If you will issue subawards or contracts, explain how you will ensure proper documentation of funds.

• Describe your organization and team’s experience managing federal grants or cooperative agreements. Include how you manage projects, accurately and precisely oversee budgets, and meet HRSA requirements. Demonstrate that you have a high-functioning team with experience managing large grants.

• Explain how you will follow the approved plan, track and report federal funds by funding year, record costs accurately, and use clear policies and internal…