OAT HRSA-24-011 (H1M) LPGP_FINAL.pdf

U.S. Department of Health and Human Services

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2024

Office for the Advancement of Telehealth

Licensure Portability Grant Program

Funding Opportunity Number: HRSA-24-011

Funding Opportunity Type(s): Competing Continuation, New

Assistance Listing Number: 93.211

Letter of Intent Requested by: March 8, 2024

Application Due Date: April 8, 2024

Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately!

We will not approve deadline extensions for lack of registration.

Registration in all systems may take up to 1 month to complete.

Issuance Date: February 7, 2024

LCDR Jenna Cope, MPH, RD, LD, CHES®

Program Coordinator, Office for the Advancement of Telehealth

Call: 301-443-5503

Email: jcope@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 U.S.C. § 254c-18 (§ 330L of the Public Health Service Act) mailto:jcope@hrsa.gov

HRSA-24-030 LPGP i

508 COMPLIANCE DISCLAIMER

Persons using assistive technology may not be able to fully access information in this file. For assistance, email or call one of the HRSA staff listed in Section VII Agency

Contacts.

SUMMARY

Funding Opportunity Title: Licensure Portability Grant Program (LPGP)

Funding Opportunity Number: HRSA-24-011

Assistance Listing Number: 93.211

Due Date for Applications: April 8, 2024

Purpose: The purpose of the LPGP is to provide support for state professional licensing boards to carry out programs under which licensing boards of various states cooperate to develop and implement state laws and related policies that will reduce statutory and regulatory barriers to telehealth.

Program Objective(s): This program seeks to support innovative multi-state collaborations that will enable licensed health care professionals to provide physical health and behavioral health services through telehealth technology across states (i.e., licensure portability).

Eligible Applicants: There are two types of eligible applicants:

(1) Competing Continuation Applicants: Eligible

“competing continuation” applicants are entities that received a Licensure Portability Grant

Program award in FY 2019 and with a period of performance ending by June 30, 2024 who seek to continue the funded project.

(2) New Applicants: Eligible applicants are state professional licensing boards including but not limited to organizations that are in consortia with, or associations of, state licensing boards that cooperate to develop and implement state policies that will reduce statutory and regulatory barriers to telehealth. See Section III.1 of this notice of

HRSA-24-011 LPGP ii funding opportunity (NOFO) for complete eligibility information.

Anticipated FY 2024 Total

Available Funding:

$500,000

Estimated Number and Type of

Award(s):

Up to 4 grants

Estimated Annual Award

Amount:

There are two types of awards available through this funding opportunity:

Competing Continuation Awards (Open to Competing Continuation Applicants):

• Up to $100,000 per award subject to the availability of appropriated funds

New Awards (Open to New Applicants):

• Up to $150,000 per award subject to the availability of appropriated funds

Cost Sharing or Matching

Required:

No

Period of Performance: July 1, 2024 through June 30, 2029 (5 years)

Agency Contacts: Business, administrative, or fiscal issues:

Kimberly Ross

Grants Management Specialist Division of Grants Management Operations, OFAM Email: kross@hrsa.gov

Program issues or technical assistance:

LCDR Jenna Cope

Program Coordinator Office for the Advancement of Telehealth

Email: jcope@hrsa.gov mailto:kross@hrsa.gov

HRSA-24-011 LPGP iii

Application Guide

You (the applicant organization / agency) are responsible for reading and complying with the instructions included in this NOFO and in HRSA Application Guide (Application

Guide). Visit HRSA’s How to Prepare Your Application page for more information.

Technical Assistance

We have scheduled the following webinar:

Wednesday, February 21, 2024

3 – 4 p.m. ET

Weblink: https://hrsa-gov.zoomgov.com/j/1600934215?pwd=WmdnU2hqZ2h5NFNTT3RaS3E5RlpGUT09

Passcode: rLv94gmy

Attendees without computer access or computer audio can use the following dial-in information:

Call-In Number: 1-833-568-8864

Meeting ID: 160 093 4215

We will record the webinar. Please contact LCDR Jenna Cope (jcope@hrsa.gov) to access the recording.

http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://hrsa-gov.zoomgov.com/j/1600934215?pwd=WmdnU2hqZ2h5NFNTT3RaS3E5RlpGUT09 https://hrsa-gov.zoomgov.com/j/1600934215?pwd=WmdnU2hqZ2h5NFNTT3RaS3E5RlpGUT09

HRSA-24-011 LPGP 2

Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING OR MATCHING

3. OTHER

IV. APPLICATION AND SUBMISSION INFORMATION

1. ADDRESS TO REQUEST APPLICATION PACKAGE

2. CONTENT AND FORM OF APPLICATION SUBMISSION

i. Project Abstract

ii. Project Narrative

iii. Budget

iv. Budget Narrative

v. Attachments

3. UNIQUE ENTITY IDENTIFIER (UEI) AND SYSTEM FOR AWARD MANAGEMENT (SAM)

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

2. REVIEW AND SELECTION PROCESS

3. ASSESSMENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

APPENDIX: PAGE LIMIT WORKSHEET

HRSA-24-011 LPGP 3

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Licensure Portability Grant Program (LPGP). The purpose of the LPGP is to provide support for state professional licensing boards to carry out programs under which licensing boards of various states cooperate to develop and implement state laws and related policies that will reduce statutory and regulatory barriers to telehealth.

Telehealth is defined by the Health Resources and Services Administration (HRSA) as the use of electronic information and telecommunication technologies to support long-distance clinical health care, patient and professional health-related education, health administration and public health1. Technologies include video conferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.

This grant aligns with HRSA’s goals of fostering a health care workforce to address current and emerging needs, improving access to quality physical health and behavioral health services, achieving health equity2, and enhancing population health. Promoting equity is essential to HRSA’s mission of protecting the health of Americans and providing essential human services3. Telehealth expanded over the past decades and experienced significant growth during and since the COVID-19 Public Health

Emergency. Coordinating care improved with the advancement and role of technology.

Through telehealth technologies, a health care professional may deliver care from a distant site in a separate state from the patient’s originating site. This wide reach allowed telehealth to emerge as a promising modality for increasing physical health and behavioral health care access, especially in rural areas and communities with workforce shortages4. While telehealth has the capacity to facilitate the delivery of health care over long distances, there may be statutory or regulatory barriers to delivering care across state lines. Licensure policies may differ from state to state, and individual states may require a license in the state where the patient is located. To address this, this program seeks to support innovative multi-state collaborations that will enable licensed health care professionals to provide telehealth across states (i.e., licensure portability).

This notice of funding opportunity solicits applications from a broad range of state licensing boards such as medicine, nursing, psychology, counseling, therapy, or other licensed health professionals with the capacity to utilize telehealth in the provision of

1 Health Resources and Services Administration, What is Telehealth? (2022) https://www.hrsa.gov/rural-health/topics/telehealth/what-is-telehealth 2 Of f ice of Health Equity, Health Resources and Services Administration (HRSA), U.S. Department of Health & Human Services (2020).

3 Executive Order 13985 on Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, 86 FR 7009, at § 2(a) (Jan. 20, 2021), https://www.govinfo.gov/content/pkg/FR- 2021-01-25/pdf /2021-01753.pdf 4 Chandrashekar P, Jain SH. Eliminating barriers to virtual care: Implementing portable medical licensure.

Am J Manag Care. 2020;26(1):20-22 https://www.hrsa.gov/rural-health/topics/telehealth/what-is-telehealth https://www.hrsa.gov/about/organization/bureaus/ohe#:%7E:text=What%20is%20health%20equity%3F,disease%2C%20disability%2C%20or%20mortality https://www.hrsa.gov/rural-health/topics/telehealth/what-is-telehealth https://www.hrsa.gov/rural-health/topics/telehealth/what-is-telehealth https://www.govinfo.gov/content/pkg/FR-2021-01-25/pdf/2021-01753.pdf https://www.govinfo.gov/content/pkg/FR-2021-01-25/pdf/2021-01753.pdf

HRSA-24-011 LPGP 4

service to patients. Given the increased behavioral health needs over the past few years, this opportunity will provide Special Consideration for social workers.

This funding opportunity is available for Competing Continuation Awards and New Awards.

• Competing Continuation Awards: Applicants with an existing HRSA funded

LPGP (Project Period Start Date: FY 2019 - Current). Applicants may seek

Competing Continuation Award to continue successful implementation and expansion of adopted state policies to maximize their impact and advance telehealth. HRSA anticipates making Competing Continuation Awards for a 5-year period of performance at up to $100,000 per year.

• New Awards: New Awards will support state professional licensing boards to carry out programs under which licensing boards of various states cooperate to develop and implement state laws and related policies that will reduce statutory and regulatory barriers to improve access to quality physical health and behavioral health services through telehealth technology. HRSA anticipates making New Awards for a 5-year period of performance at up to $150,000 per year.

Note: HRSA is including a special consideration for a multi-state licensure collaborative focused on Licensed Clinical Social Workers (LCSWs) in Section V.2

For more details, see Program Requirements and Expectations.

2. Background

The LPGP is authorized by 42 U.S.C. § 254c-18 (§ 330L of the Public Health Service Act).

HRSA, an agency of the U.S. Department of Health and Human Services (HHS), is the primary federal agency for improving health care for the geographically isolated and economically or medically vulnerable. HRSA’s 2024 Strategic Plan is to improve health outcomes and achieve health equity through access to quality services, a skilled health workforce and innovative, high value programs5.

The Office for the Advancement of Telehealth (OAT) serves as the focal point for coordinating and advancing the use of telehealth technologies across HRSA’s programs6 including, but not limited to, the provision of health care at a distance and improved information dissemination to both consumers and providers about the latest developments in telehealth.

To learn more about the Office for the Advancement of Telehealth projects, including the LPGP, see the latest OAT profiles7. Updates on policies and reimbursement, best

5 HRSA Strategic Plan FY 2024 (2023) https://www.hrsa.gov/about/strategic-plan 6 HRSA Bureaus and Off ices (2023) https://www.hrsa.gov/about/organization/bureaus 7 OAT Topics (2022) https://www.hrsa.gov/rural-health/topics/telehealth https://www.hrsa.gov/about/strategic-plan https://www.hrsa.gov/telehealth https://www.hrsa.gov/rural-health/topics/telehealth https://www.hrsa.gov/about/strategic-plan https://www.hrsa.gov/about/organization/bureaus https://www.hrsa.gov/rural-health/topics/telehealth

HRSA-24-011 LPGP 5

practice guides and resources to assist in offering telehealth services can be found at

Telehealth.hhs.gov.8

Applicants are encouraged to visit the HRSA Training and Technical Assistance

Website which houses all HRSA training and technical assistance resources to extend the reach of resources and further the impact of HRSA award recipients and stakeholders9. Resources are organized by topic and some resources may be listed under multiple topics.

II. Award Information

1. Type of Application and Award

Application type(s): Competing Continuation, New

We will fund you via a grant.

2. Summary of Funding

We estimate $500,000 will be available each year to fund up to 4 recipients. You may apply for a ceiling amount of up to $100,000 annually (reflecting direct and indirect costs) for Competing Continuation Awards and up to $150,000 annually (reflecting direct and indirect costs) for New Awards.

The period of performance is July 1, 2024, through June 30, 2029 (5 years).

This program notice depends on the appropriation of funds. If funds are appropriated for this purpose, we will proceed with the application and award process.

Support beyond the first budget year will depend on:

• Appropriation

• Satisfactory progress in meeting the project’s objectives

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

45 CFR part 75 - Uniform Administrative Requirements, Cost Principles, and Audit

Requirements for HHS Awards applies to all HRSA awards.

If you’ve never received a negotiated indirect cost rate, you may elect to charge a de minimis rate of 10 percent of modified total direct costs (MTDC)*. You may use this for the life of the award. If you choose this method, you must use it for all federal awards until you choose to negotiate for a rate. You may apply to do so at any time. See

Section 4.1.v. Budget Narrative in the Application Guide.

8 HRSA Telehealth.HHS.gov (2022) https://telehealth.hhs.gov/ 9 HRSA Training and Technical Assistance Hub https://www.hrsa.gov/library/ https://telehealth.hhs.gov/ https://www.hrsa.gov/library/index.html https://www.hrsa.gov/library/index.html https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75 https://telehealth.hhs.gov/ https://www.hrsa.gov/library/

HRSA-24-011 LPGP 6

*Note: One exception is a governmental department or agency unit that receives more than $35 million in direct federal funding.

III. Eligibility Information

1. Eligible Applicants

Competing Continuation Applicants: Entities that are currently funded under

HRSA-19-019 are eligible to apply as competing continuation applicants.

New Applicants: Eligible applicants are state professional licensing boards including but not limited to organizations that are in consortia with or associations of state licensing boards that cooperate to develop and implement state policies that will reduce statutory and regulatory barriers to telehealth.

2. Cost Sharing or Matching

Cost sharing/matching is not required for this program.

3. Other

We may not consider an application for funding if it contains any of the following non-responsive criteria:

• Exceeds the funding ceiling amount

• Fails to satisfy the deadline requirements referenced in Section IV.4

Multiple Applications

The applicant must choose which type of award they will apply for. HRSA will only review one application from an organization. Multiple applications from an organization are not allowed. HRSA will only accept and review your last validated electronic submission before the Grants.gov application due date.

IV. Application and Submission Information

1. Address to Request Application Package

We require you to apply online through Grants.gov. Use the SF-424 workspace application package associated with this notice of funding opportunity (NOFO). Follow these directions: How to Apply for Grants. If you choose to submit using an alternative online method, see Applicant System-to-System.

Note: Grants.gov calls the NOFO “Instructions.”

https://www.grants.gov/ https://www.grants.gov/applicants/grant-applications/how-to-apply-for-grants https://www.grants.gov/system-to-system/applicant-system-to-system/

HRSA-24-011 LPGP 7

Select “Subscribe” and enter your email address for HRSA-24-011 to receive emails about changes, clarifications, or instances where we republish the NOFO. You will also be notified by email of documents we place in the RELATED DOCUMENTS tab that may affect the NOFO and your application. You’re responsible for reviewing all information that relates to this NOFO.

2. Content and Form of Application Submission

Application Format Requirements

Submit your information as the Application Guide and this program-specific NOFO state. Do so in English and budget figures expressed in U.S. dollars. There’s an

Application Completeness Checklist in the Application Guide to help you.

Application Page Limit

The total number of pages that count toward the page limit shall be no more than 50 pages when we print them. We will not review any pages that exceed the page limit.

Using the pages within the page limit, HRSA will determine eligibility using Section III.

Eligibility Information of the NOFO.

These items do not count toward the page limit:

• Standard OMB-approved forms you find in the NOFO’s workspace application package

• Abstract (standard form (SF) "Project Abstract Summary”)

• Indirect Cost Rate Agreement

• Proof of non-profit status (if it applies)

If there are other items that do not count toward the page limit, we’ll make this clear in

Section IV.2.vi Attachments.

If you use an OMB-approved form that is not in the HRSA-24-011 workspace application package, it may count toward the page limit.

Applications must be complete and validated by Grants.gov under HRSA-24-011 before the deadline.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

• When you submit your application, you certify that you and your principals10 (for example, program director, principal investigator) can participate in receiving award funds to carry out a proposed project. That is, no federal department or agency has debarred, suspended, proposed for debarment, claimed you ineligible, or you have voluntarily excluded yourself from participating.

10 See def initions at eCFR :: 2 CFR 180.995 -- Principal. and eCFR :: 2 CFR 376.995 -- Principal (HHS supplement to government-wide def inition at 2 CFR 180.995).

https://www.ecfr.gov/current/title-2/subtitle-A/chapter-I/part-180/subpart-I/section-180.995 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376/subpart-I/section-376.995 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376/subpart-I/section-376.995

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• If you fail to make mandatory disclosures, we may take an action like those in 45 CFR § 75.371. This includes suspending or debarring you11.

• If you cannot certify this, you must include an explanation in Attachment 10:

Other Relevant Documents.

(See Section 4.1 viii “Certifications” of the Application Guide)

Program Requirements and Expectations

Logic Model - To lower applicant burden, a logic model will be required as a post-award activity.

Program-Specific Instructions

Include application requirements and instructions from Section 4 of the Application

Guide (budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract). Also include the following:

i. Project Abstract

Use the Standard OMB-approved Project Abstract Summary Form that you’ll find in the workspace application package. Do not upload the abstract as an attachment or it may count toward the page limit. For information you must include in the Project Abstract

Summary Form, see Section 4.1.ix of the Application Guide.

Please also include the following information in addition to the required information requested in the Project Abstract Summary Form:

o Identify if you are a new or competing continuation applicant. Applicant will be required to select New or Competing Continuation on the SF-424.

NARRATIVE GUIDANCE

The following table provides a crosswalk between the narrative language and where each section falls within the review criteria. Make sure you’ve addressed everything. We may consider any forms or attachments you reference in a narrative section during the merit review.

Narrative Section Review Criteria

Introduction Criterion 1: NEED

Organizational Information Criterion 4: IMPACT

Criterion 5: RESOURCES/CAPABILITIES

Need Criterion 1: NEED

Approach Criterion 2: RESPONSE

Criterion 4: IMPACT

11 See also 2 CFR parts 180 and 376, 31 U.S.C. § 3354, and 45 CFR § 75.113 https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75#se45.1.75_1371 https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75#se45.1.75_1371 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-I/part-180 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376 https://uscode.house.gov/view.xhtml?req=granuleid%3AUSC-prelim-title31-chapter33&edition=prelim https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-B/section-75.113

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Narrative Section Review Criteria

Work Plan Criterion 2: RESPONSE

Criterion 3: EVALUATIVE MEASURES Criterion 4: IMPACT

Resolution of Challenges Criterion 2: RESPONSE

Evaluation and Technical Support

Capacity

Criterion 3: EVALUATIVE MEASURES

Criterion 5: RESOURCES/CAPABILITIES

Budget Narrative Criterion 6: SUPPORT REQUESTED

ii. Project Narrative

This section must describe all aspects of the proposed project. Make it brief and clear.

Provide the following information in the following order. Please use the section headers.

This ensures reviewers can understand your proposed project.

▪ Introduction -- Corresponds to Section V’s Review Criterion #1 Need

Briefly describe the purpose of the proposed project to reduce statutory or regulatory barriers to telehealth through the multi-state collaboration of state professional licensing boards. Applicants must identify high-level goals and objectives of the proposed project.

▪ Organizational Information -- Corresponds to Section V’s Review Criterion #4

IMPACT and Criterion #5 RESOURCE/CAPABILITIES o Briefly describe your mission, structure, and scope of current activities.

Explain how these elements all contribute to the organization’s ability to carry out the program requirements and meet program expectations. Include a project organizational chart.

o Describe how the organization will follow the plan outlined in the application, to account for the federal funds and document all costs.

o Include a Staffing Plan (Attachment 2) that includes roles, responsibilities, and qualifications of project personnel.

o Demonstrate the qualifications of project staff in Biographical Sketches of Key Personnel (Attachment 3).

o Discuss how you’ll follow the approved plan, account for federal funds, and record all costs to avoid audit findings.

o Describe how you’ll assess and improve the unique needs of states and stakeholders involved in the project and services received.

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o If the Project Director serves as a Project Director for other federal awards, list the federal awards and the percent full-time equivalent (FTE) for that respective federal award.

o Describe relevant knowledge, skills, expertise and successes with similar projects, particularly collaborative endeavors that involve building coalitions among health care delivery sites, academic medical centers, and other necessary stakeholders.

o Discuss how the organization will follow the work plan in the application, adjust the work plan in consultation with HRSA and consistent with applicable regulation, account for the federal funds, and document all costs to avoid audit findings. If you will make subawards or expend funds on contracts, describe how your organization will ensure documentation of funds.

o Provide evidence to demonstrate commitment and ability to form collaborative, long-term relationships with key constituencies including rural health care delivery sites, and academic medical centers. Provide evidence of an existing infrastructure and extensive experience/track record of working with health care programs including rural sites.

▪ Need -- Corresponds to Section V’s Review Criterion(a) #1 Need o Outline the stakeholders, state(s) or organization’s multi-state licensure needs to improve access to quality physical and behavioral health care services through telehealth technology.

o Include current statutory or regulatory barriers to telehealth arising from issues pertaining to state professional licensure. The discussion of these barriers must clearly demonstrate the need for the proposed project using quantitative and qualitative data.

o Describe how overcoming barriers facilitates and expands the use of telehealth.

o Indicate how the need will benefit specifically from new federal funding and, similarly, that the recipient has not previously used federal funds to address the need specified in this application.

o Describe the target population and their unmet physical health and behavioral health needs.

This section will help reviewers understand whom you will serve with the proposed project.

▪ Approach -- Corresponds to Section V’s Review Criterion(a) #2 Response and #4

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

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o Propose innovative methods to develop or implement state policies pertaining to the portability of professional licenses to reduce barriers to telehealth as described in the previous section.

o Target efforts on a nationwide, multi-state model.

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

o Applicants must describe methods to communicate their efforts to the public, including through a public-facing webpage that highlights the LPGP and the

HRSA-funded activities.

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

▪ Work Plan -- Corresponds to Section V’s Review Criterion(a) #2 Response, #3

Evaluative Measures and #4 Impact o Describe how you’ll achieve each of the objectives during the period of performance. You find these in the Approach section.

o Use a timeline that includes each activity required to implement the proposed activity; key milestones associated with activity (at least annually); and identifies who is responsible for each. As needed, identify how key stakeholders will help plan, design, and carry out all activities, including the application.

o Incorporate any steps and the timeframe necessary to support ongoing aspects of the program once the federal support for the project has ended.

▪ Resolution of Challenges -- Corresponds to Section V’s Review Criterion(a) #2 Response

Discuss challenges and barriers that you are likely to encounter in designing and implementing the selected activities in the work plan. Explain approaches that you’ll use to resolve them to endure timely achievement of proposed milestones.

▪ Evaluation and Technical Support Capacity - Corresponds to Section V’s Review

Criterion(a) #3 Evaluative Measures and #5 Resources/Capabilities o Describe your organizational profile, budget, partners, key staffs’ experience, skills, and knowledge, key processes, and expected outcomes of the funded activities.

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o Describe the systems and processes that you’ll use to track performance outcomes. Describe how you’ll collect and manage data (for example, assigned skilled staff, data management software) in a way that allows for accurate and timely reporting of those outcomes.

o Describe your plan to evaluate how the program performs and how that will contribute to continuous quality improvement. The evaluation should monitor ongoing processes and the progress towards the project’s goals objectives and outcomes. Describe barriers and your plan to address them.

o Examples of potential metrics may include:

1. Number of health professionals and/or states participating in funded efforts.

2. Number of health professionals served through the LPGP-funded project who provide telehealth services to patients across state lines.

3. Number and specialty of health professionals participating in the LPGP-funded project who use telehealth.

4. Health care system benefit from implementation of proposed project (e.g., dollars and/or time saved at the state and/or individual level).

5. Patient benefit from proposed project (e.g., equity, access to care, quality and cost of care).

6. Stakeholder satisfaction with funded efforts.

7. Use of and satisfaction with related resources and Technical

Assistance (TA).

iii. Budget

The Application Guide directions may differ from those on Grants.gov.

Follow the instructions in Section 4.1.iv Budget of the Application Guide and any specific instructions listed in this section. Your budget should show a well-organized plan. A budget that follows the Application Guide will ensure that, if HRSA selects the application for funding, you will have a well-organized plan and, by carefully following the approved plan, may avoid audit issues during the implementation phase.

Reminder: The total project or program costs are all allowable (direct and indirect) costs used for the HRSA 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 MOE, if applicable).

In addition, applicants will submit a separate program-specific line-item budget for each year of requested funding of the proposed period of performance and upload it as

Attachment 5. The program specific line-item budget reflects allocations for each 12-month period of performance.

HRSA-24-011 LPGP 13

Program Income

You must use any program income you generate from awarded funds for approved project-related activities. Use program income under the addition alternative (45 CFR §

75.307(e)(2)). Find post-award requirements for program income at 45 CFR § 75.307.

Specific Instructions

As required by the Consolidated Appropriations Act, 2023 (P.L. 117-328), Division H, §

202, “None of the funds appropriated in this title shall be used to pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of

Executive Level II.” Effective January 2023, the salary rate limitation is $212,100. As required by law, salary rate limitations may apply in future years and will be updated.

iv. Budget Narrative

See Section 4.1.v. of the Application Guide.

The initial budget period for this funding opportunity is from 07/01/2024 – 06/30/2025.

The applicant must provide a budget for each year of requested funding for each Object

Class Category that reflects the cost for proposed activities. Based on the budget for each Object Class Category, the applicant will develop a consolidated budget. The submission for the Detailed Budget will be submitted as Attachment 5.

Provide a narrative that explains the amounts requested for each line in the budget. The budget justification must describe how each item will support the achievement of proposed objectives. The budget period is ONE year. However, the applicant must submit one-year budgets for each of the subsequent budget periods within the requested period of performance from 7/1/2024 – 6/30/2029 in the application. Line-item information must be provided to explain the costs entered in the SF-424A. Be careful about showing how each item in the “other” category is justified. For subsequent budget years, the justification narrative must highlight the changes from year one or indicate that there are no substantive budget changes during the period of performance. The budget justification must be concise. Do not use the justification to expand the project narrative.

v. Attachments

Provide the following attachments in the order we list them.

Most attachments count toward the application page limit. Indirect cost rate agreement and proof of non-profit status (if it applies) are the only exceptions. They will not count toward the page limit.

Clearly label each attachment. Upload attachments into the application. Reviewers will not open any attachments you link to.

https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.307 https://www.congress.gov/bill/117th-congress/house-bill/2617/text

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Attachment 1: Work Plan

Attach the project’s work plan. Make sure it includes everything that Section IV.2.ii.

Project Narrative details. If you’ll make subawards or spend funds on contracts, describe how your organization will document funds.

Attachment 2: Staffing Plan and Job Descriptions for Key Personnel (see Section 4.1. of the Application Guide)

Personnel is defined as persons funded by this award or persons conducting activities central to this program. If the Project Director serves as a Project Director for other federal awards, list the federal awards and the percent FTE for each federal award.

Each staff may not exceed 1 Full Time Equivalent (FTE) or full-time hours worked over combined federal dollars. Keep each job description to one page as much as possible.

Include the role, responsibilities, and qualifications of proposed project staff. Describe your organization’s timekeeping process. This ensures that you’ll comply with federal standards related to recording personnel costs.

Attachment 3: Biographical Sketches of Key Personnel (Do not count towards the page limit)

Include biographical sketches for people who will hold the key positions you describe in

Attachment 3. Keep it to two pages or less per person. Do not include information in the sketches that is not specified in the list below (e.g., addresses, social security numbers, phone numbers, etc.). If you include someone you have not hired yet, include a letter of commitment from that person with the biographical sketch.

Biographical sketches include the following:

1. Senior/key personnel name

2. Position Title

3. Education/Training – beginning with baccalaureate or other initial professional education, such as nursing, including postdoctoral training and residency training if applicable:

a. Institution and location

b. Degree (if applicable)

c. Date of degree (MM/YY)

d. Field of study

4. Section A (required) Personal Statement. Briefly describe why the individual’s experience and qualifications make them particularly well-suited for their role (e.g., Project Director or Principal Investigator) in the project that is the subject of the award, i.e., ample, and relevant expertise to managing a technology-enabled learning community model and building coalitions to support eligible entities in the creation of new learning community programs.

5. Section B (required) Positions and Honors. List in chronological order previous positions, concluding with the present position. List any honors. Include present membership on any Federal Government advisory committee.

6. Section C (optional) Other Support. List both selected ongoing and completed (during the last 3 years) projects (federal or non-federal support). Begin with any

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projects relevant to the project proposed in this application. Briefly indicate the overall goals of the projects and responsibilities of the Senior/Key Person identified on the Biographical Sketch.

Attachment 4: Letters of Agreement, Memoranda of Understanding (as required to document eligibility) and Project Partners

List the participating state licensing boards and other project partners. Include a key point of contact for each participant, and their contact information. Attach a letter from each of the participants that includes the service(s) provided, working relationship, number of clients and geographic areas served. The attached letters must also highlight their commitment to the project and the specific roles each will play in the development and operation of the proposed project. Documents that confirm actual or pending contracts or agreements should clearly describe the roles of the contractors and any deliverable. If applicable, provide the Memoranda of Agreement (MOA) or Memoranda of Understanding (MOU) with proposed or existing partners. MOA/MOU documents must describe the roles of subcontractors and their deliverables with dates that include the length of the agreement. Make sure you sign and date any letters of agreement.

Attachment 5: For Multi-Year Budgets--5th Year Budget

Include the program-specific line-item budget and the Revenue Summary for each year of the proposed period of performance (see Section IV.2.iv Budget Narrative for additional information). It is recommended that Attachment 5 be converted to a PDF to ensure page count does not change when the document is uploaded into Grants.gov

After using columns (1) through (4) of the SF-424A Section B for a 5-year period of performance, you need to submit the budget for the 5th year as an attachment. SF-424A

Section B does not count in the page limit; however, any related budget narrative does count. See Section 4.1.iv of the Application Guide.

Attachment 6: Project Organizational Chart

Provide a one-page figure that depicts the project's organizational structure, including subcontractors and other significant collaborators. If the program is part of a larger institution, please depict where the project fits within the larger institution.

Attachment 7: Letters of Support

Include only letters of support that specifically indicate a commitment to the project/program (in-kind services, dollars, staff, space, equipment, etc.). List other support letters on one page.

Attachment 8: Indirect Cost Rate Agreement (if applicable)

Include documentation if your organization has an established indirect cost rate. For this program, indirect costs must apply to the activities funded under this program.

Attachment 9: Tables, Charts, etc.

Provide tables or charts that give more details about the proposal (for example, Gantt or

PERT charts, flow charts).

https://www.grants.gov/

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Attachments 10–15: Other Relevant Documents (no more than 15)

Include any other documents that are relevant to the application.

3. Unique Entity Identifier (UEI) and System for Award Management (SAM)

A UEI is required to apply for this funding. You must register in the SAM.gov to receive your UEI.

You cannot use a DUNS number to apply. For more details, visit the following webpage:

General Service Administration’s UEI Update.

After you register with SAM, maintain it. Keep your information updated when you have:

an active federal award, application, or plan that an agency is considering.12

When you register, you must submit a notarized letter naming the authorized Entity

Administrator.

We will not make an award until you comply with all relevant SAM requirements. If you have not met the requirements by the time we’re ready to make an award, we will deem you unqualified and award another applicant.

If you already registered on Grants.gov, confirm that the registration is active and that the Authorized Organization Representative (AOR) has been approved.

To register in Grants.gov, submit information in two systems:

• System for Award Management (SAM) (SAM Knowledge Base)

• Grants.gov

Effective March 3, 2023, individuals assigned a SAM.gov Entity Administrator role must be an employee, officer, or board member, and cannot be a non-employee. This change is to ensure entities are in control of who has permission to control roles within their entity.

Here’s what this means:

• Entity Administrators assigning roles to non-employees will only be able to assign a

Data Entry role or lower.

• Any entities assigning Entity Administrator roles using an Entity Administrator Role

Request Letter (formerly called “notarized letter”) will no longer be able to assign the

Entity Administrator role to a non-employee.

12 Unless 2 CFR § 25.110(b) or (c) exempts you f rom those requirements or the agency approved an exemption for you under 2 CFR § 25.110(d)).

https://www.gsa.gov/entityid https://sam.gov/content/home https://www.fsd.gov/gsafsd_sp?id=gsa_kb_view2&kb_id=f66d8e6cdb76d4100d73f81d0f9619c6 https://www.grants.gov/ https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.fsd.gov%2Fgsafsd_sp%3Fid%3Dkb_article_view%26sysparm_article%3DKB0017347&data=05%7C01%7CDDixon%40hrsa.gov%7C80dfe1e3c58a4e26cd0008db143e65c3%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638126030447564740%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=nnDr7%2B8Bn1g9416eowK4Vwfx%2BO2%2BuUP1Nlu9KkvZoa4%3D&reserved=0

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• Entity Administrator roles assigned to non-employees will be converted to Data Entry roles. With a Data Entry role, non-employees can still create and manage entity registration data entry but cannot manage roles.

If you are an entity using a non-employee or if you are a non-employee working with an entity to manage registrations, please read (and share) more about this change on the

BUY.GSA.gov blog to know what to expect.

For more details, see Section 3.1 of the Application Guide.

Note: Allow enough time to register with SAM and Grants.gov. We do not grant application extensions or waivers if you fail to register in time.

4. Submission Dates and Times

Application Due Date

Your application is due on April 8, 2024, at 11:59 p.m. ET. We suggest you submit your application to Grants.gov at least 3 calendar days before the deadline to allow for any unexpected events. See the Application Guide’s Section 8.2.5 – Summary of emails from Grants.gov.

5. Intergovernmental Review

The LPGP must follow the terms of Executive Order 12372 in 45 CFR part 100.

See Section 4.1 ii of the Application Guide for more information.

6. Funding Restrictions

The General Provisions in Division H of the Consolidated Appropriations Act, 2023 (P.L.

117-328) apply to this program. See Section 4.1 of the Application Guide for information. Note that these and other restrictions will apply in fiscal years that follow, as the law requires.

Program-specific Restrictions

You must have policies, procedures, and financial controls in place. Anyone who receives federal funding must comply with legal requirements and restrictions, including those that limit specific uses of funding.

• Follow the list of statutory restrictions on the use of funds in Section 4.1

(Funding Restrictions) of the Application Guide. We may audit the effectiveness of these policies, procedures, and controls.

• 2 CFR § 200.216 prohibits certain telecommunications and video surveillance services or equipment. For details, see the HRSA Grants Policy Bulletin Number:

2021-01E.

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fbuy.gsa.gov%2Finteract%2Fcommunity%2F47%2Factivity-feed%2Fpost%2Fa14726f4-e2a9-47b3-80ec-7ceff5108706%2FA_Change_in_SAM_gov_will_Affect_Access_for_Some_Entity_Administrators&data=05%7C01%7CDDixon%40hrsa.gov%7C80dfe1e3c58a4e26cd0008db143e65c3%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638126030447564740%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=ZTRBuys3iNJZeAUQ7rDx56aVR1BrI3wE4z%2FHBoFbQTU%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fbuy.gsa.gov%2Finteract%2Fcommunity%2F47%2Factivity-feed%2Fpost%2Fa14726f4-e2a9-47b3-80ec-7ceff5108706%2FA_Change_in_SAM_gov_will_Affect_Access_for_Some_Entity_Administrators&data=05%7C01%7CDDixon%40hrsa.gov%7C80dfe1e3c58a4e26cd0008db143e65c3%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638126030447564740%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=ZTRBuys3iNJZeAUQ7rDx56aVR1BrI3wE4z%2FHBoFbQTU%3D&reserved=0 https://www.archives.gov/federal-register/codification/executive-order/12372.html https://www.congress.gov/bill/117th-congress/house-bill/2617/text https://www.congress.gov/bill/117th-congress/house-bill/2617/text https://www.hrsa.gov/sites/default/files/hrsa/grants/manage/grants-policy-bulletin-2021.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/manage/grants-policy-bulletin-2021.pdf

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7. Other Submission Requirements

Letter of Intent to Apply

The letter should identify your organization and its intent to apply and briefly describe the proposal. HRSA will not acknowledge receipt of letters of intent.

Send the letter via email by March 8, 2024 to:

HRSA Digital Services Operation (DSO) Use the HRSA opportunity number as email subject (HRSA-24-011)

HRSADSO@hrsa.gov

Although HRSA encourages letters of intent to apply, they are not required. You are eligible to apply even if you do not submit a letter of intent.

V. Application Review Information

1. Review Criteria

We use six review criteria to review and rank LPGP applications. Here are descriptions of the review criteria and their scoring points.

Criterion 1: NEED (20 points) – Corresponds to Section IV’s Introduction and Need

A. Purpose: The extent to which the application conforms with the purpose of this funding opportunity and identifies goals and objectives in alignment.

B. Current Barriers: The extent to which the applicant displays a clear understanding of the current statutory or regulatory barriers to telehealth due to issues of state professional licensure.

C. Need for Project: The extent to which the applicant demonstrates how these barriers relate to the need for the proposed project under the grant program and how overcoming these barriers will facilitate and expand the use of telehealth in clinical disciplines in which there is considerable need for interstate licensure to improve access to quality physical health and behavioral health services through telehealth technology.

D. Need for Funding: The extent to which the application demonstrates a need that the applicant has not addressed using federal funds (i.e., articulates how the activities under this notice are new activities).

Criterion 2: RESPONSE (30 points) – Corresponds to Section IV’s Approach, Work Plan, and Resolution of Challenges

Approach (12 points)

A. Strategy: The extent to which the application narrative identifies methods to address state licensure barriers to telehealth through multi-state collaborations, and sufficiently justifies why these methods constitute the best approach to

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achieve the stated goals and objectives. The appropriateness of the strategy considering the scope and length of the project.

B. Communication: The clarity and feasibility of plans to engage stakeholders and communicate findings to the public, including a public-facing webpage highlighting the LPGP program and providing information to the public and the applicant’s constituents.

C. Innovation: The extent to which the application proposes a novel plan for addressing state licensure barriers to telehealth that does not duplicate previous federally funded efforts.

D. Sustainability: The extent to which the application proposes a realistic plan to sustain key elements of the program that have been effective in improving practices and outcomes after the period of federal funding ends.

Work Plan (12 points) A. Activities: The extent to which the work plan identifies concrete activities or steps to implement the proposed strategy and achieve the identified goals and objectives.

B. Staffing and Partners: The extent to which the work plan identifies staff responsible for overseeing each activity and the partners involved with each activity.

C. Timeline: Will support continued expansion of the established multi-state collaborative or the launch of multi-state collaborative by Year 2 of the proposed 5-year award.

D. Milestones: The extent to which the work plan includes milestones that are measurable, achievable within the period of performance, and attributable to the award.

Resolution of Challenges (6 points)

A. Understanding of Challenges: The extent to which the applicant identif ies potential technical, political, and organizational challenges to implementing the proposed project.

B. Overcoming Challenges: The extent to which the approach and work plan reflect strategies and steps to overcome the challenges identified.

Criterion 3: EVALUATIVE MEASURES (15 points) – Corresponds to Section IV’s Work

Plan and Evaluation and Technical Support Capacity

A. Metrics: The extent to which the application proposes specific and appropriate metrics to report to HRSA, with a particular focus on metrics related to telehealth.

B. Data: The extent to which the application demonstrates the availability of data to calculate proposed metrics on a regular and recurring basis.

C. Analysis): The extent to which the applicant organization intends to analyze the metrics and use them to assess project activities and progress towards outcomes.

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Criterion 4: IMPACT (15 points) – Corresponds to Section IV’s Approach, Work Plan and Organizational Information

A. Outcomes-driven: The extent to which the proposed project, as demonstrated in the narrative, reflects methods designed to reduce barriers to and maximize the use of telehealth across states.

B. Timeliness: The extent to which the work plan includes milestones for each year of the 5-year period of performance that clearly link to goals and objectives. The extent to which the project can demonstrate outcomes by the end of the 5-year period of performance.

C. Reach: The extent to which project results are either nationwide or scalable, the degree to which the project activities may be replicable, and the sustainability of the program beyond the period of federal funding.

Criterion 5:…