PKG00248333-instructions.pdf

Distance Learning and Telemedicine Grant Program

Opioid Application Guide

Fiscal Year 2019

Rural Utilities Service Telecommunications Program

February 2019

DISTANCE LEARNING & TELEMEDICINE PROGRAM

GRANT APPLICATION GUIDE - Opioid Treatment

FISCAL YEAR 2019

RURAL UTILITIES SERVICE

RURAL DEVELOPMENT

UNITED STATES DEPARTMENT OF AGRICULTURE

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0575-0096.

The time required to complete this information collection is estimated to average 48 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information

Persons with disabilities who require alternative means for communications of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center on

(202) 720-1127 (TDD).

USDA is an equal opportunity provider, employer and lender.

Table of Contents

General Information:

Changes for 2019 DLT-Opioid Treatment:

Eligible Grant Purposes:

Ineligible Grant Purposes:

Additional Eligibility Criteria:

Other Considerations

Rural Areas

Online Education Services

Grant Limits

Grant Review Process

Completing the Grant Application

A. Standard Form 424 w/Site Worksheet

B. Executive Summary

C. Scoring Criteria Documentation

D. Matching Requirements

Match Documentation Specifics -

E. Scope of Work

F. Financial Information and Sustainability

G. Statement of Experience

H. Telecommunications System Plan

I. Compliance with other Federal Statutes

J. Evidence of Legal Existence and Authority to Contract with the Federal Government .. 35

K. Environmental Impact and Historic Preservation

L. Consultation with USDA State Director

M. Supplemental Information

Appendix A - Forms

Appendix B: Finding Information on the Census Website

Introduction and General Information

Distance Learning and Telemedicine Program

General Information:

Distance learning means a telecommunications link to an end user through the use of eligible equipment to provide educational programs, instruction, or information originating in one area, whether rural or not, to students and teachers who are located in rural areas.

Telemedicine means a telecommunications link to an end user through the use of eligible equipment which electronically links medical professionals at separate sites in order to exchange health care information in audio, video, graphic, or other format for the purpose of providing improved health care services primarily to residents of rural areas.

The Distance Learning and Telemedicine (DLT) Grant Program is specifically designed to assist rural communities in acquiring distance learning and telemedical technologies so that local teachers, and medical service providers who serve rural residents can link to other teachers, medical professionals, and other needed expertise located at distances too far to access otherwise. Since 1994, the DLT Grant Program has helped to establish hundreds of distance learning and telemedicine systems improving quality of life for thousands of residents in rural communities all across the United States.

!! BEFORE GETTING STARTED!!

All applicants must read:

7 CFR 1734, Subpart A and B

Funding Opportunity Announcement (FOA) posted on the DLT Program Website and Grants.gov on February 14, 2019.

DLT Program Website: https://www.rd.usda.gov/programs-services/distance-learning-telemedicine-grants;

The regulation MUST be used in conjunction with this Application Guide. Should any differences result in the interpretation of this Application Guide and the regulation, the regulation takes precedence over information contained in this

Application Guide.

https://www.rd.usda.gov/programs-services/distance-learning-telemedicine-grants

For additional information concerning this grant program, please contact:

Loan Origination and Approval Division, Telecommunications Program

(202) 720-0800 or Email: dltinfo@wdc.usda.gov

Additional information and forms are available on our website at:

When and Where to Submit Application:

GRANT applications must be postmarked by:

April 15, 2019

Applications must be submitted in EITHER of the following two ways:

1. Electronically via www.grants.gov

If submitting via grants.gov, it is the applicant’s responsibility to ensure that all required documentation is included with the submittal.

OR

2. Postmarked, shipped, or hand-delivered 2 paper copies of a completed application, one with original signatures, accompanied by a full electronic copy in the form of a USB

Flash Drive. The paper applications and the USB Flash Drive containing a digital copy of the full application must be submitted to:

Deputy Assistant Administrator

Loan Origination and Approval Division

Rural Utilities Service

STOP 1597, Room 2844

1400 Independence Ave., SW

Washington, D.C. 20250-1597

Due to the possible disruptions in mail delivery service, applicants are strongly encouraged to submit applications via express mail or hand delivery to our office.

mailto:dltinfo@wdc.usda.gov https://www.grants.gov/

Applicants that submit their applications after the deadline noted above will be notified that their applications will not be considered for funding and their applications will be returned.

Prior to official submission of applications, applicants may request technical assistance or other application guidance from the Agency, if such requests are made at least 15 days prior to the due date listed in FOA. Technical assistance is not meant to be an analysis or assessment of the quality of the materials submitted, a substitute for agency review of completed applications, nor a determination of eligibility, if such determination requires in-depth analysis. The Agency will not solicit or consider scoring or eligibility information that is submitted after the application deadline. The Agency reserves the right to contact applications to seek clarification information on materials contained in the submitted application.

Applications Delivered by Mail:

Paper applications must show proof of mailing or shipping consisting of one of the following:

1. A legibly dated U.S. Postal Service (USPS) postmark;

2. A legible mail receipt with the date of mailing stamped by the USPS by midnight Eastern

Time; or

3. A dated shipping label from a commercial carrier showing that the commercial carrier received the package on or before the application submittal deadline. Self-generated shipping labels where the actual pickup by the carrier occurs after the application submittal deadline are not acceptable.

If an application is sent through the USPS, neither of the following will be accepted as proof of mailing:

1. A private metered postmark; or

2. A mail receipt that is not dated by the USPS.

Applicants should note that the USPS does not uniformly provide a dated postmark. Before relying on this method, an applicant should check with its local post office.

Applications Delivered by Hand:

Applications delivered by hand will be accepted daily between 8:00 a.m. and 4:30 p.m. (Eastern

Time), except Saturdays, Sundays, and Federal holidays. Individuals delivering applications must provide proper identification to enter the building.

Applications Submitted Electronically:

Electronic applications will only be accepted when submitted through the Grants.gov website. Applications will not be accepted via facsimile machine transmission or electronic mail.

https://www.grants.gov

The Rural Utilities Service (RUS) strongly encourages applicants to obtain all necessary sign-ups, credentials and authorizations well in advance of the deadline including the required

SAM.gov registration. Grants.gov requires some one-time credentialing and online authentication procedures. These procedures may take several business days to complete.

Several requirements on Grants.gov and SAM.gov call for an annual update; applicants should also ensure that their credentials and authorizations are up-to-date.

The Grants.gov website, like all web facilities, has finite capacity. If several federal grant programs have the same application deadline date, periods of site overloading can be experienced. Please plan accordingly.

Please follow the instructions on Grants.gov. If applicants experience a technical problem retrieving or submitting an electronic application, they should contact the Grants.gov customer support resources (click the "Customer Support" tab on any page of Grants.gov to get started).

RUS staffers do not control the technical aspects of Grants.gov and won't be able to help if an applicant experiences a problem. However, RUS is available to answer questions about the

Program and the contents of an application.

Grants.gov applications must be submitted by midnight Eastern Time on the closing date.

Additional Registration Requirements for all Applicants:

Dun and Bradstreet Data Universal Numbering System Registration – As required by the

Office of Management and Budget (OMB), all applicants for grants must supply a Dun and

Bradstreet Data Universal Numbering System (DUNS) number when applying. The Standard

Form 424 (SF–424) contains a blank to enter the DUNS number. The DUNS number can be obtained free of charge by calling Dun & Bradstreet.

Please see: https://www.grants.gov/applicants/organization-registration/step-1-obtain-duns-number.html for more information on how to obtain a DUNS number or how to verify an organization’s number.

https://www.grants.gov/applicants/organization-registration/step-1-obtain-duns-number.html https://www.grants.gov/applicants/organization-registration/step-1-obtain-duns-number.html

The DUNS number must belong to the Applicant, not an affiliate, subsidiary or parent company.

System for Award Management Registration – Applicants, whether applying electronically or by paper, also must register in the System for Award Management (SAM) PRIOR to submitting an application. Applicants may register for the SAM free of charge at https://www.sam.gov/SAM/ .

Applicants should keep in mind that it can take up to ten (10) business days to register with

SAM. Applicants should plan accordingly and begin the process well in advance of the application deadline.

The SAM registration must remain active with current information at all times while RUS is considering an application or while a Federal Grant Award or loan is active. To maintain the registration in the SAM database the applicant must review and update the information free of charge in the SAM database annually from date of initial registration or from the date of the last update. The applicant must ensure that the information in the database is current, accurate, and complete.

Please check the applicant's SAM registration for accuracy prior to submitting an application.

Changes for 2019 DLT-Opioid Treatment:

Application Guide changes:

1. Opioid Treatment DLT Applications should address how they will strengthen local capacity to address one or more of the following focus areas:

1. Prevention—for example, educating community members and care providers or implementing harm reduction strategies to reduce the number of fatal opioid-related overdoses and the occurrence of opioid use disorder among new and at-risk users.

2. Treatment—for example, implementing or expanding access to evidence-based practices for opioid use disorder treatment, such as medication-assisted treatment.

3. Recovery—for example, expanding peer recovery and treatment options that help people with opioid use disorder start recovery and avoid relapse

2. Scoring categories have been revised. There are now 4 potential scoring categories, 3 objectives and one subjective, with a maximum of 145 points. The scoring categories are Rurality (30 points), Economic Need (30 points), Special Considerations (30 points) and Need and Benefits (55 points).

3. Special Consideration: Applications will receive 5 additional points (up to 30 points) for each hub/end-user or end-user site that is located within the 220 at-risk counties identified by the CDC. Special Consideration is addressed in Section C-3.

4. Section J: Applicants must provide acceptable evidence of legal existence along with

SAM.gov print out.

https://www.sam.gov/SAM/

Eligibility Requirements

Applicant Eligibility

To be eligible for a grant, an organization must:

1. Be legally organized as an incorporated organization, an Indian tribe or tribal organization, as defined in 25 U.S.C. 450b (e); a state or local unit of government, a consortium; or other legal entity, including a private corporation organized on a for-profit or not-for-profit basis. Each applicant must provide evidence of its legal capacity to contract with the Rural Utilities Service to obtain the grant and comply with all applicable requirements.

Consortium: A consortium is a combination or group of entities formed to undertake the purposes for which the distance learning and telemedicine financial assistance is provided.

• If the applicant is an existing established consortium with the legal ability to contract with the Federal Government, that organization can apply in the name of the formal consortium.

• If the applicant is an informal consortium which by itself lacks the legal capacity to contract with the Federal Government, each individual entity must contract with RUS in its own behalf.

• An informal consortium may have a legally organized host organization which will apply on behalf of the consortium and be designated as the project owner with all awardee responsibilities.

2. Either operate a rural community facility or deliver distance learning or telemedicine services to entities that operate a rural community facility or to residents of rural areas at rates calculated to ensure that the benefit of the financial assistance is passed through to such entities or to residents of rural areas.

Per 2 CFR 200.319 (a), contractors that develop or draft specifications, requirements, statements of work, and invitations for bids or requests for proposals must be excluded from competing for procurements of equipment or services under the grant.

Equipment vendors, manufacturers, system integrators, and other businesses whose purpose in the proposal is to sell equipment or technological services to support applicants cannot themselves be applicants or affiliates of the applicant. If the grant writer for the application is paid by a vendor, manufacturer, system integrator, or other business, the vendor, manufacturer, system integrator or other business becomes an affiliate of the applicant and cannot participate in the project.

Note: Electric or telecommunications borrowers financed through the Rural Utilities Service are eligible for grants.

Eligible Grant Purposes:

There are three categories of eligible purposes:

1. Acquiring, by lease or purchase, eligible equipment. If leased, the cost of the lease during the three-year life of the grant is eligible.

The following are examples of eligible equipment. This list is not exhaustive. Neither does it convey blanket eligibility. A computer is not automatically eligible. It must be used for an eligible purpose. Remember also that the purpose of the DLT Grant program is to deliver education or medical care between remote sites via telecommunications, not simply to furnish educational or medical technology.

• Computer hardware and software

• Site licenses and maintenance contracts

• Extended warranties (up to 3 years)

• Audio and video equipment

• Computer network components

• Telecommunications terminal equipment

• Data terminal equipment

• Interactive audio/video equipment

• Inside wiring

• Broadband facilities, if owned by the applicant

In general, equipment not electronically interconnected to the grant and match funded equipment is not eligible. The application must demonstrate both that the predominant purpose (50% or more of use) of every line-item in the grant and match budget meets the DLT Grant definition of distance learning and/or telemedicine, NOTE: All equipment purchased for this Project must be new or non-depreciated.

2. Acquiring instructional programming that is a capital asset (including the purchase or lease of instructional programming already on the market). Renewals of instructional programming are not eligible nor is classroom equipment (such as laboratory equipment).

Also, expenses (such as those for tuition, fees for coursework on a per course basis, or fees for cultural events or virtual field trips) are not capital assets and therefore, are not eligible.

3. Providing technical assistance and instruction for using eligible equipment, including any related software; developing instructional programming that is a capital asset and providing engineering or environmental studies relating to the establishment or expansion of the phase of the project to be financed with the grant. The costs for this category cannot exceed 10% of the grant amount requested.

Ineligible Grant Purposes:

The following purposes are considered ineligible grant purposes (see 7 CFR 1734.23):

• To pay for medical or educational equipment not having telemedicine or distance learning as its essential function; including telephone systems.

• To pay for Electronic Medical Records (EMS) systems.

• To pay salaries, wages, or employee benefits to medical or educational personnel;

• To pay for the salaries or administrative expenses of the applicant or the project;

• To purchase equipment that will be owned by the local exchange carrier or another telecommunications service provider unless that service provider is the applicant.

• To duplicate facilities providing distance learning or telemedicine services in place or to reimburse the applicant or others for costs incurred prior to RUS' receipt of the completed application;

• To pay costs of preparing the application package for financial assistance under this program;

• For projects whose sole objective is to provide links between teachers and students or between medical professionals who are located at the same facility or campus environment;

• For site development and the destruction or alteration of buildings;

• For the purchase of land, buildings, or building construction;

• For projects located in areas covered by the Coastal Barrier Resources Act (16 U.S.C.

3501 et seq.);

• For any purpose that the Administrator has not specifically approved;

• Except for leases provided for in §1734.21, to pay the cost of recurring or operating expenses for the project including but not limited to broadband connection fees;

• For any other purposes not specifically contained in §1734.21.

Additionally, except as otherwise provided in §1734.12, grants shall not be used to finance a project, in part, when the success of the project is dependent upon the receipt of additional financial assistance under this subpart or is dependent upon the receipt of other financial assistance that is not assured.

Additional Eligibility Criteria:

1. Minimum Rurality Score: In order to be eligible to receive a grant, an application must receive a minimum of 15 points as an average score for all hub/end-user and end-user sites included in the project. See instructions under Section C-1 for calculating the

Rurality Score.

2. Matching Contribution: The grant applicant’s matching contribution must equal 15 percent of the grant amount requested and be used for eligible grant purposes. See instructions under Section D for more information on the Matching Contribution.

Other Considerations:

Rural Areas: The intent of the DLT program is to benefit rural areas (populations of 20,000 or less). While some projects could include end-users in more urbanized areas, the Agency will evaluate projects based on their benefit to rural areas.

Online Education Services: Because this program is intended to fund end-user equipment at specifically identified sites, applications which propose to provide only web-based services which are universally available are considered ineligible. This type of project does not have a defined service area and the beneficiaries can be located anywhere, including urban areas.

Grant Limits

The minimum Grant amount which can be requested is $50,000. The maximum Grant amount which can be requested is $500,000.

Grant Review Process

1. Grant Receipt: Completed applications must be postmarked, hand-delivered, or submitted through https://www.grants.gov/ by the specified submission date to be considered for funding.

2. Incomplete Applications: RUS may request additional information that would not change the application or scoring, in order to complete the appropriate documents covering financial assistance.

3. Scoring: All complete applications will be scored in accordance with the criteria set forth in this guide, on the program website and the Grants.gov website.

4. Ineligible Applications: Applicants with applications that are deemed ineligible will be notified in writing regarding application deficiencies.

5. Appeals: RUS Telecommunications and Electric Borrowers may appeal the decision to reject their application. Any appeal must be made, in writing, within 10 days after the applicant is notified of the determination to deny the application.

6. Selection Process: Applications will be selected for approval based on scores assigned, availability of funds, and the provisions of § 1734.27.

Regardless of the number of points an application receives, the Administrator may take any of the following actions:

a) Limit the number of applications selected for projects located in any one State during a fiscal year.

b) Limit the number of selected applications for a particular type of project.

c) Select an application receiving fewer points than another application, if there are insufficient funds during a particular funding period to select the higher scoring application. If the Administrator makes this kind of selection and it affects an application, the applicant will be given an opportunity to reduce the amount of the grant request to the amount of funds available.

7. Legal Documents: All grantees will be required to execute a standard DLT Grant

Agreement. A standard form of this agreement can be found on our website under the

Forms and Resources tab at: http://www.rd.usda.gov/programs-services/distance-learning-telemedicine-grants

Completing the Grant Application

This section addresses all the information that must be submitted in order for an application to be deemed complete and considered for funding. Please make sure that all the necessary information is included in the appropriate section. All the required forms and certifications are included in Appendix A to this Guide

A. Standard Form 424 w/Site Worksheet

B. An Executive Summary of the Project

C. Scoring Criteria Documentation

D. Matching Requirements

E. Scope of Work

F. Financial Information and Sustainability

G. Statement of Experience

H. Telecommunications System Plan

I. Compliance with other Federal Statutes http://www.rd.usda.gov/programs-services/distance-learning-telemedicine-grants

J. Evidence of Legal Authority and Existence

K. Environmental Impact and Historic Preservation

L. Consultation with USDA State Director and State Strategic Plan Conformity

M. Supplemental Information

A. Standard Form 424 w/Site Worksheet

There is one attachment to the SF-424, the Site Worksheet (required). Please use the following definitions on the Site Worksheet when distinguishing a site as a Hub, Hub/End-User or End-

User Site. Applicant will keep these designations the same for Rurality and Economic Need

Worksheets.

Hub Sites: A hub site is a facility that is part of a network or telecommunications system that provides educational or medical services to hub/end-user and/or end-user sites. A pure hub receives no end-user benefits. The site is usually a connection management point or is exclusively an educational or medical source of distance learning or telemedicine.

End-User Site: An end-user site is a facility that is part of a network or telecommunications system that is utilized by end-users. For a site to be included as an end-user site for scoring purposes, the applicant must demonstrate equipment purchased will be installed or placed at the site and site will only receive benefits or services from other networked sites.

A Hub/End-User site performs both functions: a hub which also accommodates end-users.

Some of the information requested on the Site Worksheets such as population and congressional districts can be obtained at the US Census web site. Further guidance on navigating the US

Census website is available in Appendix B.

The paper application must be signed by an authorized representative of the organization who has the authority to commit the organization’s resources to carry out the project for the term of the grant. If the application is submitted through Grants.gov, the person submitting the application must be an authorized representative.

B. Executive Summary

The Executive Summary gives reviewers their first overall view of the project area, the problems that residents face, and how the proposed project will address those problems. This is the applicant's opportunity to discuss the core aspects of the project. It should contain a concise description of the project including:

1. A description of why the project is needed and how it will strengthen local capacity to address one or more of the following focus areas.

1. Prevention—for example, educating community members and care providers or implementing harm reduction strategies to reduce the number of fatal opioid-related overdoses and the occurrence of opioid use disorder among new and at-risk users.

2. Treatment—for example, implementing or expanding access to evidence-based practices for opioid use disorder treatment, such as medication-assisted treatment.

3. Recovery—for example, expanding peer recovery and treatment options that help people with opioid use disorder start recovery and avoid relapse.

2. An explanation of how the applicant will address the need cited, why the applicant requires the financial assistance, the types of education or medical services to be offered by the projects, and the benefits to rural residents;

3. A description of the applicant, documenting eligibility;

4. An explanation of the total project cost including a breakdown of the grant required and the source of matching contribution and other financial assistance for the remainder of the project;

5. A statement specifying whether the project is either a distance learning or telemedicine facility as defined in § 1734.3. If the project provides both distance learning and telemedicine services, the applicant must identify the predominant use of the system;

6. A statement specifying whether the project is requesting special consideration points for having a hub/end-user or end-user site located within the 220 at-risk counties identified by the CDC.

7. A general overview of the telecommunications system to be developed, including the types of equipment, technologies, and facilities used;

8. A description of the participating hubs, hub/end-user and end-user sites and the number of rural residents that will be served by the project at each hub/end-user or end-user site;

9. A certification by the applicant that facilities constructed with grants do not duplicate adequate established telemedicine or distance learning services; and

10. A listing of the location of each hub/end-user and end-user site (city, town, village, borough, or rural areas) plus the State.

At the end of the Executive Summary, please provide a section titled “Publicly Releasable

Project Description” which contains the following information:

1. Title of the Project

2. Description of the proposed hub/end-user and end-user site(s)

3. A brief description of project

4. Total estimated population affected by proposed project

Any information included in this section may be released to interested parties inquiring about an application, so please provide an adequate description of the project, but do not include any information that the applicant would not want released to the public. Please clearly denote the section which is publicly releasable, including where the releasable description begins AND ends.

C. Scoring Criteria Documentation

The DLT Grant Program is a competitive program. Applications are scored in objective and subjective categories. The table below lists each DLT category, and the maximum points available.

Objective Criteria

C-1 Rural Area (Rurality): This category based on Census population data.

(up to 30 points)

C-2 Economic Need (SAIPE): This category is based on the U.S. Census Bureau’s SAIPE

(up to 30 points) program used to project annual estimates of income and poverty statistics for school districts, counties, and states.

C-3 Special Consideration: Applicants will receive 5 additional points for each end-

(up to 30 points) user site that is located within the 220 at-risk counties identified by the CDC. The at-risk counties are listed in the guide and they are also available in the Application Guide and the CDC website at https://www.cdc.gov/pwid/vulnerable-counties-data.html.

Such applications will be awarded up to 30 points

Subjective Criteria

C-4 Need for Services and Project Benefits (Needs & Benefits):

(up to 55 points) The Agency is seeking applications that use DLT technologies to facilitate the following opioid-related services:

1. Specialized medical, dental, psychiatric, or pharmaceutical services

2. Group counseling and other peer support services

3. Family therapy and support services

4. Home monitoring applications to support patients in between medical visits

5. School-based or community-based health centers

6. Peer-to-peer or mentor-led training between workers in the same professional sector or across sectors (e.g., nurse-to-nurse, judge-to-judge, teacher-to-teacher exchange and/or doctor-to-teacher, judge-to-counselor, nurse-to-judge, doctor-to-police exchange, etc.)

7. Advanced training classes or “virtual clinics” led by specialty care providers to train primary or rural care providers

8. Recovery support or workforce training for people with substance use disorder https://www.cdc.gov/pwid/vulnerable-counties-data.html

C-1 Rurality – Up to 30 Points

The Rurality score is based on the population size of each community where an end user site is located. For non-fixed site projects and projects which contain non-fixed components, the

Rurality score will be based on the population of the Hub site. Applicants can use Census population data either from the Census FactFinder Website (Appendix B) or from the Rand

McNally Atlas (Atlas) that cites the 2010 Census as its source for population statistics.

Population figures used in the 2019 DLT Grant competition must use the 2010 Census as the source, whether it is from the Atlas, or from the FactFinder Website.

Please use the Rurality Worksheet to calculate the Rurality Score. The Worksheet is available as an Excel worksheet at: https://www.rd.usda.gov/files/DLT2019-

Opioid_Treatment_Worksheets.xlsx.

Include the population statistics and rurality calculations for all sites, including those designated as (pure) hubs. Use the following definitions for assistance in designating the type of site:

Hub Sites: A hub site is a facility that is part of a network or telecommunications system that provides educational or medical services to end user sites. A pure hub receives no end user benefits. The site is usually a connection management point or is exclusively an educational or medical source of distance learning or telemedicine.

End-User Site: An end-user site is a facility that is part of a network or telecommunications system that is utilized by end users. In order for a site to be included as an end-user site for scoring purposes, the applicant must demonstrate equipment purchased will be installed or placed at the site.

A Hub/End-User site performs both functions: a hub which also accommodates end-users.

The following classifications define the various population levels determining the Rurality score.

EXCEPTIONALLY RURAL AREA – 5,000 and under: 30 Points. Any area of the

USA not included within the boundaries of any incorporated or unincorporated city, village, or borough having a population in excess of 5,000 inhabitants.

RURAL AREA – 5,001-10,000: 22.5 Points. Any area of the USA included within the boundaries of any incorporated or unincorporated city, village, or borough having a population over 5,000 and not in excess of 10,000 inhabitants.

https://www.rd.usda.gov/files/DLT2019-Opioid_Treatment_Worksheets.xlsx

MID-RURAL AREA – 10,001-20,000: 15 Points. Any area of the USA included within the boundaries of any incorporated or unincorporated city, village, or borough having a population over 10,000 and not in excess of 20,000 inhabitants.

URBAN AREA - Over 20,000: 0 Points. Any area of the USA included within the population in excess of 20,000 inhabitants.

Use the Rurality Worksheet to enter: 1) the name given to the site; 2) the town, city, or Census

Designated Place within a state where the site is located; 3) the population (2010 Census) of the town, city or Census Designated Place; and 4) the Rurality score (as derived from the

Population-to-Score table).

Although pure hubs are not included in the calculation, except in the case of Non-fixed end-user applications and hybrid applications, the Agency will need this data to recalculate the score if there appears to be end user beneficiaries at the site. Place the sites in the same order and use the same numbering as on the Site Worksheet (and which will be used on the SAIPE Worksheet).

If any end-user sites are not within the boundaries of a town or a place that can be identified by the 2010 Census or found in the listing of cities, towns, and places in the Atlas, there is a possibility that the community is so rural that it is not associated with any Census-recognized community. If this is the case, the location would be considered by the RUS DLT Program as

‘Census Rural’ and be reported as an “Exceptionally Rural Area".

Adding up Individual Scores for an Overall Rurality Score

After all the sites and corresponding populations have been entered on the Rurality Worksheet, calculate the estimated score by taking the average of the scores for sites designated as end-users or hub/end-users. Do not include pure hubs in the calculation. Exception: Non-fixed end-user applications only use hub sites in the calculation and Hybrid Projects use hub sites for the non-fixed portion of the service area.

Minimum Rurality Score: In order to be eligible to receive a grant, an application must receive a minimum of 15 points as an average score for all hub/end-user and end-user sites included in the project.

Rounding

Scores should be shown with their decimals rounded to 2 decimal places (i.e., 20.49999 rounds to 20.50).

C-2 Economic Need – Up to 30 Points

Economic Need is measured by the latest County SAIPE, poverty percentage, all ages, data found at US Census SAIPE data . This criterion will be used to evaluate the relative financial need of the applicant, community, and project. All applicants are required to provide the applicable SAIPE percentage based on the county where the hub, hub/end-user and end-user sites

(as defined in §1734.3) are located.

Please use the Economic Need Worksheet to calculate the score. The Worksheet is available as an Excel worksheet at https://www.rd.usda.gov/files/DLT2019-

Opioid_Treatment_Worksheets.xlsx.

The Economic Need score is based on SAIPE data for the COUNTY where the hub/end-user and end-user sites are located. Exception: Non-fixed end-user applications only use Hub sites in the calculation and Hybrid Projects use Hub sites for the Non-fixed portion of the service area.

The SAIPE data used is from the column “poverty percentage, all ages”.

Determining the Economic Need Score:

The project SAIPE percentage will be determined by the average of the county percentages for all of the end user sites. For purposes of averaging, if a hub is also utilized as an end user site, the hub will be considered as an end user site.

The applicant will receive points as follows:

County SAIPE percentage greater than or equal to 30 percent - 30 points

County SAIPE percentage greater than or equal to 20 percent but less than 30 percent - 20 points

County SAIPE percentage greater than or equal to 10 percent but less than 20 percent - 10 points

County SAIPE percentage less than 10% percent - 0 points

How is the score calculated?

1. The “Average SAIPE” entered on the Economic Need Worksheet is the average of the relevant eligibility percentages for all the hub/end-user and end-user sites. When calculating the average, use the eligibility percentages exactly as presented in the

Census data, one decimal place.

2. Do not round: After calculating the average, enter it in the “Average SAIPE” block on the Economic Need Worksheet.

https://www.census.gov/data/datasets/2016/demo/saipe/2016-state-and-county.html

3. Use the scoring table below (it also appears on the Economic Need Worksheet) to enter the score in the “Applicant’s Estimated Economic Need Score” block.

4. Hub/End-User and End-User sites located within geographic areas for which no SAIPE data exist will be determined to have an average SAIPE poverty percentage of 30%.

Such geographic areas may include territories and other locations eligible for funding through the DLT program.

Example of Economic Need Calculation

Epsilon Central Community College (Central) will link itself, a community library, and two rural schools to the Deepwoods Nature Center for the purpose of receiving instructor-led environmental courses via videoconferencing. The Deepwoods Nature center is the source of the distance learning content and will not receive any content from the other sites. As such, it is a pure (educational) hub and the SAIPE data will not be used in the calculation. However, the applicant must still provide the data for the hub site (if the Agency were to determine that the site is also an end-user, it can recalculate the score). Central will be the electronic hub of the network, and will receive distance learning content from the Nature Center. As such, that site is categorized as a hub/end-user. The average of the four relevant percentages is 17.5%. The applicant refers to the scoring table and will enter 10 points in the “Applicant’s Estimated

Economic Need Score” block.

SAIPE County Percentage: Points

SAIPE < 10% 0

10% ≤ SAIPE < 20% 10

20% ≤ SAIPE < 30% 20

30% ≤ SAIPE 30

C-3 Special Consideration – up to 30 Points

Applications will receive 5 additional points for each hub/end-user or end-user site that is located within the 220 at-risk counties identified by the CDC. The at-risk counties are listed below. They are also available in the Application Guide and the CDC website at https://www.cdc.gov/pwid/vulnerable-counties-data.html. The maximum number of points available in this category is 30, but applicants are encouraged to connect as many sites in the at-risk counties as possible.

Alabama

Franklin, Marion, Walker, Winston

Arizona

Mohave

Arkansas

Lawrence, Sharp

California

Lake, Plumas

Colorado

Crowley

Georgia

Fannin, Haralson, Murray, Towns

Illinois

Hardin

Indiana

Crawford, Dearborn, Fayette, Henry, Jennings, Ripley, Scott, Starke, Switzerland, Washington

Kansas

Allen, Rawlins, Wilson, Woodson

Kentucky

Adair, Allen, Bath, Bell, Boyd, Boyle, Breathitt, Breckinridge, Campbell, Carroll, Carter, Casey, Clay, Clinton, Cumberland, Edmonson, Elliott, Estill, Floyd, Gallatin, Garrard, Grant, Grayson, Green, Greenup, Harlan, Hickman, Johnson, Knott, Knox, Laurel, Lawrence, Lee, Leslie, Letcher, Lewis, Lincoln, Magoffin, Martin, McCreary, Menifee, Mercer, Monroe, Owsley, Perry, Pike, Powell, Robertson, Rockcastle, Russell, Taylor, Wayne, Whitley, Wolfe

Maine

Kennebec, Somerset, Waldo, Washington

Michigan https://www.cdc.gov/pwid/vulnerable-counties-data.html

Alcona, Cheboygan, Clare, Crawford, Kalkaska, Lake, Montmorency, Ogemaw, Oscoda, Presque

Isle, Roscommon

Mississippi

Tishomingo

Missouri

Bates, Cedar, Crawford, Hickory, Iron, Madison, Ozark, Reynolds, Ripley, St. Francois, Washington, Wayne, Wright

Montana

Mineral, Treasure

Nevada

Esmeralda, Storey

North Carolina

Burke, Cherokee, Clay, Graham, Wilkes

Ohio

Adams, Athens, Brown, Clinton, Gallia, Highland, Jackson, Meigs, Pike, Scioto, Vinton

Oklahoma

Cimarron, Jefferson

Pennsylvania

Cambria, Crawford, Luzerne

Tennessee

Benton, Bledsoe, Campbell, Cannon, Carter, Claiborne, Clay, Cocke, DeKalb, Fentress, Grainger, Greene, Hamblen, Hancock, Hardin, Hawkins, Humphreys, Jackson, Jefferson, Johnson, Lake, Lawrence, Lewis, Macon, McNairy, Meigs, Morgan, Overton, Perry, Pickett, Polk, Rhea, Roane, Scott, Smith, Sullivan, Union, Warren, Washington, Wayne, White

Texas

Foard

Utah

Beaver, Carbon, Emery

Vermont

Essex, Windham

Virginia

Buchanan, Dickenson, Lee, Patrick, Russell, Tazewell, Wise, Wythe

West Virginia

Berkeley, Boone, Braxton, Brooke, Cabell, Calhoun, Clay, Fayette, Hancock, Kanawha, Lincoln, Logan, Marshall, Mason, McDowell, Mercer, Mingo, Monroe, Morgan, Nicholas, Raleigh, Roane, Summers, Taylor, Tyler, Wayne, Webster, Wyoming

C-4 Need for Service and Project Benefits – Up to 55 Points

The Agency is seeking applications that use DLT technologies to facilitate the following opioid-related services:

• Specialized medical, dental, psychiatric, or pharmaceutical services

• Group counseling and other peer support services

• Family therapy and support services

• Home monitoring applications to support patients in between medical visits

• School-based or community-based health centers

• Peer-to-peer or mentor-led training between workers in the same professional sector or across sectors (e.g., nurse-to-nurse, judge-to-judge, teacher-to-teacher exchange and/or doctor-to-teacher, judge-to-counselor, nurse-to-judge, doctor-to-police exchange, etc.)

• Advanced training classes or “virtual clinics” led by specialty care providers to train primary or rural care providers

• Recovery support or workforce training for people with substance use disorder

This criterion measures the extent to which the proposed project meets opioid-related services as listed above and the need for distance learning or telemedicine services in rural areas to address these needs. It should also address benefits derived from the services proposed by the project, and local community involvement in planning, implementing, and financial assistance of the project.

RUS will consider the extent of the applicant's documentation explaining the opioid-related challenges facing the community; the applicant's proposed plan to address these challenges; how the grant can help; and why the applicant cannot complete the project without a grant. RUS will also consider the extent to which the applicant provides evidence that opioid-related challenges could not be addressed without employing advanced technology. RUS will also consider any support by recognized experts in the opioid related field, any documentation substantiating the opioid care underserved nature of the applicant's proposed service area, and any justification for specific opioid services which are needed and will provide direct benefits to rural residents.

Other matters that will be considered by RUS under this criterion include:

1. That rural residents, and other beneficiaries, desire the educational or medical services to be provided by the project. A strong indication of need is the willingness of local end users or institutions, to the extent possible, to contribute to the capital costs of establishing the project. This could include letters of financial commitment toward the project from local institutions.

2. The extent of the project's planning, development, and support by local residents and institutions. This may include evidence of community involvement, as exemplified in community meetings, public forums, and surveys. In addition, applicants should provide evidence of local residents' participation in the project planning and development.

Additionally, a complete project may require items that are ineligible as grant or match, such as a building addition or a vehicle for mobile telemedicine. Although not eligible for in-kind matching credit, any kind of financial support and contributions from the local community (other than the applicant) does show evidence of the commitment of the community to the project.

3. The extent to which the application addresses the problems of population out-migration and how the project seeks to slow, halt, or prevent population loss.

Need for Services

Clearly state the opioid-related challenges facing the project’s respective communities and provide any documentation that demonstrates the challenges. Use verifiable data and statistics to substantiate and quantify these challenges. Demonstrate how the proposed project will help resolve these challenges and why the applicant cannot afford the project without a grant.

Document support for the project provided by professionals in the educational or health care fields. The more specific their professional opinion is regarding the situation and the proposed project as a solution, the more compelling it is. Substantiate the underserved opioid health care nature of the project’s proposed service area; and justify, explain, and document the specific educational or medical services that will provide direct benefits to rural residents.

Demonstrate demand by rural residents and other beneficiaries for the educational or medical services that the project would provide. Show that the project is designed to meet local community needs. Willingness of local end-users or community-based organizations to contribute to the costs of completing, operating, or maintaining the project is a strong indication of community support. Documentation of support includes letters of financial and non-financial commitment towards the project from local organizations.

Benefits Derived from Services

In addition to documenting the need for services, describe how the project would assist the community in solving these challenges. Document the specific benefits of the project and quantify them in terms of expected outcomes. Tie the benefits of the project DIRECTLY to the stated needs the project is intended to address. Provide measurable targets or goals such as estimates of the number of people that will benefit from the project.

D. Matching Requirements

The grant applicant’s minimum matching contribution must equal 15% of the grant amount requested. Matching contributions generally must be in the form of cash. However, in-kind contributions solely for the purposes listed in §1734.21 may be substituted for cash and appropriately identified on the budget worksheet.

Funding Commitment from other sources

The applicant must provide evidence, in form and substance satisfactory to RUS, that funding agreements have been obtained to ensure completion of the project. These agreements shall be sufficient to ensure:

a) Payment of all proposed expenditures for the project;

b) All required matching contributions in § 1734.22; and

c) Any other funds necessary to complete the project.

Please use the Matching Worksheet to calculate the match percentage. The Worksheet is available as an Excel worksheet at https://www.rd.usda.gov/files/DLT2019-

Opioid_Treatment_Worksheets.xlsx. Additionally, documentation submitted in support of the application should reflect all financial support for the project from non-Federal sources as required by §1734.22. The applicant must provide evidence, from authorized representatives of the sources, of a commitment that the funds are available and will be used for the project.

Special Matching Provisions for American Samoa, Guam, the Virgin Islands, and the

Northern Mariana Islands. Under Federal law, applications from these areas are exempt from matching requirements up to $200,000. The maximum DLT Grant – Opioid Treatment in FY

2019 is $500,000 and the required minimum match is 15%, or $75,000. This means that for the

FY 2019 DLT – Opioid Treatment Grant Program, these areas are not required to provide a minimum match.

Eligible purposes for in-kind matching funds are identical to eligible purposes for a DLT grant.

For a line-item identified as in-kind to be eligible for match funding, the application must demonstrate:

1. The match is used for eligible purposes;

2. That none of the use is to benefit sites not shown in the scoring; and

3. That the predominant purpose (over 50% of use) of that line-item is for purposes which meet the DLT grant definition of distance learning or telemedicine.

If any part of an in-kind line-item is for ineligible purposes, the line-item cannot be budgeted for match. To be eligible, items proposed as match must be integral to the project in exactly the same way as items the applicant proposes to obtain with the grant. The technology purchased with DLT grant monies or credited as in-kind match items are intended to build distance learning and/or telemedicine systems that would not otherwise be financially possible if not for the grant.

Federal funds are not eligible as matching funds. E-rate funds are federal funds and cannot be applied as matching funds to a DLT project.

Special Matching Provisions for projects located in eligible counties under Counties in

Appalachia. If counties in the proposed project are any of the counties eligible under this provision, Appalachian Regional Commission ("ARC") funds may be used as a matching contribution. Please see www.arc.gov for a list of eligible counties under the Counties in

Appalachia heading. Applying ARC funds as a match requires coordination with ARC State

Program Managers and States in the Region. See the ARC Members, Partners and Staff link also at www.arc.gov for ARC State Program Managers contact information. DLT applicants considering an ARC match are strongly encouraged to contact their ARC State Program

Manager(s) early in the process to explore the feasibility of an ARC grant.

Use of non-Federal Grants as Matching Funds: To document the match, include a copy of the announcement…