PKG00263881-instructions.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Federal Office of Rural Health Policy Office for the Advancement of Telehealth

National Telehealth Resource Center Program

Funding Opportunity Number: HRSA-21-023 Funding Opportunity Types: New, Competing Continuation

Assistance Listings (CFDA) Number: 93.211

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2021

Application Due Date: January 21, 2021

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

HRSA will not approve deadline extensions for lack of registration.

Registration in all systems, including SAM.gov and Grants.gov, may take up to 1 month to complete.

Issuance Date: October 23, 2020

Michelle Carnes Project Officer, Federal Office of Rural Health Policy Telephone: (301) 443-0007 Email: MCarnes@hrsa.gov

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

mailto:MCarnes@hrsa.gov

HRSA-21-023 i

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2021 National Telehealth Resource Center (NTRC) Program. The purpose of the NTRCs is to support the delivery of telehealth technical assistance by Regional Telehealth Resource Centers (RTRCs) Cooperative Agreement (HRSA-21-

022) recipients. Two NTRCs, focused on policy and technology, respectively, will provide training and support, disseminate information and research findings, support effective collaboration, and foster the use of telehealth technologies to increase access, timeliness, cost effectiveness or quality of health care service delivery in rural, frontier, and medically underserved areas and populations. NTRCs will share expertise through individual consultations, training, webinars, conference presentations, and a significant web presence.

Funding Opportunity Title: National Telehealth Resource Center

Program Funding Opportunity Number: HRSA-21-023 Due Date for Applications: January 21, 2021 Anticipated Total Annual Available FY 2021 Funding:

$650,000

Estimated Number and Type of Awards: Up to two (2) cooperative agreements

Estimated Award Amount: Up to $325,000 per year Cost Sharing/Match Required: No Period of Performance: September 1, 2021 through

August 31, 2024 (three (3) years) Eligible Applicants: Eligible applicants include domestic public, non-profit, and for-profit entities.

Faith-based and community-based organizations, tribes, and tribal organizations are eligible to apply.

See Section III.1 of this notice of funding opportunity (NOFO) for complete eligibility information.

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Application Guide

You (the applicant organization/agency) are responsible for reading and complying with the instructions included in HRSA’s SF-424 Application Guide, available online at http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf, except where instructed in this NOFO to do otherwise.

Technical Assistance

HRSA has scheduled the following technical assistance:

Webinar

Day and Date: Thursday, November 12, 2020 Time: 2 – 4 p.m. ET Call-In Number: 1-888-917-8036 Participant Code: 5712206 Weblink: https://hrsa.connectsolutions.com/ntrc-ta-applicants/ Playback Number: 1-866-358-4519 http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://hrsa.connectsolutions.com/ntrc-ta-applicants/

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Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AW ARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING/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. DUN AND BRADSTREET DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER

TRANSITION TO THE 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

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSMENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AW ARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

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I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the National Telehealth Resource Center (NTRC) Program. The purpose of NTRCs is to support the delivery of telehealth technical assistance through Regional Telehealth Resource Centers (RTRCs). Two NTRCs may be funded.

Policy NTRC: One NTRC will focus on policy issues of telehealth, such as reimbursement and coverage, licensing, credentialing and privileging, regulation, standards, guidelines and privacy. Many policy issues such as licensure and reimbursement may have state specific considerations and the NTRC will work with each RTRC and with other national or policy specific organizations to insure that telehealth policies are accurately tracked or reported.

Technology NTRC: One NTRC will focus on telehealth technology issues related to, for example, equipment or software, interfacing/integration with other systems, interoperability, technology support and upgrading, cyber security, technology alerts or recalls.

Each NTRC will work to support RTRCs (HRSA-21-022) in their efforts to advance telehealth. Awards are expected to be used for the following core services:

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

2. disseminating information and research findings related to telehealth services;

3. promoting effective collaboration among telehealth resource centers and the

Health Resources and Services Administration (HRSA) Office for the Advancement of Telehealth (OAT), as well as other HRSA award recipients (e.g., Telehealth Centers of Excellence, technical assistance (TA) providers);

4. conducting evaluations to determine the best utilization of telehealth technologies to meet health care needs;

5. promoting the integration of the technologies used in clinical information systems with other telehealth technologies;

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

7. implementing special projects or studies under the direction of HRSA.

On January 31, 2020, the Secretary of the U.S. Department of Health and Human Services declared a public health emergency in response to COVID-19. Should the public health emergency still be in place at the time of this funding notice, and in response to this public health emergency, you may include COVID-19 related activities in your application. Activities could include increased emphasis on support of telehealth directly to consumers or telehealth for public health emergency response. Applicants that focus on such emergency use of telehealth should also outline plans to shift priorities for changing needs and uses of telehealth.

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Applicants are encouraged to include populations that have historically suffered from poorer health outcomes, health disparities, and other inequities, as compared to the rest of the rural population, when addressing telehealth technology and policy. Examples of these populations include, but are not limited to, racial and ethnic minorities, people/persons experiencing homelessness, pregnant women, disabled individuals, youth and adolescents, etc.

A NTRC may consider a reasonable fee for continuing assistance in excess of 10 hours of technical assistance provided. The 10-hour limit is to ensure equitable access to technical assistance due to the public nature of the NTRCs. Any fees received by NTRCs must be used to supplement the HRSA award activities, must be listed, and the hours and level of effort related to those fees must be explained in progress and financial reports to HRSA. Further information will be provided in the award notice.

2. Background

This program is authorized 42 U.S.C. § 254c-14(d)(2) (§330I(d)(2) of the Public Health Service Act). The program is administered by the OAT, located within HRSA’s Federal Office of Rural Health Policy (FORHP). Please reference detailed information on OAT here: https://www.hrsa.gov/rural-health/telehealth

NTRCs support the availability of expert technical assistance and advisory services in the development of telehealth services and leveraging the experience of mature telehealth programs. The NTRCs focus, respectively, on telehealth policy and technology issues that are cross-cutting and broadly applicable across the United States to ensure that there is no duplication of effort in the Regional Telehealth Resource Centers (HRSA-21-022). For this program, telehealth services are defined as services provided through technologies relating to the use of electronic information, and telecommunications technologies, to support and promote, at a distance, health care, patient and professional health-related education, health administration, and public health.

II. Award Information

1. Type of Application and Award

Types of applications sought: Competing Continuation, New

HRSA will provide funding in the form of a cooperative agreement. A cooperative agreement is a financial assistance mechanism where HRSA anticipates substantial involvement with the recipient during performance of the contemplated project.

https://www.hrsa.gov/rural-health/telehealth

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HRSA program involvement will include:

• Participating in conference calls or meetings with recipients;

• Supporting effective collaboration among National and Regional TRCs;

• Identifying special projects or studies;

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

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

• Ongoing review of activities and suggestions on content, presentation approach, and selection of products/publications;

• Reviewing or commenting on products or publications; and

• Providing input and background on current and future issues.

The cooperative agreement recipient’s responsibilities will include:

• Adhering to HRSA guidelines pertaining to acknowledgement and disclaimer on all products produced by HRSA award funds, per Section 2.2 of the Application Guide (Acknowledgement of Federal Funding);

• Completing activities proposed by the award recipient and reviewed by HRSA, except as modified in consultation with HRSA through appropriate prior approval processes;

• Maintaining knowledge of HRSA, HHS, and other federal programs to link award recipients and stakeholders to appropriate resources and programs;

• Participating in conference calls or meetings with HRSA;

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

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

• Providing most technical assistance at no charge;

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

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

• Identifying appropriate professional meetings at which to exhibit each year; and

• Establishing of evaluation metrics and tracking related data, as reviewed by

HRSA and in collaboration with the Telehealth Research Centers, to assist in measuring the success of the cooperative agreement in advancing telehealth.

2. Summary of Funding

HRSA estimates approximately $650,000 to be available annually to fund two recipients. The actual amount available will not be determined until enactment of the final FY 2021 federal appropriation. You may apply for a ceiling amount of up to $325,000 total cost (includes both direct and indirect, facilities and administrative costs) per year. This program notice is subject to the appropriation of funds, and is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds appropriately. The period of performance is September 1, 2021 through August 31, 2024 (three years). Funding beyond the first year is subject to the availability of appropriated funds for NTRCs in subsequent fiscal years, satisfactory recipient performance, and a decision that continued funding is in the best interest of the Federal Government.

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Indirect Cost Rate for applicants is limited to the lesser of:

(i) 15 percent of the amount of the total award funds; or

(ii) the applicant’s federally negotiated indirect rate for administering the award.

All HRSA awards are subject to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements at 45 CFR part 75.

III. Eligibility Information

1. Eligible Applicants

Eligible applicants include domestic public, non-profit, and for-profit entities. Domestic faith-based and community-based organizations, tribes, and tribal organizations are also eligible to apply.

Consultation with the State Office of Rural Health See instructions for Attachment 7. Persuant to 42 U.S.C. 254c-14(g), to be eligible to receive an award, an entity, in consultation with the appropriate State Office of Rural Health or another appropriate state entity, shall prepare and submit an application, containing the following:

a) A description of the project that the eligible entity will carry out using the funds provided under the award;

b) A description of the manner in which the project funded under the award will meet the health care needs of rural or other populations to be served through the project, including improving the access to services, and quality of the services received by those populations;

c) Evidence of local support for the project, and a description of how the areas, communities, or populations to be served will be involved in the development and ongoing operations of the project;

d) A plan for sustaining the project after federal support for the project has ended;

e) Information on the source and amount of non-federal funds the entity will provide for the project; and

f) Information demonstrating the long-term viability of the project and other evidence of your institutional commitment to the project.

Consortium applications NTRCs can be collaborative organizations, composed of more than one entity, but only one entity is the applicant organization of record. All other organizations may be members of the consortium or network. See instructions for Attachment 4.

2. Cost Sharing/Matching

Cost sharing/matching is not required for this program.

http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75

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3. Other

HRSA will consider any application that exceeds the ceiling amount non-responsive and will not consider it for funding under this notice.

HRSA will consider any application that fails to satisfy the deadline requirements referenced in Section IV.4 non-responsive and will not consider it for funding under this notice.

NOTE: Multiple applications from an organization are not allowable and an organization cannot apply as both a Regional TRC (HRSA-21-022) and as a National TRC (HRSA- 21-023).

Applicants must specify in the abstract if they are applying for either the Technology NTRC or the Policy NTRC; applicants may not apply to both. This funding cycle will support up to two NTRCs, with one Technology NTRC award and one Policy NTRC award as in the Purpose above.

HRSA will only accept your last validated electronic submission, under the correct funding opportunity number, prior to the Grants.gov application due date as the final and only acceptable application.

IV. Application and Submission Information

1. Address to Request Application Package

HRSA requires you to apply electronically. HRSA encourages you to apply through Grants.gov using the SF-424 workspace application package associated with this notice of funding opportunity (NOFO) following the directions provided at http://www.grants.gov/applicants/apply-for-grants.html.

The NOFO is also known as “Instructions” on Grants.gov. You must select “Subscribe” and provide your email address for each NOFO you are reviewing or preparing in the workspace application package in order to receive notifications including modifications, clarifications, and/or republications of the NOFO on Grants.gov. You will also receive notifications of documents placed in the RELATED DOCUMENTS tab on Grants.gov that may affect the NOFO and your application. You are ultimately responsible for reviewing the For Applicants page for all information relevant to this NOFO.

2. Content and Form of Application Submission

Section 4 of HRSA’s SF-424 Application Guide provides instructions for the budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract. You must submit the information outlined in the Application Guide in addition to the program-specific information below. You are responsible for reading and complying with the instructions included in HRSA’s SF-424 Application Guide except where instructed in the NOFO to do otherwise. You must submit the application in the English language and in the terms of U.S. dollars (45 CFR § 75.111(a)).

https://www.grants.gov/ http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/applicants.html

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See Section 8.5 of the Application Guide for the Application Completeness Checklist.

Application Page Limit The total size of all uploaded files included in the page limit may not exceed the equivalent of 80 pages when printed by HRSA. The page limit includes the abstract, project and budget narratives, attachments, and letters of commitment and support required in the Application Guide and this NOFO. Standard OMB-approved forms that are included in the workspace application package do not count in the page limit.

Please note: If you use an OMB-approved form that is not included in the workspace application package for HRSA-21-023, it may count against the page limit. Therefore, we strongly recommend you only use Grants.gov workspace forms associated with this NOFO to avoid exceeding the page limit. Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count in the page limit. It is therefore important to take appropriate measures to ensure your application does not exceed the specified page limit.

Applications must be complete, within the specified page limit, and validated by Grants.gov under the correct funding opportunity number prior to the deadline.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

1) You certify on behalf of the applicant organization, by submission of your proposal, that neither you nor your principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.

2) Failure to make required disclosures can result in any of the remedies described in 45 CFR § 75.371, including suspension or debarment. (See also 2 CFR parts 180 and 376, and 31 U.S.C. § 3321).

3) Where you are unable to attest to the statements in this certification, an explanation shall be included in Attachments 11-15: Other Relevant Documents.

See Section 4.1 viii of HRSA’s SF-424 Application Guide for additional information on all certifications.

Temporary Reassignment of State and Local Personnel during a Public Health Emergency

Section 319(e) of the Public Health Service (PHS) Act provides the Secretary of the Department of Health and Human Services (HHS) with discretion upon request by a state or tribal organization to authorize the temporary reassignment of state, tribal, and local personnel during a declared federal public health emergency. The temporary reassignment provision is applicable to state, tribal, and local public health department or agency personnel whose positions are funded, in full or part, under PHS programs and allows such personnel to immediately respond to the public health emergency in the affected jurisdiction. Funds provided under the award may be used to support personnel who are temporarily reassigned in accordance with § 319(e). Please reference detailed information available on the HHS Office of the Assistant Secretary for Preparedness (ASPR) website via http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx.

http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx

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Program-Specific Instructions In addition to application requirements and instructions in Section 4 of HRSA’s SF-424 Application Guide (including the budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract), include the following:

i. Project Abstract See Section 4.1.ix of HRSA’s SF-424 Application Guide.

The abstract is a one-page, single-spaced, standalone document, and should not refer to other sections of the application. Please include the following information in your abstract (it is recommended that you provide this information in table format):

1. Project Title

2. Requested Award Amount

3. Applicant Organization Name

4. Applicant Organization Address

5. Applicant Entity Type (e.g., public, non-profit, for-profit, etc.)

6. Specify Whether Applying for Policy or Technology NTRC

7. Specify Whether a Previous or Current NTRC or RTRC Recipient

8. Specify Whether Claiming a Funding Preference (see Attachment 8)

9. Project Director Name and Title

10. Project Director Contact Information (phone number and email address)

11. Identify how the applicant first learned about the funding opportunity

(select one: TRC, State Office of Rural Health, HRSA News Release, Grants.gov, HRSA Project Officer, HRSA Website, Technical Assistance Provider, State/Local Health Department, Other: specify)

12. Identify the major goal(s) and objectives for the period of performance

13. Brief description of the programs and activities that will be used to attain the objectives. Comment on innovation, cost, and other characteristics of the methodology.

14. Brief description of the coordination planned with Regional TRCs and other organizations or entities related to the NTRC’s objectives.

ii. Project Narrative This section provides a comprehensive framework and description of all aspects of the proposed project. It should be succinct, self-explanatory, consistent with forms and attachments, and well-organized so that reviewers can understand the proposed project.

Successful applications will contain the information below. Please use the following section headers for the narrative:

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INTRODUCTION -- Corresponds to Section V’s Review Criterion (1) Need

Briefly describe the purpose of the proposed project. You must clearly describe how you propose to establish or operate an NTRC that provides technical assistance to existing or developing telehealth networks. You must clearly demonstrate what expertise you possess and how you will support RTRCs or other organizations by providing technical assistance in telehealth technology or policy issues.

NEEDS ASSESSMENT -- Corresponds to Section V’s Review Criterion (1) Need

You must outline critical telehealth policy or technology barriers that exist and identify the demand for technical assistance as it relates to the respective telehealth policy or technology areas. Use and cite demographic data whenever possible to support the information provided, including any populations identified as vulnerable, which may include, but are not limited, to people/persons experiencing homelessness, racial and ethnic minorities, disabled individuals, elderly etc. Additionally, you should include information about other technical assistance services that may be available and how such services could be used or integrated, and not duplicated to advance telehealth. This section should help reviewers understand the need for telehealth technical assistance that will be addressed by each proposed project. The needs assessment should focus on telehealth needs in HRSA designated rural areas, including tribal entities.

METHODOLOGY -- Corresponds to Section V’s Review Criteria (2) Response, (4)

Impact, and (6) Support Requested

You must describe your plan to provide technical assistance. You must identify the mechanisms by which you will identify organizations in need of assistance including methods of identifying initial contacts (e.g., through the website, toll free number, or contact at a meeting or conference), and tracking outcomes of assistance (e.g., a new site or service was established).

Evidence of an ability to share information, including lessons learned should also be included. You should clearly indicate how you have and will collaborate and share expertise with new and/or existing providers of telehealth services at the national, regional, state and local levels. NTRCs are expected to track telehealth “Best Practices” across the country. You should discuss your plan for the following core services:

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

2. disseminating information and research findings related to telehealth services;

3. promoting effective collaboration among telehealth resource centers and the HRSA OAT, as well as other HRSA award recipients (e.g., Telehealth Centers of Excellence, TA providers);

4. conducting evaluations to determine the best utilization of telehealth technologies to meet health care needs;

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5. promoting the integration of the technologies used in clinical information systems with other telehealth technologies;

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

7. implementing special projects or studies under the direction of the Office for the Advancement of Telehealth.

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

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

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

• One-to-Many: One or more NTRC staff members interacting directly and simultaneously with a group of entities made up of individuals representing different organizations or organizational units.

• Broad Public: In cooperation with Regional Telehealth Resource Centers, NTRCs should also provide public programs and webinars, recorded and posted for later viewing for example, on a public facing website.

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

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

Specific Programmatic Services: You must refer to the types of services or products you will use to help a provider or a community with its strategic development or expansion of a telehealth program. The proposed services should be clearly linked to the needs/demand identified above and must be consistent with the resources available.

You should address how you plan to track your activities and effectively provide technical assistance across the nation to address a myriad of policy or technology challenges. You must also detail the delivery modes to be used for your service (e.g., one-to-one, peer-to-peer, one-to-many, broad public) and the outreach tools to be used. In addition, you should explain how you will support the RTRCs. Examples of areas in which NTRCs could provide information and expertise include:

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Policy TRC

a) Telehealth reimbursement policy;

b) State and national rules and issues pertaining to licensing, credentialing and privileging of telehealth providers;

c) Regulatory issues including tele-prescribing;

d) Telecommunications and broadband policies and funding;

e) Policies pertaining to telehealth and Health Insurance Portability and Accountability Act (HIPAA);

f) Regulatory issues pertaining to remote patient monitoring or direct to consumer telehealth;

g) Regulatory issues concerning mobile health (mHealth); and

h) Telehealth service delivery standards and guidelines.

Technology TRC

a) Telehealth system technology planning, selection, evaluating, operating, maintaining, or upgrading;

b) Telecommunications and broadband technology and issues (terrestrial and wireless) relevant to telehealth;

c) Technical issues of hardware interfacing or integration;

d) Technical issues of system interfacing or integration, such as telehealth and health information, billing, scheduling, or administrative systems;

e) Technology for remote patient monitoring;

f) General technology problem-solving (or referral); (However, the TRC should not plan to perform technology troubleshooting.)

g) Cybersecurity issues relevant to telehealth;

h) Technology alerts for telehealth equipment; and

i) Telehealth technology standards and guidelines.

Additional policy or technology areas you plan to address should be detailed and if topics above will not be addressed, it should be explained.

Sustainability:

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

WORK PLAN -- Corresponds to Section V’s Review Criteria (2) Response, (4)

Impact and (5) Resources/Capabilities

Describe, in detail, the technical assistance services you will provide, to whom you intend to provide it, and the available tools and resources to be used in providing those services. This should include the core services listed under Methodology. In addition, clearly address how you will assess the demand for your services and track changes in this demand over time.

You must present an implementation schedule that identifies major project tasks and milestones, as well as impact. Applicants must demonstrate the ability to start implementing upon receipt of award. In addition, you must describe in detail the

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technical approach employed in the project and how the various components will be organized and work together. You must explain how you will track utilization of your services, including the number of programs/providers that use specific NTRC services and the outcomes of those services (i.e., additional telehealth sites or services, expansion or clarification of reimbursement or licensing issues, resolution of technology issues or other evidence of advancing the state of telehealth and documenting how the NTRC was involved).

In order to understand how NTRCs will build on existing resources, you must describe the expertise, resources, and services currently available to meet the project’s objectives of providing technical assistance on a wide range of telehealth issues. With respect to dissemination, you must demonstrate plans and capability for sharing best practices and lessons learned from successes and failures.

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

You must demonstrate the experience necessary to provide an understanding of policy or technological aspects of relevant telehealth services. Provide specific strategies for sharing lessons learned and collaborating with RTRCs or telehealth programs. Your work plan should include processes for improving telehealth access among identified vulnerable populations. You are encouraged to utilize the methods outlined in the National Culturally and Linguistically Appropriate Services Standards.

NTRCs are encouraged to develop a common resource that can allow interested parties to draw on the collective information of RTRCs or can direct inquiries to region or state specific information at RTRCs. NTRCs focused on policy are also encouraged to maintain a calendar of telehealth training and events offered by all NTRCs and RTRCs.

RESOLUTION OF CHALLENGES -- Corresponds to Section V’s Review Criterion

(2) Response

Discuss challenges that you are likely to encounter in designing and implementing the activities described in the work plan, and approaches that you will use to resolve such challenges.

EVALUATION AND TECHNICAL SUPPORT CAPACITY -- Corresponds to Section V’s Review Criterion (3) Evaluative Measures

In an effort to evaluate the effectiveness of award fund use for project activities, recipients must conduct a self-assessment at the end of each project year as part of your annual progress report. The self-assessment will provide information to identify your project’s strengths and areas for improvement. Specifically, the self-assessment should include, but is not limited to, the following elements:

https://thinkculturalhealth.hhs.gov/clas/standards https://thinkculturalhealth.hhs.gov/clas/standards

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a) Outcomes Focused - Ensure that the goals and objectives of the project are assessed.

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

c) Sustainability - Identify progress on strategies that could lead to viability and sustainability after federal funding ends.

d) Quality Improvement – Identify areas of improvement in your work plan based on the findings of the assessment.

Applicants should also provide baseline numbers (qualitative/quantitative) for their activities and performance measures.

While the self-assessment is due at the end of each budget period, applicants should also describe how they will monitor TA throughout the period of performance and, when necessary, make changes to improve quality and customer service.

ORGANIZATIONAL INFORMATION -- Corresponds to Section V’s Review

Criterion (5) Resources and Capabilities

Provide information on your current mission and structure, scope of current activities, and an organizational chart (Attachment 6) and describe how those contribute to your ability to be an NTRC. Clearly describe the extent to which you will involve representatives from the provider communities and/or populations in both the design and operation of an NTRC.

If you are applying as part of a consortium, you must provide information about how the various components will function, with the roles and responsibilities of all components specifically addressed in the application. Consortium applicants must clearly demonstrate a history of collaboration and have strong prior working relationships. You must also have standard protocols throughout the consortia/network for receiving, tracking, data collection and follow-up for all technical assistance requests. Clearly describe your partnerships as an ongoing and integral part of project planning and operation, as appropriate. (A list of partners should be included in Attachment 5). The applicant organization is responsible for all fiscal, administrative, and programmatic aspects of the application and award.

Equally important is your ability to be structured as a separate and distinct center and impartial source of technical assistance. You must emphasize your independence from any parent organization that is a provider of telehealth services and may be a source of competition by organizations seeking assistance from the NTRC.

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Given the spectrum and scope of work required, extensive organizational skills are considered an essential characteristic for a NTRC. You must provide information that demonstrates your ability and experience managing multiple projects, while addressing the details necessary for projects to run smoothly. You must demonstrate your ability to track all technical assistance requests and document outcomes resulting from services provided.

iii. Budget

The directions offered in the SF-424 Application Guide may differ from those offered by Grants.gov. Follow the instructions in Section 4.1.iv of HRSA’s SF-424 Application Guide and the additional budget instructions provided below. 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 the total allowable costs (inclusive of direct and indirect costs) you incur to carry out a HRSA-supported project or activity. Total project or program costs include costs charged to the award and costs borne by you to satisfy a matching or cost-sharing requirement, as applicable.

In addition, the NTRC program requires the following:

Travel: Your travel budget should include funds for a maximum of two (2) staff members to attend an annual recipient meeting in Washington, DC.

The Further Consolidated Appropriations Act, 2020 (P.L. 116-94), Division A, § 202 states, “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.” See Section 4.1.iv Budget – Salary Limitation of HRSA’s SF-424 Application Guide for additional information. Note that these or other salary limitations may apply in the following fiscal years, as required by law.

iv. Budget Narrative See Section 4.1.v. of HRSA’s SF-424 Application Guide.

http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf

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NARRATIVE GUIDANCE

To ensure that you fully address the review criteria, this table provides a crosswalk between the narrative language and where each section falls within the review criteria. Any attachments referenced in a narrative section may be considered during the objective review.

Narrative Section Review Criteria

Introduction (1) Need

Needs Assessment (1) Need

Methodology

(2) Response, (4) Impact, and (6) Support

Requested

Work Plan

(2) Response, (4) Impact and (5)

Resources/Capabilities

Resolution of Challenges (2) Response

Evaluation and Technical Support Capacity

(3) Evaluative Measures

Organizational Information (5) Resources/Capabilities

Budget and Budget Narrative (6) Support Requested

v. Attachments

Provide the following items in the order specified below to complete the content of the application. Unless otherwise noted, attachments count toward the application page limit. Indirect cost rate agreements and proof of non-profit status (if applicable) will not count toward the page limit. Clearly label each attachment.

Attachment 1: Work Plan

Attach the work plan for the project that includes all information detailed in Section IV.2.ii. Project Narrative.

Attachment 2: Staffing Plan and Job Descriptions for Key Personnel (see Section

4.1. of HRSA’s SF-424 Application Guide)

Keep each job description to one page in length as much as is possible. Include the role, responsibilities, and qualifications of proposed project staff. Also, please include a description of your organization’s timekeeping process to ensure that you will comply with the federal standards related to documenting personnel costs.

Attachment 3: Biographical Sketches of Key Personnel

Include biographical sketches for persons occupying the key positions described in Attachment 2, not to exceed two pages in length per person. In the event that a biographical sketch is included for an identified individual not yet hired, include a letter of commitment from that person with the biographical sketch.

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Attachment 4: Letters of Agreement, Memoranda of Understanding, and/or Description(s) of Proposed/Existing Contracts (if applicable)

Provide any documents that describe working relationships between your organization and other entities and programs cited in the proposal. Documents that confirm actual or pending contractual or other agreements should clearly describe the roles of the contractors and any deliverable. Make sure any letters of agreement are signed and dated.

If you are applying on behalf of a consortium of entities to be involved in the technical resource center, list the members, key contact, and contact information.

Attach the detailed agreement among the participants signed by the appropriate authority (organizations CEOs or equivalent authority). Highlight the organizational relationships within the consortium, the defined organizational role of each member in the proposed NTRC, and the financial and personnel commitment of each member to the project. Consortium members must have a proven history of collaboration together on common projects. The agreement must reflect clear organizational relationships within the consortium and the defined organizational role of each member in the proposed NTRC.

Attachment 5: List of Partners (if applicable)

Describe the agencies, organizations, or groups that are part of the project or consortia. Identify and define the work to be done by each agency supported by the project. Include name of organization and service(s) provided.

Attachment 6: Project Organizational Chart Provide a one-page figure that depicts the organizational structure of the project.

Attachment 7: Proof of Consultation with State Office of Rural Health or Other Appropriate Entity

Provide a letter signed by an official at the appropriate State Office of Rural Health (or other appropriate state entity) certifying that the applicant organization consulted with them in preparation of the application.

Attachment 8: Request for Funding Preference

To receive a funding preference, include a statement that you are eligible for a funding preference in the abstract, and identify the preference. Include documentation of this qualification. See Section V.2. Not scored during the objective review.

Attachment 9: Progress Report (if applicable)

(FOR COMPETING CONTINUATIONS ONLY)

A well-documented progress report is a required and important source of material for HRSA in preparing annual reports, planning programs, and communicating program-specific accomplishments. The accomplishments of competing continuation applicants are carefully considered; therefore, you should include previously stated goals and objectives in your application and emphasize the progress made in attaining these goals and objectives. HRSA program staff reviews the progress report after the Objective Review Committee evaluates the competing continuation applications.

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The progress report should be a brief presentation of the accomplishments, in relation to the objectives of the program during the current period of performance. The report should include:

(1) The period covered (September 1, 2017 – August 31, 2021).

(2) Specific objectives - Briefly summarize the specific objectives of the project.

(3) Results - Describe the program activities conducted for each objective.

Include both positive and negative results or technical problems that may be important.

Attachment 10: Copy of Indirect Cost Rate Agreement

The Indirect Cost Rate Agreement must be dated and not expired. Not scored during the objective review. Please refer to Funding Restrictions and Summary of Funding.

Attachments 11–15: Other Relevant Documents

Include here any other documents that are relevant to the application, including letters of support. Letters of support must be dated and specifically indicate a commitment to the project/program (in-kind services, dollars, staff, space, equipment, etc.).

3. Dun and Bradstreet Data Universal Numbering System (DUNS) Number

Transition to the Unique Entity Identifier (UEI) and System for Award Management (SAM)

You must obtain a valid DUNS number, also known as the Unique Entity Identifier (UEI), and provide that number in the application. At a future, to-be-determined date, the *DUNS number will be replaced by the UEI, a “new, non-proprietary identifier” requested in, and assigned by, the System for Award Management (SAM.gov). For more details, visit the following pages: Planned UEI Updates in Grant Application Forms and General Service Administration’s UEI Update.

You must also register with SAM and continue to maintain active SAM registration with current information at all times during which you have an active federal award or an application or plan under consideration by an agency (unless the applicant is an individual or federal agency that is exempted from those requirements under 2 CFR § 25.110(b) or (c), or has an exception approved by the agency under 2 CFR § 25.110(d)).

If you are chosen as a recipient, HRSA would not make an award until you have complied with all applicable DUNS (or UEI) and SAM requirements and, if you have not fully complied with the requirements by the time HRSA is ready to make an award, you may be deemed not qualified to receive an award and use that determination as the basis for making an award to another applicant.

https://www.grants.gov/web/grants/forms/planned-uei-updates.html https://www.gsa.gov/entityid

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If you have already completed Grants.gov registration for HRSA or another federal agency, confirm that the registration is still active and that the Authorized Organization Representative (AOR) has been approved.

*Currently, the Grants.gov registration process requires information in three separate systems:

• Dun and Bradstreet (http://www.dnb.com/duns-number.html)

• System for Award Management (SAM) (https://www.sam.gov)

• Grants.gov (http://www.grants.gov/)

For further details, see Section 3.1 of HRSA’s SF-424 Application Guide.

SAM.GOV ALERT: For your SAM.gov registration, you must submit a notarized letter appointing the authorized Entity Administrator. The review process changed for the Federal Assistance community on June 11, 2018.

In accordance with the Federal Government’s efforts to reduce reporting burden for recipients of federal financial assistance, the general certification and representation requirements contained in the Standard Form 424B (SF-424B) – Assurances – Non- Construction Programs, and the Standard Form 424D (SF-424D) – Assurances – Construction Programs, have been standardized federal-wide. Effective January 1, 2020, the forms themselves are no longer part of HRSA’s application packages and the updated common certification and representation requirements will be stored and maintained within SAM. Organizations or individuals applying for federal financial assistance as of January 1, 2020, must validate the federally required common certifications and representations annually through SAM located at SAM.gov.

If you fail to allow ample time to complete registration with SAM or Grants.gov, you will not be eligible for a deadline extension or waiver of the electronic submission requirement.

4. Submission Dates and Times

Application Due Date The due date for applications under this NOFO is January 21, 2021 at 11:59 p.m. ET.

HRSA suggests submitting applications to Grants.gov at least 3 calendar days before the deadline to allow for any unforeseen circumstances. See Section 8.2.5 – Summary of emails from Grants.gov of HRSA’s SF-424 Application Guide for additional information.

5. Intergovernmental Review

The NTRC Program is subject to the provisions of Executive Order 12372, as implemented by 45 CFR part 100.

See Section 4.1 ii of HRSA’s SF-424 Application Guide for additional information.

http://www.dnb.com/duns-number.html https://www.sam.gov/ http://www.grants.gov/ http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://sam.gov/ https://www.fsd.gov/fsd-gov/answer.do?sysparm_kbid=d2e67885db0d5f00b3257d321f96194b&sysparm_search=kb0013183 https://www.sam.gov/

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6. Funding Restrictions

You may request funding for a period of performance of up to three years, at no more than $325,000 per year (inclusive of direct and indirect costs). Awards to support projects beyond the first budget year will be contingent upon Congressional appropriation, satisfactory progress in meeting the project’s objectives, and a determination that continued funding would be in the best interest of the Federal Government.

The General Provisions in Division A of the Further Consolidated Appropriations Act, 2020 (P.L. 116-94) and Continuing Appropriations Act, 2021 and Other Extensions Act (P.L. 116-159) are in effect at the time this NOFO is posted. Please see Section 4.1 of HRSA’s SF-424 Application Guide for additional information. Awards will be made subsequent to enactment of the FY 2021 appropriation. The NOA will reference the FY 2021 appropriation act and any restrictions that may apply. Note that these or other restrictions will apply as required by law in subsequent appropriations acts for FY 2021.

You cannot use funds under this notice for the…