Cooperative Agreement to Support Navigators in Federally-facilitated Exchanges

Each year, the Centers for Medicare & Medicaid Services (CMS) awards funding to organizations who serve as Navigators in states with a Federally-facilitated Exchange (FFE). This posting reflects a 5-year funding opportunity, which began August 27, 20

Each year, the Centers for Medicare & Medicaid Services (CMS) awards funding to organizations who serve as Navigators in states with a Federally-facilitated Exchange (FFE). This posting reflects a 5-year funding opportunity, which began August 27, 2024 and runs through August 26, 2029. Funded projects are expected to operate as Navigators year-round, using the funding from CMS to conduct outreach and education in their communities-raising awareness among the remaining uninsured about the coverage options available to them, help consumers find affordable coverage that meets their needs primarily in the Health Insurance Marketplace, and to assist consumers beyond the enrollment process-ensuring they're equipped with the tools and resources needed to utilize and maintain their health coverage all year. Navigators are required to provide targeted assistance to underserved and vulnerable populations within their FFE service area (state).

This funding opportunity is open to individuals, public and private entities, and consortia capable of carrying out the program requirements at https://www.ecfr.gov/current/title-45/section-155.210 and meeting the terms and conditions of the award that will be issued to awarded applicants. Examples of eligible entities include: • Community and consumer-focused nonprofit groups • Trade, industry, and professional associations • Institutions of higher education • Indian tribes and tribal organizations (American Indian/Alaskan Native) • State or local human service agencies Examples of eligible entities include: • Community and consumer-focused nonprofit groups • Trade, industry, and professional associations • Institutions of higher education • Indian tribes and tribal organizations (American Indian/Alaskan Native) • State or local human service agencies

Navigators are required to assist all consumers who contact them seeking assistance with health care enrollment and post enrollment needs through the federal Marketplace. For purposes of this funding opportunity, Navigators are expected to target priority populations (vulnerable or underserved) who are members of communities which have been historically disenfranchised and disproportionately impacted by health disparities and inequities. Priority populations are often affected by social determinants of health (SDOH)- geographic location (e.g., rural or urban), gender, or sexual orientation and health-related social needs (HRSNs) - housing instability, housing quality, food insecurity, employment, personal safety, lack of transportation, and affordable utilities), all of which can have a major impact on people's health, well-being, and quality of life.

The use of the cooperative funding allows awarded entities to have federally and, if applicable, state certified Navigators provide outreach, education, enrollment, and post-enrollment assistance to consumers in the federally-facilitated Marketplaces. The Funding Opportunity also includes a list of unallowable uses and costs under the grant. The following costs are not allowed: • Pre-award costs. • Meeting matching requirements for any other federal funds or local entities. • Services, equipment, or supports that are the legal responsibility of another party under federal, state, or tribal law, such as vocational rehabilitation or education services, or under any civil rights laws, such as modifying a workplace or providing accommodations that are obligations under law. • Goods or services not allocable to the project.• Supplanting existing state, local, tribal, or private funding of infrastructure or services, such as staff salaries, etc. • Construction. • Capital expenditures for improvements to land, buildings, or equipment that materially increase their value or useful life as a direct cost, except with our prior written approval. • The cost of independent research and development, including their proportionate share of indirect costs (see 45 C.F.R. 75.476). • Funds related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or executive order. • Certain telecommunications and video surveillance equipment (see 2 C.F.R. 200.216). • Meals, unless in limited circumstances such as: subjects and patients under study; where specifically approved as part of the project or program activity, such as in programs providing children's services; and as part of a per diem or subsistence allowance provided in conjunction with allowable travel. • Costs to provide direct health care services to individuals. • Costs that supplant funds provided under Funding Opportunity CA-NAV-21-001, entitled "Cooperative Agreement to Support Navigators in Federally-facilitated Exchanges." • Costs that supplant funds for any other Notice of Funding Opportunity or Financial Assistance Program. • Costs of carrying out services that are the responsibility of the Exchange, such as eligibility determinations and transferring enrollment information for consumers to a QHP. • Assistance for consumers residing in a SBE or SBE-FP state or in a state the Navigator has not been awarded cooperative agreement funding to serve. • Staff retreats or promotional giveaways. • Gifts or gift cards, or promotional items that market or promote the products or services of a third party, that would be provided to any applicant or potential enrollee.

The period of performance is 5 years from the notice of award anticipated to start on August 27, 2024, through August 26, 2029. Funding will be awarded in 12-month increments called budget periods, based on funding availability. Continued funding throughout the 5-year period of performance will be contingent on a timely submission of a non-competing continuation application due 90 days prior to the start of each of the remaining budget periods , strong performance during the prior budget period, funding availability, and the awardee's ability to continue meeting all eligibility requirements laid out in the Funding Opportunity, including continuing to serve in a state(s) with a FFE.

Preapplication coordination is required

CMS conducts a pre-award risk review on all applicants prior to selection, using SAM.gov Responsibility/Qualification to make sure you've handled any past federal awards well and demonstrated sound business practices. CMS selects recipients at our sole discretion unless federal statute says otherwise. Our selections are not subject to administrative or judicial review, per Section 1115A(d)(2)(B) of the Social Security Act. CMS reserves the right to conduct pre-award Negotiations with potential awardees. When making funding decisions, we consider: • Merit review results. These are key in making decisions but are not the only factor. • The larger portfolio of agency-funded projects, including the diversity of project types and geographic distribution. • The past performance of the applicant. We may choose not to fund applicants with management or financial problems. • Other awarded Navigator recipients in a given FFE; and • The availability of remaining funds in an FFE State. We may: • Fund applications in whole or in part. • Fund applications at a lower amount than requested. • Decide not to allow a prime recipient to subaward if they may not be able to monitor and manage subrecipients properly. • Choose to fund no applications under this NOFO. Applications determined to be ineligible, incomplete, and/or nonresponsive based on the initial screening may be eliminated from further review. However, in accordance with HHS Grants Policy, the CMS, Office of Acquisition and Grants Management (OAGM), Grants Management Officer in his/her sole discretion, may continue the review process for an ineligible application if it is in the best interests of the government to meet the objectives of the program

If you are successful, your Authorized Official Representative will receive an automated email notification from GrantSolutions, notifying you that the Notice of Award (NoA) is available. We will notify you if your application is disqualified or unsuccessful within 30 days of the award date. The NoA is the only official award notification document. The NoA tells you about the amount of the award, important dates, and the terms and conditions you need to follow. You can only begin to start work as of the Budget Period Start Date, item 19 on the NoA.

The deadline for applying and other related timelines are included in the Funding Opportunity that is anticipated to be posted on https://grants.gov/ around May 17, 2024.

The start date of the 5-year period of performance was August 27, 2024 and runs through August 26, 2029. At any time, CMS could decrease funding or terminate an award if the entity fails to perform the requirements of the award. See 45 CFR 75.372 "Termination."