HEALTH RESOURCES AND SERVICES ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES

AUTHORIZATION:

Public Health Service Act, Title 111, Section 301.

OBJECTIVES:

To assist communities and consortia of health care providers to develop the infrastructure necessary to fully develop or strengthen integrated health care systems of care that coordinate health services for the uninsured.

TYPES OF ASSISTANCE:

Project Grants.

USES AND USE RESTRICTIONS:

Examples of activities that could be supported with this funding include: (1) Offering a comprehensive delivery system for the uninsured and underinsured through a network of safety net providers (single registration, eligibility systems); (2) integrating preventive, mental health, substance abuse, HIV/AIDS, and maternal and child health services within the system (Block Grant funded services, other DHHS programs, State and local programs); (3) developing a shared information system among the community's safety net providers (tracking, case management, medical records, financial records); (4) developing and incorporating shared clinical protocols, quality improvement systems, utilization management systems, and error prevention systems; (5) sharing core management functions (finance, purchasing, appointment systems); (6) coordinating and strengthening priority services to specific targeted patient groups; (7) developing affordable pharmaceutical services. Funding provided through this program may not be used to substitute for or duplicate funds currently supporting similar activities. Grant funds may support costs such as: (1) Project staff salaries; (2) consultant support; (3) management information systems (e.g. hardware and software); (4) project related travel; (5) other direct expenses necessary for the integration of administrative, clinical, and information systems, of financial functions; and (6) program evaluation activities. With appropriate justification on why funds are needed to support the following costs up to 15 percent of grant funds may be used for: (1) Alteration or renovation of facilities; (2) primary care site development; (3) service expansions or direct patient care. Grant funds may not be used for: (1) Construction; (2) reserve requirements for State insurance licensure. Twenty-five million is available for up to 20 communities to further their development of integrated delivery systems for the uninsured. Approximately 95 percent will be used for discretionary activities. Grants will vary in size based on the scope of the project and the size of the service area. A typical grant may not to exceed $1 million.

ELIGIBILITY REQUIREMENTS:

Applicant Eligibility:   Applications may be submitted by the public, private, and nonprofit entities who demonstrate a commitment to and experience with providing a continuum of care to uninsured individuals. Each applicant must represent a community-wide coalition that is committed to the project and includes safety net providers (where they exist) that have traditionally provided care to the community's uninsured and underinsured regardless of ability to pay. The community-wide coalition must consist of partners from all levels of care (i.e., primary, secondary, tertiary) and partners who represent a range of services (e.g., mental health and substance abuse treatment, maternal and child health care, oral health, HIV/AIDS). Examples of eligible applicants that may apply on behalf of the community-wide coalition include but are not limited to: (1) A consortium or network of providers (e.g. public and charitable hospitals; community, migrant, homeless, public housing, and school-based health centers; rural health clinics; free health clinics; teaching hospitals and health professions education schools); (2) local government agencies (e.g., local public health departments with service delivery components); (3) Tribal governments; (4) managed care plans or other payers (e.g., HMOs, insurance companies); (5) agencies of State governments, multi-state health systems, or special interest groups may submit applications on behalf of multiple communities if they demonstrate the ability to coordinate community health care delivery systems and bring resources to the community. Competing applications for the same patient population will not be considered for funding; therefore, applicants from the same community should collaborate.

Beneficiary Eligibility:   Examples of eligible beneficiaries include but are not limited to: (1) A consortium or network of providers (e.g., public and charitable hospitals; community, migrant, homeless, public housing, and school-based health centers; rural health clinics; free health clinics; teaching hospitals and health professions education schools); (2) local government agencies (e.g., local public health departments with service delivery components); (3) tribal governments; (4) managed care plans or other payers (HMOs, insurance companies); and (5) agencies of State governments, multi-state health systems, or special interest groups may submit applications on behalf of multiple communities if they demonstrate the ability to coordinate community health care delivery systems and bring resources to the community.

Credentials/Documentation:   None.

APPLICATION AND AWARD PROCESS:

Preapplication Coordination:   There will be a series of six preapplication workshops conducted across the county between March 7 thru 16, 2000. Consultation and assistance will be available at these workshops to aid in preparing a competitive grant application. This program is excluded from courage under E.O. 12372.

Application Procedure:   Application kits (i.e., application instructions, necessary forms, and application review criteria) will be available through the HRSA Grants Application Center. Interested applicants must complete all forms included in the kit and mail their completed applications to the HRSA GAC. The HRSA GAC will then send applications to the CAP Program Office for an eligibility and conformance review.

Award Procedure:   Each of the applications will undergo an eligibility and conformance review by Federal staff at the CAP Program Office. Applications that have passed the eligibility and conformance review will be assigned to members of an Objective Review Committee (ORC) who will review them based on the evaluation criteria listed in the application guidance. The results of the ORC reviews will be shared with the HRSA Administrator and Secretary of HHS, who will make the final decisions.

Deadlines:   Applications are due on June 1, 2000.

Range of Approval/Disapproval Time:   The time required for the applications to be approved or disapproved is 90 days (July thru September 30, 2000). Applications will be reviewed between July 3 thru 17, 2000. Site visits to selected applicants will be conducted in August, 2000. Grant awards will be announced in September, 2000.

Appeals:   None.

Renewals:   None.

ASSISTANCE CONSIDERATIONS:

Formula and Matching Requirements:   This program has no statutory formula.

Length and Time Phasing of Assistance:   Awards will be made as a lump sum.

POST ASSISTANCE REQUIREMENTS:

Reports:   Awardees must provide data as required by the CAP national evaluation program.

Audits:   None.

Records:   None.

FINANCIAL INFORMATION:

Account Identification:   75-0350-0-1-550.

Obligations:   (Grants) FY 99 $0; FY 00 est $20,000,000; and FY 01 est $20,000,000.

Range and Average of Financial Assistance:   Grant funding is for 20 grants of up to $1 million each.

PROGAM ACCOMPLISHMENTS:

It is anticipated that over 300 applications will be received and up to 20 awards will be granted in fiscal year 2000. It is anticipated that the same amount of awards will be granted in fiscal year 2001.

REGULATIONS, GUIDELINES, AND LITERATURE:

Federal Register Notice Volume 65, Number 24.

INFORMATION CONTACTS: