FY 2015 New Access Point (NAP)

Funding Opportunity Announcement HRSA-15-016

Health Resources and Services Administration

Department of Health and Human Services

NAP TA Website: http://www.hrsa.gov/grants/apply/assistance/nap

Agenda

• Overview• Eligibility• Submission Process• Project Narrative and Review Criteria• Budget Presentation• Attachments• Program Specific Forms• One-Time Funding• Funding Priorities• Important Reminders• Technical Assistance Resources• Questions & Answers

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Overview

NAP is a competitive funding opportunity for operational support for NEW primary care service delivery site(s) under the Health Center Program.

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OverviewThe Health Center

Program

The Health Center Program provides grant support to non-profit or public organizations that serve designated medically underserved areas/populations or special populations comprised of migratory and seasonal agricultural workers, homeless individuals and families, or residents of public housing. 

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OverviewThe Health Center

Program• HRSA currently provides grant support to

approximately 1,300 health centers operating more than 9,300 sites across the United States and its territories, serving more than 21 million patients.

• Health Center Program grantees target underserved and vulnerable individuals and families with the goals of increasing access to primary health care and improving patient health status.

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OverviewThe Health Center

Program• Health Center Program grantees must

provide primary care services to all, regardless of their ability to pay.

• Health Center Program grantees are expected to comply with the 19 program requirements included as Appendix F in the NAP funding opportunity announcement (FOA).

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OverviewNAP Highlights

• Up to $100 million for approximately 150 NAP grant awards

• 2-year project period starting May 1, 2015

• Authorized by Section 330 of the Public Health Service Act and supported by the Affordable Care Act

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OverviewNAP Highlights

• Open to current Health Center Program grantees and new applicants

• Applications Due in Grants.gov: – August 20, 2014, 11:59 PM ET

• Applications Due in HRSA EHB: – October 7, 2014, 8:00 PM ET

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OverviewNAP Highlights

• What is a New Access Point (NAP)?– A new service delivery site for the

provision of comprehensive primary and preventive medical health care services

• Two types of NAP applicants:– New Starts - Organizations not

currently receiving Health Center Program funding

– Satellites - Organizations currently receiving Health Center Program funding that are proposing to establish NEW service delivery site(s)

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OverviewTypes of Health Centers

Applicants may request funding to serve any combination of populations based on the proposed service area’s needs

• Community Health Centers (CHC, section 330(e)) serve the general underserved population

• Migrant Health Centers (MHC, section 330(g)) serve migratory and seasonal agricultural workers and their families

• Health Care for the Homeless (HCH, section 330(h)) serve homeless individuals and families

• Public Housing Primary Care (PHPC, section 330(i)) serve residents of public housing

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Eligibility

• Public or private, nonprofit entities, including tribal, faith based, and community based organizations.

• An applicant cannot apply on behalf of another organization.

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Eligibility

The proposed NAP project (across all sites) must:• Provide comprehensive primary medical

care as its main purpose. • Provide services without regard for

ability to pay.• Ensure access to services for all

individuals in the service area (e.g., cannot focus on a single age group, racial/ethnic group, or health issue).

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Eligibility

• An applicant must propose at least one permanent service delivery site that provides comprehensive primary medical care as its main purpose and operates for at least 40 hours per week.

• No proposed NAP site can be in any Health Center Program grantee’s scope of project, including sites pending verification at the time of NAP application.

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Eligibility

• Funding request may not exceed $650,000 in either Year 1 or Year 2.

• Application must not exceed the 200-page limit when printed by HRSA.

• New Starts applying for Community Health Center (CHC) funding must propose a service area that: (1) is designated, in whole or in part, as an MUA and/or (2) contains an MUP.

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Submission Process

Register early! Grants.gov registration process may take up to 1

month!Grants.gov registration requirements:

1. Obtain Data Universal Numbering System (DUNS) number

2. Register in System for Award Management (SAM)• Update registration every 12 months!

3. Register in Grants.gov 15

Grants.gov Electronic Handbooks

• 2-step application submission process:

Submission ProcessGrants.gov Required

DocumentsApplicants must submit the following documents in Grants.gov by 11:59 PM EST on August 20:• SF-424: Application for Federal

Assistance (upload Project Abstract in box 15)

• SF-424B: Assurances – Non-Construction Programs

• Project/Performance Site Location(s) Form

• Grants.gov Lobbying Form• SF-LLL: Disclosure of Lobbying Form

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Submission ProcessSF-424: Application for Federal Assistance

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Submission ProcessStep 1: Grants.gov

• For help with Grants.gov electronic submission, call Grants.gov Contact Center at 1-800-518-4726

• Grants.gov provides 4 emails to applicant after submission1. Submission Receipt2. System Validation3. Agency (HRSA) Validation4. HRSA EHB Tracking Number

Assignment

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Submission ProcessStep 1: Grants.gov

• Within 5 business days of Grants.gov submission, the 4th email will provide a tracking number for accessing your application in EHB.

• If you do not receive the message with the tracking number within 7 business days, contact the BPHC Helpline at 877-974-2742.

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Submission ProcessEHB Required Documents

Applicants must submit the following documents in EHB by 8:00 PM EST on October 7:• Project Narrative• SF-424A: Budget information • Budget Justification• Attachments• Program Specific Forms• Program Specific Information

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Submission ProcessStep 2: EHB

• Application can only be submitted by the Authorizing Official

• Receive an “Application successfully transmitted to HRSA” message in EHB

• For help with electronic submission in EHB, call the BPHC Helpline at 877-974-2742

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Project Narrative /Review Criteria

• The Project Narrative section details the information the applicant must include to provide a comprehensive description of the proposed NAP

• The Review Criteria are used by grant reviewers to evaluate the information presented

• Applicants should consider both sections when developing the application

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Project Narrative /Review Criteria

• Need (30 points)• Response (20 points)• Collaboration (10 points)• Evaluative Measures (5 points)• Resources/Capabilities (15 points)• Governance (10 points)• Support Requested (10 points)

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Need

Need (30 points)• 20 of the 30 points available for the

Need section are determined by the Need for Assistance Worksheet (NFA – Form 9) score

• The narrative response (10 of the 30 points) should reference the data provided in the NFA Worksheet as needed

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Response

Response (20 points)• The narrative and referenced forms and

attachments must describe the proposed project and how it will comply with the Health Center Program requirements

• Implementation Plan must demonstrate all proposed NAP sites will be open, operational, and compliant with Health Center Program Requirements within 120 days of the NAP award

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Collaboration

Collaboration (10 points)• The narrative and attachments must

demonstrate collaboration between providers within the service area

• Letters of support that are not submitted with the application will not be reviewed

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Evaluative Measures

Evaluative Measures (5 points)• The narrative and performance

measures forms must demonstrate realistic goals and evaluation planning

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Resources/Capabilities

Resources/Capabilities (15 points)• The narrative and referenced forms and

attachments must demonstrate the organizational capacity and experience to successfully open and operate all proposed NAP sites within 120 days of the NAP award.

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Governance

Governance (10 points)• The narrative and referenced forms and

attachments must document how the organization and its board are compliant with the Health Center Program governance requirements

• Governance requirements do not apply to health centers operated by Indian tribes, tribal groups, or Indian organizations

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Support Requested

Support Requested (10 points)• The budget justification and

corresponding forms and attachments must be consistent and appropriate for the proposed project

• Provide the proposed total cost and federal cost per patient (by requested funding type) and explain how this is reasonable and appropriate

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Budget Presentation

• Required components:– SF-424A: Budget Information – Budget Justification

• The budget justification must include a line-item budget and narrative justification for each year of the 2-year project period

• NEW for 2015: Detail the federal funding request and non-grant revenue supporting the project separately in the line-item budget

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Budget Presentation

• The budget must be consistent with:– Form 1B: BPHC Funding Request

Summary– Form 2: Staffing Profile– Form 3: Income Analysis Form

• If one-time funding is requested for alterations/renovations, a project budget must be provided

• If one-time funding is requested for equipment, an equipment list must be provided

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Attachments

• Attachment 1: Service Area Map and Table

• Attachment 2: Implementation Plan• Attachment 3: Applicant Organizational

Chart• Attachment 4: Position Descriptions for

Key Management Staff• Attachment 5: Biographical Sketches for

Key Management Staff• Attachment 6: Co-Applicant Agreement• Attachment 7: Summary of Contracts

and Agreements33

Attachments

• Attachment 8: Independent Financial Audit

• Attachment 9: Articles of Incorporation• Attachment 10: Letters of Support• Attachment 11: Sliding Fee Discount

Schedule(s)• Attachment 12: Evidence of Nonprofit or

Public Center Status• Attachment 13: Floor Plans• Attachment 14: Corporate Bylaws• Attachment 15: Other Relevant

Documents 34

Program Specific Forms

• Form 1A: General Information Worksheet– Realistic Projections for Unduplicated

Patients by December 31, 2016• Form 1B: BPHC Funding Request

Summary• Form 1C: Documents on File• Form 2: Staffing Profile• Form 3: Income Analysis• Form 4: Community Characteristics• Form 5A: Services Provided• Form 5B: Service Sites

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Program Specific Forms

• Form 5C: Other Activities/Locations• Form 6A: Current Board Member

Characteristics• Form 8: Health Center Agreements• Form 9: Need for Assistance Worksheet• Form 10: Annual Emergency

Preparedness Report• Form 12: Organization Contacts• Summary Page• Clinical and Financial Performance

Measures36

Need for Assistance (NFA)Worksheet

• The NFA Worksheet (Form 9) documents objective measures of need with the proposed service area and/or target population

• Use the Data Resource Guide available at http://www.hrsa.gov/grants/apply/assistance/nap for suggested data sources for all NFA indicators

• Complete based on all proposed NAP sites

• Maximum 100 points, converted to a 20-point scale

• Review the total score and converted score in EHB prior to submission

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Summary Page

• The Summary Page provides at-a-glance review of important information from various forms:– proposed sites and service area zip codes– funding requested, including one-time

funding– proposed number of patients to be served

and federal cost per patient – NFA score

• Applicants must certify that all proposed sites will be open and operational within 120 days of award and that the projected number of patients will be reached by December 31, 2016

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Performance Measures Forms

• Performance measures serve as ongoing monitoring and performance improvement tools.– Clinical – 16 required measures– Financial – 5 required measures

• BPHC will provide a separate webcast that presents the performance measures in detail. This will be available on the NAP TA webpage.

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Clinical Performance Measures

1. Diabetes2. Cardiovascular Disease3. Cancer4. Prenatal Health5. Perinatal Health6. Child Health7. Weight Assessment and Counseling for

Children and Adolescents8. Adult Weight Screening and Follow-Up

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Clinical Performance Measures

9. Tobacco Use Assessment and Cessation*

10.Asthma – Pharmacological Therapy11.Coronary Artery Disease: Lipid Therapy12.Ischemic Vascular Disease: Aspirin

Therapy13.Colorectal Cancer Screening14.New HIV Cases with Timely Follow Up*15.Depression Screening and Follow Up*16.Oral Health

*New performance measures for 2015 41

Financial Performance Measures

1. Total Cost per Patient2. Medical Cost per Medical Visit3. Change in Net Assets to Expense Ratio*4. Working Capital to Monthly Expense

Ratio*5. Long Term Debt to Equity Ratio*

*may be marked “not applicable” by tribal and public center applicants 42

Performance Measures

• Applicants may create additional performance measures specific to their proposed projects

• Applicants applying for special population funding must include additional clinical performance measures that address the health care needs of the special population(s)

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One-Time Funding

• Applicants requesting one-time funding for alteration and renovation must complete:– Equipment List (as applicable)– Alteration/Renovation Project Cover

Page– Other Requirements for Sites– Environmental Information and

Documentation Checklist– Alteration/Renovation Budget

Justification– Schematic Drawings– Landlord Letter of Consent (as

applicable)44

Funding Priorities

A funding priority is the favorable adjustment of an application’s objective review score if specific criteria are met. All applications will be assessed by HRSA for these priorities:1. Unserved, High Poverty (up to 15

points)2. Sparsely Populated (5 points)3. Health Center Program Look-Alikes (5

points)

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Funding Priorities

Unserved, High Poverty (up to 15 points)

Goal: Prioritize NAP applications that propose to serve high need, unserved communities and populations1. 75% or more of the proposed service

area’s low-income population is NOT being served by the Health Center Program

2. Unserved, low-income service area residents must be at least 1.5 times the number of proposed patients 46

Funding Priorities

Unserved, High Poverty (up to 15 points)

• For example, if you propose to serve 2,000 individuals, there must be at least 3,000 low-income residents in the proposed service area that are not being served by the Health Center Program AND only 25% or less of the low-income population in the service area is being served by the Health Center Program

• See the table on page 46 of the FOA for a breakdown of points to be assigned 47

Funding Priorities

Sparsely Populated Area (5 points)

• 5 points will be awarded if the entire proposed service area (defined by the zip codes listed on Form 5B) has seven or fewer people per square mile

• Only applicants that request all or partial CHC funding are eligible for this priority

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Funding Priorities

Health Center Program Look-Alikes (5 points)

Applicants designated as look-alikes prior to October 1, 2013 will receive 5 points if:1. NAP application Form 5B includes all

current sites in look-alike’s scope of project at time of application

2. NAP application Form 5B lists the service area zip codes in which at least 75% of current patients reside

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Funding Priorities

Health Center Program Look-Alikes (5 points)

3. Complete 2013 patient data has been reported in UDS

4. Total unduplicated patient projection by 12/31/2016 on NAP application Form 1A is greater than total unduplicated patients in the 2013 UDS report

5. Applicant does not have three or more program requirement-related conditions at time of NAP application submission

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Important Reminders

• Applications Due in Grants.gov: – August 20, 2014, 11:59 PM ET

• Applications Due in HRSA EHB: – October 7, 2014, 8:00 PM ET

• Applications may not exceed 200 pages• Failure to follow the instructions and

include all required documents may result in an application being considered non-responsive

• All sites must be operational and compliant within 120 days of award

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Technical Assistance Resources

Contact Information• Program related questions

– Joanne Galindo: BPHCNAP@hrsa.gov • Budget related questions

– Angela Wade: awade@hrsa.gov or 301.594.5296

• EHB questions– BPHC Helpline: BPHCHelpline@hrsa.gov or

877.974.2742• Grants.gov related questions

– support@grants.gov or 800.518.4726• NAP TA Website

– http://www.hrsa.gov/grants/apply/assistance/nap

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Technical Assistance Resources

NAP TA Web PageTA Webcasts

Presentation Slides for TA CallFrequently Asked Questions

Program Requirements ResourcesData Resource Guide: NFA WorksheetNAP User Guide for Grant Applicants

SamplesForms

Helpful LinksHRSA Contact Information

http://www.hrsa.gov/grants/apply/assistance/nap

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