“Where Are We Going?” HRSA/BPHC Grant Opportunities Membership Meeting

HRSA / BPHC Opportunities (July Retreat) General Considerations –Collaboration good (expected); competition not good (self- defeating) –Service Area overlap will generate scrutiny in competitive situations –More / continued emphasis on “high need areas” or populations Other –“Approved But Unfunded” FIP applications from summer 2009 –NHSC Expansion –Workforce Development Initiatives (ex: teaching health centers)

Current HRSA Initiatives Increased Demand for Services (IDS) –$9M statewide –Current project periods expiring within 6 months –continuation expected pending final appropriations –State met new patient and new uninsured patient targets by 6/30/2010 Capital Improvement Program (CIP) –$28M statewide –2-year projects expiring mid 2011 Facility Investment Program (FIP) –Round 1: 8 awards totaling $80M in December 2009 –Round 2: 8 add’l awards totaling $43.4 in October 2010 –Federal funding represents approx ½ of total statewide capital need identified by League in fall of 2009 –More than 10 add’l FIP applicants unfunded IDS, CIP, FIP Round1 funded through ARRA  separate grants and separate / multiple reporting requirements

“New Access Points” Announcement Number: HRSA Type: Open competition Amount available: up to $250M for up to 350 projects Purpose: creation of “New Starts” (new grantees) or “Satellites” (new sites not in current scope of existing grantees) Deadlines: submitted in –grants.gov by Nov. 17, 2010 –EHB by Dec. 15, 2010 Awards: August 2011, $650,000 maximum award Project Period: two years

“New Access Points”, cont’d Need: up to 30 points of 100 point score Need Narrative: up to 10 of these 30 points “Funding priorities” –Betw/ 1 and 5 add’l points if % population of entire proposed service area that is poor > 30% –Betw/ 5 and 10 add’l points if at least 25% of budget identifies costs related to serving the homeless, farmworkers, or residents of public housing. –5 add’l points if population of entire proposed service area < 7 people / sq. mile

“New Access Points”, cont’d For some centers interest in NAP dampened by –Data challenges –Service area overlap –Subsequent ES and SBHCCP opportunities –Other priorities (FIP) Expect up to 12 NAP applications from all regions of the state League Letters of Support will be provided upon request with submitted Project Abstract after grants.gov deadline

“Expanded Services” Reference Document: HRSA Amount available: between $270M and $335M Type: Supplemental Targeted amounts (ceiling): –Formula: $175,000 + ($4 * # 2009 patients) + ($10 * # 2009 uninsured patients) –MA total: $9.7M Purpose: Addition or expansion of services at sites within current scope of project to –Add new patients –Provide new services to existing patients Deadline: EHB by January 6, 2011 Awards: April 2011

“Expanded Services” cont’d An Expanded Medical Capacity project is required, with budget reflecting not < 2/3 of target amount Up to 5 optional projects, with combined budget reflecting not > 1/3 of target amount, are allowed for: –Behavioral Health / Substance Abuse * –Pharmacy, –Oral Health, –Vision Services, or –Enabling Services NOTE: costs of enabling services to increase medical patients can be included in EMC project * Guidance for separate $25M competitive opportunity for BH/SA services expected in January 2011

“School-Based Health Center Capital Program” Reference Document: HRSA Authorized by ACA Amount available: $100M Eligibility: school-based health center or sponsoring organization of a SBHC Purpose: support for Alteration and Renovation of, Construction of, or Equipment for new or existing SBHCs Up to 10 projects in 1 application with a maximum award of $500,000 Deadlines: submitted in –grants.gov by Dec. 1, 2010 –EHB by Jan. 12, 2011 Awards: July 2011

“SBHCC Program” cont’d Allowable Costs –Office equipment –Medical equipment –Mobile vans used for service provision –Land and building and acquisition –EHR systems and licenses Unallowable Costs –Staff, except those needed for capital project activities –Operating costs –Office and medical supplies –Vans if used for patient transportation

Uniform Data System 2010 Changes (Program Assistance Letter ) –Revised definition of agriculture –Adding vision services FTEs to Staffing Table –Adding Hepatitis B and C to Selected Diagnoses –League Training - Jan 13, 2011 –Preliminary Deadline - Feb 15, 2011 –2010 data finalized - March 31, Changes (draft PAL ) –Alignment with MU measures: Weight screening, assessment, follow-up Childhood immunizations at 2 y.o. Tobacco use assessment / cessation Diabetes HbA1c control Asthma treatment

Other BPHC Issues BPHC Reorganization –4 geographic divisions instead of 3, with additional branch chiefs (MA is with NJ and VI) –Reassignment of Project Officers effective Nov. 1 –Assignment of Regional ORO staff as Project Officers –Lead Clinical / Medical staff within Divisions –Centralization of Help Desk functions –Insourcing of FTCA / Risk Management help Continuing “electronification” in/through EHB