1. FY 2013 New Access Point Funding Opportunity Announcement HRSA-13-228 Objective Review Committee Health Resources and Services Administration Department of Health and Human Services NAP TA Website: http://www.hrsa.gov/grants/apply/assistance/nap http://www.hrsa.gov/grants/apply/assistance/nap

2. Agenda 1.Overview Health Center Program New Access Point Funding Opportunity Eligibility Funding Priorities 2.Application Components Project Narrative and Review Criteria Budget Presentation Attachments Program Specific Forms Program Specific Information 3.Program Review Resources and Reminders 2

3. Overview NAP is a competitive funding opportunity for operational support for NEW primary care service delivery site(s) under the Health Center Program. What is a New Access Point? A new service delivery site for the provision of comprehensive primary and preventive medical health care services. 3

4. Overview The Health Center Program The Health Center Program provides grant support to public or private non-profit 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. 4

5. Overview The 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). 5

6. Overview NAP Highlights Approximately $19 million for approximately 25 NAP grant awards Authorized by Section 330 of the Public Health Service Act Supported by the Affordable Care Act Open to current Health Center Program grantees and new applicants 6

7. Overview Types 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 Healthcare 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 7

8. Overview Special Populations Applicants proposing to serve special population(s) must address additional, specific program requirements. 8

9. Eligibility Public or private, nonprofit entity, including tribal, faith based, and community based organizations. At least one proposed NAP site must be a full- time permanent site operating at least 40 hours per week. Comprehensive primary medical care must be the main purpose of the NAP application. 9

10. Eligibility Ensure access to services for all service area populations. Proposed site(s) may not focus on a single age-group (e.g., children), lifecycle (e.g., geriatric), or health issue (e.g., HIV/AIDS). Provide comprehensive primary health care services without regard for ability to pay. Budget request may not exceed $650,000 in either Year 1 or Year 2. 10

11. Eligibility No proposed NAP site can be in any Health Center Program grantee’s scope of project. 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 is designated, in whole or in part, as an MUA and/or contains an MUP. 11

12. Funding Priorities A funding priority is the favorable adjustment of an application’s objective review score if specific criteria are met. 1. Unserved, High Poverty (up to 15 points) 2. Sparsely Populated (5 points) Reviewers do not make the determination on priority points. Applications will be automatically assessed for these priorities. 12

13. Application Components Project Narrative Attachments Program Specific Forms 13

14. Project Narrative / Review Criteria The Project Narrative 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 how well the applicant presented the information requested 14

15. Review Criteria NEW for 2013: Review Criteria reference Project Narrative items, forms, and attachments that must be considered collectively when scoring the application 15

16. 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) 16

17. Highlights: 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 17

18. Highlights: 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 NEW: Implementation Plan to demonstrate operational readiness/compliance in 120 days NEW: Describe plans for outreach and enrollment for Medicaid expansion and Health Insurance Exchanges 18

19. Highlights: Collaboration Collaboration (10 points) The narrative and attachments must demonstrate collaboration between service providers within the service area NEW for 2013: Letters of support are required from major private provider groups serving the target population 19

20. Highlights: Evaluative Measures Evaluative Measures (5 points) The narrative and performance measures forms must demonstrate realistic goals and evaluation planning NEW for 2013: New clinical performance measures are required NEW for 2013: Describe implementation of certified Electronic Health Records (EHR) for patient tracking and meaningful use 20

21. Highlights: Resources/Capabilities Resources/Capabilities (15 points) The narrative and referenced forms and attachments must demonstrate the organizational capacity and experience to successfully operate the new access point(s) NEW for 2013: Describe your current or planned integration with the state health care delivery plan 21

22. Highlights: 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 22

23. Highlights: Support Requested Support Requested (10 points) The budget justification and referenced forms and attachments must document a consistent budget presentation appropriate for the proposed project NEW for 2013: Provide the proposed total cost and federal cost per patient (by requested funding type) and explain how this is reasonable and appropriate 23

24. Budget Presentation The budget presentation must provide detailed information for each year of the 2-year project period Required components: –SF-424A: Budget Information – Non-Construction Programs –Budget Justification The budget justification should include a line- item budget and narrative justification 24

25. 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 Agreements 25

26. 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 26

27. Readiness and Full Operational Capacity NEW for 2013: An Implementation Plan has been added (Attachment 2), that details the steps necessary for an applicant to demonstrate that the new access point(s) will be operational (providing services to the target community/population) and compliant with Health Center Program requirements within 120 days of award. Full operational capacity must be achieved within 2 years of award (serving all projected patients). 27

28. Program Specific Forms Form 1A: General Information Worksheet 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 Form 5C: Other Activities/Locations 28

29. Program Specific Forms Form 6A: Current Board Member Characteristics Form 6B: Request for Waiver of Governance Requirements Form 8: Health Center Agreements Form 9: Need for Assistance Worksheet Form 10: Annual Emergency Preparedness Report Form 12: Organization Contacts Summary Page 29

30. Summary Page 30 NEW for 2013: Summary Page that presents important information from application forms Provides at-a-glance review of: –proposed sites and service area zip codes –health center type(s) –funding requested, including one-time funding –proposed number of patients to be served and federal cost per patient –NFA score Applicants must verify accuracy of data

31. Program Specific Information One-Time Funding Project Information for Alteration/Renovation projects Clinical and Financial Performance Measures serve as ongoing monitoring and performance improvement tools –Clinical – 16 required measures –Financial – 5 required measures 31

32. Clinical Performance Measures Diabetes Cardiovascular Disease Cancer Prenatal Health* Perinatal Health* Child Health Behavioral Health Oral Health *may be marked “not applicable” if services are provided only via referral and not paid for by the applicant 32

33. Clinical Performance Measures Weight Assessment and Counseling for Children and Adolescents Adult Weight Screening and Follow-Up Tobacco Use Assessment Tobacco Cessation Counseling Asthma – Pharmacological Therapy Coronary Artery Disease: Lipid Therapy Ischemic Vascular Disease: Aspirin Therapy Colorectal Cancer Screening 33

34. Financial Performance Measures Total Cost per Patient Medical Cost per Medical Visit Change in Net Assets to Expense Ratio* Working Capital to Monthly Expense Ratio* Long Term Debt to Equity Ratio* *may be marked “not applicable” by tribal and public center applicants 34

35. Performance Measures Applicants may create additional “Other” 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) 35

36. Program Review Resources Funding Opportunity Announcement Side by Side of Project Narrative and Review Criteria HRSA Scoring Rubric Frequently Asked Questions NAP Application TA Website: http://www.hrsa.gov/grants/apply/assistance/NAP http://www.hrsa.gov/grants/apply/assistance/NAP 36

37. Final Reminders Reference the FOA Base your score on the Review Criteria, with reference to the Project Narrative, as needed Substantiate your score with strengths and weaknesses Your effort is appreciated 37