“Where Are We Going?” HRSA/BPHC Grant Opportunities Membership Meeting 11.05.2010

1. “Where Are We Going?” HRSA/BPHC Grant Opportunities Membership Meeting 11.05.2010

2. 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)

3. 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

4. “New Access Points” • Announcement Number: HRSA-11-017 • 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

5. “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

6. “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

7. “Expanded Services” • Reference Document: HRSA-11-148 • 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

8. “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

9. “School-Based Health Center Capital Program” • Reference Document: HRSA-11-127 • 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

10. “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

11. Uniform Data System • 2010 Changes (Program Assistance Letter 2010-04) • 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, 2011 • 2011 Changes (draft PAL 2010-12) • Alignment with MU measures: • Weight screening, assessment, follow-up • Childhood immunizations at 2 y.o. • Tobacco use assessment / cessation • Diabetes HbA1c control • Asthma treatment

12. 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