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  5. FAQ: Rural Health Care Coordination Program

FAQ: Rural Health Care Coordination Program

Funding Opportunity Number: HRSA-23-125

General questions

Accessing the notice of funding opportunity (NOFO)

You can access the guidance for the Rural Health Care Coordination Program by using the following steps:

  • Go to the associated grants.gov funding opportunity posting
  • Click the blue tab labeled “Package”
  • Click the blue hyperlink labeled “Preview”
  • Click on the gray box labeled “Download Instruction”
    • How can I access the technical assistance webinar recording and slides?

    You may access the webinar recording and slides on Rural Health Care Coordination Program | HRSA.

    Is my project proposal acceptable?

    We are unable to provide specific guidance on whether or not a project is acceptable. Each application will be reviewed by a panel composed of external individuals who will make recommendations on which projects receive funding.

    When will successful applicants be notified?

    Generally, successful applicants are notified via email one month prior to the project period start date.

    What is the application deadline?

    All applications are due electronically by May 26, 2023 at 11:59 PM ET.

    What happens after I submit my application?

    After you submit your application via grants.gov, your application goes through the following process: 1) application screening, 2) technical review, and 3) award determination. Please review the Follow the Application Process information on the HRSA website.

    Eligibility

    a. Geography

    Are we eligible to apply if our organization’s headquarters is not in a rural census tract but our target population (where we would be implementing the project) are?

    Page 5 – “Eligible applicants shall be domestic public or private, non-profit or for-profit entities, including faith-based, community-based, tribes and tribal organizations. The applicant organization may be located in a rural or urban area, but must have demonstrated experience serving, or the capacity to serve, rural underserved populations.” This includes foundations, which are considered to be non-profit entities.

    How do I check my rural eligibility?

    You can check your rural eligibility using the HRSA Rural Health Grants Eligibility Analyzer.

    One of the counties in our organization’s service area is defined as “partially-rural?” How should we provide our census tract information?

    The Rural Health Grants Eligibility Analyzer has a link towards the bottom of the page titled "National Listings of eligible counties and census tracts (PDF - 401 KB)." This document has the census tracts and numbers.

    Is HRSA-23-125 funding open to organizations outside of the U.S.?

    Page 9 – “The applicant organization and/or network members may be located in an urban or rural area in the 50 U.S. states or in the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, the U.S. Virgin Islands, the Federated State of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.”

    b. Tribal government and faith-based organizations

    Can you verify that tribal governments and faith-based organizations are eligible for this grant as they are public entities?

    Faith-based and community-based organizations are eligible to apply for these funds. Tribes and tribal organizations are eligible to apply for these funds.

    Page 6 – Tribal exception: HRSA is aware that tribes and tribal governments may have an established infrastructure without separation of services recognized by filing for EINs. In case of tribes and tribal governments, only a single EIN located in a HRSA-designated rural area is necessary to meet the network requirements. Tribes and tribal entities under the same tribal governance must still meet the network criteria of three or more entities committed to the proposed approach, as evidenced by a signed letter of commitment that delineates the expertise, roles and responsibilities in the project, and commitments of each network member. Please submit this information, as Attachment 5.

    Are Tribal Nations required to consult with State Offices of Rural Health?

    Page 6. By statue, all applicants are required to consult their State Offices of Rural Health (SORH) or equivalent (appropriate state entity) regarding their intent to apply to this program.

    c. Consortiums/Network Partners

    How do you define “health care provider”?

    Page 45, Appendix B – “Health care provider organizations are defined as entities including but not limited to hospitals, health systems, rural health clinics (RHCs), federally qualified health centers (FQHCs), primary care providers, specialty care providers, outpatient medical practices, oral health service providers, mental health centers, critical access hospitals (CAH), Certified Community Behavioral Health Clinics (CCBHCs), local public health departments, non-health human and social service organizations, community action agencies, accountable care organizations (ACO), State Home Visit, and Health Start Program organizations.”

    How do you define “payers”?

    Page 47, Appendix B – “Payers are defined as any entity responsible for providing coverage to patients and for the payment of healthcare. This includes but is not limited to private health insurance companies, State Medicaid, federal Medicaid, Medicare, Medicare Advantage, and other types of health plans.”

    Does my network need to be composed of health care providers and payers?

    Page 10 – “Applicants must represent a network composed of three or more health care provider organizations and payers, including the applicant organization. All applicants should ensure a collaborative network that is representative of the rural underserved populations and/or organizations in the local community or region to be served. HRSA requires at least sixty six percent (66%), or two-thirds of the network composition involved in the proposed project be located in a HRSA-designated rural area, as defined by the Rural Health Grants Eligibility Analyzer.”

    Does my organization have to be a part of a consortium or network to apply for HRSA-23-125 funding?

    Page 5 – “The applicant organization must represent a network composed of members that include three or more health care providers. For the purposes of this funding opportunity, the terms “consortium” and “network” are used interchangeably.”

    Are local health departments eligible to apply? If so, are we required to have a consortium of 3 or more providers?

    Local health departments are eligible to apply for this program. Please refer to the information provided above on network/consortium requirement.

    If some members of my network are not “rural” by the guidelines of this grant, will the consortium still be considered as an acceptable partnership in my application?

    Page 9-11. Please refer to the Program Requirements and Expectations. As long as the project proposal maintains that all project activities serve rural populations. Additionally, according to page 10 of the NOFO “HRSA requires at least sixty-six percent (66%), or two-thirds of the consortium composition involved in the proposed project be located in a HRSA-designated rural area, as defined by the Rural Health Grants Eligibility Analyzer.” When the applicant organization and consortium members are located in an urban area, the activities and services of the consortium must be provided in a non-metropolitan county or rural census tract.

    Is the awardee allowed to contract with an organization that is located outside of a rural county, to help fulfill grant goals in our rural areas?

    Page 9-11. As long as the project proposal maintains that all project activities serve rural populations. Please refer to the Program Requirements and Expectations on Pages 9-11 of the NOFO for more information.

    How do health technology businesses find rural healthcare providers and coordinators with which to collaborate on this or other HRSA efforts?

    Page 10. Refer to the Application Organizational Requirements. The applicant organization must be in an established or formal network of multi-sector and multi-disciplinary partnerships, please see the definition of health care provider organizations, in Appendix B, for examples of types of partnership organizations.

    As a grant intended to fund rural consortia to provide care coordination, is there a requirement that the consortium be composed of 3 or more entities that are separate, with each having its own 501c3 exempt designation or tax ID?

    Pages 5-6. Refer to the Eligibility Information provided on pages 5-6, and the Organizational Information provided on page 19. The network must consist of at least three separately owned (i.e., different EINs) entities, including the applicant organization. Tribal entities may be exempt from this requirement.

    Could three separate hospitals that are part of the same system count as a consortium of three?

    Please refer to the information provided in the question and answer above. The network must consist of at least three separately owned (i.e., different EINs) entities, including the applicant organization.

    d. Previous FORHP Awardee

    Can previous FORHP awardees apply?

    Yes. As long as they comply with the eligibility criteria on Pages ii-iii– “Not previously received a grant under 42 U.S.C. 254c(e) for the same or similar project unless the entity is proposing to expand the scope of the project or the area that will be served through the project.”

    Additionally, if the applicant organization has received any HRSA funds within the last 5 years, the grant number and the abstract from the previous award should be included in Attachment 7.

    e. Multiple Applications

    If an organization has a pending application into HRSA, can they still apply to this NOFO, which represents a program expansion?

    Page 5 - Refer to the eligibility information. The applicant organization may not previously have received an award under 42 U.S.C. 254c(e) from the HRSA Federal Office of Rural Health Policy for the same or a similar project unless the applicant is proposing to expand the scope of the project or the area that will be served through the project. However, if the application has not reached a decision, an organization can still apply to this NOFO. For more details, see Program Requirements and Expectations.

    Can our consortium or network be partners for two different applicants?

    The only restriction is regarding the number of applications that can be submitted by an organization as the lead applicant. Page 5– “Multiple applications from an organization with the same Unique Entity Identifier (UEI) are not allowable.”

    Personnel/staffing

    Are the Network Director (ND) and Project Director (PD) required positions?

    Yes. Pages 17-18 – “Identify the network director and project director, as well as key personnel on the award, in the Project Abstract and Attachment 2. The Network Director will be responsible for overall network monitoring. The Project Director will be responsible for project/program monitoring and carrying out the award activities. The applicant should identify a permanent network and project director prior to receiving award funds. If the applicant organization has an interim network director or project director or has not yet hired a person to serve as the network director or project director, discuss the process and timeline for hiring a permanent individual for these positions.”

    Is it required that the project have a full-time Network Director (ND)?

    Pages 10-11 – “The network must have a permanent network director (i.e., network executive director) or have established an interim network director capable of overseeing the network’s administrative, fiscal, and business operations at the time an award is made. HRSA strongly recommends the network director role be 1.0 FTE and that the project director role is at least 0.5 FTE. HRSA prefers that the network director role is different from the project director.”

    Are the requirements for the Network Director the same as a Project Director? To clarify, does the Network Director need to be dedicating 1.0 FTE to the network itself, or do they just need to be in a 1.0 FTE position, while undertaking other duties as well?

    Pages 17-18. “The Network Director will be responsible for overall network monitoring. The Project Director will be responsible for project/program monitoring and carrying out the award activities... HRSA strongly recommends the Network Director and the project director allot adequate time (at least 1 FTE for the Network Director and at least 0.50 FTE for the Project Director is recommended)”.

    Funding preference

    Where can I find information regarding requesting a funding preferences?

    Pages 34-35 of the NOFO guidance further describe the funding preferences.

    If I qualify for a funding preference, does this have to be included in my application?

    Applicants receiving the preference will be placed in a more competitive position among applications that can be funded. Applications that do not receive a funding preference will receive full and equitable consideration during the review process. If requesting a funding preference, please indicate which qualification is being met in the Project Abstract.

    You only have to meet one of the qualifications stated above to receive the preference. Meeting more than one qualification does not increase an applicant’s competitive position.

    If I am submitting an application as part of a consortium, when requesting a funding preference for Qualification #1: Health Professional Shortage Area (HPSA) or Qualification #2: Medically Underserved Community/Population (MUC/MUP), should a screenshot be provided for each site address in the consortium or only for the applicant organization?

    Pages 34-25 - “You can request funding preference if the service area of the applicant is located in an officially designated health professional shortage area (HPSA).” or “if the applicant is located in a medically underserved community (MUC) or serves medically underserved populations (MUPs).” As such, you should include a screenshot or printout for the service area, not for the location of each consortium member. These items should be included in Attachment 6 and will not count toward the 60-page limit.

    Application submission

    How can I apply for HRSA-23-125 funding?

    To apply to grant funding for this program, interested applicants must complete the application package for the funding opportunity posted on the grants.gov website and submit their applications electronically on the grants.gov website under the associated grants.gov funding opportunity posting.

    A step-by-step guide explaining the process for applying, completing and submitting a grant application for Health Resources and Services Administration (HRSA) funding is available on the HRSA grant resource website.

    How do I submit an application?

    HRSA requires all applicants responding to an NOFO to apply electronically through Grants.gov. Please use the HRSA-SF-424 Application Guide (PDF - 680 KB) for additional guidance.

    We submitted our application already but would like to make a revision; do we need to submit a new application?

    If you need to correct an application, in Box 1 of the SF-424 check “Changed/Corrected Application,” and submit the corrected version before the application deadline. HRSA will only accept the applicants last validated electronic submission prior to the Grants.gov due date. Please refer to page 41 of the HRSA-SF-424 Application Guide (PDF - 680 KB) for details.

    It is incumbent for applicants to ensure that the Authorized Organization Representative (AOR) is available to submit the application to HRSA by the published due date. HRSA will not accept submission or re-submission of incomplete, rejected, or otherwise delayed applications after the deadline. Therefore, an organization is urged to submit an application in advance of the deadline. If an application is rejected by Grants.gov due to errors, it must be corrected and resubmitted to Grants.gov before the deadline date and time. Deadline extensions will not be provided to applicants who do not correct errors and resubmit before the posted deadline.

    How do I request a deadline extension?

    See page 14-15 in HRSA-SF-424 Application Guide (PDF - 680 KB) on how to request a waiver from the electronic submission requirement. Please note that HRSA is very strict on adhering to application deadlines and electronic submission requirements. Deadline extensions will not be granted for Grants.gov verification errors, last-minute registration, or other submission errors on the part of the applicant.

    What are the requirements for text formatting (i.e. font, margins etc.)?

    Refer to page 35 of the HRSA-SF-424 Application Guide (PDF - 680 KB) for formatting guidelines.

    Budget & funding limitations

    Where can I get more information on allowable vs. unallowable costs for this grant?

    Refer to Pages 24-25. Funds under this announcement may not be used for the following purposes:

    • To build or acquire real property; or
    • For construction or major renovation or alteration of any space (see 42 U.S.C. 254c(h))

    Also refer to HRSA SF-424 Application Guide (PDF - 680 KB) for more information on the funding restrictions.

    Based on the language on page 24 section 6, would the purchase of a van or ambulance be excluded from funding due to the restriction of acquisition of “real property”?

    A van or ambulance would be considered equipment and would not constitute real property (i.e. land and buildings). A van or ambulance can be included in your proposal, if it is applicable to your project.

    Is there a limit on the amount of funds that can be spend on equipment?

    No. Although the FY23 Care Coordination NOFO does not have a cap on the amount of funds that can be spent on equipment, all budgets are reviewed during the application review process. All budget expenses must align with the programmatic activities and costs charged to HRSA awards are allowable, allocable to the HRSA award, reasonable, necessary, and documented.

    Is it allowable to fund direct service delivery related to the goals, or only coordination between service providers related to the primary focus area?

    Pages 24-25 - Refer to Funding Restrictions. Funds under this announcement may not be used for the following purposes: To build or acquire real property; or for construction or major renovation or alteration of any space (see 42 U.S.C. 254c(h)).

    Note: Also refer to HRSA SF-424 Application Guide for unallowable costs.

    Miscellaneous

    What is the requirement on selecting one primary focus areas? Could projects primarily focused on mental/behavioral health or dental services be considered?

    Page 1 – Although it is required to select one primary focus area, applicants may include underlying risk factors that contribute to the selected primary focus area understanding care coordination includes the provision of care for individuals with chronic and/or medically complex diseases. Refer to Program Description and Purpose. Applicants are required to select one primary focus area from the following: 1) heart disease; 2) cancer; 3) chronic lower respiratory disease; 4) stroke; or 5) maternal health.

    Who is the target population for the Rural Health Care Coordination Program?

    HRSA requires that all applicants describe the geographic relationship to the proposed rural service population as well as the plans to ensure that rural populations are served.

    HRSA encourages applicants to include populations that have historically suffered from poorer health outcomes, health disparities, and other inequities, as compared to the rest of the rural population.

    Examples of these populations include, but are not limited to, racial and ethnic minorities, low-income populations, homeless populations, pregnant women, disabled individuals, youth and adolescents, rural Black, Indigenous, and people of color populations, and rural populations with special health care needs.

    Could you assist me in understanding how to comply with the guidance related to the “preliminary evaluation plan”?
    Pages 17 and 29 - For the preliminary evaluation plan, please include in your Project Narrative an approach for assessing the network’s progress towards achieving the desired outcomes. Describe how to track, measure, evaluate, and communicate progress toward meeting award-funded goals, and the process you will use to create a robust self-evaluation plan. Refer to Evaluation and Technical Support Capacity section on page 17 for details. Also, please refer to the Criterion 3 Evaluative Measures in the Program NOFO (page 29). A preliminary evaluation plan does not need to be in a separate attachment as noted in the NOFO.
    Date Last Reviewed: