Community Health Grant FY 2020 RFA

DHHS Division/Office issuing this notice: Office of Rural Health 

Date of this notice: November 1, 2018 

Grant Applications will be accepted beginning November 1, 2018
Deadline to Receive Applications: February 1, 2019

Working Title of the funding program: Community Health Grants

Purpose: Description of function of the program and reason why it was created:

Safety net organizations are facing increasing demand for access to services in communities across our state. The current opioid crisis, behavioral health needs, integrated patient care, creating healthy opportunities for access to food, housing, transportation, and the use of telehealth strategies to improve access and sustainability are among the many issues facing safety net providers. Collaboration among providers in the counties and regions of our state is a key component to address these issues. The Community Health Grant RFA will look for cooperation and collaboration among county and regional partners as part of the application process.  

These grant funds, supported through the North Carolina General Assembly, are for assuring access to primary and preventive care to meet the health needs of our state’s most vulnerable populations. Strengthening the safety net through increased levels of collaboration and integration of services and organizations to more effectively meet the needs of those served is also an important purpose of this grant.

Primary care safety net organizations who care for underserved and medically indigent patients in the state are eligible to apply for this funding to pay for patient care through encounter-based reimbursement (Track A) or through reimbursement for eligible expenses (Track B). Telehealth services and equipment are eligible expenses in both tracks. Applicants must select ONE track.

Track A: Encounter based reimbursement. Payment per patient encounter for low-income, uninsured and underinsured residents, who do not have health care coverage or access to primary health care services. Visits are reimbursable for medically necessary, on-site, face-to-face provider encounters. Face-to-face encounters may also include telehealth patient encounters with a provider.

NOTE: Per the Free Clinics Federal Tort Claims Act (FTCA) Program Policy Guide, grant funding that applies to reimbursement, payment, or compensation for the delivery of health services to patients falls within the statutory prohibition, while grant funding that is not intended for or applied to this purpose does not. Free clinics who are FTCA recipients that choose a “per encounter’ reimbursement methodology may void their FTCA liability protection.

Track B: Reimbursement for eligible expenses. Payment may include salary/fringe for clinical staff, medical/office supplies and equipment and capital expenses, including equipment for telehealth services.

These grants are supported through the North Carolina General Assembly.

Technical Assistance: Webinar: November 16,2018 10:00 a.m. – 11:00 a.m.

Funding Availability: Funding requests will depend on money awarded for program use.  It is anticipated that the SFY 2020 Year One grant awards will be extremely competitive. Approximately eighteen grants will be awarded this year.

Maximum Award Amount: Applicants may request up to a maximum of $150,000 for 12 months of funding. 

Proposed Project Period or Contract Term: State Fiscal Year 2020: July 1, 2019 – June 30, 2020

Eligibility: All primary care safety net organizations that provide direct primary and preventive care and serve as a medical home are eligible to apply.
This includes:

  • Federally qualified health centers and look-alikes (FQHCs),
  • Free and charitable clinics, 
  • Health departments, 
  • Hospital-owned primary care clinics, 
  •  Rural health centers, 
  • School-based and school-linked health centers, 
  • AHEC clinics
  • Other non-profit community organizations that provide direct primary and preventive patient care to low-income, uninsured, underinsured and medically vulnerable populations.

Eligible organizations that provide direct primary and preventive care may also use these funds to support any of the following:

  • telehealth patient care
  • health promotion
  • disease prevention
  • health maintenance
  • counseling
  • patient education
  • diagnosis and treatment of acute and chronic illnesses in a variety of health care settings (care coordination/care management by a primary care entity, behavioral health, oral health, women’s health, maternal and child health that supports health care services in a primary care setting).

The Office of Rural Health sees collaboration as an important tool to address community health needs.  In communities where multiple organizations are serving, often with overlapping efforts, the same uninsured populations, the need for collaboration is even more evident. In these communities, collaboration among safety net and social support organizations is critical and will be highly encouraged. All applicants must describe collaborations, outlining specific partnerships, within their community. If applicants in these communities cannot show collaborative partnerships, they must address the barriers that exist and why there is no collaboration. 

Access to health care can be a problem for patients in a remote area. It may be difficult to get to a hospital quickly in an emergency or patients may be required to travel long distances to get routine checkups and screenings. Up to five additional points may be added to applications from communities with a low ratio of providers per population.

As a condition of receiving a grant award, successful applicants must:

•    Submit a monthly expense report in a specified format for reimbursement 
•    Submit performance reports quarterly or biannually throughout the grant term
•    Use an electronic financial software application (EXCEL spreadsheets are not acceptable formats)
•    Document collaborations among safety net and social support organizations specifying distinct roles of each organization and designated fiscal responsibilities. 
•    Connect to NC HealthConnex by June 1, 2018
 

*In 2015 North Carolina passed a law (NCGS 90-414.7) establishing the North Carolina Health Information Exchange Authority (NC HIEA) to oversee and administer the NC Health Information Exchange Network called NC HealthConnex. The use of NC HealthConnex promotes the access, exchange and analysis of health information to improve patient care and coordination of care. 

The law requires that: 
Hospitals as defined by G.S. 131E-176(3), physicians licensed to practice under Article 1 of Chapter 90 of the NC General Statutes, physician assistants as defined in 21 NCAC 32S .0201, and nurse practitioners as defined in 21 NCAC 36 .0801 who provide Medicaid services and who have an electronic health record system shall connect by June 1, 2018.
All other providers of Medicaid and state-funded services shall connect by June 1, 2019.

To meet the state’s mandate, a provider is “connected” when its clinical and demographic information are being sent to NC HealthConnex at least twice daily.” For further information, please see the HIEA website: https://hiea.nc.gov

How to Apply: Applicants must submit the following documents electronically through the electronic survey. 
1. Organizational Information and Signature Sheet 
2. Organizational Profile 
3. Summary of Evaluation Criteria and Baseline Data 
4. Grant Narrative
5. Budget

Deadline for Submission: Grant applications must be received electronically by the Office of Rural Health by February 1, 2019. 
Only electronic applications will be accepted. Access to the electronic application is a two-step process:

1. You must submit your organization name and contact information through the following link which opens November 1, 2018: https://ncruralhealth.az1.qualtrics.com/jfe/form/SV_b48fSZEL8cjqD2Z

2. Once you submit your contact information, you will receive an email with a link specific to your email address and your organization. This link will give you access to the electronic application. The application closes February 1, 2019.  

How to Obtain Further Information: Funding Agency Contact/Inquiry Information:
Ginny Ingram at ginny.ingram@dhhs.nc.gov or 919-527-6457 or
David Britt at david.britt@dhhs.nc.gov or 919-527-6484

To read more about the entire RFA, please click on the Word document below in the Associated Files section (CHG RFA SFY 2020 v.7 FTCA.points.doc)

Also, please see some helpfup tools and resources below:
The North Carolina Health Atlas contains maps of North Carolina that depict county level health and health-related information. The primary purpose of the Atlas is to provide a way to interpret visually a broad range of data and information about the health of North Carolinians: https://schs.dph.ncdhhs.gov/data/hsa/

Circumstances like not having enough food, reliable transportation, or a safe place to live can make it hard to be healthy. These screening tools have been developed to help providers understand more about their patients so they can help patients be as healthy as possible. These tools can be found in the following documents below: (SDOH Screening Tool_English_2.docx and SDOH Screening Tool_Spanish_2.docx)