Rural Health Centers Program Medical Access Plan and Project Grant SFY 2020- 2021 

RFA Title: Rural Health Centers Support Grants

Funding Agency Name: North Carolina Office of Rural Health (NC ORH)

Funding Agency Address: 311 Ashe Avenue, Raleigh, NC  27603

Funding Agency Contacts/Inquiry Information
Dorothea Brock, 919 527-6477, Dorothea.Brock@dhhs.nc.gov
Monifa Charles, 919 527-6474, Monifa.Charles@dhhs.nc.gov 

Medical Access Plan (MAP), Behavioral Health (BH), and Project Grant Funding Opportunities (formerly known as Non-MAP Funding). 
Awards will be granted until all funding has been obligated. Award date 7/1/2020  

Application Closing Date and Submission Instructions:  
Grant applications must be received via electronic survey by Monday April 20, 2020

All questions regarding the application should be sent to RuralHealthOperations_Grantees@dhhs.nc.gov 

Incomplete applications and applications not completed in accordance with the instructions provided below will not be reviewed.

RFA Description

The purpose of grants awarded under this program is to support State-Designated Rural Health Centers. NC ORH assists underserved communities and populations with developing innovative strategies for improving access, quality, and cost-effectiveness of health care.  Distribution of primary care providers in North Carolina has historically been skewed toward cities and larger towns.  Rural residents, who often face transportation issues, find accessing primary care services difficult.  Through the establishment of rural health centers, NC ORH partners with local communities to provide access to their underserved populations who would otherwise be unable to receive needed primary care services due to geographic, economic, or other barriers. Thus, rural health centers have become an integral part of the health care safety net for North Carolina’s rural and underserved residents.

The SFY 2020-2021 RFA seeks to supports developing sustainable models of care as well as partnering with community-based organizations to ensure access to transportation, food, housing and personal violence resources.

North Carolina received approval of its Medicaid 1115 Waiver and Transformation. NC Department of Health and Human Services (NC DHHS) has developed tools to support the development and implementation of the Waiver and assist communities in improving health, not just paying for health care. Healthy Opportunities is the foundation for Medicaid Transformation).  

For that reason, the application encourages the implementation of a variety of strategies that align with Medicaid Transformation including:

A.    Healthy Opportunities Screening
B.    Telehealth (including Telepsychiatry) and Integrated Care 
C.    Opioid Disorder Treatment
D.    Incorporating Community Health Workers into the care setting

A new requirement for this application cycle: Project Fund grantees is strongly encouraged to address specific items identified from the Area Health Education Center (AHEC) practice assessment or another assessment report. If you are using another assessment, please reference the report in your workplan.

Grant Funding Descriptions

Medical Access Plan (MAP) – Funds available to help North Carolina residents that cannot afford primary health care coverage. Visits are reimbursable through medically necessary on-site face-to-face provider encounters, as follows: onsite x-rays, in-house labs, surgical procedures, services performed by practice providers, prophylaxis, and telemedicine.    

Behavioral Health Funds – Funds available to help North Carolina residents that cannot afford behavioral health and mental health counseling services. Visits are reimbursable through on-site face-to-face behavioral health provider encounters:  licensed social worker, advanced practice registered nurses, psychiatrics, and psychiatrists.           

Projects Funds – All projects must show ability to create systems and processes that promote sustainability of the organization being funded. Funding shall assist the applicant with accomplishing one of the following goals:

A.    Advanced Medical Home - Supports efforts to become recognized as a National Committee for Quality Assurance (NCQA) Patient Centered Medical Home (PCMH). 
Grant funds must support either:
1.    an outside subject matter expert to assist with PCMH/AMH recognition or 
2.    costs associated with educating site personnel with becoming a PCMH Certified Content Expert and/or Advanced Medical Home

B.    Supports the creation and implementation of sustainable technological infrastructure that enhances access to health care and improves quality. These efforts may include:
1.     Technological infrastructure (hardware, software, telehealth applications etc.) 
-Administrative and clinical innovations that sustain primary medical care delivery models through the adoption of Electronic Health Records (EHR) technology, and using the North Carolina HealthConnex, formerly known as the Health Information Exchange. 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. 
2.    Methods for expanding the ability to collect, exchange, store, and disseminate health information while augmenting the practice’s capacity to provide access to and delivery of primary health care 

C.    Supports rural health center’s activities that increase and/or improve efficiencies, effectiveness, transformation, sustainability, quality, or access to care. Provides rural health centers with funding to hire or retain professional services including but not limited to: legal aid, actuarial services, and other professional services deemed prudent and necessary for business operations. Grantees must use the practice assessment/workplans completed to inform request for funds in this category.

D.    Funding to support Innovative Strategies including but not limited to:

  • Healthy Opportunities Screening
  • Telehealth (including Telepsychiatry), Community Paramedicine, Integrated Care, etc. 
  • Opioid Disorder Treatment
  • Incorporating Community Health Workers into the care setting
  • Innovative collaboration with Community-Based Organizations to support Healthy Opportunities
  • Staffing and contract services  
  • The use of NC HealthConnex to promote access, exchange and analysis of health information to improve patient care and coordination of care. 

Eligibility

To be eligible to apply for these funds, your organization must be a State-Designated Rural Health Center by NC ORH and comply as a 501c (3). The maximum total grant award is dependent upon demonstrated need at the rural health center or by the organization and is contingent upon funding availability.  

Eligible organizations may use these funds to support any of the following: 

•    Telehealth patient care
•    Community health workers
•    Health promotion, health maintenance, health counseling
•    Disease prevention
•    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)
•    Collaborative community-based whole person-centered health care delivery models
•    Medication Assisted Therapy (MAT) 
•    Substance Abuse Disorder Treatment 
•    AHEC Practice Assessments action plan recommendations: (Access, Care Coordination, Optimal Use of HIT, Team Based Relationships, Patient & Family Engagement, QI Culture, Financial Health)

The Department of Health and Human Services (DHHS) and NC ORH work to advance the health, safety and well-being of all North Carolinians in collaboration with a wide array of partners and stakeholders. In its Strategic Plan, 2019-2021,  DHHS focuses on and encourages collaboration among community partners in integrating physical health and behavioral health services, increasing community awareness and prevention of drug overdose and death, and the importance of healthy children and families.

All applicants are encouraged to consider such collaborations. When describing collaborative relationships, outline specific partnerships within the community and their role in the partnership. If applicants in communities with multiple safety net organizations cannot show collaborative relationships, please address the barriers that exist to developing these relationships. 

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. 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 by the 10th of each month. 
•    Submit performance reports quarterly or biannually throughout the grant term
•    Use an electronic financial software application (EXCEL spreadsheets are not acceptable formats)
•    Document collaboration among safety net and social support organizations specifying distinct roles of each organization and designated fiscal responsibilities 
•    Connect to NC HealthConnex 
•    Agree to participate in other activities conducted by ORH to support successful completion of grant activities.

Note: 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

Application Components

Grant applications must be received by the Office of Rural Health by April 20, 2020. 

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:
https://ncruralhealth.az1.qualtrics.com/jfe/form/SV_5ngAqyHY7Y7Sd2B
2.Once you submit your contact information in the link above, you will receive an email with a personalized link specific to your organization. The link in the e-mail will give you access to the electronic application. The Application closes April 20, 2020.

1.    Organizational Information and Signature Sheet 
2.    Organizational Profile
3.    Grant Narrative 
4.    Summary of Evaluation Criteria and Baseline Data 
5.    Budget

•    Technical Assistance: Zoom Connection: March 13, 2020 12:00noon. – 1:00 p.m.

•    You must request a link to your application through the online survey tool by clicking on the following link:  
             https://ncruralhealth.az1.qualtrics.com/jfe/form/SV_5ngAqyHY7Y7Sd2B

•    Applicants may apply for MAP and Project funding

•    Grant awards are based on the availability of funding.  The maximum total grant award is dependent upon demonstrated need at the rural health center. Grant funds must be used at physical locations where primary medical care is provided and may not be used for vehicles or to pay down loans.

Funding Cycle

The funding cycle is July 1, 2020 through June 30, 2021. All grantees must fully expend grant funds prior to June 30, 2021.   All invoices for completed and projected work must be submitted to ORH for reimbursement no later than June 7, 2021.

Scoring Criteria
Applications will be reviewed and scored according to the following criteria:

Grant Narrative: Overview of the Organization - 10 Points
Grant Narrative: Community Need, Project Description, and Improved Access to Care - 30 Points
Grant Narrative: Community Collaboration (eg, health departments, departments of social services, housing authority, etc.) - 20 Points
Grant Narrative: Work Plan - 30 Points
Budget - 10 Points
Total Points Awarded - 100 Points

Attached Documents

RHC Request for Application Full Document

Budget Document