[Federal Register Volume 68, Number 146 (Wednesday, July 30, 2003)]
[Notices]
[Pages 44799-44802]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-19504]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

[HRSA-03-040]


Fiscal Year 2003 Competitive Application Cycle for Health Center 
Network Planning and Development Grants; CFDA Number 93.224

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice of availability of funds.

-----------------------------------------------------------------------

SUMMARY: The Health Resources and Services Administration (HRSA) 
announces the availability of up to $7,900,000 for fiscal year 2003 to 
support: (1) The planning and development of practice management 
networks or managed care networks or plans through the Integrated 
Services Development Initiative (ISDI); (2) development of an 
integrated management information system through the Shared Integrated 
Management Information System program (SIMIS); and (3) development of a 
technology infrastructure to integrate uniform technical information 
with business systems and care management through integrated 
information communication and technology development projects (ICT).
    Authorizing Legislation: Section 330(c)(1)(B) of the Public Health 
Service Act (Act), as amended, authorizes support to health centers to 
plan and develop a managed care network or plan. Section 330(c)(1)(C) 
of the Act authorizes support for the planning and development of 
practice management networks.

DATES: The timelines for application receipt, review, and award are as 
follows:
    Application Deadline: August 29, 2003.
    Grant awards announced: September 28, 2003.
    Applications will be considered on time if they are received by 5 
p.m. Eastern Standard Time on August 29, 2003, or before the 
established deadline date. Applications that are not received by the 
deadline will be returned to the applicant.

[[Page 44800]]

    Applicants should note that HRSA is accepting grant applications 
online in the last quarter of the Fiscal Year (July through September). 
Please refer to the HRSA grants schedule at http://www.hrsa.gov/grants.htm for more information.
    How To Request and Where To Send an Application: To obtain a 
complete application kit, (i.e., application instructions, necessary 
forms, and application review criteria), call toll free 1-877-HRSA-123 
(1-877-477-2123). When contacting the HRSA Grants Application Center 
(GAC) please refer to the program announcement number HRSA-03-040 and 
the name of this program. An original and two copies of the 
applications must be submitted to the HRSA GAC: HRSA Grants Application 
Center, 901 Russell Avenue, Suite 450, Gaithersburg, Maryland 20879, 
Fax: 1-877-HRSA-345 (1-877-477-2345), e-mail: [email protected].
    Applicants will receive a letter acknowledging receipt of their 
applications.
    Eligible Applicants: The following entities are eligible to apply 
for funding under this announcement:
    1. A health center that has received section 330(e) funding for 2 
consecutive years is eligible to apply for funding for the planning and 
development of a managed care network and plan under the ISDI program.
    2. Health centers (Community Health Center, Migrant Health Center, 
Health Care for the Homeless, Public Housing Primary Care and School-
Based Health Centers) that receive assistance under section 330 are 
eligible to apply for funding for the planning and development of a 
practice management network under the ISDI project.
    3. Health centers (Community Health Center, Migrant Health Center, 
Health Care for the Homeless, Public Housing Primary Care and School-
Based Health Centers) that receive assistance under section 330 or 
Primary Care Associations receiving support under section 330(m) that 
are applying on behalf of health centers in a State or marketplace are 
eligible to apply for funding for an integrated management information 
system.
    4. A health center (Community Health Center, Migrant Health Center, 
Health Care for the Homeless, Public Housing Primary Care and School-
Based Health Centers) that has received assistance under section 330 or 
a Primary Care Association receiving support under section 330(m) that 
is applying on behalf of health centers in a State or marketplace is 
eligible to apply for funding for an integrated information and 
communication technology development project.
    Matching or Cost Sharing Requirement: Grantees must provide at 
least 20 percent (for planning grants) or 40 percent (for developmental 
grants) of the total approved costs of the project. The total approved 
cost of the project is the sum of the HRSA share and the non-Federal 
share. Applications must demonstrate that at least 5 percent (for 
planning grants) or 10 percent (for developmental grants) of the cost 
sharing requirement is met through cash contributions for planning or 
development projects respectively. The remaining non-Federal share may 
be met by cash or in-kind contributions.
    Application Review and Funding Criteria: All eligible applications 
that are responsive to the requirements and received in time for 
orderly processing will be reviewed by an Objective Review Committee 
comprised of non-Federal reviewers using the following review criteria:

ISDI Planning Projects

    1. Appropriateness in meeting expectations of the ISDI--extent to 
which the application effectively promotes the integration and 
coordination of primary care across business and clinical functions 
through the planning phase.
    2. Readiness for Network Development--the extent to which the 
application demonstrates both an appropriate multi-year strategic 
planning process and financial plan.
    3. Strength of Proposed Collaboration--extent to which the 
application demonstrates that all health centers in the marketplace are 
collaborating in the planning project.
    4. Capacity of the Network to Integrate--extent to which the 
application demonstrates that network members are planning to 
collaborate, share, and/or integrate functions or components of their 
systems.
    5. Appropriateness to State Environment and Marketplace--the extent 
to which the applications demonstrates how the project will strengthen 
the position of health centers in the state environment and/or market 
place.

ISDI Developmental Projects

    1. Appropriateness in meeting expectations of the ISDI--extent to 
which the application effectively promotes the integration and 
coordination of primary care across business and clinical functions 
among network members.
    2. Readiness for Network Development--the extent to which the 
application demonstrates both an appropriate multi-year strategic 
planning process and commitment (as evidenced by the contribution of 
time, resources, cash, etc.) by each of the collaborators in the 
strategic planning process, work plan, budget spreadsheet, and 
memorandum of agreement.
    3. Strength of Proposed Collaboration--extent to which the 
application demonstrates that all health centers in the marketplace are 
collaborating, including, the level of involvement of key management 
staff, clinical personnel, boards among the network members in the 
development, implementation and/or performance of the project.
    4. Capacity of the Network to Integrate--extent to which the 
application demonstrates that network members will collaborate, share, 
and/or integrate functions or components of their systems.
    5. Appropriateness to State Environment and Marketplace--the extent 
to which the application demonstrates how the network will strengthen 
the position of health centers in the state environment and/or 
marketplace.

SIMIS Projects

    1. Readiness for SIMIS Development--extent to which the application 
demonstrates that it has a multi-year strategic planning process that 
provides the network's initial assessments, including completed market 
and organizational assessments, agreement among the network members on 
the mission, goals, objectives and timetable for the project, and 
planning for the SIMIS.
    2. Strength of Proposed Collaboration--extent to which all health 
centers in the State are collaborating, including the extent to which: 
(a) Key management staff of the network members are involved in the 
development, implementation and/or performance of the project; (b) the 
proposed project is suited to the organizational/administrative 
capacity of the network members based on the organizational assessment; 
and (c) economies of scale are achieved by the other than information 
system means, e.g., centralized billing/collection.
    3. Technical Capacity of the Network to Integrate--extent to which: 
(a) Network members will collaborate, share, and/or integrate functions 
or components of their systems to facilitate centralize data 
integration (e.g., common business rules/practices, data structure, 
practice management software); and (b) current business and clinical 
practices will be altered or

[[Page 44801]]

improved as a result of the SIMIS network.

ICT Projects

    1. Effectiveness--extent to which application describes how health 
outcomes and systems of care would be improved through integrating the 
health disparities collaborative care model with information and 
communications technology.
    2. Efficiency--extent to which application demonstrates how 
inefficiencies such as lost medical records, lab results, and 
ineffective appointment systems will be eliminated through combining 
information and communications technology with the care model.
    3. Safety and Risk Management--extent to which application 
demonstrates how decision support would be used throughout the delivery 
system; such as how primary care provider order entry will prevent 
medication or lab errors.
    4. Patient-Family Centeredness--extent to which the application 
documents how patients will be connected to their health information 
and describes support/educational tools, such as disease management 
patient information and on-line support groups.
    5. Equity--extent to which the application demonstrates that all 
populations, including racial and ethnic minorities and uninsured 
populations, are receiving high quality care and care that is 
customized to meeting their needs.
    6. Timeliness--extent to which the application demonstrates 
electronic communication between providers and clinicians, for example, 
a cutting edge appointment system developed for rapid responses to 
patient needs.
    Funding Preference: A funding preference is defined as the funding 
of a specific category or group of approved applications ahead of other 
categories of applications. A preference will be given to approved 
applications proposing to serve sparsely populated rural or frontier 
areas.

Funding Priorities

    A funding priority is defined as the favorable adjustment of 
aggregate review scores of individually approved applications. 
Applications for grant support may be submitted without requesting a 
funding priority; however, approval of a funding priority will enhance 
an applicant's competitive score.

ISDI, SIMIS and ICT Projects

1. Programs Demonstrating Appropriate Use of Technological Improvements
    Because significant efficiencies in the delivery of health care 
services can be realized through the appropriate use of technological 
improvements, a priority will be placed on applications that 
incorporate such improvements to enhance the quality of care, increase 
the efficiency and effectiveness of operations, and reduce costs. 
Applicants are encouraged to consider how their proposals might use 
telehealth and/or new emerging technologies to achieve their project 
goals. The advent of communication tools such as distance learning, 
remote patient monitoring, personal data assistants (PDAs), interactive 
video, satellite broadcasting, and store-and-forward technology are 
just some of the many health-care focused technological applications 
that can help improve access to care either directly or indirectly by 
improving the efficiency of health care providers. Applicants that 
propose such improvements will receive 2 additional points.

ICT Projects Only

    Priority will be given to those applicants with public/private 
collaborators with an existing track record in the development or 
support of ICT, networks, and health disparities collaboratives for 
health centers working collaboratively with the State PCA. Applicants 
meeting this priority will receive 3 additional points.
    Priority will be given to projects that address a technical 
methodology and approach that meets current technology capabilities and 
marketplace standards, as specified by the two BPHC documents, 
Functional Requirements for Practice Management Systems and Functional 
Requirements for Electronic Medical Records (available on Web site: 
http://www.bphc.hrsa.gov/chc/). Applicants meeting this priority will 
receive 3 additional points.
    Estimated Amount of Available Funds: For fiscal year 2003, 
approximately $600,000 will be available for ISDI planning projects; 
approximately $1,800,000 will be available to support ISDI development 
projects; approximately $2,500,000 will be available through the SIMIS; 
and approximately $3,000,000 will be available to support ICT 
development projects.
    Estimated Project Period: ISDI Planning Projects--up to 2 years; 
ISDI Development Projects--up to 4 years; SIMIS Projects--up to 3 
years; and ICT Projects--up to 3 years.
    Estimated Number of Awards: It is anticipated that the following 
number of awards will be made: ISDI Planning Projects--3 to 6 awards; 
ISDI Development Projects--10 to 15 awards; SIMIS Projects--4 to 6 
awards; and ICT Projects--up to 5 awards.
    Estimated Average Size of Each Award: The estimated costs are 
expected to vary considerably. Award will range from $75,000 to 
$200,000 for ISDI Planning Projects;--$150,000-$525,000 for ISDI 
Developmental Projects; $150,000 to $500,000 for SIMIS Projects and 
$450,000 to $750,000 for ICT Projects.

FOR FURTHER INFORMATION CONTACT: Applicants may contact the following 
individuals:

For ISDI: Lisa Dolan-Branton at [email protected] or (301) 594-4306.
For SIMIS: Jayne Bertovich at [email protected] or (301) 594-4318.
For ICT: Lisa Dolan-Branton at [email protected] or (301) 594-4306.

    Paperwork Reduction Act: The application for the Integrated 
Services Development Initiative has been approved by the Office of 
Management and Budget (OMB) under the Paperwork Reduction Act. The OMB 
clearance number is 0920-0428.
    Public Health System Reporting Requirements: Under these 
requirements (approved by the Office of Management and Budget under OMB 
number 0937-0195), a community-based non-governmental applicant must 
prepare and submit a Public Health System Impact Statement to the head 
of the appropriate State and local health agencies in the area(s) to be 
impacted no later than the Federal application receipt due date. This 
statement must include:
    1. A copy of the face page of the application (SF 424) and
    2. A summary of the project, not to exceed one page, which 
provides:
    a. A description of the population to be served,
    b. A summary of the services to be provided, and
    c. A description of the coordination planned with the appropriate 
State and local health agencies.
    Executive Order 12372: These programs have been determined to be 
subject to the provisions of Executive Order 12372 concerning 
intergovernmental review of Federal programs by appropriate health 
planning agencies, as implemented by 45 CFR part 100. Executive Order 
12372 allows States the option of setting up a system for reviewing 
applications from within their States for assistance under

[[Page 44802]]

certain Federal programs. The application packages pursuant to this 
notice will contain a listing of States with review systems and will 
provide a single point of contact (SPOC) in the State for review. A 
list of SPOC contacts is also available at http://www.whitehouse.gov/omb/grants/spoc.html. Applicants (other than federally-recognized 
Indian tribal governments) should contact their SPOCs as early as 
possible to alert them to the prospective applications and receive any 
necessary instructions on the State process. For proposed projects 
serving more than one State, the applicant is advised to contact the 
SPOC of each affected State.
    Except in unusual circumstances, the due date for State process 
recommendations is at least 60 days from the deadline date established 
by the Secretary. 45 CFR 100.8(a)(2). In this instance, there are less 
that 90 days before the end of the 2003 fiscal year (on September 30, 
2003). Due to this unusual circumstance, HRSA is establishing a 30-day 
due date for State process recommendations, to assure timely 
consideration of such recommendations. The granting agency does not 
guarantee that it will accommodate or explain its responses to State 
process recommendations received after the due date. (See 
``Intergovernmental Review of Federal Programs,'' Executive Order 
12372, and 45 CFR part 100, for a description of the review process and 
requirements.)

    Dated: July 25, 2003.
Dennis P. Williams,
Deputy Administrator.
[FR Doc. 03-19504 Filed 7-28-03; 1:43 pm]
BILLING CODE 4165-15-P