How will the funding mechanism change from a grant to cooperative agreement impact how I use HCCN funds?
The change in funding mechanism will allow more flexibility in how HCCN funds are used. With input and agreement from HRSA, you will be able to make changes to your Project Work Plan activities and budget allocations more easily during the budget period, to respond to emerging national priorities and/or your Participating Health Centers' (PHC) needs. As a cooperative agreement, there will be substantial involvement from HRSA/BPHC and HCCN awardees to further maximize the effectiveness and impact of HCCN awards. For instance, HRSA may add new objectives throughout the period of performance in order to better respond to emerging national priorities.
Many features of the U86 cooperative agreement such as the annual non-competing continuation progress report will be similar to the H2Q grant. However, as a cooperative agreement, you will use the Project Work Plan modification process within the EHBs to update your project work plan during the year.
Per the FY 2022 HCCN NOFO, HCCN funding may not be utilized to purchase equipment or supplies for use at the individual health center level or any other individual health center operational costs. What kinds of equipment and supplies may be allowable for HCCNs to purchase for PHCs?
HCCN funding may be utilized for equipment or supplies that directly support achieving the FY 2022 HCCN objectives. Equipment and supplies must be available to all PHCs in an HCCN. You must demonstrate in your budget narrative that the equipment or supplies you are proposing to purchase:
- Directly helps PHCs access and efficiently use digital health tools such as Electronic Health Records (EHRs), telehealth, patient portals, and electronic registries, along with virtual care platforms that support their integration, and
- Supports PHCs with translating robust clinical and population data into quality improvement and culturally competent, patient-centered care using, in part, data collected through digital health tools.
If for example, you identify a significant need across your network for specific data collection and reporting software to support data standardization and integration then made this available to all your PHCs, this may be an allowable cost.
Note that allowable costs for equipment and supplies excludes general office, medical or diagnostic items for use at the PHC level.
Will the executive salary cap be applied to FY 2022 HCCN funding?
Yes, the executive salary cap will be applied to FY 2022 HCCN funding and subsequent fiscal years of the period of performance. HCCN funds may not be used to pay the salary of an individual at a rate in excess of Federal Executive Level II of the Federal Executive Pay scale, which is $199,300 as of January 2021. This amount may change so you should verify each year you submit your budget.
My HCCN has had turnover in key staffing (e.g., quality improvement and data analytics staff), can we contract for key technical skills and consulting from external subject experts?
Yes, you may engage external subject experts and consultants through contracts. You will provide information about contracted staff in your project narrative, budget narrative, and Attachment 7: Summary of Contracts and Agreements.
Can you clarify what should be submitted in Grants.gov vs EHBs?
The NOFO is being modified to update and clarify the application components submitted in Grants.gov and in EHBs.
The following application components must be submitted in Grants.gov:
- Application for Federal Assistance (SF-424)
- Project Abstract Summary
- Project/Performance Site Locations (list only your administrative site address)
- Project Narrative Attachment Form (attach your project narrative)
- Budget Narrative Attachment Form (attach your budget narrative)
- Budget Information – Non-Construction Programs (SF-424A)
- Grants.gov Lobbying Form
- Key Contacts
- Attachment Form (submit form with or without attachments)
The following application components must be submitted in EHBs:
- Project Narrative (you may update the version submitted in Grants.gov as needed)
- Budget Information – Non-Construction Programs (SF-424A) (you may update the version submitted in Grants.gov as needed)
- Budget Narrative (you may update the version submitted in Grants.gov as needed)
- Program-Specific Forms
- The Assurances for Non-Construction Programs (SF-424B) form is not part of the application submission.
- Documents submitted through Grants.gov can be edited and reattached in EHBs, if needed. In Grants.gov, including attachments to the Attachment Form is optional, however most attachments are required in the EHBs. For more information, refer to section 2: Completing the Standard Section of the Application of the FY 2022 HCCN EHBs Application User Guide (PDF - 1 MB).
- Review section IV.2: Content and Form of Application Submission of the FY 2022 HCCN NOFO (PDF - 524 KB) and application sections of the SF-424 Two-Tier Application Guide (PDF - 690 KB) for information on what forms and attachments count towards the 80-page count limit.
Where do I describe the planned activities for all three years of the project that HCCN funding will support?
You will describe activities for the first 12 months of the period of performance in the Project Work Plan. Then in the Response section of the Project Narrative, outline in table format or through a narrative summary how the subsequent two years of activities will build upon those activities detailed in the Project Work Plan to achieve the three-year target for each objective.
PCAs and HCCNs
Our organization is also a PCA, should we provide a letter of support as a PCA?
You should provide a letter of support from your organization’s PCA if the PCA will support the proposed activities to achieve the HCCN objectives. Your organization’s PCA can meet the Project Narrative Collaboration section requirement to work with at least one PCA to support your organization in addressing PHC health IT and data needs, if applicable.
Participating Health Centers
How do HCCNs benefit their PHC?
With FY 2022 funding, HCCNs will support PHCs with health information technology (IT) and data needs with a specific focus on improvements in clinical quality, patient-centered care, and provider and staff well-being. HCCNs will support their PHCs individually and collectively to address clinical and operational needs that include strengthening care coordination, reducing administrative burden through improved workflows, utilizing digital health tools, and facilitating data exchange with local, state/territory, and national public health bodies. HCCNs are able to provide specialized training and technical assistance to leverage economies of scale, such as group purchasing power, shared resources and training, and data analytics to support quality measurement and improvement. In addition, HCCNs will assist health centers with implementing the transition to UDS+ for the 2023 UDS cycle.
What do PHCs commit to by signing an HCCN’s MOA?
Primarily, a PHC should commit to work with the HCCN for the entire three-year period of performance, to address each objective, and provide annual data. If a PHC has already met an objective measure requirement, they only need to provide data for that objective and are not required to take part in related activities. It is important for PHCs to work closely with their HCCN to develop a beneficial and productive individual work plan so they can receive health IT and data support specific to their needs.
Do PHCs in my HCCN need to be within a certain geographic location?
No. Unlike State and Regional Primary Care Associations (PCAs), PHCs can be part of an HCCN that is located in a different state or region.
If we have not confirmed how many PHCs will be part of our application or how much funding to request by the Grants.gov deadline, will we be able to update this information in our EHBs submission?
Information and documents submitted in Grants.gov will transfer over to EHBs where you can make changes such as updating the number of PHCs included in the abstract, up until you submit your application in EHBs.
Should an MOA be uploaded for each proposed PHC in my application?
You only need to upload the template that you used to create individual MOAs with each PHC. However, you must include the MOA signature page or the signature block from each PHC in Attachment 2: PHC Memorandum of Agreement Template and Signatures. As a reminder, the PHCs included in Attachment 2 must exactly align with those included in the PHC List in EHBs.
Participating Health Center Needs
Is a PHC needs assessment required for the application, and if so, how recent should the Needs Assessment be?
A PHC needs assessment is not required. However, you may include a summary of a recent health IT and data needs assessment key findings if you have conducted one in Attachment 11: Participating Health Center Needs Assessment Summary. If included, the summary should support the information on your PHCs provided in the Need section of the Project Narrative. There is no specified time period in which a Needs Assessment needs to be conducted. If you utilize a needs assessment to develop your proposed project, it should support the needs described in the Needs section of the Project Narrative, and the key findings summarized in Attachment 11: Participating Health Center Needs Assessment Summary.
Should there be a 1:1 correlation between “Needs the Activity Addresses" and "Activities" in the Project Work Plan? Or do the needs relate generally to all activities?
An activity can address one, several, or all identified PHCs needs. However, each need must be addressed by at least one activity.
What are integrated digital health tools and how often should they be used to count towards the objective measure?
There are various integrated digital health tools that PHCs can use for patient engagement; these may include, but are not limited to, electronic messages sent through patient portals to providers, telehealth visits, and reporting remote monitoring device data. As long as a patient has used integrated digital health tools at least once during the reporting period between in-person visits to communicate health information with the PHC, this will count towards the "80% of patients" requirement for this objective. The communication must be two-way; for example, a Population Health Management Tool may be acceptable but one-way texting tools may not.
What patients should be included when calculating the baseline for this objective?
To calculate the objective numerator (i.e., number of PHCs), HCCNs must determine if the PHC has achieved the 80% threshold of patients who have used integrated digital health tools at least once during the calendar year. The universe of patients is those who have had at least one in-person visit at the PHC during calendar year 2021.
What does "closed loop" referral mean?
Closed loop referrals are digital mechanisms that allow PHCs to electronically send a consultation request and other pertinent background information to a specialist or Community Based Organization and then receive a consultation summary and any other relevant information back following the completion of any tests or care coordination, without leaving the workflow of the Electronic Health Record (EHR). The goal of a closed loop referral is the transfer of relevant clinical information in both directions to track outcomes. Closed loop referrals can often address social risk factors.
Can you describe the electronic clinical quality measures (eCQM) and UDS+ data fields “test messages” that will be sent using Fast Health Interoperability Resources (FHIR) based application programming interfaces (APIs)?
Test messages are connections via FHIR based APIs to send mock or real eCQM reports or data consistent with UDS+ reporting to the upcoming UDS+FHIR "sandbox" endpoint OR during other tests such as HL7 FHIR Connectathons in support of data exchange activities that include, but are not limited to, the Da Vinci Data Exchange for Quality Measures (DEQM) or Making EHR Data More available for Research and Public Health (MedMorph) FHIR IGs streams.
How can I learn about UDS+ system requirements for sending test messages and setting targets?
The UDS Resources and UDS Modernization Initiative webpages will be updated to include UDS+ systems requirements. Information about the UDS+FHIR endpoint sandbox will be made available in 2022. The FHIR-based reporting system will be based on MedMorph and DEQM reference architecture and report content.
Can data be integrated into a population health management tool instead of an EHR?
No, to meet the objective requirement, data must be integrated into structured EHR fields. Data integrated from population health management tools will count towards the external clinical and/or non-clinical data sources requirement of the objective.
Can data, such as laboratory or radiology test results or drug monitoring program information, count towards the objective measure?
Yes, data such as test results or drug monitoring program information integrated into structured EHR fields using a digital health platform will count towards the objective requirement. Information that is entered as free text or as attachments will not.
Are predictive analytics with data visualization, natural language processing, and machine learning use required to meet the advanced data strategies requirement for the objective measure?
No, predictive analytics with data visualization, natural language processing, and machine learning are common but not the only advanced data strategies that will count towards the meeting objective measure requirement.
Is a publication plan required as part of the application?
The publication plan is part of the cooperative agreement recipient’s post-award responsibilities and is not required as part of your application. Detailed instructions regarding content and submission of the publication plan will be provided post-award.