Rural Telemedicine Grants
Published on AidPage by IDILOGIC on Jun 24, 2005
Purpose of this program:
The primary objective of the Telehealth Network Grant Program (TNGP) is to help communities build the human, technical, and financial capacity to develop sustainable telehealth programs and networks. Specifically, the purpose of the TNGP is to develop telehealth network projects in rural areas, in medically underserved areas, in frontier communities, and for medically underserved populations, to (a) expand access to, coordinate, and improve the quality of health care services; (b) improve and expand the training of health care providers; and (c) expand and improve the quality of health information available to health care providers, and patients and their families.
Possible uses and use restrictions...
Funds maybe used to demonstrate the use of telehealth technologies (i.e., the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health, and health administration) in facilitating the development of networks and for improving access to health care services; provide a baseline of information for a systematic evaluation of telehealth systems; purchase or lease and install equipment; and to operate and evaluate the telehealth system. Not more than 40 percent of grant funds may be expended for equipment. Not more than 15 percent of grant finds may be expended for indirect costs. Grant funds may not be used for purchasing and installing telecommunications transmission equipment (e.g., microwave towers, satellite dishes, amplifiers, digital switching equipment or laying cable or telephone lines) or to acquire real property. Construction costs are allowable only for minor renovations related to the installation of equipment.
Who is eligible to apply...
The applicant must be a nonprofit or public entity that will provide services through a telehealth network. Each entity participating in the telehealth network may be a nonprofit or for-profit entity. Faith-based and community based organizations are eligible to apply. Services may be provided to rural or urban communities.
Credentials/Documentation
The basis for determining the allowance and allocability of costs charged to Public Health Service (PHS) grants is set forth in 45 CFR, Part 74, Subpart Q. The four separate sets of cost principles are: (1) OMB Circular No. A-87 for State and local governments, (2) OMB Circular No. A-21 for educational institutions, (3) 45 CFR, Part 74, Appendix E for hospitals, and (4) OMB Circular No. A-122 for nonprofit organizations.
Note:This is a brief description of the credentials or documentation required prior to, or along with, an application for assistance.
About this section:
This section indicates who can apply to the Federal government for assistance and the criteria the potential applicant must satisfy.
For example, individuals may be eligible for research grants, and the criteria to be satisfied may be that they have a professional or scientific degree,
3 years of research experience, and be a citizen of the United States. Universities, medical schools, hospitals, or State and local governments may also be eligible.
Where State governments are eligible, the type of State agency will be indicated (State welfare agency or State agency on aging) and the criteria that they
must satisfy.
Certain federal programs (e.g., the Pell Grant program which provides grants to students) involve intermediate levels of application processing, i.e., applications
are transmitted through colleges or universities that are neither the direct applicant nor the ultimate beneficiary. For these programs,
the criteria that the intermediaries must satisfy are also indicated, along with intermediaries who are not eligible.
How to apply...
Application Procedure:
The standard application forms (Form PHS- 5161-1, revised 5/96), as furnished by the PHS and required by 45 CFR, Part 92, must be used for this program. This program is subject to the provisions of 45 CFR, Part 92 for State and local governments and 0MB Circular No. A-i 10 for nonprofit organizations and hospitals. Application kits can be obtained by writing to the Health Resources and Services Administration s (HRSA) Office for the Advancement of Telehealth at 5600 Fishers Lane, Room 7C-22, Rockville, Maryland 20857, or by calling 1-301-443-0447.
Note: Each program will indicate whether applications are to be submitted to the Federal headquarters, regional or local office, or to a State or local government office.
Award Procedure:
The review of applications is carried out by Federal and nonfederal experts in Telehealth and health care services development, coordination, and delivery in rural and underserved areas. Applications are evaluated for merit and are scored according to the review criteria described in the HRSA Preview. Final decisions are made by the Health Resources and Services Administration based on recommendations made by the Director, Office for the Advancement of Telehealth.
Note: Grant payments may be made by a letter of credit, advance by Treasury check, or reimbursement by Treasury check.
Awards may be made by the headquarters office directly to the applicant, an agency field office, a regional office,
or by an authorized county office. The assistance may pass through the initial applicant for further distribution by
intermediate level applicants to groups or individuals in the private sector.
Deadlines and process...
Deadlines
To be announced, subject to appropriations.
Note:
When available, this section indicates the deadlines for applications to the funding agency which will
be stated in terms of the date(s) or between what dates the application should be received.
When not available, applicants should contact the funding agency for deadline information.
Range of Approval/Disapproval Time
From 4 to 5 months.
Preapplication Coordination
A. Required Consultation in Preparing the Application - Applicants are required to notify their State Office of Rural Health (SORH) (or other appropriate state entities) of their intent to apply for the TNGP and to consult with that office regarding the content of the application. B. Public Health System Reporting - This program is subject to the Public Health System Reporting Requirements (approved under 0MB No. 0937-0195). Under these requirements, community-based non-governmental applicants must prepare and submit a Public Health System Impact Statement (PHSIS) to relevant State and local health officials to keep them apprised of proposed health services grant applications submitted by these organizations within their jurisdictions. C. Executive Order 12372? This program is 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. Applicants other than federally recognized Indian tribes must seek comments from state Single Points of Contact (SPOC). The applicant must determine if their state participates in the process and, if so, contact its SPOC as early as possible to alert the SPOC to the prospective application and receive instructions on the State process.
Note:
This section indicates whether any prior coordination or approval is required with governmental or nongovernmental units
prior to the submission of a formal application to the federal funding agency.
Appeals
None.
Note:
In some cases, there are no provisions for appeal. Where applicable, this section discusses appeal procedures or allowable rework time for resubmission
of applications to be processed by the funding agency. Appeal procedures vary with individual programs and are either listed in this section or
applicants are referred to appeal procedures documented in the relevant Code of Federal Regulations (CFR).
Renewals
Renewals have not been determined.
Note:
In some instances, renewal procedures may be the same as for the application procedure, e.g., for projects of a non-continuing nature renewals will be treated as new, competing applications; for projects of an ongoing nature, renewals may be given annually.
Who can benefit...
Health care providers in rural areas, in medically underserved areas, in frontier communities, and for medically underserved populations will benefit from this grant program. The telehealth network must include at least two (2) of the following entities (at least one (1) of which shall be a community-based health care provider: (a) community or migrant health centers or other federally qualified health centers; (b) health care providers, including pharmacists, in private practice; (c) entities operating clinics, including rural health clinics; (d) local health departments; (e) nonprofit hospitals, including community (critical) access hospitals; (0 other publicly funded health or social service agencies; (g) long-term care providers; (h) providers of health care services in the home; (i) providers of outpatient mental health services and entities operating outpatient mental health facilities; (j) local or regional emergency health care providers; (k) institutions of higher education; or (I) entities operating dental clinics.
Beneficiaries
About this section:
This section lists the ultimate beneficiaries of a program, the criteria they must satisfy and who specifically is not eligible. The applicant and beneficiary will generally be the same for programs that provide assistance directly from a Federal agency. However, financial assistance that passes through State or local governments will have different applicants and beneficiaries since the assistance is transmitted to private sector beneficiaries who are not obligated to request or apply for the assistance.
What types of assistance...
Project Grants
The funding, for fixed or known periods, of specific projects. Project grants can include fellowships, scholarships, research grants, training grants, traineeships, experimental and demonstration grants, evaluation grants, planning grants, technical assistance grants, survey grants, and construction grants.
How much financial aid...
Range and Average of Financial Assistance
The maximum allowable amount is $250,000. The average award in fiscal year 2003 was $249,437.
Note:
This section lists the representative range (smallest to largest) of the amount of financial assistance available. These figures are based upon funds awarded in the past fiscal year and the current fiscal year to date. Also indicated is an approximate average amount of awards which were made in the past and current fiscal years.
Obligations
(Grants) FY 03 $3,741,556; FY 04 est $5,000,000 and FY 05 est $5,000,000.
Note:
The dollar amounts listed in this section represent obligations for the past fiscal year (PY), estimates for the current fiscal year (CY), and estimates for the budget fiscal year (BY) as reported by the Federal agencies. Obligations for non-financial assistance programs indicate the administrative expenses involved in the operation of a program.
Account Identification
75-0350-0-1-550.
Note:
Note: This 11-digit budget account identification code represents the account which funds a particular program.
This code should be consistent with the code given for the program area as specified in Appendix III of the Budget of the United States Government.
Examples of funded projects...
University of Arkansas for Medical Sciences, South Arkansas Integrated Telehealth Oncology Program, Little Rock, AR: The project s purpose is to expand its existing telehealth network to include Tele-oncology using the Wagner model for chronic disease. Expected outcomes include improved access to treatment and follow up for chronic cancer conditions, strengthened referral patterns, improved health care outcomes due to regular and timely consultations with oncologist, better informed provider and patient population, and increased rural and minority patient participation in clinical trials. The project links locally based rural providers, the health care infrastructure and targeted populations with evidence-based prevention, screening, treatment and palliative care guidelines for oncology, rube network includes a statewide service area of 50 counties with a specific target area of 13 counties for this project of which there is one full IIPSA, 10 partial IIPSAs, 11 mental health HPSAs, 11 MUAs, and 2 dental HPSAs. 51 sites are member partners including 34 rural hospitals, a tertiary care center, 7 Area Health Education Centers, 5 community health centers, 3 certified rural health clinics, a county health department, and a high school. Services are provided using fractional Ti, ISDN, IP, 11.323 and 11.320. The network provides a range of services, including dermatology, diabetes care and management, high risk obstetrics and genetics, cardiology, neurology, endocrinology, mental health, pediatrics, pharmacy, and oncology. The network is also used for continuing education, case conferences, as well as professional and public education in cancer prevention, detection, and treatment. The network has been operational since 1995.
About this section
This section indicates the different types of projects which have been funded in the past. Only projects funded under Project Grants or Direct Payments for Specified Use should be listed here. The examples give potential applicants an idea of the types of projects that may be accepted for funding. The agency should list at least five examples of the most recently funded projects.
Program accomplishments...
New program.
Criteria for selecting proposals...
Grant applications will be evaluated on the following four criteria. 1) Documented need for the project and the likely demand for the proposed services; 2) extent to which project objectives and activities are consistent with the objectivcs of the grant program; 3) the ability of network members to implement the project and the corresponding feasibility of project s plan of activities; 4) level of Local involvement in planning and implementing the project, level of commitment as evidenced by cost participation of applicant, other network members and/or other organizations, and long-term plans for sustainability; 5) the extent to which the project measures success in meeting its goals and objectives; and, 6) reasonableness of the budget to proposed activities and anticipated outcomes/results.
Assistance considerations...
Length and Time Phasing of Assistance
Awards are made annually with up to a 3-year project period. Payments are made through an electronic transfer system or cash demand system.
Formula and Matching Requirements
There are no statutory formula or matching requirements for this program.
Note:
A formula may be based on population, per capita income, and other statistical factors. Applicants are informed whether there are any matching requirements to be met when participating in the cost of a project. In general, the matching share represents that portion of the project costs not borne by the Federal government. Attachment F of OMB Circular No. A-102 (Office of Management and Budget) sets forth the criteria and procedures for the evaluation of matching share requirements which may be cash or in-kind contributions made by State and local governments or other agencies, institutions, private organizations, or individuals to satisfy matching requirements of Federal grants or loans.
Cash contributions represent the grantees' cash outlay, including the outlay of money contributed to the grantee by other public agencies, institutions, private organizations, or individuals. When authorized by Federal regulation, Federal funds received from other grants may be considered as the grantees' cash contribution.
In-kind contributions represent the value of noncash contributions provided by the grantee, other public agencies and institutions, private organizations or individuals. In-kind contributions may consist of charges for real property and equipment, and value of goods and services directly benefiting and specifically identifiable to the grant program. When authorized by Federal legislation, property purchased with Federal funds may be considered as grantees' in-kind contribution.
Maintenance of effort (MOE) is a requirement contained in certain legislation, regulations, or administrative policies stating that a grantee must maintain a specified level of financial effort in a specific area in order to receive Federal grant funds, and that the Federal grant funds may be used only to supplement, not supplant, the level of grantee funds.
Post assistance requirements...
Reports
Annual progress and financial status reports are required 90 days from the end of the budget period and the final performance report and final financial status report are due 90 days from the end of the project period. Progress reports are to be submitted every 6 months.
Note:
This section indicates whether program reports, expenditure reports, cash reports or performance monitoring are required by the Federal funding agency, and specifies at what time intervals (monthly, annually, etc.) this must be accomplished.
Audits
In accordance with the provisions of OMB Circular No. A- 133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Nonprofit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133. In addition, grants are subject to inspection and audits by DHHS and other Federal officials.
Note:
This section discusses audits required by the Federal agency.
The procedures and requirements for State and local governments and nonprofit entities are set forth in OMB Circular No. A-133.
These requirements pertain to awards made within the respective State's fiscal year - not the Federal fiscal year,
as some State and local governments may use the calendar year or other variation of time span designated as the fiscal year period,
rather than that commonly known as the Federal fiscal year (from October 1st through September 30th).
Records
Grantees are required to maintain grant accounting records for 3 years after the end of the budget period. If any litigation, audit, or other action involving the records has been started before the expiration of the 3-year period, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the regular 3-year period expires, whichever is later.
Note:
This section indicates the record retention requirements and the type of records the Federal agency may require.
Not included are the normally imposed requirements of the General Accounting Office.
For programs falling under the purview of OMB Circular No. A-102, record retention is set forth in Attachment C.
For other programs, record retention is governed by the funding agency's requirements.
Regulations...
Authorization
Public Health Service Act, Section 3301. (The Health Care Safety Net Amendments of 2002 (Public Law 107-251) amended the Public Health Service Act by adding Section 3301.)
Note:
This section lists the legal authority upon which a program is based (acts, amendments to acts, Public Law numbers, titles, sections, Statute Codes, citations to the U.S. Code, Executive Orders, Presidential Reorganization Plans, and Memoranda from an agency head).
Regulations, Guidelines, And Literature
Program guidelines may be obtained by contacting the Headquarters Office for PHS Grants Policy Statement, DHHS Publication No. (OASH) 94-50,000, (Rev.) April 1, 1994.
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