Community Access Program (93.252)
Program
93.252 Community Access Program
Federal Agency
HEALTH RESOURCES AND SERVICES ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES
Authorization
Public Health Service Act(42 U.S.C 256), Title 111, Subpart V, Section 340.
Program Number
93.252
Last Known Status
Active
Objectives
To provide assistance to communities and consortia of health care providers and others to develop or strengthen integrated community health care delivery systems that coordinate health care services for individuals who are uninsured or underinsured, and to develop or strengthen activities related to providing coordinated care for individuals with chronic conditions who are uninsured or underinsured.
Types of Assistance
Project Grants.
Uses and Use Restrictions
Funds received under HCAP are not intended to be used to supplant/replace existing Federal categorical programs that support entities providing services to low-income populations. Grant funds may support justified direct expenses associated with achieving the greater integration of and/or to fill identified or documented gaps in the health care delivery system, so that the proposed integrated delivery system either directly provides or ensures the provision of a broad range of culturally competent services, as appropriate, including primary, secondary, and tertiary services, as well as substance abuse treatment and mental health services. No more than 15 percent of funds provided under the award may be used to provide direct patient care and services. Direct patient care and services include: the provision of patient care services or supplies that are ordinarily reimbursable (e.g., exams, therapy sessions, pharmaceuticals); primary care site development or service expansions (e.g., extended clinic hours); capital equipment used for reimbursable patient care and services (e.g., radiology equipment, ambulances). Grant funds may NOT be used for construction, reserve requirements for state insurance licensure or support for lobbying/advocacy efforts.
Eligibility Requirements
Applicant Eligibility
Applications may be submitted by entities, including tribal, faith-based and community-based organizations, that represent a consortium whose principal purpose is to provide a broad range of coordinated health care services to their defined community's uninsured and underinsured populations. For an entity to be eligible to receive a new HCAP award, the following requirements must be met: 1. The applicant entity must represent a consortium whose principal purpose is to provide a broad range of coordinated health care services to their defined community's uninsured and underinsured populations. 2. The community-wide consortium represented by the applicant entity must include at least one of each of the following providers that serve the stated community, unless such provider does not exist, declines or refuses to participate, or places unreasonable conditions on its participation: ▪ A Federally qualified health center (as defined in section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa))); ▪ A hospital with a low-income utilization rate (as defined in section 1923(b)(3) of the Social Security Act (42 U.S.C. 1396r-4(b)(3)), that is greater than 25 percent; ▪ A public health department; and ▪ An interested public or private sector health care provider or an organization that has traditionally served the medically uninsured and underserved. In addition to the required consortium members listed above, the community-wide consortium should seek partners from all levels of care who provide a range of services (e.g., preventive and primary care, specialty medical care, mental health and substance abuse services, oral health, HIV/AIDS care, social services, transportation, health education, etc.), as appropriate for the needs of the community's uninsured and underinsured populations. 3. The applicant entity is neither a current nor former Community Access Program (CAP) grantee and is proposing to serve a service area or target population of uninsured and underinsured individuals that has never been served by a CAP grant 4. The entity must submit an application in the form and manner prescribed in the application guidance.
Beneficiary Eligibility
Examples of eligible applicants that may apply on behalf of or participate as members of the community-wide consortium include but are not limited to: Community Health Center (CHC), Migrant Health Center (MHC), Health Care for the Homeless (HCH), Public Housing Primary Care (PHPC) and School-Based Health Centers Programs; Rural Health Clinics; Free and partial pay clinics; FQHC Look-alikes; local public health departments and other local government agencies; Tribal governments; Primary Care Associations; public and private hospitals; private provider or group practices; foundations; medical and dental societies and community-based non-profit organizations.
Credentials/Documentation
Preapplication Coordination: Consultation and assistance will be available to new award applicants from the Health Center Infrastructure Branch, Division of Health Center Development, Bureau of Primary Health Care, Health Resources and Services Administration. Please contact Tracy McClintock, Phone: (301) 594-4300, Email: tmcclintock@hrsa.gov. For general information regarding the Healthy Communities Access Program please visit our web site at http://bphc.hrsa.gov/cap. Competing Continuation Applicants (Existing CAP grantees, including FY 2000 CAP grantees applying under extraordinary circumstances) should refer to the CAP grantee website: http://capcommunity.hrsa.gov or contact Susan Lumsden in the Health Care Systems Branch, Division of State and Community Assistance, Bureau of Primary Health Care, Health Resources and Services Administration, Phone: (301) 443-0536, E-mail: slumsden@hrsa.gov. This program has been determined to be subject to provisions of Executive Order 12372, as implemented by 45 CFR Part 100.
Application and Award Process
Preapplication Coordination
Application Procedure: To receive a complete application kit, contact the HRSA Grants Application Center at 1-877-HRSA-123 and reference Catalog of Federal Domestic Assistance All applications meeting the deadline will be reviewed initially for eligibility and conformance. Those applications that are determined to be ineligible, incomplete, or non-responsive will be returned incomplete, or non-responsive will be returned to the applicant without further consideration. This program is excluded from coverage under E.O. 12372.
Application Procedure
Award Procedure: All eligible applications will have the technical merits of their application evaluated by a panel of non-Federal reviewers (Objective Review Committee) using the objective review criteria included in the application guidance. The results of the Objective Review Committee evaluations will be shared with the HRSA Administrator and Secretary of HHS, who will make final awards decisions. Funding decisions will be announced in September 2003.
Award Procedure
Applications will be due 30 days after the publication of the Federal Register Notice for this program.
Deadlines
Range of Approval/Disapproval Time: Grant awards will be announced in September 2003.
Range of Approval/Disapproval Time
Appeals
Receipt of continuation funding is contingent on reasonable and demonstrable progress in meeting the goals and measurable objectives set forth in the entity's grant application for the budget period (September 1-August 31) for the preceding fiscal year, annual fund availability and a determination by the awarding office that continued funding of the grant is in the best interest of the Government.
Renewals
None.
Assistance Considerations
Formula and Matching Requirements
No match or cost-sharing required. However, an HCAP grantee and all consortium members represented by the grantee will maintain their expenditures of nonfederal funds for activities funded under HCAP at a level that is not less than the level of such expenditures during the immediately preceding fiscal year. Applicants are also encouraged to identify additional financial and in-kind contributions or use cost sharing among consortium members to support and sustain the activities of this program.
Length and Time Phasing of Assistance
Up to a 3-year Project period with a 12-month budget period. Receipt of continuation funding is contingent on reasonable and demonstrable progress in meeting the goals and measurable objectives set forth in the entity's grant application for the budget period (September 1-August 31) for the preceding fiscal year, annual fund availability and a determination by the awarding office that continued funding of the grant is in the best interest of the Government. No eligible entity funded under HCAP may receive funds for more than three consecutive fiscal years except that entities may request a grant award for not more than one additional fiscal year (a 4th year of funding) under demonstrated extraordinary circumstances. Extraordinary circumstances are an event (or events) outside of the control of the eligible entity that has prevented the eligible entity from fulfilling the objectives described by such entity in their approved grant application for the budget period (September 1-August 31) for the preceding fiscal year. Granting of 4th year funding under extraordinary circumstances is contingent on demonstrated extraordinary circumstances whose event(s) and impact, or impact alone, occurred during the previous budget period and directly prevented the completion of goals and measurable objectives set forth in the entity's approved grant application for the budget period (September 1-August 31) for the preceding fiscal year so as to justify such a request, annual fund availability and a determination by the awarding office that continued funding of the grant is in the best interest of the Government and necessary to further the objectives of the HCAP program.
Post Assistance Requirements
Reports
Interim and Final reports will be required as part of program-wide monitoring and evaluation. The Financial Status Report SF- 269 is due within 90 days after expiration of the budgetperiod.
Audits
An independent annual financial audit that meets OMB A-133 requirements and includes all records that relate to the disposition of funds received through this and any other Federal grant is required. The audits are due within 30 days or receipt from the auditor or within 9 months of the end of the fiscal year, whichever occurs first.
Records
None.
Program Accomplishments
In fiscal year 2002, 22 new communities in 15 states received CAP awards and the 136 existing CAP grantees received continuing funds. Up to 35 New funding awards may be made in fiscal year 2003. The current 158 CAP grantees are eligible to apply for competing continuation awards under HCAP in fiscal year 2003. No budget is anticipated in fiscal year 2004.
Financial Information
Account Identification
75-0350-0-1-550.
Obligations
(CAP Grants) FY 02 $105,000,000; FY 03 est $105,000,000; and FY 04 est $0.
Range and Average of Financial Assistance
$162,087 to $1,925,089; $900,000.
Regulations, Guidelines and Literature
Federal Register Notice Volume 66, Number 27.
Related Programs
None.
Information Contacts
Regional or Local Office
Boston (617) 565-1420 - Ken Brown, Assistant Field Director Telephone: New York (212) 264-2549 - Manely Khaleel, Chief, Primary Care; Philadelphia (215) 861-4414 - Scott Otterbein, Regional Program Consultant; Atlanta (404) 562-4127 - Stephen Dorage, Public Health Advisor; Chicago (312) 353-1254 - Stephen A. Laslo, Regional Program Consultant; Kansas City (816) 426-5296 extension 239 - Mathew Henk, Regional Program Consultant; Dallas (214) 767-4533 - Jay McGath, Associate Field Director for Primary Care; Denver (303) 844-3203 - Nicholas Zucconi, Public Heath Advisor; San Francisco (415) 437-8078 - Irma Honda, Division Director; and Seattle (206) 615-2490 - Beryl Cochran, Regional Program Consultant.
Headquarters Office
Division of Health Center Development, Health Center Infrastructure Branch, Bureau of Primary Health Care, Health Resources and Services Administration, 4350 East-West Highway, Bethesda, MD 20814. Telephone: (301) 594-4300.
Web Site Address
Examples of Funded Projects
Please refer to the CAP website (www.bphc.hrsa.gov/cap) for information on current CAP grantees.
Criteria for Selecting Proposals
Each new award HCAP application submitted by the deadline will be screened for eligibility. An application will be considered eligible if it meets all of the specific eligibility requirements listed above. Applications that do not meet the eligibility requirements will not be accepted for processing and will be returned. An Objective Review Committee will review all eligible applications. The review criteria used by the Objective Review Committee (ORC) to assess each application (out of 100 points) will include: Community Health Care Delivery System Needs Assessment (maximum 10 points): Extent to which the applicant clearly defines the service area and target population of uninsured and underinsured individuals for the project and provides a detailed assessment of the current delivery system for the applicant's uninsured and underinsured populations so as to describe the extent of unmet need for a more coordinated system of care. Consortium Organizational and Functional Structure (Maximum 15 Points): Extent to which the applicant describes the history, membership, functional structure, accountability and strategies of the applicant's HCAP consortium in terms of its capacity to implement an efficient, higher quality, comprehensive system of care for the stated target population of uninsured and underinsured individuals. Project Work Plan (Maximum 35 Points): Extent to which the applicant's work plan demonstrates the clarity, feasibility and scope of proposed activities, goals and measurable objectives which are consistent and aligned with stated needs and will develop or strengthen an integrated community health care delivery system that provides more efficient, effective, coordinated and quality care at a lower cost for the stated population of uninsured or underinsured individuals. Program Performance Plan (Maximum 15 Points): Extent to which the applicant provides an appropriate plan for evaluation of the activities carried out under the grant that ensures monitoring and measurement of progress towards the corresponding goals and objectives as well as the use of evaluation findings to improve program performance and support sustainability. Sustainability Plan (Maximum 15 Points): Extent to which the applicant provides an appropriate plan for long-term project sustainability and community-reinvestment for HCAP activities through decreasing dependence on Federal funds. Budget (Maximum 10 Points): Extent to which the applicant presents a detailed, clear and comprehensive budget that is appropriate and reasonable for the scope of proposed activities described in the Project Work Plan and which adequately documents and demonstrate the use of nonfederal contributions to the greatest extent possible for the proposed HCAP project. Further evaluation/review criteria detail will be listed in the application guidance.
