Rural Telemedicine Grants (93.211)
Program
93.211 Rural Telemedicine Grants
Federal Agency
HEALTH RESOURCES AND SERVICES ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES
Authorization
Public Health Service Act, Title III, Section 330A, as amended; Health Centers Consolidation Act of 1996, Public Law 104-208; Public Law 104-299.
Program Number
93.211
Last Known Status
Active
Objectives
The purpose of this grant program is to expand access to, coordinate, restrain the cost of, and improve the quality of essential health care services, including preventive and emergency services, through the development of integrated health care delivery systems or networks in rural areas and regions. Specifically the purpose of the Rural Telemedicine Grant Program is to demonstrate how Telemedicine can be used as a tool in developing integrated systems of health care, improving access to health services for rural citizens and reducing the isolation of rural health care practitioners. The purpose is also to collect information for a systematic evaluation on the feasibility, costs, appropriateness and acceptability of rural Telemedicine.
Types of Assistance
Project Grants.
Uses and Use Restrictions
Funds may be used to demonstrate the use of Telemedicine in facilitating the development of rural health care networks and for improving access to health care services for rural citizens; provide a baseline of information for a systematic evaluation of Telemedicine systems serving rural areas; purchase or lease and install equipment; and to operate the Telemedicine system and evaluate the Telemedicine system. Not more than 40 percent of grant funds may be expended for equipment. Not more than 20 percent of grant funds 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). Constructions costs are allowable only for minor renovations related to the installation of equipment.
Eligibility Requirements
Applicant Eligibility
An entity that is a health care provider and a member of an existing or proposed Telemedicine network, or an entity that is a consortium of health care providers that are members of an existing or proposed Telemedicine network shall be eligible for a grant under this section. An eligible network may include for-profit entities so long as the network grantee is a nonprofit entity.
Beneficiary Eligibility
Rural health care providers, patients, and rural communities will benefit from this grant program.
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.
Application and Award Process
Preapplication Coordination
Preapplication coordination is not required. This program is eligible for coverage under E.O. 12372, "Intergovernmental Review of Federal Programs." An applicant should consult the office or official designated as the single point of contact in his or her State for more information on the process the State requires to be followed in applying for assistance, if the State has selected the program for review. Applicants are required to notify their State Office of Rural Health (or other appropriate State entity) of their intent to apply for this grant program and to consult with such agency regarding the content of the application.
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 OMB Circular No. A-110 for nonprofit organizations and hospitals. Application kits can be obtained by writing HRSA Grants Application Center, 40 West Gude Drive, Suite 100, Rockville, MD 20850, or by calling toll-free: 1-888-300-4772.
Award Procedure
The review of applications is carried out by Federal and nonfederal experts in Telemedicine and rural health care services development, coordination, and delivery. Applications are evaluated for merit and are scored according to the review criteria described in the HRSA Preview. Final decisions are made by the Director, Office for the Advancement of Telehealth.
Deadlines
Contact Headquarters Office listed below for deadline dates.
Range of Approval/Disapproval Time
Appeals
None.
Renewals
Renewals have not been determined.
Assistance Considerations
Formula and Matching Requirements
There are no statutory formula or matching requirements for this program.
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.
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.
Audits
In accordance with the provisions of OMB Circular No. A- 133 (Revised, June 24, 1997), "Audits of States, Local Governments, and Nonprofit Organizations," nonfederal entities that expend financial assistance of $300,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $300,000 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.
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.
Program Accomplishments
In fiscal year 2001, 19 non-competing continuation awards were funded. The same number is estimated for fiscal year 2002. It is estimated that 25 to 30 awards will be made in fiscal year 2003.
Financial Information
Account Identification
75-0350-0-1-550.
Obligations
(Grants) FY 02 $5,689,000; FY 03 est $5,600,000; and FY 04 est $5,000,000.
Range and Average of Financial Assistance
The maximum allowable amount is $325,000 for existing telemedicine networks and $375,000 for new networks. The average award in fiscal year 2001 was $298,947.
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.
Related Programs
None.
Information Contacts
Regional or Local Office
Not applicable.
Headquarters Office
Amy Barkin, Co-Director of Rural Telemedicine Grants, Office for the Advancement of Telehealth, 5600 Fishers Lane, Room 11A-16, Rockville, MD 20857. Telephone: (301)443- 1293, Grants Management contact: Ms. Janice Gordon, , Grants Management Office, HIV/AIDS Bureau, Health Resources and Services Administration, 5600 Fishers Lane, Rockville, MD 20857. Telephone: (301) 443-2385. Use the same numbers for FTS.
Web Site Address
http://www.telehealth.hrsa.gov
Examples of Funded Projects
Good Samaritan Hospital, Mid-Nebraska Telemedicine Network, Kearney NE: The network's goal is to provide improved access to care for rural underserved populations in central Nebraska and north-central Kansas. The network includes 12 sites, of which 10 are in Health Professional Shortage Areas (HPSAs). Members of the network include a tertiary care center, rural hospitals, psychiatric hospital, rural health clinic, and long term care facility. Services are provided using videoconferencing over T1 and ISDN lines. The network provides consultations in a range of specialties, including mental health, oncology, diabetes care and management, dermatology, cardiology, occupational therapy, speech therapy, and others. The network is also used for continuing medical education, medical resident education and training, monthly EMT training, administrative meetings, and support groups. The network will soon begin implementing telehome care using POTS based systems, and conducting a special project focused on children with special health care needs.
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; measurable project objectives; likelihood that the methodology or plan of activities will lead to attaining the project objectives, 2) extent to which project objectives and activities are consistent with the objectives of the grant program, 3) level of local involvement in planning and implementing; level of commitment as evidenced by cost participation of applicant, other network members and/or other organizations; long-term plans for sustainability, 4) reasonableness of the budget to proposed activities and anticipated outcomes/results.
