Cooperative Agreement to Support Navigators in Federally-facilitated and State Partnership Marketplaces

 

Section 1311(i) of the Affordable Care Act authorizes Navigators in States with a Federally-facilitated Marketplace (FFM). The FFM is required to develop and implement a Navigator grant program. Navigators will serve consumers in States with a FFM, including State Partnership Marketplaces. As health reform implementation continues, consumers will benefit from understanding new programs, taking advantage of new protections, and navigating the system to find the most affordable coverage that meets their needs. Marketplace Navigators are intended to assist consumers in those areas in the following ways:
•Maintain expertise in eligibility, enrollment, and program specifications and conduct public education activities to raise awareness about the Marketplace;
•Provide information and services in a fair, accurate, and impartial manner, which includes providing information that assists consumers with submitting the eligibility application; clarifying the distinctions among health coverage options, including QHPs; and helping consumers make informed decisions during the health coverage selection process. Such information must acknowledge other health programs such as Medicaid and CHIP;
•Facilitate selection of a QHP;
•Provide referrals to any applicable office of health insurance consumer assistance or health insurance ombudsman established under Section 2793 of the PHS Act, or any other appropriate State agency or agencies, for any enrollee with a grievance, complaint, or question regarding their health plan, coverage, or a determination under such plan or coverage;
•Consistent with the requirements set forth in 45 C.F.R. § 155.215, provide information in a manner that is culturally and linguistically appropriate to the needs of the population being served by the Marketplace, including individuals with limited English proficiency, and ensure accessibility and usability of Navigator tools and functions for individuals with disabilities in accordance with the Americans with Disabilities Act and Section 504 of the Rehabilitation Act; and
•Complying fully with the conflict-of-interest and training standards set forth in 45 C.F.R. § 155.215.

General information about this opportunity
Last Known Status
Active
Program Number
93.332
Federal Agency/Office
Agency: Department of Health and Human Services
Office: Centers for Medicare and Medicaid Services
Type(s) of Assistance Offered
Cooperative Agreements
Program Accomplishments
Not Applicable.
Authorization
Patient Protection and Affordable Care Act §§ 1311(d)(4)(K), 1311(i), and 1321(c)(1); 45 C.F.R. §§ 155.210 and 155.215.
Who is eligible to apply/benefit from this assistance?
Applicant Eligibility
Funding through the cooperative agreement is open to individuals and private and public entities including community and consumer-focused nonprofit groups; trade, industry and professional associations; commercial fishing industry organizations; ranching and farming organizations; chambers of commerce; unions; resource partners of the Small Business Administration; licensed insurance agents and brokers; and other public or private entities. Other entities may include but are not limited to Indian Tribes, tribal organizations, urban Indian organizations, and State or local human services.
Beneficiary Eligibility
Beneficiaries must propose to serve in a State with a FFM or State Partnership Marketplace to be eligible to be served by applicants receiving funding through this cooperative agreement.
Credentials/Documentation
Consistent with 45 C.F.R. § 155.215(a)(1)(i), all applicants (individuals, entities and all members making up a consortium) should submit a brief statement (one or two short paragraphs) within the Project Narrative attesting that they are not ineligible entities, including an attestation that no staff members have any of the prohibited relationships with health insurance or stop loss insurance issuers that are outlined above. As is explained in 45 C.F.R. § 155.215 and the preamble language discussing that provision, some conflicts of interest would not be absolute bars to service as a Navigator, provided that the conflict of interest would not ultimately prevent the entity or individual from providing information and services in a fair, accurate, and impartial manner. In addition, in accordance with 45 C.F.R. § 155.215(a)(1)(ii), successful applicants will be required to provide a written plan to remain free of conflicts of interest and to disclose to CMS, as operator of the FFM or State Partnership Marketplace, certain non-disqualifying conflicts of interest as specified in 45 C.F.R. § 155.215(a)(1)(iv). 2 CFR 200, Subpart E - Cost Principles applies to this program.
What is the process for applying and being award this assistance?
Pre-Application Procedure
Preapplication coordination is not applicable. Environmental impact information is not required for this program. This program is excluded from coverage under E.O. 12372.
Application Procedure
2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program. 1. All applicants must submit a required Letter of Intent by the due date noted in the FOA.
2. All applicants under this announcement must have an Employer Identification Number/Taxpayer Identification Number (EIN/TIN) to apply. Individuals may choose to provide their personal Social Security Numbers (SSNs) to apply via Grants.gov. Please note, the time needed to complete the EIN/TIN registration process is substantial, and applicants should therefore begin the process of obtaining an EIN/TIN immediately upon posting of this FOA to ensure this information is received in advance of application deadlines.
3. All applicants must have a Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number in order to apply. The DUNS number is a nine-digit identification number that uniquely identifies business entities. Please note that individuals will have to provide an EIN or other TIN to receive a DUNS number. This number should mirror the one used to submit an application in Grants.gov. To obtain a DUNS number, access the following website: www.dunandbradstreet.com or call 1-866-705-5711.
4. The applicant must also register in the System for Award Management (SAM) database in order to be able to submit the application. Applicants are encouraged to register early, and must have their DUNS and EIN/TIN numbers in order to do so. Information about SAM is available at https://www.sam.gov/portal/public/SAM/. The SAM registration process is a separate process from submitting an application. You should allow a minimum of five business days to complete SAM registration; however, in some cases, the registration process can take approximately two weeks or longer to be completed. Therefore, applicants should begin the SAM registration process as soon as possible after the announcement is posted to ensure that it does not impair your ability to meet required submission deadlines.
5. Authorized Organizational Representative: The Authorized Organizational Representative (AOR) who will officially submit an application on behalf of the organization must register with grants.gov for a username and password. AORs must complete a profile with Grants.gov using their organization’s DUNS Number to obtain their username and password at http://grants.gov/applicants/get_registered.jsp. AORs must wait one business day after successful registration in SAM before entering their profiles in Grants.gov. Applicants should complete this process as soon as possible after successful registration in SAM to ensure this step is completed in time to apply before application deadlines.
6. When an AOR registers with Grants.gov to submit applications on behalf of an organization, that organization’s E-Biz POC will receive an email notification. The email address provided in the profile will be the email used to send the notification from Grants.gov to the E-Biz POC with the AOR copied on the correspondence.
7. The E-Biz POC must then login to Grants.gov (using the organization’s DUNS number for the username and the special password called “M-PIN”) and approve the AOR, thereby providing permission to submit applications.
8. Any files uploaded or attached to the Grants.Gov application must be PDF file format and must contain a valid file format extension in the filename. Even though Grants.gov allows applicants to attach any file formats as part of their application, CMS restricts this practice and only accepts PDF file formats. Any file submitted as part of the Grants.gov application that is not in a PDF file format, or contains password protection, will not be accepted for processing and will be excluded from the application during the review process. In addition, the use of compressed file formats such as ZIP, RAR, or Adobe Portfolio will not be accepted. The application must be submitted in a file format that can easily be copied and read by reviewers. It is recommended that scanned copies not be submitted through Grants.gov unless the applicant confirms the clarity of the documents. Pages cannot be reduced in size, resulting in multiple pages on a single sheet, to avoid exceeding the page limitation. All documents that do not conform to the above specifications will be excluded from the application materials during the review process.
9. After you electronically submit your application, you will receive an acknowledgement from http://www.grants.gov that contains a Grants.gov tracking number. HHS will retrieve your application package from Grants.gov. Please note, applicants may incur a time delay before they receive acknowledgement that the application has been accepted by the Grants.gov system. Applicants should not wait until the application deadline to apply because notification by Grants.gov that the application is incomplete may not be received until close to or after the application deadline, eliminating the opportunity to correct errors and resubmit the application. Applications submitted after the deadline, as a result of errors on the part of the applicant, will not be accepted.
10. After HHS retrieves your application package from Grants.gov, a return receipt will be emailed to the applicant contact. This will be in addition to the validation number provided by Grants.gov.
11. All grant applications must be submitted electronically and be received through http://www.grants.gov by 1:00 pm Eastern Daylight Time on the applicable due date.
12. All applications will receive an automatic time stamp upon submission and applicants will receive an email reply acknowledging the application’s receipt.
Award Procedure
•Applications will be screened to determine eligibility for further review using the criteria detailed in Section III, Eligibility Information, of this solicitation.
•An evaluation rubric will be developed by HHS, which will consist of critical elements identified in Section V, Application Review Information, of this solicitation. This evaluation rubric will be used by qualified, unbiased experts in their review of all applications. Applicants will receive a score of up to 200 points. The objective review panel may include federal reviewers and/or non-federal reviewers.
•The results of the objective review of applications by qualified experts will be used in conjunction with the other factors noted in the FOA (See Section II. 7, Factors Affecting Application Selection) to determine the technical merit of the applications and advise the approving HHS official. Final award decisions will be made by a HHS program official. In making these decisions, the HHS program official will take into consideration: the regulatory requirement that there be at least two types of Navigators in each Marketplace and that one of these Navigators be a community and consumer-focused nonprofit; populations the applicant expects to serve; ranking of the applicant based upon recommendations of the review panel; reviews for programmatic and grants management compliance, to include performance under a current Navigator award; pre-award business review; the reasonableness of the estimated cost to the government and anticipated results; and the likelihood the proposed cost will result in the benefits expected.
•Successful applicants will receive one cooperative agreement award.
•Unsuccessful applicants will be advised by letter or electronic mail (sent to the individual signing the application on behalf of the organization) that its application will not be held for further consideration or be funded. The decision not to award a grant, or to award a grant at a particular funding level, is discretionary and is not subject to appeal to any OPDIV or HHS official or board.
Deadlines
Apr 15, 2015 to Jun 15, 2015
Approval/Disapproval Decision Time
September 2, 2015.
Appeals
Not Applicable.
Renewals
Not Applicable.
How are proposals selected?
Successful applicants are required to demonstrate that they will use cooperative agreement funds to, at a minimum, carry out all statutory and regulatory duties, as found in section 1311(i) of the Affordable Care Act, and 45 C.F.R.§§ 155.210 and 155.215, of a Navigator for the entire length of the grant period, including: maintaining expertise in eligibility, enrollment, and program specifications; conducting public education activities to raise awareness about the Marketplace; providing information and services in a fair, accurate, and impartial manner; facilitating selection of a QHP; providing referrals to any applicable office of health insurance consumer assistance or ombudsman established under Section 2793 of the Public Health Service Act, or any other appropriate State agency or agencies, to address consumer grievances, questions, or complaints about their health plan, coverage, or a determination; providing information in a manner that is culturally and linguistically appropriate and accessible to individuals with disabilities consistent with the requirements set forth at 45 C.F.R. § 155.215; and complying fully with the training and conflict of interest requirements set forth at 45 C.F.R. § 155.215.
How may assistance be used?
1.(Describe how assistance can potentially be used. This field is required)

Use of these funds should be to build a program that supports the following required duties:
•Maintain expertise in eligibility, enrollment, and program specifications and conduct public education activities to raise awareness about the Marketplace;
•Provide information and services in a fair, accurate, and impartial manner, which includes providing information that assists consumers with submitting the eligibility application; clarifying the distinctions among health coverage options, including QHPs; and helping consumers make informed decisions during the health coverage selection process. Such information must acknowledge other health programs such as Medicaid and CHIP;
•Facilitate selection of a QHP;
•Provide referrals to any applicable office of health insurance consumer assistance or health insurance ombudsman established under Section 2793 of the PHS Act, or any other appropriate State agency or agencies, for any enrollee with a grievance, complaint, or question regarding their health plan, coverage, or a determination under such plan or coverage;
•Consistent with the requirements set forth in 45 C.F.R. § 155.215, provide information in a manner that is culturally and linguistically appropriate to the needs of the population being served by the Marketplace, including individuals with limited English proficiency, and ensure accessibility and usability of Navigator tools and functions for individuals with disabilities in accordance with the Americans with Disabilities Act and Section 504 of the Rehabilitation Act; and
•Complying fully with the conflict-of-interest and training standards set forth in 45 C.F.R. § 155.215. Funds are restricted from being used:
• To cover the costs to provide direct health care services to individuals.
• To match any other Federal funds.
• To provide services, equipment, or support that are the legal responsibility of another party under Federal or State law (such as vocational rehabilitation or education services) or under any civil rights laws. Such legal responsibilities include, but are not limited to, modifications of a workplace or other reasonable accommodations that are a specific obligation of the employer or other party.
• To supplant existing State, local, or private funding of infrastructure or services such as staff salaries, etc.
• To cover any pre-award costs.
• To carry out services that are the responsibility of the Marketplace, such as eligibility determinations and transferring enrollment information for consumers to a QHP.
• To carry out any functions already funded by HHS, including through federal Marketplace Establishment grants under section 1311(a) of the Affordable Care Act or through federal Consumer Assistance Program grants under section 2793 of the Public Health Service Act, including to make payments to recipients of funds provided to states under those authorities for activities that are funded under those authorities.
• To assist consumers residing in a state with a State-based Marketplace (See Section VIII. 2, State Reference List) or in a state the Navigator does not serve. FFM/State Partnership Marketplace Navigators may provide these consumers with basic information about Marketplace, but should refer them to Navigators, the Marketplace Call Center, and other resources within the state where the consumer resides for more in-depth assistance.
• To expend funds related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or Executive order proposed or pending before the Congress or any state government, state legislature or local legislature or legislative body.
• To fund staff retreats or promotional giveaways.
• To purchase gifts or gift cards, or promotional items that market or promote the products or services of a third party, that would be provided to any applicant or enrollee.
What are the requirements after being awarded this opportunity?
Reporting
Awardees must agree to cooperate with any Federal evaluation of the program and must provide required weekly, monthly, quarterly, and final (at the end of the cooperative agreement period) reports in a form prescribed by CMS, as well as any additional reports as required. Reports will be submitted electronically. These reports will outline how cooperative agreement funds were used, describe program progress, describe any barriers encountered including how any potential conflicts of interest were mitigated and process for handling non-compliant staff or volunteers, describe how the program ensured access to culturally and linguistically appropriate services, and detail measurable outcomes to include how many staff and volunteers completed required training and became certified as Navigators and how many consumers were served. CMS will provide the format for program reporting and the technical assistance necessary to complete program reporting requirements. At each stage, CCIIO staff will evaluate reports and provide feedback to recipients.
The awardee will not include PII in any weekly, monthly, quarterly, or final reports to HHS. In addition, the applicant must ensure compliance with the standards adopted by the FFM/State Partnership Marketplace pursuant to 45 C.F.R. § 155.260 when providing Navigator services to consumers involving the use of PII. The data privacy and security standards for current Navigator awardees under opportunity CA-NAV-14-002 can be found here: http://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Marketplaces/Downloads/Privacy-and-Security-Terms-and-Conditions-FINAL508MM.pdf. Additional details, including the due dates for the quarterly and final reports, will be provided in the terms and conditions of award. Grantees must report on a quarterly basis cash transaction data via the Payment Management System (PMS) using the FFR in lieu of completing a SF-272/SF-272A. The FFR, containing cash transaction data, is due within 30 days after the end of each quarter. No progress reports are required. Grantees must report on a quarterly basis cash transaction data via the Payment Management System (PMS) using the FFR in lieu of completing a SF-272/SF-272A. The FFR, containing cash transaction data, is due within 30 days after the end of each quarter. Awardees must agree to cooperate with any Federal evaluation of the program and must provide required weekly, monthly, quarterly, and final (at the end of the cooperative agreement period) reports in a form prescribed by CMS. Grantees must report on a quarterly basis cash transaction data via the Payment Management System (PMS) using the FFR in lieu of completing a SF-272/SF-272A. The FFR, containing cash transaction data, is due within 30 days after the end of each quarter. No progress reports are required. Grantees must report on a quarterly basis cash transaction data via the Payment Management System (PMS) using the FFR in lieu of completing a SF-272/SF-272A. The FFR, containing cash transaction data, is due within 30 days after the end of each quarter. Awardees must agree to cooperate with any Federal evaluation of the program and must provide required weekly, monthly, quarterly, and final (at the end of the cooperative agreement period) reports in a form prescribed by CMS.
Auditing
In accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements, non-Federal entities that expend financial assistance of $750,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Non-Federal entities that expend less than $750,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503.
Records
Recipient must maintain expenditures and other financial records detailing the use of cooperative agreement funds for three years from the day on which the grantee submits the last financial status report for the grant period unless there is an open investigation in which case the records must be maintained during the duration of the investigation. Recipient should submit these reports to CMS on a quarterly basis along with their quarterly progress reports.
Other Assistance Considerations
Formula and Matching Requirements
This program has no statutory formula.
This program has no matching requirements.
MOE requirements are not applicable to this program.
Length and Time Phasing of Assistance
• Project period is 36 months from date of award. Funding will be awarded in 12 month increments based on funding availability. See the following for information on how assistance is awarded/released:. See the following for information on how assistance is awarded/released: • Once an award is made, the funds are posted in recipient accounts established in the Department of Health and Human Services, Division of Payment Management, Payment Management System (PMS). Grantees may then access their funds by using the PMS funds request process. Upon notification of award, recipients under this announcement will be able to drawdown funds for approved start-up costs. The remaining funds will be reimbursable upon meeting required milestones.
Who do I contact about this opportunity?
Regional or Local Office
See Regional Agency Offices. Navigatorgrants@cms.hhs.gov

Administrative Questions
Grants@cms.hhs.gov.
Headquarters Office
Christopher Clark 5600 Fishers Lane, Rockville, Maryland 20857 Email: Grants@cms.hhs.gov Phone: 301-492-4319
Website Address
http://Navigatorgrants@cms.hhs.gov
Financial Information
Account Identification
75-0511-0-1-551.
Obligations
(Cooperative Agreements) FY 14 $60,000,000; FY 15 est $67,000,000; and FY 16 est $60,000,000
Range and Average of Financial Assistance
Current Fiscal Year: 2015
Projection: up to $67,000,000.
Regulations, Guidelines and Literature
The following standard requirements apply to applications and awards under this FOA:
•Specific grant administrative requirements as outlined in 2 CFR Part 200 and implemented by HHS regulation 45 CFR Part 75, apply to this cooperative agreement opportunity.
•All awardees receiving awards under this cooperative agreement project must comply with all applicable Federal statutes relating to nondiscrimination, including, but not limited to:
a. Title VI of the Civil Rights Act of 1964,
b. Section 504 of the Rehabilitation Act of 1973,
c. The Age Discrimination Act of 1975, and
d. Title II, Subtitle A of the Americans with Disabilities Act of 1990.
•All equipment, staff, and other budgeted resources and expenses must be used exclusively for the projects identified in the applicant’s original grant application or agreed upon subsequently with HHS, and may not be used for any prohibited uses.
•Consumers and other stakeholders must have meaningful input into the planning, implementation, and evaluation of the project. All cooperative agreement budgets must include some funding to facilitate participation on the part of individuals who have a disability or long-term illness and their families.
Cooperative Agreements are administered in accordance with the following program requirements, regulations, policies, and cost principles:
•The criteria as outlined in this grant announcement and in Affordable Care Act Section 1311(i) and 45 C.F.R. §§ 155.210 and 155.215.
•Title 45, Code of Federal Regulations, Part 75, [http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=b0174eb503950e93d9857a260f9f3aeb&ty=HTML&h=L&r=PART&n=pt45.1.75] which implements Title 2, Code of Federal Regulations, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance) – effective December 26, 2014 [http://www.ecfr.gov/cgi-bin/text-idx?tpl=/ecfrbrowse/Title02/2cfr200_main_02.tpl]
•Title 48, Code of Federal Regulations, subpart 31.2 – Cost Principles for Contracts with Commercial Organizations
•HHS Grants Policy Statement, Revised 1/07
* The recently released HHS regulation (45 CFR Part 75) supersedes information on administrative requirements, cost principles, and audit requirements for grants and cooperative agreements included in the current HHS Grants Policy Statement where differences are identified.
Examples of Funded Projects
Not Applicable.

 



Federal Grants Resources