Upload
others
View
2
Download
0
Embed Size (px)
Citation preview
Office of Rural Health Policy
Technical Assistance Workshop
U.S. Department of Health & Human Services Health Resources & Services Administration
Office of Rural Health Policy
Regional Extension Center, KY September 4, 2014
Natassja Manzanero, MS Katherine Lloyd, MPH
Presentation Overview Part I
Office of Rural Health Policy 101
• ORHP Overview • ORHP Programs and Activities
Part II
Applying for a HRSA Grant • General Grant Writing Tips
Office of Rural Health Policy (ORHP)
• “Voice for Rural” within HHS
• Rural-Focused Review of HHS Regulations
• Research & Policy Development
• Rural-Specific Grant Programs
• Technical Assistance
Overview
Office of Rural Health Policy
Office of Rural Health Policy (ORHP) Rural Programs: Building a Rural Evidence Base
Policy Research Team
Community Based Programs
Hospital State Programs
Telehealth Programs
How ORHP Programs Support Rural Health Finance &
Quality
Research and Policy
Technical Assistance
Community Health
Flex SHIP Small Health Care
Provider QI
State Office of Rural Health
Technical Assistance & Services Center
Rural Assistance Center
Regulation Review Flex Monitoring
Team National Advisory
Committee on Rural Health & Human Services
Policy Briefs
Outreach Network Network Planning Telehealth Networks Workforce
“Within the total amount requested for Rural Health Activities, the Budget includes $77 million to continue the President’s initiative to improve rural health. The goal of this initiative is to improve the access to and quality of health care in rural areas.”
Improving Rural Health Initiative
Improve Rural Health Initiative: Key Elements
• Building a Programmatic “Evidence Base”
• Health Workforce Recruitment & Retention
• Telehealth/ HIT Coordination
• Cross Governmental Collaboration
2014 President’s Budget
Rural Health Policy Development $10M
Rural Health Care Services Outreach $56M
Medicare Rural Hospital Flexibility $26M
State Offices of Rural Health $10M
Telehealth $12M
Radiation Exposure Screening and Education $2M
Black Lung / Coal Miners Clinics $7M
Collaboration
HHS Partners
Federal Partners
External Partners
http://www.whitehouse.gov/administration/eop/rural-council
White House Rural Council
• NHSC Expansion to CAHs • Rural Philanthropy Partnership • Rural HIT Training Networks • Regulatory Burden Reduction for Rural Providers
Federal Partners
• Working with USDA to Expand Access to HIT Capital • Health Information Exchange for Rural Veterans • Rural Policy Collaboration with CMS
External Partners
• NRHA • State Offices of Rural Health • American Hospital Association • National Association of Rural Health Clinics • Rural Health Resource Center • Rural Assistance Center
Knowledge Check #1
• Name 2 external partners of ORHP.
• What is the name of the national council
that supports some of ORHP’s activities?
Policy and Research Team
• Responsible for analyzing possible policy effects on rural communities
• Translating the larger policy context • Conducting research that informs and is
driven by policy • Engaging with rural health stakeholders • Ensuring a voice for Rural • Reviewing the annual payment updates • Informing policy
Policy and Research Resources
http://www.ruralhealthresearch.org/
Policy and Research Resources
http://www.hrsa.gov/advisorycommittees/rural/publications/index.html
The National Advisory Committee on Rural Health & Human Services
• Policy Briefs and Recommendations Available online
Policy Briefs Available
Policy Brief: Rural Residency Training for Family Medicine Physicians: Graduate Early-Career Outcomes, 2008-2012. Patterson DG, Longenecker R, Schmitz D, Phillips Jr RL, Skillman SM, Doescher MP. Seattle, WA: WWAMI Rural Health Research Center, University of Washington; 2013. http://www.raconline.org/rtt/policy.php
Affordable Care Act Office Hours “ORHP, ACA and You”
• Rural outreach and enrollment office hours hosted by the Office of Rural Health Policy.
• E-mail [email protected] with your name and organization to be added to the office hour listserv.
• Office hours are held every 2 weeks and currently scheduled for every other Wednesdays from 3-4pm EST.
• ACA topics for discussion will vary session to session.
Hospital State Division Grants • Medicare Rural Hospital Flexibility (FLEX)
Program • Small Rural Hospital Improvement Program • State Offices of Rural Health Program
Initiatives • Flex Medicare Beneficiary Quality Improvement
Project (MBQIP) • Delta Rural Hospital Performance Improvement
Project (RHPI) • Rural Health Clinic Quality Measure Set Pilot • Medicare QIO Special Project
Hospital State Division FY2015 Competitive Grant
Programs
• The Rural Hospital Flexibility Grant Program • $25 million to 45 States with CAHs
• The Small Hospital Improvement Grant Program
• $15 million to More Than 1,500 Small Rural Hospitals
National Rural Health Resource Center &
Technical Assistance and Services Center
http://www.ruralcenter.org
Office for the Advancement of Telehealth
Programs
• Telehealth Network Grants • Telehealth Resource Centers • Evidence-Based Telehealth Network
Program • Licensure and Portability • Rural Veterans Health Access Program • Evidence-Based Tele-Emergency
Network Program
Health Information Technology and Telehealth
• Leveraging Telehealth Technology
• Grants as a Test Bed • A New Focus on the Evidence-Base • A Special Focus on Veterans • Connecting Communities with National Experts • Identifying Ongoing and Emerging Policy
Challenges
Telehealth, Health Information Exchange & Broadband
• Provides Support for Improving Access to Affordable Broadband Services
• USDA • Annual Program
• FCC • New Program
Two Key Federal Programs • FCC’s Healthcare Connect • http://www.fcc.gov/encyclopedia/rural-health-care
• USDA Broadband • http://www.rurdev.usda.gov/RUSTelecomPrograms.html
Community Health
• Developing a Rural Evidence Base • Changing Nature of the Outreach
Authority Programs • The Rural Community Health
Gateway • New and Continuing Partnerships
Community-Based Division Programs
• Rural Health Care Services Outreach • Rural Health Network Development • Rural Health Network Planning • Small Health Care Provider Quality
Improvement • Rural Health IT Workforce
• Rural Health IT Network Development • Delta States Rural Development Network
Program • Black Lung/Coal Miner Clinics • Radiation Exposure Screening and
Education Program • Public Access Defibrillation
Demonstration Projects
• Rural Access to Emergency Devices Grant Program
Community Need
Outreach Funding
Outreach Tools Performance Data/Outcomes
Build the Rural Evidence Base
Rural Health Services Outreach
Activities • Direct Health Care Services • Health Fairs and Screenings • Patient Education • Provider Education
• 3 Year Program • Up To $300,000 • Competitive FY 2017
Rural Health Network Development
Activities • Integrate Behavioral Health in
Primary Care Settings • Improve Coordination of
Services • Provide Interactive Telehealth
Services
3 Year Program Up To $300,000 Competitive FY 2017 Contact: Jayne Berube [email protected]
3 Year Program Up To $200,000 Competitive FY 2015 Contact: Linda Kwon [email protected]
Rural Health Network Development Planning
Activities • Develop a business, strategic
and/or operational plan • Conduct a Community Needs
Assessment • Perform a Network Self-
Assessment
Small Health Care Provider Quality Improvement
Activities • Develop QI Strategies to
Improve Patient Care/Chronic Disease Outcomes
• Improve health indicators and decrease ER visits/admissions to hospital
• ACA Outreach and Enrollment 3 Year Program
Up To $150,000 Competitive FY 2016 Contact: Ann Ferrero [email protected]
1 Year Program Up To $100,000 Competitive FY 2015 Contact: Amber Berrian [email protected]
Rural Health IT Workforce
Activities • Develop rural-focused health
IT curriculum • Provide health IT students
training opportunities • Retain health IT specialists in
rural areas
Rural Health IT Network Development
Activities • Improve health care and support
the adoption of health information technology (HIT) in rural America
• Facilitation of infrastructure for successful implementation of HIT and Electronic Health Records
• Targeted HIT support to existing health care networks
3 Year Pilot Program Up To $300,000 2011-2014 Funding Cycle Contact: Marcia Green [email protected]
3 Year Pilot Program Up To $300,000 2013-2016 Funding Cycle Contact: Natassja Manzanero [email protected]
Black Lung/Coal Miner Clinic Grant Program (BLCGP) and
Black Lung Center of Excellence (BLCE)
Activities • BLCGP--Screening, diagnosis, and
treatment for active, inactive, disabled, and retired coal miners
• BLCE--Technical support, training, collaboration with regional and national entities, and promotion of practices and outreach which enhance understanding of miner health and safety
Rural Access to Emergency Devices and Public Access to Defibrillation Demonstration
Projects Activities
• Develop community partnerships to purchase automated external defibrillators (AEDs)
• Provide defibrillator and basic life support training
• Place the AEDs in rural communities with local organizations
3 Year Program $150,000 (RAED and PADD)
Competitive FY 2017 Contact: Michelle Pray [email protected]
3 Year Program
$900,000 (BLCE) or $150,000 (BLCGP) Competitive FY 2017
Contact: Nadia Ibrahim [email protected]
Radiation Exposure Screening and Education (RESEP)
Program Activities
• Outreach to inform public of services available through the program
• Education programs on detection, prevention, and treatment of radiogenic cancers and diseases
• Medical screening for patients at risk of developing specific radiogenic cancers and diseases
Activities
• Development/implementation of multi-county/parish projects to address delivery of preventive or clinical health services
• Provision of outcome oriented health care services for diabetes, cardiovascular disease, or obesity
• Services for other identified areas such as pharmacy assistance, oral health, women’s health etc.
3 Year Program
$325,000-$525,000
Competitive FY 2017
Contact: Valerie Darden [email protected]
3 Year Program
Up To $300,000
Competitive FY 2017
Contact: Katy Lloyd [email protected]
Delta States Rural Development Network Program (Delta)
FY 2015 Competitive Grant Programs
Rural Health Care Services Outreach Program
• Length of award: 3 years • Award amount: $200,000 per year • Purpose: To deliver health care services in
rural communities – Evidence-based – Outcomes oriented
• Eligibility: rural, non-profit or public entity, partner with 2 other entities
• FOA available September 2014 • Start date: May 2015 • Contact: Linda Kwon, [email protected],
301-594-4205
Rural Health Network Development Planning Program
• Length of award: 1 year • Award amount: $100,000 • Purpose: To promote the planning and
development of healthcare networks • Eligibility: rural, non-profit or public entity,
network composed of at least 3 health care providers
• FOA available November 2014 • Start date: June 2015 • Contact: Amber Berrian,
[email protected], 301-443-0845
Community Health Gateway Toolkits • Resources and best practices to help you identify and
implement public health programs Rural Health Models and Innovations Hub • Find examples of approaches you can adapt for your program,
including models shown to be effective, as well as new and emerging ideas.
Sustainability Tools • The tools provided here are intended to help you consider the
sustainability of programs that address community needs and to engage your partners and stakeholders in this planning process.
Economic Impact Tool
• Show how your program’s grant funding affects your community’s economic well-being
http://www.raconline.org/communityhealth/
Georgia Health Policy Center • Technical Assistance contractor for the Rural Health Care
Services Outreach Program, Delta State Rural Development Network Grant Program, Rural Health Network Development Program, and Rural Health Information Technology (HIT) Workforce Program grantees
• Technical Assistance supports grantees with strategic planning, evaluation, consortium and network development, program implementation, and sustainability
• Focus on peer-to-peer connections and learning
• Technical assistance delivered through monthly contacts, site visits, e-learning, and webinars
• Tools, resources, and e-learning modules available at www.ruralhealthlink.org
Knowledge Check #2
Fill in the blank: The Policy Research Team in ORHP ensures the voice for ___________. What is the name of the resource that provides various toolkits related to public health?
Register with DUNS
• Go to D&B DUNS Numbers for U.S. Government Contractors and
Grantees. http://fedgov.dnb.com/webform/pages/CCRSearch.jsp
• Select the country or territory where your organization is physically located. Complete and submit the form which includes: • Your organization’s physical and mailing addresses, • Name and title of the chief executive • Primary Standard Industrial Code (SIC) • Whether or not the organization is minority-, woman- or
veteran-owned, number of employees, and annual revenue. • Your DUNS number will be e-mailed to you the same day.
Register with System for Award Management (SAM)
• Go to the SAM and select Create User Account or Register/Update Entity and
complete the form, which will take about an hour. • Be prepared with your organization’s:
• DUNS number , • Tax ID number (NOTE: If you do not have an EIN, Apply for an Employer
Identification Number (EIN) Online) organization’s • Business start date, • Congressional district • Physical mailing addresses, • E-Business Point of Contact (E-Biz POC) and a Marketing Partner
Identification Number (MPIN).
• After you submit your SAM registration , you will receive an email from SAM.gov letting you know your registration is active. To keep your SAM registration active, be sure to renew at least once each year which takes about 5 days to process. If your registration expires, you cannot submit a grant application until it is renewed.
Register with Grants.gov
• Allow 2 to 3 weeks to register with Grants.gov after DUNS and SAM registration
• Go to Get Registered with Grants.gov.
• Know your organization's DUNS number from step 1
• After each Authorized Organization Representative (AOR) registrant submits a registration form to Grants.gov, the E-BIZ POC will receive an e-mail, prompting her or him to log into Grants.gov and approve the AOR. The E-BIZ POC will need organization's MPIN acquired in Step Two to approve AOR registrations
• When the registration is approved, the submitting AOR will receive a confirmation e-mail and will be able to submit applications.
2) Find & Submit
• Find open funding opportunities in Grants.gov
• Download the instructions and application
• Complete the application • Save and Submit • Watch your E-mail
For HRSA funding opportunity announcements (FOAs)….
Remember to download: FOA Instructions
• Provides programmatic requirements
HRSA SF-424 Application Guide
• Companion guide to the FOA
• Referenced throughout the FOA
For ORHP funding opportunity announcements
http://datawarehouse.hrsa.gov/RuralAdvisor/RuralHealthAdvisor.aspx
3) Write a Strong Application
• Have I read the funding opportunity announcement?
• Is my organization eligible to apply? • Does my organization have the technical
expertise, the personnel, and the financial capacity?
• Are all stakeholders in my organization supportive?
• Is my organization prepared to do what it takes?
4) Understand the Review Process
• Standard review criteria, common among almost all opportunities, are as follows: • Needs assessment; • Response; • Evaluative measures; • Impact; • Resources/capabilities; and • Support requested
• Most funding opportunity announcements include more
specific criteria for each category and many list additional review criteria, such as cultural competence
Understand the Review Process
• Division of Independent Review (DIR) • Panel of reviewers • Review Criterion • Objective Review Committee (ORC)
Process • Rank Order Listing
How to be a Grant Reviewer • ORHP has multiple grant program
reviews each year • We need reviewers with rural
experience to be a part of our Objective Review Committee panels
• You must register to be a
reviewer: http://www.hrsa.gov/grants/reviewers/ • Indicate “rural health” as one of
your specialties in the background information
In FY12, Outreach received/funded…. State
# of applications received in 2012
# of applications funded in 2012 State
# of applications received in 2012
# of applications funded in 2012
AK 2 1 MT 11 4 AL 6 0 NC 5 1 AR 7 1 ND 9 0 AZ 3 2 NE 5 2 CA 10 3 NH 4 3 CO 7 1 NM 5 2 DE 1 1 NV 2 0 FL 9 2 NY 6 2 GA 7 3 OH 6 2 HI 4 0 OK 3 0 IA 1 0 OR 8 2 ID 1 1 PA 12 2 IL 11 0 SC 6 1 IN 5 1 SD 7 3 KS 5 1 TN 5 1 KY 17 7 TX 6 1 LA 6 3 UT 2 0 MD 8 1 VA 7 1 ME 7 1 VI 1 0 MI 8 4 VT 2 2 MN 10 2 WA 5 0 MO 13 4 WI 8 1 MS 8 1 WV 5 1
WY 1 0
FY2013 Rural Health Network Development Planning Applications Received and Awards by HRSA Region
• REGION I
• 8 Applications • 0 Awards
• REGION II • 6 Applications • 1 Award
• REGION III • 5 Applications • 1 Award
• REGION IV • 21 Applications • 4 Awards
• REGION V • 12 Applications • 2 Awards
• REGION VI • 8 Applications • 1 Award
• REGION VII • 12 Applications • 2 Awards
• REGION VIII • 8 Applications • 2 Awards
• REGION IX • 11 Applications • 3 Awards
• REGION X • 12 Applications • 4 Awards
103 Applications Received
20 Awards Made
Grant Resources
• Registration checklist: http://www.grants.gov/documents/19/18243/OrganizationRegChecklist.pdf/fc7e7c18-2497-4b08-8d9b-bfac399947a3
Knowledge Check #3
• How many different systems must you register with before submitting your grant application?
• How long will the registration process take?
Explore Options Start early
Become an expert on the
grant program that you want to apply for.
Research the types of projects that have been awarded under the program.
Application Planning Read and re-read Funding
Opportunity Announcement (FOA) Have one or two other staff read all
the program information (guidance, forms, etc.)
• You should agree on what needs to be in the application and how to proceed
Make certain you understand exactly what, how, when, etc. is required for the application
Create a Team to Work
on the Project Name the lead person (Someone
that has the authority to get things done)
Set meeting times
Identify Consortium/Network Members & Obtain Commitment early (if applicable) Determine the roles and level of
participation of each member
Application Planning
Application Planning Call the program
contact person with any questions This is very important They are there to help
Paint the Right Picture
Story Telling Tell the story of your community and its needs Make sure it aligns with the purpose of the grant
program
Find someone who is organized, writes well and is good at following directions to help with writing the grant
After the grant narrative is completed, give it to someone not involved in the project to read If they understand what the needs are, why there
are needs, who will be served and how the project will address the needs, the narrative is probably clear
Getting Started Make your proposal clear,
simple, easy and enjoyable to read
Stay focused on the project activities
Avoid jargon and acronyms
Present gaps in current services
Don’t assume reviewers know your topic or geographical area (background)
Application Content Needs Response Evaluation Impact Resources &
Capabilities Support Requested
Planning Strategies Host a meeting of interested parties
Initial reaction Review funding opportunity announcement Mission match/community impact
SWOT (Strengths, Weaknesses, Opportunities, Threats)
Needs Assessment Focus groups Survey Secondary data
How Do You Assess Needs?
Example: Focus Groups A specially selected group to
discuss an issue Open ended questions 7-10 people Contrasts with Key Informant
Key informant provides individual perspective
Focus group offers individual within the context of a group
Advantages/Disadvantages Advantage
Speed Low cost Flexibility Benefit of group dynamics
Disadvantage Less control than key informant Difficulty in assembling the
group Disadvantage of group
dynamics
How Do You Assess Needs?
Example: Survey Sample of population (entire
population) Typically a closed ended
instrument (sometimes open ended)
Mailed, telephone, personal interview
Measure attitude present services (awareness,
use, need) need for future services quality of services/care provider assessment
Advantage/Disadvantage Advantage
Most scientifically valid and reliable
Representative of population Commonly used and
accepted Amount of data gathered
Disadvantage Most expensive Less flexible
How Do You Assess Needs?
Example: Community Forum • Open public meeting with all
interested persons invited to participate
• Generally provides a means of soliciting a broad range of views and concerns
• Pose questions to the audience • What do you see as the most important
community or regional health problems?
• What areas should be addressed? • How do we address these issues?
Advantages/Disadvantages Advantage
• Speed and low cost • Flexibility • Most participatory • Educate public and form
of community development
Disadvantage
• Can be unrepresentative of population
• “Gripe” session • Challenge “expert”
perspective
Writing and Development Tips • Remember others
• Talk to others who have written grants
• Try to locate people who have been funded by organizations you plan to submit a proposal
• State Office of Rural Health • Associations and other regional or
state organizations • Rural Assistance Center (RAC)
Writing and Development Tips • Remember your audience: The panel of reviewers
• Reviewers typically do not know anything about
your situation, your community, or even your state • Explain basic facts:
• rural and frontier as a concept (distance, weather, roads); culture; and your unique circumstances
• Central goal = convince reviewer of the legitimacy
of your problem, your solution, your ability
Writing and Development Tips Don’t deviate from the FOA The order of sections and the titles
are set The rules are set
Be detailed (even to the point of being
elementary) Be concise (less words the better)
Writing and Development Tips
Put yourself in the funding source’s shoes -- ask yourself the same questions that a skeptical reader would ask: Why should anyone bother to read this? Why should they care? What difference is this going to make?
Present it in layperson’s words -- program officer and
reviewers may not be an expert in your field and they have to explain the proposal to others
Goal. Objective. Activity.
Goal: Complete a Needs Assessment Objective: Within 3
months, develop a needs assessment tool Activity: Distribute
Needs Assessment Document to all Health Fair Participants
Budget Narrative • How many organizations are
contributing to the budget
• What percent of funds are being solicited from the funding source
• Are subcontracts involved
• Annual salary increases (multiple year projects) • Allow for cost of living
increases
Budget Categories
Calculate all relevant expenses • Salary • Benefits (social security, workman’s
compensation) • Printing and photocopying • Postage and shipping • Long distance and cellular telephone service • Materials and supplies • Mileage and travel • Outside services
Presentation Summary Part I
Office of Rural Health Policy 101 • ORHP Overview • ORHP Programs and Activities
Part II
Applying for a HRSA Grant • General Grant Writing Tips
Contact Information
Natassja Manzanero 301-443-2077
Katy Lloyd 301-443-2933