No grants will be funded in FY 07, FY 08, or FY 09.

Uses and Use Restrictions

Funds received under the Healthy Communities Access Program (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.

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Eligibility Requirements

Applicant Eligibility

For an entity to be eligible to receive a new HCAP award, all of the following three 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.

3.

The applicant entity is neither a current HCAP grantee nor former Community Access Program (CAP) grantee and is proposing to serve either a service area or target population of uninsured and underinsured individuals that has not been exclusively served by a former CAP or current HCAP grant.

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), as appropriate for the needs of the community's uninsured and underinsured populations.

Existing grantees that have received three consecutive years of funding may request a grant award for not more than one additional fiscal year ONLY under demonstrated extraordinary circumstances.

Extraordinary circumstances are an event(s) outside of the control of the eligible entity where the event(s) and impact, or impact alone, occurred during the current budget period and directly prevented the completion of measurable objectives and activities set forth in the applicant's approved grant application.

Extraordinary circumstances are limited to: 1) natural disasters, 2) major security or health disruptions, or 3) significant economic deteriorations in the community served that directly and adversely affects the applicant's HCAP project.

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: Consolidated Health Center Program including Community Health Centers (CHC), Migrant Health Centers (MHC), Health Care for the Homeless (HCH), Public Housing Primary Care (PHPC) and School-Based Health Centers (SBHC); Rural Health Clinics; free and partial pay clinics; FQHC Look-Alikes; local public health departments and other local government agencies; Tribal governments; public and private hospitals; private provider or group practices; foundations; medical and dental societies; small business organizations; faith and/or community based nonprofit organizations; Primary Care Associations (PCA); Area Health Education Centers (AHEC); universities; and any other relevant stakeholders.

Credentials/Documentation

Applicants should review the individual HRSA Guidance documents issued under this CFDA program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package.

Aplication and Award Process

Preapplication Coordination

This program is excluded for coverage under E.O.

12372.

Application Procedures

Grant applications and required forms for this program can be obtained from Grants.gov. Please visit the Grants.gov Web site at www.grants.gov to both find and apply for all Federal grant opportunities. All qualified applications will be forwarded to an objective review committee which will make funding recommendations to the Associate Administrator for the Bureau of Primary Health Care. The Associate Administrator has the authority to make final selections for awards.

Award Procedures

Each applicant will receive written notification of the outcome of the objective review process, including summary of the expert committee's assessment of the application's merits and weaknesses, and whether the application was selected for funding. Applicants who are selected for funding may be required to respond in a satisfactory manner to Conditions placed on their application before funding can proceed. Letters of notification do not provide authorization to begin performance. The Notice of Grant Award, which is signed by the Grants Management Officer and is sent to the applicant agency's Authorized Representative, is the authorizing document.

Deadlines

www.hrsa.gov.

Authorization

Public Health Service Act (42 U.S.C 256), Title 111, Subpart V, Section 340.

Range of Approval/Disapproval Time

From 90 to 120 days.

Appeals

None.

Renewals

None.

Assistance Considerations

Formula and Matching Requirements

No match or cost-sharing required.

Length and Time Phasing of Assistance

Up to a 3-year Project period with a 12-month budget period for new HCAP grantees, depending upon the availability of Federal dollars. 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 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 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 for the preceding fiscal year. In order to justify such a request, there must be available funds 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. Funds may be available to existing HCAP grantees that have experienced an extraordinary circumstance where the event(s) and impact, or impact alone: (1) occurred during the previous budget period; and (2) directly prevented the completion of goals and measurable objectives set forth in the applicants' approved application may request funds in an amount up to 70 percent of their previous year's Continuation Award.

Post Assistance Requirements

Reports

Grantees are required to submit an annual report that describes the utilization costs of services provided under the grant, and provide such other information as the Secretary determines appropriate.

Financial status reports are required no later than 90 days after the end of each budget period.

Final financial status and progress reports are due 90 days after the end of a project period.

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.

Records

All records must be maintained until expiration of 3 years from the date of submission of the final expenditure report. If questions remain following the 3-uear period, such as those raised as a result of an audit or an on-going enforcement action, recipients must retain records until the matter is completely resolved.

Financial Information

Account Identification

75-0350-0-1-550.

Obigations

(Grants) FY 07 est not available; FY 08 est not available; and FY 09 est not available.

Range and Average of Financial Assistance

$355,000 to $1,200,000.

Regulations, Guidelines, and Literature

This program is subject to the provisions of 45 CFR Part 92 for State, local and tribal governments and 45 CFR Part 74 for institutions of higher education, hospitals, other nonprofit organizations and commercial organizations.

Information Contacts

Regional or Local Office

Grants Management Office: Rick Goodman, Director, Division of Grants Management Operations, Health Resources and Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Room 11A-16. Health Services Branch: (301) 443-2385; Research and Training Branch: (301) 443-3099; Government and Special Focus Branch: (301) 443-3288.

Headquarters Office

Grants Management Office: Rick Goodman, Director, Division of Grants Management Operations, Health Resources and Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Room 11A-16. Health Services Branch: (301) 443-2385; Research and Training Branch: (301) 443-3099; Government and Special Focus Branch: (301) 443-3288.

Criteria for Selecting Proposals

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 to the applicant without further consideration. An Objective Review Committee (ORC) will assess each HCAP application based on the review criteria. The maximum score is 100 points. The ORC will review the supporting program specific forms and appendices listed at the end of each review criteria, however, these documents are supplementary in nature and will not be scored. Failure to address the criteria may result in the application being recommended for disapproval by the ORC. The following are the categories for the criterion that will be used to assess each application for funding for a new HCAP grant: 1 - need (20 Points); 2 - resources/capabilities (15 Points); 3 - response (25 Points); 4 - evaluative measures (15 points); 5 - impact (15 points); 6 - support requested (10 Points). Specifics regarding the review criteria will be made available in the application guidance. HCAP grantees applying for fourth-year funding under extraordinary circumstances must demonstrate the impact of their extraordinary circumstances as well as respond to the following four competing continuation review criteria: 1 - specific program criteria (35 Points); 2 - response (40 Points); 3 - impact (15 Points); and 4: support requested (10 Points). Those competing continuation applications that are determined to be eligible, complete and responsive will have the demonstration of extraordinary circumstances component of the application evaluated by an Objective Review Committee (ORC). Initially, the ORC will evaluate the responses presented and any supporting documentation of the extraordinary circumstance to determine if the applicant meets the provision for extraordinary circumstances. If the ORC determines the applicant does meet the provision for extraordinary circumstances, the technical merits of the proposal will be evaluated by the ORC using the competing continuation review criteria presented in this program guidance with points assigned up to a maximum of 100 points total. If the ORC determines the applicant does not meet the provision for extraordinary circumstances, the technical merits of the application will not be reviewed and therefore, not selected for competing continuation funding. Please note, a determination by the ORC that the applicant meets the provision for extraordinary circumstances is not a guarantee of selection for funding. Applicants that meet the provision for extraordinary circumstances will be selected for funding based on the technical merits of the proposal using the 100-point competing continuation review criteria presented in the program guidance.