VA Form 10-10055 Grants for Transportation of Veterans in Highly Rural Ar

OMB 2900-XXXX
Estimated Burden: 25 hours

Department of Veterans Affairs

Chief Business Office

Veterans Transportation Program

Grants for Transportation of Veterans in Highly Rural Areas

(Initial Announcement)

Funding Opportunity Number:_________

CFDA: 64.035

Applicable Dates:

Grant application due date:_________

Anticipated Notice of Grant Award:__________

Grant Period of Performance: October 1, 2012-September 30, 2013

OVERVIEW INFORMATION

Agency Name: US Department of Veterans Affairs

Veterans Health Administration

Chief Business Office

Veterans Transportation Program

Funding Opportunity Title: Grants for Transportation of Veterans in Highly Rural Areas

Announcement Type: Initial

Funding Opportunity Number:_____

Catalog of Federal Domestic Assistance (CFDA) Number: 64.035

Key Dates:

Date of Issue: August 1, 2012

Application Due Date: October 1, 2012

Anticipated Notice of Award: November 1, 2012

Period of Performance: November 1, 2012-September 30, 2013

Table of Contents

The table of contents is being provided as a guide to sections in this application. Where there is a – this may denote that this is just a reference from the application. Please adhere to the page limits for each section. Your complete application will consist of items with the page limits listed below, Standard Forms (SF), Assurances, Exhibits, Tables, Spreadsheets and other attachments.

Section	Items	VA Page Numbers	Page Limit
I	Funding Opportunity Description	4	-
	Overview	4	-
	Purpose	4	-
	Authority	4	-
	Deadlines	4	-
II	Award Information (Goals, Objectives and Deliverables)	4-5	-
	Amount and Length of Awards	5
III	Eligibility	5	-
	Match Requirement	5	-
IV	Application and Submission Information (How to Apply)	5	-
	Deadlines: Registration and Application	5
	Obtaining a DUNS and Bradstreet Number (DUNS)	6	-
	Central Contracting Registration (CCR) Requirement	6	-
	What an Application Should Include	8	-
	Application for Federal Assistance (SF 424)	8	3
	Program Narrative	9	5
	Staffing Plan	10	2
	Organizational Chart	10	1
	Resume for each key personnel	10	Open
	Program Implementation Timeline	10	3
	Program Innovation	10	5
	Area of Community Linkages and Relations	10	5
	Program Evaluation Plan	11-12	5
	Performance Measures	11-12	5
	Budget Detail Worksheet (SF 424A)	12-13	3
	Budget Narrative	12-13	3
	Budget Brief	13	1
	Indirect Cost Rate Agreement	13	-
	Tribal Authorizing Resolution	13	-
	Additional Attachments	14	-
	Insert Map of Area Served By County	14	5
	List the State, Counties, VAMC & VISN	15	1
	Table of Counties with Highly Rural Areas by State	15-16	-
	Veterans Integrated Services Networks (VISNs) Map	16-17	-
	Contact Information	17	-
	Other Standard Forms	17	-
	Certifications	17-18
	Disclosure of Lobbying Activities (SF LLL)	18	2
	Accounting System and Financial Capability Questionnaire	18	2
	Standard Assurances	18
V	Application Review Information	18
	Review Process	18
	Scoring and Selection Criteria	18	-
	Initial Grant Scoring	19-20	-
	Initial Grant Selection	20	-
	Renewal Grant Scoring	20	-
	Renewal Grant Selection	21	-
VI	Award Administration	21	-
	Notice of Award	21
	Grant Agreements	21-22
	Additional Requirements	22-23	-
	Reporting (Frequency & Means of Submission)	23	-
	Progress Reports	23	-
	Program Monitoring	23	-
	Federal Financial Report (FFR SF 425)	23	-
	Audit Requirements	23	-
	Notice of New Post-Award Reporting Requirements	23-24	-
VII	Contact Information	24	-
VIII	Other Information	24	-

U.S. Department of Veterans Affairs (VA)

Grants for Transportation of Veterans in Highly Rural Areas

APPLICATION FOR TRANSPORTATION GRANT

(CFDA# 64.035)

1. Funding Opportunity Description

1. Overview: Access to care for Veterans that are in highly rural areas continues to be an issue across the United States. The VA has established this program to address the issue of access to care. This program should leverage innovative approaches to transporting veterans in highly rural areas. Veterans in highly rural areas typically have longer commute times to VA Medical Centers.

2. Purpose: The U.S. Department of Veterans Affairs (VA), Veterans Transportation Program (VTP) is pleased to announce that it is seeking applicants for Grants for Transportation of Veterans in Highly Rural Areas. This program furthers the Department’s mission by establishing a program to provide grants to eligible recipients to assist veterans in highly rural areas through innovative transportation services to travel to Department of Veterans Affairs Medical Centers (VA Medical Centers), and to otherwise assist in providing transportation services in connection with the provision of VA medical care to these veterans.

3. Authority: The program is authorized by section 307 of title III of the Caregivers and Veterans Omnibus Health Services Act of 2010. See 38 U.S.C. 1710 note.

2. Award Information (Goals, Objectives, and Deliverables)

The goal of the program is to leverage innovative approaches to transport veterans to VA Medical Centers, and to otherwise assist in providing transportation services in connection with the provision of VA medical care to these veterans. The program should be able to assist veterans that live in highly rural areas with transportation services. Successful delivery of the program would depend on the following: Record of time expended, number of trips completed, total distance covered, number of veterans served, number of locations served and the satisfaction of the veterans served. Innovative approaches to transportation would require community linkages and relations. A grantee would need to demonstrate how existing relationships with state or local agencies would enhance program effectiveness. If no such linkage exists, the grantee would show how the development of the linkage and community relationship would enhance program effectiveness. A grantee would need to demonstrate program innovation and show how the program would identify and serve veterans who otherwise would not be able to obtain medical care through conventional transportation recourses. The grantee would also need to show how the use of new or alternative transportation resources would benefit the program.

Amount and Length of Awards

Grant amounts will be specified in the Notice of Fund Availability, but no single grant will exceed $50,000, to comply with paragraph (a)(4) of section 307 of the 2010 Act. One grant may be awarded to an eligible entity per fiscal year, and no entity may receive more than one grant in a 12-month period. Designating that grants are awarded per fiscal year would ensure that grants are awarded only when funding is available, in accordance with paragraph (d) of section 307 of the 2010 Act. The twelve month limitation would further ensure that as many geographic areas are serviced as possible each year by preventing a concentration of grant awards to a single eligible entity.

All awards are subject to the availability of appropriated funds and any modifications or additional requirements that may be imposed by law.

3. Eligibility

An application may only be considered from an applicant that is an “eligible entity,” which would be defined as either a Veterans Service Organization, or a State Veterans Service Agency, in accordance with paragraphs (a)(2)(A)-(B) of section 307 of the 2010 Act. A Veteran Service Organization means an organization recognized by the Secretary of Veterans Affairs for the representation of veterans under section 5902 of title 38 United States Code.

Match Requirement

This solicitation does not require a match.

IV Application and Submission Information (How to Apply)

Deadlines: Registration and Application

Registration in Grants.gov is required prior to submission. VA strongly encourages registering with Grants.gov several weeks before the deadline for application submission. The deadline for applying for funding under this announcement is [insert time] eastern time on [insert due date, month, day, year].

A. Applications will be submitted through Grants.gov. Grants.gov is a “one-stop storefront” that provides a unified process for all customers of federal awards to find funding opportunities and apply for funding. Complete instructions on how to register and submit an application can be found at www.Grants.gov. If the applicant experiences technical difficulties at any point during this process, please call the Grants.gov Customer Support Hotline at 800–518–4726, 24 hours a day, 7 days a week, except federal holidays. Registering with Grants.gov is a one-time process; however, processing delays may occur, and it can take up to several weeks for first-time registrants to receive confirmation and a user password. VA highly recommends that applicants start the registration process as early as possible to prevent delays in submitting an application package by the specified application deadline.

All applicants are required to complete the following steps:

1. Acquire a DUNS number. A DUNS number is required for Grants.gov registration. In general, the Office of Management and Budget requires that all applicants (other than individuals) for federal funds include a DUNS (Data Universal Numbering System) number in their applications for a new award or renewal of an existing award. A DUNS number is a unique nine-digit sequence recognized as the universal standard for identifying and keeping track of entities receiving federal funds. The identifier is used for tracking purposes and to validate address and point of contact information for federal assistance applicants, recipients, and subrecipients. The DUNS number will be used throughout the grant life cycle. Obtaining a DUNS number is a free, one-time activity. Obtain a DUNS number by calling Dun and Bradstreet at 866–705–5711 or by applying online at www.dnb.com. Individuals are exempt from this requirement.

2. Acquire or renew registration with the System for Award Management (SAM) database. (formerly Central Contractor Registry or CCR) VA requires that all applicants (other than individuals) for federal financial assistance maintain current registrations in the System for Award Management (SAM) database. An applicant must be registered in the SAM to successfully register in Grants.gov. The SAM database is the repository for standard information about federal financial assistance applicants, recipients, and subrecipients. SAM is combining eight federal procurement systems and the Catalog of Federal Domestic Assistance into one system. Organizations that have previously submitted applications via Grants.gov are already registered with SAM, as it is a requirement for Grants.gov registration. Please note, however, that applicants must update or renew their SAM registration annually to maintain an active status. Information about SAM registration procedures can be accessed at www.sam.gov.

3. Acquire an Authorized Organization Representative (AOR) and a Grants.gov username and password. Complete the AOR profile on Grants.gov and create a username and password. The applicant organization’s DUNS Number must be used to complete this step. For more information about the registration process, go to www.grants.gov/applicants/get_registered.jsp.

4. Acquire confirmation for the AOR from the E-Business Point of Contact (E-Biz POC). The E-Biz POC at the applicant organization must log into Grants.gov to confirm the applicant organization’s AOR. Please note that there can be more than one AOR for the organization.

5. Search for the funding opportunity on Grants.gov. Please use the following identifying information when searching for the funding opportunity on Grants.gov. The Catalog of Federal Domestic Assistance (CFDA) number for this solicitation is 64.035, titled “Veterans transportation program,” and the funding opportunity number is [insert funding opportunity number]. [The CFDA title and solicitation title are not necessarily the same; please use the CFDA title in the space provided in this entry.]

6. Submit an application consistent with this solicitation by following the directions in Grants.gov. Within 24–48 hours after submitting the electronic application, the applicant should receive an e-mail validation message from Grants.gov. The validation message will state whether the application has been received and validated, or rejected, with an explanation. Important: Applicants are urged to submit applications at least 72 hours prior to the due date of the application to allow time to receive the validation message and to correct any problems that may have caused a rejection notification.

Note: Grants.gov will forward the application to VA’s Grants Management System (GMS). GMS does not accept executable file types as application attachments. These disallowed file types include, but are not limited to, the following extensions: “.com,” “.bat,” “.exe,” “.vbs,” “.cfg,” “.dat,” “.db,” “.dbf,” “.dll,” “.ini,” “.log,” “.ora,” “.sys,” and “.zip.”

Experiencing Unforeseen Grants.gov Technical Issues

If an applicant experiences unforeseen Grants.gov technical issues beyond the applicant’s control that prevent submission of its application by the deadline, the applicant must contact the Veterans Transportation Program Office staff within 24 hours after the deadline and request approval to submit its application. At that time, Veterans Transportation Program Office staff will instruct the applicant to submit specific information detailing the technical difficulties. The applicant must e-mail: a description of the technical difficulties, a timeline of submission efforts, the complete grant application, the applicant DUNS number, and Grants.gov Help Desk tracking number(s) received. After the program office reviews all of the information submitted, and contacts the Grants.gov Help Desk to validate the technical issues reported, VA will contact the applicant to either approve or deny the request to submit a late application. If the technical issues reported cannot be validated, the application will be rejected as untimely.

To ensure a fair competition for limited discretionary funds, the following conditions are not valid reasons to permit late submissions: (1) failure to begin the registration process in sufficient time, (2) failure to follow Grants.gov instructions on how to register and apply as posted on its Web site, (3) failure to follow all of the instructions in the VA solicitation, and (4) technical issues experienced with the applicant’s computer or information technology (IT) environment.

Notifications regarding known technical problems with Grants.gov, if any, are posted on the Grants.gov website.

B. What an Application Should Include

This section describes what an application should include and sets out a number of elements. Applicants should anticipate that failure to submit an application that contains all of the specified elements may negatively affect the review of the application; and, should a decision be made to make an award, it may result in the inclusion of special conditions that preclude access to or use of award funds pending satisfaction of the conditions.

Moreover, applicants should anticipate that some application elements are so critical that applications unresponsive to the scope of the solicitation, or that do not include a program narrative, budget detail worksheet including a budget narrative, tribal resolution (if applicable), eligibly entity designation, or a list of the highly rural county or counties to be served, will neither proceed to peer review nor receive further consideration.

Threshold Review Criteria: (Critical Elements)

• Application deadline: Applications not received by the application deadline through www.grants.gov will not be reviewed.

• Eligibility: Applications that do not conform to the eligibility requirements at the beginning section of this document will not be reviewed.

• Program narrative.

• Budget detail worksheet including a budget narrative.

• County listing: Applications will only be considered for funding if the lists of appropriate counties are included with the application package. The counties that you will serve must be in a highly rural area, which is defined as a county or counties having less than seven persons per square mile.

VA strongly recommends use of appropriately descriptive file names (e.g., “Program Narrative,” “Budget Detail Worksheet and Budget Narrative,” “Timelines,” “Memoranda of Understanding,” “Resumes”) for all attachments. VA recommends that resumes be included in a single file.

Sections B 1-7

1. Information to complete the Application for Federal Assistance (SF-424)

The SF-424 is a standard form required for use as a cover sheet for submission of pre-applications, applications, and related information. Grants.gov takes information from the applicant’s profile to populate the fields on this form. When selecting "type of applicant," if the applicant is a for-profit entity, please select "For-Profit Organization" or "Small Business" (as applicable).

A

pplicant Summary:

Your Organization’s Name:

Organization Eligibility:

Is your organization a:

V

eteran’s Service Organization

S

tate Veteran’s Service Agency

	Name	Phone	Fax
CEO/Commander/State
E-mail address for CEO/Commander/State

Person to contact about application
E-mail addresses for contact person.

Business Address:

M

ailing Address (if different from

business address):

S

ubrecipient Information (if applicable)

Name of Organization

E

mployer Identification Number (EIN) that Corresponds to the Applicant's IRS Ruling Certifying Tax-Exempt Status under the IRS Code of 1986 (Note: EIN will be used to determine whether applicant is delinquent or in default on any Federal debt, in accordance with 31 U.S.C. 3701, et seq. and 5 U.S.C. 552a at note):

2. Program Narrative

Provide a detailed narrative of your program scope and specifically discuss the innovative modes and methods of transportation services to be provided. If the provision of transportation services will necessitate procurement or use of specific equipment, such equipment must be specifically listed.

3. Staffing Plan

Define your staffing plan and indicate that there will be adequate staffing for delivery of transportation services according to the program scope. Provide an organizational chart and label it (Exhibit I) and provide a resume for each key personnel and label it (Exhibit II).

4. Program Implementation Timeline

Complete the following table describing the proposed program implementation timeline. Add additional milestones as applicable:

Milestone	# of Calendar Days from Date of Grant Agreement Execution
1. Program setup completed
2. Implementation of hiring plan (if applicable)
3. Purchase of vehicles (if applicable)
4. New staff begin work (if applicable)
5. Transporting of veterans begin
6. Other

(a) Describe the program implementation plan that will accomplish the above timeline, including any hiring plan if required. Indicate that the delivery of transportation services will be timely.

(b) Describe possible obstacles to program implementation and potential mitigation strategies.

5. Program Innovation

VA will award up to 10 points based on the innovative aspects of the program, as demonstrated by the following: (a) How the program will identify and serve veterans who otherwise would be unable to obtain medical care through conventional transportation resources. (b) How the program will use new or alternative transportation resources.

6. Area of Community Linkages and Relations

VA will award up to 20 points based on the applicant’s community relationships in the area to be serviced as demonstrated by the following indications that such community relationships provide relevant expertise: (a) Applicant has existing relationships with state or local agencies or private entities, or will develop such relationships, and has shown these relationships will enhance the program effectiveness; or (b) Applicant has established a relationship with the state or local agencies or private entities which have provided services to those offered by the program.

7. Program Evaluation Plan

Performance Measures

Information must be collected to ensure program efficacy and appropriate use of government funds. Applicants that receive funding under this solicitation must provide data that measure the results of their work. Any award recipient will be required, post award, to provide the data requested in the “Data Grantee Provides” column so that VA can calculate values for the “Performance Measures” column. Performance measures for this solicitation are as follows:

1. Record of time expended.

2. Record of grant funds expended.

3. Trips completed.

4. Total distance covered.

5. Veterans served.

6. Locations serviced.

7. Veteran satisfaction survey. (Provided by VA)

Submission of performance measures data is not required for the application. Instead, applicants must discuss in their application their proposed methods for collecting data for performance measures. Please refer to the section “What an Application Should Include” (below) for additional information.

Note on project evaluations: Applicants that propose to use funds awarded through this solicitation to conduct project evaluations should be aware that certain project evaluations (such as systematic investigations designed to develop or contribute to knowledge) may constitute “research.” However, project evaluations that are intended only to generate internal improvements to a program or service, or are conducted only to meet VA’s performance measure data reporting requirements likely do not constitute “research.”  Research is subject to applicable VA human subjects protections.  Applicants should provide sufficient information for VA to determine whether the particular project they propose would either intentionally or unintentionally collect and/or use information in such a way that it meets the VA regulatory definition of research.

Research, for the purposes of VA-funded programs, is defined as, “a systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalizable knowledge.”  38 CFR 16.102(d). 

Define measurable goals for determining the success of delivery of transportation services. How will you assess the program? How will you adjust the program, if needed? At a minimum the following should be measured:

Objective	Catalog ID [for internal use only, delete before posting]	Performance Measure(s)	Data Grantee Provides
Time it takes to pick up a veteran and drop the veteran at destination.			Record of time expended
A detailed record of grant funds expended.			Record of grant funds expended
Number of trips completed on a given day, week, month and year.			Trips completed
Total distance driven on a given day, week, month and year.			Total miles covered
Number of veterans served on a given day, week, month or year.			Number of veterans served
Location of veterans served			Locations of pick-up and drop-off (VA, Home, CBOC, etc)
Number of veterans satisfied with the service.			Veterans’ satisfaction

8. Budget Detail Worksheet and Budget Narrative

1. Budget Detail Worksheet

A sample SF 424A Budget Detail Worksheet can be found at www.grants.gov website. Please submit a budget as the example above indicates, and label it (Exhibit III).

If the budget is submitted in a different format, the budget categories listed in the sample budget worksheet must be included.

2. Budget Narrative

The Budget Narrative should thoroughly and clearly describe every category of expense listed in the Budget Detail Worksheet. The narrative should be mathematically sound and correspond with the information and figures provided in the Budget Detail Worksheet. The narrative should explain how all costs were estimated and calculated and how they are relevant to the completion of the proposed project. The narrative may include tables for clarification purposes but need not be in a spreadsheet format. As with the Budget Detail Worksheet, the Budget Narrative must be broken down by year. Note: State, Local and Indian Tribal Governments must be in compliance with 2 CFR 225 Cost Principles codified in Veteran Service Organizations must be in compliance with 2 CFR 230, Cost principles for nonprofit organizations. VA Grants awarded to State entities and Non-profit entities are also governed by 38 CFR parts 43 and 49, respectively, and all Office of Management and Budget (OMB) Regulations and Circulars. Particularly, the determination of allowable costs which may be charged to or accounted as part of a federally funded project is controlled by OMB Circular A-122, Cost Principles for Non-Profits Organizations (codified at 2 CFR part 230), and OMB Circular A-87 (2 CFR 225) Cost Principles for State, Local and Indian Tribal Governments.

3. Budget Brief

$

Our organization requests for the acquisition of _________van(s).

$

The total cost of the van(s) This is the amount requested from VA.

O

$

ur organization will utilize for innovative approaches for transporting veterans. This is the amount requested from VA for a maximum of $50,000.

Section C

1. Indirect Cost Rate Agreement (if applicable)

Indirect costs are allowed only if the applicant has a federally approved indirect cost rate. (This requirement does not apply to units of local government.) A copy of the rate approval must be attached. If the applicant does not have an approved rate, one can be requested by contacting the applicant’s cognizant federal agency, which will review all documentation and approve a rate for the applicant organization or, if the applicant’s accounting system permits, costs may be allocated in the direct cost categories. If VA is the cognizant federal agency, obtain information needed to submit an indirect cost rate proposal at the contact person listed in this solicitation.

2. Tribal Authorizing Resolution (if applicable) [INSERT if applicable. This provision does not apply to applications for provision of general technical assistance provided on behalf of VA to all eligible tribes on a national or regional basis.]

[The following should be included in any solicitation where the open period for the solicitation is at least 60 days.] If an application is being submitted by either (1) a tribe or tribal organization or (2) a third party proposing to provide direct services or assistance to residents on tribal lands, then a current authorizing resolution of the governing body of the tribal entity or other enactment of the tribal council or comparable governing body authorizing the inclusion of the tribe or tribal organization and its membership must be included with the application.  In those instances when an organization or consortium of tribes proposes to apply for a grant on behalf of a tribe or multiple specific tribes, then the application must include a resolution from all tribes that will be included as a part of the services/assistance provided under the grant. A consortium of tribes for which existing consortium bylaws allow action without support from all tribes in the consortium (i.e., without authorizing resolution or other enactment of each tribal governing body) may submit a copy of its consortium bylaws with the application in order to satisfy this requirement. 

Section D

1. Additional Attachments

Insert Map of Area to be served by County (Exhibit III)

List the State, Counties, VA Medical Center and VISN from which your program will transport veterans to VA medical centers, and to otherwise assist in providing transportation services in connection with the provision of VA medical care to these veterans. (Note that highly rural area means an area consisting of a county or counties having a population of less than seven persons per square mile). Add more rows if applicable.

State	County	VA Medical Center	VISN

UT	Beaver, Daggett, Duchesne, Emery, Garfield, Grand, Juab, Kane, Millard, Piute, Rich, San Juan, Wayne
VA	Highland
WA	Columbia, Ferry, Garfield, Lincoln, Skamania
WY	Big Horn, Carbon, Converse, Crook, Fremont, Goshen, Hot Springs, Johnson, Lincoln, Niobrara, Park, Platte, Sublette, Sweetwater, Teton, Washakie, Weston

State	Counties
AK	Aleutians East, Aleutians West, Bethel, Bristol Bay, Denali, Dillingham, Haines, Hoonah-Angoon, Kenai Peninsula, Ketchikan Gateway, Kodiak Island, Lake and Peninsula, Matanuska-Susitna, Nome, North Slope, Northwest Arctic, Petersburg, Prince of Wales-Hyder, Sitka, Skagway, Southwest Fairbanks, Valdez-Cordova, Wade Hampton, Wrangell, Yakutat, Yukon-Koyukuk
AZ	Greenlee, La Paz
CA	Alpine, Inyo, Modoc, Mono, Sierra, Trinity
CO	Baca, Bent, Cheyenne, Costilla, Custer, Dolores, Gunnison, Hinsdale, Huerfano, Jackson, Kiowa, Kit Carson, Las Animas, Lincoln, Mineral, Moffat, Rio Blanco, Saguache, San Miguel, Sedgwick, Washington, Yuma
ID	Adams, Bear lake, Caribou, Clark, Clearwater, Fremont, Idaho, Lemhi, Oneida, Owyhee, Shoshone, Boise, Butte, Camas, Custer, Lincoln, Power, Valley
KS	Barber, Chase, Chautauqua, Cheyenne, Clark, Comanche, Decatur, Edwards, Elk, Gove, Graham, Greeley, Greenwood, Hamilton, Hodgeman, Jewell, Kearny, Kiowa, Lane, Lincoln, Logan, Meade, Morton, Ness, Norton, Osborne, Rawlins, Rooks, Rush, Sheridan, Sherman, Smith, Stanton, Stafford, Trego, Wallace, Wichita,
LA	Cameron
ME	Piscataquis
MI	Keweenaw, Ontonagon
MN	Cook, Kittson, Koochiching, Lake, Lake of the Woods, Marshall, Traverse
MS	Issaquena
MT	Beaverhead, Big Horn, Blaine, Broadwater, Carbon, Carter, Chouteau, Custer, Daniels, Dawson, Fallon, Fergus, Garfield, Glacier, Golden Valley, Granite, Hill, Judith Basin, Liberty, Lincoln, Madison, McCone, Meagher, Mineral, Musselshell, Park, Petroleum, Phillips, Pondera, Powder River, Powell, Prairie, Richland, Roosevelt, Rosebud, Sanders, Sheridan, Stillwater, Sweet Grass, Teton, Toole, Treasure, Valley, Wheatland, Wibaux
ND	Adams, Benson, Billings, Bottineau, Bowman, Burke, Cavalier, Dickey, Divide, Dunn, Eddy, Emmons, Foster, Golden Valley, Grant, Griggs, Hettinger, Kidder, LaMoure, Logan, McHenry, McIntosh, McKenzie, McLean, Mountrail, Nelson, Oliver, Pierce, Renville, Sargent, Sheridan, Sioux, Slope, Steele, Towner, Wells,
NE	Arthur, Banner, Blaine, Boyd, Brown, Chase, Cherry, Custer, Deuel, Dundy, Franklin, Frontier, Garden, Garfield, Gosper, Grant, Greeley, Harlan, Hayes, Hitchcock, Holt, Hooker, Keya Paha, Kimball, Logan, Loup, McPherson, Morrill, Perkins, Rock, Sherman, Sheridan, Sioux, Thomas, Wheeler
NM	Catron, Cibola, Colfax, De Baca, Guadalupe, Harding, Hidalgo, Lincoln, Mora, Quay, San Miguel, Sierra, Socorro, Torrance, Union
NV	Churchill, Elko, Esmeralda, Eureka, Humboldt, Lander, Lincoln, Mineral, Nye, Pershing, White Pine
NY	Hamilton
OK	Beaver, Cimarron, Dewey, Ellis, Grant, Harmon, Harper, Roger Mills
OR	Baker, Gilliam, Grant, Harney, Lake Malheur, Morrow, Sherman, Wallowa, Wheeler
SD	Aurora, Bennett, Buffalo, Butte, Campbell, Clark, Corson, Custer, Day, Dewey, Edmunds, Fall River, Faulk, Gregory, Haakon, Hand, Harding, Hyde, Jackson, Jerauld, Jones, Kingsbury, Lyman, McPherson, Marshall, Mellette, Miner, Perkins, Potter, Sanborn, Spink, Stanley, Sully, Tripp, Ziebach
TX	Armstrong, Baylor, Borden, Brewster, Briscoe, Cochran, Coke, Collingsworth, Concho, Cottle, Crane, Crockett, Culberson, Dallam, Dickens, Donley, Duval, Edwards, Fisher, Foard, Glasscock, Hall, Hansford, Hardeman, Hartley, Haskell, Hemphill, Hudspeth, Irion, Jeff Davis, Jim Hogg, Kenedy, Kent, Kimble, King, Kinney, Knox, La Salle, Lipscomb, Loving, Martin, Mason, McMullen, Menard, Motely, Oldham, Pecos, Presidio, Real, Reagan, Reeves, Roberts, San Saba, Schleicher, Shackelford, Sherman, Sterling, Stonewall, Sutton, Terrell, Throckmorton, Upton, Wheeler
UT	Beaver, Daggett, Duchesne, Emery, Garfield, Grand, Juab, Kane, Millard, Piute, Rich, San Juan, Wayne
VA	Highland
WA	Columbia, Ferry, Garfield, Lincoln
WY	Big Horn, Carbon, Converse, Crook, Fremont, Goshen, Hot Springs, Johnson, Lincoln, Niobrara, Park, Platte, Sublette, Sweetwater, Teton, Washakie, Weston

Veterans Health Administration

Veterans Integrated Service Networks: (VISNs)

Veterans Integrated Service Networks:
    VISN 1: VA New England Healthcare System
    VISN 2: VA Health Care Upstate New York
    VISN 3: VA NY/NJ Veterans Healthcare Network
    VISN 4: VA Healthcare - VISN 4
    VISN 5: VA Capitol Health Care Network
    VISN 6: VA Mid-Atlantic Health Care Network
    VISN7: VA Southeast Network
    VISN 8: VA Sunshine Healthcare Network
    VISN 9: VA Mid South Healthcare Network
    VISN 10: VA Healthcare System of Ohio
    VISN 11: Veterans In Partnership
    VISN 12: VA Great Lakes Health Care System
    VISN 15: VA Heartland Network
    VISN 16: South Central VA Health Care Network
    VISN 17: VA Heart of Texas Health Care Network
    VISN 18: VA Southwest Health Care Network
    VISN 19: Rocky Mountain Network
    VISN 20: Northwest Network
    VISN 21: Sierra Pacific Network
    VISN 22: Desert Pacific Healthcare Network
    VISN 23: VA Midwest Health Care Network

Contact Information

For technical assistance with submitting the application, contact the Grants.gov Customer Support Hotline at 800–518–4726 or via e-mail to support@grants.gov.

Note: The Grants.gov Support Hotline hours of operation are 24 hours a day, 7 days a week, except Federal holidays.

For assistance with any other requirement of this solicitation, contact Darren Wallace, National Program Coordinator for Grants for Transportation of Veterans in Highly Rural Areas, at (404) 828-5380 (this is not a toll-free number) or by e-mail to Sylvester.Wallace2@va.gov

Grants.gov number assigned to announcement: [insert office-201x-xxxx]

Section E

1. Other Standard Forms

Additional forms that may be required in connection with an award are available for download on www.grants.gov. Examples of these forms can be viewed at the www.grants.gov website. For successful applicants, receipt of funds may be contingent upon submission of all necessary forms. Please note in particular the following forms.

1. Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug-Free Workplace Requirements

2. Disclosure of Lobbying Activities

(Required for any applicant that expends any funds for lobbying activities; this form must be downloaded, completed, and then uploaded)

3. Accounting System and Financial Capability Questionnaire (required for any applicant other than an individual that is a non-governmental entity and that has not received any award from VA within the past 3 years; this form must be downloaded, completed, and then uploaded)

4. Standard Assurances (SF 424B) Standard Assurances (required to be submitted in to the Veterans Transportation Program Office prior to the receipt of any award funds)

5. Application Review Information

Review Process

VA is committed to ensuring a fair and open process for awarding grants. The Veterans Transportation Program Office reviews the application to make sure that the information presented is reasonable, understandable, measurable, and achievable, as well as consistent with the solicitation.

Peer reviewers will review the applications submitted under this solicitation that meet basic minimum requirements. The Veterans Transportation Program Office may use either internal peer reviewers, external peer reviewers, or a combination to review the applications under this solicitation. An external peer reviewer is an expert in the field of the subject matter of a given solicitation who is NOT a current U.S. Department of Veterans Affairs employee. An internal reviewer is a current U.S. Department of Veterans Affairs employee who is well-versed or has expertise in the subject matter of this solicitation. Eligible applications will be evaluated, scored, and rated by a peer review panel. Peer reviewers’ ratings and any resulting recommendations are advisory only.

[For all non-formula solicitations, add the following paragraph:]

The Chief Business Office Finance Department in consultation with the Veterans Transportation Program Office conducts a financial review of applications for potential discretionary awards to evaluate the fiscal integrity and financial capability of applicants; examines proposed costs to determine if the Budget Detail Worksheet and Budget Narrative accurately explain project costs; and determines whether costs are reasonable, necessary, and allowable under applicable federal cost principles and agency regulations.

Absent explicit statutory authorization or written delegation of authority to the contrary, all final award decisions will be made by the Office of the Secretary for VA, who also may give consideration to factors including, but not limited to, underserved populations, geographic diversity, strategic priorities, past performance, and available funding when making awards.

1. Scoring and Selection Criteria

Selection of Grants for Transportation of Veterans in Highly Rural Areas is very competitive. Listed below are the scoring and selection criteria:

(A) Initial Grant Scoring: Applications will be scored using the following selection criteria: 

(1) VA will award up to 40 points based on the program’s plan for successful implementation, as demonstrated by the following:

1. Program scope is defined, and applicant has specifically indicated the mode(s) or method(s) of transportation services to be provided.

2. Program budget is defined, and applicant has indicated that grant funds will be sufficient to completely implement the program.

3. Program staffing plan is defined, and applicant has indicated that there will be adequate staffing for delivery of transportation services according to program scope.

4. Program timeframe for implementation is defined, and applicant has indicated that the delivery of transportation services will be timely.

(2) VA will award up to 30 points based on the program’s evaluation plan, as demonstrated by the following:

1. Measurable goals for determining the success of delivery of transportation services.

2. Ongoing assessment of (a), with a means of adjusting the program if required.

(3) VA will award up to 20 points based on the applicant’s community relationships in the areas to be serviced, as demonstrated by the following:

1. Applicant has existing relationships with state or local agencies or private entities, or will develop such relationships, and has shown these relationships will enhance the program’s effectiveness.

2. Applicant has established past working relationships with state or local agencies or private entities which have provided services similar to those offered by the program.

(4) VA will award up to 10 points based on the innovative aspects of the program, as demonstrated by the following:

1. How it will identify and serve veterans who otherwise would be unable to obtain care.

2. How program will utilize or integrate existing public resources (VA, State, or Other).

(B) Initial Grant Selection: VA will use the following process to award initial grants:

(1) VA will rank those applications who receive at least the minimum amount of total points and points per category set forth in the Notice of Fund Availability. The applications will be ranked in order from highest to lowest scores.

(2) VA will use the grantee’s ranking as the basis for selection for funding. VA will fund the highest ranked grantees for which funding is available.

(C) Renewal Grant Scoring: Renewal applications will be scored using the following selection criteria:

(1) VA will award up to 55 points based on the success of the grantee’s program, as demonstrated by the following:

1. Application shows that the grantee provided transportation services which allowed participants to be provided medical care timely and as scheduled.

2. Application shows that participants were satisfied with the transportation services provided by the grantee, as described in the Notice of Fund Availability.

(2) VA will award up to 35 points based on the cost effectiveness of the program, as demonstrated by the following:

1. The grantee administered the program on budget.

2. Grant funds were utilized in a sensible manner, as interpreted by information provided by the grantee to VA under § 17.725(a)(1) through(a)(7).

(3) VA will award up to 15 points based on the extent to which the program complied with:

1. The grant agreement

2. Applicable laws and regulations.

(D) Renewal Grant Selection: VA will use the following process to award renewal grants:

(1) VA will rank those grantees who receive at least the minimum amount of total points and points per category set forth in the Notice of Fund Availability. The grantees will be ranked in order from highest to lowest scores.

(2) VA will use the grantee’s ranking as the basis for selection for funding. VA will fund the highest-ranked grantees for which funding is available.

(Authority: Pub. L. 111-163, 38 U.S.C. 501)

6. Award Administration Information

1. Notice of Award

Successful applicants will receive a Notice of Award (NoA) signed and dated by the Veterans Transportation Program Office that will set forth the amount of the award and other pertinent information. The award will also include standard Terms and Conditions. Potential applicants should be aware that special requirements could apply to awards based on the particular circumstances based on deficiencies identified in the application by the review panel.

The NoA is the legal document issued to notify the awardee that an award has been made and that funds may be requested. The NoA will be sent through the U.S. Postal Service to the awardee organization as listed on its SF424. Any communication between the Veterans Transportation Program Office and awardees prior to the issuance of the NoA is not authorization to begin performance on the project.

Unsuccessful applicants will be notified by letter, sent through the U.S. Postal Service to the applicant organization as listed on its SF 424.

2. Grant Agreements

General: After an applicant is selected for a grant in accordance with § 17.05(b) or § 17.05(d), VA will draft a grant agreement to be executed by VA and the grantee. Upon execution of the grant agreement, VA will obligate the approved amount. The grant agreement will provide that:

1. The grantee must operate the program in accordance with the provisions of this section and the grant application.

2. If a grantee’s application identified a subrecipient, such subrecipient must operate the program in accordance with the provisions of this section and the grant application.

3. If a grantee’s application identified that funds will be used to procure or operate vehicles to directly provide transportation services, the following requirements must be met:

1. Title to the vehicles must vest solely in the grantee, or with leased vehicles in an identified lender.

2. The grantee must at a minimum, provide motor vehicle liability insurance for the vehicles to the same extent they would insure vehicles procured with their own funds.

3. All vehicle operators must be licensed in a U.S. State or Territory to operate such vehicles.

4. Vehicles must be safe and maintained in accordance with the manufacturer’s recommendations.

5. Vehicles must be operated in accordance with applicable Department of Transportation regulations concerning transit requirements under the Americans with Disabilities Act.

(Authority: Pub. L. 111-163, 38 U.S.C. 501)

Additional Requirements

Applicants selected for awards must agree to comply with additional legal requirements upon acceptance of an award, as applicable among the bulleted listing provided below. VA strongly encourages applicants to review the information pertaining to these additional requirements prior to submitting an application.

Veteran Service Organizations and identified subrecipients are subject to the Uniform Administrative Requirements for Grants and Agreements With Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations under 38 CFR part 49, as well as to OMB Circular A-122, Cost Principles for Non-Profit Organizations, codified at 2 CFR part 230, and 2 CFR parts 25 and 170, if applicable.

State Veteran Service Agencies and identified subrecipients are subject to the Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments under 38 CFR part 43, as well as to OMB Circular A-87, Cost Principles for State, Local, and Indian Tribal Governments, and 2 CFR parts 25 and 170, if applicable.

• All grantees and identified subrecipients must operate vehicles in accordance with applicable Department of Transportation regulations concerning transit requirements under the Americans with Disabilities Act

• Access to Records (2 CFR Part 215 & A-102)

• Awarding Agency Reporting Requirements (A-102)

• Faith-Based and Other Community Organizations

• Confidentiality

• Davis-Bacon Act (2 CFR Part 215)

• Debarment and Suspension (2 CFR Part 215 & A-102)

• Equal Employment Opportunity (2 CFR Part 215)

• Energy Policy and Conversation Act (A-102)

• Anti-Lobbying Act

• Financial and Government Audit Requirements

• National Environmental Policy Act (NEPA)

• VA Information Technology Standards (if applicable)

• Single Point of Contact Review

• Non-Supplanting of State or Local Funds

• Criminal Penalty for False Statements

• Suspension or Termination of Funding

• Nonprofit Organizations

• For-profit Organizations

• Government Performance and Results Act (GPRA)

• Records Retention Requirements (A-102)

• Rights in Intellectual Property

• Rights to Inventions (2 CFR Part 215 & A-102)

• Termination (A-102)

• Federal Funding Accountability and Transparency Act (FFATA) of 2006

• Awards in Excess of $5,000,000 – Federal Taxes Certification Requirement

• Active SAM Registration (formerly CCR)

Reporting (Frequency and Means of Submission)

A. Progress Reports

Awardees must agree to cooperate with any federal evaluation of the program and provide required quarterly, semi-annual (every six-months), annual and final (at the end of the grant) reports in a form prescribed by VTP. Reports will be submitted electronically. These reports will outline how grant funds were used, describe program progress, and describe any barriers and measurable outcomes.

B. Program Monitoring

The Veterans Transportation Program will do program monitoring. All awardees will be required to cooperate in providing the necessary data elements to the VTP. The goal of program monitoring is to ensure program requirements are met by tracking performance and providing for early detection of quality problems. The program monitoring can include: monitoring personnel, procurement, and property; collecting, analyzing data, and assessing quality of care; assessing costs and utilization; and assisting with awardee implementation. Site visit monitoring will include the above, in addition to safety assessments, driver’s license checks and vehicle insurance.

C. Federal Financial Report

Awardees are required to submit the FFR SF 425 on quarterly basis. More details will be announced in the Notice of Award.

D. Audit Requirements

Awardees must comply with the audit requirements of Office of Management and Budget (OMB) Circular A-133. Information on the scope, frequency and other aspects of the audits can be found on the internet at www.whitehouse.gov/omb/circulars.

E. Notice of New Post-Award Reporting Requirements

Applicants should anticipate that all recipients (other than individuals) of awards of $25,000 or more under this solicitation, consistent with the Federal Funding Accountability and Transparency Act of 2006 (FFATA), will be required to report award information on any first-tier subawards totaling $25,000 or more, and, in certain cases, to report information on the names and total compensation of the five most highly compensated executives of the recipient and first-tier subrecipients. Each applicant entity must ensure that it has the necessary processes and systems in place to comply with the reporting requirements should it receive funding.

It is expected that reports regarding subawards will be made through the Federal Funding Accountability and Transparency Act (FFATA) Subaward Reporting System Funding Accountability and Transparency Act Subaward Reporting System (FSRS), found at https://www.fsrs.gov. The FFATA Subaward Reporting System is the reporting tool Federal prime awardees (i.e. prime contractors and prime grants recipients) use to capture and report subaward and executive compensation data regarding their first-tier subawards to meet the FFATA reporting requirements. Prime contract awardees will report against sub-contracts awarded and prime grant awardees will report against sub-grants awarded. Prime Contractors awarded a Federal contract or order that is subject to Federal Acquisition Regulation clause 52.204-10 (Reporting Executive Compensation and First-Tier Subcontract Awards) are required to file a FFATA subaward report by the end of the month following the month in which the prime contractor awards any subcontract greater than $25,000.

Please note also that applicants should anticipate that no subaward of an award made under this solicitation may be made to a subrecipient (other than an individual) unless the potential subrecipient acquires and provides a Data Universal Numbering System (DUNS) number.

VII Agency Contact

For general program information, as well as proposal-specific questions please send an email to Sylvester.Wallace2@va.gov or Contact Darren Wallace at (404) 828-5380.

VIII Other Information

None

VA Form 10-10055
MAR 2013