State PCO NOFO HRSA-2019 - 2024 FINAL - Attachment I

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Bureau of Health Workforce
Division of Policy and Shortage Designation
State Primary Care Offices
Funding Opportunity Number: HRSA-19-005
Funding Opportunity Type: New, Competing Continuation
Catalog of Federal Domestic Assistance (CFDA) Number 93.130
NOTICE OF FUNDING OPPORTUNITY
Fiscal Year 2019

Application Due Date: November 5, 2018
Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately!
HRSA will not approve deadline extensions for lack of registration.
Registration in all systems, including SAM.gov and Grants.gov,
may take up to 1 month to complete.
Issuance Date: August 7, 2018
Matthew Salaga
Management Analyst, Division of Policy and Shortage Designation
Telephone: (301) 945-0194
Fax: (301) 443-4370
Email: MSalaga@hrsa.gov
Authority: Sections 330(l), 330(m), and 333(d) of the Public Health Service Act as amended

EXECUTIVE SUMMARY
The Health Resources and Services Administration (HRSA) is accepting applications for
fiscal year (FY) 2019 State Primary Care Offices (PCOs) program. The purpose of this
program is to assist states and/or territories in their efforts to improve primary care
service delivery, conduct a health provider needs assessment, manage shortage
designation, and address workforce availability in the various states and/or territories to
meet the needs of underserved populations.
Funding Opportunity Title:
Funding Opportunity Number:
Due Date for Applications:
Anticipated Total Annual Available
FY19 Funding:
Estimated Number and Type of Award(s):
Estimated Award Amount:
Cost Sharing/Match Required:
Period of Performance:
Eligible Applicants:

State Primary Care Offices
HRSA-19-005
November 5, 2018
$11,000,000
Up to 54 cooperative agreements
Formula awards, varies
No
April 1, 2019 through March 31, 2024
(5 years)
Eligible applicants include any State or
territory, State or territory agency, or
other statewide or territory-wide public or
nonprofit entity that operates solely within
a state or U.S. territory.
See Section III-1 of this notice of funding
opportunity (NOFO) for complete
eligibility information.

Application Guide
You (the applicant organization/agency) are responsible for reading and complying with
the instructions included in HRSA’s SF-424 R&R Application Guide, available online at
http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf, except where
instructed in this NOFO to do otherwise.

Technical Assistance
HRSA will hold a pre-application technical assistance (TA) webinar(s) for applicants
seeking funding through this opportunity. The webinar(s) will provide an overview of
pertinent information in the NOFO and an opportunity for applicants to ask questions.
Visit the HRSA Bureau of Health Workforce’s open opportunities website at
https://bhw.hrsa.gov/fundingopportunities/ to learn more about the resources available
for this funding opportunity.

HRSA-19-005

i

Table of Contents
I.

PROGRAM FUNDING OPPORTUNITY DESCRIPTION ....................................................... 1
1. PURPOSE .......................................................................................................................................... 1
2. BACKGROUND .................................................................................................................................. 1

II.

AWARD INFORMATION ............................................................................................................. 2
1. TYPE OF APPLICATION AND AWARD ............................................................................................... 2
2. SUMMARY OF FUNDING.................................................................................................................... 3

III.

ELIGIBILITY INFORMATION ..................................................................................................... 6
1. ELIGIBLE APPLICANTS ..................................................................................................................... 6
2. COST SHARING/MATCHING ............................................................................................................. 6
3. OTHER............................................................................................................................................... 6

IV.

APPLICATION AND SUBMISSION INFORMATION ............................................................. 6
1. ADDRESS TO REQUEST APPLICATION PACKAGE .......................................................................... 6
2. CONTENT AND FORM OF APPLICATION SUBMISSION .................................................................... 7
i. Project Abstract ................................................................................................................... 8
ii. Project Narrative .................................................................................................................. 8
iii. Budget .................................................................................................................................. 17
iv. Budget Justification Narrative ......................................................................................... 17
v. Attachments ........................................................................................................................ 17
3. DUN AND BRADSTREET DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER AND
SYSTEM FOR AWARD MANAGEMENT ................................................................................................. 19
4. SUBMISSION DATES AND TIMES.................................................................................................... 20
5. INTERGOVERNMENTAL REVIEW .................................................................................................... 20
6. FUNDING RESTRICTIONS ............................................................................................................... 20

V.

APPLICATION REVIEW INFORMATION ............................................................................... 21
1.
2.
3.
4.

VI.

REVIEW CRITERIA .......................................................................................................................... 21
REVIEW AND SELECTION PROCESS .............................................................................................. 24
ASSESSMENT OF RISK AND OTHER PRE-AWARD ACTIVITIES .................................................... 24
ANTICIPATED ANNOUNCEMENT AND AWARD DATES .................................................................. 24
AWARD ADMINISTRATION INFORMATION........................................................................ 25

1. AWARD NOTICES............................................................................................................................ 25
2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS ......................................................... 25
3. REPORTING..................................................................................................................................... 25
VII.

AGENCY CONTACTS ............................................................................................................... 27

VIII.

OTHER INFORMATION............................................................................................................. 28

IX.

TIPS FOR WRITING A STRONG APPLICATION ................................................................. 28

HRSA-19-005

ii

I. Program Funding Opportunity Description
1. Purpose
This notice solicits applications for the State Primary Care Offices (PCOs) program.
Program Purpose
The State PCOs program is intended to facilitate the coordination of activities within a
state or territory that assess the need for primary care services and providers, promote
the recruitment and retention of health care providers to fulfill identified needs, and
reduce shortages of health care providers. This includes working with other state or
territorial agencies, as well as organizations outside of the state whose policies affect
health care services.
Program Requirements
The State PCOs program is not intended to fund the direct delivery of services. The
purpose of this funding opportunity is to support states and territories in undertaking
the following overarching efforts:
1. Statewide Primary Care Needs Assessment
2. Technical Assistance and Collaboration
3. Shortage Designation Coordination
2. Background
This program is authorized by sections §330(l), 330(m), and 333(d) of the Public Health
Service Act as amended.
Throughout the U.S., there are geographic areas, populations, and facilities with too few
primary care, dental, and mental health providers and services. HRSA continues to
work with state and territory partners to determine which of these should be “shortage
designations,” and therefore eligible to receive certain federal resources. Shortage
designations help HRSA prioritize and focus agency resources on the areas of highest
need. PCOs play an integral role in the shortage designation process by conducting
needs assessments and tracking providers in their states and territories, then using that
firsthand knowledge to identify the highest need areas that qualify for shortage
designations. Since 2014, the PCOs worked diligently to stand up a new online system
for conducting shortage designation work, leading to the first across-the-board update in
November 2017 of 3,800 designations based on current standard national data sets. In
addition, the program has provided the agency—and individual PCOs—with
opportunities to highlight, disseminate, and discuss innovative solutions and best
practices to help address provider tracking, recruitment, and retention issues, with the
aim of improving access to care and reducing disparities.
The recipients of this funding will become vital partners in enabling HRSA to achieve the
mission of improving access to health care services for people who are uninsured,
isolated or medically vulnerable. HRSA is committed to maintaining and strengthening
partnerships to assist in expanding access to quality health care.
HRSA-19-005

1

Funding levels for FY 2019 – FY 2023 will be detailed in the Summary of Funding
section below.
Program Definitions
A glossary containing general definitions for terms used throughout the Bureau of
Health Workforce can be located at the Health Workforce Glossary. In addition, the
following definitions apply to the State PCOs program for Fiscal Year 2019:
National Plan and Provider Enumeration System (NPPES): The Administrative
Simplification provisions of the Health Insurance Portability and Accountability Act of
1996 mandated the adoption of standard unique identifiers for health care providers and
health plans. The purpose of these provisions is to improve the efficiency and
effectiveness of the electronic transmission of health information. The Centers for
Medicare & Medicaid Services (CMS) has developed the NPPES to assign these
unique identifiers.
NPPES National Provider Identifier (NPI) Registry: Healthcare providers acquire a
unique 10-digit NPI to identify themselves in a standard way throughout their industry.
Individuals or organizations apply for NPIs through the CMS NPPES. After an NPI is
supplied, CMS publishes the parts of the NPI record that have public relevance,
including the provider's name, specialty (taxonomy), and practice address. CMS
provides this service based on federal law (45 CFR Part 162).

II.

Award Information

1. Type of Application and Award
Type(s) of applications sought: New, Competing Continuation
HRSA will provide funding in the form of a cooperative agreement. A cooperative
agreement is a financial assistance mechanism where substantial involvement is
anticipated between HRSA and the recipient during performance of the contemplated
project.
In addition to the usual monitoring and technical assistance provided under the
cooperative agreement, HRSA program involvement will include:





Guidance and policy interpretation of authorizing statutes and implementing
regulations that govern shortage designation;
Participation, as appropriate, in workgroups conducted during the period of the
Cooperative Agreement;
Monitoring the activities of the work plan through progress review, meetings, and
teleconferences;
Serving as the final authority on National Health Service Corps (NHSC) Site
Applications;

HRSA-19-005

2




Serving as the final authority on shortage designation applications; and
Evaluating Needs Assessments and all other activity required under this
Cooperative Agreement.

The cooperative agreement recipient’s responsibilities will include:
 Adhering to HRSA guidelines pertaining to acknowledgement and disclaimer on all
products produced by HRSA award funds, per Section 2.2 of the R&R Application
Guide (Acknowledgement of Federal Funding);
 Completing activities proposed in response to the program requirements described
in Section IV of this NOFO;
 Maintaining communication with the Project Officer.
o Participate in face-to-face meetings and conference calls with the federal
Project Officer during the period of performance.
o Collaborate with the federal Project Officer on ongoing review of activities,
procedures and budget items;
 Conducting a statewide assessment to identify health care providers and health
service shortages, unmet need and disparities in health outcomes by areas and
population groups, and health workforce concerns;
 Coordinating the Health Professional Shortage Area (HPSAs) and Medically
Underserved Area/Population (MUA/P) designation processes within the state to
ensure consistent and accurate assessment of underservice including data
collection, verification, and analysis as applicable;
 Providing technical assistance and collaboration to expand access to primary
care, including: coordination of the NHSC and NURSE Corps programs and
provider recruitment and retention; collaboration with Health Center planning and
development; and collaboration with other HRSA partners and organizations to
support access to primary care services; and
 Developing a statewide, long-term strategic plan to reduce health provider
shortages and shortage designations.
2. Summary of Funding
HRSA expects approximately $11,000,000 to be available annually to fund
approximately 54 recipients. Ceiling amounts will vary (see below), and will include
direct, indirect, facilities, and administrative costs. The period of performance is April 1,
2019 through March 31, 2024 (5 years). Funding beyond the first year is dependent on
the availability of appropriated funds for the State PCOs program in subsequent fiscal
years, satisfactory recipient performance, and a decision that continued funding is in the
best interest of the Federal Government.
All HRSA awards are subject to the Uniform Administrative Requirements, Cost
Principles and Audit Requirements at 45 CFR part 75.
As referenced in the Background section of the NOFO, the following is the funding
methodology that will be applied. Each awardee has a base annual funding amount of
$150,000 per year plus workload funding amount whereas:

HRSA-19-005

3

Annual Funding Amount = Base Funding + [(Total Workload Funding) x (Workload
Units/Total Workload Units)]





Base Funding is $150,000 x 54 recipients = $8,100,000
Total Workload Funding is $11,000,000 – $8,100,000 = $2,900,000
Workload Units include the number of providers in eligible disciplines listed
in the National Plan and Provider Enumeration System National Provider
Identifier Registry in your state/territory as of April 24, 2018.
Total Workload Units include the total number of all Workload Units for each of
the 54 states and territories.

HRSA intends to make awards to cover every state and territory listed. HRSA aims to
award one cooperative agreement to each individual state, territory or group of states
and/or territories to achieve this goal. Please note that if you are applying to represent
a group of states and/or territories, you are eligible for the base annual funding amount
of $150,000 in addition to the annual workload unit funding amount associated with the
states and/or territories represented as shown in the chart below.
Using the stated funding methodology, a state/territory/consortium with 1000
Workload Units will request the following in annual funding:
$150,000 + [$2,900,000 x (1000/1,055,889)] = $152,747 Annual Funding

State/Territory

AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL

HRSA-19-005

Workload Units by State/Territory
Workload Units
Annual Workload
Funding
2,821
8,759
7,088
42
16,757
150,462
18,424
17,685
6,152
3,044
52,564
4
21,904
176
5,603
8,768
4,890
43,702

4

$7,748
$24,057
$19,467
$115
$46,023
$413,244
$50,602
$48,572
$16,896
$8,360
$144,367
$11
$60,159
$483
$15,389
$24,081
$13,430
$120,028

IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MP
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Total for All PCOs

HRSA-19-005

17,114
10,629
12,580
11,917
42,889
22,822
6,953
1
43,941
20,542
18,014
53
5,744
3,278
28,894
2,679
5,509
4,590
29,208
8,032
7,216
93,443
37,863
10,311
15,521
42,566
11,978
8
5,577
11,626
2,154
15,513
54,426
9,715
23,539
169
3,128
23,239
16,823
4,914
1,926
1,055,889

5

$47,004
$29,193
$34,551
$32,730
$117,795
$62,681
$19,096
$3
$120,684
$56,419
$49,475
$146
$15,776
$9,003
$79,357
$7,358
$15,130
$12,606
$80,220
$22,060
$19,819
$256,641
$103,991
$28,319
$42,628
$116,908
$32,898
$22
$15,317
$31,931
$5,916
$42,606
$149,481
$26,682
$64,650
$464
$8,591
$63,826
$46,204
$13,496
$5,290
$2,900,000

III.

Eligibility Information

1. Eligible Applicants
Eligible applicants include any State or territory, State agency, or other statewide public
or nonprofit entity that operates solely within a state or U.S. territories. In addition to the
50 states, only the District of Columbia, Guam, the Commonwealth of Puerto Rico, the
Northern Mariana Islands, American Samoa, the U.S. Virgin Islands, the Federated
States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau
may apply. Applicants must provide state/territory-wide coverage of primary health care
issues and represent or have relationships with the broad range of primary health care
delivery systems and programs in the state.
2. Cost Sharing/Matching
Cost sharing/matching is not required for this program.
3. Other
Ceiling Amount
HRSA will consider any application that exceeds the ceiling amount non-responsive and
will not consider it for funding under this notice.
Deadline
HRSA will consider any application that fails to satisfy the deadline requirements
referenced in Section IV.4 non-responsive and will not consider it for funding under this
notice.
Multiple Applications
NOTE: Multiple applications from an organization are not allowable.
If for any reason (including submitting to the wrong funding opportunity number or
making corrections/updates), an application is submitted more than once prior to the
application due date, HRSA will only accept your last validated electronic submission,
under the correct funding opportunity number, prior to the Grants.gov application due
date as the final and only acceptable application.
Failure to include all required documents as part of the application may result in an
application being considered incomplete or non-responsive.

IV.

Application and Submission Information

1. Address to Request Application Package
HRSA requires you to apply electronically through Grants.gov. HRSA encourages you
to apply through Grants.gov using the SF-424 Research and Related (R&R) workspace
application package associated with this NOFO following the directions provided at
https://www.grants.gov/applicants/apply-for-grants.html.
HRSA-19-005

6

If you’re reading this NOFO (also known as “Instructions” on Grants.gov) and reviewing
or preparing the workspace application package, you will automatically be notified in the
event HRSA changes and/or republishes the NOFO on Grants.gov before its closing
date. Responding to an earlier version of a modified notice may result in a less
competitive or ineligible application. Please note, you are ultimately responsible for
reviewing the For Applicants page for all information relevant to desired opportunities.
2. Content and Form of Application Submission
Section 4 of HRSA’s SF-424 R&R Application Guide provides instructions for the
budget, budget justification, staffing plan and personnel requirements, assurances,
certifications, and abstract. You must submit the information outlined in the SF-424
R&R Application Guide in addition to the program specific information below. You are
responsible for reading and complying with the instructions included in HRSA’s SF-424
R&R Application Guide except where instructed in the NOFO to do otherwise. You
must submit the application in the English language and in terms of U.S. dollars (45
CFR § 75.111(a)).
See Section 8.5 of the SF-424 R&R Application Guide for the Application Completeness
Checklist.
Application Page Limit
The total size of all uploaded files may not exceed the equivalent of 65 pages when
printed by HRSA. The page limit includes the abstract, project and budget narratives,
attachments including biographical sketches (biosketches), and letters of commitment
and support required in HRSA’s SF-424 R&R Application Guide and this NOFO.
Standard OMB-approved forms that are included in the workspace application package
do NOT count in the page limit. Biographical Sketches do count in the page limit.
Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count
in the page limit. We strongly urge you to take appropriate measures to ensure
your application does not exceed the specified page limit.
Applications must be complete, within the specified page limit, and validated by
Grants.gov under the correct funding opportunity number prior to the deadline to
be considered under this notice.
Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification
1) The prospective recipient certifies, by submission of this proposal, that neither it
nor its principals is presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from participation in this transaction by
any federal department or agency.
2) Failure to make required disclosures can result in any of the remedies described
in 45 CFR § 75.371, including suspension or debarment. (See also 2 CFR parts
180 and 376, and 31 U.S.C. 3321).
3) Where the prospective recipient is unable to attest to any of the statements in
this certification, an explanation shall be included in Attachment 9: Other
Relevant Documents.

HRSA-19-005

7

See Section 4.1 viii of HRSA’s SF-424 R&R Application Guide for additional information
on all certifications.
Program-Specific Instructions
In addition to application requirements and instructions in Section 4 of HRSA’s SF-424
R&R Application Guide (including the budget, budget justification, staffing plan and
personnel requirements, assurances, certifications, and abstract), include the following:
i.
Project Abstract
See Section 4.1.ix of HRSA’s SF-424 R&R Application Guide.
The Abstract must include:
1. A brief overview of the project as a whole.
2. Specific, measurable objectives that the project will accomplish, including
those pertaining to long-term strategic plans to recruit and retain health care
providers and to reduce health care provider shortages.
3. How the proposed project for which funding is requested will be
accomplished, i.e., the "who, what, when, where, why and how" of a project.
ii.

Project Narrative

This section provides a comprehensive framework and description of all aspects of the
proposed project. It should be succinct, self-explanatory and well organized so that
reviewers can understand the proposed project.
Successful applications will contain the information below. Please use the following
section headers for the narrative:
 PURPOSE AND NEED -- Corresponds to Section V’s Review Criterion #1
Briefly describe the purpose of the proposed project. Outline the needs of the program
or institution. You should include a discussion of the target population served by this
segment of the health workforce, as well as the socio-cultural determinants of health
and health disparities impacting the population or communities served and/or unmet.
Use and cite demographic data whenever possible to support the information provided.
This section will help reviewers understand the organization, as well as the needs of the
communities ultimately served by the proposed project.
This section describes the needs of your proposed program or institution and outlines
why a cooperative agreement would assist you in fulfilling those needs. To receive the
maximum score for this section, applicants must include the following:



HRSA-19-005

A brief statement of the purpose of the proposed project, outlining the
needs of your proposed program or institution;
An outline of the goals of your program or institution (e.g., to identify areas
of need in your state, assist in recruitment and retention of health care
providers, to better assess conditions related to shortage designation, or
other health workforce-related activities); and
8



Citations, wherever appropriate, to verifiable demographic data to support
the information provided (e.g., data from a government agency).



RESPONSE TO PROGRAM PURPOSE -- This section includes three sub-sections
— (a) Work Plan; (b) Methodology/Approach; and (c) Resolution of Challenges—all
of which correspond to Section V’s Review Criteria #2 (a), (b), and (c).



(a) WORK PLAN -- Corresponds to Section V’s Review Criterion #2 (a).
You must provide a detailed work plan that demonstrates your experience
implementing a project of the proposed scope (a sample work plan can be found
here: http://bhw.hrsa.gov/grants/technicalassistance/workplantemplate.docx.)
Your work plan must provide a detailed description of the activities or steps you
will use to achieve each of the objectives proposed during the entire period of
performance. This description should include the timeframes, deliverables, and
key partners required during the period of performance to address each of the
needs described in the Purpose and Need section. Explain how the work plan is
appropriate for the program design and how the targets fit into the overall timeline
of project implementation. Identify meaningful support and collaboration with key
stakeholders in planning, designing and implementing all activities and, further, the
extent to which these contributors address the cultural, racial, linguistic and/or
geographic diversity of the populations and communities served.
In addition, the work plan should specifically address your proposals regarding the
following:
1. Statewide Primary Care Needs Assessment. During the first two years of the
period of performance, each recipient is expected to conduct an overall statewide
primary care needs assessment that identifies the communities with the greatest
unmet health care needs, disparities, and health workforce shortages, and also
identifies the key barriers to access health care for these communities. Verifiable
demographic data should be used and cited whenever possible to support the
information provided. In addition, information about state and federal programs,
the economic and fiscal factors in the state or territory, telehealth use and
demand, and any other relevant data and other points that will affect a state or
territory in reaching the program goals is expected as part of the Needs
Assessment.
To receive the maximum score for this section, you must address the following:
a. A description of the target populations in your state or territory and their
unmet health needs, including:
 An analysis of standard mortality and morbidity rates among
geographic areas and/or target populations at the county and
subcounty level (applicants may include infant mortality or low-birth
rates in addition to standard mortality rates, if relevant to a specific
area or population);
 An analysis of poverty rates in your state or territory using generally

HRSA-19-005

9






accepted measures (e.g., the Federal poverty rate or concentrations of
individuals on Medicaid or other social assistance programs);
A brief description of unmet health needs in your state or territory,
including any updates or newly-emerging medical challenges since the
issuance of the previous awards under this title;
A brief description of health disparities within your state/territory (e.g.,
disparities based on race, ethnicity, sex, gender identity, sexual
orientation, geography, socioeconomic status, disability status, primary
language, health literacy, or other factors relevant to your area or target
population); and
Citations to verifiable demographic data to support the information
provided (e.g., data from a U.S. government agency or survey).

b. A discussion of any relevant barriers in the service area that the project
will work to overcome, including:
 A description of infrastructure challenges in your state or territory
(e.g. access to transportation, technological barriers, water
fluoridation, etc.);
 A description of challenges facing target populations in your state or
territory (e.g., waiting time to receive care, linguistic barriers, socioeconomic factors, etc.);
 A description of challenges facing health care providers (e.g., cultural
competence, insufficient availability of training, or key shortages of
certain provider types);
 A description of the political and/or fiscal climate in the state or
territory, or other possible issues that may affect your ability to
achieve the goals of this cooperative agreement; and
 If relevant, applicants may include information about State/Federal
programs that may affect your ability to achieve the goals of this
cooperative agreement.
c. A plan that provides for ongoing collaboration with recipients or
stakeholders in your state or territory, including:
 A plan to partner with at least two external stakeholders (e.g. public
health organizations, agencies or associations, health care facilities,
local health departments, State Health Departments, or members of
communities with higher levels of need) to effectively identify health
needs in your state or territory;
 A description of what input external stakeholders will provide in the
development of the Needs Assessment; and
 A plan and/or timeline for meeting with external stakeholders to
review and update the Needs Assessment, and conduct ongoing
assessments of health needs in your state or territory.
2. Shortage Designation Coordination. Recipients will be required to
coordinate the HPSA and MUA/P designation process within the state/territory
to ensure consistent and accurate assessment of underservice, including data
collection, verification, and analysis as applicable. The recipient will use the
HRSA-19-005

10

Shortage Designation Management System (SDMS) to manage health
workforce data for their state/territory and apply for HPSAs and MUAs/Ps.
HRSA uses SDMS to review shortage designation applications, communicate
with the awardees on specific applications, and make final shortage designation
determinations. HRSA bases SDMS business rules on shortage designation’s
governing statutes and regulations, as well as our own policies and procedures.
Note that recipients will be required to establish Rational Service Area
Plans covering their entire state/territory by year 4 of the period of
performance. The work plan should outline how this will be accomplished and
include specific annual benchmarks which can be measured to evaluate
progress.
The work plan should specifically demonstrate that the awardee is expected to
coordinate all shortage designation requests including the following:










Providing technical assistance to organizations or communities about
the designation process;
Updating existing designations and apply for new HPSA and MUA/P
designations as needed;
Ensuring that designation applications are supported with the most
up-to-date and appropriate data;
Proactively seeking designations for areas and populations with
access to care barriers as demonstrated by primary care, dental, or
mental health provider shortages or other high need indicators as
detailed in the HPSA regulations;
Maintaining knowledge of how to submit complete and accurate
HPSA and MUA/P designation applications using current procedures;
Participating in DPSD training programs (in conjunction with awardee
meetings or other meetings) or distance learning training (web-based
training modules, videoconferences, etc.) as deemed appropriate by
DPSD staff, including, but not limited to, an annual Reverse Site Visit;
and
Submitting work products by the due date specified by DPSD staff.

3. Efforts to Expand Access to Primary Care. Recipients should outline
plans for the following:
a. Recruitment and Retention Activities, including:




HRSA-19-005

Supporting outreach and education that encourages participation in
programs which help sites recruit providers to work in underserved
areas of the State. Efforts may include, but are not limited to,
distributing program information by BHW, speaking about the BHW
programs at schools in state, and distributing program materials at
public events;
Offering technical assistance to potential and current NHSC sites in
the pre-application phase of submitting an NHSC Site Application;
Maintaining knowledge and capacity to review NHSC Site Application
11



for merit (community support and need for site in the area) and
completeness (including required supporting documentation and
HPSA designation), as appropriate and desired. (Note: Final
documentation on site approval rests with HRSA); and
Coordinating and collaborating with other state agencies and state
recruitment efforts to incorporate resources including NHSC Scholars,
Loan Repayors, and State Loan Repayors, and/or other scholar and
loan repayment programs) into the state’s strategy to increase the
number of health professionals serving in HPSAs and MUA/Ps.

b. Collaboration in Health Center Planning and Development; including:








Collaborating with the state PCA and other interested entities by
providing information to assist in the development of new and
expansion of existing health centers in the State;
Serving as the point of contact to the PCA and other entities for
access to and use of relevant data to support applications for new
and expanded capacity of health centers;
Facilitating the ability of PCAs and other entities to work with various
divisions of the State Health Department to obtain data needed to
educate leaders about unmet needs and the role of health centers
and the safety net in addressing these needs, as well as the
sustainability needs of health centers;
Working with PCA, State Offices of Rural Health (SORH), Area Health
Education Centers, State Health Departments, and other entities to
seek ways through which partnerships can be maintained and
strengthened to assist with the growth and support of health centers
and to encourage the provision of quality care; and
Working with PCA, SORH, and other entities to develop reciprocal
mechanisms of communication, information dissemination, follow-up,
and referral to organizations seeking 330 and other funding
opportunities.

c. Collaboration with Other HRSA Partners and Organizations to Support
Access to Primary Care Services, including:





HRSA-19-005

Collaborating with other HRSA-supported entities, (e.g., the state
PCA, the SORH, and/or other appropriate entities) to provide
technical assistance to communities and organizations interested in
expanding access to care and to maximize the effectiveness and
impact of activities through formal linkages with diverse entities
working to strengthen the safety net in the state/region;
Collecting, maintaining, and reporting on the number of J-1 visa
waiver clinicians and other similar programs practicing in the state;
and
Supporting and enhancing access to comprehensive, culturally
competent, quality primary health care services for underserved and
vulnerable populations.
12

4. A strategic, long-term plan to reduce health provider shortages and shortage
designations. Your work plan should include a section with specific objectives and
timetables for reducing health provider shortages in key areas, thereby reducing the
number of Health Professional Shortage Area designations, and the overall need
within such designations, in your state or territory.

 (b) METHODOLOGY/APPROACH -- Corresponds to Section V’s Review Criterion
#2 (b).
You must describe your objectives and proposed activities, and provide evidence
for how they link to the project purpose and stated needs. Propose methods that
you will use to address the stated needs and meet each of the previously
described program requirements and expectations in this NOFO. As appropriate,
include development of effective tools and strategies for ongoing staff training,
outreach, collaborations, clear communication, and information
sharing/dissemination with efforts to involve patients, families and communities, if
applicable. If applicable, include a plan to disseminate reports, products, and/or
project outputs so project information is provided to key target audiences. Explain
why your project is innovative and provide the context for why it is innovative.
Additionally, you must submit a logic model for designing and managing the
project. A logic model is a one-page diagram that presents the conceptual
framework for a proposed project and explains the links among program elements
to achieve the relevant outcomes. While there are many versions of logic models,
for the purposes of this notice the logic model should summarize the connections
between the:





Goals of the project (e.g., objectives, reasons for proposing the intervention, if
applicable);



Assumptions (e.g., beliefs about how the program will work and support
resources. Base assumptions on research, best practices, and experience);



Inputs (e.g., organizational profile, collaborative partners, key staff, budget,
other resources);



Target population (e.g., the individuals to be served);



Activities (e.g., approach, listing key intervention, if applicable);



Outputs (i.e., the direct products or deliverables of program activities); and



Outcomes (i.e., the results of a program, typically describing a change in
people or systems).

(c) RESOLUTION OF CHALLENGES -- Corresponds to Section V’s Review Criterion
#2 (c)
Discuss challenges that you are likely to encounter in designing and implementing
the activities described in the work plan, and approaches that you will use to
resolve such challenges.

HRSA-19-005

13



IMPACT -- This section includes two sub-sections— (a) Evaluation and Technical
Support Capacity; and (b) Project Sustainability—both of which correspond to
Section V’s Review Criteria #3 (a) and (b).

 (a) EVALUATION AND TECHNICAL SUPPORT CAPACITY -- Corresponds to
Section V’s Review Criterion #3 (a)
You must describe the plan for program performance evaluation that will contribute
to continuous quality improvement. The program performance evaluation must
monitor ongoing processes and progress toward meeting goals and objectives of
the project. Include descriptions of the inputs (e.g., key evaluation staff and
organizational support, collaborative partners, budget, and other resources); key
processes; variables to be measured; expected outcomes of the funded activities;
and a description of how all key evaluative measures will be reported. (In the
Attachments section (IV. 2. v., Attachment 2, you must attach a complete staffing
plan and job descriptions for key personnel. Bio sketches of Key Personnel
should be uploaded in the SF-424 R&R Senior/Key Person Profile form.) You
must demonstrate evidence that the evaluative measures selected will be able to
assess: 1) the extent to which the program objectives have been met, and 2) the
extent to which these can be attributed to the project.
You must also describe the systems and processes that will support your
organization's collection of HRSA’s performance measurement requirements for
this program. At the following link, you will find the required data forms for this
program: http://bhw.hrsa.gov/grants/reporting/index.html. Describe the data
collection strategy to collect, manage, analyze and track data (e.g., assigned
skilled staff, data management software) to measure process and
impact/outcomes, and explain how the data will be used to inform program
development and service delivery in a way that allows for accurate and timely
reporting of performance outcomes. Describe current experience, skills, and
knowledge, including individuals on staff, materials published, and previous work
of a similar nature. You must describe any potential obstacles for implementing
the program performance evaluation and meeting HRSA’s performance
measurement requirements and your plan to address those obstacles. The
evaluation and reporting plan also should indicate the feasibility and effectiveness
of plans for dissemination of project results, the extent to which project results
may be national in scope, and the degree to which the project activities are
replicable.
 (b) PROJECT SUSTAINABILITY -- Corresponds to Section V’s Review Criterion
#3 (b)
You must provide a clear plan for project sustainability after the period of federal
funding ends, including a description of specific actions you will take to (a)
highlight key elements of your projects, e.g., training methods or strategies, which
have been effective in improving practices; (b) obtain future sources of potential
funding, as well as (c) provide a timetable for becoming self-sufficient. Recipients
are expected to sustain key elements of their projects, e.g., strategies or services

HRSA-19-005

14

and interventions, which have been effective in improving practices and those that
have led to improved outcomes for the target population. You must discuss
challenges that are likely to be encountered in sustaining the program and
approaches that will be used to resolve such challenges.

 ORGANIZATIONAL INFORMATION, RESOURCES AND CAPABILITIES -Corresponds to Section V’s Review Criterion #4
Succinctly describe your capacity to effectively manage the programmatic, fiscal, and
administrative aspects of the proposed project. Provide information on your
organization’s current mission and structure, including an organizational chart, relevant
experience, and scope of current activities, and describe how these elements all
contribute to the organization’s ability to conduct the program requirements and meet
program expectations. (A project organizational chart is requested in Section IV.2.v,
Attachment 4.) Discuss how the organization will follow the approved plan, as outlined
in the application, properly account for the federal funds, and document all costs so as
to avoid audit findings. Describe how the unique needs of target populations of the
communities served are routinely assessed and improved.
The staffing plan and job descriptions for key faculty/staff must be included in
Attachment 2 (Staffing Plan and Job Descriptions for Key Personnel). However, the
biographical sketches must be uploaded in the SF-424 RESEARCH & RELATED
Senior/Key Person Profile form that can be accessed in the Application Package under
“Mandatory.” Include biographical sketches for persons occupying the key positions,
not to exceed TWO pages in length each. In the event that a biographical sketch is
included for an identified individual who is not yet hired, please include a letter of
commitment from that person with the biographical sketch. When applicable,
biographical sketches should include training, language fluency, and experience
working with diverse populations that are served by their programs.
Biographical sketches, not exceeding two pages per person, should include the
following information:


Senior/key personnel name



Position Title



Education/Training - beginning with baccalaureate or other initial professional
education, such as nursing, including postdoctoral training and residency training
if applicable:
o Institution and location
o Degree (if applicable)
o Date of degree (MM/YY)
o Field of study



Section A (required) Personal Statement. Briefly describe why the individual’s
experience and qualifications make him/her particularly well-suited for his/her role
(e.g., PD/PI) in the project that is the subject of the award.

HRSA-19-005

15



Section B (required) Positions and Honors. List in chronological order previous
positions, concluding with the present position. List any honors. Include present
membership on any Federal Government public advisory committee.



Section C (optional) Peer-reviewed publications or manuscripts in press (in
chronological order). You are encouraged to limit the list of selected peerreviewed publications or manuscripts in press to no more than 15. Do not include
manuscripts submitted or in preparation. The individual may choose to include
selected publications based on date, importance to the field, and/or relevance to
the proposed research. Citations that are publicly available in a free, online
format may include URLs along with the full reference (note that copies of publicly
available publications are not acceptable as appendix material).



Section D (optional) Other Support. List both selected ongoing and completed
(during the last 3 years) projects (federal or non-federal support). Begin with any
projects relevant to the project proposed in this application. Briefly indicate the
overall goals of the projects and responsibilities of the Senior/Key Person
identified on the Biographical Sketch.
NARRATIVE GUIDANCE
To ensure that you fully address the review criteria, this table provides a crosswalk
between the narrative language and where each section falls within the review
criteria.
Narrative Section

Review Criteria

Purpose and Need

(1) Purpose and Need

Response to Program Purpose:
(a) Work Plan
(b) Methodology/Approach
(c) Resolution of Challenges
Impact:
(a) Evaluation and Technical
Support Capacity
(b) Project Sustainability
Organizational Information,
Resources and Capabilities
Budget and Budget Narrative
(below)

(2) Response to Program Purpose
(a) Work Plan
(b) Methodology/Approach
(c) Resolution of Challenges
(3) Impact:
(a) Evaluation and Technical Support
Capacity
(b) Project Sustainability
(4) Organizational Information, Resources
and Capabilities
(5) Support Requested – the budget section
should include sufficient justification to allow
reviewers to determine the reasonableness
of the support requested.

HRSA-19-005

16

iii.

Budget

See Section 4.1.iv of HRSA’s SF-424 R&R Application Guide. Please note: the
directions offered in the SF-424 R&R Application Guide may differ from those offered
by Grants.gov. Follow the instructions included the R&R Application Guide and the
additional budget instructions provided below. A budget that follows the R&R
Application Guide will ensure that, if HRSA selects the application for funding, you will
have a well-organized plan, and by carefully following the approved plan can avoid
audit issues during the implementation phase.
Reminder: The Total Project or Program Costs are the total allowable costs
(inclusive of direct and indirect costs) incurred by the recipient to carry out a HRSAsupported project or activity. Total project or program costs include costs charged to
the award and costs borne by the recipient to satisfy a matching or cost-sharing
requirement, as applicable.
iv. Budget Justification Narrative
See Section 4.1.v. of HRSA’s SF-424 R&R Application Guide. In addition, the State
Primary Care Offices program requires the following:
Participant/Trainee Support Costs: For applicants with participant/trainee support
costs, list tuition/fees/health insurance, stipends, travel, subsistence, other, and
the number of participants/trainees. Ensure that your budget breakdown
separates these trainee costs, and includes a separate sub-total entitled “total
Participant/Trainee Support Costs” which includes the summation of all trainee
costs.
Consultant/Contractor Services: If you are using consultant/contractor services, list
the total costs for all consultant/contractor services. In the budget justification,
identify each consultant/contractor, the services he/she will perform, the total
number of days, travel costs, and the total estimated costs. Costs for
consultants/contractors should include the following information: (1) Name of
consultant/contractor; (2) Method of selection; (3) Period of performance; (4)
Scope of work activities in work plan objectives; and (5) Method of accountability.
v. Attachments
Please provide the following items in the order specified below to complete the
content of the application. Unless otherwise noted, attachments count toward
the application page limit. Indirect cost rate agreements and proof of non-profit
status (if applicable) will not count toward the page limit. You must clearly label each
attachment.

HRSA-19-005

17

Attachment 1: Work Plan
Attach the work plan for the project that includes all information detailed in
Section IV. ii. Project Narrative. If applicable, also include the required logic
model in this attachment. If you will make subawards or expend funds on
contracts, describe how your organization will ensure proper documentation of
funds.
Attachment 2: Staffing Plan and Job Descriptions for Key Personnel (See Section
4.1.vi. of HRSA’s SF-424 R&R Application Guide)
Keep each job description to one page in length as much as is possible. Include
the role, responsibilities, and qualifications of proposed project staff. Also,
please include a description of your organization’s time keeping process to
ensure that you will comply with the federal standards related to documenting
personnel costs.
Attachment 3: Letters of Agreement, Memoranda of Understanding, and/or
Description(s) of Proposed/Existing Contracts (project-specific)
Provide any documents that describe working relationships between your
organization and other entities and programs cited in the proposal. Documents
that confirm actual or pending contractual or other agreements should clearly
describe the roles of the contractors and any deliverable. Make sure any letters
of agreement are signed and dated.
Attachment 4: Project Organizational Chart
Provide a one-page figure that depicts the organizational structure of the project
(not the applicant organization).
Attachment 5: Tables, Charts, etc.
To give further details about the proposal (e.g., Gantt or PERT charts, flow
charts, etc.).
Attachment 6: Progress Report
(FOR COMPETING CONTINUATIONS ONLY)
Past performance is a predictor of future success by an applicant, particularly
within the same competitive program. Identify your current grant number, include
the most important objectives from your approved application (including any
approved changes), and document overall program accomplishments under each
objective over the entire period of performance. Where possible, include the
proposed and actual metrics, outputs, or outcomes of each project objective.
HRSA program staff will review the progress report after the Objective Review
Committee reviews your competing continuation application.
The progress report should be a brief presentation of the accomplishments, in
relation to the objectives of the program during the current period of
performance. The report should include:
(1) The period covered (dates).
(2) Specific Objectives - Briefly summarize the specific objectives of the project
as actually funded.
HRSA-19-005

18

(3) Results - Describe the program activities conducted for each objective.
Include both positive and negative results or technical problems that may be
important.
Attachment 7: Letters of Support
Provide a letter of support for each organization or department involved in your
proposed project. Letters of support must be from someone who holds the
authority to speak for the organization or department (e.g., CEO, Chair, etc.),
must be signed and dated, and must specifically indicate understanding of the
project and a commitment to the project, including any resource commitments
(in-kind services, dollars, staff, space, equipment, etc.).
Attachment 8: Other Relevant Documents, including Relevant Subcontracting
Agreements (if used by applicant)
3. Dun and Bradstreet Data Universal Numbering System (DUNS) Number and
System for Award Management
You must obtain a valid DUNS number, also known as the Unique Entity Identifier for
your organization/agency and provide that number in your application. You must also
register with the System for Award Management (SAM) and continue to maintain active
SAM registration with current information at all times during which you have an active
federal award or an application or plan under consideration by an agency (unless the
applicant is an individual or federal agency that is exempted from those requirements
under 2 CFR § 25.110(b) or (c), or has an exception approved by the agency under 2
CFR § 25.110(d)).
HRSA may not make an award to an applicant until the applicant has complied with all
applicable DUNS and SAM requirements and, if an applicant has not fully complied with
the requirements by the time HRSA is ready to make an award, HRSA may determine
that the applicant is not qualified to receive an award and use that determination as the
basis for making an award to another applicant.
If you have already completed Grants.gov registration for HRSA or another federal
agency, confirm that the registration is still active and that the Authorized Organization
Representative (AOR) has been approved.
The Grants.gov registration process requires information in three separate systems:
 Dun and Bradstreet (http://www.dnb.com/duns-number.html)
 System for Award Management (SAM) (https://www.sam.gov)
 Grants.gov (http://www.grants.gov/)
For further details, see Section 3.1 of HRSA’s SF-424 R&R Application Guide.
UPDATED SAM.GOV ALERT: For your SAM.gov registration, you must submit a
notarized letter appointing the authorized Entity Administrator. The review process

HRSA-19-005

19

changed for the Federal Assistance community on June 11, 2018. Read the
updated FAQs to learn more.
SAM.gov is experiencing high volume and delays. If you have tried to create or
update your SAM.gov registration but have not been able to complete the process,
you may not be able to apply for a HRSA funding opportunity via Grants.gov in a
timely manner prior to the application deadline. If so, please email
DGPwaivers@hrsa.gov, per the instructions in Section 3.6 of your HRSA
Application Guide.
If you fail to allow ample time to complete registration with SAM or Grants.gov,
you will not be eligible for a deadline extension or waiver of the electronic
submission requirement.
4. Submission Dates and Times
Application Due Date
The due date for applications under this NOFO is November 5, 2018 at 11:59 p.m.
Eastern Time. HRSA suggests submitting applications to Grants.gov at least 3 days
before the deadline to allow for any unforeseen circumstances.
See Section 8.2.5 – Summary of emails from Grants.gov in HRSA’s SF-424 R&R
Application Guide for additional information.
5. Intergovernmental Review
The State PCOs program is not a program subject to the provisions of Executive Order
12372, as implemented by 45 CFR part 100.
See Section 4.1 ii of HRSA’s SF-424 R&R Application Guide for additional information.
6. Funding Restrictions
You may request funding for a period of performance of up to 5 years, subject to the
funding methodology previously outlined (inclusive of direct and indirect costs). Awards
to support projects beyond the first budget year will be contingent upon Congressional
appropriation, satisfactory progress in meeting the project’s objectives, and a
determination that continued funding would be in the best interest of the Federal
Government.
The General Provisions in Division H of the Consolidated Appropriations Act, 2018 (P.L.
115-141) apply to this program. Please see Section 4.1 of HRSA’s SF-424 R&R
Application Guide for additional information. Note that these or other restrictions will
apply in the following FY, as required by law.
You are required to have the necessary policies, procedures and financial controls in
place to ensure that your organization complies with all legal requirements and
restrictions applicable to the receipt of federal funding, including statutory restrictions on
use of funds for lobbying, executive salaries, gun control, abortion, etc. Like those for
HRSA-19-005

20

all other applicable grants requirements, the effectiveness of these policies, procedures
and controls is subject to audit.
All program income generated as a result of awarded funds must be used for approved
project-related activities. The program income alternative(s) applied to the award(s)
under the program will be the addition/additive alternative. You can find post-award
requirements for program income at 45 CFR § 75.307.

V.

Application Review Information

1. Review Criteria
HRSA has procedures for assessing the technical merit of applications to provide for an
objective review of applications and to assist you in understanding the standards
against which your application will be judged. HRSA has developed critical indicators
for each review criterion to assist you in presenting pertinent information related to that
criterion and to provide the reviewer with a standard for evaluation. See the review
criteria outlined below with specific detail and scoring points.
These criteria are the basis upon which the reviewers will evaluate and score the merit
of the application. The entire proposal will be considered during objective review.
In the event that a competing continuation applicant submits the only application for
the service area, HRSA will conduct a comprehensive internal review of the
application in lieu of an objective review. Applications receiving an internal review will
be subject to the same completeness and eligibility screening as those receiving an
objective review and will be assessed for compliance with all State Primary Care
Offices program requirements and projected performance goals.
Review criteria are used to review and rank applications. The State Primary Care
Offices program has five review criteria:
Criterion 1: PURPOSE AND NEED (10 points) – Corresponds to Section IV’s Purpose
and Need
The extent to which the application demonstrates the need for additional funding at the
federal level and the extent to which such funding would assist with health needs
assessments, shortage designation, provider recruitment and retention, and a reduction
in the overall number of designations in an applicant’s state or territory.
Criterion 2: RESPONSE TO PROGRAM PURPOSE (40 points) – Corresponds to
Section IV’s Response to Program Purpose Sub-section (a) Methodology/Approach,
Sub-section (b) Work Plan and Sub-section (c) Resolution of Challenges
Criterion 2 (a): WORK PLAN (20 points) – Corresponds to Section IV’s Response to
Program Purpose Sub-section (a) Work Plan

HRSA-19-005

21

The extent to which you provide a clear, comprehensive, and specific set of goals and
objectives and the concrete steps that will be used to achieve those goals and
objectives. The description should include timeline, stakeholders, and a description of
the cultural, racial, linguistic and geographic diversity of the populations and
communities served. In addition, as outlined in the “Project Narrative” section, the
work plan should specifically address your proposals regarding: (1) a Statewide
Primary Care Needs Assessment; (2) shortage designation coordination, including the
establishment of a Rational Service Area Plan by year 4 of the period of performance;
(3) specific efforts to expand access to primary care; and (4) a strategic, long-term
plan to reduce health provider shortages and shortage designations.
Criterion 2 (b): METHODOLOGY/APPROACH (10 points) – Corresponds to Section
IV’s Response to Program Purpose Sub-section (b) Methodology/Approach
The extent to which the proposed project responds to the requirements and
expectations of the program and addresses the needs highlighted in the Purpose and
Need section. The strength of the proposed goals and objectives and their
relationship to the identified project. The extent to which the activities described in the
application are capable of addressing the problem and attaining the project objectives.
This includes describing, as appropriate, tools and strategies for meeting stated
needs. The extent to which you provide a logical description of proposed activities
and describe why the project is innovative and the context for why it is innovative. The
sophistication and plausibility of the logic model proposed, if required, also will be
evaluated.
Criterion 2 (c): RESOLUTION OF CHALLENGES (10 points) – Corresponds to
Section IV’s Response to Program Purpose Sub-section (c) Resolution of Challenges
The extent to which you demonstrate an understanding of potential obstacles and
challenges during the design and implementation of the project, as well as a plan for
dealing with identified contingencies that may arise.
Criterion 3: IMPACT (30 points) – Corresponds to Section IV’s Impact Sub-section (a)
Evaluation and Technical Support Capacity, and Sub-section (b) Project Sustainability
Criterion 3(a): EVALUATION AND TECHNICAL SUPPORT CAPACITY (20 points) –
Corresponds to Section IV’s Impact Sub-section (a) Evaluation and Technical Support
Capacity





The extent to which the proposed project has a public health impact and the
project will be effective, if funded.
The extent to which you are able to effectively report on the measurable
outcomes being requested, including both your internal program performance
evaluation plan and HRSA’s required performance measures, as outlined in the
corresponding Project Narrative Section IV’s Impact Sub-section (a).
Specific criteria include:
o The strength and effectiveness of the method proposed to monitor and
evaluate the project results.

HRSA-19-005

22

o Evidence that the evaluative measures will be able to assess: 1) to what
extent the program objectives have been met, and 2) to what extent these
can be attributed to the project.
o The extent to which you are able to incorporate data collected into
program operations to ensure continuous quality improvement.
o The extent to which the evaluation plan includes necessary components
(descriptions of the inputs, key processes, variables to be measured,
expected outcomes of the funded activities, and how key measures will be
reported), as well as a description of how you will collect and manage data
in such a way that allows for accurate and timely reporting of performance
outcomes.
o The extent to which you anticipate obstacles to the evaluation and
propose how to address those obstacles.
o The extent to which you describe the feasibility and effectiveness of plans
for dissemination of project results.
o The extent to which project results may be national in scope, the degree to
which the project activities are replicable, and the sustainability of the
program beyond the federal funding.
Criterion 3 (b): PROJECT SUSTAINIBILITY (10 points) – Corresponds to Section IV’s
Impact Sub-section (b) Project Sustainability
The extent to which you describe a solid plan for project sustainability after the period of
federal funding ends. The extent to which you clearly articulate likely challenges to be
encountered in sustaining the program, and describe logical approaches to resolving
such challenges.
Criterion 4: ORGANIZATIONAL INFORMATION, RESOURCES AND CAPABILITIES
(10 points) – Corresponds to Section IV’s Organizational Information, Resources and
Capabilities
The extent to which project personnel are qualified by training and/or experience to
implement and carry out the project; this will be evaluated both through your project
narrative, as well as through your Attachments. The capabilities of the applicant
organization and the quality and availability of facilities and personnel to fulfill the
needs and requirements of the proposed project.
Criterion 5: SUPPORT REQUESTED (10 points) – Corresponds to Section IV’s
Budget Justification Narrative and SF-424 R&R budget forms
The reasonableness of the proposed budget for each year of the period of
performance, in relation to the objectives, the complexity of the activities, and the
anticipated results.
 The extent to which costs, as outlined in the budget and required resources
sections, are reasonable given the scope of work.
 The extent to which key personnel have adequate time devoted to the project to
achieve project objectives.

HRSA-19-005

23

2. Review and Selection Process
The independent review process provides an objective evaluation to the individuals
responsible for making award decisions. The highest ranked applications receive
consideration for award within available funding ranges. In addition to the ranking
based on merit criteria, HRSA approving officials may also apply other factors in award
selection, (e.g., geographical distribution). HRSA may also consider assessment of risk
and the other pre-award activities described in Section 3 below.
Please see Section 5.3 of HRSA’s SF-424 R&R Application Guide for more details.
3. Assessment of Risk and Other Pre-Award Activities
HRSA may elect not to fund applicants with management or financial instability that
directly relates to the organization’s ability to implement statutory, regulatory or other
requirements (45 CFR § 75.205).
HRSA reviews applications receiving a favorable objective review for other
considerations that include past performance, as applicable, cost analysis of the
project/program budget, assessment of your management systems, ensuring continued
applicant eligibility, and compliance with any public policy requirements, including those
requiring just-in-time submissions. HRSA may ask you to submit additional
programmatic or administrative information (such as an updated budget or “other
support” information) or to undertake certain activities (such as negotiation of an indirect
cost rate) in anticipation of an award. However, even at this point in the process, such
requests do not guarantee that HRSA will make an award. Following review of all
applicable information, HRSA’s approving and business management officials will
determine whether HRSA can make an award, if special conditions are required, and
what level of funding is appropriate.
Award decisions are discretionary and are not subject to appeal to any HRSA or HHS
official or board.
Effective January 1, 2016, HRSA is required to review and consider any information
about your organization that is in the Federal Awardee Performance and Integrity
Information System (FAPIIS). You may review and comment on any information about
your organization that a federal awarding agency previously entered. HRSA will
consider any of your comments, in addition to other information in FAPIIS in making a
judgment about your organization’s integrity, business ethics, and record of
performance under federal awards when completing the review of risk posed by
applicants as described in 45 CFR § 75.205 HHS Awarding Agency Review of Risk
Posed by Applicants.
HRSA will report to FAPIIS a determination that an applicant is not qualified (45 CFR §
75.212).
4. Anticipated Announcement and Award Dates
HRSA anticipates announcing/issuing awards prior to the start date of April 1, 2019.
HRSA-19-005

24

VI.

Award Administration Information

1. Award Notices
HRSA will issue the Notice of Award prior to the start date of April 1, 2019. See Section
5.4 of HRSA’s SF-424 R&R Application Guide for additional information.
2. Administrative and National Policy Requirements
See Section 2.1 of HRSA’s SF-424 R&R Application Guide.
Requirements under Subawards and Contracts under Grants
The terms and conditions in the Notice of Award (NOA) apply directly to the recipient
of HRSA funds. The recipient is accountable for the performance of the project,
program, or activity; the appropriate expenditure of funds under the award by all
parties; and all other obligations of the recipient, as cited in the NOA. In general, the
requirements that apply to the recipient, including public policy requirements, also
apply to subrecipients and contractors under grants, unless the NOA specifies an
exception. See 45 CFR § 75.101 Applicability for more details.
3. Reporting
Award recipients must comply with Section 6 of HRSA’s SF-424 R&R Application Guide
and the following reporting and review activities:
1) Progress Report(s). The recipient must submit a progress report to HRSA
on an annual basis. HRSA will verify that approved and funded applicants’
proposed objectives are accomplished during each year of the project.
The Progress Report has two parts. The first part demonstrates recipient
progress on program-specific goals. Recipients will provide performance
information on project objectives and accomplishments, project barriers and
resolutions, and will identify any technical assistance needs.
The second part collects information providing a comprehensive overview of
recipient overall progress in meeting the approved and funded objectives of
the project, as well as plans for continuation of the project in the coming
budget period. The recipient should also plan to report on dissemination
activities in the annual progress report.
Further information will be available in the award notice.
2) Performance Reports. The recipient must submit a Performance Report to
HRSA via the EHBs on an annual basis. All HRSA recipients are required to
collect and report performance data so that HRSA can meet its obligations
under the Government Performance and Results Modernization Act of 2010
HRSA-19-005

25

(GPRA). The required performance measures for this program are outlined in
the Project Narrative Section IV’s Impact Sub-section (a). Further information
will be provided in the award notice.
The annual performance report will address all budget year activities from
October 1 to September 30, and will be due to HRSA on November 30 each
year. If award activity extends beyond November 30 in the final year of the
period of performance, a Final Performance Report (FPR) may be required to
collect the remaining performance data. The FPR is due within 90 days after
the period of performance ends.
3) Final Program Report. A final report is due within 90 days after the period of
performance ends. The Final Report must be submitted online by recipients
in the Electronic Handbook system at
https://grants.hrsa.gov/webexternal/home.asp.
The Final Report is designed to provide HRSA with information required to
close out a grant after completion of project activities. Recipients are required
to submit a final report at the end of their project. The Final Report includes
the following sections:




Project Objectives and Accomplishments - Description of major
accomplishments on project objectives.
Project Barriers and Resolutions - Description of barriers/problems that
impeded project’s ability to implement the approved plan.
Summary Information:
 Project overview.
 Project impact.
 Prospects for continuing the project and/or replicating this project
elsewhere.
 Publications produced through this cooperative agreement activity.
 Changes to the objectives from the initially approved cooperative
agreement.

Further information will be provided in the award notice.
4) Federal Financial Report. A Federal Financial Report (SF-425) is required

according to the schedule in the SF-424 R&R Application Guide. The report
is an accounting of expenditures under the project that year. Financial
reports must be submitted electronically through the EHB system. More
specific information will be included in the NoA.
5) Integrity and Performance Reporting. The Notice of Award will contain a
provision for integrity and performance reporting in FAPIIS, as required in 45
CFR part 75 Appendix XII.

HRSA-19-005

26

VII.

Agency Contacts

You may request additional information and/or technical assistance regarding business,
administrative, or fiscal issues related to this NOFO by contacting:
Carolyn J. Cobb
Grants Management Specialist
HRSA Division of Grants Management Operations, OFAM
5600 Fishers Lane, Mailstop 10SWH03
Rockville, MD 20857
Telephone: (301) 443-0829
Email: ccobb2@hrsa.gov
You may request additional information regarding overall program issues and/or
technical assistance related to this NOFO by contacting:
Matthew Salaga
Management Analyst, Division of Policy and Shortage Designation
Telephone: (301) 945-0194
Fax: (301) 443-4370
Email: MSalaga@hrsa.gov
You may need assistance when working online to submit your application forms
electronically. Always obtain a case number when calling for support. For assistance
with submitting the application in Grants.gov, contact Grants.gov 24 hours a day, 7 days
a week, excluding federal holidays at:
Grants.gov Contact Center
Telephone: 1-800-518-4726 (International Callers, please dial 606-545-5035)
Email: support@grants.gov
Self-Service Knowledge Base: https://grantsportal.psc.gov/Welcome.aspx?pt=Grants
Successful applicants/recipients may need assistance when working online to submit
information and reports electronically through HRSA’s Electronic Handbooks (EHBs).
For assistance with submitting information in HRSA’s EHBs, contact the HRSA Contact
Center, Monday-Friday, 8:00 a.m. to 8:00 p.m. ET, excluding federal holidays, at:
HRSA Contact Center
Telephone: (877) 464-4772
TTY: (877) 897-9910
Web: http://www.hrsa.gov/about/contact/ehbhelp.aspx

HRSA-19-005

27

VIII.

Other Information

Logic Models
Additional information on developing logic models can be found at the following website:
https://www.cdc.gov/oralhealth/state_programs/pdf/logic_models.pdf.
Although there are similarities, a logic model is not a work plan. A work plan is an “action”
guide with a timeline used during program implementation; the work plan provides the
“how to” steps. A logic model is a visual diagram that demonstrates an overview of the
relationships between the 1) resources and inputs, 2) implementation strategies and
activities, and 3) desired outputs and outcomes in a project. Information on how to
distinguish between a logic model and work plan can be found at the following website:
http://www.cdc.gov/healthyyouth/evaluation/pdf/brief5.pdf.
Technical Assistance
HRSA will hold a pre-application technical assistance (TA) webinar(s) for applicants
seeking funding through this opportunity. The webinar(s) will provide an overview of
pertinent information in the NOFO and an opportunity for applicants to ask questions.
Visit the HRSA Bureau of Health Workforce’s open opportunities website at
https://bhw.hrsa.gov/fundingopportunities/ to learn more about the resources available
for this funding opportunity.

IX.

Tips for Writing a Strong Application

See Section 4.7 of HRSA’s SF-424 R&R Application Guide.
Frequently Asked Questions (FAQs) can be found on the program website, and are
often updated during the application process.
In addition, a number of recorded webcasts have been developed with information that
may assist you in preparing a competitive application. These webcasts can be
accessed at http://www.hrsa.gov/grants/apply/write-strong/index.html.

HRSA-19-005

28