GRANT OPPORTUNITY

TITLE: Medicare Rural Hospital Flexibility (FLEX) Grant Program

Critical Access Hospital Business Office Sustainability

Application Submission Due Date:

March 15, 2007 4:00 p.m.

Instructions and Application Forms

Point of Contact: Cordellia Vanover

Georgia Department of Community Health

2 Peachtree Street, NW

Grants and Vendor Management, 35th Floor

Atlanta, GA 30303-3159

Tel: 404 651-6917

Please carefully read, sign, and adhere to all attached DCH Ethics Statements and Ethics In Procurement Policy prior to responding to any Department of Community Health Request for Grant Applications (RFGA). Failure to do so could result in the disqualification of your application at any time during the application process.

Table of Contents

Medicare Rural Hospital Flexibility (FLEX) Grant Program

Critical Access Hospital Business Office Sustainability

I. / Background……………………………………………………… / iii
II.
III. / Purpose…………………………………………………………… / iii
Eligibility…………………………………………………………. / iv-v
IV. / Process Submittal, Content and Required Forms ……….. / 1-5
V. / Evaluation………………………………………………………… / 67666
Appendix A / Grant Application Form
Appendix B / Governing Board Resolution
Appendix C / Governing Board Composition
Appendix D / Ethics Statement
Appendix E / Ethics In procurement Policy
Appendix F / Business Associate Agreement
Appendix G / Project Budget
Appendix H / Biographical Sketch
Medicare Rural Hospital Flexibility (FLEX) Grant Program
Critical Access Hospital Business Office Sustainability
Program Description and Requirements
Background / The Georgia Department of Community Health (DCH) was created in 1999 (Senate Bill 241) with the responsibility for insuring over two million people in the State of Georgia to maximize the State’s health care purchasing power, to coordinate health planning for state agencies, and to propose cost-effective solutions to reducing the numbers of uninsured. Within the Department, the State Office of Rural Health works to improve access to health care in rural and underserved areas and to reduce health status disparities. Rural Georgians are more likely to be under-insured or uninsured.
Purpose / The purpose of the grant is to provide for the participation in Human Resources Services Administration (HRSA), Office of Rural Health Policy (ORHP), and the Medicare Rural Hospital Flexibility (FLEX) Grant Program. The funding is to provide all thirty-five (35) of Georgia’s Critical Access Hospitals (CAH) a measurable, performance-based business office training program. The curriculum will include topics essential to successful positive business office performance and financial benchmarking
Eligibility / Knowledge and experience in Critical Access Hospital operations, Medicare & Medicaid reimbursement, and business office practice(s). Provision of both online and onsite technical assistance and instruction.
Special Conditions / Funding contingent upon the Federal Medicare Rural Hospital Flexibility (FLEX) Program Grant funding for grant year September 1, 2007 through August 31, 2008.
Total Funds
Available / $80,000 - based on the availability and amount of grant funding
Funding Cycle / September 1, 2007 – August 31, 2008
Funding
Preference / ·  At least five (5) years experience with Georgia’s Critical Access Hospitals
Based on years of experience with Critical Access Hospital Business Office operations and staff development
Program
Requirements / ·  Indicate on all communication, marketing and promotional information that the program is funded by the Medicare Rural Hospital Flexibility Grant administered by Georgia State Office of Rural Health, a division of the Department of Community Health.
·  To provide all Critical Access Hospitals with a measurable, performance- based business office and financial education and training program.
·  To provide training courses essential to successful business office and financial operations and to provide the SORH with an inventory and description of the selected courses including the identity(s) of those responsible for their creation and instruction.
·  To provide a description of the proposed techniques to be utilized in providing business office and financial education and training and to provide the number of onsite consultations to be furnished to each of the participating Critical Access Hospitals.
·  To provide name and qualifications for who will be responsible for the overall development and execution of the business office sustainability program.
·  To provide a biographical sketch of key persons who will be engaged in all facets of the program including business office or other applicable background and experience.
·  To provide the strategy proposed to secure maximum hospital participation in the program.
·  To provide the number of planned onsite consultations to be furnished to each participating hospital.
·  To provide assessment of each business office to evaluate and measure performance against established industry benchmarks.
·  To provide the State Office of Rural Health (SORH) with benchmarks to be utilized in the measurement of business office performance.
·  To provide a detailed work plan with timeline.
·  To provide quarterly progress reports to the SORH and hospital management with corrective action plans developed collaboratively by the grantee and business office manager/personnel.
·  To conduct monthly follow-up meetings with business office managers/personnel to review performance and provide technical assistance as needed.
Deliverables / ·  Grantee shall submit no less than four (4) quarterly reports to the SORH outlining the education and training curriculum utilized, interim technical assistance provided, the total number of personnel participating in each training segment, the results of benchmarking measures and corrective action plan(s) no later than thirty (30) days after the close of the quarter.
·  Each quarterly report will contain the number of and identities of all onsite consultations conducted during the preceding quarter.
·  A final report will be due to the SORH no more 30 days after the close of the grant project period that contains hospital specific data, including graphs, which clearly demonstrates hospital’s individual performance improvement progress.
·  Status reports may be requested as needed by the federal grant.
·  Submit quarterly invoices for payment no more than thirty (30) days after the close of each quarter.
Format / ·  Narrative demonstration of need (no more than 3 pages)
·  Work Plan (format provided in separate document)
·  Desired outcome (no more than 2 pages)
·  All pages should contain footer with organization name and page number.
Evaluation Criteria / ·  Applications received will be evaluated based upon-experience with Critical Access Hospital Business Office Practice(s)
Deadline for Submission of Questions
Funding Application Deadline / Questions must be submitted in writing to by 4:00 p.m. on –2/15/07 (2 wks after posting date).
Responses to questions will be posted on 2/20/07 at www.dch.ga.gov
March 15, 2007 4:00 p.m.

Application Submittal

An original, five (5) copies and two (2) CDs of the Grant Application must be received by 4:00 p.m. on-March 15, 2007. Applications must be delivered in hard copy format via overnight mail, United State Post Office, or hand delivery to:

Mailing Address:

Cordellia Vanover, Grants Administrator

Georgia Department of Community Health

Vendor and Grant Management,

2 Peachtree Street, NW, 35th Floor

Atlanta, GA 30303-3159

Tel: 404 651-6917

Email:

Application Format

Please follow the outline provided in the “application content” section. Page format preference includes: 1 inch margins, page numbers, and name of applicant on each narrative page (not necessary on form pages or supporting documents.)

Application Content

The following outline and instructions should be used to prepare the grant application. Applications must be typewritten and follow the order and format provided in the “Program Requirements” and “Format” sections.

I. Required Forms (Appendices A,B,C,D,E,F,G,H)

A.Grant Application Form

B. Governing Board Resolution

C. Governing Board Composition

D.Ethics Statement

E. Ethics in Procurement Policy

F Business Associate Agreement

G Project Budget

H Biographical Sketch

II. Organization Information (not to exceed 3 typewritten pages)

III. Project Description (not to exceed 5 typewritten pages)

A. Problem Statement – provide a statement illustrating desired outcome and need for providing Georgia’s Critical Access Hospitals with an objective, measurable business office performance improvement program.

B. Type of Project – declare type of project and provide a description.

C. Project Need – provide a statement illustrating the need for providing a Business Office Performance Improvement Program that will assist in insuring Critical Access Hospital (CAH) sustainability.

D. Project Objectives – provide statements of the short term or intermediate term outcomes related to securing training. Objectives are to be tangible, measurable and achievable and should be specific to the proposed grant project and budget.

E. Project Work Plan or Methods – provide a detailed work plan of how the objectives will be reached through clearly defined strategies or activities. Work Plan must outline the following:

1.  Participant(s)

2.  Training and associated cost

3.  Travel expenses (conservative and reasonable)

4.  Evidence of return on investment

5.  Developmental goals

F. Timeline – provide a timeline for the grant period under which activities and objectives will be accomplished.

G. Evaluation – describe a process for documenting results of this project, including whether or not project objectives have been met.

H. Project Outcome – describe desired outcome in measurable goals.

IV. Budget and Justification (not to exceed 3 typewritten pages)

A. Budget Form (Appendix G) - Categorize your proposed expenses on the budget form provided.

B. Budget Justification - For each of the cost items on the budget form for which grant funds are requested, provide a rationale and details relative to how the budgeted cost items were calculated. This concise narrative should be labeled “Budget Justification” and be attached to the budget form.

1.Contracted Services – For each contract, provide the name of the contractor, components or services to be provided by the contractor, and cost per service, client or unit. If a subcontractor has been chosen, please include background information about that subcontractor including how the subcontractor’s previous experience relates to the project.

2.Other – Whenever possible, include proposed expenditures in the categories listed above. If it is necessary to include expenditures in this general category, include a detailed description of the activities as it relates to the project. If possible, include a separate line item budget and budget narrative.

3. The Department of Community Health (DCH) takes great pride in its ability to make grant awards to those who satisfy award requirements. Among those requirements is the limitation upon the application of indirect costs to the funding associated with the grants awarded by DCH. With limited exceptions, the current cap is set at up to and no more than *10%; although, applications requesting no direct costs are strongly encouraged.

It is DCH’s intent to provide grant dollars for the purposes expressed in the grant applications and that the greatest portion of those dollars should be applied directly to the services associated with the purpose of the grant. This serves as the basis for the indirect cost limitation of 10%.

For your information, listed below are DCH’s definition of indirect costs and a list of categories and examples of indirect costs. As noted above, limited exceptions to the 10% indirect cost limitations may be considered. Exceptions for consideration may be submitted based on the following table.

Length of time in operation / Maximum percentage of indirect costs allowed for consideration
Start-up through first year in operation / 50%
Second years in operation / 40%
Three years in operation / 30%
Four years in operation / 20%
Five or more years in operation / 10%

For the purpose of clarification, please note that length of time in operation pertains to the entity requesting funding, not the length of a time a specific program has been in operation. For example, ABC Nonprofit has been in existence for fifty years. ABC submits a application for a new program to be implemented in 2007. Based on DCH’s policies relating to indirect costs, ABC Nonprofit’s application will not be considered if the application contains a request for more than 10% indirect costs.

I It should be noted that while DCH will consider applications containing indirect costs based on the chart above; it is under no obligation to approve all or any indirect costs associated with any application.

* On a "case-by-case" basis indirect costs which exceed the limits indicated above may be considered. For special consideration, a written request should be submitted to:

Cordellia Vanover

Department of Community Health

Grants and Contracts

2 Peachtree Street, NW, 35th Floor

Atlanta, Georgia 30303

DCHwill provide a written approval notification upon review. This request may be made prior to formal submission of the grant.

Indirect costs are those costs that cannot be directly identified with a specific, single, final cost objective. The two most commonly used general classifications for indirect costs are “overhead” and “general and administrative costs”.

Below are categories and examples of indirect costs.

Financial

·  Bookkeeping and accounting

·  Annual independent audit

·  Bank charges

·  Grants administration

Occupancy

·  Facilities lease or mortgage

·  Utilities

·  Maintenance and sanitation (janitorial, grounds, trash removal)

·  Security

·  Capital improvements

Administration

·  Executive staff

·  Clerical and support staff

·  Personnel administration (executive search, benefits programs, staff orientation, retreats, employee recognition)

·  Insurance

·  Office equipment (copiers, fax machines, etc.)

·  Office furnishings

·  Telephone system and reception function

·  Technology (computers, information management)

·  Office supplies

·  Internal agency communication and coordination

Resource Development and Marketing

·  Development staff

·  Fundraising expenses

·  Donor acknowledgment and reports for funders

·  Marketing and community outreach

·  Website design and management

·  Annual report and agency newsletters

Governance

·  Strategic planning

·  Board governance and development

·  Legal counsel

Program Quality Control

·  Licenses, permits, accreditation process

·  Professional development and staff training

·  Membership fees, subscriptions and professional conferences

·  Evaluation

Evaluation

The grant application will be evaluated according to the following assessment criteria: