Facility Investment Program HRSA-10-029

1. Facility Investment ProgramHRSA-10-029 Application Technical Assistance Call June 25, 2009 —Revised June 26, 2009

2. Objectives • Discuss activities to be supported through the Facility Investment Program (FIP) • Explain the review process for FIP applications • Highlight application technical assistance

3. 2009 Mar Apr May Jun Jul Aug Sep Oct Nov Dec ARRA New Access Point Grantees Increased Demand for Services (IDS) Capital Improvement Program (CIP) Facility Investment Program (FIP) American Recovery and Reinvestment Act (ARRA) Overview • ARRA provided HRSA $2.5 billion to • Preserve and create jobs • Promote economic recovery • Help people most impacted by the recession • BPHC’s response: 4 grant opportunities in 2009

4. FIP Funding Opportunity • $515M one-time, 2-year project/budget period FY 2009 grants to support modernization and construction • Ceiling = $12,000,000 • Floor = $750,000 • Anticipate approximately 100 awards • 2-Year project/budget period (November 1, 2009 – October 31, 2011) • Applicants must • Demonstrate improvements in access to health services for the underserved populations • Create health center and construction-related jobs

5. FIP Funding, Part 2 • FIP guidance available: June 19, 2009 • Competitive funding opportunity • No on-going funding anticipated • Applicants will only be submitting one FIP application • Applicants may propose more than 1 project (maximum of 3 projects) • Applicants will submit applications/requests through EHB • Applications due no later than: August 6, 2009 8:00PM ET • EHB-generated email • Eligibility code • Sent to all eligible Health Center Program grantees on June 22, 2009 • Electronic application available: June 23, 2009

6. FIP Funding, Part 3 • FIP cannot be expended on any approved Capital Improvement Program (CIP) project activities • FIP awards must not replace any funds that have been awarded for a CIP project • The proposed FIP project(s) must be separate and distinct from projects funded under the CIP initiative

7. Eligible Applicants • Applicant is an existing health center that has had an application approved for grant support in FY 2009 under the Health Center Program • Application request for FIP funding as presented on PHS 5161-1 short form and SF-424C is equal to or greater than $750K and DOES NOT exceed $12M • Application proposes to support the costs of the alteration/ renovation or construction of a facility that is consistent with the Health Center Program’s mission—to provide comprehensive, culturally competent, quality primary healthcare services to medically underserved communities and vulnerable populations

8. Types of FIP Projects Health centers may propose up to three of the following types of FIP projects Alteration/renovation: This project type includes work required to modernize, improve, and/or change the interior arrangements or other physical characteristics of an existing facility or install equipment. This type of project should not increase square footage. Construction (new site or expansion of existing site): This project type includes—(i) adding a new structure to an existing site that increases the total square footage of the facility; and (ii) permanently affixing structure (e.g., modular units, prefabricated buildings) to real property (i.e., land).

9. Types of FIP Projects, continued A construction project is one that increases the facility’s square footage, not just the square footage of the health center organization expanding into an existing empty facility OR unused space is NOT construction whereas expanding an additional wing WOULD be construction If an applicant wishes to implement an alteration/renovation project at the SAME site at which they are proposing to construct a facility (e.g., by adding on to their current site), the alteration/renovation project should be included in and described as part of the construction project

10. Ineligible FIP Costs Costs incurred prior to February 17, 2009. Any costs related to a Capital Improvement Program (CIP) project awarded under HRSA-09-224. FIP awards must not be used to replace any funds that have been awarded for a CIP project. As a reminder, the proposed FIP project must be separate and distinct projects from what was funded under the CIP initiative. Operating costs (e.g., funding direct services, clinical full-time equivalents, rent, mortgage payments, refinanced credit facilities). Land or facility purchase costs are not eligible uses of FIP grant funding. Eligible projects may contain land/facility purchase costs; however, individual project budgets must show sufficient resources other than FIP funding to cover those expenses. Per section 1604 of the Recovery Act: None of the funds appropriated or otherwise made available under the Recovery Act may be used by any State or local government, or any private entity, for any casino or other gambling establishment, aquarium, zoo, golf course, or swimming pool.

11. Federal Interest The Federal government always retains interest in property constructed, acquired, or improved with Federal funds For ALL construction projects, applicants must file a NFI For alteration/renovation projects, Federal interest exists for the useful life attributable to the alteration/renovation funded under this grant Projects with allowable costs more than $500,000 (excluding equipment) must file a Notice of Federal Interest (NFI) Applicants not required to file a NFI (a/r projects less than $500,000) Federal interest still exists Maintain documentation regarding protection of all Federal interest

12. Leasehold Improvements If the proposed project site is leased and the a/r project has a net project cost less than $500,000, the applicant must certify that the existing lease gives the health center reasonable control of the project site, is consistent with the scope of the FIP project, and is in compliance with all terms and conditions affecting the Federal interest. If the proposed project site is leased and it is: a construction project, or an alteration/renovation project with a net project cost (total project cost less equipment costs) greater than $500,000; The applicant must either: Provide a signed Statement of Agreement from the facility owner; OR, Certify in the application that a Statement of Agreement from the facility owner will be submitted to HRSA prior to expending FIP project grant funds. The Statement of Agreement from the facility owner referenced above must address the following components: Approval of the scope of the FIP project. Agreement to provide the applicant health center reasonable control of the project site for at least 10 years. Agreement to file an NFI in the land records of the local jurisdiction before the project begins (if the proposed project is greater than $500,000).

13. Equipment Purchases • The purchase of any equipment may be an eligible use of grant funding ONLY IN conjunction with an alteration/renovation or construction project • Applicants must provide a detailed equipment list to identify the equipment to be purchased with the FIP project • Any equipment purchased through the FIP project should be pertinent to health center operations and serve an identified user group • Equipment must be maintained, tracked, and disposed of in accordance with 45 CFR Parts 74.34 and 92.32

14. Green/Sustainable Design Principles • Applicants are encouraged to incorporate sustainable design considerations when planning a FIP alteration/renovation or construction project • Sustainable design considerations must be included to the maximum extent feasible in FIP grants with total project costs of $1 million or more • Examples of such design considerations include use of low-impact materials, ensuring energy efficiency, and maximizing reuse/recycling capabilities

15. FIP Application Applicants will need to submit the following items; some items will need to be submitted for each FIP project (see Appendix 4): Application for Federal Assistance/Face Sheet SF-424 SF-424D Assurances—Construction Programs Proposal Cover Page* Proposal Abstract* Project Cover* SF-424C Budget Information—Construction Programs Budget Justification Schematic Drawings Environmental Information and Documentation Checklist Facility Owner—Statement of Agreement (as applicable) * Denotes modification from the Capital Improvement Program (CIP) guidance.

16. Proposal Overview The “Proposal Cover Page” will address all projects in the application to be submitted Components of the Proposal Cover Page: Purpose (updated!) Sustainability Plan (updated!) Green/Sustainable Design Service Impact Financial Management and Control (new!) Proposal Abstract (uploaded document) (new!)

17. Special Considerations: Proposals • Grantees should: • Ensure the project is an appropriate response to clearly identified, existing needs • Rank immediate organizational needs and prioritize how FIP funds can address those needs • Assess capacity to complete the project(s) in a 2-year period • Consider the amount of funding available to support the project • Include any appropriate and related equipment costs for alteration/renovation and construction • Evaluate any significant environmental and/or historic preservation issues that may delay implementation

18. Special Consideration: Sites Identify one site per A/R and construction project May propose up to three total projects Any site may only be associated with one project Applicants may propose: An existing site from the current scope, A site from a pending unapproved Change in Scope request, OR Add a new site (not currently in scope)

19. Project Details • Applicants may propose more than one project (maximum number of FIP projects is 3); however, the following information (items 1 through 17) will be required for EACH project • Title • Type • Current Square Foot • Project Management • Project Manager/Team (updated!) • Need (updated!) • Implementation and Monitoring (updated!)

20. Project Details, continued • Project Details also includes: • Timeline • Project Impact (updated!) • Equipment List • Budget • Budget Justification • Funding Sources (updated!) • Sites—Form 5B and Add Site Checklist, as applicable • Other Requirements for Sites (updated!) • Cultural Resource Assessment and Historic Preservation Considerations • Environmental Information and Documentation Checklist

21. Attachments Proposal Abstract (new!) The following attachments are required per project Budget Justification(s) Schematic Drawings (include square feet) Statement of Agreement from Facility Owner Environmental Information and Documentation Checklist

22. Review Criteria • The following review criteria will be used in assessing FIP applications: • Need • Response/Impact • Resource Capacity • Budget

23. Review of FIP Applications • The Division of Independent Review is responsible for managing objective reviews within HRSA • FIP proposals will be subject to an internal review (as applicable): • Completeness • Eligibility • Service Area Overlap • Architectural & Engineering Reasonableness • Federal Interest • Environmental Review • Historic & Cultural Preservation

24. Other Awarding Factors • HRSA intends to achieve a wide distribution of FIP awards.  In general, HRSA may consider the following factor, in making awards for FIP: • Rural/Urban Distribution of Awards: FIP awards in rural and urban areas may be made to ensure that no more than 60 percent and no fewer than 40 percent of the people served come from either rural or urban areas

25. ARRA General Requirements • New grant number: C80 • Separate PMS sub-account • Must be accounted for and reported separately (from section 330 funds and from other ARRA funds) • Applicants must not co-mingle or pool Federal, State, or local funds • Quarterly reports

26. FIP Reporting Impact of FIP funding Number of new/improved sites Projected number of health center jobs created and retained Projected number of construction-related jobs created Project completion status (percent complete) Actual versus projected budget information—uses of FIP grant funds Earned value management (for grants over $1 million) Other ARRA reporting required by Act

27. FIP Closeout Report • A closeout report is required within 90 days of the completion of the FIP project • The report must include the following items: • Photos of the completed project, including “before” photos • A final budget • A certificate of occupancy • A certificate of substantial completion • Earned value management (for grants over $1 million) • A letter stating that the project was completed in accordance with previously certified contract documents and in accordance with all applicable Federal statutes and regulations

28. Starting your FIP Applicationusing the EHB Go to the web address that you received in the e-mail from HRSA. You will be prompted to login. Log in using your current Username and Password. NOTE: If you have forgotten your username and password, contact HRSA Call Center. Enter the Eligibility Code from HRSA’s e-mail. If you do not have the code, contact the BPHC HelpLine listed on the program instructions document. Click the Continue button.

29. Starting/Editing yourFIP Application using the EHB SelectView Applications UnderPending Applications, find theFacility Investment Programrecord and click on Begin or Edit

30. Starting/Editing yourFIP Application using the EHB Note theSuggested Next Step Link to theFIP Guidance Application Forms Status

31. Adding Project Informationin your FIP Application

32. Adding the Budget Summaryin your FIP Application

33. Adding Program Specific Informationin your FIP Application Note the timeout reminder! The system willautomaticallyconsolidate information across all your proposed Projects

34. Contents of the Proposal Cover Pagein your FIP Application Proposal Cover Page Sections: • Purpose • Sustainability Plan • Green/Sustainable Design Principles • Service Impacts • Financial Management and Control Attach aProposal Abstract

35. Service Impacts andFinancial Management Control Projected # of AdditionalHealth Center Service Provider FTEs Projected # of Additional Patients Projected # of Additional Visits Net Assets = Total Assets – Total Liabilities Debt/Equity Ratio = Long Term Debt / Net Assets Working Capital = Current Assets – Current Liabilities

36. Adding Projects in yourFIP Application 2 types of FIP Projects: • Alteration/Renovation • Construction (new site or expansion of existing site)

37. Project Specific Informationin your FIP Application Project SpecificInformation isAutomaticallyConsolidated

38. Project Cover PageInformation in the FIP Application 6 Sections: • Site Information • Project Management • Contact Information • Need • Implementation and Monitoring • Timeline

39. Selecting Service Sites foryour FIP Application Projects Add New Sitesvia thisFIP Application Pick Sites requested to be addedin Change in Scope requests Pick Sites from current Scope of Project

40. EHB Help Resources

41. FIP Application Technical Assistance • Technical assistance materials will be posted at http://bphc.hrsa.gov/recovery/ • TA call presentation materials and transcripts • Frequently asked questions • Sample budget justification • Draft Environmental Assessment guidance

42. FIP Contacts