Capital Improvement Program HRSA-09-244

1. Capital Improvement ProgramHRSA-09-244 General Overview May 5, 2009

2. Objectives • Discuss activities to be supported through the Capital Improvement Program (CIP) • Review the CIP application process in HRSA’s EHB • 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. CIP Funding • $850M one-time, 2-year project/budget period FY 2009 grants to support • Construction • Renovation and equipment • Acquisition of health information technology • Grantees must • Demonstrate improvements in access to health services for the underserved populations • Create health center and construction-related jobs • 2-Year project/budget period (July 1, 2009 – June 30, 2011) • Maximum funding based on CY 2008 UDS Data Formula • All section 330 grantees eligible for $250K base amount • Plus $35 per patient served based on 2008 UDS as of 04/24/2009 • New Start grantees without 2008 UDS data will have $250K maximum

5. CIP Funding, part 2 • CIP guidance available: May 1, 2009 • One-time award for 2-year project/budget period • No on-going funding anticipated • Grantees will only be submitting one CIP application • Grantees may propose more than 1 project • Grantees will submit applications/requests through EHB • Applications due no later than: June 2, 2009 8:00PM ET • EHB-generated email • Eligibility code • Maximum eligible budget amount • Sent to all eligible Health Center Program grantees on May 2, 2009 • Electronic application available: May 4, 2009

6. Types of CIP Projects • The eligible project types are: • Alteration/repair/renovation, with or without IT/equipment • Construction (new site or expansion of existing site), with or without IT/equipment • IT/equipment-only purchase • HIT-only purchase (non-EHR equipment) • Certified EHR-related purchase

7. Ineligible CIP Costs • Operating costs (e.g., funding direct services, clinical full-time equivalents, rent, mortgage payments, refinanced credit facilities). • Purchase of EHR systems that are not certified by an organization recognized by the Secretary of HHS. • Land or facility purchase costs are not eligible uses of CIP grant funding. Eligible projects may contain land/facility purchase costs; however, individual project budgets must show sufficient resources other than CIP funding to cover those expenses. • 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. • Costs incurred prior to February 17, 2009.

8. CIP Application

9. Proposal Overview • The “Proposal Overview” (aka “Proposal Cover Page”) will be inclusive of all projects in the application to be submitted • Components of the Overview: • Purpose • Sustainability Plan • Green/Sustainable Design • Service Impact

10. Special Considerations: Proposals • Grantees should: • Ensure the project is an appropriate response to clearly identified, existing needs. • Rank immediate organizational needs and prioritize how CIP 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/repair/renovation and construction. • Work with their network to enhance their existing certified EHR system if they are presently within the scope of a currently-funded health center controlled network. • Demonstrate readiness for purchase of a certified EHR system and implementation prior to expending CIP funds. • Evaluate any significant environmental and/or historic preservation issues that may delay implementation.

11. Special Consideration: Sites • Identify one site per A/R/R and construction project • May propose more than one of these types of projects • Identify one or more sites for IT/equipment, HIT, or certified EHR • May propose each of these types of projects only once

12. Review of CIP Submissions • CIP proposals will be subject to an internal review (as applicable): • Completeness • Eligibility • Service Area Overlap • Architectural & Engineering Reasonableness • Federal Interest • EHR Readiness • Environmental Review • Historic & Cultural Preservation

13. ARRA General Requirements New grant number: C81 Separate PMS sub-account Must be accounted for and reported separately Quarterly reports

14. Impact of CIP funding Number of new/improved sites Number of health center jobs created and retained Number of construction-related jobs created Completion status (% complete) Actual versus projected budget information—uses of CIP grant funds Other ARRA reporting required by Act CIP Reporting

15. Getting Started on EHB (All Users) • All users who wish to work on the application must register in the HRSA EHBs. • Go to https://grants.hrsa.gov/webexternal/login.asp. • If you have registered before, you do not have to register again. Use the same username and password. • Contact the HRSA Call Center if you do not remember your username or password.

16. HRSA EHBs Notes • HRSA EHBs allows you to work on your application in parts, save it online and return to complete it later • Multiple users can workon the application at the same time • HRSA EHBs have two views—one for data entry and one for review • The view for “review” appears just like the printed form • The view for “data entry” is set up for user friendly data entry • The system “times out” after 30 minutes of inactivity! • You must hit a Save, Continue, or any navigation button within 30 minutes! • Some forms may take a long time to complete; saving work at regular intervals is strongly recommended • Only AO can submit

17. 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 HRSA Call Center or the program contact listed on the program instructions document. Click the Continue button. Starting the CIP Application

18. Structure of the CIP Application Program Specific Information Project #1 Project #2 Project #3 This diagram shows the structure of a Capital Improvement Program application, using the left side menus from the EHBs. The application consists of a Face Page and Program Specific Information, including project information which is collected through a set of forms. Project forms need to be completed for each proposed project. Multiple projects can be proposed within a single application.

19. Program Specific Information:Proposal Cover Page Complete the Proposal Cover Page. Click the “Save and Continue” button to continue to the next form.

20. Program Specific Information:Projects • Alteration/Repair/Renovation • Construction • IT/Equipment-only purchase • HIT-only purchase • Certified EHR-related purchase Click the “Add Project” button to add one of the following types of projects:

21. Program Specific Information:Projects—Add a Project Choose a project type from the list (next page shows example IT/Equipment-only purchase). If you select and confirm the wrong project type, you will not be able to change it. You will have to delete the project from the application and start over. Enter a project title.

22. Program Specific Information:Projects—Status Page Each project consists of numerous sections. Each project has its own Status page. Click the “Update” link in the Project Status table to open a section for editing.

23. Program Specific Information:Projects—Form 5B: Sites Form 5B: Sites Page. Use this page to add new sites or pick them from those already in scope.

24. Program Specific Information:Site Rules are Project Type Specific If you are creating an A/R/R or Construction project, you will need to insert a site in Form 5B by either picking sites from scope or by adding completely new site. You cannot insert more than one site per project in A/R/R and Construction projects. If you are creating an IT/Equipment, HIT or EHR project, you will be able to select sites in Form 5B by either picking sites from scope or by picking new sites already added in an A/R/R or Construction project within your application. You can also add a completely new mobile site in Form 5B. By default the completion status of site is marked as COMPLETE for sites picked from scope. You will not be allowed to update any information for such sites in the CIP application.

25. Program Specific Information:Projects—Form 5B: Sites—Select from Scope When picking a site from scope, simply select the site, and then click “Save and Continue.”

26. Program Specific Information:Projects – Add Site Checklist The Add Site Checklist page is only required for A/R/R, Construction, and IT/Equipment-only Purchase projects where the applicant is proposing to add a new site.

27. Help Resources

28. CIP Application Technical Assistance • Technical assistance conference calls have been scheduled on the following topics: • Alteration/Repair/Renovation and Construction • EHR Readiness • Equipment • ARRA New Start Grantees • Frequently asked questions will be posted soon and updated at http://bphc.hrsa.gov/recovery/

29. CIP Contacts