School Based Health Center Capital (SBHCC) Program HRSA-11-127

1. School Based Health Center Capital (SBHCC) Program HRSA-11-127 Application Technical Assistance

2. Objectives • Overview of the Affordable Care Act and SBHCs • Eligibility requirements for the School-Based Health Center Capital Program • Application requirements and process information for Grants.gov and HRSA’s Electronic Health Book (EHB). • Post-award requirements • Resources

3. The Affordable Care Act Overview • Section 4101 of the Affordable Care Act authorized: • Section 4101(a): Grants for the Establishment of School-Based Health Centers (School-Based Health Center Capital (SBHCC) Program) • Section 4101(b): Grants for the Operation of School-Based Health Centers • Section 4101(a) included appropriations of $50 million annually for FYs 2010 – 2013 to support capital expenditures.

4. SBHCC Funding • FY 2011 SBHCC grants will support significant and pressing capital needs and the purchase of moveable equipment to be used in a school-based health center (SBHC) • Maximum grant award is $500,000 per application • No minimum grant award • Applicants must demonstrate the following: • A need for the project(s) proposed; • The proposed project(s) will support the SBHC in providing effective, efficient, quality care, and optimal patient outcomes for the target population; and • The proposed project(s) will lead to improvements in access to health services for children at a SBHC.

5. SBHCC Funding • CFDA # 93.501 • 2-year project/budget period • Applicants may only submit one SBHCC application • Applicants may propose up to 10 projects within the application • Applications must be submitted through Grants.gov by December 1, 2010 at 8:00 PM EST and HRSA’s Electronic Handbooks (EHB) by January 12, 2011 by 5:00PM

6. Eligibility • Applicants must meet the definition of a school-based health center under section 2110(c)(9)(A) of the Social Security Act or a sponsoring facility of a school-based health center (as defined in section 2110(c)(9)(B) of the Social Security Act): • Section 2110(c)(9) of the Social Security Act defines a school-based health center as the following: • Is located in or near a school facility of a school district or board, or of an Indian tribe or tribal organization; • Is organized through school, community, and health provider relationships; • Is administered by a sponsoring authority; • Provides through health professionals primary health services to children in accordance with State and local law, including laws relating to licensure and certification; and • Satisfies such other requirements as a State may establish for the operation of such a clinic.

7. Eligibility • Sponsoring facility is one of the following: • Hospital • Public health department • Community health center • Non-profit health care agency • Local education agency (20 U.S.C. §7801) • A program administered by the Indian Health Service, Bureau of Indian Affairs, or operated by an Indian tribe or a tribal organization • Local education agency definition: • a public board of education or other public authority legally constituted within a State for either administrative control or direction of, or to perform a service function for, public elementary schools or secondary schools in a city, county, township, school district, or other political subdivision of a State, or for such combination of school districts or counties as are recognized in a State as an administrative agency of or for its public elementary schools or secondary schools.

8. Eligibility • Applicant administers or plans to administer a new or existing school-based health center that: • Is administered by a sponsoring authority; • Is located in or near a school facility of a school district or board, or of an Indian tribe or tribal organization; • Is organized through school, community, and health provider relationships; • Provides through health professionals primary health services to children in accordance with State and local law, including laws relating to licensure and certification; and • Satisfies such other requirements as a State may establish for the operation of such a clinic.

9. Eligibility • Application request for SBHCC funding as presented on the consolidated SF-424C Budget Form and accompanying Budget Justification(s) does not exceed $500,000. • Only one application is submitted for consideration from the same applicant organization under HRSA-11-127. • If more than one application is submitted, HRSA will accept the applicant’s last electronic submission validated by Grants.gov and/or EHB on or before the deadline date as the final application.

10. Eligibility • Application requests funding only for the purchase of moveable equipment, alteration and renovation and/or construction for a school-based health center. • Application proposes a maximum of 10 projects including any combination of site-specific, stand-alone facility projects and/or one project to purchase equipment for multiple SBHC sites.

11. Eligibility • Applicant adheres to the 80-page limit on the length of the application when printed by HRSA. • Applicant submits the SBHCC application through Grants.gov by December 1, 2010 and through EHB by January 12, 2011.

12. Project Types • Alteration and renovation (A&R) (existing facility): • caninclude the acquisition of an existing facility; associated work required to modernize, improve, and/or reconfigure the interior arrangements or other physical characteristics of a facility; and/or installation of permanently affixed equipment in an existing facility. • This type of project would not increase the total square footage within an existing building. • This type of project may include the purchase of related moveable equipment and items with a unit cost less than $5000 and a useful life of one year or greater.

13. Project Types • Construction (new site or expansion of existing site): • can include the construction of a new stand-alone structure; acquisition of vacant property or an existing facility; and/or associated work required to expand a facility. • This type of project would increase the total square footage within an existing building. • Construction projects may include use of a permanently affixed modular or prefabricated building and/or the purchase of related moveable equipment and items with a unit cost less than $5000 and a useful life of one year or greater.

14. Project Types • Equipment-only projects: • includes the purchase of moveable equipment, including mobile vans, and items with a unit cost less than $5000 and a useful life of one year or greater.

15. Allowable Costs • Moveable equipment examples: • Telehealth equipment (i.e., video cameras, software, TVs) • Equipment to support an electronic health record (EHR) system (i.e., hardware, servers, licenses) • Medical equipment (i.e., exam tables, nebulizers, AEDs) • Office equipment (i.e., computers, desks, chairs, file cabinets)

16. Allowable Costs • Mobile vans must be purchased for the purposes of service provision. • Land and building purchases -acquisition of vacant property must result in the construction or installation of a structure where services will be provided prior to the end of the grant project period. • EHR systems and licenses.

17. Unallowable Costs • Costs incurred prior to March 23, 2010 • Operating costs (e.g., funding direct health care services, clinical full-time equivalents, rent, mortgage payments, refinanced credit facilities) • Permanent relocation costs • Expenditures for personnel unrelated to the project • Mobile vans for purposes other than service delivery (i.e., patient transport) • Office supplies (e.g., paper, pencils, toner, etc.); medical supplies (e.g., syringes, blood tubes, plastic gloves, etc.), and educational supplies (e.g., pamphlets, educational videotapes, etc.)

18. Submission Process • 2-Tier Application Submission process • Grants.gov • HRSA’s EHB

19. Grants.gov • Due 8:00 PM ET on December 1, 2010 • Refer to http://www.hrsa.gov/grants/userguide.htm for detailed application and submission instructions • Registration in Grants.gov is required (registration may take up to a month—start the process as soon as possible) • The Central Contractor Registry (CCR) registration is an annual process—verify the organization’s CCR registration prior to Grants.gov submission, well in advance of the application deadline

20. Grants.gov • The Grants.gov registration process involves these basic steps: • Register the organization • Get authorized as an AOR by the applicant organization • Register an individual as the Authorized Organization Representative (AOR) for the organization • Get authorized as an AOR by the applicant organization • Please visit the Grants.gov website at http://www.grants.gov/applicants/get_registered.jsp or call the Grants.gov Contact Center at 1-800-518-4726 24 hours a day, 7 days a week (excluding Federal holidays) for additional technical assistance on the registration process

21. Grants.gov • SF-424 Face Page • Project Summary/Abstract (uploaded on line 15 of the SF-424 Face Page) • PHS-5161 HHS checklist • SF-424 LLL Disclosure of Lobbying Activities Note: Detailed instructions for completing these documents are available within the funding opportunity announcement

22. HRSA’s EHB • Due by 5:00 PM ET on January 12, 2011. • Registration in HRSA’s EHB is required. • Refer to http://www.hrsa.gov/grants/userguide.htm for registration information, process instructions, and frequently-asked questions. • For technical support, call the HRSA Call Center at 1-877-464-4772. • The Authorizing Official (AO) must complete submission of the application. • More information and technical assistance is available at http://www.hrsa.gov/grants/apply/assistance/sbhcc.

23. HRSA’s EHB • Equipment List (Required per project) • Budget Information for Construction Programs (SF-424C) (Required per project) • Form 5B Service Sites (Required per project) • Other Requirements for Sites (Required per A&R and construction project) • Forms: • Proposal Cover Page (Required per application) • Consolidated Budget (Required per application) • Consolidated Funding Sources (Required per application) • Project Cover Page (Required per project)

24. HRSA’s EHB • Attachment 6: Property Information (Required per A&R and construction project) • Attachment 7: Landlord Letter of Consent (As applicable per project) • Attachment 8: Summary of Contracts and Agreements (As applicable per project). • Attachment 9: Letters of Support (As applicable per application) • Attachment 10: Other Relevant Documents (As applicable per application) • Attachment 1: SF-424D – Assurances for Construction Programs (Required per application) • Attachment 2: Budget Justification (Required per project) • Attachment 3: Site Plan (Required per A&R and construction project) • Attachment 4: Floor Plans/Schematic Drawings (Required per A&R and construction project) • Attachment 5: Environmental Information and Documentation Checklist (Required per A&R and construction project)

25. Proposal Cover Page • Applicants will provide the following information: • Grants.gov tracking number • Sponsoring facility type • SBHC criteria certification • Funding Preference • Purpose/Need • Organizational Sustainability/Impact • Service Impact • Resources/Capabilities

26. Proposal Cover Page • Applicants will provide the following information for each project: • Project Need • Project Response • Project Timeline • Project Equipment List • Project Title • Project Type • Site Information • Project Description • Project Contact Information

27. Equipment List • Applicants must include all moveable equipment and items with a unit cost less than $5000 with a useful life of one year or greater to be purchased with SBHCC Equipment funds • Equipment type will be categorized as one of the following: • Clinical (exam tables, audiometer, nebulizers, etc.) • Non-clinical (computers, desks, furniture, etc.) • EHR (hardware, servers, licenses, etc.) • Mobile Van – if this equipment type is chosen, you must chose the site as mobile on Form 5B

28. Application Review • All applications will be subject to a completeness and eligibility review • An objective review of the applications will be performed to assess the technical merit of the eligible applications based on the review criteria in the funding announcement: • Need (20 points) • Response (25 points) • Impact (15 points) • Resource/Capabilities (20 points) • Support Requested (20 points) • Applicants should ensure the review criteria are fully addressed within the Proposal Narrative and supported by other supplementary information in the application as appropriate.

29. Application Review • Prior to beginning, all A&R and construction projects must undergo the following review: • Architectural/Engineering (A/E) • National Environmental Policy Act (NEPA) • State Historic Preservation Office (SHPO) • Federal Interest

30. Notice of Award • If the application is funded, a Notice of Award (NOA) is issued as the authorizing document; the NOA will be sent prior to the award date. • The NOA contains the following information: • Specifics of Award • Conditions of Award • Approved Budget • Amount of Federal funds awarded • Project description • Once signed by the Grants Management Officer, it is sent to the applicant agency’s Authorized Representative and is the only authorizing document.

31. Grant Terms and Conditions • Successful applicants must comply with the administrative requirements outlined in 45 CFR Part 74 (non-governmental) or 45 CFR Part 92 (governmental), as appropriate. • HRSA awards are subject to the requirements of the HHS Grants Policy Statement (HHS GPS) that are applicable based on recipient type and purpose of award. This includes, as applicable, any requirements in Parts I and II of the HHS GPS that apply to the award. The HHS GPS is available at http://www.hrsa.gov/grants/. The general terms and conditions in the HHS GPS will apply as indicated unless there are statutory, regulatory, or award-specific requirements to the contrary (as specified in the Notice of Award). • Questions regarding the terms and conditions of the NOA should be directed to the assigned Grants Management Specialist (GMS).

32. SBHCC Reporting Requirements • Audit Requirements • Comply with audit requirements of OMB Circular A-133. Information on the scope, frequency, and other aspects of the audits can be found at http://www.whitehouse.gov/omb/circulars; • Payment Management Requirements • Submit a quarterly electronic Federal Financial Report (FFR) Cash Transaction Report via the Payment Management System.  The FFR Cash Transaction Reports must be filed within 30 days of the end of each quarter.  Failure to submit the report may result in the inability to access award funds.  Go to http://www.dpm.psc.gov/ for additional information.

33. SBHCC Reporting Requirements • Submit a Financial Report • A financial report (SF-425) is required within 30 days of the end of each quarter. • Submit a semi-annual Progress Report • Project completion status (percent complete) • Actual versus project budget information—uses of SBHCC grant funds • Project Implementation Certification • Bonding/Insurance Coverage Certification (as applicable) • Construction Schedule • Earned Value management

34. SBHCC Reporting Requirements • Closeout Report • A closeout report is required within 90 days of the completion of the SBHCC project • The report must include the following items: • A letter stating that the project was completed in accordance with all applicable Federal statutes and regulations • Identify sites that received equipment • Tangible Personal Property Report • Final budget

35. Equipment Standards • Electronic Product Environmental Assessment Tool (EPEAT)—Silver Rated products, http://www.epeat.net • When EPEAT registered products are not available, the following environmental criteria should be considered: • Energy Star features http://www.energystar.gov: • Computer Power Management – Enable CPU’s to go into power save mode after an appropriate time period (e.g., 15-60 minutes). • Monitor Power Management – Enable monitors to go into power save mode after an appropriate time period (e.g., 15-60 minutes) • Establishment of a four year or higher replacement cycle (refresh rate) for desktop computers and laptops • Establishment of default setting to double sided printing for printers and print driver software.

36. Equipment Standards • When EPEAT registered products are not available, the following environmental criteria should be considered: • Recycled content, reduced packaging • Reduced toxic constituents in the product and in the manufacturing process • Designed for recycle/reuse including upgradeability considerations • Vendor provided take-back service • Vendor demonstration of corporate environmental responsibility

37. 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 A&R, 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

38. Leasehold Improvements • HRSA will determine if the term of the lease is long enough for the full value of the grant-supported improvements to benefit the grant activity. HRSA will take into account the purpose and duration of the grant, the expected life of the facility, and the use of the facility for grant-supported purposes. • The lease agreement must provide the applicant reasonable control. • “Reasonable control” for the purpose of the SBHCC is considered the ability to implement the project and realize the benefits of the project without unnecessary demands, such as unreasonably restrictive access and limited control, at the school-based health center site.

39. Leasehold Improvements • Funds may not be used to pay lease costs. • Funds for a leased property cannot address needs that are part of the terms of the lease (i.e., the responsibility of the lessor). • If funds address improvements that would impact terms of the lease (e.g., double paned windows) applicants must have written evidence of negotiated offset in the rent. • The Landlord Letter of Consent from the facility owner must address the following components: • Approval of the scope of the SBHCC project. • Agreement to provide the applicant health center reasonable control of the project site for required number of 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).

40. Resources/Contacts • Grants.gov Contact Center • Phone: 1-800-518-4726 • Email: support@grants.gov • EHB support • HRSA Call Center • Phone: 877-Go4-HRSA or 877-974-BPHC • TTY: 877-897-9910 • Fax: 301-998-7377 • Email: CallCenter@hrsa.gov

41. Resources/Contacts • BPHC Helpline: • Phone: 877-974-2742 weekdays from 8:30AM to 6:00PM EDT • Email: bhcmisys@hrsa.gov • SBHCC Resources: • Website: http://www.hrsa.gov/grants/apply/assistance/sbhcc • FAQs • EHB Registration slides • EHB User Guide

42. Resources/Contacts • Program Contact Information: • Beth Tchinski: 301-443-1389 • Matt Kozar: 301-443-1034 • Email: SBHC@hrsa.gov • Grants Management Contact Information: • Frances Woodburn: 301-443-3268 or fwoodburn@hrsa.gov

43. Questions?