Form 1 Community College HIT Consortium Application Form

Community College HIT Consortium Application Form

Application and Submission Information

Address to Request Application Package

Application materials will be available for download at http://www.grants.gov. ONC is requiring full applications for all announcements to be submitted via electronic mail [email protected]. Lead awardees will be able to download a copy of the application packet, complete it off-line, and then submit the application electronically via email to: [email protected].

APPLICATIONS WILL NOT BE ACCEPTED THROUGH ANY WEBSITE, AND WILL NOT BE ACCEPTED THROUGH PAPER MAIL, COURIER, OR DELIVERY SERVICE.

LEAD AWARDEES ARE STRONGLY ENCOURAGED TO COMPLETE AND SUBMIT APPLICATIONS AS FAR IN ADVANCE OF THE SUBMISSION DEADLINE AS POSSIBLE. THE APPLICATION INCLUDING ALL REQUIRED ATTACHMENTS AND INCLUDED FILES FOR POTENTIAL CONSIDERATION IN THE REVIEW PROCESS MUST BE RECEIVED BY 11:59 PM EASTERN TIME ON THE DATE SPECIFIED IN SECTION IV C, BELOW.

Applications procedures:

• You must access the electronic application for this program via http://www.grants.gov.  You must search the downloadable application page by the Funding Opportunity Number (- - - ) or CFDA number (93.718).

• All lead awardees should have a Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number and register in the Central Contractor Registry (CCR) (for further information see section IV.B.2 below).  You should allow a minimum of five days to complete the CCR registration. Although not required to process preliminary applications, lead awardees who do not already have a DUNS number and/or are not registered in CCR should do so as soon as possible. As there is no fee to complete these processes, lead awardees should not wait to receive the results of the preliminary application review before taking these steps.

• You must submit all documents electronically, including all information included on the SF424 and all necessary assurances and certifications.

• Your application must comply with any page limitation requirements described in this Program Guidance.

• After you electronically submit your application, you will receive an automatic email notification from the email address that demonstrates the email was received.  This notification does not provide assurance that your application was complete, only that the email was received.

• After ONC reviews your email submission, a return receipt will be emailed to the lead awardee contact indicating the files that were received and able to be successfully opened and read. Due to volume of applications received, this receipt may not be available for several days; lead awardees are strongly encouraged to submit applications as far in advance as possible if they wish to receive confirmation of receipt prior to the deadline. Organizations applying for federal grants will need to be registered with the Central Contractor Registry (CCR). You can register with the CCR online and it will take about 30 minutes (http://www.ccr.gov). If you have already registered with CCR but have not renewed your registration in the last 12 months, you will need to renew your registration at http://www.ccr.gov.

Key Contact for Applications:

Inquiries should be addressed to:

U.S. Department of Health and Human Services

Office of the National Coordinator for Health Information Technology

Email: [email protected]

Content and Form of Application Submission

Lead awardees are requested, to submit a non-binding Letter of Intent indicating their plan to apply for this funding opportunity. This Letter will not be considered as part of the evaluation process; it will merely assist ONC in planning for the review process. The deadline for submission of the Letter of Intent is January 6, 2010.

1. Letter of Intent

Letters of intent must be sent electronically to:

U.S. Department of Health and Human Services

Office of the National Coordinator for Health Information Technology

Email: [email protected]

2. Letter of Intent Content Guidelines

Lead awardees may submit a Letter of Intent to apply for this funding opportunity; the deadline for the Letter of Intent is January 6, 2010. This Letter of Intent should contain the following:

• Identify which of the five regions the proposed consortium would serve.

• Identify the lead entity.

  • List intended number of member Community Colleges, and name any Community Colleges that have tentatively agreed to participate.

3. DUNS Number

The Office of Management and Budget (OMB) requires applicants to provide a Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number when applying for Federal grants or cooperative agreements on or after October 1, 2003. It is entered on the SF 424. It is a unique, nine-digit identification number, which provides unique identifiers of single business entities. The DUNS number is free and easy to obtain.

Organizations can receive a DUNS number at no cost by calling the dedicated toll-free DUNS Number request line at 1-866-705-5711 or by using this link to access a guide: https://www.whitehouse.gov/omb/grants/duns_num_guide.pdf .

4. Project Abstract

Lead awardees shall include a one-page abstract (no more than 500 words) of the application along with the full application package. Lead awardees should prepare a clear, accurate, concise abstract that can be understood without reference to other parts of the application and which gives a description of the proposed consortium, including: the consortiums plan to achieve the goals, objectives, overall approach (including target population and significant partnerships), and anticipated outcomes of the Community College Consortia to Educate Health Information Technology Professionals program.

The project abstract must be double-spaced with a font size of not less than 11 point.

The lead awardee shall place the following information at the top of the narrative abstract (this information is not included in the 500 word maximum):

• Project Title

• Lead awardee Name

• Address

• Contact Name

• Contact Phone Numbers (Voice, Fax)

• E-Mail Address

• Web Site Address, if applicable

The Project Abstract must include a summary of the proposed consortium including 1) a description of the consortium; 2) proposed sub- awardees and all other partners; and 3) a proposal describing how the consortium plans to achieve the program outcomes.

5. Project Narrative

The project narrative must provide a detailed picture of the proposed consortium’s membership and plan of action. The narrative must provide the reader with an understanding of how the consortium will comply with the complete program structure and complete the required project activities.

The Project Narrative must be double-spaced, on 8 ½” x 11” paper with 1” margins on both sides, and a font size of not less than 11. Smaller font sizes may be used to fill in the Standard Forms and Sample Formats. The suggested length for the Project Narrative is 10 to 25 pages; 25 pages is the maximum length allowed. ONC will not review Project Narrative pages beyond the 25 pages allowed. The Project Abstract (Section IV. B.4) , Letters of Commitment from each member Community College, and Resumés of Key Personnel are not counted as part of the Project Narrative for purposes of the 25-page limit, but all of the other sections noted below are included in the limit.

The components of the Project Narrative counted as part of the 25 page limit include:

• Proposed Strategy for Achieving the Goals, Objectives, and Outcomes of the Community College Consortia to Educate Health Information Technology Professionals Program

• Selection Criteria for lead entity and member Community Colleges

• Project Management

• Evaluation

• Dissemination

• Organizational Capability Statement

The Project Narrative is the most important part of the application, because it will be used as the primary basis to determine whether or not the application meets the minimum requirements for funding under the HITECH Act, and will serve as a primary basis for the review. The Project Narrative must provide a clear and concise description of your consortium. ONC requires that your consortium narrative include the following components:

Summary/Abstract

This section should include a brief – no more than 500 words maximum – description of the consortium, including: the consortiums plan to achieve the goals, objectives, overall approach (including target population and significant partnerships), and anticipated outcomes of the Community College Consortia to Educate Health Information Technology Professionals program.

Goals, Objectives, and Outcomes

This section should elaborate upon the description of the consortium’s plan to achieve the goals, objectives and anticipated outcomes of the Community College Consortia to Educate Health Information Technology Professionals program as laid out in the Summary/Abstract. (See Appendix B.3 for more detail on goals, objectives and outcomes)

Proposed Strategy

This section should provide a clear and concise description of the strategy proposed to address the implementation of an HIT academic program in the member Community Colleges as described in the Scope of Services (see Section I D). It should also address the consortium’s implementation plan for the nationally developed HIT – course material.

Selection Criteria

The lead awardee shall provide a description of the selection criteria and process for selecting (i) member Community Colleges and the lead institution/awardee (ii) implementation of the HIT academic program supported by the consortia.

Project Management

This section should include a clear delineation of the roles and responsibilities of project staff, consultants, the advisory working group, lead institution for the consortium, and member Community Colleges of the consortium, and how they will contribute to achieving the objectives and outcomes of the Community College Consortia to Educate Health Information Technology Professionals program. It should specify who would have day-to-day responsibility for key tasks such as: leadership of project; monitoring the project’s on-going progress, preparation of reports; communications with other partners and ONC. It should also describe the approach that will be used to monitor and track progress on the nation-wide evaluation measures. The lead awardee must provide resumes for each key staff member.

A description of the management plan for the consortium must be provided.
The management plan must:

1. Be designed to ensure the effective implementation and collaboration of activities conducted together with the member Community Colleges.

2. Describe a process of convening a regional coordination committee consisting of members of each community college in the region, which, among other things, will meet quarterly to discuss issues related to the program with members of the ONC project team. This group should be tasked with the review of materials, such as educational tools/curricula that are developed to support the program. A member from the regional coordination committee will also participate in the National coordination committee.

3. Provide for technical assistance to each member Community College in addressing the challenges and identifying successful strategies.

4. Provide for regular electronic communications to and among the partners and member Community Colleges to ensure that relevant information, research, news, reminders and other items of interest are shared in a consistent manner.

Evaluation

The lead awardee will be required to gather performance measures as described in Scope of Services – progress reporting and program evaluation. This section should describe the method that will be used to track and maintain student information.

Organizational Capability Statement

This section should include a listing of consortium members, potential partners and potential participating member Community Colleges. Each of these entities’/individual’s capabilities and capacity to support the program should be explained. Each Community College sub-awardee will complete the Experience and Capacity Profile form (Appendix B.1). The lead awardee will then combine the information from the profiles of all of its sub-awardees and present the information as one Experience Profile that reflects the entire regional consortium.

6. Collaborations with and Letters of Commitment from Member Community Colleges

The application should include which key collaborating organizations or institutions have confirmed (in the form of a signed letter of intent) their intent to be a part of the project (should it be funded). Any organization that is specifically named as having a significant role in carrying out the project should be considered an essential collaborator. Lead awardees should obtain executed contracts from each of the Community College members along with an endorsed (by each institutions financial officer) budget statement. The agreements must include resource and budget requirements.

Signed Letters of commitment should be scanned and included as attachments to the application. Lead awardees unable to scan the letters of commitment may fax them to the Office of Grants Management at 202-245-0789 by the application submission deadline. In your fax, be sure to include the funding opportunity number and your agency name.

7. Budget Narrative/Justification

All lead awardees are required to provide a detail proposed budget that includes the costs that would be incurred in support of the project activities.  The budget narrative/justification must include the allowable costs that will be incurred in support of the cooperative agreement.  Costs are not allowed to be incurred until the date listed in the Notice of Award.  Whether direct or indirect, these costs must be allowable, allocable, reasonable and necessary under the applicable OMB Cost Circulars: (See, http://www.whitehouse.gov/omb/circulars and based on programmatic requirements for administering the program as outlined in Recovery Act. 

The duration of the grant award is for a maximum of two years. Each lead awardee should provide detailed budgets for their proposed expenditures in years 1 and 2 of the cooperative agreement.. Each lead awardee can propose an administrative budget of up to $500,000 in each budget year to fund the lead awardee functions that are described in Section I.  The overall budget that is submitted by the lead awardee should include detailed annual budgets from each member of the Community College that are part of the consortium. These budgets should include justification to support their training programs. See Appendices – Attachment B for detailed information on completing the budget forms.

Items that may be included in an lead awardee’s budget are:

1. Faculty release time to prepare for teaching in these programs.

2. Professional salaries for management of the process to create the program.

3. Equipment and furnishings to house and support use of the equipment.

4. Financial aid for the first and second cohort of students.

5. Student recruitment activities.

6. Expenses to establish a career placement office.

7. Expenses to establish partnerships with Regional Extension Centers and other stakeholders to find internship and employment opportunities for the graduates of the HIT academic programs.

8. Educational consultants to advise on the program design.

9. Travel to regional consortium activities, and national coordination meetings.

Format for providing budget justification/narrative: The Budget Narrative/Justification should be provided using the format included as Attachment C of this Funding Opportunity Announcement. Lead awardees are encouraged to pay particular attention to Attachment B, which provides an example of the level of detail sought.  A combined multi-year Budget Narrative/Justification, as well as a detailed Budget Narrative/Justification for each year of potential grant funding is required.

Experience and Capacity Profile
Instructions: For each consortium, the applicant institution and each proposed member community college must complete this form. Please fill in all responses in the gray cells provided. For list responses please use a comma to identify different items (e.g. Apples, Oranges, Pears) For Yes/No answers, please indicate the appropriate response by typing an "x" into the appropriate box.
I. General Information
Applicant Name (lead awardee):
Is this profile for an applicant or a member community college?
Name of Organization completing this Profile:
Organization Address:
Organization Contact Name:
Organization Contact Email:
Organization Contact Phone Number:
II. Geographic Diversity and Service Area: (an area that embraces the home addresses of 80% of the current students)
1. Please provide details about your proposed service area, using the largest increments appropriate (i.e. if a proposed service area is a state, applicants do not need to include counties or zip codes). Organizations can provide the information in an attached document, if the information exceeds the space below, however, they should note that in the form below)
A	Specify State (s) by 2 letter United States Postal Service (USPS) abbreviation(s)*
B	Specify Included Counties
C	Specify Metropolitan Service Area Code (if available)	3 Digit Code(s)	5 Digit Code(s)
D	Specify Zip Codes (three or five digit zip-code)
2. Population in the service area
A	Please estimate the total number of people living in the college’s service area:	Population	As a percentage of population in HHS region
III. Experience and Capacity:
1. Provide estimates for the following:
A	Total number of students enrolled in 2008
B	Number of faculty employed and total number of full time equivalents (FTE)	Number of faculty	Faculty FTE
C	Number and amount of federal grants received by the entity in 2008	Number of grants	Total amount of federal funding
D	Number of programs of study offered(degrees and certificates) in 2008
E	Number of students that graduated with a degree or certificate in calendar year 2008
F	Does your college offer degree or certificate programs related to Health IT. (Programs can be entitled Health IT, or Health Information Management or Health Informatics)?	Number of programs
G	Number of students currently enrolled in all HIT programs
H	Number of students that graduated from a HIT program in 2008
I	What fraction of courses currently offered by your college may be considered distance learning courses in the sense that no regular physical attendance by students is required?	Number of students
IV. Additional Comments:
1. Any additional clarification comments about criteria above (if necessary)
Please detail the source of all the information provided.

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