Rural Hospital Capital Improvement Grant Program - 2019 GRANT REQUEST FOR PROPOSALS (RFP) IMPORTANT DATES: This Request for Proposals (RFP) Issued.November 28, 2018 Application Deadline January 25, 2019 Grants Start Date (approximately).may 1, 2019 Lina Jau, Grant Manager Minnesota Department of Health PO Box 64882 St. Paul, MN 55164-0882 651-201-3809 lina.jau@state.mn.us To obtain this RFP in a Microsoft Word format, email lina.jau@state.mn.us.
Table of Contents 2019 RURAL HOSPITAL CAPITAL IMPROVEMENT GRANT RFP Rural Hospital Capital Improvement Grant Program - 2019... 1 SECTION A - RFP INFORMATION Part 1: Overview... 3 1.1 General Information... 3 1.2 Program Description... 3 1.3 Funding and Project Dates... 3 1.4 Eligible Applicants... 4 1.5 Questions and Answers... 4 Part 2: Program Details... 5 2.1 Priorities... 5 2.2 Eligible Projects... 5 2.3 Grant Management Responsibilities... 5 2.4 Grant Provisions... 6 2.5 Review and Selection Process... 8 Part 3: Application and Submission Instructions... 9 3.1 Application Deadline... 9 3.2 Application Submission Instructions... 9 3.3 Application Instructions... 10 SECTION B - APPLICATION CHECKLIST, FORMS, GUIDELINES Part 4: Application Checklist, Required Forms, and Guidelines... 11 4.1 Application Checklist... 11 4.2 Business Information and Applicant s Signature... 12 4.3 Required Data... 13 4.4 Proposal Narrative Guideline... 14 4.5 Budget... 16 4.6 Budget Narrative Guideline... 17 4.7 Key Personnel Biographical Sketch... 18 4.8 Governing Board Resolution... 19 4.9 Competitive Bidding Form... 20 4.10 Observations from past grant cycles... 21
Part 1: Overview 1.1 General Information SECTION A RFP INFORMATION Announcement Title: 2019 Rural Hospital Capital Improvement Grant Program RFP MDH Program Website: http://www.health.state.mn.us/divs/orhpc/funding/index.html Application Deadline: 4:00 PM CST, Friday, January 25, 2019 1.2 Program Description Minnesota Statutes Section 144.148 authorizes the Commissioner of Health to award grants to eligible hospitals under the Rural Hospital Capital Improvement Grant Program for undertaking needed modernization projects to update, remodel or replace aging hospital facilities and equipment necessary to maintain the operations of a hospital, including establishing an electronic health records system. 1.3 Funding and Project Dates Funding Funding will be allocated through a competitive process. If selected, you may only incur eligible expenditures when the grant agreement is fully executed and the grant has reached its effective date. Funding Estimate Estimated Amount to Grant $1,750,000 Estimated Number of Awards 20 Maximum Award Amount $125,000 Minimum Award Amount $45,000 Match Requirement Applicant hospitals must certify that at least 25 percent of the grant request amount will be matched from non-state sources. Project Dates April 1, 2019 March 31, 2023
2019 RURAL HOSPITAL CAPITAL IMPROVEMENT GRANT RFP Duration of Funding Awards will be made for a period of 12-48 months. Grantees are expected to complete their projects within the duration of the grant project dates. Applicants should include a realistic estimate of the time the project will require. 1.4 Eligible Applicants An eligible applicant for this grant program is a non-federal, general acute care hospital in Minnesota that fulfills the following criteria: It is located in a rural area in a community with a population of less than 15,000, according to United States Census Bureau statistics, and is outside the seven-county Twin Cities metropolitan area. It has 50 or fewer beds. It must certify that at least one-quarter of the grant amount, which may include in-kind services, is available for the same purposes from non-state resources. 1.5 Questions and Answers All questions regarding this RFP must be submitted by email to lina.jau@state.mn.us. Emails will be responded to within 2 business days. Questions and answers that MDH determines to be appropriate for publication will be posted on the ORHPC website on January 16, 2019 at: Rural Hospital Capital Improvement Grant Program (http://www.health.state.mn.us/divs/orhpc/funding/index.html#rural) To ensure the proper and fair evaluation of all applications, other communications regarding this RFP including verbal, telephone, written or internet initiated by or on behalf of any applicant to any employee of the Department, other than questions submitted to as outlined above, are prohibited.
2019 RURAL HOSPITAL CAPITAL IMPROVEMENT GRANT RFP Part 2: Program Details 2.1 Priorities Health Equity Priorities It is the policy of the State of Minnesota to ensure fairness, precision, equity and consistency in competitive grant awards. This includes implementing diversity and inclusion in grant-making. The Policy on Rating Criteria for Competitive Grant Review establishes the expectation that grant programs intentionally identify how the grant serves diverse populations, especially populations experiencing inequities and/or disparities. 2.2 Eligible Projects Eligible projects under this grant program are modernization projects to update, remodel or replace aging hospital facilities and equipment necessary to maintain the operations of a hospital, including establishing an electronic health records system. Eligible projects fall under these two categories: Purchase (and installation) of new hospital equipment Construction of new or existing hospital spaces Ineligible Expenses Ineligible expenses include but are not limited to: Fundraising Taxes, except sales tax on goods and services Lobbyists, political contributions Bad debts, late payment feeds, finance charges, or contingency funds 2.3 Grant Management Responsibilities Grant Agreement Each grantee must formally enter into a grant agreement. The grant agreement will address the conditions of the award, including implementation for the project. Once the grant agreement is signed, the grantee is expected to read and comply with all conditions of the grant agreement. No work on grant activities can begin until a fully executed grant agreement is in place. The funded applicant will be legally responsible for assuring implementation of the work plan and compliance with all applicable state requirements including worker s compensation insurance, nondiscrimination, data privacy, budget compliance, and reporting.
2019 RURAL HOSPITAL CAPITAL IMPROVEMENT GRANT RFP Accountability and Reporting Requirements It is the policy of the State of Minnesota to monitor progress on state grants by requiring grantees to submit written progress reports until all grant funds have been expended and all of the terms in the grant agreement have been met. The reporting schedule will be once every six months. A standard invoice and report form will be provided to grantees. Grant Monitoring Minn. Stat. 16B.97 and Policy on Grant Monitoring require the following: One monitoring visit during the grant period on all state grants over $50,000 For grants that are $50,000 or more, an employee of MDH will schedule a site visit or other forms of monitoring with the grantee at least once during the grant period. Conducting a financial reconciliation of grantee s expenditures at least once during the grant period on grants over $50,000. Grantees of this grant program are required to submit proof of expenses incurred including the 25% match requirement at the submission of all invoices to the State. Grant Payments Per State Policy on Grant Payments, grant dollars will be distributed to a grantee organization on a reimbursement basis. A standard invoice and report form, due semi-annually, will be provided. Only expenses that directly correspond to the approved grant budget or budget amendment will be reimbursed. 2.4 Grant Provisions Public Data and Trade Secret Materials All applications submitted in response to this RFP will become property of the State. In accordance with Minnesota Statute Section 13.599, all applications and their contents are private or nonpublic until the applications are opened (after the RFP deadline), at which time only the names and addresses of applicants are public. Once the applications are opened, the name and address of each applicant and the amount requested is public. All other data in an application is private or nonpublic data until completion of the evaluation process, which is defined by statute as when MDH has completed negotiating the grant agreement with the selected applicant. After MDH has completed the evaluation process, all remaining data in the applications is public with the exception of trade secret data as defined and classified in Minn. Stat. 13.37, Subd. 1(b). A statement by an applicant that the application is copyrighted or otherwise protected does not prevent public access to the application or its contents. (Minn. Stat. 13.599, subd. 3(a)).
2019 RURAL HOSPITAL CAPITAL IMPROVEMENT GRANT RFP If an applicant submits any information in an application that it believes to be trade secret information, as defined by Minnesota Statute Section 13.37, the applicant must: Clearly mark all trade secret materials in its application at the time it is submitted, Include a statement attached to its application justifying the trade secret designation for each item, and Defend any action seeking release of the materials it believes to be trade secret, and indemnify and hold harmless MDH and the State of Minnesota, its agents and employees, from any judgments or damages awarded against the State in favor of the party requesting the materials, and any and all costs connected with that defense. This indemnification survives MDH s award of a grant agreement. In submitting an application in response to this RFP, the applicant agrees that this indemnification survives as long as the trade secret materials are in possession of MDH. The State will not consider the prices submitted by the responder to be proprietary or trade secret materials. MDH reserves the right to reject a claim that any particular information in an application is trade secret information if it determines the applicant has not met the burden of establishing that the information constitutes a trade secret. MDH will not consider the budgets submitted by applicants to be proprietary or trade secret materials. Use of generic trade secret language encompassing substantial portions of the application or simple assertions of trade secret without substantial explanation of the basis for that designation will be insufficient to warrant a trade secret designation. If a grant is awarded to an applicant, MDH may use or disclose the trade secret data to the extent provided by law. Any decision by the State to disclose information determined to be trade secret information will be made consistent with the Minnesota Government Data Practices Act (Minnesota Statutes chapter 13) and other relevant laws and regulations. If certain information is found to constitute trade secret information, the remainder of the application will become public; in the event a data request is received for application information, only the trade secret data will be removed and remain nonpublic. Audits Per Minn. Stat. 16B.98 Subdivision 8, the grantee s books, records, documents, and accounting procedures and practices of the grantee or other party that are relevant to the grant or transaction are subject to examination by the granting agency and either the legislative auditor or the state auditor, as appropriate. This requirement will last for a minimum of six years from the grant agreement end date, receipt, and approval of all final reports, or the required period of time to satisfy all state and program retention requirements, whichever is later. Affirmative Action and Non-Discrimination Requirements for all Grantees The grantee agrees not to discriminate against any employee or applicant for employment because of race, color, creed, religion, national origin, sex, marital status, status in regard to public assistance, membership or activity in a local commission, disability, sexual orientation, or age in regard to any position for which the employee or applicant for employment is qualified. Minn. Stat. 363A.02. The grantee agrees to take affirmative steps to employ, advance in employment, upgrade, train, and recruit minority persons, women, and persons with disabilities.
2019 RURAL HOSPITAL CAPITAL IMPROVEMENT GRANT RFP The grantee must not discriminate against any employee or applicant for employment because of physical or mental disability in regard to any position for which the employee or applicant for employment is qualified. The grantee agrees to take affirmative action to employ, advance in employment, and otherwise treat qualified disabled persons without discrimination based upon their physical or mental disability in all employment practices such as the following: employment, upgrading, demotion or transfer, recruitment, advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship. Minnesota Rules, part 5000.3500 The grantee agrees to comply with the rules and relevant orders of the Minnesota Department of Human Rights issued pursuant to the Minnesota Human Rights Act. 2.5 Review and Selection Process Review Process Grants will be awarded through a competitive process. Review committees made up of professionals with expertise in rural hospitals and grants will evaluate all eligible and complete applications received by the deadline. They will make recommendations as to which applicants should be funded and for how much. MDH will review committee recommendations and is responsible for award decisions. The award decisions of MDH are final and not subject to appeal. Additionally: MDH reserves the right to withhold the distribution of funds in cases where proposals submitted do not meet the necessary criteria. The RFP does not obligate MDH to award a grant agreement or complete the project, and MDH reserves the right to cancel this RFP if it is considered to be in its best interest. MDH reserves the right to waive minor irregularities or request additional information to further clarify or validate information submitted in the application, provided the application, as submitted, substantially complies with the requirements of this RFP. There is, however, no guarantee MDH will look for information or clarification outside of the submitted written application. Therefore, it is important that all applicants ensure that all sections of their application are complete to avoid the possibility of failing an evaluation phase or having their score reduced for lack of information. Selection Criteria and Weight Grant reviewers will use a standardized scoring system to determine the extent to which the applicant meets the selection criteria. Each application will be scored on a 100-point scale as follows: 1. A maximum of 40 points for an applicant s clarity and thoroughness in describing the problem and the project as a solution to the problem.
2019 RURAL HOSPITAL CAPITAL IMPROVEMENT GRANT RFP 2. A maximum of 40 points for the extent to which the applicant has demonstrated adequate provisions to ensure proper and efficient operation of the facility once the project is completed. 3. A maximum of 20 points for the extent to which the proposed project is consistent with the hospital s capital improvement plan or strategic plan. 4. Reviewers may also take into account other relevant factors such as the urgency of the project to keep the hospital functioning, and the extent to which the hospital is ready to implement the project. Grantee Past Performance and Due Diligence Review Process It is the policy of the State of Minnesota to consider a grant applicant's past performance before awarding subsequent grants to them. State policy requires states to conduct a financial review prior to a grant award made of $25,000 and higher to a nonprofit organization, in order to comply with Policy on the Financial Review of Nongovernmental Organizations (https://mn.gov/admin/assets/08%2006%20grants%20policy%20revision%20dec%202016%20f inal_tcm36-265656.pdf) Notification MDH anticipates notifying all applicants via mail of funding decisions by March 15, 2019. Part 3: Application and Submission Instructions 3.1 Application Deadline Deadline Applications must be received by MDH no later than 4:00PM Central Standard Time on Friday, January 25, 2019. Late applications will not be accepted. It is the applicant s sole responsibility to allow sufficient time to address all potential delays caused by any reason whatsoever. MDH will not be responsible for delays caused by mail, delivery, computer or technology problems. 3.2 Application Submission Instructions Submit an application using only one of the submission methods below. o If you are submitting an application by courier or FedEx or any other next day delivery service, use this address: Lina Jau, Grant Manager MDH Golden Rule Building 85 E. 7 th Place, Suite 220 St. Paul, MN 55101
2019 RURAL HOSPITAL CAPITAL IMPROVEMENT GRANT RFP Please follow 3.3 Application Instructions below for the number of copies required. o If your are submitting your application via the US Post Office (USPS), use this address: Lina Jau, Grant Manager Minnesota Department of Health, ORHPC PO Box 64882 St. Paul, MN 55164-0882 Please follow 3.3 Application Instructions below for the number of copies required. o If you are submitting your application via email, use this email address: lina.jau@state.mn.us The file size limit for the email attachment is 25MB. 3.3 Application Instructions A complete grant application packet must include all of the following: 1. One (1) original of the following and they must be collated: the required forms (refer to the Application Checklist in SECTION B below) the proposal narrative, and other attachments considered necessary to be included in the application as determined by the applicant 2. Four (4) copies of the items listed in A above (must be collated and stapled or paper clipped): the required forms (refer to the Application Checklist in SECTION B below) the proposal narrative, and other attachments considered necessary to be included in the application determined by the applicant 3. Only one copy of the applicant s latest Independent Audit Applications must include all required application materials, including attachments. Do not provide any materials that are not requested in this RFP, as such materials will not be considered nor evaluated. Any application that is incomplete will not be considered for funding. By submitting an application, each applicant warrants that the information provided is true, correct, and reliable for purposes of evaluation for potential grant award. The submission of inaccurate or misleading information may be grounds for disqualification from the award, as well as subject the applicant to suspension or debarment proceedings and other remedies available by law.
2019 RURAL HOSPITAL CAPITAL IMPROVEMENT GRANT RFP SECTION B - APPLICATION CHECKLIST, REQUIRED FORMS and GUIDELINES Part 4: Checklist, forms and guidelines This section contains required application forms, guidelines and other helpful information for completing a 2019 Rural Hospital Capital Improvement grant application. Application Checklist A complete 2019 Rural Hospital Capital Improvement Grant Application must include all the required information and additional attachments listed 1 through 9 below. Please follow the application submission instructions found in SECTION A. Part 3 (above) which include the number of copies of each form and material required for submission. 1. Business Information and Applicant s Signature form 2. Required Data form 3. Proposal Narrative 4. Budget form 5. Budget Narrative 6. Key Personnel Biographical Sketch form (more than 1 may be filled out) 7. Competitive Bidding form 8. Governing Board Resolution form 9. Mandatory Attachment: The latest Independent Audit of the applicant hospital. Submit only 1 copy. If the Independent Audit covers multiple hospitals within a system/umbrella organization, please provide additional financial information such as an income statement that is specific to the applicant hospital. 10. Voluntary Attachments such as cost estimates, bids, architects blueprints or photographs may be voluntarily provided by the applicant, and incorporated throughout the application where deemed appropriate. These additional materials should be limited to information highly relevant to the specific scope and purpose of the proposed project.
Business Information and Applicant s Signature Please provide the information below: Applicant hospital: Business address: System affiliation (if applicable) Name of System: Brief Description of the Nature of Affiliation (managed by, leased by, owned by, etc.): Contact person for this application Name: Title: Phone: Email: Contact person for this application: Name: Title: Phone: Email: Person authorized to submit the application (if different from the contact person) Name: Title: Phone: Email: Project title: Grant Funding Requested $ Match Amount (must be at least 25% of Grant Funding Requested) $ Total Project Cost $ Certification. I certify that the information contained herein is true and accurate to the best of my knowledge and that I submit this application on behalf of the applicant organization. Applicant Authorized Signature: Date: Date: Type/Print Name:
Required Data Please provide the following information followed by a brief explanation narrative. Information provided must be specific for the hospital for which the grant is applied for (that is, not for the system organization). Topic Data Current days of cash on hand: Current operating margin: Current total margin: Average daily census in the last 12 months: What percent of the total hospital s revenue came from outpatient services in the last 12 months? % Using the space below, please provide a very brief narrative (if any) to give further context and explanation of the data supplied in the table above.
Proposal Narrative Guideline A clear, concise, and thorough application narrative must be presented using the format below as a guideline. The narrative must not exceed 20 double-spaced pages, font 11 or 12, and all pages must be numbered consecutively. A. The hospital and service area overview Describe the hospital, the services it provides, the population it serves, and the hospital s service area. Include information of the existing and/or unmet health care needs of the population in the service area. The hospital overview should also describe the age, size, available inpatient beds, configuration and condition of the hospital facilities and equipment, how many patients are served, capital improvement needs, distance to nearest tertiary care center, etc. Include documentation (e.g., population census data, hospital census data, architectural and engineering studies) supporting the hospital description and problem statement, as appropriate. B. The problem statement Clearly describe the nature of the problem(s) in the facility and service area that will be addressed if this project is selected for funding. The Problem Statement should document changes in service populations, community needs and hospital services, and the need to repair, replace or reconfigure facilities and equipment in response to current and anticipated changes in the hospital s operational environment. C. The project description 1. Objectives and goals of the project State the project objectives and goals. Goals are long-range benefits that are broad in scope. A goal statement describes what will exist if the stated problem(s) are solved. Objectives are statements of the short-term or intermediate-term outcomes related to the problem(s) the proposal is intended to address. Objectives are tangible, specific, measurable and achievable. 2. Project description Describe current conditions the project will address and the proposed improvements. If proposed improvements are for more than one hospital area or building (e.g., patient rooms, radiology and ER) or system (e.g., telephone, HVAC, data processing, EHR and lighting), describe each project component separately.
3. Construction, remodeling and equipment drawings or specifications Provide as attachments, if available (these do not count toward the 22-page limit). If not yet produced, note in this section and in the timeline when they will be completed. 4. Timeline Provide a timeline for each project component. The timeline should identify, in chart or table form, who will be involved in each task, and the estimated start and completion date for each task. 5. Roles and capabilities of individuals and organizations involved in the proposed project Use the Biographical Sketch Form for key project staff qualifications. 6. Results expected from the project Results discussed in this section should relate to the project objectives. D. The plan to maintain or operate facilities equipment included in the project This section provides an opportunity to discuss administrative, technical or staffing plans to maintain and operate specific pieces of equipment or structure as a result of the capital improvement project, and the business plan to generate sufficient revenue for maintenance or operations. If you are proposing improvements throughout the hospital, discuss the business plan for the hospital as an institution. E. The relationship between the proposed project and the strategic plan or capital improvement plan Is the proposed project clearly a part of the hospital s strategic plan or capital improvement plan? Demonstrate how the proposed project is consistent with the hospital s strategic direction and flows from overall hospital planning. Document the priority of the proposed project within the current strategic or capital improvement plan. If the proposed project is not a high priority in the strategic plan or capital improvement plan, please explain why there is a need for the project to be implemented now.
Exhibit A Budget Instruction: Please fill in the amounts of State Fund Requested, Match funds contribution, and Total in the table below. CATEGORIES STATE FUND REQUESTED MATCH (funding from other sources - must be at least 25% of State Fund Requested) TOTAL (State Fund plus Match) Acquisition - Land Acquisition - Building Demolition, land clearing, excavation, filling, etc. Site improvement: landscaping, sidewalks, parking, etc. Construction Architect and engineering fees Legal Permits Survey Environment Equipment Overhead (Match only) Staff training Other (describe): Other (describe): Other (describe): Other (describe): Other (describe): Other (describe): TOTAL: This Budget Table must be followed by a Budget Narrative.
Budget Narrative Guideline Identify and describe all sources of funding for the capital improvement project including the grant funds requested from the Rural Hospital Capital Improvement Program. Specify the sources of the 25% match dollars. Define the source of all funding from non-state sources for the project. For each of the line items on the Budget form, please provide the rationale and details that indicate how the budgeted line items were calculated. Consultants and contractors must be identified. (Include evidence that competitive bidding was used to select project contractors. Attach specifications or bids to show the details. The Competitive Bidding form provided must also be filled out.) If contractors have not been selected or identified, explain the selection process. If bids, drawings or specifications have not yet been produced, describe how costs were estimated. For the Overhead budget line, include the details of any hospital personnel, travel, supplies or other expenses to be charged to this project. Be sure to explain the basis for project costs. Limit the Budget Narrative to 3 double-spaced pages, font 11 or 12.
Key Personnel Biographical Sketch Provide the following information for key professional personnel only who will be involved in the capital improvement project. Duplicate this form for each key professional personnel. 1. Name of key professional personnel: 2. Title: 3. Role in proposed project: 4. Education: Institution and Location Degree and Year Earned Professional Field blank blank blank blank X x 5. Professional experience (relevant to the proposed project):
Governing Board Resolution Be it resolved that: 1) (Organization or unit of government name) apply for a Rural Hospital Capital Improvement grant from the Office of Rural Health and Primary Care of the Minnesota Department of Health. 2) (Organization or unit of government name) certifies that it will comply with the requirements of the Rural Hospital Capital Improvement Grant Program, including the requirements in Minnesota Statutes 144.148. 3) (Organization or unit of government name) enters into a grant agreement with the State of Minnesota if the application is successful. 4 (Title of Authorized Official) is hereby authorized to execute contracts and certifications as required to implement the organization s participation in the Minnesota Rural Hospital Capital Improvement Grant Program. I certify that the above resolution was adopted by the: (Governing Body) Of (Organization) on (date). SIGNED: WITNESSED: (Signature) (Signature) (Title) (Title) (Date) (Date)
Competitive Bidding Form Minnesota Statues 144.148 requires that applicants must submit to the Commissioner evidence that competitive bidding was used to select contractors for the project. Applicant Hospital (with which the grant agreement is to be executed) Legal Name: Address: Competitive bidding has been completed for the proposed project through one of the following methods (make a check next to applicable method): This hospital is owned by a local unit of government subject to the Uniform Municipal Contracting Law, M.S. section 471.345, and has complied with those requirements. (Attach documentation of the bid and award process.) This hospital is not subject to the Uniform Municipal Contracting Law, but has its own procurement policy that requires competitive bidding. (Attach relevant sections of the policy and documentation of the bid and award process.) This hospital is not subject to the Uniform Municipal Contracting Law, does not have its own procurement policy that requires competitive bidding, but has followed a competitive bidding process. (Attach relevant sections of the policy and documentation of award process.) Competitive bidding has not yet been completed for the proposed project, but will be conducted through one of the following methods. (You will be required to submit documentation of the bid and award process before any state payment will be made.) o This hospital is owned by a local unit of government subject to the Uniform Municipal Contracting Law, M.S. section 471.345, and will comply with those requirements. o This hospital is not subject to the Uniform Municipal Contracting Law, but has its own procurement policy that requires competitive bidding. (Attach relevant sections.) o This hospital is not subject to the Uniform Municipal Contracting Law, does not have its own procurement policy that requires competitive bidding, but will follow a competitive bidding process for this project, as described here (or attach description). Certification I certify that the information contained herein is true and accurate to the best of my knowledge and that I submit this application on behalf of the applicant organization. Signature: Title: Date:
memo Observations from past grant cycles DATE: November 28, 2018 TO: FROM: SUBJECT: All Interested Parties Lina Jau Office of Rural Health and Primary Care (ORHPC) 651-201-3809 or lina.jau@state.mn.us Observations from past Rural Hospital Capital Improvement Grant Program cycles Over the last several years the demand for grant funds from the Rural Hospital Capital Improvement Grant Program far exceeded the supply. Over three times the available amount of grant funds are typically requested each year. This intense competition has resulted in an increasingly close examination of the strengths and weaknesses of applications. These are difficult decisions, so we strive to give reviewers as full a context as possible in order to make appropriate funding decisions. This includes any available data on the hospitals, discussion of any major health reform efforts to which the proposed projects may be related, and information on past performance as a recipient of a grant through ORHPC. Please find attached observations and suggestions, based on several general issues that have had an impact on funding decisions by reviewers in recent grant reviews. I hope you will find this useful. Please feel free to call me any time if you have any questions.
Observations from past grant cycles Issue Comment or suggestion Application section where issue should be addressed Need for funds Collaboration, coordination and/or partnership Strategic plan, and capital improvement or facilities plan In the past, applicants that documented a clear and specific need for funds for their proposed projects fared better than others. Being competitive usually included a narrative discussion of the hospital s financial condition supported by financial statement data. If there is a local government contribution to the operation of the hospital and/or to the proposed project, it is important to note. Some applications included projects that had already started or were already scheduled to begin soon. These applications raise questions about whether grant funds are needed, since it can appear they will happen anyway (without grant funds). Applicants may want to explain these situations. Some applications have requested a grant contribution to a multimillion dollar capital campaign or project. Reviewers have asked whether the grants typically made by this program, averaging historically in the $85,000 to $125,000 range, are truly critical to the success of such large projects. Applicants may want to discuss such cases in detail, including details about the funding sources for a large project. The grant program regularly receives requests from hospitals that recently completed a multimillion dollar major renovation, update or addition project. In such a case, the grant application should address why the proposed project was not included in the major renovation. For major reconstruction projects or upgrades to a building, pictures can be very helpful in illustrating the current condition of the facility, and thus the need for funds. A number of projects propose new equipment or new uses of facilities that would be shared and/or coordinated with other facilities or providers. Being competitive on this issue includes presenting details of the collaboration and attaching letters of commitment and support from proposed partners. Projects that were not related to the strategic direction (a documented high priority activity) of the hospital or strategic plan, or were not connected to the overall facilities improvement plan, have experienced difficulty being selected for funding. Include sufficient documentation from a current strategic or capital plan, and make sure reviewers can easily deduce where the project falls specifically within the plan. Proposal Narrative: hospital and service area overview Proposal Narrative: problem statement Budget Budget Narrative Attachments Proposal Narrative: problem statement Proposal Narrative: project description Attachments Proposal Narrative: problem statement Proposal Narrative: goals/objectives Proposal Narrative: strategic plan Attachments
Issue Comment or suggestion Application section where issue should be addressed Issue Comment or suggestion Application section where issue should be addressed Affiliate Systems Other match issues Identifying the source of matching funds Proposals related to specific service lines and/or equipment Reviewers invariably ask about the perceived role of large systems with which many hospitals have an affiliation. Systems receive value from the referrals and other relationships they have with small rural hospitals. Reviewers have expressed an expectation that systems should be contributing to the capital improvement projects of their affiliates. This may not always be a realistic expectation, and this issue should be directly addressed in the application. Applicants may wish to discuss the nature of the affiliation (in addition to noting it on the application form), to contact their system to ask for support of the project, to discuss the system s response, and to document the system s position with an exchange of letters in the attachment section. Some applicants have defined match dollars as only existing staff costs and related overhead for current activities they would already be doing. In-kind match is allowed, but this approach to meeting the program s match requirement can send a message that the project is not important enough to commit new resources. An un-defined inkind match can also raise the question of how the project will be completed if the project is not fully funded. For budget purposes, include any salary under the Other category, and include a full description in the budget narrative. Specify the source of match funds. Some applicants have listed the required amount of local match without identifying the source. This can lead reviewers to question whether the match is truly available and committed. Likewise, suggesting that matching funds will only be raised after securing grant funding is likely to be scored lower by reviewers. Adding or upgrading a service line is a common proposal for this grant, and are frequently funded. However, for service expansions, redesigns, or related equipment purchases, it is important to include a rational estimate of the anticipated volume for the new service and/or equipment. Reviewers will expect sufficient strategic planning for the new service and/or equipment that includes a plan for sustainability based on reasonable volume assumptions. Include these assumptions in the project description. Some applicants that have sought to create a new service line did not include sufficient information about staffing or contracting necessary to implement the change. Include at least a plan for how medical staff and/or contracted professionals will use the equipment. Business Information and Signature form Proposal Narrative Budget Budget Narrative Attachments Budget Budget Narrative Budget Budget Narrative Proposal Narrative: goals/objectives Proposal Narrative: project description Proposal Narrative Proposal Narrative: strategic plan
Issue Comment or suggestion Application section where issue should be addressed Recipients of prior grant awards from the MDH Office of Rural Health and Primary Care HIT or EHR projects related to Meaningful Use requirements Receipt of a previous grant is not a factor in future grant selection each proposal is weighed in the context of that year s pool of applications. That said, previous grantees should address their experience in successfully administering grant awards from the Office of Rural Health and Primary Care. Grantees that have failed to complete current and previous grant funded projects in a timely and professional manner (including submission of required progress and final reports) may expect reviewers to assess their application regarding administrative capacity during the course of the application review. HIT projects are specifically defined in statute as eligible for funding by this grant, so these projects will not be excluded based on the receipt of Meaningful Use dollars. However, reviewers consistently point out that HIT and EHR projects related to obtaining Meaningful Use requirements receive funding from other sources. Discuss how Meaningful Use dollars will or will not be spent in relation to the proposed project. The discussion should at least assure reviewers that no double dipping would occur using funds from the Capital Improvement program. Proposal Narrative Proposal Narrative: project description Budget Narrative