Developing a Competitive NAP Application: Overall Grant Writing Process and the Secrets to a Successful Application

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CHCANYS New Access Point Webinar Developing a Competitive NAP Application: Overall Grant Writing Process and the Secrets to a Successful Application August 19, 2014 Pamela J. Byrnes, PhD Senior Consultant

Increasing Your Opportunity for Success It Takes Planning Not Magic!! 2

Program/Proposal Logic Model STRONG HEALTH CENTER PROGRAMS STRATEGIC PLANNING NEEDS ASSESSMENTS

Program/Proposal Logic Model The Needs Assessment Informs the Strategic Planning Process Which Forms the Basis for the Health Care Plan and Service Delivery Model Lays Out a Rational and Logical Approach to the Implementing that Plan Which is Supported by a Reasonable, Realistic and Cost Effective Budget

What HRSA Looks for in a Proposal Compliance Serving High Need Area Increased access to primary health care services, improve health outcomes and reduce health disparities All persons in the target population will have ready access to the full range of required primary, preventive, enabling and supplemental health care services, including oral health care, mental health care and substance abuse services 5

What HRSA Looks for in a Proposal collaborative and coordinated delivery systems A sound and complete plan A reasonable and accurate budget Readiness to initiate the proposed project plan 6

NEED If you don t grab them with need you are dead before you start!! Use data projection methods to accurately describe your Target Population

IDENTIFYING NEED Health Disparities Health outcome data demonstrating that the target population experiences disparities in health outcomes compared to the general population in the Service Area or other benchmarks Access to Care Data demonstrating that there is not an adequate quantity of accessible primary health care providers for the Target Population Barriers to Care Even if there are health care resources why is it that the target population cannot use them fully?

FROM NEED TO PROGRAM THE LOGIC HEALTH DISPARITIES = SERVICES ACCESS LIMITATIONS = STAFFING PROFILE BARRIERS = SERVICE DELIVERY MODEL AND STRATEGY

RULE #1A IDENTIFIED NEEDS HAVE TO RELATE TO PROGRAM HEALTH DISPARITIES = SERVICE PACKAGE ACCESS PROBLEMS = STAFFING PROFILE BARRIER PROBLEMS = DELIVERY STRATEGY

RULE #1B IDENTIFIED NEEDS HAVE TO RELATE TO PROGRAM IDENTIFYING SCORES OF PROBLEMS WITHOUT CORRESPONDING PROGRAM IS NOT A WINNING STRATEGY

Demonstrating You Can Do It Implementation and Readiness 12

READY SET GO!! Readiness Implementation Plans All applicants should demonstrate, and provide documentation, that within 120 days of receiving the grant award the health center will be operational and ready to deliver services Location is appropriate: transportation and parking, population density, available collaborative partners Proposed facility will be available and ready for occupancy Size and number of exam rooms are appropriate based on projected number of users at full capacity, proposed staffing and scope of services Staff and providers will be available and ready to provide services 13

For the Application Demonstrating the Health Center Is Ready to Provide Services As appropriate, applicants should attach signed leases, floor plans, renovation plans, provider contracts, commitment letters for staff, etc. Additional requirements for HCH and PHPC applicants (as well as health centers operating clinics in schools) as applicable, include Agreement from the site sponsor that allows services to be provided at the location Plan for compliance with certification and/or licensure processes 14

Readiness Implementation Plan Readiness Plan Not Quantifiable but definitely time framed!! What needs to be done (readiness) to implement Proposed program What needs to be done to meet Program Requirements 15

Readiness and Implementation Plan Readiness Plan Based On Application Narrative Health Center Program Requirements Reimbursement Environment Management Work Plans Grant and/or Look Alike Application Requirements Operational Readiness Sustainable Business Practice 16

The Readiness Implementation Plan Areas Covered in implementation Plan Governance Administrative/Compliance Requirements Clinical Staffing Fiscal/Financing Information Technology Systems 17

Readiness Implementation Plan UDS and other reporting requirements Federal Procurement Policies Sliding Fee Discounting Policies/procedures Renovations facility prep Supplies medical/ non medical 18

Readiness Implementation Plan Collaboration affiliation agreements Board recruiting orientation IT system selection implementation FQHC Billing Hire and Train Staff Negotiate Managed Care Contracts 19

Readiness Implementation Plan Obtain CLIA Certificates Apply for 340B Covered Entity Status Apply for Medicare (CMS) FQHC Status 855A Application Determine Medicare Cost Per Visit Apply for FQHC Medicaid State Specific Determine Medicaid Cost Per Visit 20

Readiness Implementation Plan Plan the Celebration!!!!!!!! 21

Readiness Plan Sample Format Plan/Activity Completion Date Person Responsible Comments 22

Develop The Work Plan Start at the End: Total time to complete is approximately 250 hours Decide at the beginning whether to hire out or do it in house Back up from the deadline and make realistic time estimates for each phase (planning, drafting, finalizing) Set a Deadline At Least 45 Days Out Your Goal 23

Start Organized Develop a written task list with strict timelines Schedule regular check points and stick to them Develop list of outside documents and activities (contracts, MOAs, etc.) 24

Start Organized Identify individuals responsible for each section of the application Needs Assessment/Population Description Scope of Project/Service Delivery Clinical Financial Administration Affiliations/Contracts/MOAs Community Involvement/Outside Support 25

Start Organized EVEN IF YOU HIRE A CONSULTANT YOUR STAFF AND BOARD MUST BE INVOLVED AND RESPONSIBLE PRODUCING A QUALITY PROPOSAL DEPENDS ON TIMELY AND RELIABLE INFORMATION 26

Start Organized Agree on format and style Identify who is responsible for assuring consistency and doing read throughs and edits Keep track of computer files who, what, where, how MAKE BACK UP DISKS/CDs 27

Develop The Proposal Work Concurrently Even if you hire in, the staff needs to provide information, develop the goals and objectives and review the document Focus on the requested information and answer the questions KNOW WHERE THE POINTS ARE AND WRITE TO THEM 28

Develop The Proposal Write for the Reviewers: Lay out a clear road map Be detailed and focused Leave nothing to the imagination Do not leave any questions unanswered even if you repeat yourself! Use the format, headers and language in the application guidance 29

Develop The Proposal State Clearly: What funding you are applying for What type of organization you are Any special populations or priorities you are addressing or qualify for 30

Sell the Organization!! TOOT YOUR HORN!!!! 31

Sell the Organization!! TALK STORY YOUR PATIENTS AND COMMUNITY ARE YOUR BEST SALESPEOPLE 32

Sell the Organization Why are YOU the appropriate entity to receive funding or look alike designation?? history and status as an FQHC or health care provider or organization in the community, years of uninterrupted service, involvement with and commitment to the community Staff skills and organizational capacity Prior clinical outcomes Cultural and linguistic appropriateness Evaluation capabilities 33

Sell the Organization Why are YOU the appropriate entity to receive funding?? Unique characteristics and significant accomplishments Prior experience and expertise in Working with target population(s) Addressing identified needs Developing and implementing systems and services to meet the needs Capability and commitment of the board, management, and local community to support the FQHC s operations 34

Final Steps Revise proposal as needed based on review comments Review document for content and accuracy Make sure all requested information is included in the places it is asked for Make sure all numbers match Make sure all document requirements are complied with 35

COMMON PROBLEMS mixing up levels of population descriptions service area target population patients not addressing identified needs with program or at least an acknowledgement assuming the reader knows what you are talking about having numbers that do not match!!!!!!!! 36

COMMON PROBLEMS using only national level data not explaining why data used is older Oy the forms!!!!!!!! not having letters of support from real people (seriously everyone gets a letter from their Senator) having numbers that do not match!!!!!!!! 37

RULES TO LIVE BY Everything is related The Needs Assessment Forms the Basis of the Health Plan and Service Delivery Model Which are Supported by the Business Plan and Budget 38

RULES TO LIVE BY Answer all of the questions wherever and whenever they are asked Connect the dots don t leave things hanging Make sure all numbers match 39

RULES TO LIVE BY If it is required and you don t submit it you are out Get it right the first time there is no 2 nd chance for funding applications If it is not in the budget it is not happening!! 40

THE BIG RULE THIS IS NOT A WORK OF FICTION!!!! 41

Reviewers are People Too!! Treat them with respect Let them know you appreciate them Make their job as easy as possible Make giving you what you are asking for a no brainer 42

And Most Important of All Remind Yourself and the Reviewers Why You Are Doing This!! 43

CHCANYS NAP Resource Center 1. Data Support: CHCANYS can provide assistance with Form 4 (Community Characteristics) and Form 9 (Need for Assistance Worksheet). 2. Health Care Environmental Scan: CHCANYS can provide an overview of the State environment. Applicants can have the most accurate and up-todate information on the New York State health care environment and any significant statewide changes that have affected health centers ability to provide services. 3. PCA Letter of Support: If you would like to request a letter of support from CHCANYS, please read updated Policy Regarding Requests for Letters of Support and complete CHCANYS Letter of Support Request Form. 4. Emergency Preparedness: CHCANYS has developed a number of templates and resources to help you communicate this in your application narrative. http://www.chcanys.org/index.php?src=gendocs&ref=nap%20resource%20center&category=na 44 P%20Resource%20Center[chcanys.org]

Upcoming NAP Webinars Developing a Competitive NAP Application: Budgeting, Support Requested and Sustainability Presented by: Leo Fishel President, Healthcare Consulting, Inc. Wednesday, September 3, 2014 2:00 3:00 p.m. Developing a Competitive NAP Application: Forms and Attachments Presented by: Alec McKinney, Ann Loeffler, and Alexia Eslan John Snow, Inc. Tuesday, September 9, 2014 1:00 2:30 p.m CHCANYS NAP Resource webpage: http://www.chcanys.org/index.php?src=gendocs&ref=nap%20resource%20center&categ ory=nap%20resource%20center 45

Webinar Evaluation Please take a moment to complete this brief webinar evaluation: https://www.surveymonkey.com/s/201 4NAPWebinar3 46

STAY IN TOUCH PAMELA J. BYRNES, PHD SENIOR CONSULTANT 860-739-9224 PBYRNES@JSI.COM