Title: Capital Improvement Program HRSA09244
1Capital Improvement ProgramHRSA-09-244
- Equipment Projects
- IT/Equipment and HIT
- May 8, 2009
2Objectives
- Discuss activities to be supported through
Capital Improvement Program (CIP) the various
equipment projects - Highlight specific application requirements
- Provide technical assistance resources
3CIP 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
4CIP 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
800PM 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
5Ineligible 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.
6Types of CIP Projects
- The eligible project types are
- Alteration/repair/renovation (a/r/r), 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
7RememberEquipment and Construction Projects
- Equipment that will be utilized at the site at
which an a/r/r or construction project is
occurring should be included as part of that
project. - Fixed equipment is that which requires
installation, and should be proposed as an a/r/r
project. - If IT, HIT, and EHR-related equipment will
require significant installation, the grantee
should propose an a/r/r or construction project
to account for the installation of any fixed
equipment. The grantee should also propose an
IT/equipment, HIT, or EHR project to account for
the purchase of all related IT, HIT, or EHR
components.
8Example of Equipment Projects
- IT/Equipment-only Purchase
- HIT-only Purchase
- Certified EHR-only Purchase
- These CIP project types may be
- Site-specific
- Multi-site
- Organization-wide (inclusive of all sites)
9IT/Equipment-only Purchase
- Definition
- Tangible, nonexpendable personal property
- Useful life of more than 1 year
- Acquisition costs of 5,000 or more per unit or
the capitalization threshold established by the
recipient, whichever is less - For CIP includes nonexpendable supplies costing
less than 5,000 - Examples
- Generators or back-up power supply
- Practice management system enhancements
- Telecommunication system upgrades
- Upgrade or purchase of mobile units (e.g., vans,
trailers)
10HIT-only Purchase
- Definition
- Items or services designed for or support the use
by health care entities or patients for the
electronic creation, maintenance, access, or
exchange of health information - Examples
- Telehealth-related equipment
- Electronic prescribing
- Hardware, software, and integrated technologies
- Licenses, intellectual property, upgrades
- Enhancements necessary to interface between
HIT/EHR and other electronic systems
For additional information on HIT, please see
http//healthit.ahrq.gov/toolbox.
11Certified EHR-only Purchase
- Definition
- Computer software that providers use to track all
aspects of patient care - Examples
- Certified EHR software costs EHR application
costs, maintenance, computer-based training,
provider licenses - Infrastructure clinical facility costs wireless
LAN infrastructure, LAN switches, tablets,
cameras - Data infrastructure costs servers, routers,
back-up software, fire suppression, physical
security - Implementation staffing core team training,
data migration, CIO, network administration
Unless these types of costs are bundled within
a certified EHR system project, they should be
proposed as IT/equipment project.
12Equipment and Project Sites
- ONLY for IT/equipment projects, grantees may
propose that the project occur - At a site that is currently in the grantee's
approved scope of project (Form 5B), or - At a new mobile site only for the purchase of the
mobile unit, or - At a site previously added as part of a recently
submitted but unapproved (not yet approved)
Change in Scope request, or - At a site added via an a/r/r or construction CIP
project - If a new site is proposed, the grantee must
complete the required information in Form 5B and
submit an Add Site Checklist as part of the CIP
application (pages 37-39 of application guidance) - This change in scope request will be processed as
part of the CIP application
13Project Timeline
- CIP funds must be obligated within the 2-year
project/budget period - The following milestones should be included for
8 on the Project Cover Page - Planning start and end dates
- Project development start and end dates
- Procurement start and end dates
- Project completion date
- Estimated date site will be operational
For purchase of mobile unitGrantee must verify
site is operational within 60 days of actual
completion date
14SF-424C Budget (Construction Programs)
- Allowable/Unallowable costs under CIP (pages
19-22 of the CIP application guidance) - Line 10 (Equipment) list all equipment with
costs 5,000 or greater - Line 11 (Miscellaneous) list all nonexpendable
supplies with costs less than 5,000 - Budget examples (pages 23-24) of the guidance
- Budget Justification Detailed line-by-line
narrative breakdown of all costs listed on the
SF-424C Budget Page
15Equipment List
- Any equipment (including nonexpendable supplies
that are less than 5,000) to be purchased with
CIP funds will need to be listed and specific to
the project
16Equipment ListTypes
- Clinical x-ray machine, CAT scanners, dental
exam chair, centrifuge - Non-clinical office furnishings, elevators,
telephones, HVAC/cooling, generators, mobile
vans, laptops (not supporting an existing or new
HIT or EHR) - HIT/EHR
- Include any equipment supporting a new or
existing HIT or certified EHR system
17Environmental Review (National Environmental
Policy Act)
- Environmental Information and Documentation
Checklist (EID) (template, pages 41-52) - Must be completed and submitted with EACH project
(applies to all project types) as part of the CIP
application - Environmental Assessment
- HRSA does not anticipate requiring an EA for
IT/equipment or HIT projects - HRSA will make determination if it is required
for any CIP project after review of the EID
18Additional Considerations
- Pre-award costs
- No costs incurred or obligated prior to February
17, 2009 are allowed - Costs incurred between February 17, 2009 and the
NGA date may be allowable but are incurred at the
risk of the grantee, given the parameters of the
CIP funding - HRSA encourages grantees to implement
sustainable/green design practices for all
projects - Equipment must be maintained, tracked, and
disposed of in accordance with 45 CFR 74.34 and
92.32
19Additional Considerations (cont.)
- CIP projects must be distinct stand-alone
projects (e.g., may not be used to plan for
upcoming competitive opportunity) - Mobile units are allowable as IT/equipment
projects permanently affixing modular units is
allowable as a construction project - If the CIP project will result in a new service,
the grantee should consider its capacity to
maintain the service and must request to add the
service as part of a separate Change in Scope
request (not part of the CIP application)
20General Post-Award Reminders
- For any contract, grantees will need to make sure
they follow the standard procurement principles
that apply to all HHS grants. - HHS 45 CFR Parts 74 and 92 In order to ensure
objective contractor performance and eliminate
unfair competitive advantage, contractors that
develop or draft grant applications, or contract
specifications, requirements, statements of work,
invitations for bids and/or requests for
proposals shall be excluded from competing for
such procurements. - (http//www.access.gpo.gov/nara/cfr/waisidx_07/45
cfr74_07.html) - If the grantees find out that the CIP budget
obligates money beyond 25 of the approved budget
for all projects or 250,000, projects will need
to be reviewed and possibly changed.
21CIP Reporting
- 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 informationuses
of CIP grant funds - Other ARRA reporting required by Act
22Program Specific InformationProjects
Application Budget Summary Information
Update or Delete a Project
Add Project button
23Program Specific InformationAdding a Project
- Choose a project type from the list
- 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.
24Program Specific InformationProjectsStatus Page
IT/equipment-only purchase (single or multi-site)
IT Project
- 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.
25Project InformationProject Cover Page
6 Standard Sections
- Site Information
- Project Management
- Contact Information
- Need
- Implementation
- Timeline
26Project Information Project Impact
Direct Impacts indicated in terms of
- Square feet improved
- Square feet increased
- of providers using the EHR or HIT
- patients with EHR
Projected FTEs
27Project Information Add Equipment Information
Select from 3 Types of Equipment
- Clinical
- Non-clinical
- HIT/EHR
28Project Information Project Budget
Application Budget Summary Information
Subtotalscalculated by system
These Totals carried over to Funding form (see
next slide)
29Project Information Form 5BSites
Add Sites proposed in CIP A/R/R or Construction
Project
Pick Sites from Current Scope of Project
- Grantees may not add a new site as part of an
IT/equipment-only, HIT, or certified EHR-related
project, although they may propose that these
types of projects occur at a site added
previously as part of an alteration/repair/renovat
ion or construction project in the same
application. (CIP Announcement HRSA-09-244 pages
3-4) - By default the completion status of the 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.
30Project InformationForm 5BSites, Select from
Scope
Site Name 1
Site Name 1 Address
Site Name 2
Site Name 2 Address
Site Name 3
Site Name 3 Address
- When picking a site from scope, simply select the
site, and then click Save and Continue.
31Project InformationEID Checklist
EID Checklistis a downloadable Template
that must be attached
32Help Resources
33CIP Application Technical Assistance
34CIP Contacts