ONC: CAHs and Rural Hospitals to gain add’l support from RECs–Jan 12 Deadline

Regional Extension Centers Apply for Supplemental Funds
to Support CAHs and Rural Hospitals
from Office of National Coordinator for Health IT
REC Applications Due January 12, 2011
According to a December 28, 2010 ONC announcement, Regional Extension Centers, which support the process of achieving ‘Meaningful Use’ for eligible professionals, Critical Access Hospitals, Community Health Centers and Rural Health Clinics, may be able to receive supplemental funds to bring total to $18,000 per CAHs or Rural Hospitals under 50 beds per  facility.

Posted December 28, 2010 on ONC Site
Synopsis: “This supplement will be available to recipients of the REC awards and is intended to ensure the provision of services to CAHs and Rural Hospitals in the REC’s service area. This award will be supplemental to the REC’s existing award, and the plans, metrics and reporting requirements will be included in the REC’s cooperative agreement. It is anticipated that each REC will need a total of $18,000 per CAH and Rural Hospital that it supports through this program, beyond the funding awarded in the base REC grant. RECs in Group A will be awarded $18,000/eligible CAH and Rural Hospital approved for funding. RECs in Group B will be awarded $6,000/previously approved CAH and Rural Hospital to bring the total amount of CAH/Rural Hospital supplemental funding from $12,000/hospital to $18,000/hospital. The supplemental funds will be used to ensure the delivery of the support services for CAH and Rural Hospitals and will be tied to the same milestones that are identified in the original REC FOA (EP-HIT-09-003). As with other funding milestones identified in the original FOA, recipients will be required to use the customer relationship management tool to help in meeting the milestones associated with this project.”

Key Links:
ONC Funding Announcement
Funding Announcement PDF
List of Eligible Hospitals [XLS – 175 KB]
Grants.gov Announcement and documents

Supplemental Funding Opportunity for Regional Extension Centers to assist eligible Critical Access Hospitals (CAH) and Rural Hospitals in adopting electronic health records and using them in a meaningful way

  • Funding Opportunity Number: 2010-ONC-REC-S-01
  • Closing Date for Applications: January 12, 2011, 11:59 p.m. EST
  • Estimated Total Program Funding: $12,228,000

Excerpted from Funding Announcement Dec 28, 2010:
After the initial REC awards were made, the RECs recognized the challenges of serving CAH and Rural Hospitals were significant and therefore required greater resources than were provided. ONC recognized the unique needs of these hospitals and funded this project as a supplement to the REC funding (Funding Opportunity Number: EP-HIT-09-003). Supplemental funding can only be made available to entities with existing REC cooperative agreement awards. The purpose of the supplement was to ensure the provision of services to Critical Access Hospitals (CAH) and Rural Hospitals already defined within the scope of the cooperative agreements funded under FOA No. EP-HIT-09-003, as CAHs and Rural Hospitals are vital components of the rural health care system in the United States. These hospitals were included on the priority list for the RECs. The intent of the CAH/Rural Hospital Project is to provide additional support for staffing and expertise to assist rural CAHs and Rural Hospitals with less than 50 beds in selecting and implementing meaningful electronic health record (EHR) systems. These additional staff will work in coordination with other REC staff that will be supporting the primary care providers in the REC Service Areas.

The original cooperative agreement award was comprised of a four year project period, consisting of two budget periods. The first budget period (years 1 and 2) had a 90/10 cost share requirement and the second budget period (years 3 and 4) had a 10/90 cost share requirement. For the first budget period the grantee was responsible for contributing 1 dollar for every 9 federal dollars. For the second budget period, the grantee was responsible for contributing 9 dollars for every 1 dollar of federal funds.

In December 2010, the Secretary approved additional changes to the REC program under the authority of the cost-sharing waiver per the HITECH Act, stating that “The Secretary may provide financial support to any regional center created under this subsection for a period not to exceed four years. The Secretary may not provide more than 50 percent of the capital and annual operating and maintenance funds required to create and maintain such a center, except in an instance of national economic conditions which would render this cost share requirement detrimental to the program and upon notification to Congress as to the justification to waive the cost-share requirement.” This waiver provided changes to the REC program timeline and cost-sharing requirements. The timeline was modified to lengthen the first budget period from two years to four years. The cost-sharing requirement will now reflect a 90/10 federal/grantee cost share for all four years with the execution of a revised Notice of Grant Award (NGA).

As stated in original FOA, a positive biennial evaluation will be required for grantees to continue work in years 3 and 4 of the grant; this requirement is unchanged by the December 2010 waiver. The scope of work of the REC program also remains unchanged.

The purpose of this supplement is to further ensure the provision of services to Critical Access Hospitals (CAH) and Rural Hospitals, as described above and will make available funding to the following:

Group A: Regional Extension Centers which did not apply for supplement funding under the first supplemental funding announcement or were not funded under the first supplemental funding opportunity announcement.

Group B: Regional Extension Centers which did receive supplemental funding, and are applying for an additional $6,000 per eligible Critical Access Hospital (CAH) and Rural Hospital already defined within the scope of its cooperative agreement funded under FOA No. 2010-ONC-REC-S.

Scope of Services
Each applicant has already developed a plan for supporting priority setting (including providers at CAHs and Rural Hospitals) primary care providers in their service area to achieve meaningful use of an EHR system as part of their original application. This supplement is designed to provide support to the RECs, to ensure they can provide assistance to CAH and Rural Hospitals in their service area. In their original application, RECs stated that they were planning to work with CAH and Rural Hospitals. However, it was made known that the RECs may not have sufficient resources to carry out this endeavor.

For Group A, each funded REC will plan and implement the outreach, education, and technical assistance programs necessary to meet the objective of assisting CAHs and Rural Hospitals with less than 50 beds in its geographic service area to improve the quality and value of care they furnish by attaining or exceeding meaningful use criteria established by the Secretary of the Department of Health and Human Services (HHS). On-site technical assistance will be a key service. Selected RECs will modify their operating plans that were approved upon initial award to include specific plans for the CAH and Rural Hospital projects and will report their activities through the quarterly reporting process.

Group B will be required to modify their current operating plans, that were revised and approved per the first round of the Supplement Funding Opportunity Announcement and modify their plan to account for the additional funds ($6,000 per CAH and Rural Hospital) to further meet the objectives of assisting CAHs and Rural Hospitals with less than 50 beds in its geographic service area to improve the quality and value of care they furnish by attaining or exceeding meaningful use criteria established by the Secretary of the Department of Health and Human Services (HHS).

RECs are expected to work with both CAHs and Rural Hospitals who have not yet adopted EHR systems, and those with existing EHR systems, to assist them in achieving meaningful use of certified EHR technology. The milestones for this work will be the same as those identified in the original REC FOA (Funding Opportunity Number: EP-HIT-09-003); funds are for direct assistance only.

Subject to the limitations of eligible applicants described below in Section III, there are two types of CAHs and Rural Hospital organizations that are eligible for support through this application: (1) acute care hospitals (as defined in the SSA Section 1886(d)) with 50 or fewer beds located in a rural area and (2) a critical access hospital as defined in the SSA Section 1820(c) of the Social Security Act.

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