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Q: I just found out about the grant program and have missed the deadline for the Intent to Apply (ITA). May I still submit an ITA, even if it's late? Is the ITA required? May I still submit an application?
A: Applicants will not be deemed ineligible if they do not submit the ITA before the deadline; they are, however, encouraged to submit an ITA - even after the deadline - in order to develop a communication link with the Colorado Rural Health Center in the event that additional information is made available. The ITA is not required; it is, however, strongly encouraged. Applicants who choose not to submit an ITA may still submit an application.
Q: We are located in an urban area, but we provide services to rural Colorado. Can we apply?
A: While the Council recognizes the invaluable services and resources provided to rural Colorado by urban-based providers, this small grant program is only available to applicants located in non-urbanized areas. An eligible rural-based organization could certainly apply for grant funds on behalf of their urban partner if that is how they chose to serve the needs of the underserved people in their community.
Q: My organization is located inside of an Urbanized Area. But we're rural! Are we ineligible to apply for this funding?
A: There are many different definitions of "rural" utilized by state and federal programs to determine eligibility. For the purposes of this grant program, the Council chose to rely upon the U.S. Census Bureau's definition of Urbanized Areas. Only applicants located outside one of Colorado's Urbanized Areas are
eligible to apply. The Council will allow for an appeal process in setting
eligibility criteria. If you believe your organization should be considered "rural", please submit a letter describing how your organization and project meet the intent of this grant program, and describe your location and your rationale for why your organization should be considered "rural". The council will consider your request and make a determination regarding your eligibility to apply within 10 days.
Q: What about organizations that serve large regions that include services to patients inside Urbanized Areas - are they eligible to apply for funding?
A: As long as the applicant is located outside an Urbanized Area and is requesting grant funds for a project that includes the provision of outpatient primary care services - medical, oral, or mental health services - to underserved people in rural Colorado, it is eligible for application.
Q: Can I apply for a grant to conduct a feasibility study or hire a consultant to help us examine our options?
A: The Council members realize the value and necessity of a thorough examination of need and options prior to making an infrastructure decision or investment, and that there can be costs associated with these activities. However, since the possibility exists that a feasibility study could be conducted and the decision made to NOT proceed as planned, grant funds should only be requested for the actual infrastructure investment once a decision is made. Note: Documenting in your grant application that a thorough examination or study was done prior to the request being made would certainly strengthen the application's merit.
Q. Can I apply for a grant for an item I have already purchased?
A. No. This grant cannot cover any items that have already been paid for or activities that are already in-process or accomplished outside of the grant period. For this year the grant period is July 1, 2012 – June 30, 2013.
Q: The original RFA included "vehicles and transportation" as an example of
infrastructure projects. Is transportation an eligible project?
A: Vehicles, vehicle upgrades and improvements, or repair, are not eligible projects.
Q. If I score 100 points on the score sheet, will I automatically receive funding?
A. No. The Council will make final award decisions based on various factors, including: whether the applicant has been awarded funds through this grant in the past, the scores of each application, community impact, whether the project involves oral or mental health, geographic distribution, project type, and applicant type.
Q: May I submit letters of support with my application?
A: The guidelines state that additional attachments may not be included. Evidence of the involvement and support of other organizations in your community or region strengthens your application; however, in order to keep the applications to a manageable size, Letters of Support should not be attached or included. In the narrative portion of your application, we do recommend that you mention this involvement, and specify the organizations with whom you're involved.
Q: If our clinic doesn't know exactly how many of each patient we see, should we guess?
A: Give it your best estimate, but explain below that you don't track specific data and how/why you believe your numbers are pretty accurate. But we don't want JUST percentages, we'd like to have an idea of the overall number of patients you saw last year. You can provide an explanation of how your data is collected or estimated under the "additional explanation if necessary" section of the form.
Q: Does "uninsured patients" include "self pay" patients?
A: Yes, the category includes those that do not have any other insurance which include self pay patients. Many organizations and government programs refer to "self pay" as anyone without insurance or other third party payer. Because this can include people who can certainly afford to pay out-of-pocket for any care they need, we added the question below asking you to tell us - or give it your best estimation - regarding the number of low income people (those who can't afford all the care they might need). To be eligible for this grant, you must document for us that your organization provides some level of services - takes Medicaid patients, uses a sliding fee scale, etc. - to make provisions for "underserved people." If you are providing an estimation for self pay patients, please make sure you provide an explanation of how your data is collected or estimated under the "additional explanation if necessary" section of the form.
Q: When I fill out the Low Income Patients portion, do I include the Medicaid and CHP+ numbers too, or only those in the "Uninsured Patients" line?
A: In actuality, patients in any of the categories above can also be considered low income. In addition, not all clients covered under Medicaid and CHP+ are necessarily under 200% FPL. For example, since Medicare is not means tested, wealthy and poor people can have Medicare as their Payer Source. In addition, just because someone has health care coverage doesn't mean they are over 200% FPL. Further, Medicaid covers individuals needing long-term care services up to 300% FPL while CHP+ and CICP cover clients up to 250% of the FPL so you can't automatically assume individuals on Medicaid, CHP+ and CICP are under 200% FPL. The very best scenario is if your organization collects data on income AND on Payor source for all your patients, then you could easily and accurately provide numbers and percentages to the Payer Source options above, and the Low Income options below - and yes, there will be overlap. The Low Income Patients category is a subset of the information reported on lines A through F above. However, we know that not all applicants collect all this data So IF you collect income data only on those patients who use your sliding fee scale, just explain on the form what information you are providing to us.
Q: What if we don't use 200% of poverty as an indicator?
A: If you collect any income data - for all your patients, or just those requesting the sliding fee scale - just explain to us what data you collect. You'll see that option in the Low Income Patients section. In other words, explain to us how you know you're serving people who can't afford to pay for their care, and how you do it. Remember you will have also explained how and what you do for the underserved populations in the narrative portion of your application (hopefully).
Q: Are we going to be ineligible because we don't take Medicaid and CHP+?
A: As long as you can explain to us what accommodations you make for patients that cannot afford care - providing a free clinic once-a-month, offering a discount or sliding fee scale, etc. - you are not required to also take Medicaid and CHP+. But remember, your application will probably be competing with applications from those who do.
Q: What about people who have insurance, but it is only catastrophic and we know they struggle with charges for their preventive and primary care services?
A: Please describe this situation, and your best estimate of the numbers of your patients in this situation in the narrative portion of your application. Especially IF you offer a sliding fee scale or any kind of discount for situations like this, you'll be able to state such on the form, and in the narrative section. You can provide an explanation of how your data is collected or estimated under the "additional explanation if necessary" section of the form.
Q: It seems like the forms will be filled out all kinds of different ways? How do you know the information is accurate? It seems like you'll be adding apples to oranges?
A: The Council wanted to be flexible in allowing many different kinds of rural, primary care providers who served the underserved to be eligible for these funds. For this reason, we tried to be flexible in giving them different ways to report on how and how many such patients they served. In reviewing the applications, you won't be scored on HOW MANY underserved you serve (well, within reason - frankly if you provide only one patient a year a minor discount, your application would probably not be very competitive) just that you offer some provision for people who can't afford - or easily afford the care they need. On the front application form, we ask the applicant attest that the information they provide is accurate and trust that they will honor that expectation.
Q: Are Public Health Departments eligible to apply?
A: Public Health Departments are eligible to apply if they provide primary care services such as immunizations and well-child checks (not just screenings). Proposed projects need to strengthen the department's capacity to provide primary care services.
Q: Are mobile units considered eligible projects?
A: Mobile units are eligible as long as both the organization and project meet the program eligibility requirements as stated in the grant guidance. Therefore, units owned by organizations based in urbanized areas, even if they also serve rural areas, would not be eligible for funding.