1 National Association of Community Health Centers, Inc.

1National Association of Community Health

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America’s Voice for Community Health Care

The NACHC Mission

To promote the provision of high quality, comprehensive and affordable health care that is coordinated, culturally and linguistically competent, and community directed for all medically underserved people.


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DEVELOPING EFFECTIVE FQHC PROGRAMS AND APPLICATIONS


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DEVELOPING EFFECTIVE FQHC PROGRAMS AND APPLICATIONS: SERVICE PACKAGE & DELIVERY STRATEGY


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NEEDS ASSESSMENTS

STRATEGIC PLANNING

STRONG HEALTH CENTER PROGRAMS

The Program/Proposal Logic Model


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The Program/Proposal Logic Model

The Needs Assessment Informs the Strategic Planning Process Which

Forms the Basis for the Health Care Plan and the Service Package, Staffing Profile and Delivery Strategy

Lays Out a Rational and Logical Approach to Implementing that Plan and Strategy

Which is Supported by a Reasonable, Realistic and Cost Effective Budget


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Ensuring Legal Compliance

• All FQHCs must comply with applicable Section 330-related statutory and regulatory requirements, guidelines and policies

– Community Health Centers: Section 330(e)– Migrant Health Centers: Section 330(e) and Section

330(g)– Health Care for the Homeless: Section 330(e) and

Section 330(h)– Public Housing Primary Care: Section 330(e) and

Section 330(i)• New Access Point Applicant: compliance at time of

submission or within 120 days of grant award• FQHC Look-Alike Applicant: compliance at time of

submission


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Need = 30 POINTS

• USE THE NARRATIVE SECTION TO TELL A STORY - DRAW A PICTURE

• FOCUS ON THE TARGET POPULATION

• COMPARED TO……..


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National Association of Community Health

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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


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Building Strong FQHC Programs

Identified NeedInput from PCA

Partners in the CommunityBoard Member Constituencies

Environmental Analysis

Evaluation of Options

Input from Patients

Short and Long Term Strategic Goals

Which Patients What Services How Provided How Implemented

How Supported

Input from staff


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IDENTIFYING NEED


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RULE #1A

IDENTIFIED NEEDS HAVE TO RELATE TO

PROGRAM

HEALTH DISPARITIES = SERVICE PACKAGE

ACCESS PROBLEMS = STAFFING PROFILE

BARRIER PROBLEMS = DELIVERY STRATEGY


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RULE #1B

IDENTIFIED NEEDS HAVE TO RELATE TO

PROGRAM

IDENTIFYING SCORES OF PROBLEMS WITHOUT CORRESPONDING PROGRAM IS

NOT A WINNING STRATEGY


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From the SAC FY09 Guidance:

“Information provided on need

should serve as the basis for, and

align with, the proposed activities

and goals described in the health

care and business plans and

throughout the application.”


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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


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IDENTIFYING NEED

• Access to Care

–Data demonstrating that there is not an adequate

quantity of accessible primary health care providers

for the Target Population


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IDENTIFYING NEED

• Barriers to Care – Even if there are health care resources why is it that the target population cannot use them fully?

– Cultural and/or linguistic

– Geographic/transportation

– Insurance/available income

– Other factors creating barriers

– Unique health care needs


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IDENTIFYING NEED

ATTENTION EVERYBODY!!!!

LOOK FOR REQUIRED NEEDS DATA!!!! BUT DO NOT LIMIT YOUR ANALYSIS TO THOSE

INDICATORS!!!!


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Need for Primary Care Services

Community Based Needs Assessment

IDENTIFYING NEED


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LEVELS OF DESCRIPTION

SERVICE AREA

TARGET POPULATION

PATIENTS


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SERVICE AREA


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Service Area

• Define Service Area – – A geographic area from which your target population will be

drawn (census tracts, counties, MUAs, HPSAs, etc.)– A logical and rational area for providing health care services– That relates to your target population and their accessibility and

barrier issues

• This is the character of the area

– Environmental/geographic characteristics

– Housing

– Economy – types of economic activity


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Service Area

• This is how the people here live– Education– Income– Livelihood– Transportation– Socio-demographic information

• And all of these things relate to potential health risks and barriers to care


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Service Area

• And all of these things relate to:

–Potential health risks

–Decreased access

–Barriers to care


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SERVICE AREA

TARGET POPULATION


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Target Population

• These are the people in the Service Area that I am focusing on serving:

–Socio-demographic indicators• Race Ethnicity• Income Language/culture• Education Insurance status• Age Free/reduced lunch• Employment/unemployment


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Target Population

–Health Status Indicators/Health Disparities• Maternal child health indicators

– Infant mortality–Low birth weight–Prenatal care–Teen pregnancy– Immunizations–Lead paint exposure/poisoning–Others


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Target Population

–Health Status Indicators/Health Disparities• Chronic Diseases

–Cancer–Diabetes–Asthma–Coronary Heart Disease–Hypertension–Others


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Target Population

– Health Status Indicators/Health Disparities• Mental Health Problems

– Depression– Suicide– Substance abuse– Serious mental health conditions– Add/ADHD

• Oral Health Problems– Caries– Other?


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Target Population

–Health Status Indicators/Health Disparities• HIV/AIDS• Nutrition/hunger• Obesity

–Conditions Specific to Special Populations• Environmental Exposure• Pesticide exposure• Skin disorders• Accidents


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IDENTIFYING NEED

• Define Special Populations

–specific health problems and health care needs

–significant changes in the past year impacting

specific special populations


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IDENTIFYING NEED

• Special Populations Additional Descriptions:–MCH – agricultural environment/crops; growing

seasons; special circumstances impacting demand

–HCH – availability of housing and other factors that impact demand for services

–PHPC – recent changes in availability of public housing and impact on demand


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SERVICE AREA

TARGET POPULATION

PATIENTS


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Patients


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Patients – Just the Tip of the Iceberg

• Health Status• Access to Care• Barriers to Health Care

– Patient surveys

– Focus groups

– Chart audits

– Anecdotal information


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IDENTIFYING NEED

• For those already providing health care to the target population (existing grantees-Service Area Competition and Expansion Applications–and other operational applicants)

– Who are you serving now…how many?

• For everyone– How many will be served and how many projected encounters

throughout the proposed project• Give data for end of each project year and at full capacity!• Make sure the data is consistent


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IDENTIFYING NEED

Remember:

Patient Derived Data and Information is Not Population-Based Data!

Always Use the Correct Data for the Question Being Asked


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Other Area ProvidersPatients


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ACCESS TO CARE – HOW MANY PROVIDERS ARE THERE?

• Access to Care – Are health care resources available to the Target Population?

–Data demonstrating that the Target Population has restricted access to primary health care:• Numbers of providers available• Others providing resources/services to the

target population• Other FQHCs/Section 330 grantees, rural

health clinics, public health services, etc


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ACCESS TO CARE – HOW MANY PROVIDERS ARE THERE?

• Access to Care

–Discussion of the adequacy and effectiveness of the

existing network of care for the Target Population• Absolute shortage of primary, oral, behavioral care

providers• Shortage specifically for Target Population• Numbers of providers accepting Medicaid, SCHIP, sliding

fee scale• Waiting times to get appointments, etc.


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Barriers to Care


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BARRIERS TO CARE

• Barriers to Care – Even if there are health care resources why is it that the target population cannot use them fully?

–Cultural and/or linguistic

–Geographic/transportation

– Insurance/available income

–Other factors creating barriers

–Unique health care needs


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Community Based Needs Assessment Other Area Providers

Patients

Barriers to Care

Environmental Context


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HEALTH CARE ENVIRONMENT

• Health Care Environment – What is happening in the state, region, local area that impacts the health care status and access to care for the target population?

–Federal, state, county, local Medicaid, welfare, other health care reforms

– Implementation of 1115 and 1915(b) waivers, Medicaid PPS, SCHIP, others

–Direction that state environment and health policy is going including trends in state budgets, unemployment, etc.


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HEALTH CARE ENVIRONMENT

• Health Care Environment

–How do these trends and policies impact the future

fiscal well being of the proposed program and

applicant organization?

ENVIRONMENT-NOT JUST HEALTH CARE

• What other environmental – policy – politics – will impact the proposed program?

–Immigration laws

–Changing economic structure

–Employment trends

–others????


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Barriers to Care Environmental Issues State

Priorities


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STATE PRIORITIES

• How does the proposed new site fit into the state priorities regarding health care for the underserved?

–Market Place Analysis

–Statewide Strategic Plan

–Other analyses of health care access

LET’S DIG DEEPER INTO DATA:

Understanding and Describing Your Target Population


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Data is Your Friend

Finding and Generating Relevant

Data


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Considerations For Using Data

• Quality counts• Look for and recognize bias• Doesn’t show much unless you can compare

it• Is it too small to really have meaning• Look for supporting evidence to show trends


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Primary Data Collection

THAT MEANS YOU GO OUT AND GET THE INFORMATION

YOURSELF


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Qualitative Approaches to Primary Data

Qualitative Methods involve going out to talk to people and listening to what they say!!

So, how we know who to talk to about what??


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Qualitative Approaches to Collecting Data

Step 1: Community Asset Mapping: a social "map" of the community

• different sectors of the community – business, labor, government, religious, health care, voluntary/civic organizations, growers, advocates

• as broad of a picture of the people and organizations that will potentially be involved in the health center so that you can assess clearly the needs in the community and the options for meeting those needs. In other words, this should be an inclusive activity.


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Step 1: Community Asset Mapping

– Once the sectors have been identified, make a list of the people, groups and organizations that make up each sector – for example, all of the schools and school districts for the education sector.

– Next, identify the key influences in each sector – key people and organizations as well as political and social trends.

– Lastly, identify which components of the community are likely to be barriers or facilitators to a new health center and why.


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• Key Informant Interviews– Use the Community Assets Map to identify key

stakeholders and to inform what questions you should ask of whom

The list must represent the entire community across race,

ethnicity, age, sex, years of residency and other

community characteristics you deem important.

Informants should also be chosen based upon the

longevity and/or the nature of their involvement with the

community to cover a full range of community opinion.


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• Key Informant Interviews– Develop an interview format/questionnaire

• touch on attitudes about the community as a whole

• specifics areas – perhaps economics, education, health, leadership

• what is being done to address these concerns, and his/her ideas about what should be done

– Pay attention going in to your asset map and the position of the stakeholder + the “power” they wield


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Using Knowledgeable Experts

• Persistence pays off• They won’t think your questions are “dumb”• They are great sources

- The right person will want to answer your questions - May have a special unpublished study - May know the perfect referral

• Great for hard to find information• Give local slant • Speak to “what does it mean” for your target

population


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• Focus Groups

a small, selected discussion group individuals from similar

backgrounds guided by a trained facilitator or moderator.

It is used to learn more about viewpoints on a designated

topic in combination with other information and data, to

guide future action.


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• Community Forums And Listening Sessions

–offer valuable insights into community dynamics

–opportunities for linkages where people who are

willing and able to help will surface

– raise the credibility of the needs assessment

process by enhancing openness and inclusion

–raise the level of awareness and understanding

about your issue and the community planning

initiative


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Quantitative Primary Data Collection Approaches

• Direct Surveys – Be sure you use a method that will actually connect you with the target population!

– Telephone - now that’s not going to work!!

– Mail-survey – probably not that one either!!

– Door-to-door/field-to-field – now we are getting somewhere!!

• Use available resources to assist – university students

• Actual counts; e.g., labor camps, homeless shelters, gathering places


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Quantitative Primary Data Collection Approaches

• Provider Surveys

– Be sure you focus on availability for the target

population!


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Secondary Data Collection: Using Other People’s Stuff

• Locate secondary sources- Web sites, links, internet searches

- Gather reports and other documentation

• Manipulate databases- For example: 2000 Census - can build

tailored report - Conduct records review - Ask someone to run tailored report - Find someone else’s report from database


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Secondary Data Collection: Using Other People’s Stuff

• Careful!!– Know what question was asked and how

it was asked – BIAS!!!!– Understand the definitions and

assumptions – are we talking about the same thing?

– Is it trend data or a snapshot?– Does the person making data for you

know what they are doing?


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Before You Begin: Data Guidelines

• To show a current health disparity–Compare data from the same years–National vs. local

• To show deteriorating conditions–Compare across years–Read the technical notes first

• Making bad comparisons can easily loose you credibility

• Read the technical notes to avoid data potholes


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Some places to look for data:

– Census– Local foundations and funding sources– National foundations– Academic institutions – masters and doctoral theses– State vital statistics– State, county, local health departments– Historical Society– Labor Unions– Water and Sewer Commissions????


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Describing Your Target Population

Don’t Settle For What Is

Find Legitimate and Valid Approaches to Developing Accurate and Relevant Data:

Projecting Data


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Before You Begin: Data Guidelines

• To show a current health disparity

– Compare data from the same years

– National vs. local• To show deteriorating conditions

– Compare across years

– Read the technical notes first• Making bad comparisons can easily loose you credibility• Read the technical notes to avoid data potholes


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Doing an Extrapolation

When the data does not exist to appropriately describe your Target Population – Do an extrapolation from the FY 09 SAC Guidance:

“In some cases, it may be difficult to find data specific to the proposed service area or target population, especially for applicants proposing to serve only special populations (homeless, migrant and/or public housing) at the appropriate level to effectively describe the need in the proposed service area or target population. In such situations, applicants may utilize extrapolation techniques to estimate the correct value in the service area or target population from data available at higher levels, including the use of national data sources.”


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Doing an Extrapolation Based on Race/Ethnicity Using Census and BRFSS Data

This is an example – you do not have to use these data sources

or population categories!!


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Doing the Math – Step 1Get the Denominator Data

Geo ID

Total pop: Total

Total pop: Not Hispanic or Latino

Total pop: Not Hispanic or Latino; White alone

Total pop: Not Hispanic or Latino; Black or African American alone

Total pop: Not Hispanic or Latino; American Indian and Alaska Native alone

Total pop: Not Hispanic or Latino; Asian alone

Total pop: Not Hispanic or Latino; Native Hawaiian and Other Pacific Islander alone

Total pop: Not Hispanic or Latino; Some other race alone

Total pop: Not Hispanic or Latino; Two or more races

14000US48201421100 8,341 3,003 1,393 1,105 0 420 0 0 8514000US48201421200 9,433 2,255 774 956 0 396 0 0 12914000US48201421300 6,891 3,775 1,286 948 23 1,197 38 10 27314000US48201421400 13,701 2,068 643 824 25 304 11 0 26114000US48201421500 6,748 2,809 1,468 750 32 461 0 19 7914000US48201421600 6,883 1,432 688 283 10 387 0 39 2514000US48201422700 8,148 4,025 2,853 551 22 452 0 0 147

Totals 60145 19367 9105 5417 112 3617 49 68 999


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Doing the Math - Step 2Creating Your Target Population

• Add together the population data in the respective sub-populations to create the groupings that reflect your aggregated target population

• You can use data sources other than in this example (state; county; etc.)


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Doing the Math – What Percent of Your Target Population Does Each Sub-Population Group Represent?

• Percentage:

– ethnicity divided by total

population• Excel Tips

– To reference a fixed cell

use a $ before the row

and column labels

– Use “Fill Down” or “Fill

Right” function to

automatically get values

Numbers PercentageAfrican-Am 5417 9.01%Anglo 9105 15.14%Latino 40778 67.80%Other 3931 6.54%Total 60145 100.00%

PopulationEthnicity


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Doing the Math – Step 3Getting Prevalence Data

• BRFSS Prevalence Data - Start Page http://www.cdc.gov/brfss/

1. Choose Nationwide or Your State2. Must use 2000 data3. Choose health issue4. Input overall prevalence rate into Excel

worksheet5. Click on “No Grouping” and choose “Grouped

by Race”6. Input data into Excel worksheet

http://apps.nccd.cdc.gov/brfss/index.asp

http://www.cdc.gov/brfss/





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Doing the Math – Step 3Getting Prevalence Data

Numbers Percentage State Data Target PopAfrican-Am 5417 9.01% 9.20%Anglo 9105 15.14% 6.10%Latino 40778 67.80% 8.40%Other 3931 6.54% 8.30%Total 60145 100.00% 7.10%

Target Population

Race/Ethnicity

Diabetes


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Doing the Math – Step 4Calculate the Target Population Prevalence

Multiply the percent of the total population each sub-population represents times the prevalence of the condition for that group statewide

Numbers Percentage State Data TargetAfrican-Am 5417 9.01% 9.20% 0.0083Anglo 9105 15.14% 6.10% 0.0092Latino 40778 67.80% 8.40% 0.0570Other 3931 6.54% 8.30% 0.0054Total 60145 100.00% 7.10%

Population

Ethnicity

Diabetes


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Doing the Math – Step 4 Calculate the Target Population Prevalence

Sub-Population Percentage X Known Prevalence Rate = Target Factor

– .0901% X .0920% = 0.0083

– .1514% X .0610% = 0.0092

– .6780% X .0840% = 0.0570

– .0654% X .0830% = 0.0054

Total All of the Sub-Population Rates

– 0.0083+0.0092+0.0570+0.0054=0.0799

Multiple by 100 to get a percentage = 7.99%


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Doing the Math – Step 5Identify the Disparity

Target Population Prevalence of Diabetes = 7.99%Statewide Diabetes Prevalence = 7.10%

EVEN BETTER – ROUND THOSE NUMBERS!!Target Population = 8.0% State = 7.0%

Numbers Percentage State Data TargetAfrican-Am 5417 9.01% 9.20% 0.0083Anglo 9105 15.14% 6.10% 0.0092Latino 40778 67.80% 8.40% 0.0570Other 3931 6.54% 8.30% 0.0054Total 60145 100.00% 7.10% 7.99%

Population

Ethnicity

Diabetes


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Recapping…

• Use the same years for projections

–2000 census

–2000 prevalence

• You should be able to explain how you got your numbers without blushing


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Recapping…

• This is projected data.

– Assumes that the people in your target population have the

same experiences with disease as people in the population

at large.

– Will not flush out specific issues at the census tract level • superfund site with lots of contamination effecting health• community specific epidemic

Incorporating Community Needs

RELATIONSHIP TO IDENTIFIED NEEDS

HEALTH DISPARITIES = SERVICE PACKAGE

ACCESS PROBLEMS = STAFFING PROFILE

BARRIER PROBLEMS = DELIVERY STRATEGY


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RESPONSE = 20 POINTS

• RESPONSIVE TO NEEDS AND INCORPORATING COMMUNITY AT ALL LEVELS OF PLANNING AND EVALUATION

• CREATES A RESPONSIVE AND EFFICIENT SERVICE PACKAGE

• PROVIDES A COMPREHENSIVE SYSTEM OF CARE –CONTINUITY–ALL REQUIRED SERVICES–LINKAGES TO SPECIALTY CARE


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RESPONSE = 20 POINTS

• PROVIDES CULTURALLY AND LINGUISTICALLY CARE

• PROVIDES AN EFFECTIVE CLINICAL STAFFING PLAN THAT REFLECTS THE NEEDS OF THE POPULATION

• ESTABLISHES AN APPROPRIATE SERVICE DELIVERY STRATEGY

• ELIMINATES COST AS A BARRIER TO CARE

• ENSURES QUALITY IMPROVEMENT AND RISK MANAGEMENT


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COLLABORATION = 10 POINTS

• COLLABORATES AND COORDINATES WITH COMMUNITY PROVIDERS AND PROGRAMS

• HAS DOCUMENTATION SUPPORTING THE COLLABORATIONS

–MUST ALWAYS MAINTAIN THE INTEGRITY OF THE FQHC PROGRAM AND COMPLIANCE WITH APPLICABLE LAW, REGULATION AND POLICY, REGARDLESS OF TYPE OF PARTNER


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GOVERNANCE = 10 POINTS

• DEMONSTRATES CLEARLY THAT THE GOVENING BOARD

– IS FULLY COMPLIANT WITH COMPOSITION REQUIREMENTS

– EXECUTES IT AUTONOMOUS AUTHORITIES WITHOUT HINDERANCE FROM OUTSIDE

– RECEIVES AND PARTICIPATES IN TRAINNG AND DEVELOPMENT


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SUPPORT REQUESTED = 10 POINTS

• THE BUDGET EFFECTIVELY REPRESENTS THE EFFORT NEEDED TO SUPPORT THE PROGRAM WHILE BEING

– COST EFFECTIVE– EFFICIENT– MAXIMIZING REVENUES

• HAS APPROPRIATE FISCAL CONTROL MECHANISMS


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RESOURCES AND CAPABILITIES = 10 POINTS

• DEMONSTRATES THAT THE ORGANIZATION IS STRUCTURED APPROPRIATELY TO SUPPORT THE PROGRAM

• HAS AN IMPLEMENTATION PLAN THAT IS CONCRETE, TIMEBOUND AND REALISTIC


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“Sell” the Organization!!

TOOT YOUR HORN!!!!


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“Sell” the Organization!!

TALK STORYYOUR PATIENTS AND COMMUNITY ARE

YOUR BEST SALESPEOPLE


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“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 in the community, years of uninterrupted service, and Section 330 funds received during last 5 years (including special initiatives)

– Staff skills and organizational capacity– Prior clinical outcomes– Cultural and linguistic appropriateness– Evaluation capabilities– 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


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READY – SET – GO!!Readiness-Implementation Plans

• All NAP, Expansion 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


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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


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Readiness-Implementation Plan

• Readiness Plan– Not Quantifiable - but definitely time framed!!

– No Numerator or Denominator

– What needs to be done (readiness) to implement Proposed Expanded Medical Capacity, New Access, or New Service

– What needs to be done to meet Program Expectations/ Requirements

– Typically no Baseline Available


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Readiness and Implementation Plan

• Readiness Plan Based On–Application Narrative–Section 330 Program Expectations –Reimbursement Environment–Management Work Plans–Grant and/or Look-Alike Application Requirements–Operational Readiness–Sustainable Business Practice


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The Readiness - Implementation Plan

• Areas Covered in implementation Plan

– Governance

– Administrative/Compliance Requirements

– Fiscal/Financing

– Management Information Systems

– Readiness


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Readiness – Implementation Plan

• Collaborations• Develop Supply List and Plan Purchase Activities• Purchase and Install Equipment• Select MIS Patient Management and General

Ledger System


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Readiness - Implementation Plan

–FQHC Expectations

–UDS

–Federal Procurement Policies

–Sliding Fee Program

–FQHC Billing

–Hire and Train Staff

–Negotiate Managed Care Contracts


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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• Develop and Implement Marketing/Outreach Plan• Ribbon Cutting Ceremony • Open Health Center for Patient Services!!!!!


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Readiness Plan - Sample Format

Plan/Activity CompletionDate

PersonResponsible

Comments

EVALUATIVE MEASURES = 5 POINTS

• STRATEGIC PLANNING

• ORGANIZATIONAL GOALS THAT RELATE TO STRATEGIC PLAN AND COMMUNITY/TARGET POPULATION

• QUANTIFIED PERFORMANCE MEASURES

–REQUIRED

–REFLECTING DISPARITIES, ACCESS, BARRIERS


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Business Plan/Readiness Plan

“The Narrative described in The Need Section should serve as the basis for and align with the activities described in the Implementation Plan and goals of The Business Plan”

Don’t Forget Special Populations


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Deciding--Implementation Plan or Business Plan

• Business Plan–Quantifiable Goals with denominators and

numerators

–Broad based not down to action step level

–Based on contributing or restricting factors

–Office of Performance Review Goals

–Need Baselines


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Business Plan

• Required Performance Measures• Goals that relate to identified needs• Other goals that are important to the

center’s sustainability, fiscal health• Remember Special Populations

LET’S LOOK AT SOME PERFORMANCE MEASURES

• RESPONSIVENESS TO AND INVOLVEMENT OF COMMUNITY

• ADDITIONAL ACCESS-IMPACE FOR THOSE ALREADY OPERATIONAL

• RELATIONSHIP OF GOALS AND PERFORMANCE MEASURES TO NEEDS IDENTIFIED IN THE TARGET POPULATION

IMPACT = 5 POINTS

Prepare to Go Electronic

• Register early with www.grants.gov

• Learn how to navigate the electronic submission system

• Give yourself plenty of time to upload, download, scan and test print the document before submitting


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http://www.grants.gov/

http://www.grants.gov/

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)

Make the LOI Deadline or At Least 45 Days Out Your Goal


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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.)


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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


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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


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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


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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


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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 PIN


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• 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


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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


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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 theBusiness Plan and Budget


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RULES TO LIVE BY

• Answer all of the questions wherever and whenever they are asked

• Connect the dots – don’t leave things hanging


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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 2nd chance for funding applications

• If it is not in the budget – it is not happening!!


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THE BIG RULE

THIS IS NOT A WORK OF FICTION!!!!


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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


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And Most Important of All

Remind Yourself and the Reviewers Why You Are Doing This!!


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1 National Association of Community Health Centers, Inc.

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Transcript of 1 National Association of Community Health Centers, Inc.