Rural Health Transformation Program - Building a Resilient Workforce, Healthcare Workforce Expansion

Illinois’ Rural Health Transformation Program will support rural communities across the State of Illinois in improving healthcare access, quality, and outcomes by transforming healthcare delivery. This program will strengthen healthcare delivery in rural communities by focusing on attracting and retaining health professionals. This may include physicians, advanced practitioners, and allied professionals, and may reflect a focus on maternal health, behavioral health, primary care, paramedicine, or other specialties. Program partners will include the University of Illinois State University System, the Illinois Community College Board, and the Illinois Critical Access Hospital Network who will support investments towards state universities, community colleges, and hospitals focusing on expanding educational award programs; bonuses to relocate and/or stay in rural communities; fellowships; apprenticeships; and other successful training programs. Note: Stevens Amendment Acknowledgment This funding opportunity is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $193,418,216.21 with 100 percent funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government. The Healthcare Workforce Expansion initiative is a statewide investment effort under the RHT Program designed to address persistent workforce shortages and strengthen access to care in rural Illinois. The program focuses on recruiting, training, and retaining clinical healthcare professionals by investing in education, financial incentives, and structured workforce development strategies. Funds will be deployed strategically to address the most pressing workforce gaps and to tailor programming to the needs of rural communities. Programs with demonstrated success will be prioritized. This initiative will focus exclusively on individual providers who commit to serving in rural communities for a minimum of 5 years. The objective of this program is to expand or establish new educational awards, fellowships, apprenticeships, recruitment and retention programs, or other clinical training programs. Programs will focus on expansion of the professional clinical workforce, including a broad range of licensed clinical professionals across medical, behavioral health, and dental disciplines. These include physicians and specialists, advanced practice registered nurses, physician assistances, licensed behavioral health clinicians, dentists, and registered nurses. The initiative also supports already credentialed providers seeking to expand their qualifications or scope of practice. Program funding is tied to individuals who commit to practicing in rural communities for at least five years.

This grant program utilizes federal CMS RHT Program funds. The total amount of funding expected to be awarded through this NDFI is up to $29 million in year 1 and up to a total of $149 million across years 1-5, subject to continued funding and program approval. Funding in future years is subject to CMS’ continuation, review, and award of future RHT Program grant funding. The release of this NDFI does not obligate the Department to make an award.

In order to charge indirect costs to a grant, the applicant organization must have an annually negotiated indirect cost rate agreement (NICRA). There are three types of NICRAs: a) Federally Negotiated Rate. Organizations that receive direct federal funding, may have an indirect cost rate that was negotiated with the Federal Cognizant Agency. Illinois will accept the federally negotiated rate. The organization must provide a copy of the federally NICRA. b) State Negotiated Rate. The organization may negotiate an indirect cost rate with the State of Illinois if they do not have a Federally Negotiated Rate. If an organization has not previously established in indirect cost rate, an indirect cost rate proposal must be submitted through the GATA Grantee Portal no later than three months after receipt of a Notice of State Award (NOSA). If an organization previously established an indirect cost rate, the organization must annually submit a new indirect cost proposal through the GATA Grantee Portal within six months after the close of the grantee’s fiscal year. c) De Minimis Rate. An organization that has never negotiated an indirect cost rate with the Federal Government of the State of Illinois is eligible to elect a de minimis rate of 10% of modified total direct cost (MTDC). Once established, the De Minimis Rate may be used indefinitely. The State of Illinois must verify the calculation of the MTDC annually in order to accept the De Minimis Rate. All grantees must complete an indirect cost rate negotiation or elect the De Minimis Rate to claim indirect costs. Indirect costs claimed without a negotiated rate or a De Minimis Rate election on record in the GATA Grantee Portal indirect cost rate system may be subject to disallowance. Limitations on indirect costs restrict the amount and/or type of indirect costs that are allowed to be charged to grant awards. Indirect cost limitations and restrictions must be clearly stated in this section. For example, the grant award may be subject to state and federal statutory requirements that limit the allowability of costs. The maximum amount allowable under a limitation cannot exceed the total amount under the NICRA. State and federal statutes may restrict the amount of salary that can be charged to a grant award, if the base salary exceeds the Federal Executive Level II Pay Scale. If additional statutory restrictions or limitations are imposed, such as parameters for direct administrative costs, facility costs, and indirect administrative cost levels, those restrictions or limitations must be stated in this section. The statutory reference or guidance imposing the indirect cost limitation or restriction must also be stated within this section. Grantees have discretion not to claim payment for indirect costs. Grantees that elect not to claim indirect costs cannot be reimbursed for indirect costs. The organization must record an election to “Waive Indirect Costs” into the GATA Grantee Portal. Indirect Cost election must be completed annually, for every entity’s fiscal year. More information regarding the indirect cost election process can be found on the GATA website. Code of Federal Regulations / Title 2 - Grants and Agreements / Vol. 1 / 2014-01-01191

Submission of Advance Payment Request Form.

Applicants will be screened for completeness including GATA pre-qualification and ICQ submission for the current state fiscal year through the Grant Accountability and Transparency Act (GATA) Grantee Portal at www.grants.illinois.gov/portal. Applicant must identify an individual who will submit the application via the Euna system, this person will serve as the Primary Contact for this application. However, more than one individual can have access to and complete components of the application via Euna. The Primary Contact must submit the application, including attachments, via Euna. To be considered for funding, the application must be completed and submitted via the Euna system no later than 4:00 p.m. Central Time (CT)

Applicants must upload all required documents in the designated sections of this opportunity. HFS will not accept documents sent by email, mail, or any method outside of the Euna system. Grant proposals submitted under this opportunity will be reviewed solely on a competitive/noncompetitive basis. Application materials must address all components of this opportunity and demonstrate both a need for the program and an ability to successfully implement the program. HFS will review and award applications based on completeness, budget requirements, clear and detailed responses to the program narrative questions, and inclusion of all mandatory program elements

Please use this link for any questions: https://officeofmedicaidinnovation.jotform.com/form/rural-health-transformation-program

Eligible applicant(s) include (must also be registered and in good standing with the State): University of Illinois System - Office of Medicaid Innovation Illinois Critical Access Hospital Network Illinois Community College Board

The beneficiaries of the Building a Resilient Rural Workforce initiative will be residents of rural communities where access to essential health services is limited by geographic isolation, workforce shortages and resource constraints. This initiative will help to ensure all residents of the State of Illinois will have access to high-quality, sustainable care.

Registration and pre-qualification through the Grant Accountability and Transparency Act (GATA) Grantee Portal is required, www.grants.illinois.gov/portal.

Applicants are required (unless the applicant is an individual or Federal or State awarding agency that is exempt from those requirements under 2 CFR § 25.110(b) or (c), or has an exception approved by the Federal or State awarding agency under 2 CFR § 25.110(d)) to: a) Be registered in SAM before submitting its application with a UEI assigned. To establish a SAM registration, go to www.SAM.gov. b) Always continue to maintain an active SAM registration with current information during an active award, application or plan under consideration by HFS. HFS may not issue a grant award until the applicant has complied with all applicable SAM requirements, if an applicant has not fully complied with the requirements by the time HFS is ready to make an award, HFS may determine that the applicant is not qualified to receive a grant award.

Successful applicants will receive a Notice of State Award (NOSA) to initiate the grant agreement phase. During this phase, the selected applicant(s) will be contacted by the Department of Healthcare and Family Services to develop a Uniform Grant Agreement, which can be months long process depending on complexity, cooperation and conformity with all applicable federal and state laws. The Department reserves the right to issue a reduced award, or not to issue any award if it is in the Department’s best interest to do so. The NOSA is not an authorization to begin performance or incur costs

In addition to implementing the funded project consistent with the approved project proposal and budget, agencies selected for funding must comply with applicable grant terms and conditions and other legal requirements, including the CMS Rural Health Transformation  Program funds, and GATA.   Additional programmatic and administrative special conditions may be required.

Recipients must submit periodic financial reports, periodic performance reports, final financial and performance reports, and, if applicable, an annual audit report in accordance with the 2 CFR 200 Uniform Guidelines. Future awards and fund drawdowns may be withheld if reports are delinquent.

Illinois Department of Healthcare and Family Services Dani Mendez Dani.Mendez@illinois.gov 773-720-9469

All applications will be screened for completeness including GATA pre-qualification and ICQ submission for the current state fiscal year.   HFS reserves the right to reject incomplete proposals, proposals that include unswallowable activities, proposals that do not meet eligibility or program requirements, and proposals that are otherwise unsatisfactory. The HFS may invite applicants to answer clarifying questions and modify budgets that include unallowable or unreasonable costs. The application budgets will be reviewed for allowability, completeness, and cost-effectiveness. During the budget review HFS may require budget modifications that do not materially change the nature of the program.  This application is subject to the Illinois Freedom of Information Act (FOIA). Any information that the applicant believes should be exempt under FOIA should clearly highlight the information that is exempt, and the basis of the exemption.