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Agenda 10/28/2008 Item #16D16 Agenda Item No. 16D16 October 28,2008 Page 1 of 8 EXECUTIVE SUMMARY Recommendation to accept the Health Information Technology Special Congressional Initiative earmark from the United States Department of Health and Human Services in the amount of $323,911 and approve the necessary budget amendment to recognize the revenue. OBJECTIVE: To accept the Health Information Technology Special Congressional Initiative earmark from the United States Department of Health and Human Services and approve the required budget amendment. This grant application was approved by the Collier County Board of County Commissioners on May 27,2008, item 16D4. CONSIDERATIONS: The Housing and Human Services Department was recently awarded a Federal earmark on behalf of the Physician Led Access Network (PLAN). In the fall of 2007, staff of the Housing and Human Services Department met with representatives of The Ferguson Group to discuss and present a project questionnaire on a proposed project for health care access for the uninsured in partnership with a local not for profit provider, the Physician Led Access Network (PLAN). This appropriation was approved as part of the Consolidated Appropriations Act, 2008 (PL 110-161), and signed into law on December 26,2007. The Housing and Human Services Department received an official Notice of Grant Award for this program with an effective date of September 1, 2008 and end date of August 31, 20 10. The purpose of this Collier County Government Access for the Uninsured project is to establish a shared information database to provide for a more effective and efficient method of health care service for our uninsured population. By establishing this shared information network between the portals of entry for the poor into the system, patients needs will be met by the appropriate medical service in a more timely and cost-efficient manner. This information network will be created and established throughout multiple locations in Collier County, including two area hospitals and three health care clinics. PLAN is the community-based referral network that coordinates volunteer medical care for eligible low-income, uninsured adults in need of health services in Collier County. Led by our physicians, it is a community partnership that brings together our physicians, community clinics, hospitals, diagnostic and laboratory facilities, and other heaIthcare providers through an integrated delivery system of volunteer care. PLAN is an initiative launched by the Collier County Medical Society. This past year, PLAN coordinators facilitated over 900 patient encounters; these patients received over $1,700,000 in donated care. Collier County Housing and Human Services will serve as the Fiscal Entity for this grant. There is no match required and no general fund dollars will be expended. FISCAL IMP ACT: Serving as the fiscal entity for the administration of this project will require a minimal amount of staff involvement. ,-'" Agenda Item No. 16016 October 28, 2008 Page 2 of 8 GROWTH MANAGEMENT IMP ACT: There is no growth management impact due to this request. RECOMMENDATION: Staff recommends that the Board of County Commissioners accept the Health Information Technology Special Congressional Initiative earmark and approve the necessary budget amendment. Prepared by: Terri Daniels, Accounting Supervisor, Housing and Human Services - Page 1 of 1 Agenda Item No. 16D16 October 28,2008 Page 3 of 8 COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS Item Number: 16D16 Item Summary: Recommendation to accept the Health Information Technology Special Congressional Initiative earmark from the United States Department of Health and Human Services in the amount of $323,911 and approve the necessary budget amendment to recognize the revenue, Meeting Date: 10/28/2008 9:00:00 AM Prepared By Terri A. Daniels Grants Coordinator Date Public Services Housing & Human Services 10/13/20086:35:46 PM Approved By Marcy Krumbine Director Date Public Services Housing & Human Services 10/13/2008 6:38 PM Approved By Marla Ramsey Public Services Administrator Date Public Services Public Services Admin. 10/14/200810:24 AM Approved By Marlene J. Foord Grants Coordinator Date Administrative Services Administrative Services Admin. 10/15/20089:13 AM Approved By OMB Coordinator Applications Analyst Date Administrative Services Information Technology 10/16/20089:04 AM Approved By Sherry Pryor Management & Budget Analyst Date County Manager's Office Office of Management & Budget 10116/20084:19 PM Approved By James V. Mudd County Manager Date Board of County Commissioners County Manager's Office 10/21/20081:40 PM file://C:\AgendaTest\Export\l I 5-0ctober%2028,%202008\1 6.%20CONSENT%20AGEN... 10/22/2008 . "r:-r'"'\"'lr' 1. DATE ISSUED: 12. PROGRAM CFDA: 93,888 DEPARTMENT OF HEALTH AND HU~MA~mim: 2008 0812612008 HEALTH RESOURCES AND SERVICES ADMINIST~IJ€?~ of 8 3. SUPERCEDES AWARD NOTICE dated: _R5A except thai any additions or restrictions previously imposed remain In effect unless specIfically rescinded. 4a. AWARD NO.: !4b. GRANT NO.: 15. FORMER GRANT NO.: 1 01 BIT1 0769-01-00 01 Bin 0769 6. PROJECT PERIOD: NOTICE OF GRANT AWARD AUTHORIZATION (Legislation/Regulation) FROM: 09/01/2008 THROUGH: 0813112010 Public Health Service Act, Title III, Section 330(A) as Amended 7. BUDGET PERIOD: Public Health Service Act, Title III, Section 330A FROM: 09/01/2008 THROUGH: 08/3112010 Public Health Service Act, Title III, Section 330(1), PL 107-251 8. TITLE OF PROJECT (OR PROGRAM): Congressionally-Mandated Health Information Technology Grants 9. GRANTEE NAME AND ADDRESS: 10, DIRECTOR: (PROGRAM DIRECTOR/PRINCIPAL INVESTIGATOR) Collier County Marcy Krumbine 3301 Tamiami Trail E Collier County Naples, FL 34112-3969 3301 Tamiami Trail East Naples, FL 34112-3969 11. APPROVED BUDGET: (Excludes Direct Assistance) 12. AWARD COMPUTATION FOR FINANCIAL ASSISTANCE [XI Grant Funds Only a, Authorized Financial Assistance This Period $ 323,911.00 [] Total project costs including grant funds and all other financial b, Less Unobligated Balance from Prior Budget Periods participation L Additional Authority $ 0,00 iL Offset $ 0.00 a, Salaries and Wages: $ 26.250,00 c, Unawarded Balance of Current Year's Funds $ 0.00 b, Fringe Benefits: $ 8,061,00 d, Less Cumulative Prior Award(s) This Budget $ 0,00 c, Total Personnel Costs: $ 34,311,00 Period d. Consultant Costs: $ 0,00 e, AMOUNT OF FINANCIAL ASSISTANCE THIS $ 323,911.00 e, Equipment: $ 0,00 ACTION f, Supplies: $41,300,00 13. RECOMMENDED FUTURE SUPPORT: (Subject to the availability of g, Travel: $ 4,40000 funds and satisfactory progress of project) h. Construction/Alteration and Renovation: $ 000 I YEAR I TOTAL COSTS I L Other: $ 82,400,00 I Not Applicable I j. ConsortiumlContractual Costs: $ 161,50000 14. APPROVED DIRECT ASSISTANCE BUDGET: (In lieu of cash) k. Trainee Related Expenses: $ 0,00 a, Amount of Direct Assistance $ 0,00 L Trainee Stipends: $ 0,00 b, Less Unawarded Balance of Current Year's $ 0,00 m, Trainee Tuition and Fees: $ 0,00 Funds n, Trainee Travel: $ 0,00 c, Less Cumulative Prior Awards(s) This Budget $ 0,00 o. TOTAL DIRECT COSTS: $ 323,911.00 Period p, INDIRECT COSTS: (Rate: % of S&WfTADC) $ 0.00 d, AMOUNT OF DIRECT ASSISTANCE THIS $ 0.00 q. TOTAL APPROVED BUDGET: $ 323,911.00 ACTION L Less Non-Federal Resources: $ 0,00 iL Federal Share: $ 323.911,00 I I 15. PROGRAM INCOME SUBJECT TO 45 CFR Part 74.24 OR 45 CFR 92.25 SHALL BE USED IN ACCORD WITH ONE OF THE FOLLOWING ALTERNATIVES: A=Addition B=Deduction C=Cost Sharing or Matching D=Olher [A] Estimated Program Income: $ 0,00 16. THIS AWARD IS BASED ON AN APPLICATION SUBMITTED TO, AND AS APPROVED BY HRSA, IS ON THE ABOVE TITLED PROJECT AND IS SUBJECT TO THE TERMS AND CONDITIONS INCORPORATED EITHER DIRECTLY OR BY REFERENCE IN THE FOLLOWING: a. The grant program legislation cited above. b. The grant program regulatIon cited above_ c. This award notice Jr1ciuding terms and conditions, if any, noted below under REMARKS. d, 45 CFR Part 74 or 45 CFR Part 92 as applicable. In the event there are conflicting Of otherwise Inconsistent poliCies applicable to tne grant, the above order of precede'lce snali prevail. Acceptance of the grant terms and conditions is aCknowledged by the grantee when funds are drawn or otherwise obtained from Ine grant payment system REMARKS: (Other Terms and Conditions Attached [XI Yes [I No ) Electronically signed by Dorothy M. Kelley, Grants Management Officer on: 08/26/2008 17. OBJ, CLASS: 41,51 118. CRS-EIN: 1596000558A1 119. FUTURE RECOMMENDED FUNDING: FY -CAN CFDA DOCUMENT NO. AMT. FIN. ASST. AMT. DIR. ASST. SUBPROGRAM CODE 08-3706311 93,888 D1 BIT1 0769AO $ 323,91100 $ 0,00 NIA Page 1 NOTICE OF GRANT AWARD (Continuation Sheet) HRSA Electronic Handbooks (EHBs) Registration Requirements The Project Director of the grant (listed on this NGA) and the Authorizing Official of the grantee organization are required to register (if not already registered) within HRSA's Electronic Handbooks (EHBs). Registration within HRSA EHBs is required only once for each user for each organization they represent. To complete the registration quickly and efficiently we recommend that you note the 10-digit grant number from box 4b of this NGA. After you have completed the initial registration steps (i.e., created an individual account and associated it with the correct grantee organization record), be sure to add this grant to your portfolio. This registration in HRSA EHBs is required for submission of noncompeting continuation applications. In addition, you can also use HRSA EHBs to perform other activities such as updating addresses, updating email addresses and submitting certain deliverables electronically. Visit https:/Igrants.hrsa.gov/webexternal/login.asp to use the system. Additional help is available online and/or from the HRSA Call Center at 1-877-464-4772. Terms and Conditions Failure to comply with the special remarks and condition(s) may result in a draw down restriction being placed on your Payment Management System account or denial of future funding. Program Terms: 1. Telemedicine Projects: Whenever a third-party payer can be billed for a consult, the grantee may not provide the involved c1inician(s) with a grant-funded clinician incentive payment. This remains the rule even when the clinician incentive payment is more than what the third-party payer will reimburse. This also applies when a State Medicaid agency will reimburse for a consult, but the grantee has not yet established its own internal procedure to bill Medicaid. 2. The Universal Service Provisions of the Telecommunications Act of 1996 should make telecommunication rates for eligible rural health providers comparable with rates for urban providers and in many cases thereby reduce transmission costs to rural providers. All eligible applicants and their eligible grant - funded network members must apply for a Universal Service subsidy as soon as possible or demonstrate to OHIT that applying would not provide any financial advantage. Further information on Universal Service is available at: (http://www.rhc.universalservice.org). 3. It is the policy of HRSA to make available to the public the results and accomplishments of the activities that it funds. Therefore, it is incumbent upon project directors, program directors, and principal investigators to make results and accomplishments of their activities available to the public. Prior approval is not required for publishing the results of an activity under a grant. Recipients shall place an acknowledgement of HRSA grant support and a disclaimer, as appropriate, on any publication, briefing paper, report, or other document that is written, published, or otherwise produced (e.g., website, electronic work products) with such support and, if feasible, on any document (electronic or paper) reporting the results of or describing a grant-supported activity. The acknowledgement shall read: ''This publication (report, briefing paper, document, website, etc.) was made possible by grant number from the Office of Health Information Technology, Health Resources and Services Administration, DHHS" or "The project described was supported by grant number from the Office of Health Information Technology, Health Resources and Services Administration, DHHS." THREE copies of documents or reports (electronic or paper), resulting from work performed under a HRSA grant-supported project or activity MUST be submitted to OHIT, no matter what the media by which they are disseminated (e.g., publications in journals, reports, CD-Rom, web). In addition, copies of presentations to major organizations should acknowledge HRSA support and be submitted to the OHIT project officer. THREE reprints of publications or work products resulting from work performed under a HRSA grant supported project or activity MUST be submitted to the OHIT project officer. 4. In the event the grantee organization anticipates that Federal funding available through this award will not be expended by the project period end date, the grantee is required to submit to the grants management representative and project officer indicated in the "contacts" section of this document a request for a no-cost extension to complete goals and objectives. This request, under an original signature of an authorized grant official should be submitted at least 60 days prior to the expiration of the project period and include: (a) the grant number, (b) the additional time desired, (c) the grant project goals and objectives to be completed and (d) the Federal funds available to complete the goals and objectives with categorical budget and justification. NOTICE OF GRANT AWARD (Continuation Sheet) 5. The grantee institution may retain the entire right, title and interest throughout the world to any invention (as defined in 45 CFR, Section 74.36) it conceives, develops, or implements in the performance of work under this grant, subject to the provisions of the Department of Commerce's regulation 37 CFR Part 401 and 35 U.S.C. 203. The Federal government, however, shall have a nonexclusive, nontransferable, irrevocable, paid-up license to obtain and use the invention for or on behalf of the United States throughout the world. 6. Data Collection and Evaluation: Applicants accepting this award must, if requested, participate in the Office for the Advancement of Telehealth (OAT) data collection and evaluation of telemedicine activities. 7. Telehealth Inventory Assessment: Applicants accepting this award must complete, if requested, a "HRSA Telehealth Inventory." This inventory collects data about the Telehealth capabilities of the grantee's institution and those of the network members. OHIT will provide information regarding this inventory at the time of request. 8. OAT Grantee Directory: Applicants accepting this award must provide information for OHIT's Grantee Directory/Profiles. Further instructions will be provided by OHIT. The current Telehealth directory is available online at: http://telehealth.hrsa.gov/grants/ g ra ntee. htm. 9. Grantees are requested to attend and participate in the OHIT grantee meetings. Programmatic and logistical details will be provided later. 10. When responding to reporting requirements, conditions, and requests for post award amendments to the Division of Grants Management Operations, please send a courtesy copy of your correspondence to the designated project offi cer. Standard Terms: 1. All discretionary awards issued by HRSA on or after October 1, 2006, are subject to the HHS Grants Policy Statement (HHS GPS) unless otherwise noted in the Notice of Award (NoA). Parts I through III of the HHS GPS are currently available at ftp://ftp.hrsa.gov/grants/hhsgrantspolicystatement.pdf and it is anticipated that Part IV, HRSA program-specific guidance will be available at the website in the near future. In addition, HRSA-specific contacts will be appended to Part III of the GPS which identifies Department-wide points of contact. Please note that the Terms and Conditions explicitly noted in the award and the HHS GPS are in effect. Once available, Part IV, HRSA program-specific guidance will take precedence over Parts I and II in situations where there are conflicting or otherwise inconsistent policies. 2. The HHS Appropriations Act requires that when issuing statements, press releases, requests for proposals, bid solicitations, and other documents describing projects or programs funded in whole or in part with Federal money, all grantees receiving Federal funds, including but not limited to State and local governments, shall clearly state the percentage of the total costs of the program or project which will be financed with Federal money, the dollar amount of Federal funds for the project or program, and percentage and a dollar amount of the total costs of the project or program that will be financed by nongovernmental sources. 3. Recipients and sub-recipients of Federal funds are subject to the strictures of the Medicare and Medicaid anti-kickback statute (42 U ,S.C. 1320a - 7b(b) and should be cognizant of the risk of criminal and administrative liability under this statute, speCifically under 42 U.S.C. 1320 7b(b) Illegal remunerations which states, in part, that whoever knowingly and willfully: (A) Solicits or receives (or offers or pays) any remuneration (including kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind, in return for referring (or to induce such person to refer) an individual to a person for the furnishing or arranging for the furnishing of any item or service, OR (B) In return for purchasing, leasing, ordering, or recommending purchasing, leasing, or ordering, or to purchase, lease, or order, any goods, facility, services, or item ....For which payment may be made in whole or in part under subchapter XIII of this chapter or a State health care program, shall be guilty of a felony and upon conviction thereof, shall be fined not more than $25,000 or imprisoned for not more than five years, or both. 4. The HHS Appropriations Act requires that to the greatest extent practicable, all equipment and products purchased with funds made available under this award should be American-made. NOTICE OF GRANT AWARD (Continuation Sheet) 5. Items that require prior approval from the awarding office as indicated in 45 CFR Part 74.25 [Note: 74.25 (d) HRSA has not waived cost-related or administrative prior approvals for recipients unless specifically stated on this Notice of Grant Award] or 45 CFR Part 92.30 must be submitted in writing to the Grants Management Officer (GMO). Only responses to prior approval requests signed by the GMO are considered valid. Grantees who take action on the basis of responses from other officials do so at their own risk. Such responses will not be considered binding by or upon the HRSA. In addition to the prior approval requirements identified in Part 74.25, HRSA requires grantees to seek prior approval for significant rebudgeting of project costs. Significant rebudgeting occurs when, under a grant where the Federal share exceeds $100,000, cumulative transfers among direct cost budget categories for the current budget period exceed 25 percent of the total approved budget (inclusive of direct and indirect costs and Federal funds and required matching or cost sharing) for that budget period or $250,000, whichever is less. For example, under a grant in which the Federal share for a budget period is $200,000, if the total approved budget is $300,000, cumulative changes within that budget period exceeding $75,000 would require prior approval). For recipients subject to 45 CFR Part 92, this requirement is in lieu of that in 45 CFR 92.30(c)(1 )(ii) which permits an agency to require prior approval for specified cumulative transfers within a grantee's approved budget. [Note, even if a grantee's proposed rebudgeting of costs falls below the significant rebudgeting threshold identified above, grantees are still required to request prior approval, if some or all of the rebudgeting reflects either a change in scope, a proposed purchase of a unit of equipment exceeding $25,000 (if not included in the approved application) or other prior approval action identified in Parts 74.25 and 92.30 unless HRSA has specifically exempted the grantee from the requirement(s).] 6. Payments under this award will be made available through the DHHS Payment Management System (PMS). PMS is administered by the Division of Payment Management, Financial Management Services, Program Support Center, which will forward instructions for obtaining payments. Inquiries regarding payment should be directed to: Payment Management, DHHS, P.O. Box 6021, Rockville, MD 20852, http://www.dpm.psc.gov/ or Telephone Number: 1-877-614-5533. 7. The DHHS Inspector General maintains a toll-free hotline for receiving information concerning fraud, waste, or abuse under grants and cooperative agreements. Such reports are kept confidential and callers may decline to give their names if they choose to remain anonymous. Contact: Office of Inspector General, Department of Health and Human Services, Attention: HOTLINE, 330 Independence Avenue Southwest, Cohen Building, Room 5140, Washington, D. C. 20201, Email: Htips@os.dhhs.gov or Telephone: 1-800-447-8477 (1-800-HHS-TIPS). 8. Submit audits, if required, in accordance with OMB Circular A-133, to: Federal Audit Clearinghouse Bureau of the Census 1201 East 10th Street Jefferson, IN 47132 PHONE: (310) 457-1551, (800)253-0696 toll free http://harvester.census.gov/ sac/facconta. htm 9. EO 13166, August 11, 2000, requires recipients receiving Federal financial assistance to take steps to ensure that people with limited English proficiency can meaningfully access health and social services. A program of language assistance should provide for effective communication between the service provider and the person with limited English proficiency to facilitate participation in, and meaningful access to, services. The obligations of recipients are explained on the OCR website at http://www.hhs.gov/ocr/lep/revisedlep.html. 10. This award is subject to the requirements of Section 106 (g) of the Trafficking Victims Protection Act of 2000,as amended (22 U.S.C. 7104). For the full text of the award term, go to http://www.hrsa.gov/grants/trafficking.htm. If you are unable to access this link, please contact the Grants Management Specialist identified in this Notice of Grant Award to obtain a copy of the Term. Reporting Requirements: 1. Due Date: Within 90 days of Budget End Date The grantee must submit a Financial Status Report SF-269A1Short Form (http://www.psc.gov/forms/sf) within 90 days after the budget period end date. This report should NOT reflect cumulative reporting from budget period to budget period and must be submitted to the HRSA, Division of Grants Management Operations, 5600 Fishers Lane, Room 11A-02, Rockville, MD 20857-0001. 2. Due Date: Within 365 days of Award Issue Date Technical progress reports are required at annual intervals, when the due date coincides with the conclusion of the NOTICE OF GRANT AWARD (Continuation Sheet) Agenda Item No. 16016 October 28, 2008 Page 5 Date Issued: 08/2612008 age 0 Award Number: 1 D1 Bin 0769-01.00 project, the final report will also serve as the progress report. Reports should include a summary of what has been accomplished during the reporting period and what has been learned, as well as basic information required by OHIT to measure the progress of the program. A copy of the format to be used, as well as instructions for submitting the report, will be provided by OHIT. Failure to comply with these reporting requirements will result in deferral or additional restrictions of future funding decisions. Contacts: Program Contact: For assistance on programmatic issues, please contact Makeda Clement at: OHIT 5600 Fishers Ln RM 7C-26 Rockville, MD 20857-0001 Phone: (301)443-6977 Email: MClement@hrsa.gov Division of Grants Management Operations: For assistance on grants administration issues, please contact Hazel N. Booker at: HRSA/DGMO/GSFB 5600 Fishers Ln RM 11 A-02 Rockville, MD 20857-0001 Phone: (301 )443-4236 Email: nbooker@hrsa.gov Fax: (301 )443-6686 Responses to reporting requirements, conditions, and requests for post award amendments must be mailed to the attention of the Office of Grants Management contact indicated above. All correspondence should include the Federal grant number (item 4 on the award document) and program title (item 8 on the award document). Failure to follow this guidance will result in a delay in responding to your request.