2. Grant Writing Tips The average performance can be obtained from many sources. The CHC industry standard for the community health centers in the UDS. Compare your CHC to the UDS on an ongoing basis. Reports often are available that compare a CHC to the State and also National Performance. Projected patient visits should be somewhere between the National and State with performance.

3. General Grant Writing Tips There are a number of Policy Information Notices listed in the Grant Writing Toolkit and the Application Guidance. PIN 2003-21—Schedule of Discounts PIN 99-08—FTCA PIN 2009-03—Scope of Project PIN 98-12—Governance PIN 98-23—Health Center Program Expectations PIN 97-27—Affiliation Agreements and 98-24: Amendments PIN 2007-09—Service Area Overlap PIN 98-24: Amendment to pin 97-27 Affiliation Agreement Begin reading the recommended PINS right away. Become familiar with the Contents

4. General Grant Writing Tips The HRSA Grants have page limits, acceptable fonts, and file size limits as well as a deadline for submitting the application. Not adhering to requirements can deem your application as ineligible for submission and they will return it. Adhere strictly to the format and outline prescribed.

5. General Grant Writing Tips Assemble the Grant Writing Team early and discuss who is going to do what and when. Support Letters MOUs Research Maps Floor Plans Map Community Interviews Some clinics assemble a team by sections of the grant: Needs Assessment Health Plan Business Plan Narrative Budget Section EHB Upload There should be one primary writer that pulls everything together.

6. General Grant Writing Tips The Needs Assessment must be completed before the Health Care Plan. The Business Plan and the Budget are also aligned with the Needs Assessment. All sections of the application align on the Needs Assessment.

7. General Grant Writing Tips A proposal is what you are going to do, not what you are doing. Compare the CHC to the average or better than average. If your performance is above average then the proposal should present above average. If your performance is below average, you don’t want to propose to be below average. A proposal is not a report on what you have done.

8. General Grant Writing Tips The average performance can be obtained from many sources. The CHC industry standard for the community health centers in the UDS. Compare your CHC to the UDS on an ongoing basis. Reports often are available that compare a CHC to the State and also National Performance. When developing an application, projected performance should be somewhere between the National and State with performance.

9. Needs Assessment Tips Identify the service area first— County Counties Census tracts Districts. Within the service area, identify target population— County Counties Census Tracts Districts Population group

10. Needs Assessment Tips Select the target population or target area that has the most need. Start the process early enough to look at more than one target group to select the target group that meets the most need. Compare your service area to your target if they are not the same. If the service area and target area are the same compare to National or adjacent area. If it’s in your Needs Assessment, it must be addressed in the Health Care Plan.

11. Needs Assessment Tips Make sure your research for health status indicators include conditions under eight required clinical measure Other required health status indicators listed in the grant. Unless, there is an overwhelming health problem in the community, limit the needs identified. Everything you include here must be addressed in the health care plan which requires process for tracking and reporting.

12. Health Plan Tips The Health Care Plan must address all needs described in the Needs Assessment. The objectives must be measurable and time lined. Example: Diabetes Increase the % of patients with HbA1c below 9 from 70% to 75% by 2014. Decrease the diabetic death rate from 351 to 349 within the target population by 2014. Maintain a diabetic death rate within the patient population that is below the target population rate of 351 by 2014.

13. Health Care Plan Tips Immunizations Increase the % of children <24 months of age with up to date immunizations from 78% to 82% by 2014. Increase the % of children < 24 months of age with up to date immunizations among the target population from 70% to 72%. Maintain the % of children < 24 months of age with up to date immunizations above the target population % of 70 by 2014.

14. Health Care Plan Tips Low Birth Weight Decrease the % of low birth weight infants from 2.5% to 2% by 2014. Decrease the % of low birth weight infants among the target population from 16% to 15% by 2010. Maintain the % of low birth weight infants below the target population of 10.

15. Health Care Plan Tips Keep It Simple—The CHC will be held to meeting the needs identified in the needs assessment and included in this section. Outlining goals and objectives do not restrict you from addressing other needs in the community. The Health Care Plan is not a complete plan of care or a set clinical protocol. The Quality Assurance Program can address other area of care. The complete Quality Assurance Program is address in another area of the Narrative

16. Health Care Plan tips There are eight required clinical goals and objectives. Six are defined by the funding agency and two the CHC identify under behavior health and oral health. 1. Percentage of pregnant women beginning prenatal care in the first trimester 2. Percentage of children with 2nd birthday during the measurement year with appropriate immunizations 3. Percentage of women 21-64 years of age who received one or more Pap tests during the measurement year or during the two years prior to the measurement year.

17. Health Care Plan Tips 4.Percentage diabetic patients whose HbA1c levels are less than or equal to 9 percent. 5. Percentage of adult patients 18 years and older with diagnosed hypertension whose most recent blood pressure was less than 140/90 6.Percentage of births less than 2,500 grams to health center patients 7.Behavior Health (Identify) 8.Oral Health (Identify)

18. Health Care Plan Tips Healthy People 2010/2020—Get familiar with the Healthy People 2020 goals and objectives. Identify in the comment section which objectives are in line with Healthy People 2020. Health Disparities—Present two-three needs with disparity comparisons. You can show disparities in population groups and target vs. services area. Some of the objectives can address both Healthy People 2020 and health disparity. The needs should be presented on a table that is taken from the needs assessment section of the application.

20. Grant Writing Tips The average performance can be obtained from many sources. The CHC industry standard for the community health centers in the UDS. Compare your CHC to the UDS on an ongoing basis. Reports often are available that compare a CHC to the State and also National Performance. Projected patient visits should be somewhere between the National and State with performance.

21. General Grant Writing Tips There are a number of Policy Information Notices listed in the Grant Writing Toolkit and the Application Guidance. PIN 2003-21—Schedule of Discounts PIN 99-08—FTCA PIN 2009-03—Scope of Project PIN 98-12—Governance PIN 98-23—Health Center Program Expectations PIN 97-27—Affiliation Agreements and 98-24: Amendments PIN 2007-09—Service Area Overlap PIN 98-24: Amendment to pin 97-27 Affiliation Agreement Begin reading the recommended PINS right away. Become familiar with the Contents

22. General Grant Writing Tips The HRSA Grants have page limits, acceptable fonts, and file size limits as well as a deadline for submitting the application. Not adhering to requirements can deem your application as ineligible for submission and they will return it. Adhere strictly to the format and outline prescribed.

23. General Grant Writing Tips Some Teams are Assembled by Task Grant Writer—Principle Investigator Support Letters MOUs Research Maps Floor Plans Map Community Interviews Some clinics assemble a team by sections of the grant: Grant Writer Needs Assessment Health Plan Business Plan Narrative Budget Section EHB Upload There should be one primary writer that pulls everything together. Assemble the Grant Writing Team early and discuss who is going to do what and when.

24. Critical Path Analysis for CHC Grant Writing

25. Income Analysis Information OMB No.: 0915-0285. Expiration Date: 08/31/2010

27. Budget Information Income Analysis— Once the target area and the service area are identified, the patient mix can formulated. Make sure that any category within the patient mix does not exceed to total population in the service area. It can exceed the number of patients in the target area. The patient mix coincides with the provider staffing.

28. Productivity The productivity projected should equal to and/or exceed within reason the productivity averages reported in the most recent UDS. Performance information is presented on productivity by specialty such as dental, pediatrician, family practice, ob/gyn, NP, etc. The “gold standard” for years is 4,200 per physician and 2,400 for NP. Many reviewers/project officers still apply the “gold standard”.

29. Productivity and Financial Performance The recommended average patients (users) per full time physician is 1,500 and 750 per NP. The numbers can be more or less. (Review details in the definition section of the Application Guidance) If it’s less, you should explain. The charges to costs use to be 90%. However currently, most providers are far exceeding this %. The percent collection to reimbursable charges should be close to 80%.

30. Most Recent Annual Collection Most competitive grants you also have to present the most current year’s performance. Make sure that the projected income is not out of line with the organizations most recent performance. Example: Unless you plan to double the number of providers, the income should not be expected to exceed your existing organizations income. It just has to make sense.

31. Budget Justification The Budget Justification is nothing more than a line item budget with an explanation of what the expenditure is for. It is not a narrative. This is where you get to abbreviate. You can use symbols: @ (at), X (time). Be brief. The Guidance has an example of the Budget Justification. The Grant Writing Toolkit has a sample of the Budget Justification.

32. Budget Justification (Sample)

33. Personnel

34. Fringe Benefits

35. Supplies

36. Staff Profile

40. Budget Narrative Budget Narrative— More detail description of the Budget. This section should expound upon the Budget Justification. It is in a Narrative format but can include tables.

41. Renovation Schedule Description Clinic #1Clinic #2Clinic #3Total Revenue Renovation One Time Federal Amount Requested $ 150,000 Grantee One Time Existing Excess Revenue $ 150,000 $ 300,000 Total $ 150,000 $ 450,000 Expense Week 1Permit $ 150 $ 450 Week 1Demolition $ 4,125 $ 12,375 Week 2Plumbing $ 29,318 $ 87,954 Week 2Stud Framing/Drywall/Finishing/Paint $ 38,960 $ 116,881 Week 4Acoustical Ceiling $ 5,746 $ 17,238 Week 4Doors, Frames $ 16,197 $ 48,591 Week 5Electric/Computer/Telephone Wiring $ 29,638 $ 88,914 Week 7Insulation at Ceiling $ 1,651 $ 4,953 Week 7Floor/Baseboard $ 12,722 $ 38,166 Week 8Install Telephone System $ 4,041 $ 12,123 Week 9Heating and Air tie In $ 6,902 $ 20,705 Week 10Final Clean Up $ 550 $ 1,650 Total $ 150,000 $ 450,000 Renovation Cost Schedule

42. Renovation Time Schedule Description Clinic #1Clinic #2Clinic #3 InsuranceWeek 108/04/0808/11/0808/18/08 PermitWeek 108/04/0808/11/0808/18/08 DemolitionWeek 108/04/0808/11/0808/18/08 PlumbingWeek 208/11/0808/18/0808/25/08 Stud Framing/Drywall/Finishing/PaintWeek 208/11/0808/18/0808/25/08 Plumbing (Continued)Week 308/18/0808/25/0809/01/08 Stud Framing/Drywall/Finishing/Paint (Continued)Week 308/18/0808/25/0809/01/08 Doors, FramesWeek 408/25/0809/01/0809/08/08 Acoustical CeilingWeek 408/25/0809/01/0809/08/08 Electric/Computer/Telephone WiringWeek 509/01/0809/08/0809/15/08 Stud Framing/Drywall/Finishing/Paint (Continued)Week 509/01/0809/08/0809/15/08 Stud Framing/Drywall/Finishing/Paint (Continued)Week 609/15/0809/22/0809/29/08 Electric/Computer/Telephone Wiring (Continued)Week 609/15/0809/22/0809/29/08 Insulation at CeilingWeek 709/22/0809/29/0810/06/08 Floor/BaseboardWeek 709/22/0809/29/0810/06/08 Install Telephone SystemWeek 809/29/0810/06/0810/13/08 Install Furniture and FixtureWeek 809/29/0810/06/0810/13/08 Heating and Air tie InWeek 910/06/0810/13/0810/20/08 Final Clean UpWeek 1010/13/0810/20/0810/27/08 Date to See First PatientWeek 1110/20/0810/27/0811/03/08

43. Financial Required Indicators