Opportunity Information: Apply for HRSA 10 208
Apply for HRSA 10 208
- The Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "Frontier Community Health Integration Demonstration Program" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.155 Rural Health Research Centers.
- This funding opportunity was created on May 15, 2010 and posted on May 11, 2010.
- Applicants must submit their applications by Jun 22, 2010. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The funding agency has allocated a total of $750,000.00 to eligible and selected applicants.
- The number of recipients for this funding is limited to 1 candidate(s).
- Eligible applicants include: Others (see text field entitled Additional Information on Eligibility for clarification).
- To be eligible for the Frontier Community Health Integration Demonstration, the applicant organization must meet the following requirements Under the authority of Section 330A of the Public Health Service Act the applicant organization must be a public or non profit private entity located in a rural area. To ascertain rural eligibility, please refer to http://ruralhealth.hrsa.gov/funding/eligibilitytestv2.asp and enter the applicant organization s State and County. Applications serving rural communities but whose applicant organization is not in a designated rural area will not be considered for funding under this announcement. The applicant must be composed of a network of at least three separately owned, existing organizations. At least one of the network partners must be the State Rural Hospital Flexibility Program grantee, or subgrantee, (defined under Section 1820(g) of the Social Security Act (42 U.S.C. 1395i 4(g)). The applicant must be located in a State in which at least 65 percent of the counties in the State are frontier counties. For the purposes of this demonstration, frontier counties are those that have 6 or less residents per square mile. Applicants must prepare their application in consultation with the appropriate State Office of Rural Health (SORH) or another appropriate State entity (for a list of SORH s go to http://ruralhealth.hrsa.gov/funding/50sorh.htm).
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Opportunity Summary:
The Frontier Community Health Integration Demonstration Program (HRSA-10-208) was a Health Resources and Services Administration (HRSA) discretionary grant opportunity created to support the design and testing of new, better-connected health care delivery approaches specifically for frontier areas. The central idea behind the demonstration was to improve access to care and strengthen how services are coordinated for Medicare beneficiaries who live in extremely sparsely populated regions where provider capacity is limited, distances are long, and traditional payment and regulatory frameworks often do not fit local realities.
The program focused on two main policy and operational problem areas. First, it sought to explore ways to increase access to essential services in frontier communities and to examine whether Medicare and Medicaid payments for acute care, extended care, and other core services were adequate for low-volume providers that face high fixed costs and thin staffing. Second, it aimed to evaluate regulatory barriers that frontier providers and their communities encounter, recognizing that compliance rules and program requirements designed for higher-volume systems can unintentionally restrict service delivery in remote settings. In practice, the grant was intended to support technical assistance and broad analysis of these payment and regulatory issues in connection with a related Centers for Medicare and Medicaid Services (CMS) demonstration authorized under Section 123 of the Medicare Improvements for Patients and Providers Act (MIPPA). A key caveat in the announcement was that participation in HRSA-funded activities did not guarantee selection or participation in the CMS demonstration itself, meaning the HRSA award functioned as support and infrastructure for implementation and learning rather than as automatic entry into CMS demonstration participation.
Structurally, HRSA planned to make a single award, with an estimated total funding level of $750,000, and there was no cost-sharing or matching requirement. The funding instrument type was listed as a grant, and the activity category was health. The CFDA listing associated with the opportunity was 93.155 (Rural Health Research Centers), which aligns with the technical assistance, analysis, and demonstration-support orientation of the effort rather than direct service expansion alone. The timeline for this particular competition was posted May 11, 2010, with an application closing date of June 22, 2010, and it was later archived on August 21, 2010.
Eligibility was narrow and heavily tied to frontier geography and rural organizational status. Applicants had to be public or nonprofit private entities located in a rural area, as determined by HRSA rural eligibility criteria; importantly, applications that proposed to serve rural communities but were submitted by an organization not physically located in a designated rural area were not eligible. The applicant also had to be a network of at least three separately owned, existing organizations, emphasizing partnership and integration rather than a single provider acting alone. At least one partner in that network had to be the State Rural Hospital Flexibility Program grantee or subgrantee (the Flex Program), ensuring connection to the state-level rural hospital support infrastructure. The applicant organization had to be located in a state where at least 65 percent of counties were classified as frontier counties, with “frontier†defined here as counties with six or fewer residents per square mile. In addition, applicants were required to prepare the application in consultation with the relevant State Office of Rural Health (SORH) or another appropriate state entity, reinforcing alignment with state rural health priorities and existing coordination channels.
Overall, the opportunity was designed less as a typical stand-alone service grant and more as a cooperative, implementation-support award meant to help frontier networks navigate the realities of low-volume care delivery. It emphasized practical testing of integrated care models, analysis of payment adequacy in remote contexts, and identification of regulatory pain points that could hinder access, with HRSA positioned to provide technical assistance and generate actionable insights that could inform the associated CMS demonstration and broader policy discussions about sustaining essential services in frontier America.
Frontier Community Health Integration Demonstration Program (HRSA-10-208) FAQs
What is the Frontier Community Health Integration Demonstration Program (HRSA-10-208)?
It was a Health Resources and Services Administration (HRSA) discretionary grant opportunity created to support the design and testing of new, better-connected health care delivery approaches specifically for frontier areas. The emphasis was on improving access to care and strengthening service coordination for Medicare beneficiaries living in extremely sparsely populated regions.
What problem was this program trying to solve?
The program addressed challenges common in frontier settings, including limited provider capacity, long distances to care, and payment and regulatory frameworks that often do not fit low-volume, remote realities. The goal was to improve how care is accessed and coordinated in places where traditional health system assumptions do not hold.
Who was the program intended to benefit?
The central focus was Medicare beneficiaries who live in frontier areas. The program also targeted the frontier providers and community networks that serve them by helping those organizations test integrated delivery approaches and examine payment and regulatory constraints.
What were the main focus areas of the grant?
The opportunity focused on two policy and operational areas: (1) improving access to essential services in frontier communities and assessing whether Medicare and Medicaid payments for acute care, extended care, and other core services were adequate for low-volume providers with high fixed costs; and (2) evaluating regulatory barriers that can unintentionally restrict service delivery in remote, low-volume environments.
Was this a direct service expansion grant?
It was positioned less as a typical stand-alone service grant and more as a cooperative, implementation-support award. It emphasized technical assistance, analysis, and demonstration support tied to frontier network integration and the realities of low-volume delivery.
How did this HRSA grant relate to CMS and MIPPA?
The grant was intended to support technical assistance and broad analysis connected to a related Centers for Medicare and Medicaid Services (CMS) demonstration authorized under Section 123 of the Medicare Improvements for Patients and Providers Act (MIPPA). HRSA funding served as support and infrastructure for implementation and learning in connection with that related demonstration effort.
Did receiving the HRSA award guarantee participation in the CMS demonstration?
No. A key caveat was that participation in HRSA-funded activities did not guarantee selection or participation in the CMS demonstration itself. The HRSA award supported preparation, implementation support, and learning, but it was not automatic entry into the CMS demonstration.
How many awards did HRSA plan to make?
HRSA planned to make a single award under this opportunity.
What was the estimated total funding level?
The estimated total funding level was $750,000.
Was cost-sharing or matching required?
No. There was no cost-sharing or matching requirement stated for this opportunity.
What was the funding instrument type and activity category?
The funding instrument type was a grant, and the activity category was health.
What CFDA program listing was associated with this opportunity?
The CFDA listing was 93.155 (Rural Health Research Centers). This aligns with the technical assistance, analysis, and demonstration-support orientation described in the opportunity.
When was the opportunity posted, and what were the key dates?
The opportunity was posted May 11, 2010, with an application closing date of June 22, 2010. It was later archived on August 21, 2010.
Who was eligible to apply?
Eligibility was narrow. Applicants had to be public or nonprofit private entities located in a rural area as determined by HRSA rural eligibility criteria. The applicant also had to be a network of at least three separately owned, existing organizations, and the network had to include at least one partner that was the State Rural Hospital Flexibility Program (Flex Program) grantee or subgrantee.
Does the applicant organization have to be physically located in a designated rural area?
Yes. Organizations not physically located in a designated rural area were not eligible, even if the application proposed to serve rural communities.
What does the program mean by a "network" applicant?
The applicant had to be a network of at least three separately owned, existing organizations. This requirement emphasized partnership and integration across multiple entities rather than a single provider applying alone.
Is participation by the Flex Program required?
Yes. At least one partner in the network had to be the State Rural Hospital Flexibility Program grantee or subgrantee, tying the effort to the state-level rural hospital support infrastructure.
Were there geography-based state eligibility requirements?
Yes. The applicant organization had to be located in a state where at least 65 percent of counties were classified as frontier counties.
How was a "frontier county" defined for this opportunity?
Frontier counties were defined as counties with six or fewer residents per square mile.
Was consultation with a State Office of Rural Health required?
Yes. Applicants were required to prepare the application in consultation with the relevant State Office of Rural Health (SORH) or another appropriate state entity to reinforce alignment with state rural health priorities and coordination channels.
What types of issues related to payments were expected to be examined?
The program sought to examine whether Medicare and Medicaid payments for acute care, extended care, and other core services were adequate for low-volume providers that face high fixed costs and thin staffing in frontier communities.
What kinds of regulatory barriers were in scope?
The grant aimed to evaluate regulatory barriers encountered by frontier providers and communities, especially where compliance rules and program requirements designed for higher-volume systems can unintentionally restrict service delivery in remote settings.
What was the overall approach HRSA intended with this award?
The opportunity emphasized practical testing of integrated care models, analysis of payment adequacy in remote contexts, and identification of regulatory pain points that could hinder access. HRSA was positioned to provide technical assistance and generate actionable insights to inform the related CMS demonstration and broader policy discussions about sustaining essential services in frontier America.
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