Opportunity Information: Apply for HRSA 11 139
Apply for HRSA 11 139
- The Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "Frontier Extended Stay Clinic Cooperative Agreement" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvemen.
- This funding opportunity was created on Jul 29, 2011 and posted on Jul 29, 2011.
- Applicants must submit their applications by Aug 31, 2011. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The funding agency has allocated a total of $1,500,000.00 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).
- Funds awarded under the authority of Section 330A of the Public Health Service Act must be awarded to a rural public or non profit private entity. Funds awarded under this authority also require the development of a consortium of at least three separately owned organizations that provide health care services. For profit organizations may be members of consortiums, but they are not eligible to be applicants. The purpose of the consortium requirement is to encourage creative and lasting collaborative relationships among service providers in rural areas. Members of a consortium might include hospitals, public health agencies, primary care service providers, rural health clinics, emergency services providers, tribal health providers and community and migrant health centers. Faith based organizations are eligible to apply as members of a consortium. At least one member of the consortium must be an operational clinic or hospital, currently providing primary care services and located at least 75 miles from the nearest hospital or critical access hospital or inaccessible by public road. The roles and responsibilities of each member organization must be clearly defined and each must contribute significantly to the goals of the project. Applicants that have previously received a grant award under 42 U.S.C. 254c(e) are ineligible to receive funding for the same or similar project unless they clearly demonstrate that their new proposal either expands the scope of the project or the area to be serviced in a significant way. Applicants must prepare their application in consultation with the appropriate State Office of Rural Health or another appropriate state entity. Applicants for funds under this program must also submit evidence of the support of the agency of their state s government responsible for the licensure and certification of health care entities.
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Opportunity Summary:
The Frontier Extended Stay Clinic Cooperative Agreement (HRSA-11-139) was a discretionary funding opportunity from the Health Resources and Services Administration (HRSA) to support and strengthen the Frontier Extended Stay Clinic (FESC) model in extremely remote areas. The basic idea behind the FESC concept is to test whether certain frontier clinics can safely and effectively care for patients who need more observation and treatment than a typical outpatient visit allows, but who may not be able to reach a hospital quickly due to distance, weather, terrain, or lack of road access. In practice, this model is meant to fill a real gap in rural health care by allowing short-term extended monitoring and services at a clinic site when transfer to a hospital is difficult or delayed.
This opportunity was structured as a cooperative agreement, which signals that HRSA (especially the Office of Rural Health Policy, or ORHP) expected to be actively involved rather than simply issuing a grant and stepping back. ORHP staff were to have significant involvement and input in choosing projects and shaping the work plan, meaning the recipient would operate in an ongoing partnership with the federal program office. The award was designed to align with and support a related, parallel Frontier Extended Stay Demonstration being run by the Centers for Medicare and Medicaid Services (CMS), so the cooperative agreement recipient would effectively help the broader federal demonstration effort succeed.
The funded work focused on managing and advancing FESC-type activities across participating sites. Core responsibilities included implementing and testing FESC clinical protocols at demonstration locations, evaluating both program performance and financial operations at those sites, and documenting lessons learned. The award also required an inventory and narrative summary of earlier FESC demonstration efforts that HRSA had funded previously, with the goal of carrying forward what worked, clarifying what did not, and creating a more coherent picture of the model as it evolved. Another major component was providing technical assistance to CMS and to the organizations participating in the CMS Frontier Extended Stay Demonstration, which could include troubleshooting operational issues, sharing best practices, and helping sites meet demonstration requirements.
A substantial emphasis was placed on Health Information Technology (HIT) and quality improvement. The cooperative agreement called for developing or continuing HIT and quality initiatives and, importantly, building quality measures that could capture both clinical performance and financial performance across demonstration sites. That focus reflects the practical question the demonstration was trying to answer: not only whether the FESC approach improves access and outcomes for patients in remote settings, but also whether it can function sustainably as a delivery and payment model. The announcement also left room for further development work, such as exploring whether and how the FESC model could be implemented beyond the traditional frontier contexts and into the lower 48 states, including potential connections and operational relationships with Critical Access Hospitals.
In terms of funding, HRSA anticipated making a single award, with an estimated total funding amount of $1,500,000. The program did not require cost sharing or matching funds. The assistance listing associated with the opportunity was CFDA 93.912, which is tied to rural health outreach, network development, and small provider quality improvement efforts.
Eligibility rules were specific and reflected the statutory requirements under Section 330A of the Public Health Service Act. The applicant had to be a rural public entity or a rural nonprofit private entity, and the project had to be built around a consortium of at least three separately owned health care service organizations. For-profit organizations could participate as consortium members but could not apply as the lead applicant. This consortium requirement was meant to push durable collaboration among rural providers rather than isolated, one-off projects. Examples of eligible consortium members included hospitals, public health agencies, primary care providers, rural health clinics, emergency service providers, tribal health providers, and community and migrant health centers, and faith-based organizations were eligible to participate as consortium members as well.
The opportunity also required that at least one consortium member be an operational clinic or hospital providing primary care services and located at least 75 miles from the nearest hospital or Critical Access Hospital, or otherwise inaccessible by public road. Applicants had to clearly define the roles and responsibilities of each consortium organization and show that each member would contribute in a meaningful way to project goals. There were also limits intended to avoid duplicating prior work: organizations that had previously received a grant award under 42 U.S.C. 254c(e) could not receive funding for the same or similar project unless they could clearly show the new proposal substantially expanded either the project scope or the service area.
Coordination with state-level rural health leadership and regulatory authorities was another built-in requirement. Applicants were expected to prepare the application in consultation with the appropriate State Office of Rural Health (or another suitable state entity) and to provide evidence of support from the state agency responsible for licensure and certification of health care entities. This reflects how dependent the FESC model is on state licensing, facility rules, and clinical practice standards, especially when a clinic is being positioned to provide services that resemble a short, hospital-like stay.
Finally, the posting and timeline show that this was a time-limited competition released on July 29, 2011, with an application deadline of August 31, 2011, and an archive date of October 30, 2011. HRSA provided support through the HRSA Call Center for applicants who had trouble accessing the full announcement. Overall, the cooperative agreement was designed to move the FESC model from concept and scattered pilots toward a more evidence-driven, measurable, and operationally supported approach, tightly linked to the CMS demonstration and focused on improving care options for patients in the most remote parts of the country.
Frontier Extended Stay Clinic Cooperative Agreement (HRSA-11-139) FAQs
What is the Frontier Extended Stay Clinic (FESC) concept?
The Frontier Extended Stay Clinic (FESC) concept is a model intended for extremely remote areas where patients may need more observation and treatment than a typical outpatient visit, but where reaching a hospital quickly is difficult due to distance, weather, terrain, or lack of road access. The model is meant to allow short-term extended monitoring and services at a clinic site when hospital transfer is delayed or impractical.
What was HRSA-11-139?
HRSA-11-139 was a discretionary funding opportunity from the Health Resources and Services Administration (HRSA) to support and strengthen the FESC model in frontier settings. It was designed to help move the model toward a more measurable, operationally supported approach and to align with a related Centers for Medicare and Medicaid Services (CMS) Frontier Extended Stay Demonstration.
What type of award was this opportunity?
This opportunity was structured as a cooperative agreement. That structure indicates HRSA (particularly the Office of Rural Health Policy, ORHP) expected to be actively involved, with significant input into project selection and the shaping of the work plan, creating an ongoing partnership between the recipient and the federal program office.
How was this cooperative agreement connected to CMS?
The cooperative agreement was designed to align with and support a parallel Frontier Extended Stay Demonstration run by CMS. The funded recipient was expected to help the broader federal demonstration effort succeed, including by providing technical assistance to CMS and to participating organizations.
What were the main activities the recipient was expected to carry out?
The funded work focused on managing and advancing FESC-type activities across participating sites. Core responsibilities included implementing and testing FESC clinical protocols at demonstration locations, evaluating program performance and financial operations, documenting lessons learned, and providing technical assistance tied to the CMS demonstration.
Was evaluation required under the award?
Yes. The work included evaluating both program performance and financial operations at demonstration sites and developing quality measures that could capture clinical performance and financial performance across sites.
What role did Health Information Technology (HIT) and quality improvement play?
HIT and quality improvement were emphasized as substantial components. The cooperative agreement called for developing or continuing HIT and quality initiatives and building quality measures to assess clinical and financial performance across demonstration sites.
Did the award require documenting prior FESC efforts?
Yes. The award required an inventory and narrative summary of earlier FESC demonstration efforts previously funded by HRSA. The purpose was to capture lessons learned, clarify what worked and what did not, and create a clearer picture of how the model evolved.
What kinds of technical assistance were expected?
Technical assistance was expected for CMS and for organizations participating in the CMS Frontier Extended Stay Demonstration. Examples included troubleshooting operational issues, sharing best practices, and helping participating sites meet demonstration requirements.
Did the opportunity allow exploration beyond traditional frontier contexts?
Yes. The announcement left room for further development work, including exploring whether and how the FESC model could be implemented beyond traditional frontier contexts and into the lower 48 states, including potential connections and operational relationships with Critical Access Hospitals.
How much funding was anticipated?
HRSA anticipated making a single award with an estimated total funding amount of $1,500,000.
Was cost sharing or matching required?
No. The program did not require cost sharing or matching funds.
What was the CFDA (assistance listing) number associated with this opportunity?
The assistance listing associated with the opportunity was CFDA 93.912, which is tied to rural health outreach, network development, and small provider quality improvement efforts.
Who was eligible to apply as the lead applicant?
Eligibility was tied to Section 330A of the Public Health Service Act. The lead applicant had to be a rural public entity or a rural nonprofit private entity.
Could for-profit organizations apply as the lead?
No. For-profit organizations could participate as consortium members but could not apply as the lead applicant.
Was a consortium required to apply?
Yes. The project had to be built around a consortium of at least three separately owned health care service organizations. This requirement was intended to promote durable collaboration among rural providers rather than isolated projects.
What types of organizations could be consortium members?
Examples listed as eligible consortium members included hospitals, public health agencies, primary care providers, rural health clinics, emergency service providers, tribal health providers, community and migrant health centers, and faith-based organizations.
Was there a specific geographic/remoteness requirement for at least one consortium member?
Yes. At least one consortium member had to be an operational clinic or hospital providing primary care services and located at least 75 miles from the nearest hospital or Critical Access Hospital, or otherwise inaccessible by public road.
Did the application need to specify consortium roles?
Yes. Applicants had to clearly define the roles and responsibilities of each consortium organization and demonstrate that each member would contribute in a meaningful way to project goals.
Were there restrictions related to prior federal funding for similar projects?
Yes. Organizations that had previously received a grant award under 42 U.S.C. 254c(e) could not receive funding for the same or similar project unless they could clearly show the new proposal substantially expanded the project scope or the service area.
What state-level coordination was required?
Applicants were expected to prepare the application in consultation with the appropriate State Office of Rural Health (or another suitable state entity). They also had to provide evidence of support from the state agency responsible for licensure and certification of health care entities.
Why was support from licensure and certification authorities emphasized?
The FESC model depends on state licensing, facility rules, and clinical practice standards, especially when a clinic is positioned to provide services resembling a short, hospital-like stay. Evidence of support from the relevant state authority was therefore required.
How many awards did HRSA expect to make?
HRSA anticipated making a single award under this opportunity.
When was the opportunity posted, and what were the key dates?
The competition was released on July 29, 2011. The application deadline was August 31, 2011, and the archive date was October 30, 2011.
What HRSA office was particularly involved in this program?
The Office of Rural Health Policy (ORHP) within HRSA was described as having significant involvement and input, consistent with the cooperative agreement format.
What was the practical problem the FESC approach was trying to solve?
The approach aimed to address a gap in rural health care by allowing clinics in extremely remote areas to provide short-term extended observation and treatment when patients cannot quickly access hospital care due to geography, weather, terrain, or road limitations.
Where could applicants get help accessing the full announcement?
HRSA provided support through the HRSA Call Center for applicants who had trouble accessing the full announcement.
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