Health Information Technology for Economic and Clinical Health (HITECH) Act Grants

Health Information Technology for Economic and Clinical Health (HITECH) Act Grants is sponsored by Department of Health and Human Services (HHS). Provides funding to promote the adoption and meaningful use of health information technology.

Grants Management & Process - ONC - Office of the National Coordinator for Health Information Technology website belongs to an official government organization in the to the . gov website. Share sensitive information only on official, secure websites.

Grants Management & Process Grants Management & Process Learn about opportunities for funding through grants and cooperative agreements. Investments in Interoperability Most of the ONC grant and cooperative agreements programs are based on authorities provided by the Health Information Technology and Clinical Health (HITECH) Act [PDF – 123 KB] .

The purpose of the HITECH Act, which was enacted as Title IV of the American Recovery and Reinvestment Act (Recovery Act) of 2009, is to improve health care delivery and patient care through investment in health information technology (IT).

The programs created by the HITECH Act provide technical assistance, support and incentives to health care providers, facilitate coordination among States, and provide workforce training to promote the use of certified electronic health records. The Recovery Act included an appropriation of more than $19 billion in support of HITECH Act grant programs.

As part of the Department of Health and Human Services (HHS), ONC also receives an annual appropriation. As part of the annual appropriations, ONC is currently executing awards per the legislation outlined in the 21 Century Cures Act.

This act includes a renewed focus and specific direction for ONC to take action related to transparent reporting associated with certified health information technology (healthIT) interoperability and information blocking. [1] This act also expands the scope and conditions on which certifications to health IT must be granted, including specific conditions around information blocking, application program interfacing and testing [2] .

If new funding becomes available for programs or other grant or cooperative agreement programs or activities, ONC will announce the availability of funding in the HHS Grants Forecast and at Grants. gov. [1] Title IV, 21st Century Cures Act, P. L.

114-255 [2] Section 4002(a), 21st Century Cures Act, P. L. 114-255 Types of Award Instruments ONC provides financial assistance to non-Federal entities through two types of legal instruments: grants and cooperative agreements.

As defined by the Federal Grant and Cooperative Agreement Act , the difference between the two is that a cooperative agreement provides for substantial involvement between ONC and the recipient in carrying out the programmatic activities contemplated by the award.

For the purposes of ONC cooperative agreements, substantial involvement entails close collaboration to ensure that project aims are being met, provide ongoing programmatic technical assistance and troubleshooting, and facilitate coordination among programs. This section provides an overview of the ONC grants process. This information is provided for general information only.

It does not replace the terms and conditions of an award or other actions by ONC related to a particular award or group of awards. If you need additional general information regarding a certain subject, you can search the frequently asked questions or the Grants Management Advisories (GMAs). The GMAs address a number of the subjects below and provide greater detail.

If you have specific questions, send your inquiry to ONCgrants@hhs. gov . ONC publishes a funding opportunity announcement at Grants.

gov for each competitive funding opportunity. You can search for these opportunities using several different search criteria. You can search by: ONC as a component organization of the Office of the Secretary of HHS; Catalog of Federal Domestic Assistance (CFDA) number (ONC’s current CFDA numbers are 93.

718, 93,719, and 93. 721, 93. 727, 93.

728, but this may change in the future); eligibility; or other criteria shown at Grants. gov. You also may sign-up at Grants. gov for a subscription service (under ”Manage Subscriptions”) that provides notifications of new grant opportunity postings and updates on Grants.

gov. The types of subscriptions are shown at the Grants. gov web site. You do not have to be a registered user of Grants.

gov to sign-up for this service. Each funding opportunity includes a synopsis of the funding opportunity; a detailed funding opportunity announcement, and an application package for use if you choose to apply. The synopsis provides summary information about the opportunity, including eligibility, whether cost sharing or matching is required, and due dates.

If a funding opportunity requires submission of a pre-application, the synopsis indicates the due date for that as well as the application. 2. Preparing and Submitting an Application The information that an organization needs to understand Grants.

gov requirements, including authority to submit applications on an organization’s behalf, is available at the Grants. gov web site. Applicants must register in the System for Award Management (SAM) (previously Central Contractor Registry) and have a Dun and Bradstreet Data Universal Numbering System (DUNS) number .

The information that an individual(s) preparing an application needs is included in the funding opportunity announcement and the accompanying application package. Applicants must pay particular attention to organizational eligibility, application formatting and completeness requirements, any cost limitations, period of performance, post-award reporting requirements, and due dates.

If the award instruments are cooperative agreement, the funding opportunity announcement will specify the nature of ONC’s anticipated substantial involvement during performance of the awards.

In addition to the contents of the funding opportunity announcement concerning the types of activities that are allowable or expected under an award, e.g., subawards, applicants should be aware of the cost principles that apply to them to determine what types of costs are allowable.

If matching or cost-sharing is required, the funding opportunity announcement will specify the nature of the requirement; whether it can include donated goods or services (known as third-party in-kind contributions); how the matching or cost sharing should be shown in the application budget; and any additional required documentation demonstrating the ability to comply.

All pre-applications (when required) and applications for ONC grants or cooperative agreements must be submitted through Grants. gov by the due date specified in the funding opportunity announcement. ONC will not accept any late applications (or pre-applications when required).

A late application is one received at Grants. gov after the date and time specified in the funding opportunity announcement. 3.

Application Review and Award Reviewers assess the merit of applications based on the evaluation criteria in the funding opportunity announcement and may not introduce other considerations. Each application is scored or rated as indicated in the funding opportunity announcement. The results of the objective review are arrayed in a ranking list.

Objective review is advisory to the federal approving official. For ONC, this is the National Coordinator for Health Information Technology or designee. If ONC requires that you submit a pre-application, ONC evaluates them in a manner similar to evaluation of an application.

However, as the result of the pre-application review, you may be advised that your pre-application was not judged sufficiently meritorious to warrant submission of a full application or indicate that you are invited to submit an application. Following objective review, the ONC approving official applies any selection factors specified in the funding opportunity announcement, e.g., ensuring geographic coverage.

For those applications the approving official recommends for award, the ONC grants management office performs a business management review. Even if you receive notification that your application has been selected for an award, you may not begin performance until you receive a Notice of Grant Award signed by an ONC grants management officer.

The business management review includes considerations related to both the applicant and the application.

The grants management office reviews (1) the applicant’s status to ensure that the entity or any of its principals, e.g., the Project Director, is not suspended or debarred; and (2) the applicant’s financial management capability and performance record, including a review of previously submitted Office of Management and Budget (OMB) Circular A-133 audit reports and whether the organization has any indebtedness to the Federal government.

As part of the business management review, the grants management office also reviews the application budget and budget narrative to determine whether the planned costs are allowable under the applicable cost principles. A Notice of Grant Award (NGA) signed by an ONC grants management officer serves as the authorization to begin performance.

The NGA incorporates the approved application by reference; specifies the budget period during which funds may be spent and the duration of the project period (the project period may have one or more budget periods); and the approved budget. The approved budget shows total project costs and, as applicable, the Federal and non-federal share of those costs and the indirect cost rate.

A recipient cannot claim any costs incurred before the beginning date of the budget period and can claim costs incurred after the end of the budget period only with ONC prior approval. The NGA also includes the terms and conditions of the award. These include general, program-specific, and award-specific requirements.

The general terms and conditions are included in the Department of Health and Human Services (HHS) Grants Policy Statement, and in the HHS grants administration regulations at 45 CFR Part 74 or 92, as applicable. These general terms and conditions, which include both administrative requirements and public policy requirements, are incorporated by reference in the NGA.

ONC supplements these general terms and conditions by specifying the reporting, prior-approval, payment, program income, and other requirements that pertain to its awards. In general, ONC requires annual financial and performance/progress reporting and provides advance payments The NGA also may name key personnel in addition to the Project Director.

For its Recovery Act awards, ONC also included the terms and conditions associated with Recovery Act funding. The NGA also indicates the ONC project officer and grants management officer/grants management specialist who are responsible for your award. The project officer is the point of contact concerning the technical/programmatic aspects of your award, such as health information technology or curriculum development.

The grants management officer/grants management specialist is the focal point for business, financial, and other non-programmatic matters. The grants management officer is the only ONC official who can provide required prior approval or authorize other actions that would change the terms and conditions of your award. This includes changing the funding amount, changing the duration of the award, and adding or removing special conditions.

Project officers cannot authorize these types of actions although they may be consulted concerning any plans to request changes to approved applications or budgets. Prior approval requirements originate in one or more of the following: Office of Management and Budget cost principles; Department of Health and Human Services grants administration regulations, the HHS Grants Policy Statement, and other terms and conditions of award.

If a cost or activity requires prior approval and it was explicitly addressed in the application that ONC approved, e.g., subawarding or contracting out part of the programmatic effort or proposing types of costs that require prior approval under the cost principles, then a recipient does not have to request any additional approval from ONC before incurring that cost or carrying out that activity.

If the need for the cost/activity arises after award, a recipient must request ONC approval before incurring the cost or carrying out the activity. Some prior-approval requirements only come into play after award. Recipients must submit all post-award requests for prior approval in writing to ONCgrants@hhs.

gov . Depending on the type of change, a recipient may have to submit a revised application budget.

Post-award prior-approval requirements include, but are not limited to, the following: Change in the approved scope of objectives of an award (even if any associated rebudgeting does not require ONC prior approval) Change in the recipient’s project director or other key personnel (as shown in the Notice of Grant Award) Carryover of unobligated balance of Federal funds remaining in one budget period to another budget period Extending the duration of the final budget period/project period with or without additional funds Changes in recipient status or organization Most of these changes can be addressed by a written response from the grants management officer.

In some cases, ONC may issue an amended NGA. Regardless, the formal approval or disapproval must come from the grants management officer. In addition, for any change that would result in a change in scope, the request must undergo objective review (in a manner similar to the original approved application).

Recipients are responsible for carrying out the approved project or program consistent with the terms and conditions of their awards and overseeing the activities of any subrecipients or contractors under its award.

The latter includes ensuring that any subawards or contracts including reporting and other requirements, such as audit requirements, that are consistent with the terms and conditions of the ON award and allow the recipient to fulfill its obligations to ONC. ONC has no direct relationship with subrecipients or contractors under a grant or cooperative agreement.

ONC monitors recipients’ programmatic and financial performance by several means, including review of progress, financial, and audit reports and site visits. Recipients may acquire or generate several types of property under ONC grant or cooperative agreement awards. Recipients (or subrecipients, as applicable) may purchase supplies or equipment for use carrying out the project or program.

This type of property is termed tangible personal property. The distinction between supplies and equipment relates to its acquisition cost and useful life. Equipment is defined as an article of tangible personal property with a unit acquisition cost of $5,000 or more and a useful life greater than one year.

The NGA will include terms and conditions specifying any requirements for prior approval of purchase of equipment and requirements for use. Reporting and disposition are discussed under Closeout. ONC does not support the acquisition or alteration or renovation of real property.

In the event that ONC determines that a recipient is not complying with the terms and conditions of its awards, ONC may take one or more enforcement actions. These range from actions designed to allow the recipient to take corrective action, such as withholding payment or temporarily suspending an award, to disallowing costs or terminating an award. Different processes apply depending on the type of enforcement action.

If an enforcement action is planned, generally an ONC grants management officer notifies the recipient and indicates the effect of the action. Closeout is a process that begins following the end of the project period, which may be at the end of the originally specified period of performance or any authorized extension or earlier if an award is terminated.

The closeout process consists of receipt of required final reports, reconciliation of funding amounts with expenditures and payments, and, as applicable, disposition of tangible personal property. Recipients must submit all required final reports, which include a final performance report, a final financial report (SF 425), and a final tangible personal property report (SF 428 B), within 90 days after the end of the project period.

The final financial report must have no unliquidated obligations. Unless the ONC grants management officer authorizes an extension of a final report’s due date, reports not submitted in the required time frame are delinquent. Delinquent reporting can affect consideration for future awards.

The ONC project officer reviews the final performance report to determine whether required activities have been completed. The ONC grants management office reviews the final SF 425 to determine whether matching or cost sharing has been met, aligns reported expenditures and cash on hand with records of the HHS Payment Management System, and determines the final Federal share. ONC will deobligate unobligated funds adjustment.

A recipient has to repay funds due ONC as the result of an adjustment or overpayment. ONC reviews the tangible personal property report to determine if it should provide disposition instructions for property that a recipient will not continue to use. Requirements related to final Recovery Act reporting are specified in ARRA Final Report Guidance [DOCX – 15 KB] .

10. Improper Payment and Debt Collection At any time during an award, including at closeout, ONC may determine that an amount is due ONC. A required repayment may result from disallowed costs, a reduced Federal share based on a recipient’s failure to meet a matching or cost-sharing requirement, drawing excess funds from the Payment Management System, or another reason.

When repayment is necessary, the ONC grants management officer notifies a recipient of the amount of the required repayment, the reason why the amount must be repaid, the time frame for repayment,, and any appeal rights. If the amount is not repaid, the amount due is treated as a debt and the HHS debt collection process applies, including payment of interest and penalties.

ONC does not provide any appeal rights related to pre-award determinations or the contents of its awards. A recipient may file a post-award appeals related to disallowed costs, termination of an award, or other adverse determinations as provided in Appendix A to 45 CFR Part 16 for direct, discretionary programs [PDF – 213 KB] . Other determinations, such as disapproval of a prior-approval request, are not appealable.