To
award grants for the purpose of enabling grantees, directly or through
contracts, to provide for the delivery of primary health services
and substance abuse (alcohol and/or illicit drugs) services to homeless
individuals including homeless children. The grants may be used
to continue to provide the services listed above for up to 12 months
to individuals who have obtained permanent housing if services were
provided to these individuals when they were homeless. For the purpose
of this program, the term "homeless individual" means
an individual who lacks housing (without regard to whether the individual
is a member of a family), including an individual whose primary
residence during the night is a supervised public or private facility
that provides temporary living accommodations or an individual who
is a resident in transitional housing.
TYPES
OF ASSISTANCE:
Project Grants. Place Cursor Here for Definition
USES
AND USE RESTRICTIONS:
Grant
funds must be used to provide the following services, directly or
through contract: (1) Primary health care and substance abuse services
at locations accessible to homeless individuals; (2) 24-hour emergency
primary health and substance abuse services; (3) referral, as appropriate
to medical facilities, for necessary hospital services; (4) referral
of homeless individuals who are mentally ill to entities that provide
mental health services; (5) outreach services to inform homeless
individuals of the availability of primary health and substance
abuse services; and (6) aid in establishing eligibility for assistance,
and in obtaining services under entitlement programs. Federal funds
may not supplant existing public or private resources that are currently
allocated to assist homeless populations.
ELIGIBILITY
REQUIREMENTS:
Applicant
Eligibility: Nonprofit private organizations
and public entities, including State and local governmental agencies.
Grantees and other organizations with whom they may contract for
services under this program must have an agreement with a State
under its Medicaid program, Title XIX of the Social Security Act
(if they provide services that are covered under the Title XIX plan
for the State), and be qualified to receive payments under the agreement.
Beneficiary
Eligibility: Homeless individuals including
but not limited to, children, elderly persons, handicapped persons,
families with children, Native Americans, and veterans.
Credentials/Documentation:
Costs will be determined in accordance with 45 CFR, Part 74, Subpart
Q, for nonprofit organizations and OMB Circular No. A-87, "Cost
Principles for State and Local Governments."
Pre-application
Coordination: Informal inquiries regarding the
program and intent to submit an application should be directed to
the appropriate HRSA Field Office, Health Care for the Homeless
coordinator. (See Appendix IV of the Catalog for listing of locations.)
The application package will be made available by the Department
of Health and Human Services (DHHS) (Form PHS-5161-1, with revised
factsheet, DHHS-424). The application kit contains a list of States
which have been chosen to set up a review system and will provide
a point of contact in the States for that review. This program is
eligible for coverage under E.O. 12372, "Intergovernmental Review
of Federal Programs." An applicant should consult the office or
officials designated as the single point of contact in his or her
State for more information on the process the State requires to
be followed in applying for assistance, if the State has selected
the program for review. The standard application forms, as furnished
by DHHS and required by 45 CFR 92 must be used for this program.
This program is subject to the requirements of the Public Health
System Impact Statement.
Application
Procedure: Application is made by the submission
of the DHHS Application, Form PHS-5161-1. Applications may be
obtained from the HRSA Grants Application Center. Applicants must
submit a written plan and including a description of nonfederal
contributions and must contain assurances required by statute.
This program is subject to the provisions of 45 CFR 92 for State
and local governments and 45 CFR 74 for nonprofit organizations.
Award
Procedure: Applications will be reviewed by
a committee composed of experts in the delivery of health care
to homeless people. Applications are reviewed for merit and are
recommended for approval or disapproval. Grant awards will be
made by the Director, Office of Grants Management upon approval
of the Director, BPHC.
Deadlines:
Contact appropriate HRSA Field Office for further information.
Range
of Approval/Disapproval Time: Approximately
120 days.
Appeals:
None.
Renewals:
Support is recommended for a specified project period, not in
excess of 5 years. After initial awards are made, continuation
projects will be reviewed annually and funded if approved.
ASSISTANCE
CONSIDERATIONS:
Formula
and Matching Requirements: None.
Length
and Time Phasing of Assistance: Awards are
made annually. After funds are issued, funds are released in accordance
with payment procedures of DHHS, which may be an Electronic Transfer
System or a monthly cash request system.
POST
ASSISTANCE REQUIREMENTS:
Reports:
Grantees will be required to submit reports annually on the quantity,
type, and cost of services provided to homeless individuals. Reports
will follow Uniform Data System (UDS) requirements. Annual progress
and financial status reports are required at the end of each budget
period and final reports must be submitted at the end of the project
period.
Audits:
In accordance with the provisions of OMB Circular No. A- 133 (Revised,
June 24, 1997), "Audits of States, Local Governments, and Non-Profit
Organizations," nonfederal entities that expend financial assistance
of $300,000 or more in Federal awards will have a single or a
program-specific audit conducted for that year. Nonfederal entities
that expend less than $300,000 a year in Federal awards are exempt
from Federal audit requirements for that year, except as noted
in Circular No. A-133.
Records:
Financial records must be kept available for 3 years after submission
of expenditure reports and 3 years after final disposition of
non-expendable property. If questions remain such as those raised
as a result of an audit, records must be retained until the problem
is resolved.
FINANCIAL
INFORMATION:
Account
Identification: 75-0350-0-1-550.
Obligations:
FY 01 $101,000,000; FY 02 est $116,000,000; and FY 03 est $125,800,000.
Range
and Average of Financial Assistance:
$84,500 to $2,895,000; Average: $579,000.
In fiscal year 2001, funds were available to support 140 grantees
serving nearly 500,000 individuals in 50 States, the District of
Columbia, and the Commonwealth of Puerto Rico. By the end of fiscal
year 2002, it is expected that program funds will support approximately
150 grantees. By the end of fiscal year 2003, it is expected that
funds will support approximately 155 grantees.
REGULATIONS,
GUIDELINES, AND LITERATURE:
Pertinent information is contained in the 52 CFR 32347, "Availability
of Funds for Project Grants for Health Services to the Homeless
Population."
INFORMATION
CONTACTS:
Regional
or Local Office: Contact the appropriate HRSA
Field Offices.
Headquarters
Office: Program Contact: Regan Crump, M.S.N.,
Dr. P.H., Director, Division of Programs for Special Populations,
Bureau of Primary Health Care, Health Resources and Services Administration,
Department of Health and Human Services, 4350 East-West Highway,
9th Floor, Bethesda, MD 20814. Telephone: (301) 594-4420. Grants
Management Contact: Office of Grants Management, Bureau of Primary
Health Care, Health Resources and Services Administration, Department
of Health and Human Services, 4350 East-West Highway, 11th Floor,
Bethesda, MD 20814. Telephone: (301) 594-4235. Use the same numbers
for FTS.
Web
Site Address: http://www.hrsa.gov
EXAMPLES
OF FUNDED PROJECTS:
A Health Care for the Homeless Program formed a coalition of community
representatives and providers for the provision of primary health,
substance abuse, and mental health services to homeless individuals.
Health care provider teams will travel to areas with heavy concentrations
of homeless individuals. Homeless persons will be provided with
primary care outpatient services either at a community health center
or in off-site locations, such as shelters for the homeless or welfare
hotels. The program will refer for inpatient hospitalization services
if necessary. Substance abuse services and mental health services
will be provided either directly or through existing facilities
within the community. The community coalition represents organizations
responsible for the provision of other services for homeless individuals
such as food, clothing and shelter. Through a system of case management,
the program will serve to guide homeless persons to these services.
Arrangements for 24-hour emergency services have been made through
a community hospital.
CRITERIA
FOR SELECTING PROPOSALS:
For service expansions, the review of applications for grant support
will consider the following: (1) Justification of need based upon
demographic and/or health status indicators for the use population;
(2) where applicable, justification of need for enhancing the organization's
information systems capability; (3) identification of new populations
to be served; (4) clarity and appropriateness of the proposed goals
and objectives; (5) feasibility of the planned implementation within
the resources and time frame proposed; (6) extent to which integration
of services is planned with local agencies which provide services
and support to the target population; (7) relationship of the proposal
to the existing project plan of the applicant agency; (8) evidence
of a system or program to track progress and outcomes; and (9) adequacy
and appropriateness of the budget. For special initiatives, the
review of applications for grant support will consider the following:
(1) Need for the initiative and assessment of its potential impact
upon the user population; (2) degree to which the initiative is
consistent with the grantee's overall project plan; (3) extent to
which linkages and/or coalitions are planned to strengthen outreach
and referral systems; (4) extent to which the initiative will facilitate
the delivery of effective primary health care; (5) extent to which
integration of services is planned with State and local agencies
which provide services and support to the target population; (6)
appropriateness of the plan to continue support for the initiative
after the expiration of Federal support; and (7) adequacy and appropriateness
of the budget.
