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Funding Opportunity: Connecting Kids to Coverage Healthy Kids 2019

Question 1: Does the 28-page limit include the 10-page max Business Assessment of Applicant Organization, or is that not included in the 28-page limit?

The 28-page limit does not include the Business Assessment. The only documents excluded from the page count include Standard Forms, the copy of previously submitted Letter of Intent, Cover Letter, and Project Abstract.

Question 2: What is considered newly enrolled? For example, if a participant was previously enrolled in Medicaid in the last two to five years and recently enrolls today, would it be considered a renewal or newly enrolled?

A child or parent is considered newly enrolled if he or she was not enrolled in Medicaid or the Children's Health Insurance Program (CHIP) at the time of assistance.

Question 3: Do parent mentors have to be employed by the agency or can they be volunteers?

Parent mentors can be either volunteers or employees of the agency. Please see Appendix B page 46 of the Notice of Funding Opportunity (NOFO) for further information regarding parent mentors.

Question 4: Do we need to include the questions for the business assessment or can we just include answers given the 10-page maximum?

Although the Business Assessment is involved, both questions and answers should be listed.

Question 5: Can the job descriptions be written in narrative format or numbered format? If in numbered format, can we use single space given that we have a 28-page limit?

The job descriptions should be done in narrative format and can be single spaced under the "Personnel" section of the budget worksheet.

Question 6: Do we submit a job description for key personnel such as the program director or for all staff that will be paid under the program?

Include brief job descriptions for the project director and other positions paid under the cooperative agreement (NOFO page 30). 

Question 7: Does the copy of the indirect cost rate agreement count towards page limitation?

The direct cost rate agreement does not count toward the page limit.

Question 8: We currently have a grantee in our state that serves American Indian children. If we apply for a HEALTHY KIDS 2019 grant and intend to serve a different population and a different region in our state, will the current grantee be impacted by future funding opportunities under this appropriation?

No, your application, serving a different population and geographic area, would not impact the potential funding for the current grantee. In the future, if an overlap does occur for grantees, the Centers for Medicare & Medicaid (CMS) would work with the impacted grantees to ensure cooperation and non-duplication of funding and effort.

Question 9: Can you confirm whether the award amount of $500,000 to $1.5 million is per one-year budget period or the total amount for the three-year period?

The award amount of $500,000 to $1.5 million is for the three-year period.

Question 10: What are the requirements for the Letter of Intent outside of what is on page 68 (Appendix G)? Is there a narrative required? On page 17 it indicates that applicants are required to submit a non-binding Letter of Intent to apply (see appendix F). Please expand.

The requirements for the Letter of Intent (NOFO page 68) must be completed and submitted by email to healthykids@grantreview.org on or before January 4, 2019.

The Letter of Intent must include the following information:

  1. Name of State
  2. Applicant Agency/Organization
  3. Contact Name and Title
  4. Address
  5. Phone
  6. Fax
  7. E-mail address

Question 11: Is the evidence-based outreach and enrollment model, indicated in the NOFO on page 29, what is listed in Appendix B, or are there other specific models we can choose? If so, can you provide examples?

Applicants can identify the outreach and enrollment strategies that are best suited for their organization. Appendix A: Outreach Activities to Consider (NOFO pages 44-45) details several outreach strategies for applicants to consider, and Appendix B: Using Parents of Medicaid or CHIP-eligible Children as Mentors to Parents of Uninsured Children (NOFO page 46) describes the strategy of using parent mentors. Applicants are not limited to only these outreach activities, but are encouraged to employ strategies that have proven to be effective in increasing the participation of eligible children in Medicaid and CHIP. Please also reference How Can My Organization Connect Children to Coverage? A Guide to Fundamentals and Promising Practices.

Question 12: Project abstract summary (NOFO page 20), asks for a one-page abstract that serves as a succinct description of the proposed project and should include: number of projected clinician participants and projected total cost of care savings. Can you please explain clinician and cost of care savings for our region?

Please disregard this language. It was placed in error and is not relevant to this program. 

Question 13: If we received the Medicare Access and CHIP Reauthorization Act of 2015 cycle IV grant, and received a no-cost expansion that ends in December 2018, do we submit a new application or do we submit a continuation application? If so, the continuation application is through GrantSolutions and not Grants.gov?

This opportunity is for new applications only and is not a continuation of any previous funding opportunities. 

Question 14: We are a large organization with a few programs that could apply for this grant opportunity. Is it possible to submit one grant with multiple locations?

Only one application may be submitted by any given lead eligible entity for funding of a Connecting Kids to Coverage HEALTHY KIDS 2019 cooperative agreement; however, an eligible entity may be a member of multiple applicant collaboratives. Entities working together as a collaborative shall submit one application. Only one HEALTHY KIDS 2019 cooperative agreement will be awarded to a single entity or to the lead agency of a collaborative (NOFO Page 17).

Question 15: Are the District of Columbia and the territories considered eligible entities for this funding opportunity?

Yes. The District of Columbia and U.S. territories are considered eligible entities for this funding opportunity.

Question 16: Please describe how CMS reviewers will closely evaluate the applicant's proposed goals and take that into consideration regarding funding requests as stated in the review criteria. Are there general expectations for numbers of applications, enrollments, and renewals reported yearly as a result of the project?

Reviewers will be evaluating applications using the evaluation criteria listed on pages 26-30 of the NOFO.

Question 17: A work plan and timeline is required. Should this be prepared for the duration of the grant period, or in a yearly format as is required in the statement of project goals section?

Please use a yearly format to describe your work plan and timeline.

Question 18:  For several previous CMS grant opportunities, Letters of Intent were not required.  Please clarify if they are required now under this grant opportunity and clarify the deadline for submission of this document?

Yes. Applicants are required to submit a non-binding Letter of Intent to Apply (See Appendix F). CMS reserves the right to consider an applicant ineligible without a timely Letter of Intent. Previous grant opportunities may not have required submission of Letters of Intent, but it is now a requirement as it enables CMS to better plan for the application review process (NOFO page 17). CMS has extended the deadline for the required letter of intent until Friday, January 11, 2019.

Question 19: We plan to apply as the lead with several sub recipients. Does the application require letters of support from sub recipients?  If so, are the letters included in the 28-page limit?

Please see Special Considerations for Applicants that Represent Collaborative Efforts (NOFO Page 9). This section provides detailed information regarding the required documentation for collaborative efforts. Letters of Commitment will not count towards the 28-page limit.

Question 20: Can the business management questionnaire be single spaced?

Yes, this questionnaire can be single-spaced.

Question 21: What is the average funding amount and enrollment/renewal targets for previous grantees?

Providing averages for funding amounts and enrollment and renewal targets for all previous cohorts of outreach and enrollment awardees will not be helpful to potential applicants. Rather, the applicant should thoroughly examine the rates for uninsured children in their targeted areas, the costs of the strategies that will be needed to reach, enroll and renew these children into Medicaid and CHIP, and the additional financial resources (e.g., additional salaries) needed to further assist with their plan, if awarded.

Question 22: Are job descriptions for key personnel required?

Yes, please include brief job descriptions for the Project Director and other positions paid under the cooperative agreement along with a statement of the percentage of time that each person will be working on this project and the percentage of time that is spent on duties outside of the cooperative agreement activities (NOFO Page 30).

Question 23: Based on overall scores and ranking, will you fund more than one grant in a state, or is there a prohibition of more than one per state?

CMS may award more than one grant to some states as there is no prohibition to restrict to one grant or less per state.

Question 24: If a grantee can demonstrate their outreach activities produced new and renewal consumers to existing community enrollment staff (but the application was not completed by the Connecting Kids to Coverage (CKC) paid staff) can those consumers be counted and verified for this grant?

No. Please note that all applications, enrollments and renewals need to be directly attributable to this specific grant funding (page 14 of the NOFO). All other outcomes, can be reported separately as additional outcomes but CMS is primarily focused on the outcomes that have been achieved as a direct result of Federal funding under this specific funding opportunity.

Question 25: Does 50% of the Project Director's time mean 50% FTE. If the Project Director works less than full time, but exceeds the 50% of their time, are they qualified to be the PD?

The Project Director must spend a minimum of the equivalent of 50 percent of their full time equivalent status. For example, if the Project Director works 40 hours per week, we expect the Project Director to devote 20 hours to the grant. If the Project Director works less than full time, it is expected that the Project Director will be employed for a minimum of 20 hours and those 20 hours are dedicated fully to this project.

Question 26: Our Health Care Center is owned and operated by a Tribe and we serve both Native American and Non-Native American populations.  Can we enroll both Native and Non-Native populations under the Tribal NOFO or is this opportunity specific to enrolling only Native applicants?

Please review the list of eligible applicants on page 5 of the Healthy Kids 2019 Grant Program NOFO. An applicant can include both Native Americans and Non-Native Americans in their application.

Question 27: What do you anticipate to be the average grant award for the three years of the funding period?

CMS does not have an estimate for the average grant award.  We anticipate the awards ranging from $500,000 to $1,500,000, depending on the requested grant funding amounts, the enrollment and retention goals, the related budget to support the goals, and the number of applications that will be awarded.

Question 28: Can you give examples of alternative methods for verifying new enrollments and renewals that don't depend on state or county agencies?

Successful grantees have employed a variety of alternative methods to validate the required data. In some cases, the grantee contacted the potential enrollee to verify if the potential enrollee was indeed enrolled or renewed into Medicaid or CHIP. In other cases, grantees utilized a state-maintained insurance database to verify insurance status of those they assisted.

Question 29: Can you tell me whether or not the "Business Assessment" is included in the page limit?

The Business Assessment is not included in the page limit.

Question 30: On the Applicant Teleconference call, it was verbally noted that no conference travel would be required. However, on page 22 of the Funding Opportunity Announcement (FOA), it is stated: Awardees must submit budget estimates for one in-person meeting, for up to two individuals, who directly work on the cooperative agreement to attend a two-day face-to-face meeting in the Baltimore area. Please clarify whether this needs to still be included in the budget?

Please include the funding for a national conference to be held in Baltimore sometime in the future as one of your "Travel" box line items. If this face-to-face meeting does not occur, and at the determination of CMS, grantees will be allowed to re-allocate these funds to other grant uses (as allowed by CMS).

Question 31: If you received multiple applications from a single County, would you notify prospective applicants of interest to encourage collaboration?

No. CMS does not release the names of applicants nor do they release the names of organizations that were not funded. Potential applicants can certainly reach out to other organizations within their targeted areas to work on the mutual goals that are the foci on this funding opportunity. 

Question 32: In our current MACRA grant, we have developed several partnerships with schools and school districts, with juvenile probation offices, and others groups that provide referrals to us for application assistance. These groups are separate from our subcontractor.  Under a proposal for Healthy Kids funding, may we still continue these partnerships and explore additional referral sources such as anti-hunger groups, housing advocates, and other legal aid organizations?

Yes, you may continue these initiatives, but please recognize that only enrollments and renewals that occur as a direct result of your grant funding will be counted as contributing to your enrollment and renewal goals.

Question 33: Can we describe this as a collaborative effort? Can we submit letters of commitment if there is no funding provided to these partners?

Yes, you may submit letters of commitment to document these efforts.

Question 34: Can you clarify what needs to be included in the abstract as presented on page 20? I understand that we do NOT need to include the "projected total cost of care savings." It was unclear if we need to include "the number of projected clinician participants."

A one-page abstract should serve as a succinct description of the proposed project and should include the goals of the project, the total budget, and a description of how the funds will be used. Personal identifying information should also be excluded from the abstract. Please disregard the references to the number of "the number of projected clinician participants" and the "projected total cost of care savings."

Question 35: You mentioned we should submit a copy of the Letter of Intent with the application. Should we submit that under the "Other Attachments" section or is there somewhere else you'd like us to submit that?

The letter of intent is not counted toward the page limit and can be submitted under the "Other Attachments" section.

Question 36: Could you provide more detail on the circumstances under which you might waive the 90-day planning period requirement, especially for new grantees? Is there somewhere in the narrative we should indicate we'd be interested in waiving that? What kind of justification for waiving it might you be looking for in the project narrative?

CMS requires a 90-day start-up planning period in your application. It is not recommended that you reduce this requirement. If your grant is awarded, CMS will work with the awardee, to determine complete readiness to become fully operational and may then waive or reduce this time period. You may use grant funds to employ individuals and begin operations during this planning period but you will have restricted access to funding until full readiness, as determined by CMS, is obtained.

Question 37: We recently discovered the Funding Opportunity for Connecting Kids to Coverage Outreach & Enrollment Funding. We do realize there was a teleconference held on Wednesday, December 19. We were not able to participate in this teleconference.
Our question is was the teleconference a requirement for application?

No, participation on the teleconference is optional. It is not a requirement for application for this funding opportunity. The teleconference was held to provide potential applicants an opportunity to ask questions about this announcement.

Question 38: Are the Data Collection and Reporting Plan, the Work Plan and Timeline, Evaluation, and Staffing Plan to be submitted separately from the Project Narrative, or are they included in the 28-page limit for the Project Narrative? If they are to be submitted separately, are there page limits or formatting guidelines for these documents?

Please see pages 19 and 64 of the application kit.

Question 39: Is there a page limit for the Budget Narrative?

It is considered as part of the overall 28 page limit.

Question 40: Are there key staff titles that must be included in the Budget Narrative (i.e. Project Director)?

Yes, applicants should indicate key staff positions, as proposed in their applications, in the budget narrative.

Question 41: Can you please clarify enrollments that should be included in the monthly performance reports? For example, if a grantee could verify an application for health coverage had been submitted as a direct result of CKC funding, could that enrollment be included in the monthly performance report (as described on page 40) even if the enrollment itself was completed by a Navigator not funded by CKC funding?

If an enrollment was completed by a Navigator not funded by this cooperative agreement, the enrollment may not be counted on the monthly report. Enrollments may only be counted if they are directly attributable to this funding source. Please see pages 12-14 of the NOFO.

Question 42: Does it matter who the enrollment is completed by if the reason for the enrollment is a direct result of CKC funding?

Enrollments are only considered to be directly attributable to CKC funding if they are completed by staff paid under this grant.

Question 43: If an application is NOT a collaborative, may the applicant submit letters of support? If so, where can this be uploaded in grants.gov?

Applicants that are not part of a collaborative may submit letters of support. These letters can be uploaded under section F, "Other Attachments."

Question 44: If the applicant has experience in screening and signing people up for public benefits, particularly Supplemental Nutrition Assistance Program (SNAP), may the applicant propose to include SNAP screening into the principal outreach and enrollment activities? Would this be looked upon favorably?

The purpose of this cooperative agreement is to reduce the number of children who are eligible for, but not enrolled in, Medicaid and CHIP and to improve retention of eligible children currently enrolled in these programs. SNAP enrollment, while a positive outcome that might result from screening families for public health coverage, will not be included as a performance measure outcome for this cooperative agreement program. All applications are reviewed according to the Review Criteria on pages 27-31 of the Notice of Funding Opportunity.

Question 45: Are applicants supposed to include in Grants.gov another copy of their LOI letter/email or is the submission by January 4th sufficient? If it is to be included in the Grants.gov submission, does it count toward the page limit?

A copy of the previously submitted LOI letter/email should be included in the grants.gov application submission. Letters of Intent to Apply should be submitted by email to CMS at healthykids@grantreview.org by January 11, 2018 3:00 p.m. Eastern (Baltimore) time.

Additional required documentation, including Standard Forms, copies of the previously submitted Letter of Intent, Cover Letter, and Project Abstract are excluded from the page limitations.

Question 46: As we are preparing a letter of intent for the above FOA, we cannot find an official assigned to this opportunity in the FOA. Who should we address the letter to?

The Letter of Intent to apply can be addressed in the following manner:

To whom it may concern:

Please accept this letter on behalf of {Insert your Organization Name}. Please see the requested information below:

  1. Name of State
  2. Applicant Agency/Organization
  3. Contact Name and Title
  4. Address
  5. Phone
  6. Fax
  7. E-mail address

Question 47: Is there a way I can find out what organization in my county is a current or former Connecting Kids to Coverage grantee?

Information about current and previous grantees is available at InsureKidsNow.gov.

Question 48: Does text in graphics (e.g. a color graph with labels) need to be 12 point font? Second, regarding citations for sources, would a references page count toward the narrative page limit? If so, are footnotes acceptable, considering the margin requirements?

The application must be submitted in a file format that can easily be copied and read by reviewers. It is recommended that scanned copies not be submitted through Grants.gov unless the applicant confirms the clarity of the documents. Pages cannot be reduced in size, resulting in multiple pages on a single sheet, to avoid exceeding the page limitation. All documents that do not conform to the above specifications will be excluded from the application materials during the review process. Please also refer to the Content and Format of Application in Section V. Font size must be at least 12-point with an average of 14 characters per inch (CPI). Tables included within any portion of the application should have a font size of at least 12-point with a 14 CPI and may be single-spaced.

Question 49: If we identify organizations that we'll be working with in implementing our project, should we include letters of commitment from those organizations or copies of Memoranda of Understanding (MOUs) with those organizations? And, if we include them, will they be counted against the page limit?

If you are working as a collaborative (as described on page 9 of the NOFO), please include a letter of commitment from each organization. If you have existing MOUs with these organizations, you may indicate this information in your application, but you are not required to attach the MOUs. These documents will not be counted against the page limitations, however, reviewers will not be required to review MOUs or attest to their completeness. If your application is considered for award, CMS may ask additional questions about your MOUs, but at this point, in the application process, you do not need to attach these documents to your application.   

Question 50: During the December 19 webinar, we were instructed to ignore the instructions for the Project Abstract on page 20 of the instructions, and instead use the instructions in Exhibit G. Exhibit G contains instructions for the Letter of Intent, rather than the ones for the Project Abstract. Please clarify the instructions for the required Letter of Intent and for the required Project Abstract Summary.

Please follow the instructions (page 20 of the NOFO) when completing the required Project Abstract Summary. The Letter of Intent is a different requirement.  Guidance for the Letter of Intent is Appendix G: Letter of Intent to Apply (page 68 of the NOFO).

Question 51: Is it acceptable to propose a staggered approach to a multi-county program? For example, in year 1, we would be fully operational in County A in our state. We propose to take a certain number of additional months to plan and put infrastructure in place so that, by the beginning of year 2, we would become fully operational in Counties B and C in the same state.

Yes, you may propose a staggered approach for implementation of your project.

Question 52: If we do a CHIP Perinate application for an adult, will that be considered a CHIP application for parent or unborn child?

If the pregnant woman has other children, the application would be considered to be for a parent. If the pregnant woman is age-eligible for children’s Medicaid or CHIP health coverage or the health coverage is for the unborn child in a state that provides CHIP coverage to the unborn, the application would be considered to be for a child. Otherwise, the application should be reported in “other outcomes.”

Question 53: On page 22 of the NOFO, it states "Awardees must submit budget estimates for one in-person meeting, for up to two individuals, who directly work on the cooperative agreement to attend a two-day face-to-face meeting in the Baltimore area."  Will you confirm whether this is in year one or in each year of the 3-year project?

Please propose this for just year one of the project. You do not need to include this budget item for each of the three years of the project.  

Question 54: Do you have a template available for a MOU that would be appropriate for Medicaid and CHIP state agencies?

No. CMS does not have a template for an MOU. We recognize that each applicant may have different considerations, specific language, and requirements that will need to be represented in this document. 

Question 55: Are the costs associated with marketing and advertising (print, TV and radio ads) an allowable expense?  If so, is there a cap on the percentage of funds that can be used for these expenses?

Please know that many items are currently available to assist you in our mutual goals to enroll and retain children into Medicaid and CHIP. These resources are available, at no cost to you, through the CMS Connecting Kids to Coverage National Campaign (the National Campaign). Please review these many materials on InsureKidsNow.gov as you develop your proposal. Grant funding may be used for additional resources, however, please provide a reasonable proposed budget for your expenses and how these resources will be measured against grant outcomes.   

Question 56: If a grantee is focused on American Indian and Alaska Native (AIAN) populations - is their renewal application evaluated in a separate pool for AI/AN populations or is their proposal reviewed as a part of the pool of all proposals? We are trying to understand if another organization in our state applies for a statewide grant, will it diminish a current grantee's AI/AN targeted grant? 

Current and former CKC grantees who are focused on AI/AN populations may apply for this new grant funding opportunity. CMS would like to clarify that this new NOFO is not considered a renewal application but rather a new funding opportunity. All eligible applications will be reviewed with the same panel review process. CMS will not have a separate review criteria or review pool for AI/AN entities under this NOFO. If other entities are awarded in your state or geographic area, CMS will work with the new awardee to ensure that your goals are not impacted by the new awardee’s efforts. Please know that the HEALTHY KIDS Act (Page 6 of the NOFO) also provided 10 percent of the total $120 million in allocated funding for grants focused on increasing the enrollment and retention of AI/AN Children in Medicaid and CHIP. CMS plans to release the first round of this funding ($6 million) in a new NOFO later in 2019.