Accessibility Information

Users of assistive technologies such as screen readers should use the following link to activate Accessibility Mode before continuing: Learn more and Activate accessibility mode.

Telehealth Programs

There are three separate telehealth programs as follows: Telehealth Network Grant Program TNGP Telehealth Resource Center Grant Program TRCGP Licensure Portability Grant Program LPGP
Number: 93.211
Agency: Department of Health and Human Services
Office: Health Resources and Services Administration

Program Information 

Program Number/Title (010):
93.211 Telehealth Programs
Federal Agency (030):
Health Resources and Services Administration, Department of Health and Human Services
Authorization (040):
The Telehealth Network Grant Program (TNGP) Sec. 330I(d)(1) of Public Health Service Act (42 U.S.C. 254c-14(d)(1), as amended. ; The Telehealth Resource Center Grant Program (TRCGP) is authorized by:
Sec. 330I(d)(2) of Public Health Service Act (42 U.S.C. 254c-14(d)(2), as amended by the Health Care Safety Net Amendments of 2002 (P.L. 107-251); The Licensure Portability Grant Program (LPGP) is authorized by Section 330L of Public Health Service Act as amended, (42 USC 254c-18).
Objectives (050):
The purpose of the Telehealth Network Grant Program (TNGP) is to fund grants to demonstrate how telehealth networks improve healthcare services in rural communities.

The Telehealth Resource Center Grant Program (TRCGP) is designed to expand the availability of technical assistance in the development of telehealth services, leveraging the experience of mature programs with expertise in providing and implementing telehealth services.

The Licensure Portability Grant Program (LPGP) supports State professional licensing boards to carry out programs under which licensing boards of various States cooperate to develop and implement State policies that will reduce statutory and regulatory barriers to telemedicine.
Types of Assistance (060):
PROJECT GRANTS
Uses and Use Restrictions (070):
Telehealth Network Grant Program (TNGP) - Funds support the use of telehealth networks (electronic information and telecommunications technologies to support and promote long-distance health care and ancillary services) for improving access to health care services; provide a baseline of information for a systematic evaluation of telehealth systems; purchase or lease and install equipment; and to operate and evaluate the telehealth system.

Overall, not more than 40 percent of grant funds may be expended for equipment. Not more than 15 percent of grant finds may be expended for indirect costs. Grant funds may not be used for purchasing and installing telecommunications transmission equipment (e.g., microwave towers, satellite dishes, amplifiers, digital switching equipment or laying cable or telephone lines) or to acquire real property. Construction costs are allowable only for minor renovations related to the installation of equipment.

Important: The Telehealth Network Grant Program (TNGP) seeks to fund non-profit or public organizations with a network of partners in place and committed to the project as of the date of application. Projects with prospective network partners not committed to the project will not be competitive. Applicants failing to submit verifiable information with respect to the commitment of network partners will not be funded. Projects selected for funding must provide clinical services for which performance measures can be developed. In addition, an applicant must provide evidence to show that it will be ready to begin to implement the project upon grant award.

Applicants must provide an evaluation design to measure quantitative outcomes, which should be measured in the following areas: impact on quality of care; appropriateness of use of the technology; whether access was improved; whether clinical outcomes were improved; and, how the cost of service delivery was affected in terms of efficiency and effectiveness of care. Of particular interest will be programs that can clearly measure the costs of their telehealth services and measure the impact of the telehealth program on : 1) improving access to health care services for residents of communities that did not have such services locally before the program; 2) hospitalization rates and emergency room visit rates per year for patients receiving disease management services for diabetes, congestive heart failure, stroke and other chronic diseases, as well as for patients receiving home care/home monitoring services; 3) controlling blood glucose levels in diabetic patients; 4) improving the efficiency of health care; 5) reducing medical errors; and, 6) other clear outcome measures.

Telehealth Resource Center Grant Program (TRCGP) - Funds support the establishment and development of Telehealth Resource Centers (TRCs), which serve as a focus for the provision of telehealth technical assistance across the country. Funds support both Regional Telehealth Resource Centers and two national Telehealth Resource Centers. One National TRC will focus on providing specialized technical assistance in telehealth technology. Technical assistance will be provided in the following areas: requirements for specific technologies to be used for specific clinical applications; advances in m-health including software and hardware; assessing organizations need for telehealth technology including specific cost effective solutions; multiple software systems and their application in EHRs (not specific product lines); provider and patient medical information and education; direct patient care and remote patient monitoring; and current data delivery mechanisms. The other National TRC will focus on policy issues such as state and national policies and initiatives regarding telehealth; legal and regulatory issues regarding e-Prescribing; National telecommunications implications for telehealth and the policies of the Federal Communication Commission’s (FCC) National Broadband Plan; Medicare and Medicaid reimbursement, and private insurance payment policies. Grant funds are used for salaries, equipment, operating, travel expenses, or other costs for: providing technical assistance, training and support; disseminating information and research findings related to telehealth services; promoting effective collaboration among telehealth resource centers and HRSA; conducting evaluations to determine the best utilization of telehealth technologies to meet health care needs; promoting the integration of the technologies used in clinical information systems with other telehealth technologies; fostering the use of telehealth technologies to effectively provide healthcare information and education for health care providers and consumers; and, implementing special projects that involve collaboration among TRCs to advance the field of telehealth. Grant funds are not used for: acquiring real property; equipment costs of more than 40 percent of total grant funds; for equipment or transmission costs not directly related to the grant purposes; to purchase or install general purpose voice telephone systems; construction costs; and indirect costs exceeding 15 percent of total grant funds.

Per Section 330I(g)(5) of the Public Health Service Act (42 USC 254c-14), applicants must provide information on the source and amount of non-Federal funds that the entity will provide for the project.

Important for both Regional and National TRCs:
The grantee and their partners must have experience in providing technical assistance related to the provision of telehealth services. The grantee must establish a baseline level of activity and then measure performance. Specific areas to measure/address are: Satisfaction, Efficiency, Effectiveness and Sustainability. In addition consortiums must be established and able to demonstrate a history of working together. A signed consortium agreement that outlines tasks must be provided.

The Licensure Portability Grant Program (LPGP) - Grant funds are used for salaries, equipment, software development, operating, or other costs associated with developing legislative, administrative, and technical projects to address licensure barriers that hinder the practice of telemedicine across state lines. Grant funds may also be used for activities involving significant expansion of existing state agreements for cross-state recognition of professional licenses to other states.
Eligibility Requirements (080)
Applicant Eligibility (081):
Telehealth Network Grant Program (TNGP) - A grantee must be a nonprofit or public entity that will provide services through a Telehealth Network (TNGP) to rural communities. Proof of non-profit status is required. Each entity participating in the network may be a nonprofit or for-profit entity. Faith-based and community based organizations are eligible under the Telehealth Network Grant Program (TNGP).

Telehealth Resource Center Grant Program (TRCGP) - A grantee must be a public or private nonprofit organization. Faith-based, tribal and community based organizations are eligible to apply. Services may be provided to rural or urban communities.

Licensure Portability Grant Program (LPGP) - A grantee must be a State professional licensing board, or a national organization of professional licensing boards that provides services to state licensing boards. Note: American Indian and/or Alaska Native Tribal Organizations are eligible provided those organizations meet the eligibility requirements above.
Beneficiary Eligibility (082):
Telehealth Network Grant Program (TNGP) - Health care providers in rural areas, in medically underserved areas, in frontier communities, and for medically underserved populations. TNGP grantees include in the network at least two (2) of the following entities (at least one (1) of which shall be a community-based health care provider: (a) community or migrant health centers or other federally qualified health centers; (b) health care providers, including pharmacists, in private practice; (c) entities operating clinics, including rural health clinics; (d) local health departments; (e) nonprofit hospitals, including community (critical) access hospitals; (f) other publicly funded health or social service agencies; (g) long-term care providers; (h) providers of health care services in the home; (i) providers of outpatient mental health services and entities operating outpatient mental health facilities; (j) local or regional emergency health care providers; (k) institutions of higher education; or (l) entities operating dental clinics.

Telehealth Resource Center Grant Program (TRCGP) - Health care providers in rural areas, in medically underserved areas, in frontier communities, and medically underserved populations. The regional telehealth resource centers must support the activities of existing or developing telehealth networks in their regions to meet the health care needs of rural or other populations to be served, including the improvement of access to services and the quality of the services received by those populations. Regional TRCs should have expertise in at least seven (7) of the following areas: A wide Range of Clinical Telemedicine Services; Telecommunications Technologies; Critical or Emergency Care; Residential telehealth (home care)/chronic disease management; Nursing Home/Inpatient Care; Distance Education and Training; Telehealth Technologies both Interactive and Store-and-Forward. A Regional TRC collaborates with other TRCs or organizations to address any of the seven areas where the TRC may not be expert. The National Policy TRC exhibits expertise in the following areas: Reimbursement (Medicare, Medicaid, private insurance); Licensure (legislative and regulatory issues); Privacy, security, and confidentiality legislation at federal and state levels; Food and Drug Administration regulation; Telecommunications legal and regulatory issues; and, private credentialing and accreditation organizations and issues (e.g., Joint Commission on Accreditation of Health Care Organizations). The National Technology TRC exhibits expertise in the following areas: software/hardware for clinical applications; evaluating national technology innovations, multiple software systems and their applications in EHRs (not specific product lines); requirements for specific technologies to be used for specific clinical applications; advances in m-health including software and hardware; assessing organizations need for telehealth technology including specific cost effective solutions; provider and patient medical information and education; direct patient care and remote patient monitoring; and current data delivery mechanisms. Note: American Indian and/or Alaska Native Tribal Organizations are eligible beneficiaries provided those organizations meet the beneficiary requirements above.

Licensure Portability Grant Program (LPGP) - State professional licensing boards to carry out programs under which licensing boards of various States cooperate to develop and implement State policies that will reduce statutory and regulatory barriers to telemedicine. Non Competing Continuation grants will continue to focus on licensure issues for physicians and nurses. The funded projects are to build on the first year of efforts to develop national models for implementing model agreements to expedite the licensure process and eliminate redundancies associated with applying for physician licenses in multiple jurisdictions.
Credentials/Documentation (083):
Applicants should review the individual HRSA funding opportunity announcement issued under this CFDA program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package. OMB Circular No. A-87 applies to this program.
Application and Award Process (090)
Preapplication Coordination (091):
Preapplication coordination is required. Environmental impact information is not required for this program. This program is eligible for coverage under E.O. 12372, "Intergovernmental Review of Federal Programs." An applicant should consult the office or official 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.
Application Procedures (092):
OMB Circular No. A-102 applies to this program. OMB Circular No. A-110 applies to this program. Applications are generally solicited by a program announcement in the HRSA Preview.

HRSA requires applicants (for new competitions) or grantees/awardees (for continuation applications) to submit applications electronically through Grants.gov.

The program guidance contains detailed application and submission instructions, including information on the non-competitive continuation application and submission process. Grantees/awardees must submit proposals according to the program guidance which specifies required forms, and contains additional general information and instructions for grant applications, including proposal narratives, and budgets. The program guidance, when available, may be obtained by: Downloading from http://www.grants.gov; or, Contacting the HRSA Grants Application Center: The Legin Group, Inc., 910 Clopper Road, Suite 155 South Gaithersburg, MD 20878, Telephone: 877-477-2123, HRSAGAC@hrsa.gov. Application information may also be found by visiting http://www.hrsa.gov/grants/default.htm .

All qualified applications will be forwarded to an objective review committee. Based on the advice of the objective review committee, the HRSA program official with delegated authority is responsible for final selection and funding decisions.

Award Procedure (093):
For FY 2014, new competitions for the TRCGP will be conducted. All final funding decisions are made by the Associate Administrator, Office of Rural Health Policy, Health Resources and Services Administration, based on recommendations made by the Director, Office for the Advancement of Telehealth.

Notification is made in writing by a Notice of Award.
Deadlines (094):
Contact the headquarters or regional office, as appropriate, for application deadlines.
Range of Approval/Disapproval Time (095):
2 months.
Appeals (096):
Not Applicable.
Renewals (097):
Renewals have not been determined.
Assistance Consideration (100)
Formula and Matching Requirements (101):
This program has no statutory formula.
Matching requirements are not applicable to this program.
MOE requirements are not applicable to this program.
Length and Time Phasing of Assistance (102):
Competitions are conducted every three years, with up to a four year project period. For projects awarded under a competition, grants are made annually each year for up to four years. For example, the TNGP and TRCGP projects awarded in FY 2012 have a 4-year project period commencing September 1, 2012 and ending August 31, 2016. However, the TRCGP and TNGP grants awarded in FY 2013 each have a three year project period. See the following for information on how assistance is awarded/released: Grantees drawdown funds, as necessary, from the Payment Management System (PMS). PMS is the centralized web based payment system for HHS awards.
Post Assistance Requirements (110)
Reports (111):
No program reports are required. No cash reports are required. Six-month Progress Reports are required. An electronic quarterly Federal Financial Report (FFR) is due to the Division of Payment Management within 30 days of the end of each quarter. A final FFR must be submitted to HRSA via the Electronic HandBooks (EHB) within 90 days of the end of each budget period. Annual progress and reports are required 90 days from the end of the budget period and the final performance report is due 90 days from the end of the project period.

As required by the Government Performance and Review Act (1993), all federal agencies must develop strategic plans, describing their overall goals and objectives. These "GPRA Plans" must provide annual performance reports containing quantifiable measures of each program's progress in meeting the stated goals and objectives. The performance assessment instruments developed by the Office for the Advancement of Telehealth (OAT) with its grantees fulfill GPRA requirements to report to Congress on the impact of OAT's telehealth network grants and telehealth resource center grant programs. Moreover, OAT hopes to use the information derived from these instruments to demonstrate the "value-added" that telehealth services contribute to improving health care. OAT has incorporated these performance assessment tools into the routine reporting required as part of the "mid-year or mid-cycle" and annual reports required under each grant. Each of the programs will also get reports comparing themselves to the entire set of grantees, on these same measures. There are two data reporting periods each year; during these biannual reporting periods, data is reported for the previous six months of activity. Grantees have approximately six weeks to enter their data during each biannual reporting period. No expenditure reports are required. Performance monitoring is not applicable.
Audits (112):
In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Non-Profit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133.
Records (113):
Grantees are required to maintain grant accounting records 3 years after the date they submit the Federal Financial Review (FFR). If any litigation, claim, negotiation, audit or other action involving the award has been started before the expiration of the 3-year period, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular 3-year period, whichever is later.
Financial Information (120)
Obligations (122):
(Project Grants) FY 12 $5,626,712; FY 13 est $4,909,383; and FY 14 est $4,909,383 - TNGP program. (Project Grants) FY 12 $700,000; FY 13 est $700,000; and FY 14 est $700,000 - LPGP program. (Project Grants) FY 12 $4,403,430; FY 13 est $4,187,148; and FY 14 est $4,187,148 - TRCGP program.
Range and Average of Financial Assistance (123):
TNGP – In FY 11 through FY 13, awards each year ranged from approximately $225,000 to $250,000, with an average award each year of approximately $245,000.

LPGP – In FY 11, one grantee received $350,000. From FY 12 – FY 13, two grantees received $350,000 each.

TRCGP – In FY 11 through FY 13, the financial assistance ranged from approximately $300,000 to $325,000. The average award was approximately $321,000.
Program Accomplishments (130):
Fiscal Year 2013: No Current Data Available Fiscal Year 2014: No Current Data Available Fiscal Year 2015: No Current Data Available
Regulations, Guidelines, and Literature (140):
Telehealth programs are subject to the provisions of 45 CFR Part 92 for State, local and tribal governments and 45 CFR Part 74 for institutions of higher education, hospitals, other nonprofit organizations and commercial organizations, as applicable.

HRSA awards are subject to the requirements of the HHS Grants Policy Statement (HHS GPS) that are applicable based on recipient type and purpose of award. The HHS GPS is available at http://www.hrsa.gov/grants.
Information Contacts (150)
Regional or Local Office (151) :
See Regional Agency Offices. Carlos Mena, Project Officer (TNGP), Telephone: (301) 443-3198; Monica Cowan, Program Coordinator (TRCGP), Telephone: (301) 443-0076; Robert Pie, Program Coordinator (LPGP), Telephone: (301) 443-8346.
Headquarters Office (152):
Office for the Advancement of Telehealth, Office of Rural Health Policy 5600 Fishers Lane, Room 5A-55, Rockville, Maryland 20857 Phone: (301) 443-0076.
Website Address (153):
http://www.hrsa.gov/ruralhealth/about/telehealth/.
Examples of Funded Projects (170):
Not Applicable.
Criteria for Selecting Proposals (180):
For FY 2014, the Agency is conducting competitions for the TRCGP for the project period commencing September 1, 2014 and ending August 31, 2017.

TRCGP
TRC applicants will be assessed on their current activities and success in addressing the following areas:
• Telecommunications, industry standards, and technology assessment;
• Extensive experience in providing technical assistance at the local, regional, and national levels
• Breadth of clinical services offered by their network and integration of clinical information systems;
• Ability to overcome reimbursement and other policy challenges to achieve sustainability of their networks;
• Comprehensive evaluation strategy (including collecting baseline data) and implementation as evidenced by publications, especially ones that address effectiveness, costs, and productivity;
• Experience in maintaining a strong and efficient operational/management structure; and
• Experience in developing and implementing strategic/business plans.


Non-Competing Continuation Funding
For FY 2014 non-competing continuation funding for Telehealth grantees will be based upon an evaluation of each of the grantee’s current performance, as well as their plan for continued activities and expenditure justifications.