By Chris LaPage
July 2010 (GO Know)

If you are paying close attention to the health care funding landscape, a new phrase and abbreviation has entered the grants lexicon. Many opportunities being released by the U.S. Department of Health and Human Services (HHS) are being prefaced with "Affordable Care Act" or "ACA". Apparently, this is the consensus designation for grants authorized through the health reform legislation, or the Patient Protection and Affordable Care Act that was signed into law on March 23, 2010. The ACA has authorized several grant programs over the next decade to address workforce development and professional shortages in the health arena, improve health care quality overall, and fund the deployment of comprehensive care management delivery models.

There are more than ten current ACA grant programs with deadlines in July. These grants include two programs for state partnerships to plan and implement health care workforce development initiatives (due July 19). Grant funds are also being targeted at the development of training programs for personal home health aides (due July 19) as well as Nursing Assistants (due July 22). The Primary Care Residency Expansion Program (due July 19) is one of the few programs that are currently open and targeted at physician shortages.

One of the central elements of the ACA is affordability, which is directly tied to finding value in the health care system. Value is created when you reduce wastes and costs while simultaneously maintaining or improving health care delivery and outcomes. One way to create value is to decrease the costs of providing care, which can be done by substituting lower-paid health professionals for physicians. Thus, the ACA is creating a number of grant opportunities to increase the number of physician assistants (due July 19) and nurses with advanced degrees (due July 19). In fact, one such program aims to increase the number of health clinics managed by nurse practitioners (due July 19).

Another way to create value is by emphasizing less-costly preventative (early detection) care. The Maternal, Infant and Early Childhood Home Visiting Program (due July 9) follows this mode of thinking as it aims to deploy intensive care management models for perinatal and early childhood services. The idea is to proactively monitor the conditions at the earliest possible point so that interventions can take place before serious health conditions can emerge (which are more costly to treat).

In addition to making a substantial amount of additional funding available for health care organizations, the ACA-branded grants offer some common themes that potential applicants can capitalize upon in their proposals. Potential applicants to ACA programs must be able to make the case (including any accompanying data) that their project will provide value to the health care system. Look no further than the preceding paragraph to understand how reducing waste and costs in health care are built into the grant programs. Those individuals familiar with the grants that flowed out of the American Recovery and Reinvestment Act (ARRA) understand that the majority of grant funding went to projects that spurred job creation and retention. Under the ACA, increasing the value of health care will serve as the primary indicator of a proposal's success.

In addition to value, there are some additional themes that will be important to incorporate into ACA grant submissions. You will see key words and phrases, such as "partnerships", "broad stakeholder support", "shovel-ready", "scale-up" and "expansion". From these catchphrases and terms, there are two additional themes that should be stressed in any application for ACA grant funds: collaboration and readiness.

Collaboration does not just speak to the broad stakeholder support and project partners that are involved. It also involves the ability of potential applicants to find ways to work with and compliment other federally-supported projects. The ability to partner with health facilities supported by Veteran Affairs, Indian Health Service, and Department of Defense can certainly strengthen a proposal. In addition to making sure you have the right mix of local and regional partners, be sure to research past grant recipients in your area and find ways to compliment their efforts. Finally, quick turnaround times between grant announcement and deadline are indicative of the desire of HHS to fund initiatives that have already gone through significant project development, or expand upon programs that have demonstrated past success.

Potential applicants must be able to articulate a well-rounded and comprehensive project in their proposal. If it is a scale up project, you must include data as to how the pilot project was successful. Applicants seeking funding for "new" programs must base their arguments in well-documented theory and evidence. The applicant agency must also highlight the credentials of their staff and executives as HHS will look for evidence that the necessary expertise exists within the organization to complete the proposed project.

In general, ensuring your project provides value, demonstrates collaboration and is ready to be implemented are important ingredients to any successful grant proposal. In the context of the ACA, they are the critical components that you must address during the proposal development process. Applicants that do the best job of incorporating and articulating these three elements will dramatically increase their chances of pulling down ACA funds.