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The Capital Improvement Program (CIP), Health Information Technology (HIT) systems/networks, and Facility Investments (FI) grants support the development of health center infrastructure. Projects include construction, alteration/repair/renovation, purchase of equipment and HIT, and purchase and enhancement of Electronic Health Record (EHR) systems.

CIP grants will fund capital improvements in health centers including construction, repair, renovation, and equipment purchase, including health information technology systems. An estimated 1,130 health centers will receive grants to support capital improvements.

HIT systems/networks grants will support EHR and HIT systems for health centers.
FI grants will fund major facility investments in health centers including construction, repair, renovation, and equipment purchase. FI grants will fund an estimated 100 significant facility projects.

Community Health Centers capital programs will be assessed for risk and to ensure that appropriate internal controls are in place throughout the entire funding cycle. These assessments will be done consistent with the statutory requirements of the Federal Manager’s Financial Integrity Act and the Improper Payments Information Act, as well as OMB’s circular A-123 “Management’s Responsibility for Internal Control.”

During the pre-award phase, applications for CIP and HIT grants will undergo internal HRSA review to ensure applicants propose to use funding as intended by the Recovery Act. Applications for competitive grants will be reviewed by an Objective Review Committee. HRSA will also conduct additional levels of review (e.g., environmental assessment, architectural and engineering review, etc.) on applicable proposals through the use of qualified environmental, architectural and engineering experts.

During the post-award phase, HRSA will follow established policies and procedures for health center program training, technical assistance, reporting, data verification, documentation and corrective actions. Ongoing monitoring and evaluation will occur through at least quarterly communication between grantees and Project Officers, quarterly progress reports, site visits as necessary, annual applications and annual performance reports, including audits. For construction-related projects, HRSA will utilize architectural and engineering consultants to review project progress and budget expenditures quarterly. Additionally, HRSA utilizes an early alerts monitoring process to quickly identify potential issues and track corrective actions when needed.

HRSA will be open and transparent in all grant competitions that involve spending of Recovery Act funding consistent with statutory and OMB guidance.

HRSA will ensure that recipient reporting required by Section 1512 of the Recovery Act and OMB guidance is made available to the public on Recovery.gov by October 10, 2009. HRSA will inform recipients of their reporting obligations through standard terms and conditions, grant announcements, contract solicitations, and other program guidance. HRSA will provide technical assistance to grantees and contractors and fully utilize Project Officers to ensure compliance with reporting requirements.

HRSA will continuously inform recipients of reporting requirements outlined by statutory, OMB, and HHS guidance. HRSA will ensure that recipients understand and comply with these requirements through regular communication with and provision of technical assistance to grantees, through general guidance, and through the existing Project Officer relationships.

To ensure that managers are held to high standards of accountability in achieving program goals under the Recovery Act, HRSA will build on and strengthen existing processes. Senior HRSA and Health Center Program officials will meet regularly with senior Department officials to ensure that projects are meeting their program goals, assessing and mitigating risks, ensuring transparency, and incorporating corrective actions. HRSA's personnel performance appraisal system will also incorporate Recovery Act program stewardship responsibilities for program and business function managers.

Existing processes ensure that HRSA managers are held to high standards of accountability in terms of achieving program goals and facilitating improvement. As part of their Employee Performance Plans, HRSA program managers are required to assist health center grantees with implementation of program requirements and to improve program performance. HRSA managers will be held accountable to ensure the timely awarding and appropriate management of funds and as appropriate HRSA Performance Management and Assessment Plans may be modified to incorporate the stewardship of Recovery Act funds.

HRSA has also implemented senior level governance boards, and a thorough and comprehensive A-123 internals controls testing and evaluation process, that tests, and ensures appropriate internal controls are in place throughout the entire funding cycle. The health centers program is also subject to a complete improper payments risk assessment on a regular basis by the HRSA CFO, with the last one performed during FY 2009.

Not Applicable