Telehealth Infrastructure Grant Program (Wave 2)

DHHS Division/Office issuing this notice:   Office of Rural Health

Date of this notice:   November 12, 2024

Grant Applications will be accepted beginning immediately

Deadline to Receive Applications: January 2, 2025

Working Title of the funding program:   Telehealth Infrastructure Grant Program

Purpose:

In Session Law 2023-134, the North Carolina General Assembly (NCGA) appropriated $5,000,000 in SFY 2024 and $15,000,000 in SFY 2025 in receipts (State funds) from the ARPA Temporary Savings Fund to the Office of Rural Health (ORH) in the Department of Health and Human Services to provide competitive grants to rural healthcare providers for Telehealth related items including:

  • equipment
  • high-speed internet access
  • telehealth-related training to staff and patients
  • technology equipment to patients
  • internet service support for patients to help facilitate telehealth access*
  • other infrastructure needed to establish telehealth services

*Eligible rural healthcare patients can benefit from internet service and associated equipment rentals, including modems, routers, and hotspot devices through the Telehealth Infrastructure grant. To receive this support, patients must meet at least one of the eligibility criteria defined below:

  • Total household income that is at or below 200% of the federal poverty guidelines or,
  • Participation in any ONE of these government benefit programs:
    • Lifeline
    • Supplemental Nutrition Assistance Program (SNAP)
    • Medicaid            
    • Federal Public Housing Assistance (FPHA) (including Housing Choice Voucher (HCV) Program (Section 8 Vouchers), Project-Based Rental Assistance (PBRA)/202/811, Public Housing, and Affordable Housing Programs for American Indians)
    • Veterans Pension and Survivors Benefit
    • Supplemental Security Income (SSI)
    • Free and Reduced-Price School Lunch or Breakfast Program including through the USDA Community Eligibility Provision
    • Federal Pell Grant (current award year)
    • Special Supplement Nutrition Program for Women, Infants, and Children (WIC)

Priority will be given to independent primary care practices and independent obstetrics and gynecology (OB-GYN) practices.

The ARPA Temporary Savings Fund consists of savings to the state that arise from an incentive in federal legislation related to the expansion of Medicaid. Availability of funds for specific initiatives funded from the ARPA Temporary Savings Fund is contingent upon the realization of savings related to Medicaid expansion and subject to the disbursement order set in Section 4.9(c) of S.L. 2023-134. Based on these two factors, funding for the Telehealth Infrastructure Grant Program became available in March 2024.

Grants resulting from this Request for Applications (RFA) will enhance the accessibility and effectiveness of telehealth services throughout the state. This RFA aims to support the development and improvement of the technological infrastructure required for delivering remote healthcare services, such as broadband connectivity, video conferencing systems, electronic medical records, and secure communication tools with a priority on independent primary care practices and OB-GYN practices. ORH will manage this initiative throughout the contract lifecycle.

The RFA provides a competitive process whereby grants will be awarded to rural healthcare providers for the purchase of equipment, high-speed internet access, and any other infrastructure needed to establish telehealth services. Telehealth services refer to the use of two-way, real-time interactive audio and video, enabling healthcare providers and patients to communicate and see each other. At a minimum, awards through this RFA for telehealth services must include:

  1. Essential broadband internet connection of 50-100 megabits per second (Mbps) (can vary with the number of providers accessing the same connection)
  2. Network redundancy in case of outages
  3. Dedicated network for compliance needs
  4. Security measures to prevent data breaches

When awarding grants through this initiative, ORH will adhere to the following requirements and limitations:

1) Applicants must be healthcare providers located in a rural area. Please see https://www.ncdhhs.gov/metro-micropolitan-counties/open for counties identified as rural by ORH.
2) ORH will accept EITHER the ORH prescribed definition of “rural” according to the link above or the The Rural Center’s definition of “rural?” as defined on their website. Refence website link here: https://www.ncruralcenter.org/county-data/
3) Priority will be given to independent primary care practices and independent OB-GYN practices.
4) The maximum grant amount per recipient is $250,000.
5) Only one application per organization will be accepted.
6) The term of the grant will be twelve (12) months with the option to renew up to two additional twelve-month terms.

Eligibility and Other Requirements:

ORH is accepting applications from rural healthcare providers for start-up equipment and related items for telehealth with priority given to independent primary care practices and independent OB-GYN practices that will enhance healthcare access, quality, and outcomes. This includes deploying telehealth technology, developing secure data management systems, and creating comprehensive training initiatives for practice staff and/or patients. This effort will allow patients being served in a primary care or OB-GYN setting to access non-hospital-based telehealth services.  Applicants must:

  • Be located within the state of North Carolina
  • Demonstrate the ability to maintain patient safety, ensure patient privacy and continuity of care

Projects submitted under this RFA must:

  • Provide evidence the service is an equitable healthcare delivery model, including anticipated outcomes related to impact on health care delivery and/or social determinants of health in the primary care and OB-GYN community.
  • Indicate which populations are the intended audience (historically underserved, marginalized, or adversely affected groups, economically disadvantaged communities, rural and underserved communities, etc.).
  • Develop and document a realistic and achievable project sustainability plan.

*For the purposes of this RFA, an originating site is defined as the location of the patient, and a distance site is defined as the telehealth site where the provider/specialist is seeing the patient.

All rural North Carolina-based primary care practices, including independent primary care practices and independent OB-GYN practices, are eligible to apply. Applicants must:

  • Provide evidence that they have a quantifiable and qualifiable record of healthcare provisioning relative to grantee requirements as detailed in Session Law, SECTION 9B.7A.(a)
  • Demonstrate the capacity and capability to implement telehealth infrastructure projects, including technology deployment, system integration, and workforce and patient training.

Pre-award Costs and Funding Period:

Grant awardees will be permitted to claim pre-award allowable expenditures for qualifying telehealth services they rendered retroactive to July 1, 2023.   Pre-award costs will be reimbursed for allowable expenditures which meet the program criteria beginning July 1, 2023 to January 1, 2025. Those allowable expenditures include costs related to the purchase or lease of provider-managed telehealth-related equipment, high-speed internet access, telehealth-related training to staff and patients, technology equipment for patients, internet service support for patients to help facilitate telehealth services, and any other infrastructure needed to establish telehealth services. Telehealth services refer to the use of two-way, real-time interactive audio and video, enabling healthcare providers and patients to communicate and see each other.  Other services may also include training, technical support, etc., directly related to project objectives.  The funding period for awarded contracts will be from January 1, 2025, through December 31, 2025. All awards must be expended by the contract end date, and if the contract is extended, then no later than December 31, 2027.

Award Information:

ORH will be responsible for managing grant activities.  Awards are contingent upon availability of funding. This funding is not recurring. Highest scoring applicants will receive an award based on scoring criteria established in this RFA. Awards will represent multiple geographic areas of the State.

As a condition of receiving a grant award, successful applicants must:

  • Complete the contract process by specified due date
  • Submit expense reports in a format specified by ORH for reimbursement
  • Submit performance reports quarterly or biannually throughout the grant term as specified by ORH
  • Connect or have a plan to connect to NC HealthConnex (To meet the state’s mandate, a provider is “connected” when its clinical and demographic information are being sent to NC HealthConnex at least twice daily.” For further information, please see the HIEA website:  https://hiea.nc.gov)
  • Develop and document a realistic and achievable project sustainability plan to maintain services at funded sites
  • Provide notarized letter(s) of collaboration or MOU/MOA signed by primary care offices or non-hospital settings that are not owned, operated, or managed by the applicant
  • Adhere to all state requirements on record retention and any changes to state requirements during the contract period

How to Apply:

Applicants must submit the following documents electronically through the electronic application:

  1. Organization Information and Signature Sheet
  2. Organization Profile
  3. Summary of Evaluation Criteria and Baseline Data
  4. Grant Narrative
  5. Budget

If awarded, applicants will be required to submit the following documents within 30 days of notice of award:

Required Documents - Non-Governmental Entities

Required Documents – Governmental Entities

Access to Electronic Application:   

Access to the electronic application is a two-step process:

  • Step One: Use the ORH application link to submit the organization’s name and contact information. The link opens on November 12, 2024 and closes on January 2, 2025.

ORH Application Link:

Telehealth Infrastructure Grant Application Survey Link

  • Step Two: Upon submitting the required information to the ORH Application Link, an email with a personalized link specific to your organization will be sent. The link in the email will provide access to the electronic application. The application closes January 2, 2025. Please begin the application process in time to ensure completion on or before the January 2, 2025 due date.  No new application links will be sent after January 1, 2025.     

Applications must be complete, and applicants must respond to all application requirements. Incomplete applications, or applications not completed in accordance with the instructions, will not be reviewed.

All applicants will receive a confirmation notice after an application has been successfully submitted.

For assistance with the application link contact: Eric Bell at eric.bell@dhhs.nc.gov

How to Obtain Further Information:

All questions regarding the RFA and/or application should be submitted in writing to orh_hit@dhhs.nc.gov.

Funding Agency Contact/Inquiry Information: Eric Bell at eric.bell@dhhs.nc.gov

Technical Assistance Webinar
Telehealth Infrastructure Grant Frequently Asked Questions
Technical Assistance Webinar 2

Telehealth Infrastructure Grant Timeline

  • Request for Applications (RFA) Released: 12 Nov 2024
    • Officially marks the beginning of the grant application process. The RFA will outline the eligibility criteria, funding opportunities, and deadlines.
  • Application Period: 12 Nov 2024 – 2 Jan 2025
    • Organizations interested in applying for the grant will need to submit their proposals during this time frame. The duration of the application period can vary.
  • Application Review: 2 Jan 2025 – 31 Jan 2025
    • After the submission deadline, the grant ORH review committee will score the proposals based on the criteria outlined in the RFA. Depending on the number of applicants and complexity of the grant, this process can take several weeks.
  • Notification of Awards: 1 Feb 2025
    • Once the review and scoring process is completed, successful applicants will be notified of their award status. This notification can take place anywhere from a few weeks to couple of months after the application deadline.
  • Grant Implementation: 1 Jan 2025 for Wave #1/ Feb 1 for Wave #2
    • Upon receiving the grant award, the successful applicants will begin implementing their projects. The timeline for implementation is detailed in the RFA and is monitored throughout the lifecycle of the project.
  • Reporting and Evaluation: 1 Jan 2025 - 31 Dec 2025
    • Throughout the project implementation period, grant recipients are required to submit progress reports either monthly, quarterly and/or annually to ORH, that align with established KPIs. These reports will track the project's success and ensure that deliverables and services coincide with the grant objectives. Each report validates that it meets contract obligations for reimbursement as it relates to telehealth infrastructure costs incurred during the project lifecycle.

Documents