Alaska will score rural health grant applications on cost-effectiveness

Rural health organizations applying for Alaska's fall grant round will be scored on cost-effectiveness for the first time. The Department of Health is putting the proposed scoring frameworks out for public comment this week.

The comment period opens Friday and closes Oct. 9. Final frameworks post Oct. 14, halfway through the four-week application window that runs Sept. 30 to Oct. 28.

Betsy Wood, executive director of the Office of Health Savings, told the Rural Health Transformation Program Advisory Council on Wednesday that reviewers will weigh whether applicants justified their costs, accounting for the higher shipping and operating expenses of rural and frontier Alaska. Adding the criterion meant taking weight from others. "The weights had to come from somewhere," Wood said, though none are proposed below 10 percent.

The frameworks also tighten how partnerships are reviewed. Wood said the first round produced a lot of what she called aspirational partnerships. Council member Monique Martin put it more plainly: some organizations were "surprised to see their organization named when they never heard of the applicant."

Each organization is capped at five applications per cycle, which program coordinator Allison Miller said is meant to help applicants focus rather than to restrict them. Deputy Commissioner Emily Ricci called it a ceiling rather than a target.

Council member Jared Kosen criticized the overlapping timeline while saying it was not the department's fault. "This is just, again, an example of just how terrible these timelines are," he said, adding that the federal spending window leaves no room to wait.

The department has compressed the fall cycle to about 11 weeks from 24. Alaska's first-year award of $272.2 million is part of a five-year, $50 billion federal initiative that must be fully spent by Sept. 30, 2027. As of Sept. 18 the state had announced $239 million across 244 projects, figures officials say are still projected, with more awards expected.