Alaska Dept. of Health: Implementation Application Walkthrough Webinar (June 1, 2026)

All right. Good afternoon, everyone, and welcome to the Department of Health Alaska Rural Health Transformation webinar. This is an informal webinar on the application process. So my name is Heidi Hedberg. I am the Commissioner for the Department of Health.

And with me today presenting on the implementation application, we have Alex Nikkei. She is the CEO of the Alaska Community Foundation, and Megan, she's the Vice President of Programs and Grants for the Alaska Community Foundation. In addition to Deputy Commissioner Emily Ricci, Betsy Wood, Director of Office of Health Savings, and Allison Miller, she is an RHTP Program Coordinator. And so we will be answering your questions today. Next slide.

So first and foremost, I wanna extend my thank you to all of you. We were really excited to see the participation in this LOI process. We cast our net really wide because our healthcare system really transforms and touches the lives of so many aspects of a person's wellbeing. And we were overwhelmed with the response. We received almost 1,800 letters of interest that represent about $2.5 billion in requests.

And really, I think that is a reflection that the needs far exceed the available funding. When we looked at all of the LOIs, what we saw were some common themes. Around behavioral health, access to specialty care, needs around facility and equipment upgrades, chronic disease management as we're really looking at improving our health outcomes, traditional healing, and a lot around workforce. Those were some of the top common themes from the letters of interest. As we reviewed all of those letters of interest, About 400 were advanced to the full application process.

This is a recording, and so if your counterparts were advanced and they are not able to participate, this recording will be sent out to everyone whose application or whose LOI was forwarded to or advanced to a full application process. Again, of those 400, the needs exceed the available funding. And so it's really, I wanna reiterate to all of you that this is a competitive grant and we're gonna walk through that application process and how those applications are going to be evaluated. Next slide. So I'd like to turn it over to Allison and she is going to share with you the components of the application process.

Thanks so much, Commissioner Hudberg. Hi everyone, my name's Allison. I serve on the RHTP team as a program coordinator. We are going to get a detailed walkthrough of the actual application from our partners at the Alaska Community Foundation in just a few minutes, but I do kind of wanna set the stage by giving you a sort of high-level overview of what you can expect to see. So for those of you who were involved in the LOI process for your organization, some of this information will look really familiar, particularly the project So that's a good summary and some of the basic information.

I do really want to reiterate that the goal in asking for this information again is not to make you repeat yourselves or create busywork for the sake of busywork. One of the biggest pieces of feedback we got was that people felt they didn't have enough space to really say the things they wanted to say. So this is your opportunity to go into as much detail as you want, to clarify if you want to. If you do feel that the language that you used in your LOI is still applicable, you're welcome to use that. We're not going to be checking that or anything like that.

So feel free to elaborate if you'd like. New information, we'll really be looking for the how you plan to accomplish the things you want to accomplish, making sure that you have a work plan in place and that you're looking at outcomes and tracking your projects and anticipating risks that might arise. And then in addition to the field entries, we are also going to require a handful of attachments that we've outlined here. All of these will be available as templates in the actual application portal, so there's no need to reinvent the wheel or come up with your own formats. We've tried to make this as accessible and user-friendly as possible.

In particular, we'll be asking for attachments around your work plan, your budget spreadsheet and narrative, as well as a partnership matrix. One thing we noticed with the LOIs was a lot of organizations listed partnerships that were aspirational or intended and maybe not quite in existence yet. So what we're looking for here is not necessarily evidence that you've been partners with a new organization for a long, long time, but at least that you've had preliminary conversations about what you plan to do and how you plan to achieve it, and that there's buy-in across all of the partners. All right. With that, I'm going to pass it to Betsy Wood, who is going to talk a little bit more about technicalities of funding caps and limitations.

Thank you, Alison. Hi everyone, I'm Betsy Wood. I'm the Director for the Office of Health Savings, and we are Thrilled to have you all here with us today walking through the various components of the full application. If you have been to one of these webinars with us before, you've probably heard me talk through some of these various components about funding limitations or caps that are applied across the program. And we wanted to remind you of some of these and also share a little bit of additional context and, and policies that I think will be helpful as you develop your budget moving forward through the full application.

So the first category that I'd like to talk about is administrative expenses. I think you have heard us say before that there is a program-wide cap on administrative expenses that applies across all of the award and all of the activities that the state is undertaking. We also have talked about how we are not—. Thank you. Accepting indirect costs, indirect administrative costs from subrecipients, but that we did want to provide an opportunity for subrecipients to propose limited direct administrative costs to assist with covering the activities associated with administering the grant.

So we are limiting direct administrative costs for subrecipients to up to 3% of your individual project budget. So as you're proposing your individual project budget, that means that You know, you'll see when the application portal opens later today and you spend your afternoon looking at all of the parts and pieces there, you'll see in the budget template an opportunity for you to put— to detail some of your direct administrative costs. The costs there need to be limited by no more than 3% of your overall project budget. And I'm hearing that there's an echo, so I will pause for a moment. Yeah, thanks, Betsy.

So for those of you that were sharing that there's an echo, we don't hear it on our end, but we wanna make sure that you guys can resolve it 'cause we wanna make sure that you hear this information. Great, the echo is gone. Okay, thank you so much, Jason, for confirming Betsy back. Thank you, I love the real-time update. That's really helpful.

So yeah, so back to, The administrative expenses up to 3% of your individual project budget, and you'll see in the budget kind of roll-up template. I see some questions coming in about what does that look like, how will that be? And I'm just gonna foreshadow that Megan's going to give us a kind of a preview into what the components of that looks like. Also, today we'll be talking about resources. If you have questions around how to, how to address the different pieces where you can reach out for help.

So just as a reminder, this is meant to help us budget towards the overall cap that the entire program has on administrative costs, and to help you understand kind of what part of it will be available for you to look at. How does that, that work within your own budget? We will be providing an applicant resource guide on our website later today that kind of has a more in-depth discussion of how you could be thinking about administrative costs versus programmatic costs. But in general, think about your administrative costs for this program as what activities are associated with managing and overseeing the grant itself. So your financial management of the grant, accounting, compliance, reporting, that's what we're talking about when we talk about administrative activities.

You'll have programmatic costs that are different, and those are the costs of actually carrying out your project. Things like delivering the services, implementing the activities, supporting your participants, operating technology. So don't think about it as, you know, staff time is not automatically administrative. A lot of your staffing costs or personnel costs will be programmatic if they're directly tied to implementing the proposed project, and you can describe that in your budget narrative. The detail here is really helpful.

We recognize that, you know, it's a lot of work. To do the program implementation for what we've seen come in. And we want you to propose your costs and detail how they would be tied to the project. And if you're saying, this isn't a cost that I need in order to manage the actual grant aspects of it, think of that as administrative. And if you are managing the program or the project, think of that as programmatic.

I think there are gonna be a lot of questions. I see a lot of questions coming in today already. Where there may be case-by-case questions or individual questions. So, keep your eyes peeled for a little bit later when we kind of go over again the opportunities to ask for questions and ask for guidance. And just know that we will be putting out as much information as we have and as we can to help people understand how to correctly classify their costs so that we understand what your costs are going towards, and we can share that up to CMS so that they can understand to how our proposed costs meet the program requirements.

One thing that CMS has been very clear on from the beginning of this program is that the requirements that the state is held to flow down to our subrecipients as well. So that's where we are putting together as much information as we can to help, help you understand what we understand about those requirements so that we can all be working from the same, you know, shared—. Thank you. Shared understanding.

I just want to remind folks about the next 3 items together, the provider payments, EMR replacements, and capital and infrastructure expenditures. These are specific types of costs or specific cost categories that have been identified as part of the federal allowable uses for these funds. And there are also very specific, you know, caps on how much of our funds can we spend in any of these given areas across the entire program. So, for provider payments, you know, you're thinking about maybe piloting a new service. It can't be a payment for a service that you already could receive payment for today.

But in the space of provider payments, Federal limits require that we spend no more than 15% of the overall RHGP award for provider payments. What does that translate to? It means we have about $40 million across the entire program that can go to provider payments. For EMR replacements, those are replacements of high-tech— previously high-tech certified EMR, or electronic medical record systems, that were in place as of September 1, 2025. Okay.

It's a very specific requirement, right? That's not going to apply to upgrades to the EMR, to a regular EMR upgrade or to other areas. But if you need to do a full replace of your system, there's a cap across the entire program. That means that the state collectively has about $13 million that we can dedicate towards that type of project. For capital expenditures and infrastructure, I know that this is a very— this is a place of a lot of interest for a lot of folks.

What goes into capital expenditures and infrastructure? What does it mean to kind of be in this space of renovations, alterations, and equipment upgrades? Well, we know that this is a non-construction grant opportunity, so we can't build new buildings. We can't do, you know, major building expansions. We can't tear down buildings, but for those minor renovations or alterations, um, and then also equipment upgrades versus buying new equipment, but equipment upgrades fall into this capital and infrastructure expenditure category.

Um, these types of costs are limited to just over $54 million across the entire program. So think about that. I know there are a lot of infrastructure renovation equipment upgrade type projects out there, and it's not a cap that you need to manage towards individually in your own project, other than if you came in and asked us for, for a project that is $60 million and is all a renovation, then we would say we don't have the available funds there, of course. But, but think about this is this is the amount of money that across the entire program we have to dedicate to these types of expenses. So managing towards these caps and understanding how do these projects fit together, how do these pieces come together, and how are we funding, um, if these types of funds are being asked for, that's something that is, um, managed at the state level.

When we look at how are we able to move projects forward, we're— Thank you. Keying in on, okay, this project has, you know, $200,000 in capital and infrastructure expenditures, and this project has $5 million, and this project has X, and then it's on us to put those pieces together and make sure that we're maximizing the available funds in this area. We also wanted to flag again, new construction, major facility expansions. These are not allowed. I see a lot of questions coming in.

And again, we think that a lot of the questions people are going to have are going to be on that individual case-by-case basis. We're going to do the best that we can at the end of this call to answer some of those questions live here, but also recognize that there are opportunities to send your questions to ACF and to the DOH program team. And between those venues, we will be updating our frequently asked questions as best we can and providing, you know, responses to individuals that, that have questions about their, their own piece of it too, throughout the, the application period. Um, I think it's one last thing I'll say on this is that when we look at these limits and these caps, we're really talking about this budget period and this part of the funding cycle right now, that 3% for the individual project budget. That's for you coming in today.

Through this application cycle. I imagine that we will try to keep that as close or as similar in future cycles, but each cycle is going to be its own, you know, its own ball of wax. So, we will— I will say that you'll want to look at the program guidance that comes out every time you apply to participate in this program over the coming years. When we look at the other caps that I've discussed, those are based off of program percentages. And they're based off of the award that we received and that Alaska received in the first year.

So if Alaska's year 2 award is a different amount than the year 1 award, the amount that's available for future, you know, for future groups of projects under capital and infrastructure expenditures, that's going to shift a little bit based off of what future year awards are.

Allison, can you— thank you very much. I will touch on the evaluation process. We want you to understand how your full proposals, your full applications are going to be reviewed. The first step will be a completeness and administrative review. We'll verify the required attachments and the certifications that you've provided, the budget information, and look at program requirements.

We expect that, that all applications will be able to, to advance through this, but we want to check and make sure that we've received everything that we need from the applicant to understand, you know, what's in your project, what's in your proposal, understand what you're trying to do. The applications that move forward will then go into project-level evaluation, and that will be assessed using the Project Application Evaluation Framework. That's posted on our website. We put a preliminary version of this out for public comment a few months ago. We've made some changes.

We received great comments back from, from the public and from our partners and our advisors, and we have put together a version that you can look at today and you can have with you as you're building out your full applications. You can understand what we'll be looking for and how that project will be assessed. There are various components in that evaluation framework that will be really, I think, informative for all of you to go and to look at and to understand what the, the DOH and subject matter expert reviewers are looking for in assessing, in assessing your individual project. I want to highlight that projects, there is a minimum score. We are looking for projects to score at least a 3.

In every category in order to advance into the next stage. So, you'll see that on the website. There's a framework. There's— I think it's a 1 to 5 scoring that we're looking for at least the midline across all of those categories so that we feel that when we move into the portfolio review stage of it and we look across all of the projects and look, you know, how are these distributed geographically, how do these align with our initiatives, You know, the service mix. How does this, you know, like I mentioned before, looking at the funding limitations and those budget caps, trying to make sure that we maximize available funding if there's, if there are kind of limited areas we want to think about.

That in order to move into that portfolio-level review stage, projects do need to score at least a 3 in every category at the project-level evaluation. And both of the evaluation tools for the project-level evaluation and that portfolio-level review are available on our website. So you can go and review them and understand, you know, where you want to be driving towards as you're building out your application.

Go to the next slide, please, Alison. Thank you. So this is— this slide Describes the performance period for this funding cycle, which is the Spring 2026 Rural Health Transformation Program funding cycle. So the performance periods throughout the life of the program determine when you can carry out project activities and when you can spend those awarded funds. For this spring funding cycle, and we've shown you what the future spring funding cycles will look like too, so you can think about if you have a multi-year project, okay, I have this performance period, when would my next one start?

Would I be able— how can I plan ahead? But for the first performance period, implementation projects will have an 11-month performance period running from August 1st of this year through June 30th of 2027. In future years, we anticipate that those performance periods would be 12-month performance periods. We're just all on a bit of a shorter timeline this first round, given the program buildup and given the shorter budget period that, that the state and CMS are working under here as well. So again, the future performance periods will be 12 months, but we would like applicants to use these dates when you're developing your work plans, your milestones, your staffing plans, and your budgets.

I'm sure many of you are furiously screenshotting this right now. Don't worry. This is also in the Applicant Resource Guide that will be on the website later today. This webinar is being recorded. You can go back and reference it if you need to.

But we're trying to provide you with a little bit of that future look at, okay, how can I plan to fit within these, these time periods for this funding opportunity, for this next one coming up, and then into the future too.

So these— oh, Alison, if you could go back one slide. I just want to say a few more things on this one. You know, it is a 5-year program, but we really do want people to be thinking about these awards as being structured into these annual performance periods. I think it'll also be helpful to understand how does that fit within the state's budget periods and expenditure windows with CMS, and that's what I'll talk about on the next slide. But we— I want to just flag that we know a lot of the applications that we expect to receive are for multiyear projects where people are saying, "I need a few years to really build what I'm doing here." We think that kind of having this window into what the future performance periods are, when they begin and when they end, will help you think about how does your project fit within those future performance periods.

And when we walk through the application materials, you'll see that there are spaces to provide us with detail on your budget for this first performance period, but to provide us with some high-level budget information for future years too, so we can understand what you think you might need next year and the year after and, and so on, because that's helpful for us as we're making decisions. , And, and kind of understanding what are the needs of your project as we go on. Okay, Alison, please. Oh, sorry, one more. The grace period.

I'm sorry, I'm not reading the slide correctly. Um, I want to note that the— there is a grace period, um, between the end of the performance period and the end, and the end of the state's window to finish expending funds for any given budget period. And that grace period is really intended to support the reporting and closeout activities. We recognize that the— there may be asks to further extend that performance period. We'll consider a request for that on a case-by-case basis.

We'll be providing more information to awardees about how to do that should you need to do that. But I want to stress that this is a fast-moving opportunity, and we really want everyone to be thinking about how can I accomplish— what can I— and be realistic about what you can accomplish within these performance periods so that we can continue to move forward and complete all the closeout activities that we need to do in order to fully leverage this opportunity across the state. Okay, next slide now, please. Thank you. I won't spend too much time here.

This is meant to be a visual representation to show you how do these performance periods fit within the state's funding timeline. We have stacking budget periods and expenditure windows for each, for each year of this grant that the state manages through the cooperative agreement with CMS, and those performance periods bridge between those budget periods and those expenditure windows. And you can see in the graphic here that the performance periods again end just before that expenditure window closes to give us time to fully close out and wrap up all of those activities by the time we reach the end of that spend window. I've been seeing a few of the questions coming in on the chat asking about future cycles. We will have future cycles.

There will be future funding opportunities on this spring cycle that we're in right now. We also anticipate having a fall cycle. So, I would say the next funding opportunity under the Rural Health Transformation, we're anticipating launching this in the fall. Those performance periods would likely begin January 1st, 2027. This is, you know, we'll provide more information with more detailed dates as soon as we have them.

Thank you. But we did want to just key in and let you know that there will be more opportunities coming down the pike.

And with that, I think I'll hand this back over to Allison to give us some general application guidance. Thank you, Betsy. I am not going to go through all of these one by one because I want to make sure we have enough time to go through the actual application. And like Betsy said, this is going to be recorded. We'll have copies of all of the resources that she mentioned on our website later.

So don't worry about copying down every single one of these. Two things that I really want to call out though are one, that the more concise you can be in developing your application, the better. And that doesn't necessarily mean that you have to intentionally shorten your answers or censor yourself if there's something that you really feel needs to be said. But I do think that one thing that reviewers will really value is very direct, concrete language about what you what you intend to accomplish, and how you're going to do it. And then on this second bullet, I also want to talk a little bit about evidence.

We recognize and are very sensitive to the fact that for many communities and peoples and issues in Alaska, there is a huge dearth of what is often considered to be authoritative— and I say that with big scare quotes—. Evidence. And so we recognize that for many of you, the problems that you're trying to address will not have big resources in terms of large datasets or peer-reviewed evidence or things like that. So we really do encourage you to be out-of-the-box thinking, creatively thinking when it comes to evidence. We will recognize data.

We will also recognize things like community-informed knowledge, practitioner experience, and other sources. So don't feel like you are constricted to those really narrow—. Yeah. Versions of what is traditionally considered evidence. And then finally, I would also just call out the sustainability and transformational bullet down here at the bottom.

I think that in a lot of the LOIs, we saw projects that had really good sustainability or really good transformational potential, but not both all of the time. And so the more that you can speak to both of those things separately and in conjunction, I think the better. Thank you.

Betsy alluded to this already, but we do have several resources that are already posted on our website or will be very soon. The project evaluation framework and the portfolio analysis are intended to provide more context on what reviewers will be looking for and how your proposals will be evaluated. The applicant resource guides contains a lot more detail about everything that we have discussed here in terms of funding limitations and what can be considered administrative costs. All that good stuff. And then, as we mentioned before, the Alaska Community Foundation is a great resource for any technical questions that you have about the application or any of those things.

We've gotten a handful of questions already, and we will continue to update the FAQ section on our website as more come in. We're trying to be as nimble about that as possible, but a few ones we've already seen are, can my LOI— can the full proposal that I submit be different from my LOI? And the answer is Yes, to a degree. So any changes that you can make to your LOI that will make it more efficient, that will make you better able to achieve your goals, I think are very welcome. However, structural changes, so changes to the basic nature of what you are trying to do or what you are trying to accomplish, I think are not going to be considered.

And in particular, what we're trying to prevent here is people rolling projects that were not selected to move forward into projects that are advancing if your organization submitted multiple projects. Multiple LOIs. So do keep that in mind. We've gotten a lot of questions about multi-year projects too, and how you should navigate this application if you have a multi-year project in mind. And we welcome proposals for multi-year projects with the understanding that we are, are not totally clear what our funding is going to be next year.

And so there may be changes in terms of what we can do, and also that any multi-year your proposals will be contingent on the performance of the first-year proposal as well as CMS approval. So keep those things in mind. And then as far as questions, we've got a couple of email addresses listed here. The Alaska Community Foundation will be your go-to for any questions about the application portal, the submission process. Any questions about the program itself, what is allowable, can be directed to the RHTP inbox.

And with that, I will hand it over to our friends at the Alaska Community Foundation, and I believe Alex McKay, the CEO, is going to kick us off. Okay, great. Thank you, Alison. I'll try to make it quick. I just want to say one thing is that the team here at Alaska Community Foundation who's working on this program is really honored to be doing it with the Department of Health and just to be a part of bringing Rural Health Transformation Program to communities across Alaska.

We know how much work you're putting into these proposals, and this is a really complicated process with the very complicated timeline, and the team is working hard to make it as straightforward as possible. Um, with that, I'll turn it over to Megan Cassiola so she can get started and walk you through the full proposal application process. You will be working the same portal as you submitted your letters of interest, so hopefully much of it will feel familiar. Okay, Megan.

Oh, you're on mute. Thank you. Thank you, Alex. So this application portal probably looks pretty familiar to you all, given that you've spent time on the letter of interest. But just to make sure you know how to navigate to the full application, since it's a limited opportunity rather than one available to all.

You are going to click on this apply button after you log into your account, and when you click on that— oops, sorry, go back— you're going to get this list of opportunities. You'll notice that none of the opportunities available right now are the RHTP full application. That's because Yours requires an access code. You'll receive the access code later today via email, and once you have that access code, this is where you're going to enter it in this search box here. When you enter that access code, you are going to then press enter, and you'll be taken to this page here where you can access the—.

Thank you. Full Implementation Proposal. There, like there was for the LOI, there is a link to get a PDF of all of the questions. And so if you're going to be collaborating with others ahead of submission, you may want to download this and send it to your collaborators. Otherwise, you can just click the Apply link and go directly to the application.

Thank you. So you'll see application instructions at the top. And one of the things that we just recommend is that our system requires that we do character counts as limits rather than word counts, but there are occasionally word count recommendations. And so we provided a quick guide here to that. But your answers, if you are typing into another place rather than in the application itself to draft your answers, your limitations are going to be character count based.

You'll start by entering the project title. You can revise the title, and if you do that, you will have to say that you have revised it. This is because we are going to be comparing LOIs to the submitted applications. Obviously, a password is one level of protection, but it doesn't prevent everyone from submitting, and so we will have to do that check. But if you need to revise your title, you can do so here.

Okay.

The— this is something that creates form logic. So if this is not the same, you'll get a question where you are able to answer this. One of the things that Allison had mentioned is that we're trying to avoid you having to answer questions over again and trying to avoid you having to answer questions that are irrelevant. Relevant to your application. That's why we've used FormLogic to make sure that you don't have to answer too many questions that aren't relevant to you.

Um, there are going to be a few types of questions like the one that I just provided. There's dropdowns, radio dials, um, Both of those are— you can only select one option. With the checkboxes, you can select multiple options, and then the textboxes. And again, there's always going to be some sort of character limit that you'll want to pay attention to. There were a lot of questions earlier about the idea of— Oh, wait, before I go to Melissa, Uh, applications.

I do want to pause really quickly at the initiative. Um, once you get into doing your budget, you will recognize that your budget will be much simpler if you identify a single primary initiative. And so we recognize that many projects fall into a variety of initiatives and could support the, the goals of several of the initiatives that have been identified for the state of Alaska. That being said, uh, we need to know your primary initiative, and ideally your project will fall entirely into that initiative. If necessary, we do have the option of adding additional initiatives, but this will make your budget more complicated to fill out because you will have to— because we have to submit budgets by initiative to CMS, you'll have to divide your budget up by initiative as well.

So obviously there are strong advantages to identifying a primary initiative for your whole project. You're also going to want to look at the alignment with the RHDP goals and initiatives, we really need you to provide a strong explanation for why your project fits into this initiative area. And I highly recommend the Applicant Resource Guide that will be posted later to the DOH website, which provides much more detail about about each initiative rather than just basing your answer on the, the kind of high-level title. There's a lot more detail about what each initiative entails there. So then again, there were a lot of questions about multi-year applications.

And so this particular Form is going to be focused on year 1 with high-level priorities and so forth for future years. We will ask for our own planning purposes to get a budget for future years so that we can think through what that looks like for the future of the program, but you're only going to need to do a detailed budget narrative for the first year. We only need the detailed work plan for the first year, the partnership matrix that is detailed with those partnerships documented for the first year. Everything else is at a very high level. Um, And this, this framing here, the anticipated funding horizon, provides the opportunity to share whether your project is expected to produce impact within 1 year, but also benefit from future expansion, versus its success is entirely dependent on multiple years of funding to achieve the intended outcomes.

Or that it's just a 1-year project and you'll be complete by the time the period of performance is over.

Run through this really quickly. The— there are several cases where you will have to download a template and then upload the document. To download, you're going to click on the link. So you'd click on the work, uh, work plan template, and then, uh, it will download in your browser into your download files for your computer. One quick note: some browsers have security settings that will prevent the download from occurring.

You may need to look up to the top of your browser to see if there's a little notification that there's a download that has been requested and that— and asking for your permission to move forward with the download. So if you're having trouble and not seeing the document actually download, it's probably a browser setting. And you can look for that little, little indication that there's a security question, or you may want to work with your IT people directly to get to it if it doesn't pop up immediately. The templates have a specific naming convention that we are requesting. That naming convention is in the downloaded template name, and so you'll just want to rename it according to that convention, and it is also included in the instruction.

Okay. Um, and the last thing that I will leave you all with is just that, um, this Applicant Resource Guide is absolutely essential to read before submitting your application. There is a lot of very program-specific information that you'll want details on. Um, and so when it comes to, uh, specific work words that are coming up for the program. There's more definitions.

There have been lots of questions in the chat that'll be answered by the Applicant Resource Guide. And so we recommend that you use that Applicant Resource Guide in tandem with the instructions that are here. So with that, I'm going to stop sharing and pass it over to Commissioner Hedberg. Thank you, Sarah.

Thank you. Alison. Great. So what to expect on coming up. We are gonna open up our portal today.

The estimated time is at 3 o'clock. If it doesn't open up exactly at 3 o'clock, it's okay. It's gonna open up today.

It's going to close 9:00 AM on June 22nd. Between June 22nd to mid-July, we are going to go through the review process and decisions will be— notifications on funding decisions. Our goal is late July. Our goal is that funding and program work starts August 1st. So you can see this compressed timeline that we are under.

And again, I just want to appreciate all of the work that ACF and their team has put into developing this grant process, to our staff that have been working very closely with CMS And to all of you that have asked us really, really good questions, we are creating this program as we are all learning from each other, and this is the timeline that is before us. I do want to reiterate, though, of the 403 proposals, um, there, the funding request exceeds the available funding. And so I see many questions about Can I shore it up? Will that make my application more competitive? I would say it, it will definitely help the dollar go further, but make sure that you're really focusing in on answering the questions as Megan walked you through the different elements of the application.

Alison communicated, make sure it's just really clear what your intent in and how it aligns to RHTP goals. All of us are here to help answer any questions that you may have as you are developing a very competitive application. Next slide.

So to stay informed, we continue to update our website. We will have a recording, a transcript of this recording, and the documents on our website later today. There, our email is also available, [email protected]. Next slide.

All right, so we are at the end. We have 13 minutes and we are going to try to answer as many questions as we can. Thank you to everyone that has been posting questions in the chat. I know that a handful of our staff have been trying to answer them as we've been working through this presentation, but I do think it would be good to start from the top. And so I'm not sure, Emily, are you in a position to start your review of questions, or should I start with somebody else?

Commissioner, I defer to you. Okay. Well, why don't we start with Trish? Why don't you answer one of the questions, which is about workforce?

Which one, please? Well, there was a couple of them. One was FTEs and clinicians. Yeah, that one was a little more complicated, so I put kind of a longer response and some links to information. So, when we're funding provider payments, those are payments to healthcare providers for providing healthcare services that are not paid by insurers or other programs.

If we're funding an individual clinician for recruitment and retention purposes, That's when our 5-year service commitment would apply. And those 2 points, the provider payments and the 5-year service commitment, actually have CMS guidance documents that could help you flesh out some of those nuances. And then there's this project staffing cost. So, of course, this allows you to do personnel costs for these projects if they don't fall under provider payments or clinician service commitment type payments for recruitment and retention. Perfect.

Here's Beth. Bethany, do you want to add into that, or we might jump back to performance periods, budget periods? Yes, I think I want to touch on— I saw some questions coming in in the chat around the LOI periods and the performance periods. Performance periods. And I think this is a place where, you know, like I said, we've introduced it here today in the webinar.

We'll be putting more information on our website when you see the Applicant Resource Guide posted to the website later this afternoon. It will have some discussion in there, but I think it's helpful to be thinking about as we move forward through the program, this round of funding that we're working on now, we're calling it the spring cycle. So you, you should be able to anticipate that every year there will be an application and funding process that generally follows the same timeline and is aligned off of these budget periods that begin, you know, kind of mid-year and go to mid-year. That's one budget cycle, the July through the end of June performance period and budget cycle. And then as I foreshadowed and mentioned, we are looking ahead to a future funding round, and we anticipate that we would have a second cycle.

That's our fall cycle where we start that application process. This year, it'll come, you know, hot on the heels of this one, that there will be another funding opportunity that opens in the fall, and we'll make decisions, you know, through the fall and into the winter, but we're targeting having performance periods for that fall cycle begin on the first of the calendar year. Mm-hmm. I think it's helpful to think about that the performance periods, regardless of whether your project is on this spring cycle or your project enters onto a fall cycle, that the performance period is always going to be 12 months. That's helpful for you from a planning purposes perspective.

You know, we think about— there are a lot of really great projects that are coming in, and I may answer, I think, one of some of the other questions that we've come in where organizations have said, like, "Should I submit an application for all of the ones that advance?" We wanna think about where to focus our efforts, where to focus our energies, and I will get to that in a second. But on the budget period piece of it, I think it's helpful to think about if you can plan your projects in 12-month time blocks, that allows you to take those projects if we're unable to advance it in this round, but you say, "Wow, I really wanna try again in the next," you've already done the work in that same time period. So the performance periods should be 12 months regardless going forward. Before I address the multiple projects, Megan, is there anything that you would add on the performance periods that you think is helpful for people to know? I, I think the only thing that I think is helpful is that we worked really hard to make sure that those align with typical fiscal year quarters as well, so that you're not having to, to create custom reporting, financial reporting systems that it'll already be on a quarterly cadence that your accounting and finance teams are familiar with.

Thanks, Megan. Then the next one that I'd like to mention, I saw a question in there about, okay, I've got multiple projects. Should I move forward with all of them? Are you giving organizations, do we each only get one? How does this work?

I think, you know, if you— we would recommend that you submit an application for what you have put forward. If your organization has the capacity to implement all of your LOIs that have moved to this stage, if you say we could really do it for all of them, put that application forward. However, I say that with the caveat that there is a question in the in the application that asks if you have multiple applications in, can you please prioritize them for us? Can you rank, you know, put them in order so that when we are making decisions, if it does look like, wow, we may not be able to move forward all of this organization's applications, we'd really like to know which one is your biggest priority. That's helpful for us.

And I think, you know, as we've built this process and have moved through this process, We've learned a lot and we'll continue to learn a lot each time. And that's certainly something that we've taken away that we're very interested to know what is your highest priority. Yep. Betsy, there's a really good question. How much funding do we expect to be available for the next cycle?

And I think that you've touched on this a little bit, but again, to rephrase, $272 million is year 1. We are prioritizing, um, the, the funding towards the request through this LOI process. There are some state activities, but it's very small and very limited. Again, all of the work that we are doing is focused on the transformation of the healthcare system, improving health outcomes across our 3 goals that represents 6 different initiatives. The year 2 cycle— and Betsy, I want you to correct me if I'm wrong— some of the year 1 will have continuing funding needs because it's a multi-year application.

And so there will be funding available for new projects in year 2, but there's also gonna be funding for projects carrying on from year 1 to year 2. We don't know what those percentages are going to be because this is live action as we are creating this with all of you in real time. Betsy, do you want to clarify anything?

I think you didn't misspeak. You've got it correct, Commissioner. And I would just say, as we think ahead to a fall funding cycle, we are trying to get into a cadence where we can have applications applications come in, we can understand what the asks are. We can be thinking about what that looks like so that we're, that we're ready to execute as we understand what the state's following year's awards are. So I can't answer exactly how much will be available in the next cycle, but we're hopeful that if we all are successful in the projects that we do and that we fund, that we will be able to continue to maintain or even increase the state's Exactly.

Here's another question. Betsy, and you can call many lifelines if you would like. This question is regarding procurement. So putting your procurement brain on the federal requirements, what is CMS looking for if a hospital wants to do a sole source or there's different types of contractual engagements by hospitals by a clinic, what do they need to do to get under contract? Are pre-awards— so can they sign a contract today even though they're not awarded funds, and can they retroactively reimburse that contract?

Can you describe the pre-award and procurement rules? Well, I— the procurement rules is a more in-depth question, and I would say that in our— You know, I think that we'll put out as much guidance as we can. Megan, I may call on you for a little bit of a lifeline to help folks understand where they should be looking to understand what federal procurement rules they may need to align with underneath the grant. What I will address is with the kind of, can we sign pre-contracts? Can we start things ahead of time?

My advice, what we've heard heard from CMS is not to execute any activities until you have received an award. I think it would be risky to enter into a contract that is dependent on you receiving this award. As the Commissioner has mentioned, this is still a competitive cycle, so I would advise you to be thoughtful about that, about those choices. Perfect. Thank you.

And we are almost at time. We have 3 minutes. So we're gonna speed up the question and the answer just a little bit. The next question is, are we going to continue to have office hours? And the answer is no.

We are recording this. We are sharing it with everyone. We do believe that the slide deck and this Q&A is very beneficial. If you have questions that were not answered, you need to email either the Department of Health or OACF, we work hand in glove together hourly. So we will make sure to get your questions answered.

The second comment really, and I think this is part of the strategy, is hedging. If we need full funding but we only submit for half of the funding, is that a really good idea? And I think we would all have a different answer to that. Betsy, Emily, do either of you want to take that question?

Is partial funding an option? That's the question.

So, Betsy, I can, I can do this if you want. So what I would recommend is if you have a project that you think will span multiple years, or if you have a project where there are some alternatives that could result in the project being successful with partial funding, I think it would be helpful to include that in the application, and there are ways that you can do that. Again, we want to fund as many projects as possible. We also know that the amount of funding we have does not meet the level of interest from entities, and that's okay, right? Because this is a multi-year project.

So this is just year 1, and year 2 is coming right around the corner. But it would be helpful for us again, if your project can be successful and there are alternative ways to fund that project over different time periods to help identify that for us. Perfect. Thank you. And I would just add one thing that, that to me the question is, is around, you know, if I had, if I asked for this much, I could do this amount, but if I received this much, I could still do something, but it would be a smaller amount.

As Deputy Commissioner Ricci mentioned, that's really helpful for us to know if there's some scalability in that ask. I will flag if there is another funding source that can cover your project that you would wanna be really thoughtful about whether or not this is the right funding opportunity for that, right? Mm-hmm. You know, we were very cautious about avoiding supplanting other funding sources, and if there is another identified avenue for you to fund your project, you know, there are a lot of asks here, and, and we would recommend that you would pursue other opportunities if they're available to you too. Great.

Thank you so much. And I'm gonna round out the last question and then close us out. But there's, uh, one last question about planning grants. It was asked by several entities. Much of the content of this webinar, uh, for the implementation pathway applies to the planning pathway.

There is a much, much, much smaller number of planning awards, and so we will be reaching out to you to share that work plan and that budget because we do need that information so we can report it back to CMS. I am going to now close this out. Thank you all for your participation today. We are here to help you through this application process. Take care.

Bye-bye. Thank you.