Regional Disaster Health Response System Frequently Asked Questions

The awards will be granted to partnerships that include one or more hospitals, at least one of which shall be a designated trauma center, one or more other local health care facilities, including clinics, health centers, community health centers, primary care facilities, mental health centers, mobile medical assets, or nursing homes; one or more political subdivisions; one or more States or one or more states and one or more political subdivisions, and one or more emergency medical service organizations or emergency management organizations. The awards focus on the rapid expansion of medical surge capacity of the existing healthcare system, coordination of patient and resource movement to support disaster response, and the swift involvement of highly specialized clinical professionals. Accordingly, the involvement of both public- and private-sector health care partners is essential. The composition of these partnerships is required under the statutory authority that authorizes these funding awards. For additional details, see Section 319C-2 of the Public Health Service (PHS) Act (42 U.S.C. § 247d-3b), as amended.

A primary objective of this cooperative agreement is to establish a statewide partnership of health care and governmental partners relevant to the coordinated delivery of patient care in disasters. There is no limitation on the number of entities that can participate in the partnership. Applicants will propose an overall governance structure for the partnership, including the roles and responsibilities of all participating entities and organizations. While the direct and primary recipient in a cooperative agreement program must perform a substantial role in carrying out project objectives and not merely serve as a conduit for an award to another party or provider who is ineligible, it is not expected that they conduct all of the activities and objectives described in this cooperative agreement. Therefore, it is not expected that a single hospital provides statewide care.

Eligible applicants are defined in the statutory authority for this cooperative agreement, section 319C-2 of the Public Health Service (PHS) Act (42 U.S.C. § 247d-3b), as amended. Unless a hospital association can be described as a “hospital”, “local health care facility”, or “political subdivision” or “state” or “emergency medical service organization”, or “emergency management organization”, then it is not an eligible entity and thus cannot be a primary applicant. However, hospital associations would be welcomed as an additional (optional) partner by submitting a letter of support and ensuring that the applicant clearly defines the role and responsibilities of this partner in achieving the requirements of the cooperative agreement.

Eligible applicants are defined in the statutory authority for this cooperative agreement, section 319C-2 of the Public Health Service (PHS) Act (42 U.S.C. § 247d-3b), as amended. One of the required members of the partnership is “one or more political subdivisions, one or more States, or one or more States and one or more political subdivisions.” A political subdivision is a local government, such as a territory or freely associated state, county, city, town, or village. Authorized departments or agencies that are part of a political subdivision office are eligible to apply as part of the partnership.

The awards will be granted to partnerships that include one or more hospitals, at least one of which shall be a designated trauma center, one or more other local health care facilities, including clinics, health centers, community health centers, primary care facilities, mental health centers, mobile medical assets, or nursing homes; one or more political subdivisions; one or more States or one or more states and one or more political subdivisions, and one or more emergency medical service organizations or emergency management organizations. Although applicants are welcome to partner with entities from other states as optional partners, the required members of this partnership as outlined above must be from the same state. Accordingly, political subdivisions or states can only serve as the primary applicant for one application. However, additional political subdivisions and/or neighboring states would be welcomed as an additional (optional) partner by submitting a letter of support and ensuring that the primary applicant clearly defines the role and responsibilities of this partner in achieving the requirements of the cooperative agreement.

The applicant must be a partnership comprised of (1) hospitals (including at least one trauma center), (2) health care facilities, (3) one or more political subdivisions and/or one or more States (this could be the State Health Department), and (4) one or more emergency medical service organizations or emergency management organizations. The applicant will have to designate a primary recipient, which according to the statutory authority for this cooperative agreement can be any of those entities. However, please note that the scoring criteria favors primary applicants that have experience with direct patient care and can demonstrate capability for the ongoing, complex clinical management of patients requiring specialty expertise in (1) chemical, (2) radiation, (3) burn, (4) trauma, (5) high consequence infectious disease, and/or (6) pediatric care. Furthermore, a large proportion of the points awarded to applicants are tied to the Partnership’s ability to carry out the required capabilities listed in the NOFO, and many of these are highly clinically focused and will require ongoing participation and ownership from the health care community. Strong applications will clearly demonstrate the participation and buy-in from hospitals/trauma centers, health care facilities, and the clinical experts needed to be successful in the NOFO objectives.

The ACS sets the standards for Trauma Center Designation. A Trauma Center (TC) is designated in one of two ways: (1) TC directly contacts the ACS Verification Program or (2) The State has passed laws for its own designation process and the designations are done at the State level. ASPR strongly encourages partnerships to include an ACS/COT designated Level 1 trauma center.

To be eligible for an award through this announcement an entity shall be a Partnership consisting of the following required members:

• one or more hospitals, at least one of which shall be a designated trauma center;
• one or more other local health care facilities, including clinics, health centers, community health centers, primary care facilities, mental health centers, mobile medical assets, or nursing homes;
• one or more emergency medical service organizations or emergency management organizations;
• one or more States and/or one or more political subdivisions;
• and one or more emergency medical service organizations or emergency management organizations

The lead applicant for this award could be any one of the entities described above (e.g., a hospital, designated trauma center, a local health care facility, a political subdivision or state) applying on behalf of the partnership or a partnership or other legal entity consisting of all of the required members listed above.

Eligible applicants are defined in the statutory authority for this cooperative agreement, section 319C-2 of the Public Health Service (PHS) Act (42 U.S.C. § 247d-3b), as amended. Unless an academic medical institution can be described as a “hospital”, “local health care facility”, or “political subdivision”, or “state”, or “emergency medical service organization”, or “emergency management organization”, then it is not an eligible entity and thus cannot be a primary recipient. However, academic medical institutions would be welcomed as an additional (optional) partner by submitting a letter of support and ensuring that the applicant clearly define the role and responsibilities of this partner in achieving the requirements of the cooperative agreement.

The awards will be granted to partnerships that include hospitals (including at least one trauma center), health care facilities, one or more emergency medical service organizations or emergency management organizations, and one or more political subdivisions and/or one or more States. The composition of these partnerships is required under the statutory authority that authorizes these funding awards. For additional details, see Section 319C-2 of the Public Health Service (PHS) Act (42 U.S.C. § 247d-3b), as amended. The State Office of EMS must send a letter of support for the overall application to be considered.

The awards will be granted to partnerships that include hospitals (including at least one trauma center), health care facilities, one or more emergency medical service organizations or emergency management organizations, and one or more political subdivisions and/or one or more States. The composition of these partnerships is required under the statutory authority that authorizes these funding awards. For additional details, see Section 319C-2 of the Public Health Service (PHS) Act (42 U.S.C. § 247d-3b), as amended.

A primary goal of the cooperative agreement is to establish strong, statewide partnerships across health care, public health, emergency management, EMS, and other critical partners focused on specialized clinical care in disasters. Although applicants are welcome to partner with entities from other states, the required members of this partnership as outlined above must be from the same state. 

However, for States that do not have Trauma centers, partnerships may include Trauma centers in neighboring States that are willing to become partners. The application must clearly demonstrate how funds will be shared with the Trauma center despite the fact it is in different State from the partnership.

The Regional Disaster Health Response System aims to establish a network that coordinates both state-level clinical response assets and multi-state regional assets. This NOFO focuses primarily on the maturation of state-level medical surge and specialty clinical care in response, and therefore partnerships include primarily state-level entities.

Through these demonstration sites, however, ASPR aims to demonstrate the effectiveness and viability of the overall RDHRS concept – including the regional mechanisms for sharing clinical expertise and coordinating patient care across state lines. ASPR prioritized building an RDHRS across the nation which includes a demonstration site in each HHS Region. Currently, demonstration sites have been established in Region 1, Region 7, and Region 8. Applicants from the same region may apply so long as all application criteria are met, and there is no overlap in function.

While applicants are not awarded any designated priority or preference for involvement of regional partners, it is a desired component throughout all 5 required capabilities and will therefore be considered as part of the overall application’s review.

Eligible applicants are defined in the statutory authority for this cooperative agreement, section 319C-2 of the Public Health Service (PHS) Act (42 U.S.C. § 247d-3b), as amended. Unless a health care system can be described as “one or more hospitals”, “one or more other local health care facilities”, or “one or more political subdivisions” or “one or more states” or “one or more emergency medical service organizations”, then it is not an eligible entity and thus cannot be a primary recipient.

This NOFO focuses primarily on the maturation of regional-level medical surge and specialty clinical care in response; however, strong foundations at the state level are key components and therefore the required partnerships include primarily state-level entities. The eligibility criteria in the statute does allow for a partnership to consist of “one or more states” or “one or more political subdivisions”. In addition, involvement of regional partners is a desired component across all 5 required capabilities and will therefore be considered as part of the overall application’s review.

Of note, there is also an applicable funding preference that can be applied for demonstration of “Regional Coordination” as described here: “The partnership demonstrates how it will enhance coordination among the hospitals and designated trauma center and between other local health care facilities, including clinics, health centers, community health centers, primary care facilities, mental health centers, mobile medical assets, or nursing homes and includes a significant percentage (greater than 51%) of the hospitals and health care facilities within the geographic area served by such partnership.”

Should applicants partner with entities across state lines, letters of support from the partnering state’s State Office of Public Health/Health, State Trauma Advisory Council (or equivalent), or State Office of Emergency Medical Services are not required unless the partnership is meant to be encompassing of “one or more states” in their entirety. For example, if the partnership is intended to be inclusive of the whole state of New York and the whole state of New Jersey, then letters of support from both states’ required entities will be requested. However, if the state of New Jersey would like to include New York City in their partnership, letters of support for state entities in New Jersey are required while those in New York are not.

Grant funds may be used to cover the costs of personnel, consultants, equipment, supplies, grant-related travel, and other grant-related costs.

Please refer to the NOFO for a complete list of funding restrictions.

ASPR is not designating a specific percentage of funding for management and admin costs. The Budget Summary is used to determine reasonableness and allowability of costs for the project. All of the proposed costs listed, whether supported by federal funds or non-federal funds, must be reasonable, necessary to accomplish project objectives, allowable in accordance with applicable federal cost principles, auditable, and incurred during the budget period.

Additionally, the direct and primary recipient in a cooperative agreement program must perform a substantial role in carrying out project objectives and not merely serve as a conduit for an award to another party or provider who is ineligible.

The purpose of this NOFO is to fund one demonstration project that will help identify issues, develop promising practices, and demonstrate the potential effectiveness and viability of the RDHRS concept. Specifically, the Partnership will implement and demonstrate the 5 specific capabilities listed in the NOFO, each with a number of associated objectives and activities. Accordingly, funding for this NOFO is meant to implement a demonstration project rather than conceptualize a concept.

Grant funds may be used to cover costs of: personnel, consultants, equipment, supplies, grant-related travel, and other grant-related costs. Applicants should include personnel costs in the required Budget Narrative/Justification as shown in Attachment B.

All costs directly related to the Partnership for Disaster Health Response Cooperative Agreement Notice of Funding Opportunity project activity and within scope of the approved budget that are consistent with the statutory authority for this award (section 319C-2 of the PHS Act, as amended) and applicable regulations including the Cost Principles in 45 CFR. Part 75, subpart E may be charged directly to the cooperative agreement. “Reimbursable expenses” are only paid through the subcontract cost category of the budget and such expenses are direct charges to the cooperative agreement. Attachment B “Budget Narrative/Justification - Sample Format” provides example and definitions of the cost categories.

Applicants may reference Attachment B “Budget Narrative/Justification - Sample Format” and Attachment C “Project Work Plan and Timeline - Sample Template” for guidance in preparing their budgets.

Recipients are expected to use all awarded funds for the approved project Activity and Budget.

There is not a cap on Personnel support funding or number of personnel.

Travel costs for partners, sub-contractors and sub-recipients of the Partnership for Disaster Health Response Cooperative Agreement Notice of Funding Opportunity award to participate in site visits are allowable as direct costs to the cooperative agreement provided the recipient has policies and procedures for site visits and travel of personnel and such costs are in the approved budget.

Applicants may reference various tools via the internet to determine the labor market rate for professions. ASPR does not endorse any internet tools. Applicants may also reference the Bureau of Labor and Statistics for compensation ranges.

Yes. Applicants are encouraged to demonstrate their organizational capacity of executing the tasks provided in the Partnership for Disaster Health Response Cooperative Agreement Notice of Funding Opportunity.

Yes. Such tasks must support the Partnership for Disaster Health Response Cooperative Agreement Notice of Funding Opportunity as detailed in the proposed budget.