Recovery Assistance for Physicians and Medical Practitioners

Table of Contents

Medicaid and Medicare Funded Health Information Technology

Recovery Funds

  • $14 billion nationwide

New York State's Share

  • To be determined

The Recovery Act provides a federal contribution to the amounts States pay as incentives to providers to adopt electronic health records (EHR). Health care providers, including hospitals are eligible.

A formula adjusts a base annual incentive payment, including discharge and other factors. Outlays are not expected until 2010-2019.

On May 15, 2009 the U.S. Department of Health and Human Services released its plan for Accelerating the Adoption of Health Information Technology.

On September 1, 2009, the Center for Medicaid and State Operations issued initial guidance on the States' administration of the incentive payments, outlining the timeline and necessary steps that must occur before payments can be made.

On December 9, 2009, CMS announced New York was one of the first seven States to be awarded funds for planning activities. Approximately $5.91 million can be used to ensure proper incentive payments through audits and to promote interoperability and meaningful use of electronic health records.

Other Information Technology to Foster Electronic Health Records (EHR)

Recovery Funds

  • $2 billion nationwide

New York State's Share

  • To be determined

National Coordinator for Health IT (ONCHIT) to oversee:

  • Privacy and Security, $24.285 million
  • National Institute of Standards & Technology, $20 million
  • Regional HIT Exchange, $300 million
  • Unspecified, $1.7 billion

On May 15, 2009 the U.S. Department of Health and Human Services released its plan for Accelerating the Adoption of Health Information Technology.

On August 20, 2009, ONCHIT set aside $564 million to be distributed to states through cooperative agreements which will be used to advance the necessary governance, policies, technical services, business operations and funding mechanisms for health information exchange, building off existing efforts to advance regional and state level towards nationwide interoperability.

On the same day, ONCHIT also announced that certain not-for-profit organizations are eligible to compete for grants for the HIT Extension Program, Regional Centers Cooperative Agreement Program. On November 25, the original amount announced was increased by $42 million to a national total of $640 million and the award cycle was compressed from three application deadlines to two: preliminary applications for the first round were due September 8, 2009, and for the second, December 22, 2009. More information on eligibility requirements and submitting applications.

Also on November 25, 2009, ONCHIT announced that $70 million would be awarded competitively across the country to public and private institutions of higher education, targeted especially to community colleges, to develop and strengthen training programs for health information technology professionals.

  • Five awards are expected to be made, with a minimum amount of $6.2 million and a maximum of $21.15 million.
  • Applications are due January 22, 2010.

Another $10 million in Recovery funds has been set aside by ONCHIT for up to five institutions fo higher education to develop materials for these programs: Information Technology Professionals in Health Care: Curriculum Development Centers. Applications are due January 14, 2010.

On December 2, 2009, ONCHIT announced that $235 million in competitive grants would be awarded through a new Beacon Community Cooperative Agreement Program.

  • Eligible applicants include state, county, city, township, special district and tribal governments; institutions of higher education and not-for-profit organizations. However, selected communities must already be national leaders in the advancement of health information technology and have advanced rates of electronic health record adoption and health information exchange.
  • ONCHIT expects to make 15 awards, totaling $220 million, with an award ceiling of $20 million and floor of $10 million.
  • $15 million is set aside to provide technical assistance and to evaluate the grant recipients.
  • Applications are due February 1, 2010.

On December 17, 2009, three more HIT training related opportunities were announced, all with applications due January 25, 2010:

  • $6 million to be awarded to an institution of higher education, or a consortia of colleges and universities, to develop and initially administer a set of health information technology competency examinations.
  • $32 million to be awarded to up to 11 public or private four-year institutions of higher education, or consortia of institutions that can include community or career colleges, to expand or create programs leading to a baccalaureate degree, masters degree, or certificate of advanced studies in one or more of the following six targeted roles:
    • clinical / public health leader;
    • health information management and exchange specialist;
    • health information privacy and security specialist;
    • research and development scientist;
    • programmer and software engineer; and
    • health IT subspecialist.
  • $60 million, with a minimum award of $10 million and a maximum of $18 million, to be awarded to approximately four public or private institutions or other organizations with a research mission, to establish Strategic Health IT Advanced Research Projects (SHARP) to focus on where breakthrough advances are needed to address well-documented problems that have impeded adoption of health IT and to accelerate progress towards achieving nationwide meaningful use.

NYS Recovery Act Handbook

Health Research – National Institutes of Health (NIH) and Agency for Healthcare Research and Quality (AHRQ)

Recovery Funds

  • $10.4 billion nationwide
    • $1.8 billion is targeted for infrastructure, both at NIH buildings and other research facilities, for construction projects and equipment purchases,
    • $400 million for comparative effectiveness research (to AHRQ),
    • $8.2 billion for research ($7.4 billion to common fund for percentage formula distribution, and $.8 billion to Director's discretion, for example, Challenge Grants).

New York State's Share

  • NIH lists the over 1,200 awards, totaling over $407 million, that have been made directly to research facilities in New York State on its web site. Specific details about the nature of the research and the amount of each award are also posted. In addition, NIH has granted New York State over $3 million in supplements to employ about 250 students and teachers in summer research projects.

The Recovery Act provides funds for health research to focus on specific knowledge gaps, scientific opportunities, new technologies, data generation, or research methods and to improve the facilities to accommodate accelerated research. Grant opportunities continue to be announced.

On September 18, 2009, NIH announced a new program: Building Sustainable Community-Linked Infrastructure to Enable Health Science Research, or the Infrastructure Grants program.

  • $30 million to be awarded to support the development, expansion, or reconfiguration of infrastructure needed to facilitate collaboration between academic health centers and community-based organizations for health science research, to accelerate the pace, productivity, dissemination and implementation of health research.
  • Eligible applicants include: institutions of higher education; independent school districts; state, county, municipal and tribal governments; both for profit and non-profit businesses; and regional organizations.
  • NIH expects to award 30 or more grants. Applications were due December 11, 2009.

On September 25, AHRQ two new limited competitive grants for comparative effectiveness:

  • Clinical and Health Outcomes Initiative in Comparative Effectiveness (CHOICE) Grants
    • $100 million expected to be awarded to 10 large projects aimed at generating new knowledge to help inform decision making in priority areas of clinical care; specifically, arthritis and non-traumatic joint disorders; cancer; cardiovascular disease, including stroke and hypertension; dementia, including Alzheimer's disease; depression and other mental health disorders; developmental delays, attention-deficit hyperactivity disorder and autism; diabetes mellitus; functional limitations and disability; infectious diseases including HIV/AIDS; obesity; peptic ulcer disease and dyspepsia; pregnancy including pre-term birth; pulmonary disease/asthma; and substance abuse.
    • Eligibles include State, local and tribal governments, institutions of higher education, and faith-based and community-based organizations.
    • Letters of intent were due November 18; applications, December 16, 2009
  • Innovative Adaption and Dissemination of AHRQ Comparative Effectiveness Research Products (iADAPT) Grants
    • $29.5 million to be awarded, with a grant ceiling of $1.5 million for innovative customizations or adaptations to the content presentation and/or delivery mechanisms to increase their use, implementation and impact among difficult-to-reach populations, including the elderly, those with limited English proficiency, limited education or insurance coverage, minority or immigrant status, health literacy problems, or other underserved populations.
    • Eligibles include State, county and tribal governments, institutions of higher education, and faith-based and community-based organizations.
    • Applications were due December 16, 2009.

AHRQ announced another two new comparative effectiveness research (CER) grant limited competition opportunities on December 8, 2009.

  • Prospective Outcome Systems using Patient-specific Electronic data to Compare Tests and Therapies (PROSPECT) projects to advance the quality, depth and scale of electronic data collection infrastructure and to enhance the nation's ability and capacity to systematically collect prospective data to inform CER on diagnostics, therapeutics, devices, behavioral interventions, and procedures used in clinical care, especially in populations who are typically under-represented in randomized control clinical trials or who have limited access to healthcare.
    • Eligible institutions include units of local, tribal, State and Federal government; institutions of higher education; and faith-based or community-based organizations.
    • $44 million is available over three years to be awarded to an estimated five recipients in amounts between $1.5 million and $3 million per year.
    • Letters of intent are due January 27 and final applications February 17, 2010.
  • Electronic Data Methods (EDM) Forum for Comparative Effectiveness Research to engage large conference support to advance methods related to the development of the infrastructure and methodology for collecting and analyzing prospective data from electronic clinical databases. The planned EDM Forum will convene a series of meetings and workshops for the investigators from PROSPECT studies in order to identify the challenges and to propose realistic solutions to their resolution.
    • $4 million is expected to be awarded to one recipient over a maximum of three years.
    • Applications were due January 20, 2010.

On December 11, 2009, AHRQ announced two additional limited competitions, both with applications due January 20, 2010 to provide supervised study and research to cohorts of clinical and research doctorates:

On December 17, 2009, AHRQ announced a limited competitive opportunity, Comparative Effectiveness Research to Optimize Prevention and Healthcare Management for the Complex Patient, with $6 million available nationwide to be awarded to between 12 to 18 recipients.

  • Eligible applicants include Federal agencies and local, tribal and State units of government; institutions of higher education; and public or non-profit institutions such as faith-based or community-based organizations.
  • Letters of intent were due January 8, 2010 and full applications on January 20, 2010.
  • Applications must fall into one of three categories, with differing project budget limits and varying durations:
    • Epidemiologic descriptions based on secondary analysis of large data sets of specific chronic illnesses.
    • Analytic epidemiologic studies to assess benefits and harms of preventive and therapeutic interventions for patients who have multiple chronic co-morbid conditions.
    • Modeling studies.

A related limited competition grant opportunity was announced on December 22, 2009: Expansion of Research Capability to Study Comparative Effectiveness in Complex Patients. AHRQ expects to make twelve awards, totaling $12 million, for two year projects that will build or enhance partnerships, datasets and methodologies to improve the capacity to study, and the quality of studies, of patients with multiple chronic illnesses. Competition is open to the same eligible entities as above with the same application deadline of January 20, 2010.

On November 2, 2009, NIH announced a limited competitive grant opportunity: Administrative Supplements to Support Core Consolidation.

  • Approximately $15 million available nationwide to encourage such activities as:
    • Merging two core facilities from different departments or campuses into a single core;
    • Moving equipment to make it accessible to a much larger group of investigators;
    • Consolidating two different technologies; or
    • Combining core facilities at different institutions into a single facility.
  • Applications were due January 13, 2010 and may contain requests for no more than $500,000 for equipment, no more than $500,000 for alteration and renovation, and no more than $200,000 for direct costs such as personnel and supplies.

On December 28, 2009, NIH announced five new limited competition grant opportunities. Three of them, for a total of $30 million, target advancing comparative effectiveness research, generally, through clinical trials, pilot research and methodology development; one CER opportunity for $15 million is specifically for gastro-esophageal reflux disease, for eradication of MRSA and for dementia detection and management strategies. The fifth opportunity valued at $80 million is for Directors awards in five thematic areas, including genomics, global health and using science to advance health care reform. Eligible entities includes, State local and tribal units of government; institutions of higher education and independent school districts; for profit and small businesses and non-profit organizations; community-based and faith-based organizations and public housing authorities. Applications vary for each opportunity with due dates between February 26 and April 7, 2010.

On January 4, 2010, NIH announced that $3 million is available nationwide for a limited competitive grant opportunity: Research on Biosamples from Selected Diabetes Clinical Studies. Funds may be used to access and/or perform validated laboratory assays on non-renewable (non- DNA) samples generated by six specific NIDDK-funded clinical trials and studies. Between five and ten awards are expected to be made, with a maximum grant of $400,000 each for two year projects. Eligible entities includes, State local and tribal units of government; institutions of higher education and independent school districts; for profit and small businesses and non-profit organizations; community-based and faith-based organizations and public housing authorities. Applications are due March 11, 2010.

Also on January 4th, NIH advised current grant recipients with comparative effectiveness research projects that they are eligible to submit an application for administrative supplements, not to exceed $500,000, to develop, expand and/or increase CER training, education, and career development. Up to sixteen awards will be made with applications due March 1, 2010.

On January 5, 2010, NIH announced that current grant recipients may apply for supplemental administrative funds to provide an opportunity to introduce basic behavioral and social science research (b-BSSR) into their NIH-funded research projects. Between ten and twenty awards will be made, totaling $2 million nationwide. Applications are due February 18, 2010.

On January 11, 2010, NIH announced that $14 million would be available nationwide to support approximately five to ten grants of between $300,000 and $3 million per award for Accelerating the Adoption of Comparative Effectiveness Research Results by Providers and Patients. Applications are due March 11, 2010 and the following types of organizations are eligible:

  • Integrated health care systems
  • Integrated provider systems
  • Academic medical centers
  • Provider consortia
  • Community health center networks
  • Private payers
  • Other non-governmental organizations that administer or directly provide health care services
  • Organizations that serve health care consumers
  • University-based school (e.g. School of Public Policy or Public Health)
  • Private research institutes

On January 13, 2010, NIH announced a limited competitive grant opportunity of $25 million, the Institutional Comparative Effectiveness Research Mentored Career Development Award. Research-intensive institutions, including State and tribal governments, non-profit and for profit organizations (except small businesses) and colleges and universities can submit applications to support mentored career development in support of CER in an interdisciplinary environment catering to the needs of diverse populations of scholars including those with backgrounds in biostatistics, epidemiology, health economics, pharmacology, medicine, and dentistry. Between eight and ten awards are expected, each limited to no more than $2.5 million for a project that lasts up to three years. Applications are due March 25, 2010.

On January 21, 2010, AHRQ announced two limited competitive grant opportunities for:

  • Enhanced Registries for Quality Improvement and Comparative Effectiveness Research.
    • Grants must be used to develop the infrastructure and improve the methodology for collecting prospective data from electronic clinical databases in order to generate new evidence on the comparative effectiveness of healthcare interventions.
    • City, county, State and tribal governments and institutions of higher education, along with eligible Federal agencies, can submit applications which are due March 29, 2010.
    • AHRQ expects to make two awards for projects not to exceed three years and annual budgets below $4 million.
  • Scalable Distributed Research Networks for Comparative Effectiveness Research.
    • Funds must be used to enhance the capability and capacity of electronic health networks designed for distributed research to conduct prospective, CER on outcomes of clinical interventions, including but not limited to diagnostics, therapeutics (drugs and biologics), medical devices, behavioral interventions and surgical procedures used in clinical care.
    • State, local and tribal governments, certain Federal agencies and public or non-profit institutions such as colleges and universities and community-based and faith-based organizations can submit applications which are due March 10, 2010.
    • AHRQ expects to make three awards for projects not to exceed three years and annual budgets below $2.77 million.

On January 26, 2010, NIH announced that institutions of higher education could compete for one-year grants to enhance their infrastructure and opportunities for training post-doctoral investigators to carry out innovative, multidisciplinary research in Global Health. Between six and ten awards are expected, capped at $250,000 for single institutions and $400,000 for consortia. Applications are due March 22, 2010. A second small grant for Global Health Research Involving Human Subjects in low- and middle-income countries was announced January 28, 2010. National funds total $650,000 with 12 - 13 grants expected to be awarded. In addition to institutions of higher education, nonprofit organizations are eligible with applications due March 22.

On February 2, NIH announced a new $7 million grant opportunity to Support Comparative Effectiveness Research for Eliminating Disparities (CERED). Eligibles are limited to only those institutions/organizations with active National Center on Minority Health and Health Disparities (NCMHD) grants for Exploratory Centers of Excellence and Comprehensive Centers of Excellence. NIH expects to make five awards for projects not to exceed two years with budgets capped at $1.4 million. Applications are due April 6, 2010.

National Institute of Health(NIH) / National Center for Research Resources (NCRR) make awards directly to successful applicants, including public or private institutions of higher education.

New York Recovery Act Handbook

Workforce Training: US Department of Labor

Recovery Funds

  • $500 million allocated nationwide for adult employment
  • $250 million nationwide for competitive grants in high growth & emerging industries

New York State's Share

Funds from the US Department of Labor (USDOL) are awarded to the NYSDOL to support One-Stop employment centers and to distribute through local workforce training boards to community colleges and other training facilities. Funds are used to train adults and place them in jobs, including the health care sector.

A competitive grant opportunity for worker training and placement in health care jobs was announced by US DOL in late July, with applications due October 5, 2009. Public entities or private nonprofit entities, local Workforce Investment Boards and their One Stop Systems, Tribal organizations, education and training providers, labor organizations, health care providers, and faith-based and community organizations are eligible.

New York Recovery Act Handbook

Workforce Training: US Health and Human Services; Health Resources and Services Administration (HRSA)

Recovery Funds

  • $500 million nationwide

New York State's Share

  • To date, $.5 million; more is expected later this year.

The Recovery Act provides supplemental funding for HRSA Financial Aid for Health Professions Students & Practitioners programs, such as National Health Service Corps and the Nursing Education Loan Repayment Program.

In exchange for their grants or loan repayments, recipients are required to serve a minimum of two years in a community that has a shortage of doctors, nurses and other healthcare professionals.

HRSA announced a new program, SEARCH, Student / Resident Experiences and Rotations in Community Health, to strengthen systems of care in underserved communities through the development of links between community-based sites and academic institutions. Proposals were due July 20, 2009.

Also, HRSA has announced how it will target and distribute $200 million of the available funds:

  • $80.2 million for scholarships, loans and loan repayment awards to students, health professionals and faculty:
    • $39 million for nurses and nurse faculty,
    • $40 million to disadvantaged students in a wide range of professions, and
    • $1.2 million to health professions faculty from disadvantaged backgrounds.
  • $50 million in grants to health professional training programs to purchase equipment needed to expand programs and improve the quality of the training.
  • $47.6 million to support primary care training programs - for example for residents, medical students, physician assistants and dentists - many of whom will practice in underserved areas.
  • $10.5 million to strengthen the public health workforce by supporting traineeships to increase the number of individuals trained in preventive medicine and dental public health residencies.
  • $10.2 million to increase diversity of the health professional workforce.
  • $1.5 million to support the efforts of State professional licensing boards in reducing barriers to telemedicine.

Funds are awarded directly to applicants for scholarships, loans, and loan repayments. Typically, in exchange they required to serve a minimum of two years in a community that has a shortage of doctors, nurses and other health care professionals. Applications are continuously being accepted and a listing of the location of vacancies and the medical specialty of the positions is available for search.

In August, 2009, HRSA distributed $8.1 million through its Nurse Education Loan Repayment Program to healthcare facilities across the nation. Five downstate facilities in New York received ARRA funds to use to help nurses repay their education debts. Six other colleges and universities in New York were awarded grants totaling almost $500,000 to support the training of masters and doctors nursing degree students who commit to teach in this field.

On September 11, 2009, HRSA announced the award of seventeen grants to New York State colleges and universities totaling approximately $3.8 million for scholarships for disadvantaged students, public health traineeships, dental public health residency and for centers of excellence to expand programs for minority students and retain minority faculty.

On September 17, 2009, the Department of Health received a grant of $54,000 to collaborate with other State agencies and resources to increase the number of NHSC applicants that are placed in qualified sites in New York State and to continue to coordinate these placements with Doctors Across New York.

New York Recovery Act Handbook

Federally Qualified Community Health Centers (Section 330 of PHS Act)

Recovery Funds

  • $1.5 billion for infrastructure nationwide
    • $500 million for services nationwide

New York State's Share

  • To be determined; $79.7 million to date to Health Centers

The Recovery Act provides funds to the US Department of Health and Human Services (USDHHS) to assist medically underserved populations. The funds are distributed directly to recipients by the Health Resources and Services Administration (HRSA).

The Recovery funds permit new and expanded location construction and also address increased demand for services as more people resort to community health centers for diagnosis and treatment. Such investments can include hiring additional physicians and other medical staff.

Information on NY Awards

On March 2, 2009, five centers in NYS were awarded a total of $7 million in New Access Point grant awards - four in NYC and one upstate in Penn Yan – expecting to serve an additional 45,000 and create 335 jobs.

On March 27, 2009, fifty-one federally-qualified community health care centers in NYS – twenty-eight of them in NYC boroughs – received a total of $19.4million in Increased Demand for Services (IDS) grants .

On July 2, 2009, another round of capital improvement grant awards was announced which totaled more than $850 million nationwide.

  • Fifty-one centers in NYS received grants totaling $53.2 million, or approximately 6.25% of the national amount available.
  • Five centers received that maximum amount of $2.5 million.
  • Twenty-nine of the centers receiving these grants are in New York City and obtained a total of $30.2 million or 58% of the State total.

More information, including the full list of recipients for all three of the above grants.

On December 9, 2009, HRSA announced that $88 million has been set aside to enhance the funding of health center controlled networks (HCCNs) to provide additional services in support of ARRA-funded acquisitions of electronic health records and health information technology systems by Section 330 community health centers and HCCNs.

  • HRSA expects to make 36 awards.
  • There are 69 HCCNs across the nation, including one in Albany and two in New York City.
  • Applications are due February 5, 2010.

Also on December 9th, HRSA listed the 85 community health centers that received grants totaling $508.5 million from the Facility Investment Program that was announced in June. Four centers in New York received FIP funds:

  • Montefiore Medical Center, Bronx: $795,000
  • Urban Health Plan Inc., Bronx: $12,000,000
  • Family Health Network of Central NY Inc., Cortland: $1,400,387
  • Community Healthcare Network, Manhattan: $1,365,788

NY Recovery Act Handbook

Rural Development Grants

Recovery Funds

  • $130 million nationwide

NYS Share

  • To be determined

The Recovery Act provides funding for the US Department of Agriculture (USDA) to award grants and loans directly to rural areas of up to 20,000 in population.

Funds can be used, among other purposes, for hospitals, outpatient clinics and rehabilitation centers; medical and dental clinics; and assisted living facilities and nursing homes.

The goal of the Community Facilities Direct Loan and Grant Programs is to improve the quality of life for rural residents through the provision of essential community facilities such as health care, public safety, and education. The program provides facilities, equipment, and furnishings to house and provide these services; operating funds are not available through this program.

NY Recovery Act Handbook