Monthly Archives: May 2013

Health Navigator Grants: The Walking Around Money Concept Confirmed

In a recent post about the new ObamaCare Health Navigators program, I said that it looks like classic grant walking around money that should be of great interest to almost all nonprofits and many public agencies, regardless of whether or not they’ve ever done any health related activities. This particular RFP is for the 34 states that are not setting up their own Health Insurance Exchanges.

The other 16 states are doing their own “thang,” to quote The Isley Brothers, with respect to ObamaCare outreach and education. In California, this effort is the wonderfully named “Covered California,” which sounds more like a teen pregnancy prevention program than something about affordable health insurance.

Just sayin’.

Last week I received a call from a prospective client who was interested in applying to the Covered California Outreach and Education Grant Program, which is California’s equivalent to the federal Health Navigators program. My caller was out of luck because the RFP process concluded in March. But there’ll be additional RFPs, so I advised him to watch the skies for the next RFP. One interesting point about the California RFP process: the organizations that submitted Letters of Intent are conveniently available at the above download link in the first sentence.

Look at the Letter of Intent (“LOI”) list and the phenomena of walking around money will be instantly illustrated. Prospective applicants included a cornucopia of nonprofit and pubic agencies, many of which seemingly have much to do with health insurance needs. Here’s a few that caught my eye in the 13 pages of would-be applicants:

The Actors Fund, Rancho Santiago Community College District, California Association of Black Pastors, Apple Valley Chamber of Commerce, San Bernardino Employment Training Agency, Union of Pan Asian Communities, Office of Small Business of the City and County of San Francisco, County of Ventura Area Agency on Aging, Partnership for Affordable Housing, Rasin City Elementary School District, Jamboree Housing Corporation, California Latino Water Coalition (who knew there was such a thing as “Latino water”), Girls After School Academy, the California Teachers Association, SIEU Locals 521 and 99, and—my personal favorite—The California Restaurant Association.

Based on a close reading of that list, it should be obvious that California organizations recognize a gravy train when they see one. As I said in my earlier post, if you like grants—and who doesn’t?—squeeze in close and get your snout in the Health Navigator trough. This free-for-all is too good to pass up.

The Street Outreach Program (SOP) and Seliger’s quick guide to outreach components

The Department of Health and Human Services (DHHS) Administration for Children and Families (ACF) Family and Youth Services Bureau (FYSB) just issued the Street Outreach Program (SOP) FY ’13 Funding Opportunity Announcement (FOA),* which offers an opportunity for us to describe a common funder program paradigm: outreach. Last week, faithful readers will recall that we blogged about yet another outreach program: Health Navigators.

Not all of our readers are likely hip to outreach program design. In essence, all outreach programs use more or less the same design and have changed little since the halcyon days of outreach of the 1970s. Actually, this is not entirely true: these days a soupçon of social media should be added to the outreach stew, but otherwise things remain the same.

Unless there is a static client input stream (e.g., domestic violence offenders being court-referred), almost all human services programs require some outreach component; even if the RFP doesn’t require one, smart, imaginative grant writers will include outreach anyway. An SOP or Health Navigator proposal is just a gigantic outreach effort, but the basic structure of outreach can be applied to most any project design.

The point of outreach is to connect some target population with something that is supposed to improve their life outcomes (free proposal phrase here). Within this context (another free proposal phrase here), there are two basic types of outreach: local and regional/statewide. Local outreach almost always includes:

  • One-on-one information meetings conducted with the staff of other providers to give them the good news about the program, so that they will refer their eligible clients.
  • Presentations to community groups, faith-based organizations and any other group that has a constituency that could benefit from the program, or, barring that, any other constituency that can be gathered in one place at one time.
  • Press releases to whatever print media that remains alive in your target area.
  • Radio and TV public service announcements (PSAs), although these have largely been superseded by YouTube uploads.
  • Direct mailings and email blasts, using as many mailing lists as you can find and/or develop.
  • Widespread distribution of posters and other printed material touting the project’s message, ideally in every language spoken by the target population, up to and including Elbonian.
  • The ever-popular “street-based” outreach, which requires a brave Outreach Worker to actually leave the comforts of their warm agency nest and venture out to where the target population hangs out: parks, community centers, welfare offices, public housing projects, liquor store parking lots, minimarts, barber shops, basket ball courts, and so on.
  • Use of Facebook, Twitter, SnapChat, group texting, and whatever other “new” media seems plausible. We’re often tempted to include a social media tool that doesn’t actually exist, but we choose the path of righteous honesty and have not actually done so.
  • The only real question is whether to use a dedicated outreach worker, usually a peer of the target population, or a portion of the time of other proposed staff. Keep in mind that having a dedicated outreach person can lead to unfortunate acronyms like “Peer Outreach Worker” (POW), or even worse (particularly for female target populations): a Community Outreach Worker. You’ve been warned, watch your acronyms!

For regional/statewide outreach initiatives like Health Navigators, one or both of the following complications are usually added to make the funder think you’ll actually find eligible clients in distant places:

  • Propose a hub-and-spoke system with a circuit riding Outreach Worker. Your agency is the hub in Minneapolis and you find collaborators in Owatonna, Climax, Blue Earth, and Sleepy Eye Minnesota, to periodically host an Outreach Worker. She’s in Blue Earth on Tuesdays, Climax on Thursdays, and so forth. When in Sleepy Eye, the Outreach Worker reaches out, using the above toolkit. If you’re really frisky, you can open small site offices in other towns, so the Outreach Worker has a place to nest and preen while visiting.
  • Use a train-the-locals approach in which your Outreach Worker trains staff or volunteers from indigenous organizations in the region to conduct the various outreach strategies, using social media to watch over her dispersed brood.

Now you know how to develop an outreach component: no need to convene a group-think, draw circles and arrows on white boards, and eat donuts.


* For those of you keeping score at home, this makes it the DHHS ACF FYSB SOP FOA. I know it looks like cryptography, but the acronym is actually just your tax dollars at work.

Links: LED Bulbs, Condoms, Education, News is Bad For You, Marriage, Detroit, Foundations, Congress and ObamaCare, and More!

* Great news: we’re (slowly) moving toward a world where education looks at competency, not hours with ass-in-seat. This is flying under the radar of the national press but is hugely important, especially for nonprofits involved with education.

* Get LED lightbulbs. I use Switch LED bulbs, which are ludicrously expensive upfront but pay for themselves within a couple months.

* Possibly related to the above, Human extinction is an underrated threat.

* “News is bad for you [. . .] The real news consists of dull but informative reports circulated by consultancies giving in-depth insight into what’s going on. The sort of stuff you find digested in the inside pages of The Economist. All else is comics.”

* Last year we posted “Have you seen a Federal agency request a low-quality program?“, and this week we saw another example in HUD’s “Transformation Initiative: Sustainable Communities Research Grant Program,” which says that the NOFA offers “researchers the opportunity to submit grant applications to fund quality research under the broad subject area of sustainability.” This would be far more notable if the program offered money for low-quality research.

* “The Shadowy Residents of One Hyde Park—And How the Super-Wealthy Are Hiding Their Money.” I don’t think I’d want to live in a $5M+ apartment even if I had the money for it.

* How marriage changes relationships and gender dynamics (maybe); actual title includes the phrase “the boob test.”

* Seattle Needs to Welcome Growth and Get Over Itself.

* Detroit locals unhappy about the manager who is supposed to clean up the mess made by politicians elected by Detroit locals.

* What are foundations for? A theoretical discussion of problems many of you experience on a daily basis.

* “A Childless Bystander’s Baffled Hymn;” sample: “Why all the choices — ‘What would you like to wear?’— and all the negotiating and the painstakingly calibrated diplomacy? They’re toddlers, not Pakistan.”

* Austin gets Google Fiber, becomes a more attractive place to live.

* American Indians move to cities and face new challenges.

* Women and the crab basket effect.

* “New Publisher Authors Trust: Themselves.” File this under “Calling Captain Obvious.”

* The future of U.S. space policy, a topic that is under-discussed yet very important. This might be related to “News is bad for you,” above.

* Is China covering up another flu pandemic?

* “Will Congress exempt itself from ACA exchanges?” If so, this tells you more about the exchanges aspect of ObamaCare than any statement on the part of Congresspeople could.

* “One look at why income inequality is growing,” hat tip and headline tip Tyler Cowen.

* “Why still so few use condoms;” spoiler: because it doesn’t feel as good.

* “Topless Jihad: Why Femen Is Right.”

* “Nobody Walks in L.A.: The Rise of Cars and the Monorails That Never Were” but should have been.

* “Who Killed The Deep Space Climate Observatory?” This story, along with pathetic “Superconducting Super Collider” debacle, is the sort of thing that, if the U.S. really does take an intellectual and cultural backseat to the rest of the world, will be cited by future historians as examples of how the U.S. turned away from the very traits and behaviors that made it successful in the first place. “Who Killed the Deep Space Climate Observatory?” is also an example of how the real news is very seldom the news you read in the headlines.

* “Documentary ‘Aroused’ explores what makes women turn to porn careers.”

* David Brooks: “Engaged or detached?” “Writers who are at the classic engaged position believe that social change is usually initiated by political parties [. . .] the detached writer wants to be a few steps away from the partisans. [. . . ] She fears the team mentality will blinker her views.” Read the whole thing because the context is important, but as a writer I lean heavily towards the “detached” point of view.

* “[A]rtists and writers love to cast gigantic stores as misbegotten cathedrals.” I’m guilty as charged.

Another New Federal Grant Program Emerges: PPHF – 2013 – Cooperative Agreement to Support Navigators in Federally-facilitated and State Partnership Exchanges

Despite sequestration and budget worries, the Feds are churning out a new grant program every month or so; today, let’s consider this tasty if poorly named treat from the Centers for Medicare and Medicaid Service: “PPHF – 2013 – Cooperative Agreement to Support Navigators in Federally-facilitated and State Partnership Exchanges.” The trade name for this FOA is “Health Navigators,” and it is the first of what should be a tsunami of federal and state FOAs designed to help clueless Americans understand how to access the cornucopia of subsidies and benefits glittering like tiny jewels in the 25,000 pages (so far) of the byzantine Affordable Health Care Act (“ObamaCare”) regulations.

ObamaCare is roaring at us from the distance and is supposed to arrive at the station on January 1, 2014. Without getting too far inside baseball, the subsidies and Medicaid expansion at the heart of ObamaCare are supposed to provide health insurance for millions of uninsured Americans. These programs are structured as a series of state-run Health Insurance Exchanges. Somewhere along the way, however, only 16 states actually opted to set up their own exchanges, with the balance deciding to join the Federally-facilitated and State Partnership Exchanges.

The new Health Navigators program has $54,000,000 up for grabs for nonprofits in the 34 states without Exchanges. If you’re in a state with a proto-Exchange, like California or New York, don’t worry—they’ll issue their Health Navigator FOAs.

In the federal program, however, here’s a section that should warm the cockles of the stone-like heart of even the most jaded nonprofit Executive or, in my case, grizzled grant writer:

Section 1311(i) of the Affordable Care Act requires each Exchange to develop and implement Navigator grant programs. This funding opportunity announcement (FOA) is open to . . . serve consumers in States with an FFE or State Partnership Exchange. As health reform implementation continues, consumers will need to understand new programs, take advantage of consumer protections, and navigate the health insurance system to find the most affordable coverage that meets their needs. Exchange Navigators are intended to assist consumers in those areas.

Health Navigator grantees will be responsible for ObamaCare outreach and education to uninformed populations—which is just about anybody in America, since nobody understands it. Maybe a few health policy wonks do.

If there is any nonprofit Executive Director reading this post who doesn’t think their agency could run a Health Navigator program, call me, because you’ve missed one essential aspect of human service providers: virtually all nonprofits do some kind of outreach and education. This makes the Health Navigator program an exceptionally great opportunity, and perhaps the best in recent memory, for getting “walkin’ around money“—a grant concept we’ve written about before.

Although the Health Navigator FOA clearly presents a very attractive grant opportunity on the street, with its promise of walking around money for vaguely defined and impossible-to-measure activities (just the kind we love to write proposals about and our clients love to operate), the real reason to apply now is to be on the ground floor of this emerging class of grants. As I noted in my recent blog about another new grant program, Face Forward, it is always a good idea to apply for the first funding round of any new grant program.

In the case of the Health Navigators FOA, this general principle is even more important because ObamaCare has created an entirely new class of service delivery organizations—”Health Navigators”—which is presumably going to provide never-ending grant competitions.

This reminds me of about 20 years ago, when the HIV/AIDS crisis was in the full bloom of its first major publicity salvo and a mounting public outcry. The Feds responded with Ryan White Act grants. The agencies that originally received Ryan White and similar HIV/AIDS grants formed what we termed an “AIDS Mafia” that slurped up all the available HIV/AIDS grant funds.

If your agency was not in the local AIDS Mafia, your chances of getting grants was very low. The same thing happened about 18 years ago with HUD McKinney Act Homeless Assistance Grants (and we’ve written about the knock-on effects in “HUD’s Confusing Continuum of Care (CoC) Program Explained“). As with Ryan White, it soon became obvious that if you weren’t part of the Homeless Mafia, your agency would not be likely to get HUD homeless grants.

I think the same will be true for Health Navigator grants: if you want to get your organization’s snout into the ObamaCare trough, make sure you apply for this first Health Navigator funding round. When you get funded, your agency will instantly become an expert! In grant writing, I sometimes refer to programs like this as grant herpes: it’s the gift that keeps on giving.