Monthly Archives: November 2016

Yes, it is possible for your FQHC to lose its HRSA Section 330 grant

If you’re a Federally Qualified Health Center (FQHC), you’ve probably seen announcements like this one, from the Federal Register: “Service Area Competition – Additional Areas (SAC-AA) – Honolulu, Hawaii; College Station, Texas; and Rock Springs, Wyoming.” Those announcements may seem curious: why announce for a strangely small number of additional service areas?

Answers vary. Sometimes it’s because the current FQHC Section 330 grantee has screwed something up badly enough to have its SAC grant yanked (though this is rare). More often, HRSA simply didn’t get any qualified applications for SAC grants in a certain geography, leaving a given area without a Section 330 provider needs for basic healthcare.

We’ve been told some funny stories about HRSA’s reaction to inadequate applicants. Our favorite probably involves an FQHC that called us on a Wednesday or Thursday about a SAC application that was due Monday. We were flabbergasted by this request and knew that a SAC FOA wasn’t on the street anyway. Our client explained what happened: She’d forgotten about the SAC deadline and failed to submit an application. HRSA did the initial review and realized that our client’s application was missing, and no one else had submitted for that rural service area.

HRSA probably isn’t supposed to extend the deadline for applicants who forget about the competition, but HRSA also doesn’t want healthcare gaps. So in the case of our client, HRSA called, told the client to get off their rear, and demanded a proposal by the following Monday. Our client panicked and called us.

We were able to complete the proposal on time (professional grant writer at work, don’t try this at home), and not surprisingly the client got funded. In short, depending on your FQHC’s relationship with HRSA, you can get wildly different outcomes from the same inputs. Our client got lucky. You may not be. We recommend attending to SAC deadlines and making sure you submit a complete, technically accurate proposal before the due date.

We’ve worked on SAC projects for insurgents attempting to take down the current grantee, and we’ve also worked on projects for the current grantee who suddenly realizes that they need a more serious application due to the threat of upstarts. Both kinds of projects are fun for us, albeit in slightly different ways. Both kinds of projects are also a reminder to FQHCs: SAC stands for “Service Area Competition.” Don’t get cocky. We’ve seen lots of cocky clients lose their primary funding streams via hubris, laziness, or both. Success is never final. There are no guarantees in grant writing, and you should know that you may have to compete for your dinner at any time.

Book review: Matthew Desmond’s “Evicted”

If you’re a nonprofit executive director you’re probably already aware of the eviction crisis many of your clients face, and by now you may have seen articles about Matthew Desmond, like “The Great Expectations of Matthew Desmond.” He’s appeared in The New York Times. His media exposure builds on the reason to cite Desmond in proposals: If he’s in the media, some grant reviewers will already be primed by his name or his book’s title (though if we’re talking about grant reviewers we doubt they’ll have actually read the book). That creates a sensation of greater credibility, since familiarity makes a person, thing, or idea seem right—which is why citing things that “everyone knows” works, even if the thing “everyone knows” is factually false.

evicted_DesmondMoreover, Evicted: Poverty and Profit in the American City is itself good and gets into the mechanics of eviction, why it is so traumatic for families involved it. The book also usefully details what the eviction process looks like for landlords who rent to low-income individuals and families. You may be expecting a book that valorizes renters and demonizes landlords, but Desmond deftly avoids that trap.

The landlords Desmond writes about do not see running frequently low-margin and always high-risk properties as a way to make tons of money fast, although some eventually do make surprisingly large amounts of money. Landlords are not presented as cruel media caricatures. They themselves are sometimes struggling and working to keep themselves afloat. We find for example that

Sherrena had a lot of bills: mortgage payments, water charges, maintenance expenses, property taxes. Sometimes a major expense would come out of nowhere—a broken furnace, an unexpected bill from the city—and leave her close to broke until the first of the month.

Ouch. Sherrena is not so distant from the world of her renters. The “major expense” she worries about is the mirror image of the major expenses her tenants worry about. Among landlords, many would rather be managing glamorous Manhattan or Seattle high rises than evicting tenants who often have brutal, true stories of their own misfortune.

One obvious question may be why, if running trailer parks and low-end housing developments can be wildly profitable, more people do not attempt to do so. I don’t have a good answer to this, though it is possible to speculate on some of the reasons.

Everywhere in Evicted, zoning is the real and unstated villain. One wishes that most city- and state-level politicians in America would read Evicted back-to-back with Matt Yglesias’s The Rent Is Too Damn High, which describes how most U.S. zoning has evolved to protect and enrich wealthy homeowners and exclude people perceived to be poor. Even in a superficially progressive city like Seattle, the local government strangled micro-housing, which was (and to some extent is) a way to provide more affordable housing to Seattle’s citizens, present and future. But incumbent property owners hated it and killed it through regulation.

Despite that oversight, I will say that urban governments interaction occurs throughout Evicted. For example:

When city or state officials pressured landlords—by ordering them to hire an outside security firm or by having a building inspector scrutinize their property—landlords often passed the pressure on to their tenants.

Much of the hassling that landlords do to tenants is actually a passthrough from those who have control over them.

Still, the book’s most powerful passages concern tenants. In the prologue, Desmond writes about “The rent was $550 a month, utilities not included, the going rate in 2008 for a two-bedroom unit in one of the worst neighborhoods in America’s fourth-poorest city.” Yet that “rent would take 88 percent of Arleen’s $628-a-month welfare check.” We don’t know how one lives on what remains. No one does, really.

The tenants themselves have numerous problems. One landlord illegally withholds funds from a tenant, and “Ned might have raised hell if he didn’t have an outstanding warrant for his arrest, stemming from another drug charge.” In the facing page, we find that “After jail, Pam had a difficult time finding work with her recent drug conviction.” Dope, dropouts, poor relationship choices: The problems proliferate tragically across the pages. One wonders what level of wraparound supportive services it would take to make many of the tenants whole. Maybe there are not enough supportive services in the world.

There are a handful of books we cite routinely in proposals. Dreamland, which Isaac wrote about at the link, is one. Sudhir Venkatesh’s Off the Books: The Underground Economy of the Urban Poor is another. Evicted is going to join the list. As you become a more experienced grant writer, you should build up a reference list of commonly cited books and articles. That will make both your job easier—you will already know important things that your narrative needs to cover—and your proposals better fleshed out and more believable to reviewers, even if those reviewers never track down any of your citations.

But you should read Evicted not primarily because you want to cite it. You should read it primarily because it is beautiful.