The Center for Consumer Information & Insurance Oversight
Frequently Asked Questions about the CAP Grant Opportunity
Q1: What is the grant period of performance for this award?
A1: The grant period of performance is 12 months, from August 23, 2012 – August 22, 2013.
Q2: Can I request funds under this announcement to perform activities I am currently performing under the 2010 Consumer Assistance Program award funds or under the 2012 Consumer Assistance Program Limited Competition award funds?
A2: Yes. For prior award recipients, these grant funds can be used to extend or enhance activities being funded under the 2010 grants and/or the 2012 Limited Competition grants as well as funding new activities. For example, if a Consumer Assistance Program was performing an outreach campaign that included a 6-month public service announcement (PSA) on the radio under the 2010 grant award, that Consumer Assistance Program could extend the PSA beyond the original six months, or add a different PSA. The Consumer Assistance Program could also use these funds to add to the radio campaign through other media not currently included in their project plans, such as newspapers, local magazines, or television. Funds awarded under this grant funding opportunity announcement cannot supplant activities funded under the prior grant(s) or by any future Consumer Assistance Program funding opportunities if grant periods were to overlap.
Q3: How long is the budget period for this award? Can I apply for this opportunity if my program is currently operating under the 2010 Consumer Assistance Program grant in a No-Cost Extension period?
A3: The budget period is 12 months. 2010 Consumer Assistance Program grantees may apply for this grant opportunity regardless of their status as a currently operating program. Applicants must be in good standing to qualify for an award, which includes being up to date on all quarterly Federal Financial Reports at the time of submission of this application through the award date of this grant. Project plans for this grant opportunity must expand upon work currently in progress through any Consumer Assistant Program No-Cost Extension period, but can also provide new funding for projects or activities, including those that may have ended under previous grant periods.
Q4: Will there be future funding for this grant program?
A4: The program was authorized for FY 2011 and beyond by the Affordable Care Act. Additional grants may be announced at some point in the future depending on availability of funding.
Q5: What is the scope of work required involving Medicare, Medicaid, and CHIP?
A5: A program that receives funding from a Consumer Assistance Program grant is expected to refer consumers, when appropriate, to other entities that can help them better understand the Medicare, Medicaid, and CHIP programs in the State. Programs do not need to be capable of providing direct assistance to consumers on issues and problems related to Medicare, Medicaid, and CHIP. However, programs must be capable of making appropriate referrals for such consumers. Consumer Assistance Programs will be required to provide to HHS information on the number of referrals made to these programs.
Q6: Are grantees expected to help consumers enroll in self-insured group health plans?
A6: Yes. Section 2793(c)(1), (3) and (4) describe duties to consumers with respect to group health plans and health insurance issuers. Section 2793(c)(2) is even broader, requiring consumer assistance programs to collect data about problems encountered “by consumers.”
Q7: Are grantees required to file an appeal, internal and/or external, on behalf of consumers?
A7: Yes. As a requirement for receiving Consumer Assistance Program grant funds, grantees will act on behalf of, or as the designated agent for, the consumer throughout the appeals process with respect to group health plans and health insurance coverage unless prohibited from doing so under State law. In this instance, the grantee must devise an alternative plan to ensure that consumers receive that service (i.e., grantee may contract out this specific activity to a non-profit entity).
Q8: How long will the grantees have to provide Consumer Assistance Program progress reports to HHS?
A8: Grantees have to provide progress reports to HHS during the budget period. The budget period under this grant is 12 months. The initial progress report for services provided under this grant award will be due on February 15, 2013. Quarterly reports under this grant award are due thereafter. Additionally, an annual report will be due on November 15, 2013.
Q9: Is SF-LLL a required form?
A9: Yes. Grant funds cannot be used for lobbying activities. This form is placed under the mandatory section in Grants.gov. Please complete the form by indicating “N/A” before uploading onto Grants.gov. If the form is not completed, regardless of the lobbying activities, Grants.gov will not allow you to submit your application.
Q10: Why does the project abstract summary require that we input a number for the federal share requested for five (5) years?
A10: The applicant must submit a 12-month budget proposal. The grant period of performance is 12 months in duration, which happens to cross Fiscal Years. Funds may be used through the end of the grant period of performance to support grant activities under the grant project. Since the grant period of performance for this award is for 12 months, the applicant should enter $0 for the other years in the application.
Q11: What does the prohibition on using funds for direct health care services mean? Can programs use the money to pay for their counseling staff or are you considering the counseling a direct health care service?
A11: Assisting consumers in reviewing their health insurance options is clearly a permitted use of grant funds. However, if counseling staff is providing health care services to the consumers, then that would be interpreted as a “direct health care service” to the individual and it would be considered a prohibited use of grant funds. Examples of direct health care services include administration of medication, outpatient visits, and specialty visits with a provider.
Q12: On page 30 of the FOA, language is included that requires meaningful input from consumers into the planning, implementation, and evaluation of the project, and that all grant budgets must include some funding to facilitate participation on the part of individuals who have a disability or long-term illness and their families. What does this requirement mean?
A12: This requirement is meant to be satisfied by the program after it receives funding from HHS. Examples where a program could obtain consumer input may be in the form of consumer satisfaction surveys, brown-bag meetings with consumer groups, or by establishing a consumer advisory committee, just to name a few. In obtaining consumer input, programs must take the necessary steps to ensure that the modes of communication used accommodate the needs of and facilitate the participation of consumers with disabilities.
Q13: There is no option for the work plan and timeline in the list of "mandatory documents" on the cover page of the grant application package. How do we submit the work plan and timeline?
A13: The applicant can attach the work plan and timeline to the “Other Attachment File.”
Q14: Are States required to continue financial support of the program in the event that federal grant funding stops?
Q15: Will training be provided during this grant cycle on how grantees can help consumers resolve problems with obtaining premium tax credits?
A15: No. Since individuals will not be able to receive an eligibility determination for advance payment of the premium tax credit for coverage through an Exchange until the Exchange initial open enrollment period begins in October 2013, grantees will not be required to satisfy this statutory duty during this grant’s 12-month period of performance. Should a grantee extend their period of performance beyond the 12 months, CMS plans to provide additional training and information on appropriate parameters of providing assistance in obtaining premium tax credits, including information on ensuring the protection of a consumer’s personally identifiable information.
Q16: What database software will HHS provide to grantees?
A16: HHS has developed a database that is available to all CAP grantees free of charge. This database collects all required CAP consumer data.
Q17: Are grantees required to use the database software that HHS has developed?
A17: Use of the HHS Consumer Assistance Program – Case Worker Tool is discretionary. Grantees may use alternative systems to collect and report on required data elements. The database provided by HHS allows grantees to collect and track consumer data.
Q18: Can community-based organizations apply?
A18: No. Only States are eligible to apply. For the purposes of this funding opportunity, “State” means each of the 50 States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. States may contract with or enter into an agreement with one or more non-profit community-based organizations (working as a consortium) that otherwise meet the requirements of the grant to perform some or all of the grant activities under this funding opportunity.