What are eligible hospitals?

Does there have to be a Table of Contents for each attachment?

What does "Supporting Hospitals" mean?

Must a budget justification be submitted for one or more years?

Eligible Hospitals are now defined as SHIP-eligible hospitals that are not CAHs.

You do not need to provide Table of Contents for each Attachment. If any attachment consists of more than one type of document, say a Staffing Plan of 4 pages followed by a set of Position Descriptions, you should provide a Table of Contents on which page the second section begins.

But for all attachments, please have a header on each page with the Attachment title and page numbers, eg

Attachment 6 - Report on Prior Year’s Activities, Page #

Several Flex applicants have pointed out the lack of guidance on what constitutes “Supporting Hospitals” which is a required objective.

In essence this is what the Flex Programs have been doing all along. It involves (1) knowing what hospitals need in order to improve their performance (financial, clinical, quality, operational, etc.) and then (2) developing and implementing strategies that will help them improve their performance in a measurable way. The one aspect that would not be allowed would be using Flex funds for the purchase of clinical supplies or equipment.

On page 11 of the guidance, section v. on the Budget Justification states, "The budget justification should specifically describe how each item will support the achievement of proposed objectives. The budget period is for ONE year. However, the applicant must submit one-year budgets for each of the two subsequent project period years at the time of application."

In Section E of the SF 424a, Budget Estimates of Federal Funds for Balance of the Project, put total funds for the Second and Third Year of the Project Period on the appropriate lines. But the budget justification or a line by line explanation is only required for the first year.