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Frequently Asked Questions about the Grant Opportunity

Q1: Will there be future funding for this grant program?

A1:  The program is authorized for FY 2011 and beyond by the Affordable Care Act.  The Administration has formally requested a supplemental appropriation of $30 million for this program for FY 2011.  Additional grants may be announced at some point in the future depending on availability of funding.  In addition, grant funding for other initiatives related to consumer assistance programs (for example, the toll free consumer assistance hotlines and data systems) may also be available in FY 2011.

Q2: Are States required to continue financial support of the program in the event that federal grant funding stops?  Is a maintenance-of-effort required of States? 

A2:  States can decide each year whether to re-apply for the program.  If a State seeks to build upon an existing agency or program, States are required to use federal grant funds to expand capacity, and may not use grant funds to refinance existing consumer assistance services that States already support.

Q3: What is the scope of work required involving Medicaid and CHIP?

A3: A program that receives funding from a consumer assistance program grant is expected to refer clients, when appropriate, to other entities that can help them navigate the Medicaid and CHIP programs in the State.  Consumer assistance programs will be required to provide to HHS information on the number of referrals made to these programs.

However, grantees have the flexibility to expand the scope of program assistance.  Grantees are permitted to provide direct assistance to consumers with Medicaid, CHIP or other public coverage inquiries and complaints.

Q4: Are grantees expected to help consumers enrolled in self-insured group health plans?

A4: Yes.

Q5: Are grantees required to file an appeal, internal and external, on behalf of consumers?

A5:  Yes.  As a requirement for receiving consumer assistance program grant funds, grantees will be required to 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.  For many grantees, this will be a new function that must be established to fulfill the requirements of the grant.

Q6: Will training be provided this year on how grantees can help consumers resolve problems with obtaining premium tax credits?

A6:  No.  Since premium tax credits for individuals buying coverage through a State Exchange will not start until 2014, training grantees on how to help consumers resolve problems with obtaining premium tax credits will not be provided at this time.

Q7: What type of caller demographic information will States be required to collect?

A7: Age, income, gender, marital status, employment status and insurance status must be reported to HHS.

Q8: What database software will HHS provide to grantees?

A8: At this time, we do not yet know what database software we will use, but we are trying our best to develop one that is user friendly and is easily downloadable (with minimal cost to grantee).  It is our hope that the database software will be available in October.

Q9: Are grantees required to use the database software that HHS is developing?

A9: Use of the database is discretionary.  Grantees may use alternative systems to collect and report on required data elements.  The database provided by HHS will allow grantees to collect and track casework.  The database will also provide data collection reports, which can be used by both users and non-users.

Q10: How long will the grantees have to provide consumer assistance program data collection reports to HHS?

A:  The budget period under this grant is 12 months.  The initial data collection report is due in April 2011.  Two quarterly reports are due thereafter. 

Q10: Is SF-LLL a required form?

A:  Yes.  The form is placed under the mandatory section in  However, if there are no lobbying activities to report, please complete the form by indicating “N/A” before uploading onto  If the form is not completed, regardless of the lobbying activities, will not allow you to submit your application.

Q11: The budget period is 12 months.  Are we allowed to submit a proposal stretching the 2010 grant award to multiple years?  Why does the project abstract summary require that we input a number for the federal share requested for five (5) years?

A11:  The applicant must submit a 12-month budget proposal.  The project/budget period is 12 months in duration which happens to cross Fiscal Years.  Funds may be used through the end of the budget/project period to support grant activities under the grant project.  Since the project length for this award is for 12 months, the applicant should enter $0 for the out years in the application.

Q12: What does the prohibition on using funds for direct service mean?  Can programs use the money to pay for their counseling staff or are you considering the counseling a direct service?

A12:  The determination is not whether funds are available for “counseling staff,” but whether the counseling staff is performing a permissible function.  Assisting consumers in navigating 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 service” to the individual and it would be considered a prohibited use of grant funds.  Examples of direct services include outpatient visits and specialty visits with a provider.

Q13: On page 19 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?

A13:  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.

Q14: 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?

A14: The applicant can attach the work plan and timeline to the “Other Attachment File.”