Federal ACA Grants for States: An Orchard of Opportunity?
In the forest of federal grant opportunities contained in the ACA, it can be a major task for states to find the tree that yields the ripest fruit. In this difficult budget climate, it is more important than ever to align federal funding with state priorities. Federal grant opportunities in the ACA are quite diverse. They include: grants to plan for and build Exchange infrastructure, opportunities to improve public health, grants to expand the safety net and develop the healthcare workforce, and funds to enhance care delivery.
Some grant funds provided through the ACA will be compelling and available to nearly all states. The Exchange planning grants are an early example; 48 states applied for and received them. Other grant opportunities in the ACA are competitive or of more interest to some states than others.
Several states have begun compiling lists of federal funding opportunities in various sections of the ACA. These lists may be organized by category (e.g. workforce development, insurance reforms, maternal and child health) like New Mexico and Ohio, or by title and section of the ACA, like Vermont. These states have designated lead agencies or entities to assess and pursue federal health reform grants. The list developed by Wisconsin also includes opportunities for non-state entities.
A few states have undertaken additional activities to prepare for the many federal funding opportunities in the ACA.
- Maine has developed a list of criteria for state agencies to use in deciding whether to apply for a federal grant. The criteria include strategic considerations, for example, does the funding opportunity fit well with priority issues in the state’s health plan, as well as practical concerns, such as the size of the state funding contribution to the project.
- Vermont is preparing to respond to funding opportunities by pre-qualifying vendors to assist the state with writing grant applications. Using this process, the state identified three firms that are ready to assist with writing proposals when the state decides to pursue federal funding opportunities.
Additional resources are also available to states to help forge a path through the funding forest:
- State Coverage Initiatives has developed a framework to help states categorize and select among the many federal funding opportunities in the ACA. An archived webinar and PowerPoint slide set that present this framework are available here. SCI also offers individualized technical assistance to help states prioritize funding opportunities.
- Grantmakers in Health is offering financial assistance to state and local foundations that provide grant-writing support to state government agencies. Applications to the State Grant Writing Assistance Fund are due February 1, 2011.
Update (March 11, 2011): Grantmakers in Health re-released this RFP on March 1, 2011. Applications are being accepted on a rolling basis, until the Fund is depleted.
How will your state identify federal grant opportunities in the ACA and decide which to pursue? Let us know at State Refor(u)m.
For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
