3 = superior/exceeds criteria Applicant effectively described what Point Values: quality improvement activity the clinic 1 = not acceptable implemented this past year and 2 = unsatisfactory described what quality improvement 3 = satisfactory/meets criteria activities will be conducted in the next 4 = superior/slightly exceeds criteria year. (Questions 9 & 10) 5 = exceptional/exceeds criteria Applicant effectively described how the Point Values: grant funds will be used to improve 1 = unsatisfactory patient outcomes. (Question 11) 2 = satisfactory/meets criteria 3 = superior/exceeds criteria Section 5: Attachments The grant signature page is required for all applications. The FY2019 signature page can be found here: . All applicants are required to upload the documents requested in the attachments section. The documents are available for download on the webpage. Clinic Site Table – this form requests demographic information on all clinic’s in your organization. Operating Budget – This form requests total program revenue and expenses. In-Kind Contributions – This form is only applicable to applicants reporting donations to meet the 1:1 local match requirement. Community Engagement Examples – Please upload examples of your clinic’s community engagement projects. CONTACT INFORMATION Primary Care Office: Rubina Ranjit, Program Coordinator Cynthia Snyder, Director, Special Population Health, Primary Care and Rural Health Budgeting Technical Assistance Kevin Shaughnessy
3 = superior/exceeds criteria Applicant effectively described what quality improvement activity the clinic implemented this past year and described what quality improvement activities will be conducted in the next year. (Questions 9 & 10) Point Values: 1 = not acceptable 2 = unsatisfactory 3 = satisfactory/meets criteria 4 = superior/slightly exceeds criteria 5 = exceptional/exceeds criteria Applicant effectively described how the grant funds will be used to improve patient outcomes. (Question 11) Point Values: 1 = unsatisfactory 2 = satisfactory/meets criteria 3 = superior/exceeds criteria Section 5: Attachments The grant signature page is required for all applications. The FY2019 signature page can be found here: . All applicants are required to upload the documents requested in the attachments section. The documents are available for download on the webpage. Clinic Site Table – this form requests demographic information on all clinic’s in your organization. Operating Budget – This form requests total program revenue and expenses. In-Kind Contributions – This form is only applicable to applicants reporting donations to meet the 1:1 local match requirement. Community Engagement Examples – Please upload examples of your clinic’s community engagement projects. CONTACT INFORMATION Primary Care Office: Rubina Ranjit, Program Coordinator Cynthia Snyder, Director, Special Population Health, Primary Care and Rural Health Budgeting Technical Assistance Kevin Shaughnessy
FY19_CBPCC_Paper_Application_Submission_Instructions.docx