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UMass Memorial Health - HealthAlliance-Clinton Hospital works with and reports to the Massachusetts Department of Public Health (DPH). The Determination of Need law and regulation governs Health Care Facilities as that term is defined in M.G.L. c 111, § 25B. Under Massachusetts law M.G.L. c. 111, §§ 25C and 51, proposals for a Substantial Capital Expenditure, Substantial Change in Services and Original Licensure as well as many Transfers of Ownership and Changes in Site for Health Care Facilities must be reviewed and approved under the DoN Regulatory scheme.
The purpose and objective of the DoN program is to encourage competition with a public health focus; to promote population health; to support the development of innovative health delivery methods and population health strategies within the health care delivery system; and, to ensure that resources will be made reasonably and equitably available to every person within the Commonwealth at the lowest reasonable aggregate cost. To that end, health care organizations must file a Determination of Need (DoN) application with DPH when capital improvement projects are planned for its facilities. New capital improvement projects (new construction and purchases) must be approved by the state’s Public Health Council, and five percent of expenses must go to community health. DPH has developed requirements and has issued guidelines on how these funds are distributed and monitored.
Since 2020, UMass Memorial Health - HealthAlliance-Clinton Hospital has been distributing $2,350,000 in community benefits through the Determination of Needs (DoN) funding from our emergency department capital project. These funds represent 5% of the total cost of the ED renovation as approved by the Department of Public Health January 17, 2017.
Total amount to be distributed: $2,354,926
Term: FY20 – FY24 (October 1, 2019 – September 30, 2024)
Type of Distribution: RFP (Request for Proposal)
Criteria (revised as of 2022) is Based on:
Criteria Committee: Comprised of hospital officials, the Executive Director of the CHNA9 (Health Equity Partnership) and members of the Community Health Advisory Board
Distribution Committee: Comprised of hospital officials and community members unaffiliated with organizations completing the RFP to insure transparency and eliminate conflicts of interest
Funds distributed to date: $1,352,002
Remaining funds available through 9/30/24: $988,064
Priority Areas (revised as of 2022): Seven priority areas have been identified as a focus for funding
Social determinants of health:
Focus Area: For the purposes of this RFP, the region is comprised of the cities and towns of Ashburnham, Ashby, Athol, Ayer, Barre, Clinton, Devens, Fitchburg, Gardner, Groton, Harvard, Hubbardston, Lancaster, Leominster, Lunenburg, Orange, Pepperell, Petersham, Phillipston, Princeton, Royalston, Shirley, Sterling, Templeton, Townsend, Westminster, and Winchendon
Target Populations (revised as of 2022): Black, Indigenous and other people of color, recent immigrants and non-English speakers, people and families with low income, older adults, veterans, people experiencing homelessness, children and adolescents, people who identify as LGBTQIA+
For additional background information of the FY’22-FY’24 Determination of Needs Funding Announcement (available for download)
Tier 3 Funding: Limited to current Tier 3 Grantees (by invitation only)
The Public Health Council of the Department of Health and Human Services accepts, reviews and approves all DoN applications within the Commonwealth.
Based on the Scope of the project, UMass Memorial Health - HealthAlliance-Clinton Hospital did submit an application for not only the expansion but also the merger with Clinton Hospital. Both projects were approved by the Public Health Council which was announced in a press release on February 8, 2017.
Upon completion of the expansion project, UMass Memorial Health - HealthAlliance-Clinton Hospital through its Foundation will be required to distribute $2,354,926 over a five-year period that will support programs which provide primary and preventative health services to underserved populations in our service area.
In accordance with the purpose and objectives of the DoN program, we are committed to support programs that will help promote population health and address the critical health care issues in our community. This will be done by providing funding within the community to our community partners.
Seven priority areas* have been identified as health indicators and social determinants of health, based on feedback from community stakeholders:
Social determinants of health:
Updated as of 2022 based on:
Target Populations: Black, Indigenous, and other people of color; recent immigrants and non-English speakers; people and families with low income; older adults, veterans; homeless people, children and adolescents; people who identify as LGBTQIA+
Focus Area: For the purposes of this RFP, the region is comprised of the cities and towns of Ashburnham, Ashby, Athol, Ayer, Barre, Clinton, Devens, Fitchburg, Gardner, Groton, Harvard, Hubbardston, Lancaster, Leominster, Lunenburg, Orange, Pepperell, Petersham, Phillipston, Princeton, Royalston, Shirley, Sterling, Templeton, Townsend, Westminster, and Winchendon.
An allocation committee will be established and will include members of the UMass Memorial Health – Health-Alliance-Clinton Hospital Community Benefits Advisory Committee, representation from the Community Health Network Area 9 (CHNA9/Health Equity Partnership) Committee along with local health members from UMass Memorial Health-HealthAlliance-Clinton Hospital and key leadership from the community. On an annual basis, a formal RFP will be issued to all 501(c)(3) nonprofits serving in the North Worcester County. In coordination with HealthAlliance- Clinton leadership, the designated allocation committee will review, score, discuss and recommend final funding on an annual basis for all Tier 2 funds. Tier 1 funding will be reviewed by an internal committee and reported to the designated allocation committee on a biannual basis.
UMass Memorial Health – Health-Alliance-Clinton Hospital remains committed to the delivery of strategies to improve health and wellness within vulnerable populations. As a result, the hospital will set aside sufficient funds to successfully meet the DoN grant requirements. Over a five-year period, the hospital will have allocated a total of $1,352,002 to the community. To date, over $988,064 has been granted to community projects.
Approximately $1.5 million is available between 2022-2024. It is anticipated that approximately 40% will be made available in 2022, 30% in 2023 and 30% in 2024.
Yes, institutions of higher education are eligible to apply for the DoN Funds.
It is recommended that no more than a 15% of eligible expenses be requested to support indirect costs. Projects exceeding that amount should provide strong justification in their applications.
Yes, technically an organization can apply for Tier 1 and Tier 2. However, the distribution committee will seek to provide equitable distribution of the funding.
Yes, Tier 3 funds are reserved for current Tier 3 applicants in accordance with the original 2020 DoN RFP process.
Our intent is not to burden applicants with multiple funding requests. If appropriate, the distribution committee may ask if a project could still be completed if a lower grant amount were to be awarded. The distribution committee reserves the right to provide lower funding amounts than requested.
Yes, we urge applicants to develop rich collaborations with other organizations and entities to further leverage the DoN resources and create sustainability for their programming and projects.
Yes, the organization would be eligible to apply for funding.