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Funding Request Details

Once you Save Draft on the Contact Information section, the Health Care Provider and Funding Request Details tabs will appear. You must provide information about any of the services and connected devices for which you are seeking funding in the funding request detail tab so that reviewers can confirm that you are requesting funding on eligible services and connected devices. Funding will only be awarded to applications that request eligible services and connected devices, and reviewers will remove any ineligible charges from the total funding amount requested on an application. Completion of these tabs is mandatory.

Funding Request Details 1

  • Click the Funding Request Details tab to toggle to that view.
  • Click New to input a new funding request.
    • Note: For each funding request line item, you must attach supporting documentation that confirms the amount of funding requested.  For example, if you want to request funding for 10 tablets, priced at $800 each, you must submit a vendor quote that demonstrates that each tablet cost $800 or that 10 tablets costs $8,000.
  • All entered funding requests will appear in the table displayed. You can scroll across and down the table to view all details. If you have not submitted any funding requests, this will be blank as on the previous slide.

Funding Request Details 2

  • The Funding Request Details window will appear.
  • Enter the Category for you funding request. As a reminder, the categories are:
    • Telecommunications and Voice Services,
    • Information Services, and
    • Connected Devices/Equipment
  • Enter a Description of the services and/or connected devices.
    • If applicable, you can reference how many institutions will receive the devices or services from this request. This is particularly helpful if you have recurring expenses for multiple locations.

Funding Request Details 3

  • If you are purchasing Devices, enter the Quantity of Devices.
  • If you are purchasing Devices, enter the Cost per Device.
  • If you are purchasing services that have a One-Time Expense, enter the cost into the corresponding field.

Funding Request Details 4

  • If you are purchasing services that incur monthly expenses, enter the Total Monthly Expenses into the corresponding field.
    • Note: If you incur costs on a per-user basis (e.g., cellular data plans), you must enter the total cost for all users into this field. For example, if you would like to request data plans that cost $40/month for 10 users, you would enter $400 into the total monthly expenses field.
  • If you are purchasing services that incur monthly expenses, enter the Total Number of Months into the corresponding field.
  • Enter the Date [Purchased or] To Be Purchased (optional, but you must certify that you purchased or will purchase the devices after March 20, 2021).

Reminder: For Round 2, you may receive up to 12 months of reimbursement for eligible recurring services or annual license agreements.

Funding Request Details 5

  • Provide all supporting documentation for a funding request items using the Funding Request Detail attachment button, shown as a paperclip, at the bottom of the window (see image below).
    • Please do not attach these using the paperclip at the top of the application form.
    • Documentation must support the funding amount requested. Without this information, a reviewer will not be able to verify the cost of the service or connected device.
  • Click Add to add the funding request to your application. The application will automatically perform all calculations necessary to sum funding requests.

Note: Applicants must provide supporting cost documentation (e.g., an invoice or a vendor quote) for all eligible services and devices for which funding is requested.

Funding Request Details 6

  • The total number of entered funding requests appears at the top of the tab.
  • Use the hamburger menu (three horizontal lines, above the Funding Request Detail Actions column) to see additional table options (e.g., export to Excel).
  • Use Actions to make table updates, including:
    • If you wish to delete the funding request entry, click the ‘X’ icon.
    • If you wish to edit the funding request entry, use the pencil icon to reenter the Funding Request Detail line item.

Funding Request Details 7