AMF FAQs_Final BHW to OFAM 12.20.19.pdf

Addiction Medicine Fellowship – HRSA 20‐013

Frequently Asked Questions (FAQs) (12/20/2019)

Application Submission

1. Where can I access the Addiction Medicine Fellowship (AMF) funding announcement?

Access the full funding announcement at Grants.gov. Please make sure you click on the “package” tab. You will see two hyperlinks next to the opportunity, "Preview" and "Apply." Click "Apply," then click "Download Instructions."

2. Is the technical assistance webinar recorded?

Yes. You can access the AMF Technical Assistance webinar recording here. There will also be a follow up technical assistance call to address the modifications and respond to pertinent questions on Tuesday, January 7, 2020 from 1:30-3:00 pm EST. That second webinar will also be recorded and the link will be provided. Please check the HRSA website for updates.

3. Do all attachments count towards the page limit?

Standard OMB-approved forms included in the application package, an organization’s approved Indirect Cost Rate Agreement, and proof of non-profit status are NOT included in the page limit. All other documents will count toward the page limit, unless noted in the Notice of Funding Opportunity (NOFO).

4. If an attachment is not applicable, should we skip that number in the attachment section or renumber the attachments?

Do not include an attachment that is not applicable to your application. However, please do not renumber the attachments. Attachments should be submitted with the same numbers as specified in the NOFO.

5. Can an application have more than one Program Director/Program Investigator?

Yes, the choice to have more than one Program Director/Program Investigator is up to you. However, HRSA only recognizes one Program Director/Program Investigator, who will be accountable to HRSA. Please clearly designate who will fulfill that role.

6. When does the AMF funding opportunity close?

This funding opportunity closes on Wednesday, February 25, 2020, 11:59 p.m. ET.

7. Are Letters of Support required for this grant application?

As described in the NOFO (page 21), letters of support should be provided as applicable for this grant application. If you are proposing a partnership with an external entity please provide a Letter of Support as Attachment 9.

8. Are multiple applications allowed? Is it possible for fellowships (Addiction Medicine and Addiction Psychiatry) to submit collaborative applications in partnership?

Multiple applications from an institution with the same Data Universal Number System (DUNS) number are not allowed. If an institution has both an addiction medicine and an addiction psychiatry program and share a DUNS number, the applicant can apply as a collaborative program, as long as eligibility requirements are met and applicants are able to provide appropriate resources to both programs.

9. Will you accept applications every year or do you plan to award all of them in the first year?

For the Fiscal Year (FY) 2020 competition, HRSA will not be accepting additional applications after the closing date of February 25, 2020. Future funding opportunities cannot be determined until after enactment of future FY federal appropriations.

10. If we are eligible and choose to expand our program (add fellows) through this grant, when would you expect the fellows to start, since it is too late to recruit for the academic year starting in 2020?

Fellows can be appointed anytime during a budget period for an entire six or 12-month period. In doing so, the entire six or 12-month stipend is charged (obligated) to the current year. Thus, a fellowship that begins during the project period may extend beyond the budget period end date. Since the entire stipend is charged at the time of the appointment, the stipend amount committed but not yet expended at the end of the budget period should be reported as an unliquidated obligation on the Federal Financial Report (FFR). Once all funds have been liquidated, the final FFR will be updated to show all funds expended.

Applicant Eligibility

11. Are consortium applications limited to one fellowship program and a teaching health center?

The consortium is not limited. The requirement is to have at least one teaching health center and a sponsoring institution of Addiction Medicine and/or Addiction Psychiatry fellowship program.

12. Can a Federally Qualified Health Center (FQHC) apply directly for this grant? Or must they partner with the lead applicant?

Yes, a health center can apply directly if the community health center or FQHC is a teaching health center that is a part of a consortium. Per the NOFO (page 5), eligible applicants include U.S. based sponsoring institutions of accredited addiction medicine or psychiatry fellowship programs, or a consortium consisting of at least one domestic teaching health center and one domestic addiction medicine/psychiatry fellowship program.

13. Are federally recognized tribes eligible applicants?

Yes, as long as they meet the eligibility criteria noted in the NOFO (page 5). Eligible applicants include the following: U.S based sponsoring institutions of accredited addiction medicine or psychiatry fellowship programs, or a consortium consisting of at least one domestic teaching health center and one domestic addiction medicine/psychiatry fellowship program.

Accreditation

14. Is our program expected to expand our fellowship slots beyond what is currently approved by our accrediting body?

The purpose of the AMF Program is to expand the number of fellows at accredited AMF and Addiction Psychiatry Fellowship (APF) programs trained as addiction medicine specialists. The NOFO aims to achieve this purpose by providing stipends for new fellowship slots. New AMF or APF slots are defined in this NOFO (page 1) as slots that

(1) were unfilled, accredited slots, or (2) additional slots that expand beyond the currently approved accredited number of slots.

15. If applicant organizations want to increase the number of fellowship slots beyond their current accredited capacity, will they have to show that the accrediting body has approved an increase in complement by the time of application submission?

No. Applicant organizations do not have to have already received approval for their planned increases in slots by the time of application submission. Applicants are required to submit documentation of their current accreditation at the time of application submission, and applicants are responsible for maintaining current documentation throughout the length of the five-year project period.

16. We are in the process of applying for accreditation, but we will not have our official accreditation letter until after the NOFO deadline. Can we still apply? Are programs that have an initial accreditation eligible to apply?

The applicant organization must provide documentation of its ACGME or ACAAM accreditation at the time of application. The details of required accreditation documentation are described in the NOFO (page 21). Programs may apply if they have received an initial accreditation from ACGME.

Use of Funds

17. Is the HRSA stipend in addition to the GME salary that is already provided for the fellow? May the grant be used to bring existing fellows’ salaries to $100,000?

No, the HRSA AMF program has a separate funding source than GME. The HRSA AMF Program allows a stipend that may be up to $100,000, and is intended to only support one fellow. Please note, per HRSA policy, fellows are not considered employees and do not receive salaries, nor fringe benefits through this grant. Per the NOFO, (page 19) stipends are subsistence allowances for fellows to help defray living expenses during the training experience, and are not provided as a condition of employment. Grant recipients may not offset the amount of stipends for tuition, fees, health insurance, or other costs associated with the training program. The AMF grant does not set rules for how Fellows expend their stipends. Fellows have the latitude to expend the stipend funds as they deem reasonable with examples including but not limited to, the cost associated with housing, transportation, health care and professional expenses they may incur such as medical malpractice insurance.

18. What can be budgeted under the administration and program management portion of the award?

Per the NOFO (page 18) under Administration and Program Management, the following is allowed: project staff salaries and fringe, faculty development, conferences, travel related expenses, indirect costs and other program support costs. Participant/Trainee Support Costs fall under Administration and Program Management. For application budgets with participant/trainee support costs (other than stipends), list tuition/fees/health insurance, travel, subsistence, other, and the number of fellows.

Ensure that your budget breakdown separates these fellows cost and includes a separate sub-total entitled “Participant/Trainee Support Costs”.

19. Do I have to pay the fellow $100,000?

No, per the modified NOFO (page 18), stipends may be up to $100,000. Please note that at least 50% of the total five-year budget must to be dedicated to stipends.

20. We have a full time two year fellowship program; one year clinical and one year research. Can we only fund one of the two years per fellow?

The AMF NOFO provides funding for one year (12 months for full-time and up to 24 months for part-time fellows) of clinical addiction medicine or addiction psychiatry training.

21. Is the purchase of hardware and software for students, faculty, and participants an allowable cost?

Yes, hardware and software costs are allowable, but must be reasonable and necessary. These costs must be allocated out of the Administrative and Management portion of the requested budget. No more than 50 percent of funding over the 5-year period of award can be used for the administration and management of the program, and may be dedicated to recipient activities other than stipend support.

22. Can we provide stipends to fellows that are more than $100,000?

Award recipients may choose to provide higher stipend amounts by including funds from other non-federal sources, which must be identified in the application.

23. Does the grant allow us to include tuition in the budget (in addition to trainee stipends)?

Applicants may request funding for other Trainee/Participant support costs, including tuition, however, these costs must be allocated out of the Administrative and Program Management portion of the budget.

24. Is health insurance for fellows an allowable expense?

Yes. Per the NOFO, health insurance is allowable as a fellow-related expense;

however, the cost must be allocated out of the Administrative and Program Management portion of the budget.

25. We are a state university. Would we use our negotiated cost agreement rate or the 8 percent?

Per federal grant regulations, indirect costs on training grants for all applicants other than state, local or Indian tribal governments are limited to the training rate of 8 percent of modified total direct costs. Direct cost amounts for equipment and capital expenditures, tuition and fees, and sub-grants in excess of $25,000 are excluded from the direct cost base for the purpose of this calculation. If your state university is classified as a state government the 8 percent limitation would not apply; otherwise it would apply.

26. Is Maintenance of Effort (MOE) required and what is it?

Yes, applicants are required to include the MOE form in the application.

The recipient must agree to maintain non-federal funding for award activities at a level that is not less than expenditures for such activities during the fiscal year prior to the fiscal year for which the recipient receives the award, as required by PHS Act section 797(b). Complete the MOE information and submit as Attachment 5. The underlying principle is to ensure that federal award recipients maintain the same level of support already being provided (and as described in their application) after receipt of a federal grant award. The MOE intent is to ensure federal funds “supplement” rather than “supplant” (replace) normal activities.

Rotation Placements

27. In regards to Table 1 Attachment 4, we anticipate partnering with multiple training sites. Should we list all of these training sites within Attachment 4, or only select a few sites to highlight?

The applicant must list all of the partnering sites in Table 1.

28. Given the page count, do we need to include Letters of Agreement (LOA) for all training sites we will be using or should we pick several to highlight? Is there any specific language the LOA's need to include?

LOAs are not a required attachment and should be submitted as applicable. In the past, applicants have formatted more than one LOA onto one page of their application. It is not necessary to include the entire contents of lengthy agreements, so long as the included document provides the information that relates to the requirements of the NOFO (page 20).

29. Does the entirety of the one year fellowship need to take place in a community-based setting or just one rotation?

At least one fellowship rotation needs to be in an underserved, community-based setting.

30. What is the definition of community-based?

As noted in the Program Specific Definitions of the NOFO, (page 39) a community-based setting is an organization centered in and around a particular community. They are designed to reach people outside of traditional health care settings. This includes, but is not limited to, a teaching health center or a federally qualified health center.

Funding Preference and Priority

31. In order to meet the funding priority, does a training site need to have both a county Mental Health HPSA and a Primary Care HPSA score of 16 or above?

The AMF Program has three funding priorities, Team-Based Care, Health Information Technology, and Rural, Tribal or Underserved Communities. In order to qualify for the

Rural, Tribal or Underserved Communities priority, the training site(s) must be located in a Mental Health or Primary Care HPSA. Applicants must submit data as outlined in the NOFO and is subject to verification. Please note, you will only be awarded a maximum of five (5) priority points total even if you satisfy multiple priority qualifications. For more information see the NOFO (page 30).

32. Do we figure funding preferences for total graduates of Addiction Medicine and Addiction Psychiatry, or do we figure per fellowship?

An applicant may list individual completers of AMF or APF Programs for a funding preference on one table formatted in Attachment 8.