BHW HRSA-22-045 (D85) Predoc Training Dentistry_Final.pdf

U.S. Department of Health and Human Services

Bureau of Health Workforce

Division of Medicine and Dentistry

Predoctoral Training in General, Pediatric, and Public Health Dentistry and Dental Hygiene

Funding Opportunity Number: HRSA-22-045

Funding Opportunity Type(s): Competing Continuation, New

Assistance Listings (AL/CFDA) Number: 93.059

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2022

Application Due Date: February 7, 2022 Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately!

HRSA will not approve deadline extensions for lack of registration.

Registration in all systems may take up to 1 month to complete.

Issuance Date: November 17, 2021

LCDR Cynthia Chennault, RDH, BSDH, MPH Senior Public Health Analyst, Bureau of Health Workforce Telephone: (301) 443-6691 Email: cchennault@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 U.S.C. § 293k-2 (Section 748 of the Public Health Service Act)

HRSA-22-045 i

508 COMPLIANCE DISCLAIMER

Note: Persons using assistive technology may not be able to fully access information in this file. For assistance, please email or call one of the HRSA staff listed in Section VII.

Agency Contacts

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2022 Predoctoral Training in General, Pediatric, Dental Public Health Dentistry, and Dental Hygiene. The purpose of this program is to enhance predoctoral dental, dental hygiene, and other oral health care trainee’s clinical ability to care for populations and individuals with medically complex health conditions, special and/or behavioral health care needs, and focus on patient-centered care so that students gain a better understanding of the social determinants of health, in order to improve the oral health of vulnerable, underserved, and rural populations.

Funding Opportunity Title: Predoctoral Training in General, Pediatric, and Public Health Dentistry, and Dental Hygiene

Funding Opportunity Number: HRSA-22-045

Due Date for Applications: February 7, 2022

Anticipated Total Annual Available

FY 2022 Funding:

$4,500,000

Estimated Number and Type of Award(s): Up to 15 grants

Estimated Annual Award Amount: Up to $300,000 per year

Cost Sharing/Match Required: No

Period of Performance: July 1, 2022 through June 30, 2027 (5 years)

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Eligible Applicants: Eligible entities include accredited schools of dentistry or dental hygiene, public or private nonprofit hospitals, or other public or nonprofit entities which the Secretary has determined capable of carrying out such a grant such as public health dentistry training programs.

See Section III.1 of this notice of funding opportunity (NOFO) for complete eligibility information.

Application Guide

You (the applicant organization/agency) are responsible for reading and complying with the instructions included in HRSA’s SF-424 R&R Application Guide, available online at http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf, except where instructed in this NOFO to do otherwise.

Technical Assistance HRSA will hold a pre-application technical assistance (TA) webinar for applicants seeking funding through this opportunity. The webinar will provide an overview of pertinent information in the NOFO and an opportunity for applicants to ask questions.

Visit the HRSA Bureau of Health Workforce’s open opportunities website at https://bhw.hrsa.gov/fundingopportunities/default.aspx to learn more about the resources available for this funding opportunity.

http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf https://bhw.hrsa.gov/fundingopportunities/default.aspx

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Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING/MATCHING

3. OTHER

IV. APPLICATION AND SUBMISSION INFORMATION

1. ADDRESS TO REQUEST APPLICATION PACKAGE

2. CONTENT AND FORM OF APPLICATION SUBMISSION

i. Project Abstract

ii. Project Narrative

iii. Budget

iv. Budget Justification Narrative

v. Standardized Work Plan (SWP Form

vi. Attachments

3. DUN AND BRADSTREET DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER TRANSITION

TO THE UNIQUE ENTITY IDENTIFIER (UEI) AND SYSTEM FOR AWARD MANAGEMENT (SAM)

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSMENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

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I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Predoctoral Training in General, Pediatric, and Public Health Dentistry, and Dental Hygiene program.

Program Purpose

The purpose of this program is to improve the oral health of vulnerable, underserved, or rural populations by enhancing the ability of oral health care trainees’ (predoctoral dental, dental hygiene, other approved public health dentistry trainees) ability to care for populations and individuals with medically complex conditions, special and behavioral health care needs, and focus on patient-centered care, so that students gain a better understanding of the social determinants of health and their impact on oral and systemic health.

Program Goals

The goal of this program is to educate and train predoctoral dental, dental hygiene, and other oral health care trainees, as defined in this notice of funding opportunity (NOFO), to be able to care for populations with medically complex conditions, special health care and behavioral health care needs, and incorporate the Social Determinants of Health (SDOH) into clinical care.

Program Objectives

• Increase the ability for dental students, dental hygiene students, and other approved primary care dental trainees to care for the needs of patients with complex health conditions and address the SDOH.

• Improve the training of, or increase the number of, dentists, dental hygienists, and other oral health care students trained in predoctoral training programs located in rural or underserved areas.

• Train dental students, dental hygiene students, and other health care students to practice in new models that stress the integration of oral health into the larger primary health care delivery systems.

• Increase the number of primary care dentists, dental hygienists, and other oral health care providers who care for rural, underserved, or vulnerable populations.

For more details, see Program Requirements and Expectations.

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General Emergency Preparedness Statement

Eligible entities must be ready to continue programmatic activities in the event of a public health emergency – both those that are expected and unexpected.

A training-focused emergency preparedness plan is critical for HRSA-funded projects and helps ensure that recipients are able to continue programmatic activities, can coordinate effectively, and can implement recovery plans when emergencies disrupt project activities. You must develop and maintain a flexible training-focused emergency preparedness plan in case of public health emergencies to ensure continuation of programmatic and training activities, including but not limited to predoctoral oral health training.

2. Background

The Predoctoral Training in General, Pediatric, and Public Health Dentistry, and Dental Hygiene program is authorized by 42 U.S.C § 293k-2 (Section 748 of the Public Health Service Act). For more information about the Predoctoral Training in General, Pediatric, and Public Health Dentistry, and Dental Hygiene program or other Oral Health Workforce Development programs at the Bureau of Health Workforce, go to https:bhw.hrsa.gov/funding/apply-grant#oral-health.

Populations with special health care needs and complex medical conditions across the life span are more prone to oral diseases and require particular skills and knowledge in order for providers to adequately and appropriately address their oral health needs. 1,2,3 Dental care has been identified as one the greatest unmet health care needs for these populations; their dental needs are often more complex than the general population and complicated by underlying congenital or acquired anomalies. 4 Individuals with complex health conditions and special health care needs can require specific knowledge and skills to adequately and appropriately manage the medical, behavioral, physical, and cognitive challenges. Therefore, it is not surprising that access to dental care poses a challenge for these populations because of the difficulty in finding a dentist who is adequately trained and willing to care for them. 5 Additionally, it is important to have oral health trainees from underrepresented groups as studies have shown that trainees from

1Chavez, EM., Wong, LM., Subar, P., Young, DA., Wong, A. 2018 April. Dental Care for Geriatrics and Special Needs Populations. Dental Clinics North America. https://doi.org/10.1016/j.cden.2017.11.005 2 American Academy of Pediatric Dentistry 2016: Management of Dental Patients with Special Health Care Needs. https://www.aapd.org/research/oral-health-policies--recommendations/management-of-dental-patients-with-special-health-care-needs/#section-references 3 Gallagher, J.E. and Fiske, J. 26 May 2007. British Dental Journal. Special Care Dentistry: A Professional Challenge.

4 Scambler, S., & Curtis, S. (2019). Contextualizing disability and dentistry: challenging perceptions and removing barriers. British Dental Journal 2019; 227(1) 55-57. doi: 10.1038/s41415-019-0463-8 5 Davidovich E, Pessov Y, Baniel A, and Ram D (2015) Levels of Stress among General Practitioners, Students and Specialists In Pediatric Dentistry during Dental Treatment. Journal of Clinical Pediatric Dentistry: Fall 2015, Vol. 39, No. 5, pp. 419-422. Doi: http://dx.doi.org/10.17796/1053-4628-39.5.419 https://bhw.hrsa.gov/funding/apply-grant#oral-health https://doi.org/10.1016/j.cden.2017.11.005 https://www.aapd.org/research/oral-health-policies--recommendations/management-of-dental-patients-with-special-health-care-needs/#section-references https://www.aapd.org/research/oral-health-policies--recommendations/management-of-dental-patients-with-special-health-care-needs/#section-references http://dx.doi.org/10.17796/1053-4628-39.5.419

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underrepresented groups are more likely to provide health care services in underserved communities. 6,7 Enhancing training and clinical experiences in training of predoctoral dental students, dental hygiene students, and other oral health carecare professionals will increase confidence and competence in caring for individuals with special health care needs and complex medical conditions and increase access to dental services for these underserved and vulnerable populations.

In 2012, the U.S. Department of Health and Human Services (HHS) published an Environmental Justice Strategy and Implementation Plan, which examined the relationship between the physical and social environments in which people are born, grow, live, work, and play and how that relationship can impact human health. 8 Because there is a strong relationship between employment status, unsafe neighborhoods, financial stress, and oral health status, it is essential that dental students receive training that integrates the SDOH broadly and understand concepts of health equity. 9,10 Though dental educators recognize the need to teach future health care professionals to deliver effective care, integrating these crucial concepts within dental education is challenging and requires faculty and leadership buy-in. 11

Program Definitions

A glossary containing general definitions for terms used throughout the Bureau of Health Workforce NOFOs can be located at the Health Workforce Glossary. In addition, the following definitions apply to the Predoctoral Training in General, Pediatric, and Public Health Dentistry, and Dental Hygiene Program for fiscal year (FY) 2022:

Community-based organizations – For the purpose of this NOFO, these are generally non-health care focused organizations, such as schools, community centers, senior centers, and faith-based organizations.

Dental Health Professional Shortage Area (Dental HPSA) – See Health Professional Shortage Area (HPSA).

Innovative Program – A new or significantly changed program or service delivery system that uses new ideas, methods and/or approaches, designed to improve how the dental workforce needs of designated Dental HPSAs are addressed. Maintenance, 6 Walker KO, Moreno G, Grumbach K. 2012. The Association Among Speciality, Race, Ethnicity, and Practice Location Among California Physicians. J Nat Med Assoc. 104(1-2):46-51.

7 Xierali IM, Nivet MA. The Racial and Ethnic Composition and Distribution of Primary Care Physicians. J Health Care Poor Underserved. 2018;29(1):556-570.

8 US Department of Health And Human Services. 2012. Environmental Justice Strategy and Implementation Plan. https://www.hhs.gov/sites/default/files/environmentaljustice/strategy.pdf 9 Sabato E, Owens J, Mauro AM, Findley P, Lamba S, Fenesy K. Integrating Social Determinants of Health into Dental Curricula: An Interprofessional Approach. J Dent Educ. 2018 Mar;82(3):237-245 10 National Academies of Sciences, Engineering, and Medicine 2021. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care.

Washington, DC: The National Academies Press. https://doi.org/10.17226/25983.

11 Stakeholders Center for Integration of Primary Care and Oral Health, https://cipcoh.hsdm.harvard.edu /and National Collaborative for Education to Address the Social Determinants of Health https://sdoheducation.org/ .

https://www.hhs.gov/sites/default/files/environmentaljustice/strategy.pdf https://bhw.hrsa.gov/grants/resourcecenter/glossary https://www.hhs.gov/sites/default/files/environmentaljustice/strategy.pdf https://cipcoh.hsdm.harvard.edu/ https://sdoheducation.org/

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expansion, or minor changes to an established program or service is not considered an innovative program. Programs that simply increase funded positions or services capabilities through efforts very similar to those already in use are not considered innovative programs.

Oral Health Care Trainees – In this NOFO, oral health care trainees refers to predoctoral dental, dental hygiene, dental therapy, and dental health aide therapy trainees.

Other Health Care Trainees – Other health professions trainees who will train alongside or are trained by the primary trainees as part of the interprofessional education, such as medical residents, nursing students, etc.

Patient-Centered Care – Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.

Primary Trainees –Dental students, dental hygiene students, dental hygienists, dental therapists, dental health aide therapists being trained through the proposed training program.

Primary Care Dentistry – For the purposes of this NOFO, primary care dentistry is defined as general dentistry, pediatric dentistry, public health dentistry or dental hygiene.

Public Health Dentistry – In this NOFO, public health dentistry is defined as dental therapy and dental health aide therapy.

Team-Based Care – Care delivered by intentionally created work groups of at least two health providers, who are recognized by others as well as by themselves as having a collective identity and shared responsibility for a patient, group of patients, their families, and/or communities to improve health outcomes. Characteristics of team-based care include: respect for diversity of skills and knowledge of teams members, an open environment in which to raise concerns and make suggestions, an emphasis on comprehensive patient care and quality improvement, and team member willingness to take on additional roles and responsibilities.

Teledentistry – In this NOFO, teledentistry is defined as the use of electronic information and telecommunications technologies to support and promote long-distance oral health care, patient and professional oral health-related education, community/populations oral health, and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.

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II. Award Information

1. Type of Application and Award

Type(s) of applications sought: Competing Continuation, New

HRSA will provide funding in the form of a grant.

2. Summary of Funding

HRSA estimates approximately $4,500,000 to be available annually to fund up to 15 recipients. The actual amount available will not be determined until enactment of the final FY 2022 federal appropriation. You may apply for a ceiling amount of up to $300,000 total cost (includes both direct and indirect, facilities and administrative costs).

This program notice is subject to the appropriation of funds, and is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds appropriately.

The period of performance is July 1, 2022 through June 30, 2027 (5 years). Funding beyond the first year is subject to the availability of appropriated funds for the Predoctoral Training in General, Pediatric, and Public Health Dentistry, and Dental Hygiene program in subsequent fiscal years, satisfactory progress, and a decision that continued funding is in the best interest of the Federal Government. HRSA may reduce recipient funding levels beyond the first year if recipients are unable to fully succeed in achieving the goals listed in the application.

All HRSA awards are subject to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements at 45 CFR part 75.

Limitations on indirect cost rates

Indirect costs under training awards to organizations other than state or local governments or federally recognized Indian tribes, will be budgeted and reimbursed at 8 percent of modified total direct costs rather than on the basis of a negotiated rate agreement, and are not subject to upward or downward adjustment. Direct cost amounts for equipment, tuition and fees, as otherwise allowable, and subawards and subcontracts in excess of $25,000 are excluded from the direct cost base for purposes of this calculation.

III. Eligibility Information

1. Eligible Applicants

Eligible applicants include accredited schools of dentistry or dental hygiene, public or private nonprofits hospitals, or other public or private nonprofit entities which the Secretary of Education has determined are capable of carrying out such grants to plan, http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75

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develop, and operate an approved professional training program in the field of general dentistry, pediatric dentistry, public health dentistry for dental students, dental hygienists, or other approved primary care trainees such as dental therapists that emphasizes training for public health dentistry.

Domestic faith-based and community-based organizations, community colleges, as well as Tribes and Tribal organizations, are eligible to apply provided they are capable of carrying out grants to plan, develop, and operate an approved professional training program in the field of general dentistry, pediatric dentistry, public health dentistry for dental hygiene students, or dental hygienists, or other approved primary care dental trainees as defined in the NOFO. All training activities must be conducted by an accredited entity. Programs in the process of receiving accreditation may apply however; the applicant or partner organization(s) must be accredited by the Secretary of Education or by the Commission on Dental Accreditation (CODA). Applicants can propose to develop an accredited program; however, the applicant organization responsible for the training must be an accredited program by July 1, 2023. HRSA will check the CODA website for accreditation confirmation. Accreditation must be maintained throughout the remainder of the project period. Failure to maintain accreditation will result in the termination of award funding under this NOFO.

2. Cost Sharing/Matching

Cost sharing/matching is not required for this program.

3. Other

HRSA may not consider an application for funding if it contains any of the non-responsive criteria below:

• Exceeds the ceiling amount.

• Fails to satisfy the deadline requirements referenced in Section IV.4.

Maintenance of Effort

The recipient must agree to maintain non-federal funding for award activities at a level that is not less than expenditures for such activities maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives the award, as required by 42 U.S.C. § 295n-2(b) (Title VII, Sec. 797(b) of the Public Health Service Act). Such federal funds are intended to supplement, not supplant, existing non-federal expenditures for such activities. Complete the Maintenance of Effort information and submit as Attachment 6.

HRSA will enforce statutory MOE requirements through all available mechanisms.

NOTE: Multiple applications from an organization are not allowable.

An ‘organization” for this NOFO is defined as an institution with a single Data Universal Numbering System (DUNS) number or Unique Entity Identifier (UIE).

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HRSA will only accept your last validated electronic submission, under the correct funding opportunity number, before the Grants.gov application due date as the final and only acceptable application.

Failure to include all required documents as part of the application may result in an application being considered incomplete or non-responsive.

Beneficiary Eligibility Requirements

Financial support of dental trainees is an allowable expense under this program. Dental trainees receiving financial support must 1) be a citizen of the United States, a non-citizen national, or foreign national having in his/her possession a visa permitting permanent residence in the United States, 2) demonstrate need of the support, and 3) plan to work in the practice of general dentistry, pediatric dentistry, dental hygiene, or public health dentistry.

IV. Application and Submission Information

1. Address to Request Application Package

HRSA requires you to apply electronically. HRSA encourages you to apply through Grants.gov using the SF-424 Research and Related (R&R) workspace application package associated with this notice of funding opportunity (NOFO) following the directions provided at http://www.grants.gov/applicants/apply-for-grants.html.

The NOFO is also known as “Instructions” on Grants.gov. You must select “Subscribe” and provide your email address for HRSA-22-045 in order to receive notifications including modifications, clarifications, and/or republications of the NOFO on Grants.gov.

You will also receive notifications of documents placed in the RELATED DOCUMENTS tab on Grants.gov that may affect the NOFO and your application. You are ultimately responsible for reviewing the For Applicants page for all information relevant to this

NOFO.

2. Content and Form of Application Submission

Application Format Requirements Section 4 of HRSA’s SF-424 R&R Application Guide provides general instructions for the budget, budget justification, staffing plan and personnel requirements, assurances, certifications, etc. You must submit the information outlined in the HRSA SF-424 R&R Application Guide in addition to the program-specific information below. You are responsible for reading and complying with the instructions included in HRSA’s SF-424 R&R Application Guide except where instructed in the NOFO to do otherwise. You must submit the application in the English language and in the terms of U.S. dollars (45 CFR § 75.111(a)).

https://www.grants.gov/ http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/applicants.html http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf

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See Section 8.5 of the HRSA SF-424 R&R Application Guide for the Application Completeness Checklist.

Application Page Limitation The total size of all uploaded files included in the page limit shall not exceed the equivalent of 65 pages when printed by HRSA. The page limit includes project and budget narratives, attachments including biographical sketches (biosketches), and letters of commitment and support required in HRSA’s SF-424 R&R Application Guide and this NOFO.

Please note: Effective April 22, 2021, the abstract is no longer an attachment that counts in the page limit. The abstract is the standard form (SF)”Project Abstract Summary.”

Standard OMB-approved forms that are included in the workspace application package, including the Standardized Work Plan (SWP), do not count in the page limit.

Biographical sketches do count in the page limitation. Note: If you use an OMB-approved form that is not included in the workspace application package for HRSA-22- 045, it may count against the page limit. Therefore, we strongly recommend you only use Grants.gov workspace forms associated with this NOFO to avoid exceeding the page limit. Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count in the page limit. It is therefore important to take appropriate measures to ensure your application does not exceed the specified page limit. Any application exceeding the page limit of 65 pages will not be read, evaluated, or considered for funding.

Applications must be complete, within the maximum specified page limit, and validated by Grants.gov under HRSA-22-045 prior to the deadline.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

1) You certify on behalf of the applicant organization, by submission of your proposal, that neither you nor your principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.

2) Failure to make required disclosures can result in any of the remedies described in 45 CFR § 75.371, including suspension or debarment. (See also 2 CFR parts 180 and 376, and 31 U.S.C. § 3321).

3) If you are unable to attest to the statements in this certification, you must include an explanation in Attachment 10: Other Relevant Documents.

See Section 4.1 viii of HRSA’s SF-424 R&R Application Guide for additional information on all certifications.

http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75#se45.1.75_1371

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Program Requirements and Expectations Propose predoctoral training programs in general, pediatric, or public health dentistry for dental students, dental hygienists, dental hygiene students, or public health dentistry students that address at least one of the following two focus areas:

Focus Area 1: Enhancing training to support integration of oral health within the broader primary health care delivery system to improve access to oral health care for populations and individuals with medically complex health conditions, special and/or behavioral health care needs in vulnerable, underserved, or rural communities:

Applications under this area must include:

• Partnerships with non-dental primary health care training programs to provide both didactic and experiential learning in interprofessional teams;

• Partnerships with community-based primary care delivery sites for vulnerable, underserved, or rural communities where trainees will have substantive clinical experience working in an integrated health care delivery system, which must include collaborative practice across disciplines, mechanisms to improve care coordination, and system level initiatives, such as integrated electronic health records or care protocols, to improve the quality of care provided; and

• Partnerships with community-based organizations to provide training experiences developing and demonstrating community level interventions to improve oral health care for vulnerable, underserved, or rural communities.

Focus Area 2: Training to support oral health providers caring for vulnerable, underserved, or rural communities:

Applications under this area must include:

• Clinical training to prepare oral health care trainees to care for vulnerable, underserved, or rural communities

As part of each of the proposed Focus Area(s) 1 and 2, and per PHSA Act Section 748(c)(3), applicants may develop and implement innovative programs to encourage and support students from underrepresented minorities, disadvantaged or rural backgrounds, and/or veterans to apply for, and be successful in, oral health professions training programs that are designed to ultimately place students in vulnerable, underserved, or rural communities. Examples of such programs include:

• Engaging with students in established pipeline programs to enhance knowledge and interest of oral health training programs focused on the eventual placement of students into vulnerable, underserved, or rural communities;

• Establishing linkages with institutions that serve underserved or rural populations, including minority serving institutions, to make students in those schools aware of this dental training, per PHS Act Section 796(d);

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• Supporting strategies to ensure graduation such as mentoring programs; and

• Assisting students, including from underrepresented minorities, disadvantaged, or rural backgrounds, to attend postdoctoral training programs in general, pediatric, or dental public health.

Program-Specific Instructions In addition to application requirements and instructions in Section 4 of HRSA’s SF-424 R&R Application Guide (including the budget, budget justification, staffing plan and personnel requirements, assurances, certifications, and abstract), include the following:

i. Project Abstract Use the Standard OMB-approved Project Abstract Summary Form 2.0 that is included in the workspace application package. Do not upload the abstract as an attachment or it will count toward the page limitation. For information required in the Project Abstract Summary Form, see Section 4.1.ix of HRSA’s SF-424 R&R Application Guide.

The Abstract must include:

1. A brief overview of the project as a whole;

2. Specific measurable objectives that the project will accomplish;

3. Which of the clinical priorities will be addressed by the project, if applicable;

and

4. How the proposed project for which funding is requested will be accomplished, i.e., the "who, what, when, where, why, and how" of a project.

NARRATIVE GUIDANCE

To ensure that you fully address the review criteria, the table below provides a crosswalk between the narrative language and where each section falls within the review criteria. Any forms or attachments referenced in a narrative section may be considered during the objective review.

Narrative Section Review Criteria

Purpose and Need (1) Purpose and Need

Response to Program Purpose:

(a) Work Plan

(b) Methodology/Approach

(c) Resolution of Challenges

(2) Response to Program Purpose

(a) Work Plan

(b) Methodology/Approach

(c) Resolution of Challenges http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf

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Narrative Section Review Criteria

Impact:

(a) Evaluation and Technical Support Capacity

(b) Project Sustainability

(3) Impact:

(a) Evaluation and Technical Support Capacity

(b) Project Sustainability

Organizational Information, Resources, and Capabilities

(4) Organizational Information, Resources, and Capabilities

Budget and Budget Justification Narrative

(5) Support Requested

ii. Project Narrative This section provides a comprehensive description of all aspects of the proposed project. It should be succinct, self-explanatory, consistent with forms and attachments, and organized in alignment with the sections and format below so that reviewers can understand the proposed project.

Use the following section headers for the narrative:

PURPOSE AND NEED -- Corresponds to Section V’s Review Criterion 1

Briefly describe the purpose of the proposed project, what you plan to accomplish and the needs it will address. Use and cite data wherever possible to support the information provided.

Discuss the needs of the community/communities in which the training program is located and how they are currently served by the segment of the health workforce that will be trained through the proposed project. Include the socio-cultural determinants of health, health disparities, and any unmet needs. Provide documentation of demographics and other relevant data that demonstrate the vulnerable, underserved, or rural community to be served. Describe how these needs are aligned with this program.

Provide a brief statement of the purpose of the proposed project. Describe how the program is relevant at the national or state level. Describe gaps in the current health workforce, the programs’ targeted discipline(s) and their training needs, and explain how developing training to support this/these disciplines will address the health workforce gaps you have identified. Describe any existing policies at the state or regional level that can be leveraged by the proposed project to improve oral health care delivery for individuals and populations across the lifespan, focusing on those with medical complex health conditions, special and behavioral health care needs, to improve the oral health in vulnerable, underserved, or rural communities.

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• Develop a Disparity Impact Statement using local data (e.g., the CDC Social Vulnerability Index (SVI) (https://www.atsdr.cdc.gov/placeandhealth/svi/index.html) to identify populations at highest risks for health disparities, low health literacy and infrastructure to receive necessary services in rural, underserved, or marginalized communities.

RESPONSE TO PROGRAM PURPOSE -- This section includes three sub-sections

— (a) Work Plan; (b) Methodology/Approach; and (c) Resolution of Challenges—all of which correspond to Section V’s Review Criteria 2 (a), (b), and (c).

(a) WORK PLAN -- Corresponds to Section V’s Review Criterion 2 (a)

Provide a detailed work plan that demonstrates your experience implementing a project of the proposed scope (a sample work plan can be found here:

http://bhw.hrsa.gov/grants/technicalassistance/workplantemplate.docx.).

Your work plan must be submitted through the Standardized Work Plan (SWP) Form located in the Grants.gov workspace. The SWP form is organized by budget period and must include all activities and deliverables for each objective and program goal. The program goals for this NOFO must be entered in the Program Goals section of the SWP form. For example, Goal 1 in the Purpose section of the NOFO will need to be entered as Goal 1 in the SWP form.

Objectives and sub-objectives can be tailored to your project needs. Objectives may be tagged with areas of focus by selecting applicable priorities on the SWP form. For the purpose of this NOFO, please write in COVID-19 or Health Equity in the “Other Priority Linkage” if your objective or sub-objectives align with those priorities. Form instructions are provided along with the SWP form, and are included in the application package found on Grants.gov.

You must complete the Standardized Work Plan (SWP) mandatory form in the Application Package.

• Describe the activities or steps you will use to achieve each of the objectives proposed during the entire period of performance identified in the Methodology section and how they related to the attainment of the Disparities Impact Statement.

• Describe the timeframes, deliverables, and key partners required during the period of performance to address each of the needs described in the Purpose and Need section.

• Explain how the work plan is appropriate for the program design and how the targets fit into the overall timeline of award implementation.

https://www.atsdr.cdc.gov/placeandhealth/svi/index.html http://bhw.hrsa.gov/grants/technicalassistance/workplantemplate.docx

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• Identify meaningful support and collaboration with key stakeholders in planning, designing, and implementing all activities, including development of the application and, further, the extent to which these contributors address the cultural, racial, linguistic, and/or geographic diversity of the populations and communities served.

• If funds will be subwarded or expended on contracts, describe how your organization will ensure the funds are properly documented.

You must include an annual training chart that indicates the number of students you plan to train through the proposed activities to include both:

• Dental Students, Dental Hygiene Students, Dental Therapy Students, or Dental Health Aide Therapy Students.

• Interprofessional/Other Healthcare Trainees: include the expected number of other health professions trainees, by discipline, that you propose to train alongside your dental students, dental hygiene students, dental therapy students and dental health aide students during each year of the five-year project period.

Please note that grant funds may not be used to plan a training program solely for Other Health Care Trainees or to provide Assistance to Other Health Care Trainees.

The chart must include information on the following:

• The number you propose to train each year;

• The number you project to graduate each year;

• If applicable, the projected number of participants in any pipeline support activity;

• As applicable, the number of underrepresented minorities you project to train each year;

• As applicable, the number of students from a rural or disadvantaged background that you project to train each year; and

The number of veterans that you project to train each year.

Provide a work plan chart that includes the goal, key objectives, staff, and a timeline (a sample work plan can be found here:

http//bhw.hrsa.gov/grants/technicalassistance/workplantemplate.docx). Your work plan must include, but note be limited to, evaluation and dissemination activities, any needed facility improvements for the training environment, and non-federal grant-funded construction or renovations envisioned.

https://bhw.hrsa.gov/grants/technicalassistance/workplantemplate.docx

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(b) METHODOLOGY/APPROACH -- Corresponds to Section V’s Review Criterion 2 (b)

Describe your objectives and proposed activities, and provide evidence for how they link to the project purpose and stated needs. Propose methods that you will use to address the stated needs and meet each of the previously described program requirements and expectations in this NOFO. As appropriate, include development of effective tools and strategies for ongoing staff training, outreach, collaborations, clear communication, and information sharing/dissemination with efforts to involve patients, families, and communities. If applicable, include a plan to disseminate reports, products, and/or project outputs so that key target audiences receive the project information.

Include a description of any innovative methods that you will use to address the stated needs.

Specifically, clearly describe:

• Institutional support and plans to integrate or enhance dental, dental hygiene, or other oral health training in the school’s core student curriculum;

• Partnerships with community-based sites to provide both didactic and experiential training for individuals and populations with medically complex health conditions, special and/or behavioral healthcare needs, and incorporate the social determinants of health, with the goal of improved oral health care for vulnerable, underserved, or rural populations;

• Proposed procedures and/or activities targeting individuals with medically complex health conditions, or special and/or behavioral healthcare needs, including preventative, diagnostic, and/or treatment services, as well as oral health education targeting trainees, community partner providers, and/or families;

• Plans to incorporate population health and social determinants of health into predoctoral student training; and

• The proposed facilities, including proposed equipment, for the training program is clear, is reasonable, and adequate to accomplish the goal(s) of the proposed training project.

Describe any plans to develop and implement innovative programs to encourage and support students, including from underrepresented minorities, rural or disadvantaged backgrounds, and/or veterans. Include in your description the strategies and activities to be employed as well as partnerships or outreach to existing programs or institutions. Discuss how your program will facilitate placement of trainees in vulnerable, underserved, or rural communities.

In this section, you must also describe the roles and responsibilities of the lead applicant and all partner organizations. Provide evidence supporting the proposed

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methodologies, including published literature, prior experience, and historical data for the appropriateness of the proposed methodology/approach. Describe any needed facility construction or significant renovations required to implement your plan, what non-grant resources will be used for this, and a timeline for completion.

Note that grant funds may not be used for construction and/or renovation activities.

Logic Models

Submit a logic model for designing and managing the project in Attachment 1. A logic model is a one-page diagram that presents the conceptual framework for a proposed project and explains the links among program elements. While there are many versions of logic models, for the purposes of this notice, the logic model should summarize the connections between the:

• Goals of the project (e.g., reasons for proposing the intervention, if applicable);

• Assumptions (e.g., beliefs about how the program will work and support resources. Base assumptions on research, best practices, and experience.);

• Inputs (e.g., organizational profile, collaborative partners, key personnel, budget, other resources);

• Target population (e.g., the individuals to be served);

• Activities (e.g., approach, listing key intervention, if applicable);

• Outputs (i.e., the direct products of program activities); and

• Outcomes (i.e., the results of a program, typically describing a change in people or systems).

Although there are similarities, a logic model is not a work plan. A work plan is an “action” guide with a time line used during program implementation; the work plan provides the “how to” steps. You can find additional information on developing logic models at the following website:

https://www.acf.hhs.gov/sites/default/files/documents/prep-logic-model-ts_0.pdf.

(c) RESOLUTION OF CHALLENGES -- Corresponds to Section V’s Review Criterion 2 (c)

Discuss challenges that you are likely to encounter in designing and implementing the activities described in the work plan, and approaches that you will use to resolve such challenges.

IMPACT -- This section includes two sub-sections— (a) Evaluation and Technical Support Capacity; and (b) Project Sustainability—both of which correspond to Section V’s Review Criteria 3 (a) and (b).

(a) EVALUATION AND TECHNICAL SUPPORT CAPACITY -- Corresponds to Section V’s Review Criterion 3 (a)

Describe the plan for the program performance evaluation that will contribute to continuous quality improvement. The program performance evaluation should https://www.acf.hhs.gov/sites/default/files/documents/prep-logic-model-ts_0.pdf

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monitor ongoing processes and the progress towards meeting the goals and objectives of the project and clearly identify those directly related to the Disparities Impact Statement. Additionally, monitor progress of the project as a whole, toward attainment of the Disparities Impact Statement. Include descriptions of the inputs (e.g., organizational profile, collaborative partners, key personnel, budget, and other resources), key processes, variables to be measured, and expected outcomes of the funded activities. In the Attachments section (IV. 2. vi., Attachment 2), attach a complete staffing plan and job descriptions for key personnel. Bio sketches of Key Personnel should be uploaded in the SF-424 R&R Senior/Key Person Profile form. Demonstrate evidence that the evaluative measures selected will be able to assess: 1) the extent to which the program objectives have been met, and 2) the extent to which these can be attributed to the project.

Describe the systems and processes that will support your organization's collection of HRSA’s performance management requirements through effective tracking of performance outcomes, including a description of how the organization will collect and manage data (e.g., assigned skilled staff, data management software) in a way that allows for accurate and timely reporting of performance outcomes. At the following link, you will find the required data forms for this program:

http://bhw.hrsa.gov/grants/reporting/index.html. Describe current experience, skills, and knowledge, including individuals on staff, materials published, and previous work of a similar nature. As appropriate, describe the data collection strategy to accurately collect, analyze and track data to measure process and impact/outcomes, and explain how the data will be used to inform program development and service delivery. Describe any potential obstacles for implementing the program performance evaluation and your plan to address those obstacles.

Document the procedure for assuring the data collection, management, storage, and reporting of National Provider Identifier (NPI) numbers for individuals participating in the Program. Describe current experience, skills, and knowledge, including individuals on staff, materials published, and previous work of a similar nature. Describe any potential obstacles for implementing the program performance evaluation and meeting HRSA’s performance measurement requirements and your plan to address those obstacles. The evaluation and reporting plan also should indicate the feasibility and effectiveness of plans for dissemination of project results, the extent to which project results may be national in scope, and the degree to which the project activities are replicable. Describe your process to track trainees after program completion/graduation for up to 1 year, to include collection of trainees’ NPI. (Note: Trainees who receive HRSA funds as a result of this award are encouraged to apply for an NPI for the purpose of collecting post-graduation employment demographics).

Include a plan for Rapid Cycle Quality Improvement (RCQI) for the continuous monitoring of ongoing project processes, outcomes of implemented activities, and http://bhw.hrsa.gov/grants/reporting/index.html

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progress toward meeting grant goals and objectives and the implementation of necessary adjustment to planned activities to effect course corrections. You may choose to require RCQI as part of an activity to be included under some or all program objectives and submitted as under the SWP. Additional information on RCQI is available at the following website: https://www.healthworkforceta.org/wp-content/uploads/2016/06/RCQI_Resource_Guide.pdf.

(b) PROJECT SUSTAINABILITY -- Corresponds to Section V’s Review Criterion 3 (b)

Propose a plan for project sustainability after the period of federal funding ends, including a description of specific actions you will take to (a) highlight key elements of your award projects, e.g., training methods or strategies, which have been effective in improving practices; (b) obtain future sources of potential funding; as well as (c) provide a timetable for becoming self-sufficient. Recipients are expected to sustain key elements of their projects, e.g., strategies or services and interventions, which have been effective in improving practices and those that have led to improved outcomes for the target population. Discuss challenges that are likely to be encountered in sustaining the program and approaches that will be used to resolve such challenges.

ORGANIZATIONAL INFORMATION, RESOURCES, AND CAPABILITIES --

Corresponds to Section V’s Review Criterion(a) 4

Succinctly describe your organization’s current mission, structure, and scope of current activities and how these elements all contribute to the organization’s ability to implement the program requirements and meet program expectations. Include an organizational chart (requested in Section IV.2. vi., Attachment 4.) Discuss how the organization will follow the approved plan, as outlined in the application, properly account for the federal funds, and document all costs to avoid audit findings.

Describe how you will routinely assess and improve the unique needs of target populations of the communities served.

The staffing plan and job descriptions for key faculty/staff must be included in Attachment 2 (Staffing Plan and Job Descriptions for Key Personnel). However, the biographical sketches must be uploaded in the SF-424 RESEARCH & RELATED Senior Key Person Profile (Expanded) form that can be accessed in the Application Package under “Mandatory.” Include biographical sketches for persons occupying the key positions, not to exceed TWO pages in length each. In the event that a biographical sketch is included for an identified individual who is not yet hired, please include a letter of commitment from that person with the biographical sketch.