BHW HRSA-22-047 (EO1) NFLP_Final.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Bureau of Health Workforce Division of Nursing and Public Health

Nurse Faculty Loan Program (NFLP)

Funding Opportunity Number: HRSA-22-047

Funding Opportunity Type(s): Competing Continuation, New

Assistance Listings (CFDA) Number: 93.264

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2022

Application Due Date: January 13, 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, including SAM.gov and Grants.gov, may take up to 1 month to complete.

Issuance Date: October 14, 2021

Linda Wierzechowski Nurse Consultant, Division of Nursing & Public Health Telephone: (301) 443-0819 Email: NFLP@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 U.S.C. § 297n-1 (Public Health Service Act Section 846A).

mailto:NFLP@hrsa.gov

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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 above in Section VII.

Agency Contacts.

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2022 Nurse Faculty Loan Program (NFLP). The purpose of this program is to increase the number of qualified nursing faculty nationwide. NFLP seeks to accomplish this by providing funding to accredited schools of nursing to establish and operate a student loan fund and provide loans to students enrolled in advanced education nursing degree programs who are committed to becoming nurse faculty. In exchange for completion of up to four years of post-graduation full-time nurse faculty employment in an accredited school of nursing, the program authorizes cancellation of up to 85 percent of the original student loan amount (plus interest thereon).

Funding Opportunity Title: Nurse Faculty Loan Program (NFLP) Funding Opportunity Number: HRSA-22-047 Due Date for Applications: January 13, 2022 Anticipated Total Annual Available FY 2022 Funding:

$26.5 million

Estimated Number and Type of Award(s):

Up to 80 Grants

Estimated Award Amount: Formula based. Subject to the availability of appropriated funds

Cost Sharing/Match Required: Yes Period of Performance: July 1, 2022 through June 30, 2023

(one year) Eligible Applicants: See Section III.1 of this notice of funding opportunity (NOFO) for complete eligibility information.

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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(s) for applicants seeking funding through this opportunity. The webinar(s) 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. Program-Specific Forms

vi. Attachments

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

APPENDIX: A

APPENDIX B

APPENDIX: C

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I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Nurse Faculty Loan Program (NFLP). This is a one-year funding opportunity.

Program Purpose The purpose of this program is to increase the number of qualified nursing faculty nationwide. NFLP seeks to accomplish this by providing funding to accredited schools of nursing to establish and operate a student loan fund and provide loans to students enrolled in advanced education nursing degree programs who are committed to becoming nurse faculty. In exchange for completion of up to four years of post-graduation full-time nurse faculty employment in an accredited school of nursing, the program authorizes cancellation of up to 85 percent of the original student loan amount (plus interest thereon).

Program Goals The goals of this program are to:

• Support training of advanced education nursing students who will serve as nurse faculty upon graduation, with a focus on doctorate preparation;

• Decrease the financial barrier of serving as nurse faculty through loan cancellation;

• Increase the number of adequately prepared and qualified nursing faculty nationwide;

• Address the nationwide primary care provider shortage by increasing access to designated joint nurse faculty (serving as Advance Practice Registered Nurses (APRN) preceptors, etc.); and

• Foster the recruitment and training of a diverse nurse faculty workforce. This NOFO encourages applicants and grant recipients to recruit and train a diverse nursing workforce, but please note the NFLP is a formula-based award and award selections will not be impacted by applicants’ (including new and continuing competing award recipient) diversity recruitment efforts.

Program Objectives To accomplish the goals, NFLP projects will:

• Establish and/or maintain a distinct NFLP loan fund account and provide fiscal oversight in accordance with NFLP requirements;

• Conduct an active training program, operate an active loan fund, disburse loans to students, and provide accurate programmatic and financial data to show successful project implementation;

• Recruit, train and graduate advanced nurse education students who will serve as nurse faculty post-graduation;

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• Develop collaborative partnerships to address health disparities, social determinants of health, and the needs of rural and underserved population through training, and to encourage nurse faculty employment post-graduation;

• Promote the diversity of the nursing faculty workforce by supporting students from diverse backgrounds, in becoming nurse faculty to address health disparities and increase health equity; and

• Provide up to 85 percent loan cancellation of the original loan amount through four years of post-graduation full-time nurse faculty employment (plus interest thereon).

For more details, see Program Requirements.

HHS and HRSA Priorities This program will build upon HRSA’s existing health workforce development investments, increasing access to quality health care services. You are encouraged to select and address one of the following HHS and HRSA priorities:

• Transforming the workforce –by targeting the need

• Strengthening health care access through telehealth

Promoting equity is essential to the Department’s mission of protecting the health of Americans and providing essential human services. This view is reflected in Executive Order 13985 entitled Advancing Racial Equity and Support for Underserved Communities Through the Federal Government (Jan. 20, 2021).

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 grantees are able to continue programmatic activities, can coordinate effectively, and can implement recovery plans when emergencies disrupt project activities. Applicants 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.

2. Background

This program is authorized by 42 U.S.C. § 297n-1 (Public Health Service (PHS) Act Section 846A).

Nursing workforce projections show shortages and maldistribution of supply across the U.S. as the need for health care grows.1 2 Compounding the problem is the recent

1 U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. (2017). National and Regional Supply and Demand Projections of the Nursing Workforce: 2014-2030. Rockville, Maryland 2 American Association of Colleges of Nursing. (2019). Fact Sheet: Nursing Shortage. Washington, DC.

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Coronavirus Disease 2019 (COVID-19) pandemic that has affected the capacity of both nurses and nursing schools across the country.3 HRSA’s nursing workforce projections also show that the national registered nurse (RN) supply across all race and ethnicity groups is projected to grow from 2,806,100 Full-Time Equivalents (FTEs) to 3,895,600 FTEs between 2014 and 2030.4 Nursing shortages and maldistribution are partially attributed to nursing school faculty shortages, which hamper nursing program enrollments.5 The American Association of Colleges of Nursing (AACN) reported that 80,407 qualified applicants were denied admission to baccalaureate and graduate nursing programs in 2019 due to insufficient number of faculty, clinical preceptors, clinical sites, classroom space, and budget constraints.6 AACN found that out of the total number of qualified applicants, 8,417 and 3,157 were turned away from masters and doctoral programs respectively.7

Most of the nursing schools responding to the AACN survey reported a shortage of faculty and/or clinical preceptors as top reasons for not accepting all qualified applicants into their programs. The shortages of minority nurse faculty also adds to the challenge of recruitment of students.8 Few minority nurses pursue faculty roles. AACN reported in their 2017 survey data that only 16.0% of full-time nursing school faculty were from minority backgrounds.9 A diverse nursing workforce is a high priority for addressing the nursing shortage and for meeting the cultural needs of an increasingly diverse population, and achieving health equity in the US.10 The recruitment, retention and graduation of a diverse student nurse population, results in a diverse nursing workforce.

The recruitment and retention of nurse faculty from minority populations is pertinent as such faculty will be key in attracting diverse student populations, and serve as mentors and academic role models to encourage and enrich learning.11 It is imperative to have a diverse nursing workforce to meet the needs of an increasingly diverse population and to address the nursing shortage.12. Additionally, nursing faculty members from diverse

3 Jackson, D., Bradbury‐Jones, C., Baptiste, D., Gelling, L., Morin, K., Neville, S., & Smith, G. D. (2020). Life in the pandemic: Some reflections on nursing in the context of COVID‐19. Journal of Clinical Nursing 4 U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. (2017). National and Regional Supply and Demand Projections of the Nursing Workforce: 2014-2030. Rockville, Maryland 5 American Association of Colleges of Nursing. (2019). Fact Sheet: Nursing Shortage. Washington, DC.

6 American Association of Colleges of Nursing. (2019). Special Survey on Vacant Faculty Positions for Academic Year 2018-2019. Washington, DC.

7 American Association of Colleges of Nursing. (2020). Fact Sheet: Nursing Faculty Shortage. Washington, DC.

(2020, September). https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Faculty-Shortage 8 American Association of Colleges of Nursing Fact Sheet - Enhancing diversity in the nursing force. (2019, April 1). https://www.aacnnursing.org/News-Information/Fact-Sheets/Enhancing- Diversity 9 American Association of Colleges of Nursing. (2019). Special Survey on Vacant Faculty Positions for Academic Year 2018-2019. Washington, DC.

10 U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. (2017). National and Regional Supply and Demand Projections of the Nursing Workforce: 2014-2030. Rockville, Maryland 11 American Association of Colleges of Nursing. (2019). Special Survey on Vacant Faculty Positions for Academic Year 2018-2019. Washington, DC.

12 American Association of Colleges of Nursing. (2019). Fact Sheet: Nursing Shortage. Washington, DC.

https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Faculty-Shortage https://www.aacnnursing.org/News-Information/Fact-Sheets/Enhancing-Diversity https://www.aacnnursing.org/News-Information/Fact-Sheets/Enhancing-Diversity

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backgrounds, are essential in educating students on the culturally competent care they need to provide care to diverse populations in the future and can contribute to ensuring an environment and curriculum that is inclusive.13

In AACN’s 2019 Special Survey on Vacant Faculty Positions, responding schools of nursing identified 1,637 faculty vacancies, a vacancy rate of 7.2 percent, with a cited need to create an additional 134 faculty positions to accommodate student demand.

The data showed that most of the vacancies (89.7 percent) were faculty positions requiring or preferring a doctoral degree. Respondents to the survey also reported that the most critical challenges related to faculty recruitment include the limited pool of doctoral prepared faculty, lack of faculty with the right specialty mix, noncompetitive salaries, difficulty finding faculty for schools in rural areas, etc.14 In addition, 33 percent of the current nursing faculty workforce in baccalaureate and graduate programs are expected to retire by 2025.15 In order to encourage students to become nurse faculty, evidence has shown the following to be effective: student support and mentorship;

adequate nurse educator preparation; and monetary support to pursue education, including fellowships and loan forgiveness. Additionally, increasing the diversity of nursing faculty can encourage retention and graduation by providing support to nursing students looking for academic role models, mentors, and a supportive community.16

Not only is the nation facing the issue of the nursing workforce shortage, but also the demand for primary care services has increased largely due to both a growing and an aging population. The Bureau of Health Workforce (BHW) National Center for Health Workforce Analysis (NCHWA) projects that the demand for primary care physicians will increase by 28,700 to 241,200 full time employees by the year 2020.17 Addressing the gap in primary care providers, especially for rural and underserved populations, is important for the health of the nation. APRNs can help to address this gap because they are often the primary care providers at the forefront of providing preventive care services to the public. APRNs treat and diagnose illnesses, advise the public on health issues, and manage chronic diseases.18 The issue is that nationwide, APRN education programs are experiencing a number of challenges, including increased demand for APRN education, the national faculty shortage, and a shortage of APRN preceptors. In a 2013 multidiscipline site survey, over 60 percent of schools with Nurse Practitioner

13 Whitfield-Harris, L., Lockhart, J. S., Zoucha, R., & Alexander, R. (2017). The lived experience of Black nurse faculty in predominantly White schools of nursing. Journal of Transcultural Nursing, 28(6), 608–615.

14 American Association of Colleges of Nursing. (2019). Special Survey on Vacant Faculty Positions for Academic Year 2018-2019. Washington, DC.

15 Kesten, K., Fang, Di, (2017 September). Retirements and succession of nursing faculty in 2016-2025, Nursing Outlook 65(5) 633-642 16 National Advisory Council for Nursing Education and Practice. Eleventh report to the Secretary of the Department of Health and Human Services and the Congress, 2013, Achieving Health Equity through Nursing Workforce Diversity. http://www.hrsa.gov/advisorycommittees/bhpradvisory/nacnep/Reports/eleventhreport.pdf.

17 U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. (2016). National and Regional Projections of Supply and Demand for Primary Care Practitioners: 2013-2025. Rockville, Maryland.

18 American Nurses Association. (n.d.). Advanced Practice Registered Nurse (APRN).

https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/aprn/ http://www.hrsa.gov/advisorycommittees/bhpradvisory/nacnep/Reports/eleventhreport.pdf

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(NP) programs expressed concern over the limited number of clinical sites. Additionally, 59 percent of respondents reported inadequate supplies of qualified primary care preceptors.19

Supporting and encouraging academic practice partnerships to increase the number of qualified nurse faculty preceptors help addresses the nationwide nurse faculty shortage.

Programs focused on addressing the nursing faculty shortage through training should include student nurse educator development activities in their training curriculum to ensure students are prepared and qualified to become nurse faculty upon graduation.20,21 Student nurse educator development activities include completion of nurse educator courses, mentorship, teaching practicum, nurse education focused workshops, and certification. These activities assure attainment of essential teaching skills, enhance confidence, promote proficiency, facilitate transition into the faculty role and promote faculty practice/retention.22 The activities also address the nurse faculty shortage by ensuring that the students trained to become nurse faculty are qualified and adequately prepared for an effective transition into faculty roles, thereby expanding educational capacity in the nursing profession.

In order to address the shortage of nurse faculty, including preceptor shortage, partnerships are vital.23 Partnerships among academic institutions and between academic and practice institutions are beneficial in addressing both nurse faculty shortage, the limited supply of APRN preceptors, and increasing diversity amongst nurse faculty.14 These partnerships provide an avenue for shared resources and increase opportunities for recruitment of diverse student population, teaching/learning, student nurse educator development activities, and employment post-graduation.

Partnerships among academic institutions expand access to educational resources and are especially beneficial to institutions located in rural and underserved areas.14 Partnerships between academic and practice partners enable institutions to build capacity by engendering collaboration between clinicians and academia.

The NFLP grant addresses the national nursing faculty shortage by supporting institutions committed to preparing advanced degree nursing students to serve as nurse faculty, especially those with a focus on doctoral preparation. Institutions are encouraged to use their NFLP projects to increase the diversity of nurse faculty and to prepare and connect nurse faculty to serve in communities in need.

19 Jones, K., Petri, L. & Statler, M. (2013). Recruiting and Maintaining U.S. Clinical Training Sites: Joint Report of the 2013 Multi-Discipline Clerkship/Clinical Training Site Survey.

20 National Advisory Council on Nurse Education and Practice. (2010, August). Ninth Report: The impact of nurse faculty shortage on nurse education and practice. https://www.hrsa.gov/sites/default/files/hrsa/advisory-committees/nursing/reports/2010-ninthreport.pdf 21 Oermann, M. H. (2017). Preparing nurse faculty: it’s for everyone. Nurse educator, 42(1), 1 22 Booth, T. L., Emerson, C. J., Hackney, M. G., & Souter, S. (2016). Preparation of academic nurse educators.

Nurse Education in Practice, 19, 54-57.

23 National Advisory Council on Nurse Education and Practice. (2020, December). Seventeenth Report: Preparing Nurse Faculty, and Addressing the Shortage of Nurse Faculty and Clinical Preceptors.

https://www.hrsa.gov/sites/default/files/hrsa/advisory-committees/nursing/reports/nacnep-17report-2021.pdf

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Additionally, NFLP addresses the nationwide primary care provider shortage by encouraging APRNs to serve as full-time preceptors within an academic-practice partnership framework. The student nurse educator development activities are essential in ensuring that advanced degree nursing students are adequately prepared to become nurse educators, acculturate successfully and flourish in a teaching role upon graduation.

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 Nurse Faculty Loan Program for Fiscal Year 2022:

Advanced Education Nursing Program – Refers to advanced education nursing degree programs (including individuals in combined Registered Nurse (RN)/graduate degree programs and post-nursing Master’s certificate programs) that train individuals to serve as nurse practitioners, clinical nurse specialists, nurse-midwives, nurse anesthetists, nurse educators, nurse administrators, and public health nurses.

Collaborative Academic and Academic-Practice Partnerships Collaborative partnerships are formal and strategic relationships between entities established to advance their mutual interests related to practice, education and research. Collaboration between academic and preceptor practice partners leverages resources to: maximize student learning; ensure safety of care delivery; and optimize patient outcomes.14 Academic partnerships with preceptors/health facilities provide crucial access to preceptors and clinical training opportunities for APRN students/graduates, foster clinical innovation, and promote continuing education.

For the purposes of this NOFO, Academic Partnerships refers to formal collaboration between multiple academic institutions to create innovative opportunities for networking, training, student nurse educator development activities, and nurse faculty employment post-graduation.

For the purposes of this NOFO, Academic Practice Partnerships refers to formal collaboration between academic and clinical practice settings, to support training, student nurse educator development activities, and preceptor appointment.

For the purpose of the NFLP, NFLP graduates serving as full-time preceptors for APRN students within an academic-practice partnership and are considered full time nurse faculty (in a joint nurse faculty appointment).

Equity – “The consistent and systematic fair, just, and impartial treatment of all individuals, including individuals who belong to underserved communities that have been denied such treatment, such as Black, Latino, Indigenous and Native American persons, Asian Americans and Pacific Islanders and other persons of color; members of religious minorities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons;

https://bhw.hrsa.gov/grants/resourcecenter/glossary

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persons with disabilities; persons who live in rural areas; and persons otherwise adversely affected by persistent poverty or inequality.”24

Addressing issues of equity should include an understanding of intersectionality and how multiple forms of discrimination impact individuals’ lived experiences. Individuals and communities often belong to more than one group that has been historically underserved, marginalized, or adversely affected by persistent poverty and inequality.

Individuals at the nexus of multiple identities often experience unique forms of discrimination or systemic disadvantages, including in their access to needed services.

Full-Time Employment – Refers to the status of a student borrower who has graduated and is employed and serving in a nurse faculty capacity that qualifies for loan cancellation. For the purpose of the Nurse Faculty Loan Program, the institution which provided NFLP support to a borrower makes the determination about meeting the full-time employment requirement. This may include one of the following criteria: (1) employment as a full-time faculty member at an accredited school of nursing; (2) employment as a part-time faculty member at an accredited school of nursing in combination with another part-time faculty position or part-time clinical preceptor/educator position affiliated with an accredited school of nursing that together equates to full-time employment; or 3) designation of nurse faculty in a joint nurse faculty appointment serving as full-time advanced practice registered nurse (APRN) preceptor for an accredited school of nursing, within an academic-practice partnership framework.

Health equity – The absence of disparities or avoidable differences among socioeconomic and demographic groups or geographical areas in health status and health outcomes such as disease, disability, or mortality.

Joint Nurse Faculty Appointment – Joint nurse faculty appointments are appointments that involve practicing as both clinician and nurse faculty with mutually established responsibilities in both the academic institution and practice entity.1 APRNs may be assigned a joint nurse faculty appointment for serving as preceptors for APRN students in an affiliated school of nursing, while maintaining their primary staff appointment.

For the purpose of NFLP, an NFLP graduate who is designated as nurse faculty (a joint nurse faculty appointment) serving as an APRN student preceptor in a full- time capacity, qualifies for loan cancellation. The joint nurse faculty appointment can be designated to the an NFLP graduate who holds a primary appointment as a practicing APRN for a health care entity, and who agrees to, and is qualified to precept APRN students.

1. The NFLP graduate must receive loan cancellation in exchange for their service as a full time APRN preceptor in a joint nurse faculty appointment.

24 Executive Order 13985 on Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, 86 FR 7009, at § 2(a) (Jan. 20, 2021), https://www.govinfo.gov/content/pkg/FR-2021-01- 25/pdf/2021-01753.pdf https://www.govinfo.gov/content/pkg/FR-2021-01-25/pdf/2021-01753.pdf https://www.govinfo.gov/content/pkg/FR-2021-01-25/pdf/2021-01753.pdf

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2. The NFLP institution which provided NFLP support to the borrower makes the determination about meeting the full-time employment requirement for preceptorship service.

3. The school of nursing whose students are being precepted will provide the designation of nurse faculty for the NFLP graduate, and complete all required documentation (e.g., Employment certification) needed for the graduate to receive loan cancellation in exchange for full time preceptorship service.

4. The NFLP graduate’s affiliation with the accredited school of nursing must be signified by entering into a formal agreement as part of an academic-practice partnership based on the institution’s existing policies. The academic-practice partnership may occur between the academic institution (with students to precept) and the NFLP graduate’s employing (health care/practice) institution; or directly between the academic institution and the NFLP graduate. The designation of nurse faculty for the NFLP graduate serving as a full time APRN preceptor in a joint nurse faculty appointment must be denoted through a formal agreement documenting the individual as nurse faculty.25

As part of the COVID-19 emergency relief measures, the requirement to obtain full-time nurse faculty employment within 12 months of graduation has been extended from 12 months to 24 months for NFLP beneficiaries with graduation dates during the 2019- 2022 academic years.

II. Award Information

1. Type of Application and Award

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

HRSA will provide funding in the form of a formula award. The amount of funding awarded to each recipient will be determined according to a formula described in section V.1.

25 Joint Appointments are faculty appointments for faculty members who make a substantial contribution to the academic institution or department and who typically hold a primary staff appointment in an affiliated healthcare institution. Examples of joint appointments in academic institutions include: Faculty Associate appointments which are offered to individuals who make significant contributions to the academic unit’s teaching or research mission, such as serving regularly as preceptors or participating in research; and Affiliate Clinical Faculty appointments which are offered to selected qualified professionals employed outside of the academic institution, providing primarily clinical related service (for example clinical preceptors). These individuals are recognized for their commitment and service to the practice mission of the academic institution.

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2. Summary of Funding

HRSA estimates approximately $26.5 million to be available to fund approximately 80 recipients. The actual amount available will not be determined until enactment of the final FY 2022 federal appropriation. 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, 2023 (1 year). Funding beyond this award is subject to the availability of appropriated funds for NFLP in subsequent fiscal years, satisfactory recipient performance, and a decision that continued funding is in the best interest of the Federal Government.

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

This program does not allow NFLP funds to be used for any indirect costs.

III. Eligibility Information

1. Eligible Applicants

Eligible applicants are accredited schools of nursing with advanced education nursing programs. Any school(s) of nursing affiliated with this application must be accredited at the time of application – and for the duration of the award – by a recognized body or bodies, or a State agency, approved by the Secretary of Education for nurse education accreditation. Applicants must submit official documentation of accreditation in Attachment 1 for all affiliated nursing programs.

Eligible applicants must be located in the United States, Guam, Commonwealth of Puerto Rico, Northern Mariana Islands, American Samoa, U.S. Virgin Islands, Federated States of Micronesia, Republic of the Marshall Islands, or the Republic of Palau. Tribes and Tribal organizations may apply for these funds, if otherwise eligible.

Individuals and foreign entities are not eligible under this NOFO.

2. Cost Sharing/Matching

Cost sharing/matching is required for this program. Recipient institutions are required to deposit an institutional capital contribution (ICC) that is equal to not less than one-ninth of the FY 2021 Federal award amount, hereafter referred to as the Federal Capital Contribution (FCC). The ICC must be deposited at the time the FCC is received and deposited into the loan fund account.

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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3. Other

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

• 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. § 297n-1(b)(2)(B) and 296b (Public Health Service Act sections 846A(b)(2)(B) and 803). 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 3. For NFLP, the MOE is the ICC contributed.

Multiple Applications Multiple applications from an organization with the same DUNS number or Unique Entity Identifier (UIE) are allowable if the applications propose separate and distinct projects; however, applicants can submit only one application per campus. A campus is defined as a division of a university that has its own grounds, buildings (e.g., school of nursing) and faculty. A clinical facility is defined as a health care facility, whether part of a system or not, which has its own grounds containing its own leadership (chief nursing officer, chief medical officer, chief executive officer, etc.). Independent organizations are those entities that have unique DUNS numbers.

If for any reason (including submitting to the wrong funding opportunity number or making corrections/updates) an application is submitted more than once prior to the application due date, HRSA will only accept your last validated electronic submission, under the correct funding opportunity number, prior to 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. Applications received without the appropriate tables will be deemed non-responsive to the NOFO and will not be considered for funding under this notice.

Beneficiary Eligibility An eligible beneficiary must be a citizen, national, or permanent resident of the United States. Individuals on temporary or student visas are not eligible to receive NFLP support.

Award recipients must use this funding to support a beneficiary: (1) Enrolled in a course of study in an advanced education nursing degree program; (2) Who maintains an acceptable level of academic standing; and (3) Is eligible to work in the United States.

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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-22-047 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 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)).

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

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 http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf

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Application Page Limitation The total size of all uploaded files included in the page limit may not exceed the equivalent of 40 pages when printed by HRSA. The page limit includes the project narratives and attachments required in the 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 included in the workspace application package do not count in the page limit. If you use an OMB-approved form that is not included in the workspace application package for HRSA-22-047, 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 40 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-22-047 before 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) Where you are unable to attest to the statements in this certification, an explanation shall be included in Attachment 7: Other Relevant Documents.

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

Temporary Reassignment of State and Local Personnel during a Public Health Emergency Section 319(e) of the Public Health Service (PHS) Act provides the Secretary of the Department of Health and Human Services (HHS) with discretion upon request by a state or tribal organization to authorize the temporary reassignment of state, tribal, and local personnel during a declared federal public health emergency. The temporary reassignment provision is applicable to state, tribal, and local public health department or agency personnel whose positions are funded, in full or part, under PHS programs and allows such personnel to immediately respond to the public health emergency in the affected jurisdiction. Funds provided under the award may be used to support personnel who are temporarily reassigned in accordance with § 319(e). Please reference detailed information available on the HHS Office of the Assistant Secretary for

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Preparedness (ASPR) website via http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx.

Program-Specific Instructions

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

1. Establish and/or maintain a student loan fund and develop a standard operating procedure to guide project administration;

2. Draw down the entire FCC amount within 60 days of receipt, contribute the ICC amount (equal to not less than one-ninth of the FCC); and deposit both the FCC and ICC funds into the student loan fund account;

3. Develop collaborative partnerships or engagements to recruit students, provide access to training resources, and connect graduates with post-graduation employment opportunities. Engage and/or partner with community based entities, including HRSA-supported health centers and other HRSA-funded sites, and connect students and graduates with HRSA training and employment resources;

4. Incorporate the principles of equity in the recruitment, training and graduation of students;

5. Conduct an active training for students pursuing a course of study in an advanced education nursing degree program that prepares them to become nurse faculty;

6. Disburse NFLP loan funds to advanced education nursing students in accordance with NFLP’s purpose, objective and goals;

7. Applicants/awardees that do not disburse NFLP loan funds will be identified as non-compliant and subject to additional penalties (such as remittance of unobligated funds), up to and including termination of the NFLP award;

8. Support student nurse educator development activities within the course of study, as a reasonable educational expense;

9. Enhance didactic and experiential training activities to develop competencies of NFLP beneficiaries to address health disparities, social determinants of health, and health equity for populations they serve upon graduation;

10. Support post-graduation employment and connect nurse faculty graduates to communities of need (rural and/or undeserved areas) upon graduation;

11. Provide cancellation of up to 85 percent of the original student loans (plus interest thereon) for completion of up to four years of post-graduation full-time nurse faculty employment; and

12. Collect on principal and interest for all loans made from the NFLP student loan fund (and any other earnings of the fund) for deposit into the fund. NFLP funds may be used to cover the costs of collection of NFLP loans including designated institutional structures to collect costs such as personnel and third party servicers.

NOTE: More information about the administration of these requirements is available on the NFLP webpage, specifically at:

https://bhw.hrsa.gov/fundingopportunities/buckets/NFLP-admin- guidelines2017.pdf.

http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf https://bhw.hrsa.gov/fundingopportunities/buckets/NFLP-admin-guidelines2017.pdf https://bhw.hrsa.gov/fundingopportunities/buckets/NFLP-admin-guidelines2017.pdf

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NOTE: Additional HRSA Training Resources are located in Appendix C of this NOFO.

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:

• A brief overview of the project as a whole

• Specific, measurable objectives that the project will accomplish

• Which of the clinical priorities will be addressed by the project, if applicable; and

• 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.

ii. Project Narrative

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

Successful applications will contain the information below. Please use the following section headers for the narrative:

PURPOSE AND NEED

This section will help reviewers understand the institution that will receive funding for training, as well as the needs of the communities that recipients would ultimately serve.

• Briefly describe the purpose of the proposed project.

• Demonstrate the alignment of the project and institution with the NFLP purpose;

including an alignment of the project with HRSA’s mission to improve the health of underserved and vulnerable populations by strengthening the health workforce and connecting skilled professionals to communities in need.

• Describe the need for more qualified and diverse nurse faculty within your geographical area.

• Discuss how your students will benefit from this program and how your graduates impact the nurse faculty health workforce locally and nationally, including benefit to rural or underserved populations, as applicable.

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

(a) Work Plan; (b) Methodology/Approach; and (c) Resolution of Challenges

(a) WORK PLAN -- You must provide a detailed work plan that demonstrates your plan to implement project of the proposed scope. Your work plan outlines the contents of

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your institution’s NFLP Standard Operating Procedure (SOP). A sample work plan can be found here: http://bhw.hrsa.gov/grants/technicalassistance/workplantemplate.docx.

You must:

• Describe steps you will take to achieve each of the objectives proposed during the entire period of performance.

• Describe the timeframes, deliverables, and key partners required during the grant 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 grant implementation.

• Identify meaningful support and collaboration with key stakeholders in planning, designing, and implementing all activities.

• Describe how the institution will increase diversity in nurse faculty.

• Describe how the intuition will address health equity and health disparities in the training curricula.

• Describe the collaborative academic or academic-practice partnership formed to support training, student nurse educator development, faculty employment and service obligation, if applicable.

(b) METHODOLOGY/APPROACH

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. If applicable, include a plan to disseminate reports, products, and/or project outputs so project information is provided to key target audiences.

Logic Model Submit a logic model for designing and managing the project. A logic model is a one-page diagram that presents the conceptual framework for a proposed project and explains the links among program elements to achieve the relevant outcomes. 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 or deliverables of program activities); and

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

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

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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. A logic model is a visual diagram that demonstrates an overview of the relationships between the 1) resources and inputs, 2) implementation strategies and activities, and 3) desired outputs and outcomes in a project. 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

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

• Identifying and recruiting a diverse student cohort who plan to become nurse faculty;

• Establishing confirmation of students’ understanding of the commitment involved in receiving the loan and the service obligation;

• The management of borrower records and the institution’s loan fund account (including prevention of high default rates, etc.);

• The management of loan cancellation, repayment and collection activities, including coordinating third party loan servicing and collection entities; and

• Tracking and assisting NFLP-supported graduates with obtaining employment and meeting their service obligation as full-time nursing faculty to include rural and underserved areas.

IMPACT -- This section includes two sub-sections— (a) Evaluation and Technical Support Capacity; and (b) Project Sustainability

(a) EVALUATION AND TECHNICAL SUPPORT CAPACITY

You must describe the plan for program performance evaluation that will contribute to continuous quality improvement.