BHW HRSA-23-007 (K01) GACA_Final.pdf

U.S. Department of Health and Human Services

Bureau of Health Workforce

Division of Medicine and Dentistry

Geriatrics Academic Career Awards

Funding Opportunity Number: HRSA-23-007

Funding Opportunity Type(s): New

Assistance Listings (AL/CFDA) Number: 93.250

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2023

Application Due Date: November 3, 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: August 5, 2022

Jacqueline Friedman Kreinik, MS, RN Project Officer Telephone: (301) 945-9839 Email: GACAProgram@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: Title VII, Section 753(b) of the Public Health Service Act (42 U.S.C. § 294c(b))

HRSA-23-007 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 above in Section VII.

Agency Contacts.

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2023 Geriatrics Academic Career Award program. The purpose of this program is to support the career development of junior faculty as academic geriatricians or academic geriatrics specialists.

Funding Opportunity Title: Geriatrics Academic Career Award Program

Funding Opportunity Number: HRSA-23-007

Due Date for Applications: November 3, 2022

Anticipated FY 2023 Total Annual Available Funding:

$2,100,000

Estimated Number and Type of Award(s): Up to 26 grants

Estimated Annual Award Amount: Up to $81,746 per award

Cost Sharing/Match Required: No

Period of Performance: July 1, 2023 through June 30, 2027 (4 years)

HRSA-23-007 ii

Eligible Applicants: Eligible applicants are:

• accredited health professions schools or graduate programs approved by the Secretary including schools of allopathic medicine, osteopathic medicine, nursing, dentistry, pharmacy, allied health, physician assistant programs, chiropractic, podiatric medicine, optometry, public health, and veterinary medicine.

• accredited graduate programs in health administration and behavioral health and mental health practice including clinical psychology, clinical social work, professional counseling, and marriage and family therapy

• Tribes and tribal organizations are eligible if they otherwise meet the eligibility requirements.

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 this NOFO and in HRSA’s HRSA’s SF-424 R&R Application Guide. Visit HRSA’s How to Prepare Your Application page for more information.

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://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://bhw.hrsa.gov/fundingopportunities/default.aspx

HRSA-23-007 iii

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. 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 REVIEW CRITERIA

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

HRSA-23-007 1

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Geriatrics Academic Career Award (GACA) program.

Program Purpose The purpose of the GACA program is to support the career development of junior faculty as academic geriatricians or academic geriatrics specialists.

Program Goals The goals of the program are for the GACA candidate to: a) develop the necessary knowledge and skills to lead health care transformation in a variety of settings, including rural and/or medically underserved settings, b) be age-friendly, and c) provide training in clinical geriatrics, including the training of interprofessional teams of healthcare professionals to provide healthcare for older adults.

Program Objectives

1. Develop junior faculty for a career as an academic geriatrician or academic geriatrics specialist to address the above program goals.

2. Educate and train the healthcare workforce, within the context of the age-friendly health systems framework, to address dementia-risk reduction, dementia across the disease trajectory including training on dementia medications as they are approved for use, health disparities and social determinants of health, and nursing home care.

3. Advance the GACA candidate’s career development through participation in leadership positions in professional organizations.

For more details, see Program Requirements and Expectations.

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 GACA training.

2. Background

The program is authorized by Title VII, Section 753(b) of the Public Health Service Act (42 U.S.C. § 294c(b)). The focus of this subsection is to support the career development of individual junior faculty in geriatrics at accredited health professions schools and

HRSA-23-007 2

programs. This GACA Notice of Funding Opportunity (NOFO) seeks to address the continuing shortages of academic geriatrics specialists.

The United States Census Bureau reports1 the United States will reach a new milestone in 2034, people age 65 and over are expected to outnumber children under age 18 (77 million vs 76.5 million), a demographic already reached in other countries. Starting in 2030, when those born in America between 1946 and 1964, referred to as ‘boomers’, will be older than 65, the number of people older than 65 will make up 21 percent of the population, the number of people 85 and older 85-plus will triple, and the country will add a half million centenarians.2 The Alzheimer’s Association projects growing numbers of Americans with Alzheimer’s or other dementias will escalate rapidly in coming years and projects this group to grow from 58 million in 2021 to 88 million by 2050.3 More deaths due to Alzheimer’s disease occur at home, making it critical for families and caregivers to develop the knowledge and skills to care for persons living with dementia.

Using the Age-Friendly Health System framework and incorporating the 4M’s [What Matters, Medication, Mentation, and Mobility] into primary care, where the interprofessional team learns to first ask what matters to the patient and provides the platform to discuss home, family and lifestyle and helps provider and patient plan and prepare to maximize health outcomes.

The size of the healthcare workforce is currently inadequate to meet the increased healthcare and psychosocial needs of older adults. The National and Regional Projections of Supply and Demand for Geriatricians: 2013-2025 report projected the demand for geriatricians will exceed supply, resulting in a national shortage of 26,980 full time equivalent positions in 2025.4 Furthermore, the education and training of the national healthcare workforce are hampered by a lack of well-trained geriatrics faculty.

The purpose of the GACA program is to promote the career development of junior faculty as academic geriatricians and academic geriatrics specialists to address the shortage of geriatrics faculty. A four-year project period for the GACA program is proposed to allow adequate time to implement career development, establish training and curricular activities, and develop a nationwide network with GACA recipients to serve as a continuing resource for sharing updates on caring for older adults and address the chronic gap of trained geriatrics specialists.

1 Vespa, J., The U.S. Joins Other Countries With Large Aging Populations, Retrieved May 18, 2022 from Https://www.census.gov/library/stories/2018/03/graying-america.html.

2 Ibid.

3 Alzheimer’s Association. 2021 Alzheimer’s disease Facts and Figures. Alzheimers Dement 2021; 17(3).

4U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. 2017. National and Regional Projections of Supply and Demand for Geriatricians: 2013-2025. Rockville, Maryland. Retrieved on June 3, 2022 from https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/geriatrics-report-51817.pdf.

https://www.census.gov/library/stories/2018/03/graying-america.html

HRSA-23-007 3

Program Definitions A glossary containing general definitions for terms used throughout the Bureau of Health Workforce NOFOs can be located at the HRSA Health Workforce Glossary. In addition, the following definitions apply to the GACA program for Fiscal Year 2023:

Age Friendly Health System means a healthcare system that improves the quality of care for older adults and optimizes value for health systems by providing older adults with the best care possible; reducing healthcare related harms to older adults to close to zero; satisfying older adults with their care; and optimizing value for individuals including patients, families, caregivers, direct care workers, healthcare providers, and health professions students, residents, fellows, and faculty, and health systems. The essential elements of age-friendly health systems are a) What Matters (to the older adult); b) Medication; c) Mentation; and d) Mobility.5

Allied Health Professionals means a health professional (other than a registered nurse or physician assistant)—(A) who has received a certificate, an associate’s degree, a bachelor’s degree, a master’s degree, a doctoral degree, or postbaccalaureate training, in a science relating to health care; (B) who shares in the responsibility for the delivery of health care services or related services, including— (i) services relating to the identification, evaluation, and prevention of disease and disorders; (ii) dietary and nutrition services; (iii) health promotion services; those who have received a certificate, an associate’s degree, a bachelor’s degree, a master’s degree, a doctoral degree, or post baccalaureate training, in a science relating to health care. For Title VII Programs, allied health professionals do not include: registered nurses, physician assistants, doctors of medicine, doctors of osteopathy, dentists, veterinarians, optometrists, podiatrists, pharmacists, individuals with graduate degrees in public health, health administration, or other equivalent degrees, chiropractors, clinical psychologists, social workers, or individuals with a degree in counseling or an equivalent degree.6

Full-Time Junior Faculty refers to a full-time academic rank of instructor or assistant professor.

Value-based care refers to reimbursement that ties payments for care delivery to quality of care provided and supports better care for individuals, better health for populations, and lower costs.7

Primary Mentor advises and provides guidance and supervision to the GACA candidate regarding planning, directing, executing, and evaluating the proposed activities in the GACA candidate’s career development plan. The mentor(s) must have expertise in the area of the GACA candidate’s proposed career development plan, be

5 The John.A. Hartford Foundation & The Institute for Healthcare Improvement. (2018). Age-Friendly Health Systems. Retrieved from: https://www.johnahartford.org/grants-strategy/current-strategies/age-friendly-hospitals/ 6 Public Health Service Act-Title VII (Health Professions Education) [As Amended Through P.L. 116–260, Enacted December 27, 2020].

7 Retrieved from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment- Instruments/Value-Based-Programs/Value-Based-Programs.html https://bhw.hrsa.gov/grants/resourcecenter/glossary https://www.johnahartford.org/grants-strategy/current-strategies/age-friendly-hospitals/ https://www.johnahartford.org/grants-strategy/current-strategies/age-friendly-hospitals/ https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/Value-Based-Programs.html https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/Value-Based-Programs.html

HRSA-23-007 4

committed both to the GACA candidate’s career development and to the direct supervision of the GACA’ candidate’s project. The primary mentor must be of the same discipline as the GACA candidate.

II. Award Information

1. Type of Application and Award

Type of applications sought: New

HRSA will provide funding in the form of a grant.

2. Summary of Funding

HRSA estimates approximately $2,100,000 to be available annually to fund 26 recipients. The actual amount available will not be determined until enactment of the final FY 2023 federal appropriation. The award amount is $81,746 total cost (includes both direct and indirect (facilities and administrative costs)) per year.

The period of performance is July 1, 2023 through June 30, 2027 (4 years). Funding beyond the first year is subject to the availability of appropriated funds for GACA in subsequent fiscal years, satisfactory progress, 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.

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 per Section 753(b)(2) provides that eligible entities are those described in paragraph (1), (3), or (4) of section 799B or section 801(2) or “another accredited health professions school or graduate program approved by the Secretary.”

http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75

HRSA-23-007 5

The legislative authority includes the following:

• accredited health professions schools or graduate programs approved by the Secretary including schools of allopathic medicine, osteopathic medicine, nursing, dentistry, pharmacy, allied health, physician assistant programs, chiropractic, podiatric medicine, optometry, public health, and veterinary medicine.

• accredited graduate programs in health administration and behavioral health and mental health practice including clinical psychology, clinical social work, professional counseling, and marriage and family therapy

• Tribes and tribal organizations are eligible if they otherwise meet the eligibility requirements.

Eligible individuals (GACA candidates) must:

1. Be board certified or board eligible in internal medicine, family practice, psychiatry, or licensed dentistry, or have completed any required training in a discipline and be employed in an accredited health professions school or graduate program or an program that is approved by the Secretary; and

2. Have completed an approved fellowship program in geriatrics or have completed specialty training in geriatrics as required by the discipline; and for disciplines that do not have specialty training in geriatrics, the GACA candidate must have completed an accredited graduate level certificate program in geriatrics within the past three years; and

3. Have a full-time junior, nontenured, faculty appointment in an accredited health professions school or graduate program in geriatrics or a geriatrics health profession.

If an eligible individual is promoted during the period of an award under this program and thereby no longer meets the criteria listed above, the individual shall continue to be treated as an eligible individual through the term of the award.

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 $81,746.00 total cost per year

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

HRSA-23-007 6

Accreditation Applicants must provide documentation of accreditation for the health professions school or program where the GACA candidate has a full time junior faculty appointment must be submitted as Attachment 1. The full letter of accreditation is not required.

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. Such federal funds are intended to supplement, not supplant, existing non-federal expenditures for such activities. Complete the Maintenance of Effort (MOE) information and submit as Attachment 6.

HRSA will enforce statutory MOE requirements through all available mechanisms.

NOTE: Multiple applications from an organization with the same Unique Entity Identifier (UEI) are allowable if the applications propose separate and distinct projects. An organization is defined as a single campus for a division of a university that has its own grounds, buildings, and faculty. Please note: while an eligible entity can submit multiple applications, each application must be submitted on behalf of unique junior faculty and no more than two awards will be made per organization. If two awards are made to an organization, they will be from different disciplines.

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. 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 A GACA candidate receiving support from grant funds must be a citizen, national, or permanent resident of the United States.

Current and former GACA recipients are not eligible individuals for this GACA funding opportunity.

Adjunct and associate professor positions are not eligible faculty appointments for this award.

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 https://www.gsa.gov/about-us/organization/federal-acquisition-service/office-of-systems-management/integrated-award-environment-iae/iae-information-kit/unique-entity-identifier-update https://www.grants.gov/

HRSA-23-007 7

package associated with this notice of funding opportunity (NOFO) following the directions provided at Grants.gov: HOW TO APPLY FOR GRANTS. If you use an alternative electronic submission, see Grants.gov: APPLICANT SYSTEM-TO-SYSTEM.

Form Alert: For the Project Abstract Summary, applicants using the SF-424 R&R Application Package are encountering a “Cross-Form Error” associated with the Project Summary/Abstract field in the “Research and Related Other Project Information” form, Box 7. To avoid the “Cross-Form Error,” you must attach a blank document in Box 7 of the “Research and Related Other Project Information” form, and use the Project Abstract Summary Form in workspace to complete the Project Abstract Summary. See Section IV.2.i Project Abstract for content information.

The NOFO is also known as “Instructions” on Grants.gov. You must select “Subscribe” and provide your email address for HRSA-23-007 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, and certifications. 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 this NOFO and HRSA’s SF-424 R&R Application Guide. 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.

Application Page Limit The total of uploaded attachment pages that count against the page limit shall be no more than the equivalent of 70 pages when printed by HRSA. Standard OMB-approved forms included in the workspace application package do not count in the page limit. The abstract is the standard form (SF) "Project_Abstract Summary.” If there are other attachments that do not count against the page limit, this will be clearly denoted in Section IV.2.vi Attachments.

The abstract is no longer an attachment that counts in the page limit. Additionally, Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count in the page limit. However, if you use an OMB-approved form that is not included in the workspace application package for HRSA-23-007 it will count against the page limit.

http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/s2s/applicant-system-to-system.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

HRSA-23-007 8

Therefore, we strongly recommend you only use Grants.gov workspace forms associated with this NOFO to avoid exceeding the page limit.

It is important to take appropriate measures to ensure your application does not exceed the specified page limit. Any application exceeding the page limit 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-23-007 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. § 3354).

3) If you are unable to attest to the statements in this certification, you must include an explanation in Attachments 10-15: 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), which sunsets / terminates on September 30, 2023. Please reference detailed information available on the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) website.

Program Requirements and Expectations

The GACA candidate must:

1. Describe the methodological framework that guides the GACA candidate’s career development.

2. Develop the necessary knowledge and skills for career development as an academic geriatrician or academic geriatrics specialists.

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 http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx

HRSA-23-007 9

3. Spend at least 75 percent of the GACA candidate’s time per the statutory service requirement providing training in clinical geriatrics, including the training of interprofessional teams of healthcare professionals.

4. Identify and work with a primary mentor within the institution who has had a faculty appointment teaching geriatrics and will advise and provide guidance and supervision regarding planning, directing, executing, and evaluating the proposed activities in the GACA candidate’s Faculty Career Development Plan.

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. Name of the project director who is the GACA candidate and the specific discipline;

2. A brief overview of the GACA candidate’s project including a description of the GACA candidate’s faculty development plan, how the GACA candidate will meet the statutory service requirement that 75 percent of the GACA candidate’s time will be devoted to the training of clinical geriatrics including the training of interprofessional teams, and the role of the GACA candidate’s mentor;

3. Specific, measurable objectives that the project will accomplish;

4. HHS and HRSA clinical priorities (i.e., behavioral health, community health, COVID-19, health equity, resilience of the workforce and strengthening healthcare access through telehealth), that will be addressed by the project, if applicable; and

5. 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

HRSA-23-007 10

Narrative Section Review Criteria

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

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 This section will help reviewers understand the organization and the role of a junior faculty GACA candidate, and the community that will benefit from the GACA candidate’s activities.

1. Describe the purpose of the GACA candidate’s proposed project.

2. Outline the need for faculty with geriatrics expertise and interprofessional geriatrics education and training at the GACA candidate’s institution.

3. Describe the GACA candidate’s prior training, teaching experience, and academic career. Include a description of the GACA candidate’s primary duties and professional responsibilities at their r institution, any publications related to the proposed project, and other relevant experience.

4. Describe the GACA candidate’s commitment to a career in interprofessional geriatrics clinical education and describe how the GACA candidate is expected to advance his/her academic career.

5. Provide evidence of the GACA candidate’s potential to develop into a clinician educator/faculty leader to transform health systems, including

HRSA-23-007 11

nursing homes and health systems in rural and/or medically underserved areas, to be age-friendly.

6. Provide evidence of the GACA candidate’s potential to develop into a clinician educator/faculty leader to strengthen healthcare access through telehealth.

7. Describe the socio-cultural determinants of health and health disparities that the GACA candidate will be addressing in their training, within the context of the age-friendly health systems framework, to address dementia-risk reduction, dementia across the disease trajectory including training on dementia medications as they are approved for use in nursing homes and any rural and/or medically underserved population(s)/community(ies) served.

8. Identify the targeted learners and their health professions/disciplines that the GACA candidate’s will be training (their training needs, and the population(s)/community(ies) served, including in nursing homes and any rural and/or medically underserved population(s)/community(ies).

9. Use and cite demographic data whenever possible to support the information provided.

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 the GACA candidate’s experience implementing a project of the proposed scope. The GACA candidate’s 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 the GACA candidate’s project needs. Objectives may be tagged with organizational priorities 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 the GACA candidate’s 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 SWP mandatory form in the Application Package.

1. 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.

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

HRSA-23-007 12

Purpose and Need section including the Age-Friendly Health Systems Framework and telehealth.

3. Explain how the work plan is appropriate for the program design and how the targets fit into the overall timeline of the four-year period of performance.

4. Identify meaningful support and collaboration with the GACA candidate’s mentor in planning, designing, and implementing all activities, including development of the application, and the extent to which the GACA candidate’s faculty development plan addresses the educational needs of the healthcare professionals to be trained and the populations and communities they serve, including any rural and/or medically underserved populations. The GACA candidate’s primary mentor must be an academic geriatrician or an academic geriatrics and have a faculty appointment at the GACA candidate’s institution.

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

Describe the GACA candidate’s 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 program requirements and expectations in this NOFO.

1. Describe the GACA candidate’s faculty career development plan and how the GACA candidate’s plan is designed to help develop the necessary knowledge and skills as a clinician educator in geriatrics to transform and lead Age-Friendly Health Systems and strengthen healthcare access through telehealth.

2. Describe the GACA candidate’s proposed interprofessional training activities and how you will meet the statutory service requirement.

3. Describe the activities you will use to become a successful clinician educator, including, but not limited to, how you will:

• Obtain the necessary pedagogical experience to facilitate development as an academician;

• Develop effective culturally and linguistically competent interprofessional curricula, tools, and training materials that address the social determinants of health and health disparities of the targeted population(s)/community(ies), including in any rural and/or medically underserved population(s)/community(ies);

• Provide interprofessional geriatrics education and training to health professions students, faculty, providers, direct care workers, patients, families, and caregivers, as appropriate, to practice in Age-Friendly Health Systems; to include dementia-risk reduction, dementia across the disease trajectory including training on dementia medications as they are approved for use,

• Transform clinical training environments to be age-friendly;

HRSA-23-007 13

• Interact and learn from other clinician educators as well as other program participants at both the local and national levels;

• Publish educational outcomes; and

• Actively participate in national professional societies.

4. Describe the targeted learners and population(s)/community(ies) that the

GACA candidate’s will train including nursing homes that will benefit from the project, including any rural and/or medically underserved population(s)/community(ies). Describe how GACA candidate’s experiences will be enhanced, and how the proposed activities are expected to improve access, quality, and cost of care for patients.

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

6. Explain how the GACA candidate’s faculty career development plan is innovative in educating and training interprofessional teams.

(c) RESOLUTION OF CHALLENGES -- Corresponds to Section V’s Review Criterion 2 (c) Discuss challenges that the GACA candidate are likely to encounter in designing and implementing the GACA activities described in the work plan, and approaches that the GACA candidate will use to resolve such challenges.

1. Describe the challenges the GACA candidate’s may encounter in achieving the program specific requirements.

2. Describe challenges related to achievement of project objectives, carrying out the work plan according to the proposed timetable, and project implementation.

3. Describe proposed solutions to the challenges that are identified.

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)

1. Describe the plan for the program performance evaluation that will contribute to value-based care and continuous quality improvement. The program performance evaluation must monitor ongoing processes and the progress towards meeting the goals and objectives of the project. Include descriptions of the inputs (e.g., key evaluation staff ({this may be the GACA candidate’s and their mentor) organizational support, budget, and other resources), key processes, variables to be measured, expected outcomes, and a description of how all key evaluative measures will be reported.

HRSA-23-007 14

2. Describe the systems and processes that will support the GACA candidate’s 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 performance measures and data forms required for the GACA program in Academic Year 2021-2022:

http://bhw.hrsa.gov/grants/reporting/index.html.

NOTE: Performance measures and data forms are subject to change each academic year.

3. 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 the GACA candidate’s plan to address those obstacles.

4. Document the procedure for assuring the data collection, management, storage, and reporting of National Provider Identifier (NPI) numbers for individuals participating in the Program. 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’s activities are replicable.

5. Include a plan for Rapid Cycle Quality Improvement (RCQI) for the continuous monitoring of the GACA candidate’s ongoing career development plan, project processes, outcomes of implemented activities, and progress toward meeting GACA goals and objectives and the implementation of necessary adjustments to planned activities to effect course corrections. Additional information on RCQI is available at the following website: https://www.healthworkforceta.org/wp-content/uploads/2016/06/RCQI_Resource_Guide.pdf.

6. Program Impact Evaluation: You must include an evaluation plan to show program impact related to the GACA candidate’s clinical training in geriatrics, their interprofessional training of health care professionals, and their career development activities. The GACA candidate is encouraged to evaluate patient outcomes matched to existing measures. For example, the Institute for Healthcare Improvement suggests using the What Matters CollaboRATE tools8 to survey care concordance or that you develop a

8 Forcino, R. C., Barr, P. J., O'Malley, A. J., Arend, R., Castaldo, M. G., Ozanne, E. M., Percac-Lima, S., Stults, C. D., Tai-Seale, M., Thompson, R., & Elwyn, G. (2018). Using CollaboRATE, a brief patient-reported measure of shared decision making: Results from three clinical settings in the United States.

Health expectations: an international journal of public participation in health care and health policy, 21(1), 82–89. Retrrieved from https://doi.org/10.1111/hex.12588.

http://bhw.hrsa.gov/grants/reporting/index.html https://www.healthworkforceta.org/wp-content/uploads/2016/06/RCQI_Resource_Guide.pdf.

https://www.healthworkforceta.org/wp-content/uploads/2016/06/RCQI_Resource_Guide.pdf.

https://doi.org/10.1111/hex.12588

HRSA-23-007 15

similar tool to measure goal concordant care in an Age-Friendly Framework.9

(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 the GACA candidate’s grant 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

1. Succinctly describe the organizational structure of the career development plan (not the applicant organization) (requested in Section IV.2.v./ Attachment 7).

2. 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.

3. Identify and describe the primary mentor who will advise and provide guidance and supervision regarding planning, directing, executing, and evaluating the proposed activities in the GACA candidate’s career development plan. Mentors must have expertise in the area of the GACA candidate’s proposed career development plan be committed to both the GACA candidate career development and the direct supervision of their program. Primary mentors must have a faculty appointment at the same institution as the GACA candidate.

4. Describe the expertise and role of the primary mentor in the development of the GACA candidate’s career development and provide a letter of support from the primary mentor (Attachment 4). The primary mentor must document a strong commitment to the GACA candidate’s career development and must:

• Demonstrate expertise in the area of the GACA candidate’s proposed faculty career development plan and a commitment to

9 Institute for Healthcare Improvement. 2020. Guide to Using the 4Ms in the Care of Older Adults.

Retrieved from http://www.ihi.org/Engage/Initiatives/Age-Friendly-Health- Systems/Documents/IHIAgeFriendlyHealthSystems_GuidetoUsing4MsCare.pdf http://www.ihi.org/Engage/Initiatives/Age-Friendly-Health-Systems/Documents/IHIAgeFriendlyHealthSystems_GuidetoUsing4MsCare.pdf http://www.ihi.org/Engage/Initiatives/Age-Friendly-Health-Systems/Documents/IHIAgeFriendlyHealthSystems_GuidetoUsing4MsCare.pdf

HRSA-23-007 16

both the GACA candidate’s career development and the direct supervision of the GACA candidate’s within the context of their career development plan;

• Demonstrate how the award will enhance the development of the GACA candidate’s academic/clinical career in geriatrics;

• Document that they have a full-time academic appointment located at the same institution as you;

• Attest that the GACA candidate has the necessary resources to implement the faculty development plan, meet the statutory service requirement, and spend 75 percent of the GACA candidate’s time that is supported by the award on teaching and developing skills in interdisciplinary education in geriatrics; and

• Commit to providing an annual evaluation of the GACA candidate’s progress.

5. Document the applicant organization in a letter of commitment (Attachment 4), has a strong, well-established career development program related to the GACA candidate’s area of interest, including:

• Assurances that the GACA candidate has a full-time faculty appointment in an accredited health professions school and that the institution has a documented commitment to spend 75 percent of the trainee’s total time on teaching and developing skills in interprofessional geriatrics education;

• Resources and facilities that will be available to the GACA candidate, to include appropriate office space, equipment, and other resources and facilities, including access to clinical populations, necessary to carry-out the proposed career development plan.

• How the organization will follow the approved plan, as outlined in the application, properly account for the federal funds, and document all costs so as to avoid audit findings.

• Document the date of the GACA candidate’s junior faculty appointment and anticipated month and year of promotion.

Biographical sketches for the GACA candidate, Primary Mentor, Department Chairperson, and other key personnel, such as Secondary Mentor(s) and consultants not exceeding two pages per person must be uploaded in the SF-424 RESEARCH & RELATED Senior-Key Person Profile form, should include the following information:

• Senior/key personnel name

• Position Title

HRSA-23-007 17

• Education/Training - beginning with baccalaureate or other initial professional education, such as nursing, including postdoctoral training and residency training if applicable:

o Institution and location o Degree (if applicable) o Date of degree (MM/YY) o Field of study

• Section A (required) Personal Statement. Briefly describe why the individual’s experience and qualifications make them particularly well-suited for their role (e.g., PD/PI) in the project that is the subject of the award.

• Section B (required) Positions and Honors. List in chronological order previous positions, concluding with the present position. List any honors.

Include present membership on any Federal Government public advisory committee.

• Section C (optional) Peer-reviewed publications or manuscripts in press (in chronological order). You are encouraged to limit the list of selected peer-reviewed publications or manuscripts in press to no more than 15. Do not include manuscripts submitted or in preparation. The individual may choose to include selected publications based on date, importance to the field, and/or relevance to the proposed research.

Citations that are publicly available in a free, online format may include URLs along with the full reference (note that copies of publicly available publications are not acceptable as appendix material).

• Section D (optional) Other Support. List both selected ongoing and completed (during the last 3 years) projects (federal or non-federal support). Begin with any projects relevant to the project proposed in this application. Briefly indicate the overall goals of the projects and responsibilities of the Senior/Key Person identified on the Biographical Sketch.

HRSA-23-007 18

iii. Budget

• The directions offered in the SF-424 R&R Application Guide may differ from those offered by Grants.gov. Follow the instructions in Section 4.1.iv of HRSA’s SF-424 R&R Application Guide and the additional budget instructions provided below. A budget that follows the R&R Application Guide will ensure that, if HRSA selects your application for funding, you will have a well-organized plan and, by carefully following the approved plan, may avoid audit issues during the implementation phase.

Reminder: The Total project or program costs are the total allowable costs (inclusive of direct and indirect costs) you incur to carry out a HRSA-supported project or activity.