BHW HRSA-23-123 (T5C) PCTE LDA_final__DMD_Modification 6-5-23.pdf

U.S. Department of Health and Human Services

NOTICE OF FUNDING OPPORTUNITY

Bureau of Health Workforce

Division of Medicine and Dentistry

Primary Care Training and Enhancement-Language and

Disability Access (PCTE: LDA)

Funding Opportunity Number: HRSA-23-123

Funding Opportunity Type(s): New

Assistance Listings Number: 93.884

Fiscal Year 2023

Application Due Date: July 3, 2023 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: May 26, 2023

MODIFIED on June 5, 2023: Changed Period of Performance throughout the NOFO; clarified clinical rotation for medical students throughout the NOFO. Fixed a typo on page 12.

Lauren Simons, MPH Project Officer, Division of Medicine and Dentistry Telephone: (301) 443-1632 Email: PCTE-LDAFY23NOFO@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: Section 747 of the Public Health Service (PHS) Act (42 U.S.C. § 293k(a)).

mailto:PCTE-LDAFY23NOFO@hrsa.gov

HRSA-23-123 i

508 COMPLIANCE DISCLAIMER

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

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2023 Primary Care Training and Enhancement-Language and Disability Access (PCTE-LDA) Program. The purpose of the PCTE-LDA program is to develop curricula and to train medical students, physician assistant students, and primary care medical residents to provide high quality primary care services to individuals with limited English proficiency (LEP) and/or individuals with physical disabilities and/or intellectual and developmental disabilities (IDD) with goals of improving health outcomes for these populations.

Funding Opportunity Title: Primary Care Training and Enhancement- Language and Disability Access (PCTE-

LDA)

Funding Opportunity Number: HRSA-23-123

Due Date for Applications: July 3, 2023

Anticipated FY 2023 Total Available Funding:

$8,150,000

Estimated Number and Type of Award(s): Approximately 16 grant(s)

Estimated Annual Award Amount: Up to $400,000 per year – one focus area Up to $600,000 per year – both focus areas

Cost Sharing/Match Required: No

Period of Performance: September 30, 2023, through September 29, 2028, 5 years

HRSA-23-123 ii

Eligible Applicants: Eligible entities include accredited public or nonprofit private hospitals, schools of allopathic medicine or osteopathic medicine, academically accredited affiliated physician assistant training program, or a public or private non-profit entity that the Secretary has determined capable of carrying out such a grant.

Accredited residency training programs in family medicine, general internal medicine, general pediatrics, or combined general internal medicine and general pediatrics (“med-peds”).

Tribes and tribal organizations are also eligible to apply if otherwise eligible.

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

Application Guide

You (the applicant organization/agency) are responsible for reading and complying with the instructions included in HRSA’s SF-424 R&R Application Guide, except where instructed in this NOFO to do otherwise. 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 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://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://bhw.hrsa.gov/fundingopportunities/default.aspx

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Table of Contents

I. PROGRAM 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

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-23-123 1

I. Program Description

1. Purpose

This notice announces the opportunity to apply for funding under the Primary Care Training and Enhancement-Language and Disability Access (PCTE-LDA) program. The purpose of the PCTE-LDA program is to develop curricula and to train medical students, physician assistant students, and primary care medical residents to provide high quality primary care services to individuals with limited English proficiency (LEP) and/or individuals with physical disabilities and/or intellectual and developmental disabilities (IDD) with goals of improving health outcomes for these populations.

The program has two focus areas:

Focus Area: Language Assistance for Individuals with LEP Supports individuals with LEP by training primary care medical students, physician assistant students, or medical residents to provide culturally and linguistically appropriate health information and services. Trainees may participate in medical language immersion programs, and training should incorporate language resources available to residents in the program, including language immersion courses, language applications/software, language tools, and community resources. Residents and Physician Assistant (PA) students would be required to participate in a minimum two-month clinical rotation that provides health care services for individuals with LEP.

Medical students would be required to participate in a minimum two-week clinical rotation.

Focus Area: Care for Individuals with Physical Disabilities and/or IDD Supports primary care residents in developing culturally competent skills in providing care to individuals with physical and/or intellectual and developmental disabilities.

Residents and PA students would be required to participate in a minimum two-month clinical rotation that provides health care services for individuals with physical disabilities and/or IDD. Medical students would be required to participate in a minimum two-week clinical rotation.

Applicants must focus on one or both of these focus areas and must identify which focus area they are proposing in the application.

Program Goal

The goal of the PCTE-LDA program is to increase access to quality primary care services for individuals with LEP and/or individuals with physical disabilities and/or IDD.

Program Objectives

1. Increase the number of primary care trainees (medical students, or physician assistant students, or medical residents) who are trained to provide culturally and linguistically appropriate care and services to individuals with LEP and/or individuals with physical disabilities and/or IDD.

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2. Develop and implement a culturally competent didactic and clinical curriculum to educate primary care trainees, faculty, and preceptors to care for individuals with LEP and/or individuals with physical disabilities and/or IDD.

3. Provide opportunities for clinical training in community-based settings where medical students, physician assistant students, and medical residents can care for individuals with LEP and/or individuals with physical and/or IDD.

For more details, see Program Requirements and Expectations

2. Background

The PCTE-LDA Program is authorized by Section 747 of the Public Health Service (PHS) Act (42 U.S.C. § 293k(a)).

Approximately 25 million people in the United States have limited English proficiency (LEP).1 Sixty-one million speak another language besides English in their homes.2 Language affects individuals’ interactions with the health care system and the quality of care received. It can contribute to poor health outcomes, longer hospital stays and higher rates of hospital admissions.3

Individuals with disabilities experience health disparities resulting from the lack of accessibility and communication. Reports suggest that 1 in 7 American adults live with physical disability affecting their mobility.4 Many patients may be deaf or hard of hearing, have speech or vision issues or experience an intellectual disability.5 Health professionals have limited training in caring for individuals with disabilities and individuals with disabilities also experience barriers related to health literacy, continuity of care, and stigma.6

1 US Department of Health and Human Services. Office of Civil Rights. HHS Continues to Improve Access for LEP Individuals. (October 2021). Retrieved January 17, 2023 from, https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/hhs-continues-to-improve-access-for-lep-individuals/index.html.

2 IBID

3 US Department of Health and Human Services. Center for Medicare and Medicaid Services. Providing Language Services to Diverse Populations: Lessons from the field. (Revision date July 2022). Retrieved January 6, 2023, from https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/Lessons-from-the-Field.pdf.

4 VanPuymbrouck, L., People With Disability Face Barriers to Basic Health Care. US News and World Report, Oct. 4, 2019. Retrieved April 12, 2023, from https://www.usnews.com/news/healthiest-communities/articles/2019-10-04/commentary-people-with-disability-face-barriers-to-basic-health-care 5 Centers for Disease Control and Prevention. Disability and Health Information for Health Care Providers. Retrieved April 12, 2023, from https://www.cdc.gov/ncbddd/disabilityandhealth/hcp.html 6 Shady, k., Phillips, S., Newman, S. Barriers and Facilitators to Healthcare Access in Adults with Intellectual and Developmental Disorders and Communication Difficulties: an Integrative Review. Review Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s40489-022-00324-8 https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/hhs-continues-to-improve-access-for-lep-individuals/index.html https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/hhs-continues-to-improve-access-for-lep-individuals/index.html https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/hhs-continues-to-improve-access-for-lep-individuals/index.html https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/Lessons-from-the-Field.pdf https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/Lessons-from-the-Field.pdf https://www.usnews.com/news/healthiest-communities/articles/2019-10-04/commentary-people-with-disability-face-barriers-to-basic-health-care https://www.usnews.com/news/healthiest-communities/articles/2019-10-04/commentary-people-with-disability-face-barriers-to-basic-health-care https://www.cdc.gov/ncbddd/disabilityandhealth/hcp.html https://doi.org/10.1007/s40489-022-00324-8

HRSA-23-123 3

Program Definitions

The following definitions apply to the PCTE-LDA Program for Fiscal Year 2023 and the dictionary of key program-related terms in Health Workforce Glossary also provides useful information.

Limited English Proficiency (LEP) are individuals for whom English is not their primary language and have limited ability to read, write, speak, or understand the English language.7

Intellectual and developmental disabilities (IDD) are differences usually present at birth and that uniquely affect the trajectory of the individual’s physical, intellectual, and/or emotional development. Many of these conditions affect multiple body parts or systems.

1. Intellectual disability starts any time before a child turns 18 and is characterized by differences with intellectual functioning and adaptive behavior.

2. Developmental disabilities are a broader category of lifelong challenges that can be intellectual, physical, or both.8

Primary Care Trainees – For the purposes of this NOFO are medical students, physician assistant students, or primary care medical residents.

Residency- For the purposes of this NOFO a residency program must be in family medicine, general internal medicine, general pediatrics or combined general internal medicine and general pediatrics (“med-peds”).

II. Award Information

1. Type of Application and Award Type(s) of applications sought: New

HRSA will provide funding in the form of a grant.

2. Summary of Funding

HRSA estimates approximately $8,150,000 to be available annually to fund approximately 16 recipients. You may apply for a ceiling amount of up to $400,000 annually (reflecting direct and indirect) per year if applying for one focus area or for a

7 Office of Civil Rights. Guidance to Federal Assistance Recipients Regarding Title VI and the Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons-Summary. Retrieved January 13, 2023, from https://www.hhs.gov/civil-rights/for-providers/laws-regulations-guidance/guidance-federal-financial-assistance-title-vi/index.html.

8 Eunice Kennedy Shriver National Institute of Child Health Development. About Intellectual and Developmental Disabilities. Retrieved January 13, 2023, from https://www.nichd.nih.gov/health/topics/idds/conditioninfo#.

https://bhw.hrsa.gov/grants/resourcecenter/glossary https://www.hhs.gov/civil-rights/for-providers/laws-regulations-guidance/guidance-federal-financial-assistance-title-vi/index.html https://www.hhs.gov/civil-rights/for-providers/laws-regulations-guidance/guidance-federal-financial-assistance-title-vi/index.html https://www.nichd.nih.gov/health/topics/idds/conditioninfo

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ceiling amount up to $600,000/year if applying for both focus areas. Your request for each subsequent year of the period of performance cannot exceed your year 1 request.

The period of performance is September 30, 2023, through September 29, 2028 (5 years). Funding beyond the first year is subject to the availability of appropriated funds 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 entities include accredited public or nonprofit private hospitals, accredited schools of allopathic medicine or osteopathic medicine, accredited academically affiliated physician assistant training programs, and a residency training program in family medicine, general internal medicine, general pediatrics or combined general internal medicine and general pediatrics (“med-peds”).

Tribes and tribal organizations are also eligible to apply if otherwise eligible.

Eligible applicants must provide documentation of accreditation from the relevant accrediting body as Attachment 7.

• Allopathic Medical Schools - Liaison Committee on Medical Education (LCME) or

• Osteopathic Medical Schools – American Osteopathic Association’s Commission on Osteopathic College Accreditation – (COCA)

• Physician Assistant Programs - Accreditation Review Commission on Education for the Physician Assistant (ARC-PA)

• Primary Care Medical Residencies - Accreditation Council for Graduate Medical Education (ACGME) 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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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 funding ceiling amount

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

• Fails to include all required documents as part of the application

• Fails to include the appropriate tables in Attachment 8, where 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(b). 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 4.

HRSA will enforce statutory MOE requirements through all available mechanisms.

Beneficiary Eligibility Requirement

A participant/trainee receiving support from grant funds under this program must be a citizen, non-citizen national of the United States, an individual lawfully admitted for permanent residence to the United States, or any other “qualified alien” under section 431(b) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Pub. L. 104-193, as amended.

Multiple Applications

Multiple applications from an organization with the same Unique Entity Identifier (UEI) are allowable; however, only one application from an organization with the same UEI will be funded . For example, an organization that operates a primary care residency program, PA program and medical school may submit an application for each, but only the one with the highest score has the potential to be funded.

Alternatively, an organization may submit an application that includes one or more eligible training programs (i.e., medical students and PA students; internal medicine and family medicine residencies).

HRSA will accept the last validated electronic submission for each unique proposal that is received before the Grants.gov application due date as the final and only acceptable application that will be evaluated.

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

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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 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-23-123 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 narrative, staffing plan and personnel requirements, assurances, certifications, etc. You must submit the information outlined in HRSA’s 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 budget figures expressed in 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 to assist you in completing your application.

Application Page Limit The total number of pages that count toward the page limit shall be no more than the equivalent of 60 pages when we print them. HRSA will not review any pages that https://www.grants.gov/ 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/sf424guide.pdf

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exceed the page limit. Using the pages within the page limit, HRSA will determine eligibility using Section 3. Eligibility Information of the NOFO.

These attachments don’t count toward the page limit:

• Standard OMB-approved forms you find in the NOFO’s workspace application package

• Abstract (standard form (SF) "Project_Abstract Summary”)

• Indirect Cost Rate Agreement

• Proof of non-profit status (if it applies)

If there are other items that don’t count toward the page limit, we’ll make this clear in Section IV.2.vi Attachments.

If you use an OMB-approved form that isn’t in the HRSA-23-123 workspace application package, it may count toward the page limit. We recommend you only use Grants.gov workspace forms related with this NOFO to avoid going over the page limit.

Applications must be complete, within the maximum specified page limit, and validated by Grants.gov under HRSA-23-123 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. § 3354).

3) If you are unable to attest to the statements in this certification, you must include an explanation in Attachments 11-15: Other Relevant Documents.

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

Program Requirements and Expectations

Applicants must focus on one or both of the two focus areas identified below.

Focus Area: Language Assistance for Individuals with LEP Successful recipients must address the following program expectations:

Program design and implementation

1) Develop and implement a didactic and clinical curriculum to educate primary care trainees (medical students, PA students, and/or primary care medical residents) to provide culturally competent and linguistically appropriate primary care services for https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75#se45.1.75_1371

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individuals with LEP. Applicants should detail how the curriculum will provide didactic and clinical training opportunities that:

a. Provide training focused on primary care trainees’ understanding and use of the language of population(s) to be served including participation in language immersion programs and other language learning tools specializing in health care;

b. Provide clinical rotations in community-based settings for trainees who care for individuals with LEP for

• medical students for a minimum of two weeks,

• physician assistant students and/or primary care medical residents for a minimum of two months;

c. Teach patient advocacy, including both ensuring that patients understand the information being communicated by providers and that trainees’ understand patients’ preferences and needs; and

d. Increase trainees’ understanding of health literacy and its impact on individuals with LEP to find, understand, and use health care information and services to inform and assist them in making health-related decisions.

2) Develop and implement strategic partnerships with community-based organizations that provide interprofessional services to train primary care trainees to care for individuals with LEP.

Evaluation

1) Develop a plan for how this curriculum will be available to use with other students and residents after the grant project period is completed.2) Develop a plan to evaluate the program including:

a. Collection of post-graduation/program completer employment demographics of graduates/program completers from the training program for one-year after completion of the residency or medical/PA school:

b. Ensuring primary care trainees apply for a National Provider Identifier (NPI) number, as applicable, and collect the NPI numbers of trainees who participate in the program to assess longitudinal performance: and,

c. Award recipients must adhere to HHS Evaluation Policy and evaluation standards and best practices described in OMB Memorandum M-20-12 when evaluating their program, and award recipients are required to participate in federally designed evaluations to assess program effectiveness and efficiency upon request.

Focus Area: Care for Individuals with Physical Disabilities and/or IDD

Program design and implementation https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Faspe.hhs.gov%2Fsites%2Fdefault%2Ffiles%2Fmigrated_legacy_files%2F200386%2Fhhs-evaluation-policy.pdf&data=05%7C01%7CSLevant%40hrsa.gov%7C4da63050dfbf4d87051308db18eb40c0%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638131170900085621%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=xyhOds0iigSBn0DWngs5JJpgIwe3ZEkdzU6LN7NIZN4%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.whitehouse.gov%2Fwp-content%2Fuploads%2F2020%2F03%2FM-20-12.pdf&data=05%7C01%7CSLevant%40hrsa.gov%7C4da63050dfbf4d87051308db18eb40c0%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638131170900241838%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=JN8M4caEcCscyj3As0acTWMkdTnvuPa2P6Pg0ANItf0%3D&reserved=0

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1) Develop and implement a culturally competent didactic and clinical curriculum to train primary care trainees (medical students, PA students, and/or primary care medical residents) to support individuals with physical disabilities and/or IDD.

Applicants should detail how the curriculum will provide didactic and clinical training opportunities that:

a. Provide training focused on primary care trainees’ understanding of how to assess, diagnose, manage, treat, refer, and advocate for individuals with physical disabilities and/or IDD;

b. Provide a clinical rotations for trainees at clinical sites that serve individuals with physical disabilities and/or IDD for:

• medical students for a minimum of two weeks,

• physician assistant students and/or primary care medical residents for a minimum of two months;

c. Teach patient advocacy, which includes both ensuring that patients with physical disabilities and/or IDD understand the information being communicated by providers and that trainees’ understand patients with IDD preferences and needs; and,

d. Provide training opportunities to increase trainees’ understanding of health literacy and its impact on individuals with physical disabilities and/or IDD to find, understand, and use health care information and services to inform and assist them in making health-related decisions.

2) Develop and implement strategic partnerships with and community-based organizations that provide interprofessional services to train primary care trainees to care for individuals with physical disabilities and/or IDD.

Evaluation

1) Develop a plan for how this curriculum will be available to use with other students and residents after the grant project period is completed.

2) Develop a plan to evaluate the program including:

a) Collection of post-graduation/program completer employment demographics of graduates/program completers from the training program for one-year after completion of the residency or medical/PA school:

b) Ensuring primary care trainees apply for a National Provider Identifier (NPI) number, as applicable, and collect the NPI numbers of trainees who participate in the program to assess longitudinal performance: and, HRSA-23-123 10

c) Award recipients must adhere to HHS Evaluation Policy and evaluation standards and best practices described in OMB Memorandum M-20-12 when evaluating their program, and award recipients are required to participate in federally designed evaluations to assess program effectiveness and efficiency upon request.

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

i. Project Abstract Use the Standard OMB-approved Project Abstract Summary Form that is included in the workspace application package. Do not upload the abstract as an attachment or it may count toward the page limit. See Form Alert in Section IV.1 Application Package.

For information required in the Project Abstract Summary Form, see Section 4.1.ix of HRSA’s SF-424 R&R Application Guide. When applicable, identify if a funding preference is being requested. You must identify the focus area of this application and the primary care trainees to be trained (medical school students, PA students, or primary care residents).

NARRATIVE GUIDANCE

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

Narrative Section Review Criteria

Purpose and Need (1) Purpose and Need

Response to Program Purpose:

(a) Work Plan

(b) Methodology/Approach

(c) Resolution of Challenges

(2) Response to Program Purpose

(a) Work Plan

(b) Methodology/Approach

(c) Resolution of Challenges

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 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Faspe.hhs.gov%2Fsites%2Fdefault%2Ffiles%2Fmigrated_legacy_files%2F200386%2Fhhs-evaluation-policy.pdf&data=05%7C01%7CSLevant%40hrsa.gov%7C4da63050dfbf4d87051308db18eb40c0%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638131170900085621%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=xyhOds0iigSBn0DWngs5JJpgIwe3ZEkdzU6LN7NIZN4%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.whitehouse.gov%2Fwp-content%2Fuploads%2F2020%2F03%2FM-20-12.pdf&data=05%7C01%7CSLevant%40hrsa.gov%7C4da63050dfbf4d87051308db18eb40c0%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638131170900241838%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=JN8M4caEcCscyj3As0acTWMkdTnvuPa2P6Pg0ANItf0%3D&reserved=0 http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf

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Narrative Section Review Criteria

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. Successful applications will contain the information below. Use and cite demographic data whenever possible to support the information provided. Please use the following section headers for the narrative:

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

In your application:

1. Briefly describe the purpose of the proposed project as it relates to the goal of this notice of funding opportunity.

2. Outline the needs of the training program to increase language and communication skills of trainees and its impact on individuals with LEP and/or to increase capacity for trainees to serve individuals with physical disabilities and/or IDD.

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) In your application, provide a detailed work plan that demonstrates your ability implementing a project of the proposed scope. Your work plan must be submitted through the Standardized Work Plan (SWP) Form located in the Grants.gov workspace.

Include a brief narrative element outlined below, in addition to completing the SWP.

In your work plan (SWP and narrative section):

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 grant period of performance to address each of the needs described in the Purpose and Need section.

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

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

If funds will be sub-awarded or expended on contracts, describe how your organization will ensure the funds are properly documented and appropriately used.

The SWP form is organized by budget period and must include all activities and deliverables for each objective and program goal. The program goal for this NOFO must be entered in the Program Goal section of the SWP form. For example, the goal in the Purpose section of the NOFO will need to be entered as the goal in the SWP form. The three objectives noted on page 1 entitled Program Objectives are the three objectives to be used in the SWP. Sub-objectives can be tailored to the program objectives. For the purpose of this NOFO, please write in Health Equity in the “Other Priority Linkage” if the sub-objectives align with this priority. Form instructions are provided along with the SWP form and are included in the application package found on Grants.gov. The Project Director must register in the HRSA electronic handbook (EHB) once award is made, to review and finalize the completed SWP.

(b) METHODOLOGY/APPROACH -- Corresponds to Section V’s Review Criterion 2 (b) In your application, and consistent with the Program Requirements and Expectations in this NOFO:

1. List the project objectives (specific, measurable, achievable, realistic, and time-framed) and proposed activities, and provide evidence for how they link to the project purpose and needs. These are the same project objectives in the SWP.

2. Provide a training chart as Attachment 8 that includes: (note: if you are doing both focus areas, please provide 2 training charts)

a) the total number of primary care medical students, PA students and/or residents in your program;

b) the projected number of primary care trainees trained per year by this grant program; and

c) the projected number of residents expected to complete the residency program for each year of the project period and medical school students or PA students expected to graduate.

Language Assistance for Individuals with LEP Primary Care Trainee Training Chart Example: (if applicable)

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Year Total Number of primary care trainees in your training program

Total Number of primary care trainees trained by the Focus: LEP

Projected Number of Primary Care trainees expected to complete the training program

Residents PA students

Medical students

Residents PA students Medical Students

Residents PA Medical students

Year 1 Year 2 Year 3 Year 4 Year 5

Focus Area: Language Assistance for Individuals with LEP

1. Describe how you plan to develop and implement a didactic and clinical curriculum to educate primary care trainees to provide culturally competent and linguistically appropriate primary care services for individuals with LEP, to include:

a. Provide training focused on primary care trainees’ understanding and use of the language of population(s) to be served including participation in language immersion programs and other language learning tools specializing in health care;

b. Provide clinical rotations in community-based settings for trainees who care for individuals with LEP for

• medical students for a minimum of two weeks,

• physician assistant students and/or primary care medical residents for a minimum of two months with LEP;

c. Teach patient advocacy, including both ensuring that patients understand the information being communicated by providers and that trainees understand patients’ preferences and needs; and

d. Increase trainees’ understanding of health literacy and its impact on individuals with LEP to find, understand, and use health care information and services to inform and assist them in making health-related decisions.

Physical Disabilities/IDD Primary Care Trainee Training Chart Example:

(if applicable)

Year Total Number of primary care trainees in your training program

Total Number of primary care trainees trained by the Focus: Physical Disabilities and/or IDD

Projected Number of Primary Care trainees expected to complete the training program

Residents PA students

Medical students

Residents PA students Medical Students

Residents PA Medical students

Year 1 Year 2 Year 3

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Year 4 Year 5

Focus Area: Care of Individuals with Physical Disabilities and/or IDD:

1. Describe how you plan to develop and implement a culturally competent didactic and clinical curriculum to support individuals with physical disabilities and/or IDD, to include:

a. Provide training focused on primary care trainees’ understanding of how to assess, diagnose, manage, treat, refer, and advocate for individuals with physical disabilities and/or IDD:

b. Provide clinical rotations for trainees at clinical sites that serve individuals with physical disabilities and/or IDD for:

• medical students for a minimum of two weeks,

• physician assistant students and/or primary care medical residents for a minimum of two months;

c. Teach patient advocacy, which includes both ensuring that patients with physical disabilities and/or IDD understand the information being communicated by providers and that trainees understand patients with IDD preferences and needs; and,

d. Provide training opportunities to increase trainees’ understanding of health literacy and its impact on individuals with physical disabilities and/or IDD to find, understand, and use health care information and services to inform and assist them in making health-related decisions.

2. Describe how you plan to develop and implement strategic partnerships with community-based organizations that provide interprofessional services to educate primary care trainees to care for individuals with physical disabilities and/or IDD.

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

In your application:

1. Discuss challenges that you are likely to encounter in designing and implementing the activities described.

2. Describe potential challenges with recruitment of primary care trainees (medical students, PA students and/or medical residents) and faculty/instructors in the clinical training sites.

3. Discuss approaches that you will use to resolve challenges in arranging clinical rotations for the learning experiences described in the NOFO.

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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)

In your application:

• Describe the systems and processes that will use to collect program performance information for the PCTE-LDA program. This should include your strategy for collecting, managing, and reporting required performance data in an accurate and timely manner. Performance measures have not been developed for this program yet, and measures and data forms are subject to change each academic year. Sample data elements that you may be required to collect include—but are not limited to—the following: Primary care trainees’ (medical student, PA student, or medical resident) race, ethnicity, and gender

• Primary care trainees’ (medical student, PA student or medical resident) disadvantaged background status

• Primary care trainees’ (medical student, PA student or medical resident) clinical training setting

• Resident trainees’ employment information at completion of the residency and one year later

• PA student employment information one-year post graduation

1. Describe and document the procedure for assuring the data collection, management, storage, and reporting of National Provider Identifier (NPI) numbers for individuals participating in the Program. (Note: Trainees who receive HRSA funds as a result of this award are required to apply for an NPI for the purpose of collecting post-graduation employment demographics).

2. Describe the plan for the program performance evaluation that will contribute to continuous quality improvement. The program performance evaluation should monitor ongoing processes and the progress towards meeting the goals and objectives of the project. Evaluations must adhere to HHS Evaluation Policy and evaluation standards and best practices described in OMB Memorandum M-20- 12.

3. Describe any potential obstacles for implementing the program performance evaluation and meeting HRSA’s performance measurement requirements and your plan to address those obstacles.

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4. The evaluation and reporting plan also should indicate the feasibility and effectiveness of plans for dissemination of project results, the extent to which project results may be national in scope, and the degree to which the project activities are replicable.

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

In your application:

1. Include a description of specific actions you will take to (a) highlight key elements of your grant projects, e.g., training methods or strategies, which have been effective in improving practices; (b) obtain future sources of potential funding;

and (c) provide a timetable for becoming self-sufficient.

2. Describe challenges that are likely to be encountered in sustaining the program and propose approaches that will be used to resolve these challenges.

ORGANIZATIONAL INFORMATION, RESOURCES, AND CAPABILITIES --

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

In your application:

1. Succinctly describe your organization’s current mission, structure, and scope of current activities and how these elements all contribute to the organization’s ability to implement the program requirements and meet program expectations.

2. Describe tools and strategies for ongoing staff training, outreach, collaborations, communication, and information sharing/dissemination with efforts to involve communities.

3. Describe briefly what additional resources, including personnel or partners, are needed to accomplish the stated goals and objectives.

4. Include an organizational chart of the project (requested in Section IV.2.v./vi., Attachment 2.)

5. 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.

6. Include the staffing plan and job descriptions for key faculty/staff in the Attachment 1.

o Describe the minimum qualifications for each faculty position in the job description.

o Functional and program responsibilities should be specified in the narrative and position descriptions. A position description should not exceed one page in length but can be as short as one paragraph in length due to page limits.

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7. Include biographical sketches for key personnel in the SF-424 RESEARCH & RELATED Senior Key Person Profile (Expanded) form that can be accessed in the Application Package under “Mandatory.” Even though the document has an OMB clearance number, it is not a standard form but a format, and so biographical sketches do count against the page limit (See details below).

8. Describe organizations who will partner with yours to fulfill the goals of the program and meet the training objectives.

9. Include in Attachment 3, noting overall page limits, select copies of agreements, letters of support or similar documents from key organizations/individuals of their willingness to perform in accordance with the plan presented in the application.

Biographical Sketches

Provide a biographical sketch for key faculty/staff contributing to the project. The information must be current, indicating the individual’s position and sufficient detail to assess the individual’s qualifications for the position being sought and consistent with the position description. Each biographical sketch should be limited to one page as they count toward the overall page limit. Include all degrees and certificates.

Biographical sketches should include the following information:

• Senior/key personnel name

• Position Title

• 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 o Language training or training in health care delivery for individuals with disabilities/IDD (including certificates or other training)

• 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) 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.