BHW HRSA-23-129 NEPQR SET (T48)_Final_clean_051923.pdf

U.S. Department of Health and Human Services

NOTICE OF FUNDING OPPORTUNITY

Bureau of Health Workforce

Division of Nursing and Public Health

Nurse Education, Practice, Quality and Retention (NEPQR) Simulation Education Training (SET) Program

Funding Opportunity Number: HRSA-23-129 Funding Opportunity Type(s): New

Assistance Listings Number: 93.359

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 22, 2023

Felicia Peterson, BSN, RN, CCHP Project Officer, Division of Nursing and Public Health Telephone: (301) 287-9860 Email: fpeterson@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 U.S.C. § 296p (Section 831 of the Public Health Service Act) mailto:fpeterson@hrsa.gov

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508 COMPLIANCE DISCLAIMER

Note: Persons using assistive technology may not be able to fully access information in this file. For assistance, 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 Nurse Education, Practice, Quality and Retention (NEPQR)- Simulation Education Training (SET) Program. The goal of the NEPQR-SET program is to increase the number and capacity of nursing students by addressing the health care needs and improving patient outcomes of rural and/or medically underserved populations.

Funding Opportunity Title: Nurse Education, Practice, Quality and Retention (NEPQR)- Simulation Education Training (SET) Program

Funding Opportunity Number: HRSA-23-129

Due Date for Applications: July 3, 2023

Anticipated FY 2023 Total Available Funding:

$10,500,000

Estimated Number and Type of Award(s): Up to 22 grants

Estimated Annual Award Amount:

Up to $500,000 per award subject to the availability of appropriated funds

Cost Sharing/Match Required: No

Period of Performance: September 30, 2023, through September 29, 2026 (3 years)

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Eligible Applicants: Eligible applicants under PHS Act Section 831 (f) provides, “eligible entity” includes accredited schools of nursing, as defined in section 801 (2), health care facilities, including federally qualified health centers or nurse-managed health clinics, or a partnership of such a school and facility.

Domestic community-based organizations, tribes, and tribal organizations are also eligible to apply if otherwise eligible.

Schools of nursing affiliated with the proposed project must be accredited public or private non-profit schools. 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

APPENDIX A: HIGH BURDEN STATES

APPENDIX B: PAGE LIMIT WORKSHEET

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I. Program Description

1. Purpose

This notice announces the opportunity to apply for funding under the Nurse Education, Practice, Quality and Retention (NEPQR)-Simulation Education Training (SET) Program. The purpose of the NEPQR-SET program is to enhance nurse education and strengthen the nursing workforce by increasing training opportunities for nursing students through the use of simulation-based technology, including equipment, to increase their readiness to practice upon graduation. This training expands the capacity of nurses to advance the health of patients, families, and communities in rural or medically underserved areas experiencing diseases and conditions such as stroke, heart disease, behavioral health, maternal mortality, HIV/AIDS, and obesity.

Program Goal

The goal of the NEPQR-SET program is to increase the number and capacity of nursing students to address the health care needs and improve patient outcomes of rural and/or medically underserved populations.

Program Objectives Implement or expand academic-clinical partnerships to create experiential learning opportunities that prepare nursing students to efficiently address health equity for rural and underserved populations.

Increase the diversity of the nursing workforce to better address the needs of the populations they serve by recruiting and supporting students and faculty, including those from diverse populations.

For more details, see Program Requirements and Expectations

2. Background

The NEPQR-SET program is authorized by Section 831 of the Public Health Service Act.

Clinical practice is a critical yet complex and challenging component of professional development for student nurses.1 Because new graduate nurses often struggle to apply clinical judgment, the National Council of State Boards of Nursing (NCSBN) has reemphasized competency in clinical judgment as a requirement for registered nurse licensure.2 Human patient simulation activities are used routinely in nursing education to bridge the gap between theoretical knowledge and practical application of clinical

1 Spence, D.; Zambas, S.; Mannix, J.; Jackson, D.; Neville, S. Challenges to the provision of clinical education in nursing. Contemp. Nurse 2019, 55, 458–467 2 Poledna M, Gómez-Morales A, Hagler D. Nursing students' cue recognition in educational simulation: a scoping review. Nurse Educ. 2022;47(5):283-287. doi: 10.1097/NNE.0000000000001198

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judgment.3 Students rely on simulation to support clinical practice experiences to meet regulatory requirements for progression and graduation. Furthermore, the International Nursing Association for Clinical Simulation and Learning (INACSL) states simulation-based training and experiences incorporate best practices from adult learning, education, instructional design, and clinical standards of care.4 Incorporating these best practices can develop student nurses’ professional knowledge, skills, and attitudes while allowing them to train in a safe environment. Expanding innovative simulation-based training can enhance quality, safety, and develop competence and confidence in students and practicing health professionals.5

The COVID-19 pandemic created unprecedented challenges in healthcare. As a result, health disparities for individuals that live in underserved communities that are often economically and medically under-resourced and/or geographically isolated, have significantly increased, increasing the need for health care professionals in these communities.6 NEPQR-SET aims to emphasize and support the training of rural health care professionals in states with high rates of chronic age-related illness, including stroke, heart disease, and chronic obstructive pulmonary disease.

There are a wide variety of training activities for health professions that aim to increase cultural competency and improve health outcomes for underrepresented groups.

Moreover, the activities and behaviors of a health care professional can have a significant impact on their patient’s health outcomes.7 Health professionals of various backgrounds, including but not limited to geographic (rural, urban), racial, ethnic, and underrepresented minorities, are more likely to care for those patients reflecting similar populations. In addition, research showed that implicit bias was significantly related to patient–provider interactions, treatment decisions, treatment adherence, and patient health outcomes. Implicit attitudes were more often significantly related to patient– provider interactions and health outcomes than treatment processes.7 Additionally, health professionals from underrepresented minority (URM) groups are more likely to care for URM patients and serve in impoverished areas and thus improve access for

3 Poledna M, Gómez-Morales A, Hagler D. Nursing students' cue recognition in educational simulation: a scoping review. Nurse Educ. 2022;47(5):283-287. doi: 10.1097/NNE.0000000000001198 4 Poledna M, Gómez-Morales A, Hagler D. Nursing students' cue recognition in educational simulation: a scoping review. Nurse Educ. 2022;47(5):283-287. doi: 10.109 5 Ka Ming Chow, Ricky Ahmat, Alice W.Y. Leung, Carmen W.H. Chan,Is high-fidelity simulation-based training in emergency nursing effective in enhancing clinical decision-making skills? A mixed methods study,Nurse Education in Practice,Volume 69,2023,103610,ISSN 1471- 5953,https://doi.org/10.1016/j.nepr.2023.103610.

6 Andraska EA, Alabi O, Dorsey C, Erben Y, Velazquez G, Franco-Mesa C, Sachdev U. Health care disparities during the COVID-19 pandemic. Semin Vasc Surg. 2021 Sep;34(3):82-88. doi:

10.1053/j.semvascsurg.2021.08.002. Epub 2021 Aug 9. PMID: 34642040; PMCID: PMC8349792.

7 William J. Hall, Mimi V. Chapman, Kent M. Lee, Yesenia M. Merino, Tainayah W. Thomas, B. Keith Payne, Eugenia Eng, Steven H. Day, and Tamera Coyne-Beasley, 2015:

Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes:

A Systematic Review American Journal of Public Health 105, e60_e76, https://doi-org.ezproxyhhs.nihlibrary.nih.gov/10.2105/AJPH.2015.302903

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underserved populations.8 Therefore, increasing the diversity of the nursing workforce has been shown to decrease disparities and increase health equity9. Furthermore, increasing racial and ethnic diversity in simulations and clinical training for nurses is linked to improved access to care, better communication, and improved cultural competence.

Nurses are well positioned to improve health equity, especially for patients and families in rural and underserved communities where health inequities are widespread. A diverse nursing workforce is a high priority for addressing the nursing shortage, meeting the cultural needs of an increasingly diverse population, and achieving health equity in the US.10 Nurses with diverse backgrounds may be more sensitive to the issues of inequities, and are more likely to work in underserved areas, providing health care to those who experience health disparities.11 Given the central role of the nurse workforce in providing patient care, it is important that the nursing workforce reflect the diversity of the US population.

To better understand this NOFO, go to the dictionary of key program-related terms at Health Workforce Glossary. In addition, see Appendix A for NEPQR-SET Program definitions for Fiscal Year 2023.

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 $10,500,000 to be available annually to fund up to 22 recipients. You may apply for a ceiling amount of up to $500,000 annually (reflecting direct and indirect costs) per year. Your request for each subsequent year of the period of performance cannot exceed your year 1 request.

8 Glazer, G., Tobias, B., & Mentzel, T. (2018). Increasing healthcare workforce diversity: Urban universities as catalysts for change. Journal of Professional Nursing, 34(4), 239-244.

https://doi.org/10.1016/j.profnurs.2017.11.009 9 Glazer, G., Tobias, B., & Mentzel, T. (2018). Increasing healthcare workforce diversity: Urban universities as catalysts for change. Journal of Professional Nursing, 34(4), 239-244.

https://doi.org/10.1016/j.profnurs.2017.11.009 10 American Association of Colleges of Nursing. (2020). Fact Sheet: Enhancing Diversity in the Nursing Workforce. Washington, DC. https://www.aacnnursing.org/Portals/42/News/Factsheets/Enhancing- Diversity-Factsheet.pdf 11 How Nurses Can Help Address the Health Disparities Problem. (n.d.). Eastern Michigan University Online. Retrieved June 16, 2022, from https://online.emich.edu/articles/rnbsn/the-health-disparities-problem.aspx#:~:text=Workplace%20Diversity%3A%20A%20diverse%20nursing%20workforce https://bhw.hrsa.gov/grants/resourcecenter/glossary

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The period of performance is September 30, 2023, through September 29, 2026 (3 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 applicants under PHS Act Section 831 (f) provides, “eligible entity” includes accredited schools of nursing, as defined in section 801(2), health care facilities, including federally qualified health centers or nurse-managed health clinics, or a partnership of such a school and facility. Domestic community-based organizations, tribes, and tribal organizations are also eligible to apply if otherwise eligible.

Schools of nursing affiliated with the proposed project must be accredited public or private non-profit schools. Applicants must provide documentation of current accreditation by a recognized body or bodies or by state agency approved for such purpose by the U.S. Department of Education as Attachment 8.

Eligible applicants located in the 50 states of the U.S., the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau, may apply for these funds. Foreign entities are not eligible for this HRSA award.

Individuals and for-profit entities are not eligible applicants under this NOFO.

2. Cost Sharing/Matching

Cost sharing/matching is not required for this program.

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

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3. Other

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

• Exceeds the funding ceiling amount

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

Maintenance of Effort

The recipient must agree to maintain non-federal funding for award activities at a level that is not less than expenditures for such activities maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives the award, as required by 42 U.S.C. § 296b (Section 803(b) of the Public Health Service Act). Such federal funds are intended to supplement, not supplant, existing non-federal expenditures for such activities. Complete the Maintenance of Effort (MOE) information and submit as Attachment 4.

HRSA will enforce statutory MOE requirements through all available mechanisms.

Beneficiary Eligibility Requirement

A 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 not allowable.

HRSA will only accept your last validated electronic submission 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. Where required, applications received without the appropriate tables will be deemed non-responsive to the NOFO and will not be considered for funding under this notice.

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 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/

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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-23-129 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 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 60 pages when we print them. HRSA will not review any pages that exceed the page limit.

Using the pages within the page limit, HRSA will determine eligibility using Section III.

Eligibility Information of the NOFO.

These items 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) http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/s2s/applicant-system-to-system.html https://www.hrsa.gov/sites/default/files/hrsa/grants/sf-424-rr-app-guide.pdf 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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If there are other items that don’t count toward the page limit, we’ll make this clear in Section IV.2.vii Attachments.

If you use an OMB-approved form that isn’t in the HRSA-23-129 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-23-129 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 Attachment 9: 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

Successful recipients should address the following program expectations:

• Address critical skill gaps identified in clinical practice with the use of simulation-based technology for care and treatment of communities, patients/populations that are disproportionately burdened by health inequities and access to care.

Simulation based training must include:

o Collaborative interprofessional team-based care.

o Integration of International Nursing Association for Clinical Simulation and

Learning competencies.

o Populations at highest risk of low health literacy.

o Integration of health equity as it relates to at least two of the following clinical priorities areas:

o Behavioral/Mental Health, o Maternal and Child Health, o Homelessness, o Survivors of domestic abuse, o HIV/AIDS; and/or o Aging Populations.

• Allocate funds for an academic nursing faculty/coordinator(s) to support best practice simulation scenarios.

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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• Establish or enhance strategic academic-practice partnerships to inform simulation scenarios.

• Recruit and retain clinical faculty/preceptors to facilitate clinical and simulation training.

• Increase the diversity of nursing students and faculty by recruiting students and faculty from diverse populations, including individuals from disadvantaged backgrounds and underrepresented racial and ethnic minorities; and

• Evaluate the program:

o 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.

o 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:

Applicants are expected to develop and upload (in Attachment 7) a Disparities Impact Statement.

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 priority or preference is being requested.

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 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

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.

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

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

This section will help reviewers understand the organization that would receive funding for training, as well as the needs of the communities that trainees would ultimately serve. Use and cite demographic data whenever possible to support the information provided. Provide a clear description of the purpose of the proposed project including:

• Characteristics of the target population(s) served including demographics, health status, social determinants of health, unmet health needs and population health disparities within the target population/community and barriers.

• A Disparities Impact Statement as Attachment 7, which is an instrument used to measure and describe how training will support trainees’ capacity to meet the needs of underserved populations.

• Gaps in education and training of nursing students and qualified faculty/preceptors in simulation-based training.

• Simulation-based equipment and training needed to implement the proposed project.

• How you plan to increase the diversity of the nursing workforce by recruiting and retaining diverse nursing students and faculty.

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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(a) 2 (a)

In your application, provide a detailed work plan that demonstrates your experience or 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. Applicants should include a brief narrative element outlined below, in addition to completing the SWP.

In your work plan (SWP and narrative) you must:

• Describe the activities or steps you will use to achieve each of the goals and objectives proposed during the entire period of performance.

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

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

o The number of nursing students you plan to train each year with qualified preceptors using grant funds in the proposed project and a plan for the recruitment of students, including those from diverse backgrounds, that will receive training from qualified clinical preceptors including any partnerships used to facilitate efforts.

• Identify meaningful support and collaboration with key stakeholders in planning, designing, and implementing all activities and the extent to which these contributors reflect the needs of the target population served.

The SWP form is organized by budget period and must include all activities and deliverables for each objective and program goal. The program goals for this NOFO must be entered in the Program Goals section of the SWP form. For example, Goal 1 in the Purpose section of the NOFO will need to be entered as Goal 1 in the SWP form. Objectives and sub-objectives can be tailored to your project needs. Objectives may be tagged with organizational priorities by selecting applicable priorities on the SWP form. 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, in order to review and finalize the completed SWP.

METHODOLOGY/APPROACH – Corresponds to Section V’s Review Criterion 2 (b) In this section, you must describe your objectives and proposed activities and provide evidence for how they will link to Purpose and Need and Program Requirements and Expectations. Your approach to these objectives should be specific, measurable, realistic, achievable, and timely (completable within the period of performance). Proposed methods should:

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• Include a description of any innovative methods integrating simulation into the clinical training curriculum that you will use to address the identified needs.

• Include development of effective tools and strategies for ongoing staff training, outreach, collaborations, clear communication, and information sharing/dissemination with efforts to involve patients, families, and communities.

• Detail how the project will provide financial and other support to trainees and faculty/preceptors.

• Describe academic-clinical partnerships to provide community-based clinical training experiences using simulation-based technology to strengthen readiness for practice, including scenarios that address health disparities, social determinants of health and/or needs of rural and/or medically underserved communities.

• Describe the roles of partners and the relevant system level and organizational change initiatives, educational strategies and curricula enhancements that will be used to accomplish the objectives of the project.

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

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

In this section, provide information including:

• Challenges related to project implementation and the achievement of the proposed goals and objectives.

• Challenges related to the workforce development such as recruitment and retention of nursing students and faculty/preceptors.

• Challenges that are likely to be encountered in sustaining the program and approaches that will be used to resolve such challenges.

• Potential obstacles for implementing the program performance evaluation and your plan to address those obstacles.

• Resources and plans available to resolve and overcome these challenges and obstacles.

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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 plan for the NEPQR-SET 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. Include descriptions of the inputs (e.g., organizational profile, collaborative partners, key personnel, budget, and other resources), key processes, variables to be measured, and expected outcomes of the funded activities.

• Demonstrate evidence that the evaluative measures selected will be able to assess: 1) the extent to which the NEPQR-SET program objectives have been met, and 2) the extent to which these can be attributed to the project.

• Describe the systems and processes that will support your organization's collection of HRSA’s performance management requirements through effective tracking of performance outcomes, including a description of how the organization will collect and manage data (e.g., assigned skilled staff, data management software) in a way that allows for accurate and timely reporting of performance outcomes. To understand the performance measures that will be used by HRSA to measure “success” go to (Report on Your Grant).

• As appropriate, describe the data collection strategy to accurately collect, analyze and track data to measure process and impact/outcomes, and explain how the data will be used to inform program development and service delivery.

• Describe any potential obstacles for implementing the program performance evaluation and your plan to address those obstacles.

• Describe current experience, skills, and knowledge, including individuals on staff, materials published, and previous work of a similar nature.

• Describe your process to track trainees after program completion/ graduation for up to 1 year.

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

• Recipients are expected to sustain key elements of their projects that have been effective in improving practices and that have led to improved outcomes for the target population. Propose a plan for project sustainability after the period of federal funding ends.

https://bhw.hrsa.gov/funding/report-on-your-grant

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• 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 that will be retained in curricula after federal funding ends; (b) obtain future sources of potential funding; and (c) provide a timetable for becoming self-sufficient.

• Discuss challenges that are likely to be encountered in sustaining the program and approaches that will be used to resolve such challenges.

ORGANIZATIONAL INFORMATION, RESOURCES, AND CAPABILITIES --

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

Succinctly describe your capacity to effectively manage the programmatic, fiscal, and administrative aspects of the proposed project. Include information on your organization’s current mission and structure, relevant experience, and scope of current activities, and describe how these elements all contribute to the organization’s ability to implement the program requirements and meet program expectations (A project organizational chart is requested in Attachment 2).

Staffing Plan:

A staffing plan and job descriptions for key faculty/staff must be included in Attachment 1. Describe the minimum qualifications for each faculty position in the job description. 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.

If staff are required but not yet identified, describe the recruitment and retention plan to meet the project’s needs. In the event that a biographical sketch is included for an identified individual who is not yet hired, please include a letter of commitment from that person with the biographical sketch. When applicable, biographical sketches should include training, language fluency, and experience working with diverse populations that are served by their programs.

Project Director Qualification: Identify one Project Director. The Project Director for the proposed project must be a licensed Registered Nurse. NOTE:

There may only be one Project Director for the NEPQR-SET project.

Academic Nursing Faculty/ Coordinator: The NEPQR-SET project should include an Academic Nursing Faculty/Coordinator to support simulation scenarios and their role in the success and sustainability of the project.

Capabilities of the Applicant Organization: Describe how the organizational structure, including the capability and commitment of administration, management, and governing board, is appropriate for the implementation, operations, and oversight necessary to implement integrated services and curriculum enhancements. In addition, applicants should provide evidence of the financial capability and organizational commitment needed to operate the project.

Applicants should describe the facilities available to meet the needs of the project. Provide a letter of support from the President of the academic institution

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or other higher level academic officer that demonstrates the institution’s commitment to the project. In addition, provide a letter of support or commitment from each partner organization or department, internal and external, involved in your proposed project; include letters of support or commitment as Attachment 6.

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 qualif ications 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 must be uploaded in the SF-424 RESEARCH & RELATED Senior Key Person Profile (Expanded) form that can be accessed in the Application Package under “Mandatory.”

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

• 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. Briefly indicate the overall goals of the projects and responsibilities of the Senior/Key Person identified on the Biographical Sketch.

• When applicable, biographical sketches must include training, language fluency and experience working with populations that are culturally and linguistically different from their own.

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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 any additional budget instructions provided below. A budget that follows the 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.

Additional Budget Instructions

Subawards/subcontracts

A detailed line-item budget form is required for each subaward and should be uploaded to the Subaward Budget Attachment(s) Form.

NOTE: The R&R Subaward Budget Attachment Form limits the number of attachments for subawards to 10. If you need to include additional line-item budget forms, upload the attachment in R&R Other Project Information Form, block 12 “Other Attachments.”

These additional line-item budget forms for subawards will not count against the page limit. Note that any additional budget justifications (i.e., back-up information) are included in the page limit.

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.

Total project or program costs include costs charged to the award and costs borne by you to satisfy a matching or cost-sharing requirement, as applicable.

As required by the Consolidated Appropriations Act, 2023 (P.L. 117-328), Division H, § 202, “None of the funds appropriated in this title shall be used to pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of Executive Level II.” Effective January 2023, the salary rate limitation is $212,100. Note that these or other salary rate limitations may apply in the following fiscal years, as required by law.

In addition, the NEPQR-SET Program requires the following:

Equipment is defined as a unit cost of $5,000 or more and a useful life of one or more years. See SF-424 R&R Application Guide. for details.

This program allows for the budgeting of equipment in support of project simulation activities, including related minor Alteration and Renovation (A&R). Minor A&R may not include a structural change (e.g., to the foundation, roof, floor, or exterior or load-bearing walls of a facility, or extension of an existing facility) to achieve the following: Increase the floor area; and/or, change the function and purpose of the facility. You may request up to $20,000 for minor A&R to accommodate the equipment to make the space suitable for use for the proposed project.

Indirect costs under training awards to organizations other than state or local governments, or federally recognized Indian tribes, will be budgeted, and reimbursed at http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf

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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, and subawards and subcontracts in excess of $25,000 are excluded from the direct cost base for purposes of this calculation.

iv. Budget Justification Narrative

See Section 4.1.v. of HRSA’s SF-424 R&R Application Guide.

All budgets must provide sufficient details to fully explain and justify the resources needed to accomplish all program objectives.

In your application:

• Describe all line-item federal funds (including subawards), proposed for this project. Please note: all budget justification narratives count against the page limit.

In addition, NEPQR-SET requires the following:

• List equipment costs and provide justification for the need of the equipment to carry out the program’s goals. Provide a detailed itemized per unit cost which shows how costs were estimated and total cost.

Participant/Trainee Support Costs: For applicants with participant/trainee support costs, list tuition/fees/health insurance, stipends, travel, other, and the number of participants/ trainees. Ensure that your budget breakdown separates these trainee costs, and includes a separate sub-total entitled “Total Participant/ Trainee Support Costs” which includes the summation of all trainee costs. Participants are NOT your employees.

Consultant Services: If you are using consultant services, list the total costs for all consultant services. In the budget justification, identify each consultant, the services they will perform, the total number of days, travel costs, and the total estimated costs.

v. Standardized Work Plan (SWP) Form As part of the application package submitted through Grants.gov. You must complete and electronically submit the SWP Form by the application due date.

Ensure it includes all the information detailed in Section IV.2.ii. Project Narrative.

vi. Attachments

Provide the following items in the order specified below to complete the content of the application. Unless otherwise noted, attachments count toward the application page limit. Your indirect cost rate agreement and proof of non-profit status (if applicable) will not count toward the page limit. Clearly label each attachment. You must upload attachments into the application. HRSA and the objective review committee will not open/review any hyperlinked attachments.

Attachment 1: Staffing Plan and Job Descriptions for Key Personnel (Required) (See Section 4.1.vi. of HRSA’s SF-424 R&R Application Guide) https://www.hrsa.gov/sites/default/files/hrsa/grants/sf-424-rr-app-guide.pdf

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Keep each job description to one page in length as much as is possible. Include the role, responsibilities, and qualifications of proposed project staff. Also include a description of your organization’s timekeeping process to ensure that you will comply with the federal standards related to documenting personnel costs.

Attachment 2: Project Organizational Chart (Required)

Provide a one-page figure that depicts the organizational structure of the project (not the applicant organization)

Attachment 3: Letters of Agreement, Memoranda of Understanding, and/or contracts (Required)

Provide any documents that describe working relationships between your organization and other entities and programs cited in the proposal. Documents that confirm actual or pending contractual or other agreements should clearly describe the roles of the contractors and any deliverable. Make sure any letters of agreement are signed and dated. It is not necessary to include the entire contents of lengthy agreements, so long as the included document provides the information that relates to the requirements of the NOFO.

Attachment 4: Maintenance of Effort Documentation (Required) You must provide a baseline aggregate expenditure for the prior fiscal year and an estimate for the next fiscal year using a chart similar to the one below. HRSA will enforce statutory MOE requirements through all available mechanisms.

NON-FEDERAL EXPENDITURES

FY 2022 (Actual)

Actual FY 2022 non-federal funds, including in-kind, expended for activities proposed in this application.

Amount: $____________

FY 2023 (Estimated)

Estimated FY 2023 non-federal funds, including in-kind, designated for activities proposed in this application.

Amount: $______________

Attachment 5: Request for Funding Preference or Priority (As Applicable) To receive a funding preference, include a statement that you are eligible for a funding preference and identify the preference. Include documentation of this qualification. See Section V.2.

Attachment 6: Letters of Support and/or Commitment (Required)

Provide a letter of support or commitment for each organization or department involved in your proposed project. Letters of support must be dated and specifically indicate a commitment to the project/program (in-kind services, dollars, staff, space, equipment, etc.).

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Attachment 7: Disparities Impact Statement (Required) A Disparities Impact Statement (DIS) is an instrument used to measure and describe how training will support trainees’…