HRSA-21-042.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Maternal and Child Health Bureau Division of Maternal and Child Health Workforce Development

Pediatric Audiology Competitive Supplement to Leadership Education in Neurodevelopmental and Related Disabilities (LEND)

Funding Opportunity Number: HRSA-21-042

Funding Opportunity Type(s): Competing Supplement, New Assistance Listings (CFDA) Number: 93.877

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2021

Application Due Date: July 1, 2021

Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately!

HRSA will not approve deadline extensions for lack of registration.

Registration in all systems, including SAM.gov and Grants.gov, may take up to 1 month to complete.

Issuance Date: April 15, 2021

Robyn Schulhof, MA, Rita Maldonado, MPH, and Karla Brewer, M.Ed.

Public Health Analysts/ LEND Project Officers Telephone: (301) 443-0258; (301) 443-3622; (301) 443-2520 Email: rschulhof@hrsa.gov; rmaldonado@hrsa.gov; kbrewer@hrsa.gov

Authority: 42 U.S.C. § 280g-1(a) (Title III, § 399M(a) of the Public Health Service Act) mailto:rschulhof@hrsa.gov mailto:rmaldonado@hrsa.gov mailto:kbrewer@hrsa.gov

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EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB) is accepting applications for fiscal year (FY) 2021 for the Pediatric Audiology Competitive Supplement to Leadership Education in Neurodevelopmental and Related Disabilities (LEND) programs. The purpose of this supplement is to support the clinical and leadership training of pediatric audiology trainees within LEND programs with the following specific goals:

1) To strengthen the focus on screening, treatment, and follow-up in infants and young children who are deaf or hard-of-hearing (DHH) and who have or are at risk for autism spectrum disorder (ASD) and/or other developmental disabilities (DD).

2) To increase the number of pediatric audiologists with clinical and leadership skills and expertise in delivering care to infants and young children with ASD/DD, utilizing these unique skills to work across disciplines to better serve children with hearing loss and their families.

3) To increase the Early Hearing Detection and Intervention (EHDI) systems’ capacity to serve infants/children who are DHH and who have or are at risk for ASD/DD.

Funding Opportunity Title: Pediatric Audiology Competitive

Supplement to Leadership Education in Neurodevelopmental and Related Disabilities (LEND)

Funding Opportunity Number: HRSA-21-042 Due Date for Applications: July 1, 2021 Anticipated Total Annual Available FY 2021 Funding:

$900,000

Estimated Number and Type of Award(s): Up to 12 grant supplements Estimated Award Amount: Up to $75,000 per year Cost Sharing/Match Required: No Period of Performance: July 1, 2021 through June 30, 2026

(5 years to align with the base awards funded under HRSA-21-041 Leadership Education in Neurodevelopmental and Other Related Disabilities (LEND))

Eligible Applicants: Eligible applicants include all current LEND funding recipients funded under NOFO HRSA-21-041 (start date of July 1, 2021).

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See Section III.1 of this Notice of Funding Opportunity (NOFO) for complete eligibility information.

Application Guide

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

Technical Assistance

HRSA has scheduled the following technical assistance:

Webinar

Day and Date: Thursday, May 6, 2021 Time: 1–2 p.m. ET Call-In Number: 1 (833) 568-8864 Participant Code: 576710111 Weblink: https://hrsa-gov.zoomgov.com/j/1615077506?pwd=d0FLU0J6aEhCU1diNlNobngxZys5UT09

HRSA will record the webinar and make it available at:

https://mchb.hrsa.gov/fundingopportunities/default.aspx.

http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf https://hrsa-gov.zoomgov.com/j/1615077506?pwd=d0FLU0J6aEhCU1diNlNobngxZys5UT09 https://hrsa-gov.zoomgov.com/j/1615077506?pwd=d0FLU0J6aEhCU1diNlNobngxZys5UT09 https://mchb.hrsa.gov/fundingopportunities/default.aspx

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TABLE OF CONTENTS

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING/MATCHING

3. OTHER

IV. APPLICATION AND SUBMISSION INFORMATION

1. ADDRESS TO REQUEST APPLICATION PACKAGE

2. CONTENT AND FORM OF APPLICATION SUBMISSION

i. Project Abstract

ii. Project Narrative

iii. Budget

iv. Budget Justification Narrative

v. Program-Specific Forms

vi. Attachments

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

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

4. SUBMISSION DATES AND TIM ES

5. INTERGOV ERNM ENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSM ENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIV E AND NATIONAL POLICY REQUIREM ENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

APPENDIX: APPLICABLE STANDARDS FOR USING GRANT FUNDS TO SUPPORT LEND

TRAINEES/FELLOWS

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I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity for current Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program recipients to apply for funding under the Pediatric Audiology Competitive Supplement to the LEND program.

This supplement will support the clinical and leadership training of pediatric audiology trainees within LEND programs as well as continuing education for practicing professionals. Each recipient will train an average of 2 long-term, pediatric audiology trainees each year, for a minimum total of 10 long-term, pediatric audiology trainees by the end of the 5-year period of performance. The program aims to achieve the following goals:

• to strengthen the focus on screening, treatment, and follow-up in infants and young children who are deaf or hard-of-hearing (DHH) and who have or are at risk for autism spectrum disorder (ASD) and/or other developmental disabilities

(DD);

• to increase the number of pediatric audiologists with clinical and leadership skills and expertise in delivering care to infants and young children with ASD/DD, utilizing these unique skills to work across disciplines to better serve children with hearing loss and their families; and

• to increase the Early Hearing Detection and Intervention (EHDI) systems’1 capacity to serve infants/children who are DHH and who have or are at risk for ASD/DD by providing technical assistance.

2. Background

The LEND Training Program is authorized by § 399BB of the Public Health Service Act (PHS Act), as amended by Public Law 116-60, Autism Collaboration, Accountability, Research, Education, and Support Act of 2019 (Autism CARES Act of 2019). The LEND program provides interdisciplinary opportunities for trainees to access content and experiences beyond the scope of their respective academic disciplines. The goal of the program is to increase the capacity of the workforce trained to meet the complex needs of individuals with ASD/DD by enhancing the expertise and leadership skills of practicing professionals, families, and self-advocates dedicated to working with and improving the system of care for individuals with ASD/DD.

Audiology awards funded under this NOFO are authorized by Universal Newborn Hearing Screening (UNHS) legislation (PHS Act, § 399M(a) [42 U.S.C. 280g–1(a)]).

This legislation supports grants or cooperative agreements to develop statewide newborn and infant hearing screening, evaluation, diagnosis, and intervention programs and systems, and programs to assist in the recruitment, retention, education, and training of qualified personnel and health care providers. The reauthorization of the EHDI Act of 2017, which amended the PHS Act, expands the target population for

1 For the purposes of this NOFO, the EHDI system of care refers to families, consumers, providers, services, and programs that work towards developing coordinated and comprehensive state and territory systems so that families with newborns, infants, and young children who are deaf or hard of hearing receive appropriate and timely services that include hearing screening, diagnosis, and intervention.

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hearing screening beyond newborns to include young children up to the age of 3. The EHDI legislation also supports programs and systems that:

• Foster family-to-family and deaf and hard-of-hearing consumer-to-family support.

• Identify or develop educational and medical models to ensure that children who are identified as deaf or hard-of-hearing through screening receive follow-up by qualified early intervention or health care providers (including those at medical homes for children), and referrals, as appropriate to early intervention services under Part C of the Individuals with Disabilities Education Act (IDEA).

• Encourage state agencies to increase the rate of such follow-up and referral.

Additionally, the legislation calls for ensuring that information provided to families when children are identified as deaf or hard-of-hearing is accurate, comprehensive, up-to-date, and evidence-based as applicable to allow families to make important decisions for their children in a timely manner.2

There is a shortage of audiologists with expertise in evidence-based practices in newborn hearing screening and utilizing current diagnostic technology for evaluating infants and young children.3 Audiologists are needed to facilitate a critical point of entry and transition for families and their infants into and through the EHDI system. They provide timely follow-up screening and necessary diagnostic audiological evaluations, connect and guide families through the EHDI process, communicate with the child’s EHDI team, and provide ongoing audiological management. The implementation of universal newborn hearing screening across the nation, and the expansion of the target population for hearing screening beyond newborns to include young children up to the age of 3, necessitates more pediatric audiologists. The highest priority of the EHDI system is to ensure that each child meets the 1-3-6 guidelines (screening by 1 month, diagnosis by 3 months, and enrollment into early intervention by 6 months) published by the Joint Committee on Infant Hearing (JCIH).4 Connecting families of these children to the EHDI system of care is critical for children to achieve optimal linguistic and developmental outcomes. Audiologists have a key role in providing a seamless progression of care in the EHDI system.

Experts project that the shortage of audiology professionals in the United States could persist over the next 30 years.5 Furthermore, the Joint Committee on Infant Hearing acknowledges the continued need for audiologists with pediatric knowledge and skills to address the serious shortage of qualified providers.6

The Maternal and Child Health Bureau’s (MCHB) Division of MCH Workforce Development (DMCHWD) and Division of Services for Children with Special Health Needs (DSCSHN), jointly determined that LEND programs had the requisite experience

2 Early Hearing Detection and Intervention Act of 2017, Public Health Service Act, Title III, Section 399M (as added by P.L. 106-310, Sec. 702; as amended by P.L. 111-337 and P.L. 115-71.

3 Russ et al. Improving Follow-Up to Newborn Hearing Screening: A Learning-Collaborative Experience. Pediatrics 2010; 126: S59- S69.

4 Yoshinaga-Itano, C., Sedey, A. L., Wiggin, M., & Chung, C. (2017). Early hearing detection and vocabulary of children with hearing loss. Pediatrics, 140(2).

5 Windmill IM, Freeman BA. Demand for audiology services: 30-yr projections and impact on academic programs. J Am Acad Audiol. 2013 May; 24(5):407-416.

6 Year 2019 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. (2019). Journal of Early Hearing Detection and Intervention, 4(2), 1-44.

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and expertise to increase didactic content and augment clinical experiences in pediatric audiology training. Beginning in 2009, supplemental funds have been competitively awarded annually to a subset of entities conducting LEND programs with existing graduate-level pediatric audiology programs or externship sites to increase the number of pediatric audiology trainees with the necessary clinical and leadership skills to improve the testing of hearing status in young infants and children with ASD/DD. Since 2009, 475 long-term and 224 medium-term LEND pediatric audiology trainees have benefited from this supplemental funding. Of former long-term pediatric audiology trainees, 86.5 percent now work with individuals with disabilities. Of these trainees, 76 percent are working with underserved populations and 79 percent are working in an interdisciplinary manner.7

II. Award Information

1. Type of Application and Award

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

Funding will be provided in the form of a grant.

2. Summary of Funding

HRSA estimates approximately $900,000 to be available annually to fund up to 12 entities conducting HRSA-funded LEND programs. This program expects to provide funding for 5 years from FY 2021–2026 to coincide with the LEND funding cycle under previously issued notices of award. Applicants may apply for a ceiling amount of up to $75,000 total cost (includes both direct and indirect, facilities and administrative costs) per year. The period of performance is July 1, 2021 through June 30, 2026 (5 years) to align with the base awards funded under HRSA-21-041 Leadership Education in Neurodevelopmental and Other Related Disabilities (LEND). Funding beyond the first year is dependent on the availability of appropriated funds for the Pediatric Audiology Competitive Supplement to LEND in subsequent fiscal years, satisfactory recipient performance, and a decision that continued funding is in the best interest of the Federal Government.

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

Indirect costs under training awards to organizations other than state, local, or Indian tribal governments 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, and subawards and subcontracts in excess of $25,000 are excluded from the direct cost base for purposes of this calculation.

7 National Information and Reporting System (NIRS), 2016–2020 (not publically available).

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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III. Eligibility Information

1. Eligible Applicants

Entities conducting LEND training programs funded under NOFO HRSA-21-041 (start date of July 1, 2021) are eligible to apply for this competitive supplement.

2. Cost Sharing/Matching

Cost sharing/matching is not required for this program.

3. Other

HRSA will consider any application that exceeds the ceiling amount non-responsive and will not consider it for funding under this notice.

HRSA will consider any application that exceeds the page limit referenced in Section_IV non-responsive and will not consider it for funding under this notice.

HRSA will consider any application that fails to satisfy the deadline requirements referenced in Section IV.4 non-responsive and will not consider it for funding under this notice.

NOTE: Multiple applications from an organization are not allowable.

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

A student/trainee/fellow receiving support from grant funds must be a citizen, national, or permanent resident of the United States.

IV. Application and Submission Information

1. Address to Request Application Package

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

The NOFO is also known as “Instructions” on Grants.gov. You must select “Subscribe” and provide your email address for each NOFO you are reviewing or preparing in the workspace application package 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.

https://www.grants.gov/ http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/applicants.html

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2. Content and Form of Application Submission

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

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

Application Page Limit The total size of all uploaded files included in the page limit shall not exceed the equivalent of 20 pages when printed by HRSA. The page limit includes the abstract, project and budget narratives, attachments including biographical sketches (biosketches), and letters of commitment and support required in HRSA’s SF-424 R&R Application Guide and this NOFO. Standard OMB-approved forms that are included in the workspace application package do not count in the page limit. Biographical sketches do count in the page limitation. Please note: If you use an OMB-approved form that is not included in the workspace application package for HRSA-21-042, it may count against the page limit. Therefore, we strongly recommend you only use Grants.gov workspace forms associated with this NOFO to avoid exceeding the page limit. Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count in the page limit. It is therefore important to take appropriate measures to ensure your application does not exceed the specified page limit. Any application exceeding the page limit of 20 will not be read, evaluated, or considered for funding.

Applications must be complete, within the maximum specified page limit, and validated by Grants.gov under the correct funding opportunity number prior to the deadline.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

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

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

3) Where you are unable to attest to the statements in this certification, an explanation shall be included in Attachment 6: Other Relevant Documents.

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

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

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Temporary Reassignment of State and Local Personnel during a Public Health Emergency

Section 319(e) of the Public Health Service (PHS) Act provides the Secretary of the Department of Health and Human Services (HHS) with discretion upon request by a state or tribal organization to authorize the temporary reassignment of state, tribal, and local personnel during a declared federal public health emergency. The temporary reassignment provision is applicable to state, tribal, and local public health department or agency personnel whose positions are funded, in full or part, under PHS programs and allows such personnel to immediately respond to the public health emergency in the affected jurisdiction. Funds provided under the award may be used to support personnel who are temporarily reassigned in accordance with § 319(e). Please reference detailed information available on the HHS Office of the Assistant Secretary for Preparedness (ASPR) website via http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx.

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

i. Project Abstract See Section 4.1.ix of HRSA’s SF-424 R&R Application Guide.

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

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

INTRODUCTION -- Corresponds to Section V’s Review Criterion 1: Need

This section will relate the project objectives to the purpose of the grant program described in Section I.1. Purpose of this NOFO.

In your application:

• Describe the proposed training program and how it fits into the existing LEND program, and state concisely the importance of the project.

• Describe the relationship between the proposed project and Section I.1 Purpose section of this NOFO.

http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx

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NEEDS ASSESSMENT -- Corresponds to Section V’s Review Criterion 1: Need

The program should be developed upon an understanding of the national, regional, state, and local demand for the training. You should demonstrate the need for additional pediatric audiologists.

In your application:

• Identify the gaps which the project intends to fill. Include and cite data to support the information provided.

• Describe the unmet needs of the community as they relate to children who are DHH and have or are at risk for ASD/DD.

• Describe social determinants of health and health disparities for children who are DHH and have or are at risk for ASD/DD.

• Provide an overview of the community and organizational needs to be addressed by the proposed project.

• Document the needs related to services and systems of care for children who are DHH and have or are at risk for ASD/DD and how the training program will address those needs.

METHODOLOGY -- Corresponds to Section V’s Review Criterion 2: Response and 4: Impact

This section describes the proposed program’s methodology across a number of areas.

1) Goals and Objectives

The proposed program goals and objectives should respond to the stated purpose and need for the project. Program goals and objectives should aim to coordinate and advance early identification, diagnosis, and intervention services for children who are DHH and have or are at risk for ASD/DD.

In your application:

• State the overall goal(s) and objectives of the project. The objectives must be specific, measurable, attainable, relevant, and time-based (SMART) for each project year.

2) LEND Audiology Trainees

Trainees supported by this supplement must be graduate-level audiology doctoral candidates (including externs) or students enrolled in post-masters/post-doctoral clinical fellowships. Candidates must have demonstrated interest in ASD/DD as well as interest in developing their leadership skills. Per year, an average of 2 audiology trainees are expected to participate as long-term LEND trainees that complete 300+ hours of didactic, clinical, and leadership training, with a minimum of 10 audiology trainees participating by the end of the 5-year period of performance. The minimum number of audiology LEND trainees is in addition to the minimum annual trainee requirements of the base LEND grant. Please note, while audiology trainees supported by the base LEND grant may be masters or

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doctoral-level, audiology trainees supported by this supplement are more advanced in their training and therefore must be post-masters level or above.

In addition to the required long-term trainees (LTTs), programs may also train short-term (1–149 hours) and/or medium-term trainees (150–299 hours).

In your application:

• Describe the program’s criteria and strategies for recruiting a minimum of two audiology doctoral or post-masters/post-doctoral candidates per year to participate as long-term LEND trainees for each year of the project.

• Describe the program’s strategies for recruiting and retaining trainees from diverse backgrounds and for evaluating the success of these efforts.

• Describe how medium- and/or short-term trainees will be recruited and engaged in the program and in the didactic, clinical, and field experiences available to LTTs, if applicable.

3) Curriculum and Training Content

A strong LEND curriculum for audiology LTTs will incorporate interdisciplinary clinical, leadership, and didactic content to meet the broad range of trainee needs, and prepare trainees to address the needs of DHH children with or at risk for ASD/DD. Audiology trainees are expected to participate in the interdisciplinary LEND cohort and engage in LEND network-wide activities (e.g., workshops, webinars, and trainee poster presentations). By participating in LEND activities with the interdisciplinary cohort, the audiology trainees will also contribute to the knowledge of the other trainees and their ability to serve children who are DHH and who have or are at risk for ASD/DD.

LEND audiology trainees under this supplement are expected to:

• Receive training in the EHDI system and current guidelines for practice, including:

o 1-3-6 recommendations.

o the need for hearing screening in young children up to 3 years of age.

o the benefits of a family-centered medical home.

o the importance of communicating accurate, comprehensive, up-to-date, evidence-based information to families to facilitate decision-making processes.

• Receive training in family support, defined as the practices that ensure that the holistic nature of the process for families is sustained through the timelines, policies, and procedures by the varying entities that the family encounters through hearing screening, diagnosis, early intervention, and beyond.8

• Receive training in family engagement, defined as the patients, families, their representatives, and health professionals working in active partnership at

8 Global Coalition of Parents of Deaf/Hard of Hearing Children (2010). Position Statement and Recommendations for Family Support in the Development of Newborn Hearing Screening Systems (NHS)/Early Hearing Detection and Intervention (EHDI) Systems Worldwide.

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various levels across the health care system to improve health and health care.9

• Participate in innovative and collaborative efforts to engage EHDI system stakeholders at the state/territory level to improve developmental outcomes of children with ASD and/or other DD who are DHH.

Trainees are expected to participate in activities that are especially relevant to the field of audiology. LEND trainees may attend the annual EHDI Meeting, including planning and participating in the LEND audiology trainee workshop and presenting their research at the meeting.

Opportunities for short- and medium-term trainees may take various forms, including offering a menu of training options based on the long-term LEND program.

In your application:

• Describe the specific curriculum and training content targeted to audiology trainees and how these will address the EHDI system and guidelines for practice described above.

• Describe how the audiology curriculum will build upon the core LEND training curriculum.

• Describe the clinical experiences specific to DHH children and those with or at risk for ASD/DD.

• Describe the leadership opportunities available to audiology trainees, including their participation in national LEND network activities.

• Describe the leadership opportunities available to audiology trainees to foster partnerships for referral, training, and information sharing with various stakeholders across the state/territory EHDI system of care as defined in the Purpose section on page 1.

• Describe how the audiology component of LEND will add value to the training experience for trainees from other academic disciplines.

• Describe the training opportunities, experiential and didactic, of any planned cohorts of medium- and/or short-term trainees, if applicable.

4) Continuing Education, Technical Assistance, and Product Dissemination

LEND programs conduct continuing education (CE) activities each year (such as conferences, workshops, or similar training activities) to enhance the skills of practicing professionals in the field and disseminate new information. LEND programs also provide technical assistance (TA) and consultation to the field, to collaborate with partners in their problem-solving efforts.

LEND audiology supplement recipients should provide CE and TA activities that focus on the audiological needs of individuals who are DHH and who have or are at risk for ASD/DD. It is encouraged that both LEND audiology faculty and trainees

9 Carman et. al. (2013). Patient and Family Engagement: A Framework for Understanding the Elements and Developing Interventions and Policies. Health Affairs. 32(2), 223–231.

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be involved in the provision of CE and TA when appropriate. Of particular interest to MCHB are CE and TA focused on improving systems of care for individuals with ASD/DD and/or are DHH.

As programs revise and develop new curricular materials, teaching models, other educational resources, and research findings, these products should be disseminated to other relevant programs, including, but not limited to, other HRSA grants funded under the Autism CARES Act of 2019.

In your application:

• Describe the audiology-focused CE activities that your organization is prepared to offer as well as the role of your LEND audiology faculty and trainees. Include the types of professionals you will be targeting.

• Describe the type of audiology-focused TA activities that your organization will offer as well as the role of your LEND audiology faculty and trainees. Include the organizations and state EHDI program(s) to whom you will seek to provide technical assistance.

• Describe how your program will disseminate reports, products, and/or project outputs in order for information to be provided to key target audiences.

WORK PLAN -- Corresponds to Section V’s Review Criteria 2: Response and

4: Impact A work plan is critical in planning and describing the activities of the proposed training program, including how training will be implemented and evaluated. A work plan is a chart of the activities or steps that will be used to achieve each of the goals and objectives proposed in the Methodology section.

Programs are expected to formulate a work plan to guide the implementation of their supplemental funds and articulate how the activities will augment their LEND program.

• The narrative should include a brief descriptive overview referencing the work plan in Attachment 1.

• Include the work plan in Attachment 1.

• The work plan should describe each training activity, didactic, clinical and practicum, with regard to purpose, methodology, content, time commitment, and method of evaluation.

• The work plan should include a timeline with all planned activities for the entire period of performance (5 years).

• The work plan should identify responsible staff and, as appropriate, meaningful support and collaboration with key stakeholders in planning, designing and implementing all activities.

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RESOLUTION OF CHALLENGES -- Corresponds to Section V’s Review Criterion 2: Response

Programs may encounter challenges in implementation. Examples include challenges pertaining to trainee recruitment, ensuring the availability of appropriately qualified, university-affiliated faculty, and sufficient interdisciplinary clinical opportunities.

You should anticipate challenges you are likely to encounter during implementation and develop strategies to address those challenges. Build on previous approaches to addressing challenges.

In your application:

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

• Describe approaches that you will use to resolve identified challenges.

EVALUATION AND TECHNICAL SUPPORT CAPACITY -- Corresponds to Section V’s Review Criteria 3: Evaluative Measures and 5: Resources/Capabilities

A strong evaluation protocol, managed by qualified staff, is necessary to document program processes, inputs, outputs, and impacts. Mechanisms for monitoring progress towards the goals and objectives of the project and implementing continuous quality improvement of the LEND program are also vital components of the evaluation.

The evaluation should assess experiences of LEND audiology LTTs and their attainment of desired skills and competencies.

Section VI. 3. Reporting describes required data collection and reporting of performance data to MCHB. This includes tracking of former trainees to collect data via follow-up surveys in years 2, 5, and 10 following completion of LEND training. Long-term LEND audiology trainees under this supplement are subject to the same tracking requirements.

If your evaluation may involve human subjects research as described in 45 CFR part 46, you must comply with the regulations for the protection of human subjects as applicable.

In your application:

• Describe the overall evaluation strategy to address program goals and objectives, and ongoing quality improvement efforts.

• Describe the approaches to assess experiences and changes in skills and competencies that audiology trainees are expected to attain during the LEND training.

• Describe the plans to assess the quality of the CE and TA provided.

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ORGANIZATIONAL INFORMATION -- Corresponds to Section V’s Review Criterion 5: Resources/Capabilities

LEND pediatric audiology supplements are awarded to entities conducting existing LEND programs. All programs must have the infrastructure necessary to implement the requirements of the supplement in addition to the base LEND program. The LEND program must have the ability to recruit audiology trainees from their own or partner institution(s). The program must also have access to interdisciplinary clinical and community experiences appropriate for audiology trainees. Audiology training under this supplement should differ from non-LEND audiology training experiences available to trainees by adding interdisciplinary content and experiences related to ASD/DD and by engaging with other LEND disciplines in the cohort.

The official project director (PD) is the same as the PD named on the base LEND award. Only one PD is formally recognized by HRSA on the notice of award (NOA) and will receive key HRSA communications. Programs may designate a lead faculty member to oversee the implementation of audiology supplement activities.

Faculty under this supplement should be qualified to provide mentorship to audiology trainees.

The staffing plan and job descriptions for key faculty/staff must be included in Attachment 2 (Staffing Plan and Job Descriptions). However, the biographical sketches must be uploaded in the SF-424 RESEARCH & RELATED Senior Key Person Profile form that can be accessed in the Application Package under “Mandatory.”

• Describe the administrative and organizational structure within which the LEND audiology supplement activities will function, including relationships with other relevant departments, institutions, organizations, or agencies.

• Include a staffing plan and job descriptions for key faculty/staff as Attachment 2.

• Include a chart outlining organizational structures as Attachment 4.

• Describe the personnel/faculty needed to accomplish the goals and objectives of the project.

• Demonstrate that project personnel are qualified (by training and/or experience) to implement and carry out the project.

• Describe how audiology faculty will provide mentorship of audiology trainees and promote leadership in the field.

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

• Describe your organization’s experience in implementing a similar training program reaching interdisciplinary trainees and/or serving DHH children and/or those with ASD/DD.

• Describe the settings in which the program will take place.

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• Describe the distance learning strategies for the program, particularly if the curriculum will be delivered remotely, or accessed remotely by any trainees or faculty.

• Explain how the physical and virtual training environments will maximize the participation of trainees and faculty from multiple disciplines to ensure an interdisciplinary experience.

• Describe your organization’s plan for ensuring that curricula, materials, and virtual and physical settings are accessible for all participants.

iii. Budget

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

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

The Consolidated Appropriations Act, 2021 (P.L. 116-260), Division H, § 202 states, “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.” See Section 4.1.iv Budget – Salary Limitation of HRSA’s SF-424 R&R Application Guide for additional information. Note that these or other salary limitations may apply in the following fiscal years, as required by law.

Indirect costs under training awards to organizations other than state, local or Indian tribal governments 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, and sub-awards and subcontracts in excess of $25,000 are excluded from the direct cost base for purposes of this calculation.

Because this supplement is supported by different funding than that used for other LEND Program purposes, recipients are required to internally budget and track expenditures for these activities separate from activities under the base LEND HRSA-21-041 notice of funding opportunity (NOFO). Reporting on the supplement activities will be part of the LEND reporting structures.

• Ensure that the budget for each project year does not exceed $75,000.

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

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iv. Budget Justification Narrative A budget narrative provides details to justify the proposed costs outlined on the line-item budget form. For complete instructions on what to include in the budget narrative see Section 4.1.v of HRSA’s SF-424 R&R Application Guide.

The budget narrative must fully explain the resources needed to accomplish the LEND supplement training objectives. Activities budgeted for in the audiology supplement should be distinct from the activities of the base LEND grant.

• Ensure that the budget narrative demonstrates support for the proposed project activities.

• Specify the number of LEND audiology trainees planned for each project year, and provide a clear description of how many stipends will be supported by the grant each year.

• Identify any costs associated with training short- and/or medium-term LEND audiology trainees, if applicable.

• Include a description of the faculty FTE commitment to the LEND audiology supplemental activities, and documentation to support that faculty will be allotted adequate time to meet project objectives. If faculty time for LEND audiology supplement will be supported by other funds, please indicate this in the budget narrative.

• Provide a description of the travel funds requested, indicating that LEND audiology trainees have the opportunity to participate in annual EHDI meetings.

NARRATIVE GUIDANCE

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

Narrative Section Review Criteria

Introduction (1) Need

Needs Assessment (1) Need

Methodology (2) Response

Work Plan (2) Response and (4) Impact

Resolution of Challenges (2) Response

Evaluation and Technical Support Capacity

(3) Evaluative Measures and

(5) Resources/Capabilities

Organizational Information (5) Resources/Capabilities

Budget and Budget Narrative

(6) Support Requested

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v. Program-Specific Forms Program-specific forms are not required for application.

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. Indirect cost rate agreements and proof of non-profit status (if applicable) will not count toward the page limit. Clearly label each attachment.

Attachment 1: Work Plan

Attach the work plan for the project that includes all information detailed in Section IV.2.ii. Project Narrative. If you will make subawards or expend funds on contracts, describe how your organization will ensure proper documentation of funds.

Attachment 2: Staffing Plan and Job Descriptions for Key Personnel (see Section 4.1.vi. of HRSA’s SF-424 R&R Application Guide)

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, please include a description of your organization’s time keeping process to ensure that you will comply with the federal standards related to documenting personnel costs.

Attachment 3: Letters of Agreement, Memoranda of Understanding, and/or Description(s) of Proposed/Existing Contracts (project-specific)

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.

Attachment 4: Project Organizational Chart Provide a one-page figure that depicts the organizational structure of the LEND Audiology Supplement project.

Attachment 5: Tables, Charts, etc.

To give further details about the proposal (e.g., Gantt or PERT charts, flow charts).

Attachment 6: Other Relevant Documents Include here any other documents that are relevant to the application, including letters of support. 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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3. Dun and Bradstreet Data Universal Numbering System (DUNS) Number Transition to the Unique Entity Identifier (UEI) and System for Award Management (SAM)

You must obtain a valid DUNS number, also known as the Unique Entity Identifier (UEI), and provide that number in the application. In April 2022, the *DUNS number will be replaced by the UEI, a “new, non-proprietary identifier” requested in, and assigned by, the System for Award Management (SAM.gov). For more details, visit the following pages: Planned UEI Updates in Grant Application Forms and General Service Administration’s UEI Update.

You must also register with SAM and continue to maintain active SAM registration with current information at all times during which you have an active federal award or an application or plan under consideration by an agency (unless the applicant is an individual or federal agency that is exempted from those requirements under 2 CFR § 25.110(b) or (c), or has an exception approved by the agency under 2 CFR § 25.110(d)).

If you are chosen as a recipient, HRSA would not make an award until you have complied with all applicable DUNS (or UEI) and SAM requirements and, if you have not fully complied with the requirements by the time HRSA is ready to make an award, you may be deemed not qualified to receive an award and use that determination as the basis for making an award to another applicant.

If you have already completed Grants.gov registration for HRSA or another federal agency, confirm that it is still active and that the Authorized Organization Representative (AOR) has been approved.

*Currently, the Grants.gov registration process requires information in three separate systems:

• Dun and Bradstreet (http://www.dnb.com/duns-number.html)

• System for Award Management (SAM) (https://www.sam.gov)

• Grants.gov (http://www.grants.gov/)

For further details, see Section 3.1 of HRSA’s SF-424 R&R Application Guide.

SAM.GOV ALERT: For your SAM.gov registration, you must submit a notarized letter appointing the authorized Entity Administrator. The review process changed for the Federal Assistance community on June 11, 2018.

In accordance with the Federal Government’s efforts to reduce reporting burden for recipients of federal financial assistance, the general certification and representation requirements contained in the Standard Form 424B (SF-424B) – Assurances – Non- Construction Programs, and the Standard Form 424D (SF-424D) – Assurances – Construction Programs, have been standardized federal-wide. Effective January 1, 2020, the forms themselves are no longer part of HRSA’s application packages and the updated common certification and representation requirements will be stored and maintained within SAM. Organizations or individuals applying for federal financial https://www.grants.gov/web/grants/forms/planned-uei-updates.html https://www.gsa.gov/entityid https://www.gsa.gov/entityid http://www.dnb.com/duns-number.html https://www.sam.gov/ http://www.grants.gov/ http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://sam.gov/ https://www.fsd.gov/fsd-gov/answer.do?sysparm_kbid=d2e67885db0d5f00b3257d321f96194b&sysparm_search=kb0013183

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assistance as of January 1, 2020, must validate the federally required common certifications and representations annually through SAM located at SAM.gov.

If you fail to allow ample time to complete registration with SAM or Grants.gov, you will not be eligible for a deadline extension or waiver of the electronic submission requirement.

4. Submission Dates and Times

Application Due Date The due date for applications under this NOFO is July 1, 2021 at 11:59 p.m. ET. HRSA suggests submitting applications to Grants.gov at least 3 calendar days before the deadline to allow for any unforeseen circumstances. See Section 8.2.5 – Summary of emails from Grants.gov of HRSA’s SF-424 R&R Application Guide for additional information.

5. Intergovernmental Review

The Pediatric Audiology Competitive Supplement to Leadership Education in Neurodevelopmental and Related Disabilities (LEND) is not a program subject to the provisions of Executive Order 12372, as implemented by 45 CFR part 100.

See Section 4.1 ii of HRSA’s SF-424 R&R Application Guide for additional information.

6. Funding Restrictions

Applicants responding to this announcement may request funding for a period of performance of up to 5 years, at no more than $75,000 per year (inclusive of direct and indirect costs). Awards to support projects beyond the first budget year will be contingent upon Congressional appropriation, satisfactory progress in meeting the project’s objectives, and a determination that continued funding would be in the best interest of the Federal Government.

The General Provisions in Division H of the Consolidated Appropriations Act, 2021 (P.L.

116-260) apply to this program. Please see Section 4.1 of HRSA’s SF-424 R&R Application Guide for additional information. Note that these or other restrictions will apply in the following fiscal years, as required by law.

See restrictions and non-allowable costs in Appendix:…