HRSA-24-0018 GWEP MODIFIED.pdf

U.S. Department of Health and Human Services

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2024

Bureau of Health Workforce

Division of Medicine and Dentistry

Geriatrics Workforce Enhancement Program

Funding Opportunity Number: HRSA-24-018

Funding Opportunity Type(s): New

Assistance Listing Number: 93.969

Application Due Date: February 26, 2024 Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately!

We will not approve deadline extensions for lack of registration.

Registration in all systems may take up to 1 month to complete.

Issuance Date: November 27, 2023

MODIFIED January 11, 2024: Added and revised definitions on pages 3, 4, and 5. Clarified and revised eligible applicant accreditation language for certified nurse assistant program on page 8.

Revised apprenticeship program language on pages 11 and 17. Clarified Project Director qualification on Page 26. Added U.S. Department of Labor Apprenticeship Program resource to page 46.

Jennifer Solomon, MA Project Officer, Division of Medicine and Dentistry Call: 301-443-0024 Email: GWEP@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 U.S.C. § 294c(a) and 298; Public Health Service Act sections 753(a), and 865.

mailto:GWEP@hrsa.gov

HRSA-24-018 GWEP i

508 COMPLIANCE DISCLAIMER

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.

SUMMARY

Funding Opportunity Title: Geriatrics Workforce Enhancement Program

Funding Opportunity Number: HRSA-24-018

Assistance Listing Number: 93.969

Due Date for Applications: February 26, 2024

Purpose: The purpose of the Geriatrics Workforce Enhancement Program (GWEP) is to educate and train the health care and supportive care workforces to care for older adults by collaborating with community partners. Applicants must maximize patient and family engagement to address care gaps and improve health outcomes for older adults by integrating geriatrics with primary care and other appropriate specialties using the Age-Friendly Health Systems Framework.1

Program Objective(s): 1. Develop reciprocal partnerships between academia, primary care sites/delivery systems (including nursing homes), and community organizations, to transform clinical training environments into integrated geriatrics and primary care sites/delivery systems that are age-friendly and dementia-friendly.

1 The John A. Hartford Foundation & The Institute for Healthcare Improvement. (2009- 2023). Age- Friendly Health Systems. Retrieved on August 2, 2023 from https://www.johnahartford.org/grants-strategy/current-strategies/age-friendly/age-friendly-health-systems-initiative.

https://www.johnahartford.org/grants-strategy/current-strategies/age-friendly/age-friendly-health-systems-initiative https://www.johnahartford.org/grants-strategy/current-strategies/age-friendly/age-friendly-health-systems-initiative

HRSA-24-018 GWEP ii

2. Provide interprofessional geriatrics clinical training and education to students, residents, fellows, faculty, and preceptors in Tribal, Tribal Organizations, Underserved and/or Rural (TTOUR) primary care sites/delivery systems with the intent to have them practice in these sites upon completion of their program.

3. Establish and/or maintain education and training programs in TTOUR primary care sites/delivery systems that provide the supportive care workforce, direct care workers, and the primary care workforce with the knowledge and skills to improve the care of older adults, including persons living with dementia, by using innovative technology and methods.

Eligible Applicants: The following entities are eligible applicants:

• Schools of Allopathic Medicine

• Schools of Osteopathic Medicine

• Schools of Nursing

• Schools of Allied Health

• Schools of Pharmacy

• Schools of Dentistry

• Schools of Public Health

• Schools of Optometry

• Schools of Chiropractic

• Schools of Veterinary Medicine

• Schools of Podiatric Medicine

• Physician Assistant Education Programs

The following accredited graduate programs are also eligible applicants:

• Health Administration

• Behavioral Health and Mental Health Practice including:

• Clinical Psychology

• Clinical Social Work

• Professional Counseling

• Marriage and Family Therapy

Additional eligible applicants include:

• a health care facility, HRSA-24-018 GWEP iii

• a program leading to certification as a certified nurse assistant,

• a partnership of a school of nursing and health care facility, or

• a partnership of a program leading to certification as a certified nurse assistant, and a health care facility.

Community-based organizations, Tribes, and tribal organizations may apply if otherwise eligible.

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

Anticipated FY 2024 Total Available Funding:

$43,000,000

We’re issuing this notice to ensure that, should funds become available for this purpose, we can process applications and award funds appropriately. You should note that we may cancel this program notice before award if funds are not appropriated.

Estimated Number and Type of Award(s):

Up to 43 new cooperative agreements

Estimated Annual Award Amount:

Up to $1,000,000 per award, subject to the availability of appropriated funds

At least $230,000 must be used for Alzheimer’s Disease and Related Dementias (ADRD) activities annually.

Cost Sharing or Matching Required:

No

Period of Performance: July 1, 2024 through June 30, 2029 (5 years)

Agency Contacts: Business, administrative, or fiscal issues:

Sheila Burks Grants Management Specialist Division of Grants Management Operations, OFAM Email: sburks@hrsa.gov mailto:sburks@hrsa.gov

HRSA-24-018 GWEP iv

Program issues or technical assistance:

Jennifer Solomon, MA Project Officer, Division of Medicine and Bureau Attn: GWEP Program Bureau of Health Workforce Email: GWEP@hrsa.gov

Application Guide

You (the applicant organization / agency) are responsible for reading and complying with the instructions included in this NOFO and in HRSA R&R Application Guide (R&R Application Guide). Visit HRSA’s How to Prepare Your Application page for more information.

Technical Assistance

We 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.

mailto:GWEP@hrsa.gov https://www.hrsa.gov/sites/default/files/hrsa/grants/sf-424-rr-app-guide.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/sf-424-rr-app-guide.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/sf-424-rr-app-guide.pdf https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://bhw.hrsa.gov/fundingopportunities/default.aspx

HRSA-24-018 GWEP v

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 OR 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: PAGE LIMIT WORKSHEET

APPENDIX B: RESOURCES

HRSA-24-018 GWEP 1

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Geriatrics Workforce Enhancement Program (GWEP). The purpose of the GWEP is to educate and train the health care and supportive care workforces to care for older adults by collaborating with community partners. Applicants must maximize patient and family engagement to address care gaps and improve health outcomes for older adults by integrating geriatrics with primary care and other appropriate specialties using the Age- Friendly Health Systems Framework.2

Program Goal:

The goal of the GWEP is to educate and train the primary care and geriatrics workforces and other appropriate specialties to provide age-friendly and dementia-friendly care for older adults in integrated geriatrics and primary care sites/delivery systems.

Program Objectives

1. Develop reciprocal partnerships between academia, primary care sites/delivery systems (including nursing homes), and community organizations, to transform clinical training environments into integrated geriatrics and primary care sites/delivery systems that are age-friendly and dementia-friendly.

2. Provide interprofessional geriatrics clinical training and education to students, residents, fellows, faculty, and preceptors in Tribal, Tribal Organizations, Underserved and/or Rural (TTOUR) primary care sites/delivery systems with the intent to have them practice in these sites upon completion of their program.

3. Establish and/or maintain education and training programs in TTOUR primary care sites/delivery systems that provide the supportive care workforce, direct care workers, and the primary care workforce with the knowledge and skills to improve the care of older adults, including persons living with dementia, by using innovative technology and methods.

For more details, see Program Requirements and Expectations.

2. Background

The GWEP is authorized by 42 U.S.C. § 294c(a) and 298; Public Health Service Act sections 753(a) and 865.

2 Op Cit. The John A. Hartford Foundation & The Institute for Healthcare Improvement.

HRSA-24-018 GWEP 2

One in five Americans will be 65 years or older by 2040.3 Approximately 80 percent of older adults have at least one chronic condition, such as Alzheimer’s Disease and Related Dementias (ADRD).4 The current health care workforce is inadequate to meet their health care and long-term services and supports needs, and the demand for geriatrics providers will exceed supply by 2035.5

This generation of older adults will be unique from its predecessors due to higher education levels, increased longevity, more widely dispersed families, and more racial and ethnic diversity, making their need for health care services much different than previous generations.6 There are critical shortages of health professionals in rural, urban, and tribal communities.7, 8 Across the health professions, training is inadequate for both the formal and informal primary care workforces in how to integrate geriatrics with primary care.9 Patients, families and caregivers need education and training to improve self-management skills and knowledge, to understand acute and chronic disease management, and how to work within the health care delivery system.10

The GWEP program will address these issues by providing support to eligible entities for age-friendly and dementia-friendly education and training activities in geriatrics for the primary care and geriatrics health care workforces that are in TTOUR primary care sites/delivery systems.

Program Definitions

To better understand this NOFO, go to the dictionary of key program-related terms at Health Workforce Glossary.

The following definitions apply to the GWEP Program for Fiscal Year 2024 NOFO.

3 The Urban Institute. The US Population is Aging. (no date). Retrieved on July 7, 2023 from https://www.urban.org/policy-centers/cross-center-initiatives/program-retirement-policy/projects/data-warehouse/what-future-holds/us-population-aging.

4 National Council on Aging. The Top 10 Most Common Chronic Conditions in Older Adults. (April 23, 2021) Retrieved on July 7, 2023 from https://www.ncoa.org/article/the-top-10-most-common-chronic-conditions-in-older-adults.

5 National Center for Workforce Analysis. (November 2022). Primary Care Workforce: Projections, 2020-2035. Retrieved on February 27, 2023 from https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/Primary-Care-Projections-Factsheet.20f.

6 Vincent GK, Velkoff VA. The next four decades: The older population in the United States: 2010 to 2050.

U. S. Census Bureau. ( 2010). Retrieved on September 20, 2023 from The Next Four Decades: The Older Population in the United States: 2010 to 2050 (census.gov).

7 American Hospital Association, Strengthening the Health Care Workforce. (November 2021). Retrieved June 30, 2023 from strengthening-the-health-care-workforce-II.pdf (aha.org).

8 Minemyer, P., OIG identifies care quality issues plaguing Indian Health Service Hospitals. Fierce Healthcare. (October 10, 2016). Retrieved on June 30, 2023 OIG identifies care quality issues plaguing Indian Health Service hospitals | Fierce Healthcare.

9 Foley KT, Luz CC. Retooling the Health Care Workforce for an Aging America: A Current Perspective.

Gerontologist. (June 2, 2021). Retrieved on July 7, 2023 from Retooling the Health Care Workforce for an Aging America: A Current Perspective – PubMed (nih.gov).

10 Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness.

JAMA, 288. (October 9, 2002). Retrieved on September 20, 2023 from https://pubmed.ncbi.nlm.nih.gov/12365965/ https://bhw.hrsa.gov/grants/resourcecenter/glossary https://www.urban.org/policy-centers/cross-center-initiatives/program-retirement-policy/projects/data-warehouse/what-future-holds/us-population-aging https://www.urban.org/policy-centers/cross-center-initiatives/program-retirement-policy/projects/data-warehouse/what-future-holds/us-population-aging https://www.ncoa.org/article/the-top-10-most-common-chronic-conditions-in-older-adults https://www.ncoa.org/article/the-top-10-most-common-chronic-conditions-in-older-adults https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/Primary-Care-Projections-Factsheet.pdf https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/Primary-Care-Projections-Factsheet.pdf https://www.census.gov/content/dam/Census/library/publications/2010/demo/p25-1138.pdf https://www.census.gov/content/dam/Census/library/publications/2010/demo/p25-1138.pdf https://www.aha.org/system/files/media/file/2021/11/strengthening-the-health-care-workforce-II.pdf https://www.fiercehealthcare.com/healthcare/oig-identifies-care-quality-issues-plaguing-indian-health-service-hospitals https://www.fiercehealthcare.com/healthcare/oig-identifies-care-quality-issues-plaguing-indian-health-service-hospitals https://pubmed.ncbi.nlm.nih.gov/33095881/ https://pubmed.ncbi.nlm.nih.gov/33095881/ https://pubmed.ncbi.nlm.nih.gov/12365965/

HRSA-24-018 GWEP 3

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

Caregiver means a family member, friend, neighbor, or other individual who provides unpaid assistance to a person with a chronic illness or disabling condition.

Certification means a process by which an agency or organization validates, based upon predetermined standards, an individual health provider’s qualifications and knowledge for practice in a defined functional or clinical area.

Certified Nursing Assistant (CNA) Program means a CNA program provided by a community college, trade school, or medical facility that provides a 6-to-12 week CNA certificate program that is approved by the state’s nursing board.

Community-based organization (CBO) means a public or private non-profit that is representative of a community or a significant segment of a community, and is engaged in meeting human, educational, environmental, or public safety community needs.

Direct Care Worker per the PHS Act definition, has the meaning given that term in the 2010 Standard Occupational Classifications of the Department of Labor for Home Health Aides [31–1011], Psychiatric Aides [31–1013], Nursing Assistants [31–1014], and Personal Care Aides [39–9021].11

Fellowship program means at least a one-year, interprofessional, organized training effort sponsored by an eligible applicant that is designed to provide training in integrating clinical geriatrics into primary care and geriatrics/primary care education for healthcare professionals who have completed a graduate education program in their discipline, and now seek to develop specialized knowledge and skill in the care of older adults. The fellowship program goal is to prepare the learner for interprofessional practice, and certification, in one or more specialties related to the care of older adults. Fellows may be awarded fellowships at a rate to be determined by the applicant organization. The goal of this program is to prepare individuals to be geriatrics specialists.

11 U.S. Bureau of Labor Statistics. Standard Occupational Classification. (2010). Retrieved on August 31, 2023 from https://bls.gov/soc/2010/2010_major_groups.htm https://bls.gov/soc/2010/2010_major_groups.htm

HRSA-24-018 GWEP 4

Graduate Education Program or Training means a program administered by an institution of higher learning, leading to a master’s or higher degree.

Health Care Facility means an Indian Health Service health center, a Native Hawaiian health center, a hospital, a federally qualified health center, a rural health clinic, a nursing home, a home health agency, a hospice program, a public health clinic, a state or local department of health, a skilled nursing facility, and/or an ambulatory surgical center.

Health Care Workforce means geriatrics specialists, primary care providers, other appropriate specialists, direct care workers, community health workers, health care support workers, and health professions students, residents, fellows, faculty, and other health care professionals.

Health Care Support Workers means the following occupations: Home Health and Personal Care Aides; Psychiatric Aides; Orderlies; Nursing Assistants; Occupational Therapy Aides; Occupational Therapy Assistants; Physical Therapist Aides; Physical Therapist Assistants; Massage Therapists; Healthcare Support Workers, All Other;

Pharmacy Aides; Medical Transcriptionists; Medical Equipment Preparers; Veterinary Assistants and Laboratory Animal Caretakers; Phlebotomists; Dental Assistants;

Medical Assistants.12

Level 1 Age Friendly Health Systems Recognition means a participant has completed a 4Ms Care Description to outline how it will assess, document, and act on all 4Ms at its care setting. At first, their 4Ms Care Description might represent a plan that they will test and work towards reliably performing.

Level 2 Age Friendly Health Systems Recognition means a participant has - Committed to Care Excellence and is working towards a reliable practice of addressing of the 4Ms. They have achieved Level 1 recognition and have submitted to the Institute for Healthcare Improvement at least three months of counts of the number of older adults that have received care that included all 4Ms.

Longitudinal Clinical Rotation means a continuous clinical immersion in TTOUR primary care sites/delivery systems for a duration of one eight-week or two four-week periods within an academic year. The rotations must be at least twenty hours per week per trainee.

Schools of Nursing means an accredited collegiate, associate degree, or diploma school of nursing in a State where graduates are— (A) authorized to sit for the National Council Licensure Examination-Registered Nurse (NCLEX–RN); or (B) licensed registered nurses who will receive a graduate or equivalent degree or training to become an advanced education nurse.

Nonprofit refers to the status of an entity owned and operated by one or more

12 U.S. Bureau of Labor Statistics. Occupational Employment and Wage Statistics. (May 2022). Retrieved on August 31, 2023 from https://www.bls.gov/oes/current/oes310000.htm .

https://www.bls.gov/oes/current/oes310000.htm

HRSA-24-018 GWEP 5

corporations or associations no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual.

Private Entity means a non-governmental entity which is not affiliated, through ownership or control, with State and local governments.

Registered Apprenticeship Program - A Registered Apprenticeship Program (RAP) is a proven model of apprenticeship that has been validated by the U.S. Department of Labor or a State Apprenticeship Agency. Recipient organizations that are tribes or tribal organizations may request to use the Indian Health Service Community Health Aide Program model of apprenticeship. An apprenticeship is a proven approach for preparing workers for jobs while meeting the needs of business for a highly-skilled workforce. It is an employer-driven, “learn-while-you-earn” model that combines on-the- job training, provided by the employer that hires the apprentice, with job-related instruction in curricula tied to the attainment of national skills standards.

Stipends are not salary and do not create an employment relationship with either the federal government or the recipient/subrecipient organization.

Supportive Care Workforce means patients, families, caregivers, and nonmedical service providers (such as housekeepers, food servers, and transportation providers).

TTOUR Primary Care Sites/Delivery Systems include but are not limited to the below sites:

Adult Daycare Sites Nursing Homes/Facilities

Ambulatory Care Clinics Primary Care Clinics

Assisted Living Sites Rural Health Clinics

Critical Access Hospitals

Emergency Care

Federally Qualified Health Centers

Home and Community-based Services

Ryan White Centers

Senior Centers

Senior Housing

HRSA Funded Teaching Health Centers

II. Award Information

1. Type of Application and Award

Application type(s): New

We will fund you via a cooperative agreement.

A cooperative agreement is like a grant in that we award money, but we are substantially involved with program activities.

https://www.ihs.gov/ihm/circulars/2020/community-health-aide-program/

HRSA-24-018 GWEP 6

Aside from monitoring and technical assistance (TA), we also get involved in these ways:

1) Participating in the planning, development, and evaluation of all phases of the project.

2) Reviewing procedures to be implemented for accomplishing the objectives of the cooperative agreement.

3) Reviewing project training and education products such as videos, toolkits, assessment tools, on-line curricula, manuscripts, and special issues of journals as they are being developed and prior to dissemination.

4) Assisting recipients and their partners in developing a national GWEP network to share resources, best practices, and lessons learned.

5) Providing assistance in the establishment and facilitation of effective reciprocal partnerships with federal, state, and local agencies, HRSA projects and other resource centers, and other entities that may be relevant to the project’s mission.

6) Providing programmatic input and consultation for development and delivery of education and training materials.

7) Working with recipients and their partners to develop and implement quality improvement assessment and evaluation strategies to provide age-friendly and dementia-friendly care, and quality improvement initiatives.

8) Working with the recipients in finalizing the Standardized Work Plan (SWP) and with the quarterly progress updates.

9) Providing information resources.

You must follow all relevant federal regulations and public policy requirements. Your other responsibilities will include:

1) Participating in ongoing monthly technical assistance calls with other recipients and HRSA staff.

2) Discussing quarterly reviews of the SWP with the HRSA staff.

3) Providing the HRSA project officer with an opportunity to review project information prior to dissemination.

4) Establishing contacts relevant to the project’s mission such as GWEP partners, federal, state, and local partners, and other HRSA projects.

5) Coordinating activities with other GWEP recipients where possible.

6) Working with HRSA to evaluate program performance and respond to HRSA reporting requirements.

HRSA-24-018 GWEP 7

2. Summary of Funding

We estimate $43,000,000 will be available each year to fund 43 recipients. You may apply for a ceiling amount of up to $1,000,000 annually (reflecting direct and indirect costs). Your request for each subsequent year of the period of performance cannot exceed your year 1 request.

The actual amount available will not be determined until the enactment of the final FY 2024 federal appropriation.

At least $230,000 must be budgeted to provide ADRD education and training annually.

Funds must be used to educate and train the health care and supportive care workforces in ADRD in TTOUR primary care sites and delivery systems and provide financial support to trainees in these sites.

A budget that is 100% for ADRD education is allowed if it includes stipend/traineeships/fellowships support activities.

The period of performance is July 1, 2024 through June 30, 2029 (5 years).

This program notice depends on the appropriation of funds. If funds are appropriated for this purpose, we will proceed with the application and award process.

Support beyond the first budget year will depend on:

• Appropriation

• Satisfactory progress in meeting the project’s objectives

• A decision that continued funding is in the government’s best interest

45 CFR part 75 - Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards applies to all HRSA awards.

Limitations on Indirect Cost Rates for Training and Education Grants:

Training awards are budgeted and reimbursed at 8 percent of modified total direct costs (MTDC). To calculate the (MTDC), we exclude from the direct cost base:

• Direct cost amounts for, equipment, tuition, fees and participant support costs

• Subawards and subcontracts exceeding $25,000

State or local governments, and federally recognized Indian tribes, receive reimbursement based on their negotiated rate or state cost allocation plans. State universities or hospitals are not considered governmental agencies.

III. Eligibility Information

1. Eligible Applicants

The following domestic entities are eligible applicants:

https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75

HRSA-24-018 GWEP 8

• Schools of Allopathic Medicine

• Schools of Osteopathic Medicine

• Schools of Nursing

• Schools of Allied Health

• Schools of Pharmacy

• Schools of Dentistry

• Schools of Public Health

• Schools of Optometry

• Schools of Chiropractic

• Schools of Veterinary Medicine

• Schools of Podiatric Medicine

• Physician Assistant Education Programs

The following accredited graduate programs are also eligible applicants:

• Health Administration

• Behavioral Health and Mental Health Practice including:

o Clinical Psychology o Clinical Social Work o Professional Counseling o Marriage and Family Therapy

• Additional eligible applicants include:

o a health care facility o a program leading to certification as a certified nurse assistant, o a partnership of a school of nursing and health care facility, or o a partnership of a program leading to certification as a certified nurse assistant, and a health care facility.

Community-based organizations, Tribes, and Tribal organizations may apply if otherwise eligible.

All eligible applicants must be accredited except certified nurse assistant programs which must be approved by the state. In Attachment 7 the applicant organization must provide:

• a statement that they hold continuing accreditation from the relevant accrediting body and are not under probation, and

• the dates of initial accreditation and next accrediting body review. The full letter of accreditation is not required.

If a partner institution holds the accreditation for the training program, a letter of agreement should be provided as well.

HRSA-24-018 GWEP 9

2. Cost Sharing or Matching

Cost sharing or matching is not required for this program.

3. Other

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

• Exceeds the funding ceiling amount of $1,000,000 annually.

• Fails to have budgeted at least $230,000 annually for ADRD activities.

• Fails to include accreditation documentation for the applicant organization.

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

Maintenance of Effort

You must agree to maintain non-federal funding for award activities. This must be at least at the same spending level for the fiscal year prior to the fiscal year for which you receive the award, as 42 U.S.C. § 295n-2(b) requires.

Federal funds should add to, not replace, existing non-federal spending for such activities. Complete the Maintenance of Effort information and submit as Attachment 4.

We will enforce statutory Maintenance of Effort requirements through all available mechanisms.

Multiple Applications

Multiple applications from an institution will be accepted; however, only one application will have the potential for being funded. We will only review your last validated application for each distinct project before the Grants.gov due date.

Beneficiary Eligibility

A trainee receiving support from award 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.

IV. Application and Submission Information

1. Address to Request Application Package

We require you to apply online through Grants.gov. Use the SF-424 Research and Related (R&R) workspace application package associated with this notice of funding opportunity (NOFO). Follow these directions: How to Apply for Grants. If you choose to submit using an alternative online method, see Applicant System-to-System.

https://www.grants.gov/ https://www.grants.gov/applicants/grant-applications/how-to-apply-for-grants https://www.grants.gov/system-to-system/applicant-system-to-system/

HRSA-24-018 GWEP 10

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.

Note: Grants.gov calls the NOFO “Instructions.”

Select “Subscribe” and enter your email address for HRSA-24-018 to receive emails about changes, clarifications, or instances where we republish the NOFO. You will also be notified by email of documents we place in the RELATED DOCUMENTS tab that may affect the NOFO and your application. You’re responsible for reviewing all information that relates to this NOFO.

2. Content and Form of Application Submission

Application Format Requirements Submit your information as the R&R Application Guide and this program-specific NOFO state. Do so in English and budget figures expressed in U.S. dollars. There’s an Application Completeness Checklist in the R&R Application Guide to help you.

Application Page Limit The total number of pages that count toward the page limit shall be no more than 80 pages when we print them. We 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 do not 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)

• Accreditation Documentation

• Biographical Sketches

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

If you use an OMB-approved form that is not in the HRSA-24-018 workspace application package, it may count toward the page limit.

Applications must be complete and validated by Grants.gov under HRSA-24-018 before the deadline.

HRSA-24-018 GWEP 11

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

• When you submit your application, you certify that you and your principals13 (for example, program director, principal investigator) can participate in receiving award funds to carry out a proposed project. That is, no federal department or agency has debarred, suspended, proposed for debarment, claimed you ineligible, or you have voluntarily excluded yourself from participating.

• If you fail to make mandatory disclosures, we may take an action like those in 45 CFR § 75.371. This includes suspending or debarring you.14

• If you cannot certify this, you must include an explanation in Attachment 11-15:

Other Relevant Documents.

(See Section 4.1 viii “Certifications” of the R&R Application Guide)

Program Requirements Successful recipients must address the following program requirements.

1. Develop reciprocal partnerships between applicant and a) academic schools of health professions, b) TTOUR primary care sites/delivery systems, and c) community organizations to transform primary care sites/delivery systems that provide age-friendly and dementia-friendly care for older adults.

2. Train the health care workforce in TTOUR primary care sites/delivery systems to provide age-friendly and dementia-friendly health care for older adults and achieve and maintain Level 1 and/or Level 2 Age-Friendly Health System recognition.

3. Provide students, residents, and/or fellows with a minimum of eight weeks per year of longitudinal clinical rotations in TTOUR primary care sites/delivery systems including nursing homes. Provide stipends/traineeships/fellowships to students, residents and/or fellows while they are in clinical rotation(s) at TTOUR primary care sites/delivery systems.

4. Provide faculty and preceptors with the knowledge and skills to educate the health care workforce to provide age-friendly and dementia-friendly care to older adults in TTOUR primary care sites/delivery systems.

5. Using the U.S. Department of Labor or a State Apprenticeship Agency registered apprenticeship program, provide education and training for direct care workers to support career advancement (ex. Certificate, etc.) within their discipline as geriatrics specialists. Recipient organizations that are tribes or tribal organizations may request to use the Indian Health Service Community Health Aide Program model of apprenticeship. These apprenticeship programs must be in place before the end of the 5-year project period of performance. For example, the development of career ladders for certified nursing assistants to become

13 See definitions at eCFR :: 2 CFR 180.995 -- Principal. and eCFR :: 2 CFR 376.995 -- Principal (HHS supplement to government-wide definition at 2 CFR 180.995).

14 See also 2 CFR parts 180 and 376, 31 U.S.C. § 3354, and 45 CFR § 75.113.

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 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 https://www.ihs.gov/ihm/circulars/2020/community-health-aide-program/ https://www.ihs.gov/ihm/circulars/2020/community-health-aide-program/ https://www.ecfr.gov/current/title-2/subtitle-A/chapter-I/part-180/subpart-I/section-180.995 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376/subpart-I/section-376.995 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376/subpart-I/section-376.995 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-I/part-180 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376 https://uscode.house.gov/view.xhtml?req=granuleid%3AUSC-prelim-title31-chapter33&edition=prelim https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-B/section-75.113

HRSA-24-018 GWEP 12

advanced geriatrics specialists and/or for community health workers to become advanced geriatrics specialists.

6. Provide interprofessional training that involves at least three health care professions, one of which is medicine. Interprofessional training and education must address the primary care needs of older adults in TTOUR primary care sites/delivery systems including all of the following topics:

o continuum of care for older adults;

o ADRD and other mental health issues including delirium, anxiety, depression, substance use and opioid use disorders, and serious mental illness;

o risk reduction for chronic disease, including dementia;

o early detection, diagnosis, treatment, and management of dementia;

o enrollment of older adults in clinical trials;

o impact of climate change, emergencies, and disasters on the health and health care of older adults;

o health inequities, disparities, social determinants of health and culturally and linguistically competent health care;

o elder justice;

o training on performing the annual wellness visit;

o training on vaccinations; and o use of methods such as MCC e-Care Plan, artificial intelligence and assistive technology, and mobile health technologies to provide telehealth and in-person care delivery.

7. Deliver age-friendly and dementia-friendly programs that provide health care and supportive care workers with the knowledge and skills to improve care to older adults.

8. Partner with schools of nursing and nursing homes to integrate into the curriculum age-friendly didactic content and clinical care learning opportunities on care of older adults, including persons living with dementia, who reside in nursing homes. The overall goal is to increase the number of nurses who elect to practice in nursing homes after graduation.

9. Adhere to HHS Evaluation Policy and evaluation standards and best practices described in OMB Memorandum M-20-12 when evaluating their program.

10. Participate in federally-designed evaluations to assess program effectiveness and efficiency upon request.

Program-Specific Instructions Include application requirements and instructions from Section 4 of the R&R Application Guide (budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract). Also include the following:

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

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i. Project Abstract

Use the Standard OMB-approved Project Abstract Summary Form that you’ll find 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 you must include in the Project Abstract Summary Form, see Section 4.1.ix of the R&R Application Guide. When applicable, identify if a funding priority/ preference is being requested.

NARRATIVE GUIDANCE

The following table provides a crosswalk between the narrative language and where each section falls within the review criteria. Make sure you’ve addressed everything. We may consider any forms or attachments you reference in a narrative section during the merit review.

Narrative Section Review Criteria

Introduction and Purpose Criterion 1: PURPOSE AND NEED

Organizational Information Criterion 4: ORGANIZATIONAL

INFORMATION, RESOURCES, AND

CAPABILITIES

Need Criterion 1: PURPOSE AND NEED

Approach Criterion 2: RESPONSE TO PROGRAM PURPOSE sub-section (b) APPROACH

Work Plan Criterion 2: RESPONSE TO PROGRAM PURPOSE sub-section (a) WORK PLAN

Resolution of Challenges Criterion 2: RESPONSE TO PROGRAM PURPOSE sub-section (c) RESOLUTION

OF CHALLENGES

Evaluation and Technical Support Capacity

Criterion 3: IMPACT sub-section (a)

EVALUATIVE MEASURES

Sustainability Criterion 3: IMPACT sub-section (b)

SUSTAINABILITY

Budget and Budget Justification Narrative

Criterion 5: SUPPORT REQUESTED

ii. Project Narrative

This section must describe all aspects of the proposed project. Make it brief and clear.

Project activities must comply with the non-discrimination requirements described in Section VI.

HRSA-24-018 GWEP 14

Provide the following information in the following order. Please use the section headers.

This ensures reviewers can understand your proposed project.

Introduction and Purpose – Corresponds to Section V’s Review Criterion #1Purpose and Need

1. Briefly describe the purpose of the proposed project as it relates to the goal of this NOFO, the needs of the target population to be served, current social determinants of health and health inequities experienced by this population, and the geriatric education and training needs of health care and supportive workers to improve care to older adults.

2. Include the efforts you will make to address the non-academic barriers (physical health, psychological health, physical environment, social environment, and economic stability) to trainees’ (students’, program participants’) access to education and success in your program.

3. Propose a framework (an actionable model) that targets learning disparities and expands learning opportunities to support diversity, equity, and inclusion, which may include recruitment of students from rural and underserved areas.

Organizational Information – Corresponds to Section V’s Review Criterion #4 Organizational Information/Resources/Capabilities

1. Succinctly describe your organization’s current mission, structure, personnel, organizational partners, and scope of current activities and how these elements all contribute to the organization’s ability to implement the goals, objectives and program requirements.

2. Describe tools and strategies for ongoing staff training, outreach, collaborations, communication, and information sharing/dissemination.

3. Include a project organizational chart (requested in Section IV.2.v./vi., Attachment 2). Discuss how the organization will follow the approved plan, as outlined in the application, properly account for the federal funds, and document all costs to avoid audit findings.

4. Include in Attachment 3, memorandums of understanding or agreement, and letters of agreement or similar documents from key organizations/individuals of their willingness to perform in accordance with the plan presented in the application.

5. Include in Attachment 6 a letter of support from the applicant organization that specifically indicates an understanding and commitment to the project/program (in-kind services, dollars, staff, space, equipment, etc.) by the applicant organization.

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

o Describe the minimum qualifications for each faculty position in the

HRSA-24-018 GWEP 15

job description.

o Functional and program responsibilities must 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.

Biographical Sketches

Provide a biographical sketch for key faculty/staff contributing to the project. Include the individual’s current position and sufficient detail to assess their qualifications for the position. Each biographical sketch should be limited to one page. Include all degrees and certificates.

Biographical sketches should include the following information:

• Senior/key personnel name

• Position Title

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

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

• 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.

Need – Corresponds to Section V’s Review Criterion #1 Purpose and Need Sample Text:

1. Describe the interprofessional geriatrics team-based education and training needs of the health care workforce that will transform your TTOUR primary care sites/delivery systems to provide age-friendly and dementia-friendly health care and long-term services and supports and improve health outcomes.

HRSA-24-018 GWEP 16

This section will help reviewers understand whom you will serve with the proposed project. Use and cite demographic data whenever possible to support the information provided.

Approach – Corresponds to Section V’s Review Criterion #2 Response to Program Purpose sub-section (b) Methodology/Approach

In your application, and consistent with the Program Requirements in this NOFO:

1. List the project objectives and proposed activities and provide evidence for how they link to the project purpose and needs. These are the same project objectives in the SWP.

2. Discuss how students, residents, and fellows with an interest in choosing to practice in TTOUR primary care sites/delivery systems and nursing homes will be identified.

3. Demonstrate how you will provide TTOUR primary care sites/delivery systems training to the supportive care workforce, direct care workers, and the primary care workforce on topics that include using, MCC e-Care Plan, artificial intelligence and assistive technology, and mobile health technologies to provide telehealth and in-person care delivery.

4. Demonstrate how your GWEP project will assist your primary care partners in TTOUR clinics in achieving and maintaining Level 1 and/or Level 2 Age-Friendly Health System recognition from the Institute for Healthcare Improvement.

5. Provide a table description of the TTOUR training site(s) in Attachment 8.

Include the name of the TTOUR primary care site and number of trainees (students, residents, and fellows) for each year of the award. A sample is provided below.

Table 1: TTOUR Primary Care Sites

Name of Health Clinic Training Site

Clinic Training Site Full Address

(EXAMPLE

Main Street, Town, State, Extended Zip code)

Number of trainees involved in grant activities per year.

Is site located in a tribal facility listed in https://www.i hs.gov/findhe althcare/?

(Yes or No)

Is site located in rural area as determined by the Federal Office of Rural Health Policy (FORHP), using the Rural Health Grants Eligibility Analyzer at https://data.hrsa.gov/t ools/rural-heal

Is site located in a Primary Care HPSA with a score of 17 or greater as listed at https://data.hrsa.g ov/tools/shortage-area/hpsa-find https://www.ihs.gov/findhealthcare/ https://www.ihs.gov/findhealthcare/ https://www.ihs.gov/findhealthcare/ https://www.ihs.gov/findhealthcare/ https://data.hrsa.gov/tools/rural-health https://data.hrsa.gov/tools/rural-health https://data.hrsa.gov/tools/rural-health https://data.hrsa.gov/tools/shortage-area/hpsa-find https://data.hrsa.gov/tools/shortage-area/hpsa-find

HRSA-24-018 GWEP 17

6. Explain how you will educate and train the health care and supportive care workforces with the knowledge and skills to improve health care and outcomes for older adults, with an emphasis on care provided to persons living with a dementia diagnosis.

7. Explain how you will use the U.S. Department of Labor or a State Apprenticeship Agency registered apprenticeship program to provide education and training for direct care workers to support career advancement (ex. Certificate, etc.) within their discipline as geriatrics specialists.