HRSA-24-098 NEPQR WEP Final.pdf

HRSA

Health Resources & Services Administration

Bureau of Health Workforce

Division of Nursing and Public Health

Notice of Funding Opportunity

Issuance Date: 06/14/2024

Application Due Date: 07/26/2024

Step 1: Review the Opportunity

Basic information

Summary

Key dates

Funding detail

Eligibility

Types of eligible organizations

Other eligibility criteria

Cost sharing

Program description

Purpose

Background

Program goals

Program requirements and expectations

Funding policies & limitations

Step 2: Get Ready to Apply

Get registered

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Find the application package

Application writing help

Join the webinar

Step 3: Write Your Application

Application contents & format

Project abstract

Project narrative

Budget & budget narrative

Attachments

Other required standard forms

Step 4: Learn About Review & Award

Application review

Initial review

Merit review

Risk review

Selection process

Award notices

Step 5: Submit Your Application

Application submission & deadlines

Deadlines

Submission method

Other submissions

Application checklist

Step 6: Learn What Happens After Award

Post-award requirements & administration

Administrative & national policy requirements

Non-discrimination & assurance

Reporting

Contacts & Support

Agency contacts

Program & eligibility

Financial & budget

HRSA Contact Center

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1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information

Eligibility

Program description

HRSA-24-098 2

Basic information The key facts

Bureau of Health Workforce

Division of Nursing and Public Health

Nurse Education, Practice, Quality and Retention (NEPQR) - Workforce Expansion Program

(WEP)

Opportunity number: HRSA 24-098

Federal Assistance Listing Number: 93.359

The NEPQR - WEP is authorized by 42 U.S.C. § 296p (Section 831 of the Public Health Service Act)

Summary The purpose of the Nurse Education, Practice, Quality, and Retention (NEPQR) - Workforce Expansion Program (WEP) is to increase the nursing workforce in rural1 (non-metro2) and underserved areas to address the critical shortage of nurses, specifically in acute and long-term care settings.

Have questions?

Go to Contacts & Support.

Key dates Application deadline: July 26, 2024

NOFO issue date: June 14, 2024

Expected award date is by: September 30, 2024

Expected start date: September 30, 2024

Funding detail

1 Defining Rural Population. https://www.hrsa.gov/rural-health/about-us/what-is-rural. Term is interchangeable with term non-metro cited below.

2 Non-metropolitan counties are micropolitan counties in micropolitan statistical area; Noncore counties not in micropolitan statistical area. Data Access - Urban Rural Classification Scheme for Counties (cdc.gov). Term is interchangeable with term rural cited below.

https://www.hrsa.gov/rural-health/about-us/what-is-rural https://www.cdc.gov/nchs/data_access/urban_rural.htm

HRSA-24-098 3

Application Type: New

Expected total available FY 2024 funding: Up to $4,750,000

Expected number and type of awards: Approximately 5 Grants

Funding range per award: Up to $1,000,000 per annual award subject to the availability of appropriated funds (reflecting direct and indirect costs).

This program has a 4-year period of performance. We plan to fund awards in 4 budget periods.

Each budget period is 12-months in length. The period of performance for this program is September 30, 2024, to September 29, 2028. Your funding request for years 2, 3, and 4 cannot exceed your request for year 1.

Eligibility Who can apply?

The following entities are eligible to apply for this award: an accredited school of nursing3 such as baccalaureate nursing programs and community colleges that train associate degree nurses, a health care facility, including federally qualified health centers or nurse-managed health clinics, or partnership of such a school and facility.

Types of eligible organizations These types of domestic organizations (see note) may apply:

Institutions of higher education

• Public or Private Accredited Schools of Nursing, such as community colleges

Health care facilities

• Nursing centers

• Nurse-managed health clinics

• Ambulatory surgical center

• Academic health centers

• Indian Health Service Health Centers

3 Per PHS Act section 801(2): “SCHOOL OF NURSING.—The term ‘‘school of nursing’’ means an accredited (as defined in paragraph 6) 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 as defined by section 811(b).”

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• Native Hawaiian Health Center

• Hospital

• Nursing Home

• Home Health Agency

• Hospice Program

• Public Health Clinic

• Skilled Nursing Facility

• State or local department of public health

• Federally Qualified Health Centers

• Rural Health Clinics

Tribes & tribal organizations (if otherwise eligible)

• Native American tribal governments

• Native American tribal organizations

Note: “Domestic” means located in the 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.

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

Other eligibility criteria Trainee eligibility A trainee who receives support under this program must be one of the following:

• A U.S. citizen or non-citizen national.

• An individual lawfully admitted for permanent residence to the United States.

• 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.

Cost sharing This program does not have a cost-sharing requirement. We will hold you accountable for any funds you add, including through reporting.

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Program description

Purpose The purpose of the Nurse Education, Practice, Quality, and Retention (NEPQR) – Workforce Expansion Program (WEP) is to increase the nursing workforce in rural (non-metro) and underserved areas to address the critical shortage of nurses, specifically in acute and long-term care settings.

Through the training of additional associate and baccalaureate degree nursing students, the NEPQR - WEP aims to enhance nursing education and clinical practice to expand the workforce and improve the retention of the nursing workforce practicing in acute care settings and long-term care facilities.

Background Nursing, the largest health care profession in the United States,4 is facing a critical workforce shortage that threatens the U.S. health care system. The shortage of available nurses in acute and long-term care facilities is a major contributor to medical errors and increased health disparities in communities with the greatest need. 5 There are various factors that drive the nursing workforce shortage. The retirement of experienced nurses, nurse burnout from the COVID-19 pandemic,6 and the limited number of available clinical faculty and preceptors all decrease the capacity for enrollment of more nursing students.7 The U.S. Bureau of Labor Statistics (BLS) projected there will be 193,100 registered nurse (RN) openings on average, each year until 2032,8 HRSA’s National Center for Health Workforce Analysis’ Nurse Workforce Projections, 2021-2036 note a national shortage of RNs each year through 2036 and by 2036, the projected shortage is 9% (a shortage of just over 300K full-time equivalent RNs). In addition, non-metro (rural) areas are projected to have a higher RN shortage than metro areas.9 The

4 American Association of Colleges of Nursing. (2024). Nursing Workforce Fact Sheet Nursing Workforce Fact Sheet (aacnnursing.org) 5 Haddad, LM., Annamaraju, P., Toney-Butler, TJ. (2023). Nursing Shortage.

https://www.ncbi.nlm.nih.gov/books/NBK493175/ 6 Ibid 7 Nursing Faculty Shortage. (2022). https://www.aacnnursing.org/news-data/fact-sheets/nursing-faculty-shortage

8. Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Registered Nurses, at https://www.bls.gov/ooh/healthcare/registered-nurses.htm 9 Health Resource and Services Administration. (2024). Nurse Workforce Projections 2021-2036.

https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/nursing-projections-factsheet.pdf https://www.aacnnursing.org/news-data/fact-sheets/nursing-workforce-fact-sheet#:%7E:text=Nursing%20is%20the%20nation%27s%20largest%20healthcare%20profession%2C,with%20nearly%204.7%20million%20registered%20nurses%20%28RNs%29%20nationwide.

https://www.aacnnursing.org/news-data/fact-sheets/nursing-workforce-fact-sheet#:%7E:text=Nursing%20is%20the%20nation%27s%20largest%20healthcare%20profession%2C,with%20nearly%204.7%20million%20registered%20nurses%20%28RNs%29%20nationwide.

https://www.ncbi.nlm.nih.gov/books/NBK493175/ https://www.aacnnursing.org/news-data/fact-sheets/nursing-faculty-shortage https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.bls.gov%2Fooh%2Fhealthcare%2Fregistered-nurses.htm&data=05%7C02%7CWWildberger%40hrsa.gov%7Cc66a5a9b0d5c4de0e31208dc8c9ddc57%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638539856832447171%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=KI30UR3%2BFHoZ1l1wBoA0gDqBNlkR3LZZZ%2BnxlzA4VrI%3D&reserved=0 https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/nursing-projections-factsheet.pdf#:%7E:text=Non-metro%20areas%20are%20projected%20to%20have%20a%20higher,in%202031%2C%20and%2022%25%20vs%208%25%20in%202026.

https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/nursing-projections-factsheet.pdf#:%7E:text=Non-metro%20areas%20are%20projected%20to%20have%20a%20higher,in%202031%2C%20and%2022%25%20vs%208%25%20in%202026.

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recent Centers for Medicare & Medicaid Services regulation establishing RN staffing minimums in Medicare and Medicaid funded long-term care facilities has further intensified the demand.10

To address these shortages, academic institutions must increase enrollment and hire clinical faculty and preceptors to address the critical need for nurses. Community college nursing programs are a pathway to address the nursing workforce shortage. Nursing students who graduate from community college nursing programs are eligible to sit for the NCLEX-RN exam and enter the workforce quicker; they increase nursing diversity in underrepresented communities11 and serve as a foundation for RNs to obtain higher levels of nursing education.12 Community college graduates are more likely to live and work in their communities after graduation. They are twice as likely to work in rural and economically distressed areas to provide service in home care and long-term care environments.13 Recruiting and increasing clinical faculty and preceptors significantly contributes to addressing the nursing shortage.

Culturally aligned training helps nursing students transition into professional, competent nurses who provide safe, high-quality, and equitable health care in the communities in which they live and work.

Program goals

• Increase the number of nursing students enrolled in, retained, and graduated from associate and/or baccalaureate nursing degree programs.

• Increase the number of undergraduate nursing students receiving additional specialized training in acute and long-term care settings.

• Increase the number of undergraduate nurses employed in acute and long-term care settings post-graduation.

• Increase the number of preceptors and clinical faculty to train nursing students in associate and/or baccalaureate nursing degree programs.

Program requirements and expectations All applicants funded under this funding opportunity will be required to:

10 Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting Final Rule (CMS 3442-F) | CMS 11 Mahaffey EH. The relevance of associate degree nursing education: past, present, future. Online J Issues Nursing.

2002;7(2):3. PMID: 12059279.

12 Health Resources and Services Administration. (2024). Nursing Education and Training Data from the 2022 NSSRN. Nursing Education and Training: Data from the 2022 NSSRN (hrsa.gov) 13 Organization for Associate Degree Nurses. (2019) OADN’s Written Testimony To The Future Of Nursing 2020- 2030 Committee (2019). OADN's Written Testimony To The Future Of Nursing 2020-2030 Committee - OADN https://www.cms.gov/newsroom/fact-sheets/medicare-and-medicaid-programs-minimum-staffing-standards-long-term-care-facilities-and-medicaid-0 https://www.cms.gov/newsroom/fact-sheets/medicare-and-medicaid-programs-minimum-staffing-standards-long-term-care-facilities-and-medicaid-0 https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/nssrn-education-training-report.pdf https://oadn.org/resource/oadns-written-testimony-to-the-future-of-nursing-2020-2030-committee-2/#_bookmark3

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• Implement a system for recruitment and retention of associate and/or baccalaureate degree nursing students committed to practicing in acute and long-term care settings post-graduation.

• Increase nursing student enrollment 5-10% above current baseline, proportionate with the budget request.

• Implement specialized education and training for nursing students on care of patient populations in long-term care and acute care settings, focusing on clinical excellence and quality improvement through established partnerships between two-or four-year RN programs and acute and long-term care clinical sites. The specialized training includes a minimum of 80 hours of additional training. At a minimum, 50% of the training hours must be dedicated to long-term care. This training is in addition to nursing student’s normal clinical rotations and may be a combination of clinical training and the use of simulation-based technology with the intent of students to become employed in these settings post-graduation.

• Provide student support to nursing students enrolled in the specialized training rotations.

o Student support includes:

Financial support in the form of stipends and/or scholarships;

Academic and peer support, including but not limited to tutoring and mentoring; and

Other necessary wraparound services such as instructional methods, educational services, or resources provided to students to help accelerate their learning progress, meet learning standards, or foster success.

• Establish or expand meaningful collaborative partnerships (academic, practice, and community) that:

o Inform the enhancement of nursing didactic and clinical training curriculums for associate or baccalaureate registered nursing programs related to long-term and acute care.

o Provide culturally sensitive didactic and clinical training that integrates the Social Determinants of Health (SDOH) that impact the health and well-being of patient populations residing in rural (non-metro) and underserved areas.

o Support student readiness to practice in interprofessional care teams that provide care to patients with acute and/or chronic health conditions in acute and long-term care settings.

o Assist in the recruitment and employment of nursing clinical faculty and preceptors supported by this grant program.

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o Assist in the employment of new nursing undergraduates supported through this grant program.

• Recruit and retain nursing faculty and clinical faculty/preceptors.

o Provide faculty and clinical faculty/preceptor support, such as continuing professional education, development, or training opportunities.

• Evaluate your program’s efficacy by:

o Following the HHS Evaluation Policy and standards described in OMB Memorandum M-20-12.

o Completing HRSA’s annual performance reporting requirements.

o Following up with graduates to collect employment information for a minimum of 1 year after graduation.

o Participating in federally designed evaluations to assess program effectiveness and efficiency upon request.

Funding policies & limitations

Policies Support beyond the first budget year will depend on:

o Continued appropriation of funds o Satisfactory progress in meeting the project’s objectives.

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

If we receive more funding for this program, we consider options such as:

o Funding more applicants from the rank order list.

o Extending the period of performance.

o Awarding supplemental funding.

Maintenance of effort Federal funds must add to any existing non-federal funds for your proposed activities. If you receive an award, you will have to spend at least as much as you spent in the last fiscal year before the award. This policy is required by 42 U.S.C. § 296b(b) (Section 803(b) of the Public Health Service Act). We will enforce these statutory requirements through all available mechanisms. You must provide supporting documentation in your Attachments.

General limitations

For guidance on some types of costs we do not allow or restrict, see Budget in Section https://aspe.hhs.gov/sites/default/files/migrated_legacy_files/200386/hhs-evaluation-policy.pdf https://www.whitehouse.gov/wp-content/uploads/2020/03/M-20-12.pdf

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4.1.iv of the R&R Application Guide. You also can see 45 CFR part 75, General Provisions for Selected Items of Cost.

The salary rate limitation imposed by the current appropriations act applies to this program. As of January 2024, the salary rate limitation is $221,900. Note this limitation may apply in future years and will be updated.

Additionally, these specific costs are not allowed:

• Accreditation costs like renewals or annual fees, credentialing, licensing, continuing education fees, certification exam/licensing fees, and franchise fees and expenses.

• Membership dues that directly fund lobbying activities.

• Laboratory fees.

• Food or drinks.

• Liability insurance, unemployment insurance, life insurance, taxes, fees, retirement plans, or other fringe benefits for trainees.

o Health insurance for trainees is allowed.

• Payment of temporary personnel replacement costs for the time faculty/ preceptors/participants are away from usual worksite during involvement in project activities.

• Paid release time for project faculty.

• Construction or major renovation.

• Foreign travel.

You cannot earn profit from the federal award. See 45 CFR 75.216(b).

See Manage Your Grant for other information on costs and financial management.

Indirect costs Indirect costs are those incurred for a common or joint purpose across more than one project and that cannot be easily separated by project (like utilities for a building that supports multiple projects). Learn more at 45 CFR 75.414, Indirect Costs.

Indirect costs for training awards cannot exceed 8% of modified total direct costs. 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

To further understand what is included in modified total direct costs, see 45 CFR 75.2.

https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D22 https://www.ecfr.gov/current/title-45/part-75/subject-group-ECFR5d90ba314caea08 https://www.ecfr.gov/current/title-45/part-75/subject-group-ECFR5d90ba314caea08 https://www.ecfr.gov/current/title-45/part-75#p-75.216(b) https://www.hrsa.gov/grants/manage-your-grant https://www.ecfr.gov/current/title-45/section-75.414 https://www.ecfr.gov/current/title-45/part-75#p-75.2(Modified%20Total%20Direct%20Cost)

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State or local governments and federally recognized Indian tribes can charge their negotiated rate or use their state cost allocation plans. For calculating indirect costs, we do not consider state universities, community colleges, community-based organizations, long-term care facilities, or hospitals as government agencies.

Program income Program income is money earned as a result of your award-supported project activities. You must use any program income you generate from awarded funds for approved project-related activities. Find more about program income at 45 CFR 75.307.

https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.307

Step 2:

Get Ready to Apply

In this step

Get registered

Find the application package

Application writing help

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Get registered

SAM.gov You must have an active account with SAM.gov. This includes having a Unique Entity Identifier (UEI). SAM.gov registration can take several weeks. Begin that process today.

To register, go to SAM.gov Entity Registration and select Get Started. From the same page, you can also select the Entity Registration Checklist to find out what you’ll need to register.

Grants.gov You must also have an active account with Grants.gov. You can see step-by step instructions at the Grants.gov Quick Start Guide for Applicants.

Need Help? See Contacts & Support.

Find the application package The application package has all the forms you need to apply. You can find it online. Go to Grants Search at Grants.gov and search for opportunity number HRSA-24-098.

After you select the opportunity, we recommend that you click the Subscribe button to get updates.

Application writing help Visit HHS Tips for Preparing Grant Proposals.

Visit HRSA’s How to Prepare Your Application page for more guidance.

Join the webinar We will hold a pre-application technical assistance (TA) webinar. 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.

https://sam.gov/content/entity-registration https://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants https://www.grants.gov/search-grants https://www.grants.gov/search-grants https://www.hhs.gov/grants-contracts/grants/get-ready-for-grants-management/tips-for-preparing-grant-proposals/index.html https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://bhw.hrsa.gov/fundingopportunities/default.aspx

Step 3:

Write Your Application

In this step

Application contents & format

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Application contents & format Applications include 5 main components. This section includes guidance on each.

There is a 50-page limit for the overall application.

Submit your information in English and express budget figures using U.S. dollars.

Make sure you include each of these:

Components Submission Form Included in the page limit?

Project abstract Use the Project Abstract Summary Form. No

Project narrative Research and Related Other Project Information Yes

Budget & budget narrative

Use the Research and Related Budget form. (Line L) Yes

Attachments Insert each in the Other Attachments form. Yes, unless otherwise marked below.

Other required forms Upload using each required form. Indicated in the other required forms section.

See the application checklist for a full list of all application requirements. See form instructions for more detail on completing each form.

Required format You must format your narratives and attachments using our required formats for fonts, size, margins, etc. See the formatting guidelines in section 4.2 of the R&R Application Guide.

Any hyperlinked attachments will not be reviewed/opened by HRSA.

Project abstract Complete the information in the Project Abstract Summary Form. Include a short description of your proposed project. Include the needs you plan to address, the proposed services, and the population groups you plan to serve. When applicable, identify if you are requesting a funding priority or preference. For more information, see section 4.1.ix of the R&R Application Guide.

Project narrative In this section, you will describe all aspects of your project.

Use the section headers and the order below.

Project activities must comply with the non-discrimination requirements described in Non-discrimination & assurance.

https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page=1

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Introduction & purpose Purpose See merit review criterion 1: Purpose & need

• Briefly describe the purpose of your project.

• Include efforts you will make to address systemic barriers to trainees’ access to education and program success.

o These barriers might include physical and/or psychological health, physical and/or social environment, and economic stability.

• Propose an actionable framework that targets learning disparities and expands learning opportunities to support diversity, equity, and inclusion. This framework may include recruitment of students from rural and underserved areas.

Need See merit review criterion 1: Purpose & need

• Describe the trainees and their unmet needs that this program will address. Trainees include students and program participants.

• Describe the needs of the community including health care facilities that will benefit from the proposed project activities. Include information and quantifiable data, such as:

o demographics of the population, o health status, including existing health disparities and unmet health care needs of the community, o social determinants of health (SDOH), o staffing needs or concerns, and o barriers accessing care in acute and long-term care settings.

• Explain the education and training needs of the future nursing workforce as it relates to acute and long-term care settings.

• Describe your nursing curricula modifications and enhancements that incorporates acute and long-term care nurse training.

• Describe the partnerships needed to develop and implement this project, including potential employment opportunities in acute and long term for new graduate Registered Nurses supported by this project.

• Discuss any current barrier(s) you hope to overcome with the proposed project.

• Use and cite demographic data as part of the descriptions and explanations above, as applicable.

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Approach See merit review criterion 2: Response

• Explain how you will assess and address the unique needs of the people who live in the community you serve.

• Explain how you will meet the program’s requirements and expectations.

• Include how you will recruit, retain, and support students with this grant program. Include current and projected enrollment and graduate data in Attachment 9.

• Include strategies for faculty and clinical faculty/preceptor recruitment, retention, and support.

• Describe strategies for identifying current or new clinical training sites in acute and long-term care, placing trainees in those sites, and identifying preceptors/clinical faculty for trainees in these sites.

• Explain how trainees will be taught to integrate knowledge of SDOH factors that impact the health and well-being of the patient population residing in rural (non-metro) and underserved areas.

• Explain your strategies to improve trainees’ cultural competence to meet the needs of underserved communities. Include those that increase the use of culturally and linguistically appropriate services by providing training based on the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care Standards.

• If it applies, explain how you will disseminate and showcase the project, and distribute reports, products, or project outputs to target audiences.

High-level work plan See merit review criterion 2: Response

• Describe how you’ll achieve each of your objectives and project goals during the period of performance.

• Provide a timeline that includes each activity and identify the responsible stakeholder(s) for each activity.

• Identify key stakeholders responsible for planning, designing, and executing all project activities.

• Include the extent to which these stakeholders address the needs of the populations and communities served.

• Provide a detailed work plan in your Standardized Work Plan (SWP). See Standard Forms.

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Resolving challenges See merit review criterion 2: Response

• Discuss challenges that you are likely to encounter in developing and executing the work plan activities.

• Explain approaches that you’ll use to address and resolve the challenges.

Performance reporting and evaluation See merit review criteria 3: Impact & 4: Resources & capabilities

• Outcomes. Describe the expected outcomes (desired results) of the funded activities.

• Performance Measurement and Reporting. See Report on Your Grant for performance measure requirements and examples of reporting forms.

o Describe how you will collect, and report required performance data accurately and on time.

o Describe how you will manage and securely store data.

o Describe your process to track trainees after program completion for up to 1 year.

o Describe how you will monitor and analyze performance data to support continuous quality improvement.

• Program Evaluation. If applicable, the evaluation should examine processes and progress towards goals, program objectives, and expected outcomes. Evaluations must follow the HHS Evaluation Policy, as well as the standards and best practices described in OMB Memorandum M-20-12. Describe your plan to evaluate the project. Include:

o The evaluation questions, methods, data to be collected, and timeline for implementation.

o The evaluation barriers and your plan to address them.

o The evaluation capacity of your organization and staff. Include experience, skills, and knowledge.

o How you will disseminate results, how you will assess whether your dissemination plan is effective, whether the results are national in scope, and the extent of potential replication.

See Reporting for more information.

Sustainability See merit review criterion 3: Impact

We expect you to sustain key project elements that improve practices and outcomes for the target population. Propose a plan for project sustainability after the period of federal funding ends.

• Describe the actions you’ll take to:

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

HRSA-24-098 18

o Highlight key elements of your projects. Examples include training methods or strategies that have been effective in improving practices.

o Obtain future sources of funding.

o Determine the timing to become self-sufficient.

• Discuss challenges that you’ll likely encounter in sustaining the program. Include how you will resolve these challenges.

Organizational information See merit review criterion 4: Resources & capabilities.

Briefly describe your mission, structure, and the scope of your current activities. Explain how they support your ability to carry out the program requirements. Include a project organization chart.

• Discuss how you’ll follow the approved plan, account for federal funds, and record all costs to avoid audit findings.

• Describe how you’ll assess the unique needs of the trainees you serve.

• Describe the organizations you will partner with to fulfill the program goals and meet the training objectives. Include key agreements and letters of support in Attachment 3 and Attachment 10.

• Include a staffing plan and job descriptions for key faculty and staff in Attachment 4.

• Include biographical sketches for key staff using the Research & Related Senior/Key Person Profile form. See Standard Forms.

Budget & budget narrative See merit review criterion 5: Support requested

Your budget should follow the instructions in section 4.1.iv of the R&R Application Guide and any specific instructions listed in this section. Your budget should show a well-organized plan.

Reminder: The total project or program costs are all allowable (direct and indirect) costs incurred for the HRSA award activity or project. This includes costs charged to the award and non-federal funds used to satisfy any matching or cost-sharing requirement (which may include maintenance of effort, if applicable).

The budget narrative supports the information you provide in the Research and Related Budget Form. See other required forms. The merit review committee reviews both.

The budget narrative includes an itemized breakdown and a clear justification of the requested costs. As you develop your budget, consider:

• If the costs are reasonable and consistent with your project’s purpose and activities.

HRSA-24-098 19

• The restrictions on spending funds. See funding policies & limitations.

• Salary for staff involved should be proportionate to their level of effort dedicated to the project and reasonable.

• If the projected increase in enrollment is proportionate with the proposed costs.

To create your budget narrative, see detailed instructions in section 4.1.v of the R&R Application Guide. Below are some additional instructions specific to this NOFO.

Participant and trainee support costs If you include participant or trainee support costs:

• List tuition, fees, health insurance, stipends, travel, and other costs.

• Identify the number of participants and trainees.

• Separate these costs from others so we can identify them easily.

• Include a sub-total entitled “Total Participant and Trainee Support Costs” with the summary of these costs.

Preceptor costs Preceptors can be either your employee, contractor, or consultant. Preceptor costs are unique and different than trainee costs, which are for your students. Allowable preceptor costs may include:

• Stipends (other than to employees)

• Percent of salary (for employees)

• Continuing education, other trainings, and related fees

• Travel

Note: Students supported under this grant are not responsible for preceptor costs.

• If the preceptor is an employee, specify those costs under section B. Other Personnel, Section D Travel and Section F Other Direct Costs.

• If the preceptor is a consultant or contractor, lists those costs under section F. Other Direct Costs.

• Include the number of preceptors in your budget narrative.

Consultant services Identify each consultant, the services they will perform, the total number of days, travel costs, and the total estimated costs.

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Attachments Place your PDF attachments in order in the Other Attachments form.

Attachment 1: Accreditation documentation Required- Counts toward page limit.

Schools of nursing must provide documentation of accreditation, or probationary accreditation to be deemed eligible. Please do not provide only the web link to the accreditation body’s website. HRSA will not open any hyperlinks included in the application.

You must submit documentation that:

• Demonstrates continuing accreditation/approval from the relevant accrediting/ approval body and that you are not on probation.

• Includes the name of the accrediting/authorizing body.

• Provides the date of initial accreditation approval.

• Outlines the date of the next expected accrediting/approval body review (or expiration date of current accreditation/approval).

If your accreditation/approval status cannot be verified, you will be considered nonresponsive and deemed ineligible.

If you are on provisional accreditation status, provide proof of this status.

You are responsible for verifying that your project partner(s) maintain current accreditation/approval throughout the project period.

Schools of Nursing/Nursing Program Accreditation All nursing programs that are associated with the project must be accredited for the purpose of nursing education.

Schools of nursing affiliated with the proposed project that provide formal degree programs must be accredited by a national nurse education accrediting agency or state approval agency recognized by the Secretary of the U.S. Department of Education for the purposes of nursing education.

These agencies include, but are not limited to the:

• Accreditation Commission for Education in Nursing

• Commission on Collegiate Nursing Education

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Substantive change notification

Programs that modify or add a nursing specialty must include documentation of such approval of the change from the accrediting agency.

Newly established programs of nursing accreditation

If a nursing program is new and therefore not yet accredited, but will likely be accredited in the future, the Secretary of Education may deem it accredited if there is reasonable assurance that the program will meet the accreditation standards of such body or bodies before the second entering class begins their academic year.

The Letter of Reasonable Assurance from the U.S. Department of Education must be submitted as Attachment 1.

Attachment 2: Project organizational chart Required- Counts toward page limit.

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

Attachment 3: Letters of agreement, memoranda of understanding, and contracts

Required- Counts toward page limit.

Provide any documents that describe working relationships between your organization and other organizations and programs you cite in the proposal.

Documents that confirm actual or pending contractual or other agreements should clearly describe the roles of the contractors and partners and any deliverables.

Attachment 4: Staffing plan & job descriptions Required- Counts toward page limit.

Include a staffing plan that shows the roles that will support the project and key information about each role. Justify your staffing choices, including education and experience qualifications and your reasons for the amount of time you request for each role.

For key personnel, attach a one-page job description. It must include the role, responsibilities, and qualifications.

See Section 4.1.vi of the SF-424 R&R Application Guide.

Attachment 5: Maintenance of effort documentation Required- Counts toward page limit.

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Specify the non-federal funds that support proposed activities. These include cash, in-kind, or other contributions. Do not include any federal funds. See Maintenance of Effort requirement.

Use the sample format below to provide the Maintenance of Effort documentation.

FY Before Application:

Actual Non-Federal Expenditures

First FY of Award:

Estimated Non-Federal Expenditures

Attachment 6: Funding preference and/or priority documentation As Applicable- Counts toward page limit.

Provide documents that prove you qualify for a funding preference and/or priority and identify the preference.

See Selection Process for information about how these apply.

Attachment 7: Tables & charts As Applicable- Counts toward page limit.

Provide tables or charts that give more details about the proposal. These might be Gantt, PERT, or flow chart.

Attachment 8: Proof of nonprofit status As Applicable- Does not count toward page limit.

If your organization is a non-profit, you need to attach proof. We will accept any of the following:

• A copy of a current tax exemption certificate from the IRS.

• A letter from your state's tax department, attorney general, or another state official saying that your group is a non-profit and that none of your net earnings go to private shareholders or others.

• A certified copy of your certificate of incorporation. This document must show that your group is a non-profit.

• Any of the above for a parent organization. Also include a statement signed by an official of the parent group that your organization is a non-profit affiliate.

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Attachment 9: Student data Required- Counts toward page limit.

Please provide your current and projected student data in the table. Academic Year 2023-2024 will serve as baseline data for current student enrollment and graduation. You must project the number of students that you plan to enroll and the number of students that you project to graduate from your nursing degree program in each subsequent year.

Academic Year

2023-2024 (current)

Academic Year

2024-2025

Academic Year

2025-2026

Academic Year

2026-2027

Academic Year

2027-2028

Number of Enrollees

Number of Graduates

Attachment 10: Letters of support As Applicable - Counts toward page limit.

You may provide letters of support from organizations or departments involved in the proposed project.

Letters of support can also be from individuals within your institution who hold the authority to speak for the organization or department such as a CEO or chair.

Recommenders should indicate an understanding of and commitment to the project.

Recommenders should sign and date their letter of support.

Attachment 11-15: Other relevant documents As Applicable - Counts toward page limit.

Include here any other document that is relevant to the application.

Other required standard forms You will need to complete some other forms. Upload the forms listed below at Grants.gov. You can find them in the NOFO application package or review them and any available instructions at Grants.gov Forms. See the application checklist for a full list of all application requirements.

https://www.grants.gov/forms

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* Only what you attach in addition to these forms counts against the page limit. The form itself does not count.

Form Instructions

SF-424 R&R form Does not count toward the page limit

Follow the instructions in section 4.1 of the R&R Application Guide.

Research and Related Other Project Information Only the project narrative counts toward the page limit

In addition to the requirements in the project narrative section, you will provide some additional information in this form.

• Complete sections 1 through 6.

• Upload a blank document in item 7: Project Summary/Abstract to avoid a cross-form error with your Project Abstract Summary Form.

• Upload your project narrative in item 8.

• Leave items 9, 10, and 11 blank.

• If you have more than 10 subawards, you may use item 12 to add subaward budgets that could not fit in your R&R Subaward Budget Attachment(s) Form.

Standardized Work Plan form Does not count toward the page limit

In addition to the requirements in project narrative, high-level work plan, follow these instructions:

Forms Submission Requirement

SF-424 R & R (Application for Federal Assistance) form

Yes, with application.

Research and Related Other Project Information Yes, with application.

Standardized Work Plan (SWP) form Yes, with application.

Research and Related Senior/Key Person Profile (Expanded) form

Yes, with application.

Research and Related Budget form Yes, with application.

R & R Subaward Budget Attachment(s) Form Yes, with application.

Project/Performance Site Locations(s) form Yes, with application.

Disclosure of Lobbying Activities (SF-LLL) Form If applicable, with the application or before the award.

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• Submit your workplan through the SWP Form. Provide a detailed work plan that demonstrates your experience or ability implementing a project of the proposed scope.

• Follow the instructions in the SWP Form.

• Select your organizational priorities that best fit the objective.

• Write Health Equity in the “Other Priority Linkage” if your objective or sub-objectives align with this priority.

• As specified on the NOFO, goals must be copied as stated.

Research and Related Senior/Key Person Profile (Expanded) form The attached biographical sketches do not count toward the page limit

In addition to the requirements in Project Narrative, Organizational Information, follow these instructions.

• Include biographical sketches for people who will hold the key positions.

• Try to use no more than two pages per person.

• Do not include personally identifiable information.

• If you include someone you have not hired yet, include a letter of commitment from that person with their biographical sketch.

• Upload sketches in this form.

• Include:

o Name and title o Education and training – for each entry include Institution and location, degree and date earned, if any, and field of study.

o Section A, Personal Statement. Briefly describe why the individual’s experience and qualifications make them well-suited for their role.

o Section B, Positions and Honors. List in chronological order previous and current positions. List any honors. Include present membership on any federal government public advisory committee.

o Section C, Other Support. This section is optional. List selected ongoing and completed projects during the last three years. Begin with any projects relevant to the proposed project. Briefly indicate the overall goals of the projects and responsibilities of the person.

o Other information. If they apply, include language fluency and experience working with populations that are culturally and linguistically different from their own.

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Please note, the R&R Application Guide states that biographical sketches count toward the page limit. However, per this Notice of Funding Opportunity, your biographical sketches will not count toward the page limit.

The Project Director:

• Must be a licensed Registered Nurse

• Cannot be the same individual as the Authorizing Official

Research and Related Budget form Only the budget narrative counts toward the page limit

In addition to the requirements in the budget and budget narrative section, follow these instructions:

Complete the Research and Related Budget Form. Follow the instructions in section 4.1.iv of the R&R Application Guide.

You will complete the form for each budget year for the proposed performance period. After completing the first budget period in the form, you may click “Add Period” to move to the next.

R & R Subaward Budget Attachment(s) Form Counts toward the page limit*

You will also complete the R & R Subaward Budget Attachment Form for each subaward you propose. These include subcontracts. You will do this using the R & R Subaward Budget Attachment(s) Form.

To complete the budget forms, follow the instructions in section 4.1.iv of the R&R Application Guide.

If you have more than 10 subawards, you may upload the extra budget forms in the Research and Related Other Project Information form in Block 12 “Other Attachments”.

Project/Performance Site Location(s) form Counts toward the page limit*

Follow the form instructions in Grants.gov.

Disclosure of Lobbying Activities (SF-LLL) Form Does not count toward the page limit

Follow the form instructions in Grants.gov.

* Only what you attach in addition to these forms counts against the page limit. The form itself does not count.

https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page=43 https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page=1

Step 4:

Learn About Review & Award

In this step

Application review

Award notices

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Application review

Initial review We review each application to make sure it meets basic requirements. We will not consider an application that:

• Is from an organization that does not meet all eligibility criteria.

• Requests funding above the award ceiling shown in the funding range.

• Is submitted after the deadline.

• Does not include the appropriate tables, required attachments, and documentation of accreditation.

Also, we will not review any pages over the page limit.

Merit review A panel reviews all applications that pass the initial review. The members use the criteria below.

Criterion Total number of points = 100

1. Purpose & need 10 points

2. Response 40 points

3. Impact 25 points

4. Resources & capabilities 15 points

5. Support requested 10 points

Criterion 1: Purpose & need 10 points

See Project Narrative Introduction & purpose, and Need sections.

The panel will review your application for how well it:

• Describes the problem and its contributing factors.

• Describes the needs within the target community including health facilities that will benefit from the project that status indicators, SDOH, staffing needs, and barriers to care and unmet health needs.

• Describes the efforts you will make to address the non-academic barriers to trainees’ access to education and success in your program. These barriers might include physical and/or

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psychological health, physical and/or social environment, and economic stability. Trainees include students.

• Describe your efforts to recruit and retain faculty and clinical faculty/preceptors.

• Describes the education and training needs of the future nurse workforce for acute and long-term care.

• Describes the partnerships needed to develop and implement this project, including potential employment opportunities in acute and long term for new graduate Registered Nurses supported by this project.

• Describes current barriers and your plan to overcome them according to your project proposal.

Criterion 2: Response 40 points

See Project Narrative Approach, High-level work plan, and Resolving challenges sections.

Approach (25 points). The panel will review your application for how well it:

• Proposes a project that responds to the program’s purpose.

• Proposes to meet program requirements and expectations.

• Proposes strategies for faculty and clinical faculty/preceptor support and training.

• Proposes strategies to recruit, retain, and graduate associate and/or baccalaureate degree nursing students.

• Proposes strategies for identifying current or creating new clinical training sites in acute and long-term care, placing trainees in those sites and identifying preceptors/clinical faculty for trainees in these sites.

High-Level Work Plan (10 points). The panel will review your application for how well it:

• Explains the plan, design, and execution of the project to meet the proposed goals.

• Describes activities, timeframe, outcomes/deliverables, and key partners required each year to meet the project’s proposed goals.

Resolution of Challenges (5 points). The panel will review your application for how well it:

• Describes potential barriers and challenges you may face during project design and implementation. This includes the quality of your plan to address the challenges.

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Criterion 3: Impact 25 points

See Project Narrative…