Mission Zero Q&A.docx

00:00:00.000 --> 00:00:29.500 Beck, Leslie (OS/ASPR/EMMO) We decided based on the number of questions that we would address them all at once during this call. If your questions are answered, feel free to drop or you can stay and we'll have a Q&A at the end. If you could raise your hand with the emoji, I will then call on you and unmute your phone so that we can answer your questions.

00:00:30.130 --> 00:00:34.620 Beck, Leslie (OS/ASPR/EMMO) So we're going to start by turning it over to Joe Lamana, the readiness director at ASPR.

00:00:36.890 --> 00:00:48.700 Lamana, Joseph (OS/ASPR/EMMO) Thank you, Leslie, and thank you everybody for getting on the phone today. We're really excited about this opportunity. We've always long maintained our desire to have strong civilian military collaboration and working relationship with our DoD partners. Well, the relationship is the largest and most robust. So we're really looking forward to hearing from you all and answering your questions.

00:01:31.710 --> 00:02:00.920 Lamana, Joseph (OS/ASPR/EMMO) We know that you probably have a lot and you know we've got the right subject matter experts on the on the phone here as this has been developed and has been an effort that has been in the works for a number of years. So I look forward to listening and we certainly will capture all of the questions for later and hopefully you can answer everything that that you come up with that based on this call regarding this particular announcement.

00:02:01.030 --> 00:02:05.070 Lamana, Joseph (OS/ASPR/EMMO) I will turn it back to you. Thank you very much and look forward to the discussions.

00:02:06.640 --> 00:02:18.590 Beck, Leslie (OS/ASPR/EMMO) Thanks we appreciate that. So we'll turn it over to DoD who will review the questions that were submitted and any additional questions we can go over after their presentation. So we'll turn over to the DoD.

00:02:22.920 --> 00:02:24.490 Sarady Tan (Guest) OK. Thank you, Leslie.

00:02:28.300 --> 00:02:44.740 Sarady Tan (Guest) Alright, good afternoon. My name is Matt Grandstaff and I work for Colonel Tan and we're going to try to answer several of the questions which were generated, I think from several of the participants on this phone call and that will provide it for us through Miss Beck and Mr. Lamana.

00:02:49.670 --> 00:02:53.880 Sarady Tan (Guest) Q: How is the military trauma medical staff person paid? Through this grant our by the DoD?

00:02:57.510 --> 00:03:07.560 Sarady Tan (Guest) A: The answer is the salary is paid for by the DoD. So no, it does not need to be included in the proposed budget.

00:04:06.830 --> 00:04:25.950 Sarady Tan (Guest) Q: One of the other questions we got was what is the process for securing a current and active agreement with the SECDEF (Secretary of Defense), is this contingent upon the award of funds?

00:04:27.270 --> 00:04:41.560 Sarady Tan (Guest) A: For the purposes of this year's grant, the facility competing for the agreement needs to have an agreement with the DoD by the time the grant is awarded, which is no later than 31 September, 2022. So essentially what we're looking at is those facilities which have an existing agreement with the DoD being eligible for a grant for this particular year of award.

00:05:41.690 --> 00:06:10.700 Schwartz, Richard Q: So I'm at the Medical College of Georgia and we our emergency medicine residency is a joint army civilian programs. So half of my emergency medicine residents are active duty army. We also do training for civil affairs medics. Each of those requires an agreements with the Army and DoD is this okay?

00:06:35.570 --> 00:06:38.560 Sarady Tan (Guest) A: All agreements that currently set for this Mission Zero. We will have to look at the current existing agreement that you outlined because the attempt here is not for training. This is for skills sustainment. So all of our providers, physicians are already fully board certified and are current. We just need to make sure they maintain and sustain their skill set.

00:07:18.810 --> 00:07:33.120 Q: Schwartz, Richard Would we be eligible to submit for the grant having those existing relationships with DoD or I or would we be considered disqualified because we don't have a specific Mission zero letter?

00:07:36.590 --> 00:07:39.840 A: Sarady Tan (Guest) Yes, your program that you currently have would make you qualify for this.

00:08:00.350 --> 00:08:05.960 Goralnick, Eric,MD, MS A: Perfect. Thanks. Appreciate it. Calling in from mass General Brigham in Boston, MA. Thank you. I guess the question specifically is what I heard initially the response to this is by the time of awarding of the grant, you need a letter of agreement with DoD. So when this grant is due on August 31st, can we have a phrase in there that essentially says that we are in the process of applying for agreement as the first part and the second part is, do you have a specific contact that we should be reaching out to for this particular?

00:09:46.100 --> 00:10:03.690 Sarady Tan (Guest) A: For this iteration, yes, we need to have the existing agreement. There is insufficient time to you know enter into an agreement quote to have another agreement. So for this year that is that is the answer over.

00:10:04.720 --> 00:10:06.810 Goralnick, Eric,MD, MS Q: Got it. Our institution, similar to the last caller, has some agreements with the DoD and a variety of different topics. So I guess when we apply, we can reference those at least for a baseline. Is that sufficient?

00:10:23.120 --> 00:10:25.480 Sarady Tan (Guest) A: Yes, that should be sufficient to start off over.

00:10:49.070 --> 00:10:55.930 Connor Van Alstine (ANTHC) (Guest) Q: Hi there. Yeah. Connor Vanalstine with the Alaska Native Tribal health consortium. So my our facility has an existing agreement with the 673rd Medical Group at Joint base Elmendorf Richardson in Anchorage, AK. It's a memorandum of understanding.

00:11:25.690 --> 00:11:30.570 Connor Van Alstine (ANTHC) (Guest) It does that agreement qualify as an agreement with the DoD?

00:11:33.760 --> 00:11:34.240 Sarady Tan (Guest) A: Yes.

00:11:47.950 --> 00:12:02.010 Leslie-Ann Bolden (Guest) Q: Hi. Hello. Good afternoon everyone. I'm calling from Jackson health system in Miami-Dade County, Florida, and it's similar to the other questions we have agreements with the army. But none specifically with the Secdef. How do we proceed? Should we?

00:12:15.240 --> 00:12:34.160 Sarady Tan (Guest) A: Yes, ma'am. This is Matt grandstaff. We can take care of answering that question. So essentially within the Congressional language, when we say DoD, we mean through essentially it's with the DoD through one of the services, our Special Operations Command. So the answer is yes to your existing agreement with the army qualifies.

00:12:44.310 --> 00:12:49.590 Gofman, Gene Q: Hey, good afternoon. Thank you so much, Penn Medicine. Thank you for answering. Regarding DoD SEC, uh UM had a very similar question, but one of my colleagues actually posted this in the chat. We do cover some of the malpractice and other administrative costs. As we looked at the FOA, they are covered and listed in the work for. Uh. Skill sustainment. Uh readiness uh it is that what we're expected to delineate in our budget proposal?

00:13:38.040 --> 00:13:52.990 Gofman, Gene So our in our institution currently covers the malpractice cost, for example, for the native personnel, while the military personnel or paid by the DoD, the malpractice coverage in the state is covered by the agreement by the entity where they are practicing.

00:13:59.770 --> 00:14:05.280 Sarady Tan (Guest) A: So yes, so the agreement that you made either with the Navy or other services to provide various different support for the medical personnel, military medical personnel in your institution that will be again addressed in that agreement. So if your institution right now and the agreement you have. I think that your institution will provide that malpractice insurance that will continue.

00:14:57.670 --> 00:15:04.870 Michel Aboutanos Q: Yes, hello. Thanks for taking the call. So this this Michael telling us from Richmond, VA, our question with regard eligibility. If we have currently an MOU with the Navy Special Warfare Group to really train the Navy SEAL medics and the Corman. Would this MU suffice for legibility? That's one question and the 2nd. We also are close to finishing in another Mau with the Navy Medical Hospital for readiness for their deployment with that also qualify for eligibility.

00:15:39.570 --> 00:15:48.820 Sarady Tan (Guest) A: Yeah. So you're two question on the first one, it appears without having a quick look at it and detail, it does cover that. We'll make you eligible for this program over.

00:16:07.760 --> 00:16:23.420 Martin Schreiber Hello everyone. My question relates more to the nature of the funding. We're a MCT three site with an existing agreement. My concern is that there's 100 people on this call and I know there's only $2,000,000 available total. So my question is, as we budget for a for the grant…If we ask for too much money, we're going to price ourselves out. Can it be partially funded? How do we deal with this tiny budget? I mean, if you if we're gonna take $2,000,000 and divide it by 100.

00:16:42.920 --> 00:16:50.020 Martin Schreiber There's not much money left, so strategically speaking, how do we write these budgets? And then the second question is, for a large center like ours, we can apply for a five year grant. And should we be escalating the budget, can you give us some clarification on the budget? With so many places applying?

00:17:20.760 --> 00:17:48.870 Jennifer Gurney A: This is Colonel Jennifer Gurney. I just wanted to address one part of Doctor Schreiber's comment if I can. You know, Doctor Schreber, I think that you should ask for what you think your institution wants or needs for this grant and not worry about how many people are applying or what the budget is. And so then, you know, if it if it's less than that and then in subsequent years you have your ask or if you want to escalate your ask and subsequent years based on your needs or.

00:17:48.990 --> 00:18:19.220 Jennifer Gurney The needs of the program, so I wouldn’t worry about how many people ask for money because you know, that's something that has to be worried about on another level. But just ask for what you think is appropriate for your institution and after it gets figured out in the end that's, you know, I think everybody should, I think that should be the advice for everybody. Don't worry about how much money is there this year or next year. Ask for what you need is without that consideration. That's my thought on it. I don't know if anybody from the grants office or HA has anything to add to that or to.

00:18:26.160 --> 00:18:56.160 Martin Schreiber I think in response to that, Jen, thank you for that response. I mean, you know there's a lot that can be done to improve the training of these personnel or the sustainment of the skills of the personnel that are here. And there's really no limit to what we could ask for and we could ask for, you know, a training facility upgrade that allows us to reenact downrange warfare. And you know, it can get very expensive. So I was hoping to get some guidance on this.

00:19:00.230 --> 00:19:04.110 Beck, Leslie (OS/ASPR/EMMO) A: So within the agreement or within the NOFO is the limit. Your proposal should be based upon what you're asking for, right? So there's two different terms. It seems like you're asking for the trauma team, which is the first one which is up to $1,000,000. And so you would write it based on which proposal you're looking for - individuals or the complete trauma team: $100,000 for MD's and $50,000 for everybody else.

00:19:36.190 --> 00:19:47.190 Beck, Leslie (OS/ASPR/EMMO) You can write your proposal using all or some of those, knowing that all this is based on funding. So right now we have $2,000,000, next year it could be $9 million or nothing. Just write your proposal how you think it should be for this year and for following years and it will all be dependent on budget.

00:20:14.120 --> 00:20:42.810 Brown, Nancy (OS/ASPR/ORM) I was just going to also say that as long as they don't go over the ceiling amount, but either way it is what you ask for. It can change with programs request. So if you put in the amount that's sufficient and then only choose fewer awards as possible, they're going ask you to change your budget anyway.

And then if they, if you get chosen as an awardee, they're going to work with you and then the negotiation process to change your budget and your budget narrative anyway.

00:20:53.680 --> 00:20:57.580 Goralnick, Eric,MD, MS Q: Alright, thanks. I'll go through the questions in the chat. First is should the application reflect specific rotational education planning for certain types of military trauma care providers you know, be specific to emergency medicine trauma surgeons, RNS, et cetera, or be generalized to accommodate various types of rotators. As my first question.

00:21:27.710 --> 00:21:37.740 Sarady Tan (Guest) A: Yeah, the answer should be both. Uh, basically, what the emphasis on team as long as the privilege provider participate in some sort of CME process. So I think what we're looking for is what does your institution have the ability to offer based on the criteria that's listed this way. It allows us in DoD to find the appropriate place.

00:21:55.060 --> 00:22:01.170 Sarady Tan (Guest) Personnel with the skill set needed by looking at what you can offer to our personnel. Will there be trauma, whether it be turn certain type of surgical capabilities, whatever the case may be that kind of meet what the notebooks mentioned that will help us say, alright, this institution has the requirements that we need for our subset of personnel that we will send those individual to yours institution. Does that make sense over?

00:22:29.660 --> 00:22:33.790 Goralnick, Eric,MD, MS Q: Yeah, that's perfect. That's very helpful. Thank you. Follow on question, does the PI need to be a designated Surgeon champion? You know, per the clearly a lot of this was drawn from the blue book with ACS. Does the champion need to be a surgeon or can it be an emergency medicine physician or another specialist since we're really talking about a multidisciplinary training program or do you specifically want the π to be a trauma surgeon?

00:23:28.940 --> 00:23:37.710 Sarady Tan (Guest) A: No it does not. But if we're using the emergency medicine provider, that individual should have the knowledge and all areas of the hospital to which trauma patient flow. And again, it's probably easier for a surgeon, but it's not a requirement, at least from DoD perspective.

00:28:02.340 --> 00:28:31.070 Jennifer Gurney A: If it's combat casualty care relevant. So when the Blue book was written, the Blue book was written mostly by surgeons and it has been adopted as joint trauma training education criteria. So it is very surgeon focused. But if you can have another champion to the other question, I think the this other one that could be GP or could it be somebody else, I think you could make an argument for it if there's already an agreement in place if training is happening and if there's a champion for trauma care and combat casualty care and for these providers.

00:24:00.000 --> 00:24:31.750 Stephanie Hasselbacher Q: Yes, thank you so much. I have a follow up to Doctor Schreiber and Doctor Grolnick budgeting questions. So we are a level 2 trauma center. As such, we are capped on our budget proposal by the number of in our case surgeons. I believe the NOFO said 100,000 but those rotations are relatively brief and our case they're only four weeks long. So I am curious does that still count as you know one whole surgeon for the purposes of our budgeting. Obviously, will incorporate the malpractice insurance and all of this, but as we build our proposal. And what counts as one surgeon, one staff member, while we are looking at how much we can write the proposal for.

00:25:39.280 --> 00:25:43.030 Brown, Nancy (OS/ASPR/ORM) A: Will need to research the level of effort.

00:26:21.590 --> 00:26:35.500 Connor Van Alstine (ANTHC) (Guest) Q: Uh, that question is well in terms of the FTE requirements. But beyond that in terms of the basic requirement for what qualifies as a physician versus. Other military trauma care providers. Uh does physician. I know later down in the key definitions the NOFO makes a distinction between physician and surgeon, so I'm wondering if surgeons qualify.

00:27:07.410 --> 00:27:10.940 Sarady Tan (Guest) A: Yes, the surgeon broadly speaking.

00:27:12.360 --> 00:27:20.060 Sarady Tan (Guest) We'll talk by because we're trying to be all-encompassing all of our combat casualty care team composed of a variety of different surgical specialties.

00:27:24.660 --> 00:27:51.990 Sarady Tan (Guest) As well as for physicians who may be working in the emergency room as well. So yes, it's applicable to both position and surgeon who are of course positioned now if you're looking for the DMD oral surgeon, that may be a little bit unique and I will let Doctor Gurney chime in if she believed that also qualify under the surgeon umbrella over.

00:28:02.340 --> 00:28:31.070 Jennifer Gurney A: If it's combat casualty care relevant. So when the Blue book was written, the Blue book was written mostly by surgeons and it has been adopted as joint trauma training education criteria. So it is very surgeon focused. But if you can have another champion to the other question, I think the this other one that could be GP or could it be somebody else, I think you could make an argument for it if there's already an agreement in place if training is happening and if there's a champion for trauma care and combat casualty care and for these providers.

00:28:31.320 --> 00:28:39.880 Jennifer Gurney Then I think that there could be a good argument for that. I hope that answer the question. Only call at the end of it. If I didn't, then please ask it again over.

00:28:45.830 --> 00:28:57.490 Connor Van Alstine (ANTHC) (Guest) Q: in addition to reiterate, if there are FTE requirements of the for what qualifies as a physician, where we would also be interested because we were in a similar situation where surgeons or military personnel who are coming to our facility or going through shorter rotations and four to five week periods.

A: So our understanding from the congressional language the intent here is to be able to provide full time status for all of our trauma team, especially the one that's doing the five year program where we're trying to kind of embed the entire team into your institution? While the individual we know that some place may not be able to absorb the entire team and thus we provide one individual or two whatever your institution capacity will be for us to enter that agreement in terms of the intermittency and how frequency that is, I think that's forthcoming based on what the need of our various.

00:29:47.430 --> 00:30:03.220 Taghavi, Sharven Q: Yeah. Thanks, shravan. Taghavi from Tulane. I have two questions. One is, could you elaborate on what a trauma team is defined as? And then the second question is, are trauma center in New Orleans is staffed by two different schools? And so I'm wondering if and we want work together for a proposal, I'm wondering if we can route it through so Tulane is not technically a trauma Center for the definition, but we would work through a University Medical Center, which is a trauma center. Can we still route it through Tulane or are we still eligible to apply or does the entity of University Medical Center technically have to supply apply?

00:30:44.020 --> 00:30:50.900 Sarady Tan (Guest) A: Yes, ma'am. I it the answer this question I I think the best answer at this point in time is who is the agreement with. So if the agreement is with the Medical Center, then that's who needs to submit the application. If they want to compete for the award over.

00:31:15.590 --> 00:31:30.540 Jennifer Gurney Yeah, absolutely. Uh. So what makes up a trauma team? Actually, it's written in the document. So military trauma care provider. So the team is surgeons, it's nurses, it's medics. It's anesthesia providers.

00:31:31.680 --> 00:31:53.930 Jennifer Gurney So it's it's the trauma care team. That's what makes up the trauma team. It doesn't, I noted and acknowledged that Blue Book is surgeon focused, but the way the holistic view from the DoD is that it takes the entire team and not just the surgeon. So it's all the providers that are on the trauma care delivery team and the deployable setting, which is pretty broad over.

00:32:23.530 --> 00:32:43.120 Lekawa, Michael Q: Yes, I put my question in a chat and there's a few other similar, but I continue to be confused about the differentiation between the two types of programs. The first one described more as full time and the three to five year versus the second one our contracts the question asked earlier about full time or not.

00:32:52.890 --> 00:33:20.840 Lekawa, Michael Are all military tuitions and so it worked better for them to not a full time person placed with us, but to actually maintain their skills by putting them in intermittently so they can continue doing what they do with their own hospitals. Would that limit us to then being because we're very busy level 1 center? It's over 5000 activations. I'm trying but what would be by that description we would be in there.

00:33:37.310 --> 00:34:00.080 Beck, Leslie (OS/ASPR/EMMO) A: Each program is not about intermittent work or full time work. The two different categories. One is for a full trauma team and the other one is for individual providers. So that's the difference within the two. Now I'm going to turn it over to DoD if they want to discuss full time vs intermittent work.

00:34:16.450 --> 00:34:20.280 Sarady Tan (Guest) A: So our understanding from the congressional language the intent here is to be able to provide full time status for all of our trauma team, especially the one that's doing the five year program where we're trying to kind of embed the entire team into your institution? While the individual we know that some place may not be able to absorb the entire team and thus we provide one individual or two whatever your institution capacity will be for us to enter that agreement in terms of the intermittency and how frequency that is, I think that's forthcoming based on what the need of our various.

00:35:11.150 --> 00:35:13.360 Sarady Tan (Guest) And let's start the Gurney having additional input over.

00:35:16.530 --> 00:35:17.960 Jennifer Gurney Nope, you answered that really well.

00:35:20.200 --> 00:35:32.980 Lekawa, Michael But if you could have a full Time Team that they weren't there all the time, meaning the entire team could be there, but they don't want to be there all the time because they have other obligations that would still count as part of the first one, is that right?

00:35:34.980 --> 00:35:36.280 Sarady Tan (Guest) Both are the intent here.

00:35:35.700 --> 00:36:03.770 Jennifer Gurney The military trauma teams that are preparing to take care of patients in the deployed environment. They might not be there full time, but the overall intent for the team is to have a full time imbedded with the team.

00:36:04.030 --> 00:36:21.330 Jennifer Gurney Knowing that they're not gonna all be one, you know, full one 1.0 FTE. So, but then if you wanted to look at these, This is why it's $1,000,000 for a team and less for provider intent of the DoD is for these operational units and these teams to be able to work.

00:36:22.220 --> 00:36:37.730 Jennifer Gurney And exercise their capability set that they use when they're deployed in a civilian trauma center. I hope that answered the question because you did come in a little bit broken up. But if it didn't just put in the chat so we can read it, to answer your question more precisely.

00:37:15.640 --> 00:37:45.430 Sarady Tan (Guest) A: Asked the question, please explain this desired component of the funding announcement performance measures for the project period include clinical workload, data for participating military providers that include or allow calculation of Med-J KSAs which stand for joint knowledge, skills and abilities. I'll start off with you know, attempting to answer this question, then turn it over to our colleagues, Colonel Gurney and team. Once again, these knowledge skills and abilities, their criteria for military personnel that we've established that basically cover down on their professional scope of practice for what they would do in the deployed setting. So those procedures, those things they need to be proficient in. So that when we deploy forces of the DoD, they can provide the requisite.

00:38:11.590 --> 00:38:34.300 Sarady Tan (Guest) UM surgical and resuscitative type care and one of the ways this is done is that facilities provide their ICD 10 and CPT code information for those practicing providers to the DoD, so that once again we can measure and better ascertain the workload. If they're getting those. Required reps to meet their primary mission, which is to to support our deployed forces.

00:38:40.170 --> 00:38:49.280 Sarady Tan (Guest) Uh Colonel Gurney, is there anything else to add with respect to this issue, which is part of the funding award announcement over?

00:38:51.090 --> 00:39:19.370 Jennifer Gurney Nothing to add, but I think the take away should be that if you don't have a mechanism to report what the clinical activity is and we're still figuring out some of the mechanisms that capture these JKS's from the midst of partnerships. But we know that it's gonna take some administrative support at the level of the civilian hospital to be able to provide us this data, but we are gonna just like quick benchmarks. Trauma centers were eventually we don't have all the mechanisms in place yet, but eventually be able to look.

00:39:19.700 --> 00:39:47.210 Jennifer Gurney Across the scope of places that our providers are getting clinical readiness and say, you know, these are this is better for this type of team. This is better for this individual. So reporting will be a requirement. It's not as stringent requirement this year but certainly in future funding years, it's gonna there's gonna be somewhat of an Order of Merit based on if you're not. If you're a great center but you're not able to show us that with data then it's gonna be less optimal to put people there over.

00:39:51.460 --> 00:40:10.110 Beck, Leslie (OS/ASPR/EMMO) Q&A: So just to go over some of the chat, we will post the jsas as appendix one. It's saying that they are unable to locate that. So we'll go in there and make sure that that is there after the call. They're also asking if this meeting that's being recorded will be posted. And yes, either that will be posted and if it cannot, we'll post the transcript.

00:40:30.360 --> 00:40:39.740 Caterina Mackowiak Q: I'm actually one of the grant administrators who's assisting our API with this submission, and I just had a couple of questions from the grant admin side that I wanted to ask. We wanted to know if you want just a regular CV or if a DOD or an NIH biosketch was going to be required for this.

00:41:01.780 --> 00:41:02.670 Beck, Leslie (OS/ASPR/EMMO) A: A general CV.

00:41:25.020 --> 00:41:33.290 Caterina Mackowiak Q: Perfect. And then are you guys requiring other support? I couldn't find anything noted regarding that.

00:41:34.600 --> 00:41:36.170 Brown, Nancy (OS/ASPR/ORM) What do you mean when you say other support?

00:41:37.200 --> 00:41:42.190 Caterina Mackowiak A pending and current projects that already are being funded.

00:41:43.390 --> 00:41:44.900 Brown, Nancy (OS/ASPR/ORM) A: No, the flow doesn't ask for that.

00:41:47.770 --> 00:42:07.710 Caterina Mackowiak Q: Our last question was just there was one section where it's discussing the letters from High Level Administration letters of support. It has two different bullet points under that, but it was saying you only need one was that one from each of those bullet points or one?

00:42:31.580 --> 00:42:39.750 Brown, Nancy (OS/ASPR/ORM) A: It's either or if you have both, that's fine. At least one of them.

00:42:50.370 --> 00:42:59.840 Sarady Tan (Guest) Hey, just for just for clarification from DoD perspective, the main thing is understand that if it's within a hospital facility.

00:43:00.580 --> 00:43:23.290 Sarady Tan (Guest) You know, maybe appropriate to get the letter from the Dean or the CEO, but if we're talking about EMS, paramedics or medics, you know, if they're again a working closely with the state of local, maybe the Department of Health or the state or the regional designated authority may be warranted to allow those individuals to participate. That's the only clarification that would like to offer for this.

00:44:09.120 --> 00:44:21.880 Susie Salem Q: Hi, my name is Susie. Yes, thank you. Thanks for taking the call. I had two questions in the chat. I'll just ask him here quick. The first one is that the notice says that maintenance of effort is not required.

00:44:23.390 --> 00:44:33.660 Susie Salem For this grant, which is great, I just wanna make sure that that means we won't be completing effort certifications in case and an auditor or leadership team asks us. We don't, we don't have to do that.

00:44:41.820 --> 00:44:43.860 Brown, Nancy (OS/ASPR/ORM) Is that for grants? Did you refer that to grants?

00:44:47.000 --> 00:44:59.700 Susie Salem Sure. I mean normally it's a requirement in my experience for a federal grant that we would have to submit effort, certifications or track our effort. But I don't think it's required for this one based on the notice. And I just wanted to confirm that.

00:45:01.050 --> 00:45:06.450 Brown, Nancy (OS/ASPR/ORM) A: Right is what I was trying to get too earlier because I do remember reading that it's not required level of network.

00:45:15.890 --> 00:45:18.130 Susie Salem Document and say that no, it's not required.

00:45:19.080 --> 00:45:20.060 Susie Salem Even though it's federal.

00:45:19.240 --> 00:45:25.940 Brown, Nancy (OS/ASPR/ORM) I know there's a sample budget at the bottom and the sample where they have it listed, but that's just a sample budget.

00:45:31.090 --> 00:45:34.040 Susie Salem OK. But normally we would track our effort.

00:45:34.860 --> 00:45:38.110 Brown, Nancy (OS/ASPR/ORM) If we require it, we have to put it inside the NOFO, yes.

00:45:39.590 --> 00:46:09.060 Susie Salem Q: OK, perfect. And then my other question is about building a budget across multiple years. It said if you wanna build in a cost of living then you need something from your institution that says that that's a policy. I don't think that I'll be able to provide that just because we're state funded and it depends on the legislature how much we get per cola. And so is it OK to build a budget where a cola is averaged out across the three years?

00:46:09.540 --> 00:46:14.640 Susie Salem With the anticipation that we're going to get it or should I build it in each year?

00:46:15.720 --> 00:46:19.070 Susie Salem But I wouldn't. I don't think I'd be able to provide documentation.

00:46:20.010 --> 00:46:31.360 Brown, Nancy (OS/ASPR/ORM) A: Now when you submit the five year, I don't know if this was five or three years, but the number of years each year you would do a different budget narrative where you're gonna lift that as well.

00:46:32.320 --> 00:46:33.410 Susie Salem OK, so we could build.

00:46:51.490 --> 00:46:54.040 Brown, Nancy (OS/ASPR/ORM) For the actual money coming from program varies.

00:46:55.400 --> 00:46:56.160 Susie Salem Right. OK.

00:46:55.760 --> 00:46:56.300 Brown, Nancy (OS/ASPR/ORM) Thank you.

00:46:58.920 --> 00:47:00.090 Susie Salem OK. Thank you.

00:47:09.610 --> 00:47:29.010 Leahy, Eleanor A And really quickly, it feels like there's a lot to get through in the maximum of 20 pages, double spaced project narrative. And I just wanted to clarify that from what I'm reading, it seems that the budget narrative is included in the project narrative is being requested there. And I just wanted to confirm that.

00:49:18.570 --> 00:49:27.260 Brown, Nancy (OS/ASPR/ORM) Yeah, I'm looking at it right now. 00:50:53.880 --> 00:50:58.770 Beck, Leslie (OS/ASPR/EMMO) So just to reiterate, the budget narrative is within the within the 20 page limit.

So, Leslie, do you know when you guys are asking for an administrator preparing the plan execution, you have any details on what that would entail?

00:49:31.730 --> 00:49:33.040 Beck, Leslie (OS/ASPR/EMMO) I'm reading it now, Matt.

00:49:35.190 --> 00:49:37.690 Beck, Leslie (OS/ASPR/EMMO) Do you know would you be looking for something specific?

00:49:42.260 --> 00:49:45.000 Sarady Tan (Guest) Leslie, can you, can you repeat that question one more time please?

00:49:45.870 --> 00:49:52.430 Beck, Leslie (OS/ASPR/EMMO) Would you be looking for anything specific in the administrative preparedness plan, execution within the project narrative?

00:49:57.640 --> 00:50:27.440 Sarady Tan (Guest) We don't have anything specific right now outline, but the main thing for us, if it's your institution, just making sure that personnel, when they checked in, have the appropriate access to the various different credential office, different office areas and what have you. They need some computer system setup. You know, all those other trainings that typical new employee would be in part of your institution is what we're thinking about in terms of the administrative preparation for those individuals.

00:50:31.590 --> 00:50:32.220 Beck, Leslie (OS/ASPR/EMMO) Thank you, Sir.

00:50:31.700 --> 00:50:47.820 Brown, Nancy (OS/ASPR/ORM) Unless you can I just say one thing because I'm seeing this when she asked if the budget narrative and justification is part of the 20 pays, I have to say yes because that's what you guys have listed in the forward and I can't say no because it wouldn't be fair to the other applicants.

00:50:48.510 --> 00:50:49.500 Beck, Leslie (OS/ASPR/EMMO) Yeah, that sounds good.

00:50:53.880 --> 00:50:58.770 Beck, Leslie (OS/ASPR/EMMO) So just to reiterate, the budget narrative is within the within the 20 page limit.

00:51:18.070 --> 00:51:21.880 Ypma-Wong, Mary Q: Hi. I just wanted to get a clear definition of key personnel.

00:51:38.990 --> 00:51:44.780 Ypma-Wong, Mary You ask for CV for key personnel on page about page 12.

00:51:50.180 --> 00:52:19.710 Brown, Nancy (OS/ASPR/ORM) A: The key personnel listed in your budget and budget narrative of individuals like the authorizing official, the PI, the people who work primarily on the award that aren't the admin, people who support them. So the key personnel of individuals. If you change one now you have to let us know and get permission. Well, it's not a cooperative agreement, but you do have to let us know that you're changing out. So the key personnel, especially the individuals whose names would appear on the notice of award.

00:52:25.340 --> 00:52:42.180 Jennifer Gurney Just add something I I don't know exactly what you're referring to in the grant, but from the from the DoD is kind of readiness perspective. They keep personnel are also the people that are interacting directly with the individuals getting their clinical activity there and keep personnel.

00:52:44.440 --> 00:52:52.710 Jennifer Gurney Director if they're engaged and interacting in the sustainment activities of the individuals or teams that are at the partnership.

00:53:00.520 --> 00:53:07.710 Beck, Leslie (OS/ASPR/EMMO) So I just saw a question pop up. I wanna reiterate to that within the 20 page narrative, it does include the budget description So exactly what the NOFO says those all need to fit within the 20 page.

00:53:19.760 --> 00:53:28.830 Connor Van Alstine (ANTHC) (Guest) Q: Hi. Yeah, my question relates to application review information, specifically the required components and desired component section. I was wondering when it when it comes to the required components, is each and every item listed under those components actually a requirement for eligibility for the grant? Or how does the scoring work? If not, is the scoring weighted in any way? For example, we meet most of these, but in terms of physical requirements we do not serve 1200 emission admissions per year.

00:54:30.930 --> 00:54:46.880 Brown, Nancy (OS/ASPR/ORM) A: Yes you will, you can lose points for that. So since this is a competition, you can you will end up having less points than the other individuals you're competing with because you don't meet all the requirements. So yes it does count.

00:54:54.820 --> 00:55:02.240 Connor Van Alstine (ANTHC) (Guest) OK. But just to just to clarify it only docks point, it does not disqualify us from the competition entirely.

00:55:10.000 --> 00:55:16.340 Brown, Nancy (OS/ASPR/ORM) Is what we would if your application doesn't make it through, it would be for something else. It would because you don't have a lot. Everything that's asked for.

00:55:16.970 --> 00:55:29.890 Brown, Nancy (OS/ASPR/ORM) Where as far as going into the application that's gonna be decided by the review panel. So if you there will dock points as far as you're not meeting the requirements, but if you have your entire package, your packet can go through to be reviewed.

00:55:31.680 --> 00:55:46.950 Connor Van Alstine (ANTHC) (Guest) And when it comes to each of the points that has scoring attached to it, are each of the points under institutional administrative requirements and physical requirements weighted equally within that 60 points?

00:55:47.590 --> 00:55:53.850 Connor Van Alstine (ANTHC) (Guest) Umm. Or are some of the different pieces worth different amounts of points if they're missing or present?

00:55:55.270 --> 00:56:01.870 Brown, Nancy (OS/ASPR/ORM) Leslie, you guys, would you be talking points for something if they don't have all of the requirements as far as if they're just missing one?

00:56:03.150 --> 00:56:10.890 Beck, Leslie (OS/ASPR/EMMO) Yes, we haven't gotten our panel together to discuss how they'll be waited at this time. But yes, each individual one will need to be represented and if they're not, points will be docked. We haven't weighted them yet.

00:56:19.880 --> 00:56:21.530 Connor Van Alstine (ANTHC) (Guest) And they will be weighted eventually.

00:56:22.470 --> 00:56:22.900 Beck, Leslie (OS/ASPR/EMMO) Yes.

00:56:23.600 --> 00:56:24.570 Connor Van Alstine (ANTHC) (Guest) OK. Thank you.

00:56:43.840 --> 00:57:03.450 Roberto haddad Yes, I just have a question regarding the requirement to have a contract with SEC def to train military personnel. Is that an independent requirement from the grant as in we have to have that in place before we can apply for the grant or is applying for the grant you know does that lead to the to this contract?

00:57:04.660 --> 00:57:08.610 Beck, Leslie (OS/ASPR/EMMO) No, it's needed in advance, so that would be a qualification needed for the grant.

00:57:10.540 --> 00:57:16.790 Roberto haddad OK, do do you all have any in the OR guidance of where do where in the DoD to go and get that?

00:57:20.470 --> 00:57:42.880 Beck, Leslie (OS/ASPR/EMMO) So at this time, for this fiscal year, they're unable to process any additional agreements. So an agreement would already have to be in place if we're looking for an agreement in the future, you can send me an e-mail leslie.back@hs.gov and I'll coordinate with the DoD and they'll look to see if an agreement is something that would benefit both the Institute and DoD and Asper.

00:57:58.990 --> 00:58:17.880 Ariel Medoff Q: So most of my questions have actually just been answered, but I had a couple of just clarifying. So it's noted in the NOFO that the award date and the start date are both September 30th, 2022. And I just wanted to clarify that that's right that we should make the start date September 30th.

00:58:48.010 --> 00:58:48.430 Brown, Nancy (OS/ASPR/ORM) A: Yes.

00:58:51.880 --> 00:59:02.710 Ariel Medoff Q: All right. I just wanted to make sure. And then just one super quick question. Umm, so when we send the letter of intent, should that be sent to you separately from the submission or as a part of the submission?

00:59:26.270 --> 00:59:35.310 Beck, Leslie (OS/ASPR/EMMO) A: Yeah, I was. Those come to myself, leslie.beck@hs.gov. And that should be in the Novo.

00:59:45.280 --> 00:59:52.330 Ariel Medoff Q: For us, it would be the million per year that includes the IDC, right? That is the total cost, not just direct it over here.

00:59:53.090 --> 01:00:02.490 Brown, Nancy (OS/ASPR/ORM) A: As the total cost, that's the question I was trying to answer, but for the person who asked that question, you don't get IDC on top of the money you get IDC included within your budget. So yes.

01:00:22.210 --> 01:00:41.900 Caterina Mackowiak Q: Hi, thanks. I just had one other question because I was really looking through the notice as we've been going through this, it's specifically as says that we have to submit documentation of our active agreement, which is what a lot of people have been discussing. Is that being submitted as the full agreement as part of this?

01:01:00.700 --> 01:01:11.460 Sarady Tan (Guest) A: Yeah, Miss beck. Umm, I we think the answer is yes, uh. Whatever agreement that facility currently has with the DoD should be submitted as part of the package.

01:01:12.590 --> 01:01:15.900 Caterina Mackowiak OK. I just wanted to confirm it. Just said you know it.

01:01:16.760 --> 01:01:23.300 Caterina Mackowiak Was gonna be submitted, but it didn't really say where it needed to be submitted, so I just wanted to make sure it was being submitted as part of the package.

01:01:26.710 --> 01:01:38.310 Sarady Tan (Guest) Lively. Hopefully I did not misspeak in terms of the mechanics. The intent of course is that the agreement be, you know, provided how that's technically done. I'd have to defer to you ma'am.

01:01:38.850 --> 01:01:49.090 Beck, Leslie (OS/ASPR/EMMO) Yes, I was just asking if you needed the full agreement. So yes, the full agreement should be a part of your package to qualify for the grant, it would be needed with the package.

01:01:50.760 --> 01:01:52.110 Caterina Mackowiak Alright, thank you very much.

01:01:55.140 --> 01:02:11.900 Beck, Leslie (OS/ASPR/EMMO) Q: I'm going to go through a couple of the chat. It's very difficult to do both, so I may miss some, hopefully not. Is the current capacity information requested because the DoD has an interest exploring the possibility of expanding existing programs beyond the scope of whatever is currently outlined in the institutions existing agreement.

01:02:19.060 --> 01:02:30.670 Sarady Tan (Guest) A: Yes, the intent for us is that if your institution have a a large capacity and if one team is not going to be sufficient for us. We may send the second team or subsequent, depending on what you had the capacity. But if your facility do not then, you know, we may have to look elsewhere, but this just kind of allow us some opportunity to future forecasting.

01:03:00.500 --> 01:03:03.690 Beck, Leslie (OS/ASPR/EMMO) Q: OK. Does the champion have to have a military background?

01:03:07.300 --> 01:03:07.510 Jennifer Gurney A: No.

01:03:16.640 --> 01:03:38.720 Jennifer Gurney We will save partnerships that one in Baltimore is a example, Tom Scalenus, a champion of that. He doesn't have a military background and if you look at the partnership early in Oregon, Marty Schreiber is a champion in 2000 military background. So that's gonna be very diverse. But as long as they're their champion for the partnership, that's that takes priority for their background.

01:03:40.660 --> 01:03:49.330 Beck, Leslie (OS/ASPR/EMMO) Q: Thank you. On page 17, sites report data for measurement of Medj KSA's. What is the Med J piece of the KSA's?

01:03:54.670 --> 01:03:55.230 Jennifer Gurney A: Joint.

01:03:57.330 --> 01:04:16.580 Jennifer Gurney But it's really the Expeditionary medical skill set, so if somebody is getting experience managing chemotherapy for a cancer patient, that might be important for their specialty, but that's not important for the Expeditionary scope of practice, what they're gonna do in the operational environment to take care of combat casualties.

01:04:20.780 --> 01:04:36.470 Beck, Leslie (OS/ASPR/EMMO) Q&A: Thank you. On Page 6, for project period length are both years meant to be 2025? That is correct, though one is up to three years and the other is up to five years. For this, we've made them both three years for guidance from OGC.

01:04:39.370 --> 01:04:47.680 Beck, Leslie (OS/ASPR/EMMO) Q: Are we only providing documents outlined in the NOFO or is this an addition to standard DoD attachments required for an application?

01:04:50.610 --> 01:05:11.450 Beck, Leslie (OS/ASPR/EMMO) A: I'm not exactly sure what that means, but I would include all documents that you have. We definitely need the DoD agreement with your package to even qualify for the grant to be forwarded to the panel. Q: Is the project abstract included in the 20 page limit or is that only the narrative and those components?

01:05:12.400 --> 01:05:15.230 Beck, Leslie (OS/ASPR/EMMO) I'm going to go to the NOFO: And read the 20 page limit includes Background current capacity approach and work plan, administrative preparedness plan execution, budget, narrative and justification, performance measurement and evaluation strategy.

01:05:39.120 --> 01:05:54.710 Beck, Leslie (OS/ASPR/EMMO) What does not count towards the 20 page limit is C's letter of commitment copy of the applicant's recent indirect cost agreement and other documents as needed. So, for example, the DoD agreement. So that's on pages 11 and 12 of the nofo.

01:06:22.860 --> 01:06:25.450 Howard Pryor (Guest) Q: Is there any interest in trauma experience with Pediatrics since they represent a a fraction of the downrange patients in the JTS.

01:06:48.260 --> 01:07:00.990 Peggy Knudson A: I can answer that I can answer that. Jennifer. Yes, there is an interest because it's, you know it's it occasionally required for the in the deployed environment. So yes, pediatric trauma is of interest.

01:07:08.090 --> 01:07:21.040 Beck, Leslie (OS/ASPR/EMMO) Q&A: OK, some of the application or some of the chat asked for. If we're looking for rotational educational planning for certain types of military trauma providers, which we already had talked about FT we were looking for full time.

01:07:22.600 --> 01:07:26.070 Beck, Leslie (OS/ASPR/EMMO) Q&A: Who is the DoD point of contact for preliminary? Because it's about agreement information, that would be myself. Leslie beck@hs.gov and I will work with DoD.

01:08:32.340 --> 01:08:35.330 Beck, Leslie (OS/ASPR/EMMO) Q&A: When you write your proposal, can you apply for both options? Yes.

01:09:01.240 --> 01:09:21.990 Cummings, Lynn Q: There is a separate upload for a budget narrative form in addition to the project narrative. I think that's what's confusing everybody. We know that the budget narrative and justification has to be part of the 20 pages for the project narrative, but there's an additional attachment asked for that's called a budget narrative. So can someone help explain that?

01:09:30.220 --> 01:10:00.930 Brown, Nancy (OS/ASPR/ORM) Hi this is. Yeah, this is me again. So that's a standard format for our when we put documents in grants.gov for grantees and like I mentioned earlier, I didn't know that it was when this particular fella it was included as a part of the narrative. So what you can do is put a comment in on the if you have your budget narrative as part of your the the 20 pages, then I'm gonna open up the comments. And so you could just state in the comments section when you upload your packet.

01:10:01.020 --> 01:10:09.170 Brown, Nancy (OS/ASPR/ORM) That it is included in the 20 pages. So when we pull all the packets over, you won't get dinged for that because we will know that it's inside your application.

01:10:27.480 --> 01:10:33.100 Ariel Medoff Q: Yeah, I just one quick question. So should we list the sponsor is DoD or HHS?

01:10:39.560 --> 01:10:41.080 Beck, Leslie (OS/ASPR/EMMO) A: The grant goes through HHS.

01:10:41.590 --> 01:10:43.230

01:11:00.160 --> 01:11:07.110 Beck, Leslie (OS/ASPR/EMMO) All right, so I don't see any further hands up. I'm going to go back to the DoD and see if they have any closing remarks.

01:11:11.180 --> 01:11:30.320 Sarady Tan (Guest) Thank you for everyone for your interest and again, we're attempt to try to provide as much information as we can for you all, but understand that this is the first time for our program and so we would have to rely on our teammate it and ask to kind of refine some of the mechanics. But we look forward to the opportunity to expand the jointness between our DoD as well as our civilian partnership going forward. So again appreciate you all telling me and that's a Gurney. Anything else over?

01:11:41.020 --> 01:11:43.050 Jennifer Gurney No. Concur with everything you said. Well said.

01:11:46.220 --> 01:12:09.550 Beck, Leslie (OS/ASPR/EMMO) Great. Thank you everybody for getting on the call. I see that I have quite a few emails from this call, which I'll need to answer with the DoD. So expect questions to be answered next week so that we can collaborate together and make sure that we're giving similar the same answers to everybody. And then I would ask Nancy to upload those onto grants.gov so that everyone has the same opportunity to see the questions and see the answers.

01:12:10.300 --> 01:12:15.660 Beck, Leslie (OS/ASPR/EMMO) So thank you everybody for getting on the call and we'll talk with you soon. Thank you. Everyone's free to drop.