PKG00252428-instructions.docx

U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response Office of Emergency Management and Medical Operations National Disaster Medical System

Funding Opportunity Announcement and Grant Application Instructions

Funding Opportunity Title: Pediatric Disaster Care Centers of Excellence

CFDA# 93.889

Funding Opportunity Number: EP-U3R-19-002 Application Due Date: August 27, 2019 at 11:59 p.m. ET Optional Letter of Intent Due Date: July 15, 2019 at 11:59 p.m. ET

Announcement Type: Cooperative Agreement Funding Opportunity Number: EP-U3R-19-002

Contents

I. FUNDING OPPORTUNITY DESCRIPTION

Statutory Authority Section 311(c)(1) of the Public Health Service Act, as amended

BACKGROUND:

Government Agency The Office of the Assistant Secretary for Preparedness and Response (ASPR) is a staff division within the Office of the Secretary, U.S. Department of Health and Human Services (HHS). ASPR leads the nation’s efforts to prevent, protect against, mitigate, respond to and recover from the adverse health effects of public health incidents. ASPR focuses on preparedness planning and response; federal emergency medical operational capabilities; medical countermeasures research, advance development, and procurement; and grants to strengthen the capabilities of hospitals and health care systems to prepare for, respond to, and recover from disasters and other public health emergencies and disasters [hereinafter referred to as “disasters”].

Executive Summary Children represent 25 percent of the U.S. population and face specialized medical issues due to their unique developmental and physiologic characteristics. Pediatric care requires specialized equipment, supplies, and pharmaceuticals. While specialized pediatric hospitals provide excellent care for children on a day-to-day basis, special consideration needs to be given to providing pediatric care during public health emergencies and disasters, such as mass casualty incidents. Though much progress has been made in this area, significant gaps in pediatric disaster readiness remain.[footnoteRef:2] These gaps are most evident in highly specialized areas such as trauma[footnoteRef:3],[footnoteRef:4] emerging infectious disease (EID)[footnoteRef:5], exposures to chemical, biological, radiological, and nuclear (CBRN) agents,[footnoteRef:6] and behavioral health. [2: Emergency Medical Services for Children: Pediatric Readiness, Results and Findings. https://emscimprovement.center/projects/pediatricreadiness/results-and-findings/ ] [3: Nance, M. L., Carr, B. G., & Branas, C. C. (2009). Access to pediatric trauma care in the United States. Arch Pediatr Adolesc Med, 163(6), 512-518. doi: 10.1001/archpediatrics.2009.65] [4: Myers, S. R., Branas, C. C., French, B., Nance, M. L., & Carr, B. G. (2019). A National Analysis of Pediatric Trauma Care Utilization and Outcomes in the United States. Pediatr Emerg Care, 35(1), 1-7. doi: 10.1097/pec.0000000000000902] [5: National Advisory Committee on Children and Disasters: Near-Term Strategies to Improve Pediatric Surge Capacity During Infectious Disease Outbreaks. https://www.phe.gov/Preparedness/legal/boards/naccd/meetings/Documents/naccd-surge-capacity-rpt042815.pdf, April 2015] [6: National Advisory Committee on Children and Disasters: Pediatric Disaster Training Report, September 2018. https://www.phe.gov/Preparedness/legal/boards/naccd/Documents/naccd-pdt-recommendations.pdf ]

ASPR envisions that this funding opportunity announcement (FOA) is part and parcel to a multiyear plan to address pediatric disaster care needs as ASPR aims to address known gaps in pediatric disaster care of all pediatric patient populations by augmenting the existing clinical capabilities within states and across multi-state regions. Future elements of the vision would include field equipment, mobile medical facilities, telemedicine, and training and education.

Through this FOA, ASPR will support the creation of up to two Pediatric Disaster Care Centers of Excellence (COE) that will serve as pilot sites. The pilots will build upon the existing foundations for pediatric clinical care (e.g. pediatric hospitals, state Emergency Medical Services for Children (EMSC) programs, etc.) and emergency response (e.g. healthcare coalitions, etc.) by enhancing coordination mechanisms and incorporating relevant capabilities at the local, state and regional levels. The pilots are intended to define the delivery of pediatric clinical care when existing referral patterns and health care delivery capacity and capabilities are compromised by catastrophic events. The pilots will enable the rapid sharing of assets and expertise throughout the state and region and ensure that a well-trained cohort of highly specialized pediatric clinical care providers are available for onsite care and remote consultation. The needs of all pediatric patient populations, including children with special health care needs, and their parents and caregivers will be considered.

This FOA funds demonstration projects that will help identify issues, develop best practices, and demonstrate the potential effectiveness and viability of this concept. COEs will be expected to develop and/or improve their capability and capacity to provide highly specialized care to pediatric patients within and outside their own region through the pursuit of the objectives of this announcement. To be maximally successful in the project period, recipients should have existing pediatric preparedness capabilities and the capacity to manage pediatric patients within their own state and within a self-defined multi-state region[footnoteRef:7] during a disaster. [7: For the purposes of this FOA, “region” is defined as a geographic area that is inclusive of at least two states within the applicant’s respective HHS region. Applicants must define the geographic region intended to be served under this FOA in their application. ]

Purpose The purpose of this FOA is to fund two COEs to:

1. Develop a coordinated pediatric disaster care capability for pediatric patient care in disasters;

2. Strengthen pediatric disaster preparedness plans and health care system coordination related to pediatric medical surge in disasters;

3. Enhance statewide and regional medical surge capacity for pediatric patients;

4. Increase and maintain health care professional competency through the development and delivery of a standardized training program; and

5. Enhance situational awareness of pediatric disaster care capabilities and capacity and assess regional pediatric readiness.

Specific focus will be given to the management of pediatric care related to trauma, infectious diseases including pandemic influenza (PI) and other EID, burn, and CBRN incidents.

Implementation Recipients must address all activities and strategies listed below in their application. Where possible, it is expected that recipients will pursue sustainable, long-term solutions and identify plans beyond the pilot phase. The two recipients are required to collaborate, coordinate, plan, and work directly together on Activity D to provide unified and comprehensive educational and training deliverables and Activity E, Strategies 1-3. Recipients may coordinate with each other on additional activities; however, each recipient is required to develop their own pediatric disaster response capability.

Activity A: Develop a coordinated pediatric disaster care capability for pediatric patient care in disasters Strategy 1: Define the core elements of a pediatric disaster care capability and identify the respective contributions of regional partners and other available assets.

· Identify statewide and regional risks and vulnerabilities related to the clinical management of pediatric patients during disasters.

· Identify the essential capabilities and capacity required to ensure effective and safe management of pediatric patients within the state and multi-state region during a disaster, specifically capability and capacity for the management of pediatric patients requiring highly specialized care (e.g. trauma, infectious diseases including PI and other EID, burn, and CBRN care).

· Compare the identified requirements with existing resources in the state and multi-state region to identify where there are capability and capacity gaps that can be filled by the regional pediatric disaster care system, including any gaps in health care resources and service that are vital to continuity of pediatric health care delivery during a disaster (e.g. clinical services, infrastructure, supply chain, caches, health care workforce, etc.).

· Ensure the capability includes, at minimum:

· a coordinated mechanism for patient movement within the state and multi-state region;

· a shared understanding of likely referral patterns for critically ill or injured pediatric patients who require highly specialized care (e.g. trauma, PI/EID, burn CBRN);

· an inventory of potential sources of paid or volunteer emergency health care workers;

· a plan for the use of telemedicine for augmentation of existing capability and capacity;

· and provisions for supply chain management and the distribution of equipment, supplies, and other resources throughout the state and region, specifically related to disasters; pre-, during, & post-.

Strategy 2: Develop a partnership with pediatric health care entities, disaster response entities, other relevant entities (e.g., supply chain vendors/distributors), and subject matter experts (e.g., pediatric professional medical organizations) across the region that are necessary to facilitate statewide and regional pediatric disaster health care response.

Specific focus of this partnership should be on building the response capabilities required for the coordinated regional care of pediatric patients in disasters, including as related to the management of pediatric trauma, infectious disease (including PI and other EID), burn, and CBRN incidents.

· Identify and build the necessary relationships to enable statewide and regional coordination of pediatric medical care in disasters.

· Collaborators should include, at minimum:

· hospitals (including critical access hospitals, a Level I pediatric trauma center, a Level IV neonatal intensive care unit, a Level I pediatric intensive care unit), and a pediatric emergency department;

· emergency medical services (EMS) (including inter-facility and other non-EMS patient transport systems);

· emergency management organizations;

· public health agencies;

· State EMSC programs;

· primary and urgent care facilities;

· obstetric and pediatric care providers;

· healthcare coalitions;[footnoteRef:8] [8: For the purposes of this FOA, reference to healthcare coalitions refer to ASPR’s Hospital Preparedness Program (HPP) healthcare coalitions. https://www.phe.gov/Preparedness/planning/hpp/Pages/default.aspx ]

· Federal health care facilities; and

· experts in pediatric emergency care, disaster medicine, trauma, infectious disease (including PI and other EID), burn, toxicology, and CBRN incidents.

Activity B: Strengthen pediatric disaster preparedness plans and health care system coordination related to pediatric medical surge in disasters Strategy 1: Review and update existing disaster preparedness plans and annexes to ensure they incorporate pediatric considerations

· Convene relevant partners to collectively inventory existing disaster preparedness plans and identify gaps related to statewide and regional coordination of pediatric patients, including plans related to pediatric triage, surge, and/or evacuation.

· Recommend guidelines and draft language to facilitate the alignment of disaster plans throughout the state and multi-state region and ensure the incorporation of pediatric considerations.

· Provide technical assistance and expertise to state and regional partners interested in updating their plans, and support the development of Pediatric Annexes in statewide and regional preparedness plans, seeking concurrence from appropriate officials/entities where appropriate.

· Educate state and regional pediatric health care providers regarding considerations for conventional, contingency, and crisis standards of care for pediatric populations and provide recommendations for the inclusion of these considerations into disaster plans.

Strategy 2: Explore legal and policy coordination and alignment.

· Identify laws, regulations, and policies that impact the establishment of regional (i.e. multi-state) coordination of pediatric health care in disaster planning and response, and explore mechanisms to overcome any identified barriers to allow for regional coordination of pediatric assets during disaster planning and response.

· Identify and explore mechanisms to resolve potential conflicts related to coordination of pediatric health care assets (e.g. patient movement, patient tracking, expertise and resource sharing, and policy support) across the region.

Activity C: Enhance statewide and regional medical surge capacity for pediatric patients Note: The funds provided under this FOA are not eligible to cover costs associated with providing clinical care.

Strategy 1: Develop regional capability to provide highly specialized clinical care for pediatric patients including children with special health care needs.

· Develop a tiered regional pediatric disaster care capability for the state and region to ensure that pediatric care sites are not overwhelmed by large numbers of pediatric patients or a rapid influx of highly clinically complex pediatric patients.

· Develop the regional capability and capacity to manage pediatric patients with trauma, infectious diseases including PI and other EID, burn, and CBRN incidents.

· Develop the regional capability to manage the psychosocial/behavioral health needs of pediatric patients and their caregivers during and after disasters.

Strategy 2: Develop a regional deployable pediatric response capability

· Identify methods to utilize existing pediatric response expertise in the state and region and deploy it through specialized pediatric medical teams to support pediatric medical surge in large-scale and highly specialized disaster scenarios. Include capability and capacity in the deployable response team to effectively manage pediatric patients with trauma, infectious diseases including PI and EID, burn, and CBRN.

· Develop a model and plan for the establishment, deployment, and sustainment of specialized pediatric medical teams to respond to disasters within the region that result in significant numbers of pediatric casualties.

· Identify and document regional mobile/deployable equipment, supplies, and clinical capabilities (e.g., personnel, pediatric equipment, pharmaceutical needs) required to effectively manage and treat pediatric patients during disasters.

· Identify available interstate medical resources and personnel (e.g. Emergency Medical Assistance Compact, etc.) so that they may be rapidly shared across state lines.

· Ensure the availability and rapid acquisition of pediatric supplies and equipment in disasters by participating in healthcare coalitions’ supply chain vulnerability assessments and working with other relevant partners as necessary.

Strategy 3: Coordinate with entities within and outside of the region to develop a model for pediatric telemedicine and telementoring capability

· Demonstrate how pediatric critical care medical direction, oversight, and guidance may be provided during a medical surge response by using telemedicine and telementoring[footnoteRef:9]. [9: American Academy of Pediatrics, Telementoring program helps health professionals provide specialized care. 2019. https://www.aappublications.org/news/2019/02/22/projectecho022219 ]

· Identify methods to utilize existing response expertise (e.g. National Ebola Training and Education Center, Radiation Injury Treatment Network, trauma, etc.), including pediatric care expertise (e.g. pediatric mental and behavioral health, trauma, etc.), through telemedicine or other technological platforms to support medical surge in large-scale and highly specialized disaster scenarios throughout the state and region.

· In addition to the clinical services described, consider and provide solutions to potential challenges related to operational/logistical requirements, dependencies (i.e., electrical grid), regulatory considerations (i.e., licensing, credentialing, Health Insurance Portability and Accountability Act (HIPAA)), professional liability coverage, workforce/on-call requirements, payment for services, and technology (i.e., interoperability and connectivity).

Strategy 4: Assess and enhance pediatric tracking, transport, and reunification capabilities within the state and multi-state region.

· Convene relevant partners to discuss whether bi-directional inter-facility and interstate transport (including aeromedical and ground critical care transport) plans have been developed for pediatric patients, and identify any shortcomings in existing pediatric patient evacuation and relocation plans across the region, particularly as related to the transport and care of pediatric patients who require highly specialized care (e.g. trauma, burn, PI/EID, and CBRN).

· Explore and document if and how electronic medical records or health information exchanges (HIEs) can improve existing patient tracking and transport capabilities and develop a model for an improved regional pediatric patient tracking and transport system.

· Develop a state and regional capability for family notification and reunification of pediatric patients who arrive unaccompanied or are evacuated or discharged out of health care settings during disasters. Include processes for collecting detailed descriptions of unaccompanied minors and designating safe locations for children awaiting reunification and address any ambiguity surrounding laws and decision-making processes regarding the treatment of non-critical pediatric patients in a disaster without parental consent.

Activity D: Increase and maintain health care professional competency through the development and delivery of a standardized training program Each COE will be a resource for the broader health care sector in providing expert training and technical assistance related to providing pediatric care during disasters. Recipients should consider collaboration with other entities that provide resources related to pediatric care, such as the National Center for Disaster Medicine and Public Health, and ASPR’s Technical Resources Assistance Center & Information Exchange (TRACIE) to promote a comprehensive, unified pediatric training program for the health care community.

Strategy 1: Educate and train the health care and medical workforce on identified preparedness and response gaps related to the clinical management of pediatric patients.

· Identify basic elements to be included in a standardized training program for medical response personnel (e.g. state-sponsored medical teams, deployable teams developed under Activity C, etc.), health care providers (e.g. prehospital providers, pediatricians and obstetricians, family medicine providers, emergency medicine physicians, etc.), and medical volunteers as it relates to the management of pediatric patients during disasters.

· The training program must align with current and relevant published guidance, evolving scientific and clinical evidence based research, and reflect standard treatment protocols and procedures for pediatric disaster care.

· Where training gaps exist, develop educational materials including training curricula, just-in-time training modules, and train-the-trainer modules to complete the training program.

· Consider, in particular, training related to management of pediatric patients exposed to CBRN, PI, EID, burn, and trauma. Additionally, training should include considerations for the behavioral and mental health impact that disasters may have on the pediatric population, parents, caregivers, and first responders/health care workforce.

· Include training for health care and public health personnel, EMS, and other necessary partners regarding disclosures allowed under HIPAA and other applicable laws in disasters.

· Include guidance and best practices on how to best use FDA-approved treatments in pediatric populations, with special consideration to emergency medical countermeasures.

· Include guidance, training, and protocols for movement and transport of pediatric patients.

· Document whether existing pediatric triage and treatment protocols related to the management of pediatric patients during a disaster require revision or updates.

· Develop in-person and online courses that will enable health care workers to obtain continuing education credit appropriate to their discipline.

· Demonstrate how just-in-time (JIT) training may be provided to increase health care worker resilience as required for response to different hazards (e.g., CBRN) and by professionals of different clinical specialty expertise.

· Develop training with regional team capability (Activity C) to ensure familiarization with the equipment and supplies, and treatment protocols and procedures.

Strategy 2: Provide expert training and technical assistance

· Build capacity for the provision of training and technical assistance related to, at a minimum, the management of pediatric patients exposed to pediatric trauma, infectious disease (including PI and other EID), burn, and CBRN incidents.

· Develop internal and external evaluation tools to allow for tracking the number of participants trained, demographic information of participants, whether there is a demonstrated increase in knowledge, and participant confidence to apply the skills learned when appropriate.

· Develop a mechanism to allow facilities to submit requests for subject matter expert based technical assistance.

Strategy 3: Develop an open-access online resource repository

· Establish an online, centralized and searchable repository to support dissemination of timely and relevant materials. At minimum, the online repository should contain all educational and training resources, and templates developed under this FOA.

· Disseminate, as appropriate, updated or newly available materials to health care providers and facilities.

Per the HHS grant regulations at 45 CFR part 75.322(b), the awardee may copyright any work that is subject to copyright and was developed, or for which ownership was acquired, under this award (in this and all other sections of the FOA). ASPR reserves a royalty-free, nonexclusive and irrevocable right to reproduce, publish, or otherwise use the work for Federal purposes, and to authorize others to do so.

Activity E: Enhance situational awareness of pediatric disaster care capabilities and capacity and assess regional pediatric readiness Strategy 1: Improve regional situational awareness

· Define the essential elements of information (EEI) related to pediatric trauma, infectious disease (including PI and other EID), burn, and CBRN incidents (1) to be shared in an emergency to facilitate medical surge response; (2) necessary for patient movement and tracking; and (3) necessary for regional health care situational awareness and decision-making

· Explore the role of integration of these EEI into interoperable health information technology systems and HIEs Strategy 2: Develop regional pediatric readiness metrics

· Develop regional readiness metrics that measure a region’s pediatric readiness to effectively respond to and treat the pediatric population during disasters and public health emergencies, with particular emphasis on the ability to manage the impact of CBRN agents, burn, EID, PI, and trauma.

· Metrics should address regional assets, risks, and vulnerabilities related to the clinical management of pediatric patients during disasters, to include an inventory of health care resources and services that are vital to continuity of pediatric health care delivery during a disaster (e.g. clinical services, infrastructure, supply chain, caches, health care workforce, etc.). Metrics should address the regional level of readiness to respond to for potential disaster scenarios with varying levels of impact and scale, to include large-scale, mass casualty events (e.g., pediatric trauma, infectious disease (including PI and other EID), burn, and CBRN incidents).

Strategy 3: Create a regional readiness self-assessment tool

· Create a regional pediatric disaster readiness self-assessment tool based on identified metrics (Activity E, Strategy 2) to establish a benchmark and identify areas of opportunity for future development of pediatric readiness. The tool should be made available to other regions to conduct self-assessments.

Strategy 4: Conduct regional exercise(s) to test capabilities

· Conduct at least one readiness exercise (minimum, tabletop exercise) during the project period utilizing CBRN and EID scenarios that measures the readiness of the region’s pediatric surge capacity, to include mobile team and telemedicine capabilities, validates plans, and demonstrates the ability to coordinate pediatric health care service delivery at the regional level.

· Develop templates for exercises, after-action reports, and corrective action and improvement plans that can be adapted and used to practice scenarios including, but not limited to CBRN and EID scenarios with a pediatric clinical care component. Such resources should be made readily available via the online repository.

· Complete after-action reports (Attachment F) and corrective action plans (Attachment G) based on the exercise(s).

Additional Requirements Project Meetings

· Kick Off and Quarterly Meetings (with Government). The recipient and the Government shall participate in project meetings to coordinate the performance of the cooperative agreement. These meetings may include face-to-face meetings at the recipient site or ASPR/HHS facilities. Such meetings may include, but are not limited to, meetings to discuss technical approach, operational capabilities, and regulatory and ethical aspects of the program. These meetings will also serve to formulate and agree upon the activities for the subsequent three months. In order to facilitate review of agreement activities, it is expected that the recipient will provide data, reports, and presentations to ASPR and/or other HHS or U.S. Government personnel as requested by the project officer. Dates for these meetings will be determined post-award.

· Bi-weekly Teleconferences. A conference call between ASPR and the recipient shall occur every two weeks or as directed by the ASPR project officer. During this call, the recipient will discuss the activities during the reporting period, any problems or challenges that have arisen, and the activities planned for the ensuing reporting period. Any relevant key project personnel may participate on the conference call to give detailed updates on specific project activities, or the ASPR project officer may make this request. The recipient will maintain a table of expected activities, an actions log, and an identified risk log as a means of managing and conducting these teleconferences. The quarterly meeting may be held in lieu of the monthly teleconference at the discretion of the ASPR project officer.

· Quarterly Meetings of the Recipients. Recipients funded under this cooperative agreement shall meet quarterly. To the extent possible, representatives from supporting organizations and additional partners may also participate. The purpose of these meetings is to identify and understand roles and responsibilities, formulate and agree on the activities for the subsequent three months, perform a progress check on the activities in the work plan, undergo a budget review, troubleshoot any barriers or challenges related to completing the deliverables of this cooperative agreement, and prepare for kick-off and quarterly meetings with ASPR and/or other HHS or U.S. Government personnel. These meetings may be conducted virtually (e.g. phone- or web-conference) or in-person.

Reporting Requirements

· The recipient will be required to submit quarterly progress reports, including an end of year report using the template provided in Attachment E.

· The recipient will be required to submit an annual After Action Report and Corrective Action Plan as a result of the exercise(s) conducted as part of Activity E using the templates in Attachments F and G, respectively.

II. AWARD INFORMATION

The Federal Grant and Cooperative Agreement Act of 1977, 31 U.S.C. 6305, defines the cooperative agreement as similar to a grant in that a thing of value is transferred to a recipient to carry out a public purpose. However, a cooperative agreement is used whenever substantial federal involvement with the recipient during performance is anticipated. The difference between grants and cooperative agreements is the degree of federal programmatic involvement rather than the type of administrative requirements imposed. This award is subject to the recipient(s) and collaborative requirements and responsibilities set forth in the Cooperative Agreement outlined in the program announcement under this funding opportunity and are hereby incorporated by reference as terms and conditions of this award.

Substantial federal involvement by the HHS may include but is not limited to the following functions and activities:

1. In accordance with applicable laws, regulations and policies the authority to take corrective actions if detailed performance specifications (e.g. activities in this funding guidance; approved work plan activities; budgets; performance measures and reports) are not met.

2. Review and approval of work plans and budgets before work can begin on a project during the period covered by this assistance or when a change in scope of work is proposed.

3. Review of proposed contracts.

4. Involvement in the evaluation of key recipient personnel supported through this assistance.

5. HHS and recipient collaboration or joint participation in the performance of the activities supported through this assistance.

6. Monitoring to permit specified kinds of direction or redirection of the work because of interrelationships with other projects.

7. Substantial and/or direct operational involvement or participation during the performance of the assisted activity prior to award of the cooperative agreement to ensure compliance with such generally applicable statutory requirements as civil rights, environmental protection, and provision for the handicapped.

The direct and primary recipient in a cooperative agreement program must perform a substantial role in carrying out project objectives and not merely serve as a conduit for an award to another party or provider who is ineligible. Applicants who are successful in obtaining awards under this solicitation will be eligible to compete for additional demonstration project awards, should funding be available. As with all federal grants future offerings are dependent on the availability of appropriated funds in subsequent fiscal years and a decision that funding is in the best interest of the Federal government.

ASPR may award all or part of the funds, up to $6 million dollars subject to availability of funds.

III. ELIGIBILITY INFORMATION

Eligible Applicants Eligible applicants are limited to one or more public or private hospitals and/or corporate health systems. For the purposes of this FOA, a corporate health system is defined as an organized, coordinated, and collaborative network that (1) links various health care providers, via common ownership or contract, across three domains of integration – economic, noneconomic, and clinical – to provide a coordinated, vertical continuum of services to a particular patient population or community, and (2) is accountable both clinically and fiscally for the clinical outcomes and health status of the population or community served, and has systems in place to manage and improve them.[footnoteRef:10] [10: Integrated Delivery Systems: The Cure for Fragmentation. AJMC, 15 Dec. 2009. Web. Accessed 20 Jul. 2016. www.ajmc.com/journals/supplement/2009/a264_09dec_hlthpolicycvrone/a264_09dec_enthovens284to290/ ]

Recipients funded under this cooperative agreement will collaborate, coordinate, plan, and work directly together on appropriate activities described in this FOA.

Special Requirements Required Letters of Support The applicant will:

· Submit letters of support from the following agencies/organizations with the application package:

· State Department of Health or State Hospital Association within the applicant’s state and at least one additional state in the applicant’s defined region

· State Office of Emergency Management within the recipient’s state

· State Office of Emergency Medical Services within applicant’s state

· Children’s Hospital[footnoteRef:11] within at least one additional state in the applicant’s defined region [11: In this instance, “Children’s Hospital” is defined as: Self-governing, not-for-profit children's hospitals that care for patients with conditions normally requiring a stay of less than 30 days; Pediatric units of not-for-profit medical institutions caring for patients normally requiring stays of less than 30 days and serving as the primary teaching sites of organized pediatric departments of approved medical schools; or Not-for-profit medical institutions each with a pediatric graduate education program affiliated with a medical school, but not the primary teaching site, and having a minimum daily pediatric census of 45 and recognition as a pediatric referral center. https://www.childrenshospitals.org/About-Us/Membership

All letters should have a point of contact listed, as ASPR may conduct random reference verifications. In addition, letters should emphasize any past performance of coordinating with the respective organization.

Desired Letters of Support Awardees should also collaborate with the following individuals and entities within the state, at minimum, throughout the course of the project period. While letters of support from these entities are not required as part of the application package, applicants will receive additional credit in the application scoring criteria for additional letters of support:

· Acute Care Hospitals/Medical Centers within the applicant’s state or at least one additional state in the applicant’s defined region

· State Office of Emergency Management within at least one additional state in the applicant’s defined region

· State Office of Emergency Medical Services within at least one additional state in the applicant’s defined region

IV. COST SHARING AND MATCHING

Cost Sharing and Match Requirements There is no cost sharing or match requirement for this project.

V. APPLICATION AND SUBMISSION INFORMATION

Address to Request Application Package Application materials can be obtained from http://www.grants.gov.

Contact person regarding this Funding Opportunity Announcement is: Virginia Simmons, Virginia.Simmons@hhs.gov.

Required Registrations Applicants must register with the System for Award Management (SAM) and Grants.gov (see below for all registration requirements).

1. GET REGISTERED

You are required to complete three (3) registration processes:

1. Dun & Bradstreet Data Universal Numbering System (to obtain a DUNS number);

2. System for Award Management (SAM);and

3. Grants.gov If this is your first time submitting an application, you must complete all three registration processes. If you have already completed registrations for DUNS and SAM, you need to ensure that your accounts are still active, and then register in Grants.gov. If your organization is not registered by the deadline, the application will not be accepted.

The organization must maintain an active and up-to-date SAM and DUNS registrations in order for ASPR to make an award.

1.1 Dun & Bradstreet Data Universal Numbering System (DUNS) Registration Applicants are required to obtain a valid DUNS Number, also known as the Unique Entity Identifier, and provide that number in the application. Obtaining a DUNS number is easy and there is no charge.

To obtain a DUNS number, access the Dun and Bradstreet website at: http://www.dnb.com or call 1-866-705-5711. To expedite the process, let Dun and Bradstreet know that you are a public/private nonprofit organization getting ready to submit a federal grant application. The DUNS number you use on your application must be registered and active in the System for Award Management (SAM).

1.2 System for Award Management (SAM) Registration

You must also register with the System for Award Management (SAM) and continue to maintain active SAM registration with current information during the period of time your organization has an active federal award or an application under consideration by an agency. To create a SAM user account, Register/Update your account, and/or Search Records, go to https://www.sam.gov.

It is also highly recommended that you renew your account prior to the expiration date. SAM information must be active and up-to-date, and should be updated at least every 12 months to remain active (for both recipients and sub-recipients). Once you update your record in SAM, it will take 48 to 72 hours to complete the validation processes. Grants.gov rejects electronic submissions from applicants with expired registrations.

1.3 Grants.gov Registration

Grants.gov is an online portal for submitting federal grant applications. It requires a one-time registration in order to submit applications. While Grants.gov registration is a one-time only registration process, it consists of multiple sub-registration processes (i.e., DUNS number and SAM registrations) before you can submit your application.

You can register to obtain a Grants.gov username and password at http://www.grants.gov/web/grants/register.html.

If this is your first time submitting an application through Grants.gov, registration information can be found at the Grants.gov “Applicants” tab.

The person submitting your application must be properly registered with Grants.gov as the Authorized Organization Representative (AOR) for the specific DUNS number cited on the SF-424 (first page). See the Organization Registration User Guide for details at the following Grants.gov link: http://www.grants.gov/web/grants/applicants/organization-registration.html.

Application Screening Criteria Applications that fail to meet the screening criteria described below will not be reviewed and will receive no further consideration.

Applications should be submitted electronically via http://www.grants.gov no later than 11:59 p.m. Eastern Time on August 27, 2019.

Applications that do not meet the following responsiveness criteria will be administratively eliminated and will not be reviewed:

· Applications submitted after the due date and time will not be reviewed.

· Applications submitted by non-eligible entities will not be reviewed.

· Applications submitted by entities that do not meet the eligibility criteria will not be reviewed.

· Applications failing to include the required forms will not be reviewed.

· Applications that fail to submit the required letters of support will not be reviewed.

· ASPR will not accept applications with a Project Narrative that exceeds 12 pages. NOTE: The Letters of Support, budget narrative and justification forms, Curriculum Vitae (CV)/Biosketch of Key Project Personnel and Other Relevant Appendices (e.g. partner table, statement of funding preference, Attachment C) are not counted as part of the Project Narrative for purposes of the 12-page limit. Any narrative drafted to accompany Attachment C and fulfill the required “Work Plan and Timeline of Proposed Activities” section of the project narrative will be included in the 12 pages.

Content and Form of Application Submission The following documents and sections must be submitted to ASPR in your proposal in order to be considered for funding. Required forms are available on http://www.grants.gov within the application package:

· Application for Federal Assistance – Standard Form SF 424

· Budget Information – Standard Form SF 424A

· Assurances (Non-Construction Programs) - Standard Form SF 424B Section 1.0 Project Narrative The Project Narrative must be double-spaced, on 8 ½” x 11” paper with 1” margins on top, left, right, and bottom, Calibri or Times New Roman font, point size of not less than 11. You can use smaller point sizes to fill in the Standard Forms and Sample Formats. Page numbers, footnotes, running heads, and other information that is generally located in the header or footer of the page may be placed in the margins; any citations should be collated and attached as an appendix that does not count toward the 12 page limit; you may use any citation style (e.g. APA, AMA, MLS, etc.) but please use the same style throughout the submission. ASPR will not accept applications with a Project Narrative that exceeds 12 pages.

The sub-components of the Project Narrative counted as part of the page limit include:

1.1 Overview

1.2 Work Plan and Timeline of Proposed Activities – these plans must be in narrative form and may be accompanied by an additional table (see Attachment C for suggested format that will not be counted as part of the page limitation). Any narrative submitted to meet this required section will be counted as part of the page limitation. Applicants should provide their proposed approach that addresses all activities and strategies in both the narrative and the optional Attachment C.

1.3 Organizational Capability – the organizational capability section should be in narrative and/or chart form, at the discretion of the applicant. Any forms submitted to meet this required section will be counted as part of the 12 page limitation.

1.4 Evaluation and Performance Measurement Plan (EPMP) – these plans may be in narrative or chart form (see Attachment D for suggested guidelines). Any forms submitted to meet this required section will be counted as part of the 12 page limitation.

Any Other Relevant Appendices that do not count toward the page limit include:

· Key Personnel CV/Biosketch – Key personnel and any technical consultants that are part of this project. Key Personnel are defined as all individuals who contribute in a substantive, meaningful way to the scientific development or execution of the project, whether or not salaries are requested. Each CV or Biosketch should be no more than 2 pages each, and while there is no required format, CVs or Biosketches should be double-spaced, on 8 ½” x 11” plain white paper with 1” margins on all sides, Calibri or Times New Roman font and a point size of not less than 11. CVs or Biosketches should clearly convey the required qualifications of personnel and include the specialized expertise and experience that personnel’s affiliated health care entity exhibits to complete the activities and strategies under the cooperative agreement.

· Letters of Support – of required supporting organizations listed in the Special Requirements section

· Budget Narrative – see suggested format in Attachment B

· Other documents and required forms, as needed – this includes the Standard Form 424, Standard Form 424A, and Standard Form 424B

· Attachment C – the required narrative for the Work Plan and Timeline of Proposed Activities will count toward the page limit, but the use of Attachment C (or a modified version of it) does not The Project Narrative is the most important part of the application, since it will be used as the primary basis to determine whether or not the project meets the minimum requirements of this cooperative agreement. The Project Narrative should provide a clear and concise description of the project. ASPR recommends that the project narrative include the following sub-components:

1.1 Overview

This section provides a brief but comprehensive (no more than 2 pages) summary of the application. Because the overview is often distributed to provide information to the public and Congress, please prepare a narrative that is clear, accurate, concise, and without reference to other parts of the application. This section should be succinct, self-explanatory and well organized so that reviewers can understand the proposed project, including a summary of the overall goal of the project, proposed activities, the defined geographic area being served, timelines, and deliverables.

1.2 Work Plan and Timeline of Proposed Activities

Each proposed activity within the proposal should have clear timelines for execution and completion. The Project Work Plan must be in narrative form and should reflect and be consistent with the proposal Overview and the proposal Budget and Justification. The narrative should cover the entire project period and all activities and strategies. It should include a statement of the project’s overall goal, anticipated outcome(s), key objectives, and the major tasks/action steps that will be pursued to achieve the goal and outcome(s). For each major task/action step, the work plan should identify timeframes involved, and the lead person responsible for completing the task. In addition to the required narrative, applicants may use the optional Work Plan format included in Attachment C.

1.3 Organizational Capability

The organizational capability statement should describe how the applicant agency is organized, the nature and scope of their work and/or the capabilities possessed to successfully implement the proposed project activities and strategies. It should include a description of the roles and responsibilities of any key personnel, consultants, and partner organizations and how they will contribute to achieving the project’s objectives and outcomes. If applicable, applications should include a description of any infrastructure already in place in which to build on to meet project goals/requirements and a description of any relevant past performance of coordinating with pediatric health care entities across the state/region, including a description of previous collaborations with the supporting organizations and additional partners that have provided the required or desired letters of support in the application package. It should include a relevant description of the capabilities and experience of any of the supporting organizations and additional partners that have provided letters of support as part of the application process.

1.4 Evaluation and Performance Measurement Plan

At the time of application, recipients must include in their project narrative a brief description of how they plan to fulfill the requirements described in the “Work Plan and Timeline of Proposed Activities” and “Evaluation and Performance Measurement Plan” sections of this FOA. Recipients also must briefly outline the scope of work, planned activities, and intended outcomes of work performed via any sub-awardee contracts.

The EPMP is a written document describing the overall approach that will be used to guide an evaluation, including why the evaluation is being conducted, how the findings will likely be used, and the design and data collection sources and methods. The EPMP specifies what will be done, how it will be done, who will do it, and when it will be done. The EPMP evaluation plan is used to describe how the recipient and/or ASPR will determine whether activities are implemented appropriately and outcomes are achieved.

The EPMP should track progress related to the proposal objectives, activities, tasks, and outcomes that the applicant is promising to deliver. The EPMP should describe how outcomes are achieved, and how these outcomes are related to the required performance measures in the Award Administration Information/Reporting Requirements section.

ASPR does not require recipients to follow a specific EPMP template but provides sample guidelines for developing an EPMP in Attachment D.

Section 2.0 Appendices

2.1 Personnel

Please attach Personnel CV/Biosketch for key personnel and any technical consultants that are part of this project. Key Personnel are defined as all individuals who contribute in a substantive, meaningful way to the scientific development or execution of the project, whether or not salaries are requested. Key personnel must include, at minimum, a designated Medical Director that meets or exceeds the following qualifications:

· Physician with a current in-state license and demonstrated pediatric clinical experience.

· Board Certified in an American Board of Medical Specialties recognized pediatric specialty and clinically active.

· Familiarity with EMS, Emergency Management and Public Health laws and regulations.

· Education and/or experience with mass casualty, bioterrorism, Nuclear, Biological Chemical, Weapons of Mass Destruction (WMD) and/or disaster preparedness.[footnoteRef:12] [12: While the position’s job responsibilities and salary are designed to encompass work of a .25 FTE, the expectation of the employer is not limited to a set number of work hours, but rather the completion of all necessary tasks to meet the objectives of the grant that would naturally be attributed to the chief clinician.]

Each CV or Biosketch should be no more than 2 pages each, and while there is no required format, CVs or Biosketches should be double-spaced, on 8 ½” x 11” plain white paper with 1” margins on all sides, and a font size of not less than 11.