PKG00256622-instructions.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Bureau of Health Workforce Division of Medicine and Dentistry

Postdoctoral Training in General, Pediatric, and Public Health Dentistry

Funding Opportunity Number: HRSA-20-005

Funding Opportunity Type(s): Competing Continuation, New

Assistance Listings (CFDA) Number: 93.059

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2020

Application Due Date: February 12, 2020

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

HRSA will not approve deadline extensions for lack of registration.

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

Issuance Date: November 13, 2019

Jennifer Holtzman, D.D.S., M.P.H.

Dental Officer, Bureau of Health Workforce Telephone: (301) 945-3368 Fax: (301) 443-8890 Email: JHoltzman@hrsa.gov

Authority: Title VII, Sec. 748 of the Public Health Service Act mailto:JHoltzman@hrsa.gov

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EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for fiscal year (FY) 2020 Postdoctoral Training in General, Pediatric, and Public Health Dentistry program. The purpose of this grant program is to improve access to, and the delivery of, oral health care services for all individuals, particularly low income, underserved, uninsured, underrepresented minority, health disparity, and rural populations. This program provides funds to plan, develop, operate, and participate in, approved postdoctoral training programs in the fields of general dentistry, pediatric dentistry, and dental public health that improves the health of these populations.

The FY 2020 President’s Budget does not request funding for this program. This notice is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds in a timely manner. You should note that this program may be cancelled prior to award.

Funding Opportunity Title: Postdoctoral Training in General, Pediatric, and Public Health Dentistry Funding Opportunity Number: HRSA-20-005 Due Date for Applications: February 12, 2020 Anticipated Total Annual Available FY 2020 Funding:

$13,000,000

Estimated Number and Type of Awards: Up to 28 grants Estimated Award Amount: Up to $450,000 per year-single discipline

Up to $650,000 per year-collaborative, multi-discipline Subject to the availability of appropriated funds

Cost Sharing/Match Required: No Period of Performance: July 1, 2020 through June 30, 2025

(5 years) Eligible Applicants: Eligible entities include entities that have programs in dental schools, or approved residency or advanced education programs in the practice of general, pediatric or public health dentistry, which may include dental schools, public or private not-for-profit hospitals, or other public or private non-profit entities, including faith-based and community-based organizations.

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

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Application Guide

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

Technical Assistance

HRSA will hold a pre-application technical assistance (TA) webinar(s) for applicants seeking funding through this opportunity. The webinar(s) will provide an overview of pertinent information in the NOFO and an opportunity for applicants to ask questions.

Visit the HRSA Bureau of Health Workforce’s open opportunities website at https://bhw.hrsa.gov/fundingopportunities/default.aspx to learn more about the resources available for this funding opportunity.

http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf https://bhw.hrsa.gov/fundingopportunities/default.aspx

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Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING/MATCHING

3. OTHER

IV. APPLICATION AND SUBMISSION INFORMATION

1. ADDRESS TO REQUEST APPLICATION PACKAGE

2. CONTENT AND FORM OF APPLICATION SUBMISSION

i. Project Abstract

ii. Project Narrative

iii. Budget

iv. Budget Justification Narrative

v. Attachments

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

SYSTEM FOR AWARD MANAGEMENT

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSMENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

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I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Postdoctoral Training in General, Pediatric, and Public Health Dentistry Program.

Program Purpose The purpose of the Postdoctoral Training in General, Pediatric, and Public Health Dentistry program is to improve access to, and the delivery of, oral health care services for all individuals, particularly vulnerable populations and individuals located in rural and/or underserved areas. Grants under this NOFO will prepare general, pediatric, and public health dentists to practice in, and lead, new models of oral health care delivery by supporting innovative postdoctoral dental residency training programs.

Program Goals The NOFO supports the development or enhancement of existing residency training programs to incorporate and test new and innovative models of care delivery for rural, underserved and vulnerable populations.

You may apply for funding to plan, develop and implement projects in community-based training sites that focus on one or more of the following three areas:

1) caring for underserved and/or vulnerable populations,

2) developing/expanding rural training sites, or

3) dental public health.

Program Objectives There are several objectives of this program:

• increase the ability of dentists to care for the needs of patients with complex medical needs and address the social determinants of oral health,

• increase the number of dentists trained to manage oral health programs, evaluate systems of care, and design surveillance systems to measure oral health status,

• improve the training of, or increase the number of, primary care dentists trained in postdoctoral training programs located in rural areas, and

• increase the number of postdoctoral trained primary care dentists (general, pediatric, and public health dentistry) who choose to practice in rural and/or underserved areas or with vulnerable populations.

HHS and HRSA Priorities You are encouraged to address one of the clinical priorities below which include HHS’s and HRSA’s priorities for combatting the opioid crisis and improving value based care as well as other HRSA priorities.

• Combatting the opioid crisis/improving Mental health

• Value-based care delivery and quality improvement initiatives

• Transforming the workforce – targeting the need

• Telehealth

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• Childhood obesity

• Maternal mortality

2. Background

This program is authorized by Title VII, Sec. 748 of the Public Health Service Act. For more information about the Postdoctoral Training in General, Pediatric, and Public Health Dentistry program or other Oral Health Workforce Development programs at the Bureau of Health Workforce, go to https://bhw.hrsa.gov/grants/oralhealth.

Approximately 48 percent of dental school graduates go into private practice, 36 percent pursue residencies, 4 percent go into the public sector, for example through employment at a Federally Qualified Health Center (FQHC), a non-profit clinic or with the U.S. Public Health Service (USPHS), and the remaining 12 percent have less easily categorized choices (e.g., unsure, U.S. Armed Forces, other dental positions, government service, academics, other student learning, non-dental related positions).1 Most dental school graduates have provided comprehensive care to less than 10 individuals and few have experience with advanced services at the time of their graduation.2 Given this, it is not surprising that many seek additional training. Fifty-four percent of dental school graduates go into general practice residencies (General Practice Residency or Advanced Education in General Dentistry) and less than 12 percent enter into a pediatric postdoctoral training program. According to the American Dental Association’s Survey of Advanced Dental Education3 for the Academic Year (AY) 2017- 2018, the demand for residencies was significantly greater than the supply (from 7 to 20 times more). It is likely that many more dental graduates would pursue postdoctoral training if it were available and did not add significant debt, as many dental residency programs charge tuition.

Caring for Vulnerable and Underserved Populations The demand for additional training in general practice/primary care dentistry may reflect graduates’ recognition of the gaps in their training to address the needs of patient populations. Though the supply of dentists is projected to grow at the national level, there is still a need to implement strategies that improve access to care for particularly underserved populations and communities4 such as special needs, medically complex, and the aging.5,6 Estimates indicate there will be more people 65 and older than under the age of 18 by 2035.7 While dental schools recognize the need for their trainees to

1 American Dental Education Association. (November 2018). ADEA Survey of Dental School Seniors, 2018 Graduating Class Tables Report. Table 27. Washington, D.C. accessed from https://www.adea.org/data/seniors/ 1.3.2019.

2 Formicola AJ, Bailit HL. Community-based dental education: History, current status, and future. J Dent Educ. Jan 2012:76(1):98.

3 There were 11,213 applications to the 181 General Practice Residency (GPR) programs (1,123 slots), 5,821 applications to the 89 Advanced Education in General Dentistry (AEGD) residency programs (791 slots), and 9,597 applications to the 80 pediatric dentistry programs (463 slots). https://www.ada.org/en/science-research/health-policy-institute/data-center/dental-education.

4 Surdu S, et al. The Pediatric dental workforce in 2016 and beyond. J Amer Dent Assoc 2019:150(7):609 5 Giddon DB, et al. Should Dental Schools Train Dentists to Routinely Provide Limited Preventive Primary Care? J Dent Educ May 2017:81(5):561.

6 Lee DR, et al. Understanding functional and social risk characteristics of frail older adults: a cross –sectional survey study. BMC Fam Pract Oct 2018:19(1):170.

7 https://www.census.gov/newsroom/press-releases/2018/cb18-41-population-projections.html.

https://bhw.hrsa.gov/grants/oralhealth https://www.adea.org/data/seniors/ https://www.ada.org/en/science-research/health-policy-institute/data-center/dental-education https://www.ada.org/en/science-research/health-policy-institute/data-center/dental-education https://www.census.gov/newsroom/press-releases/2018/cb18-41-population-projections.html

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have more preparation in primary care skills, they often lack the capacity to include more clinical training in primary care particularly in caring for individuals with complex medical needs.8 Therefore, dental professionals initially attracted to primary care dental practice may become discouraged by the demands and seek a non-primary care career, a trend also found in medicine.9 Primary care postdoctoral dental training can provide an important mechanism to address gaps in predoctoral education with more training in comprehensive dental services, interdisciplinary, and interprofessional approaches to address the needs of patients with complex medical needs, and benefit from population-based training including the social determinants of oral health.10,11

Link Between Dental HPSAs and Rural Areas The number of Dental Health Professional Shortage Areas (HPSA) have increased to 5,304 in 201912 from 4,670 in 201113 and are disproportionately in rural areas. HRSA estimates over 7,000 dental providers are needed to remove those designations.14 Large metropolitan areas have 83 dentists per 100,000 population while rural counties have about 30 per 100,000.15 Fifty-nine percent of dental HPSAs are located in rural areas.16 With less providers, residents in rural communities are more likely to have more untreated tooth decay, have lost teeth, and are more vulnerable to the non-dental consequences of poor oral health (lower quality of life, difficulty finding/maintaining employment, higher mortality).17,18 The recent meeting of the National Advisory Committee on Rural Health and Human Services noted the value of increasing the mentoring and training of oral health professionals in rural communities.19 Primary care postdoctoral programs in rural areas bring more oral health providers to a community, increasing access to preventive and comprehensive care, and may encourage oral health professionals to ultimately practice in rural communities, as has been found in medical training programs.20,21 Community Health Centers and hospitals in towns with populations of roughly 10,000 to 50,000 persons may have sufficient number of patients to be able to support dental practices,22 and may be able to make relatively modest

8 Jiang T et al. Interprofessional education in dental schools: results of a national survey. Journal of Interprofessional Education & Practice, https://doi.org/10.1016/j.xjep.2019.04.001 9 Whitcomb ME, Cohen JJ. The future of primary care medicine. N Engl J Med. Aug 2004:351(7):710.

10 https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Oral-Health/data.

11 https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/healthlittoolkit2.html.

12 Third Quarter of Fiscal Year 2019 Designated HPSA Quarterly Summary, June 30, 2019. Accessed 7.18.2019.

13 Third Quarter of Fiscal Year 2011 Designated HPSA Quarterly Summary, June 30, 2011. Accessed 7.18.2019.

14 U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. National and State-Level Projections of Dentists and Dental Hygienists in the U.S., 2012-2025. Rockville, Maryland, 2015.

15 Rural Health Research Gateway – www.ruralhealthresearch.org 16 Third Quarter of Fiscal Year 2019 Designated HPSA Quarterly Summary, June 30, 2019. Accessed 7.18.2019.

17 RG Watt, et al. Health disparities in Children: a canary in the coalmine. Ped Clin of N Amer 2018:65(5):965.

18 Henshaw MW, Garcia RI, Weintraub JA. Oral Health Disparities across the life span. Dent Clin of N Amer 2018:62(2):177.

19 National Advisory Committee on Rural Health & Human Services, Policy Brief. December 2018: Improving Oral Health Care Services in Rural America. Available at: https://www.hrsa.gov/advisory-committees/rural-health/publications/index.html 20 Lopez N, Sager J, Gonzaga A. Dental and Dental Therapy Students’ Perspectives on How to Build Interest in and Commitment to Rural Dentistry. J Dent Educ August 2019: 83(8):946.

21 Farmer J, Kenny A, McKinstry C, Huysmans RD. A scoping review of the association between rural medical education and rural practice location. Human Resources for Health. 2015:13:27.

22Rural Health Research Center Final Report #135, June 2015. Dentist Supply, Dental Care Utilization, and Oral Health Among Rural and Urban U.S. Residents. Available at:

http://depts.washington.edu/uwrhrc/uploads/RHRC_FR135_Doescher.pdf.

https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Oral-Health/data https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/healthlittoolkit2.html https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/healthlittoolkit2.html https://www.hrsa.gov/advisory-committees/rural-health/publications/index.html https://www.hrsa.gov/advisory-committees/rural-health/publications/index.html http://depts.washington.edu/uwrhrc/uploads/RHRC_FR135_Doescher.pdf

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changes to existing infrastructure to house a sustainable residency program. Through their affiliation with academic programs, rural residencies can also address some of the challenges faced by current rural health providers - access to specialty expertise and training. These affiliations may decrease the sense of isolation for the rural health provider and improve the quality of care for the rural population served.

Dental Public Health Dental Public Health (DPH) focuses on preventing and controlling dental diseases and promoting dental health through organized community efforts and serving the community as a patient. The practice of DPH requires skills not taught in depth in dental schools such as public health administration, research methodology, and the delivery and financing of oral health care. Therefore, before an individual can even be accepted to most DPH programs they must have already completed a Master’s in Public Health. DPH is a small, but vital specialty; as of July 2019, there were only 164 active DPH professionals across the nation.23 These professionals play vital roles in public health dentistry as leaders in the USPHS Commissioned Corps and federal government agencies, as dental school deans and department chairs; and as leaders in state dental offices, health insurance companies and health systems.

There are currently only 15 active DPH programs across the nation.24 In 2018, there were 195 applications and 38 slots filled for this specialty.25 Often, the choice to pursue a DPH specialty is made by individuals wishing to pursue a career in public service or in the public sector. Gaining particular traction have been DPH programs offering training in combination (e.g., pediatric/dental public health) to better prepare individuals for careers that could include a clinical care component, which this program supports. The Postdoctoral Training in General, Pediatric, and Public Health Dentistry program is currently the only federal program to provide direct financial support to DPH programs.

Program Definitions A glossary containing general definitions for terms used throughout the Bureau of Health Workforce NOFOs can be located at the Health Workforce Glossary. In addition, the following definitions apply specifically to the Postdoctoral Training in General, Pediatric, and Public Health Dentistry Program for Fiscal Year 2020:

Interprofessional (or collaborative) Care (IPC) – occurs when multiple health workers from different professional backgrounds provide comprehensive health services by working with patients, their families, carers [caregivers], and communities to deliver the highest quality of care across settings. (WHO, 2010).

Other Health Care Trainees – other health professions trainees who will train alongside or are trained by the primary trainees as part of the interprofessional training, such as medical residents, nursing students, etc.

23 American Board of Dental Public Health. https://www.aaphd.org/abdph. Accessed 8.15.2019 24 https://www.ada.org/en/science-research/health-policy-institute/data-center/dental-education. SADV 2018-19 .

Table 3: Applications1, Enrollment, Graduates, and Number of Accredited Advanced Dental Education Programs, 2018-19. Accessed 8.15.2019 25 Ibid.

https://bhw.hrsa.gov/grants/resourcecenter/glossary https://www.aaphd.org/abdph https://www.ada.org/en/science-research/health-policy-institute/data-center/dental-education

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Primary Trainees – residents in General Dentistry, Pediatric Dentistry, or Dental Public Health residency programs that are being trained through the proposed program.

Primary Care Dentistry – For the purposes of this NOFO, primary care dentistry is defined as general dentistry, pediatric dentistry, dental public health or dental hygiene.

School of Public Health – an accredited public or nonprofit private school in a State that provides training leading to a graduate degree in public health or an equivalent degree. (See Sec 799B(1)(A) of the Public Health Service Act)

Team-Based Care – care delivered by intentionally created work groups of at least two health providers, who are recognized by others as well as by themselves as having a collective identity and shared responsibility for a patient, group of patients, their families, and/or communities to improve health outcomes. Characteristics of team-based care include: respect for diversity of skills and knowledge of team members, an open environment in which to raise concerns and make suggestions, an emphasis on comprehensive patient care and quality improvement, and team member willingness to take on additional roles and responsibilities.

Vulnerable Populations – populations at increased susceptibility for poor medical, mental, and oral health outcomes that are influenced by conditions such as disparate healthcare access, healthcare quality, and genetic, personal, behavioral, environmental, socioeconomic, and community risk factors. Vulnerable populations include older adults, homeless individuals, individuals with mental health or substance-related disorders, individuals with disabilities, and people living with HIV.

II. Award Information

1. Type of Application and Award

Type(s) of applications sought: Competing Continuation, New.

HRSA will provide funding in the form of a grant.

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2. Summary of Funding

HRSA expects approximately $13,000,000 to be available annually to fund up to 28 recipients. You may apply for a ceiling amount of:

• Up to $450,000 per year (inclusive of direct and indirect costs) for an application that includes accredited residency programs in one of the following disciplines:

general dentistry, pediatric dentistry, or dental public health; or

• Up to $650,000 per year (inclusive of direct and indirect costs) for a collaborative, multi-discipline application in at least two of the following disciplines: general dentistry, pediatric dentistry, or dental public health. One residency would be identified as the primary residency and serve as the applying entity. The applying entity must include in their proposed application significant collaboration to include joint planning and implementation of proposed activities and include “collaboration” as one of the grant objectives.

The FY 2020 President’s Budget does not request funding for this program. The actual amount available will not be determined until enactment of the final FY 2020 appropriation. This program notice is subject to the appropriation of funds, and is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds in a timely manner.

The period of performance is July 1, 2020 through June 30, 2025 (5 years). Funding beyond the first year is subject to the availability of appropriated funds for the Postdoctoral Training in General, Pediatric, and Public Health Dentistry Program in subsequent fiscal years, satisfactory recipient performance, and a decision that continued funding is in the best interest of the Federal Government.

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

Limitations on indirect cost rates.

Indirect costs under training awards to organizations other than state, local or Indian tribal governments will be budgeted and reimbursed at 8 percent of modified total direct costs rather than on the basis of a negotiated rate agreement, and are not subject to upward or downward adjustment. Direct cost amounts for equipment, tuition and fees, and subawards and subcontracts in excess of $25,000 are excluded from the direct cost base for purposes of this calculation.

http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75

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III. Eligibility Information

1. Eligible Applicants

Eligible entities include entities that have programs in dental schools, or approved residency or advanced education programs in the practice of general, pediatric, or public health dentistry, which may include dental schools, or public or private not-for-profit hospitals.

Public or private non-profit hospitals or other public or private non-profit entities, including faith-based and community-based organizations, as well as Tribes and Tribal organizations, are eligible to apply for these funds as long as they can carry out such grants and are otherwise eligible.

All training activities must be conducted within a postdoctoral training program accredited by the Commission on Dental Accreditation (CODA). Applicants can propose to develop an accredited program however, either the applicant or a partner organization responsible for the training should be an accredited program in general dentistry, pediatric dentistry, or dental public health by July 1, 2021. HRSA will check the CODA website for accreditation confirmation. Accreditation must be maintained continuously throughout the grant period. For programs applying for a planning year, initial accreditation must be received at or before, July 1, 2021, and maintained for the remainder of the project period.

2. Cost Sharing/Matching

Cost sharing/matching is not required for this program.

3. Other

Ceiling Amount HRSA will consider any application that exceeds the ceiling amount of up to $450,000, per year, for a single discipline or up to $650,000, per year, for a collaborative, multi-discipline application non-responsive and will not consider it for funding under this notice.

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

Maintenance of Effort The recipient must agree to maintain expenditures of non-federal amounts for award activities at a level that is not less than the level of such expenditures maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives the award, as required by Sec. 797(b) of the Public Health Service Act (U.S.C. 295n–2(b)).

Complete the Maintenance of Effort information and submit as Attachment 6.

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Multiple Applications NOTE: Multiple applications from an organization are not allowable. Institutions with more than one interested and eligible program should consider submitting one collaborative application.

If for any reason (including submitting to the wrong funding opportunity number or making corrections/updates) an application is submitted more than once prior to the application due date, HRSA will only accept your last validated electronic submission, under the correct funding opportunity number, prior to the Grants.gov application due date as the final and only acceptable application.

Failure to include all required documents as part of the application may result in an application being considered incomplete or non-responsive.

Beneficiary Eligibility Requirements Financial support for residents is an allowable expense under this program. Residents receiving financial support must 1) be a citizen of the United States, a non-citizen national, or a foreign national having in his/her possession a visa permitting permanent residence in the United States, 2) demonstrate need of the support, and 3) plan to work in the practice of general dentistry, pediatric dentistry, or dental public health.

Planning Year A planning year is allowed. However, funded proposals must have primary trainees being trained through funded grant activities by the beginning of the second budget period, July 1, 2021. Applications choosing to develop new formal partnerships with rural or tribal health clinics/hospitals or those applications proposing new tracks within rural and/or underserved areas are encouraged to consider this option.

IV. Application and Submission Information

1. Address to Request Application Package

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

The NOFO is also known as “Instructions” on Grants.gov. You must provide your email address when reviewing or preparing the workspace application package in order to receive notifications including modifications and/or republications of the NOFO on Grants.gov before its closing date. You will also receive notifications of documents placed in the RELATED DOCUMENTS tab on Grants.gov that may affect the NOFO and your application. Responding to an earlier version of a modified notice may result in a less competitive or ineligible application. Please note you are ultimately responsible for reviewing the For Applicants page for all information relevant to desired opportunities.

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

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2. Content and Form of Application Submission

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

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

Application Page Limit The total size of all uploaded files may not exceed the equivalent of 65 pages when printed by HRSA. The page limit includes the abstract, project and budget narratives, attachments including biographical sketches (biosketches), and letters of commitment and support required in HRSA’s SF-424 R&R Application Guide and this NOFO.

Standard OMB-approved forms that are included in the workspace application package do not count in the page limit. Biographical sketches do count in the page limitation.

Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count in the page limit. We strongly urge you to take appropriate measures to ensure your application does not exceed the specified page limit.

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

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

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

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

3) Where you are unable to attest to the statements in this certification, an explanation shall be included in Attachment 11: Other Relevant Documents.

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

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

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Program-Specific Instructions

Program Requirements Applicants must apply for funding to plan, develop and implement projects in community-based training sites that focus on one or more of the following three areas:

Focus Area 1 (Underserved and Vulnerable Populations):

Preparing dentists to provide care for underserved communities and/or vulnerable populations by developing and testing new training and delivery models in community-based clinical training sites or enhancing existing ones.

This should include an emphasis on serving those with complex medical and dental issues. Examples include:

• Developing or enhancing integrated oral and primary care clinical training sites;

• Developing or enhancing training to prepare residents to enter into, and lead, community-based service sites; and

• Developing and implementing clinical training to care for underserved communities, vulnerable populations, or populations located in rural communities.

Focus Area 2 (Rural Training Sites):

Preparing dentists to provide care in rural communities, by developing and testing new training and delivery models in community-based clinical training sites or enhancing existing ones. Developing or expanding rural dental training sites for postdoctoral training programs in primary care dentistry with the purpose of preparing dental residents to practice in rural areas. Examples include:

• Developing new or expanded primary care dental residencies within rural training sites through formal partnerships between rural or tribal health clinics/hospitals and academic centers;

• Developing sustainable, GME-eligible, rural or tribal primary care dental residencies; and

• Developing new primary care dental rural rotation sites through formal partnerships between rural or tribal health clinics/hospitals and schools of dental medicine.

Focus Area 3 (Dental Public Health):

Developing and testing new or enhanced training in dental public health.

Applications should include didactic and experiential training to provide dentists with the skills to assess population needs and use data to drive health system processes. Examples include:

• Using data to develop sustainable models of accessible oral health services for underserved and vulnerable populations;

• Assessing needs of vulnerable populations within a community, formulating, and implementing policy/programmatic options including evaluation to determine impact; and

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• Developing or enhancing a Dental Public Health residency program that combines clinical exposure and business management practices with research elements.

All recipients, regardless of choice of focus area, will be encouraged to develop or enhance training sites for postdoctoral dental trainees in integrated safety net health care delivery systems such as community health centers located in a Dental HPSA or serving underserved populations. Utilization of telehealth systems for the purpose of increasing access to oral health services in safety net sites and for the delivery of training is encouraged. Additionally, applications may include some faculty development for the purpose of preparing program completers for roles as community-based clinician educators and mentors.

Applicants are encouraged to target programs towards dentists who are likely to provide care for underserved groups and communities. Successful award recipients require all trainees to obtain National Provider Identifier (NPI) numbers to aid long-term assessment of the program’s impact on access and delivery of quality oral health care services. Trainees who receive HRSA funds through this award must apply for an NPI for the purpose of collecting post-completion employment demographics, and grantees are required to report the NPI numbers for all individuals participating in the program to

HRSA.

Eligible entities may partner with schools of public health to permit the education of dental residents for a master’s year or a certificate in public health at a school of public health. Programs must identify residents who will be enrolled in a Masters of Public Health program prior to acceptance. Programs may use dedicated match or non-match slots. The Masters of Public Health programs must either be 1) completed after acceptance to the program, but prior to the actual specialty residency training, or 2) demonstrate a well-integrated MPH curriculum within the residency program curriculum.

Proposals may include training, including an MPH, to enhance the population health knowledge and skills of existing faculty engaged in teaching residents.

The use of a planning year is allowed. Applications choosing to develop new formal partnerships with rural or tribal health clinics/hospitals or those applications proposing new tracks within rural and/or underserved areas are encouraged to consider this option.

Per the recommendation of the Advisory Committee on Training in Primary Care Medicine and Dentistry, “to leverage funding streams to reduce barriers and foster programmatic collaboration,”26 HRSA has designed the Postdoctoral Training in General, Pediatric, and Public Health Dentistry program to give primary care dental residents experience and competency in areas that make them more likely to serve in underserved areas. The National Health Service Corps (NHSC) is committed to strengthening the primary care workforce through the recruitment and retention of high quality primary care providers through its scholarship and loan repayment programs in exchange for a commitment to serve in a HPSA. Therefore HRSA encourages awarded

26 Advisory Committee on Training in Primary Care Medicine and Dentistry. Training Health Professionals in Community Settings During a Time of Transformation: Building and Learning in Integrated Systems of Care.

December, 2014.

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programs to strongly consider participants in the NHSC Scholarship Program and NHSC Students to Service (S2S) Loan Repayment Program (LRP) for their residency programs.

Applicants are strongly encouraged to describe how they will provide information to residents throughout their program about the NHSC, especially the loan repayment program, and how they will connect program graduates to the HRSA Health Workforce Connector and other existing support resources so they can obtain primary care employment with entities serving rural and/or underserved populations or areas, preferably in community-based clinical settings, including NHSC approved sites and in HPSAs after they graduate.

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

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

In addition to the instructions provided in the guide, please include the following information at the top of the abstract

• Period of performance

• The name and credentials of the project director

• The name of the training program

• Discipline(s) of the residency program

• Organization website

• Planning year, if applicable

The Abstract must include:

1. A brief overview of the project as a whole, to include which Focus Area(s) are addressed;

2. Specific, measurable objectives that the project will accomplish;

3. Which of the clinical priorities will be addressed by the project, if applicable;

4. How the proposed project for which funding is requested will be accomplished, i.e., the "who, what, when, where, why and how" of a project;

and

5. Identify the requested funding priority or priorities, as applicable.

ii. Project Narrative

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

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

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

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PURPOSE AND NEED -- Corresponds to Section V’s Review Criterion #1

Briefly describe the purpose of the proposed project, what you plan to accomplish and the needs it will address. Use and cite data whenever possible to support the information provided.

Describe the current state of the health care delivery system that will serve as a training site for your training program. Identify specific gaps in your current training program that will be addressed through the proposed training program.

Discuss the needs of the specific community/communities in which the proposed training will take place and identify those that will be addressed through your proposed training program. You should include a discussion of the target population served by this segment of the health workforce, as well as the socio-cultural determinants of health and health disparities impacting the population or communities served and/or unmet. Provide documentation of demographics and other relevant data that demonstrate it is an underserved or rural community and describe how these needs are reflective of needs at the State or national level.

Describe gaps in the current oral health care workforce, particularly in the proposed targeted disciplines, including training needs. Describe how the program is relevant at the national or State level. Explain how developing the proposed training will address the health workforce gaps you have identified.

RESPONSE TO PROGRAM PURPOSE -- This section includes three sub-sections

— (a) Work Plan; (b) Methodology/Approach; and (c) Resolution of Challenges—all of which correspond to Section V’s Review Criteria #2 (a), (b), and (c).

(a) WORK PLAN -- Corresponds to Section V’s Review Criterion #2 (a).

You must provide a detailed work plan that demonstrates your experience implementing a project of the proposed scope (a sample work plan can be found here: http://bhw.hrsa.gov/grants/technicalassistance/workplantemplate.docx). You must:

• Describe the key milestones for each task or activity, timeframe for completion, and a description of your staff responsible to achieve each of the objectives proposed during the entire period of performance identified in the Methodology section. Be sure to include evaluation and dissemination activities, any needed facility improvements for the training environment, and any non-grant funded construction or renovations envisioned.

• Describe your process to track trainees after program completion/ graduation for up to five years to assess career choices. At a minimum this must include tracking trainees’ NPIs.

• Describe any plans to consider NHSC Scholars or S2S LRP recipients for your program.

http://bhw.hrsa.gov/grants/technicalassistance/workplantemplate.docx

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• Describe any plans to recruit, retain, and help place residents in rural and/or underserved areas.

• Describe the timeframes, deliverables, and key partners that will be required during the grant period of performance to address each of the needs described in the Purpose and Need section.

• Explain how the work plan is appropriate given the program design and how the targets fit into the overall timeline of grant implementation.

• Identify meaningful support and collaboration with key stakeholders in planning, designing and implementing all activities, including development of the application and, further, the extent to which these contributors reflect the populations and communities served.

• If funds will be sub-awarded or expended on contracts, describe how your organization will ensure the funds are properly documented.

You must also include an annual training chart that indicates the number of trainees you plan to train through the proposed activities in Attachment 11: Other Relevant Documents. The chart must include information on the following:

• Information on the Primary Trainees that will be trained through the grant.

For each discipline include the following:

o the number of primary care residents (General Dentistry, Pediatric

Dentistry or Dental Public Health) you propose to train each year, o the number of primary care residents you project to complete the program each year, o the projected number of primary care residents in your recruitment, retention, and placement plan, if applicable, o the number of individuals who are underrepresented minorities you project to train each year, as applicable, o the number of residents from a rural or disadvantaged background you project to train each year, as applicable, o the number of veterans you project to train each year, o estimated number of primary care residents receiving public health training, and o the estimated number of primary care residents you will train to work collaboratively with other health professionals.

• Other Health Care Trainees (see Program Definitions in Section I.2):

o the expected number of other health professions trainees, by discipline, that will receive training alongside your Primary Trainees during each year of the project period, o the number of partnerships with community-based organizations actively contributing to primary care resident training, as applicable, o the number of primary care dental training program partnerships providing interprofessional training, and o the number and discipline of other health professionals trained to address oral health needs.

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Please note that grant funds may not be used to plan a training program solely for Other Health Care Trainees or to provide financial assistance to Other Health Care Trainees.

(b) METHODOLOGY/APPROACH -- Corresponds to Section V’s Review Criterion #2 (b).

Clearly indicate which Focus Area(s) your proposal addresses and how the proposed activities align with them.

Within each Focus Area, describe, in detail, your proposed project goals, objectives, and intended outcomes. Objectives should be specific, measurable, realistic, and achievable within the project period. Clearly relate the project goals and objectives to the overall purpose of your proposed project. Describe the key activities proposed for accomplishing project goals and objectives including, but not limited to, any proposed didactic or clinical curricula to be developed or enhanced and any proposed changes to the clinical learning environment.

Clearly describe how your proposed project addresses the requirements noted in the focus area(s) for which you are applying. Indicate how the project goals and objectives address the identified needs of the training program and those of the community in which the training will take place. Discuss how the proposed methodology will prepare postdoctoral dentists to provide care for specified vulnerable and/or underserved groups or communities. Provide evidence supporting the proposed methodologies. Provide the context and explain why your project is new or an enhancement of your current program.

Identify the key partner organizations, departments, or programs involved and describe how you will function and coordinate carrying out the grant activities.

Describe partnerships with primary care delivery organizations and other community-based organizations.

As appropriate, include development of effective tools and strategies for ongoing staff training, outreach, collaborations, clear communication, and information sharing/dissemination with efforts to involve patients, families and communities, if applicable.

Include a plan to disseminate reports, products, and/or project outputs so project information is provided to key target audiences.

The methodology should include a description of the Primary Trainees (see Program Definitions in Section I.2) and the accredited programs they will be drawn from, how any training in integrated, interdisciplinary teams will be structured and what other disciplines will be included, and any didactic or clinical curricula to be developed or enhanced. Also include any initiatives to assist the transition of trainees into practice in evolving delivery models for underserved communities, and how the initiative is expected to facilitate transition of trainees into practice.

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Specific only to Focus Area 3: Clearly describe the didactic and experiential training proposed and how it will provide residents with the skills to assess population health needs and use data to drive health programs and system processes.

For all Focus Areas, describe any planned innovative programs to encourage or support Primary Trainees underrepresented in dentistry, such as certain minorities, individuals from rural or disadvantaged backgrounds, and/or veterans.

Programs should be designed to help these Primary Trainees to apply for, and be successful in, oral health professional training programs. If applying for Priority 3 (Student Background), applicants may describe how this innovative plan will improve the institution’s record of training individuals who are from a rural, disadvantaged background, or an underrepresented minority.

Include in your description the recruitment, retention, and placement strategies and activities to be employed and any partnerships or outreach to existing programs or institutions.

Discuss how your program will facilitate placement of Primary Trainees in rural and/or underserved areas. At a minimum, applicants must describe how the applicant will use the HRSA Health Workforce Connector and other existing employment resources to help program completers not looking for academic positions, find jobs in rural and/or underserved settings, preferably in community-based settings.

If support for a Master in Public Health degree for residents is proposed, indicate what school(s) of public health you are partnering with, how it will operate, and how eligibility for such support will be determined.

Describe any needed…