PKG00260689-instructions.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Bureau of Health Workforce Division of Nursing and Public Health

Nurse Education, Practice, Quality and Retention (NEPQR) Simulation Education

Training (SET) Program

Funding Opportunity Number: HRSA-20-110 Funding Opportunity Type(s): New

Assistance Listings (CFDA) Number: 93.359

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2020

Application Due Date: June 1, 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: April 1, 2020

Kirk Koyama, MSN, RN, PHN, CNS Nurse Consultant Division of Nursing and Public Health Bureau of Health Workforce Telephone: (301) 443-4926 Email: kkoyama@hrsa.gov

Authority: 42 U.S.C. § 296p and 42 U.S.C. § 296p-1 (Public Health Service Act, Sections 831 and 831A) mailto:kkoyama@hrsa.gov

HRSA-20-110 i

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for Fiscal Year (FY) 2020 Nurse Education, Practice, Quality and Retention (NEPQR) - Simulation Education Training (SET) Program. The purpose of this program is to enhance nurse education and strengthen the nursing workforce through the expansion of experiential learning opportunities. This includes using simulation-based technology, including equipment, to advance the health of patients, families, and communities in rural and medically underserved areas experiencing diseases and conditions that affect public health such as: high burden of stroke, heart disease, behavioral and mental health, maternal mortality, HIV/AIDS, and/or obesity. This program intends to strengthen the capacity of undergraduate public health nursing students to address the complex health care needs of those living in rural and medically underserved areas as authorized by Public Health Service (PHS) Act sections 831 and 831A. The program seeks to accomplish this, through expanding the use of technology-based learning to meet the needs of rural and underserved populations.

Funding Opportunity Title: Nurse Education, Practice, Quality and

Retention (NEPQR)-Simulation Education Training (SET) Program

Funding Opportunity Number: HRSA-20-110 Due Date for Applications: June 1, 2020

Anticipated Total Annual Available FY 2020 Funding:

$2,000,000

Estimated Number and Type of Award(s): Up to four cooperative agreement(s)

Estimated Award Amount: Up to $500,000 (Fully funded at the outset for use over the period of performance)

Cost Sharing/Match Required: No Period of Performance: September 1, 2020 through

August 31, 2022 (2 years)

Eligible Applicants: Eligible applicants include accredited schools of nursing, health care facilities, or a partnership of such a school and facility.

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

HRSA-20-110 ii

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

HRSA-20-110 iii

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

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

APPENDIX I

HRSA-20-110 1

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Nurse Education Practice Quality and Retention (NEPQR)-Simulation Education Training (SET) Program.

Program Purpose The NEPQR-SET program aims to enhance to enhance nurse education and strengthen the nursing workforce through the expansion of experiential learning opportunities, including the use of simulation-based technology, including equipment, to advance the health of patients, families, and communities in rural and medically underserved areas experiencing diseases and conditions that affect public health such as: high burden of stroke, heart disease, behavioral and mental health, maternal mortality, HIV/AIDS and or obesity.

Program Goals The NEPQR-SET program seeks to expand the use of experiential learning and innovative simulation-based technology to strengthen the capacity of undergraduate public health nursing students to better address population health outcomes in rural and underserved areas.

Program Objective The objective of the NEPQR-SET program is to strengthen the capacity of undergraduate public health nursing students to address complex public health care needs.

HRSA and HHS Priorities You are encouraged to select and address one of the clinical priorities below which include HHS’s and HRSA’s priorities.

● Ending the crisis of opioid addiction and overdose in America

● Improving mental health access and care

● Transforming the healthcare system through value-based care delivery and quality improvement initiatives

● Transforming the workforce by targeting the need

● Strengthening health care access through telehealth

● Preventing and reducing childhood obesity

● Preventing and reducing maternal mortality

● Ending the HIV epidemic

2. Background

The NEPQR Training Program is authorized by Sections 831 and 831A of the Public Health Service Act. The three priority areas defined in the statute for this program are

(1) Education, (2) Practice, and (3) Retention.

The NEPQR-SET program addresses the following priority areas:

HRSA-20-110 2

• Education Priority 2: To provide education in new technologies, including distance learning methodologies (§831).

• Practice Priority 2: To provide care for underserved populations and other high-risk groups such as the elderly, individuals living with HIV/AIDS, individuals with substance use disorder (SUD)s, the homeless, and victims of domestic violence (§831).

• Practice Priority 3: To provide coordinated care, and develop other skills needed to practice in existing and emerging organized health care systems (§831).

• Retention Priority 2: To improve the retention of nurses, and enhance patient care that is directly related to nursing activities, by enhancing collaboration and communication among nurses and other health care professionals, and also by promoting nurse involvement in the organizational and clinical decision making processes of a health care facility (§831).

Changes in the U.S. health care system have placed increased emphasis on care provided in community-based practice settings, rather than in hospitals and other health institutions. This shift has caused for a needed change in the dynamic of the nursing workforce, including an increased emphasis on preparing nursing students to work in community-based settings and as public health nurses, in order to better address population health outcomes. Public health nurses apply systems-level thinking to assess the potential or actual assets, needs, opportunities, and inequities of individuals, families, and populations and translate this assessment into action for public good.1 With their positions embedded within communities, public health nurses are vital to the interprofessional teams needed to assure that all people have equitable access to high quality care and healthy environments.2 Their assessment skills, primary prevention focus, and system-level perspectives can assure that local and state needs are met, services and programs are coordinated, and communities are engaged.

Simulation-based training has become an essential part of educating health care providers over the past two decades. It has demonstrated benefits in nursing, developing strong, effective practice skills, and providing exposure to a variety of authentic life situations within a safe environment, to prepare graduating nurses for the practice environment.3 Due to the rapid changes in nursing education, patient safety, complex conditions of patients, and best practices for addressing needs of patients with complex health care needs, expanding simulation-based education for public health nurses as part of their clinical education may provide opportunities to practice more effectively without compromising the health and well-being of patients.

1 Swider, S., Krothe, J., Reyes, D., Cravetz, M. (2013). The Quad Council practice competencies for public health nursing. Public Health Nursing. doi: 10.1111/phn.12090 2 American Public Health Association. (2013). ACA basics and background. Retrieved from:

https://www.apha.org/~/media/files/pdf/membergroups/phn/nursingdefinition.ashx 3 Swider, S., Krothe, J., Reyes, D., Cravetz, M. (2013). The Quad Council practice competencies for public health nursing. Public Health Nursing. doi: 10.1111/phn.12090 4 McGaghie, W. C., Issenberg, S. B., Cohen, M. E. R., Barsuk, J. H., & Wayne, D. B. (2011). Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Academic Medicine, 86(6), 706.

5 Kim, J, Park, J, and Shin, S. (2016), Effectiveness of simulation-based nursing education depending on fidelity: A meta-analysis, BMC Medical Education, p. 2-8.

3 Aebersold, M., Tschannen, D., (May 31, 2013) "Simulation in Nursing Practice: The Impact on Patient Care" OJIN: The Online Journal of Issues in Nursing Vol. 18, No. 2, Manuscript 6.

https://www.apha.org/%7E/media/files/pdf/membergroups/phn/nursingdefinition.ashx

HRSA-20-110 3

Research supports that simulation-based education with deliberate practice is effective in achieving specific clinical goals related to patient safety.4 Simulation-based education and training has been shown to be effective at validating competencies and helping to transition new graduates into clinical practice, along with educating nursing students how to recognize, respond and improve their skills and abilities to specific populations such as geriatric populations without impacting real patients.5 Expanding the use of simulation-based education in training public health nurses can bring similar benefits to this critical type of nurses. In the creation of simulation-based education programs, ensuring the faculty and staff are prepared with the appropriate skills and knowledge is essential to their success. Core competencies for best practice have been defined by the American Nurses Association (ANA) Scope and Standards of Public Health Nursing and the International Nursing Association for Clinical Simulation and Learning (INACSL)4. These identified skill sets and competencies align with and support effective public health nursing education and practice in transforming healthcare delivery systems and supporting the health of communities.

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 to the NEPQR-SET Program for Fiscal Year 2020:

Public Health Nursing: the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences.

Population health: the health outcomes of a group of individuals, including the distribution of such outcomes within the group. It involves applying health strategies, interventions, and policies at the population level rather than through the episodic, individual-level actions common within acute care.

Simulation-based learning: the use of simulation-based technology for an array of structured activities that represent actual or potential situations in education and practice. These activities allow trainees to develop or enhance knowledge, skills, and ability to analyze and respond to realistic situations in a simulated environment.

High Poverty Community: Community where the poverty rate is greater than 11.8% which was the official poverty rate for 2018, the most recent year available.5 Use U.S.

Census Bureau Poverty Estimates from 2018 to determine if your community meets this definition.

Poverty: HRSA uses the HHS Poverty Guidelines to determine poverty by household.

The poverty guidelines are not defined for Puerto Rico, the U.S. Virgin Islands, American Samoa, Guam, the Republic of the Marshall Islands, the Federated States of Micronesia, the Commonwealth of the Northern Mariana Islands, and Palau.

4 Information on core competencies can be found at the National Council of State Boards of Nursing National Simulation Guidelines for Prelicensure Nursing Programs: https://www.ncsbn.org/9535.htm as well as the International Association for Clinical Simulation and Learning Simulation Standards: https://www.inacsl.org/ 5 United States Census Bureau. Income and Poverty in the United States: 2018. Available at:

https://www.census.gov/library/publications/2019/demo/p60-266.html https://bhw.hrsa.gov/grants/resourcecenter/glossary https://www.census.gov/data/datasets/2018/demo/saipe/2018-state-and-county.html https://aspe.hhs.gov/poverty-guidelines https://www.ncsbn.org/9535.htm https://www.inacsl.org/ https://www.census.gov/library/publications/2019/demo/p60-266.html

HRSA-20-110 4

II. Award Information

1. Type of Application and Award

Type(s) of applications sought: New

HRSA will provide funding in the form of a cooperative agreement. A cooperative agreement is a financial assistance mechanism where substantial involvement is anticipated between HRSA and the recipient during performance of the contemplated project. In addition to the usual monitoring and technical assistance provided under the cooperative agreement, HRSA shall:

• Provide ongoing input in all phases of the project to accomplish the goals;

• Participate, as appropriate, in meetings or site visits;

• Review and approve project information prior to dissemination;

• Provide direction, assistance and referral in the establishment and facilitation of effective collaborative relationships with federal and state agencies, HRSA-funded projects, and other resource centers and entities relevant to the project’s mission;

• Provide guidance concerning the content, structure and format of required reports;

• Participate, as appropriate, in meetings or site visits conducted during the period of the cooperative agreement;

• Provide information resources; and

• Support and direct the dissemination of effective clinical and/or community practice models that emerge from the NEPQR-SET Program, and identify opportunities to expand best practice models to diverse populations.

The cooperative agreement recipient’s responsibilities will include:

• Fulfilling program requirements as detailed in Section IV.2 of this NOFO;

• Developing, implementing, and conducting an impact evaluation of their proposed project to ensure that they meet the goals outlined in Section I of this

NOFO;

• Work with HRSA to evaluate priorities and respond to HRSA reporting requirements;

• Engaging, collaborating, and communicating with HRSA staff for input on project activities, quality improvement, and dissemination of lessons learned and effective practice models;

• Participating in HRSA-provided training and technical assistance as appropriate;

• Engaging with relevant stakeholders to ensure project success and sustainability;

• Engaging, collaborating, and communicating with other NEPQR-SET awardees in a learning community to share practice innovations and leverage resources;

• As applicable, ensuring that equipment purchases, supported all or in part by

NEPQR-SET funding, will be maintained, tracked, and disposed of in accordance with 45 CFR Part 75.302; and

• Adhering to HRSA guidelines pertaining to acknowledgement and disclaimer on all products produced by HRSA award funds, per Section 2.2 of the SF424 R&R Application Guide (Acknowledgement of Federal Funding).

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

HRSA-20-110 5

2. Summary of Funding

HRSA expects approximately $2,000,000 to be available to fund four recipients. You may apply for a ceiling amount of up to $500,000 total cost (includes both direct and indirect, facilities and administrative costs) with a two-year period of performance. The period of performance is September 1, 2020 through August 31, 2022 (2 years).

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

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 sub-awards and subcontracts in excess of $25,000 are excluded from the direct cost base for purposes of this calculation.

III. Eligibility Information

1. Eligible Applicants

In accordance with Sections 831(g) and 831A(f) of the PHS Act, eligible applicants include accredited schools of nursing, health care facilities, or a partnership of such a school and facility.

Schools of nursing affiliated with the proposed project must be accredited public or private schools. Applicants must provide documentation of current accreditation by a recognized body or bodies or by a state agency approved for such purpose by the U.S.

Department of Education as Attachment 5.

In addition to the 50 states, the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau may apply. Tribes and Tribal organizations may apply for these funds, if otherwise eligible. Foreign entities are not eligible for this HRSA award.

Individuals are not eligible to apply.

2. Cost Sharing/Matching

Cost sharing/matching is not required for this program.

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

HRSA-20-110 6

3. Other

Ceiling Amount HRSA will consider any application that exceeds the ceiling amount of $500,000 over the two-year period of performance, 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 non-federal funding for award activities at a level that is not less than expenditures for such activities maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives the award, as required by Sec. 803(b) of the Public Health Service Act. Complete the Maintenance of Effort information and submit as Attachment 6.

Multiple Applications Eligible applicants may submit only one application in response to this NOFO. Multiple applications from any single organization are not allowed. Separate organizations are those entities that have unique DUNS numbers.

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. Applications received without the appropriate tables or required attachments will be deemed non-responsive to the NOFO and will not be considered for funding under this notice.

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.

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

HRSA-20-110 7

The NOFO is also known as “Instructions” on Grants.gov. You are strongly encouraged to select “subscribe” and provide your email address for each NOFO you are reviewing or preparing in the workspace application package in order to receive notifications including modifications, clarifications, and/or republications of the NOFO on Grants.gov.

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 this NOFO.

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 included in the page limit may not exceed the equivalent of 70 pages when printed by HRSA. The page limit includes the abstract, project and budget narratives, attachments, including biographical sketches (bio-sketches) attachments, 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. The Research and Related Senior/Key Person Profile (Expanded) form itself does not count against the page limit, but the attached Biographical sketches do count in the page limitation. Please note: If you use an OMB-approved form that is not included in the workspace application package for HRSA-20-110, it may count against the page limit.

Therefore, we strongly recommend you only use Grants.gov workspace Forms associated with this NOFO to avoid exceeding the page limit. 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, https://www.grants.gov/web/grants/applicants.html 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 http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf

HRSA-20-110 8

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 10: Other Relevant Documents.

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

Program-Specific Instructions

Program Requirements Applicants are required to establish the following activities:

• Develop and implement innovative, reliable evidence based simulation training programs that include provisions for rural or medically underserved populations burdened by chronic illnesses such as stroke, heart disease, behavioral and mental health, maternal mortality, HIV/AIDS and obesity. Simulation must include:

o Use of collaborative, interprofessional team-based care o Integration of Public Health Nursing Competencies6

• Allocate a full-time academic nursing faculty/coordinator to support best practice simulation scenarios;

• Establish or enhance strategic academic, practice, and community partnerships to inform simulation scenarios; and

• Provide longitudinal community health-based clinical experiences for nursing students to improve access to primary care within medically underserved communities.

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.

The Abstract must include:

1. A brief overview of the project as a whole;

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

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

6 Public Health Nursing Competency information can be found on the following sites:

Quad Council Coalition Public Health Competencies: http://www.quadcouncilphn.org/documents-3/2018-qcc-competencies/ National Council of State Boards of Nursing National Simulation Guidelines for Prelicensure Nursing Programs:

https://www.ncsbn.org/9535.htm International Association for Clinical Simulation and Learning Simulation Standards: https://www.inacsl.org/ http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.quadcouncilphn.org/documents-3/2018-qcc-competencies/ https://www.ncsbn.org/9535.htm

HRSA-20-110 9

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.

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:

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

Using a numerical, data-rich/supported response to the extent possible, you must describe the purpose and need for the proposed project, including:

• Characteristics of the target population(s) served including demographics, health status, social determinants of health, unmet health needs and population health disparities within the target population/community and barriers;

• Unmet education and training needs of current and future public health nursing workforce; including recruitment and retention barriers;

• Gaps in the current public health nursing workforce;

• Gaps in the current use of simulation-based learning technology training;

• Type of simulation-based training needed, including specific simulation training equipment;

• Gaps in the implementation and use of public health nursing competencies and curricula modifications/enhancements needed; and

• Education and training gaps in simulation-based training of nursing faculty and preceptors.

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 as Attachment 1. You must state objectives and sub-objectives that are specific, measurable, achievable, realistic, and time-framed and clearly explain how they will be implemented 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.). The work plan must include:

• Goals of the project (including objectives and sub-objectives);

• Responsible entity/entities (i.e., key staff and partners);

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

HRSA-20-110 10

• Describe the activities or steps you will use to achieve each of the objectives proposed during the entire period of performance;

• Describe the simulation resources and equipment that will be used to achieve the objectives, following your institutional procurement policies in accordance with 45 CFR 75.

• Explain how the work plan is appropriate for the program design and the targets fit into the overall timeline of implementation;

• Describe the timeframes, deliverables, and key partners required during the period of performance to address each of the needs described in the Purpose and Need Section;

• Identify meaningful support and collaboration with key stakeholders (including community, academic and organizational partners) in planning, designing and implementing all activities, including development of the application and the extent to which these contributors reflect the needs of the target population served; and

• Describe how your organization will ensure the funds are properly documented, if funds will be sub-awarded or expended as contracts.

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

(b).

In this section, you must describe your objectives and proposed activities, and provide evidence for how they will link to the project purpose, stated needs and requirements listed in Section IV. Program Requirements. Your approach to these objectives should be specific, measurable, realistic, achievable, and timely (completable within the period of performance). Proposed methods should:

• Describe the roles of partners and the relevant system level and organizational change initiatives, educational strategies and curricula enhancements that will be used to accomplish the objectives of the project;

• Describe how the proposed project plans to leverage existing standards of practice and/or education paradigms to strengthen readiness for practice for the next generation of the public health nursing workforce;

• Provide evidence supporting the effectiveness and/or evidence behind the proposed methodologies, by citing literature, reflecting on prior experience, and using data to the extent feasible; and

• Explain why your project is innovative and provide the context of why you believe this is so.

Logic Model

You must submit a logic model for designing and managing the project as Attachment 1. A logic model is a one-page diagram that presents the conceptual framework for a project and explains the links among program elements to achieve the relevant outcomes. For the purposes of this announcement, the logic model should summarize the connections between the:

• Goals of the project (e.g., objectives, reasons for proposing the intervention);

• Assumptions (e.g., beliefs about how the program will work based on research, best practices, and experience);

HRSA-20-110 11

• Inputs (e.g., organizational profile, collaborative partners, key staff, budget, etc.);

• Target population (e.g., individuals served);

• Activities (e.g., approach, key interventions);

• Outputs (i.e., direct products or deliverables of program activities); and

• Outcomes (i.e., program results, change in people or systems).

Your logic model should consider both your own program’s activities and outcomes as well as those of HRSA and the NEPQR-SET program (i.e., the cooperative agreement objectives). Although there are similarities, a logic model is not a work plan. A work plan is an “action” guide with a time line used during program implementation; the work plan provides the “how to” steps. A logic model is a visual diagram that demonstrates an overview of the relationships between the 1) resources and inputs, 2) implementation strategies and activities, and 3) desired outputs and outcomes in a project. You can find additional information on developing logic models at the following website:

https://www.cdc.gov/eval/tools/logic_models/index.html.

(c) RESOLUTION OF CHALLENGES -- Corresponds to Section V’s Review Criterion #2 (c)

Discuss challenges that you are likely to encounter in designing and implementing the activities described in the work plan, and approaches that you will use to resolve such challenges.

In this section, provide information including, but not limited to:

• Challenges related to project implementation and the achievement of the proposed goals and objectives (e.g., recruitment of students into proposed project team; billing/payment systems; and health information technology);

• Challenges related to the workforce development such as recruitment and retention and interprofessional education and training; and

• Resources and plans available to resolve and overcome these challenges and obstacles.

IMPACT -- This section includes two sub-sections— (a) Evaluation and Technical

Support Capacity; and (b) Project Sustainability—both of which correspond to Section V’s Review Criteria #3 (a) and (b).

(a) EVALUATION AND TECHNICAL SUPPORT CAPACITY -- Corresponds to Section V’s Review Criterion #3 (a)

You must describe the plan for program performance evaluation that will contribute to continuous quality improvement. The program performance evaluation must monitor ongoing processes and progress toward meeting goals and objectives of the project. Include descriptions of the inputs (e.g., key evaluation personnel and organizational support, collaborative partners, budget, and other resources); key processes; proposed outcomes including the number of nursing students who will be trained; variables to be measured; expected outcomes of the funded activities;

https://www.cdc.gov/eval/tools/logic_models/index.html

HRSA-20-110 12

and a description of how all key evaluative measures will be reported. The proposed plan should describe:

• Impact evaluation plan (e.g., description of inputs, variables measured, and evidenced-based tools to be used);

• The extent to which the proposed simulation-based training program improves outcomes; and

• The extent to which assessment of progress toward increasing the number of public health nurses practicing at the full scope of their license.

You must also describe your plan to use evidenced-based evaluative tools to measure the impact of the project.

You must also describe the systems and processes that will support your organization's collection of HRSA’s performance measurement requirements for this program. At the following link, you will find the required data forms for this program: http://bhw.hrsa.gov/grants/reporting/index.html. Describe the data collection strategy to accurately collect, manage, analyze, store, and track/report data (e.g., assigned skilled staff, data management software) to identify measures and evidenced-based tools to evaluate impact/outcomes, and explain how the data will be used to inform program development and service delivery in a way that allows for accurate and timely reporting of performance outcomes.

You must describe any potential obstacles for implementing the program performance evaluation and meeting HRSA’s performance measurement requirements and your plan to address those obstacles. The evaluation and reporting plan also should indicate the feasibility and effectiveness of plans for dissemination of project results, the extent to which project results may be national in scope and the degree to which the project activities are replicable.

(b) PROJECT SUSTAINABILITY -- Corresponds to Section V’s Review Criterion

#3 (b)

You must provide a clear plan for project sustainability after the period of federal funding ends, including a description of specific actions you will take to:

• Highlight key elements of your projects under this award, e.g., training methods or strategies, which have been effective in improving practices;

• Describe a business model that demonstrates the added value of public health nurses on interprofessional teams;

• Provide a timetable for becoming self-sufficient;

• Leverage strategies or services and interventions, which have been effective in improving practices and those that have led to improved outcomes for the target population;

• Demonstrate commitment to support, to the extent possible, the education and training of current students to enter the public health nursing workforce;

• Demonstrate commitment to support, to the extent possible, the use of simulation-based technology implemented through this funding opportunity beyond the period of federal funding;

http://bhw.hrsa.gov/grants/reporting/index.html

HRSA-20-110 13

• Disseminate outcomes as a result of the implementation of public health nursing competencies and replicable evidenced-based practices; and

• Describe challenges that are likely to be encountered in sustaining the program and resources that will be used to resolve such challenges.

ORGANIZATIONAL INFORMATION, RESOURCES AND CAPABILITIES --

Corresponds to Section V’s Review Criterion #4

Succinctly describe your capacity to effectively manage the programmatic, fiscal, and administrative aspects of the proposed project. Provide information on your organization’s current mission and structure, including an organizational chart, relevant experience, and scope of current activities, and describe how these elements all contribute to the organization’s ability to conduct the program requirements and meet program expectations (A project organizational chart is requested in Attachment 4).

You must include the following information:

Key Personnel

Project Director Qualification: Identify one Project Director. The Project Director for the proposed project must be a licensed Registered Nurse. NOTE: There may only be one Project Director for the NEPQR-SET project.

Academic nursing faculty/ Coordinator: Identify one full-time individual to support simulation scenarios and their role in the success and sustainability of the project.

Capabilities of the Applicant Organization: Describe how the organizational structure, including the capability and commitment of administration, management and governing board, is appropriate for the implementation, operations, and oversight necessary to implement integrated services and curriculum enhancements. In addition, applicants should provide evidence of the financial capability and organizational commitment needed to operate the project. Applicants should describe the facilities available to meet the needs of the project. Provide a letter of support from the President of the academic institution or other higher level academic officer that demonstrates the institution’s commitment to the project. In addition, provide a letter of support from each partner organization or department, internal and external, involved in your proposed project; include letters of support as Attachment 8.

Staff: Describe capacity and institutional mechanisms to implement the project.

Provide the qualifications and position descriptions for the leadership and care team;

include as Attachment 2. Include a biographical sketch (no more than 2 pages) for key personnel; bio sketches should be uploaded in the Research and Related Senior/Key Person Profile (Expanded) form. If staff are required but not yet identified, describe the recruitment and retention plan to meet the project’s needs.

The staffing plan and job descriptions for key faculty/staff must be included in Attachment 2 (Staffing Plan and Job Descriptions for Key Personnel). However, the biographical sketches must be uploaded as attachments in the Research and Related Senior/Key Person Profile (Expanded) form, which can be accessed in the Grants.gov workspace Application Package for this NOFO under “Mandatory.” Include biographical

HRSA-20-110 14

sketches for persons occupying the key positions, not to exceed TWO pages in length each. In the event that a biographical sketch is included for an identified individual who is not yet hired, please include a letter of commitment from that person with the biographical sketch. When applicable, biographical sketches should include training, language fluency, and experience working with diverse populations that are served by their programs.

Biographical sketches, not exceeding two pages per person, should include the following information:

• Senior/key personnel name

• Position Title

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

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

• Section A (required) Personal Statement. Briefly describe why the individual’s experience and qualifications make him/her particularly well-suited for his/her role (e.g., PD/PI) in the project that is the subject of the award.

• Section B (required) Positions and Honors. List in chronological order previous positions, concluding with the present position. List any honors. Include present membership on any Federal Government public advisory committee.

• Section C (optional) Peer-reviewed publications or manuscripts in press (in chronological order). You are encouraged to limit the list of selected peer-reviewed publications or manuscripts in press to no more than 15. Do not include manuscripts submitted or in preparation. The individual may choose to include selected publications based on date, importance to the field, and/or relevance to the proposed research. Citations that are publicly available in a free, online format may include URLs along with the full reference (note that copies of publicly available publications are not acceptable as appendix material).

• Section D (optional) Other Support. List both selected ongoing and completed (during the last 3 years) projects (Federal or non-Federal support). Begin with any projects relevant to the project proposed in this application. Briefly indicate the overall goals of the projects and responsibilities of the Senior/Key Person identified on the Biographical Sketch.

HRSA-20-110 15

iii. Budget - Corresponds to Section V’s Review Criterion #5 See Section 4.1.iv of HRSA’s SF-424 R&R Application Guide. Please note: the directions offered in the SF-424 R&R Application Guide may differ from those offered by Grants.gov. Follow the instructions included in the R&R Application Guide and the additional budget instructions provided below. A budget that follows the R&R Application Guide will ensure that, if HRSA selects the application for funding, you will have a well-organized plan, and by carefully following the approved plan can avoid audit issues during the implementation phase.

The project will be fully funded at the outset for use over the period of performance.

Therefore, only one SF-424 Research and Related (R&R) budget form is required and must reflect a single budget period of two years. See additional instructions under budget justification.

Reminder: The Total Project or Program Costs are the total allowable costs (inclusive of direct and indirect costs) incurred by the recipient to carry out a HRSA supported project or activity. Total project or program costs include costs charged to the award and costs borne by the recipient to satisfy a matching or cost-sharing requirement, as applicable.

In addition, the NEPQR-SET Program requires the following:

Equipment is defined as a unit cost of $5,000 or more and a useful life of 1 or more years. See SF-424 R&R Application Guide for details.

This program allows for the budgeting of equipment in support of project simulation activities, including related minor Alteration and Renovation (A&R). Minor A&R may not include a structural change (e.g., to the foundation, roof, floor, or exterior or load-bearing walls of a facility, or extension of an existing facility) to achieve the following:

Increase the floor area; and/or, change the function and purpose of the facility. You may request up to $20,000 for minor A&R to accommodate the equipment to make the space suitable for use for the proposed project.

The Further Consolidated Appropriations Act, 2020 (P.L. 116-94), Division A, § 202 states, “None of the funds appropriated in this title shall be used to pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of Executive Level II.” See Section 4.1.iv Budget – Salary Limitation of HRSA’sSF-424 R&R Application Guide for additional information. Note that these or other salary limitations may apply in the following fiscal years, as required by law.

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 and capital expenditures, tuition and fees, and sub-grants and subcontracts in excess of $25,000 are excluded from the direct cost base for purposes of this calculation.

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

HRSA-20-110 16

iv. Budget Justification Narrative Corresponds to Section V’s Review Criterion #5 See Section 4.1.v of HRSA’s SF-424 R&R Application Guide. Although there is only one SF 424 R&R budget form required for the entire period of performance, applicants must submit individual budgets for each 12-month increment of activity for funding requested at the time of application. This yearly breakdown must be included in the budget justification narrative ONLY. Each year must be clear and concise, with totals for each section that aligns with the SF-424 R&R budget form and MUST include a total requested per year.

The budget justification narrative must describe all line-item federal funds (including sub-awards and equipment), proposed for this project. Please note: all budget justification narratives count against the page limit. List equipment costs and provide justification for the need of the equipment to carry out the program’s goals. Provide a detailed itemized per unit cost which shows how costs were estimated and total cost.

NARRATIVE GUIDANCE

To ensure that you fully address the review criteria, this table provides a crosswalk between the narrative language and where each section falls within the review criteria. Any attachments referenced in a narrative section may be considered during the objective review.

Narrative Section Review Criteria Purpose and Need (1) Purpose and Need

Response to Program Purpose:

(a) Work Plan

(b) Methodology/Approach

(c) Resolution of Challenges

(2) Response to Program Purpose

(a) Work Plan

(b) Methodology/Approach

(c) Resolution of Challenges

Impact:

(a) Evaluation and Technical Support Capacity

(b) Project Sustainability

(3) Impact:

(a) Evaluation and Technical Support Capacity

(b) Project Sustainability

Organizational Information, Resources and Capabilities

(4) Organizational Information, Resources and Capabilities

Budget and Budget Narrative (5) Support Requested – the budget section should include sufficient justification to allow reviewers to determine the reasonableness of the support requested.

HRSA-20-110 17

v. Attachments Provide the following items in the order specified below to complete the content of the application. Unless otherwise noted, attachments count toward the application page limit. Indirect cost rate agreements and proof of non-profit status (if applicable) will not count toward the page limit. Clearly label each attachment.

Attachment 1: Work Plan (Required)

Attach the work plan for…