PKG00260690-instructions.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Bureau of Health Workforce Division of Nursing and Public Health

Nursing Workforce Diversity-Eldercare Enhancement (NWD-E2) Program

Funding Opportunity Number: HRSA-20-117

Funding Opportunity Type(s): New

Assistance Listings (CFDA) Number: 93.178

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2020

Application Due Date: June 4, 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

Aja H. Williams, MS, RN Nurse Consultant/ Project Officer

Telephone: (301) 945-9658 Fax: (301) 443-0791 Email: Awilliams4@hrsa.gov

Authority: 42 U.S.C. § 296m (Section 821 of the Public Health Service Act) mailto:Awilliams4@hrsa.gov

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EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA), Bureau of Health Workforce, Division of Nursing and Public Health, is accepting applications for the Fiscal Year (FY) 2020 Nursing Workforce Diversity-Eldercare Enhancement (NWD-E2) Program. The overall purpose of the NWD program is to increase and strengthen the eldercare workforce in rural counties where there are health care disparities related to access and delivery of care through the expansion of educational opportunities for individuals from disadvantaged backgrounds (including racial and ethnic minorities underrepresented among registered nurses). The NWD-E2 program provides enhanced eldercare education and training opportunities to nursing students from disadvantaged backgrounds, including underrepresented racial and ethnic minorities among registered nurses. This program aims to achieve a sustainable eldercare nursing workforce equipped with the competencies necessary to address healthcare disparities related to access and delivery of care of elderly populations in rural and underserved areas.

Funding Opportunity Title: Nursing Workforce Diversity - Eldercare

Enhancement (NWD-E2) Program Funding Opportunity Number: HRSA-20-117 Due Date for Applications: June 4, 2020 Anticipated Total Annual Available FY 2020 Funding:

$1,000,000

Estimated Number and Type of Award(s): Up to two grants

Estimated Award Amount: Up to $500,000 per year 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, nursing centers, academic health centers, State or local governments, and other private or public non-profit entities determined appropriate by the Secretary. Eligible faith-based organizations, community-based organizations, and Tribes and Tribal Organizations can apply for these funds if otherwise eligible.

For profit entities are not eligible under this notice of funding opportunity (NOFO).

Individuals are not eligible to apply for these funds. See Section III-1 of this 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 Justification Narrative

iv. 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 1

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I. Program Funding Opportunity Description

1. Purpose This notice announces the opportunity to apply for funding under the Nursing Workforce Diversity (NWD)-Eldercare Enhancement Program, referred to as NWD-E2.

Program Purpose The overall purpose of the NWD program is to increase nursing education opportunities for individuals from disadvantaged backgrounds (including racial and ethnic minorities underrepresented among registered nurses). The purpose of this NOFO is to strengthen the eldercare workforce in rural communities where there are health care disparities related to access and delivery of care through the expansion of these opportunities for students from disadvantaged backgrounds.

Program Goals The Nursing Workforce Diversity- Eldercare Enhancement (NWD-E2) program provides enhanced eldercare education and training opportunities to nursing students from disadvantaged backgrounds, including racial and ethnic minorities underrepresented among registered nurses.

Program Objectives The objective of the NWD-E2 program is to achieve a sustainable eldercare nursing workforce by providing enhanced educational opportunities to individuals from disadvantaged backgrounds. The program seeks to equip the nursing students with the competencies necessary to address health care disparities related to access and delivery of care of elderly populations in rural and underserved areas.

Program Priorities You are encouraged to select and address one HHS’s and HRSA’s clinical priorities below, as applicable.

● 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

2. Background

This program is authorized under Section 821 of the Public Health Service (PHS) Act (42 U.S.C. § 296m). In nursing education, multiple factors including social, environmental, and structural determinants have powerful effects on an institution’s ability to retain students from disadvantaged backgrounds. These factors, social in nature, present as educational determinants that impede the success of disadvantaged student populations. Similarly as with achieving desired health outcomes, the use of a social determinants framework in education, can help to identify the economic, social, environmental, and structural support barriers that can impede a student’s success, thus increasing an institution’s ability to support its students from enrollment through

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graduation. Financial and interpersonal levers such as scholarships, loans, and mentoring are necessary, but not wholly sufficient to recruit, enroll, retain, and graduate underrepresented populations needed to diversify the workforce1. Therefore, workforce structural and multi-level approaches at the systems level guided by the social determinants of education must be used in order to enhance scholarship, stipend, and pre-entry mentoring activities.

Evidence shows that individuals from disadvantaged, including underrepresented racial/ethnic minority providers more often practice in underserved areas and thereby improve access to health care for the most vulnerable communities2. The current nursing workforce does not reflect the ethnic and cultural diversity of rural and underserved communities in the United States. According to a 2017 survey conducted by the National Council of State Boards of Nursing (NCSBN) and The Forum of State Nursing Workforce Centers, nurses from minority backgrounds represent 19 percent of the registered nurse (RN) workforce3. A 2018 National Sample Survey of Registered Nurses (NSSRN) conducted by National Center for Health Workforce Analysis (NCHWA) in collaboration with the U.S. Census Bureau, shows that only 26.7 percent of RNs were from racial/ethnic minority groups compared to 73.3 percent White, non- Hispanic RNs, accounting for the largest proportion4. A diverse health care workforce contributes to continued efforts to meet the needs of a diverse population and to better achieve population health equity. Diversity in nursing has been linked to improved health care delivery, increased cultural competence and increased patient satisfaction.

Reflective of the growth of America’s increasingly diverse population, the elderly population has also become more racially and ethnically diverse. By 2030, over 20 million of America’s elderly population will identify as a member of a minority group.

Between 2017 and 2060, the share of the older population that is non-Hispanic white is projected to drop by 22 percentage points, from 77 percent to 55 percent. During this same time period it is projected that Hispanic, Black-non Hispanic, and Asian non- Hispanic populations making up 42% of the elderly population5.

As this population becomes more diverse, the need for culturally competent professionals will become increasingly more important in order to sufficiently address the complex health and social needs of older Americans. The care for these individuals may be complicated by functional deficits, cognitive deficits, and mental and behavioral

1 World Health Organization. (2008). Closing the gap in a generation: Health equity through action on the Social Determinants of Health. (Final Report of the Commission on Social Determinants of Health). Geneva.

2 Sullivan, L.W. (2004). Missing persons: Minorities in the Health Professions. A Report of the Sullivan Commission on Diversity in the Healthcare Workforce. Located at: http://www.aacn.nche.edu/media-relations/SullivanReport.pdf 3American Association of Colleges of Nursing (AACN) > News & Information > Fact Sheets > Enhancing Diversity in the Nursing Workforce. (n.d.). https://www.aacnnursing.org/News-Information/Fact-Sheets/Enhancing-Diversity 4 U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. 2019. Technical Report for the National Sample Survey of Registered Nurses, Rockville, Maryland.

5 Scommegna, P., Mather, M., and Kilduff, L., (2018) Eight demographic trends transforming Americas older population. Retrieved from Population Reference Bureau: https://www.prb.org/eight-demographic-trends-transforming-americas-older-population/ https://www.prb.org/eight-demographic-trends-transforming-americas-older-population/ https://www.prb.org/eight-demographic-trends-transforming-americas-older-population/

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health problems. Additional challenges include language and cultural differences, poverty, and social isolation6. These challenges are especially burdensome for those that live in rural communities.

In coming years, the nation’s population is anticipated to have an increasingly larger component of older Americans, relative to other age groups. As a result of this, the number of jobs related to eldercare will increase, with an expected 1.6 million new jobs being added to the economy. Registered nurses are the largest and one of the most essential healthcare occupations for providing coordinated care to the aging population.

A projected 439,200 RN positions will be added to the workforce by 20247. In order to provide a foundation for developing care sensitive to elderly populations, education should focus on improving the recognition of age-related changes in older adult patients and enhancing communication skills with older patients and their families8.

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 NWD-E2 Program for Fiscal Year 2020:

Disadvantaged background – An individual who comes from an economically and/or educationally disadvantaged background.

Economically disadvantaged – An individual from a family with an annual income below a level based on low-income thresholds, according to family size established by the U.S. Census Bureau, adjusted annually for changes in the Consumer Price Index, and adjusted by the Secretary of the U.S. Department of Health and Human Services, for use in all health professions programs. The Secretary updates these income levels in the Federal Register annually.

Educationally disadvantaged – An individual from a social, cultural, or educational environment that has demonstrably and directly inhibited the individual from obtaining the knowledge, skills, and abilities necessary to develop and participate in a health professions education or training program.

Eldercare – is specialized care that is designed to meet the needs and requirements of senior citizens (persons 65 years old or older) at various stages. Eldercare encompasses high-quality care that requires a health care team with a diverse range of skills for addressing this population’s physical, mental, cognitive, and behavioral needs.

6 National Advisory Council on Nurse Education and Practice (NACNEP). (2019, May 21). The 139th meeting of the National Advisory Council on Nurse Education and Practice (NACNEP) [webinar and teleconference].

Retrieved from https://www.hrsa.gov/sites/default/files/hrsa/advisory-committees/nursing/meetings/2019/nacnep-may-21-2019-minutes.pdf 7 Rolen, E. (2017). The Growing Need for Eldercare Workers. Retrieved from U.S. Department of Labor website:

http://blog.dol.gov/tag/aging-population 8 Capezuti, E., Boltz, M., Cline, D., Dickson, V. V., Rosenberg, M., Wagner, L., Nigolian, C. (2012). Nurses Improving Care for Healthsystem Elders- a model for optimizing the geriatric nursing practice environment. Journal of Clinical Nursing, 21(21-22), 3117-3125. doi:10.1111/i.1365-2702.2012.04259x https://bhw.hrsa.gov/grants/resourcecenter/glossary https://sharepoint.hrsa.gov/sites/BHW/DPSD/GR/Reference%20Information/Poverty%20Guidelines/HHS%202020%20Poverty%20Guidelines%20FR%2001172020.pdf https://www.hrsa.gov/sites/default/files/hrsa/advisory-committees/nursing/meetings/2019/nacnep-may-21-2019-minutes.pdf https://www.hrsa.gov/sites/default/files/hrsa/advisory-committees/nursing/meetings/2019/nacnep-may-21-2019-minutes.pdf

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Social determinants of education – The conditions in which people are born, grow, live, work and age, including inherent factors and barriers in the education system itself.

These circumstances are shaped by social, physical, economic and educational factors at national and local levels, which are influenced by policy choices. Different factors occur simultaneously. The social determinants of education are mostly responsible for educational inequities—the unfair and avoidable differences in education access and success at the national and local levels. The NWD program seeks to address the social, physical, economic, and educational factors that affect the academic access and hence increase the likelihood of educational success of students from disadvantaged backgrounds (including racial and ethnic minorities underrepresented among registered nurses) in addition to addressing the social, environmental, and structural factors that affect an institution’s ability to recruit, retain, and graduate students of this same student population.

II. Award Information

1. Type of Application and Award

Type(s) of applications sought: New

HRSA will provide funding in the form of a grant.

2. Summary of Funding

HRSA expects approximately $1,000,000 to be available annually to fund two recipients. You may apply for a ceiling amount of up to $500,000 total cost (includes both direct and indirect, facilities and administrative costs) per year. The period of performance is September 1, 2020 through August 31, 2022 (2 years). Funding beyond the first year is subject to the availability of appropriated funds for NWD-E2 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.

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 applicants include accredited schools of nursing, nursing centers, academic health centers, State or local governments, and other private or public non-profit entities determined appropriate by the Secretary. Eligible faith-based organizations, community-based organizations, and Tribes and Tribal Organizations can apply for these funds if they are otherwise eligible.

For profit entities are not eligible under this Notice of Funding Opportunity.

Individuals are not eligible to apply.

Project Participants Project participants (students and trainees educated/supported as a result of HRSA programmatic funding provided through NWD-E2) must be enrolled in an accredited nursing program and be a citizen of the United States, a non-citizen national of the United States, or a foreign national who possesses a visa permitting permanent residence in the United States. Individuals on temporary or student visas are not eligible participants and may not receive NWD-E2 grant support.

Accreditation Schools of nursing affiliated with the proposed project must be an accredited public or private non-profit collegiate, associate degree or diploma school of nursing. 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 9.

Applications that do not include this documentation will be considered non-responsive and will not be considered for funding under this announcement.

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 $500,000 per year, for a total of $1,000,000 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.

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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 during the fiscal year prior to receiving the award, as required by Section 803(b) of the Public Health Service Act 42 U.S.C. § 296b(b). Complete the Maintenance of Effort information and submit as Attachment 6.

Multiple Applications Eligible applicants may submit only one application to this NOFO. Multiple applications from any single organization are not allowed. Independent 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 the applicant’s 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.

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

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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 (biosketches) 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, 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, 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 8: Letters of Support.

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

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Program-Specific Instructions

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:

Program Requirements

Applicants must implement a comprehensive systems approach using all of the following evidence-based strategies:

• Social Determinants of Education- assessing the social determinants that impeded the educational success of students from disadvantaged backgrounds, identifying the needs of these students, and implementing tailored, evidence-based strategies to address their identified social determinants and needs.

• Academic and peer supports– tailoring services necessary to facilitate and maintain the success of students from disadvantaged backgrounds.

• Mentoring– incorporating professional, academic, and peer mentors, including those from diverse backgrounds underrepresented among registered nurses.

• Student financial support– tailoring resources to address the social determinants and needs of students from disadvantaged backgrounds.

• Academic, clinical, and community partnerships –addressing the social determinants that impede access to education and success of students from disadvantaged backgrounds; and building partnerships that strengthen the training standards and provide extensive education and training opportunities to produce a competent eldercare nursing workforce.

Partnerships are required to:

• Implement a system for recruitment of nursing students from disadvantaged backgrounds most committed to practicing in settings that improve access to eldercare in medically underserved communities;

• Provide enhanced clinical training experiences for undergraduate nursing students in community-based settings, including primary care delivery sites, with an emphasis on eldercare;

• Enhance didactic and clinical training curricula to integrate the care of elderly populations in rural areas and underserved areas with an emphasis on chronic disease prevention, population health, and health equity; and

Identify a partnership liaison as a formal facilitator between academic, clinical and community partnerships.

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

The Abstract must include:

1. Whether you are applying under a funding preference or priority

2. A brief overview of the project as a whole

3. Specific, measurable objectives that the project will accomplish

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

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

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5. 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

The Project Narrative 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

You must identify and describe the characteristics of targeted student and community populations and provide a comprehensive framework and description of the proposed project. You must ensure to directly link all aspects of the project to the goals and objectives, including contribution to diversifying the eldercare nursing workforce.

Successful applications will contain the information below.

You must describe the following:

• Demographic data of the geographic area where education and training will occur;

• Local and state needs and resources necessary to support the health care of elderly population.

• Gaps in eldercare education and training of current and future nursing workforce;

• Unmet education and training needs of the target student population that will participate in this project;

• Establishment or enhancement of academic, clinical, and community partnerships that will increase the eldercare educational opportunities for students from disadvantaged backgrounds;

• Challenges (with supporting evidence) applicant organizations have experienced with enrolling, retaining, and graduating students from disadvantaged backgrounds;

• Implementation or enhancement of academic environments that are adaptive to diverse student needs and facilitate academic success;

• and

• Social determinants of education of students to be recruited that impede the success of the identified target student population.

NOTE: You must cite externally available, verifiable data whenever possible to support the information provided in the need section. All data is subject to verification.

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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).

In this section, you must provide a detailed work plan that is comprehensive, feasible, and demonstrates your experience implementing a project of the proposed scope.

You must:

• Provide a detailed description of the specific activities, timeline, and implementation activities of each of the evidence-based strategies and the project personnel responsible for completing the activities;

• Explain how the work plan is appropriate for the program design and how the targets for key activities, personnel, and resources fit into the overall timeline of NWD-E2 program implementation;

• Implement a system for recruitment of nursing students from disadvantaged backgrounds most committed to practicing in settings that improve access to eldercare in medically underserved communities;

• Provide enhanced clinical training experiences for undergraduate nursing students in community-based settings with an emphasis on eldercare;

• Deliver continuing professional development for practicing RNs, clinical preceptors, and faculty with an emphasis on eldercare;

• Enhance didactic and clinical training curricula to integrate the care of elderly populations in rural areas and underserved areas with an emphasis on chronic disease prevention, population health, and health equity;

• Identify a partnership liaison as a formal facilitator between academic, clinical and community and partnerships;

• Project the number of students from the identified target population to be enrolled, retained, and graduated who will receive support through the proposed project; and

• Identify meaningful support and collaboration with key internal and external partners in planning, designing and implementation of program activities.

A Sample work plan can be found here:

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

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

#2(b).

Describe your project goals and objectives and how they will address the project purpose and stated needs. You must describe how the objectives link to each of the previously described requirements listed in Section IV. Program Requirements.

You must describe:

• Your commitment to enrolling, retaining, and graduating students from disadvantaged backgrounds;

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

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• The approaches used to overcome the identified gaps in educational opportunities for students from disadvantaged backgrounds stated in the previous purpose and needs section, including challenges and successes of using these approaches;

• How the assessment of the social determinants affecting students from disadvantaged backgrounds in the target student population and the identification of the students’ needs will be incorporated into the evidence-based strategies;

• How implementation of the evidence-based strategies will enhance the ability to address the challenges that impede recruitment, retention, and graduation of students from disadvantaged backgrounds; and

• The enhancement of didactic and clinical training curricula to integrate the care of elderly populations in rural and underserved areas with an emphasis on chronic disease prevention, population health and health equity.

You must submit a logic model (Attachment 1) for designing and managing the project. A logic model is a one-page diagram that presents the conceptual framework for a proposed project and explains the links among program elements to achieve the relevant outcomes. While there are many versions of logic models, for the purposes of this notice the logic model should summarize the connections between the:

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

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

• Inputs (e.g., organizational profile, collaborative partners, key personnel, budget, other resources);

• Target population (e.g., the individuals to be served; the students to be trained);

• Activities (e.g., approach, listing key intervention, if applicable);

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

• Outcomes (i.e., the results of a program, typically describing a change in people or systems).

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.

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

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

• Challenges related to project implementation and the achievement of the proposed goals and objectives (i.e., recruitment and retention of students from disadvantaged backgrounds);

• Challenges related to the eldercare workforce development such as recruitment and retention;

• Challenges related to establishing or expanding academic, clinical and/or community partnerships;

• Challenges with increasing the number of didactic or experiential learning hours focused on eldercare; 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 Criterion #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:

• Describe systems and processes that will support your organization's collection of HRSA’s performance measurement requirements for this program. Including potential obstacles and plan to address those obstacles. At the following link, you will find the required data forms for this program:

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

• 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; variables to be measured; expected outcomes of the funded activities;

• Describe how all key evaluative measures will be reported and demonstrate program objectives have been met and are attributed to the project;

• Data collection strategy to accurately collect, manage, analyze, store, and track/report data (e.g., assigned skilled staff, data management software) to measure process and impact/outcomes;

• 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;

• Document the procedure for assuring the data collection, management, storage, and reporting for individuals participating in the program and for up to one year post participation; and

• Describe current experience, skills, and knowledge, including individuals on staff, materials published, and previous work of a similar nature.

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

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In Attachment 2, you must attach a complete staffing plan and job descriptions for key personnel. Bio sketches of Key Personnel should be uploaded in the SF-424 R&R Senior/Key Person Profile form.

You must include a plan for Rapid Cycle Quality Improvement (RCQI) for the continuous monitoring of ongoing project processes, outcomes of implemented activities, and progress toward meeting project goals and objectives and the implementation of necessary adjustment to planned activities to effect course corrections. Additional information on RCQI is available at the following website:

http://www.healthworkforceta.org/resources/rapid-cycle-quality-improvement-resource-guide/.

(b) PROJECT SUSTAINABILITY -- Corresponds to Section V’s Review Criterion #3

You must provide a clear plan for project sustainability after the period of federal funding ends. Discuss challenges that are likely to be encountered in sustaining the program and approaches that will be used to resolve such challenges. You must describe:

• Actions to highlight key project elements (e.g., training methods or strategies) which have been effective in improving practices;

• Plan to obtain future funding;

• Timetable to become sustainable in the absence of federal funding;

• Plan to sustain a culture of diversity and inclusion; and

• Demonstrate commitment to support, to the extent possible, the activities implemented through this funding opportunity beyond the period of federal funding – including: recruitment of nursing students from disadvantaged backgrounds, improving access to eldercare in medically underserved communities, and efforts to strengthen professional development opportunities, curricula, and partnerships.

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.)

Specifically, you must describe:

• Facilities and infrastructure in place to implement the evidence-based strategies;

• Qualifications, training, and/or experience of key personnel that demonstrate the ability to support students from disadvantaged backgrounds;

• Education and training needs of key personnel and other staff and how they will be prepared to participate in implementation of the project;

http://www.healthworkforceta.org/resources/rapid-cycle-quality-improvement-resource-guide/ http://www.healthworkforceta.org/resources/rapid-cycle-quality-improvement-resource-guide/

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• Organizational structure, including the capacity and commitment of administration, faculty, and staff is appropriate for the operational and oversight needs necessary to implement the requirements of this funding opportunity;

• Partnerships with other entities both internal and external to the applicant’s academic institution including the type and role of the partners and any leveraged resources;

• Percentage of time, including in-kind, dedicated to the project by the Project Director;

• Founding and guiding policies, organizational structure(s), strategic plan, recruitment and supportive strategies and program initiatives that demonstrate institutional commitment to train students from disadvantaged backgrounds, including racial and ethnic minorities underrepresented among registered nurses with a focus on eldercare education and training; and

• Evidence of transformative learning and active faculty development and continuing professional development that demonstrates commitment to eldercare education and training.

Biographical sketches must be uploaded in the SF-424 RESEARCH & RELATED Senior/Key Person Profile (Expanded) form, which can be accessed in the Application Package under “Mandatory.” Include biographical 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 the populations 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.

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• 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.

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.

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.

A minimum of 30 percent of the total annual budget must be allocated to participant/trainee support (See Participant/Trainee Support Costs budget category description below).

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’s SF-424 Application Guide for additional information. Note that these or other salary limitations may apply in the following fiscal years, as required by law.

iii. Budget Justification Narrative See Section 4.1.v of HRSA’s SF-424 R&R Application Guide.

The NWD program requires the following:

Personnel Costs: Applicants shall identify only one Project Director. The Project Director for NWD projects must be a licensed Registered Nurse.

http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf

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Indirect Costs for Training Grants: Indirect costs under training grants 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 actual direct cost base for purposes of this calculation.

Participant/Trainee Support Costs: A minimum of 30 percent of the total annual budget must be allocated to participant/trainee support costs. List tuition/fees/health insurance, stipends, travel, subsistence, other, and the number of participants/trainees.

Budget breakdown must separate trainee costs, and include a separate sub-total entitled “total Participant/Trainee Support Costs” which includes the summation of all trainee costs.

On the SF-424 R&R, do not enter a dollar amount for tuition, fees, health insurance or subsistence. Follow the form directions.

Scholarships: Student scholarships cover tuition, fees, books, and other related educational expenses. Scholarship funds must be disbursed in logical increments throughout the academic or calendar year and may or may not cover the total expenses required by the school. Awards dedicated for tuition should be disbursed at the beginning of each period within the academic year (e.g., semester, quarter, term). A student can receive both a scholarship and a stipend as long as the award limitations are not exceeded and awards do not cover the same expenses. Students are designated to receive scholarships by the applicant institution in accordance with the guidelines established by the applicant organization. The proposed project must use NWD scholarship funds in a manner that will meet the needs of eligible students. The budget narrative must indicate the number of students to receive scholarships for each year of the grant and the proposed amount of each scholarship per student. Whatever is stated in the budget narrative should concur with the total amount listed in the budget line item.

Stipends: Student stipend support is provided to assist in covering a student’s general living expenses. The budget narrative must indicate the stipend rate (e.g., $500/month), the number of stipends to be awarded, and the total stipend amount for each educational level as appropriate. It is the responsibility of the applicant to justify the basis for the stipend rate requested. Stipends are to be prorated and paid to eligible participants at regular intervals during the budget period.

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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…