PKG00264196-instructions.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Bureau of Health Workforce Division of Nursing and Public Health

Nursing Workforce Diversity (NWD) Program

Funding Opportunity Number: HRSA-21-020

Funding Opportunity Type(s): New and Competing Continuations

Assistance Listings (CFDA) Number: 93.178

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2021

Application Due Date: January 19, 2021

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

HRSA will not approve deadline extensions for lack of registration.

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

Issuance Date: November 20, 2020

LT Renee Nwankwo, MPH, BSN, RN Nurse Consultant/Project Officer Telephone: (301) 443-1587 Email: rnwankwo@hrsa.gov

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

HRSA-21-020 i

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2021 Nursing Workforce Diversity (NWD) Program. The purpose of this program is to assist students from disadvantaged backgrounds (including ethnic and racial minorities underrepresented among registered nurses) throughout the educational pipeline in becoming registered nurses. This purpose is accomplished by supporting diploma or associate degree registered nurses as they become baccalaureate-prepared registered nurses, and preparing practicing registered nurses for advanced nursing education.

The NWD program uses a comprehensive systems approach to implementing evidence-based strategies successful in supporting nursing students from disadvantaged backgrounds from enrollment through graduation. This approach includes an assessment of the social determinants that impede the educational success of students from disadvantaged backgrounds, identification of the needs of these students, and implementation of tailored, evidence-based strategies to address their identified social determinants and multi-faceted needs.

The FY 2021 President’s Budget does not request funding for this program. This notice is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds appropriately. You should note that this program may be cancelled prior to award.

Funding Opportunity Title: Nursing Workforce Diversity (NWD)

Program Funding Opportunity Number: HRSA-21-020 Due Date for Applications: January 19, 2021 Anticipated Total Annual Available FY 2021 Funding:

$16,100,000

Estimated Number and Type of Award(s): Up to 29 grants Estimated Award Amount: Up to $555,000 per year Cost Sharing/Match Required: No Period of Performance: July 1, 2021 through

June 30, 2025 (4 years)

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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).

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

Application Guide

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

Technical Assistance

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

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

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

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Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING/MATCHING

3. OTHER

IV. APPLICATION AND SUBMISSION INFORMATION

1. ADDRESS TO REQUEST APPLICATION PACKAGE

2. CONTENT AND FORM OF APPLICATION SUBMISSION

i. Project Abstract

ii. Project Narrative

iii. Budget

iv. Budget Justification Narrative

v. Attachments

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

TO THE UNIQUE ENTITY IDENTIFIER (UEI) AND SYSTEM FOR AWARD MANAGEMENT (SAM)

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSMENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

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I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Nursing Workforce Diversity (NWD) Program.

Program Purpose The purpose of the NWD program is to increase nursing education opportunities for individuals who are from disadvantaged backgrounds (including racial and ethnic minorities underrepresented among registered nurses).

Program Goals The NWD program aims to expand and support a nursing workforce that includes individuals who are from disadvantaged backgrounds, and that is equipped with the tools to provide quality, culturally-aligned care to rural and underserved communities in need.

Program Objective The objective of the NWD program is to increase the diversity of the nursing workforce by supporting students from disadvantaged backgrounds in becoming registered nurses to decrease health disparities and increase health equity.

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

• 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

Entities must be ready to continue programmatic activities in the event of a public health emergency – both those that are expected and unexpected. A training-focused emergency preparedness plan is critical for HRSA-funded projects and helps ensure that grantees are able to continue programmatic activities, can coordinate effectively, and can implement recovery plans when emergencies disrupt project activities.

Applicants must develop and maintain a flexible training-focused emergency preparedness plan in case of public health emergencies to ensure continuation of programmatic and training activities, including but not limited to clinical experiential training.

2. Background

This program is authorized by Section 821 of the Public Health Service (PHS) Act (42 U.S.C. § 296m). A diverse nursing workforce is a high priority for addressing the nursing

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shortage and for meeting the cultural needs of an increasingly diverse population.1 By 2044, the minority population will surpass the majority population with nearly half of the U.S. belonging to a group other than non-Hispanic White. According to HRSA’s Nursing Workforce Projections, the national Registered Nurse (RN) supply across all race and ethnicity groups is projected to grow from 2,806,100 Full-Time Equivalents (FTEs) to 3,895,600 FTEs between the year 2014 and 2030.2 The lack of diversity in nursing education programs continues to contribute to the lack of diversity in the RN workforce.

Over the years, nursing institutions have made great strides to enroll students from disadvantaged backgrounds by implementing holistic admissions, providing student academic and financial support and addressing social and educational determinants that impede student success.3 In academic year (AY) 2018–2019, a year after the implementation of holistic admissions, the NWD program supported the training of more than 11,000 students, with 51% of trainees from underrepresented minorities, 61% from disadvantaged backgrounds, and approximately 13% from rural residential backgrounds.

The nursing literature shows 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 workforce.

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, pre-entry and retention activities. Studies have also shown that a social determinants framework can help to identify the economic and support barriers that can impede a student’s success, and the social, environmental, and structural barriers that impede an institution’s ability to support its students from enrollment through graduation.

Further, a systems approach to address these barriers affords institutions the opportunity to examine and adjust current admissions, recruitment, and retention practices, and better utilize evidence-based strategies that address the structural changes necessary to create an environment that is culturally inclusive and adapts to the unique needs of a diverse student population.4,5

1 Woods-Giscombe, C. L., Johnson Rowsey, P., Kneipp, S., Lackey, C., & Bravo, L. (2020). Student perspectives on recruiting underrepresented ethnic minority students to nursing: Enhancing outreach, engaging family, and correcting misconceptions. Journal of Professional Nursing, 36(2), 43-

49. https://doi.org/10.1016/j.profnurs.2019.08.006 2 Nursing workforce projections by ethnicity and race 2014-2030. (2017, December). Bureau of Health Workforce |. https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/hrsa-bhw-rn-lpn-factsheet-12-17.pdf 3 Murray, T. (2019). Diversity matters: Why don't we see it in the registered nurse workforce? Journal of Nursing Education, 58(12), 679-680. https://doi.org/10.3928/01484834-20191120-01 4 Marmot M, Friel S. (2008) Global health equity: Evidence for action on the Social Determinants of Health. Journal of Epidemiology and Community Health, 62, 1095-1097.

http://dx.doi.org/10.1136/jech.2008.081695 5 Marmot M., Allen J., Bell R., Bloomer, E., and Goldblatt, P. (2012) WHO European review of social determinants of health and the health divide. The Lancet, 380(9846), 1011-1029.

http://dx.doi.org/10.1016/S0140-6736(12)61228-8 https://doi.org10.1016/j.profnurs.2019.08.006 https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/hrsa-bhw-rn-lpn-factsheet-12-17.pdf https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/hrsa-bhw-rn-lpn-factsheet-12-17.pdf https://doi.org10.3928/01484834-20191120-01 http://dx.doi.org/10.1136/jech.2008.081695 http://dx.doi.org/10.1016/S0140-6736(12)61228-8

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Academic nursing must continue to make efforts to ensure that the future nursing workforce represents the diversity of the U.S. population. According to the American Association of Colleges of Nursing’s (AACN) 2018-2019 graduating report, nursing students from minority backgrounds represent 34.2 percent of students in entry-level baccalaureate programs, 34.7 percent of master’s degree students, and 34.6 percent of Doctor of Nursing (DNP) students.6 The emphasis on having a diverse nursing workforce population is based on research suggesting that health professionals from underrepresented minority (URM) groups are more likely to care for URM patients and serve in impoverished areas and thus improve access for underserved populations.7

A lack of diversity in the nursing education pipeline has led to a lack of diversity among registered nurses.8 Diversity in education environments can improve learning outcomes, improving skills such as active thinking, intellectual engagement, and motivation, as well as certain social and civic skills, such as the ability to empathize and have racial and cultural understanding.9

In addition, as a result of interaction with individuals from a variety of backgrounds during their training, health professionals are better able to serve the nation’s diverse society by having a broadened perspective of racial, ethnic, and cultural similarities. In 2016-2017, the National League for Nursing Faculty Census Survey revealed the racial background of full-time faculty was 80.8 percent white, compared to 8.8 percent African American, 3.2 percent Hispanic, 2.2 percent Asian, and less than 1 percent multiracial and Native American.10 A barrier to the success of students from disadvantaged backgrounds is the lack of faculty and staff that reflect the backgrounds of the students being educated. According to the National Advisory Council on Nurse Education and Practice, in addition to encouraging underrepresented minority student recruitment, minority faculty members provide underrepresented minority students with mentors, and help create a community of support that encourages retention and graduation.11

Additionally, social determinants relevant to education can negatively impact the success of a disadvantaged student progressing through a nursing program. To address the complex and multi-faceted needs of students from disadvantaged backgrounds, it is imperative that academic institutions provide adaptive and tailored

6 American Association of Colleges of Nursing (AACN) fact sheet - Enhancing diversity in the nursing workforce. (2019, April 1).. https://www.aacnnursing.org/News-Information/Fact-Sheets/Enhancing- Diversity 7 Glazer, G., Tobias, B., & Mentzel, T. (2018). Increasing healthcare workforce diversity: Urban universities as catalysts for change. Journal of Professional Nursing, 34(4), 239-

244. https://doi.org/10.1016/j.profnurs.2017.11.009 8 Gates, S. A. (2018). What works in promoting and maintaining diversity in nursing programs. Nursing Forum, 53(2), 190-196. https://doi.org/10.1111/nuf.12242 9 Gurin, P., Dey, E., Hurtado, S., & Gurin, G. (2002). Diversity and higher education: Theory and impact on educational outcomes. Harvard Educational Review, 72(3), 330-367.

https://doi.org/10.17763/haer.72.3.01151786u134n051 10 National League for Nursing Faculty Census Survey 2016-2017. http://www.nln.org/docs/default-source/default-document-library/disposition-of-full-time-nurse-educators-by-race-ethnicity- 2017.pdf?sfvrsn=0 11 National Advisory Council for Nursing Education and Practice. Eleventh report to the Secretary of the Department of Health and Human Services and the Congress, 2013, Achieving Health Equity through Nursing Workforce Diversity. Available from:

http://www.hrsa.gov/advisorycommittees/bhpradvisory/nacnep/Reports/eleventhreport.pdf.

https://www.aacnnursing.org/News-Information/Fact-Sheets/Enhancing-Diversity https://www.aacnnursing.org/News-Information/Fact-Sheets/Enhancing-Diversity https://doi.org10.1016/j.profnurs.2017.11.009 https://doi.org/10.1111/nuf.12242 https://doi.org10.17763/haer.72.3.01151786u134n051 http://www.nln.org/docs/default-source/default-document-library/disposition-of-full-time-nurse-educators-by-race-ethnicity-2017.pdf?sfvrsn=0 http://www.nln.org/docs/default-source/default-document-library/disposition-of-full-time-nurse-educators-by-race-ethnicity-2017.pdf?sfvrsn=0 http://www.nln.org/docs/default-source/default-document-library/disposition-of-full-time-nurse-educators-by-race-ethnicity-2017.pdf?sfvrsn=0 http://www.hrsa.gov/advisorycommittees/bhpradvisory/nacnep/Reports/eleventhreport.pdf

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student academic and nonacademic support services. Academic support may include pre-nursing immersion experiences to prepare students for the rigorous demands of a nursing program, individual and group tutoring (faculty-guided and peer-to-peer tutoring) to improve classroom and clinical skills, professional writing, and speaking.

Nonacademic support may include peer-to-peer mentoring and supportive networks of diverse faculty and peers, creation of environments of inclusivity, and social support services to address resiliency and overall well-being.

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. Please see Section VIII: Other Information, Program Definitions applicable to this NOFO).

II. Award Information

1. Type of Application and Award

Type(s) of applications sought: New and Competing-Continuations.

HRSA will provide funding in the form of a grant.

2. Summary of Funding

HRSA estimates approximately $16,100,000 to be available annually to fund up to 29 recipients. You may apply for a ceiling amount of up to $555,000 (includes both direct and indirect facility) per year. The period of performance is July 1, 2021 through June 30, 2025 (4 years). Funding beyond the first year is subject to the availability of appropriated funds for the NWD program in subsequent fiscal years, satisfactory recipient performance, and a decision that continued funding is in the best interest of the Federal Government.

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

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.

https://bhw.hrsa.gov/grants/resourcecenter/glossary 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 supported by HRSA programmatic funding provided through NWD) must be enrolled in an accredited nursing program and be a citizen, national, or permanent resident of the United States. Individuals must be from educationally or economically disadvantaged backgrounds (including racial and ethnic minorities underrepresented among registered nurses).

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 10.

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 $555,000 per year 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 maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives the award, as required by 42 U.S.C. § 296b(b). Such Federal funds are intended to supplement, not supplant, existing non-Federal expenditures for such activities. 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. An organization is defined by having a valid Data Universal Numbering System (DUNS) number or Unique Entity Identifier

(UEI).

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.

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 NOFO following the directions provided at http://www.grants.gov/applicants/apply-for-grants.html.

The NOFO is also known as “Instructions” on Grants.gov. You must 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. 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 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 http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf

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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), and letters of commitment and support required in HRSA’s SF-424 R&R Application Guide and this NOFO.

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

Please note: If you use an OMB-approved form that is not included in the workspace application package for HRSA-21-020, 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. Proof of non-profit status (if applicable) does not count in the page limit. It is therefore important 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.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

1) You certify on behalf of the applicant organization, 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 12: Other Relevant Documents.

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

Temporary Reassignment of State and Local Personnel during a Public Health Emergency

Section 319(e) of the PHS Act provides the Secretary of the Department of Health and Human Services (HHS) with discretion upon request by a state or tribal organization to authorize the temporary reassignment of state, tribal, and local personnel during a declared federal public health emergency. The temporary reassignment provision is applicable to state, tribal, and local public health department or agency personnel whose positions are funded, in full or part, under PHS programs and allows such personnel to immediately respond to the public health emergency in the affected http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf

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jurisdiction. Funds provided under the award may be used to support personnel who are temporarily reassigned in accordance with § 319(e). Please reference detailed information available on the HHS Office of the Assistant Secretary for Preparedness (ASPR) website via http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx.

Program-Specific Instructions

Program Requirements

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 implementing key evidence-based strategies to address the social determinants and other structural factors that impede the academic success of students from disadvantaged backgrounds. The key evidence-based strategies include:

• Student support services – tailoring services (academic, peer, and social supports) necessary to facilitate and maintain the academic success of students from disadvantaged backgrounds, including the implementation of strategies to improve student resiliency and well-being in order to prevent burnout throughout the nursing pipeline;

• Faculty recruitment and retention – recruiting and retaining faculty from diverse backgrounds that reflect the population of the target student population being supported and are sufficient to address the needs of the students;

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

• Student financial support – providing financial support such as scholarships and stipends to eligible project trainees to promote retention, and to address the social determinants and multi-faceted needs of students from disadvantaged backgrounds;

• Holistic review – implementing criteria that are evidence-based, driven by the mission of the school of nursing, promote diversity, and use a balance of experiences, attributes, and academic metrics. Within this strategy applicants will:

o Establish a plan to implement a formal arrangement with a health professions organization for new or continued training and technical assistance with regards to holistic review processes, practices, and implementation, as well as to increase the level of diversity training.

• Collaborative partnerships (academic, practice, and community) – addressing the social determinants that impede access to education and academic success of students from disadvantaged backgrounds.

http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx

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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

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

5. Funding preference for which the applicant is requesting, if applicable

(e.g., rural, underserved, or public health nursing).

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 You must identify and describe the target student population and communities served by the proposed project. You must directly link all aspects of the project to its goals and objectives, including its contribution to improving diversity, inclusion, and representation within the nursing workforce. You must describe the following:

• Demographic data of the geographic area of the proposed project where education and training will occur – and the health needs of the communities served, including a description of the health care access and health disparity issues associated with that area;

• Demographics of the current nursing workforce in the geographic area of the proposed project;

• Data from Academic Year 2018-2019 on the number and percentage of students from disadvantaged backgrounds (including racial and ethnic minorities underrepresented among registered nurses who are enrolled, retained, and graduated from the program, and passed the National Council Licensure Examination (NCLEX-RN) on the first attempt. Newly established schools that do not have performance data from Academic Year 2018-2019 should indicate this in their response and provide current recruitment and admissions data for the identified target population;

• Demographic data of the target student population, including but not limited disadvantaged background characteristics, geographic background, and race/ethnicity background;

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

• Demographics of current faculty and staff within the school of nursing;

• Existing barriers in services, infrastructure, or opportunities that impede the academic success of individuals from disadvantaged backgrounds, at any point along the educational pipeline; and

• Challenges in the creation of academic environments that are adaptive to diverse student and faculty needs and facilitate academic success.

• 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).

• 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. A sample work plan can be found here:

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

You must:

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

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

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

• Identify the plan for the recruitment and retention of students and faculty from diverse backgrounds;

• 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 program implementation;

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

• Identify meaningful support and collaboration with key internal and external partners in planning, designing and implementing program activities;

• Outline the plan to provide student financial support to eligible project participants; and

• Provide a plan for using training and/or learning experiences that address cultural awareness, social determinants of health and health disparities.

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

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• (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 provide a clear and comprehensive description of how you will implement or enhance each of the key evidence-based strategies to address the needs identified above:

1. Student support services;

2. Faculty recruitment and retention;

3. Mentoring;

4. Student financial support;

5. Holistic review; and

6. Collaborative partnerships

In addition, you must describe:

• How the implementation of student support services will enhance the ability to address the challenges that impede recruitment, retention, and graduation of students from disadvantaged backgrounds;

• How the examination of applicant review practices to assess if criteria are mission-driven, evidence-based, and assess a balance of experience, attributes, and academic metrics and to incorporate holistic review practices based on assessment;

• Plan for the recruitment, retention, and development of diverse faculty;

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

• 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;

and

• Emergency preparedness plan, in case of public health emergency, to ensure continuation of programmatic and training activities.

Logic Model 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 following:

• Goals of the project (e.g., 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);

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

• 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:

http://www.acf.hhs.gov/sites/default/files/fysb/prep-logic-model-ts.pdf.

• (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, applicants must 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 recruitment and retention of diverse faculty;

• Challenges related to the implementation of holistic review; 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:

• 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.

• 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 http://www.acf.hhs.gov/sites/default/files/fysb/prep-logic-model-ts.pdf http://bhw.hrsa.gov/grants/reporting/index.html

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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;

• Describe 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.

Award recipients may be asked to collect and report the following qualitative data:

• Frequent assessment and evaluation of social determinants and holistic review metrics used to inform incoming class in order to tailor evidence-based strategies;

• Strategies for rapid-cycle quality improvement to test the effectiveness of the project and plan for ongoing feedback and improvement;

• Measures of institutional progress toward the implementation of program requirements;

• Depth and increase of institutional support for the grant program and activities from leadership, faculty, and staff during the progress of the project;

• Level of involvement and activities with internal and external community-academic partnerships;

• Baseline evaluation of school’s applicant review practices; and

• Progress toward and sustainability of a culture of diversity and inclusion.

In Attachment 2, you must attach a complete staffing plan and job descriptions for key personnel. Biosketches 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/.

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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• (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. 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 strategies) which have been effective in improving practices;

• Timetable to become sustainable in the absence of federal funding, including student support services; and

• Plan to sustain a culture of diversity and inclusion. Demonstrate a 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 care access 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 implement the program requirements and meet program expectations. (A project organizational chart is requested in Section IV.2.v., 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;

• 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

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demonstrate institutional commitment to train students from disadvantaged backgrounds, including racial and ethnic minorities underrepresented among registered nurses;

• Evidence of transformative learning and active faculty recruitment, retention, and continuing professional development that demonstrates commitment to diversity; and

• Presence of an emergency preparedness plan to continue grant activities in the event of a public health emergency.

The staffing plan and job descriptions for key faculty/staff must be included in Attachment 2 (Staffing Plan and Job Descriptions for Key Personnel).

Biographical sketches must be uploaded in the SF-424 RESEARCH & RELATED Senior/Key Person Profile (Expanded) form that 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 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

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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.

iii. Budget The directions offered in the SF-424 R&R Application Guide may differ from those offered by Grants.gov. Follow the instructions in Section 4.1.iv of HRSA’s SF-424 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, may 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) you incur to carry out a HRSA-supported project or activity. Total project or program costs include costs charged to the award and costs borne by you 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 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, tuition and fees, and subawards and subcontracts in excess of $25,000 are excluded from the direct cost base for purposes of this calculation.

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

The budget justification narrative must describe all line-item federal funds (including subawards). Please note: all budget justification narratives count against the page limit.

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