Transcript Title VII Primary Care Training Grants for PA Programs

Title VII Primary Care Training Grants for
PA Programs: Tips for a Successful
Application
David Keahey, PA-C, MSPH
Constance Goldgar, MS, PA-C
University of Utah Physician Assistant Program
PAEA Annual Education Forum
November 7, 2009
Portland, Oregon
Tips for a Successful Title VII Application
Goal:
– Attendees will gain understanding of federal
funding in support of physician assistant education
and obtain knowledge that will help them write
approved and funded Title VII grants.
Tips for a Successful Title VII Application
Objectives:
– Understand the evolution of federal support of
physician assistant training over the past 40 years
and the purpose of the Physician Assistant Training
in Primary Care Program.
– Develop the skills necessary to identify needs in
their programs that would benefit from Title VII
funding.
– Acquire the knowledge of the application format,
review criteria, budget justification, and funding
priorities and preferences to permit the successful
authorship of a Title VII grant.
Tips for a Successful Title VII Application
Objectives:
– Describe the organizational skills and administrative
support necessary to develop, achieve, and
measure objectives that will be made possible with
grant funding.
– Understand the reporting requirements for grantees.
HRSA Mission and Goals
HRSA provides national leadership, program resources and
services needed to improve access to culturally competent,
quality health care.
As the Nation's access agency, HRSA focuses on
uninsured, underserved, and special needs populations in
its goals and program activities:
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Improve Access to Health Care.
Improve Health Outcomes.
Improve the Quality of Health Care.
Eliminate Health Disparities.
Improve the Public Health and Health Care Systems.
Enhance the Ability of the Health Care System to Respond to
Public Health Emergencies.
– Achieve Excellence in Management Practices
Title VII
Training in Primary Care Medicine and
Dentistry Grant Program
• Includes six program areas:
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Residency Training
Predoctoral Training
Faculty Development Training
Academic Administrative Units
Physician Assistant Training
Residency Training in General and
Pediatric Dentistry
Title VII Funding for Physician Assistants
Purpose
To meet the costs of projects to plan, develop, and operate or
maintain programs for the training of physician assistants
and for the training of individuals who will teach in programs
to provide training of physician assistants.
Eligibility
Public or nonprofit private hospitals, accredited public or
nonprofit private schools of allopathic or osteopathic
medicine, or public or nonprofit private entities.
Current PA Funding1
1http://www.acofp.org/.../Fri%208am-12pm,%20Grant%20Writing,%20Williamson,
%20Brenda.pdf
Title VII
Section 747
History
• ~$200 million since 1972 has been invested in PA
education2
• FY 2008 18 PA programs funded
– Range: $56,000-$232,500/year
– Average: $140,398/year over 3 years
2Cawley,
JF. Physician Assistants and Title VII Support. Academic Medicine. 2008;83(11):1049-1056.
Step 1: Connected with a grants
management division in your institution?
• Obtain an organizational Data Universal Number System
(DUNS) number
• Register the organization with Central Contractor Registry
(CCR)
• Identify the organization’s E-Business POC (Point of
Contact)
• Confirm the organization’s CCR “Marketing Partner ID
Number (M-PIN)” password
• Register an Authorized Organization Representative
(AOR)
• Obtain a username and password from the Grants.gov
Credential Provider
Step 2: Funding Factors and Funding
Priorities
• A funding priority is defined as a numeric
adjustment of an application’s review score
when specific criteria are met.
• Each funding priority has a point value of five
(5) points. Partial points will not be awarded
• Disadvantaged Priority
Disadvantaged Priority Funding Factors
Disadvantaged
Priority Funding
Factors
Medically Underserved Community
(MUC) Funding Preference
• Have a high rate for placing graduates/program
completers in practice settings having the principal
focus of serving residents of medically underserved
communities; or
• During the 2-year period preceding the fiscal year for
which an award is sought, have achieved a
significant increase in the rate of placing
graduates/program completers in such settings; or
• Meet the criteria for a new program.
2006 Program Comple ters as of July 2006
Re si de n cy
FM
GIM
GP
Faculty
FM
De velopme n t GIM
GP
PA
De n tal
Gen
Re si de n cy
P eds
2003 Gradu ate sas of July 2006
Pre doc/AAU
FM/GIM/GP
TO TAL
2007 Program Comple ters as of July 2007
Re si de n cy
FM
GIM
GP
Faculty
FM
De velopme n t GIM
GP
PA Stu de n ts
De n tal
Gen
Re si de n cy
P eds
2004 Gradu ate sas of July 2007
Pre doc/AAU
FM/GIM/GP
TO TAL
% Grads
or Prog
Comp
in these
settings
Total # Grads
or Prog Comp
Total # of
Grads or
ProgComp in
these settings
Sites
Designated
by State Gov.
Health Depts
HPSAs,
Dental
HPSAs
FQHCs
IHS
Sites
NHSC
Sites
Rural Health
Clinics
Public Housing
Primary
Care
Grantees
Health
Care for
the
Homeless
MHC
MUC
Prefere n ce
Re qu e st Tab
le
CHC
MUC Table
Step 3: Special Considerations
• Special consideration shall be given to
projects that prepare practitioners to care for:
– underserved populations
– other high risks groups
e.g., elderly, individuals with HIV/AIDS, substance
abusers, homeless, and victims of domestic
violence
• Healthy People 2010 goals
Step 4: Writing the Grant
• Use the Program Guidance!
• Create the outline from the Program
Guidance
• One person should coordinate the grant
• Assign action items and timelines for each
objective
• Write the content to be consistent with the 7
Review Criteria
Program Guidance Outline--80 page
limit not including tables
• Project Abstract--2 pages
• Progress Report--3 pages
– Specific Objectives and
Methodology
– Outcomes and
Evaluation
• Project Narrative
– Introduction
• Organizational Information
• Needs Assessment
(Rationale)
• Methodology
• Work Plan
– Resolution of Challenges
• Outcome Measures and
Dissemination
• Forms (multiple)
• Attachments
– Organizational charts
– Letters of agreement
– Budget
Application Review Information
100 Points Total--7 Criteria
•
Need (10 pts)
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– Narrative section: Needs
Assessment
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Evaluative Measures (10 pts)
– Narrative sections: Evaluation
and Technical Support
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– Narrative sections:
Organizational Information,
Work Plan, and Progress
Report
Response (30 pts)
– Narrative sections:
Methodology, Work Plan,
Resolution of Challenges
Impact (10 pts)
– Narrative sections: Outcome
Measures and Dissemination
Resources/Capabilities (15 pts)
•
Support Requested (10 pts)
– Budget Justification
•
Specific Program Criteria (15
pts)
– Special Considerations
Needs Assessment…
Getting Started:
Planning the Grant Writing
• Identify a leader and form a small team with diverse skills
• Develop timeline for grant prep/writing/submission
• Task responsible persons with internal deadlines (sections,
full draft, budget)
• Assess impact of proposed project on program
• Negotiate needs of project (space, curriculum time, faculty
resources)
• Identify partnerships/collaborators where applicable and
think about potential letters of support
Focus on access and improving healthcare outcomes
What Do You Want to Do? (Objectives)
• Can you state what you want to do in educational
terms?
• How does it relate to the training of PA students?
– Improvement in the didactic and/or clinical instruction
(especially re primary care)?
– Implementation of a new program/service to learners
or community?
– Addition of new skill sets to learners?
– New curriculum or programs for learners?
– Faculty development?3
3 Glicken,
AD. Excellence in Physician Assistant Training Through Faculty Development.
Academic Medicine. 2008;83(11): 1107-1110.
Rationale
Can You Justify the Need for this Activity?
• Can you provide a rationale and assumptions
upon which the project objectives will be
based?
• Has a recent accreditation review created a
need for change?
• Is there an emerging medical education topic
that merits incorporation into the curriculum?
• Have you done a literature review?
• Did you perform a needs assessment?
Literature Review
• Have you researched the literature on the
topic or proposed activities?
– Is there any PA literature?
• If not, what exists for medical residencies, graduate
medical education?
– Does the literature support
• Your rationale?
• Your methodology?
Needs Assessment
• Don’t use old needs assessments
• Survey data from students, faculty, community-e.g.,
– Indicating that this competency or core clinical skill
was weak once they were out in practice
– Interest & eligibility of students and faculty (or
community)
– Demonstrated need in a specific area--e.g., cultural
competence, health literacy
• Focus groups
• Baseline data - don't wait until you're writing a
proposal to collect It!
Needs Assessment
• Decide what information is most needed
about targeted learners--e.g.,
– Students’ previous experiences or proficiencies
– Different learning styles
– Learning environment
• e.g., barriers, reinforcing factors
– Resources available
• e.g., patients/clinical experiences, information sources,
computers, mentors, etc.
Needs Assessment
• Use data to support that it is a compelling
need
– Census data
– Historical data
– Geographical data
– State Statistical data
– Pilot studies/research--yours and others
Alignment with Special
Consideration Areas
• Special populations
– Elderly, Homeless, Victims of Domestic Violence,
Substance Abuse, Patients with HIV/AIDS
• Areas of innovation
– Quality Improvement/Patient Safety, Health
Literacy/Cultural Competency, PCMH
• Healthy People 2010 Overarching Goals
– Increase quality and years of life, eliminate health
disparities
Frame with SMART Objectives
Specific
Be specific about what you are going to achieve
(i.e., use strong action verbs, be concrete).
Measurable Quantify objectives (i.e., numeric, quantity,
cost). How will you know you have reached
your objective?
Achievable Are your objectives achievable and attainable?
Realistic
Do you have the resources to achieve your
objectives (i.e., personnel, facilities, equipment
and in-kind contribution and requested in
project)?
Timely
State when you will achieve the objectives
(i.e., weekly, monthly, annually, by January ‘12).
Narrative
• Background
– Description of
• Your current program, setting and resources
• Your program’s/institution’s strengths relevant to the project
• Need for the project (needs assessment)
– National trends/drivers
(e.g., service learning, learner-centered instruction, patientcentered care models, HP 2010)
– Impact on learners, educational community, and
patients
– Relevance of your project to national priorities
Methodology
• Describe what is new or different
• Link activities to specific objectives
• Describe staffing/expertise you have in place
to conduct the activities
• Timeline
• Think about how activities will be evaluated
Resolution of Challenges
• For each objective, or where pertinent, what are the
specific barriers or perceived barriers to getting the
activities accomplished, e.g.,
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Identifying key personnel
Personnel training
Establishing partnerships
Insertion of curricular components
Other
Evaluation
• Be specific in the evaluation
– Have clear and measurable objectives
– Allow for feedback into the process
– Develop process and outcome measures
• Is the evaluation summative, formative,
qualitative?
• Is it objective with realistic outcomes
measures?
Other Points
• Make it easy for reviewers to find required elements
• Sustainability after the grant is key
• The proposed project should be doable by your
group in your institution
• The proposed project should be relevant to the
mission of HRSA
Budget
• Need rough idea of what it will cost to
undertake each component of the study
• Need to account for time, equipment, office
costs, etc. This could include:
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Consultant costs
Travel
Rental and leases
Office supplies
Equipment cost/maintenance
Other…
Budget Justification
• Justify all personnel
– List all personnel involved even if no salary is
requested: “in kind contributions”
• Identify unique roles each person will play
• Justify all costs/travel/expenses
– Who will travel and why (purpose)
– Estimate expenses for actual meetings
Performance Reviews and Progress
Reports
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Set up monitoring system
Involve key support personnel
Continuously gather data
PD (PI) should monitor due dates and assure
that reports are submitted in a timely manner
Take Home Points
• Know the purpose of HRSA grant support
• Identify program needs within the HRSA framework
• Strongly consider investing faculty time as HRSA grant
reviewers
• Register at Grants.gov or become familiar with grants
management at your institution (DUNS, POC, M-PIN, AOR)
• Study the Program Guidance (don’t be intimidated)
• Use the Program Guidance as an outline
• Use the Review Criteria as a sub-outline
• Write the content in the comprehensive framework and to
be consistent with the 7 Review Criteria
Take Home Points
• From the outset, use tables from the Program Guidance
to track faculty and students (disadvantaged, gender,
race, ethnicity, medically underserved training and
employment)
• Continuously track data for future reporting on
performance reviews and progress reports
• Contact successful Program Directors (PIs) to see if they
will share copies of their grants
• Your thoughts?
• Tips?
• Questions
References
• Catalog of Federal Domestic Assistance (CFDA) No.
93.884. Training in Primary Care Medicine and
Dentistry. Authority: Title VII, Section 747, Public
Health Service Act, as amended, (42 U.S.C-293k).
• Cawley, JF. Physician Assistants and Title VII Support.
Academic Medicine. 2008;83(11):1049-1056.
• Glicken, AD. Excellence in Physician Assistant Training
Through Faculty Development. Academic Medicine.
2008;83(11): 1107-1110.