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Primary Care Training and Enhancement: Training Primary Care Champions

Grants to USA Medical Schools, Hospitals, Nonprofits, and
Public Agencies for Primary Care Fellowship Programs

Agency Type:

Federal

Funding Source:

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U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), Bureau of Health Workforce, Division of Medicine and Dentistry

Conf. Date:

12/18/17

Deadline Date:

01/30/18 11:59 PM ET

Description:

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Grants to USA medical schools, hospitals, and other public or nonprofit agencies to establish a fellowship program for the training of practicing primary care physicians and physician assistants. Applicants are advised that registrations required to apply may take up to one month to complete. The purpose of this program is to strengthen primary care.

Program Purpose:

The purpose of this program is to strengthen primary care and the workforce by establishing fellowship programs to train community-based practicing primary care physician and/or physician assistant champions to lead health care transformation and enhance teaching in community-based settings. Characteristics of transformed health care delivery systems identified by the Centers for Medicare and Medicaid Services (CMS) include:

-Providers across the care continuum participate in integrated or virtually integrated delivery models,
-Care is coordinated across all providers and settings,
-High level of patient engagement and quantifiable results on patient experience,
-Providers leverage the use of health information technology to improve quality,
-Providers perform at the top of their license and board certification,
-Population health measures are integrated into the delivery system, and
-Data are used to drive health system processes.

HRSA also recognizes addressing social determinants of health as a characteristic of transformed health care delivery systems.

Program Requirements:

In FY 2018, applicants for the PCTE: Training Primary Care Champions program must develop academic-community partnerships to train and support primary care physician and/or physician assistant champions to lead health care transformation in community-based settings and enhance teaching in community-based settings.

The applicant organization must include or partner with the following organizations:
1. An academic medical school or physician assistant school; and
2. One or more community-based primary care sites. Applicants are encouraged to partner with National Health Service Corps-approved sites. Sites also can be health centers, rural health clinics, and Indian Health Service sites.

If the applicant organization is a medical school or physician assistant school they are not required to partner with another medical school or physician assistant school.

Applicants must identify community-based primary care partners at the time of application, and are expected to expand these partnerships over the 5-year grant period. For example, the applicant may add partnerships with additional community health centers, other community-based primary care organizations, or other sites in the second , third, fourth, and fifth years of the project. They would then be able to recruit Fellows from the additional partner sites.

HRSA also encourages partnerships with other health and community-based organizations, including local departments of health, Department of Veterans Affairs medical facilities, Area Health Education Centers, AIDS Education and Training Centers, and Public Health Training Centers.

Applicants must develop and operate a program for the training of physicians and physician assistants who will teach in community-based settings and provide training in new competencies, consistent with health care transformation principles. Applicants may provide financial assistance in the form of fellowships to the participants of these programs. Applicants must:

1. Develop and implement these fellowship programs through academic-community partnerships. Community-based primary care sites must be committed to identifying and supporting physicians and/or physician assistants from their organizations to participate in the PCTE: Training Primary Care Champions program. Fellows must continue to provide clinical services at the primary care site through the course of the fellowship program. Understanding of and commitment to these requirements should be delineated in a letter of agreement from each partnering primary care site.

2. Train fellows in the areas of leadership, health care transformation, and education. Training must include content to address competencies in the areas of leadership, team-based integrated health care, quality improvement, population health, social determinants of health, health policy, and education.

3. Support fellows in the selection and implementation of a health care transformation project in their community-based primary care site. These projects must match the needs of the primary care site, have clearly defined goals, objectives, and expected outcomes, and have clear evaluation plans to determine the impact of these projects on improving health among the community served by the primary care site. Fellows must receive appropriate mentorship and support for these projects, and evaluation outcomes should be matched to relevant quality outcomes, for example Uniform Data Systems (UDS) quality outcomes for Health Centers and CMS Clinical Quality Measures for EHR Incentive Programs quality measures.

The fellowship training program must be at least one year and not longer than two years. The minimum number of fellows per training period is four physicians or physician assistants for one-year programs and eight for two-year programs. HRSA will convene grant recipients and fellows annually for an in-person meeting; applicants should include the cost of this travel in their budget request.

Applicants are encouraged to address the Department of Health and Human Services (HHS) clinical priorities of opioid abuse, mental health, and childhood obesity through their training and fellows’ health care transformation projects.

Applicants should be committed to increasing the diversity of the health workforce. This commitment helps to ensure, to the extent possible, that the workforce addresses the diversity of the Nation. Training programs should develop the competencies and skills needed for intercultural understanding and expanded cultural fluency, recognizing that bringing people of diverse backgrounds and experiences together facilitates innovative and strategic practices that enhance the health of all people.

Additional Program Information:

The PCTE program is partnering with the National Health Service Corps (NHSC), per the recommendation of the Advisory Committee on Training in Primary Care Medicine and Dentistry “to leverage funding streams to reduce barriers and foster programmatic collaboration.” The NHSC Loan Repayment Program (LRP) is authorized under section 338B of the Public Health Service (PHS) Act (42 U.S.C. § 2541-1) to provide loan repayment assistance to primary health care professionals in exchange for a commitment to serve in a Health Professional Shortage Area (HPSA).

The NHSC is committed to strengthening the primary care workforce through the recruitment and retention of high quality primary care providers at NHSC-approved sites. Studies show that Title VII funding of departments of family medicine at U.S. medical schools is significantly associated with expansion of the primary care physician workforce and increased accessibility to physicians for the residents of rural and underserved areas. For example, a recent study found that physicians who have trained in Title VII-funded programs are more likely to work with the underserved in community health center and NHSC sites than those who do not.

Acknowledging the importance of these Title VII programs, and their impact on the preparation and training of health professionals that serve in underserved areas, HRSA designed the PCTE: Training Primary Care Champion program to give PCTE fellows experience and competency in areas that make them more likely to serve in underserved areas. Therefore, HRSA intends to provide physicians and physician assistants who have completed PCTE fellowships with priority status when applying for

NHSC LRP awards and continuation awards consistent with PHS Act section 338B(d)(2)(B), which provides a priority to NHSC LRP applicants who have “characteristics that increase the probability that the individual will continue to serve in a health professional shortage area after the period of obligated service ...is completed.”

Participants in the NHSC LRP, NHSC Scholarship Program (SP), and NHSC Students to Service (S2S) LRP interested in participating in a PCTE primary care leadership fellowship program may convert to a half-time contract and continue satisfying their service obligation.

Funding Preference:

This notice includes a funding preference (section 791(a)(1) of the PHS Act). The funding preference is for applicants that:

a) demonstrate a high rate for placing graduates in practice settings having the principal focus of serving residents of Medically Underserved Communities or demonstrate a significant increase in the rate of placing graduates in Medically Underserved Communities settings over the preceding two years; or

b) are new programs as defined by PHS Act section 791(c).

In order to receive the funding preference, applicants must clearly indicate the funding preference for which they are applying in the Abstract as well as the school and discipline they are applying for (i.e., medical or physician assistant school), provide all required information, and meet the designated targets. Applicants may apply for this notice of funding opportunity without requesting a funding preference; applicants receiving a funding preference will be placed in a more competitive position among applications that can be funded. Refer to Section V.2 of this NOFO for detailed information on qualifying for a funding preference. Requested information to apply for the funding preference must be submitted in Attachment 6.

Background:

This program is authorized by Title VII of the Public Health Service Act, Section 747(a) (42.U.S.C. 293k(a)). The focus of this authority is on improving the Nation’s access to well-trained primary care physicians and physician assistants by supporting enhanced primary care training for physician and physician assistant students, residents, faculty, and practicing providers.

Research shows that a strong primary care foundation is critical for health care system performance and improved health. Recent evidence also suggests that expanding primary care workforce and availability of primary care services is associated with higher quality care at lower spending. Despite this evidence, the U.S. primary care workforce shortages limit access to high quality health care for the Nation. The demand for primary care services is projected to increase largely due to population aging and growth. However, increases in supply are not expected to meet the increases in demands for primary care providers, and shortages are magnified for underserved communities. Substantial disparities exist in the distribution of primary care providers, and shortages of health care providers impact rural areas disproportionately.

Evidence suggests that a number of strategies are effective in promoting primary care and rural and underserved career choices. Role model, health professional school culture, and positive training experiences in rural and underserved communities can drive primary care career choices, as well as practice location. Medical schools where students report positive experiences in primary care increased the likelihood of practicing primary care. In contrast, students who attended schools with high levels of negative reinforcement for primary care were less likely to practice in primary care.

In order to have positive role models, cultural changes, and community-based training, it is necessary to support and develop future community-based primary care physician and physician assistant champions. Calls for transformed health care systems to achieve the vision of patient-centered primary care also highlight the need for champions – particularly primary care leaders. Primary care leadership requires training and support in specific knowledge and skills. Programs to develop primary care leaders for underserved practice have demonstrated early success in retaining individuals in community health, placing individuals into leadership positions, and positioning individuals to obtain grants to support ongoing projects. Graduates from these programs have also reported benefits for community-based teaching and preceptors as a result of these programs, including increased financial support, faculty development for community preceptors, and enhanced community-based curriculum for students.

The goal of the PCTE: Training Primary Care Champions program is to train community-based primary care champions to lead health care transformation, enhance recruitment and retention in community-based settings, and grow academic-community partnerships to support enhanced teaching in community-based settings.

GrantWatch ID#:

GrantWatch ID#: 182501

Estimated Total Program Funding:

$4,000,000

Number of Grants:

Funding is expected to be available annually to fund up to 10 awards.

Estimated Size of Grant:

Applicants may apply for a ceiling amount of up to $400,000 total cost (includes both direct and indirect, facilities, and administrative costs) per year.

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

Term of Contract:

The project period is September 1, 2018 through August 31, 2023 (5 years).

Funding beyond the first year is dependent on the availability of appropriated funds for the PCTE: Training Primary Care Champions program in subsequent fiscal years, satisfactory recipient performance, and a decision that continued funding is in the best interest of the Federal Government.

Additional Eligibility Criteria:

Eligible applicants must be accredited schools of allopathic or osteopathic medicine, academically affiliated physician assistant training programs, accredited public or nonprofit private hospitals, or a public or nonprofit private entity that the Secretary has determined is capable of carrying out such grants. Faith-based and community-based organizations, tribes and tribal organizations may apply for these funds, if otherwise eligible.

The applicant must submit accreditation documentation for the medical or physician assistant school partner(s).

Pre-proposal Conference:

The following technical assistance webinar and conference call have been scheduled:

Webinar #1
-Tuesday, November 28, 2017, 2:00 to 3:30 PM ET

TA session #2 Conference Call - Frequently Asked Questions
-Monday, December 18, 2017, 2:00 PM to 3:30 PM ET

Pre-Application Information:

Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately. Deadline extensions are not granted for lack of registration. Registration in all systems, including SAM.gov and Grants.gov, may take up to one month to complete.

The due date for applications under this NOFO is January 30, 2018 at 11:59 PM, Eastern Time.

View this opportunity on Grants.gov:
https://www.grants.gov/web/grants/view-opportunity.html?oppId=298677

Contact Information:

Before starting your grant application, please review the funding source's website listed below for updates/changes/addendums/conferences/LOIs.

To attend the November 28, 2017 webinar:
-Call-In Number: 1-888-972-6410
-Participant Code: 8968481
-Web link: https://hrsa.connectsolutions.com/fy18pctenofo/

To attend the December 18 conference call:
-Conference Number: 1-888-972-6410
-Participant Passcode: 8968481
-Playback Number: 1-866-475-8046

You may request additional information regarding business, administrative, or fiscal issues related to this NOFO by contacting:

Kimberly Ross, Grants Management Specialist
HRSA Division of Grants Management Operations
OFAM 5600 Fishers Lane, Mailstop 10NWH04
Rockville, MD 20857
Telephone: (301) 443-2353
Fax: (301) 443-6343
Email: kross@hrsa.gov

You may request additional information regarding program issues and/or technical assistance related to this NOFO by contacting:

Anthony Anyanwu, Project Officer
Division of Medicine and Dentistry Bureau of Health Workforce, HRSA
5600 Fishers Lane, Room 15N-186B
Rockville, MD 20857
Telephone: 301-443-8437
Fax: 301-443-0162
Email: aanyanwu@hrsa.gov

CFDA Number:

93.884

Funding or Pin Number:

HRSA-18-013

URL for Full Text (RFP):

Geographic Focus:

USA: Alabama;   Alaska;   Arizona;   Arkansas;   California;   Colorado;   Connecticut;   Delaware;   Florida;   Georgia;   Hawaii;   Idaho;   Illinois;   Indiana;   Iowa;   Kansas;   Kentucky;   Louisiana;   Maine;   Maryland;   Massachusetts;   Michigan;   Minnesota;   Mississippi;   Missouri;   Montana;   Nebraska;   Nevada;   New Hampshire;   New Jersey;   New Mexico;   New York City;   New York;   North Carolina;   North Dakota;   Ohio;   Oklahoma;   Oregon;   Pennsylvania;   Rhode Island;   South Carolina;   South Dakota;   Tennessee;   Texas;   Utah;   Vermont;   Virginia;   Washington, DC;   Washington;   West Virginia;   Wisconsin;   Wyoming