Funding Opportunity Number: HRSA-21-111
Is the GWEP PI required to be the PI for this supplement application?
Yes. The Project Director (PD) for the GWEP must be the PD for the GWEP supplemental.
Can you please speak about the goal/plan for funding to each of the HRSA regions?
HRSA will aim for a proportionate distribution of awards across the Health and Human Services (HHS) 10 geographical regions based on the number of eligible applications received and recommended for funding by the objective review committee. The highest ranked applications in each HHS region will receive consideration for award.
Note: HRSA may need to fund out of rank order in order the distribution of awards.
Please define HHS regions.
The United States is divided into ten HHS regions. Access the maps of the states in each region.
Are we required to recruit nursing homes in our HHS region even though this may mean competing with other GWEP’s in their home states?
You must recruit nursing homes in your HHS region but may recruit additional nursing homes in any other state that you wish to, whether they are in your HHS region or they are in HHS regions outside of your own.
Note: Be courteous to inquire of other PDs who are in that state/region whether you are interfering with their plans or whether you might collaborate.
Do we need to stick to our main GWEP region or can we extend to our own GWEP partner regions? I.e. one of our GWEP partners is at Tulane University - can we extend to their region as well and provide education to nursing homes in Louisiana?
See answer to questions 2 and 4 above.
Should aims and outcomes focus on one year or two since second year funding is dependent on funding availability?
This funding opportunity has a two-year cycle, contingent upon the availability of funds. Provide aims and outcomes for both years of the cycle.
Is the end-date for Year-1, June 30 or August 31?
The length of the first year of funding is September 1, 2021 to June 30, 2022.
The length of the second year of funding is July 1, 2022 to June 30, 2023.
Is it required to identify specific nursing home partners or interested partners in the application?
Identify potential nursing homes and community-based partners with which you will work. If you have not yet identified any, you should indicate how many nursing homes you expect to recruit during each of the two years of the award, as well as the types of community-based partners you will need to recruit in order to meet your objectives.
May we include supportive living facilities (SLFs) which are congregate housing for older adults in addition to nursing homes?
HRSA understands that, ever since the beginning of the pandemic, the health impact of COVID-19 on older adults has been great, especially those in long-term care facilities and congregate settings. HRSA also knows that some communities provide long-term care in congregate settings that are not called long-term care facilities.
Example: Some states and territories do not have nursing homes but they do have small congregate living centers, which are sometimes called assisted living facilities.
Describe your community’s method of providing long-term care and explain how these alternative settings will allow you to meet the requirements of this funding opportunity if you wish to work with such settings.
You will need to include an explanation in your application of local needs for long-term care, and a description of these alternative settings if you live in such an area.
Can assisted living facilities be considered nursing homes or community organizations?
Yes. Assisted living facilities can be considered nursing homes or community organizations. Describe your community’s method of providing long-term care and how it will be impacted by your program.
Note: Independent sites with no primary or long-term care is not eligible.
Are all attachments included in the total page count?
Yes. Refer to page 13 of the NOFO for additional page count guidance.
Trainees and Training Questions
Can we use the AHRQ curriculum in order to reach more nursing homes?
Yes. You may use the ARHQ nursing home curriculum if you are providing training in nursing homes that are partnering with you for the first time. We encourage the use of evidence-based curricula.
Note: New training is required for nursing homes where you have already used the ARHQ curriculum.
Are we required to involve all the types of trainees? Workers, families, patients, etc. or can we focus on one group?
You must educate and train all groups, which are the nursing home workforce, nursing home residents and their families and caregivers for this supplement.
Is there an average number or required number of nursing homes we should be training?
No. HRSA expects each applicant to determine, via a needs assessment or focus group, the needs of a defined service area. The number of nursing homes will be determined by that need, not by a number stated in the NOFO.
The NOFO indicates using telehealth modalities for outreach to "families and caregivers" - what is meant by "caregivers" does this refer to the staff in the nursing homes?
You can find the definition of caregivers within the Definitions section on pages 2-4 of the NOFO. Staff in nursing homes are included under the definition of nursing home workforce.
As we are recruiting nursing homes, similar to Project ECHO, I imagine the recruitment may take time to determine the number of LTC facilities to be involved. What if our number of involved nursing homes is more or less than what we indicated in the application?
Indicate a possible range and describe how that range will influence your ability to fulfill your proposed activities if you are unsure about how many nursing homes will be involved.
Budget and Budget Justification Questions
On page 12 of the NOFO, “Participant/Trainee Support Costs” mentions CNAs. Are participant support cost supports limited to CNAs or could we also include other SNF staff such as nurses, social workers, etc. Can we provide stipends to NH ancillary services workers in addition to CNAs? (i.e., housekeeping, dietary, activities)?
Participant support cost support is limited to stipends for CNAs for this supplemental.
Can we "buy-out" the CNAs floor time?
No. Stipends cannot be used to “buy-out” time of CNAs to attend training rather than work. However, it is allowable to provide stipends to CNAs to attend training sessions during non-work hours.
You mentioned 22 months to spend can you please clarify?
The first year of funding is September 1, 2021 to June 30, 2022. The second year of funding is July 1, 2022 to June 30, 2023. That timeframe constitutes 22 months of funding, contingent upon availability of funding.
Can we incentivize homes to participate? For example, are we allowed to use the supplemental funds to pay nursing home to participate or can we pay nursing homes to participate in ECHO? This was part of the AHRQ project, at least during phase 1.
No. HRSA GWEP supplemental funds cannot be used to pay nursing homes to participate in training. Unlike the AHRQ ECHO Project that many of you participated in during this past year, you may NOT incentivize nursing home to participate.
Can we provide/fund technology to participating nursing homes, such as cameras?
Yes. You may provide/fund technology to participating nursing homes if this technology aids the meeting of the education and training objectives.
Note: You must have an inventory-monitoring program to ensure for any IT equipment (similar to the COVID-19 CARES Act supplement funds). That plan must be described in your application.
Are Advanced Care Plan (ACP) and depression screens/assessments in the Minimum Data Set (MDS)?
ACP is not in the MDS, but depression is. The MDS uses the PHQ-2 and PHQ-9 to screen for depression and the BIMS (Brief Inventory of Mental Status) for cognitive screening.
Shouldn't we use the MDS for our MIPS outcomes?
The MDS does not collect MIPS Measures. You will need to develop an evaluation strategy that involves chart review to collect the numerator and denominator of the MIPS Measure for reporting to HRSA. You must describe this evaluation strategy in your application.