Received: from JNET-Daemon by UNCVX1.BITNET; Wed, 24 Jul 91 13:26 EDT
Received: From UNC(MAILER) by UNCVAX1 with Jnet id 0280 for PJONES@UNCVAX1;
 Wed, 24 Jul 91 13:26 EST
Date: Wed, 24 Jul 91 13:25 EST
From: Dot Baker <UNCDOT@UNC.BITNET>
Subject: NIH GUIDE - RFA HS-91-03 - V20(26) 07/26/91
To: pjones@UNCVX1.BITNET

Hi Paul,
   This is the second part of three coming to you.  Please post
as:  RFAHS-91-03.910726
    Dottie
 ---------------------------- Text of forwarded message -----------------------
 
$$XID RFA HS9103 HS-91-03 P1O1 *****************************************
 
REQUEST FOR APPLICATIONS
 
NATIONAL RESEARCH SERVICE AWARD-- INSTITUTIONAL GRANTS
 
POLICY AND GUIDELINES
 
RFA:  HS-91-03
 
P.T. 44; K.W. 0720005, 0730050, 1004017, 0408006
 
Agency for Health Care Policy and Research
 
Application Receipt Date:  October 10, 1991
 
PURPOSE
 
The Agency for Health Care Policy and Research (AHCPR) awards National
Research Service Award (NRSA) institutional grants (T32) to eligible
institutions to develop or enhance research training opportunities for
qualified individuals of the institution's selection who seek to prepare
for careers in health services research.
 
The purpose of these awards is to assist domestic institutions in
supporting predoctoral and postdoctoral academic training.  The awards
allow trainees to gain experience in applying research methods to the
systematic analyses and evaluation of health services.  Individuals are
selected by institutions on the basis of a demonstrated interest and
relevant background in health services research.
 
MECHANISM OF SUPPORT
 
This announcement is made subject to availability of funds.  The Agency
for Health Care Policy and Research reserves the right to withdraw this
announcement if funds do not become available.  This is a one-time
announcement.  Applications will not be accepted after October 10, 1991.
AHCPR expects to fund no more than five new awards in response to this
RFA.
 
LEVELS AND AREAS OF TRAINING
 
Applicant institutions may apply for support for predoctoral students,
postdoctoral students, or a combination.  Applicants must include a
rationale for their choice of supporting type(s) of students.
 
Research training must provide the conceptual and methodological
foundation for investigating some or all of the following health care
areas:
 
  o  Primary care issues, including the development of techniques to
     measure the effectiveness of managing health care conditions.
 
  o  The appropriateness and effectiveness of alternative treatments in
     terms of patient outcomes and use of services.
 
  o  Factors affecting the dissemination and assimilation of information
     on health care technologies and other aspects of clinical practice.
 
  o  Alternative approaches to organizing, financing, and reimbursing
     for health care services and their effects on cost, quality, and
     access.
 
  o  Application of medical informatics to the development of expert
     systems for treatment selection and diagnosis.
 
  o  Practice-based research, including clinical practice variations and
     guideline development.
 
  o  Medical malpractice and liability.
 
  o  Delivery of health services to the medically underserved,
     especially in rural areas.
 
  o  Availability, accessibility, and quality of care for low-income
     groups, minorities, and the elderly.
 
  o  Cost-effectiveness and cost-benefit analysis, including the
     allocation of health care resources and relationship to health
     status.
 
  o  Alternative delivery systems, providers, and practice patterns in
     long-term care, including home and community-based care.
 
  o  Organizational structure, resource use, and costs of care for
     persons with HIV-related illnesses.
 
APPLICANT ELIGIBILITY REQUIREMENTS
 
Domestic nonprofit, private or public, institutions may apply for grants
to support research training programs.  The applicant institution must
have the staff and facilities required for the proposed program.  The
training program director at the institution will be responsible for the
selection and appointment of trainees and for the overall direction of
the program.
 
GENERAL PROVISIONS
 
An NRSA may not be used to support studies leading to the M.D. or other
similar professional degrees, or to support residencies, i.e.,
postgraduate training for health professionals providing health care
directly to patients where the majority of their time is spent in
nonresearch clinical training.  However, if a specified period of
full-time research training is creditable toward specialty board
certification, the NRSA may support such research training if the
trainee has shown a clear interest in a research career.
 
Trainees are required to pursue their research training on a full-time
basis.  Because of the close relationship between teaching and research
in the academic environment, trainees are permitted, with the approval
of AHCPR, to teach if it can contribute meaningfully to their academic
training.  Teaching by trainees may not take up more than ten percent of
work time during the year or exceed four hours each week.
 
TRAINEE ELIGIBILITY REQUIREMENTS
 
Individuals to be trained must be citizens or noncitizen nationals of
the United States or have been lawfully admitted for permanent residence
(i.e., in possession of the Alien Registration Receipt Card I-551 or
I-151) at the time of appointment.  Individuals on temporary or student
visas are not eligible.
 
AHCPR NRSAs emphasize support of multidisciplinary training.  A
postdoctoral student, by the beginning date of the NRSA appointment,
must have a Ph.D., M.D., or other doctoral degree, or an equivalent
degree from any accredited domestic or foreign institution.  It is
acceptable if an authorized official of the degree-granting institution
certifies that all requirements for the doctoral degree have been met.
 
Predoctoral trainees must have received a baccalaureate degree by the
beginning date of the NRSA appointment and must be enrolled in a program
leading to a Ph.D., Dr. P.H., or equivalent degree.  Individuals working
toward a medical or dental degree who wish to interrupt their studies
for a year or more to engage in full-time research training before
completing their degree are eligible for support.  NRSA awards may not,
however, support study leading to the D.D.S., M.D., or similar
professional degree; neither may they support residency training.
 
RECRUITMENT AND APPOINTMENT OF MINORITY TRAINEES
 
The primary objective of this NRSA program is the preparation of
qualified individuals for careers in health services research.  Within
the framework of the program's commitment to excellence and projected
needs for investigators in particular areas of health services research,
it is important that attention be given to recruiting individuals from
minority groups that now are underrepresented nationally in health
services research.  Information on plans for the recruitment of trainees
must include a description of efforts to recruit individuals from
underrepresented minority groups.  Renewal applications must include
cumulative information on the subsequent career development of all
trainees, including information about their minority status.
 
PAYBACK PROVISIONS
 
Trainees must sign an agreement that they will fulfill the NRSA payback
requirements.  Recipients agree to engage in health services research
and/or teaching for a period equal to the period of NRSA support in
excess of 12 months.  Once an individual has had 12 months of
postbaccalaureate NRSA support, all subsequent NRSA support is subject
to payback.
 
Recipients must undertake the obligated service on a continuous basis
within three years after termination of NRSA support.  Individuals who
do not fulfill their obligation through service must pay back the total
amount of NRSA funds paid to the individual for the obligation period
plus interest at a rate determined by the Secretary of the Treasury.
Financial payback must be completed within three years beginning on the
date the United States becomes entitled to recover such amount.  Under
certain conditions, the Secretary of Health and Human Services may
extend the period for starting service or for repayment, permit breaks
in the period of service or repayment, or otherwise waive or suspend the
payback obligation of an individual.
 
Officials of the applicant organization responsible for recruitment of
trainees must be familiar with the terms of the service requirements and
explain them carefully to prospective training candidates before an
appointment at the institution is offered.
 
STIPENDS AND OTHER TRAINING COSTS
 
For predoctoral trainees at all levels of experience, the stipend level
is $8,800 per annum effective October 1, 1990.
 
For postdoctoral trainees, the stipend for the first year of support is
determined by the number of years of relevant postdoctoral experience at
the time of appointment.  Relevant experience may include research
experience (including industrial), teaching, internship, residency,
clinical practice, or other time spent in full-time studies in a
health-related field beyond that of the qualifying doctoral degree.  The
stipend for each additional year of NRSA support is the next level on
the stipend scale.  Postdoctoral stipend levels, effective October 1,
1990, are as follows:
 
Years of relevant experience       Stipend
 
0                                  $18,600
1                                   19,700
2                                   25,600
3                                   26,900
4                                   28,200
5                                   29,500
6                                   30,800
7 or more                           32,300
 
NRSA stipends may be supplemented by an institution from non-Federal
funds.  Federal funds may be used for stipend supplementation only if
specifically authorized under the terms of the program from which the
supplemental funds are derived.  An individual may make use of Federal
educational loan funds or VA benefits when permitted by those programs.
Under no circumstances may the condition of stipend supplementation
detract from or prolong the training.
 
The Tax Reform Act of 1986, Public Law 99-514, affects the tax liability
of all individuals supported under the NRSA program.  Degree candidates
who, prior to the enactment of Public Law 99-514, were able to exclude
all monies received under an NRSA award from their reported income, may
now exclude only course tuition, fees, books, supplies, and equipment
required for attendance.  Nondegree candidates, who formerly were able
to exclude from stipends $300 a month for a period not to exceed three
years, will now be required to report all stipends and any monies paid
on their behalf for course tuition and fees required for attendance.
These new statutory requirements became effective January 1, 1987.
 
AHCPR is not in a position to advise students or institutions about
their tax liability.  In any event, changes in the taxability of
stipends in no way alter the relationship between NRSA fellows,
trainees, and institutions.  NRSA stipends are not now, and never have
been, salaries.  Trainees supported under an NRSA are not in any
employer-employee relationship with AHCPR or the institution at which
they are pursuing research training.
 
Tuition and fees, including medical insurance, are allowable trainee
costs if such charges are required of all persons in a similar training
status at the institution, without regard to their source of support.
Tuition at the postdoctoral level, if justifiable, is limited to that
required for specific courses in support of the approved training
program.  Annual increments in tuition costs beyond the first year of a
multiyear award (generally five years) may not exceed six percent.
 
Trainee travel, including attendance at scientific meetings, that the
institution determines to be necessary to the individual's training, is
an allowable trainee cost.
 
Institutional costs of $1,500 per year per predoctoral trainee and
$2,500 per year per postdoctoral trainee may be requested to defray the
cost of other training related expenses, such as staff salaries,
consultant costs, equipment, research supplies, and staff travel.  Also,
the institution will receive indirect costs based on eight percent of
total allowable direct costs or their actual indirect cost rate,
whichever is less.  Applications from State and local government
agencies may request full indirect cost reimbursement.
 
PERIOD OF SUPPORT
 
Institutional grants are made for competitive segments of five years and
are renewable.  No individual trainee may receive more than five years
of total NRSA support at the predoctoral level and three years of
aggregate NRSA support at the postdoctoral level, including any
combination of support from institutional training grants and individual
fellowship awards, except under certain circumstances.  Any exception to
this policy requires a waiver from AHCPR.
 
REVIEW PROCESS
 
Applications will be evaluated for merit by an AHCPR initial review
group (IRG).  Site visits may be involved.  The IRG will consider the
following criteria in its review:
 
  o  The goals of the proposed training program and the probability of
     achieving them.
 
  o  The substantive content of the proposed program and its relevance
     to current health care concerns, including courses offered.
 
  o  The qualifications and responsibilities of the program director.
 
  o  The qualifications of the program's faculty, including ongoing
     health services research, and commitment to tracking graduates
     following training.
 
  o  The program's ability to recruit qualified trainees.
 
  o  Commitment to adequate space, curriculum time, financial support,
     and appropriate facilities.
 
  o  Cooperation of related agencies or organizations in providing
     experience and research training sites for trainees.
 
  o  Proposed methods for monitoring and evaluating the performance of
     trainees as well as the overall program.
 
  o  The reasonableness of the proposed budget in relation to the
     proposed research training.
 
  o  The number and types of students for whom support is requested.
     (An applicant may request as many postdoctoral or predoctoral
     trainee positions as the proposed program can accommodate.
     However, the number of positions awarded will be decided by the
     review process, program needs, and availability of funds.)
 
After IRG review, applications will be reviewed by the National Advisory
Council for Health Care Policy, Research, and Evaluation.  In addition
to the recommendations made by the IRG, the Council will consider the
applicant's plans for (and likely success in) recruitment of individuals
from underrepresented minority groups into the training program.
Funding decisions will be based on the review groups' recommendations,
the need for research personnel in specified program areas, and the
availability of funds.
 
AHCPR will not fund more than one training grant from the same
institution.
 
REVIEW SCHEDULE
 
The NRSA training grant receipt date and review cycle for all
applications submitted in response to this RFA is indicated below.
 
Application        Initial review     Council      Earliest
receipt date       group meeting      meeting      possible
                                                   start date
 
October 10,        November 1991      January      March 1992
1991                                  1992
 
This review schedule is designed to allow program directors time to
recruit candidates during the fall/winter of the academic year for
appointments to begin the following summer.
 
ADDITIONAL INFORMATION
 
Effective July 1, 1990, all competing NRSA institutional training grant
applications must include a description of formal or informal activities
related to instruction about the responsible conduct of research to be
incorporated into the proposed research training program.  This
announcement was published in the NIH Guide for Grants and Contracts,
Vol. 18, No. 45, December 22, 1989.
 
For additional information, including the grounds for approving
extensions of support and payback provisions, please refer to the
announcement in the NIH Guide for Grants and Contracts entitled,
"National Research Service Awards - Guidelines for Individual Awards -
Institutional Grants," Special Edition, Volume 13 (I), dated January 6,
1984.  Further information is also available in the brochure entitled,
"National Institutes of Health - National Research Service Award,
Institutional Grants (T32) - April 1989."  These are usually available
at the applicant institution and may be obtained by contacting:
 
DonnaRae Castillo
NRSA Project Officer
Agency for Health Care Policy and Research
Parklawn Building, Room 18A-10
Rockville, MD  20857
Telephone:  (301) 443-2904
 
Information on grants management issues may be obtained from:
 
Ralph Sloat, Chief
Grants Management Branch
Agency for Health Care Policy and Research
Parklawn Building, Room 18A-27
Rockville, MD  20857
Telephone:  (301) 443-4033
 
APPLICATION PROCEDURES
 
Applications must be made on grant application form PHS 398 (rev.
10/88).  This revision contains special instructions for preparing
institutional NRSA applications.  Application forms are usually
available at institutional offices of sponsored research or their
equivalent.  If forms are not available locally, send a request
accompanied by a self-addressed mailing label to:
 
Office of Scientific Review
Agency for Health Care Policy and Research
Parklawn Building, Room 18A-20
Rockville, MD  20857
Telephone:  (301) 443-3091
 
Applications must be received at the Division of Research Grants on or
before October 10, 1991.  Late applications will be returned.  An
original and four copies of the completed application must be mailed to:
 
Division of Research Grants
National Institutes of Health
Westwood Building, Room 240
Bethesda, MD  20892**
 
Insert the title of this RFA ("National Research Service
Award--Institutional Grants") and RFA number (HS-91-03) on line 2 of the
application face page.  The RFA label (found in the 10/88 revision of
application form PHS 398) must be affixed to the bottom of the face page
of the original copy of the application.  Failure to use this label
could result in delayed processing of your application such that it will
not reach the review committee in time for review.
 
Two information copies must be sent to:
 
Director, Office of Scientific Review
Agency for Health Care Policy and Research
Parklawn Building, Room 18A-20
Rockville, MD  20857
 
Awards are made under authority of Section 487 of the Public Health
Service (PHS) Act as amended (42 USC 288).  Title 42 of the Code of
Federal Regulations, Part 66, is applicable to this program.  The
program is described under Catalog of Federal Domestic Assistance No.
93.225.

