U.S. Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) Bureau of Health Workforce (BHW) Division of Medicine and Dentistry (DMD) Primary Care Training and Enhancement (PCTE) Program Pre- Review Conference Call Funding Opportunity Announcement (FOA) Number: HRSA January 13, 2016 Project Officer: Anthony Anyanwu

Welcome Maria Portela Chief Medical Training and Geriatrics Division of Medicine and Dentistry Bureau of Health Workforce 2

PCTE Purpose To strengthen the primary care workforce by supporting enhanced training for future primary care clinicians, teachers and researchers promoting primary care practice in rural and underserved areas. 3

Eligible Applicants Eligible entities include accredited public or nonprofit private hospitals, schools of allopathic or osteopathic medicine, academically affiliated PA training programs, or a public or nonprofit private entity that the Secretary has determined is capable of carrying out such grants Tribes and Tribal organizations are eligible to apply for these funds so long as they can carry out such grants and meet all eligibility requirements ***Organizations that competed for the FY 2015 Primary Care Training and Enhancement program funding opportunity and successfully received an award are not eligible for this competition Multiple applications from one organization/institution are not allowable 4

Accredited public or nonprofit private hospitals, schools of allopathic medicine or osteopathic medicine, academically affiliated PA training programs, or a public or nonprofit private entity that the Secretary has determined is capable of carrying out such grants All training activities must be conducted by an accredited entity. If a partner organization holds the accreditation for a training program, a letter of agreement must be provided in Attachment 6. Relevant accrediting bodies include: LCMELiaison Committee on Medical Education AOAAmerican Osteopathic Association ACGMEAccreditation Council for Graduate Medical Education ARC-PAAccreditation Review Commission on Education for the Physician Assistant Eligible Applicants 5

Program Requirements (Part 1) o Focus on training for transforming healthcare systems, particularly enhancing the clinical training experience of trainees. o Providers across the care continuum participate in integrated or virtually integrated delivery models, o Care is coordinated across all providers and settings, o There is a high level of patient engagement and quantifiable results on patient experience, o Providers leverage the use of health information technology to improve quality, o Providers perform at the top of their license and board certification, o Population health measures are integrated into the delivery system, and o Data is used to drive health system processes. o *In addition, projects that address the social determinants of health while addressing health care delivery transformation are encouraged. o Lead applicant training programs for this FOA must be from one of the following professions/disciplines: family medicine, general internal medicine, general pediatrics, medical students, physician assistant students, or faculty in any of these areas. o Collaborative projects must propose training across the continuum (e.g., student, resident, faculty development, and practicing primary care physician or physician assistants) and across primary care professions (2 disciplines, 2 training levels). 6

Program Requirements (Part 2) There are two types of projects that an applicant can propose for this FOA: Single training level and discipline project: Project that proposes activities for at least one of the following eligible groups:student, resident, faculty development, practicing primary care physician, or physician assistants; and only one of the following disciplines: family medicine, general internal medicine, general pediatrics, physician assistants. * Applicants may apply for a ceiling amount of up to $250,000 per year 7

Program Requirements (Part 3) Collaborative projects: These are inter-professional projects that will provide training across the continuum and across primary care disciplines and professions. Collaborative projects are encouraged and will qualify for a higher funding ceiling amount, up to $500,000 per year. o Collaborative projects must: Include activities targeted at more than one training level (student, resident, faculty development, practicing primary care physician, or physician assistants). MD-MD partnerships do not qualify as collaborators Propose training for more than one primary care discipline or profession (family medicine, general internal medicine, general pediatrics*, geriatrics, physician assistants, nurse practitioners, dentists, mental health providers, pharmacists, and other allied health professionals ). **Applicants must clearly describe how the different training levels and disciplines/ professions will equitably benefit from the project and the budget justification must include a budget table that provides a budget breakdown for each of the proposed training levels and disciplines/professions. * Med-Peds can qualify under either general internal medicine or general pediatrics.

Program Requirements (Part 4) Evaluation Plan Applicants must propose an evaluation plan focused on the assessment of outcomes related to changes in patient access, quality of care, and cost effectiveness related to graduates of the program or in transformed clinical training environments. Evaluation plan required to assess outcomes. Continuous Quality Improvement Plan to assess program performance. 9

Purpose and Need (10 points) Response to Program Purpose: three sub-sections (35 points) o Methodology/Approach (20 points) o Work Plan (10 points) o Resolution of Challenges (5 points) Impact: two sub-sections (30 points) o Evaluation and Technical Support Capacity (25 points) o Project Sustainability (5 points) Organizational Information, Resources and Capabilities (10 points) Support Requested (15 points) o Budget Form SF-424 R&R and Budget Justification Application Content & Format: Project Narrative Outline – FOA 10

Some Review Criteria Highlights Project Narrative: Purpose & Need Describe how the proposed program is relevant at the national, state, or local level. Explain how developing the proposed training will address health workforce gaps as identified in your application. Discuss the target population served by this segment of the health workforce and the needs of the specific communities in which the proposed training will take place. Describe the current state of the health care delivery system that will serve as a training site for your training program. Identify specific gaps in your current training program that will be addressed through the proposed training program. 11

Some Review Criteria Highlights: Budget Justification Narrative (Part 1) Describe how the budget for the project period ( 7/1/2016 – 6/30/2021 ) correlates with project goals and objectives. Describe the extent to which the budget is reasonable given the proposed scope of work for the project. Total Project or Program Costs are the total allowable costs (inclusive of direct and indirect costs) incurred by the grantee to carry out a grant-supported project or activity. Indirect costs: 8 percent of the modified total direct costs. 12

Some Highlights : Budget Justification Narrative(Part 2) ***For current grantees for example D57, T85 there can be NO duplication of effort in overlapping budget periods (7/1/2016 – 9/30/2017 ). For proposed Collaborative Projects, the budget should reflect an equitable distribution between at least two of the designated training levels and in at least two of the primary care disciplines and professions. For proposed Collaborative Projects, provide a line item budget for each of the proposed disciplines/professions and training levels involved. 13

Attachment 1: Work Plan Attachment 2: Staffing Plan and Job Descriptions for Key Personnel Attachment 3: Project Organizational Chart Attachment 4: Funding Preference, if applicable Attachment 5: Maintenance of Effort Documentation Requested Attachments 14

Attachment 6: Letters of Agreement or Support Attachment 7: Accreditation Documents Attachment 8: Biographical Sketches of Key Personnel Attachment 9: Logic Model Attachment 10: Other Relevant Documents Attachments 15

What are the Funding Preferences? o In PCTE they are related to the number of graduates practicing in Medically Underserved Communities (MUC); a geographic location or population of individuals that is eligible for designation by the federal government as a Health Professional Shortage Area, Medically Underserved Area, Medically Underserved Population, or Governor’s Certified Shortage Area for Rural Health Clinic purposes. o As an umbrella term, MUC also includes populations such as homeless individuals, migrant or seasonal workers, and residents of public housing. o An applicant can only receive a maximum of one funding preference. o In order to qualify for a funding preference, the applicant must provide the required data for the identified lead applicant training program. The requested data must be provided for the lead applicant institution and training program, i.e. the medical school, physician assistant school, residency program (Family Medicine, Internal Medicine or General Pediatrics), or fellowship program. 16

Funding Preferences (Part 1) Significant Increase Funding Preference To qualify under Significant Increase you must demonstrate a Percentage Point Increase of 25% in the rate of placing program completers in practice in a MUC for the academic years indicated. To calculate the MUC Preference by demonstrating a Significant Increase with medical school graduates, calculate the difference between the percent of graduates between AY and AY who are currently practicing in a MUC. Medical school graduates in residency or fellowship training are not considered in practice and should not be included in the numerators. To calculate the MUC Preference by demonstrating significant increase for all other graduates and program completers calculate the difference between the percent of graduates/program completers in AY and AY who are currently practicing in a MUC. 17

Funding Preferences (Part 2) High Rate Funding Preference To qualify under High Rate you must demonstrate that the percentage of graduates/program completers placed in practice settings serving a MUC for the two academic years (AY) indicated below is greater than or equal to 30 percent for student trainees (i.e. medical and physician assistant students) or greater than or equal to 80 percent for resident or fellow trainees For example, an applicant can calculate the MUC Preference by demonstrating High Rate with medical school graduates, the numerator will be the number of graduates from AY who are currently practicing in a MUC added to the number of graduates in AY who are currently practicing in a MUC ****Medical school graduates who are currently in residency or fellowship training are not considered in practice and should not be included in the numerator 18

Funding Preferences (Part 3) New Program Funding Preference New programs for the purpose of this FOA have completed training of less than three consecutive classes. As a result they lack the required data to apply for the MUC preference through the above qualification. New programs can qualify for the New Program funding preference if they meet at least four of the criteria in the funding announcement, and have completed training for less than three consecutive classes. New “tracks,” such as primary care or rural tracks within existing institutions DO NOT qualify under either the Medical Underserved Community or the New Program funding preference qualification. Programs that have been significantly changed or improved with a new focus also DO NOT qualify for the New Program qualification. 19

QUESTIONS?