**U.S. Department of Health and Human Services**

**Health Resources and Services Administration**

Bureau of Health Professions

Division of Nursing

**Title VIII**

**Nurse Education, Practice and Retention (NEPR) Program**

**New or Competing Continuation Award**

**Announcement Number HRSA-08-028**

**Catalog of Federal Domestic Assistance (CFDA) No. 93.359**

**PROGRAM GUIDANCE**

Fiscal Year 2008

**Application Due Date in Grants.gov: December 6*,* 2007**

**Release Date: October 4, 2007**

**Date of Issuance*:* October 4, 2007**

CAPT. Catherine Rupinta, MSN, CFNP CDR Daniel Reed, MPH

Nurse Consultant, Division of Nursing (DN) Sr. Program Management
Officer, DN

Telephone: (301) 443-6193 Telephone: (301) 443-6193

Fax: (301) 443-0791 Fax: (301) 443-0791

Janice B. Young, PhD., RN

Nurse Consultant, DN

Telephone: (301) 443-6193

Fax: (301) 443-0791

Authority: Public Health Service Act, Title VIII, Section 831, (42
U.S.C. 296p)

**Executive Summary**

The **Nurse Education, Practice, and Retention (NEPR)** program is a
broad authority with targeted purposes under each of the education,
practice, and retention priority areas, which addresses the growing
nursing shortage. The NEPR program provides grant support for academic,
service and continuing education projects designed to strengthen the
nursing workforce and improve nurse retention and quality of patient
care. **There are three major priority areas with nine associated
purposes. Applicants [must]{.underline} select [one]{.underline} of the
[nine purposes]{.underline}, listed below, as the main project focus for
the grant proposal.** Applicant organizations may only submit **one**
application per NEPR Purpose under this announcement.

**I.** **Education (E) Priority Area:**

-   Purpose E1: Expanding enrollment in baccalaureate nursing programs;

-   Purpose E2: Developing and implementing internship and residency
    programs to encourage mentoring and the development of specialties;
    [or]{.underline}

-   Purpose E3: Providing education in the area of new technologies,
    including distance learning methodologies.

**II.** **Practice (P) Priority Area:**

-   Purpose P1: Establishing or expanding nursing practice arrangements
    in non-institutional settings (Nurse Managed Centers) to demonstrate
    methods to improve access to primary health care in medically
    underserved communities;

-   Purpose P2: Providing care for underserved populations and other
    high-risk groups such as the elderly, individuals with HIV/AIDS,
    substance abusers, the homeless, and victims of domestic violence;

-   Purpose P3: Providing managed care, quality improvement, and other
    skills needed to practice in existing and emerging organized health
    care systems; [or]{.underline}

-   Purpose P4: Developing cultural competencies among nurses.

**III. Retention (R) Priority Area:**

-   Purpose R1: Career ladder programs which promote career advancement
    for registered nurses and nursing personnel; [or]{.underline}

-   Purpose R2: Enhancing patient care delivery systems through
    improving the retention of registered nurses and enhancing patient
    care.

For purposes of PHS Act Section 831, eligible entities include a school
of nursing, a health care facility, or a partnership of such a school
and facility. See Section 831(g) of the PHS Act. Eligible applicants are
schools of nursing, academic health centers, State or local governments,
and other private or public entities determined appropriate by the
Secretary. Schools of nursing must be accredited by a national nurse
education accrediting agency or State approval agency recognized by the
Secretary of the U.S. Department of Education. For FY 2008, these
agencies include the Commission on Collegiate Nursing Education,
[National League for Nursing Accrediting
Commission](http://www.nlnac.org/), Iowa Board of Nursing, Maryland
Board of Nursing, Missouri Board of Nursing, Montana Board of Nursing,
North Dakota Board of Nursing or New York Board of Nursing, the Division
of Accreditation of the American College of Nurse-Midwives, and the
Council on Accreditation of Nurse Anesthesia Programs of the American
Association of Nurse Anesthetists). The eligible applicant must be
capable of carrying out the legislative purpose of the NEPR program.

**Accreditation for Newly Established Program of Nursing**: A new
program of nursing that, by reason of an insufficient period of
operation, is not, at the time of the submission of an application for a
grant under this title, eligible for accreditation by such a recognized
body or bodies or State agency, shall be deemed accredited for the
purposes of this title if the Secretary of Education finds, after
consultation with the appropriate recognized State approval or
accrediting body or bodies, that there is reasonable assurance that the
program will meet the accreditation standards of such body or bodies
prior to the beginning of the academic year following the normal
graduation date of students of the first entering class in such a
program.

All nursing programs and consortium partners, if applicable, that are
associated with the project must be accredited for the purpose of
nursing education. Applicants must submit documentation providing proof
of accreditation (e.g., an accreditation letter from the accrediting
agency or a copy of the certificate of accreditation) with the HRSA
grant application**. [Failure to provide proof of accreditation with the
HRSA grant application will render the application non-responsive and
the application will not be considered for funding under this
announcement. ]{.underline}**

Project participants must be U.S. Citizens, non-citizen nationals, or
foreign nationals who possess visas permitting permanent residence in
the United States. **Individuals on temporary student visas are not
eligible**.

**[All applicants must provide written assurance that projects will be
operational (with project participants) by January 31,
2009]{.underline}.**

It is estimated that for FY 2008, 38 new competitive awards and/or
competing continuations will be awarded at an average of \$250,000 per
grant per year. The application due date is **December 6, 2007**.

**Table of Contents**

I.  *FUNDING OPPORTUNITY DESCRIPTION* 6

> Purpose 6
>
> Background 6

II. *AWARD INFORMATION* 7

> Type of Award 7
>
> Summary of Funding 7

III. *ELIGIBILITY INFORMATION* 8

     1.  Eligible Applicants 8

     2.  Cost Sharing/Matching 10

     3.  Other Eligibility Information 10

IV\. *APPLICATION AND SUBMISSION INFORMATION* 10

1.  Address to Request Application Package 10

> *Application Materials* 10

2.  Content and Form of Application Submission 11

> Application Format Requirements 11
>
> Application
> Format..................................................................\...12
>
> SF424 R&R Table of
> Contents......................................................12
>
> i\. Application Face
> Page....................................................16

ii. Table of
    Contents.......................................................\...16

iii. Application Checklist.........
     .....................\.....................\...16

iv. Budget.......................................................................16

v.  Budget
    Justification.....................................................\...17

vi. Staffing Plan and Personnel Requirements
    ..........................\...19

vii. Assurances
     ...............................................................\...19

viii. Certifications................................................................19

ix. Project
    Abstract.............................................................19

x.  Program
    Narrative..........................................................19

xi. Program Specific
    Forms...................................................35

xii. Attachments.................................................................35

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3.  Submission Dates and
    Times.........................................................\...36

4.  Intergovernmental Review
    ..............................................................37

5.  Funding Restrictions
    .....................................................................37

6.  Other Submission Requirements
    .......................................................37

> *V. APPLICATION REVIEW INFORMATION*
> ...............................................38

1.  Review
    Criteria..........................................................................38

2.  Review and Selection Process
    ...........................................................43

3.  Anticipated Announcement and Award Dates
    ........................................44

*VI. AWARD ADMINISTRATION INFORMATION*
.............................................\...44

1.  Award
    Notices.............................................................................44

2.  Administrative and National Policy
    Requirements...................................44

3.  Reporting...................................................................................45

*VII. AGENCY
CONTACTS*......................................................................\......47

*VIII. TIPS FOR WRITING A STRONG
APPLICATION*............................................47

*IX. APPENDICES*
......................................................................................49

> Appendix A: HRSA's Electronic Submission User
> Guide...............................50
>
> Appendix B: Registering and Applying Through
> Grants.gov...........................66
>
> Appendix C: Instructions for the SF 424 R&R (Research and
> Related)............\...71
>
> Appendix D: NEPR Program
> Synopsis..................................................\...86
>
> Appendix E: Purpose Specific Information
> Tables....................................\...87
>
> Appendix F: Program
> Definitions..........................................................89

**I. Funding Opportunity Description**

**Purpose**

This program is authorized under Title VIII, Section 831 of Public
Health Service Act (42 U.S.C. 296p). This announcement solicits grant
applications for the Nurse Education, Practice, and Retention **(NEPR)**
Program. Grants are awarded to eligible institutions to strengthen the
capacity for registered nurse education, practice and retention to
address the registered nursing shortage.

**There are three major priority areas with nine associated purposes.
Applicants must select and focus** on **[one]{.underline}** of the
**[nine purposes]{.underline}** in the grant application. Failure to
select one purpose, [or]{.underline} selection of multiple purposes
within a single application will render the application non-responsive
and the application will not be considered for funding under this
announcement. **Projects that include proposed tracks or exit points of
CNA, LPN, or any point other than RN are not eligible under any NEPR
purposes.**

***The "Education" priority area includes*:** Purpose E1) expanding
enrollment in baccalaureate nursing programs; Purpose E2) developing and
implementing internship and residency programs to encourage mentoring
and the development of specialties; and, Purpose E3) providing education
in new technologies, including distance learning methodologies.

***The "Practice" priority area includes*:** Purpose P1) establishing or
expanding nursing practice arrangements in non-institutional settings to
demonstrate methods to improve access to primary health care in
medically underserved communities; Purpose P2) providing care for
underserved populations and other high-risk groups such as the elderly,
individuals with HIV/AIDS, substance abusers, the homeless, and victims
of domestic violence; Purpose P3) providing managed care, quality
improvement, and other skills needed to practice in existing and
emerging organized health care systems; and, Purpose P4) developing
cultural competencies among nurses.

***The "Retention" priority area includes:*** Purpose R1) career ladder
bridge programs which promote career advancement for registered nurses
and nursing personnel; and, Purpose R2) enhancing patient care delivery
systems through improving the retention of registered nurses and
enhancing patient care.

**Background**

The mission of the Health Resources and Services Administration's
(HRSA's) Bureau of Health Professions (BHPr) is to improve the health
status of the population by providing national leadership and resources
to develop, distribute, and retain a diverse, culturally competent
health workforce that provides the highest quality health care for all,
especially the underserved. To accomplish this mission, BHPr's programs
assist with connecting the right people, with the right skills, in the
right places, to achieve the right health outcomes. The goals are:

> **Goal 1**: Eliminate Health Barriers: Assure the appropriate supply,
> diversity, composition and distribution of the health professions
> workforce.
>
> **Goal 2**: Eliminate Health Disparities: Assure the availability of a
> full range of healthcare skills and services to populations bearing a
> disproportionate share of disease and disability.
>
> **Goal 3**: Assure Quality of Care: Improve the knowledge, skills,
> competencies and outcomes of health professions workforce.
>
> **Goal 4**: Improve Public Health and Health Care Systems: Assure the
> infrastructure to support an efficient and effective health
> professions workforce.

Under the Nurse Education, Practice and Retention Program, the applicant
will be required to provide baseline and yearly data on BHPr goals and
their corresponding outcome(s). Specific guidance on these requirements
is included under the instructions for the "Objectives" and "Evaluation"
sections included in the application guidance.

**II. Award Information**

**Type of Award**

Funding will be provided in the form of a grant. New grant awards are
for three years, except Purposes P1 and R2 which are for five years.
[All]{.underline} competing continuations are three-year grant awards.

**Competing Continuation Awards**

Competing continuation applications shall be submitted for a three-year
continuance of grant funding beyond the initial project period for all
purposes, **EXCEPT Purpose R2**. Competing continuation proposals build
on the current project to expand and/or enhance project outcomes. A
competing continuation application must be submitted during the
beginning of the last year of the initial project period. The
requirements for competing continuation applications are the same as for
new applications, with exceptions that can be found under the sections
"Program Narrative" (IV.2.x) and "Budget (IV.2.iv)." The submission date
is the same for new applications and competing continuation
applications. All applications are reviewed in the same manner and at
the same time.

**Summary of Funding**

[]{.mark}

This program will provide funding for Federal fiscal years 2008 -- 2010
(or for fiscal years 2008 - 2012, as applicable). Approximately \$12
million is expected to be available annually to fund 38 grantees.
Funding beyond the first year is dependent on the availability of
appropriated funds for NEPR in subsequent fiscal years, satisfactory
grantee performance, and a decision that continued funding is in the
best interest of the Federal government.

New NEPR applications, ***with the exceptions of Purposes P1 and R2,***
shall be submitted for three (3) years of support. The period of support
for approved and funded new projects begins July 1, 2008 and ends June
30, 2011. New Purpose P1 and R2 proposals are 5-year grants and funding
begins July 1, 2008 and ends June 30, 2013. [All]{.underline} competing
continuations are three-year grant awards, regardless of the purpose
selected. Purpose R2 grants are not eligible for competing continuation
funding

The average annual award for a new grant is about \$250,000. *This
amount is only an estimate of the average grant request, for the first
year, and it is suggested that the amount requested be aligned with the
amount needed to carryout and justify the goals and objectives of the
project.*

III. **ELIGIBILITY INFORMATION**

     **1. Eligible Applicants**

Eligible applicants are schools of nursing, academic health centers,
State or local governments, and other private or public entities
determined appropriate by the Secretary. Schools of nursing must be
accredited by a national nurse education accrediting agency or State
approval agency recognized by the Secretary of the U.S. Department of
Education. For FY 2008, these agencies include the Commission on
Collegiate Nursing Education, [National League for Nursing Accrediting
Commission](http://www.nlnac.org/), Iowa Board of Nursing, Maryland
Board of Nursing, Missouri Board of Nursing, Montana Board of Nursing,
North Dakota Board of Nursing or New York Board of Nursing, the Division
of Accreditation of the American College of Nurse-Midwives, and the
Council on Accreditation of Nurse Anesthesia Programs of the American
Association of Nurse Anesthetists). The eligible applicant must be
capable of carrying out the legislative purpose of the NEPR program.

All nursing programs and consortium partners, if applicable, that are
associated with the project must be accredited for the purpose of
nursing education. Applicants must submit documentation providing proof
of accreditation (e.g., an accreditation letter from the accrediting
agency or a copy of the certificate of accreditation) with the HRSA
grant application**.  [Failure to provide proof of accreditation with
the HRSA grant application will render the application non-responsive
and the application will not be considered for funding under this
announcement. ]{.underline}**

**Accreditation for Newly Established Program of Nursing**: A new
program of nursing that, by reason of an insufficient period of
operation, is not, at the time of the submission of an application for a
grant or contract under this title, eligible for accreditation by such a
recognized body or bodies or State agency, shall be deemed accredited
for the purposes of this title if the Secretary of Education finds,
after consultation with the appropriate recognized State approval or
accrediting body or bodies, that there is reasonable assurance that the
program will meet the accreditation standards of such body or bodies
prior to the beginning of the academic year following the normal
graduation date of students of the first entering class in such a
program.

**The following process must be followed for new program applicants just
beginning the accreditation process who wish to establish eligibility
based on the provisions above:**

-   The applicant must contact a national nursing accrediting or State
    approval body recognized by the Secretary of the Department of
    Education and obtain a reasonable assurance letter.  These agencies
    are listed above. The letter from the recognized body should state
    that the new program falls within the scope of the Secretary's
    recognition and that there is reasonable assurance that the new
    program will meet the accreditation/approval standards prior to the
    beginning of the academic year following the normal graduation date
    of students of the first entering class in such a program.   The
    letter from the recognized body must answer/report the following
    questions/information related to the new program: 

    1.  Is this program actively pursuing accreditation with your
        agency?

    2.  Provide the date of each program's pending application for
        accreditation and the date or approximate date when your
        decision-making body is likely to decide whether to grant or
        deny accreditation for this program.

    3.  Are any other nursing education programs at this institution
        currently accredited by your agency, and are those programs in
        good standing with your agency?

    4.  At this point in the pending application process, what stages of
        the accreditation process has this program completed, and what
        stages remain to be completed?  Please summarize the kinds of
        materials already submitted in support of the program's
        application and reviewed by your agency, as well as any on-site
        visits that have occurred.

    5.  Based on your records, what will be the start date or
        approximate start date of the program's academic year that
        immediately follows the expected graduation date for the
        students comprising the program's first entering class?

    6.  Based on your agency's review of each program to date, do you
        have any reason to believe that the program will be unable to
        demonstrate compliance with your standards and requirements and
        gain accreditation by the beginning of the academic year
        following the normal graduation date of students of the first
        entering class in such a program?  If so, why?

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-   The applicant will submit the request for a letter of assurance
    along with copies of the letter from the recognized body and any
    supporting documentation regarding the accreditation or approval of
    the nursing program to:

> U.S. Department of Education
>
> Attn: Accreditation and State Liaison Unit
>
> 1990 K Street, NW, Room 7126
>
> Washington, DC 20006-8509
>
> Telephone: (202) 219-7011
>
> Fax: (202) 219-7005
>
> Attn:  Cathy Sheffield
>
> Or by email to:  <cathy.sheffield@ed.gov>

-   To allow for sufficient processing time by the Department of
    Education, applicants are encouraged to submit their request **[at
    least 30 days prior to the HRSA grant application due date of
    December 6, 2007]{.underline}**. [The applicant will need to include
    a contact name(s), address(es), phone number(s), and email
    address(es) with all correspondence sent to the Department of
    Education. ]{.underline}

-   The Department of Education staff will review the documents
    submitted by the applicant, make a "reasonable assurance"
    determination, and send the applicant a letter documenting the
    Secretary's determination.

-   [The applicant must include this letter from the Department of
    Education with the HRSA grant application (Attachment
    8)]{.underline}. **Failure to provide the Department of Education's
    letter with the HRSA grant application will render the application
    non-responsive, and the application will not be considered for
    funding under this announcement**.

**Eligible Project Participants**

Project participants must be U.S. Citizens, non-citizen nationals, or
foreign nationals who possess visas permitting permanent residence in
the United States. **Individuals on temporary student visas are not
eligible.**

**2. Cost Sharing/Matching**

Cost sharing/matching is not required for the NEPR program.

**3. Other Eligibility Information**

**Maintenance of Effort:**

**Grant funds shall not be used to take the place of current funding for
activities described in the application**. The applicant organization
must agree to maintain non-Federal funding for grant activities at a
level which is not less than expenditures for such activities during the
fiscal year prior to receiving the grant. Applicants must complete and
submit the Maintenance of Effort Table included below. The sample
Maintenance of Effort Table below may be copied, completed, and included
in the budget narrative to fulfill this requirement.

**Maintenance of Effort Table**

NON-FEDERAL EXPENDITURES

+------------------------------------+---------------------------------+
| **FY 2007 (Actual)**               | **FY 2008 (Estimated)**         |
|                                    |                                 |
| Actual FY 2007 non-Federal funds,  | Estimated FY 2008 non-Federal   |
| including in-kind, expended for    | funds, including in-kind,       |
| activities proposed in this        | designated for activities       |
| application. If proposed           | proposed in this application.   |
| activities are not currently       |                                 |
| funded by the institution, enter   | **Amount**:                     |
| \$0.                               | [\$\_\_\_\_\_                   |
|                                    | \_\_\_\_\_\_\_\_\_]{.underline} |
| **Amount**:                        |                                 |
| [\$\_\_\                           |                                 |
| _\_\_\_\_\_\_\_\_\_\_]{.underline} |                                 |
+------------------------------------+---------------------------------+

**Other Limitations**:

The use of grant funding for: 1) payment of time release for
trainees/participants; or, 2) payment of temporary personnel replacement
costs for time trainees/participants are away from usual worksite during
involvement in project activities is NOT allowable under NEPR.

IV. **Application and Submission Information**

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1.  **Address to Request Application Package**

    **Application Materials**

The application and submission process has changed significantly. HRSA
is ***requiring*** applicants for this funding opportunity to apply
electronically through Grants.gov. All applicants ***must*** submit in
this manner unless the applicant is granted a written exemption from
this requirement in advance by the Director of HRSA's Division of Grants
Policy. Grantees must request an exemption in writing from
<DGPWaivers@hrsa.gov>, and provide details as to why they are
technologically unable to submit electronically through the Grants.gov
portal. Applicants shall make sure to specify the announcement number
for which they are seeking relief. As indicated in this guidance, **HRSA
and its Grants Application Center (GAC) will only accept paper
applications from applicants that received prior written approval.
Applicants technologically unable to scan the signed face sheet should
also contact the DGPWaivers mailbox to provide information and request
further instructions. However, the application must be submitted under
the deadline.**

Refer to Appendix A for detailed application and submission
instructions. Pay particular attention to Section 3, which provides
detailed information on the competitive application and submission
process.

Applicants must submit proposals according to the instructions in
Appendix A, using this guidance in conjunction with Standard Form 424
Research and Related (SF 424 R&R). This form contains additional general
information and instructions for grant applications, proposal
narratives, and budgets. These forms may be obtained from the following
sites by:

(1) Downloading from <http://www.hrsa.gov/grants/forms.htm>

> or

(2) Contacting the HRSA Grants Application Center at:

> HRSA Grants Application Center
>
> The Legin Group, Inc.
>
> 910 Clopper Road
>
> Suite 155 South
>
> Gaithersburg, MD 20878
>
> Telephone: 1-877-477-2123
>
> <HRSAGAC@hrsa.gov>

Instructions for preparing portions of the application that must
accompany SF 424 R&R appear in the "Application Format" section below.

**2. Content and Form of Application Submission**

**Application Format Requirements**

See Appendix A, Section 4 for detailed application submission
instructions. These instructions must be followed.

The total size of all uploaded files **may not exceed the equivalent of
80 pages when printed by HRSA, approximately 10 MB.** **This 80-page
limit includes the abstract, project and budget narratives, attachments,
and letters of commitment and support.** Standard forms are NOT included
in the page limit.

**Applications that exceed the specified limits (approximately 10 MB, or
that exceed 80 pages when printed by HRSA) will be deemed non-compliant.
All non-compliant applications will be returned to the applicant without
further consideration.**

# Application Format

# Applications for funding [must]{.underline} consist of the following documents in the following order:

# SF 424 R&R -- Table of Contents

-   It is mandatory to follow the instructions provided in this section
    to ensure that your application can be printed efficiently and
    consistently for review.

-   Failure to follow the instructions may make your application
    non-compliant. Non-compliant applications will not be given any
    consideration and those particular applicants will be notified.

-   For electronic submissions, applicants only have to number the
    electronic attachment pages sequentially, resetting the numbering
    for each attachment, i.e., start at page 1 for each attachment. Do
    not attempt to number standard OMB approved form pages.

-   For electronic submissions no table of contents is required for the
    entire application. HRSA will construct an electronic table of
    contents in the order specified.

-   When providing any electronic attachment with several pages, add
    table of content page specific to the attachment. Such page will not
    be counted towards the page limit.

-   For paper submissions (when allowed), number each section
    sequentially, resetting the page number for each section. i.e.,
    start at page 1 for each section. Do not attempt to number standard
    OMB approved form pages.

-   For paper submissions ensure that the order of the forms and
    attachments is as specified below.

+------------------+------+-----------------------+-------------------+
| **Application    | **   | **Instruction**       | **HRSA/Program    |
| Section**        | Form |                       | Guidelines**      |
|                  | Ty   |                       |                   |
|                  | pe** |                       |                   |
+==================+======+=======================+===================+
| SF 424R&R Cover  | Form | Pages 1 & 2 of the    | Not counted in    |
| Page             |      | R&R face page         | the page limit    |
+------------------+------+-----------------------+-------------------+
| Pre-application  | At   | Can be uploaded on    | Not Applicable to |
|                  | tach | page 2 of SF 424      | HRSA; Do not use. |
|                  | ment | R&R - Box 20          |                   |
+------------------+------+-----------------------+-------------------+
| HHS 5161         | Form | Also known as PHS     | Not counted in    |
| Checklist        |      | 5161 checklist        | the page limit    |
+------------------+------+-----------------------+-------------------+
| SF 424R&R        | Form | Supports 8 structured | Not counted in    |
| Senior/Key       |      | profiles              | the page limit    |
| Person Profile   |      |                       |                   |
|                  |      | (PD + 7 additional)   |                   |
+------------------+------+-----------------------+-------------------+
| Senior Key       | At   | Can be uploaded in SF | Counted in the    |
| Personnel        | tach | 424R&R Senior/Key     | page limit.       |
| Biographical     | ment | Person Profile form.  |                   |
| Sketches         |      | One per each          |                   |
|                  |      | senior/key person.    |                   |
|                  |      | The PD/PI             |                   |
|                  |      | biographical sketch   |                   |
|                  |      | should be the first   |                   |
|                  |      | biographical sketch.  |                   |
|                  |      | Up to 8 allowed       |                   |
+------------------+------+-----------------------+-------------------+
| Senior Key       | At   | Can be uploaded in SF | Not Applicable to |
| Personnel        | tach | 424R&R Senior/Key     | HRSA; Do not use. |
| Current and      | ment | Person Profile form   |                   |
| Pending Support  |      |                       |                   |
+------------------+------+-----------------------+-------------------+
| Additional       | At   | Can be uploaded in SF | Not counted in    |
| Senior/Key       | tach | 424R&R Senior/Key     | the page limit    |
| Person Profiles  | ment | Person Profile form.  |                   |
|                  |      | Single document with  |                   |
|                  |      | all additional        |                   |
|                  |      | profiles              |                   |
+------------------+------+-----------------------+-------------------+
| Additional       | At   | Can be uploaded in    | Counted in the    |
| Senior Key       | tach | the Senior/Key Person | page limit        |
| Personnel        | ment | Profile form. Single  |                   |
| Biographical     |      | document with all     |                   |
| Sketches         |      | additional sketches   |                   |
+------------------+------+-----------------------+-------------------+
| Additional       | At   | Can be uploaded in    | Not Applicable to |
| Senior Key       | tach | the Senior/Key Person | HRSA; Do not use. |
| Personnel        | ment | Profile form          |                   |
| Current and      |      |                       |                   |
| Pending Support  |      |                       |                   |
+------------------+------+-----------------------+-------------------+
| SF 424R&R        | Form | Supports primary and  | Not counted in    |
| Performance Site |      | 7 additional sites in | the page limit    |
| Locations        |      | structured form       |                   |
+------------------+------+-----------------------+-------------------+
| Additional       | At   | Can be uploaded in SF | Counted in the    |
| Performance Site | tach | 424R&R Performance    | page limit        |
| Location(s)      | ment | Site Locations form.  |                   |
|                  |      | Single document with  |                   |
|                  |      | all additional site   |                   |
|                  |      | locations             |                   |
+------------------+------+-----------------------+-------------------+
| Project          | At   | Can be uploaded in SF | Required          |
| Summary/Abstract | tach | 424R&R Other Project  | attachment.       |
|                  | ment | Information form, Box | Counted in the    |
|                  |      | 6                     | page limit. Refer |
|                  |      |                       | guidance for      |
|                  |      |                       | detailed          |
|                  |      |                       | instructions.     |
|                  |      |                       | Provide table of  |
|                  |      |                       | contents specific |
|                  |      |                       | to this document  |
|                  |      |                       | only as the first |
|                  |      |                       | page              |
+------------------+------+-----------------------+-------------------+
| Project          | At   | Can be uploaded in SF | Required          |
| Narrative        | tach | 424R&R Other Project  | attachment.       |
|                  | ment | Information form, Box | Counted in the    |
|                  |      | 7                     | page limit. Refer |
|                  |      |                       | guidance for      |
|                  |      |                       | detailed          |
|                  |      |                       | instructions.     |
|                  |      |                       | Provide table of  |
|                  |      |                       | contents specific |
|                  |      |                       | to this document  |
|                  |      |                       | only as the first |
|                  |      |                       | page              |
+------------------+------+-----------------------+-------------------+
| SF 424R&R Budget | Form | Supports structured   | Not counted in    |
| Period (1-5) -   |      | budget for up to 5    | the page limit    |
| Section A -- B   |      | periods               |                   |
+------------------+------+-----------------------+-------------------+
| Additional       | At   | SF 424R&R Budget      | Not counted in    |
| Senior Key       | tach | Period (1-5) -        | the page limit    |
| Persons          | ment | Section A - B, Box 9. |                   |
|                  |      | One for each budget   |                   |
|                  |      | period                |                   |
+------------------+------+-----------------------+-------------------+
| SF 424R&R Budget | Form | Supports structured   | Not counted in    |
| Period (1-5) -   |      | budget for up to 5    | the page limit    |
| Section C -- E   |      | periods               |                   |
+------------------+------+-----------------------+-------------------+
| Additional       | At   | SF 424R&R Budget      | Not counted in    |
| Equipment        | tach | Period (1-5) -        | the page limit    |
|                  | ment | Section C -- E, Box   |                   |
|                  |      | 11. One for each      |                   |
|                  |      | budget period         |                   |
+------------------+------+-----------------------+-------------------+
| SF 424R&R Budget | Form | Supports structured   | Not counted in    |
| Period (1-5) -   |      | budget for up to 5    | the page limit    |
| Section F -- J   |      | periods               |                   |
+------------------+------+-----------------------+-------------------+
| SF 424R&R        | Form | Total cumulative      | Not counted in    |
| Cumulative       |      | budget                | the page limit    |
| Budget           |      |                       |                   |
+------------------+------+-----------------------+-------------------+
| Budget Narrative | At   | Can be uploaded in SF | Required          |
|                  | tach | 424R&R Budget Period  | attachment.       |
|                  | ment | (1-5) - Section F - J | Counted in the    |
|                  |      | form, Box K. Only one | page limit. Refer |
|                  |      | consolidated budget   | guidance for      |
|                  |      | justification for the | detailed          |
|                  |      | project period.       | instructions.     |
|                  |      |                       | Provide table of  |
|                  |      |                       | contents specific |
|                  |      |                       | to this document  |
|                  |      |                       | only as the first |
|                  |      |                       | page              |
+------------------+------+-----------------------+-------------------+
| SF 424R&R        | Form | Supports up to 10     | Not counted in    |
| Subaward Budget  |      | budget attachments.   | the page limit    |
|                  |      | This form only        |                   |
|                  |      | contains the          |                   |
|                  |      | attachment list       |                   |
+------------------+------+-----------------------+-------------------+
| Subaward Budget  | At   | Can be uploaded in SF | Filename should   |
| Attachment 1-10  | tach | 424R&R Subaward       | be the name of    |
|                  | ment | Budget form, Box 1    | the organization  |
|                  |      | through 10. Extract   | and unique.       |
|                  |      | the form from the SF  | Counted in the    |
|                  |      | 424R&R Subaward       | page limit        |
|                  |      | Budget **PureEdge**   |                   |
|                  |      | form and use it for   |                   |
|                  |      | each                  |                   |
|                  |      | consortium            |                   |
|                  |      | /contractual/subaward |                   |
|                  |      | budget as required by |                   |
|                  |      | the program guidance. |                   |
|                  |      | Supports up to 10     |                   |
+------------------+------+-----------------------+-------------------+
| SF 424 R&R       | Form | Assurances for the SF | Not counted in    |
| Assurances for   |      | 424 R&R package       | the page limit    |
| Non-Construction |      |                       |                   |
| Programs         |      |                       |                   |
+------------------+------+-----------------------+-------------------+
| Other Project    | Form | Allows additional     | Not counted in    |
| Information      |      | information and       | the page limit    |
|                  |      | attachments           |                   |
+------------------+------+-----------------------+-------------------+
| Bibliography &   | At   | Can be uploaded in    | Optional. Counted |
| References       | tach | Other Project         | in the page limit |
|                  | ment | Information form, Box |                   |
|                  |      | 8.                    |                   |
+------------------+------+-----------------------+-------------------+
| Facilities &     | At   | Can be uploaded in    | Optional. Counted |
| Other Resources  | tach | Other Project         | in the page limit |
|                  | ment | Information form, Box |                   |
|                  |      | 9.                    |                   |
+------------------+------+-----------------------+-------------------+
| Equipment        | At   | Can be uploaded in    | Optional. Counted |
|                  | tach | Other Project         | in the page limit |
|                  | ment | Information form, Box |                   |
|                  |      | 10.                   |                   |
+------------------+------+-----------------------+-------------------+
| Other            | Form | Supports up to 15     | Not counted in    |
| Attachments Form |      | numbered attachments. | the page limit    |
|                  |      | This form only        |                   |
|                  |      | contains the          |                   |
|                  |      | attachment list       |                   |
+------------------+------+-----------------------+-------------------+
| Attachment 1-15  | At   | Can be uploaded in    | Refer to the      |
|                  | tach | Other Attachments     | attachment table  |
|                  | ment | form 1-15             | provided below    |
|                  |      |                       | for **specific**  |
|                  |      |                       | sequence. Counted |
|                  |      |                       | in the page limit |
+------------------+------+-----------------------+-------------------+
| Other            | At   | Can be uploaded in SF | Not Applicable to |
| Attachments      | tach | 424 R&R Other Project | HRSA; Do not use  |
|                  | ment | Information form, Box |                   |
|                  |      | 11.                   |                   |
+------------------+------+-----------------------+-------------------+

-   To ensure that attachments are organized and printed in a consistent
    manner, follow the order provided below. Note that these
    instructions may vary across programs.

-   Additional supporting documents, if applicable, can be provided
    using the available rows. Do not use the rows assigned to a specific
    purpose in the program guidance.

  -----------------------------------------------------------------------
  **Attachment        **Attachment Description (Program Guidelines)**
  Number**            
  ------------------- ---------------------------------------------------
  Attachment 1        **Copy of Signed SF-424 R&R Face Sheet**

  Attachment 2        **NEPR Project Synopsis.** The synopsis of the
                      proposed project will assist the reviewers and the
                      federal staff in identifying key components of the
                      application. The ***required*** form is located in
                      Appendix D of the application guidance. Please
                      place the synopsis at the front of the submitted
                      application.

  Attachment 3        **Organizational Chart.** Attach a one-page figure
                      that depicts the organizational structure of the
                      project staff, including any collaborating
                      partners.

  Attachment 4        **Letters of Agreement and/or Description(s) of
                      Proposed/Existing Contracts (project specific)**.
                      Provide any documents that describe working
                      relationships between the applicant organization
                      and other agencies and programs cited in the
                      proposal. Letters of agreement from key
                      organizations/individuals must document their
                      willingness to perform in accordance with the plan
                      presented in the application. Documents that
                      confirm actual or pending contractual agreements
                      should clearly describe the roles of the
                      subcontractors and any deliverable.

  Attachment 5        **Position Descriptions for Key Personnel.** Attach
                      position descriptions that include the roles,
                      responsibilities, and qualifications of proposed
                      project key personnel. Please merge all
                      descriptions and biographical sketches into a
                      single document.

  Attachment 6        **Letters of Support**. Include only letters of
                      support which specifically indicate a commitment to
                      the project/program (in-kind services, dollars,
                      staff, space, equipment, etc.) Letters of
                      agreements and support must be dated. List all
                      other support letters on one page.

  Attachment 7        **Program Specific Tables. Applicants applying
                      under the R2 purpose must c**omplete the table,
                      located in Appendix E of the application guidance.

  Attachment 8        **Accreditation Documentation.** Provide a copy of
                      the nursing accreditation letter, certificate of
                      accreditation or Department of Education assurance
                      letter.

  Attachment 9        **(Optional).** Additional Project Information:
                      Tables, charts, etc. to give further details about
                      the proposal.
  -----------------------------------------------------------------------

**SF 424 R&R Application Format (continued)**

i.  ***Application Face Page***

SF 424 R&R, provided with the application package. Prepare this page
according to instructions provided in the form itself. For information
pertaining to the Catalog of Federal Domestic Assistance, the Catalog of
Federal Domestic Assistance Number is 93.*359*.

**DUNS Number**

All applicant organizations are required to have a Data Universal
Numbering System (DUNS) number in order to apply for a grant from the
Federal Government. The DUNS number is a unique nine-character
identification number provided by the commercial company, Dun and
Bradstreet. There is no charge to obtain a DUNS number. Information
about obtaining a DUNS number can be found via the worldwide web at
<http://www.hrsa.gov/grants/dunsccr.htm> or via telephone at
1-866-705-5711. Please include the DUNS number in item 5 on the Cover
Page. Applications ***will not*** be reviewed without a DUNS number.

Additionally, the applicant organization will be required to register
with the Federal Government's Central Contractor Registry (CCR) in order
to do electronic business with the Federal Government. Information about
registering with the CCR can be found at
<http://www.hrsa.gov/grants/dunsccr.htm>.

ii.  ***Table of Contents***

The application should be presented in the order of the Table of
Contents provided earlier. Again, for electronic applications no table
of contents is necessary as it will be generated by the system. (Note:
the Table of Contents will not be counted in the page limit).

iii.  **Application Checklist**

     HHS 5161 Checklist, provided with the application package.

iv. ***Budget***

SF 424 R&R, provided with the application package. Follow all
instructions in SF 424 R&R.

Please complete **Budget Sections A, B, C, D, E, F, G, H, I and K**, and
provide a **line item budget** for [each grant year]{.underline} using
the budget categories in the SF 424 R&R. The budget period is one year
and the project period is three years (or five years for Purposes P1 and
R2 only).

The Cumulative Budget provides the total budget information for
[each]{.underline} year of the grant request. SF 424 R&R -- Budget
Sections A through F list the direct costs requested for each year of
the project. The applicant must provide an itemized cost-effective
budget, compatible with stated objectives, and a detailed
justification/rationale for each budget line item, using the categories
listed in Sections A through F. The requested budget and financial plan
should reflect institutional commitment to the project by listing
in-kind contributions. Please fill in each budget form completely and
then click the button in the upper left-hand corner to move to the form
for completing the next budget period. Complete these steps until
[all]{.underline} required budget forms, for either three or five years
as applicable, have been completed.

v.   ***Budget Justification***

Provide a narrative that explains the amounts requested for each line in
the budget. The budget justification should specifically describe how
each item will support the achievement of proposed objectives. The
budget period is for ONE year. However, the applicant must submit
one-year budgets for each of the subsequent project period years
(usually one to three years or more) at the time of application. Line
item information must be provided to explain the costs entered in
appropriate form, SF 424 R&R. **The budget justification must clearly
describe each cost element and explain how each cost contributes to
meeting the project's objectives/goals.** Be very careful about showing
how each item in the "other" category is justified. The budget
justification MUST be concise. Do NOT use the justification to expand
the project narrative.

***Budget for Multi-Year Grant Award***

This announcement is inviting applications for project periods of three
years (or five years for Purposes P1 and R2 only). Awards, on a
competitive basis, will be for a one-year budget period, although
project periods are for three or five years, as applicable. Applications
for continuation grants funded under these awards beyond the one-year
budget period but within the three-year or five year project period will
be entertained in subsequent years on a noncompetitive basis, subject to
availability of funds, satisfactory progress of the grantee, and a
determination that continued funding would be in the best interest of
the Government.

Include the following in the Budget Justification narrative:

**1. Non-trainee Expenses**

**Personnel Costs:** Personnel costs should be explained by listing each
staff member who will be supported from funds, name (if possible),
position title, percent full time equivalency (FTE), annual salary, and
the exact amount requested for each project year. Describe the roles and
responsibilities under the budget justification for grant supported and
non-grant supported personnel. This information is essential for
reviewers to determine if project resources are adequate.

**Consultant Costs:** Give name and institutional affiliation,
qualifications of each consultant, if known, and indicate the nature and
extent of the consultant service to be performed. Include expected rate
of compensation and total fees, travel, per diem, or other related costs
for each consultant.

**Indirect Costs:** Indirect costs are those costs incurred for common
or joint objectives which cannot be readily identified but are necessary
to the operations of the organization, e.g., the cost of operating and
maintaining facilities, depreciation, and administrative salaries. For
institutions subject to OMB Circular A-21, the term "facilities and
administration" is used to denote indirect costs. Indirect costs under
training grants to organizations other than state, local or Indian
tribal governments will be budgeted and reimbursed at 8% of modified
total direct costs rather than on the basis of a negotiated cost
agreement, and are not subject to upward or downward adjustment. Direct
cost amounts for equipment (capital expenditures), tuition and fees, and
subgrants and subcontracts in excess of \$25,000 are excluded from the
actual direct cost base for purposes of this calculation.

**Fringe Benefits**: List the components that comprise the fringe
benefit rate, for example - health insurance, taxes, unemployment
insurance, life insurance, retirement plan, and/or tuition
reimbursement. The fringe benefits should be directly proportional to
that portion of personnel costs that are allocated for the project.

**Travel:** List travel costs according to local and long distance
travel. For local travel, the mileage rate, number of miles, reason for
travel, and staff member/consumers completing the travel should be
outlined. The budget should also reflect the travel expenses associated
with participating in meetings and other proposed trainings or
workshops.

*Note: Project Directors are expected to include in their budgets one
annual meeting in the Washington, D.C., area during the project period
to report and share experiences with other grantees.*

**Equipment:** List equipment costs and provide justification for the
need of the equipment to carry out the program's goals. Extensive
justification and a detailed status of current equipment must be
provided when requesting funds for the purchase of computers and
furniture items that meet the definition of equipment *(a unit cost of
\$5000 and a useful life of one or more years). **Proposals for the sole
purpose of setting up/constructing a skills lab are not eligible under
the NEPR program.***

**Supplies:** List the items that the project will use. In this
category, separate office supplies from educational purchases. Office
supplies could include paper, pencils, and the like; and educational
supplies may be pamphlets, educational videotapes, etc. Remember, they
must be listed separately.

> []{.mark}

**Subcontracts:** To the extent possible, all subcontract budgets and
justifications should be standardized, and contract budgets should be
presented by using the same object class categories contained in the SF
424 R&R. Provide a clear explanation as to the purpose of each contract,
how the costs were estimated, and the specific contract deliverables.

[]{.mark}

**Other Expenses:** Put all costs that do not fit into any other
category into this category and provide and explanation of each cost in
this category. In some cases, grantee rent, utilities and insurance fall
under this category if they are not included in an approved indirect
cost rate.

**Note: Accreditation, Credentialing, Licensing, and Franchise fees and
expenses are [NOT]{.underline} allowable.**

Funds may be used to support appropriate and justifiable costs directly
related to meeting data reporting requirements. Identify and justify how
these funds will be used under the appropriate budget category.

2.  **Trainee Expenses** **-- ARE NOT APPLICABLE UNDER THE NEPR
    PROGRAM.**

***Student support, including but not limited to, tuition, stipends,
scholarships, bonuses, subsidies, or paid release time for program
participants is [NOT]{.underline} allowable.***

vi.  ***Staffing Plan and Personnel Requirements***

Applicants must present a staffing plan and provide a justification for
the plan that includes education and experience qualifications and
rationale for the amount of time being requested for each staff
position. Position descriptions that include the roles,
responsibilities, and qualifications of proposed project staff must be
included in Attachment 4. Copies of biographical sketches for any key
employed personnel that will be assigned to work on the proposed project
must be uploaded and included in **SF 424 R&R: Senior/Key Person
Profile**.

vii. ***Assurances***

Please include all assurances relevant to the specific program. SF 424
R&R, provided with the application package.

viii. ***Certifications***

      Please include all certifications relevant to the specific
      program. SF 424 R&R, provided with the application package.

ix. **Project Abstract**

Provide a summary of the application. ***The project abstract must
indicate the [ONE]{.underline} specific NEPR Purpose of the project by
letter/number\--E1, E2, E3, P1, P2, P3, P4, R1, [or]{.underline} R2\--
in the first sentence***. Because the abstract is often distributed to
the public and Congress, please prepare this so that it is clear,
accurate, concise and without reference to other parts of the
application. It must include a brief description of the proposed grant
project including the needs to be addressed, the proposed services, and
the population group(s) to be served. The project abstract must be
single-spaced, limited to one page in length and uploaded in SF 424 R&R
Other Project Information Form, Box 6.

**[The following information must be placed at the top of the
abstract]{.underline}:**

-   Project Title

-   Applicant Organization Name

-   Project Director

-   Address

-   Project Director Phone Numbers (Phone and Fax)

-   Email Address

-   Organizational Website Address, if applicable

x.   **Program Narrative**

This section provides a comprehensive framework and description of all
aspects of the proposed program. It should be succinct,
self-explanatory, and well organized so that reviewers can understand
the proposed project.

**Use the following section headers for the Program Narrative:**

-   **Introduction**

-   **Needs Assessment**

-   **Methodology**

-   **Work Plan**

-   **Resolution of Challenges (Competing Continuation grants only)**

-   **Evaluation and Technical Support Capacity**

-   **Organizational Information**

Explanation of content for each section is provided below:

-   **Introduction**

This section should briefly describe the purpose of the proposed
project.

-   **NEEDS ASSESSMENT**

This section outlines the needs of your community and/or organization
and should help reviewers understand the population to be served by the
proposed project. It should lead clearly to the identification of the
student or project participant pool and the target population for the
project. The target population and its unmet health needs must be
described and documented. Demographic data should be used and cited
whenever possible to support the information provided. Applicants may
use, but are not limited to, surveys, pilot studies, needs assessments,
or focus groups to document the need for the project, as well as methods
of ongoing data collection for evaluation purposes. [Criterion 1a "Need"
may be addressed in this section]{.underline}. Applicants must ensure
that the needs assessment is reflective of the specific purpose
selected. Applicants must describe:

-   The geographic area (local or regional) in which the project will
    focus and the specific health care access, health disparity, and
    quality issues in that area.

-   The composition of the current nursing workforce in relation to the
    demographics of the geographic area it serves.

-   How the proposal will address/respond to the needs of the workforce,
    students and/or target population.

-   How they meet the funding preference if requested.

**Competing Continuation Applications ONLY: Include a Progress Report
Summary within your Needs Assessment**

All applicants, excluding those for Purpose R2, who are in the third
year of funding (or fifth year for Purpose P1) and who wish to continue
the initial project, should submit a Competing Continuation Application.
Applicants must provide a statement of need for continuation of the
currently funded project: a competing continuation is an extension of
the original project. For the competing continuation application the
needs statement should:

-   Highlight the critical elements documented in the original needs
    assessment and justify the need for three additional years of
    support (it is not necessary to recreate the original need
    documentation for the renewal application such as a feasibility
    study. The need is to be updated as necessary.)

-   Provide a [Progress Report Summary]{.underline} (see review
    criteria). Failure to include a progress report, **for competing
    continuations only**, will render the application non-responsive and
    the application will not be considered for funding under this
    announcement.

-   Identify gaps in achievement of objectives and work that remains to
    be done.

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-   **Methodology**

Propose methods that will be used to meet each of the previously
described program requirements and expectations in this grant
announcement. Clearly document all linkages and relationships.
[Criterion 4 "Impact" may be addressed in this section]{.underline}.

**1. Program Information**

**PROGRAM SPECIFIC Requirements FOR EACH PURPOSE**

The applicant [must]{.underline} select and focus on only
[one]{.underline} of the nine purposes illustrated below. For example,
E1 or P1 or R1, etc.). Failure to select one purpose [or]{.underline}
selection of multiple purposes will render the application
non-responsive and the application will not be considered for funding
under this announcement.

**[Education Purposes (E)]{.underline}**

> **PURPOSE E1: Expanding the enrollment in baccalaureate nursing
> programs.**
>
> The intent of Purpose E1 is to prepare baccalaureate-level nurses to
> meet the complex health care needs in the ever-changing health care
> system. The intended outcome is to increase enrollment and graduation
> rates of undergraduate nursing students prepared at the baccalaureate
> level. Applicants are encouraged to be innovative and use a
> combination of activities to accomplish this desired outcome. The
> [only]{.underline} eligible applicant organizations for the E1 purpose
> are accredited schools of nursing, which offer a Bachelor of Science
> in Nursing (BSN) degree.
>
> Strategies for increasing baccalaureate enrollment may include but are
> not limited to program expansion, capacity building, and improvement
> of infrastructure. Approaches for increasing or expanding
> baccalaureate nursing programs may include increasing nursing faculty,
> clinical practice site development for nursing students, nursing
> curriculum innovations, expanding the nursing student applicant pool,
> and creation of accelerated nursing programs.
>
> **Excluded and/or not allowed items or participants are:**

1.  Pipeline and recruitment activities for high school students;

2.  Remedial programs and activities; and

3.  Academic enrichment activities and pre-college participants

> **[Purpose E1 Eligible Project Participants:]{.underline}**
>
> Students enrolled full or part time in baccalaureate nursing programs
> that will be eligible to take the NCLEX-RN after graduation
>
> **[Required Application Documentation for Purpose E1:]{.underline}**

1.  Provide the most current enrollment, NCLEX-RN pass rates, and
    graduation data for the baccalaureate nursing program, as of October
    15, 2007.

2.  Describe the innovative approach (es) for improving the
    infrastructure to accommodate the increased undergraduate nursing
    student enrollment.

3.  Describe the activities for increasing enrollments, NCLEX-RN pass
    rates, and graduations in generic undergraduate baccalaureate
    nursing programs or registered nurse to baccalaureate programs, or
    both.

4.  Indicate the projected number and percent of the increase in
    enrollment for each project year.

5.  Provide a description of the current and proposed curriculum.

**[PURPOSE E2:]{.underline}** **Developing and implementing internship
and residency programs to encourage mentoring and the development of
specialties.**

> The intent of Purpose E2 is to develop and implement internship and
> residency programs to improve education and registered nursing
> practice in the workplace; and to increase the quality of care and the
> retention of registered nurses (RNs) in the workforce. The internship
> and residency programs are expected to offer theory and clinical
> educational opportunities for eligible participants in one or more of
> three professional transitions.
>
> **Excluded and/or not allowed within this program are:**

1.  Participation of students in existing nursing programs of study;

2.  Substitution for hospital orientation programs;

3.  Use of HRSA funds for individual financial support for interns or
    residents; and,

4.  Use of HRSA funds for individual costs associated with certification
    examinations in the proposed nursing specialty

> [**Purpose E2 Eligible Project Participants**:]{.underline}

1.  Recent graduate registered nurses (GRNs) of diploma, associate
    degree, baccalaureate, and masters level programs effectively
    transitioning into first professional nursing role in which they
    will be employed;

2.  Employed GRNs and RNs to assist transition into specialty roles in
    nursing; and

3.  RNs who are re-entering into the nursing workforce to meet the
    current and increasing demand for registered nurses whose employment
    is based on successful completion of the internship or residency
    program.

**[Required Application Documentation for Purpose E2:]{.underline}**

1.  Describe the registered nurse project participant pool.

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a)  Describe the target registered nurse audience and provide evidence
    of participant interest in, and support for, the proposed
    educational offering through the internship or residency.

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2.  Describe the internship or residency program, including the
    following:

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a)  program design including number of hours and percent of theory and
    clinical practice;

b)  clinical practice site(s), including incidence of acute and chronic
    illness consistent with the basic and advanced nursing specialties
    in the project to insure adequate clinical experiences for interns
    and residents;

c)  clinical competencies expected;

d)  mentor and preceptor activities;

e)  recognition provided for interns and residents who successfully
    complete the program and for mentors and preceptors; and

f)  obligations of the interns or residents to the employing
    institution.

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3.  Describe the proposed impact of the internship or residency on
    quality of care and retention of nurses in the workforce.

4.  Specify the length of time of the theoretical and clinical
    components of the internship or residency program.

5.  Describe the sequence of courses and clinical activities that will
    be offered during the project period for each year of the grant.

6.  Provide the number of RN interns or residents enrolled in and
    projected to be enrolled in the internship and residency program for
    each project year.

7.  Provide a plan demonstrating employer support for the proposed
    activity (e.g. reduced workloads, reduced evening or night hours,
    post completion unit assignment, paid time release, etc.).

> **[PURPOSE E3:]{.underline} Providing nursing education in new
> technologies, including distance-learning methodologies.**
>
> The intent of Purpose E3 is to incorporate innovative approaches in
> the use of new technologies to enhance nursing education. Increased
> knowledge and availability of new technology are essential for all
> nurses to function effectively in the current health care environment.
>
> **[Purpose E3 Eligible Project Participants:]{.underline}**

1.  Registered nurses

2.  Undergraduate nursing students who will be eligible to take the
    NCLEX-RN after graduation and graduate nursing students

> **[Required Application Documentation for Purpose E3:]{.underline}**

1.  Provide a plan to enhance education in new technologies by providing
    opportunities that will lead registered nurses and nursing students
    to be competent in the use of these technologies. The plan should
    demonstrate creative educational models and innovative methods for
    delivering the content and include the following content:

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a)  the design of curriculum or course offering(s) and learning
    experiences;

b)  the number, length and frequency of educational sessions;

c)  a one paragraph course description and a topical outline for each
    course to be offered;

d)  a description of anticipated clinical experiences, if appropriate;
    and

e)  the type of recognition to be awarded (e.g. certificate, continuing
    education units, academic credit).

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2.  Describe the target registered nurse/nursing student audience and
    provide evidence of participant interest in, and support for, the
    proposed educational offering.

3.  For educational offerings, describe how the proposed activity will
    be integrated into the existing curriculum.

4.  Provide an estimate of the number of registered nurse/nursing
    student participants for each year of the project.

> **[Practice Purposes (P)]{.underline}**
>
> **[PURPOSE P1:]{.underline} Establishing or expanding nursing practice
> arrangements in non-institutional settings to demonstrate methods to
> improve access to primary health care in medically underserved
> communities.**
>
> The intent of Purpose P1 is to establish or expand non-institutional
> nursing practice arrangements (NPA), also known as nurse managed
> centers, to improve access to primary health care in medically
> underserved areas and provide nursing practice and structured clinical
> experiences for nursing students. NPAs are a delivery system managed
> by a school of nursing and operated by faculty, students, and staff to
> increase access to primary health care for medically underserved
> communities and populations.
>
> **[Purpose P1 Eligible Project Participants:]{.underline}**

1.  Registered nurses, advanced practice nurses and faculty; and

2.  Undergraduate nursing students and graduate nursing students

> **[Required Application Documentation for Purpose P1:]{.underline}**

1.  Provide an overall **business plan** for the NPA. The application
    **must** include a detailed description of the business plan
    containing the following elements:

    a.  A description of the NPA, including strategies for improving
        access to primary health care in the medically underserved
        community;

    b.  Describe the medically underserved community and target
        population(s) to be served by the NPA;

    c.  Describe the marketing plan (client recruitment, managed care
        organization affiliation, quality indicators, advertising,
        community linkages/partnerships, etc);

    d.  Describe the faculty practice plan;

    e.  Describe the staff recruitment, including outreach to target
        populations;

    f.  Describe a financial plan (reimbursement, e.g., Medicaid,
        Medicare, other third party reimbursement, donations, self-pay);

    g.  Describe the management information system plan for patient data

collection, billing, and outcome measurement;

h\) Describe the quality improvement plan; and,

> i\) The NPA must describe a plan for establishing or maintaining a
> community advisory group and how it relates to planning,
> implementation of the NPA project and incorporating input from a
> target population.

2.  Describe the authority and responsibility of the applicant
    organization in the organizational structure and in the operation of
    the NPA. Provide an organizational chart, which shows the
    relationship between the NPA and the applicant organization.

3.  Describe how the NPA will deliver services within a teaching-

> learning environment, include a description of the nursing practice
> and the structured clinical experiences.

4.  Describe strategies that will be implemented to provide culturally
    competent care to patients being served at the NPA.

5.  Identify the number of undergraduate and graduate students who will
    rotate through the NPA.

6.  Provide the projected number of clients and client encounters that
    will be seen for the five years of the project.

7.  Describe the proposed/actual hours that the NPA will be open for
    patient care services.

8.  Describe the didactic and the structured clinical experiences for
    undergraduate and graduate nursing students in the NPA as it relates
    to the nursing school curriculum.

> **[PURPOSE P2]{.underline}: Providing care for underserved populations
> and other high-risk groups such as the elderly, individuals with
> HIV/AIDS, substance abusers, the homeless, and victims of domestic
> violence.**
>
> The intent of Purpose P2 is to improve and enhance access to direct
> patient care for targeted underserved and high-risk populations
> through development of innovative projects, [which include an academic
> or continuing education component]{.underline}, for registered nurses
> or nursing students.
>
> **[Purpose P2 Eligible Project Participants:]{.underline}**

1.  Registered nurses; and/or

2.  Undergraduate nursing students

> **[Required Application Documentation for Purpose P2:]{.underline}**

1.  Describe the applicant's experience in and/or plan for treating the
    population(s) to be served and how this project will improve the
    registered nursing care for underserved populations and other
    high-risk groups. Include the following:

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a)  the types of patient care services to be offered;

b)  a description of how, when and where patient care services will be
    provided; and,

c)  strategies to provide culturally competent care to a diverse
    population.

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2.  Describe the registered nurse/nursing student target audience and
    provide evidence of participant interest in, and support for, the
    proposed educational offering.

3.  Provide projected number of program participants for each year of
    the project.

4.  Describe a plan for providing courses/course offerings that will
    improve the care for the underserved population(s) or high-risk
    group(s) to be served. Include the following content:

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a)  the design of curriculum or course offering(s) and learning
    experiences;

b)  the number, length and frequency of educational sessions;

c)  a one paragraph course description and a topical outline for each
    course to be offered;

d)  a description of anticipated clinical experiences, if appropriate;
    and,

e)  the type of recognition to be awarded (e.g. certificate, continuing
    education units, academic credit).

> 5\. Provide evidence of employer support for the proposed activity
> (e.g. release time, tuition reimbursement, facilities), if applicable.
>
> 6\. Provide a plan for continuous quality improvement.
>
> **[PURPOSE P3:]{.underline} Providing managed care, quality
> improvement, and other skills needed by registered nurses to practice
> in existing and emerging organized health care systems.**
>
> The intent of Purpose P3 is to develop or enhance the knowledge,
> skills, and abilities of registered nurses and nursing students in the
> management of complex existing and emerging health care systems in
> order to adequately practice in new and changing interdisciplinary
> environments.
>
> **[Purpose P3 Eligible Project Participants:]{.underline}**

1.  Registered Nurses; and/or

2.  Undergraduate nursing students

> **[Required Application Documentation for Purpose P3:]{.underline}**

1.  Describe a plan for providing an academic credit or a continuing
    education offering on management of patient care, improvement in the
    quality of patient care, or other skill(s) needed by registered
    nurses to practice in existing and emerging organized health care
    systems.

2.  The curriculum should be consistent with identified competencies.
    Include the following content:

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a)  the design of curriculum or course offering(s) and learning
    experiences;

b)  the number, length and frequency of educational sessions;

c)  a one paragraph course description and a topical outline for each
    course to be offered;

d)  a description of anticipated clinical experiences, if appropriate;
    and

e)  the type of recognition to be awarded (e.g. certificate, continuing
    education units, academic credit).

> 3\. Describe the registered nurse/nursing student target audience and
> provide evidence of participant interest in, and support for, the
> proposed educational offering.
>
> 4\. Provide the projected number of student participants for each year
> of the project.

**[PURPOSE P4:]{.underline} Developing cultural competencies among
registered nurses.**

> The intent of Purpose P4 is to develop culturally competent registered
> nurses who possess cultural and linguistic competence as a set of
> congruent behaviors, attitudes, and policies that come together in a
> system, agency, or among nursing and other professionals and enable
> that system, agency, or those professionals to work effectively in
> cross-cultural and linguistically diverse situations.
>
> **[Purpose P4 Eligible Project Participants:]{.underline}**

1.  Registered Nurses; and/or

2.  Undergraduate nursing students

> **[Required Application Documentation for Purpose P4:]{.underline}**

1.  Describe a plan for providing an educational offering for academic
    credit or a continuing education offering for developing cultural
    competence among registered nurses/nursing students. Include the
    following:

    a.  the design of curriculum or course offering(s) and learning
        experiences;

    b.  the number, length and frequency of educational sessions;

    c.  a one paragraph course description and a topical outline for
        each course to be offered;

    d.  a description of anticipated clinical experiences, if
        appropriate; and,

    e.  the type of recognition to be awarded (e.g. certificate,
        continuing education units, academic credit).

2.  Describe the registered nurse/nursing student target audience and
    provide evidence of participant interest in, and support for, the
    proposed educational offering.

3.  Provide the projected number of participants for each year of the
    project.

4.  Describe a plan of cultural competency that:

    a.  Promotes the development of a culturally diverse and
        representative nursing workforce;

    b.  Promotes the integration of cultural competency into nursing
        programs/care practices;

    c.  Recruits and retains key staff with demonstrated experience
        serving the specific target population and familiarity with the
        culture of the particular communities served;

    d.  Summarizes specific training, and/or learning experiences to
        foster knowledge and appreciation of how culture influences
        health literacy, patient safety, and access to high quality,
        effective and predictably safe healthcare services. 

    e.  Uses training to increase self-awareness of multicultural and
        health literacy issues and engage individuals, families, and
        communities from diverse social, cultural, and backgrounds in
        self-managing their health care.

    f.  Increases nurses' awareness in serving the specific target
        population and familiarity with the culture of the particular
        target group.

> **[Retention Purposes (R)]{.underline}**
>
> **[PURPOSE R1:]{.underline} Career Ladder Programs**
>
> The intent of Purpose R1 is to: 1) promote career advancement for
> registered nurses in a variety of training settings, including
> cross-training and specialty training; **[or]{.underline}**, 2)
> promote career advancement for individuals who desire to become
> registered nurses or transition from diploma or associate degrees in
> nursing (ADN) to a bachelor degrees in nursing (BSN).
>
> The career ladder programs are expected to offer project participants
> the opportunity for career advancement. The grant project must focus
> on **[one]{.underline}** area such as cross training/specialty
> training or academic nursing program:

1.  **Continuing Education or Specialty Nurse Training Projects.** These
    projects offer registered nurses career advancement by augmenting
    their current skills in their existing nursing roles. [Eligible
    participants MUST be registered nurses]{.underline} who want to
    acquire the necessary skills, knowledge, and abilities for assuming
    new or expanded roles and responsibilities. Projects provide
    registered nurses cross training and specialty training among
    diverse population groups in a variety of training settings. All
    projects must include at least one project objective related to
    career counseling and mentoring.

2.  **Academic Nursing Projects**. These projects offer individuals
    career advancement opportunities through formal academic nursing
    programs to become entry-level registered nurses [or]{.underline}
    for registered nurses to obtain a BSN degree. **Project participants
    MUST be enrolled in an accredited nursing education program that
    provides registered nursing training. Projects that include proposed
    tracks or exit points of CNA, LPN, or other than RN are not eligible
    under NEPR.**

> **NOTE: Advanced education nursing projects such as Masters of Science
> in Nursing (MSN) programs and combined RN/MSN programs will be
> supported under the Advanced Education Nursing o authorized under the
> Public Health Service Act, Section 811.** Advanced education nursing
> projects, which are currently funded under the R1 purpose, are
> [not]{.underline} eligible for competing continuations under NEPR. All
> applications for new or competing continuation advanced education
> nursing projects must be submitted under the Advanced Education
> Nursing Program. (funding opportunity HRSA-08-020). [All]{.underline}
> applications *for advanced education nursing projects*, submitted for
> the R1 purpose whether new or continuing, will be deemed
> non-responsive and the application will not be considered for funding
> under this announcement.
>
> **[Purpose R1 (Focus 1) Eligible Project Participants:]{.underline}**

1.  Registered Nurses

> **[Required Application Documentation for R1 (Focus 1): Continued
> Education/Specialty Training Career Ladder Programs]{.underline}**:
> **Projects that promote career advancement opportunities for
> registered nurses in a variety of training settings, to include
> cross-training and specialty training.**

1.  Provide a plan for providing an educational offering to enhance
    career advancement for registered nursing personnel. The plan should
    demonstrate creative educational models and innovative methods
    designed to augment skills in their existing roles and acquire the
    necessary skills, knowledge and abilities for new or expanded roles
    and responsibilities and include the following content:

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a)  the design of curriculum or course offering(s) and learning
    experiences;

b)  the number, length and frequency of educational sessions; Provide
    the number, titles, and descriptions of courses/course offerings
    directly related to the purpose of the project.

c)  a one paragraph course description and a topical outline for each
    course to be offered;

d)  a description of anticipated clinical experiences, if appropriate;
    and

e)  the type of recognition to be awarded (e.g. certificate, continuing
    education units, academic credit).

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2.  Describe the target registered nurse participants and provide
    evidence of participant interest in, and support for, the proposed
    educational offering.

3.  Include the projected number of registered nurse participants for
    each year of the project.

4.  Describe the mentoring/counseling activities.

> **[Purpose R1 (Focus 2) Eligible Project Participants:]{.underline}**

1.  Registered nurses (who already possess ADN or Diploma degrees)

2.  Current CNAs or LPNs who are enrolled in nursing programs who will
    be eligible to take the NCLEX-RN after graduation

3.  Second-degree students who are enrolled in nursing programs who will
    be eligible to take the NCLEX-RN after graduation.

> **[Required Application Documentation for R1 (Focus 2)]{.underline}:
> Academic Nursing Bridge [Career Ladder Programs]{.underline}**:
> **Projects that promote individuals who desire to
> [transition]{.underline} from one career/career level to the next
> through a formal academic nursing educational program.**

1.  Describe the target participant pool and provide evidence of
    participant interest in, and support for, the proposed registered
    nursing educational offering.

2.  Define in detail the transition methodology from the current level
    of the student to that of a registered nurse.

3.  Describe selection criteria for participants in nursing program.

4.  Describe the registered nursing curriculum, include the following:

    a.  the design of nursing curriculum or course offering(s) and
        learning experiences;

    b.  the number, sequence, length, and frequency of educational
        sessions;

    c.  a one paragraph course description and a topical outline for
        each course to be offered;

    d.  a description of anticipated clinical experiences;

    e.  the type of recognition to be awarded (e.g., academic credit),
        and,

    f.  the total estimated time required to complete the program(s)
        associated with this project.

5.  Provide the most current enrollment, NCLEX-RN pass rates, and
    graduation data for the nursing program, as of October 15, 2007.

6.  Provide a description of the current and proposed curriculum.

7.  Describe a plan for mentoring and career counseling to ensure
    retention and successful completion of the program.

8.  Include a plan and a signed agreement for articulation or transfer
    between or among institutions participating in the project, as
    applicable.

9.  Include nursing program accreditation letter.

    **[PURPOSE R2]{.underline}: Enhancing Patient Care Delivery
    Systems.**

The intent of Purpose R2 is to improve the [retention of registered
nurses,]{.underline} and thus enhance patient care that is directly
related to nursing activities. The intent may be realized by enhancing
collaboration and communication among registered nurses and other health
care professionals, and by promoting registered nurse involvement in the
organizational and clinical decision making processes of a health care
facility. **[Project funding must be used for activities involving
registered nurses]{.underline}.**

> The overall goal of purpose R2 is measured by the proposed project
> addressing 2 nurse retention core measures: 1) registered nurse
> retention rate and 2) registered nurse vacancy rate for the
> organization, **[and]{.underline}** the 4 organizationally identified
> patient care core indicators that would be impacted by increased nurse
> retention of registered nurses.
>
> Applicants must identify problematic areas, within the organization,
> which can be measured by the four patient care indicators to
> demonstrate improvement as a result of the project. **These core
> measures and core indicators must be integrated throughout the
> project. Applications must provide baseline documentation of
> registered nurse retention/vacancy measures and patient care core
> indicators**.

[The project period for Purpose R2 is **five-year**s]{.underline}. Years
1 through 3 are to be used for the implementation of project activities,
data collection, and evaluation. [Years 4 and 5 are for data collection,
evaluation, and reporting ***only,***]{.underline} and will provide for
ongoing validation of the activities/strategies implemented by the
project. Therefore, the requested funding for **[each]{.underline}** of
the years 4 and 5 shall be no more than [20%]{.underline} of the
requested funds for year 3. **Applicants must provide a 5-year budget,
as outlined above, in order to be considered for the R2 purpose.**

**In making awards under the R2 purpose, the Secretary shall give a
preference to applicants that have not previously received an award
under this purpose (Section 831(c)(2)(B).**

> **[Purpose R2 Eligible Project Participants:]{.underline}**

1.  Registered Nurses

> **[Required Application Documentation for Purpose R2:]{.underline}**

1.  Discuss the retention and vacancy rates of registered nurses. This
    background discussion should include:

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a)  A comprehensive description of the project's purpose and/or
    problematic areas within the organization;

b)  Work environment, administrative and organizational culture;

c)  A comparison of nurse retention and vacancy rates against the
    corresponding national rates.

d)  Baseline data for the 2 retention core measures and the formula used
    for calculating these measures. [All]{.underline} projects shall
    describe nurse retention with [these]{.underline} retention core
    measures:

    1.  Registered nurse retention rate; and,

    2.  Registered nurse vacancy rate.

> 2\. Discuss **[four]{.underline} patient care core indicators of [your
> choice]{.underline} that demonstrate improvement and/or enhancement of
> patient care**. **These indicators can be reported either
> quantitatively or qualitatively.** Be specific when describing these
> indicators. These four core measures [cannot be changed]{.underline}
> once approved within the original grant application, and must be
> measured and reported in the exact same manner as used to establish
> the baseline measurements. The discussion of the [four selected
> patient care core indicators must]{.underline}**:**

a.  Compare the current status of your registered nurse retention and
    patient care issue to existing nursing standards of practice and/or
    nursing professional performance;

b.  Describe how patient care is impacted due to a lack of
    retention**;**

c.  Provide the background/rationale for the choice of the 4
    organizational specific patient care core indicators.

d.  Address areas of specific concern to the selected organizations
    and/or organizational units;

e.  Demonstrate improvement in the quality of patient care within the
    applicant's selected organizations and/or organizational units as a
    result of project activities; and,

f.  Describe method of measurement in a concise way that is
    understandable and [consistent within baseline measurement for the
    entire 5-year grant period]{.underline}.

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2.  Describe a comprehensive plan for enhancing patient care and
    retaining registered nurses and the goals that your organization
    plans on achieving through this project. The plan should directly
    relate to [nursing activities]{.underline} that will improve
    registered nurse retention and enhance patient care. Discuss the
    plan from the perspective of a specific standard of nursing
    practice, professional performance, or organizational expectation
    and its related impact on patient care. The plan should address:

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a.  [Intertwining]{.underline} the concepts of registered nurse
    retention [and]{.underline} enhancement of patient care, as
    identified in the core measures and core indicators.

b.  Enhanced collaboration and communication among registered nurses and
    other health care professionals.

c.  Full involvement of registered nursing professionals in the
    organizational and clinical decision-making processes of the
    organization(s).

d.  The specific registered nurse population(s) targeted and the numbers
    of registered nurses.

e.  Partnerships and linkages necessary to accomplish the project.

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3.  Describe project activities (as applicable), data collection, and
    evaluation activities for all 5 years of the grant:

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a.  For Years 1 through 3: Describe implementation of the project
    activities, including data collection, analysis, and evaluative
    processes projected, as part of the activities.

b.  For Years 4 and 5: Describe on-going data collection, analysis, and
    evaluation activities **[only]{.underline}.**

    2.  Describe an overall project outcome evaluation plan, for each of
        the **five** project years, which address the goals of
        registered nurse retention and patient care enhancement. This
        plan should address the ongoing data collection, analysis, and
        opportunity for trend validation in Years 4 and 5. At a minimum
        this plan should include:

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    a.  A starting point of reference for the project to anticipated
        end-outcomes;

    b.  Evaluation method of activities in meeting the outcome
        indicators for that specific objective or sub objective.

    c.  Expected outcomes for the retention core measures and patient
        care core indicators.

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    3.  Provide the projected Core Retention Measures and Patient Care
        Core Indicators on Table 1 in Appendix E of the application.

**2. Project Objectives**

A.  At least [one]{.underline} project specific objective must
    illustrate the project's commitment link towards one of the Healthy
    People 2010 goals identified under the Administrative and National
    Policy Requirements of this application guidance document.

B.  At least [one]{.underline} project specific objective must address
    how the grant project will contribute to meeting at least one of the
    following BHPr goals:

    -   **Goal 1**: Eliminate Health Barriers: Assure the appropriate
        supply, diversity, composition and distribution of the health
        professions workforce.

    -   **Goal 2**: Eliminate Health Disparities: Assure the
        availability of a full range of healthcare skills and services
        to populations bearing a disproportionate share of disease and
        disability.

    -   **Goal 3**: Assure Quality of Care: Improve the knowledge,
        skills, competencies and outcomes of the health professions
        workforce.

    -   **Goal 4**: Improve Public Health and Health Care Systems:
        Assure the infrastructure to support an efficient and effective
        health professions workforce.

C.  Project objectives must be reasonable, measurable, and time-framed
    objectives with specific outcomes and evaluation methods identified
    for each project year.

-   **Work Plan**

1\. **Approach**

A.  Describe the activities, methods, techniques, or steps that will be
    used to achieve [each]{.underline} of the objectives proposed in the
    methodology section; each activity must support the yearly project
    outcomes. Describe how the activities define the process and help
    achieve the desired measurable outcome. The description should
    include information that clearly indicates what is going to be done
    and how it will be done.

B.  Provide a graphical summary (i.e. table illustration) of the
    activities/strategies displayed by quarter that includes:

> 1\. Overall objectives by year;
>
> 2\. Specific sub-objectives in measurable terms;
>
> 3\. Activities to carry out each objective;
>
> 4\. Specific person responsible for facilitating the activities; and,
>
> 5\. Time frame for implementation of activities.

C.  Develop a plan for the dissemination of project outcomes or products
    (i.e. conferences, presentations, publications, etc.) and lessons
    learned. **Materials developed for dissemination must include the
    following disclaimer** **and acknowledgment:** "*This project is/was
    supported by funds from the Division of Nursing (DN), Bureau of
    Health Professions (BHPr), Health Resources and Services
    Administration (HRSA), Department of Health and Human Services
    (DHHS) under \[grant number and title for \$\] (specify grant
    number, title and total award amount). The information or content
    and conclusions are those of the author and should not be construed
    as the official position or policy of, nor should any official
    endorsement be inferred by, the DN, BHPr, HRSA, DHHS, or the US
    Government."*

[Criterion 2 "Response"]{.underline} [and Criterion 5
"Resources/Capabilities" may be addressed in this section]{.underline}.

**[ELECTRONIC DISTANCE LEARNING Requirements]{.underline}**

All grant projects using **electronic distance learning methodologies**
should include the information below:

***[A. Educational Program]{.underline}***

1\. Describe the distance learning method to be used in the project.
Provide a rationale for the method chosen.

2\. Describe the coursework distance learning students will take.
Applicants should consider number, sequencing, clinical experiences, and
length of program. Compare to traditional program where appropriate.

3\. Describe the faculty's expertise with the proposed distance learning
format.

4\. Describe the process for developing distance-learning courses and
materials.

5\. Describe the measures that will be taken to ensure scholarly
dialogue and interaction between students and faculty.

6\. Describe how resources will be made available to off-site students.
These should include library and administrative (i.e., orientation,
registration) resources.

7\. Describe the plan for evaluating the distance learning methods used.

***[B. Equipment and Technical Support]{.underline}***

1.  Describe the hardware, software, peripherals, and other equipment
    which will be used. Applicants should consider compatibility with
    other computer systems and use and upgrading following the award
    period.

2.  Detail preparation and technical support that will be offered to
    faculty and students.

***[C. Experience and Financing]{.underline}***

1.  Describe the financing of distance learning courses.

2.  Describe the applicant's and any partner organization's previous
    experience with distance learning.

**2. Roles and Responsibilities**

**Position descriptions** that include the roles, responsibilities, and
qualifications of proposed project staff must be included in **SF 424
R&R: Attachment 4**. Copies of **biographical sketches** for any key
employed personnel that will be assigned to work on the proposed project
must be uploaded and included in **SF 424 R&R: Senior/Key Person
Profile**. Specifically describe the functions and time commitment of
the Project Director and other key project staff including their
academic and professional backgrounds and past experience in working
with project participant. Describe current experience, skills, and
knowledge of individuals on staff, including materials published and
previous work of a similar nature.

**3. Self-Sufficiency**

Provide specific information that describes the extent and means by
which your program plans to become self-sufficient. This should include
other sources of income and the nature of the income, future funding
initiatives and strategies, Federal funding plans by year for the
remaining project period, and a timetable for becoming self-sufficient.
Describe problems to overcome in order to become self-sufficient and a
plan to address those problems.

-   **RESOLUTIONS OF CHALLENGES**

Include resolutions of challenges for competing continuation
applications.

-   **Evaluation and Technical Support Capacity**

Describe current experience, skills, and knowledge, including
individuals on staff, materials published, and previous work of a
similar nature*.* Evaluation strategy must be tied explicitly to the
project objectives and the proposed performance outcomes.

> 1\. Specify qualitative and/or quantitative evaluation measures (as
> appropriate) for each objective.
>
> 2\. Describe the methods and techniques which will be used to measure
> the outcomes of the project for each objective.
>
> 3\. Specify what data will be collected, the method for collecting the
> data, the manner in which data will be reported and analyzed, and what
> personnel will be involved with these activities.

[Criterion 3 "Evaluative Measures" may be addressed in this
section]{.underline}.

-   **Organizational Information**

Provide information on the applicant agency's current mission and
structure, scope of current activities, and an organizational chart, and
describe how these all contribute to the ability of the organization to
conduct the program requirements and meet program expectations. Include
the organizational chart in SF 424 R&R: Attachment 3.

1.  Identify institutional and human resources available to implement
    and support the project.

2.  Provide evidence of support for the project from faculty,
    administrative and institutional personnel. Include letters of
    agreement or letters of support from key organizations/individuals
    of their willingness to perform in accordance with the plan
    presented in the application in SF 424R&R: Attachment 4 and
    Attachment 5. [Criterion 5 "Resources/Capabilities" may be *further*
    addressed in this section]{.underline}.

+-----------------------------------+-----------------------------------+
| **ADDITIONAL NARRATIVE GUIDANCE** |                                   |
|                                   |                                   |
| In order to ensure that the six   |                                   |
| (6) review criteria are fully     |                                   |
| addressed, this box provides a    |                                   |
| cross-reference between the       |                                   |
| narrative text language and the   |                                   |
| review criteria.                  |                                   |
+-----------------------------------+-----------------------------------+
| **[Narrative                      | **[NEPR Review                    |
| Section]{.underline}**            | Criteria]{.underline}**           |
+-----------------------------------+-----------------------------------+
| Introduction                      | (1a) Need                         |
|                                   |                                   |
|                                   | (1b) Progress Report Summary (for |
|                                   | Competing Continuations only)     |
+-----------------------------------+-----------------------------------+
| Needs Assessment                  | \(2\) Response                    |
+-----------------------------------+-----------------------------------+
| Methodology                       | \(3\) Evaluative Measures         |
+-----------------------------------+-----------------------------------+
| Work Plan                         | \(2\) Response                    |
|                                   |                                   |
|                                   | \(4\) Impact                      |
+-----------------------------------+-----------------------------------+
| Evaluation and Technical Support  | \(5\) Resources/Capabilities      |
| Capacity                          |                                   |
+-----------------------------------+-----------------------------------+
| Organizational Information        | \(5\) Resources/Capabilities      |
+-----------------------------------+-----------------------------------+
| []{.mark}                         | \(6\) Support Requested-- the     |
|                                   | budget section should be          |
|                                   | sufficient to allow reviewers to  |
|                                   | determine the reasonableness of   |
|                                   | the requested support.            |
+-----------------------------------+-----------------------------------+

xi. ***Program Specific Forms***

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a.  The NEPR Project Synopsis (Appendix D) ***is strongly recommended*
    for application processing** by staff and should be **uploaded as
    Attachment 3 within the SF 424 R&R.**

b.  The Purpose Specific Information Table 1 (Appendix E) ***is required
    for the R2 purpose,*** and should be **uploaded as Attachment 7
    within the SF 424 R&R.**

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xii. ***Attachments***

     These and any other required application attachments must either be
     referenced in the Application Section if already listed, or
     included as specific "Attachment Numbers" in that portion of your
     Table of Contents listed in section IV.2. The required application
     attachments include:

**Attachment 1: Copy of Signed SF-424 R&R Face Sheet**

**Attachment 2: NEPR Project Synopsis.** The NEPR Project Synopsis
assists the reviewers and the federal staff in identifying the purpose
detailed in the application. The NEPR Project Synopsis is located in
Appendix D of this guidance.

**Attachment 3: Organizational Chart**. Attach a one-page figure that
depicts the organizational structure of the project, including any
collaborating partners.

**Attachment 4 Letters of Agreement/Support and/or Description(s) of
Proposed/Existing Contracts (project specific).** Provide any documents
that describe working relationships between the applicant agency and
other agencies and programs cited in the proposal. Letters of agreement
from key organizations/individuals must document their willingness to
perform in accordance with the plan presented in the application.
Documents that confirm actual or pending contractual agreements should
clearly describe the roles of the subcontractors and any deliverable.
Include only letters of support which specifically indicate a commitment
to the project/program (in-kind services, dollars, staff, space,
equipment, etc.) Letters of agreements and support must be dated. List
all other support letters on one page.

**Attachment 5: Position Descriptions for Key Personnel**. Attach
position descriptions that include the roles, responsibilities, and
qualifications of proposed project staff.

**Attachment 6: Letters of Support**. Include only letters of support
which specifically indicate a commitment to the project/program (in-kind
services, dollars, staff, space, equipment, etc.) Letters of agreements
and support must be dated. List all other support letters on one page.
Please merge similar documents into a single document and include a
table of content cover page specific to this attachment. The table of
content page will not be counted in the page limit.

**Attachment 7: Program Specific Tables.** Complete the tables, located
in Appendix E of the application guidance, ***as appropriate for the
purpose** to which the applicant is responding*.

**Attachment 8: Accreditation Documentation.**

**Attachment 9: (Optional).** Additional Project Information: Tables,
charts, etc. to give further details about the proposal.

**Any additional information** the applicant desires to provide for
further details about the proposal should be entered as SF 424 R&R.
Additional information will be counted in the page limit.

**3. Submission Dates and Times**

**Application Due Date**

The due date for applications under this new or competing continuation
award announcement is **December 6, 2007 at 8:00 P.M. ET.** Applications
will be considered as meeting the deadline if they are E marked on or
before the due date. Please consult Appendix A, Section 3, for detailed
instructions on submission requirements.

The Chief Grants Management Officer (CGMO) or a higher level designee
may authorize an extension of published deadlines when justified by
circumstances such as acts of God (e.g. floods or hurricanes),
widespread disruptions of mail service, or other disruptions of
services, such as a prolonged blackout. The authorizing official will
determine the affected geographical area(s).

Applications must be submitted by **8:00 P.M. ET**. **To ensure that you
have adequate time to follow procedures and successfully submit the
application, we recommend you register immediately in Grants.gov (see
Appendix B) and complete the forms as soon as possible, as this is a new
process and may take some time.**

**Please refer to Appendix B for important specific information on
registering, and Appendix A, Section 3, for important information on
applying through Grants.gov.**

**Late Applications:**

Applications which do not meet the criteria above are considered late
applications. The Health Resources and Services Administration (HRSA)
shall notify each late applicant that its application will not be
considered in the current competition.

**4. Intergovernmental Review**

The NEPR program is not a program subject to the provisions of Executive
Order 12372, as implemented by 45 CFR 100.

[]{.mark}

**5. Funding Restrictions**

Awards to support projects beyond the first budget year will be
contingent upon Congressional appropriation, satisfactory progress in
meeting the project's objectives, and a determination that continued
funding would be in the best interest of the government. For Purpose R2
only, the requested funding for **[each]{.underline}** of the years 4
and 5 should be no more than [20%]{.underline} of the requested funds
for year 3.

Proposals for the sole purpose of setting up/constructing a skills lab
are not eligible under the NEPR program

Indirect costs under training grants to organizations other than state,
local or Indian tribal governments will be budgeted and reimbursed at 8%
of modified total direct costs rather than on the basis of a negotiated
cost agreement, and are not subject to upward or downward adjustment.

Direct cost amounts for equipment (capital expenditures), tuition and
fees, and subgrants and subcontracts in excess of \$25,000 are excluded
from the actual direct cost base for purposes of this calculation.

**6.** **Other Submission Requirements**

As stated in Section IV.1, except in rare cases HRSA will no longer
accept applications for grant opportunities in paper form. Applicants
submitting for this funding opportunity are ***required*** to submit
***electronically*** through Grants.gov. To submit an application
electronically, please use the
[http://www.Grants.gov](http://www.Grants.gov/) apply site. When using
Grants.gov you will be able to download a copy of the application
package, complete it off-line, and then upload and submit the
application via the Grants.gov site.

As soon as you read this, whether you plan on applying for a HRSA grant
later this month or later this year, it is incumbent that your
organization ***immediately register*** in Grants.gov and become
familiar with the Grants.gov site application process. If you do not
complete the registration process you will be unable to submit an
application. The registration process can take up to one month, so you
need to begin immediately.

To be able to successfully register in Grants.gov, it is necessary that
you complete all of the following required actions:

• 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

Instructions on how to register, tutorials and FAQs are available on the
Grants.gov web site at [www.grants.gov](http://www.grants.gov/).
Assistance is also available from the Grants.gov help desk at
<support@grants.gov> or by phone at 1-800-518-4726.

More specific information, including step-by-step instructions on
registering and applying, can be found in Appendix B of this guidance.

 

**Formal submission of the electronic application:** Applications
completed online are considered formally submitted when the Authorizing
Official electronically submits the application to HRSA through
Grants.gov. You must, however, ensure that a copy of the SF 424 R&R Face
Sheet is printed, [signed]{.underline}, scanned, and included with your
electronic application submission as Attachment 1. The SF 424R&R
**must** be printed from Grants.gov.

Applications will be considered as having met the deadline if: (1) the
application has been successfully transmitted electronically by your
organization's Authorizing Official on or before the deadline date and
time, and (2) the signed SF 424R&R Face Sheet is included in the
electronic application submission.

**It is incumbent on applicants to ensure that the AO is available to
submit the application to HRSA by the application due date. We will
[not]{.underline} accept submission or re-submission of incomplete,
rejected, or otherwise delayed applications after the deadline.**

**Again, please understand that we will not consider additional
information and/or materials submitted after your initial application.
You must therefore ensure that all materials are submitted together.
Further information on the HRSA electronic submission policy can be
obtained at <http://www.hrsa.gov/grants/electronicsubmission.htm>.**

V.  **Applicat****ion Review Information**

    **1. Review Criteria**

Procedures for assessing the technical merit of grant applications have
been instituted to provide for an objective review of applications and
to assist the applicant in understanding the standards against which
each application will be judged. Critical indicators have been developed
for each review criterion to assist the applicant in presenting
pertinent information related to that criterion and to provide the
reviewer with a standard for evaluation. Review criteria are used to
review and to rank applications. The NEPR program has **(6)** review
criteria. All applications will be evaluated, by peer reviewers based on
the criteria listed below. The points allocated to each criterion are
provided beside each criterion. The weights are based on a total
possible score of 100. The peer reviewers will use these values during
the technical review process to determine the extent to which the
applicant meets the following criteria:

**Criterion 1a. Need (New =20 points, Competing Continuation=15
points).** The extent to which the application describes the problem and
associated contributing factors to the problem.

-   The purpose is clearly stated and is consistent with the legislative
    intent of the appropriate purpose.

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-   The need for the proposed project thoroughly describes the problem
    and associated contributing factors to the problem including:

    -   The health care needs (such as demographics, morbidity and
        mortality, acute and chronic health conditions) of the
        populations who will be served by the program's participants;
        and,

    -   How will the proposed project affect the health care needs of
        the target population(s);

    -   Documented evidence of an eligible enrollee, project, and
        applicant pool based on the selected purpose;

    -   Description of the targeted participants.

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-   Rationale describes how the proposed project will contribute to
    meeting the documented needs. Narrative discusses how the project is
    consistent with related Federal, State, and regional nursing
    workforce programs, plans, and priorities, and how it will
    contribute to decreasing the registered nursing shortage.

**Criterion 1b. Progress Report Summary (New=N/A, Competing Continuation
= 15 points).** A clearly stated need for [continuing]{.underline} grant
support for the project is provided by competing continuation
applicants.

***[Progress Report Summary (Competing Continuations
only)]{.underline}***

The Progress Report should provide adequate information that
demonstrates progress towards the project meeting the objectives and
outcomes of the program. **The summary of the report should include**:

-   **The project period of the initial grant application.** All
    activities related to the current **project** period. Specify
    whether the initial grant application was awarded for 3 or 5 years
    of funding. Regardless of initial award, please do not request more
    than 3 years of continued funding;

-   The original objectives of the initial project: Restate the original
    objectives of the project. For each of the stated objectives provide
    outcome data in quantitative and qualitative terms using actual
    numbers and percentages. Indicate the **baselines** by which
    outcomes (results) were measured;

-   Milestones that have been achieved and their significance: Where
    milestones have not been achieved, indicate the reasons and actions
    to be taken to address the issue(s). Proposed revised dates should
    be included and referred to those objectives that will be modified
    in the continuation application;

-   Publications: Note any publications arising from the current project
    and identify any project-related publication activities being
    conducted at the applicant organization. Of these projects, explain
    how many are related to nursing shortage issues;

-   Evaluation: In the narrative state, whether your results actually
    made a difference or impact on the project objectives. Include
    quantitative and qualitative data to show impact. If results fell
    short of stated objectives, include any corrective measures for
    future objectives;

-   Staffing modifications: Discuss any staffing changes related to the
    project, including additions or deletions of positions. Indicate the
    reasons why funded positions were not filled, if applicable. Discuss
    the impact of the project due to unfilled positions and expectations
    for staffing positions.

**Criterion 2. Response (New =25 points, Competing Continuation=20
points)** The extent to which the proposed project responds to the
applicant selected NEPR purpose. The extent to which the activities
(scientific or other) described in the application are capable of
addressing the problem and attaining the project objectives. How well
did the applicant describe the proposed goals and objectives and their
relationship to the identified project purpose. **To receive full points
under criterion 2, applicants must document the following in their
application:**

-   The application **[explicitly demonstrates that the project will be
    operational (]{.underline}***will have active program
    participants\--[either]{.underline} **licensed registered nurses or
    students in accredited registered nursing programs**) **by January
    31, 2009.***

-   The proposal explicitly addresses all of the "Required Application
    Documentation" [for the specific purpose selected]{.underline}.

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-   The objectives for the project relate to the identified
    problems/needs and the program purpose of decreasing the registered
    nursing shortage.

-   The number of targeted participants and the projects' impact on the
    participants are clearly defined.

-   At least one objective must address one of the BHPr goals.

-   **Objectives must be:**

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-   Specific to what the program wants to achieve for each year of the
    project.

-   Measurable and inclusive of baseline data and outcome goals in
    quantitative and qualitative terms.

-   Realistic and achievable with the resources described.

-   Indicative of the time frame within which each objective should be
    achieved during the project period.

-   Reflective of expected outcomes for each educational level of
    student projected to participate in the project.

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-   Project activities are described which will be used to accomplish
    each objective for each year of the project and are appropriate for
    the registered nurse/nursing student participants.

-   Proposed activities are reasonable given the proposed level of
    staff, resources available, length of the project period, the
    qualifications of the project director and staff, and the adequacy
    of the facilities available to the applicant to carry out the
    proposed project.

-   Established and/or planned linkages and partnerships with relevant
    educational and health care entities, and interdisciplinary
    education programs for other health professionals are described, are
    relevant to project objectives, and will assist in the attainment of
    project objectives.

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-   Distance learning methodology is addressed, if applicable.

**Criterion 3. Evaluative Measures (New=10 points, Competing
Continuation=10**

**points).** The effectiveness of the method proposed to monitor and
evaluate the project

results. Evaluative measures must be able to assess: 1) to what extent
the program

objectives have been met; and, 2) to what extent these can be attributed
to the project.

Evaluation differs from outcomes. Outcomes are direct results or outputs
of the

methodologies identified in the proposal. Evaluation measures the actual
impact the

results had on the stated objectives. The proposed methods for
evaluating the project are

described including:

-   The data collection, analysis and reporting procedures to be used,
    and the personnel involved;

-   Appropriate quantitative and/or qualitative evaluation measures for
    each objective; and,

-   Outcome and process evaluation indicators.

**Criterion 4. Impact (New=20 points, Competing Continuation=20
points).** The extent and effectiveness of plans for dissemination of
project results and/or the extent to which project results may be
national in scope and/or degree to which the project activities are
replicable, and the sustainability of the program beyond the Federal
Funding

The potential effectiveness of the proposed project in carrying out the
intent of the NEPR Program including:

-   Potential effectiveness and impact of project activities in
    relationship to the needs of the population(s) to be served;

-   An established relationship and congruency between the number of
    individuals impacted through the project in relation to the budget;

-   Demonstration of ongoing plans for assessment of continuous quality
    improvement and program impact; and,

-   A plan for dissemination of information about the results and impact
    of the project.

Specific information is provided that describes the extent and means by
which the project [plans to become self-sufficient after the period of
grant support including]{.underline}:

-   Other sources of income; the nature of income, future funding
    initiatives and strategies, Federal funding plans by year, and a
    timetable for becoming self-sufficient; and,

-   Problems to overcome to reach self-sufficiency are discussed.

**Criterion 5**. **Resources/Capabilities (New=15 points, Competing
Continuation=15**

**points).** The extent to which project personnel are qualified by
training and/or experience

to implement and carry out the projects. The capabilities of the
applicant organization,

and quality and availability of facilities and personnel to fulfill the
needs and

requirements of the proposed project. For competing continuations, past
performance

will also be considered.

-   Evidence is provided of the institution's commitment, experience,
    and success in working with registered nurses;

-   Evidence of support for the project from faculty, administrative,
    and institutional personnel is provided;

-   Letters of agreement or support are provided from key
    organizations/individuals indicating their willingness to perform in
    accordance with the plan presented in the application;

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-   Identified activities and outcomes that are related to the outcome
    objectives given the qualifications of the project director and the
    proposed level of staff, resources available, length of the project
    period, adequacy of the facilities available to the applicant to
    carry out the proposed project, and institutional eligibility;

-   The established and/or planned **linkages** that describe
    **partnerships** with relevant educational and health care entities,
    and interdisciplinary education programs involving other health
    professionals, when applicable, are described, are relevant to
    project objectives, and will assist in the attainment of project
    objectives; and,

-   There is a plan to describe the institutional resources and
    community support.

**Criterion 6. Support Requested (New=10 points, Competing
Continuation=5 points).** The reasonableness of the proposed budget in
relation to the objectives, the complexity of the activities, and the
anticipated results.

[The Fiscal Plan]{.underline}

-   The administrative and managerial capability of the applicant to
    carry out the project is demonstrated;

-   A plan assuring effective use of grant funds and resources to carry
    out the project is provided. The proposed budget is reasonable and
    reflects effective use of the funds requested. It is accompanied by
    a detailed justification for each line item;

-   The level of in-kind support, if applicable, and other sources of
    funds, both Federal and non-Federal, that the applicant proposes to
    use for carrying out the project are indicated.

2.  **Review and Selection Process**

**The Division of Independent Review** is responsible for managing
objective reviews within HRSA. Applications competing for federal funds
receive an objective and independent review performed by a committee of
experts qualified by training and experience in particular fields or
disciplines related to the program being reviewed. In selecting review
committee members, other factors in addition to training and experience
may be considered to improve the balance of the committee, e.g.,
geographic distribution. Each reviewer is screened to avoid conflicts of
interest and is responsible for providing an objective, unbiased
evaluation based on the review criteria noted above. The committee
provides expert advice on the merits of each application to program
officials responsible for final selections for award.

Applications that pass the initial HRSA eligibility screening will be
reviewed and rated by a panel based on the program elements and review
criteria presented in relevant sections of this program announcement.
The review criteria are designed to enable the review panel to assess
the quality of a proposed project and determine the likelihood of its
success.  The criteria are closely related to each other and are
considered as a whole in judging the overall quality of an application.

**Funding Preferences**

A "funding preference" is defined as the funding of a specific category
or group of approved applications ahead of other categories or groups of
approved applications. The authorizing legislation provides a statutory
funding preference for some applicants. Applications receiving the
preference will be placed in a more competitive position among
applications that can be funded. Applications that do not receive a
funding preference will be given full and equitable consideration during
the review process.

As provided in Public Health Service Act Section 805, a funding
preference shall be granted to qualified applicants with projects that:

1.  substantially benefit **rural populations**;

2.  substantially benefit **underserved populations; and/or**

3.  **help meet public health nursing needs** in state or local health
    departments.

In making awards under the R2 purpose, the Secretary shall give a
preference to applicants that have not previously received an award
under this purpose (Section 831(c)(2)(B).

To be considered for this statutory funding preference, [the applicant
must specifically request]{.underline} the preference and meet the
preference criteria.

3.  **Anticipated Announcement and Award Dates**

    All funding determinations will be completed in a timely manner to
    enable HRSA to make awards by the July 1, 2008 project start date.

    **VI. Award Administration Information**

    []{.mark}

    **1. Award Notices**

Each applicant will receive written notification of the outcome of the
objective review process, including a summary of the expert committee's
assessment of the application's merits and weaknesses, and whether the
application was selected for funding. Applicants who are selected for
funding may be required to respond in a satisfactory manner to
Conditions placed on their application before funding can proceed.
Letters of notification do not provide authorization to begin
performance.

The Notice of Grant Award sets forth the amount of funds granted, the
terms and conditions of the grant, the effective date of the grant, the
budget period for which initial support will be given, the non-Federal
share to be provided (if applicable), and the total project period for
which support is contemplated. Signed by the Grants Management Officer,
it is sent to the applicant agency's Authorized Representative, and
reflects the only authorizing document. It will be sent prior to the
start date of July 1, 2008.

**2. Administrative and National Policy Requirements**

Successful applicants must comply with the administrative requirements
outlined in 45 CFR Part 74 (non-governmental) or 45 CFR Part 92
(governmental), as appropriate.

HRSA grant awards are subject to the requirements of the HHS Grants
Policy Statement (HHS GPS) that are applicable to the grant based on
recipient type and purpose of award. This includes, as applicable, any
requirements in Parts I and II of the HHS GPS that apply to the award,
as well as any requirements of Part IV. The HHS GPS is available at
<http://www.hrsa.gov/grants/>. The general terms and conditions in the
HHS GPS will apply as indicated unless there are statutory, regulatory,
or award-specific requirements to the contrary (as specified in the
Notice of Award).

**PUBLIC POLICY ISSUANCE**

**HEALTHY PEOPLE 2010**

**Healthy People 2010** is a national initiative led by HHS that sets
priorities for all HRSA programs. The initiative has two major goals: 1)
To increase the quality and years of a healthy life; and 2) Eliminate
our country's health disparities. The program consists of 28 focus areas
and 467 objectives. HRSA has actively participated in the work groups of
all the focus areas, and is committed to the achievement of the Healthy
People 2010 goals.

Applicants must summarize the relationship of their projects and
identify which of their programs objectives and/or sub-objectives relate
to the goals of the Healthy People 2010 initiative.

Copies of the Healthy People 2010 may be obtained from the
Superintendent of Documents or downloaded at the Healthy People 2010
website: [http://www.health.gov/healthypeople/document]{.underline}/.

The Public Health Service strongly encourages all award recipients to
provide a smoke-free workplace and to promote the non-use of all tobacco
products. Further, Public Law 103-227, the Pro-Children Act of 1994,
prohibits smoking in certain facilities (or in some cases, any portion
of a facility) in which regular or routine education, library, day care,
health care or early childhood development services are provided to
children.

**3. Reporting**

The successful applicant under this guidance must comply with the
following reporting and review activities:

a.  **Audit Requirements**

> Comply with audit requirements of Office of Management and Budget
> (OMB) Circular A-133. Information on the scope, frequency, and other
> aspects of the audits can be found on the Internet at
> [www.whitehouse.gov/omb/circulars](http://www.whitehouse.gov/omb/circulars);

b.  **Payment Management Requirements**

> Submit a quarterly electronic PSC-272 via the Payment Management
> System. The reports identify cash expenditures against the authorized
> funds for the grant. Failure to submit the report may result in the
> inability to access grant funds. The PSC-272 Certification page should
> be faxed to the PMS contact at the fax number listed on the 272 form,
> or it may be submitted to the:
>
> Division of Payment Management
>
> HHS/ASAM/PSC/FMS/DPM
>
> PO Box 6021
>
> Rockville, MD 20852
>
> Telephone: (877) 614-5533;

c.  **Status Reports**

> 1\. **Submit a** **Financial Status Report**. A financial status
> report is required within 90 days of the end of each grant year. The
> report is an accounting of expenditures under the project that year.
> More specific information will be included in the award notice; and
>
> 2\. **Submit a Progress Report**(s). Further information will be
> provided in the award notice.
>
> All Bureau of Health Professions grantees are required to submit
> progress reports to HRSA on an annual basis. These reports take the
> form of Uniform Progress Reports (UPR I & II), Final Reports and
> Comprehensive Performance Management System (CPMS) Reports. The UPR I
> section allows the grantee to report on project objectives while UPR
> II focuses on program specific data variables. CPMS builds on the BHPr
> focus of assuring access through programs that improve the
> distribution, diversity and quality of the healthcare workforce, as
> seen in the BHPR goals already discussed earlier in this document.
>
> Progress reports must be submitted on-line by the grantee. The
> grantees will be able to access and complete their reports on the
> internet using a web-based data entry tool. Information on this new
> system will be updated regularly on the Bureau's web page. Due dates
> for the reports will be posted on the web page as soon as they are
> available. The BHPR's web page address is
> [www.bhpr.hrsa.gov/grants](http://www.bhpr.hrsa.gov/grants) and once
> on the web page, click on **Grantee Reports**.

**d. Performance Review**

> HRSA's Office of Performance Review (OPR) serves as the agency's focal
> point for reviewing and enhancing the performance of HRSA funded
> programs within communities and States. As part of this agency-wide
> effort, HRSA grantees are required to participate, where appropriate,
> in an on-site performance review of their HRSA funded program(s) by a
> review team from one of the ten OPR regional divisions. Grantees
> should expect to participate in a performance review at some point
> during their project period. When a grantee receives more than one
> HRSA grant, each of the grantee's HRSA funded programs will be
> reviewed during the same performance review.
>
> The purpose of performance review is to improve the performance of
> HRSA funded programs. Through systematic pre-site and on-site
> analysis, OPR works collaboratively with grantees and HRSA
> Bureaus/Offices to measure program performance, analyze the factors
> impacting performance, and identify effective strategies and
> partnerships to improve program performance, with a particular focus
> on outcomes. Upon completion of the performance review, grantees will
> be required to prepare an Action Plan that identifies key actions to
> improve program performance as well as addresses any identified
> program requirement issues. In addition, performance reviews also
> provide an opportunity for grantees to provide direct feedback to the
> agency about the impact of HRSA policies on program implementation and
> performance within communities and States.
>
> For additional information on performance reviews, please visit:
> <http://www.hrsa.gov/performancereview>.

VII. **Agency Contacts**

> []{.mark}

Applicants may obtain additional information regarding business,
administrative, or fiscal issues related to this grant announcement by
contacting:

[]{.mark}

Brad Barney, Grants Management Specialist

Attn.: NEPR Program

HRSA Division of Grants Management Operations, OFAM

5600 Fishers Lane Room 11A-16

Rockville, MD 20857

Telephone: 301-443-6916

Fax: 301-443-6343

bbarney@hrsa.gov

Additional information related to the overall program issues and
technical assistance regarding this funding announcement may be obtained
by contacting:

For Purposes E1, P1 & R1

Catherine Rupinta, Program Officer

<crupinta@hrsa.gov>

For Purposes E3, P2, P3, P4, & R1

Daniel Reed, Program Officer

<dreed1@hrsa.gov>

For Purposes E2, R1 & R2

Janice Young, Program Officer

[jyoung2@hrsa.gov](mailto:cbrown@hrsa.gov)

Attn.: NEPR Program

Health Resources and Services Administration

Bureau of Health Professions, HRSA

Parklawn Building, Room 9-36

5600 Fishers Lane Room

Rockville, MD 20857

Telephone: 301-443-6193

Fax: 301-443-0791

VIII. **Tips for Writing a Strong Application**

> **Include DUNS Number.** You must include a DUNS Number to have your
> application reviewed. Applications ***will not*** be reviewed without
> a DUNS number. To obtain a DUNS number, access
> [www.dunandbradstreet.com](http://www.dunandbradstreet.com/) or call
> 1-866-705-5711. Please include the DUNS number in item 5 on the
> application face page.
>
> **Keep your audience in mind.** Reviewers will use only the
> information contained in the application to assess the application. Be
> sure the application and responses to the program requirements and
> expectations are complete and clearly written. Do not assume that
> reviewers are familiar with the applicant organization, service area,
> barriers to health care, or health care needs in your community. Keep
> the review criteria in mind when writing the application.
>
> **Start preparing the application early.** Allow plenty of time to
> gather required information from various sources.
>
> **Follow the instructions in this guidance carefully.** Place all
> information in the order requested in the guidance. Avoid the risk of
> having reviewers hunt through your application for information.
>
> **Be brief, concise, and clear.** Make your points understandable.
> Provide accurate and honest information, including candid accounts of
> problems and realistic plans to address them. If any required
> information or data is omitted, explain why. Make sure the information
> provided in each table, chart, attachment, etc., is consistent with
> the proposal narrative and information in other tables. Your budget
> should reflect back to the proposed activities, and all forms should
> be filled in accurately and completely.
>
> **Be organized and logical.** Many applications fail to receive a high
> score because the reviewers cannot follow the thought process of the
> applicant or because parts of the application do not fit together.
>
> **Be careful in the use of attachments.** Do not use the attachments
> for information that is required in the body of the application. Be
> sure to cross-reference all tables and attachments to the appropriate
> text in the application. Be sure to upload the attachments in the
> order indicated in the forms.
>
> **Carefully proofread the application.** Misspellings and grammatical
> errors will impede reviewers in understanding the application. Be sure
> that page limits are followed. Limit the use of abbreviations and
> acronyms, and define each one at its first use and periodically
> throughout application. Make sure you submit your application in final
> form, without markups.
>
> **Print out and carefully review an electronic application to ensure
> accuracy and completion.** When submitting electronically, print out
> the application before submitting it to ensure appropriate formatting
> and adherence to page limit requirements. **Check to ensure that all
> attachments are included before sending the application forward.**
>
> **Ensure that all information is submitted at the same time. We will
> not consider additional information and/or materials submitted after
> your initial submission, nor will we accept e-mailed applications or
> supplemental materials once your application has been received.**

**IX. Appendices**

The following guidance appendices contain additional forms and
information that are required for completion of the grant application.

> Appendix A: HRSA's Electronic Submission User Guide
>
> Appendix B: Registering and Applying Through Grants.gov
>
> Appendix C: Instructions for the SF 424 R&R (Research and Related)
>
> Appendix D: NEPR Project Synopsis
>
> Appendix E: Recommended R2 Purpose-Specific Information Table 1
>
> Appendix F: Program Definitions

APPENDIX A: HRSA's Electronic Submission User Guide

User Guide Table of Contents

> 1\. INTRODUCTION
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 1.1. DOCUMENT PURPOSE AND
> SCOPE\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 1.2. DOCUMENT ORGANIZATION AND VERSION
> CONTROL\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 2\. NONCOMPETING CONTINUATION
> APPLICATION\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 2.1. PROCESS
> OVERVIEW\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 2.2. GRANTEE ORGANIZATION NEEDS TO REGISTER WITH
> [[GRANTS.GOV]{.underline}](http://GRANTS.GOV/) (IF NOT ALREADY
> REGISTERED)...................................................................................................\...\...\...\...\...
>
> 2.3. PROJECT DIRECTOR AND AUTHORIZING OFFICIAL NEED TO REGISTER WITH
> HRSA EHBS
>
> (IF NOT ALREADY REGISTERED)
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 2.4. APPLY THROUGH [[GRANTS.GOV]{.underline}](http://GRANTS.GOV/)
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 2.4.1 Find Funding
> Opportunity\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 2.4.2 Download Application Package
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 2.4.3 Complete
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 2.4.4 Submit
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 2.4.5 Verify Status of Application
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 2.5. VERIFY IN HRSA ELECTRONIC HANDBOOKS
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 2.5.1 Verify Status of Application
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 2.5.2 Manage Access to Your Application
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 2.5.3 Check Validation
> Errors\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 2.5.4 Fix Errors and Complete
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 2.5.5 Submit
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 3\. COMPETING
> APPLICATION\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 3.1. PROCESS
> OVERVIEW\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 3.2. GRANTEE ORGANIZATION NEEDS TO REGISTER WITH
> [[GRANTS.GOV]{.underline}](http://GRANTS.GOV/) NOT ALREADY
> REGISTERED)\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 3.3. APPLY THROUGH
> [[GRANTS.GOV]{.underline}](http://GRANTS.GOV/)\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 3.3.1 Find Funding
> Opportunity\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 3.3.2 Download Application
> Package\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 3.3.3 Complete
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 3.3.4 Submit
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 3.3.5 Verify Status of Application
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 4\. GENERAL INSTRUCTIONS FOR APPLICATION
> SUBMISSION\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 4.1. NARRATIVE ATTACHMENT
> GUIDELINES\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 4.1.1
> Font\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 4.1.2 Paper Size and
> Margins\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 4.1.3
> Names\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 4.1.4 Section Headings
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 4.1.5 Page
> Numbering\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 4.1.6 Allowable Attachment or Document
> Types\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 4.2. APPLICATION CONTENT ORDER (TABLE OF
> CONTENTS)\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 4.3. PAGE
> LIMIT\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 5.0 CUSTOMER SUPPORT INFORMATION
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 5.1.1 Grants.gov Customer
> Support\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 5.1.2 HRSA Call
> Center\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 5.1.3 HRSA Program
> Support\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 6.0
> FAQs\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 6.1.
> SOFTWARE\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 6.1.1 What are the software requirements for using
> Grants.gov?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 6.1.2 Why can\'t I download PureEdge Viewer onto my
> machine?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 6.1.3 I have heard that Grants.gov is not Macintosh compatible. What
> do I do if I use only a
> Macintosh?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> \...\...\...\...\...\...\.....
>
> 6.1.4 What are the software requirements for HRSA
> EHBs?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 6.1.5 What are the system requirements for using HRSA EHBs on a
> Macintosh computer?\...\...\...\...\...\...\....
>
> 6.2. APPLICATION RECEIPT
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...

6.2.1 What will be the receipt date\--the date the application is
stamped as received by Grants.gov

> or the date the data is received by HRSA?
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 6.2.2 When do I need to submit my application?
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 6.2.3 What emails can I expect once I submit my application? Is email
> reliable? \...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 6.2.4 If a resubmission is required because of Grants.gov system
> problems, will these be
>
> considered
> \"late\"?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 6.3. APPLICATION
> SUBMISSION\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....

6.3.1 How can I make sure that my electronic application is presented in
the right order for

> objective
> review?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 6.4 GRANT.GOV
> HELP\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....

# 1. Introduction

## 1.1 Document Purpose and Scope {#document-purpose-and-scope .unnumbered}

Major changes are coming to HRSA's Grant Application Process. For
guidance's released/posted on or after January 1, 2006, HRSA will no
longer accept applications for grant opportunities on paper. Applicants
submitting new and competing continuations and a selected number of
noncompeting continuation applications will be required to submit
electronically through Grants.gov. All applicants must submit in this
manner unless the applicant is granted a written exemption from this
requirement in advance by the Director of HRSA's Division of Grants
Policy.

The purpose of this document is to provide detailed instructions to help
applicants and grantees submit applications electronically to HRSA
through Grants.gov. The document is intended to be the comprehensive
source of all information related to the new processes that HRSA and its
customers have to adopt and will be updated periodically. This document
is not meant to replace program guidance documents for funding
announcements.

## 1.2 Document Organization and Version Control {#document-organization-and-version-control .unnumbered}

This document contains 5 sections apart from the Introduction. Following
is the summary:

  ------------------------------ ----------------------------------------
  **Section**                    **Description**

  Noncompeting Continuation      Provides detailed instructions to
  Application                    existing HRSA grantees for applying
                                 electronically using Grants.gov for all
                                 noncompeting announcements

  Competing Application          Provides detailed instructions to
                                 applicant organizations for applying
                                 electronically using Grants.gov for all
                                 competing announcements

  General Instructions for       Provides instructions and important
  Application Submission         policy guidance on application format
                                 requirements

  Customer Support Information   Provides contact information to address
                                 technical and programmatic questions

  Frequently Asked Questions     Provides answers to frequently asked
  (FAQs)                         questions by various categories
  ------------------------------ ----------------------------------------

This document is under version control. Please visit
<http://www.hrsa.gov/grants> to retrieve the latest published version.

# 2. Noncompeting Continuation Application

## 2.1 Process Overview {#process-overview .unnumbered}

Following is the process for submitting a noncompeting continuation
application through Grants.gov:

1\. HRSA will communicate noncompeting announcement number to the
project director (PD) and authorizing official (AO) via email. The
announcement number will be required to search for the announcement in
Grants.gov.

2\. Search for the announcement in Grants.gov Apply
(<http://www.grants.gov/Apply>).

3\. Download the application package and instructions from Grants.gov.
The program guidance is also part of the instructions that must be
downloaded.

4\. Save a local copy of the application package on your computer and
complete all the forms based on the instructions provided in the program
guidance.

5\. Submit the application package through Grants.gov. (Requires
registration)

6\. Track the status of your submitted application at Grants.gov until
you receive a notification from Grants.gov that your application has
been received by HRSA.

7\. HRSA Electronic Handbooks (EHBs) software pulls the application
information into EHBs and validates the data against HRSA's business
rules.

8\. HRSA notifies the project director, authorizing official, business
official (BO) and application point of contact (POC) by email to check
HRSA EHBs for results of HRSA validations and enter additional
information, including in some cases performance measures, necessary to
process the noncompeting continuation.

9\. AO verifies the application in HRSA EHBs, fixes any validation
errors, makes necessary corrections and submits the application to HRSA.
(Requires registration)

## 2.2 Grantee Organization Needs to Register With Grants.gov (if not already registered) -- See Appendix B {#grantee-organization-needs-to-register-with-grants.gov-if-not-already-registered-see-appendix-b .unnumbered}

Grants.gov requires a **one-time** registration by the applicant
organization. This is a three step process and should be completed by
any organization wishing to apply for grant. If you do not complete this
registration process you will not be able to submit an application. The
registration process will require some time (anywhere from 5 business
days to a month). Therefore, applicants or those considering applying at
some point in the future should register immediately. Registration with
Grants.gov provides the individuals from the organization the required
credentials in order to apply.

If an applicant organization has already completed Grants.gov
registration for another Federal agency, this section can be skipped.

For those applicant organizations still needing to register with
Grants.gov, registration information can be found on the Grants.gov Get
Started website (<http://www.grants.gov/GetStarted>). To be able to
successfully register in Grants.gov, it is necessary that you complete
all of the following required actions:

• 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)

o Obtain a username and password from the Grants.gov Credential Provider

o Register the username and password with Grants.gov

o Get authorized as an AOR by your organization

In addition, if an applicant does not have a Taxpayer Identification
Number (TIN) or Employer Identification Number (EIN), allow for extra
time. Beginning Oct. 30, 2005, the CCR also validates the EIN against
Internal Revenue Service records, a step that will take one to two
business days.

Please direct questions regarding Grants.gov registration to the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time,
excluding Federal holidays.

-   It is recommended that this registration process be completed at
    least two weeks prior to the submittal date of your organization's
    first Grants.gov submission.

## 2.3 Project Director and Authorizing Official Need to Register with HRSA EHBs (if not already registered) {#project-director-and-authorizing-official-need-to-register-with-hrsa-ehbs-if-not-already-registered .unnumbered}

In order to access your noncompeting continuation application in HRSA
EHBs, existing grantee organizations must register within the EHBs. The
purpose of the registration process is to collect consistent information
from all users, avoid collection of redundant information and allow for
the unique identification of each system user. Note that registration
within HRSA EHBs is required only **once for each user for each
organization they represent.**

Registration within HRSA EHBs is a two-step process. In the first step,
individual users from an organization who participate in the grants
process such as applying for noncompeting continuations must create
**individual** system accounts. In the second step, the users must
associate themselves with the appropriate grantee organization. **To
find your organization record use the 10-digit grant number from the
Notice of Grant Award (NGA) belonging to your grant.** Note that since
all existing grantee organization records already exist within EHBs,
there is no need to create a new one.

To complete the registration quickly and efficiently we recommend that
you have the following information handy:

1.  Identify your role in the grants management process. HRSA EHBs offer
    the following three functional roles for individuals from
    applicant/grantee organizations:

-   Authorizing Official (AO),

-   Business Official (BO), and

-   Other Employee (for project directors, assistant staff, AO designees
    and others).

For more information on functional responsibilities refer to the HRSA
EHBs online help.

2.  10-digit grant number from the latest NGA belonging to your grant
    (Box 4b on NGA). You must use the grant number to find your
    organization during registration. All individuals from the
    organization working on the grant must use the same grant number to
    ensure correct registration.

In order to access the noncompeting application, the project director
and other participants have to register the specific grant and add it to
their respective portfolios. This step is required to ensure that only
the authorized individuals from the organization have access to grant
data. **Project directors will need the last released NGA in order to
complete this additional step**. Again, note that this is a one time
requirement.

The project director must give the necessary privileges to the
authorizing official and other individuals who will assist in the
noncompeting continuation application submission using the administer
feature in the grant handbook. The project director should also delegate
the "Administer Grant Users" privilege to the authorizing official.

Once you have access to your grant handbook, use the "Noncompeting
Continuations" link under the deliverables section to access your
noncompeting application.

Note that registration with HRSA EHBs is independent of Grants.gov
registration.

For assistance in registering with HRSA EHBs, call 877-GO4-HRSA
(877-464-4772) between 9:00 am to 5:30 pm ET or email
<callcenter@hrsa.gov>.

-   You must use your 10-digit grant number (box 4b from NGA) to
    identify your organization.

## 2.4 Apply through Grants.gov {#apply-through-grants.gov .unnumbered}

### 2.4.1 Find Funding Opportunity {#find-funding-opportunity .unnumbered}

Search for the announcement in Grants.gov **Apply**
(<http://www.grants.gov/Apply>).

Enter the announcement number communicated to you in the field *Funding
Opportunity Number*. (Example announcement number: 5-S45-06-001)

-   Noncompeting announcements are not available in Grants.gov FIND!

### 2.4.2 Download Application Package {#download-application-package .unnumbered}

Download the application package and instructions. In order to view
application package and instructions, you will also need to download and
install the PureEdge Viewer (<http://www.grants.gov/DownloadViewer>).
This small, free program will allow you to access, complete, and submit
applications electronically and securely.

-   Please review the system requirements for PureEdge Viewer on the
    Grants.gov website.

### 2.4.3 Complete Application {#complete-application .unnumbered}

Complete the application using both the built-in instructions and the
instructions provided in the program guidance. Ensure that you save a
copy of the application on your local computer.

-   Ensure that you provide your 10-digit grant number (box 4b from NGA)
    in the Federal Award Identifier field (box 5b in SF424 or box 4 in
    SF424 R&R)

Please direct questions regarding PureEdge to Grants.gov. Contact the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time,
excluding Federal holidays.

For assistance with program guidance related questions, please contact
the program contact listed on the program guidance.

-   You can complete the application offline -- you do not have to be
    connected to the Internet.

### 2.4.4 Submit Application {#submit-application .unnumbered}

The \"Submit\" button on the application package cover page will become
active after you have downloaded the application package, completed all
required forms, attached all required documents, and saved your
application package. Click on the \"Submit\" button once you have done
all these things and you are ready to send your completed application to
Grants.gov.

Review the provided application summary to confirm that the application
will be submitted to the program you wish to apply for. To submit, you
will be asked to Log into Grants.gov. Once you have logged in, your
application package will automatically be uploaded to Grants.gov. A
confirmation screen will appear once the upload is complete. Note that a
Grants.gov Tracking number will be provided on this screen. Please
record this number so that you may refer to it for all subsequent help.

Please direct questions regarding application submission to the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time,
excluding Federal holidays.

-   You must be connected to the Internet and must have a Grants.gov
    username and password to submit the application package.

### 2.4.5 Verify Status of Application {#verify-status-of-application .unnumbered}

Once Grants.gov has received your submission, Grants.gov will send email
messages to advise you of the progress of your application through the
system. Over the next 24 to 48 hours, you should receive two emails. The
first will confirm receipt of your application by the Grants.gov system
("Received"), and the second will indicate that the application has
either been successfully validated ("Validated") by the system prior to
transmission to the grantor agency or has been rejected due to errors
("Rejected with Errors").

In case of any errors, you must correct the application and resubmit it
to Grants.gov. If you are unable to resubmit because the opportunity has
since closed, **contact the HRSA Call Center** at 877-GO4-HRSA
(877-464-4772) between 9:00 am to 5:30 pm ET or email
<callcenter@hrsa.gov>. You may be asked to provide a copy of the
"Rejected with Errors" notification you received from Grants.gov.

You can check the status of your application(s) anytime after
submission, by logging into Grants.gov using the black \'Applicants\'
link at the top of any page, and clicking on the \'Check Application
Status\' link.

If there are no errors, the application will be downloaded by HRSA. On
successful download at HRSA, the status of the application will change
to "Received by Agency" and you will receive an additional email from
Grants.gov. Subsequently within two to three business days the status
will change to "Agency Tracking Number Assigned."

-   It is recommended that you check the status of your application in
    Grants.gov until the status is changed to "Agency Tracking Number
    Assigned".

## 2.5 Verify in HRSA Electronic Handbooks {#verify-in-hrsa-electronic-handbooks .unnumbered}

For assistance in registering with or using HRSA EHBs, call 877-GO4-HRSA
(877-464-4772) between 9:00 am to 5:30 pm ET or email
<callcenter@hrsa.gov>.

-   Grant Project Director must be registered in HRSA EHBs and have
    access to the specific grant for which the noncompeting application
    is being submitted for further actions.

### 2.5.1 Verify Status of Application {#verify-status-of-application-1 .unnumbered}

Once your application is received by HRSA, it will be processed to
ensure that the application is submitted for the correct funding
announcement, with the correct grant number and grantee organization.
Upon this processing, which is expected to take up to two to three
business days, HRSA will assign a unique tracking number to your
application. This tracking number will be posted to Grants.gov and the
status of your application will be changed to "Agency Tracking Number
Assigned". Note the HRSA tracking number and use it for all
correspondence with HRSA. At this point, your application is ready for
review and submission in HRSA EHBs.

You should also receive an email from HRSA EHBs confirming the
successful receipt of your application at HRSA. The email is sent to the
project director, authorizing official, point of contact for the
application and the business official -- all from the submitted
application. The email is also sent to the current project director
listed on the NGA. Because email is not always reliable, please check
the HRSA EHBs or Grants.gov to see if the application is available for
review in HRSA EHBs.

-   Because email is not reliable, check HRSA EHBs within two to three
    business days from submission within Grants.gov for availability of
    your application.

### 2.5.2 Manage Access to Your Application {#manage-access-to-your-application .unnumbered}

You must be registered in HRSA EHBs to get access to your application.
To ensure that only the right individuals from the organization get
access to the application, you must follow the process described
earlier.

The project director, using the Administer feature in the grant
handbook, must give the necessary privileges to the authorizing official
and other individuals who will assist in the submission of the
noncompeting continuation application. Project directors must also
delegate the "Administer Grant Users" privilege to the authorizing
official so that future administration can be managed by the authorizing
official.

Once you have access to your grant handbook, use the "Noncompeting
Continuations" link under the deliverables section to access your
noncompeting application.

### 2.5.3 Check Validation Errors {#check-validation-errors .unnumbered}

HRSA EHBs will apply HRSA's business rules to the application received
through Grants.gov. All validation errors are recorded and displayed to
the applicant. To view the validation errors use the 'Grants.gov Data
Validation Comments' link on the application status page in HRSA EHBs.

### 2.5.4 Fix Errors and Complete Application {#fix-errors-and-complete-application .unnumbered}

Applicants must review the errors in HRSA EHBs and make necessary
changes. Applicants must also complete the detailed budget and other
required forms in HRSA EHBs and assign an AO registered in HRSA EHBs to
the application. HRSA EHBs will show the status of each form in the
application package and all forms must be complete before submission.

### 2.5.5 Submit Application {#submit-application-1 .unnumbered}

To submit an application, you must have the 'Submit Noncompeting
Continuation' privilege. This privilege must be given by the project
director to the authorizing official or a designee. Once all forms are
complete, the application can be submitted to HRSA.

-   You will have two weeks from the date the application was due in
    Grants.gov for submission of the remaining information in HRSA EHBs.
    The new due date will be listed in HRSA EHBs.

-   Face page must be printed from HRSA EHBs and not from Grants.gov
    application.

# 3. Competing Application

## 3.1 Process Overview {#process-overview-1 .unnumbered}

Following is the process for submitting a competing application through
Grants.gov:

1\. HRSA will post all competing announcements on Grants.gov FIND
(<http://grants.gov/search/>). Announcements are typically posted at the
beginning of the fiscal year when HRSA releases its annual Preview,
although program guidance's are generally not available until later. For
more information visit <http://www.hrsa.gov/grants>.

2\. When program guidance is available, search for the announcement in
Grants.gov Apply (<http://www.grants.gov/Apply>).

3\. Download the application package and instructions from Grants.gov.
The program guidance is also part of the instructions that must be
downloaded.

4\. Save a local copy of the application package on your computer and
complete all the forms based on the instructions provided in the program
guidance.

5\. Submit the application package through Grants.gov. (Requires
registration)

6\. Track the status of your submitted application at Grants.gov until
you receive a notification from Grants.gov that your application has
been received by HRSA.

## 3.2 Grantee Organization Needs to Register With Grants.gov (if not already registered) -- See Appendix B {#grantee-organization-needs-to-register-with-grants.gov-if-not-already-registered-see-appendix-b-1 .unnumbered}

Grants.gov requires a **one-time** registration by the applicant
organization. This is a three step process and should be completed by
any organization wishing to apply for grant. If you do not complete this
registration process you will not be able to submit an application. The
registration process will require some time (anywhere from 5 business
days to a month). Therefore, applicants or those considering applying at
some point in the future should register immediately. Registration with
Grants.gov provides the individuals from the organization the required
credentials in order to apply.

If an applicant organization has already completed Grants.gov
registration for another Federal agency, this section can be skipped.

For those applicant organizations still needing to register with
Grants.gov, registration information can be found on the Grants.gov Get
Started website (<http://www.grants.gov/GetStarted>). To be able to
successfully register in Grants.gov, it is necessary that you complete
all of the following required actions:

• 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)

o Obtain a username and password from the Grants.gov Credential Provider

o Register the username and password with Grants.gov

o Get authorized as an AOR by your organization

In addition, if an applicant does not have a Taxpayer Identification
Number (TIN) or Employer Identification Number (EIN), allow for extra
time. Beginning Oct. 30, 2005, the CCR also validates the EIN against
Internal Revenue Service records, a step that will take one to two
business days.

Please direct questions regarding Grants.gov registration to the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time,
excluding Federal holidays.

-   It is recommended that this registration process be completed at
    least two weeks prior to the submittal date of your organization's
    first Grants.gov submission.

## 3.3 Apply through Grants.gov {#apply-through-grants.gov-1 .unnumbered}

### 3.3.1 Find Funding Opportunity {#find-funding-opportunity-1 .unnumbered}

Search for announcements in Grants.gov **FIND**
(<http://grants.gov/search/>) and select the announcement that you wish
to apply for. Refer to the program guidance for eligibility criteria.

Please visit <http://www.hrsa.gov/grants> to read annual HRSA Preview.

-   All competing announcements should be available in Grants.gov FIND!
    When program guidance is release, announcements are made available
    in Grants.gov APPLY.

### 3.3.2 Download Application Package {#download-application-package-1 .unnumbered}

Download the application package and instructions. In order to view
application package and instructions, you will also need to download and
install the PureEdge Viewer (<http://www.grants.gov/DownloadViewer>).
This small, free program will allow you to access, complete, and submit
applications electronically and securely.

-   Please review the system requirements for PureEdge Viewer on the
    Grants.gov website.

### 3.3.3 Complete Application {#complete-application-1 .unnumbered}

Complete the application using both the built-in instructions and the
instructions provided in the program guidance. Ensure that you save a
copy of the application on your local computer.

-   If you are applying for a competing continuation or a supplemental
    grant, ensure that you provide your 10-digit grant number (box 4b
    from NGA) in the Federal Award Identifier field (box 5b in SF424 or
    box 4 in SF424 R&R)

Please direct questions regarding PureEdge to Grants.gov. Contact the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time,
excluding Federal holidays.

For assistance with program guidance related questions, please contact
the program contact listed on the program guidance.

-   You can complete the application offline -- you do not have to be
    connected to the Internet.

### 3.3.4 Submit Application {#submit-application-2 .unnumbered}

The \"Submit\" button on the application package cover page will become
active after you have downloaded the application package, completed all
required forms, attached all required documents, and saved your
application package. Click on the \"Submit\" button once you have done
all these things and you are ready to send your completed application to
Grants.gov.

Review the provided application summary to confirm that the application
will be submitted to the program you wish to apply for. To submit, you
will be asked to Log into Grants.gov. Once you have logged in, your
application package will automatically be uploaded to Grants.gov. A
confirmation screen will appear once the upload is complete. Note that a
Grants.gov Tracking number will be provided on this screen. Please
record this number so that you may refer to it for all subsequent help.

Please direct questions regarding application submission to the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time,
excluding Federal holidays.

-   You must be connected to the Internet and must have a Grants.gov
    username and password to submit the application package.

### 3.3.5 Verify Status of Application {#verify-status-of-application-2 .unnumbered}

Once Grants.gov has received your submission, Grants.gov will send email
messages to advise you of the progress of your application through the
system. Over the next 24 to 48 hours, you should receive two emails. The
first will confirm receipt of your application by the Grants.gov system
("Received"), and the second will indicate that the application has
either been successfully validated ("Validated") by the system prior to
transmission to the grantor agency or has been rejected due to errors
("Rejected with Errors").

In case of any errors, you must correct the application and resubmit it
to Grants.gov. If you are unable to resubmit because the opportunity has
since closed, **contact the Director of the Division of Grants Policy**
via email at <DGPWaivers@hrsa.gov> and thoroughly explain the situation;
include a copy of the "Rejected with Errors" notification.

You can check the status of your application(s) anytime after
submission, by logging into Grants.gov using the black \'Applicants\'
link at the top of any page, and clicking on the \'Check Application
Status\' link.

If there are no errors, the application will be downloaded by HRSA. On
successful download at HRSA, the status of the application will change
to "Received by Agency" and you will receive an additional email from
Grants.gov.

Once your application is received by HRSA, it will be processed to
ensure that the application is submitted for the correct funding
announcement, with the correct grant number (if applicable), and
applicant/grantee organization. Upon this processing, which is expected
to take up to two to three business days, HRSA will assign a unique
tracking number to your application. This tracking number will be posted
to the Grants.gov and the status of your application will be changed to
"Agency Tracking Number Assigned". Note the HRSA tracking number and use
it for all correspondence with HRSA.

-   It is recommended that you check the status of your application in
    Grants.gov until the status is changed to "Agency Tracking Number
    Assigned".

# 4. General Instructions for Application Submission

-   It is mandatory to follow the instructions provided in this section
    to ensure that your application can be printed efficiently and
    consistently for review.

-   

-   Failure to follow the instructions may make your application
    non-compliant. Non-compliant applications will not be given any
    consideration and the particular applicants will be notified.

## 4.1 Narrative Attachment Guidelines {#narrative-attachment-guidelines .unnumbered}

-   The following guidelines are applicable to both electronic and paper
    submissions (when allowed) unless otherwise noted.

### 4.1.1 Font  {#font .unnumbered}

Please use an easily readable serif typeface, such as Times Roman,
Courier, or CG Times. The text and table portions of the application
must be submitted in not less than 12 point and 1.0 line spacing.
Applications not adhering to 12 point font requirements may be returned.
Do not use colored, oversized or folded materials. For charts, graphs,
footnotes, and budget tables, applicants may use a different pitch or
size font, not less than 10 pitch or size font. However, it is vital
that when scanned and/or reproduced, the charts are still clear and
readable.

Please do not include organizational brochures or other promotional
materials, slides, films, clips, etc. 

### 4.1.2 Paper Size and Margins {#paper-size-and-margins .unnumbered}

For duplication and scanning purposes, please ensure that the
application can be printed on 8 ½" x 11" white paper. Margins must be at
least one (1) inch at the top, bottom, left and right of the paper.
Please left-align text.

### 4.1.3 Names {#names .unnumbered}

Please include the name of the applicant and 10-digit grant number (if
competing continuation, supplemental or noncompeting continuation) on
each page.

### 4.1.4 Section Headings {#section-headings .unnumbered}

Please put all section headings flush left in bold type.

### 4.1.5 Page Numbering {#page-numbering .unnumbered}

**Electronic Submissions**

For electronic submissions, applicants only have to number the
electronic attachment pages sequentially, resetting the numbering for
each attachment, i.e., start at page 1 for each attachment.

Do not number the standard OMB approved form pages.

**Paper Submissions (When allowed)**

Do not number the standard OMB approved forms. Please number each
attachment page sequentially. Reset the numbering for each attachment.
(Treat each attachment/document as a separate section.)

### 4.1.6 Allowable Attachment or Document Types {#allowable-attachment-or-document-types .unnumbered}

**Electronic Submissions**

The following attachment types are supported in HRSA EHBs. Even though
grants.gov may allow you to upload any type of attachment, it is
important to note that HRSA only accepts the following types of
attachments:

.DOC - Microsoft Word

.RTF - Rich Text Format

.TXT - Text

.WPD - Word Perfect Document

.PDF - Adobe Portable Document Format

.XLS - Microsoft Excel

## 4.2 Application Content Order (Table of Contents) {#application-content-order-table-of-contents .unnumbered}

When applications were submitted in paper, it was easy to direct the
applicants to prepare a table of contents and make it as a part of the
application. Applicants did not have any problem in preparing the
package that included standard forms as well as attachments. All the
pages were numbered sequentially. Preparation instructions were given in
the program guidance. With the transition to electronic application
receipt, this process has changed significantly. HRSA is using an
approach that will ensure that regardless of the mode of submission
(electronic or paper when exemptions are granted), all applications will
look the same when printed for objective review.

HRSA uses two standard packages from Grants.gov.

SF 424 (otherwise known as 5161) -- For service delivery programs

SF 424 R&R -- For research and training programs (programs previously
using the 398 or the 6025 and 2590 application packages)

For each package HRSA has defined a standard order of forms and that
order is available within the program guidance. The program guidance may
also provide applicants with explicit instructions on where to upload
specific documents.

If you are applying on paper (when allowed), you must use the program
guidance for the order of the forms and all other applicable guidelines.

## 4.3 Page Limit {#page-limit .unnumbered}

HRSA prints your application for review regardless of whether it is
submitted electronically or by paper (when allowed).

When your application is printed, the narrative documents may not exceed
80 pages in length unless otherwise stated in the program guidance.
These narrative documents include the abstract, project and budget
narratives, and any other attachments such as appendices, letters of
support required as a part of the guidance. This 80 page limit does not
include the OMB approved forms. Note that some program guidance may
require submission of OMB approved program specific forms as
attachments. These attachments will not be included in the 80 page
limit.

Applicants must follow the instructions provided in this section and
ensure that they print out all attachments on paper and count the number
of pages before submission.

-   Applications, whether submitted electronically or on paper, that
    exceed the specified limits will be deemed non-compliant.
    Non-compliant competing applications will not be given any
    consideration and the particular applicants will be notified.
    Non-compliant noncompeting applications will have to be resubmitted
    to comply with the page limits.

# 5. Customer Support Information

### 5.1.1 Grants.gov Customer Support {#grants.gov-customer-support .unnumbered}

Please direct ALL questions regarding Grants.gov to Grants.gov Contact
Center at Tel.: 1-800-518-4726. Contact Center hours of operation are
Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time, excluding
Federal holidays.

Please visit the following support URL for additional material on
Grants.gov website.

<http://www.grants.gov/CustomerSupport>

### 5.1.2 HRSA Call Center {#hrsa-call-center .unnumbered}

For assistance with or using HRSA EHBs, call 877-GO4-HRSA (877-464-4772)
between 9:00 am to 5:30 pm ET or email <callcenter@hrsa.gov>.

Please visit HRSA EHBs for online help. Go to:

<https://grants.hrsa.gov/webexternal/home.asp> and click on 'Help'

### 5.1.3 HRSA Program Support {#hrsa-program-support .unnumbered}

For assistance with program guidance related questions, please contact
the program contact listed on the program guidance. Do not call the
program contact for technical questions related to either Grants.gov or
HRSA EHBs.

# 6. FAQs

## 6.1 Software {#software .unnumbered}

### 6.1.1 What are the software requirements for using Grants.gov? {#what-are-the-software-requirements-for-using-grants.gov .unnumbered}

Applicants will need to download the PureEdge viewer. Grants.gov website
provides the following information:

**System Requirements:**

For PureEdge Viewer to function properly, your computer must meet the
following system requirements:

Windows 98, ME, NT 4.0, 2000, XP\
500 MHz processor\
128 MB of RAM\
40 MB disk space\
Web browser: Internet Explorer 5.01 or higher, Netscape Communicator
4.5 - 4.8, Netscape 6.1, 6.2, or 7

If you do not have a Windows operating system, you will need to use a
Windows Emulation program.

Please visit <http://www.grants.gov/DownloadViewer> for all details and
any updates.

### 6.1.2 Why can't I download PureEdge Viewer onto my machine? {#why-cant-i-download-pureedge-viewer-onto-my-machine .unnumbered}

Depending on your organization's computer network and security protocols
you may not have the necessary permissions to download software onto
your workstation. Contact your IT department or system administrator to
download the software for you or give you access to this function.

### 6.1.3 I have heard that Grants.gov is not Macintosh compatible. What do I do if I use only a Macintosh? {#i-have-heard-that-grants.gov-is-not-macintosh-compatible.-what-do-i-do-if-i-use-only-a-macintosh .unnumbered}

Grants.gov is aware of the issues facing Macintosh users who apply for
Federal grants electronically. Grants.gov has provided the following
response regarding this issue on its website at
<http://www.grants.gov/MacSupport>:

> *Grants.gov recognizes that support to users of Non-Windows operating
> systems and the PureEdge Viewer is often required across a distinct
> segment of the grant applicant community. Although at this time, the
> PureEdge Viewer is only available for Windows based installs,
> Grants.gov offers support for Non-Windows platforms.*
>
> *Grants.gov is working with PureEdge in the development of a
> Non-Windows compatible viewer. PureEdge has committed to providing a
> platform independent viewer by November 2006. Information related to
> the Non-Windows compatible viewer will be posted to this webpage
> (http://www.grants.gov/MacSupport). Please bookmark this page and
> return at your convenience for more details.*

Grants.gov and NIH have partnered to provide free access to Citrix
servers for Macintosh Users who are looking for an alternative to using
PC emulation software with the PureEdge forms. A Citrix server
connection allows Macintosh users to remotely launch a Windows session
on their own machines by using the free Citrix client application.
Applicants will need to download and install the free Citrix client
application in order to work. This service is now available for use.

Grants.gov website states:

> *Non-Windows users will be able to download and complete the PureEdge
> forms by taking advantage of the free Citrix server. Non-Windows users
> are also able to submit completed grant applications via the Citrix
> environment.*

For details, please visit <http://www.grants.gov/MacSupport>

### 6.1.4 What are the software requirements for HRSA EHBs? {#what-are-the-software-requirements-for-hrsa-ehbs .unnumbered}

HRSA EHBs can be accessed over the Internet using Internet Explorer (IE)
v5.0 and above and Netscape 4.72 and above. HRSA EHBs are 508 compliant.

IE 6.0 and above is the recommended browser.

HRSA EHBs use pop-up screens to allow users to view or work on multiple
screens. Ensure that your browser settings allow for pop-ups.

In addition, to view attachments such as Word and PDF, you will need
appropriate viewers.

### 6.1.5 What are the system requirements for using HRSA EHBs on a Macintosh computer?  {#what-are-the-system-requirements-for-using-hrsa-ehbs-on-a-macintosh-computer .unnumbered}

Mac users are requested to download the latest version of Netscape for
their OS version. It is recommended that Safari v1.2.4 and above or
Netscape v7.2 and above be used.

Note that Internet Explorer (IE) for Mac has known issues with SSL and
Microsoft is no longer supporting IE for Mac. HRSA EHBs do not work on
IE for Mac.

In addition, to view attachments such as Word and PDF, you will need
appropriate viewers.

## 6.2 Application Receipt {#application-receipt .unnumbered}

### 6.2.1 What will be the receipt date\--the date the application is stamped as received by Grants.gov or the date the data is received by HRSA? {#what-will-be-the-receipt-date--the-date-the-application-is-stamped-as-received-by-grants.gov-or-the-date-the-data-is-received-by-hrsa .unnumbered}

**Competing Submissions:**

The submission/receipt date will be the date the application is received
by Grants.gov.

**Noncompeting Submissions:**

The submission/receipt date will be the date the application is
submitted in HRSA EHBs.

### 6.2.2 When do I need to submit my application? {#when-do-i-need-to-submit-my-application .unnumbered}

**Competing Submissions:**

Applications must be submitted to Grants.gov by 8 PM ET on the due date.

**Noncompeting Submissions:**

Applications must be submitted to Grants.gov by 8 PM ET on the due date.

Applications must be verified and submitted in HRSA EHBs by 5:00 PM ET
on the due date. (2 weeks after the due date in Grants.gov) Refer to the
program guidance for specific dates.

###  {#section .unnumbered}

### 6.2.3 What emails can I expect once I submit my application? Is email reliable? {#what-emails-can-i-expect-once-i-submit-my-application-is-email-reliable .unnumbered}

**Competing Submissions:**

When you submit your noncompeting application in Grants.gov, it is first
received and validated by Grants.gov. Typically, this takes a few hours
but it may take up to 48 hours during peak volumes. You should receive
two emails from Grants.gov.

The first will confirm receipt of your application by the Grants.gov
system ("Received"), and the second will indicate that the application
has either been successfully validated ("Validated") by the system prior
to transmission to the grantor agency or has been rejected due to errors
("Rejected with Errors").

Subsequently, the application will be downloaded by HRSA. This happens
within minutes of when your application is successfully validated by
Grants.gov and made available for HRSA to download. On successful
download at HRSA, the status of the application will change to "Received
by Agency" and you will receive another email from Grants.gov.

Because email is not reliable, you must check the respective systems if
you do not receive any emails within the specified timeframes.

**Noncompeting Submissions:**

When you submit your noncompeting application in Grants.gov, it is first
received and validated by Grants.gov. Typically, this takes a few hours
but it may take up to 48 hours during peak volumes. You should receive
two emails from Grants.gov.

Subsequently, the application will be downloaded by HRSA. This happens
within minutes of when your application is successfully validated by
Grants.gov and made available for HRSA to download. On successful
download at HRSA, the status of the application will change to "Received
by Agency" and you will receive another email from Grants.gov.

Subsequently, it is processed by HRSA to ensure that the application is
submitted for the correct funding announcement, with the correct grant
number and grantee organization. This may take up to 3 business days. At
this point you will receive an email from HRSA confirming the successful
receipt of your application and asking the PD and AO to review and
resubmit the application in HRSA EHBs.

Because email is not reliable, you must check the respective systems if
you do not receive any emails within the specified timeframes.

-   For more information refer to sections 2.4 and 2.5 in this guide

### 6.2.4 If a resubmission is required because of Grants.gov system problems, will these be considered \"late\"? {#if-a-resubmission-is-required-because-of-grants.gov-system-problems-will-these-be-considered-late .unnumbered}

**Competing Submissions:**

No. But you must **contact the Director of the Division of Grants
Policy** via email at <DGPWaivers@hrsa.gov> and thoroughly explain the
situation. Include a copy of the "Rejected with Errors" notification you
received from Grants.gov.

**Noncompeting Submissions:**

No. But you must **contact the HRSA Call Center** at 877-GO4-HRSA
(877-464-4772) between 9:00 am to 5:30 pm ET or email
<callcenter@hrsa.gov>. You may be asked to provide a copy of the
"Rejected with Errors" notification you received from Grants.gov.

## 6.3 Application Submission {#application-submission .unnumbered}

### 6.3.1 How can I make sure that my electronic application is presented in the right order for objective review? {#how-can-i-make-sure-that-my-electronic-application-is-presented-in-the-right-order-for-objective-review .unnumbered}

Follow the instructions provided in section 4,2 to ensure that your
application is presented in the right order and is compliant with all
the requirements.

## 6.4 Grants.gov {#grants.gov .unnumbered}

For a list of frequently asked questions and answers maintained by
Grants.gov please visit the following URL:

<http://www.grants.gov/GrantsGov_UST_Grantee/!SSL!/WebHelp/GrantsGov_UST_Grantee.htm#index.html>

**Appendix B -- Registering and Applying Through Grants.gov**

**Prepare to Apply through Grants.gov:**

HRSA, in providing the grant community a single site to Find and Apply
for grant funding opportunities, is [requiring]{.underline} applicants
for this funding opportunity to apply electronically through Grants.gov.
By using Grants.gov you will be able to download a copy of the
application package, complete it off-line, and then upload and submit
the application via the Grants.gov site. You may [not]{.underline}
e-mail an electronic copy of a grant application to us.

Please understand that we will not consider additional information
and/or materials submitted after your initial application. You must
therefore ensure that all materials are submitted together.

Note: Except in rare cases, paper applications will NOT be accepted for
this grant opportunity. If you believe you are technologically unable to
submit an on-line application you MUST contact the Director of the
Division of Grants Policy, at <DGPWaivers@hrsa.gov> and explain why you
are technologically unable to submit on-line. Make sure you specify the
announcement number you are requesting relief for. HRSA and its Grants
Application Center (GAC) will only accept paper applications from
applicants that received prior written approval.

In order to apply through Grants.gov the Applicant must register with
Grants.gov. This is a three step process that must be completed by any
organization wishing to apply for a grant opportunity. The registration
process will require some time. Therefore, applicants or those
considering applying at some point in the future should register
**[immediately]{.underline}**. Registration in Grants.gov does not
require the organization to apply for a grant; it simply provides the
organization the required credentials so that the organization may apply
for a grant in the future. Registration is required only once.

**[REGISTRATION:]{.underline}**

GET STARTED NOW AND COMPLETE THE ONE-TIME REGISTRATION PROCESS TO BEGIN
SUBMITTING GRANT APPLICATIONS AS SOON AS YOU READ THIS.

You don't need to be registered to search or to begin selecting,
downloading and completing grant applications. Registration is required
to submit applications. Therefore, it is essential that your
organization be registered prior to attempting to submit a grant
application or your organization will not be able to do so. **Be sure to
complete the process early as the registration process may take some
time (anywhere from 5 days to 1 month).**

**There are three steps to the registration process:**

Step 1: Register your organization

Step 2: Register yourself as an Authorized Organization Representative

Step 3: Get authorized by your organization to submit grants

These instructions will walk you through the three basic registration
steps. Additional assistance is available at Grants.gov at
[www.grants.gov](../www.grants.gov). Individual assistance is available
at [http://www.grants.gov/Support](http://www.grants.gov/Support  ) or
1-800-518-4726. Grants.gov also provides a variety of support options
through online Help including Context-Sensitive Help, Online Tutorials,
FAQs, Training Demonstration, User Guide, and Quick Reference Guides.

Follow this checklist to complete your registration---

1\. Register Your Organization

\- Obtain your organization's Data Universal Number System (DUNS) number

\- Register your organization with Central Contractor Registry (CCR)

\- Identify your organization's E-Business POC (Point of Contact)

\- Confirm your organization's CCR "Marketing Partner ID Number (M-PIN)"
password

2\. Register Yourself as an Authorized Organization Representative (AOR)

\- Obtain your username and password

\- Register your username and password with Grants.gov

3\. Get Yourself Authorized as an AOR

\- Contact your E-Business POC to ensure your AOR status

\- Log in to Grants.gov to check your AOR status

The Grants.gov/Apply feature includes a simple, unified application
process to enable applicants to apply for grants online. The information
applicants need to understand and execute the steps is at
http://www.grants.gov/GetStarted. Applicants should read the Get Started
steps carefully. The site also contains registration checklists to help
you walk through the process. HRSA recommends that you download the
checklists and prepare the information requested before beginning the
registration process. Reviewing information required and assembling it
before beginning the registration process will save you time and make
the process faster and smoother.

**REGISTER YOUR ORGANIZATION**

Before you can apply for a grant via Grants.gov, your organization must
obtain a Data Universal Number System (DUNS) number and register early
with the Central Contractor Registry (CCR).

**Obtain your organization's DUNS number**

A DUNS number is a unique number that identifies an organization. It has
been adopted by the Federal government to help track how Federal grant
money is distributed. Ask your grant administrator or chief financial
officer to provide your organization's DUNS number.

\-**How do you do it**? If your organization does not have a DUNS
number, call the special Dun & Bradstreet hotline at 1-866-705-5711 to
receive one free of charge.

\- **How long will this take?** You will receive a DUNS number at the
conclusion of the phone call.

**Register your organization with CCR**

The CCR is the central government repository for organizations working
with the Federal government. Check to see if your organization is
already registered at the CCR website. If your organization is not
already registered, identify the primary contact who should register
your organization.

When your organization registers with CCR, it will be required to
designate an E-Business Point of Contact (E-Business POC). The designee
authorizes individuals to submit grant applications on behalf of the
organization and creates a special password called a Marketing Partner
ID Number (M-PIN) to verify individuals authorized to submit grant
applications for the organization.

\-**How do you do it?** Visit the CCR website at http://www.ccr.gov.
Check whether your organization is already registered or register your
organization right online. Be certain to enter an MPIN number during
this process as this is an optional field for the CCR registration but
mandatory for Grants.gov.

\- **How long will this take?** It may take a few days for you to
collect the information needed for your organization's registration, but
once you finish the registration process, you can move on to Step 2 the
very next business day. Note it will take up to a month for the total
registration- therefore this should be done as soon as possible.

**GET AUTHORIZED as an AOR by Your Organization**

The registration process is almost complete. All that remains is the
final step ---getting authorized. Even though you have registered, your
E-Business POC must authorize you so Grants.gov will know that you are
verified to submit applications.

\- **Obtain your E-Business POC authorization**

After your Authorized Organizational Representative (AOR) profile is
completed, your organization's E-Business POC will receive an email
regarding your requested AOR registration, with links and instructions
to authorize you as an AOR.

\- **How do you do it?** Instruct your E-Business POC to login to
Grants.gov at http://www.grants.gov/ForEbiz and enter your
organization's DUNS number and M-PIN. They will select you as an AOR
they wish to authorize and you will be verified to submit grant
applications.

\- **How long will this take?** It depends on how long it takes your
E-Business POC to log in and authorize your AOR status. You can check
your AOR status by logging in to Grants.gov at
http://www.grants.gov/ForApplicants.

**REGISTER YOURSELF as an Authorized Organization Representative (AOR)**

Once the CCR Registration is complete, your organization is finished
registering. You must now register yourself with Grants.gov and
establish yourself as an AOR, an individual authorized to submit grant
applications on behalf of your organization. There are two elements
required to complete this step --- both must be completed to move onto
Step 3.

1\. **Obtain your username and password**

In order to safeguard the security of your electronic information, and
to submit a Federal grant application via Grants.gov, you must first
obtain a username and password from the Grants.gov Credential Provider.

\- **How do you do it**? Just register with Grants.gov's Credential
Provider at http://www.grants.gov/Register1. You will need to enter your
organization's DUNS number to access the registration form. Once you
complete the registration form you will be given your username and you
will create your own password.

\- **How long will this take?** Same day. When you submit your
information you will receive your username and be able to create your
password.

**2. Register with Grants.gov**

Now that you have your username and password, allow about 30 minutes for
your data to transfer from the Credential Provider, then you must
register with Grants.gov to set up a short profile.

\> **How do you do it?** Simply visit http://www.grants.gov/Register2 to
register your username and password and set up your profile. Remember,
you will only be authorized for the DUNS number which you register in
your Grants.gov profile.

\> **How long will this take?** Same day. Your AOR profile will be
complete after you finish filling in the profile information and save
the information at Grants.gov.

You have now completed the registration process for Grants.gov. If you
are applying for a [new or competing continuation]{.underline} you may
find the application package through Grants.gov FIND. If you are filling
out a [non-competing continuation]{.underline} application you must
obtain the announcement number through your program office, and enter
this announcement number in the search field to pull up the application
form and related program guidance. Download the required forms and enter
your current grant number in the appropriate field to begin the
non-competing continuation application which you will then upload for
electronic submittal through Grants.gov. For continuation applications
which require submittal of performance measures electronically,
instructions are provided in the program guidance on how to enter the
HRSA electronic handbooks to provide this information.

**How to submit an electronic application to HRSA via Grants.gov/Apply**

a\. [Applying using Grants.gov.]{.underline} Grants.gov has a full set
of instructions on how to apply for funds on its website at
<http://www.grants.gov/CompleteApplication>. The following provides
simple guidance on what you will find on the Grants.gov/Apply site.
Applicants are encouraged to read through the page entitled, "Complete
Application Package" before getting started. See Appendix A for specific
information.

b\. [Customer Support]{.underline}. The grants.gov website provides
customer support via (800) 518-GRANTS (this is a toll-free number) or
through e-mail at support@grants.gov. The customer support center is
open from 7:00 a.m. to 9:00 p.m. Eastern time, Monday through Friday,
except federal holidays, to address grants.gov technology issues. For
technical assistance to program related questions, contact the number
listed in the Program Section of the program you are applying for.

**Timely Receipt Requirements and Proof of Timely Submission**

a\. Electronic Submission. All applications must be received by
www.grants.gov/Apply by 8:00 P.M. Eastern Time on the due date
established for each program.

Proof of timely submission is automatically recorded by Grants.gov. An
electronic time stamp is generated within the system when the
application is successfully received by Grants.gov. The applicant will
receive an acknowledgement of receipt and a tracking number from
Grants.gov with the successful transmission of their application.
Applicants should print this receipt and save it, along with facsimile
receipts for information provided by facsimile, as proof of timely
submission. When HRSA successfully retrieves the application from
Grants.gov, Grants.gov will provide an electronic acknowledgment of
receipt to the e-mail address of the AOR. Proof of timely submission
shall be the date and time that Grants.gov receives your application.

Applications received by grants.gov, after the established due date and
time for the program, will be considered late and will not be considered
for funding by HRSA. HRSA suggests that applicants submit their
applications during the operating hours of the Grants.gov Support Desk,
so that if there are questions concerning transmission, operators will
be available to walk you through the process. Submitting your
application during the Support Desk hours will also ensure that you have
sufficient time for the application to complete its transmission prior
to the application deadline. Applicants using dial-up connections should
be aware that transmission should take some time before Grants.gov
receives it. Grants.gov will provide either an error or a successfully
received transmission message. The Grants.gov Support desk reports that
some applicants abort the transmission because they think that nothing
is occurring during the transmission process. Please be patient and give
the system time to process the application. Uploading and transmitting
many files, particularly electronic forms with associated XML schemas,
will take some time to be processed.

Note the following additional information regarding submission of all
HRSA applications through Grants.gov:

• You must submit all documents electronically, including all
information typically included on the SF424 and all necessary assurances
and certifications.

• Your application must comply with any page limitation requirements
described in this program announcement.

• After you electronically submit your application, you will receive an
automatic acknowledgement from Grants.gov that contains a Grants.gov
tracking number. HRSA will retrieve your application from Grants.gov.

**Formal Submission of the Electronic Application**

Applications completed online are considered formally submitted when the
Authorizing Official electronically submits the application to HRSA
through Grants.gov. You must, however, ensure that a copy of the SF-424
R&R Face Sheet is printed, signed, scanned, and included with your
electronic application submission as Attachment 1. For competitive
applications, the SF-424 R&R Face Sheet must be printed from Grants.gov.

Competitive applications will be considered as having met the deadline
if: (1) the application has been successfully transmitted electronically
by your organization's Authorizing Official through Grants.gov on or
before the deadline date and time, and (2) the signed SF-424/5161 Face
Sheet is included in the electronic application submission.

**Performance Measures for Competitive Applications**

Many HRSA guidance include specific data forms and require performance
measure reporting. If the completion of performance measure information
is indicated in this guidance, successful applicants receiving grant
funds will be required, within 30 days of the Notice of Grant Award
(NGA), to register in HRSA's Electronic Handbooks (EHBs) and
electronically complete the program specific data forms that appear in
this guidance. This requires the provision of budget breakdowns in the
financial forms based on the grant award amount, the project abstract
and other grant summary data, and objectives for the performance
measures.

**Performance Measures for Non-Competing Continuation Applications**

For applications which require submittal of performance measures
electronically through the completion of program specific data forms,
instructions will be provided both in the program guidance and through
an e-mail, notifying grantees of their responsibility to provide this
information, and providing instructions on how to do so.

**Appendix C: [Instructions for the SF424 R&R (Research and
Related)]{.underline}**

This application form has replaced the 6025 training application form
and the 398 application form. The 424 R&R is now used for all HRSA
training and research programs.

**INSTRUCTIONS FOR THE APPLICATION FACE PAGES**

Below are detailed instructions for the completion of the 424 R&R form:

+----+-----------------------------------------------------------------+
| F  | Instructions                                                    |
| ie |                                                                 |
| ld |                                                                 |
+----+-----------------------------------------------------------------+
| 1  | Select **Type of Submission**: Check the appropriate type from  |
| \. | the submission options. Select **Application** for all HRSA     |
|    | grant programs                                                  |
+----+-----------------------------------------------------------------+
| 2  | **Date Submitted**: Enter the date the application is submitted |
| \. | to the Federal agency.                                          |
+----+-----------------------------------------------------------------+
| 3  | **Date Received by State**: State Use Only (if applicable)      |
| \. |                                                                 |
+----+-----------------------------------------------------------------+
| 4  | **Federal Identifier**: New Project Applications should leave   |
| \. | this field blank. If this is a Continuation application         |
|    | (competing or non-competing) or a Supplement, enter your grant  |
|    | number located on your Notice of Grant Award (NGA.              |
+----+-----------------------------------------------------------------+
| 5  | **Applicant Information**: All items in bold are required       |
| \. | fields and must be completed                                    |
|    |                                                                 |
|    | Enter your **Organization's DUNS** Number (received from Dun    |
|    | and Bradstreet), Enter the **Legal Name**, **Applicant          |
|    | Department** (if applicable) and **Division** (if applicable)   |
|    | who will undertake the assistance activity. In **Street 1**     |
|    | enter the first line of the street address of your              |
|    | organization. In **Street2** enter the second line of your      |
|    | organization, if applicable. Enter the **City, County** and     |
|    | **State,** **Zip Code** and **Country** where your organization |
|    | is located. Enter the **Person to be Contacted on Matters       |
|    | Involving the Application:**                                    |
|    |                                                                 |
|    | **This is the POINT OF CONTACT, the person to be contacted**    |
|    | for the matters pertaining to this specific application (i.e.   |
|    | principle investigator, project director, other)**.** Enter the |
|    | **Prefix, First Name, Middle Name and Last Name and Suffix**    |
|    | (if applicable) of the person to be contacted on matters        |
|    | relating to this application. Enter the **Phone** and **Fax**   |
|    | number as well as the **E-MAIL** address of this person.        |
|    | **These are all required fields.**                              |
+----+-----------------------------------------------------------------+
| 6  | **Employer Identification (EIN)/ (TIN)**                        |
| \. |                                                                 |
|    | Enter the 9 Digit Employer Identification Number as Assigned by |
|    | the Internal Revenue Services.                                  |
+----+-----------------------------------------------------------------+
| 7  | **Type of Applicant :** Select the appropriate letter from one  |
| \. | of the following:                                               |
|    |                                                                 |
|    | A.  State Government                                            |
|    |                                                                 |
|    | B.  County Government                                           |
|    |                                                                 |
|    | C.  City or Township Government                                 |
|    |                                                                 |
|    | D.  Special District Government                                 |
|    |                                                                 |
|    | E.  Independent School District                                 |
|    |                                                                 |
|    | F.  State Controlled Institution of Higher Education            |
|    |                                                                 |
|    | G.  Native American Tribal Government (Federally Recognized)    |
|    |                                                                 |
|    | H.  Public/Indian Housing Authority                             |
|    |                                                                 |
|    | I.  Native American Tribal Organization (other than Federally   |
|    |     recognized)                                                 |
|    |                                                                 |
|    | J.  Nonprofit with 501C3 IRS status (other than Institute of    |
|    |     Higher Education)                                           |
|    |                                                                 |
|    | K.  Nonprofit without 501C3 IRS status (other than Institute of |
|    |     Higher Education                                            |
|    |                                                                 |
|    | L.  Private Institution of Higher Education                     |
|    |                                                                 |
|    | M.  Individual                                                  |
|    |                                                                 |
|    | N.  For Profit Organization(other than small business)          |
|    |                                                                 |
|    | O.  Small Business                                              |
|    |                                                                 |
|    | P.  Other (specify)                                             |
|    |                                                                 |
|    | **Women Owned:** Check if you are a woman owned small business( |
|    | 51% owned/controlled and operated by a woman/women)             |
|    |                                                                 |
|    | **Socially and Economically Disadvantaged:** Check if you are a |
|    | socially and economically disadvantaged small business, as      |
|    | determined by the U.S. SBA pursuant to Section 8(a) of the SBA  |
|    | U.S.C.637(a).                                                   |
+----+-----------------------------------------------------------------+
| 8  | **Type of Application: Select the Type from the following list  |
| \. | :**                                                             |
|    |                                                                 |
|    | \- **New**: A new assistance award                              |
|    |                                                                 |
|    | \- **Resubmission** ( not applicable to HRSA)                   |
|    |                                                                 |
|    | \- **Renewal --** An application for a competing continuation   |
|    | -- this is a request for an extension for an additional         |
|    | funding/budget period for a project with a projected            |
|    | completion.                                                     |
|    |                                                                 |
|    | \-**Continuation**: A non-competing application for an          |
|    | additional funding/budget period for a project within a         |
|    | previously approved projected period                            |
|    |                                                                 |
|    | \- **Revision**: Any change in the Federal Governments          |
|    | financial obligation or contingent liability from an existing   |
|    | obligation. Indicate the **Type of Revision** by checking the   |
|    | appropriate box:                                                |
|    |                                                                 |
|    | A. Increase in Award (supplement, competing supplement)         |
|    |                                                                 |
|    | B. Decrease Award                                               |
|    |                                                                 |
|    | C. Increase Duration                                            |
|    |                                                                 |
|    | D. Decrease Duration                                            |
|    |                                                                 |
|    | E. Other (Enter text to Explain)                                |
|    |                                                                 |
|    | **Is Application being submitted to Other Agencies:** Indicate  |
|    | by checking **YES** or **NO** if the application is being       |
|    | submitted to HRSA only.                                         |
|    |                                                                 |
|    | **What other Agencies:** Enter Agency Name ( if applicable)     |
+----+-----------------------------------------------------------------+
| 9  | **Name of Federal Agency:** Enter the Name of the Federal       |
| \. | Agency from which assistance is being requested                 |
+----+-----------------------------------------------------------------+
| 10 | **Catalogue of Federal Domestic Assistance Number (CFDA):** Use |
| \. | the CFDA Number found on the front pea of the program guidance  |
|    | and associated Title of the CFDA (if available).                |
+----+-----------------------------------------------------------------+
| 11 | **Descriptive Title of Applicant's Project:** Enter a brief     |
| \. | descriptive title of the project**.** A continuation or         |
|    | revision must use the same title as the currently funded        |
|    | project.                                                        |
+----+-----------------------------------------------------------------+
| 12 | **Areas Affected by Project**: List only the largest political  |
| \. | Entities affected by the project ( ex. states, counties,        |
|    | cities)                                                         |
+----+-----------------------------------------------------------------+
| 13 | **Proposed Project:** Enter the project **Start Date** of the   |
| \. | project in the Start Date Field and the project **Ending Date** |
|    | in the Ending Date Field. ( ex.11/01/2005 to 10/31/2008)        |
+----+-----------------------------------------------------------------+
| 14 | **Congressional District Applicant and Congressional District   |
| \. | Project:** Enter your Congressional District(s) in Applicant    |
|    | Field. Enter the Congressional District (s) of Project, the     |
|    | primary site where the project will be performed.               |
|    | (http://www.gpoaccess.gov/cdirectory/browse-cd-05.html)         |
+----+-----------------------------------------------------------------+
| 15 | **Project Director/Principal Investigator Contact Information   |
| \. | :** All items in bold are required fields and must be completed |
|    |                                                                 |
|    | Enter the **Prefix, First Name, Middle Name and Last Name and   |
|    | Suffix** (if applicable) of the Project Director/Principle      |
|    | Investigator (PD/PI) for the project. Enter the **Title** of    |
|    | the PD/PI and the **name of the organization** of the PD/PI.    |
|    | Enter the name of the primary organization **Department** and   |
|    | **Division** of the PD/PI. In **Street 1** enter the first line |
|    | of the street address of the PD/PI for the project. In          |
|    | **Street2** enter the second line of the street address for the |
|    | PD/PI, if applicable. Enter the **City, County** and **State,** |
|    | **Zip Code** and **Country** of the PD/PI. Enter the **Phone**  |
|    | and **Fax** number as well as the **E-MAIL** address of this    |
|    | person. **These are all required fields.**                      |
+----+-----------------------------------------------------------------+
| 16 | **Estimated Project Funding:**                                  |
| \. |                                                                 |
|    | **a. Total Estimated Project Funding** Enter the total          |
|    | **Federal Funds** requested for the **BUDGET PERIOD** for which |
|    | you are applying**. Enter only the amount for the year you are  |
|    | applying, NOT the amount for the entire project period.**       |
|    |                                                                 |
|    | **b. Total Federal and Non-Federal Funds:** Enter the total     |
|    | Federal and non-Federal funds for the **BUDGET PERIOD** for     |
|    | which you are applying.                                         |
|    |                                                                 |
|    | **c.** **Estimated Program Income:** Identify any Program       |
|    | Income for the **BUDGET PERIOD.**                               |
+----+-----------------------------------------------------------------+
| 17 | **Is Application Subject to Review by State Executive Order     |
| \. | 12372 Process:**                                                |
|    |                                                                 |
|    | If YES: Check the YES box if the announcement indicates that    |
|    | the program is covered under State Executive Order 12372. If    |
|    | NO: Place a check in the NO box.                                |
+----+-----------------------------------------------------------------+
| 18 | **Complete Certification**                                      |
| \. |                                                                 |
|    | Check the "I agree" box to attest to acceptance of required     |
|    | certifications and assurances listed at the end of the          |
|    | Application**.**                                                |
+----+-----------------------------------------------------------------+
| 19 | **Authorized Representative** (Authorizing Official - This is   |
| \. | the person who has the authority to sign the application for    |
|    | the organization ) All items in bold are required fields and    |
|    | must be completed                                               |
|    |                                                                 |
|    | Enter the name of Authorized Representative/Authorizing         |
|    | Official. Enter the **Prefix, First Name, Middle Name and Last  |
|    | Name and Suffix** (if applicable) of the Authorized             |
|    | Representative (AR) or Authorizing Official (AO). Enter the     |
|    | **Title** of the Authorized Representative and the              |
|    | **organization** of the AR/AO. Enter the name of the primary    |
|    | organization **Department** and **Division** of the AO. In      |
|    | **Street1** enter the first line of the street address of the   |
|    | AR/AO for the project. In **Street2** enter the second line of  |
|    | the street address for the AR/AO, if applicable. Enter the      |
|    | **City, County** and **State,** **Zip Code** and **Country** of |
|    | the AR/AO. Enter the **Phone** and **Fax** number as well as    |
|    | the **E-MAIL** address of AR/AO this person. **These are all    |
|    | required fields .**                                             |
|    |                                                                 |
|    | **Date Signed: If you are submitting this electronically please |
|    | print off a copy of the face/cover pages of the application,    |
|    | sign and send them to HRSA's Grants Application Center (GAC)    |
|    | --( See the program guidance for the GAC's address)**           |
|    |                                                                 |
|    | Note: Applicant applying in paper must send their entire grant  |
|    | application with the signed face/cover pages to the GAC         |
+----+-----------------------------------------------------------------+
| 20 | **Pre-Application**                                             |
| \. |                                                                 |
|    | This is Not applicable to HRSA. A limited number of HRSA        |
|    | programs require a Letter of Intent which is different from a   |
|    | preapplication. Information required and the process for        |
|    | submitting such a Letter of Intent is outlined in the funding   |
|    | opportunity announcements for those programs with such a        |
|    | requirement. .                                                  |
+----+-----------------------------------------------------------------+

INSTRUCTIONS FOR 5161 CHECKLIST (This is used for the 424 R&R as well)

+-----------------+----------------------------------------------------+
| Field           | Instructions                                       |
+-----------------+----------------------------------------------------+
| Type of         | Check one of the boxes corresponding to one of the |
| Application     | following types:                                   |
|                 |                                                    |
|                 | \- **New**: A new application is a request for     |
|                 | financial assistance for a project or program not  |
|                 | currently receiving DHHS support.                  |
|                 |                                                    |
|                 | **-Non competing Continuation**: A non-competing   |
|                 | application for an additional funding/budget       |
|                 | period for a project within a previously approved  |
|                 | project period                                     |
|                 |                                                    |
|                 | \- **Competing Continuation (** same as Renewal    |
|                 | from 424R&R face page)                             |
|                 |                                                    |
|                 | --this is a request for an extension of support    |
|                 | for an additional funding/budget period for a      |
|                 | project with a projected completion.               |
|                 |                                                    |
|                 | **- Supplemental (**same as Revision from 424 R&R  |
|                 | face page) An application requesting a change in   |
|                 | the Federal Governments financial obligation or    |
|                 | contingent liability from an existing obligation.  |
+-----------------+----------------------------------------------------+
| Part A          | Leave this Section Blank                           |
+-----------------+----------------------------------------------------+
| Part B          | Leave this Section Blank                           |
+-----------------+----------------------------------------------------+
| Part C          | In the Space Provided below, please provide the    |
|                 | requested information                              |
+-----------------+----------------------------------------------------+
| Business        | Enter the name of Business Official to be notified |
| Official to be  | if an award is to be made. Enter the **Prefix,     |
| notified if an  | First Name, Middle Name and Last Name and Suffix** |
| award is to be  | (if applicable) of the Business Official and the   |
| made            | **organization. Enter the Address** Street1 enter  |
|                 | the first line of the street address of the        |
|                 | Business Official. In **Street2** enter the second |
|                 | line of the street address for the AR/AO, if       |
|                 | applicable. Enter the **City, County** and         |
|                 | **State,** **Zip Code** and **Country** of the     |
|                 | business official. Enter the **Telephone** and     |
|                 | **Fax** number as well as the **E-MAIL** address   |
|                 | of Business Official. Enter the Applicant          |
|                 | Organizations 12 Digit DHHS EIN ( if already       |
|                 | assigned) -- This should be the same information   |
|                 | as supplied in file number 5 of the 424 R&R face   |
|                 | page .                                             |
+-----------------+----------------------------------------------------+
| Project         | Enter the name of Project Director/Principle       |
| Dir             | Investigator (PD/PI) -- this should be the same    |
| ector/Principle | information as supplied on the 424 R & R face page |
| Investigator    | field number 15. Enter the **Prefix, First Name,   |
| designated to   | Middle Name and Last Name and Suffix** (if         |
| direct the      | applicable). Enter the name of the primary         |
| proposed        | organization and Address: **Street1** enter the    |
| project         | first line of the street address of the AR/AO for  |
|                 | the project. In **Street2** enter the second line  |
|                 | of the street address for the AR/AO, if            |
|                 | applicable. Enter the **City, County** and         |
|                 | **State,** **Zip Code** and **Country** of the     |
|                 | PD/PI. Enter the **Telephone Number, E-Mail** and  |
|                 | **Fax** number. **DO NOT** enter the social        |
|                 | security number. Enter the highest degree earned   |
|                 | for the PD/PI.                                     |
+-----------------+----------------------------------------------------+

INSTRUCTIONS FOR R&R SENIOR/KEY PERSON PROFILE

Starting with the PD/PI, provide a profile for each senior/key person
proposed. Unless otherwise specified in an agency announcement senior
key personnel are defined as all individuals who contribute in a
substantive, measurable way to the execution of the project or activity
whether or not salaries are requested. Consultants should be included if
they meet this definition. For each of these individuals a Biosketch
should be attached which lists the individual's credentials/degrees.

+-----------+----------------------------------------------------------+
| Field     | Instruction                                              |
+-----------+----------------------------------------------------------+
| Prefix    | Ex. Mr., Ms. Mrs. Rev. Enter the Prefix for the          |
|           | Individual identified as a key person for the project.   |
|           | If this is the entry for the Project Director and you    |
|           | are submitting electronically this field will be         |
|           | prepopulated with the prefix for the project director    |
|           | identified on the face page of the 424 R&R.              |
+-----------+----------------------------------------------------------+
| First     | This is the first (given) name of the Individual         |
| Name      | identified as a key person for the project. If this is   |
|           | the entry for the Project Director and you are           |
|           | submitting electronically this field will be             |
|           | prepopulated with the name of the project director       |
|           | identified on the face page of the 424 R&R.              |
+-----------+----------------------------------------------------------+
| Middle    | This is the middle name of the Individual identified as  |
| Name      | a key person for the project. If this is the entry for   |
|           | the Project Director and you are submitting              |
|           | electronically this field will be prepopulated with the  |
|           | name of the project director identified on the face page |
|           | of the 424 R&R.                                          |
+-----------+----------------------------------------------------------+
| Last Name | This is the last name of the Individual identified as a  |
|           | key person for the project. If this is the entry for the |
|           | Project Director and you are submitting electronically   |
|           | this field will be prepopulated with the last name of    |
|           | the project director identified on the face page of the  |
|           | 424 R&R.                                                 |
+-----------+----------------------------------------------------------+
| Suffix    | Enter the Suffix (Ex. Jr., Sr., PhD.,) for the           |
|           | Individual identified as a key person for the project.   |
|           | If this is the entry for the Project Director and you    |
|           | are submitting electronically this field will be         |
|           | prepopulated with the prefix for the project director    |
|           | identified on the face page of the 424 R&R.              |
+-----------+----------------------------------------------------------+
| Posit     | Enter the Title for the Individual identified as a key   |
| ion/Title | person for the project. If this is the entry for the     |
|           | Project Director and you are submitting electronically   |
|           | this field will be prepopulated with the Title for the   |
|           | project director identified on the face page of the 424  |
|           | R&R.                                                     |
+-----------+----------------------------------------------------------+
| D         | This is the name of the primary organizational           |
| epartment | department, service, laboratory, or equivalent level     |
|           | within the organization for the Individual identified as |
|           | a key person for the project. If this is the entry for   |
|           | the Project Director and you are submitting              |
|           | electronically this field will be prepopulated with the  |
|           | Department for the project director identified on the    |
|           | face page of the 424 R&R.                                |
+-----------+----------------------------------------------------------+
| Org       | This is the name of the organizational for the           |
| anization | Individual identified as a key person for the project.   |
| Name      | If this is the entry for the Project Director and you    |
|           | are submitting electronically this field will be         |
|           | prepopulated with the Organization Name for the project  |
|           | director identified on the face page of the 424 R&R.     |
+-----------+----------------------------------------------------------+
| Division  | This is the primary organizational division, office, or  |
|           | major subdivision of the individual. If this is the      |
|           | entry for the Project Director and you are submitting    |
|           | electronically this field will be prepopulated with the  |
|           | Division for the project director identified on the face |
|           | page of the 424 R&R.                                     |
+-----------+----------------------------------------------------------+
| Street1   | This is the first line of the street address for the     |
|           | individual identified as a key/senior person. If this is |
|           | the entry for the Project Director and you are           |
|           | submitting electronically this field will be             |
|           | prepopulated with the Street address for the project     |
|           | director identified on the face page of the 424 R&R.     |
+-----------+----------------------------------------------------------+
| Street 2  | This is the second line of the street address (if        |
|           | applicable) for the individual identified. If this is    |
|           | the entry for the Project Director and you are           |
|           | submitting electronically this field will be             |
|           | prepopulated with the second line of the Street address  |
|           | ( if applicable) for the project director identified on  |
|           | the face page of the 424 R&R                             |
+-----------+----------------------------------------------------------+
| City      | Enter the city where the key/senior person is located.   |
|           | If this is the entry for the Project Director and you    |
|           | are submitting electronically this field will be         |
|           | prepopulated.                                            |
+-----------+----------------------------------------------------------+
| County    | Enter the County where the key/senior person is located. |
|           | If this is the entry for the Project Director and you    |
|           | are submitting electronically this field will be         |
|           | prepopulated.                                            |
+-----------+----------------------------------------------------------+
| State     | Enter the state where the key/senior person is located.  |
|           | If this is the entry for the Project Director and you    |
|           | are submitting electronically this field will be         |
|           | prepopulated                                             |
+-----------+----------------------------------------------------------+
| ZIP Code  | Enter the Zip Code where the key/senior person is        |
|           | located. If this is the entry for the Project Director   |
|           | and you are submitting electronically this field will be |
|           | prepopulated                                             |
+-----------+----------------------------------------------------------+
| Phone     | Enter the daytime phone number for the senior/key        |
| Number    | person. If this is the entry for the Project Director    |
|           | and you are submitting electronically this filed will be |
|           | prepopulated                                             |
+-----------+----------------------------------------------------------+
| Fax       | Enter the fax number for the senior/key person. If this  |
| Number    | is the entry for the Project Director and you are        |
|           | submitting electronically this filed will be             |
|           | prepopulated                                             |
+-----------+----------------------------------------------------------+
| Email     | Enter the email address for the senior/key person. If    |
| address   | this is the entry for the Project Director and you are   |
|           | submitting electronically this filed will be             |
|           | prepopulated- This is a required field                   |
+-----------+----------------------------------------------------------+
| C         | Leave this field blank                                   |
| redential |                                                          |
| e.g.      |                                                          |
| agency    |                                                          |
| login     |                                                          |
+-----------+----------------------------------------------------------+
| Project   | Enter the project role from the list below               |
| Role      |                                                          |
|           | 1\. Project Director (PD)/Principle Investigator(PI)     |
|           |                                                          |
|           | 2\. Co- PD/Co- PI                                        |
|           |                                                          |
|           | 3.Faculty                                                |
|           |                                                          |
|           | 4\. Post Doctoral                                        |
|           |                                                          |
|           | 5\. Post Doctoral Associate                              |
|           |                                                          |
|           | 6\. Other Professional                                   |
|           |                                                          |
|           | 7\. Graduate Student                                     |
|           |                                                          |
|           | 8\. Undergraduate Student                                |
|           |                                                          |
|           | 9\. Technician                                           |
|           |                                                          |
|           | 10\. Consultant                                          |
|           |                                                          |
|           | 11\. Other (Specify)                                     |
+-----------+----------------------------------------------------------+
| Other     | Complete if you selected "Other "as a project role. For  |
| Project   | example, Engineer, social worker.                        |
| Role      |                                                          |
| Category  |                                                          |
+-----------+----------------------------------------------------------+
| Attach    | Provide a biographical sketch for the PD/PI or Senior    |
| Bio       | Key Person identified. For each of these individuals a   |
| graphical | Biosketch should be attached which lists the             |
| Sketch    | individual's credentials/degrees. Recommended            |
|           | information includes: education and training, research   |
|           | and professional and synergistic activities. Save the    |
|           | information in a single file and attach by clicking Add  |
|           | attachment --if applying electronically                  |
+-----------+----------------------------------------------------------+
| Attach    | Follow the individual program guidance pertaining to     |
| Current & | this issue. If current and pending support on level of   |
| Pending   | effort documentation is required, please attach          |
| Support   | accordingly.                                             |
+-----------+----------------------------------------------------------+

INSTRUCTIONS FOR R&R PROJECT PERFORMANCE SITE LOCATION(S) FORM

Indicate the primary site/sites where the work or activity will occur.
If a portion of the project is at any other location(s), identify it in
the section provided. If more than eight project/performance site
locations are proposed, provide the information in a separate file and
attach these in a file in the space provided at the bottom of the form.
If applying in paper add this information as part of the appendix.

Enter the Primary Performance Site first. Add all other performance
sites in the space provided.

  -------------- ------------------------------------------------------------
  Field name     Instructions

  Organization   Enter the Name of the Performance Site/Organization
  Name           

  Street 1       Enter the first line of the street address of the
                 performance site location

  Street 2       Enter the second line of the street address of the
                 performance site location, if applicable

  City           Enter the city of the performance site.

  County         Enter the county where the performance site is located.

  State          Select from the list of States or enter the State/province
                 in which the performance site is located

  Zip Code       Enter the zip code of the performance sit location

  Country        Enter the country of the performance site from the list
  -------------- ------------------------------------------------------------

> INSTRUCTIONS FOR R&R BUDGET

**Section A & B**

**SECTION** A

+-------------+--------------------------------------------------------+
| Field Name  | Instructions                                           |
+-------------+--------------------------------------------------------+
| Org         | Enter the DUNS or DUNS +4 number of your organization. |
| anizational | For applicants applying electronically, this field is  |
| DUNS        | pre-populated from the R&R SF424 Cover Page.           |
+-------------+--------------------------------------------------------+
| Budget Type | Check the appropriate block. Check Project if the      |
|             | budget requested is for the primary applicant          |
|             | organization. Check Subaward/consortium organizations  |
|             | (if applicable). Separate budgets are usually required |
|             | only for Subaward Budgets and are not allowed by HRSA  |
|             | unless legislatively authorized or requested in the    |
|             | program application guidance. Use the R&R Subaward     |
|             | Budget Attachment and attach as a separate file on the |
|             | R&R Budget Attachment(s) form..                        |
+-------------+--------------------------------------------------------+
| Enter Name  | Enter the name of your organization                    |
| of          |                                                        |
| O           |                                                        |
| rganization |                                                        |
+-------------+--------------------------------------------------------+
| Start Date  | Enter the requested Start Date of Budget Period        |
+-------------+--------------------------------------------------------+
| End Date    | Enter the requested End Date of the Budget Period (    |
|             | these should cover 1 full year/12 months)              |
+-------------+--------------------------------------------------------+
| Budget      | Identify the specific budget period (1 for first year  |
| Period      | of the grant, 2 for second year of the grant, 3 for    |
|             | third etc.)                                            |
+-------------+--------------------------------------------------------+
| A.          | Enter the **Prefix**, F**irst/(Given) name**, **Middle |
|             | name** (if applicable), **Last Name** and **Suffix**   |
| Senior/Key  | of the senior/key person                               |
| Person      |                                                        |
+-------------+--------------------------------------------------------+
| Project     | Enter the project role of the Senior/Key person.       |
| Role        |                                                        |
+-------------+--------------------------------------------------------+
| Base Salary | Enter the annual compensation paid by the employer for |
| (\$)        | each Senior/Key person. This includes all activities   |
|             | such as research, teaching, patient care. etc.         |
+-------------+--------------------------------------------------------+
| Cal. Months | Enter the number of Calendar months devoted to the     |
|             | project in the applicable box for each project role    |
|             | category                                               |
+-------------+--------------------------------------------------------+
| Acad.       | Enter the number of academic year months devoted to    |
| Months      | the project in the applicable box for each project     |
|             | role category ( If your institution does not use a 9   |
|             | month academic period, indicate your institution's     |
|             | definition of academic year in the budget              |
|             | justification)                                         |
+-------------+--------------------------------------------------------+
| Sum. Months | Enter the number of summer months devoted to the       |
|             | project in the applicable box for each project role    |
|             | category ( If your institution does not use a 3 month  |
|             | summer period, indicate your institution's definition  |
|             | of summer period in the budget justification)          |
+-------------+--------------------------------------------------------+
| Requested   | Regardless of the number of months being devoted to    |
| Salary (\$) | the project, indicate only the funds being requested   |
|             | to cover the amount of salary/wages for each           |
|             | senior/key person for this budget period               |
+-------------+--------------------------------------------------------+
| Fringe      | Enter applicable fringe benefits, if any, for each     |
| Benefits    | senior/key person                                      |
| (\$)        |                                                        |
+-------------+--------------------------------------------------------+
| Funds       | Enter federal funds requested for salary/wages &       |
| Requested   | fringe benefits for each senior/key person for this    |
| (\$)        | budget period for this project.                        |
+-------------+--------------------------------------------------------+
| Line 9.     | Enter the total federal funds requested for all        |
| Total Funds | senior/key persons listed in the attached file (these  |
| Requested   | requested funds would be for key persons over and      |
| for all     | above those listed in the preceding rows/fields of     |
| Senior Key  | section A). If applicants are applying in hardcopy     |
| Persons in  | please attach a table listing the key personnel over   |
| the         | and above the 8 persons listed on the budget page      |
| attached    | using the same format appearing in the budget table    |
| Files       | and enter the total funds requested for these          |
|             | additional by people in row 9.                         |
+-------------+--------------------------------------------------------+
| Additional  | If applying electronically attach a file here          |
| Senior Key  | detailing the funds requested for key personnel over   |
| Persons     | and above the 8 senior/key persons already listed in   |
| (attach     | this section; include all pertinent budget             |
| file)       | information. The total funds requested in this file    |
|             | should be entered in "**the total funds requested for  |
|             | all additional senior/key persons in line 9 of Section |
|             | A** . If applying in hardcopy please be certain to     |
|             | provide detailed information on the key personnel as   |
|             | well as funds requested in the same format appearing   |
|             | in the budget table. Be certain to include the total   |
|             | funds for these additional key persons in **the total  |
|             | funds requested for all additional senior/key persons  |
|             | in line 9 of Section A.**                              |
+-------------+--------------------------------------------------------+

**SECTION B. Other Personnel**

  ------------- ---------------------------------------------------------
  Field Name    Instructions

  Number of     For each project role/category identify the number of
  Personnel     personnel proposed.

  Project Role  If project role is other than Post-Doctoral Associates,
                Graduate Students, Undergraduate students, or
                Secretarial/Clerical, enter the appropriate project role
                ( for example, Engineer, Statistician, IT Professional
                etc. ) in the blanks.

  Cal. Months   Enter the number of Calendar months devoted to the
                project in the applicable box for each project role
                category/stipend category

  Acad. Months  Enter the number of academic year months devoted to the
                project in the applicable box for each project role
                category ( If your institute does not use a 9 month
                academic period , indicate your institution's definition
                of academic year in the budget justification)

  Sum. Months   Enter the number of summer months devoted to the project
                in the applicable box for each project role category ( If
                your institute does not use a 3 month summer period ,
                indicate your institution's definition of summer period
                in the budget justification)

  Requested     Regardless of the number of months being devoted to the
  Salary (\$)   project, indicate only the amount of salary/wages/stipend
                amount being requested for each project role

  Fringe        Enter applicable fringe benefits, if any, for each
  Benefits (\$) project role category

  Funds         Enter requested salary/wages & fringe benefits for each
  Requested     project role category
  (\$)          

  Total Number  Enter the total number of other personnel and related
  Other         funds requested for this project
  Personnel     

  Total Salary, Enter the total funds requested for all senior key
  Wages and     persons, stipends and all other personnel- If applying
  Fringe        electronically this will be computed based on detailed
  Benefits (A   information provided. If applying through hard copy
  &B)           please enter this number, ensuring that the total is
                equal to the detailed information provided
  ------------- ---------------------------------------------------------

RESEARCH AND RELATED BUDGET

SECTION C, D, E,

**Section C, D & E**

**SECTION C: Equipment Description**

  ---------------- ---------------------------------------------------------
  Field Name       Instructions

  Organizational   Enter the DUNS or DUNS +4 number of your organization.
  DUNS             For Project applicants and those applying electronically,
                   this field is pre-populated from the R&R SF424 Cover
                   Page.

  Budget Type      Check the appropriate block. Check Project if the budget
                   requested is for the primary applicant organization.
                   Check Subaward/consortium organizations (if applicable).
                   Separate budgets are usually required only for Subaward
                   Budgets and are not allowed by HRSA unless legislatively
                   authorized or requested in the program application
                   guidance. Use the R&R Subaward Budget Attachment and
                   attach as a separate file on the R&R Budget Attachment(s)
                   form)

  Enter Name of    Enter the name of your organization
  Organization     

  Start Date       Enter the requested Start Date of Budget Period

  End Date         Enter the requested/proposed End Date of the Budget
                   Period ( these should cover 1 full year/12 months)

  Budget Period    Identify the specific budget period (1 for first year of
                   the grant, 2 for second year of the grant, 3 for third
                   etc. )

  Equipment Item   Equipment is identified as an item of property that has
                   an acquisition cost of \$5,000 or more (unless the
                   organization has established lower levels) and an
                   expected service life of more than 1 year. List each item
                   of equipment separately and justify each in the budget
                   justification section. Ordinarily allowable items are
                   limited to those which will be used primarily or
                   exclusively in the actual conduct or performance of grant
                   activities.

  Funds Requested  Enter the estimated cost of each item of equipment,
                   including shipping and any maintenance costs and
                   agreements.

  Total Funds      Enter the estimated cost of all equipment listed in any
  Requested for    attached documents/files.
  all equipment    
  listed in the    
  attached files   

  Additional       If the space provided can not accommodate all the
  Equipment        equipment proposed, attach a file or document delineating
                   the equipment proposed. If applying in hardcopy please
                   provide this information on a separate/attached sheet.
                   List the total funds requested on line 11 of this
                   section.
  ---------------- ---------------------------------------------------------

**SECTION D. Travel**

  -------------- ---------------------------------------------------------
  Field Name     Instructions

  Domestic       Enter the total funds requested for domestic travel.
  Travel Costs   Domestic travel includes Canada, Mexico and US
  (Incl. Canada, possessions. In the budget justifications section,
  Mexico, and US include the purpose , destinations, dates of travel (if
  Possessions)   known) , and number of individuals for each trip. If the
                 dates of travel are known, specify estimated length of
                 trip (for example, 3 days)

  Foreign Travel Enter the total funds to be used for foreign travel.
  Costs          Foreign travel includes any travel outside of the United
                 States, Canada, Mexico and or the U.S. Possessions. In
                 the budget justification section, include the purpose,
                 destination, travel dates (if known), and number of
                 individuals for each trip. If the dates of travel are not
                 known , specify estimated length of trip ( ex. 3 days)

  Total Travel   The total funds requested for all travel related to this
  Costs          project-- this should equal the total of all domestic and
                 foreign and may be computed if applying electronically.
                 If applying in hardcopy please enter this amount
  -------------- ---------------------------------------------------------

RESEARCH AND RELATED BUDGET

SECTION C, D, E,

**SECTION E: Participant/Trainee Support Costs**

  --------------------- -----------------------------------------------------
  Field Name            Instructions

  Tuition/Fees/Health   Enter the total amount of funds requested for
  Insurance             participant /trainee tuition, fees, and /or health
                        insurance. (if applicable)

  Stipends              Enter the total amount of funds requested for
                        participant /trainee stipends.

  Travel                Enter the total funds requested for
                        participant/trainee travel associated with this
                        project (if applicable)

  Subsistence           Enter the total funds requested for
                        participant/trainee subsistence (if applicable)

  Other                 Describe and enter the total funds requested for any
                        other participant/trainee costs/institutional
                        allowances, scholarships etc. Please identify these
                        in the space provided.

  Number of             Enter the total number of proposed
  Participants          participants/trainees (those receiving stipends,
                        scholarships, etc.)

  Trainee Costs         Enter the total costs associated with the above
                        categories (i.e. participants/trainees- items 1-5).
                        If applying electronically this total will be
                        calculated for you.
  --------------------- -----------------------------------------------------

RESEARCH AND RELATED BUDGET - SECTION F-K Budget Period

  ---------------- ---------------------------------------------------------
  Field Name       Instructions

  Organizational   Enter the DUNS or DUNS +4 number of your organization.
  DUNS             For Project applicants and those applying electronically,
                   this field is pre-populated from the R&R SF424 Cover
                   Page.

  Budget Type      Check the appropriate block. Check Project if the budget
                   requested is for the primary applicant organization.
                   Check Subaward/consortium organizations (if applicable).
                   Separate budgets are usually required only for Subaward
                   Budgets and are not allowed by HRSA unless legislatively
                   authorized or requested in the program application
                   guidance. Use the R&R Subaward Budget Attachment and
                   attach as a separate file on the R&R Budget Attachment(s)
                   form.

  Enter Name of    Enter the name of your organization
  Organization     

  Start Date       Enter the requested Start Date of the Budget Period

  End Date         Enter the requested/proposed End Date of the Budget
                   Period (these should cover 1 full year/12 months)

  Budget Period    Identify the specific budget period (1 for first year of
                   the grant, 2 for second year of the grant, 3 for third
                   etc. )
  ---------------- ---------------------------------------------------------

**SECTION F. Other Direct Cost**

+---------------------------+------------------------------------------+
| Field Name                | Instructions                             |
+---------------------------+------------------------------------------+
| 1\. Materials and         | Enter the total funds requested for      |
| Supplies                  | materials and supplies. In the budget    |
|                           | justification attachment please itemize  |
|                           | all categories for which costs exceed    |
|                           | \$1,000. Categories less than \$1,000 do |
|                           | not have to be itemized.                 |
+---------------------------+------------------------------------------+
| 2\. Publication Costs     | Enter the total publication funds        |
|                           | requested. The budget may request funds  |
|                           | for the cost of documenting, preparing,  |
|                           | publishing or otherwise disseminating    |
|                           | the findings of this project to others.  |
|                           | In the budget justification include      |
|                           | supporting information.                  |
+---------------------------+------------------------------------------+
| 3\. Consultant Services   | Enter the total funds requested for      |
|                           | consultant services. In the budget       |
|                           | justification identify each consultant,  |
|                           | the services to be performed, travel     |
|                           | related to this project and the total    |
|                           | estimated costs.                         |
+---------------------------+------------------------------------------+
| 4\. ADP/Computer Services | Enter total funds requested for          |
|                           | ADP/computer services. In the budget     |
|                           | justification include the established    |
|                           | computer service rates at the proposed   |
|                           | organization (if applicable)             |
+---------------------------+------------------------------------------+
| 5\. Subawards/Consortia/  | Enter total funds requested for          |
| Contractual Costs         | subaward, consortium and/or contractual  |
|                           | costs proposed for this project.         |
+---------------------------+------------------------------------------+
| 6\. Equipment/Facility    | Enter total funds requested for          |
|                           | equipment or facility rental or users    |
| Rental/ User Fees         | fees. In the budget justification please |
|                           | identify and justify these fees.         |
+---------------------------+------------------------------------------+
| 7\. Alterations and       | Enter the total funds requested for      |
| Renovations               | alterations and renovations. In the      |
|                           | budget justification itemize by category |
| (not applicable to        | and justify the costs including repairs, |
| training program grants)  | painting, removal or installation of     |
|                           | partitions. Where applicable provide     |
|                           | square footage and costs.                |
+---------------------------+------------------------------------------+
| Items 8-10                | In items 8-10 please describe any        |
|                           | "other" direct costs not requested       |
|                           | above. Use the Budget Justification      |
|                           | attachment to further itemize and        |
|                           | justify these costs. If line space is    |
|                           | inadequate please use line 10 to combine |
|                           | all remaining "other direct costs" and   |
|                           | include details of these costs in the    |
|                           | budget justification.                    |
+---------------------------+------------------------------------------+
| Total Other Costs         | The total funds requested for all Other  |
|                           | Direct Costs                             |
+---------------------------+------------------------------------------+

**SECTION G: Direct Costs**

**If applying electronically, this item will be computed as the sum of
sections A-F . If applying in paper please enter the sum of sections A-F
in this field**

**SECTION H: Indirect Costs**

  ----------------- -----------------------------------------------------
  Field Name        Instructions

  Indirect Cost     Indicate the type of indirect cost. Also indicate if
  Type              this is off-site. If more than one rate/base is
                    involved, use separate lines for each. If you do not
                    have a current indirect cost rate (s) approved by a
                    Federal Agency indicate "None---will negotiate" and
                    include information for proposed rate. Use the budget
                    justification if additional space is needed.

  Indirect Cost     Indicate the most recent indirect cost rate(s), also
  Rate (%)          known as Facilities and Administrative Costs {F&A}
                    established with a cognizant Federal office or, in
                    the case of for--profit organizations, the rate(s)
                    established with the appropriate agency. If you do
                    not have a cognizant oversight agency and are
                    selected for an award, you must submit your requested
                    indirect cost rate documentation to the awarding
                    department. For HHS this would be the Division of
                    Cost Allocation in DHHS.

  Indirect Cost     Enter amount of the base for each indirect cost type.
  Base (\$)         

  Funds Requested   Enter the total funds requested for each indirect
                    cost type.

  Cognizant Federal Enter the name of the cognizant Federal Agency, name
  Agency            and telephone number of the individual responsible
                    for negotiating your rate. If no cognizant agency is
                    known, enter None.
  ----------------- -----------------------------------------------------

**SECTION I: Total Direct and Indirect Institutional Costs (Section G+
Section H)**

Enter the total funds requested for direct and indirect costs. If
applying electronically this field will be calculated for you.

**SECTION J: Fee**

Generally, a fee is not allowed on a grant or cooperative agreement. Do
not include a fee in your budget, unless the program announcement
specifically allows the inclusion of a fee. If a fee is allowable, enter
the fee requested in this field.

**SECTION K: Budget Justification**

Detailed instructions for information to include in this section will be
provided in the program application guidance. Use the budget
justification to provide the additional information in each budget
category and any other information necessary to support your budget
request. Please use this attachment/section to provide the information
requested/required in the program guidance. Please refer to the guidance
to determine the need for and placement of (ex. in Appendix section) any
other required budget tables stipulated in the guidance.

RESEARCH AND RELATED BUDGET --CUMULATIVE BUDGET

If applying electronically, all of the values on this form will be
calculated based on the amounts that were entered previously under
sections A through K for each of the individual budget periods.
Therefore, if this application is being submitted electronically no data
entry is allowed or required in order to complete this Cumulative Budget
section.

If any amounts displayed on this form appear to be incorrect you may
correct the value by adjusting one or more of the values that
contributed to the total from the previous sections. To make such an
adjustment you will need to revisit the appropriate budget period
form(s) to enter corrected values.

If applying in paper form please ensure that entries in the cumulative
budget are consistent with those entered in Sections A-K.

+-----------------+----------------------------------------------------+
| Field Name      | Instructions                                       |
+-----------------+----------------------------------------------------+
| **Section A:**  | The cumulative total funds requested for all       |
| **Senior/Key    | Senior/Key personnel.                              |
| Person**        |                                                    |
+-----------------+----------------------------------------------------+
| **Section B:**  | The cumulative total funds requested for all other |
|                 | personnel.                                         |
| **Other         |                                                    |
| Personnel**     |                                                    |
+-----------------+----------------------------------------------------+
| Total Number    | The cumulative total number of other personnel.    |
| Other Personnel |                                                    |
+-----------------+----------------------------------------------------+
| Total Salary,   | The cumulative total funds requested for all       |
| Wages, and      | Senior/Key personnel and all other personnel.      |
| Fringe Benefits |                                                    |
| (Section A +    |                                                    |
| Section B)      |                                                    |
+-----------------+----------------------------------------------------+
| **Section C:    | The cumulative total funds requested for all       |
| Equipment**     | equipment.                                         |
+-----------------+----------------------------------------------------+
| **Section D:**  | The cumulative total funds requested for all       |
|                 | travel.                                            |
| **Travel**      |                                                    |
+-----------------+----------------------------------------------------+
| 1\. Domestic    | The cumulative total funds requested for all       |
|                 | domestic travel.                                   |
+-----------------+----------------------------------------------------+
| 2\. Foreign     | The cumulative total funds requested for all       |
|                 | foreign travel.                                    |
+-----------------+----------------------------------------------------+
| **Section E:    | The cumulative total funds requested for all       |
| Part            | participant/trainee costs.                         |
| icipant/Trainee |                                                    |
| Support Costs** |                                                    |
+-----------------+----------------------------------------------------+
| 1\.             | Enter the number of Calendar months devoted to the |
| Tuit            | project in the applicable box for each project     |
| ion/Fees/Health | role category.                                     |
| Insurance       |                                                    |
+-----------------+----------------------------------------------------+
| 2\. Stipends    | Enter the cumulative total funds requested for     |
|                 | participants/trainee stipends.                     |
+-----------------+----------------------------------------------------+
| 3\. Travel      | The cumulative total funds requested for Trainee   |
|                 | /Participant travel.                               |
+-----------------+----------------------------------------------------+
| 4\. Subsistence | The cumulative total funds requested for           |
|                 | Trainee/Participant subsistence.                   |
+-----------------+----------------------------------------------------+
| 5\. Other       | The cumulative total funds requested for any Other |
|                 | participant trainee costs including scholarships.  |
+-----------------+----------------------------------------------------+
| 6\. Number of   | The cumulative total number of proposed            |
| partic          | participants/trainees.                             |
| ipants/trainees |                                                    |
+-----------------+----------------------------------------------------+
| **Section F:    | The cumulative total funds requested for all other |
| Other Direct    | direct costs.                                      |
| Costs**         |                                                    |
+-----------------+----------------------------------------------------+
| 1\. Materials   | The cumulative total funds requested for Materials |
| and Supplies    | and Supplies.                                      |
+-----------------+----------------------------------------------------+
| 2\. Publication | The cumulative total funds requested for           |
| Costs           | Publications.                                      |
+-----------------+----------------------------------------------------+
| 3\. Consultant  | The cumulative total funds requested for           |
| Services        | Consultant Services.                               |
+-----------------+----------------------------------------------------+
| 4\.             | The cumulative total funds requested for           |
| ADP/Computer    | ADP/Computer Services.                             |
| Services        |                                                    |
+-----------------+----------------------------------------------------+
| 5\. Subawards/  | The cumulative total funds requested for 1) all    |
| Consortium/     | subaward/ consortium organization(s) proposed for  |
| Contractual     | the project, and 2) any other contractual costs    |
| Costs           | proposed for the project.                          |
+-----------------+----------------------------------------------------+
| 6\. Equipment   | The cumulative total funds requested for Equipment |
| or Facility     | or Facility Rental/ User Fees.                     |
| Rental/User     |                                                    |
| Fees            |                                                    |
+-----------------+----------------------------------------------------+
| 7\. Alterations | The cumulative total funds requested for           |
| and Renovations | Alterations and Renovations.                       |
+-----------------+----------------------------------------------------+
| 8\. Other 1     | The cumulative total funds requested in line 8 or  |
|                 | the first Other Direct Costs category.             |
+-----------------+----------------------------------------------------+
| 9\. Other 2     | The cumulative total funds requested in line 9or   |
|                 | the second Other Direct Costs category.            |
+-----------------+----------------------------------------------------+
| 10\. Other 3    | The cumulative total funds requested in line 10 or |
|                 | the third Other Direct Costs category.             |
+-----------------+----------------------------------------------------+
| **Section G:    | The cumulative total funds requested for all       |
| Direct Costs    | direct costs.                                      |
| A-F**           |                                                    |
+-----------------+----------------------------------------------------+
| **Section H:    | The cumulative total funds requested for all       |
| Indirect        | indirect costs.                                    |
| Costs**         |                                                    |
+-----------------+----------------------------------------------------+
| **Section I :   | The cumulative total funds requested for direct    |
| Total Direct    | and indirect costs.                                |
| and Indirect    |                                                    |
| Costs**         |                                                    |
+-----------------+----------------------------------------------------+
| **Section J:    | The cumulative funds requested for Fees (if        |
| Fee**           | applicable).                                       |
+-----------------+----------------------------------------------------+

INSTRUCTIONS FOR R&R SUBAWARD BUDGET ATTACHMENT(s) FORM

Subawards are not allowed by HRSA unless legislatively authorized or
requested in the Program Application Guidance. Please click on the
subaward budget attachment to obtain the required budget forms. Attach
all budget information by attaching the files in line items 1-10. Please
do not attach any files to the subaward documents as they will not be
transferred to HRSA. All justification for expenditures should be added
to the budget justification for the project in section K of the project
budget.

SF 424 R&R ASSURANCES

Read the 424 R&R Assurances in the program guidance. Signing of the
application FACE Page and sending the signed face page to the Grants
Application Center (see guidance) indicates acceptance of these
Assurances listed.

SF 424 R&R OTHER PROJECT INFORMATION COMPONENT

**SF 424 R&R Other Project Information:**

**If this is an application for a Research Grant Please Respond to All
of the Questions on this page.**

**If this is an application for a Training Grant Please Respond to Items
1 and Items 6-11.**

+----------------+-----------------------------------------------------+
| Field Name     | Instructions                                        |
+----------------+-----------------------------------------------------+
| 1\. Are Human  | If activities involving human subjects are planned  |
| Subjects       | at any time during proposed project check YES.      |
| Involved       | Check this box even if the proposed project is      |
|                | exempt from Regulations for the protection of Human |
|                | Subjects. Check NO if this is a training grant or   |
|                | if no activities involving human subjects are       |
|                | planned and skip to step 2.                         |
+----------------+-----------------------------------------------------+
| 1.a If YES to  | Skip this section if the answer to the previous     |
| Human Subjects | question was NO. If the answer was YES, indicate if |
| Involved       | the IRB review is pending. If IRB has been approved |
|                | enter the approval date. If exempt from IRB         |
|                | approval enter the exemption numbers corresponding  |
|                | to one or more of the exemption categories. See:    |
|                | http://ohrp                                         |
|                | .osophs.dhhs.gov/humansubjects/guidance/45cfr46.htm |
|                |                                                     |
|                | for a list of the six categories of research that   |
|                | qualify for exemption from coverage by the          |
|                | regulations are defined in the Common Rule for the  |
|                | Protection of Human Subjects.                       |
|                |                                                     |
|                | For Human Subject Assurance Number enter the IRB    |
|                | approval number OR the approved Federal Wide        |
|                | Assurance ( FWA) , multiple project assurance (MPA) |
|                | , Single Project Assurance(SPA) Number or           |
|                | Cooperative Project Assurance Number that the       |
|                | applicant has on file with the Office of Human      |
|                | Research Protections, if available.                 |
+----------------+-----------------------------------------------------+
| 2\. Are        | If activities using vertebrae animals are planned   |
| Vertebrae      | at any time during the proposed project at any      |
| Animals Used   | performance site check the YES box; otherwise check |
|                | NO and proceed to step 3.                           |
+----------------+-----------------------------------------------------+
| 2 a. If YES to | Indicate if the IACUC review is pending by checking |
| Vertebrae      | YES in this field otherwise check NO. Enter the     |
| animals        | IACUC approval Date in the approval date field      |
|                | leave blank if approval is pending.                 |
|                |                                                     |
|                | For Animal Welfare Assurance Number , enter the     |
|                | Federally approved assurance number if available    |
+----------------+-----------------------------------------------------+
| 3\. Is         | Patentable ideas, trade secrets, privileged or      |
| Proprietary    | confidential commercial or financial information,   |
| /Privileged    | disclosure of which may harm the applicant, should  |
| Information    | be included in the application only when such       |
| Included in    | information is necessary to convey an understanding |
| the            | of the proposed project. If the application         |
| Application    | includes such information, check the YES box and    |
|                | clearly mark each line or paragraph of the pages    |
|                | containing proprietary/privileged information with  |
|                | a legend similar to: "the following contains        |
|                | proprietary /privileged information that (name of   |
|                | applicant) requests not be released to persons      |
|                | outside the Government, except for purposes of      |
|                | review and evaluation.                              |
+----------------+-----------------------------------------------------+
| 4a. Does this  | If your project will have an actual or potential    |
| project have   | impact on the environment check the YES box and     |
| an actual or   | explain in the box provided in **4b.** Otherwise    |
| potential      | check NO and proceed to question 5a.                |
| impact on the  |                                                     |
| environment?   |                                                     |
+----------------+-----------------------------------------------------+
| 4.b. If yes,   | If you checked the YES box indicating an actual or  |
| please explain | potential impact on the environment, enter the      |
|                | explanation or the actual or potential impact on    |
|                | the environment here.                               |
+----------------+-----------------------------------------------------+
| 4c. If this    | If an exemption has been authorized or an EA or EIS |
| project has an | has been performed check the YES box in 4d.         |
| actual or      | Otherwise check the NO box.                         |
| potential      |                                                     |
| impact on the  |                                                     |
| environment    |                                                     |
| has an         |                                                     |
| exemption been |                                                     |
| authorized or  |                                                     |
| an             |                                                     |
| Environmental  |                                                     |
| Assessment     |                                                     |
| (EA) or an     |                                                     |
| Environmental  |                                                     |
| Impact         |                                                     |
| Statement      |                                                     |
| (EIS) been     |                                                     |
| performed?     |                                                     |
+----------------+-----------------------------------------------------+
| 4d. If yes     | If you checked the YES box indicating an exemption  |
| please explain | has been authorized or an EA or EIS has been        |
|                | performed, enter the explanation.                   |
+----------------+-----------------------------------------------------+
| 5a. Does the   | If your project involves activities outside of the  |
| project        | U.S. or partnerships with international             |
| involve        | collaborators check the YES box and list the        |
| activities     | countries in the box provided in 5b and an optional |
| outside of the | explanation in box 5c. Otherwise check NO and       |
| U.S. or        | proceed to item 6.                                  |
| partnership    |                                                     |
| with           |                                                     |
| international  |                                                     |
| collaborators? |                                                     |
+----------------+-----------------------------------------------------+
| 5b. If yes     | If the answer to 5a is YES -- identify the          |
| Identify       | countries with which international cooperative      |
| Countries      | activities are involved.                            |
+----------------+-----------------------------------------------------+
| 5c. Optional   | Use this box to provide any supplemental            |
| explanation    | information, if necessary. If necessary you can     |
|                | provide the information as an attachment by         |
|                | clicking "Add Attachment" to the right of Item 11   |
|                | below.                                              |
+----------------+-----------------------------------------------------+
| 6\. Project    | Please refer to the guidance for instructions       |
| Summary/       | regarding the information to include in the project |
| Abstract       | summary/abstract. The project summary must contain  |
|                | a summary of the proposed activity suitable for     |
|                | dissemination to the public. It should be a         |
|                | self-contained description of the project and       |
|                | should contain a statement of the objectives and    |
|                | methods employed. The summary must NOT include any  |
|                | proprietary/confidential information.               |
|                |                                                     |
|                | If applying electronically attach the               |
|                | summary/abstract by clicking on "Add Attachment"    |
|                | and browse to where you saved the file on your      |
|                | computer and attach.                                |
+----------------+-----------------------------------------------------+
| 7\. Project    | Provide the project narrative in accordance with    |
| Narrative      | the program guidance/announcement and/or            |
|                | agency/program specific instructions. If you are    |
|                | applying electronically, to attach project          |
|                | narrative click "Add Attachment," browse to where   |
|                | you saved the file, select the file, and click to   |
|                | attach. .                                           |
+----------------+-----------------------------------------------------+
| 8\.            | Provide a bibliography of any references cited in   |
| Bibliography   | the Project Narrative. Each reference must include  |
| and References | the names of all authors (in the sequence in which  |
| Cited          | they appear in the publication), the article and    |
|                | journal title, book title, volume number, page      |
|                | numbers and year of publication. Include only       |
|                | bibliographic citations. Be especially careful to   |
|                | follow scholarly practices in providing citations   |
|                | for source materials relied upon when preparing any |
|                | section of this application. If applying            |
|                | electronically -- attach the bibliography by        |
|                | clicking "Add Attachment" on line 8.                |
+----------------+-----------------------------------------------------+
| 9\. Facilities | This information is used to assess the capability   |
| and Other      | of the organizational resources available to        |
| Resources      | perform the effort proposed. Identify the           |
|                | facilities to be used (Laboratory, Animal,          |
|                | Computer, Office, Clinical and Other). If           |
|                | appropriate, indicate their pertinent capabilities, |
|                | relative proximity and extent of availability to    |
|                | the project (e.g. machine shop, electronic shop),   |
|                | and the extent to which they would be available to  |
|                | the project.                                        |
|                |                                                     |
|                | To attach a Facilities and Other Resources file,    |
|                | click Add Attachment, browse to where you saved the |
|                | file, select the file and then click open.          |
+----------------+-----------------------------------------------------+
| 10\. Equipment | List major items of equipment already available for |
|                | this project and if appropriate identify location   |
|                | pertinent capabilities. To attach an Equipment file |
|                | click "Add Attachment " and select the file to be   |
|                | attached.                                           |
+----------------+-----------------------------------------------------+
| 11\. Other     | Attach a file to provide any program specific forms |
| Attachments    | or requirements not provided elsewhere in the       |
|                | application in accordance with the agency or        |
|                | program specific guidance. Click "Add Attachment"   |
|                | and select the file for attachment from where you   |
|                | saved the file.                                     |
+----------------+-----------------------------------------------------+

ATTACHMENTS FORM

Use this form to add files/attachments required in the program guidance
whose location has not been specified elsewhere in the application
package. Use the first line item to attach the file with information on
your organization's Business Official. Name this file BUSINESS OFFICIAL
INFORMATION. Attach other files as required in the program guidance.

**Appendix D: NURSE EDUCATION, PRACTICE AND RETENTION (NEPR) FY2008
PROJECT SYNOPSIS**

The following synopsis of the proposed project will assist the reviewers
and the federal staff in identifying key components of the application.
Please place this outline at the front of the submitted application.

Applicant Organization Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Project Director Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Project Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

> **[Applicants MUST check only ONE box that reflects the type of
> application:]{.underline}**

-   **New** Application

-   **Competing Continuation** Application

Identify the Purpose Area addressed by the application; **[applicants
MUST check only ONE box that reflects the purpose of this
application:]{.underline}**

> **Education Priority Areas**

-   **Purpose E-1** *Expanding Enrollment in Baccalaureate Nursing
    Programs*

-   **Purpose E-2** *Developing and Implementing Internship and
    Residency Programs*

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-   **Purpose E-3** *Providing Education in New Technologies, Including
    Distance Learning Methodologies*

> **Practice Priority Areas**

-   **Purpose P-1** *Establishing or Expanding Nurse Practice
    Arrangements*

-   **Purpose P-2** *Providing Care for Underserved Populations and
    Other High-Risk Groups*

-   **Purpose P-3** *Providing Managed Care, Quality Improvement, and
    Other Skills Needed to Practice in Existing and Emerging Organized
    Health Care*

-   **Purpose P-4** *Development of Cultural Competencies Among Nurses*

> **Retention Priority Area**

-   **Purpose R-1** *Career Ladder Programs*

-   **Purpose R-2** *Enhancing Patient Care Delivery Systems/Nurse
    Retention*

Identify if requesting any of the following preferences; **[please check
all boxes that apply:]{.underline}**

-   Substantially benefit rural populations

-   Substantially benefit underserved populations

-   Help meet public health nursing needs in State or local health
    departments

> **It is encouraged that the applicant select and document how they met
> at least one of the preferences listed above.**

**Appendix E: Recommended R2 Purpose-Specific Information Table 1**

**Table 1.** should be completed by all applicants responding to
**Purpose R2.** It is recommended that Purpose R2 applicants complete
all [un-shaded]{.underline} areas of Table 1.

> **Table 1. CORE RETENTION MEASURES and PATIENT CARE CORE INDICATORS**

  --------------- ------------ -------- --------- --------- --------- --------
  **Core          **Baseline   **YR.    **YR. 2** **YR. 3** **YR. 4** **YR.
  Retention       (prior to    1**                                    5**
  Measures**      start of                                            
                  project)**                                          

  **Nurse         **%**                                               
  Retention                                                           
  Rate**                                                              

  **Nurse Vacancy **%**                                               
  Rate**                                                              
  --------------- ------------ -------- --------- --------- --------- --------

  --------------- ------------ -------- --------- --------- --------- --------
  **Patient Care  **Baseline   **YR.    **YR. 2** **YR. 3** **YR. 4** **YR.
  Core            (prior to    1**                                    5**
  Indicators**    start of                                            
                  project)**                                          

  **1.**          **%**                                               

  **2.**          **%**                                               

  **3.**          **%**                                               

  **4.**          **%**                                               
  --------------- ------------ -------- --------- --------- --------- --------

**Instructions for completing Table 1:**

-   Nurse Retention Baseline Rate (NRBR) = the retention rate [reported,
    using percentages (%), in the original grant proposal]{.underline}.
    This figure should reflect your initial retention rate at the
    beginning of your funded project.

-   Nurse Vacancy Baseline Rate (NVBR) = the vacancy rate [reported,
    using percentages (%), in the original grant proposal]{.underline}.
    This figure should reflect your initial vacancy rate at the
    beginning of your funded project.

-   Enter the NRBR, using percentages (%), as proposed in your original
    proposal under 'Baseline Rate.'

**[NOTE]{.underline}**: The following information is provided with the
intention [ONLY to inform]{.underline} Purpose R2 applicants how the
information requested in the application for Table 1. will correspond
with annual reporting requirements, if funded. [**FUNDED** **Purpose R2
grantees are required to complete this table CUMULATIVELY each year**
**for the five years of the grant**]{.underline}**.**

[The following is an EXAMPLE of reporting requirements for the 1^st^
year, if fund]{.underline}: If funded, for the 1^st^ year of the funding
period, a grantee must enter the 'Nurse Retention' rate as of February
1st of the report year through January 31^st^ of the year in which the
data is [actually]{.underline} being reported under 'Actual Rate at the
End of the Year' for the appropriate 'Measurement Year. For the 2008
Annual Progress Report:

1.  Data is actually reported on February 01, 2009.

2.  'Actual Rate at the End of the Year' reflects NRBR as of July 01,
    2008 (the date project was funded) through December 31, 2008.

-   If funded, for the 1^st^ year of the funding period, a grantee must
    enter the 'Nurse Vacancy' rate as of February 1st of the report year
    through January 31^st^ of the year in which the data is
    [actually]{.underline} reported under 'Actual Rate at the End of the
    Year' for the appropriate 'Measurement Year.'

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-   If funded, for the 1^st^ year of the funding period, a grantee must
    list the four patient care core indicators just as selected and
    listed in the original proposal. The patient care core measures are
    items that are unique to the individual grantee organizations, and
    will vary among the grantees. Next, enter the baseline rates, using
    percentages (%), for the [four]{.underline} patient care core
    indicators as proposed in your original proposal. This figure should
    reflect your initial patient care core indicator rates at the
    beginning of your funded project under 'Baseline Rate.' Finally,
    enter the four core indicator rates as of February 1st of the report
    year through January 31^st^ of the year in which the data is
    [actually]{.underline} reported under 'Actual Rate at the End of the
    Year' for the appropriate 'Measurement Year.'

> **Appendix F: Program Definitions**

The following definitions shall apply to the *Nurse Education, Practice
and Retention Program* for Fiscal Year 2008.

**"Academic Health Center"** refers to an institution that includes a
school of medicine, a teaching hospital, and at least one additional
health education program (e.g., nursing) and which is owned and/or
affiliated with clinical agencies providing for the delivery of patient
services. Each entity generally maintains a separate identity and
autonomy.

**"Access"** means to assure health care services to all by improved
health professions distribution.

**"Accredited"** means a program accredited by a nationally recognized
body or bodies, or by a State agency approved for such purposes by the
Secretary of Education and when applied to a hospital, school, college
or university (or unit thereof) means a hospital, school, college or
university (or unit thereof) which is accredited by a recognized body or
bodies, or by a State agency, approved for such purpose by the Secretary
of Education. The Secretary of Education publishes a list of recognized
accrediting bodies, and of State agencies, which the Secretary of
Education determines to be a reliable authority as to the quality of
education offered at
<http://www.ed.gov/offices/OPE/accreditation/natlagencies.html>.

There are two forms of accreditation: (1) professional or specialized
accreditation and (2) institutional accreditation. Professional or
specialized accreditation is focused on programs of study in
professional or occupational fields. Institutional accreditation is
focused on the quality and integrity of the total institution, assessing
the achievement of the institution in meeting its own stated mission,
goals, and expected outcomes. Professional accrediting agencies assess
the

extent to which programs achieve their stated mission, goals, and
expected outcomes. Professional accrediting agencies also consider the
program's mission, goals, and expected outcomes in determining the
quality of the program and the educational preparation of members of the
profession or occupation.

**Accreditation for Newly Established Program of Nursing**: A new
program of nursing that, by reason of an insufficient period of
operation, is not, at the time of the submission of an application for a
grant or contract under this title, eligible for accreditation by such a
recognized body or bodies or State agency, shall be deemed accredited
for the purposes of this title if the Secretary of Education finds,
after consultation with the appropriate recognized State approval or
accrediting body or bodies, that there is reasonable assurance that the
program will meet the accreditation standards of such body or bodies
prior to the beginning of the academic year following the normal
graduation date of students of the first entering class in such a
program.

**"Assistive Nursing Personnel"** refers to unlicensed individuals who
assist nursing staff in the provision of basic care to clients and who
work under the supervision of licensed nursing personnel. Included in
this category are nurses' aides, nursing assistants, orderlies,
attendants, personal care aides, home health aides, and technicians.

**"Associate Degree School of Nursing"** means a department, division,
or other administrative unit in a junior college, community college,
college, or university which provides primarily or exclusively a
two-year program of education in professional nursing and allied
subjects leading to an associate degree in nursing or to an equivalent
degree, but only if such program, unit, college or university is
accredited, as defined in section 801(4) of the PHS Act.

**"Career Mobility"** means progressive learning to improve knowledge
and skills in an existing nursing role or to assume a new professional
nursing role with improved capacity to perform the new role.

**"Certification"** means a process by which an agency or organization
validates, based upon predetermined standards, an individual nurse's
qualifications and knowledge for practice in a defined functional or
clinical area of nursing.

**"Client Encounter"** means a client visit to a health care provider in
any setting or a contact between the client and health care provider by
telephone or telehealth for the purpose of improving the client's
health.

**"Collegiate School of Nursing"** means a department, division, or
other administrative unit in a college or university which provides
primarily or exclusively a program of education in professional nursing
and allied subjects leading to a degree of bachelor of arts, bachelor of
science, bachelor of nursing, or to an equivalent degree, or to a
graduate degree in nursing, and including advanced education related to
such program of education provided by such school, but only if such
program, or such unit, college or university is accredited.

**"Continuing Education Program"** means a formal, post-licensure
educational program designed to increase knowledge and/or skills of
nurses. Continuing education programs may include: workshops,
institutes, clinical conferences, staff development courses, and
individual studies. It does not include study for an academic degree,
post-master's certificate or other evidence of completing such a
program.

**"Cross Training"** means that training which focuses on improving or
increasing knowledge and/or skills in order to expand the professional
role functions of the registered nurse in existing or other roles.

**"Cultural Competence"** means a set of academic and interpersonal
skills that allow an individual to increase their understanding and
appreciation of cultural differences and similarities within, among and
between groups. This requires a willingness and ability to draw on
community-based values, traditions, and customs and to work with
knowledgeable persons of and from the community in developing targeted
interventions, communications, and other supports.

"**Culturally and Linguistically Appropriate Services"** means health
care services that are respectful of and responsive to cultural and
linguistic needs.

**"Culturally Competent Program"** means a program that demonstrates
sensitivity to and understanding of cultural differences in program
design, implementation, and evaluation.

**"Cultural Diversity"** means differences in race, ethnicity, language,
nationality, or religion among various groups within a community, an
organization, or a nation.

**"Diploma School of Nursing"** means a school affiliated with a
hospital or university, or an independent school, which provides
primarily or exclusively a program of education in professional nursing
and allied subjects leading to a diploma or to equivalent indicating
that such program has been satisfactorily completed, but only if such
program, or such affiliated school or such hospital or university or
such independent school is accredited, as defined in section 801(5) of
the PHS Act.

**"Distance Learning Methodologies"** means electronic media are used to
deliver education content when the learner and teacher are separated by
distance. An electronic medium may be a computer, World Wide Web
technologies, teleconferencing, television or CD ROM/DVD.

**"Faculty Development"** means activities and/or programs designed to
improve project faculty's ability to teach.

**"Full-time Student"** means a student who is enrolled on a full-time
basis as defined by the institution.

**"Graduate"** means an individual who has successfully completed all
institutional requirements necessary to be granted a degree/certificate.

**"Graduate Nurse"** means an individual permitted to practice
registered nursing under rules and regulations of the state Board of
Nursing if the individual has an application for license pending before
the Board, or has taken the nurse licensing examination, but the results
are not yet known.

**"Informatics"** means nursing informatics and is defined as combining
nursing science, information management science, and computer science to
manage and process nursing data, information, and knowledge to deliver
quality care to the public.

**"In-service Education"** means learning experiences provided in the
work setting for the purpose of assisting staff in performing their
assigned functions in that particular agency.

**"Licensed Practical/vocational Nurse" (LPN/LVN)** means an individual
who is currently licensed as a licensed practical nurse or a licensed
vocational nurse in at least one jurisdiction of the United States and
employed in a nursing facility or home health agency.

**"Local Government"** means a local unit of government, including
specifically a county, municipality, city, town, township, local public
authority, school district, special district, intra-State district,
council of governments (whether incorporated as a nonprofit corporation
under State law or not), any other regional or interstate entity, or any
agency or instrumentality of local government.

**"Managed Care"** means a system that integrates the financing and
delivery of health care services to covered individuals by means of
arrangements with providers to furnish comprehensive services to
members; explicit criteria for the selection of health-care providers;
significant financial incentives for members to use providers and
procedures associated with the plan; and formal programs for quality
assurance and utilization.

**"Medically Underserved Communities"** as defined in section 799(6) of
the law, means an urban or rural area or population that:

\(1\) is eligible for designations under section 332 as a health
professional shortage area;

(2) is eligible to be served by a migrant health center (MHC) under
    section 329, a community health center (CHC) under section 330, a
    grantee under section 330(h) (relating to homeless individuals), or
    a grantee under section 340A (relating to residents of public
    housing);

(3) has a shortage of personal health services, as determined under
    criteria issued by the Secretary under section 1861(aa)(2) of the
    Social Security Act (relating to rural health clinics); or

(4) is designated by a State Governor (in consultation with the medical
    community) as a shortage area or Medically Underserved Community.

In keeping with the Congressional intent that eligible entities should
not be limited to formally designated Health Professional Shortage Areas
(HPSA\'s) and populations served by CHCs, MHCs, or homeless health
centers, the list of types of practice sites that can be claimed under
this provision has been expanded to include the following:

-   Community Health Centers (CHC) (section 330)

-   Migrant Health Centers (MHC) (section 329)

-   Health Care for the Homeless Grantees (section 340)

-   Public Housing Primary Care Grantees (section 340A)

-   Rural Health Clinics, federally designated (section 1861(aa)(2) of
    the Social Security Act)

-   National Health Service Corps (NHSC) Sites, freestanding (section
    333)

-   Indian Health Services (IHS) Sites (Pub. L. 93-638 for tribal
    governed sites and

Pub. L. 94-437 for IHS operated sites)

-   Federally Qualified Health Centers (section 1905(I)(2)(B) of the
    Social Security Act)

-   Primary Medical Care Health Professional Shortage Areas (HPSA\'s)
    (facilities and

> geographic) (section 332), for primary care physicians, other
> personnel except dentists and nurses

-   Dental HPSA's (facilities and geographic) (section 332) for dentist
    only

-   Nurse Shortage Areas (section 846)

-   State or Local Health Departments (regardless of sponsor - for
    example, local health

departments who are funded by the state would qualify)

-   Ambulatory practice sites designated by State Governors as serving
    medically underserved communities

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-   Information on HPSAs, CHCs, MHCs, and/or homeless health centers is
    available on

> HRSA's web site under the Bureau of Primary Health Care (BPHC) at
> \<http://www.bphc.hrsa.gov/bphc.database.htm\> or you may call
> 1-800-400-2742.

**"Minority"** means an individual whose race/ethnicity is classified as
American Indian or Alaska Native, Asian, Black or African American,
Hispanic or Latino, Native Hawaiian or Pacific Islander.

-   **American Indian or Alaska Native** means a person having origins
    in any of the original

> Peoples of North and South America (including Central America), and
> who maintains
>
> Tribal affiliation or community attachment.

-   **Asian** means a person who has origins in any of the original
    peoples of the Far East, Southeast Asia, or the Indian subcontinent
    including, for example, Cambodia, China, India, Japan, Korea,
    Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.

-   **Black or African American** means a person having origins in any
    of the black racial groups of Africa.

-   **Hispanic or Latino** means a person of Cuban, Mexican, Puerto
    Rican, South or Central American or other Spanish culture or origin,
    regardless of race. The term "Spanish origin," can be used in
    addition to "Hispanic or Latino."

-   **Native Hawaiian or Other Pacific Islander** means a person having
    origins in any of the original peoples of Hawaii, Guam, Samoa or
    other Pacific Islands.

-   **White** means a person having origins in any of the original
    peoples of Europe, the Middle East, or North Africa.

**"National of the United States"** means an individual who owes his
sole allegiance to the United States, including all U.S. citizens, and
including some individuals who are not U.S. citizens. These individuals
would include citizens of certain U.S. possessions such as American
Samoa and Northern Mariana Islands.

**"Nonprofit"** means any school, agency, organization or institution
which is a corporation or association or is owned and operated by one or
more corporations or associations, no part of the net earnings of which
inures, or may lawfully inure to the benefit of any private shareholder
or individual as defined in Section 801(7) of the PHS Act.

**"Nursing Center"** means an organization in which the client has
direct access to professional nursing service. Nurses in these centers
are responsible and accountable for diagnosing, treating, and promoting
health and optimal functioning of the client. Overall center
accountability remains with the nurse executive. Nursing centers are
commonly referred to as nurse-managed clinics, community nursing
centers, nursing clinics, or nursing practice arrangements.

**"Nursing Personnel"** is the collective term used to identify
providers of nursing services and includes both licensed and unlicensed
individuals.

**"Nursing Practice Arrangement"** means a delivery system managed by a
school of nursing and operated by faculty, students, and staff to
increase access to primary health care for medically underserved
communities and populations.

**"Nursing Workforce"** means the registered nurse (RN) workforce.

**"Organized Health Care System"** means a network of organizations that
provides or manages the provision of a coordinated continuum of services
to a defined population and is willing to be held clinically and
fiscally accountable for the healthcare outcomes and health status
indicators of the populations served.

**"Primary Care"** means the provision of integrated, accessible health
care services by clinicians who are accountable for addressing a large
majority of personal health care needs, developing a sustained
partnership with patients, and practicing in the context of family and
community.

**"Primary Health Care"** means care which may be initiated by the
client or provider in a variety of settings and which consists of a
broad range of personal health care services including:

> \(1\) promotion and maintenance of health;
>
> \(2\) prevention of illness and disability;
>
> \(3\) basic care during acute and chronic phases of illness;
>
> \(4\) guidance and counseling of individuals and families;
>
> \(5\) referral to other health care providers and community resources
> when appropriate; and,
>
> \(6\) nurse-midwifery services when appropriate.

In providing such services:

> \(1\) physical, emotional, social, and economic status, as well as the
> cultural and environmental backgrounds of individuals, families and
> communities (where applicable) are considered;
>
> \(2\) the client is provided access to the health care system; and

(2) a single provider or team of providers, along with the client, is
    responsible for the continuing coordination and management of all
    aspects of basic health services needed for individual and family
    care.

**"Professional Nurse"** means a registered nurse who has received
initial nursing preparation from a diploma, associate degree, or
collegiate school of nursing and who is currently licensed in a State to
practice nursing.

**"Program"** means a combination of identified courses and other
educational or training experiences at a specified academic level, the
sum of which provides the required competencies to practice.

**"Project"** means all proposed activities, including educational
programs, specified or described in a grant application as approved for
funding.

**"Public Health Nursing"** means the practice of promoting and
protecting the health of populations using knowledge from nursing,
social, and public health sciences.

**"Public Health Nursing Practice"** means the systematic process by
which:

> \(1\) the health and health care needs of a population are assessed in
> order to identify sub-populations, families, and individuals who would
> benefit from health promotion or who are at risk of illness, injury,
> disability, or premature death;
>
> \(2\) a plan for intervention is developed with the community to meet
> identified needs that takes into account available resources, the
> range of activities that contribute to health and the prevention of
> illness, injury, disability, and premature death;
>
> \(3\) the plan is implemented effectively, efficiently, and equitably;
>
> \(4\) evaluations are conducted to determine the extent to which the
> interventions have an impact on the health status of individuals and
> the populations; and
>
> \(5\) the results of the process are used to influence and direct the
> current delivery of care, deployment of health resources, and the
> development of local, regional, State and national health policy and
> research to promote health and prevent disease. (APHA Public Health
> Nursing Section, 1996).

**"Quality Improvement"** means an organizational philosophy that seeks
to meet client needs and expectations with the minimum of effort or
rework or waste, by using a structured process that selectively
identifies and improves all aspects of care and service on an ongoing
basis.

**"Registered Nurse"** means a person who has graduated from a school of
nursing and is licensed to practice as a registered nurse in a state.

**"Rural Area"** means an area other than a Metropolitan Statistical
Area (MSA) as designated by the Office of Management and Budget based on
current census data. Census tracts in certain metropolitan areas may
also be eligible if they are located a significant distance from the
major city in the Standard Metropolitan Area (SMA). Rural means people
who live in places with small populations or unincorporated areas with
population density less than 1,000 per square mile. A rural place is any
incorporated place or Census Designated Place with fewer than 2500
inhabitants that is located outside of an Urbanized Area (UA). An UA is
defined as a continuously built-up area with a population of 50,000 or
more.

**"Rural Clinical Experience"** means a structured clinical experience
in any appropriate outpatient, home health, public health agency
setting, nursing center or hospital located in a rural area.

**"Rural Health Facility"** means a hospital of less than 100 beds or
other patient care facility located outside Office of Management and
Budget (OMB) designated metropolitan areas. Census tracts in certain
metropolitan areas may also be eligible if they are located at a
significant distance from the major city in the SMA.

**"Rural Populations"** means populations who reside in rural areas.

**"School of Nursing"** means a collegiate, associate degree, or diploma
school of nursing as defined in Section 801(2) of the PHS Act.

**"State Government"** means the government of any of the several states
of the United States, the District of Columbia, the Commonwealth of
Puerto Rico, and any territory or possession of the United States, or
any agency or instrumentality of a state exclusive of local governments.
For purposes of PHS grants, federally recognized Indian Tribes are
treated the same way as State governments. State institutions of higher
education and state hospitals are considered non-governmental
organizations for purposes of this program.

**"Web-delivered instruction"** means all instruction is delivered
through the World Wide Web (WWW).