Form 1 Application Form

OMB Number 0990-XXXX

Expiration Date 05/31/2010

Information Technology

Professionals in Health Care:

Competency Examination for Individuals

Completing Non-Degree Training

Application Form

Application and Submission Information

Address to Request Application Package

Application materials will be available for download at http://www.grants.gov. ONC is requiring full applications for all announcements to be submitted via electronic mail. Applicants will be able to download a copy of the application packet, complete it off-line, and then submit the application electronically via email.

APPLICATIONS WILL NOT BE ACCEPTED THROUGH ANY WEBSITE, AND WILL NOT BE ACCEPTED THROUGH PAPER MAIL, COURIER, OR DELIVERY SERVICE.

APPLICANTS ARE STRONGLY ENCOURAGED TO COMPLETE AND SUBMIT APPLICATIONS AS FAR IN ADVANCE OF THE SUBMISSION DEADLINE AS POSSIBLE. THE APPLICATION INCLUDING ALL REQUIRED ATTACHMENTS AND INCLUDED FILES FOR POTENTIAL CONSIDERATION IN THE REVIEW PROCESS MUST BE RECEIVED BY 11:59 PM EASTERN TIME ON THE DATE SPECIFIED IN SECTION IV C, BELOW.

Applications procedures:

• Applicants must access the electronic application for this program via http://www.grants.gov.  Applicants must search the downloadable application page by the Funding Opportunity Number (- - - ) or CFDA number (93.721).

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990-XXXX. The time required to complete this information collection is estimated to average 150 hours per response, including the time to review instructions, search existing data resources, gather the data needed and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to:  U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Avenue, SW, Suite 537-H, Washington, DC 20201 Attention: PRA Reports Clearance Officer.

• All lead applicants should have a Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number and register in the Central Contractor Registry (CCR) (for further information see section IV.B.2 below).  Applicants should allow a minimum of five days to complete the CCR registration. Although not required to process preliminary applications, lead applicants who do not already have a DUNS number and/or are not registered in CCR should do so as soon as possible. As there is no fee to complete these processes, applicants should not wait to receive the results of the preliminary application review before taking these steps.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990-XXXX. The time required to complete this information collection is estimated to average 150 hours per response, including the time to review instructions, search existing data resources, gather the data needed and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to:  U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Avenue, SW, Suite 537-H, Washington, DC 20201 Attention: PRA Reports Clearance Officer.

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

• The applicant’s application must comply with any page limitation requirements described in this Program Guidance.

• After the application is electronically submitted, the applicant will receive an automatic email notification from the email address that demonstrates the email was received.  This notification does not provide assurance that the application was complete, only that the email was received.

• After ONC reviews the email submission, a return receipt will be emailed to the applicant contact indicating the files that were received and able to be successfully opened and read. Due to volume of applications received, this receipt may not be available for several days; applicants are strongly encouraged to submit applications as far in advance as possible if they wish to receive confirmation of receipt prior to the deadline. Organizations applying for federal grants will need to be registered with the Central Contractor Registry (CCR). Applicants can register with the CCR online and it will take about 30 minutes (http://www.ccr.gov). If the applicant has already registered with CCR but have not renewed their registration in the last 12 months, they will need to renew their registration at http://www.ccr.gov.

Key Contact for Applications:

Inquiries should be addressed to:

U.S. Department of Health and Human Services

Office of the National Coordinator for Health Information Technology

Email: [email protected]

Content and Form of Application Submission

1. Letter of Intent

Applicants are requested, to submit a non-binding Letter of Intent indicating their plan to apply for this funding opportunity. This Letter will not be considered as part of the evaluation process; it will merely assist ONC in planning for the review process. The deadline for submission of the Letter of Intent is January 4, 2010.

Letters of intent must be sent electronically to:

U.S. Department of Health and Human Services

Office of the National Coordinator for Health Information Technology

Email: [email protected]

2. Letter of Intent Content Guidelines

Applicants may submit a Letter of Intent to apply for this funding opportunity; the deadline for the Letter of Intent is January 6, 2010. This Letter of Intent should contain the following:

• Number and title of the funding opportunity

• Name, address, and telephone number of the primary point of contact.

• Names of other key personnel

• Participating collaborators, especially community colleges and employers

3. DUNS Number

The Office of Management and Budget (OMB) requires applicants to provide a Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number when applying for Federal grants or cooperative agreements on or after October 1, 2003. It is entered on the SF 424. It is a unique, nine-digit identification number, which provides unique identifiers of single business entities. The DUNS number is free and easy to obtain.

Organizations can receive a DUNS number at no cost by calling the dedicated toll-free DUNS Number request line at 1-866-705-5711 or by using this link to access a guide: https://www.whitehouse.gov/omb/grants/duns_num_guide.pdf .

4. Project Abstract

Applicants shall include a one-page abstract (no more than 500 words) in the application. Applicants should prepare a clear, accurate, concise abstract that can be understood without reference to other parts of the application and that provides a description of the proposed project, including a summary of the proposed approach and plans for collaborator involvement. The project abstract must be double-spaced, formatted to 8 ½” x 11” (letter-size) pages with 1” or larger margins on top, bottom, and both sides, and a font size of not less than 11 point.

The applicant shall place the following information at the top of the narrative abstract (this information is not included in the 500 word maximum):

• Project Title

• Applicant Name

• Address

• Contact Name

• Contact Phone Numbers (Voice, Fax)

• E-Mail Address

• Web Site Address, if applicable

5. Project Narrative

The project narrative must be double-spaced, formatted to 8 ½” x 11” (letter-size) pages with 1” or larger margins on top, bottom, and both sides, and a font size of not less than 11 point. The suggested length for the project narrative is 15 to 20 pages; 25 pages is the maximum length allowed. The 25-page limit excludes resumes or curriculum vitae, letters of commitment, program abstract, and other attachments. ONC will not accept applications with a project narrative that exceeds 25 pages.

The project narrative will be used as the primary basis to determine whether or not the application meets the minimum requirements for grants under the Recovery Act. The project narrative should provide a clear and concise description of the applicant’s plans.

(Note: a concise resource offering tips for writing proposals for HHS grants can be accessed via the Web at: http://www.hhs.gov/grantsnet/AppTips.htm)

The project narrative must include the following components. These components will be counted as part of the 25-page limit:

• Problem Statement (1-2 pages)

• Proposed Approach (7-12 pages)

• Collaborator Involvement (1-2 pages)

• Project Management (1-2 pages)

• Evaluation (1-2 pages)

• Organizational Capability (4-5 pages exclusive of curriculum vitae and attachments describing examination statistics)

Problem Statement. This section should describe, from the applicant’s perspective, the challenges of creating a competency evaluation program for national utilization in a highly dynamic, competency-based subject matter domain. (1-2 pages)

Proposed Approach. This section should provide a clear and concise description of the approach the applicant proposes to use to develop the competency examinations and address the challenges described in the Problem Statement. This section must address all of the program components delineated in Section I, Part 3, Project Approach. The applicant should note any major problems they anticipate encountering, and how they will be able to overcome those problems. This section should describe the examination technology and format that the applicant would prefer to use. This section should also describe how the proposed approach will address the needs of individuals with disabilities and disadvantaged populations, including limited-English speaking populations. . (7-12 pages)

Collaborator Involvement. This section should describe the role and makeup of any mechanisms the applicant plans to employ in ensuring appropriate stakeholder input to the program, including but not limited to other institutions of higher education or employer groups. (1-2 pages)

Project Management. This section should include a clear delineation of the roles and responsibilities of project staff, participating professionals, consultants and collaborating organizations, how they will contribute to achieving the project’s outcomes, and what mechanisms will be used to coordinate their efforts and keep the project on schedule. The roles and functions to be carried out by sub-recipients should also be clearly delineated. This section should specify who would have day-to-day responsibility for key tasks such as: leadership of project; monitoring the project’s on-going progress, preparation of reports; communications with other collaborating organizations and ONC. It should also describe the approach that will be used to monitor and track progress on the project’s tasks and objectives. (1-2 pages)

Evaluation. Recipients will be required to maintain information relevant to achieving the milestones specified in Section II, Part 3, Evaluation and Milestones. (1-2 pages)

Organizational Capability Statement. The application should include an organizational capability statement and roles and curriculum vitae for key project personnel. It is not required that applicants provide the names of domain experts for examination development committees, but the criteria and mechanisms for choosing these members should be described.

This section should provide detailed descriptions of current and previous work of the applicant organization related to health IT education and to examination development in any domain. If an applicant institution does not have an established degree-granting program in health information technology, health informatics, or health information management, it should describe any equivalent or similar programs in this section. The applicant should detail any experience with administration of computer-based examinations.

This description should also cover capabilities of the applicant not included elsewhere in the program narrative. If appropriate, include an organization chart showing the relationship of the project to the current organization. Please attach short vitae for key project staff only. Neither curriculum vitae nor an organizational chart will count towards the narrative page limit.

This section should include information about any contractual organization(s) that will have a significant role(s) in implementing project and achieving project goals. These capabilities should be described in specific relationship to each organization’s proposed role in the project. (4-5 pages exclusive of curriculum vitae and attachments describing examination statistics)

6. Work Plan

The Project Work Plan should reflect and be consistent with the project narrative and budget and should cover both years of the project period.  The work plan should identify important milestones and each major task or action step needed to reach those milestones (see Section II, Part 3, Evaluation and Milestones). For each major task or action step, the work plan should identify timeframes involved, including start- and end-dates.  (1-2 pages)

7. Letters of Commitment from Key Participating Organizations and Agencies

Include confirmation of the commitments to the project (should it be funded) made by key collaborating organizations and agencies in this part of the application. Any organization that is specifically named to have a significant role in carrying out the project should be considered an essential collaborator. Signed letters of commitment should be scanned and included as attachments. In the transmission, the applicant should be sure to include the funding opportunity number and the organization’s name.

8. Budget Narrative/Justification

Each application must include a detailed budget for the first year of funding requested and a detailed summary of the request for both years. The applicant may request up to $6.0M total costs for up to 2 years, inclusive of indirect costs.

A typical budget could include (but is not restricted to) these elements:

• Salary support for faculty members and staff involved

• Costs for examination development and production, including psychometric services

• Costs for validation of the blueprint and test questions by subject matter experts

• Costs for continuous revision of the examinations

• Costs for administering the examination free of charge to the first 10,000 examinees

• Facilities and administration costs at a federally approved indirect cost rate

• Expenses associated with sub-recipients

A combined multi-year Budget Narrative/Justification, as well as a detailed Budget Narrative/Justification for each year of potential grant funding is required. If contractors will be used to support the work of the awardee, detailed budget narratives/justifications must also be provided for each contractor for each year of potential grant funding.

Application Review Criteria

Applications are scored by assigning a maximum of 100 points across four criteria:

• Understanding of Project Purpose - (10 points)

• Approach, Work Plan and Activities - (40 points)

• Applicant Capabilities – (30 points)

• Budget and Level of Effort - (20 points)

1. Understanding of Project Purpose

Weight: 10 points

• The extent to which the application reflects a clear understanding of the tasks to be performed and the challenges inherent in this work. (10 points)

2. Approach, Work Plan and Activities

Weight: 40 points

• The extent to which the application offers an overall plan in the project narrative for developing an examination system that is feasible and secure to administer and addresses the existing competencies for the health IT workforce (See Appendix B).(15 points)

• The extent to which the application includes sensible and feasible timeframes in the project work plan for the accomplishment of the specific tasks presented. (5 points)

• The extent of the evidence that the development effort can proceed on the proposed timeline. (5 points)

• The extent to which the application includes a clear and coherent management plan in the project narrative with the roles and responsibilities of project staff, consultants, and collaborators clearly defined and linked to specific tasks. (5 points)

• The extent to which the plan for collaborator involvement contains mechanisms to ensure that the input of the collaborators will be incorporated into the materials. (5 points)

• The extent to which the project approach addresses the needs of individuals with disabilities and disadvantaged populations, including limited-English speaking populations. (5 points)

3. Applicant Capabilities

Weight: 30 points

• The extent to which the applicant and its contractors and collaborators bring all necessary components of expertise to the effort. For example, the applicant institution has developed a relationship with one or more professional psychometricians¹ or organizations offering psychometric services and demonstrating experience in the area of competency examinations. (15 points)

• The depth of the relevant experience of all components of the project team. (10 points)

• The extent to which the applicant can provide the technology and the technological experience needed to perform the proposed work. (5 points)

4. Budget and Level of Effort

Weight: 20 points

• The extent to which the proposed level of effort of the project director(s), key staff and consultants is adequate to advance the project in accord with the timelines. (10 points)

• The extent to which the budget is justified with respect to the adequacy and reasonableness of resources requested. For example, budget line items are clearly delineated and consistent with work plan tasks. (10 points)

Appendix B ─ Health IT Workforce Roles and Competencies

Categories of Health IT Workforce Roles Requiring Short-Term Training

Mobile Adoption Support Positions

These members of the workforce will support implementation at specific locations for a period of time, and when their work is done, will move on to new locations.  Workers in these roles might be employed by regional extension centers, providers, vendors, or state/city public health agencies, and would work together in teams. Preparation for this set of roles will typically require six months of intense training for individuals with appropriate backgrounds.

1. Practice workflow and information management redesign specialists:

Workers in this role assist in reorganizing the work of a provider to take full advantage of the features of health IT in pursuit of meaningful use of health IT to improve health and care. Individuals in this role may have backgrounds in health care (for example, as a practice administrator) or in information technology, but are not licensed clinical professionals. Workers in this role will:

• Conduct user requirements analysis to facilitate workflow design

• Integrate information technology functions into workflow

• Document health information exchange needs

• Design processes and information flows that accommodate quality improvement and reporting

• Work with provider personnel to implement revised workflows

• Evaluate process workflows to validate or improve practice’s systems

2. Clinician/practitioner consultants:

This role is similar to the “redesign specialist” role listed above but brings to bear the background and experience of a licensed clinical and professional or public health professional. In addition to the activities noted above, workers in this role will:

• Suggest solutions for health IT implementation problems in clinical and public health settings

• Address workflow and data collection issues from a clinical perspective, including quality measurement and improvement

• Assist in selection of vendors and software

• Advocate for users’ needs, acting as a liaison between users, IT staff, and vendors

3. Implementation support specialists:

Workers in this role provide on-site user support for the period of time before and during implementation of health IT systems in clinical and public health settings. The previous background of workers in this role includes information technology or information management. Workers in this role will:

• Execute implementation project plans, by installing hardware (as needed) and configuring software to meet practice needs

• Incorporate usability principles into design and implementation

• Test the software against performance specifications

• Interact with the vendors as needed to rectify problems that occur during the deployment process

4. Implementation managers:

Workers in this role provide on-site management of mobile adoption support teams for the period of time before and during implementation of health IT systems in clinical and public health settings. Workers in this role will, prior to training, have experience in health and/or IT environments as well as administrative and managerial experience. Workers in this role will:

• Apply project management and change management principles to create implementation project plans to achieve the project goals

• Interact with office/hospital personnel to ensure open communication with the support team

• Lead implementation teams consisting of workers in the roles described above

• Manage vendor relations, providing feedback to health IT vendors for product improvement

Permanent Staff of Health Care Delivery and Public Health Sites

These roles are needed for ongoing support of health IT that has been deployed in office practices, hospitals, health centers, long-term care facilities, health information exchange organizations and state and local public health agencies. Preparation for this set of roles will typically require six months of intense training for individuals with appropriate backgrounds.

1. Technical/software support staff: 

Workers in this role maintain systems in clinical and public health settings, including patching and upgrading of software. The previous background of workers in this role includes information technology or information management. Workers in this role will:

• Interact with end users to diagnose IT problems and implement solutions

• Document IT problems and evaluate the effectiveness of problem resolution

• Support systems security and standards

2. Trainers:

Workers in this role design and deliver training programs, using adult learning principles, to employees in clinical and public health settings. The previous background of workers in this role includes experience as a health professional or health information management specialist. Experience as a trainer in the classroom is also desired. Workers in this role will:

• Be able to use a range of health IT applications, preferably at an expert level

• Communicate both health and IT concepts as appropriate

• Assess training needs and competencies of learners

• Design lesson plans, structuring active learning experiences for users

• Track training records of the users and develop learning plans for further instruction

Appendix D ─ Suggested Content for Letter of Intent to Apply

Date

David Blumenthal MD, MPP

National Coordinator for Health Information Technology

Department of Health and Human Services

200 Independence Avenue, S.W.

Washington, DC 20201

Dear Dr. Blumenthal,

(Name of organization submitting the letter) intends apply for the Competency Examination Development grant program that is part of the American Recovery and Reinvestment Act of 2009, Section 3016, Information Technology Professionals in Health Care.

Be sure to include the following information:

• Number and title of this funding opportunity

• Name, address, and telephone number of the primary point of contact

• Names of other key personnel

• Participating collaborators, especially community colleges and employers

Sincerely,

Name

Title

Organization

Division (if applicable)

State

Address

Phone

Fax Number

Email

1 Psychometry, or psychometrics, is defined by the American Heritage Dictionary as “the branch of psychology that deals with the design, administration, and interpretation of quantitative tests for the measurement of psychological variables such as intelligence, aptitude, and personality traits.”

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