Pediatric Disaster Care Centers of Excellence: Pediatric FOA Call Transcript

Welcome and thank you for standing by. At this time all participants will be on listen-only until the question and answer session of today’s conference. At that time you may press Star 1 to ask a question. Today’s conference is being recorded. If you have any objections please disconnect at this time. I’d now like to hand the meeting over to your host, Dr. Kevin Yeskey. You may begin.

Thank you. This is Kevin Yeskey. I’m the principal Deputy in the Office of the Assistant ­­Secretary for Preparedness and Response. And good afternoon everyone and thanks for joining today’s technical assistance call regarding the Pediatric Disaster Care Centers of Excellence Funding Opportunity Announcement.

Here at ASPR we’re real excited about this opportunity to enhance our healthcare system’s ability to provide pediatric care during public health emergencies and disasters. And through our funding opportunity announcement ASPR will support the creation of up to two Pediatric Disaster Care Centers of Excellence that will serve as pilot sites. The pilot sites will build upon the existing foundations for pediatric clinical care and emergency response by enhancing coordination mechanisms and incorporating relevant capabilities at the local, state and regional levels.

The pilot projects are intended to help identify issues, develop best practices and demonstrate the potential effectiveness and viability of this concept. Recipients of the awards will be expected to develop or improve their capability and capacity to provide highly specialized care to pediatric patients within and outside of their own region through the pursuit of the objectives of this announcement.

So again I want to thank you all for your interest in this opportunity and for being on the call today. I’m now going to hand the call over to my colleague, Tara Holland to address any questions that you may have.

Hi, good afternoon everybody and thank you Dr. Yeskey for providing those opening comments and again thanks all of you for being on the call today. During the call today we will have an open question and answer session that will allow you to ask any questions that you might have.

But first I’ll just introduce myself. I’m Tara Holland. I’m a Program Analyst here at the National Disaster Medical System at ASPR. And I’ve been working closely with the staff on this project including the project officer, Dr. Helga Scharf-Bell who will be joining up a little bit later on the call today.

Also in the room and on the phone with me there’s some other ASPR staff who can help in addressing your questions. We have Jack Herrmann from the Office of External Affairs, Lauren Walsh from ASPRs Hospital Preparedness Program, Jennifer Ray Gorrie from Office of the General Counsel and also Virginia Simmons will be joining us from the ASPR Grants Office.

So before we get started with the open question and answer session I’d just like to share some overarching thoughts and comments with you. These comments are broadly useful as we conceptualize and begin to draft your applications.

First I just want to mention that we’re in the process of developing question and answer pages of frequently asked questions on the ASPR Webpage which can be accessed at phe.gov. That’s public health emergency, phe.gov. The questions are not posted as of yet but we’re in the process of posting them. So hopefully within the next 24 to 48 hours we can have that posted. And that can act as a really great resource for you all as you’re preparing your applications. We intend to update this page frequently as we receive more questions. So really focus on that as one of your resources in this and check back on that frequently to get updated information.

As the moderator mentioned on this call, this call is being recorded. And hopefully within the next week or so we will have this call posted to the Web site as well in both audio and transcript versions. So if you know people who weren’t able to attend you can certainly share that resource with them so they can get all the information that we discussed today.

Also I just want to mention the letters of intent. We have received a few from some of you so thank you for that and for showing your interest in this opportunity. I just want to reiterate that the letter of intent was not required. So if you have not submitted a letter of intent you’re certainly still eligible to apply for this opportunity.

Lastly I just want to stress to you all to please read the funding opportunity in its entirety. I know that it’s a very lengthy document but there’s a lot of useful information in there. And as you’re putting together your applications you want to make sure that you’re really going through it with a fine-toothed comb and certainly getting out all of the relevant information to put together a strong proposal that meets all of the requirements.

So to date we’ve received multiple questions from you all. So before we get to the open question and answer session I just wanted to go over some of the most recently asked questions that we’ve received around some of those things. So first we received a few questions about the roles and responsibilities of the key personnel under this FOA including the medical director and the principal investigator or project director.

So just briefly key personnel are defined as all individuals who contribute in a substantive and meaningful way to meeting the requirements of the funding opportunity announcement. The key personnel that’s required specifically includes the medical director and their specific qualifications that I’d like you to note that are listed within the FOA. So you want to make sure whoever person you designate as that does meet those requirements.

And also for the HHS grant’s management policy which you can reference for more information and that will be listed in the FAQ page on PHE. We are also required to have a principal investigator or a program or project director as well as an authorized organizational representative. And you can again reference the grant’s management policy for more details about what those positions entail and expectations of those.

Also we received some questions about the use of allowable funds. So generally speaking grant funds can be used to cover the costs of personnel, consultants, equipment, supplies, grant related travel and other grant related costs. But I’d just like to point out on Page 23 for reference in the funding opportunity announcement it does go over some specific funding restrictions. So I’d just like you to be cognizant of that and reference that as you’re moving forward.

Also we received some questions about the definition of a region which is listed in the beginning portion of the FOA that’s just for visibility for the purposes of this funding opportunity. We’ve defined region as a geographic area that’s inclusive of at least two states within the applicant’s respective region. And in your application you must define which geographic region you intend to serve throughout the process of the FOA.

In addition we’ve received a few questions about applicant eligibility. And in the FOA it goes over who is an eligible applicant and certainly if you have questions about if your specific entity is eligible you can feel free to reach out to us. We’re more than happy to have that discussion with you and see if you do meet the criteria specified in the funding opportunity.

Lastly we’ve received a few questions about the project period and future funding. First of all as mentioned the project period is 12 months. And recipients need to meet the requirements of the FOA within those 12 months. And in terms of additional funding we hope that is something that will be available but that’s going to be dependent upon identified priorities and funding appropriations.

And finally before we turn this call over to all of you I just want to go over some items about how the application scoring and the process works once we’ve receive all of the applications. And just for reference this is listed in the funding opportunity in the review and selection process section. And we’ll be following the steps that are outlined there. So basically first the applications will undergo an administrative review to make sure that they meet all of their required components that are listed in the screening and criteria section.

After it goes through and meets all the requirements of this administrative review we will turn the applications over to an objective review committee who will meet and select and review all of the applications to make sure that they meet the minimum criteria. And in doing this review they’ll be following the grading review which you can reference on Pages 25 to 28 of the FOA. So basically the applications are scored out of 100 total points. And within the FOA you can find out those criteria and what points will be allocated for meeting specific requirements of the application.

And for the objective review, we will apply funding priorities for the applications and with these priorities you can receive up to five additional points. And these are referenced on Page 28 of the FOA. And then in making final award decisions ASPR will take into consideration the geographic distribution of applicants. No more than one recipient will be funded per each HHS region. And applications that don’t receive special consideration will be given full and equitable consideration during the review process.

And finally the notice of award is authorizing documents from the ASPR authorizing official, the Office of Grant’s Management and the ASPR Office of Budget and Finance. The notice of award will be sent electronically upon successful review of the application. The notice of the award sets forth the amount of funds granted, terms and conditions, the effective date, the budget period. A non-federal share will be provided if applicable in the total project period for which a supportive is contemplated. And again I know this is a lot of information but just want to reiterate that all of this is available within the FOA for further details.

So lastly I just want to go over some important dates regarding this opportunity. Applications are due August 27, 2019, at 11:59 pm Eastern time. Notice of awards will be made at the end of September 29, 2019. The funding must be awarded by ASPR to the applicant on or before September 29, 2019. And the project period or the funding opportunity on September 30, 2019.

So with that being said I’ll just ask if anyone in the room or on the phone has anything additional to say and otherwise we can open the lines for questions and answers from all of you.

Let’s proceed.

Okay (Amber) if you don’t mind allowing the participants now to ask any questions that they may have.

Thank you. We’ll now begin the question and answer session. If you would like to ask a question please press Star 1. You will be prompted to record your name. Please be sure to unmute your phone. Once again if you’d like to ask a question please press Star 1. And we will pause for just a moment to allow those questions to start coming through. One moment for your first question. Your first question comes from (Chuck Russell). Your line is open.

Thank you Tara. The application -- not the application -- the start date notes September 30. Is that a window at which point it could start after or is that a firm start date, the clock starts on that date?

Yes this is Virginia Simmons, Grants Officer. The project period start date which is synonymous with the budget start date of 9 September 30 is the actual start date of your project activity. So there is no window. That’s the official start date when you can begin your project.

Thank you.

And the project period to be clear on September 29, 2020.

Very good. If I have an additional question shall I ask it or shall I punch in again?

Sure.

So we made note of the overall page limits for each component. But with the significant number of letters of support is there an overall page limit to the application or is it unlimited based on the number of letters of support?

So currently within the funding opportunity and thank you for noting that, the only page limits I believe we apply are to that of the project narrative which cannot exceed 12 pages. And then I believe we required some page limitations on the CV. But otherwise those are the only requirements with the page numbers.

Very good thank you. And one last question if I may.

Sure.

IT asks for metrics and data regarding potential impact of interventions. Is that something you might be able to provide examples of in the FAQ at a future time?

Yes I do believe that we’ve received that question and we’re working through some answers to that and they will be posted to our frequently asked question page.

Great thank you. That’s the end of my questions.

Thank you.

And the next question comes from (Roger Smith). Your line is open.

Yes we had a question from our medical director team. Would we be allowed to use a co-medical director, multiple persons for that role?

Let us confer here for a moment just to make sure we’re clear on the requirement.

((Crosstalk))

We don’t have a page number.

((Crosstalk))

Jack Herrmann from External Affairs. So it is our understanding that for the medical director position it would have to at least reach the 25% amount effort on the project. And so if you have multiple or co-medical directors as long as it meets that threshold of 25%. Again understanding the spirit of this is that you have adequate subject matter experts to be able to advise the PI and the work plan relevant to the requirements of the FOA.

That’s perfect actually. That answers our question.

And this is Tara. I’ll just mention that we estimated that that position would be 25% but certainly however many percentages it takes to meet all of the requirements that is up to the discretion of the recipient.

Thank you.

Our next question comes from Matthew Butler. Your line is open.

Hi. Under Strategy 2 it states to develop a regional deployable pediatric response capability. To be clear is that a plan and model or is that a team that would be able to be operationalized?

So I think again, you know, we’re trying to be as realistic as we can. We have a 12-month period here. And we understand that in order to create a deployable team there are a number of challenges that you would need to address in order to make that team deployable. Not the least of which it says in the requirement that that team should be deployable not only within your jurisdiction but also in the region in which you serve that crossing state lines could be difficult.

So the spirit of this is we are trying to better understand the challenges and capabilities of creating these deployable teams. And after this pilot be able to better direct our focus of how we can address those challenges, remove some of those burdens so we ultimately can achieve what needs to be done and that is to ensure that our pediatric patients get the right care at the right time by the right people.

So developing models, looking and trying to address potential legislative language in order to mobilize those teams and address some of the particular legal nuances around deploying clinical teams within your jurisdiction obviously would be useful in looking at within the scope of this project. Does that sufficiently answer your question Matthew?

Yes thank you.

And next we’ll go to (Karen Greeley). Your line is open.

This is (Karen) from CA2 DMAT. I currently am gone to the AET and AETCC training for adults through NDMS. I was wondering how viable that model is for a neonatal week and a (PICU) week. And if Miami is currently going to be doing that in the beginning or you’re going to be looking at the pilot study children’s hospital for this model.

(Karen) I think what we want to do is make sure that again this is a federal funding opportunity that looks at various models. And we leave this up to the applicants to determine how they’re going to meet the requirements of this particular funding opportunity announcement.

While the federal government may have particular models in training that we are using now in order to address the needs of pediatric patients that this is separate and distinct from those models. It is a new pilot to begin to vision out how we’re going to overall meet the needs of our pediatric population in disaster.

Thank you.

As a reminder if you would like to ask a question please press Star 1. Our next question comes from Michael Frogel. Your line is open.

Yes hi thank you very much. This is Michael Frogel from the National Pediatric Disaster Coalition. I still have a question about the principle investigator as opposed to, you know, the applicant. Are the applicant and the principle investigator the same? There are points assigned and on Page 27 there are various specific things, like, clinical expertise, CBRN and participation in home disaster preparedness issues.

So the medical director seems to be clear. I’m just trying to clarify the applicant versus principle investigator is that the same thing. Are those requirements on Page 27 basically the principle investigator or not? And secondly can that be a shared principle investigator as we’ve kind of said with the medical director what would be the ability to do that?

So hi this is Virginia Simmons, Grants Officer. The principle investigator can be anyone that the applicant organization designates. And the principle investigators – one of their major responsibilities in regard to the grant is to have oversight of daily operations and administration of that grant. And to answer your last question in regards to whether or not the principle investigator can be the same as the medical director absolutely.

The recipient or the applicant has full discretion in terms of the delegations of those roles. But for the most part in regard to that principle investigator yes there’s a definition on Page 27. But I just really needed to highlight one of their main responsibilities. Did I answer your question? I think you had a second one.

The issue was can there be let’s say there’s a separate medical director. Can there be co-principle investigators?

Absolutely.

Yes so there can be co-investigators. And if both people have the necessary things that are stated on Page 27, let’s say there were two people and one has done CBRN and one has not okay but both of them together have accomplished all the goals will that satisfy the points?

Are you talking about the top of Page 27 does the primary applicant have experience with that sentence right…

Right after the bullets the next paragraph.

Does the primary applicant demonstrate capability for the ongoing complex clinical management of pediatric patients as it applies to those things?

And Michael I think it is helpful to understand the applicant is really the system, the institution, the facility that much, like, any grant it is the institution that is the applicant. And within that institution they have identified the PI who has the authority vested upon them from the institution to make all decisions around this particular grant. But ultimately is accountable and responsible for meeting the requirements of the grant on behalf of the institution, the applicant.

Right. Okay so are you saying that the applicant complies with all of those requests because it talks about clinical expertise and things, like, that. I know I’m trying to parse words but in discussions we’ve been trying to address this. So do we have to find one person or two people who have complied with all of those things or is it just that the hospital, the system that’s done those roles?

The latter, the system that will fund those rules.

Yes okay…

And the applicant as a whole is the legal entity responsible for the grant.

Right.

And those individuals, the staff, that will satisfy all those requirements within this criterion that you reference on Page 27 would in capacity, would be the applicant, the entity.

And so as an example if you’re thinking of a PI who is actually not part of that entity, that would not meet the criteria. The facility, the institution has to have ownership if you will over that PI meaning they have to be an employee of that system or some type of legal relationship in order to be able to be an extension of the facility or the institution which is the applicant to this grant.

Okay I think that’s very helpful. Just a second question. If there are multiple states involved in the FOA and say multiple children’s hospitals, etcetera. One model is to have kind of like an executive leadership group who would function almost as the applicant in a consortium. Or is it prescribed to one or two hospital systems, etcetera that would take the primary role and then the others would be collaborator supporters, etcetera?

Just give us a second. We’re discussing this in the room.

Okay.

So (Mike) on Page 15 under the eligibility information you’ll see eligible applicants. And there’s a key word there that says for the purposes of this FOA a corporate health system and then it talks about how it’s defined. If you’re talking about a consortium of either institutions or individuals that would make up your primary group, that consortium has to be a legal entity as described within this FOA. And if it is not – that consortium is not a legal entity as defined as a corporate health – then you would have to select a primary applicant if you will that meets that criteria.

Okay that’s a very good clarification. And basically I think it aligns with what you said about the PI, etcetera on the…

Correct.

It says one or more which I think led to a little bit of perhaps not understanding it appropriately. But it seems, like, it needs to be a lead organization and they can bring in others, etcetera in multi-state. So thank you very much for that. Those are helpful.

Great, thank you.

And our next question comes from (Chris Newton). Your line is open.

Thanks. I think the previous questions that (Mike) and others have raised about the co-PI and the roles of the medical directors and how we structure collaboration was really my primary focus. And I think that the team has answered the majority of that. I would like to ask one additional question. Are there for purposes of the grant’s restrictions on utilizing federal agencies or entities as subject matter experts, advisors and collaborators – and what I’m getting at is things, like, military expertise and having them on as collaborators.

Give us one moment here. So in essence this is the spirit of this award. And that is fostering collaboration between our federal and private sector partners. On the other hand the grant cannot supplement a federal resource. So under the grant you can’t fund a federal employee to carry out your requirements under the FOA.

I understand. Unfunded, you know, advisory role would be acceptable however yes am I hearing that correctly?

Absolutely.

Okay perfect. Thank you.

Our next question comes from (Debra Kuhls). Your line is open.

Yes this is (Debra Kuhls) from Las Vegas. And my question is similar to (Chris’) but with a little different nuance. Some of the trauma centers in our proposed region actually have existing military civilian partnerships. And we may be able to have subject matter experts from those. And I would assume that a letter of support would be helpful. I’d just like to clarify that. And within our region we may have more than one military civilian partnership. And they may be with different branches of the military. Do we need to include all of those partnerships or can we pick and choose depending upon our needs.

So I think this first question that you asked would a letter of support from these military partners be helpful? I don’t think that we can address whether that would be helpful or not. I think what we are looking at is for the applicant to determine how to meet the requirements of the FOA and the partnerships and collaborations that they need to pull together in order to meet those requirements.

Letters of support as you see in the FOA are certainly encouraged and supported as inclusion with your application. How far you branch out with those collaborations in partnership is entirely up to you. And part of your application that ultimately will be determined by the review committee it meets the qualifications and strong enough to carry out the requirements as in the FOA.

Thank you.

Once again if you would like to ask a question please press Star 1 and record your name. We have a question from (Vernon). I’m sorry it’s actually (Dilsay Florez). Your line is open.

Good afternoon (Dilsay) here. Quick question. On Page 4 of the document it says future elements of division would include field equipment, helmets and training and education. Yet throughout the different activities and throughout the different strategies we are to weave telemedicine training and education. So is that more of a future goal and graph or are we correct in reading throughout the document training and telemedicine?

I think what we will need to do we want to make sure we understand your question sufficiently. So you were interpreting can you just say that one more time how you’re interpreting the FOA?

Sure. In reading throughout the FOA it’s very clear that telemedicine capability, training and education should be implemented throughout our activities and strategies. However on Page 4 it states the percentage in future elements of division would include things such as telemedicine and training and education. So is that a future goal and graph or are we to approach that as we read the entire document it’s very included throughout?

So our interpretation of that is that it is included throughout. So again in the spirit of this if we know that we are trying to create a system that includes capabilities that make actions to equipment, mobile medical facilities, telemedicine and ensure that the teams who are responding to take care of the pediatric needs are trained and educated adequately to do so. Then part of this initial pilot is to look at the feasibility of establishing those capabilities. Recognizing that within a year’s period of time there’s only so much that you can do.

So we’re looking for a well-articulated application that recognizes the importance of these capabilities and can speak to whether or not any of those currently exist in your area or how you would go about building those. And where those could be instituted within the 12-month project period. That should be noted and where those would need to be future capability that should be noted as well.

Thank you very much. Excited to move forward.

Thank you.

We have no other question at this time. But as a reminder if you would like to ask a question please press Star 1 and record your name. We did just get another question. One moment please. The name was not recorded for the Q&A but we did catch it when you dialed in. So I believe this is Matthew Butler. You may want to check your mute button. Your line is open.

Hi thanks sorry about that. Can you clarify the Web site where this information’s going to be posted, where the Q&As going to be posted?

Yes it will be phe.gov. That’s Public Health Emergency, phe.gov.

Thank you.

I’m not sure exactly where it will be on that site but it will be there and certainly if you do, like, a Google search of PHE, ASPR and pediatric FAQ you should find it there.

Okay.

I will mention there is one that is currently there which is a little bit outdated. But I’ve asked our communications team to remove that and we’re in the process of revamping it and putting out the newly revised one specific to just this funding opportunity announcement. So if you look right now you might find stuff that’s a little bit outdated but hopefully within the next 24 to 48 hours we get that sorted out.

Okay thank you.

We have no other questions at this time.

Great so no other questions we can end the call.

Thank you.

Thank you for your time.

That concludes today's conference. Thank you for participating. You may now disconnect.