Pediatric Disaster Care Centers of Excellence: Frequently Asked Questions

ASPR aims to address known gaps in pediatric disaster care of all pediatric patient populations by augmenting the existing clinical capabilities within states and across multi-state regions.

Through this Funding Opportunity Announcement, ASPR seeks to fund up to two Pediatric Disaster Care Centers of Excellence to:

• Develop a coordinated pediatric disaster care capability for pediatric patient care in disasters;
• Strengthen pediatric disaster preparedness plans and health care system coordination related to pediatric medical surge in disasters;
• Enhance statewide and regional medical surge capacity for pediatric patients;
• Increase and maintain health care professional competency through the development and delivery of a standardized training program; and
• Enhance situational awareness of pediatric disaster care capabilities and capacity and assess regional pediatric readiness.

Specific focus will be given to the management of pediatric care related to trauma, infectious diseases including pandemic influenza and other emerging infectious disease, burn, and chemical, biological, radiological, and nuclear incidents.

For the purposes of this Funding Opportunity Announcement, “region” is defined as a geographic area that is inclusive of at least two states within the applicant’s respective HHS region. Applicants must define the geographic region intended to be served under this Funding Opportunity Announcement in their application.

The Office of Intergovernmental and External Affairs hosts 10 Regional Offices that directly serve state and local organizations. More information and a map of the HHS Regions can be accessed here.

For the purposes of this Funding Opportunity Announcement (FOA), “region” is defined as a geographic area that is inclusive of at least two states within the applicant’s respective HHS region. Applicants must define the geographic region intended to be served under this FOA in their application.

Letters of support are required from:

• State Department of Health or State Hospital Association within the applicant’s state and at least one additional state in the applicant’s defined region
• State Office of Emergency Management within the applicant’s state
• State Office of Emergency Medical Services within applicant’s state
• Children’s Hospital* within at least one additional state in the applicant’s defined region

The project period for this cooperative agreement is 12 months, and the requirements outlined in the funding opportunity announcement must be completed during that time. Specific investments beyond this funding opportunity announcement are contingent upon identified gaps, Department of Health and Human Services priorities, and funding appropriations. Applicants are expected to plan for completion of the project, have a sustainability plan in place and expend all awarded funds by the end of the project period. ASPR will evaluate recipient progress and provide technical assistance throughout the period of performance.

Specific investments beyond this funding opportunity announcement are contingent upon identified gaps, Department of Health and Human Services priorities, and funding appropriations pending availability of funds.

Specific investments beyond this funding opportunity announcement are contingent upon identified gaps, Department of Health and Human Services priorities, and funding appropriations.

This is the first ASPR sponsored funding opportunity announcement related to Pediatric Disaster Care Centers of Excellence.

The project narrative should cover the entire project period and address all required activities and strategies. This would be inclusive of Activities D and E, however we understand that Activities cannot be executed until both award recipients are announced. Therefore, recipients should acknowledge in their applications that (or how) they will collaborate, coordinate, plan, and work directly with the other award recipient on Activity D and Activity E, Strategies 1-3.

ASPR will not accept applications with a Project Narrative that exceeds 12 pages. The Letters of Support, budget narrative and justification forms, Curriculum Vitae (CV)/Biosketch of Key Project Personnel and Other Relevant Appendices (e.g. partner table, statement of funding preference, Attachment C) are not counted as part of the Project Narrative for purposes of the 12-page limit. Any narrative drafted to accompany Attachment C and fulfill the required “Work Plan and Timeline of Proposed Activities” section of the project narrative will be included in the 12 pages. Any CV or Biosketch included should not exceed 2 pages.

Each CV or Biosketch should be no more than 2 pages each, and while there is no required format, CVs or Biosketches should be double-spaced, on 8 ½” x 11” plain white paper with 1” margins on all sides, Calibri or Times New Roman font and a point size of not less than 11. CVs or Biosketches should clearly convey the required qualifications of personnel and include the specialized expertise and experience that personnel’s affiliated health care entity exhibits to complete the activities and strategies under the cooperative ag

Eligible applicants are limited to one or more public or private hospitals and/or corporate health systems. For the purposes of this Funding Opportunity Announcement, a corporate health system is defined as an organized, coordinated, and collaborative network that (1) links various health care providers, via common ownership or contract, across three domains of integration – economic, noneconomic, and clinical – to provide a coordinated, vertical continuum of services to a particular patient population or community, and (2) is accountable both clinically and fiscally for the clinical outcomes and health status of the population or community served, and has systems in place to manage and improve them.

Yes.

The applicant will submit letters of support from the following agencies/organizations with the application package:

• State Department of Health or State Hospital Association within the applicant’s state and at least one additional state in the applicant’s defined region
• State Office of Emergency Management within the applicant’s state
• State Office of Emergency Medical Services within applicant’s state
• Children’s Hospital* within at least one additional state in the applicant’s defined region

While letters of support from these entities are not required as part of the application package, applicants will receive additional credit in the application scoring criteria for additional letters of support:

• Acute Care Hospitals/Medical Centers within the applicant’s state or at least one additional state in the applicant’s defined region
• State Office of Emergency Management within at least one additional state in the applicant’s defined region
• State Office of Emergency Medical Services within at least one additional state in the applicant’s defined region

Eligible applicants are limited to one or more public or private hospitals and/or corporate health systems. For the purposes of this Funding Opportunity Announcement, a corporate health system is defined as an organized, coordinated, and collaborative network that (1) links various health care providers, via common ownership or contract, across three domains of integration – economic, noneconomic, and clinical – to provide a coordinated, vertical continuum of services to a particular patient population or community, and (2) is accountable both clinically and fiscally for the clinical outcomes and health status of the population or community served, and has systems in place to manage and improve them.

Applicants can be a single entity, or a ‘corporate health system,’ as defined above. If an entity applies representing a consortium of entities, one entity will need to be designated as the recipient entity, who will be responsible for carrying out duties related to management of the grant. Additional entities may provide support to the designated recipient entity in the capacity of consultants, subcontractors or subrecipients.

Yes, an eligible entity (one or more public or private hospitals or corporate health systems, as defined in the Funding Opportunity Announcement (FOA)) can include entities from other HHS regions in the application. However, only one entity can apply as the primary recipient. In all instances, the primary recipient must provide all required letters of support referenced in the FOA and designate the “region” to be served as defined in the FOA.

It is allowable to submit one letter of support to meet this requirement, if the letter of support indicates support from both the State Department of Health and Office Emergency Medical Services.

All applications will undergo the same administrative and objective review and will be scored according to the criteria outlined in the Application and Submission Information and Application Review Information sections of the Funding Opportunity Announcement.

Key Personnel are defined as all individuals who contribute in a substantive, meaningful way to the scientific development or execution of the project, whether or not salaries are requested. Key personnel must include, at minimum, a designated Medical Director that meets or exceeds the following qualifications:

• Physician with a current in-state license and demonstrated pediatric clinical experience.
• Board Certified in an American Board of Medical Specialties recognized pediatric specialty and clinically active.
• Familiarity with EMS, Emergency Management and Public Health laws and regulations.
• Education and/or experience with mass casualty, bioterrorism, Nuclear, Biological Chemical, Weapons of Mass
• Destruction (WMD) and/or disaster preparedness.

The applicant has discretion to determine additional key personnel to involve, as well as their designated project titles. Per the HHS Grants Policy Statement, the roles and responsibilities of designated individuals at recipient organizations, who serve as agents of the recipient, are as follows:

Authorized Organizational Representative. The authorized organizational representative is the designated representative of the applicant/recipient organization with authority to act on the organization’s behalf in matters related to the award and administration of grants. In signing a grant application, this individual agrees that the organization will assume the obligations imposed by applicable Federal statutes and regulations and other terms and conditions of the award, including any assurances, if a grant is awarded. These responsibilities include accountability both for the appropriate use of funds awarded and the performance of the grant-supported project or activities as specified in the approved application. Although HHS requires that the recipient organization designate such an individual, HHS does not specify the organizational location or full set of responsibilities for this individual.

Principal Investigator/Program or Project Director (PI/PD). The PI/PD is the individual, designated by the recipient, responsible for the scientific, technical, or programmatic aspects of the grant and for day-to-day management of the project or program. The PI/PD generally is an employee of the recipient. However, because the grant, if awarded, is made to the recipient organization, if the PI/PD is not an employee of that organization, the organization must have a formal written agreement with the PI/PD that specifies an official relationship between the parties even if the relationship does not involve a salary or other form of remuneration. If the PI/PD is not an employee of the applicant organization, ASPR will assess whether the arrangement will result in the organization being able to fulfill its responsibilities under the grant, if awarded.

The PI/PD is a member of the recipient team responsible for ensuring compliance with the financial and administrative aspects of the award. This individual works closely with designated officials within the recipient organization to create and maintain necessary documentation, including both technical and administrative reports; prepare justifications; appropriately acknowledge Federal support in publications, announcements, news programs, and other media; and ensure compliance with other Federal and organizational requirements. The PI/PD is encouraged to maintain contact with the Project Officer with respect to the scientific, technical, or programmatic aspects of the project or program and, as applicable, the Grants Management Officer concerning the business and administrative aspects of the award.

Please reference the Grants Policy Statement for detailed information on roles and responsibilities

The Principal Investigator need not also serve as the Medical Director. However, should applicants prefer that the Principal Investigator also serve in the role of Medical Director, it is allowable. In these cases, please be sure to account for the clear delineation of roles and responsibilities of the individual as both the Principal Investigator and Medical Director and take into consideration that ASPR has estimated the role of Medical Director to require at least 25% level of effort.

An Executive Director is not required for this Funding Opportunity Announcement. The Principal Investigator/Project Director is the individual, designated by the recipient, responsible for the scientific, technical, or programmatic aspects of the grant and for day-to-day management of the project or program.

Applicants must designate a Medical Director to act as a leader of clinical preparedness and response and neutral broker among the applicant and supporting organizations. The Medical Director position need not come from the applicant entity, unless the Medical Director is also performing the role of a Project Director/Principal Investigator. In this case, the Medical Director must be an employee of the applicant. ASPR has estimated the role of Medical Director to require at least 25% level of effort.

While an Executive Director is not required for this Funding Opportunity Announcement, the expectation of designated personnel is not limited to a set number of work hours, but rather the completion of all necessary tasks to meet the objectives of the grant.

Recipients may only charge to this award the level of effort/salary that corresponds with work on this project. Employee’s may conduct work for the HPP award in addition to this award, but must ensure the level of effort/salary is charged to the respective award.

ASPR has no preclusion to individual subject matter experts (SME) being named on more than one application. If an SME's salary is charged to the budget of any application, level of effort must not exceed 100% across multiple applications.

The Executive Level II Salary Cap is specific to all salaries charged to a Federal award and should not exceed the FY 2019 salary cap of $192,300. Overhead/F&A costs are generally indirect costs vs direct cost of a (proposed) budget and applicants may negotiate an indirect cost rate agreement with a cognizant Federal agency for a determined rate. Applicants that have never received a negotiated IDCR have the option of a flat rate of up to 10% modified total direct costs (MTDC) which may be used indefinitely. Applicants may contact Program Support Center for detailed information on cost rate agreements.

All overhead/F&A costs charged to a Federal award must be charged as indirect and as part of the budget for the total amount of award. In this case of the total Federal share of $3M.

Any non-Federal entity that has never received a negotiated indirect cost rate, may elect to charge a de minimis rate of 10% of modified total direct costs (MTDC) which may be used indefinitely. As described in 45 CFR Part 75.403, costs must be consistently charged as either indirect or direct costs, but may not be double charged or inconsistently charged as both. If chosen, this methodology once elected must be used consistently for all Federal awards until such time as a non-Federal entity chooses to negotiate for a rate, which the non-Federal entity may apply to do at any time.

Any non-Federal entity that has a current federally negotiated indirect cost rate may apply for a one-time extension of the rates in that agreement for a period of up to four years. This extension will be subject to the review and approval of the cognizant agency for indirect costs. If an extension is granted the non-Federal entity may not request a rate review until the extension period ends. At the end of the 4-year extension, the non-Federal entity must re-apply to negotiate a rate. Subsequent one-time extensions (up to four years) are permitted if a renegotiation is completed between each extension request.

All overhead/F&A costs charged to a Federal award must be charged as indirect and as part of the budget for the total amount of award. In this case of the total Federal share of $3M.

Prior approval is required and the tent must not be affixed to any property. Construction is not allowable.

Recipients of Federal financial awards are expected to administer funds in accordance with financial management standards provided in 45 CFR 75.302, “Financial management and standards for financial management systems.”

(b) In accordance with 45 CFR 75.302(b), the financial management system of each non-Federal entity must provide for the following (see also §§ 75.361, 75.362, 75.363, 75.364, and 75.365):

1. Identification, in its accounts, of all Federal awards received and expended and the Federal programs under which they were received. Federal program and Federal award identification must include, as applicable, the CFDA title and number, Federal award identification number and year, name of the HHS awarding agency, and name of the pass-through entity, if any.
2. Accurate, current, and complete disclosure of the financial results of each Federal award or program in accordance with the reporting requirements set forth in §§ 75.341 and 75.342. If an HHS awarding agency requires reporting on an accrual basis from a recipient that maintains its records on other than an accrual basis, the recipient must not be required to establish an accrual accounting system. This recipient may develop accrual data for its reports on the basis of an analysis of the documentation on hand. Similarly, a pass-through entity must not require a subrecipient to establish an accrual accounting system and must allow the subrecipient to develop accrual data for its reports on the basis of an analysis of the documentation on hand.
3. Records that identify adequately the source and application of funds for federally-funded activities. These records must contain information pertaining to Federal awards, authorizations, obligations, unobligated balances, assets, expenditures, income and interest and be supported by source documentation.
4. Effective control over, and accountability for, all funds, property, and other assets. The non-Federal entity must adequately safeguard all assets and assure that they are used solely for authorized purposes. See § 75.303.
5. Comparison of expenditures with budget amounts for each Federal award.
6. Written procedures to implement the requirements of § 75.305.
7. Written procedures for determining the allowability of costs in accordance with subpart E of this part and the terms and conditions of the Federal award.

The period of performance is 12 months; therefore, carryover of funds is not applicable. Successful recipients are expected to be proactive and accountable for all expenditures of their budget. ASPR recommends frequent and open communications with Federal project officers on all program activities and expenditures on such activities.

A pre-application teleconference will be held on July 23, 2019 from 1:00 p.m.-2:00 p.m. Eastern Time. No RSVP is necessary to attend this call. The call can be accessed at 1-888-455-8509; participant code 5518640. This call will allow potential applicants to ask questions regarding the Funding Opportunity Announcement and the application process. Also, ASPR accepts all questions regarding the program expectations and application assistance up to the application due date.

Applicants intending to apply subcontracts to their proposals must comply with applicable Federal procurement provisions in 45 CFR 75.326-75.335, including but not limited to competition 45 CFR 75.328 and procurement procedures 45 CFR 75.329. Effective 6/20/18, the threshold for micro-purchases is $10,000 and $250,000 for simplified acquisitions. Under the micro-purchase procurements with federal award funds (e.g. 45 CFR 75.329(a)), the purchases at or under the established threshold may be awarded without soliciting competitive quotations. There are two primary methods of selecting a subcontractor: sole/single source selection or competitive bidding. A detailed justification is required with the proposal for all types of procurements.

A pre-application teleconference will be held on July 23, 2019 from 1:00 p.m. -2:00 p.m. Eastern Time. No RSVP is necessary to attend this call. The call can be accessed at 1-888-455-8509; participant code 5518640. During this call, participants will be able to ask questions about the funding opportunity announcement and application process.

No, the Letter of Intent is not binding. Applicants will not be evaluated on the Letter of Intent.

Yes. Submission of a Letter of Intent is not required to submit an application.

Recipients are required to determine which essential elements of information are essential for regional coordination of pediatric patients. At this time, no, we don’t require sharing actual data. However, in a functioning pediatric disaster medical care system we would expect recipients of these funds to responsibly share and use data that would reduce morbidity and mortality of pediatric patients. Such data sharing should be compliant with applicable laws, regulations, and policies such as HIPAA.

Specific investments beyond this funding opportunity announcement are contingent upon identified gaps, Department of Health and Human Services priorities, and funding appropriations. Expectations of centers awarded similar grants in future years will be defined in subsequent funding opportunity announcements.

ASPR does not require recipients to use a single data platform. However, in developing essential elements of information (EEI), the recipients are required to explore the role of integration of these EEI into interoperable health information technology systems and Health Information Exchanges (HIEs). The Centers of Excellence are also required to collaborate with one another on this activity and will work closely with ASPR pediatric disaster project staff throughout the duration of the cooperative agreement.

Recipients are required to maintain all documentation that demonstrates accomplishment of the performance measures in the Award Administration Information/Reporting Requirements section of the Funding Opportunity Announcement and provide relevant documents to Federal staff, as requested, during site visits or through other requests. ASPR does not provide examples of specific metrics and/or data that must be captured through the process of achieving these performance measures. Such metrics are determined and proposed by the applicants.

When submitting applications, applicants must include an Evaluation and Performance Measurement Plan (EPMP). The EPMP is used to describe how the recipient and/or ASPR will determine whether activities are appropriately implemented and intended outcomes are achieved, and how these outcomes are related to the required performance measures in the Award Administration Information/Reporting Requirements section of the Funding Opportunity Announcement.