The purpose of this supplement is to provide support for the conduct of worker-based training to prevent and reduce exposure of hospital employees, emergency first responders, and other workers who are at risk of exposure to Coronavirus through their work duties. The NIEHS Superfund Worker Training Program (WTP) will work collaboratively to develop and target safety and health training for those workers supporting the national Coronavirus response. Using our hazmat trainers understanding of worker safety and health protection issues, knowledge of personal protective equipment (PPE) usage, and experience in training disaster workers, WTP will coordinate with the Centers for Disease Control and Prevention (CDC), the Occupational Safety and Health Administration (OSHA), and the National Institute for Occupational Safety and Health (NIOSH) to provide awardees with material to develop an evidence-based curriculum that addresses the science of Coronavirus (clinical symptoms, mode of transmission, persistence in the environment, and treatment); infection control and worker protection (isolation/quarantine and PPE); working in the contaminated environment (sampling and decontamination); and behavioral health resiliency . The funding for this supplement is provided from the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020.

This Notice of Special Interest (NOSI) requests applications for FY 2020 administrative supplements to provide support to conduct worker-based training to prevent and reduce exposure of hospital employees, emergency first responders, and other workers who are at risk of exposure to Coronavirus through their work duties. Under the Infectious Disease Response (IDR) program the WTP implemented an infectious disease response training for workers across sectors who may be exposed to infectious diseases. The program, funded under RFA-ES-15-018 began June 1, 2016, and ran through May 31, 2019 and built federal capacity for biosecurity, biopreparedness, and rapid response to emerging infectious diseases, including developing an infrastructure of trainers and organizations who can be a resource during emergencies. As of May 31, 2019, program grantees delivered approximately 1,700 courses to 36,000 workers, with more than 145,000 contact hours. In-person trainings occurred in 36 states and one territory. A Pathogen Safety Data course was created and piloted to improve workers' health literacy and empower them to perform job hazard analysis on specific pathogens allowing them to mitigate or reduce their exposure while performing their assigned duties.

NIEHS WTP program has over 30 years of experience providing workers health and safety training related to potential exposures to biological hazards as they perform their job duties. Many of the training courses provided by WTP grantees are based off of OSHA’s Bloodborne Pathogens standard (29 CFR 1910.1030 (https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030)), OSHA’s Respirator Protection standard (29 CFR 1910.134 (https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=12716)), OSHA’s Personal Protective Equipment (PPE) standard (29 CFR 1910.132 (https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9777)) and Section 5(a)(1) of the Occupational Safety and Health (OSH) Act of 1970 (https://www.osha.gov/laws-regs/oshact/section5-duties), often referred to as the General Duty Clause, and OSHA Best Practices for Hospital-Based First Receivers of Victims (https://www.osha.gov/dts/osta/bestpractices/firstreceivers_hospital.html). WTP grantees have been involved in providing biosafety health and safety training to workers during the H5N1 outbreak, the 2001 Anthrax attacks, the H1N1 Avian Influenza 2009, mold remediation from Hurricanes Katrina and Sandy, to Ebola starting in 2013. Their audiences have spanned the worker population from healthcare workers to volunteers.

Currently, NIEHS WTP grantees are re-programming existing extramural funds to provide Coronavirus preparedness training to their worker populations. The newly proposed training under this announcement would be utilized to award supplemental funding to expand these ongoing Coronavirus response training efforts.

Specific Areas of Training

The NIEHS WTP Coronavirus Bio-Safety Training initiative will be comprised of both awareness and operations level health and safety training either directly with specific organizations and agencies or through Train-the-Trainer methods. A standard process is required by all applicants in collaboration with NIEHS to ensure that the quality and content of information is consistent and takes into consideration organization’s administrative, engineering, and personal protection policies, procedures, and supplies. The skills of the instructor to assess their audience for tasks to be performed, literacy level, and cultural or language needs is critical to conveying information that is relevant for the worker. In addition, this program is strongly encouraged to engage a whole community approach which promotes improved communications and integration of activities with local response organizations, both inside and outside of hospitals and health care facilities.

For purposes of this administrative supplement (and within the parent application) the following approaches are considered responsive to the intent of the supplement.

Specifically, applicants should develop safety and health training for those workers supporting the national Coronavirus response. Applicants should develop targeted pilot training for those at high risk of accepting or potentially being closely exposed (such as transport cabin crew) to Coronavirus-exposed patients and waste and bodily fluid through air transport, medical treatment, environmental services, waste handling, and cleanup.

Applicants must have direct access to the target training population and be able to initiate training immediately. Using our hazmat trainers understanding of worker safety and health protection issues, knowledge of PPE usage, and experience in training disaster workers, WTP would coordinate with CDC, Health and Human Services Assistant Secretary for Preparedness and Response (ASPR), OSHA and NIOSH to develop an evidence-based curriculum that addresses the science of Coronavirus (clinical symptoms, mode of transmission, persistence in the environment, treatment); infection control and worker protection (isolation/quarantine, PPE); working in the contaminated environment (sampling and decontamination); and behavioral health resiliency .

The competency-based curriculum would include a training-of-trainers component that would permit the creation of a large cadre of trainers who could then provide local/regional training as needed. Locations for the pilot bio-safety training will be targeted in consultation with HHS, CDC and other state and local bio-safety response organizations. The proposed training program will build substantial capacity for pandemic preparedness and response for a broad spectrum of infectious disease conditions. The NIEHS Coronavirus Training Plan is focused on reaching the at-risk populations which have been identified by the interagency working groups. This would involve all of the target populations in both health care and non-health care.

Appropriate infection control recommendations from CDC and appropriate occupational safety recommendations from OSHA and NIOSH are to be incorporated into the resources and other training materials developed based on the needs of the target population being trained. Those resources can be found at https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html, https://www.osha.gov/SLTC/covid-19/ , and https://www.cdc.gov/niosh/emres/2019_ncov.html

Train-the-Trainer (TTT) Model. WTP grantee instructors will provide a TTT to representative healthcare instructors' local emergency response teams selected b parent organizations to attend a TTT with the objectives of providing prospective instructors with tools needed to return to their organizations and provide awareness or operations level training to their members.

Awareness level will provide audiences with basic information on recognizing and mitigating hazards (if appropriate) associated with activities that may be impacted by a potential Coronavirus exposure, but not have direct contact with infected body fluids. This training emphasizes recognition and the use of universal precautions, hand washing, and current immunizations, and self-care (diet, exercise, rest, etc.).

Operations level will provide audiences with information on recognizing and mitigating hazards associated with activities that include direct contact with infected body fluids. This training emphasizes hands-on putting on and removing PPE and personal medical surveillance.

WTP Direct Training Model. WTP grantee instructors will provide training to designated healthcare audiences utilizing site specific information with regards to protocols, supplies, and job tasks. This may be conducted at the sponsor’s location with smaller groups where operations level training is desired with hands-on activity to include putting on and taking off PPE.

The process to conduct such training would include, but not limited to, the following elements:

• Outreach to stakeholder organizations in each of the target pilot sites for site-specific and facility -specific issues affecting Coronavirus response workers with the formation of local advisor groups.
• Development of curriculum and materials in collaboration with CDC, NIOSH, OSHA and ASPR subject matter experts (SME s)
• Creation of course modules and learning activities for a 4-8 hour awareness-level training course
• Creation of course modules and learning activities for a 32-hour operations-level training course which will include a full PPE dress-out.
• Facilitator and Participants handbook
• Train-the-trainer curriculum and handbook
• Pilot testing in selected locations
• Pilot testing in selected WTP grantee training facilities
• Evaluation of training effectiveness and quality

The WTP is developing a series of PowerPoint slides that will be used by instructors after identifying the training needs of the organization and the targeted training population. Training curriculum can then be developed incorporating hands-on and small group activities encouraging participant engagement to promote and demonstrate understanding and proficiency. The training will incorporate an evaluation process that will include a pre- and post-training assessment. In addition, follow up evaluation may be performed to measure training benefit and information retention in an effort to improve training and presentation methodologies.

Through the application of distance learning and on-line training, NIEHS WTP encourages the development and deployment of advanced training technology for meeting the national challenge to expeditiously train and protect infectious disease responders during the emerging COVID-19 pandemic. In adopted a blended learning approach to advanced training technology deployment, NIEHS WTP not only recognizes the importance of considering the learner and instructor perspectives on e-learning technologies, but has demonstrated successes in deploying these technologies for effective HAZMAT training for cleanup workers and emergency responders.

A number of NIEHS WTP grantees have already adapted in-classroom learning modules for mobile applications and on-line experiences; created opportunities that Virtual Reality and immersive technologies offer for workers in different occupations; created E-learning resources and learning management systems (LMS), such as Massive Open Online Courses (MOOC). With this announcement, we continue to encourage applicants to facilitate distance-education and interactive learning experiences, which can provide opportunities for instructors to remain engaged, and to maintain contact with learners and response workers on the frontlines of the national COVID-19 pandemic response and recovery

Eligibility

Applicants must be an active grantee of RFA-ES-19-003, "Hazardous Materials Worker Health and Safety Training (U45 Clinical Trials Not Allowed)", RFA-ES-19-004, "HAZMAT Training at DOE Nuclear Weapons Complex (UH4 Clinical Trial Not Allowed)" , RFA-ES-15-018, "Worker Training Program (WTP) Ebola Biosafety and Infectious Disease Response Training (UH4)", or RFA-ES-19-009 - SBIR E-Learning for HAZMAT and Emergency Response (R43/R44 Clinical Trial Not Allowed).

Application and Submission Information

Applications for this initiative must be submitted using the following opportunity or its subsequent reissued equivalent.

PA-20-135 - Emergency Competitive Revision to Existing NIH Awards (Emergency Supplement - Clinical Trial Optional)

All instructions in the SF424 (R&R) Application Guide and must be followed, with the following additions:

• Application Due Date(s) April 24, 2020, by 5:00 PM local time of applicant organization.
• For funding consideration, applicants must include NOT-ES-20-014 (without quotation marks) in the Agency Routing Identifier field (box 4B) of the SF424 R&R form. Applications without this information in box 4B will not be considered for this initiative.
• Requests may be for one to three years of support only.
• The Research Strategy section of the application is limited to 6 pages.
• Only existing awardees of NIEHS WTP program are eligible to apply.
• The process for Streamlined Submissions using the eRA Commons cannot be used for this initiative.
• Applicants are strongly encouraged to notify the program contact at the Institute supporting the parent award that a request has been submitted in response to this FOA in order to facilitate efficient processing of the request.