Expired PA-06-320: Economics of Prevention and Treatment Services for Drug and Alcohol Abuse (R03)

Department of Health
and Human Services (HHS)

NIH... Turning Discovery Into Health^®

Table of Contents

Part I Overview Information

Part II Full Text of Announcement

Section I. Funding Opportunity Description
1. Research Objectives

Section II. Award Information
1. Mechanism of Support
2. Funds Available

Section III. Eligibility Information
1. Eligible Applicants
A. Eligible Institutions
B. Eligible Individuals
2.Cost Sharing or Matching
3. Other - Special Eligibility Criteria

Section IV. Application and Submission Information
1. Request Application Information
2. Content and Form of Application Submission
3. Submission Dates and Times
A. Submission, Review, and Anticipated Start Dates
1. Letter of Intent
B. Sending an Application to the NIH
C. Application Processing
4. Intergovernmental Review
5. Funding Restrictions
6. Other Submission Requirements

Section V. Application Review Information
1. Criteria
2. Review and Selection Process
A. Additional Review Criteria
B. Additional Review Considerations
C. Sharing Research Data
D. Sharing Research Resources
3. Anticipated Announcement and Award Dates

Section VI. Award Administration Information
1. Award Notices
2. Administrative and National Policy Requirements
3. Reporting

Section VII. Agency Contact(s)
1. Scientific/Research Contact(s)
2. Peer Review Contact(s)
3. Financial/Grants Management Contact(s)

Section VIII. Other Information - Required Federal Citations

Part II - Full Text of Announcement

Section I. Funding Opportunity Description

1. Research Objectives

Purpose

The purpose of this Funding Opportunity Announcement (FOA) issued by the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) of the National Institutes of Health (NIH) is to seek research on the economics of prevention and treatment services associated with drug and alcohol abuse. Drug abuse and dependence were estimated to generate an economic burden of $143 billion in 1998, driven by health care expenditures (drug abuse services and medical consequences), productivity losses (death, job problems, incarceration, crime careers, and crime victims), and juvenile and adult criminal justice expenditures. In 2004, the Federal government budgeted $12.6 billion for prevention, treatment and enforcement related to drug abuse. The NIDA Services Research and the Prevention Research Branches of the Division of Epidemiology, Services and Prevention Research, as part of the Institute's health services research program, will jointly support these economic research projects.

Similarly, alcohol abuse and dependence were estimated to generate an economic burden of about $185 billion in 1998. The NIAAA Division of Epidemiology and Prevention Research will support these economic research projects.

Research Objectives

The NIH solicits applications to conduct research related to: (1) financing of prevention and treatment services associated with either drug or alcohol abuse, including health insurance and/or payment mechanisms; (2) alternative delivery systems and managed care; (3) cost-benefit, cost-effectiveness, or cost-utility analyses; (4) services costs and production; and (5) methodological research.

Background

Economic research on services for drug and alcohol abuse informs decisions related to the allocation of resources and efforts to enhance efficiency and equity in the delivery of such resources. Applied research on alternative payment systems, public and private financing systems, and the design of insurance must be grounded in sound microeconomic principles. Economic research on interventions may build on prevention and treatment effectiveness studies or on randomized clinical trials. With social policy and institutional changes, many natural experiments are suitable for the application of economic analysis.

Public financing for services associated with drug and alcohol abuse is derived from federal, state, and local government funds. Private sources of funding for these services include health insurance, consumer out-of-pocket expenditures, and charity. Scientific inquiry into financing these services requires normative and positive economic analyses on allocation and distribution issues. For example, because different levels of government are involved in public financing for these types of health care services, fiscal federalism is a central issue. Because indigent health status is a major concern, distributive issues must be addressed. Analyses of both public and private provision of health insurance would be essential. Service delivery systems for prevention and treatment associated with drug and alcohol abuse are undergoing redesign, and studies about payment mechanisms are encouraged to examine implications and outcomes related to such redesigned systems.

Behavioral health care organizations (BHOs) have expanded dramatically, and require economic analyses in conjunction with organizational and management aspects of service delivery. Usually for-profit, BHOs administer the mental health, alcohol, and drug abuse prevention and treatment benefits in private or publicly sponsored health insurance plans. BHOs utilize managed care mechanisms to manage the access to, quality, outcomes, and costs of delivering services related to drug abuse and alcohol abuse. Managed care systems require research on principal-agent relationships and design of incentives, contracts, and regulations for drug abuse services. Economic analysis also has a role in outcome monitoring that contributes to improving the quality, allocation, and distribution of resources and interventions within such delivery systems.

Cost-benefit, cost-effectiveness, and cost-utility analyses are collaborative activities conducted by economic and health services researchers who investigate the effectiveness of innovative preventive or therapeutic interventions, as well as the effectiveness of delivering such services in real-world settings. Rigorous methodological work is needed to quantify health costs, benefits, and outcomes, as well as other non-health-related costs, benefits, and outcomes.

Costs could include direct and indirect costs associated with prevention and treatment programs, as well as savings associated with the social costs related to drug and alcohol abuse. Unfortunately, most currently available information on the unit costs of substance abuse services is rudimentary. This has hampered the quantification of prices and costs associated with service delivery for innovative and standard substance abuse services. This is particularly a problem with respect to prevention, in which services often involve costs embedded and expended in other systems, such as schools, law enforcement, community services, or employee assistance programs (EAPs). Treatment costs for other diseases can be increased if patients exhibit a concurrent drug or alcohol abuse disorder, but treating such substance abuse disorders might generate overall cost savings (or cost-offsets ) in integrated health care or community service networks. Conceptualizing and measuring the relationships among accounting and economic cost, marginal cost, incremental cost, average cost, and total cost remain important topics for economic evaluation in prevention and treatment programs and service delivery systems for drug abuse and alcohol abuse problems. Research in these areas is needed so that standardized estimates and methods for measuring the costs and outcomes of prevention and treatment can be generated. Economic research is also sought on the production cost associated with delivering discrete units of services associated with prevention and treatment of drug and/or alcohol abuse disorder.

A comprehensive bibliography on the economics of drug abuse prevention and treatment services can be found on the NIDA web site at: http://www.drugabuse.gov/pdf/despr/EconBiblio2005.pdf.

In May 2003, NIDA convened the Health Services Research Blue Ribbon Task Force to review it's the portfolio of health services research; and to advise the Institute on strategies for increasing its relevance and facilitating the utilization of research-based prevention and treatment interventions into practice and policies. A complete copy of the report can be accessed via the NIDA website at: http://www.drugabuse.gov/about/organization/nacda/CouncilPresentations.html.

In the area of prevention, the Task Force identified a need for an increase in the number of studies fully dedicated to economics issues. The Task Force recommended more studies examining such topics as: financial flows; economic incentives; the level of prevention financing; implementation costs for those programs that have shown promising outcomes; quantifications of cost-benefit, cost-effectiveness, and cost-utility associated with those prevention interventions that emphasize long-term outcomes, particularly for high-risk individuals; financial decision-making about prevention practices; allocation of funds for such services; decision-making processes and how decisions influence program quality and sustainability. In the area of treatment, the Task Force recommended more studies related to: different methods of financing drug abuse treatment services within and outside of conventional health insurance and payment mechanisms; the application of new methods for quantifying cost-benefit, cost-effectiveness, and cost-utility; quantifying changes in quality-of-life associated with successful treatment of drug abuse disorders; performance-contracting models designed to provide payment contingent upon outcomes; and different models of risk adjustment to health plans and providers.

NIDA's Clinical Trials Network (CTN) is an important foundation upon which to conduct economics research sought in this FOA. The CTN was established in 1999 to study the impact of evidence-based practices in diverse settings and populations. Economic research is needed to determine the cost-benefit or cost-effectiveness of the interventions under study in CTN. Research in financing and managed care could also be beneficial in the context of the CTN program.

Cross-Cutting Themes: HIV/AIDS and Health Disparities

HIV/AIDS. HIV/AIDS as it relates to the prevention and treatment of drug use, abuse, and dependency continues to represent high public health priorities for these Institutes. The catastrophic medical expenses and premature disability due to AIDS can have a devastating impact on the well being of the afflicted individual. Society also experiences numerous negative consequences from the HIV/AIDS and indeed some nations are experiencing health system failures. Furthermore, persons with HIV/AIDS also face other blood borne infections, and of particular concern, is hepatitis C (HCV).

Public health experts maintain that in order to achieve declines in AIDS incidence and deaths, HIV-infected persons must seek testing earlier in the course of their disease, receive and adhere to treatment, and follow prevention guidelines. Research to achieve these goals must involve an economic component concerned with the economic behavior of consumers, providers, government agencies, and third party payers. Applications are sought that would employ the methods of economic analysis to pressing problems in the financing and delivery of HIV/AIDS services and drug abuse treatment and/or prevention services. For information on grant solicitation on HIV/AIDS, see PA-02-164 at: http://grants.nih.gov/grants/guide/pa-files/PA-02-164.html.

Health Disparities. Substantial disparities exist in the distribution of health services to various populations in the United States. Research on the economics of health disparities is needed to expand the theoretical and conceptual basis as well as improve empirical measurements of health disparities. Considerable work is needed in both health care financing and service distribution and the concept of health equity. Economic research may improve our knowledge about causes of drug abuse, alcohol abuse, and addiction among all racial/ethnic groups, recognizing diversity by gender, socioeconomic status, and other factors affecting racial/ethnic populations. Economic research might also focus on prevention and treatment for racial/ethnic groups at highest risk for abuse or addiction and the medical consequences of drug and/or alcohol abuse.

Research Areas

Researchers are encouraged to develop rigorous designs for studies in the economics of prevention and treatment services for drug and/or alcohol abuse. The following are illustrative problem areas that may be addressed under this announcement. The examples are not exhaustive, and applications that address additional or different research questions are anticipated.

Financing of Prevention and Treatment Services for Drug and/or Alcohol Abuse

Fundamental questions to be examined include: (1) What criteria should be applied in judging budget policies? (2) What are the social, political, economic, and historical forces that have formed the present funding pattern and will determine contemporary and future patterns? (3) What are the interactions between the private and public drug services sectors as various funding plans are devised? Financing issues are complex, and in addition to analytical studies, this area of research requires descriptive studies to identify the sources of funding and their relationship to the organization and delivery of prevention and treatment services. Research topics in this broad area may be refined into two subtopics:

Health Insurance. Private and publicly sponsored health insurance coverage for prevention and treatment services for drug abuse or alcohol abuse affects many participants in the prevention and treatment service delivery systems. Examples of research topics include:

Studies of different methods of financing prevention and treatment services for drug abuse and alcohol abuse, for example, within and outside of conventional health insurance and payment mechanisms, as well as publicly-sponsored beneficiary programs including Medicare and Medicaid;
Financing issues for expanding use of new, potentially effective medications, devices and interventions;
Analysis of market functioning, market failure, moral hazard, adverse selection, risk pools, and reinsurance;
Economic evaluation of benefit parity, generosity of benefits, federal or state mandates, and design of prevention and treatment benefit structures in private and publicly-sponsored health insurance plans;
Analysis of the prevalence and adequacy of insurance coverage for prevention and treatment services, types of coverage available to insured and uninsured persons, and studies about the degree to which uninsured persons who need drug or alcohol treatment services are able to obtain such services; and
Insurance studies related to patients with or highly susceptible to HIV/AIDS.

Payment Mechanisms. Payment mechanisms affect the degree of access to, and delivery, utilization, and quality of prevention and treatment services for drug abuse or alcohol abuse. Examples of such studies include:

Effectiveness evaluation of performance-contracting models designed to provide payment contingent upon satisfactory patient performance outcomes;
Risk adjustment methods pursued by health plans and among providers;
Reimbursement levels and service adjustments; and
Carve-outs, risk contracting, provider incentives, and performance contracting.

Alternative Delivery Systems and Managed Care

Substance abuse treatment services are frequently delivered in managed, behavioral health care organizations that combine insurance and delivery functions. Research is needed on access to, and quality, outcomes, and costs of delivering services in alternative or capitated payment environments. Examples of such studies include:

Economic evaluation of well-defined, public and private, managed cared systems on quality, access, outcomes, and costs of service delivery;
Economic evaluation of prevention programs under managed care designed to avert or minimize the onset or effects of drug abuse or alcohol abuse;
Managed care effects on clinical decision-making, and the effects on therapeutic or economic outcomes wrought by differing structures and functions among treatment provider organizations;
Variable effects associated with different organizational structures of substance abuse treatment delivery, for example, treatment services that are either carved-out or integrated into a managed care system;
Economic evaluation of HIV/AIDS prevention and treatment services, delivered concurrently with drug or alcohol abuse prevention and treatment services offered within managed care systems;
Cost-benefit analysis of actual or hypothetical rationing schemes; and
Economic evaluation of employee assistance programs.

Cost-Benefit, Cost-Effectiveness, and Cost-Utility Analysis

The analysis of the economic costs and benefits associated with prevention and treatment services for drug and alcohol abuse interventions has usually been pursued in conjunction with effectiveness studies. Cost-effectiveness studies are useful in comparing different prevention and treatment interventions, including comparisons of innovative vs. standard interventions. There is a paucity of cost-utility studies reflecting the preference-based assessment of health outcomes associated with treatment for drug abuse or alcohol abuse; more such studies are needed. Examples of such studies include:

Innovative prevention and treatment methods targeted at special populations, e.g., injection drug users, women, pregnant women, women with children, criminal justice populations, adolescents, patients with co-occurring chronic diseases, ethnic minorities, persons with disabilities, gay and lesbian populations, and patients with or highly susceptible to HIV/AIDS;
Prevention interventions in various family, school, faith-based, and/or community settings and delivery systems;
Utilization of new medications, including complementary or alternative medications, for treating substance abuse disorders or other behavioral disorders;
Business practice innovations intended to increase service efficiency, including workforce training and human resource management initiatives;
Evaluation of widely-practiced conventional services such as group counseling, intensive outpatient treatment, placement criteria, community coalitions, and recovery communities, with particular emphasis on structural variations or innovative models that might yield enhanced outcomes;
Benefit valuation with methodologies related to quality-adjusted life years (QALYS) or willingness-to-pay; and
Technical assistance provided within delivery systems related to the adoption and maintenance of substance abuse prevention and treatment practices and policies.

Cost and Production of Prevention and Treatment Services for Drug and Alcohol Abuse

A strong conceptualization and measurement of economic costs is needed to support economic evaluations of prevention and treatment programs, as well as studies of the economic costs to society associated with substance abuse and dependency disorders. Additional production function studies are a key complement to drug prevention and treatment cost studies and have not been done. Examples of such cost and production research include:

Studies of implementation costs of evidence-based programs in prevention and treatment
Estimation of the direct medical, direct non-medical, and indirect costs, component unit service costs, costs of ancillary services, and full costs of prevention and treatment services for drug and alcohol abuse;
Drug court costs and other criminal justice-related treatment systems;
Studies of technology, elasticity of substitution, distributional effects, and returns to scale.

Methodological Research

Research is encouraged that will develop and test the application of new methods of economic analysis in substance abuse health services research. Examples include:

Developing theoretical and empirical approaches to measuring health disparities;
Advancing health insurance theory related to drug and alcohol abuse services coverage;
Improving quantitative and qualitative assessment of alternative delivery systems and managed care organizations;
Developing new statistical methods associated with economic analyses of delivering prevention and treatment services. This might involve methods for handling of truncated outcomes and costs in economic evaluations or methods for endogeneity bias in non-experimental research designs, including observational data, natural experiments, or quasi-experimental designs;
Developing simulation models that advance analytic understanding of the financing and delivering of prevention and treatment services for drug or alcohol abuse;
Improving methodologies of cost-benefit, cost-effectiveness, and cost-utility analysis in substance abuse economic studies;
Incorporating dynamic models of disease, prevention, and treatment progression into broader or societal-level economic models;
Cost, financing, regulations, organization, and workforce factors in shaping dissemination, uptake, and ultimately adoption and delivery of new interventions and services; and
Estimating of the current and anticipated labor force required to meet demand for substance abuse prevention and treatment services, including multivariate modeling studies of factors such as payment environment, service intensity, and clinical license categories.

See Section VIII, Other Information - Required Federal Citations, for policies related to this announcement.

Section II. Award Information

1. Mechanism of Support

This FOA invites applications for small research projects that can be carried out in a short period of time with limited resources. The applicant will be solely responsible for planning, directing, and executing the proposed project.

This FOA uses just-in-time concepts. It also uses the modular budget formats (see the Modular Applications and Awards section of the NIH Grants Policy Statement). Specifically, if you are submitting an application with direct costs in each year of $250,000 or less (excluding consortium Facilities and Administrative [F&A] costs), use the PHS398 Modular Budget component provided in the SF424 (R&R) Application Package and SF424 (R&R) Application Guide (see specifically Section 5.4, Modular Budget Component, of the Application Guide).

Competing renewal (formerly competing continuation ) applications will not be accepted for the R03 grant mechanism. Small grant support may not be used for thesis or dissertation research. Up to two resubmissions (formerly revisions/amendments") of a previously reviewed small grant application may be submitted. See NOT-OD-05-046, April 25, 2005.

For specific information about the R03 programs, see: http://grants.nih.gov/grants/funding/r03.htm.

2. Funds Available

Although the financial plans of the NIH Institutes and Centers (ICs) provide support for this program, awards pursuant to this funding opportunity are contingent upon the availability of funds and the submission of a sufficient number of meritorious applications.

A project period of up to two years and a budget for direct costs of up to two $25,000 modules, or $50,000 per year, may be requested (i.e., a maximum of $100,000 over two years in four modules of $25,000 each). Commensurate F&A costs are allowed.

F&A costs requested by consortium participants are not included in the direct cost limitation. See NOT-OD-05-004, November 2, 2004.

Section III. Eligibility Information

1. Eligible Applicants

1.A. Eligible Institutions

You may submit (an) application(s) if your organization has any of the following characteristics:

For-profit organizations
Non-profit organizations
Public or private institutions, such as universities, colleges, hospitals, and laboratories
Units of State government
Units of local government
Eligible agencies of the Federal government
Foreign Institutions
Domestic Institutions
Faith-based or community-based organizations
Units of State Tribal government
Units of Local Tribal government

1.B. Eligible Individuals

Any individual with the skills, knowledge, and resources necessary to carry out the proposed research as the Project Director/Principal Investigator (PD/PI) is invited to work with his/her institution to develop an application for support. Individuals from underrepresented racial and ethnic groups as well as individuals with disabilities are always encouraged to apply for NIH support.

2. Cost Sharing or Matching

This program does not require cost sharing as defined in the current NIH Grants Policy Statement.

3. Other-Special Eligibility Criteria

Applicants may submit more than one application, provided each application is scientifically distinct.

Section IV. Application and Submission Information

Registration and Instructions for Submission via Grants.gov

To download a SF424 (R&R) Application Package and SF424 (R&R) Application Guide for completing the SF424 (R&R) forms for this FOA, link to http://www.grants.gov/Apply/ and follow the directions provided on that Web site.

A one-time registration is required for institutions/organizations at both:

Grants.gov (http://www.grants.gov/GetStarted) and
eRA Commons (http://era.nih.gov/ElectronicReceipt/preparing.htm)

PDs/PIs should work with their institutions/organizations to make sure they are registered in the eRA Commons.

Several additional separate actions are required before an applicant institution/organization can submit an electronic application, as follows:

1) Organizational/Institutional Registration in Grants.gov/Get Started

Your organization will need to obtain a Data Universal Number System (DUNS) number and register with the Central Contractor Registration (CCR) as part of the Grants.gov registration process.
If your organization does not have a Taxpayer Identification Number (TIN) or Employer Identification Number (EIN), allow for extra time. A valid TIN or EIN is necessary for CCR registration.
The CCR also validates the EIN against Internal Revenue Service records, a step that will take an additional one to two business days.
Direct questions regarding Grants.gov registration to:
Grants.gov Customer Support
Contact Center Phone: 800-518-4726
Business Hours: M-F 7:00 a.m. - 9:00 p.m. Eastern Time
Email [email protected]

2) Organizational/Institutional Registration in the eRA Commons

To find out if an organization is already Commons-registered, see the "List of Grantee Organizations Registered in NIH eRA Commons.
Direct questions regarding the Commons registration to:
eRA Commons Help Desk
Phone: 301-402-7469 or 866-504-9552 (Toll Free)
TTY: 301-451-5939
Business hours M-F 7:00 a.m. - 8:00 p.m. Eastern Time
Email [email protected]

3) ) Project Director/Principal Investigator (PD/PI) Registration in the NIH eRA Commons: Refer to the NIH eRA Commons System (COM) Users Guide.

The individual designated as the PD/PI on the application must also be registered in the NIH eRA Commons. It is not necessary for PDs/PIs to register with Grants.gov.
The PD/PI must hold a PD/PI account in the Commons and must be affiliated with the applicant organization. This account cannot have any other role attached to it other than the PD/PI.
This registration/affiliation must be done by the Signing Official (SO) or their designee who is already registered in the Commons.
Both the PD/PI and SO need separate accounts in the NIH eRA Commons since both are required to verify the application.

Note that if a PD/PI is also an NIH peer-reviewer with an Individual DUNS and CCR registration, that particular DUNS number and CCR registration are for the individual reviewer only. These are different than any DUNS number and CCR registration used by an applicant organization. Individual DUNS and CCR registration should be used only for the purposes of personal reimbursement and should not be used on any grant applications submitted to the Federal Government.

Several of the steps of the registration process could take four weeks or more. Therefore, applicants should immediately check with their business official to determine whether their organization/institution is already registered in both Grants.gov and the Commons. The NIH will accept electronic applications only from organizations that have completed all necessary registrations.

1. Request Application Information

Applicants must download the SF424 (R&R) application forms and SF424 (R&R) Application Guide for this FOA through Grants.gov/Apply.

Note: Only the forms package directly attached to a specific FOA can be used. You will not be able to use any other SF424 (R&R) forms (e.g., sample forms, forms from another FOA), although some of the "Attachment" files may be useable for more than one FOA.

For further assistance contact GrantsInfo, Telephone 301-710-0267, Email: [email protected].

Telecommunications for the hearing impaired: TTY 301-451-5936.

2. Content and Form of Application Submission

Prepare all applications using the SF424 (R&R) application forms and in accordance with the SF424 (R&R) Application Guide (MS Word or PDF).

The SF424 (R&R) Application Guide is critical to submitting a complete and accurate application to NIH. There are fields within the SF424 (R&R) application components that, although not marked as mandatory, are required by NIH (e.g., the Credential log-in field of the Research & Related Senior/Key Person Profile component must contain the PD/PI’s assigned eRA Commons User ID). Agency-specific instructions for such fields are clearly identified in the Application Guide. For additional information, see Tips and Tools for Navigating Electronic Submission on the front page of Electronic Submission of Grant Applications.

The SF424 (R&R) application is comprised of data arranged in separate components. Some components are required, others are optional. The forms package associated with this FOA in Grants.gov/APPLY will include all applicable components, required and optional. A completed application in response to this FOA will include the following components:

Required Components:
SF424 (R&R) (Cover component)
Research & Related Project/Performance Site Locations
Research & Related Other Project Information
Research & Related Senior/Key Person
PHS398 Cover Page Supplement
PHS398 Research Plan
PHS398 Checklist
PHS Modular Budget

Optional Components:
PHS398 Cover Letter File
Research & Related Subaward Budget Attachment(s) Form

Note: While both budget components are included in the SF424 (R&R) forms package, the NIH R03 uses ONLY the PHS 398 Modular Budget. (Do not use the detailed Research & Related Budget.)

Foreign Organizations
Several special provisions apply to applications submitted by foreign organizations:

Charge back of customs and import fees is not allowed.
Format: Every effort should be made to comply with the format specifications which are based upon a standard U.S. paper size of 8.5 x 11 within each PDF.
Funds for up to 8% administrative costs (excluding equipment) may be requested. See NOT-OD-01-028, March 29, 2001.
Organizations must comply with Federal/NIH policies on human subjects, animals, and biohazards.
Organizations must comply with Federal/NIH biosafety and biosecurity regulations. See Section VI.2., Administrative and National Policy Requirements.

Proposed research should provide a unique research opportunity not available in the United States.

3. Submission Dates and Times

See Section IV.3.A for details.

3.A. Submission, Review and Anticipated Start Dates

Opening Date: May 2, 2006 (Earliest date an application may be submitted to Grants.gov
Letters of Intent Receipt Date(s): Not Applicable
Application Submission/Receipt Date(s): Standard dates apply, please see
http://grants.nih.gov/grants/funding/submissionschedule.htm.
AIDS Application Submission/Receipt Date(s): Please see http://grants.nih.gov/grants/funding/submissionschedule.htm#AIDS.
Peer Review Date(s): Please see http://grants.nih.gov/grants/funding/submissionschedule.htm#reviewandaward.
Council Review Date(s): Please see http://grants.nih.gov/grants/funding/submissionschedule.htm#reviewandaward.
Earliest Anticipated Start Date(s): See http://grants.nih.gov/grants/funding/submissionschedule.htm#reviewandaward.

3.A.1. Letter of Intent

A letter of intent is not required for the funding opportunity.

3.B. Sending an Application to the NIH
To submit an application in response to this FOA, applicants should access this FOA via http://www.grants.gov/Apply and follow steps 1-4. Note: Applications must only be submitted electronically.
PAPER APPLICATIONS WILL NOT BE ACCEPTED.

3.C. Application Processing
Applications may be submitted on or after the opening date and must be successfully received by Grants.gov no later than 5:00 p.m. local time (of the applicant institution/organization) on the application submission/receipt date(s). (See Section IV.3.A. for all dates.) If an application is not submitted by the receipt date(s) and time, the application may be delayed in the review process or not reviewed.

Upon receipt, applications will be transferred from Grants.gov to the NIH Electronic Research Administration process for validation. Both the PD/PI and the Signing Official for the organization must verify the submission via Commons within two (2) business days of notification of the NIH validation.

Upon receipt, applications will be evaluated for completeness by the Center for Scientific Review, NIH. Incomplete applications will not be reviewed.

There will be an acknowledgement of receipt of applications from Grants.gov and the Commons . Information related to the assignment of an application to a Scientific Review Group is also in the Commons.

The NIH will not accept any application in response to this FOA that is essentially the same as one currently pending initial merit review unless the applicant withdraws the pending application. The NIH will not accept any application that is essentially the same as one already reviewed. This does not preclude the submission of an application already reviewed with substantial changes, but such application must include an Introduction addressing the previous critique. Note that such an application is considered a "resubmission" for the SF424 (R&R).

4. Intergovernmental Review

This initiative is not subject to intergovernmental review.

5. Funding Restrictions

All NIH awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.

Pre-Award Costs are allowable. A grantee may, at its own risk and without NIH prior approval, incur obligations and expenditures to cover costs up to 90 days before the beginning date of the initial budget period of a new award if such costs: are necessary to conduct the project, and would be allowable under the grant, if awarded, without NIH prior approval. If specific expenditures would otherwise require prior approval, the grantee must obtain NIH approval before incurring the cost. NIH prior approval is required for any costs to be incurred more than 90 days before the beginning date of the initial budget period of a new award.

The incurrence of pre-award costs in anticipation of a competing or non-competing award imposes no obligation on NIH either to make the award or to increase the amount of the approved budget if an award is made for less than the amount anticipated and is inadequate to cover the pre-award costs incurred. NIH expects the grantee to be fully aware that pre-award costs result in borrowing against future support and that such borrowing must not impair the grantee's ability to accomplish the project objectives in the approved time frame or in any way adversely affect the conduct of the project. See the NIH Grants Policy Statement

6. Other Submission Requirements

The NIH requires the PD/PI to fill in his/her Commons User ID in the PROFILE Project Director/Principal Investigator section, Credential log-in field of the Research & Related Senior/Key Person Profile component. The applicant organization must include its DUNS number in its Organization Profile in the eRA Commons. This DUNS number must match the DUNS number provided at CCR registration with Grants.gov. For additional information, see Tips and Tools for Navigating Electronic Submission on the front page of Electronic Submission of Grant Applications.

Renewal (formerly competing continuation or Type 2 ) applications are not permitted.

All application instructions outlined in the SF424 (R&R) Application Guide (MS Word or PDF) are to be followed, with the following requirements for R03 applications:

R03 applications will use the modular budget format and Just-in-Time concepts, with direct costs of up to two $25,000 modules, or $50,000 per year, may be requested for up to two years (i.e., a maximum of $100,000 over two years in four modules of $25,000 each).
Items 2-5 of the PHS398 Research Plan component of the R03 application may not exceed 10 pages, including tables, graphs, figures, diagrams, and charts.
"Introduction (required for a resubmission application) is limited to one page.
Preliminary data are not required but may be included if available.
R03 Appendix materials may include graphic images of gels, micrographs, etc. provided that the image (may be reduced in size) is contained within the 10-page limit of Items 2-5 of the Research Plan. No images may be included in the Appendix that are not also represented within the Research Plan. No publications or other printed material, with the exception of pre-printed questionnaires or surveys, may be included in the Appendix.
Do not use the Appendix to circumvent the page limitations of the Research Plan. An application that does not observe these limitations may be delayed in the review process.

Note: While each section of the Research Plan needs to be uploaded separately as a PDF attachment, applicants are encouraged to construct the Research Plan as a single document, separating sections into distinct PDF attachments just before uploading the files. This approach will enable applicants to better monitor formatting requirements such as page limits. All attachments must be provided to NIH in PDF format, filenames must be included with no spaces or special characters, and a .pdf extension must be used.

Plan for Sharing Research Data

Not Applicable.

Sharing Research Resources

NIH policy requires that grant awardee recipients make unique research resources readily available for research purposes to qualified individuals within the scientific community after publication (See the NIH Grants Policy Statement http://grants.nih.gov/grants/policy/nihgps_2003/NIHGPS_Part7.htm#_Toc54600131). Investigators responding to this funding opportunity should include a sharing research resources plan addressing how unique research resources will be shared or explain why sharing is not possible.

The adequacy of the resources sharing plan and any related data sharing plans will be considered by Program staff of the funding organization when making recommendations about funding applications. The effectiveness of the resource sharing will be evaluated as part of the administrative review of each Non-Competing Grant Progress Report (PHS 2590). See Section VI.3., Reporting.

Section V. Application Review Information

1. Criteria

Only the review criteria described below will be considered in the review process.

2. Review and Selection Process

Applications submitted for this funding opportunity will be assigned to the ICs on the basis of established PHS referral guidelines.

Appropriate scientific review groups convened in accordance with the standard NIH peer review procedures (http://www.csr.nih.gov/refrev.htm) will evaluate applications for scientific and technical merit.

As part of the initial merit review, all applications will:

Undergo a selection process in which only those applications deemed to have the highest scientific merit, generally the top half of applications under review, will be discussed and assigned a priority score.
Receive a written critique.
Receive a second level of review by an appropriate national advisory council or board.

Applications submitted in response to this funding opportunity will compete for available funds with all other recommended applications. The following will be considered in making funding decisions:

Scientific merit of the proposed project as determined by peer review
Availability of funds
Relevance of program priorities

The NIH R03 small grant is a mechanism for supporting discrete, well-defined projects that realistically can be completed in two years and that require limited levels of funding. Because the research plan is restricted to 10 pages, a small grant application will not have the same level of detail or extensive discussion found in an R01 application. Accordingly, reviewers should evaluate the conceptual framework and general approach to the problem, placing less emphasis on methodological details and certain indicators traditionally used in evaluating the scientific merit of R01 applications, including supportive preliminary data. Appropriate justification for the proposed work can be provided through literature citations, data from other sources, or from investigator-generated data. Preliminary data are not required, particularly in applications proposing pilot or feasibility studies.

The goals of NIH-supported research are to advance our understanding of biological systems, to improve the control of disease, and to enhance health. In their written comments, reviewers will be asked to comment on each of the following criteria in order to judge the likelihood that the proposed research will have a substantial impact on the pursuit of these goals. The scientific review group will address and consider each of these criteria in assigning the application's overall score, weighting them as appropriate for each application.

Significance
Approach
Innovation
Investigator
Environment
Additional Review Criteria

Note that an application does not need to be strong in all categories to be judged likely to have major scientific impact and thus deserve a high priority score. For example, an investigator may propose to carry out important work that by its nature is not innovative but is essential to move a field forward.

Significance: Does this study address an important scientific health problem? If the aims of the application are achieved, how will scientific knowledge or clinical practice be advanced? What will be the effect of these studies on the concepts, methods, technologies, treatments, services, or preventative interventions that drive this field?

Approach: Are the conceptual or clinical framework, design, methods, and analyses adequately developed, well integrated, well reasoned, and appropriate to the aims of the project? Does the applicant acknowledge potential problem areas and consider alternative tactics?

Innovation: Is the project original and innovative? For example: Does the project challenge existing paradigms or clinical practice; address an innovative hypothesis or critical barrier to progress in the field? Does the project develop or employ novel concepts, approaches, methodologies, tools, or technologies for this area?

Investigators: Are the investigators appropriately trained and well suited to carry out this work? Is the work proposed appropriate to the experience level of the PD/PI and other researchers? Does the investigative team bring complementary and integrated expertise to the project (if applicable)?

Environment: Does the scientific environment in which the work will be done contribute to the probability of success? Do the proposed studies benefit from unique features of the scientific environment, or subject populations, or employ useful collaborative arrangements? Is there evidence of institutional support?

2.A. Additional Review Criteria:

In addition to the above criteria, the following items will continue to be considered in the determination of scientific merit and the priority score:

Protection of Human Subjects from Research Risk: The involvement of human subjects and protections from research risk relating to their participation in the proposed research will be assessed. See item 6 of the Research Plan component of the SF424 (R&R).

Inclusion of Women, Minorities and Children in Research: The adequacy of plans to include subjects from both genders, all racial and ethnic groups (and subgroups), and children as appropriate for the scientific goals of the research will be assessed. Plans for the recruitment and retention of subjects will also be evaluated. See item 7 of the Research Plan component of the SF424 (R&R).

Care and Use of Vertebrate Animals in Research: If vertebrate animals are to be used in the project, the five items described under item 11 of the Research Plan component of the SF424 (R&R) will be assessed.

Biohazards: If materials or procedures are proposed that are potentially hazardous to research personnel and/or the environment, determine if the proposed protection is adequate.

2.B. Additional Review Considerations

Budget and Period of Support: The reasonableness of the proposed budget and the appropriateness of the requested period of support in relation to the proposed research may be assessed by the reviewers. Is the percent effort listed for the PD/PI appropriate for the work proposed? Is each budget category realistic and justified in terms of the aims and methods?

2.C. Sharing Research Data

Not Applicable.

2.D. Sharing Research Resources

NIH policy requires that grant awardee recipients make unique research resources readily available for research purposes to qualified individuals within the scientific community after publication (See the NIH Grants Policy Statement http://grants.nih.gov/grants/policy/nihgps_2003/NIHGPS_Part7.htm#_Toc54600131). Investigators responding to this funding opportunity should include a sharing research resources plan addressing how unique research resources will be shared or explain why sharing is not possible.

Program staff will be responsible for the administrative review of the plan for sharing research resources.

The adequacy of the resources sharing plan will be considered by Program staff of the funding organization when making recommendations about funding applications. Program staff may negotiate modifications of the data and resource sharing plans with the awardee before recommending funding of an application. The final version of the data and resource sharing plans negotiated by both will become a condition of the award of the grant. The effectiveness of the resource sharing will be evaluated as part of the administrative review of each Non-Competing Grant Progress Report (PHS 2590). See Section VI.3., Reporting.

Model Organism Sharing Plan: Reviewers are asked to assess the sharing plan in an administrative note. The sharing plan itself should be discussed after the application is scored. Whether a sharing plan is reasonable can be determined by the reviewers on a case-by-case basis, taking into consideration the organism, the timeline, the applicant's decision to distribute the resource or deposit it in a repository, and other relevant considerations. For the R03 mechanism, the presence or adequacy of a plan should not enter into the scoring of the application.

3. Anticipated Announcement and Award Dates

Not Applicable.

Section VI. Award Administration Information

1. Award Notices

After the peer review of the application is completed, the PD/PI will be able to access his/her Summary Statement (written critique) via the NIH eRA Commons.

If the application is under consideration for funding, NIH will request "just-in-time" information from the applicant. For details, applicants may refer to the NIH Grants Policy Statement Part II: Terms and Conditions of NIH Grant Awards, Subpart A: General.

A formal notification in the form of a Notice of Award (NoA) will be provided to the applicant organization. The NoA signed by the grants management officer is the authorizing document. Once all administrative and programmatic issues have been resolved, the NoA will be generated via email notification from the awarding component to the grantee business official.

Selection of an application for award is not an authorization to begin performance. Any costs incurred before receipt of the NoA are at the recipient's risk. These costs may be reimbursed only to the extent considered allowable pre-award costs. See Section IV.5., Funding Restrictions.

2. Administrative and National Policy Requirements

All NIH grant and cooperative agreement awards include the NIH Grants Policy Statement as part of the NoA. For these terms of award, see the NIH Grants Policy Statement Part II: Terms and Conditions of NIH Grant Awards, Subpart A: General and Part II: Terms and Conditions of NIH Grant Awards, Subpart B: Terms and Conditions for Specific Types of Grants, Grantees, and Activities

3. Reporting

When multiple years are involved, awardees will be required to submit the Non-Competing Grant Progress Report (PHS 2590) annually and financial statements as required in the NIH Grants Policy Statement.

Section VII. Agency Contacts

We encourage your inquiries concerning this funding opportunity and welcome the opportunity to answer questions from potential applicants. Inquiries may fall into three areas: scientific/research, peer review, and financial or grants management issues:

1. Scientific/Research Contacts:

Sarah Q. Duffy, Ph.D.
Division of Epidemiology, Services and Prevention Research
National Institute on Drug Abuse
6001 Executive Blvd.
Room 5181, MSC 9589
Bethesda, MD 20892-9589
Rockville, MD 20852 (for express/courier service)
Telephone: (301) 451-4998
Fax: (301) 443-6815
Email: [email protected]

2. Peer Review Contacts:

Not Applicable.

3. Financial or Grants Management Contacts:

Gary Fleming, J.D.
Chief, Grants Management Branch/OPRM
National Institute on Drug Abuse/NIH/DHHS
6101 Executive Boulevard, Room 270
Bethesda, MD 20892-8403
Telephone: (301) 443-6710
Fax: (301) 594-6849
Email: [email protected]

Judy Fox
Chief, Grants Management Branch
National Institute on Alcohol Abuse and Alcoholism
5635 Fishers Lane, Room 3023, MSC 9304
Bethesda, MD 20892-9304
Telephone: (301) 443-4704
Email: [email protected]

Section VIII. Other Information

Required Federal Citations

Use of Animals in Research:
Recipients of PHS support for activities involving live, vertebrate animals must comply with PHS Policy on Humane Care and Use of Laboratory Animals (http://grants.nih.gov/grants/olaw/references/PHSPolicyLabAnimals.pdf) as mandated by the Health Research Extension Act of 1985 (http://grants.nih.gov/grants/olaw/references/hrea1985.htm), and the USDA Animal Welfare Regulations (http://www.nal.usda.gov/awic/legislat/usdaleg1.htm) as applicable.

Human Subjects Protection:
Federal regulations (45CFR46) require that applications and proposals involving human subjects must be evaluated with reference to the risks to the subjects, the adequacy of protection against these risks, the potential benefits of the research to the subjects and others, and the importance of the knowledge gained or to be gained (http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm).

Data and Safety Monitoring Plan:
Data and safety monitoring is required for all types of clinical trials, including physiologic toxicity and dose-finding studies (Phase I); efficacy studies (Phase II); efficacy, effectiveness and comparative trials (Phase III). Monitoring should be commensurate with risk. The establishment of data and safety monitoring boards (DSMBs) is required for multi-site clinical trials involving interventions that entail potential risks to the participants (NIH Policy for Data and Safety Monitoring, NIH Guide for Grants and Contracts, http://grants.nih.gov/grants/guide/notice-files/not98-084.html).

Sharing Research Data:
Investigators submitting an NIH application seeking $500,000 or more in direct costs in any single year are expected to include a plan for data sharing or state why this is not possible (http://grants.nih.gov/grants/policy/data_sharing).

Investigators should seek guidance from their institutions on issues related to institutional policies and local IRB rules, as well as local, State and Federal laws and regulations, including the Privacy Rule. Reviewers will consider the data sharing plan but will not factor the plan into the determination of scientific merit or the priority score.

Access to Research Data through the Freedom of Information Act:
The Office of Management and Budget (OMB) Circular A-110 has been revised to provide access to research data through the Freedom of Information Act (FOIA) under some circumstances. Data that are (1) first produced in a project that is supported in whole or in part with Federal funds and (2) cited publicly and officially by a Federal agency in support of an action that has the force and effect of law (i.e., a regulation) may be accessed through FOIA. It is important for applicants to understand the basic scope of this amendment. NIH has provided guidance at http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm. Applicants may wish to place data collected under this funding opportunity in a public archive, which can provide protections for the data and manage the distribution for an indefinite period of time. If so, the application should include a description of the archiving plan in the study design and include information about this in the budget justification section of the application. In addition, applicants should think about how to structure informed consent statements and other human subjects procedures given the potential for wider use of data collected under this award.

Sharing of Model Organisms:
NIH is committed to support efforts that encourage sharing of important research resources including the sharing of model organisms for biomedical research (see http://grants.nih.gov/grants/policy/model_organism/index.htm). At the same time the NIH recognizes the rights of grantees and contractors to elect and retain title to subject inventions developed with Federal funding pursuant to the Bayh Dole Act (see the NIH Grants Policy Statement http://grants.nih.gov/grants/policy/nihgps_2003/index.htm). All investigators submitting an NIH application or contract proposal, beginning with the October 1, 2004 receipt date, are expected to include in the application/proposal a description of a specific plan for sharing and distributing unique model organism research resources generated using NIH funding or state why such sharing is restricted or not possible. This will permit other researchers to benefit from the resources developed with public funding. The inclusion of a model organism sharing plan is not subject to a cost threshold in any year and is expected to be included in all applications where the development of model organisms is anticipated.

Inclusion of Women And Minorities in Clinical Research:
It is the policy of the NIH that women and members of minority groups and their sub-populations must be included in all NIH-supported clinical research projects unless a clear and compelling justification is provided indicating that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research. This policy results from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43). All investigators proposing clinical research should read the "NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical Research (http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-001.html); a complete copy of the updated Guidelines is available at http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm. The amended policy incorporates: the use of an NIH definition of clinical research; updated racial and ethnic categories in compliance with the new OMB standards; clarification of language governing NIH-defined Phase III clinical trials consistent with the SF424 (R&R); and updated roles and responsibilities of NIH staff and the extramural community. The policy continues to require for all NIH-defined Phase III clinical trials that: a) all applications or proposals and/or protocols must provide a description of plans to conduct analyses, as appropriate, to address differences by sex/gender and/or racial/ethnic groups, including subgroups if applicable; and b) investigators must report annual accrual and progress in conducting analyses, as appropriate, by sex/gender and/or racial/ethnic group differences.

Inclusion of Children as Participants in Clinical Research:
The NIH maintains a policy that children (i.e., individuals under the age of 21) must be included in all clinical research, conducted or supported by the NIH, unless there are scientific and ethical reasons not to include them.

All investigators proposing research involving human subjects should read the "NIH Policy and Guidelines" on the inclusion of children as participants in research involving human subjects (http://grants.nih.gov/grants/funding/children/children.htm).

Required Education on the Protection of Human Subject Participants:
NIH policy requires education on the protection of human subject participants for all investigators submitting NIH applications for research involving human subjects and individuals designated as key personnel. The policy is available at http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-039.html.

Human Embryonic Stem Cells (hESC):
Criteria for federal funding of research on hESCs can be found at http://stemcells.nih.gov/index.asp and at http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-005.html. Only research using hESC lines that are registered in the NIH Human Embryonic Stem Cell Registry will be eligible for Federal funding (http://escr.nih.gov). It is the responsibility of the applicant to provide in the project description and elsewhere in the application as appropriate, the official NIH identifier(s) for the hESC line(s)to be used in the proposed research. Applications that do not provide this information will be returned without review.

NIH Public Access Policy:
NIH-funded investigators are requested to submit to the NIH manuscript submission (NIHMS) system (http://www.nihms.nih.gov) at PubMed Central (PMC) an electronic version of the author's final manuscript upon acceptance for publication, resulting from research supported in whole or in part with direct costs from NIH. The author's final manuscript is defined as the final version accepted for journal publication, and includes all modifications from the publishing peer review process.

NIH is requesting that authors submit manuscripts resulting from 1) currently funded NIH research projects or 2) previously supported NIH research projects if they are accepted for publication on or after May 2, 2005. The NIH Public Access Policy applies to all research grant and career development award mechanisms, cooperative agreements, contracts, Institutional and Individual Ruth L. Kirschstein National Research Service Awards, as well as NIH intramural research studies. The Policy applies to peer-reviewed, original research publications that have been supported in whole or in part with direct costs from NIH, but it does not apply to book chapters, editorials, reviews, or conference proceedings. Publications resulting from non-NIH-supported research projects should not be submitted.

For more information about the Policy or the submission process please visit the NIH Public Access Policy Web site at http://PublicAccess.nih.gov/ and view the Policy or other Resources and Tools including the Authors' Manual (http://publicaccess.nih.gov/publicaccess_manual.htm).

Standards for Privacy of Individually Identifiable Health Information:
The Department of Health and Human Services (DHHS) issued final modification to the "Standards for Privacy of Individually Identifiable Health Information", the "Privacy Rule", on August 14, 2002. The Privacy Rule is a federal regulation under the Health Insurance Portability and Accountability Act (HIPAA) of 1996 that governs the protection of individually identifiable health information, and is administered and enforced by the DHHS Office for Civil Rights (OCR).

Decisions about applicability and implementation of the Privacy Rule reside with the researcher and his/her institution. The OCR Website (http://www.hhs.gov/ocr/) provides information on the Privacy Rule, including a complete Regulation Text and a set of decision tools on "Am I a covered entity?" Information on the impact of the HIPAA Privacy Rule on NIH processes involving the review, funding, and progress monitoring of grants, cooperative agreements, and research contracts can be found at http://grants.nih.gov/grants/guide/notice-files/NOT-OD-03-025.html.

HIV/AIDS Counseling and Testing Policy for the National Institute on Drug Abuse : Researchers funded by NIDA who are conducting research in community outreach settings, clinical, hospital settings, or clinical laboratories and have ongoing contact with clients at risk for HIV infection, are strongly encouraged to provide HIV risk reduction education and counseling. HIV counseling should include offering HIV testing available on-site or by referral to other HIV testing service for persons at risk for HIV infection including injecting drug users, crack cocaine users, and sexually active drug users and their sexual partners. For more information see http://grants.nih.gov/grants/guide/notice-files/NOT-DA-01-001.html.

National Advisory Council on Drug Abuse Recommended Guidelines for the Administration of Drugs to Human Subjects : The National Advisory Council on Drug Abuse recognizes the importance of research involving the administration of drugs to human subjects and has developed guidelines relevant to such research. Potential applicants are encouraged to obtain and review these recommendations of Council before submitting an application that will administer compounds to human subjects. The guidelines are available on NIDA's Home Page at http://www.nida.nih.gov under the Funding, or may be obtained by calling (301) 443-2755.

URLs in NIH Grant Applications or Appendices:
All applications and proposals for NIH funding must be self-contained within specified page limitations. Unless otherwise specified in an NIH solicitation, Internet addresses (URLs) should not be used to provide information necessary to the review because reviewers are under no obligation to view the Internet sites. Furthermore, we caution reviewers that their anonymity may be compromised when they directly access an Internet site.

Healthy People 2010:
The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of "Healthy People 2010," a PHS-led national activity for setting priority areas. This PA is related to one or more of the priority areas. Potential applicants may obtain a copy of "Healthy People 2010" at http://www.health.gov/healthypeople.

Authority and Regulations: This program is described in the Catalog of Federal Domestic Assistance at http://www.cfda.gov/ and is not subject to the intergovernmental review requirements of Executive Order 12372 or Health Systems Agency review. Awards are made under the authorization of Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284) and under Federal Regulations 42 CFR 52 and 45 CFR Parts 74 and 92. All awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement. The NIH Grants Policy Statement can be found at http://grants.nih.gov/grants/policy/policy.htm.

The PHS strongly encourages all grant recipients to provide a smoke-free workplace and discourage the use of all tobacco products. In addition, 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. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people.

Loan Repayment Programs:
NIH encourages applications for educational loan repayment from qualified health professionals who have made a commitment to pursue a research career involving clinical, pediatric, contraception, infertility, and health disparities related areas. The LRP is an important component of NIH's efforts to recruit and retain the next generation of researchers by providing the means for developing a research career unfettered by the burden of student loan debt. Note that an NIH grant is not required for eligibility and concurrent career award and LRP applications are encouraged. The periods of career award and LRP award may overlap providing the LRP recipient with the required commitment of time and effort, as LRP awardees must commit at least 50% of their time (at least 20 hours per week based on a 40 hour week) for two years to the research. For further information, please see: http://www.lrp.nih.gov.