NATIONAL RESEARCH SERVICE AWARD INDIVIDUAL POSTDOCTORAL FELLOWSHIPS NIH GUIDE, Volume 23, Number 19, May 20, 1994 PA NUMBER: PA-94-068 P.T. 22 Keywords: Biomedical Research Training Health Services Delivery Agency for Health Care Policy and Research Application Receipt Dates: August 5, December 5, and April 5 PURPOSE The Agency for Health Care Policy and Research (AHCPR) announces the continuing availability of postdoctoral National Research Service Award (NRSA) individual fellowships (F32) in health services research. These postdoctoral research fellowships provide opportunities for one or more years of academic training and supervised experience in applying quantitative research methods to the systematic analysis and evaluation of health services. Women, minorities, and individuals with disabilities are encouraged to apply. HEALTHY PEOPLE 2000 The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of "Healthy People 2000," a PHS-led national activity for setting priority areas. The AHCPR urges applicants to submit grant applications with relevance to the specific objectives of this initiative. Potential applicants may obtain a copy of "Healthy People 2000" (Full Report: Stock No. 017-001-00474-0, or Summary Report: Stock No. 017-001-004374-1) through the Superintendent of Documents, Government Printing Office, Washington, DC 20402-9325 (telephone 202-783-3238). ELIGIBILITY Applicants for postdoctoral fellowships must, at the time they apply, be citizens of the United States, noncitizen nationals, or noncitizens who have been lawfully admitted to the United States for permanent residence and have in their possession an Alien Registration Receipt Card I-551 or I-151 or other legal verification of such status at the time of application. Individuals on temporary or student visas are not eligible. Applicants must have received, by the activation date of the NRSA fellowship, a Ph.D., M.D., D.D.S., D.M.D., Sc.D., Dr.P.H., D.Pharm., or equivalent doctoral degree from an accredited domestic or foreign institution. Certification from an authorized official of the degree-granting institution that all degree requirements have been met is acceptable. (Persons possessing the J.D. degree as the sole advanced degree are not considered postdoctoral for NRSA purposes.) NRSA fellowships may not be used to support studies leading to the M.D., D.O., D.D.S., D.M.D., or equivalent health professional degree nor do they support residency training. MECHANISM OF SUPPORT This program announcement (PA) uses the National Research Service Award individual postdoctoral fellowship (F32) mechanism. Responsibility for the planning, direction, and execution of the proposed project will be solely that of the applicant and the sponsoring institution. This program announcement replaces PA-92-08. RESEARCH OBJECTIVES AHCPR-sponsored NRSA fellowships emphasize multidisciplinary health services research training. This training should provide a rigorous conceptual and methodological foundation for investigating topics that include, but are not limited to, the following: o Determinants of successful health care market reform, including incentives for selection of efficient health plans by health care purchasers and effective management by health care providers; o Cost-effectiveness and cost-benefit analysis, including allocation of health care resources and its relationship to health status; o Analysis of service delivery, resource use, and costs of care for persons with HIV-related illnesses; o Primary care issues, including relationships between the structure and organization of service delivery, access to care, and costs and outcomes of care; o Evaluation of managed care and other approaches to organizing, financing, and reimbursing health care services; o Alternative delivery systems, providers, and practice patterns in long-term care including home and community- based care; o Medical treatment effectiveness issues, including evaluation of outcomes associated with the use of clinical practice guidelines; o Availability, accessibility, effectiveness, and quality of care for underserved populations such as low-income groups and minority populations; o Rural health issues, including primary care access, service delivery, technology diffusion, and supply of health professionals; o Medical malpractice and liability; o Appropriateness and effectiveness, including cost effectiveness, of alternative treatments and technologies; o Factors affecting dissemination and assimilation of health and clinical information to practitioners and patients; o Development of measures, methods, and technologies to support quality assurance and foster quality improvement in health care; and o Application of medical informatics to developing and improving expert systems for clinical diagnosis and treatment selection. STUDY POPULATIONS INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of AHCPR that women and members of minority groups must be included in all AHCPR supported health services research projects involving human subjects, unless a clear and compelling rationale and justification are provided that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research. A new NIH policy resulting from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43) supersedes and strengthens NIH's previous policies (Concerning the Inclusion of Women in Study Populations, and Concerning the Inclusion of Minorities in Study Populations), which were in effect since 1990 and which AHCPR had adopted. The new NIH policy contains some provisions that are substantially different from the 1990 policies. AHCPR plans to publish guidelines specific to AHCPR. In the interim, AHCPR will follow the NIH guidelines, as applicable. All investigators proposing research involving human subjects should read the "NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical Research," published in the Federal Register of March 9, 1994 (FR 59 11146-11151) and reprinted in the NIH Guide for Grants and Contracts, Volume 23, Number 11, March 18, 1994. Investigators also may obtain copies of the NIH policy from the AHCPR program staff listed under INQUIRIES. AHCPR program staff may also provide additional relevant information concerning this policy. APPLICATION PROCEDURES Prior to making formal application, an individual applicant must be accepted by an appropriate institution (private or public, for-profit or non-profit) and by a sponsor who will supervise the training and research experience. The applicant's research training plan should include a description of the proposed activities under the award and the aims, significance, and experimental design and methods of the research proposal. The sponsor must describe in detail the research training plan and the availability of suitable staff and facilities. Formal training is not necessarily limited to a single academic institution or discipline. The sponsor must be an established investigator who is active in health services research and who personally will supervise the applicant's training and research program. Fellowship applicants requesting continued training at the doctorate institution or under the same sponsor in an institution where they have been training for more than a year should describe those opportunities for new or additional training experiences that will broaden the scientific background and perspective. Applicants must submit the original and two copies of Public Health Service form PHS 416-1 (rev. 10/91), Individual National Research Service Award Application. If the applicant is lawfully admitted to the United States for permanent residence, a notarized statement documenting this status is required. NRSA fellowship material for AHCPR applications is available from Global Exchange Inc., 7910 Woodmont Ave. Suite 400, Bethesda, MD 20814-3015, telephone 301-656-3100 (FAX 301-652-5264). Do not send applications to AHCPR. The completed, signed original application and two copies must be sent or delivered to: Fellowship Division of Research Grants National Institutes of Health Westwood Building, Room 240 Bethesda, MD 20892** REVIEW CONSIDERATIONS The following is the schedule for individual NRSA application receipt and review: Application Receipt Date: Aug 5 Dec 5 Apr 5 Study Section Review: Oct Feb Jun Earliest Notification of Award: Dec Apr Aug Earliest Possible Start Date: Jan May Sep Applications for NRSA fellowships will be reviewed by a review committee that includes consultants from appropriate scientific fields. The committee will use the following criteria in evaluating applications: o Applicant's past academic and research accomplishments; o Applicant's research and training goals and potential for a health services research career; o Research training program proposed (including the training potential, as well as the scientific merit of the research project); o Qualifications and suitability of the proposed sponsor and appropriateness of the institutional environment; and o References and other relevant information. AWARD CRITERIA For applications assigned to the AHCPR, awards will be made based on the recommendations of the review committee, relevance of the application to AHCPR research priorities and training needs, and availability of funds in making the final selection of awardees. Stipends and Other Training Costs A stipend is provided to each NRSA fellow to help defray living expenses during the research training experience. The stipend amount is determined by the number of full years of relevant postdoctoral experience as of the date the award is issued. Relevant experience may include research experience, teaching, internship, residency, or other time spent in full-time studies in a health-related field beyond that of the qualifying doctoral degree. No departure from the standard stipend schedule may be negotiated between the institution and the fellow. Current postdoctoral stipend levels are listed below: Full years of relevant Annual experience stipend None $19,608 1 20,700 2 25,600 3 26,900 4 28,200 5 29,500 6 30,800 7 or more 32,300 AHCPR will provide an allowance of $3,000 per 12-month period to non-Federal, non-profit sponsoring institutions to cover such awardee expenses as tuition and fees, self-only health insurance, research supplies, equipment, travel to scientific meetings, and related items. There is no institutional allowance for individuals sponsored by for-profit institutions; but AHCPR will provide up to $2,000 for the fellow's tuition and fees, self-only health insurance, scientific meeting travel expenses, and books. The $2,000 is paid to the for-profit institution for disbursement to the fellow, and any unexpended funds are to be returned to AHCPR. Additional funds may be requested by the institution for extraordinary costs for fellows who are disabled, as defined by the Americans with Disabilities Act. Such additional funds are provided only in exceptional circumstances and must be fully justified and explained by the institution. Supplementation: Institutions may use non-Federal funds to supplement NRSA stipends. Federal funds may be used for stipend supplementation only if specifically authorized under the terms of the program from which the supplemental funds are derived. An individual may make use of Federal educational loan funds or VA benefits when permitted by these programs. Supplementation, when provided, must be without obligation to the trainee. Compensation: Trainees may be permitted to receive compensation for work in some other position (for example, teaching or laboratory assistance) when the trainee is in an employee-employer relationship, the payments are for services rendered, and the situation otherwise meets conditions for student compensation as specified in the PHS Grants Policy Statement. Compensation may not be from a research grant that supports the same research that is part of the NRSA experience. Compensation for services must occur on a limited, part-time basis apart from the normal full-time training activities that require a minimum of 40 hours per week. Under no circumstances may the conditions of either stipend supplementation or student compensation for coincidental employment detract from or prolong the research training. Further information on stipend supplementation and compensation is available in "National Research Service Awards -- Guidelines for Individual Awards - Institutional Grants," NIH Guide for Grants and Contracts (special edition), Volume 13, Number 1, January 6, 1984. Conditions of the Award Applications may be for one, two, or three years of fellowship support. No one is eligible for more than three years of aggregate NRSA support at the postdoctoral level, including any combination of support from institutional training grants and individual fellowships. Fellowships are awarded for full-time research training. However, it is recognized that a close interrelationship between teaching and research may exist in the academic environment. Fellows are permitted, with the approval of the sponsor, to undertake teaching that can contribute meaningfully to their academic training. Any teaching undertaken by a fellow may not occupy more than 10 percent of work time during the year or exceed four hours per week. Fellows in clinical areas are expected to devote their time to the proposed research training program and to confine limited clinical duties to those that are part of the research training. Concurrent awards: An NRSA postdoctoral fellowship may not be held concurrently with another federally sponsored fellowship or similar Federal award that provides a stipend or otherwise duplicates provisions of the NRSA. Activation: The awardee must start work on the fellowship within six months of the date the award is issued. No funds may be disbursed until the award is activated. Tax liability of stipends: Section 117 of the Internal Revenue Code applies to the tax treatment of all scholarships and fellowships. It must be emphasized that the interpretation and implementation of tax laws are the domain of the Internal Revenue Service (IRS) and U.S. courts. AHCPR does not have the authority to advise students or institutions about their tax liability. The business office of the sponsoring institution is responsible for the annual preparation and issuance of the IRS Form 1099 for postdoctoral fellows training at the institution. Individuals should consult their local IRS office for more detailed information on the proper steps to be taken regarding their tax obligations. The taxability of stipends in no way alters the relationship between NRSA fellows and their institutions. NRSA stipends are not now, and never have been, salaries. Fellows supported under a National Research Service Award are not in an employer-employee relationship with AHCPR or with the institution in which they are pursuing research training. It is inappropriate and unallowable for institutions to seek funds or to charge individual fellowship awards for costs normally associated with employee benefits (such as FICA, workers' compensation, or unemployment insurance). Termination and postaward reporting: At the conclusion of the fellowship, the fellow must submit a termination notice (form PHS 416-7) to AHCPR. NRSA fellowship recipients are responsible for informing AHCPR of changes in their status or address and for submitting the Annual Payback Activities Certification (form PHS 6031-1) yearly until any required payback service obligation is satisfied. Payback provision: Before an award is made, the fellow must sign an agreement to fulfill the congressionally mandated payback requirements. The NIH Revitalization Act of 1993 substantially modifies the existing service payback requirements for individuals supported under NRSA programs. For fellowship awards beginning after June 10, 1993, only fellows in the first 12 months of postdoctoral NRSA support will incur a service obligation of one month for each month of support. Postdoctoral fellows in the 13th and subsequent months of NRSA support will not sign the Payback Agreement Form (Form PHS 6031) and will incur no further obligation. The 13th and each subsequent month of postdoctoral NRSA support will be considered acceptable payback service; therefore, individuals who begin the initial postdoctoral fellowship on or after June 10, 1993, and continue under that award for two years will have fulfilled their first year obligation by the end of the second year of training. Service payback obligations can also be repaid after the period of training by engaging in health services related research (including research assistantships/associateships and fellowships) and/or teaching for at least 20 hours per week averaged over a full year. Positions after training are arranged by the individual, not AHCPR. Recipients must undertake the obligated service on a continuous basis within two years after termination of NRSA support. The period for undertaking payback service may be delayed for temporary disability, for completion of residency requirements, or for completion of the requirements for a graduate degree. Requests for an extension must be made in writing to AHCPR and must specify the need for additional time and the length of the required extension. Individuals who fail to fulfill any required obligation through service must pay back the total amount of NRSA funds paid to them for the obligation period plus interest at a rate determined by the Secretary of the Treasury. Financial payback must be completed within three years beginning on the date the United States becomes entitled to recover such amount. Under certain conditions, the Secretary of Health and Human Services may extend the period for starting service or for repayment, permit breaks in the period of service or repayment, or otherwise waive or suspend the payback obligation of an individual. INQUIRIES Written and telephone inquiries are encouraged. The opportunity to clarify any issues or questions from potential applicants is welcome. Direct inquiries regarding programmatic issues to: DonnaRae Castillo NRSA Project Officer Agency for Health Care Policy and Research 2101 East Jefferson Street, Suite 501 Rockville, MD 20852 Telephone: (301) 594-1362 Direct inquiries regarding fiscal and administrative matters to: Ralph Sloat Grants Management Officer Agency for Health Care Policy and Research 2101 East Jefferson Street, Suite 601 Rockville, MD 20852 Telephone: (301) 594-1447 AUTHORITY AND REGULATIONS NRSA individual postdoctoral fellowships are made under authority of Section 487 of the Public Health Service Act, as amended (42 USC 288). Title 42 of the Code of Federal Regulations, Part 66, is applicable to this program. The program is described under Catalog of Federal Domestic Assistance No. 93.225 and is not subject to the intergovernmental review requirements of Executive Order 12372. .
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