Full Text HS-98-001
NIH GUIDE, Volume 26, Number 20, June 13, 1997
RFA:  HS-98-001
P.T. 22, 44

  Biomedical Research Training 
  Grants Administration/Policy+ 

Agency for Health Care Policy and Research
Letter of Intent Receipt Date:  July 10, 1997
Application Receipt Date:  September 23, 1997
The Agency for Health Care Policy and Research (AHCPR) awards
National Research Service Award (NRSA) institutional training grants
(T32) to eligible institutions to develop research training
opportunities for qualified individuals selected by the institution
who have demonstrated an interest in health services research and who
seek to prepare for careers in the systematic examination of the
organization, provision, financing, and effectiveness of health care
services.  The purpose of the NRSA program is to help ensure that
adequate numbers of highly trained individuals are available to carry
out the Nation's health services research agenda, in order to improve
quality, assure value for health dollars spent, and enhance access to
services.  A goal is to equip students with the necessary knowledge,
skills, and experiences to conduct future research which will meet
the needs of patients, providers, plans, purchasers, and/or policy
makers.  Accomplishing the above effectively will require fostering a
mixture of academic and applied training opportunities to meet the
needs of students who wish to pursue traditional academic careers, as
well as those who opt for careers in applied research settings.
Applicants are encouraged to foster cooperation and partnerships with
relevant components of the health care delivery system.
NRSA institutional training grants assist domestic institutions in
supporting predoctoral and postdoctoral academic training.  The
awards allow trainees to gain one or more years of experience in
applying research methods to the evaluation of health services.  The
AHCPR will not support short-term training through this mechanism.
Predoctoral Training.  Predoctoral research training must lead to the
Ph.D. Degree or a comparable research doctoral degree.  Students
enrolled in health-professional programs that are not part of a
formal, combined program (e.g., M.D./Ph.D.) and who wish to postpone
their professional studies in order to gain research experience may
also be appointed to a T32 grant.  Predoctoral research training must
emphasize fundamental training in areas relevant to health services
Postdoctoral Training.  Postdoctoral research training is for
individuals who have a Ph.D., M.D., D.D.S., or comparable doctoral
degree from an accredited domestic or foreign institution.  Research
training at the postdoctoral level must emphasize specialized
training to meet national priorities in health services research.
A research training grant is a desirable mechanism for the
postdoctoral training of physicians and other health professionals
who have extensive clinical training, but limited research
experience.  For such individuals, the training may be a part of a
research degree program.  In all cases, health-professional
postdoctoral trainees should agree to engage in at least two years of
research, research training, or comparable activities beginning at
the time of appointment since the duration of training has been shown
to be strongly correlated with post-training research activity.
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 high priority areas.  AHCPR
encourages 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- 00473-1)
through the Superintendent of Documents, Government Printing Office,
Washington, DC 20402-9325, telephone 202- 512-1800.
Applicant Institutions
Only domestic non-profit private and public institutions may apply
for grants to support doctoral and postdoctoral health services
research training programs.  The applicant institution must have the
staff and facilities required for the proposed program.  The research
training program director at the institution will be responsible for
the selection and appointment of trainees and for the overall
direction of the program.
Institutions may apply for support for predoctoral students,
postdoctoral students, or a combination.  Applicants should include a
rationale for their proposed choice of supporting the level(s) of
students requested.  An applicant may request as many postdoctoral or
predoctoral positions as the proposed program can adequately
accommodate; but the number of positions awarded will be determined
by the review process, program needs, and availability of funds.
Institutions currently approved for receipt of AHCPR institutional
training support beyond FY 1997 in response to applications they
submitted under AHCPR's program announcement entitled, "National
Research Service Award-- Institutional Grants Policy and Guidelines
(PAR-95-002, NIH guide, Volume 23, Number 36, October 14, 1994) are
eligible to apply.  If these institutions opt not to apply, they will
still continue to receive support under conditions stipulated in
their existing grant.  However, upon completion of the existing grant
projects, the next opportunity for these institutions to apply for
competing grant support from AHCPR will be when AHCPR announces a new
Trainees appointed to the proposed training program must have the
opportunity to carry out supervised health services research with the
primary objective of extending their research skills and knowledge in
preparation for a health services research career.  Prospective
trainees must be U.S. citizens or noncitizen nationals or permanent
residents of the United States in possession of an Alien Registration
Receipt Card I-551, or other legal verification of such status at the
time of appointment.  Individuals on temporary or student visas are
not eligible.
Positions on NRSA institutional grants may not be used for study
leading to the M.D., D.D.S., or other clinical, health-professional
degrees except when those studies are a part of a formal combined
research degree program, such as the M.D./Ph.D.  Similarly, trainees
may not accept NRSA support for studies which are part of residency
training leading to certification in a medical specialty or
subspecialty, except when the residency program credits a period of
full-time, postdoctoral research training toward board certification
and the trainee intends to pursue a research career.
A postdoctoral student, as of the beginning date of the NRSA
appointment, must have a Ph.D., M.D., O.D., D.D.S., Dr.P.H., Sc.D,
D.N.Sc. or other doctoral degree, or an equivalent degree from any
accredited domestic or foreign institution. (Persons holding the J.D.
as the sole advanced degree are not considered postdoctoral for
purposes of NRSA appointments.) Certification by an authorized
official of the degree-granting institution that all requirements for
the doctoral degree have been met is acceptable.
Trainees are required to pursue their research training on a
full-time basis, devoting at least 40 hours per week to the program.
Within the 40 hours per week training period, research trainees in
clinical areas must devote their time to the proposed research
training and must confine clinical duties to those that are an
integral part of the research training experience.
The mechanism of support will be the National Research Service Award
(NRSA) institutional training grant (T32). The total requested
project period for an application may not exceed 5 years.  The
earliest anticipated award date is May 1, 1998.
Depending on the availability of funds, AHCPR expects to award up to
$3,500,000 in FY 1998 to support the first year for approximately
15-24 projects under this RFA.  The number of awards is dependent on
the number of high quality applications and their individual budget
requirements; it is not the intent of AHCPR that the awards be equal
in size. Funding beyond the initial budget period will depend upon
annual progress reviews by AHCPR and the availability of funds.
Areas of Training
AHCPR-sponsored NRSA Awards emphasize multidisciplinary health
services research training.  Training should provide individuals with
rigorous academic and health services research experiences that will
allow them to address emerging issues in our changing health care
system.  It is expected that AHCPR-supported health services research
training programs be responsive to research needs associated with the
ongoing shifts in the source and demand for services, and provide
training in identified areas of need, such as outcomes/health status
measurement, biostatistics, epidemiology, health economics, decision
analysis, cost- effectiveness analysis, and health policy.  At the
conclusion of the training program, trainees should have the
conceptual, methodological, and practical foundation to conduct
research that would:
o  Help consumers make more informed choices;
o  Determine what works best in clinical care;
o  Measure and improve quality of care;
o  Monitor and evaluate health care delivery;
o  Improve the cost-effective use of health care resources;
o  Provide health care policy makers with the information needed to
make informed decisions;
o  Address issues of relevance to priority populations, including
women, children, persons with chronic diseases or disabilities, the
elderly, and minority populations; and
o  Build and sustain the health services research infrastructure.
Duration of Support
Institutional NRSA research training grants may be made for periods
of up to five years.  Awards are normally made in 12-month increments
with support for additional years based on satisfactory progress and
the continued availability of funds.  As noted below, an award
received in response to this RFA will supersede previous AHCPR
approved NRSA institutional awards, which extend beyond FY 1997.
Trainee appointments are normally made in 12-month increments.  No
trainee may be appointed for less than nine months during the initial
period of appointment, except with the prior approval of the Grants
Management Office.  No individual trainee may receive more than five
years of aggregate NRSA support at the predoctoral level and three
years of aggregate NRSA support at the postdoctoral level, including
any combination of support from institutional training grants and
individual fellowship awards.  Any exception to this policy requires
a waiver from AHCPR.
Payback Provisions
As specified in the NIH Revitalization Act of 1993, NRSA recipients
incur a service payback obligation only during their first 12 months
of postdoctoral support. Additionally, the NIH Revitalization Act of
1993 specifies that the second and subsequent years of postdoctoral
NRSA training will serve to pay back a postdoctoral service payback
obligation.  Accordingly, the following guidelines apply:
o  Predoctoral trainees are not required to sign the payback
agreement and do not incur a service payback obligation.
o  Postdoctoral trainees in the first 12 months of postdoctoral NRSA
support must sign the payback agreement form (PHS form 6031) and will
incur 1 month of service payback obligation for each month of
o  Postdoctoral trainees in the 13th and subsequent months of NRSA
postdoctoral support are not required to sign the payback agreement
form and will not incur a service payback obligation.
o  The 13th and subsequent months of postdoctoral NRSA support are
considered acceptable payback service for prior postdoctoral support.
Individuals who continue under that award for 2 years, have fulfilled
their obligation by the end of the second year.  Service payback
obligations can also be paid back by conducting health-related
research or teaching averaging more than 20 hours per week of a full
work year after the award.
o  Recipients must begin to undertake obligated service on a
continuous basis within two years of NRSA support termination.  The
period for undertaking payback service may be delayed for such
reasons as temporary disability, completion of residency
requirements, or completion of the requirements for a graduate
degree.  Requests for an extension must be made in writing to AHCPR's
Grants Management Office, specifying the need for additional time and
the length of the required extension.
o  Recipients of NRSA support are responsible for informing the AHCPR
Grants Management Office of changes in status or address.
o  For individuals who fail to fulfill their obligation through
service, the United States is entitled to recover the total amount of
NRSA funds paid to the individual for the obligated period plus
interest at a rate determined by the Secretary of the Treasury.
Financial payback must be completed within 3 years, beginning on the
date the United States becomes entitled to recover such amount.
o  Under certain conditions, the Secretary, U.S. Department of Health
and Human Services (or those delegated this authority), may extend
the period for starting service or repayment, permit breaks in
service, or in cases in which service or financial repayment would
constitute an extreme hardship, the approving official may waive or
suspend the payback obligation of an individual.
o  Officials at the awardee institution have the responsibility of
explaining the terms of the payback requirements to all prospective
training candidates before appointment to the training grant.
Additionally, all trainees recruited into the training program should
be provided with information related to the career options available
to individuals who complete the program and whether the types of
positions available are consistent with the nature of the training
provided and where applicable whether those positions are likely to
satisfy any outstanding service payback obligation.
Trainee Reporting Requirements
The institution must submit a completed Statement of Appointment (PHS
Form 2271) for each trainee appointed or reappointed to the training
grant.  Additionally, a completed Payback Agreement (PHS Form 6031)
must be submitted for each trainee in his/her first twelve months of
postdoctoral support.  At the end of the total support period for
each trainee, the institution must submit a Termination Notice (PHS
Form 416-7).  Failure to submit the required forms in a timely manner
may result in an expenditure disallowance.
In general, trainees may receive stipends during periods of vacation
and holidays observed by individuals in comparable training positions
at the grantee institution.  For the purpose of these awards,
however, the period between the spring and fall semesters is
considered to be an active time of research and research training,
and is not considered to be a vacation or a holiday.
Trainees may receive stipends for up to 15 calendar days of sick
leave per year.  Sick leave may be used for the medical conditions
related to pregnancy and childbirth pursuant to the Pregnancy
Discrimination Act (42 USC 2000 e(l)). Trainees may also receive
stipends for up to 30 calendar days of parental leave per year for
the adoption or the birth of a child when those in comparable
training positions at the grantee institution have access to paid
leave for this purpose and the use of parental leave is approved by
the program director.
A period of terminal leave is not permitted and payment may not be
made from grant funds for leave not taken. Individuals requiring
periods of time away from their research training experience longer
than specified must seek approval from AHCPR's Grants Management
Office for an unpaid leave of absence.  At the beginning of a leave
of absence, the trainee must submit a Termination Notice (PHS Form
416- 7) and upon return form 2271).  Trainees within the first twelve
months of postdoctorate support must also submit a Payback Agreement
(PHS Form 6031) upon return from a leave of absence.
Stipends and Other Trainee Support
National Research Service Awards provide funds in the form of
stipends to predoctoral and postdoctoral trainees.  A stipend is
provided as an allowance for trainees to help defray living expenses
during the research training experience.  It is not provided as a
condition of employment with either the Federal Government or the
institution. Stipends must be paid to all trainees at the levels
approved by the Secretary of the Department of Health and Human
Services.  Trainees may not receive stipends for periods during which
they are not enrolled in the training program.
For predoctoral trainees at all levels of experience, the stipend
level (effective October 1, 1996) is $11,496 per year.  For
appointments of less than a year, the stipend will be based on a
monthly proration.
For postdoctoral trainees, the current annual stipend for
postdoctoral trainees is determined by the number of FULL years of
relevant postdoctoral experience at the time of appointment.
Relevant experience may include research experience (including
industrial), teaching, internship, residency, clinical duties, or
other time spent in full-time studies in a health-related field
following the date of the qualifying doctoral degree.  Current
postdoctoral stipend levels, effective October 1, 1996, are as
Full years of relevant experience       Stipend
   Less than 1                          $20,292
             1                           21,420
             2                           25,600
             3                           26,900
             4                           28,200
             5                           29,500
             6                           30,800
             7 or more                   32,300
A trainee with a health-professional doctoral degree who is enrolled
in a graduate degree program is considered to be in postdoctoral
training and will receive the appropriate postdoctoral stipend listed
No departure from the established stipend schedule may be negotiated
by the institution with the trainee.  The stipend for each additional
full year of stipend support is the next level in the stipend
structure and does not change in the middle of an appointment.  The
grantee institution is allowed to provide funds to an individual in
addition to the stipends paid by the AHCPR.  Such additional amounts
may be either in the form of augmented stipends (supplementation) or
in the form of compensation, such as salary or tuition remission for
services such as teaching or serving as a laboratory assistant,
provided the following conditions are met:
o  Stipend Supplementation.  Supplementation or additional support to
offset the cost of living may be provided by the grantee institution,
but must not require any additional obligation from the trainee.
Federal funds may not be used for supplementation unless specifically
authorized under the terms of both the program from which such
supplemental funds are to be received and the program whose funds are
to be supplemented.  Under no circumstances may PHS funds be used for
o  Compensation.  An institution may provide additional funds to a
trainee in the form of compensation (as salary and/or tuition
remission) for services such as teaching or serving as a laboratory
assistant.  A trainee may receive compensation for services as a
research assistant or in some other position on a Federal research
grant, including a PHS research grant.  However, compensated services
should occur on a limited, part-time basis apart from the normal
research training activities, which require a minimum of 40 hours per
week.  In addition, compensation may not be paid from a research
grant supporting research that is part of the research training
Under no circumstances may the conditions of stipend supplementation
or the services provided for compensation interfere with, detract
from, or prolong the trainee's approved NRSA training program.
Educational Loans or G.I. Bill.  An individual may make use of
Federal educational loan funds and assistance under the Veterans
Readjustment Benefits Act (G.I. Bill).  Such funds are not considered
supplementation or compensation.
Concurrent Awards.  A NRSA traineeship may not be held concurrently
with another federally sponsored fellowship or similar Federal award
that provides a stipend or otherwise duplicates provisions of the
Tax Liability
Internal Revenue Code Section 117 applies to the tax treatment of all
scholarships and fellowships.  Under that section, non-degree
candidates are required to report as gross income all stipends and
any monies paid on their behalf for course tuition and fees required
for attendance. Degree candidates may exclude from gross income (for
tax purposes) any amount used for tuition and related expenses such
as fees, books, supplies, and equipment required for courses of
instruction at a qualified educational organization.
The taxability of stipends, however, in no way alters the
relationship between NRSA trainees and institutions.  NRSA stipends
are not considered salaries.  In addition, trainees supported under
the NRSA are not considered to be in an employee-employer
relationship with the AHCPR or the awardee institution.
It must be emphasized that the interpretation and implementation of
the tax laws are the domain of the Internal Revenue Service (IRS) and
the courts.  AHCPR takes no position on what the status may be for a
particular taxpayer, and it does not have the authority to dispense
tax advice.  Individuals should consult their local IRS office about
the applicability of the law to their situation and for information
on their tax obligations.
Tuition Fees and Health Insurance
Tuition and fees, including self-only medical insurance, are
allowable trainee costs if such charges are required of all
individuals in a similar training status at the institution,
regardless of  their source of support.  Family medical insurance
coverage is not an appropriate charge to the NRSA research training
grant.  Tuition at the postdoctoral level is limited to that required
for specific courses in support of the approved research training
program.  On an annual basis, for each trainee, the training grant
will cover 100% of the first $2,000 of the combined cost of tuition,
fees, and self-only  health insurance and 60% of any amount above
$2,000.  Institutions are instructed to reflect the full amount of
these costs in competing applications.
Other Training Costs
Trainee travel, including attendance at scientific meetings that the
institution determines to be necessary to the individual's research
training, is an allowable trainee expense.  In addition, support for
travel to a research training experience away from the institution
may be permitted.  Research training experiences away from the parent
institution must be justified considering the type of opportunities
for training available, how these opportunities differ from those
offered at the parent institution, and the relationship of the
proposed experience to the trainee's career stage and goals.
Justification for research training experience away from the
institution must be described in detail in the budget justification
section of the application.
Institutional costs of up to $1,500 a year per predoctoral trainee
and up to $2,500 a year per postdoctoral trainee may be requested to
defray the costs of other research training related expenses, such as
staff salaries, consultant costs, equipment, research supplies, and
staff travel.
Under exceptional circumstances, which can include accommodating the
disabilities of a trainee, it is possible to request institutional
costs above the standard rate. Requests for additional costs must be
explained in detail and carefully justified in the application.
Consultation with program staff in advance of such requests is
strongly advised.
A facilities and administration allowance (indirect cost allowance)
based on 8 percent of total allowable direct costs (this excludes
tuition) may be requested. Applications from State and local
government agencies may request full indirect cost reimbursement (see
PHS Grants Policy Statement).
Confidentiality of Data
Information obtained in the course of this study that identifies an
individual or entity must be treated as confidential in accordance
with section 903(c) of the Public Health Service Act.  Applicants
must describe in the Human Subjects section of the application
procedures for ensuring the confidentiality of identifying
information.  The description of the procedure should include a
discussion of who will be permitted access to the information, both
raw data and machine readable files, and how personal identifiers
will be safeguarded.
This special term of award is in addition to, and not in lieu of,
otherwise applicable PHS grant policies and Federal regulations.
It is the policy of AHCPR that women and members of minority groups
be included in all AHCPR-supported 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.
The NIH policy resulting from the NIH Revitalization Act of 1993
(Section 492B of Public Law 103-43) supersedes and strengthens the
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 NIH policy contains provisions that are substantially
different from the 1990 policies.
All investigators proposing research involving human subjects should
read the "NIH Guidelines on the Inclusion of Women and Minorities as
Subjects in Clinical Research," which has been published in the
Federal Register of March 28, 1994 (FR 59 14508-14513), and in the
NIH GUIDE FOR GRANTS AND CONTRACTS of March 18, 1994, Volume 23,
Number 11.  AHCPR follows the revised NIH Guidelines, as applicable.
Investigators may obtain copies from those sources or from the AHCPR
contractor, Global Exchange, Inc., listed under INQUIRIES.
AHCPR is also encouraging investigators to consider including
children in study populations, as appropriate. AHCPR announced in the
NIH Guide, Volume 26, Number 15, May 9, 1997, that it is developing a
policy and implementation plan on the inclusion of children in health
services research.  The Notice is available through AHCPR's WEB site
(http://www.ahcpr.gov) and AHCPR Instant FAX.  For instruction in
using Instant FAX, call (301) 594-2800, using a fax machine with a
telephone handset.
AHCPR program staff may also provide information concerning this
policy (See INQUIRIES).
Prospective applicants are asked to submit, by July 10, 1997, a
letter of intent that includes the names, addresses, and telephone
numbers of the proposed Program Director and other key personnel; and
the number and title of the RFA. Although a letter of intent is not
required, is not binding, and does not enter into the consideration
of any subsequent application, the information allows AHCPR staff to
estimate the potential review workload and avoid conflicts of
interest in the review.  AHCPR will not provide responses to letters
of intent.
The letter of intent is to be addressed to:
Karen Rudzinski, Ph.D.
NRSA Project Officer
Agency for Health Care Policy and Research
2101 East Jefferson Street, Suite 400
Rockville, MD  20852-4908
Email:  training@ahcpr.gov
The research grant application form PHS 398 (rev. 5/95) is to be used
in applying for these grants.  State and local government applicants
may use form PHS 5161-1, Application for Federal Assistance (rev.
5/96), and follow those requirements for copy submission.  Applicants
are reminded that the 25-page limit on the narrative section must be
Application kits are available at most institutional offices of
sponsored research and may be obtained from the Division of
Extramural Outreach and Information Resources, Office of Extramural
Research, National Institutes of Health, 6701 Rockledge Drive MSC
7910, Bethesda, MD 20892-7910, Telephone: 301-710-0267, E-mail:
AHCPR applicants should obtain application materials from the AHCPR
contractor:  Global Exchange, Inc., 7910 Woodmont Avenue, Suite 400,
Bethesda, MD 20814-3015, Telephone: 301- 656-3100, Fax: 301-652-5264.
The RFA label available in the form PHS 398 (rev. 5/95) must be
affixed to the bottom of the face page of the original application.
Failure to do so could result in delayed processing of the
application such that it may not reach the review committee in time
for review.  In addition, the RFA title and number must be typed on
line 2 of the face page of the application form and YES must be
Submit a signed, typewritten original of the application, including
the checklist, and three signed photocopies, in one package to:
BETHESDA, MD  20892-7710
BETHESDA, MD  20817 (for express/courier service)
At the time of submission, two additional copies of the application
must be sent to:
Karen Rudzinski, Ph.D.
NRSA Project Officer
Office of Scientific Affairs
Agency for Health Care Policy and Research
2101 East Jefferson Street, Suite 400
Rockville, MD  20852-4908
Applications submitted under this RFA must be received in the
Division of Research Grants, NIH, by September 23, 1997. If an
application is received after that date, it will be returned to the
applicant without review.  Applications received on that date will be
for awards to begin no earlier than July 1, 1998.
Applications will be reviewed for technical and educational merit by
an AHCPR peer review group.
Review Criteria
The peer review group will consider the following criteria in its
Program Characteristics
o  Objectives, design, and direction of the research training program
-- including the probability of achieving stated goals.
o  Substantive and methodological content of the proposed program and
its relevance to the Program Objectives noted above, including
relevant descriptions of courses and experiential opportunities
offered and/or required.
o  The extent to which proposed approaches address areas in need of
research given changes in the health care delivery system.
Program Support and Organizational Structure and Plans
o  The institutional training environment, including the level of
institutional commitment, quality of the facilities, availability of
appropriate courses, and availability of research support.
o  Organizational structure of the proposed training program,
including delineation of administrative responsibilities for
planning, oversight, and evaluation.
o  Demonstration of cooperation by any proposed collaborating
facilities, institutions, or departments in providing research
experiences and/or sites for trainees, including (where applicable)
documentation of mechanisms by which trainees will be integrated into
the ongoing health services research activities of other entities.
o  Demonstration of extent to which and ways in which AHCPR support
will be (has been in the past) leveraged through the use of other
Federal and private resources to maximize health services research
training within the institution.
o  Availability of other relevant support.
Trainee Recruitment & Retention Plans
o  Recruitment and selection plans for trainees and the availability
of high quality candidates, including minority trainees (see below
for details).
o  When appropriate, record of the research training program in
retaining health-professional postdoctoral trainees for at least two
years in research training or other research activities.
Program Record and Evaluation Plans
o  Past research training record of both the program and the
designated preceptors as determined by the success of former trainees
in seeking further career development and in establishing productive
scientific careers.  Evidence of further career development can
include receipt of fellowships, career awards, a prestigious training
appointment, and similar accomplishments.  Evidence of a productive
scientific career can include a record of successful competition for
individual research grants, receipt of special honors, a record of
publications, receipt of patents, promotion to prestigious positions
in academe, industry, or health policy and any other appropriate
measure of success consistent with the nature and duration of the
training received.
o  Record of the research training program in recruiting and
retaining trainees, noting past annual success rates in filling
committed slots;
o  Proposed methods for monitoring and evaluating performance of
trainees and the overall program, including tracking of graduates
after completion of training, record of trainees in obtaining
individual research awards or fellowships following training and in
establishing careers in health services research.
o  Reasonableness of the proposed budget, including number and levels
of trainees, in relation to the research training.
Additional Review Considerations
Minority Recruitment Plan:  The AHCPR remains committed to increasing
the participation of individuals from underrepresented minority
groups in health services research.  As announced in 1989, all
applications for institutional NRSA research training grants must
include a specific plan to recruit minorities.  If an application is
received without a plan, it will be considered incomplete and may be
returned to the applicant without review. Additional information on
this requirement was published in the NIH Guide for Grants and
Contracts, Volume 22, Number 25, July 16, 1993.
After the overall educational and technical merit of an application
has been assessed, peer reviewers will examine and evaluate the
minority recruitment plan and any record of recruitment and
The findings of the panel will be included in an administrative note
in the summary statement.  If the minority recruitment plan of the
application is judged to be unacceptable, funding will be withheld
until a revised plan that addresses the deficiencies is received.
Staff within the AHCPR will determine whether amended plans and
reports submitted after the initial review are acceptable.
Training in the Responsible Conduct of Research:  Every Predoctoral
and Postdoctoral NRSA trainee supported by an institutional research
training grant must receive instruction in the responsible conduct of
research.  (or more information on this provision, see the NIH Guide
for Grants and Contracts, Volume 21, Number 43, November 27, 1992.)
Applications must include a description of a program to provide
formal or informal instruction in scientific integrity or the
responsible conduct of research. Applications without plans for
instruction in the responsible conduct of research will be considered
incomplete and may be returned to the applicant without review.
o  Although the AHCPR does not establish specific curricula or formal
requirements, all programs are encouraged strongly to consider
instruction in the following areas:  conflict of interest,
responsible authorship, policies for handling misconduct, policies
regarding the use of human and animal subjects, data management, and
confidentiality and privacy. Within the context of training in
scientific integrity it is also useful to discuss the mutual
responsibilities of the institution and the graduate students or
postdoctorates appointed to the program.
o  Plans must address the subject matter of the instruction, the
format of the instruction, the degree of faculty participation,
trainee attendance, and the frequency of instruction.
o  The rationale for the proposed plan of instruction must be
o  Program reports on the type of instruction provided, topics
covered, and other relevant information, such as attendance by
trainees and faculty participation, must be included in future
competing continuation and noncompeting applications.
The AHCPR encourages institutions to provide instruction in the
responsible conduct of research to all graduate students and
postdoctorates in a training program or department, regardless of the
source of support.
AHCPR initial review groups will assess the applicant's plans on the
basis of the appropriateness of topics, format, amount and nature of
faculty participation, and the frequency and duration of instruction.
The plan will be discussed after the overall determination of merit,
so that the quality of the plan will not be a factor in the
determination of the priority score.  Plans will be judged as
acceptable or unacceptable.  The acceptability of the plan will be
described in an administrative note on the summary statement.
Regardless of the priority score, applications with unacceptable
plans will not be funded until a revised, acceptable plan is provided
by the applicant.  The acceptability of the revised plan will be
judged by AHCPR staff.
Funding decisions will be based on peer review, research program
priorities, the need for research personnel in specified program
areas, balance among types of research training supported by AHCPR,
and the availability of funds. Awards made under this announcement
will automatically supersede all prior awards received in response to
AHCPR's program announcement entitled, "National Research Service
Award--Institutional Grants Policy and Guidelines" (PAR-95- 002, NIH
Guide, Volume 23, Number 36, October 14, 1994).
Written and telephone inquires concerning this RFA are encouraged.
Copies of the RFA and related materials are available from:
Global Exchange, Inc.
7910 Woodmont Avenue, Suite 400
Bethesda, MD  20814-3015
Telephone:  (301) 656-3100
FAX:  (301) 652-5264
This RFA is available through the AHCPR's website:
http:\\www.ahcpr.gov and through AHCPR InstantFAX at 301- 594-2800.
To use InstantFAX, you must call from a facsimile (FAX) machine with
a telephone handset.  Follow the voice prompt in order to obtain a
copy of the table of contents which has the document order number
(not the same as the RFA number).  The RFA will be sent at the end of
the ordering process.  AHCPR InstantFAX operates 24 hours a day, 7
days a week.  For questions about this service, call AHCPR's Division
of Communications at 301-594-1364, ext. 1389.
Direct inquiries regarding programmatic issues, including information
on the inclusion of women, minorities, and children in study
populations, to:
Karen Rudzinski, Ph.D.
NRSA Project Officer
Agency for Health Care Policy and Research
2101 East Jefferson Street, Suite 400
Rockville, MD  20852-4908
Telephone:  (301) 594-1452
Email:  training@ahcpr.gov
Direct fiscal and administrative inquiries to:
Mable L. Lam
Grants Management Officer
Agency for Health Care Policy and Research
2101 East Jefferson Street, Suite 601
Rockville, MD  20852
Telephone:  (301) 594-1447, ext. 1165
FAX:  (301) 594-3210
Email:  mlam@ahcpr.gov
NRSA Institutional Research Training Grants are made under the
authority of Section 487 of the Public Health Service Act as amended
(42 U.S.C. 288).  Title 42 of the Code of Federal Regulations, Part
66, is applicable to this program. This program is also described the
Catalog of Federal Domestic Assistance No. 93.225.  The program is
not subject to the intergovernmental review requirements of Executive
Order 12372 or Health Systems Agency review.
The PHS strongly encourages all grant and contract recipients to
provide a smoke-fee workplace and promote the non-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.

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